bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the feasibility and outcomes of a resident-led school-based pediatric clinic
Authors: D’Arienzo David , Xu Shiqi , Shahid Abeera , Meloche David , Hebert Julie , Dougherty Geoffrey , Li Patricia , Sternszus Robert 
Published: May 2023

Abstract

Objective
A resident-led school-based clinic to serve low-income populations was established in 2019 and served as a continuity clinic for pediatric residents at a single university. Our aim was to assess the feasibility, clinic outcomes, and resident experience of a resident-led school-based clinic (RLSBC), established in an elementary school that serves an underserved population.

Methods
A retrospective chart review for the first 6 months (October 2019 to March 2020) of clinic operations was conducted. Feasibility metrics included the number of patients, visits and planned follow-ups; clinic outcomes included the number and type of presenting complaint, new diagnoses and interventions. Residents were also surveyed to assess their satisfaction and perceived learning in training at the school-based clinic.

Results
Over the first 19 clinic days, 48 children were seen at the school-based clinic. Of the clinic users, 60% did not have a primary care physician, 46% received a new diagnosis, 46% received an intervention in the form of medication prescription, laboratory/imaging requisitions or referrals, and 96% received a treatment plan. Residents positively rated the experience of staffing the school-based clinic in all aspects, including learning environment, clinic and team environment, teaching obtained, practice management, and overall experience.

Conclusion
A RLSBC is feasible and our outcomes suggest that such clinics may address health care needs of low-income families and children, while being a positively rated educational experience for pediatric residents.
Prophylactic mastectomy and bilateral salpingo-oophorectomy in patients with breast cancer: a systematic review of postsurgical sexual function and menopausal hormone therapy symptom mitigation
Authors: Morgan Orly , Belda Rocio , Schnur Julie , Montgomery Guy , Parmar Shivangi , Chirivella Isabel , Cano Antonio 
Published: May 2023

Abstract

Introduction
Preventative surgical procedures for patients who are breast cancer (BRCA) positive—namely, bilateral salpingo-oophorectomy and mastectomy—have been linked to changes in sexual function, including surgically induced menopause. A patient’s decision to undergo preventive surgery as opposed to high-risk screening is heavily reliant on advice received from one’s health care provider. Quality of life should be considered when shared decision making is conducted with patients.

Objectives
To assemble and analyze findings related to patient-reported sexual function after these surgical procedures, to see if and how either procedure affects sexual function from patient baseline, and to determine whether the effects can be mitigated with menopausal hormone therapy.

Methods
A literature review based on the PubMed, Embase, and MEDLINE databases was conducted from inception through January 25, 2022. To be included, studies had to meet an a priori list of Medical Subject Headings: “BRCA” AND “sexual dysfunction” OR “dyspareunia.” GRADE criteria were used to determine the quality of studies relating to menopause hormone therapy.

Results
The search yielded 14 results, and 11 reported sufficient data for systematic review. Sexual function was measured via validated and investigator-generated surveys. All studies, no matter the survey metric, found significant reduction in sexual function with bilateral salpingo-oophorectomy; no studies revealed sexual function changes associated with mastectomy postsurgery. Few studies indicated that menopause hormone therapy resulted in significant improvement in sexual function, and all studies reported that postoperative sexual function could not reach baseline levels with therapy. No studies were high quality by GRADE metrics.

Conclusion
Prophylactic mastectomies and bilateral salpingo-oophorectomies among patients who are BRCA positive cause SF changes postprocedure. Menopausal hormone therapy offers little help in mediating symptoms. Significantly more research is needed to explore potential changes in sexual function, as it is an important aspect of quality of life for patients with BRCA positivity.
The Extensile Lateral Approach to the Calcaneus
Authors: Bhimani Rohan , Shah Kush C. , Kadakia Rishin J. 
Published: May 2023

Abstract:
Accounting for 1% to 2% of all fractures, calcaneus fractures are the most common tarsal bone fracture. Although often managed nonoperatively, operative management is preferred for cases that involve significant displacement, joint height loss, and malalignment in patients with limited complication profiles. The extensile lateral approach has historically been a commonly utilized approach for the operative management of displaced calcaneus fractures. Although minimally invasive approaches, such as the sinus tarsi approach, have gained recent traction, they have inherent limitations that result in the extensile lateral approach being the preferable technique in certain cases. In this technique guide, we outline the surgical technique for calcaneus fracture repair using the extensile lateral approach and reported outcomes in the literature.

