bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paratesticular rhabdomyosarcoma: a rare case report from Syria
Authors: Sabbagh Aziz , Hamza Amr , Sukkari Mohamad Walid , Fattal Abdualh , Chammout Anwar , Ayoub Kusay , AL-Hadid Ibrahim 
Published: April 2023

Introduction:
Paratesticular rhabdomyosarcoma (RMS) is a rare aggressive tumor manifesting in children and young adults. This tumor derives from mesenchymal elements of the Tunica vaginalis, epididymis, and spermatic cord. It is a very metastatic lesion that can spread by lymphatics to the iliac, para-aortic nodes, lung, and bone.

Case presentation:
In this paper, the authors report a case of a 6-year-old child who presented to the clinic with a painless mass in the right side of the scrotum. The mass was misdiagnosed and had evolved rapidly over 2 weeks. The mass measured 16×32 mm on ultrasound, and therefore, an orchiectomy was performed. The histological examination of the excised tissue confirmed the diagnosis of paratesticular RMS.

Discussion:
Paratesticular RMS mainly presented as a painless mass in the scrotum. It was a very metastatic lesion that required an immediate management. However, a lot of cases of paratesticular RMS misdiagnosed at first time, which worsens the overall prognosis.

Conclusion:
Eventually, paratesticular RMS should be always taken into consideration when a scrotal mass is suspected. Due to its extremely serious metastatic potential, this condition requires early diagnosis and management. The treatment is currently well codified combining surgery, chemotherapy, and radiotherapy.
Exophthalmos and hemiheadache caused by osteoma in the greater wing of sphenoid bone: an extremely rare case report
Authors: Tawashi Yamama , Tawashi Kenana , Beski Tasneem , Alhakeem Khaleel 
Published: April 2023

Introduction and importance:
Osteoma is the most common benign tumor of the nose and paranasal sinuses. It is usually asymptomatic and diagnosed accidentally. In our case, the tumor formed in an unusual location and led to unexpected symptoms, which created a big challenge in diagnosis and treatment.

Case presentation:
A 53-year-old woman complained of hemiheadache, exophthalmos in the right eye, and limitation in lateral eye movements progressing to diplopia in the past 2 months. The physical examination of the rest systems was unremarkable. The radiological investigations revealed a hyperdense lesion arising from the right greater wing of the sphenoid bone and compressed on the orbit’s components and eye muscles, which caused proptosis. The radiological findings suggested osteoma and the tumor was excised by craniotomy. The patient gets rid of the symptoms and the follow-up for 6 months was uneventful.

Clinical discussion:
Even hemiheadache, exophthalmos, limitation in eye movements, and diplopia are unfamiliar findings in osteoma, they may be its manifestations. Also, MRI is used as a diagnostic method with computed tomography scan in intracranial osteoma. These cases are treated by craniotomy.

Conclusions:
Even though osteoma is a benign tumor, it may form in unusual locations and cause unexpected symptoms. So, it should be a differential diagnosis in skull bony tumors. Also, it should be treated when exists in sensitive places to avoid irreversible outcomes.
Assessment of routine medical checkups for common noncommunicable diseases and associated factors among healthcare professionals in Addis Ababa, Ethiopia, in 2022 a cross-sectional study
Authors: Getahun Genanew Kassie , Arega Meron , Keleb Gebretsadik , Shiferaw Addis , Bezabih Dawit 
Published: April 2023

Background:
Routine medical checkups are one strategy for detecting and treating noncommunicable diseases early. Despite the effort to prevent and control noncommunicable diseases in Ethiopia, the prevalence of the problem is significantly increasing. The aim of this study was to assess the uptake of routine medical checkups for common noncommunicable diseases and associated factors among healthcare professionals in Addis Ababa, Ethiopia, in 2022.

Methods:
A facility-based cross-sectional study was conducted, enroling 422 healthcare providers in Addis Ababa. A simple random sampling method was used to select study participants. Data entry was made using Epi-data and exported to STATA for further analysis. A binary logistic regression model was used to determine predictors of routine medical checkups. In the multivariable analysis, the adjusted odds ratio along with a 95% confidence interval were determined. Explanatory variables whose p value less than 0.05 were selected as significant factors.

