bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality After Nocardiosis: Risk Factors and Evaluation of Disseminated Infection
Authors: Yetmar Zachary A , Khodadadi Ryan B , Chesdachai Supavit , McHugh Jack W , Challener Douglas W , Wengenack Nancy L , Bosch Wendelyn , Seville Maria Teresa , Beam Elena 
Published: August 2023

Abstract

Background
Nocardia primarily infects patients who are immunocompromised or those with chronic lung disease. Although disseminated infection is widely recognized as an important prognostic factor, studies have been mixed on its impact on outcomes of nocardiosis.

Methods
We performed a retrospective cohort study of adults with culture-confirmed nocardiosis. Advanced infection was defined as disseminated infection, cavitary pulmonary infection, or pleural infection. The primary outcome was 1-year mortality, as analyzed by multivariable Cox regression.

Results
Of 511 patients with culture growth of Nocardia, 374 (73.2%) who had clinical infection were included. The most common infection sites were pulmonary (82.6%), skin (17.9%), and central nervous system (14.2%). In total, 117 (31.3%) patients had advanced infection, including 74 (19.8%) with disseminated infection, 50 (13.4%) with cavitary infection, and 18 (4.8%) with pleural infection. Fifty-nine (15.8%) patients died within 1 year. In multivariable models, disseminated infection was not associated with mortality (hazard ratio, 1.16; 95% CI, .62–2.16; P = .650) while advanced infection was (hazard ratio, 2.48; 95% CI, 1.37–4.49; P = .003). N. farcinica, higher Charlson Comorbidity Index, and culture-confirmed pleural infection were also associated with mortality. Immunocompromised status and combination therapy were not associated with mortality.

Conclusions
Advanced infection, rather than dissemination alone, predicted worse 1-year mortality after nocardiosis. N. farcinica was associated with mortality, even after adjusting for extent of infection. While patients who were immunocompromised had high rates of disseminated and advanced infection, immunocompromised status did not predict mortality after adjustment. Future studies should account for high-risk characteristics and specific infection sites rather than dissemination alone.
E-cigarette attitudes and behaviours amongst 15-30-year-olds in the UK
Authors: Pinho-Gomes Ana-Catarina , Santos Joseph A , Jones Alexandra , Thout Sudhir Raj , Pettigrew Simone 
Published: August 2023

Abstract

Background
The use of e-cigarettes has been rising in the UK, particularly by young people. This study investigated behaviours, attitudes and beliefs about e-cigarettes amongst 15–30-year-olds in the UK.

Methods
An online survey was administered to a sample of 1009 15–30-year-olds in the UK.

Results
About one in five participants currently used e-cigarettes at least monthly, with 1 in 10 using them daily. Amongst those using e-cigarettes at least monthly, 90% had used e-cigarettes containing nicotine. E-cigarettes were mainly obtained from vape shops and used at home. Having friends who used e-cigarettes and using them to help quit/reduce smoking were the most common reasons for vaping. About half of participants had been exposed to e-cigarette advertising, especially online, and warning labels on e-cigarettes. Most participants agreed that e-cigarettes are addictive (75%), help people quitting smoking (64%) and are bad for health (63%). Previous or current tobacco smokers were 9 and 22 times more likely to use e-cigarettes than never smokers, respectively. Perceiving e-cigarettes as harmful was associated with a 40% lower likelihood of use.

Conclusion
Raising awareness on the uncertain long-term consequences of vaping and regulation of marketing and sales are crucial to protect young people in the UK.
Trend and distribution analysis of occupational radiation exposure among medical practices in Chongqing, China (2008–2020)
Authors: Zhou Jinghua , Li Wei , Deng Jun , Li Kui , Jin Jing , Zhang Huadong 
Published: August 2023

Abstract
The personal dose levels of medical radiation workers in Chongqing from 2008 to 2020 were investigated and analysed. The results showed that a total of 68 379 people were monitored from 2008 to 2020. The number of radiation workers increased year by year, and the number of female radiation workers increased rapidly. The monitoring data were analysed by Mann–Whitney test, Mann-Kendall test and Bonferroni method. The annual mean effective dose from 2008 to 2020 showed a decreasing trend (P &lt; 0.0001). At the 5% significance level, six occupational categories showed a significant decreasing trend (P &lt; 0.0001).The average annual effective dose for medical radiation workers in Chongqing in 2020 was 0.4482 mSv and 94.73% of radiation workers received annual doses less than the public dose limit (1 mSv). Personal dose monitoring results for most radiation workers were low. The protection of radiation workers in interventional radiology and nuclear medicine should be concerned.
The Relevance of Animal Models of Social Isolation and Social Motivation for Understanding Schizophrenia: Review and Future Directions
Authors: Powell Susan B , Swerdlow Neal R 
Published: August 2023