Level of Evidence:
Level V.
Well-Being and Professional Fulfillment in Mohs Surgeons: An Explanatory Sequential Mixed-Method Design Study
Authors: Lam Charlene , Kim Yesul , Costigan Heather J. , Stuckey Heather , Vidimos Allison T. , Billingsley Elizabeth M. , Albertini John G. , Miller Jeffrey J. , Shanafelt Tait D. 
Published: May 2023

BACKGROUND
There are limited data evaluating specific themes of well-being and professional fulfillment in Mohs surgeons.

OBJECTIVE
To identify factors that drive occupational distress and those that promote well-being and professional fulfillment among Mohs surgeons.

METHODS
This is an explanatory sequential mixed-method study, using semistructured individual interviews. Common drivers of physician well-being and fulfillment were identified based on the independent assessment of the coding in the interview transcripts.

RESULTS
This study reports the following qualitative themes: (1) gratitude for the chosen profession and relationships, (2) unrealistic standards of perfection that may have contributed to past career success but are unattainable and create emotional burden, and (3) ability to practice in a manner aligned with personal values promotes professional fulfillment.

CONCLUSION
This study suggests that gratitude, self-compassion, and ability to practice in a manner aligned with personal values promote well-being and professional fulfillment in Mohs surgeons. Notably, we found that unrealistic standards of perfection and personal-organization practice incongruences contribute to burnout.
Relationship between Total Expenditure on Cosmetic Procedures in the United States and NASDAQ 100 Index
Authors: Moon Jiyeon , Ha Jisoo , Kang Daihun 
Published: May 2023

Background:
The volume of cosmetic procedures and expenditures has increased over the past 15 years. Recent studies have shown that the market for cosmetic procedures follows the standard laws of economics. However, no studies published in the literature have found a direct correlation between US stock market indices and expenditures on cosmetic surgery and minimally invasive procedures.

Methods:
The authors analyzed annual cosmetic procedure statistics from the American Society of Plastic Surgeons for 2005–2020 against economic indices, including major US stock market indices [NASDAQ 100, S&P 500, Dow Jones Industrial Average (DJIA), Russell 2000 indices from the New York Stock Exchange, gross domestic product (GDP)], median income of US citizens, and the US population from the Federal Reserve Bank of St. Louis. Pearson correlation coefficient and multiple regression analysis were used for the statistical analysis.

Results:
Total expenditure on cosmetic surgery and minimally invasive procedures (TECP) has more than doubled since 2005 to 2020. TECP revealed statistically significant correlations with all other indicators. TECP had the greatest correlation with DJIA (r = 0.952, P < 0.001). In the multiple regression analysis, the increase in TECP led to the rise of the NASDAQ 100 index (adjusted R2 was 0.790, P < 0.001).

Conclusions:
There was a statistically significant correlation between the TECP in USA and the major indices of the US stock market. In particular, the increase in TECP led to the rise of the NASDAQ 100 index.
The prevalence and factors associated with acute postoperative pain in elective gynecologic surgical patients at two referral hospitals in Addis Abeba, Ethiopia, 2021: a cross-sectional study
Authors: Amberbir Wubet Dessie , Bayable Samuel Debas , Fetene Melaku Bantie 
Published: May 2023

Background:
Postoperative pain is an expected and undesirable by-product of all surgical procedures. The provision of effective and safe postoperative pain management should be one of the top priorities of any healthcare, where surgical procedures are carried out. Major abdominal surgical operations require pain management services, regular pain assessment, and timely management of breakthrough pains in the postoperative period.

