bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time to Radiation after Oncoplastic Reduction versus After Lumpectomy
Authors: Marxen Troy , Chan Patricia , Baker Nusaiba , Godette Karen D. , Styblo Toncred M. , Carlson Grant W. , Losken Albert 
Published: May 2023

Background:
Prior studies contrasting oncoplastic reduction (OCR) to traditional lumpectomy have validated oncoplastic reduction surgery with similar survival and oncological outcomes. The purpose of this study was to evaluate if there was a significant difference in the time to initiation of radiation therapy after OCR in comparison with the standard breast-conserving therapy (lumpectomy).

Methods:
The patients included were from a database of breast cancer patients who all underwent postoperative adjuvant radiation after either OCR or lumpectomy at a single institution between 2003 and 2020. Patients who experienced delays in radiation for nonsurgical reasons were excluded. Comparisons were made between the groups in the time to radiation and complication rates.

Results:
A total of 487 patients underwent breast-conserving therapy, with 220 having undergone OCR and 267 lumpectomy patients. There was no significant difference in days to radiation between patient cohorts (60.5 OCR, 56.2 lumpectomy, P = 0.059). There was a significant difference in the number of complications between OCR and lumpectomy patients (20.4% OCR, 2.2% lumpectomy, P < 0.001). However, of patients who had complications, there was no significant difference in the number of days to radiation (74.3 OCR, 69.3 lumpectomy, P = 0.732).

Conclusions:
Compared with lumpectomy, OCR was not associated with an increased time to radiation but was associated with higher complications. Statistical analysis did not reveal surgical technique or complications to be independent, significant predictors of increased time to radiation. Surgeons should be aware that although complications may remain higher in OCR, this does not necessarily translate to delays in radiation.
Overcoming Pandemic-Related Challenges in Recruitment and Screening
Authors: Halloway Shannon , Volgman Annabelle Santos , Schoeny Michael E. , Arvanitakis Zoe , Barnes Lisa L. , Pressler Susan J. , Vispute Sachin , Braun Lynne T. , Tafini Susan , Williams Martina , Wilbur JoEllen 
Published: May 2023

Background
Recruiting participants with cardiovascular disease into research during the COVID-19 pandemic was challenging, particularly those at risk of health disparities.

Objective
During the pandemic, 12 cohorts of older women with cardiovascular disease were recruited from cardiology clinics into a lifestyle intervention trial to prevent cognitive decline. Objectives were to (a) describe the results of modified recruitment/screening strategies to overcome pandemic-related challenges and (b) evaluate differences in age, race, and ethnicity between patients recruited/randomized, recruited/not randomized (entered recruitment but not randomized because of being ineligible or not interested), and not recruited (clinic patients who met preliminary criteria but did not enter recruitment).

Methods
This was a cross-sectional descriptive analysis. In-person study strategies proposed before the COVID-19 pandemic were modified before study onset (September 2020). Women 65 years or older with cardiovascular disease were recruited from cardiology clinics by clinicians, posted flyers, and letters mailed to patients randomly selected from electronic health record data extractions. Patients were classified as recruited/randomized, recruited/not randomized, and not recruited.

Results
Of 5719 patients potentially eligible, 1689 patients entered recruitment via referral (49.1%), posted flyers (0.5%), or mailed letters (50.3%), and 253 patients were successfully recruited/randomized. Recruited/randomized participants were, on average, 72.4 years old (range, 65–90 years old), non-Hispanic White (54.2%), non-Hispanic Black (38.3%), Hispanic/Latinx (1.6%), and other/not reported (5.1%). The recruited/randomized group was significantly younger with fewer patients of Hispanic/Latinx ethnicity compared with those not recruited.

Conclusions
During the pandemic, all recruitment/screening goals were met using modified strategies. Differences in sociodemographic representation indicate a need for tailored strategies.
Associations of Prenatal Agricultural Farm Work with Fetal Overgrowth and Pregnancy Complications in State of Arizona Birth Records
Authors: Parra Kimberly L. , Harris Robin B. , Farland Leslie V. , Beamer Paloma , Furlong Melissa 
Published: May 2023

Objective
The purpose of this study is to examine fetal growth outcomes from agricultural worker households.

Methods
Using Arizona 2006 to 2013 birth certificates with parental occupation, we identified N = 623,185 live births by agricultural household status. Logistic regression models estimated adjusted odds ratios (aORs) for macrosomia (>4000 g), postterm birth (>41 weeks), low birth weight (<2500 g), preterm birth (<37 weeks), large for GA, small for GA, and 5-minute APGAR (<7).