AbstractBackground and HypothesesSocial dysfunction in schizophrenia includes symptoms of withdrawal and deficits in social skills, social cognition, and social motivation. Based on the course of illness, with social withdrawal occurring prior to psychosis onset, it is likely that the severity of social withdrawal/isolation contributes to schizophrenia neuropathology.Study DesignWe review the current literature on social isolation in rodent models and provide a conceptual framework for its relationship to social withdrawal and neural circuit dysfunction in schizophrenia. We next review preclinical tasks of social behavior used in schizophrenia-relevant models and discuss strengths and limitations of existing approaches. Lastly, we consider new effort-based tasks of social motivation and their potential for translational studies in schizophrenia.Study ResultsSocial isolation rearing in rats produces profound differences in behavior, pharmacologic sensitivity, and neurochemistry compared to socially reared rats. Rodent models relevant to schizophrenia exhibit deficits in social behavior as measured by social interaction and social preference tests. Newer tasks of effort-based social motivation are being developed in rodents to better model social motivation deficits in neuropsychiatric disorders.ConclusionsWhile experimenter-imposed social isolation provides a viable experimental model for understanding some biological mechanisms linking social dysfunction to clinical and neural pathology in schizophrenia, it bypasses critical antecedents to social isolation in schizophrenia, notably deficits in social reward and social motivation. Recent efforts at modeling social motivation using effort-based tasks in rodents have the potential to quantify these antecedents, identify models (eg, developmental, genetic) that produce deficits, and advance pharmacological treatments for social motivation.
Increasing Cultural Awareness in the Advanced Nursing Practice Program Through Active Learning
Authors: Franco-Tantuico Monina , Pajaro Annie 
Published: August 2023

Abstract
As student cultural diversity increases in higher education, educators must implement bias-free evaluations and active learning activities. The objective structured clinical examination (OSCE), an active learning strategy where simulated patients role-play specific clinical scenarios, can be part of the advanced nursing practice (ANP) educational program for either formative or summative competencies evaluation. This article describes active learning and theatrical techniques used in a grant-funded workshop to increase cultural awareness among ANP students, nurse educators, and simulated patients. The participants’ increased understanding of their potential biases can create a psychologically safe and bias-free OSCE for culturally diverse students.
The Prognostic Significance of the Depth of Cervical Stromal Invasion in Women With FIGO Stage II Uterine Endometrioid Carcinoma
Authors: Al Khatib Sondos , Bhatnagar Aseem , Elshaikh Noor , Ghanem Ahmed I , Burmeister Charlotte , Allo Ghassan , Alkamachi Bassam , Paridon Alex , Elshaikh Mohamed A. 
Published: August 2023

Objective:
The objective of this study was to investigate the prognostic significance of the depth of cervical stromal invasion (CSI) in women with FIGO stage II uterine endometrioid adenocarcinoma (EC).

Methods:
Our database of women with EC was quired for patients with stage II EC. Pathologic slides were retrieved and reviewed by gynecologic pathologists to determine cervical stromal thickness and depth of CSI as a percentage of stromal thickness (%CSI). Kaplan-Meier, univariate, and multivariate analyses were used to compare recurrence-free, disease-specific (DSS), and overall survival (OS) between women who had<50% versus ≥50% CSI. Univariate and multivariate analyses were used to assess other prognostic variables associated with survival endpoints.

Results:
A total of 117 patients were included in our study who had hysterectomy between 1/1990 and 8/2021. Seventy-nine patients (68%) with <50% and 38 (32w%) with ≥50% CSI. After a median follow-up of 131 months, 5-year DSS was significantly worse for women with ≥50% CSI (78% vs. 91%; P=0.04). However, %CSI was not an independent predictor for any of the studied survival endpoints. Independent predictors of worse 5-year recurrence-free survival and DSS included FIGO grade 3 tumors (P=0.02) and the presence of lymphovascular space invasion (P=0.03). Grade 3 tumors were the only independent predictor of worse 5-year OS (P=0.02).