Objective:
This study aimed to determine the prevalence and factors associated with acute postoperative pain.

Methods:
A cross-sectional study was conducted at Minilik and Zewditu Referral hospitals from October to December 2021 and chart review and face-to-face interviews were the methods of data collection. The pain was measured at the 2, 12, and 24 h postoperatively through a numerical rating scale, and the pain was categorized as no pain (score=0), mild pain (score 1–3), moderate pain (score 4–6), or severe pain (score 7–10). All independent variables with P less than or equal to 0.2 in the univariable logistic regression were reanalyzed with multivariable logistic regression at 95% CI to determine predictive factors and a P-value of less than 0.05 was considered statistically significant.

Results:
In the study period, a total of 368 eligible patients were involved, out of this 11 patients were discharged before 24 h, four patients refuse to participate two incomplete documentation and one patient was ICU admitted, therefore 350 patients were involved with a response rate of 95.1%. Among those patients 73.1% of respondents’ experience at least one episodes of moderate to severe postoperative pain within the first 24 h. Preoperative anxiety (AOR: 2.2, 95% CI: 1.2, 5.1), urban residency (AOR: 2.3, 95% CI: 1.2, 50), participants who have not formal education (AOR: 2.5, 95% CI: 1.3, 4.1), surgical patients without pre-emptive analgesia (AOR: 2.7, 95% CI: 1.3, 3.6), abdominal incision greater than 10 cm (AOR: 3.5, 95% CI: 2.1, 7.2), and surgical duration greater than or equal to 60 min (AOR: 2.3, 95% CI: 1.1, 3.1) were factors associated with acute postoperative pain following elective gynecologic surgery.

Conclusion:
In this study, the overall incidence of moderate to severe postoperative pain after gynecologic surgery was unacceptably high, and patients undergoing gynecologic surgical procedures suffer sufficient postoperative pain need of intervention.
Comparison of SARS-CoV-2 virus detection using the Xpert Xpress rapid molecular test on Abbott M2000 Real-Time System: a cross-sectional study
Authors: Hasanah Miftah , Aulia Fauqa Arinil , Wardhani Puspa , Aryati  
Published: May 2023

Introduction:
Emergency use of molecular rapid test kits approved by the Food and Drug Administration (FDA) includes the Xpert Xpress SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) kit. The rapid molecular test is one of the examinations using the reverse transcription-polymerase chain reaction (RT-PCR) method. Compared to conventional PCR, the examination time is faster, so it is suitable for diagnostic purposes.

Objectives:
Determining the diagnostic capabilities of the Xpert Xpress SARS-CoV-2 rapid molecular test in detecting the SARS-CoV-2 virus in the Indonesian population.

Methods:
A cross-sectional study was conducted with consecutive sampling, in which participants were diagnosed with coronavirus disease 2019 (COVID-19) infection using the RT-PCR Abbott M2000 SARS-CoV-2 System. A molecular rapid test examination was carried out using the Xpert Xpress SARS-CoV-2 kit. Assessing the correlation between the cycle threshold (CT) value of Xpert Xpress SARS-CoV-2 and the Abbott M2000 SARS-CoV-2 System using the Pearson and Spearmen test with P<0.05.

Results:
Molecular rapid test using Xpert Xpress has a compatibility of 100% with RT-PCR using Abbott M2000 SARS-CoV-2 and a sensitivity and specificity value of 100%. The Xpert Xpress SARS-CoV-2 CT value had a significant correlation with the Abbott M2000 SARS-CoV-2 System CT value, with moderate correlation strength for the CT protein E value (r=0.444; P=0.007) and robust correlation for CT value of protein N2 (r=0.829; P<0.001). The negative predictive and positive predictive values were 100% each.