Results:
The overall uptake of routine medical checkups for common noncommunicable disease was 35.3% (95% CI: 32.34–38.26). Moreover, being married [adjusted odds ratio (AOR)=2.60, 95% CI=1.42–4.76], income level less than 7071 (AOR=3.05, 95% CI=1.23–10.05), absence of chronic medical disease (AOR=0.40, 95% CI=0.18–0.88), good provider commitment (AOR=4.80, 95% CI=1.63–14.05), drinking alcohol (AOR=0.35, 95% CI=0.19–0.65), and poor perception of health status (AOR=2.1, 95% CI=1.01–4.44) were the significant factors.

Conclusion:
The uptake of routine medical checkups was found to be low, owing to marital status, level of income, perception of health status, drinking alcohol, the absence of chronic medical conditions, and the availability of committed providers, which needs intervention. We recommend using committed providers for noncommunicable diseases and considering fee waivers for healthcare professionals to increase uptake of routine medical checkups.
Endovascular management of RCC in one-kidney patient: a case report study
Authors: Ghareeb Amjad , Salameh Bairak , Halaweh Malaz , Al-Tawil Muhamad , Nahas Mohammed Ali 
Published: April 2023

Introduction and importance:
Renal cell carcinoma is considered one of the most common and deadly cancers, which remain asymptomatic until the late stage, needing total nephrectomy when it is detected. In mono-kidney patients this will lead to hemodialysis and later a kidney transplant.

Case presentation:
This case represents our center’s experience and strategy in managing renal cell carcinoma in a one-kidney patient by endovascular management first followed by partial nephrectomy.

Clinical discussion:
The patient’s postoperative follow-up has a good quality of life with no signs of tumor recurrence or metastasis in addition to normal kidney functions tests.

Conclusion:
Preoperative endovascular intervention can represent a good and accepted solution for a partial nephrectomy preserving not only a normal renal function, without the need for kidney transplantation, but also a good quality of life.
Creating a Learning Plan for Prelicensure Students in Primary Care Clinical Experiences
Authors: Nielsen Ann , Taylor Cynthia , Claudson Robin , Keller Ginger , Barfield Patricia 
Published: April 2023

Background:
Registered nurses (RNs) working to the full scope of licensed practice can expand the capacity of the health care system and influence patient care quality. However, preparation of prelicensure nursing students to practice in primary care is particularly challenging due to curricular and practice site barriers.

Approach:
As part of a federally funded project to expand the primary care RN workforce, learning activities to teach key concepts of primary care nursing were designed and implemented. Students studied the concepts while placed in a primary care clinical setting and debriefed in a topical, instructor-facilitated, seminar. Current and best practices in primary care were explored, compared, and contrasted.

Outcomes:
Pre- and postsurveys revealed significant student learning related to selected primary care nursing concepts. Overall knowledge, skills, and attitudes increased significantly pre- to post-term.

Conclusion:
Concept-based learning activities can effectively support specialty nursing education in primary and ambulatory care settings.
CATCH IT: The Effect of Bladder Ultrasound in Decreasing the Time to Collect a Clean-Catch Urine Sample in the Nontoilet-Trained Child
Authors: Lennon Richard , Krishnamohan Anirudh , Fitzpatrick Lesley , Gillett Mark 
Published: April 2023

Objectives
Clean-catch urine is essential in the investigation of an unwell child but can unfortunately be difficult to obtain in nontoilet-trained children. To this end, we compared the difference in time taken to collect clean-catch urine in nontoilet-trained children via the use of point-of-care ultrasound and traditional methods.

Methods
A single-center randomized controlled trial was conducted at an urban pediatric emergency department, recruiting 80 patients, of which 73 underwent data analyses. Participants were randomized to either the control arm, which consisted of the traditional “watch and wait” method of collecting a clean-catch sample, or to the intervention arm, which used point-of-care ultrasound to assess bladder volume and to stimulate the micturition reflex. The primary outcome measured was the mean time taken to collect a clean-catch urine sample.