Conclusions:
Our results suggest that deep CSI is not an independent prognostic factor for survival endpoints in women with stage II uterine endometroid adenocarcinoma. The lack of independent prognostic significance of the depth CSI needs to be validated in a multi-institutional analysis.
Outcomes of Negative Pressure Wound Therapy on Immediate Breast Reconstruction after Mastectomy
Authors: Akhter Haris M. , Macdonald Collin , McCarthy Philip , Huang Ye , Meyer Bria R. , Shostrum Valerie K. , Cromer Kerry J. , Johnson Perry J. , Wong Shannon L. , Hon Heidi H. 
Published: August 2023

Background:
Immediate expander/implant-based breast reconstruction after mastectomy has become more sought after by patients. Although many patients choose this technique due to good aesthetic outcomes, lack of donor site morbidity, and shorter procedure times, it is not without complications. The most reported complications include seroma, infection, hematoma, mastectomy flap necrosis, wound dehiscence, and implant exposure, with an overall complication rate as high as 45%. Closed incision negative pressure therapy (ciNPT) has shown value in wound healing and reducing complications; however, the current literature is inconclusive. We aimed to examine if ciNPT improves outcomes for patients receiving this implant-based reconstruction.

Methods:
This is a retrospective single-institution study evaluating the ciNPT device, 3M Prevena Restor BellaForm, on breast reconstruction patients. The study was performed between July 1, 2019 and October 30, 2020, with 125 patients (232 breasts). Seventy-seven patients (142 breasts) did not receive the ciNPT dressing, and 48 patients (90 breasts) received the ciNPT dressing. Primary outcomes were categorized by major or minor complications. Age, BMI, and final drain removal were summarized using medians and quartiles, and were compared with nonparametric Mann-Whitney test. Categorical variables were compared using chi-square or Fisher exact test.

Results:
There was a statistically significant reduction in major complications in the ciNPT group versus the standard dressing group (P = 0.0247). Drain removal time was higher in the ciNPT group.

Conclusion:
Our study shows that ciNPT may help reduce major complication rates in implant-based breast reconstruction patients.
Association of biopsy core number and location with pain in patients undergoing a transperineal prostate biopsy under local anaesthesia: A secondary analysis of the APROPOS trial
Authors: He Bi-Ming , Yang Qi-Wei , Shi Zhen-Kai , Ji Tang-Rao , Wang Shuai-Dong , Zhou Hai , Jin Zhi-Chao , Yan Zhi-Chao , Zhang Jia-Jun , Wang Hai-Feng 
Published: August 2023

Background:
APROPOS was a multicentre, randomized, blinded trial focus on investigating the perineal nerve block versus the periprostatic block in pain control for men undergoing a transperineal prostate biopsy. In the analysis reported here, we aimed to evaluate the association of biopsy core count and location with pain outcomes in patients undergoing a transperineal prostate biopsy under local anaesthesia.

Methods:
APROPOS was performed at 6 medical centres in China. Patients with suspected prostate cancer were randomized to receive either a perineal nerve block or a periprostatic block (1:1), followed by a transperineal prostate biopsy. The secondary analysis outcomes were the worst pain experienced during the prostate biopsy and post-biopsy pain at 1,6 and 24 hours.

Results:
Between August 12, 2020, and July 20, 2022, a total of 192 patients were randomized in the original trial, and 188 were involved in this analysis, with 94 patients per group. Participants had a median (IQR) age of 68 (63-72) and a median (IQR) prostate volume of 42.51 (30.04-62.84). The patient population had a median (IQR) number of biopsy cores of15 (12-17.50), and 26.06% of patients had a biopsy cores count of more than 15. After adjusting tthe baseline characteristics, the number of biopsy cores was associated with the worst pain during the biopsy procedure in both the perineal nerve block group (Beta 0.19, 95% CI 0.12-0.26, P<0.001) and the periprostatic block group (beta 0.16, 95% CI 0.07-0.24, P<0.001). A similar association was also evident for the post-biopsy pain at 1, 6 and 24 hours. A lesser degree of pain in both groups at any time (r range −0.57 to −0.01 for both groups) was associated with biopsy cores from the peripheral zone of the middle gland, while other locations were associated with a higher degree of pain. In addition, the location of the biopsy core had less of an effect on pain during the biopsy (r range −0.01 to 0.25 for both groups) than it did on postbiopsy pain (r range −0.57 to 0.60 for both groups).