Conclusion:
The Xpert Xpress SARS-CoV-2 molecular rapid test has a sensitivity and specificity of 100% and can be recommended for diagnosing COVID-19.
Does Linear or Spot Injection Technique Matter in Upper Face Botulinum Toxin Type A Application? A Split-Face Randomized Trial
Authors: Li Yunzhu , Sun Yixin , Lan Xinze , Wu Tingting , Xiao Yiding , Xia Zenan , Wang Hayson Chenyu , Yu Nanze , Wang Xiaojun , Long Xiao 
Published: May 2023

Background:
Although the efficacy of botulinum toxin type A (BoNTA) has been shown to vary depending on injection layer, reconstitution volume, and BoNTA formulation, the effect of injection pattern has rarely been mentioned. The authors compared the therapeutic effects in patients treated with BoNTA with retrograde linear and traditional spot injection techniques.

Methods:
Twenty-eight participants were enrolled in a split-face, patient-blinded randomized clinical trial. Each patient received BoNTA injected with linear injection technique on one side and with spot injection technique on the other side. Outcomes included wrinkle improvement rates (WIRs) of the 2 injection techniques determined by wrinkle scores derived from an Antera 3-dimensional camera, muscle activity assessed by ultrasound, and patient-reported pain rating on a numeric rating scale.

Results:
All participants completed the study. For forehead wrinkles, WIR on the linear side was significantly larger than that on the spot side at 1 week and 1 month (P < 0.02). For glabellar wrinkles, WIR on the linear injection side was significantly larger than that on the spot side at 1 week (P = 0.04). However, for periorbital wrinkles, WIR on the spot side was significantly larger than that on the linear side at 1 week (P < 0.03). No significant difference was observed between the injection patterns in terms of muscle contraction and numeric rating scale pain scores.

Conclusions:
Compared with the traditional spot injection, retrograde linear injection was superior in reducing forehead lines and glabellar lines, but less effective in reducing periorbital lines when identical dosages were injected.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
Patient Safety Climate, Quality of Care, and Intention of Nursing Professionals to Remain in Their Job During the COVID-19 Pandemic
Authors: Herrera Claire Nierva , Guirardello Edinêis de Brito 
Published: May 2023

Objective
This study aimed to examine the relationship between patient safety climate, quality of care, and intention of nursing professionals to remain in their job.

Methods
A cross-sectional study was carried out in a teaching hospital in Brazil wherein nursing professionals were surveyed. The Brazilian version of the Patient Safety Climate in Healthcare Organizations tool was applied to measure the patient safety climate. Spearman correlation coefficient and multiple linear regression models were applied for the analysis.

Results
A high percentage of problematic response was observed for most dimensions, except for fear of shame. Quality of care resulted in a strong correlation with organizational resources for safety and with overall emphasis on patient safety, and the nurse-perceived staffing adequacy was strongly correlated with organizational resources for safety. The multiple linear regression model showed higher scores in quality of care in dimensions related to organizational, work unit, and interpersonal aspects as well as in the adequacy of the number of professionals. A higher score in intention to stay in one’s job was also found in the dimensions of fear of blame and punishment, provision of safe care, and adequacy of the number of professionals.

Conclusions
The organizational and work unit aspects can lead to a better perception of the quality of care. Improving interpersonal relationships and increasing the number of professionals on staff were found to increase nurses’ intention to remain in their jobs. Assessing a hospital’s patient safety climate will enable improvement in the provision of safe and harm-free health care assistance.
Chemical Bowel Preparation Exerts an Independent Preventive Effect Against Surgical Site Infection Following Elective Laparoscopic Colorectal Surgery
Authors: Ichimura Kentaro , Imaizumi Ken , Kasajima Hiroyuki , Sato Aya , Sato Kentaro , Yamana Daisuke , Tsuruga Yosuke , Umehara Minoru , Kurushima Michihiro , Nakanishi Kazuaki 
Published: May 2023

Background:
We investigated the independent clinical value of mechanical bowel preparations (MBP) and chemical bowel preparations (CBP) for preventing surgical site infection (SSI) in patients undergoing elective laparoscopic colorectal surgery.