Results
Eighty patients (ultrasound, n = 41; standard care, n = 39) underwent randomization using a random number generator. Seven patients were removed from final analysis due to loss to follow-up for various reasons. Seventy-three patients (ultrasound, n = 37; standard care, n = 36) underwent statistical analysis. The ultrasound group had a median time to clean-catch urine of 40 minutes (interquartile range, 52) and mean time of 52 minutes (standard deviation, 42), and the control group had a median time of 55 minutes (interquartile range, 81), and mean time of 82 minutes (standard deviation, 90). This reached statistical significance (1-tail t test, P = 0.033). The baseline characteristics were similar between both groups for sex and age distribution; however, the mean ages were significantly different (2-tail t test, P = 0.049) with 8.4 months in the control group, and 12.3 months in the ultrasound group.

Conclusions
We found that there was a statistically and clinically significant reduction in mean time taken to collect clean-catch urine in nontoilet-trained children using point-of-care ultrasound compared with the traditional watch and wait method.
Introduction of the L-PAP Flap: Bipedicled, Conjoined, and Stacked Thigh-Based Flaps for Autologous Breast Reconstruction
Authors: Chu Carrie K. , Largo Rene D. , Lee Z-Hye , Adelman David M. , Egro Francesco , Winocour Sebastian , Reece Edward M. , Selber Jesse C. , Butler Charles E. 
Published: April 2023

Summary:
Thigh based-flaps are increasingly popular options for autologous breast reconstruction in the setting of abdominal donor site inadequacy, previous surgery, or patient preference, but the volume and skin associated with these flaps are often lacking relative to the abdomen. An individualized, shared-decision making approach to donor site selection was adopted based on body shape, surgical history, lifestyle, reconstructive needs, and patient expectations. Different thigh-based flaps combined in stacked, bipedicled, and/or conjoined configurations were selected to maximize efficient use of available soft tissue skin and volume while optimizing donor site aesthetics. A total of 23 thigh-based stacked, bipedicled, and/or conjoined profunda artery perforator (PAP), lateral thigh perforator (LTP), and/or gracilis musculocutaneous flap components were used in six patients. Configurations included bilateral stacked PAP and LTP flaps, bipedicled posterolateral thigh flaps based on the LTP and PAP perforators (L-PAP flaps), and bipedicled thigh flaps based on the gracilis and PAP pedicles. Most anastomoses were performed to the antegrade and retrograde internal mammary vessels, while intra-flap anastomoses were performed in one case. There were no partial or total flap losses. There was one donor site seroma. Design of stacked, bipedicled, and conjoined thigh-based flaps using multiple conventional flap components allows for tailored approaches to donor site utilization based on individual body shape in selected patients. Bipedicled design with the L-PAP flap represents one strategy in appropriate patients to overcome skin and volume deficiencies while facilitating coning and projection.
“Close the GAPS: A Standardized Perioperative Protocol Reduces Breast Reconstruction Implant Infections”
Authors: Brown Owen H. , Danko Dora , Muret-Wagstaff Sharon L. , Emefiele Jesse , Argüello-Angarita Marvin , Baker Nusaiba F. , Losken Albert , Carlson Grant , Cheng Angela , Walsh Mark , J. Muralidharan Vignesh , Thompson Peter W. 
Published: April 2023

Background:
Implant-based breast reconstruction (IBBR) is a complex process with significant practice variability. Infections after IBBR are associated with higher rates of readmission, reoperation, and reconstructive failure. To reduce process variability and postoperative infections, we implemented an evidence-based, standardized protocol for IBBR.

Methods:
The protocol was applied to all patients undergoing IBBR at a single institution from 12/2019 to 02/2021. Intraoperative protocol adherence was recorded, and infection events were considered minor (managed with outpatient antibiotics) or major (managed with readmission or reoperation). A historic control group was retrospectively analyzed for comparison.

Results:
Sixty-nine patients (120 breasts) in the protocol group were compared to 159 (269 breasts) in the retrospective group. No differences were found in demographics, comorbidities, or type of reconstruction (expander vs. implant). Intraoperative protocol adherence was 80.5% (STD=13.9%). Overall infection rate was significantly lower in the protocol group vs. controls (8.7% vs 17.0%, p < 0.05). When dichotomized, protocol patients had a lower rate of both minor (2.9% vs. 5.7%, p=0.99) and major (5.8% vs 11.3%, p=0.09) infections, though this was not statistically significant. Rate of reconstructive failure secondary to infection was significantly lower in the protocol group (4.4% vs. 8.8%, p<0.05). Among protocol patients, those without infection had higher protocol adherence (81.5% vs 72.2%, p < 0.06) that neared statistical significance.