Conclusions:
In this secondary analysis of a randomized trial, biopsy core count and location were associated with pain in patients undergoing a transperineal prostate biopsy under local anaesthesia. These results may be helpful for making clinical decisions about the anaesthetic approach forscheduled transperineal prostate biopsies.
Single-incision robotic assisted surgery: a non-randomized cohort pilot study on a novel surgical platform in colorectal surgery
Authors: Guo Zichao , Shi Yiqing , Song Zijia , Jia Wenqing , Wang Shaodong , Zhang Yaqi , Ji Xiaopin , Liu Kun , Zhang Tao , Cheng Xi , Zhao Ren 
Published: August 2023

Background:
The technological barriers and steep learning curve of single-incision laparoscopic surgery had kept it from further applications. Literature review had reported that robotic technology could preserve its advantages while simplifying its difficulties. This non-randomized cohort pilot study aims to evaluate the feasibility and safety of single-incision robotic assisted colorectal surgery based on a novel robotic surgical platform, the SHURUI Endoscopic Surgical Robotic System (SR-ENS-600).

Method:
This study enrolled 7 patients with colorectal malignancy who underwent single-incision robotic assisted surgery (SIRAS) at a tertiary general surgery center, and retrospectively included 23 patients who underwent robotic assisted surgery (RAS) from September 2015 to June 2016 and 35 patients who underwent single-incision laparoscopic surgery (SILS) from June 2017 to March 2018, which were labelled as the initial in-learning-curve attempts from the same surgical team. Technological feasibility and safety of SIRAS were evaluated. Perioperative outcomes, short-term postoperative outcomes, clinicopathologic outcomes and follow-up were reported.

Results:
Six SIRAS operations were completed successfully without eventful intraoperative complications, except one operation encountered a large volume of intraoperative hemorrhage. Two SIRAS cases were converted to multiport laparoscopic surgery because of intraoperative hemorrhage and difficulty in retraction. Postoperative pathology reported satisfactory specimen qualities. There was no short-term postoperative complication, no short-term mortality, no tumor recurrence or metastasis reported. There was 1 incisional hernia reported half a year after operation. Patients with advanced staging were sent to standard evaluation and chemotherapy, and follow-up is still on-going.

Conclusions:
SIRAS can be feasibly performed by skilled surgical team via SR-ENS-600 platform for strictly-selected patients, which provides preferable instrument maneuverability and stability in confined surgical fields and overcomes the technical difficulty of multisite dissection through a single incision. Large-volume investigations and high-level evidences are required to further validate its safety and superiority.
Long-term health-related quality of life in patients with gastric cancer after total or distal gastrectomy: A propensity score-matched cohort study
Authors: Yu Jianhong , Wang Zaozao , Yang Hong , Zhang Chenghai , Xing Jiadi , Cui Ming , Liu Hui , Wu Yu , Su Xiangqian 
Published: August 2023

Background:
Surgical resection remains the cornerstone of treatment for locally advanced gastric cancer (LAGC) and is accompanied by potential deterioration in patients’ health-related quality of life (HRQOL). As an important indicator of the psychosocial burden, HRQOL has become an essential endpoint to evaluate the efficacy and impact of cancer treatment. We examined longitudinal changes in HRQOL among patients with LAGC receiving total gastrectomy (TG) or distal gastrectomy (DG) over time.

Materials and methods:
The patients in this study were from a prospective observational study (NCT) conducted during 2018–2022. We used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 and the stomach module questionnaire to evaluate HRQOL at baseline and at postoperative months 1, 3, 6, and 12. We used linear mixed models to analyze longitudinal changes in HRQOL between groups and correlations with follow-up time.

Results:
A total of 219 patients were included. After propensity score matching, 186 patients were ultimately analyzed. Compared with the DG group, patients in the TG group reported significantly poorer global health status, physical functioning, and role functioning and more severe fatigue, insomnia, appetite loss, pain, and financial problems. Gastric-specific symptoms, dysphagia, chest and abdominal pain, reflux, restricted eating, and anxiety were more common and severe in the TG group. Most scales showed deterioration at months 1 and 3 after surgery, with gradual recovery thereafter, except the scales for global health status, pain, chest and abdominal pain, and reflux, which improved continually compared with baseline. TG was associated with worsening in ≥ six HRQOL domains for each measure after baseline, compared with DG.