Results
Newborns of agricultural households (n = 6371) had a higher risk of macrosomia (aOR, 1.15; 95% CI, 1.05–1.26), large for GA (aOR, 1.12; 95% CI, 1.03–1.22), postterm birth (aOR, 1.20; 95% CI, 1.09–1.33), and low 5-minute APGAR (aOR, 1.39; 95% CI, 1.07–1.81), whereas low birth weight (aOR, 0.85; 95% CI, 0.76–0.96) and preterm birth (aOR, 0.82; 95% CI, 0.74–0.92) were inversely related.

Conclusions
Having an agriculture working parent increased the likelihood of fetal overgrowth and low APGAR.
Anal Intraepithelial Neoplasia and Anal Squamous Cell Carcinoma: Updates From the Last 3 Years
Authors: Albuquerque Andreia 
Published: May 2023

Abstract
In the last 3 years, new and relevant information has been published on anal cancer and anal precancerous lesions epidemiology, screening, treatment, and vaccination. This information will likely change prevention and treatment strategies for these patients in the upcoming years.
Understanding the knowledge, awareness, and attitudes of the public towards liver diseases in Malaysia
Authors: Mohamed Rosmawati , Yip Christina , Singh Shikha 
Published: May 2023

Background
Viral hepatitis B and C (HBV, HCV) and non-alcoholic fatty liver disease (NAFLD) are the commonest etiologies of liver-related deaths in Malaysia. Herein, this study aims to explore and understand the knowledge and attitudes of the public toward liver-related health and diseases in Malaysia.

Methods
A cross-sectional, self-reported, web-based questionnaire was conducted among 500 adults between February and March 2020. Questionnaire items pertained to the knowledge and attitudes toward liver-related health and diseases.

Results
Half of the respondents were aged ≥35 years and 52.0% were males. Gaps in knowledge included the lack of awareness of different types of hepatitis, including the potential transmission risks and complications of HBV and HCV. About half acknowledged liver fibrosis and cirrhosis as key determinants of liver-related disease progression. A higher proportion rightly recognized the diagnostic test for HCV (40.8%) than HBV (30.0%) despite more being aware of HBV than HCV. Less than one-third were aware of the risk factors, screening tests, and complications of NAFLD. Despite the majority (92.8%) agreeing that regular screening was important for liver health, only 67.0% attended recent health screening and one-fifth were unlikely to seek medical consultation upon exposure to viral hepatitis risk factors. Reasons for this low urgency included the perception of being healthy, cost-related concerns, and societal discrimination.

Conclusion
Robust education efforts are needed to raise awareness and empower the community with knowledge of liver-related diseases, particularly viral hepatitis and NAFLD in Malaysia.
Differential Effects of an Emergency Department-to-Home Care Transitions Intervention in an Older Adult Population
Authors: Green Rebecca K. , Nieser Kenneth J. , Jacobsohn Gwen C. , Cochran Amy L. , Caprio Thomas V. , Cushman Jeremy T. , Kind Amy J.H. , Lohmeier Michael , Shah Manish N. 
Published: May 2023

Background:
Older adults frequently return to the emergency department (ED) within 30 days of a visit. High-risk patients can differentially benefit from transitional care interventions. Latent class analysis (LCA) is a model-based method used to segment the population and test intervention effects by subgroup.

Objectives:
We aimed to identify latent classes within an older adult population from a randomized controlled trial evaluating the effectiveness of an ED-to-home transitional care program and test whether class membership modified the intervention effect.

Research Design:
Participants were randomized to receive the Care Transitions Intervention or usual care. Study staff collected outcomes data through medical record reviews and surveys. We performed LCA and logistic regression to evaluate the differential effects of the intervention by class membership.

Subjects:
Participants were ED patients (age 60 y and above) discharged to a community residence.

Measures:
Indicator variables for the LCA included clinically available and patient-reported data from the initial ED visit. Our primary outcome was ED revisits within 30 days. Secondary outcomes included ED revisits within 14 days, outpatient follow-up within 7 and 30 days, and self-management behaviors.

Results:
We interpreted 6 latent classes in this study population. Classes 1, 4, 5, and 6 showed a reduction in ED revisit rates with the intervention; classes 2 and 3 showed an increase in ED revisit rates. In class 5, we found evidence that the intervention increased outpatient follow-up within 7 and 30 days (odds ratio: 1.81, 95% CI: 1.13–2.91; odds ratio: 2.24, 95% CI: 1.25–4.03).