Materials and Methods:
This retrospective cohort study included 475 patients who underwent elective laparoscopic colorectal surgery between January 2018 and March 2022. CBP was introduced in January 2021 and included kanamycin (1 g) and metronidazole (1 g) 2 times a day, the day before surgery. In some cases, MBP was omitted in patients who planned to undergo right-sided colectomy, those with tumor obstruction, and those with poor general conditions, depending on the judgment of the physician. The primary endpoint was the overall SSI incidence, while the secondary endpoints were the incidences of incisional SSI and organ-space SSI, culture from the surgical site, and length of postoperative hospital stay.

Results:
In total, 136 patients underwent CBP. MBP was omitted in 53 patients. Overall, SSI occurred in 80 patients (16.8%), including 61 cases of incisional SSI (12.8%) and 36 cases of organ-space SSI (7.6%). Multivariate logistic regression revealed that CBP exerted an independent preventive effect on overall and incisional SSI, whereas MBP did not. However, CBP was not associated with a decreased risk of overall SSI in patients who had undergone preoperative therapy, those with benign disease, and those with stoma formation in the subgroup analysis. Levels of Bacteroides species at the surgical site were significantly lower in the CBP group than in the non-CBP group. Postoperative hospital stay was significantly longer in the incisional SSI group than in the non-SSI group and was significantly longer in the organ-space SSI group than in the other groups.

Conclusions:
CBP, but not MBP, exerts an independent preventive effect on SSI, especially incisional SSI, in patients undergoing elective laparoscopic colorectal surgery.
Evolutionary mechanisms modulating the mammalian skull development
Authors: Kyomen Stella , Murillo-Rincón Andrea P. , Kaucká Markéta 
Published: May 2023

Mammals possess impressive craniofacial variation that mirrors their adaptation to diverse ecological niches, feeding behaviour, physiology and overall lifestyle. The spectrum of craniofacial geometries is established mainly during embryonic development. The formation of the head represents a sequence of events regulated on genomic, molecular, cellular and tissue level, with each step taking place under tight spatio-temporal control. Even minor variations in timing, position or concentration of the molecular drivers and the resulting events can affect the final shape, size and position of the skeletal elements and the geometry of the head. Our knowledge of craniofacial development increased substantially in the last decades, mainly due to research using conventional vertebrate model organisms. However, how developmental differences in head formation arise specifically within mammals remains largely unexplored. This review highlights three evolutionary mechanisms acknowledged to modify ontogenesis: heterochrony, heterotopy and heterometry. We present recent research that links changes in developmental timing, spatial organization or gene expression levels to the acquisition of species-specific skull morphologies. We highlight how these evolutionary modifications occur on the level of the genes, molecules and cellular processes, and alter conserved developmental programmes to generate a broad spectrum of skull shapes characteristic of the class Mammalia.
This article is part of the theme issue ‘The mammalian skull: development, structure and function’.
Evolution, conservatism and overlooked homologies of the mammalian skull
Authors: Koyabu Daisuke 
Published: May 2023

In the last decade, studies integrating palaeontology, embryology and experimental developmental biology have markedly altered our homological understanding of the mammalian skull. Indeed, new evidence suggests that we should revisit and restructure the conventional anatomical terminology applied to the components of the mammalian skull. Notably, these are classical problems that have remained unresolved since the ninteenth century. In this review, I offer perspectives on the overlooked problems associated with the homology, development, and conservatism of the mammalian skull, aiming to encourage future studies in these areas. I emphasise that ossification patterns, bone fusion, cranial sutures and taxon-specific neomorphic bones in the skull are virtually unexplored, and further studies would improve our homological understanding of the mammalian skull. Lastly, I highlight that overlooked bones may exist in the skull that are not yet known to science and suggest that further search is needed.
This article is part of the theme issue ‘The mammalian skull: development, structure and function’.