Conclusions:
In contrast with DG, TG had an adverse impact on postoperative HRQOL scales in patients with LAGC. Different HRQOL scales had various recovery trajectories after surgery. Effects of the gastrectomy scope on patients’ HRQOL should be considered together with sound oncology principles.
Evaluation of the Listening Environment of Bilateral Cochlear Implant Users through Data Logging: A Comparison of Bilateral Simultaneous and Sequential Implantation
Authors: Yoshida Tadao , Hara Daisuke , Kobayashi Masumi , Sugimoto Satofumi , Fukunaga Yukari , Sone Michihiko 
Published: August 2023

Objective
To evaluate the listening conditions of bilateral cochlear implant (CI) users in their daily living environment.

Study Design
Retrospective study.

Setting
University hospital.

Patients
Thirty-one adult CI users 16 years or older; 18 underwent sequential surgery, and 13 underwent simultaneous surgery. Inclusion criteria included the availability of CI data logging features and a minimum duration of binaural use of 6 months.

Intervention
Retrospective analysis of data obtained from the automatic scene classifier data logging system.

Main Outcome Measure
Comparison of data logging and maximum speech discrimination scores of the two surgery groups (sequential vs. simultaneous) to investigate the potential influence of these factors on the listening conditions of CI users.

Results
The maximum speech discrimination score of the second CI in the sequential group was significantly worse than that of any other CI in the sequential and simultaneous CI groups. Additionally, the longer the interval between surgeries, the more significant the difference in “time on air” between the first and the second CIs. The second CI in sequential CI surgery had a shorter “time on air” than the first or the bilateral simultaneous CIs; the second CI was also used more frequently in noisy and speech with background noise environments.

Conclusions
A second CI may be more frequently used in challenging listening environments because of its binaural auditory effect, despite its lower speech discrimination performance. The timing of sequential implantation and the potential impact of binaural hearing should be considered when developing rehabilitation strategies for individuals with bilateral CIs.
MEESSI-AHF score to estimate short-term prognosis of acute heart failure patients in the Emergency Department: a prospective and multicenter study
Authors: Oberlin Mathieu , Buis Guillaume , Alamé Karine , Martinez Mikaël , Bitard Marie Paule , Berard Lise , Losset Xavier , Balen Frederic , Lehodey Bruno , Taheri Omide , Delannoy Quentin , Kepka Sabrina , Tran Duc-Minh , Bilbault Pascal , Godet Julien , Le Borgne Pierrick 
Published: August 2023

Background
The assessment of acute heart failure (AHF) prognosis is primordial in emergency setting. Although AHF management is exhaustively codified using mortality predictors, there is currently no recommended scoring system for assessing prognosis. The European Society of Cardiology (ESC) recommends a comprehensive assessment of global AHF prognosis, considering in-hospital mortality, early rehospitalization rates and the length of hospital stay.

Objective
We aimed to prospectively evaluate the performance of the Multiple Estimation of risk based on the Emergency department Spanish Score In patients with AHF (MEESSI-AHF) score in estimating short prognosis according to the ESC guidelines.

Design, settings and patients
A multicenter study was conducted between November 2020, and June 2021. Adult patients who presented to eleven French hospitals for AHF were prospectively included.

Outcome measures and analysis
According to MEESSI-AHF score, patients were stratified in four categories corresponding to mortality risk: low-, intermediate-, high- and very high-risk groups. The primary outcome was the number of days alive and out of the hospital during the 30-day period following admission to the Emergency Department (ED).

Results
In total, 390 patients were included. The number of days alive and out of the hospital decreased significatively with increasing MEESSI-AHF risk groups, ranging from 21.2 days (20.3–22.3 days) for the low-risk, 20 days (19.3–20.5 days) for intermediate risk,18.6 days (17.6–19.6 days) for the high-risk and 17.9 days (16.9–18.9 days) very high-risk category.

Conclusion
Among patients admitted to ED for an episode of AHF, the MEESSI-AHF score estimates with good performance the number of days alive and out of the hospital.