Conclusions:
Class membership modified the intervention effect. Population segmentation is an important step in evaluating a transitional care intervention.
Nurse Work Environment and Hospital-Onset Clostridioides difficile Infection
Authors: Jung Olivia S. , Aiken Linda H. , Sloane Douglas M. , Fridkin Scott K. , Li Yin , Kang Yu Jin , Becker Edmund R. , Joski Peter J. , Cimiotti Jeannie P. 
Published: May 2023

Background:

Clostridioides difficile is the leading cause of hospital-onset diarrhea and is associated with increased lengths of stay and mortality. While some hospitals have successfully reduced the burden of C. difficile infection (CDI), many still struggle to reduce hospital-onset CDI. Nurses—because of their close proximity to patients—are an important resource in the prevention of hospital-onset CDI.

Objective:
Determine whether there is an association between the nurse work environment and hospital-onset CDI.

Methods:
Survey data of 2016 were available from 15,982 nurses employed in 353 acute care hospitals. These data, aggregated to the hospital level, provided measures of the nurse work environments. They were merged with 2016 hospital-onset CDI data from Hospital Compare, which provided our outcome measure—whether a hospital had a standardized infection ratio (SIR) above or below the national average SIR. Hospitals above the average SIR had more infections than predicted when compared to the national average.

Results:
In all, 188 hospitals (53%) had SIRs higher than the national average. The odds of hospitals having higher than average SIRs were significantly lower, with odds ratios ranging from 0.35 to 0.45, in hospitals in the highest quartile for all four nurse work environment subscales (managerial support, nurse participation in hospital governance, physician-nurse relations, and adequate staffing) than in hospitals in the lowest quartile.

Conclusions:
Findings show an association between the work environment of nurses and hospital-onset CDI. A promising strategy to lower hospital-onset CDI and other infections is a serious and sustained commitment by hospital leaders to significantly improve nurse work environments.
General Anxiety Disorder and Primary Hypertension
Authors: Seifaei Asal , Askarinejad Amir , Bazrafshan Drissi Hamed , Keshtvarz Hesam Abadi Alimohammad , Sasannia Sarvin , Moghadami Mana , Izadpanah Peyman , Bazrafshan Hanieh 
Published: May 2023

Abstract
Chronic forms of morbidity, including mental disorders and hypertension, play a dominant role in determining a disease load in the developing world. This article investigates the associations between the diagnoses of primary hypertension and generalized anxiety disorder (GAD) and the severity of GAD in individuals with primary hypertension. The association of GAD and age, sex, marriage, education level, income, chronic medical conditions, family history of mental disorders, adverse life events, and hypertension was assessed in 470 patients with the diagnosis of primary hypertension. Data analysis was performed with IBM SPSS Statistics software version 16. A significant relationship was found between the prevalence of GAD and the following variables: history of mental disorders (p < 0.0001), chronic medical conditions (p < 0.0001), and adverse life events (p < 0.0001). The mean anxiety score was higher among patients with uncontrolled blood pressure, and a significant relationship was observed between the prevalence of GAD and blood pressure (p < 0.0001). Because of the significant association between GAD and primary hypertension, it is recommended that anxiety disorders be considered in patients in whom primary hypertension is not controlled easily. This may lead to more proper control of hypertension while taking fewer antihypertensive medications.
Whole genome sequence of a Treponema pallidum strain from a formalin-fixed paraffin-embedded fine needle aspirate of a cervical lymph node
Authors: Aldrete Sol , Kroft Steven H. , Romeis Emily , Lieberman Nicole A.P. , Greninger Alexander L. , Giacani Lorenzo , Kron Michael A. 
Published: May 2023

ABSTRACT
A patient with unilateral cervical lymphadenopathy suspicious for malignancy underwent a fine needle aspiration. Histology demonstrated mixed inflammatory infiltrates with abundant spirochetes. Sufficient spirochete DNA was extracted from paraffin-embedded tissue sections to obtain the near-complete genome sequence of a macrolide resistant strain belonging to the SS14 omega strain of Treponema pallidum.
Application of botulinum toxin at the Yonsei point for the treatment of gummy smile: A randomized controlled trial
Authors: Gong Xi , Tang Hao-Nan , Zhang An-Ran , Wang Zhi , Tang Zhi-Hui , Han Xue-Feng , Su Jia-Zeng 
Published: May 2023

Background:
Over the years, demand for less invasive procedures for treating gummy smile, such as botulinum toxin A injections, has substantially increased. Meanwhile, the optimal injection site for botulinum toxin A injection is still debatable.