Conclusions:
A standardized peri-operative protocol for IBBR reduces process variability and significantly decreases rate of overall infections and reconstructive failure secondary to infection.
Assessing the efficacy of the S-PECS block in breast augmentation surgery – a randomised double-blind control trial
Authors: Sforza Marcos , Saghir Reyan , Saghir Norman , Husein Rodwan , Okhiria Renee , Okhiria Terrell , Sidhu Manu , Poojary Manoj 
Published: April 2023

Introduction:
Postoperative acute and chronic pain following breast surgery is a common complication which needs resolving to allow for improved patient outcomes. Previously thoracic epidurals and paravertebral blocks (PVB) have been the gold standard administered intra-operatively. However, more recently the introduction of the Pectoral nerve block (PECS and PECS-2 blocks) has looked promising to control the pain more effectively, but further robust analysis is required to prove its efficacy.

Objectives:
The authors aim to study the efficacy of a new block S-PECS that combines a serratus anterior and a PECS-2 block.

Methods:
In this study we performed a prospective, single-centre randomised controlled double-blind group trial in 30 female patients undergoing breast augmentation surgery with silicone breast implants and the S-PECS block. Divided into groups of 15, the PECS group received local anaesthetics with the no-PECS control group receiving a saline injection. All participants were followed up at recovery (REC), 4, 6 and 12 (4H, 6H and 12H) hourly postoperatively.

Results:
Our results showed that the pain score in the PECS group was significantly less than the no-PECS group across all time points REC, 4H, 6H and 12H. Furthermore, the patients that received the S-PEC block were 74% less likely to request pain medications compared to the no-PECS group (p<0.05).

Conclusion:
Overall, the modified S-PECS block is an effective, efficient and safe method of controlling pain in patients undergoing breast augmentation surgery with additional applications yet to be explored.
The Volumetric effect of Botulinum Toxin Type A Injection on Parotid Gland: A Prospective Randomized Controlled Trial
Authors: Jeong Woo Shik , Hong Dae Won , Ahn Tae Joo , Han Hyun Ho 
Published: April 2023

Backgrounds:
Botulinum neurotoxin type A (BTX-A) to masseter muscle is a useful tool for the aesthetic narrowing the width of the lower face. The administration of BTX-A to visible parotid glands is also effective to reduce lower facial width. However, no studies quantitatively analyzed the effect of BTX-A on the parotid glands.

Methods:
The purpose of this study is to confirm the impact of BTX-A injection on the parotid gland and to suggest the effective dosage of BTX-A in facial slimming. This study was conducted by selecting patients that desired facial slimming from among patients that required surgery for a facial bone fracture. Patients undergoing BTX-A injection were prospectively randomized to high-dose, low-dose, and placebo groups, and different doses of BTX-A for each group were injected into both parotid glands during facial bone surgery.

Results:
A total of thirty patients were enrolled in this study. Ten patients in the high-dose, eight in the low-dose group, and nine in the control group completed the clinical trial. There were significant changes in each high and low dose groups compared to the control group (p < 0.001, p < 0.001), and in interaction of time and group (p < 0.001). The volume recovery after three months was found with 7.6% in the high-dose group and 4.8% in the low-dose group.

Conclusion:
BTX-A injection into parotid glands can be an effective treatment option in managing salivary gland enlargement for lower face contouring.
Open Science in Health Psychology and Behavioral Medicine: A Statement From the Behavioral Medicine Research Council
Authors: Segerstrom Suzanne C. , Diefenbach Michael A. , Hamilton Kyra , O’Connor Daryl B. , Tomiyama A. Janet ,   with the Behavioral Medicine Research Council
Published: April 2023

Abstract
Open Science practices include some combination of registering and publishing study protocols (including hypotheses, primary and secondary outcome variables, and analysis plans) and making available preprints of manuscripts, study materials, de-identified data sets, and analytic codes. This statement from the Behavioral Medicine Research Council (BMRC) provides an overview of these methods, including preregistration; registered reports; preprints; and open research. We focus on rationales for engaging in Open Science and how to address shortcomings and possible objections. Additional resources for researchers are provided. Research on Open Science largely supports positive consequences for the reproducibility and reliability of empirical science. There is no solution that will encompass all Open Science needs in health psychology and behavioral medicine’s diverse research products and outlets, but the BMRC supports increased use of Open Science practices where possible.
A Network Analysis of Cardiovascular Risk Factors in Patients With Heart Disease: The Role of Socioeconomic Status and Sex
Authors: van den Houdt Sophie C.M. , Mommersteeg Paula M.C. , Widdershoven Jos , Kupper Nina 
Published: April 2023

ABSTRACT

Objective
Diverse risk factors influence the development and prognosis of coronary heart disease (CHD) independently and mutually. Low socioeconomic status (SES) seems to exacerbate these risk factors’ influences. In addition, sex differences have been identified for individual risk factors. Network analysis could provide in-depth insight into the interrelatedness of the risk factors, their predictability, and the moderating role of sex, to ultimately contribute to more refinement in prevention and cardiac rehabilitation.

Methods
A total of 1682 participants (78% male; mean [standard deviation] age = 69.2 [10.6] years) with CHD completed questionnaires on psychosocial factors and health behaviors. Cardiometabolic data were retrieved through medical records. An SES index was created based on self-reported occupation, education, and area (i.e., postal code)-based median family income. Using R, we conducted a mixed graphical model network analysis on all risk factors combined with and without the moderating role of sex.

Results
SES belonged to the more influential risk factors with moderate to high levels of expected influence and degree centrality, indicating that it plays a considerable role in the risk factor network. When considering the moderating role of sex, relationships between SES and most risk factors were found to be stronger for women (b = 0.06–0.48).

Conclusions
The current study provided an insight into an interrelated network of psychosocial and medical risk factors among CHD patients. With SES belonging to the more influential risk factors and female sex influencing the strength of all the SES–risk factor relationships, cardiac rehabilitation and prevention techniques could be more refined by accounting for both influences.
PROGNOSTIC VALUE OF LOW-DOSE ADRENOCORTICOTROPIC HORMONE TEST IN CRITICALLY ILL PATIENTS
Authors: Abdelrehim Ahmad B. , Mohsen Fatma M. , Haredi Mostafa A. , Hameed Zeinab Abdel , Ibrahim Walaa H. 
Published: April 2023

ABSTRACT

Background: Previous trials evaluated the incidence of critical illness–related corticosteroid insufficiency (CIRCI) using 250 μg adrenocorticotropic hormone (ACTH). However, this supraphysiological dose could result in false-positive levels. We aimed to determine the incidence of CIRCI in septic patients using a 1 μg ACTH stress test. Methods: We conducted a prospective cohort study on 39 patients with septic shock. Critical illness–related corticosteroid insufficiency was defined as a Δ max cortisol <9 μg/dL after 1 μg ACTH stress test. The primary outcome of the study was death. Secondary outcomes included days of vasopressors, days of mechanical ventilation (MV), amount of fluid per day, the incidence of acute kidney injury (AKI), and days of intensive care unit (ICU) stay. Results: The incidence of CIRCI in our cohort was 43.6% using 1 μg ACTH. There were no significant differences between groups in terms of ICU scores, laboratory investigations, vasopressors, MV days, amount of fluid per day, and the ICU stay (P = > 0.05). The CIRCI group had lower median survival and survival probability rates (5 days and 48.4%, respectively) compared with the non-CIRCI group (7 days and 49.5%, respectively). In addition, the CIRCI group had a shorter time to develop AKI and a higher probability of developing AKI (4 days and 44.6%, respectively) in comparison with the non-CIRCI group (6 days and 45.57%, respectively). Conclusion: We concluded that the CIRCI group had a lower mean survival rate and a higher incidence of AKI. We recommend the use of 1 μg ACTH test in septic shock patients to identify this subgroup of patients.