Objective:
To investigate the efficacy of botulinum toxin A injection at the Yonsei point for treating gummy smile.

Methods:
In this double-blind single-site randomized clinical trial, healthy participants with a gummy smile (anterior gingival exposure of ≥3.0 mm) were enrolled and randomized (1:1 ratio) into two groups. The experimental group was administered with 6 units (U)(a single-site injection of 3 U was given to the right Yonsei point and 3 U to the left Yonsei point), while the control group received the same dose in the bilateral levtor labii superioris alaeque nasi (LLSAN) muscle sites. The patients were assessed at baseline and 4, 12, 24, and 48 weeks after the first injection by a digital vernier caliper.

Results:
A total of 49 participants were enrolled. Anterior and bilateral posterior gingival exposure were reduced at 4, 12, and 24 weeks (P ≤ 0.05) and returned to baseline at 48 weeks in both groups; there was no difference between the groups at these time points. The increase in satisfaction among patients was significant, and few adverse events were observed in both groups.

Conclusions:
Both the Yonsei point and the LLSAN muscle site could be used as botulinum toxin A injection sites for treating gummy smiles.
The Impact of a Patient Participating in Evaluating Patient Safety by Using the Patient Measure of Safety in Saudi Arabia: A Cross-Sectional Study
Authors: Al Zahrani Amani K. , Alaska Yasser A. , Alqahtani Nawaf M. , Alotaibi Faisal , Majrashi Mecciya , Alhazani Lamya , Binkheder Samar , Alghadheeb Fatemah , Alkhaldi Ghadah , Hamdan Abdullah B. , Alkutbe Rabab B. 
Published: May 2023

Background
Patient safety is an essential element for delivering quality of healthcare. Many studies focus on measuring patient safety from the healthcare provider’s perspective to improve patient safety in healthcare facilities. However, patient participation may reduce medical errors and improve patient safety by providing information regarding the safety of their care. This study aimed to evaluate patient safety from the inpatients’ perspective and the extent of the influence of the sociodemographic factors on their assessment.

Methods
A cross-sectional study was conducted at hospitals in different Saudi Arabian regions with 1569 inpatient adults 18 years of older who voluntarily completed an online questionnaire using the Patient Measure of Safety tool (Arabic translated). Two questions were added to assess patient feedback about the overall perception of safety and witnessing patient safety events. COVID-19 patients and those with a mental disorder or incapable of providing informed consent were excluded.

Result
The total number of participants was 1569 inpatients from 17 hospitals. Sixty-one percent of the participants were female, and 41.62% were from the 18- to 35-year age group. Less than half (38.69%) of patients stayed at the hospital between 3 and 5 days. Percentages of positive responses were more than 90% observed in dignity and respect, communication and teamworking, and organization and care planning domains. Percentages of negative responses were more than 20% found in organization and care planning, access to resources, and ward type and layout domains. Among the respondents, 57.3% (n = 899) rated the safety of their wards as excellent as opposed to 2.9% (n = 46) who rated it as poor. Approximately 5% (n = 79) have noticed 1 event, and 2.3% (n = 36) have noticed 2 or 3 events. Unemployed participants had a significantly lower rate of positive responses in domains of communication, access to resources, and ward type. In contrast, the no-schooling group had a significantly greater rate of negative responses in care planning and ward-type domains.

Conclusions
The patient plays a key role in enhancing the quality of care and has the potential to detect adverse events. The study highlighted the need to focus on better communication processes for patients with low education levels to enhance their engagement in their care. Further steps should be taken to understand the extent of the patient’s involvement in the improvement that could be tackled from feedback on the safety of care.
Frontline Worker Safety in the Age of COVID-19: A Global Perspective
Authors: Kavanagh Kevin T. , Maiwald Matthias , Pontus Christine , Cimiotti Jeannie P. , Palmieri Patrick A. , Cormier Lindsay E. 
Published: May 2023

The third annual Health Watch USAsm webinar conference assembled 16 speakers from 4 continents who shared information regarding frontline worker safety in the age of COVID-19. The U.S. Bureau of Labor Statistics reported a nearly 4000% increase in workplace illness in 2020 compared with 2019. It is estimated that 2% of the U.S. workforce is not working because of long COVID. In addition, the impact is growing with each surge. After the acute illness, patients are often described as recovered, when in fact many have only survived and are coping with the multisystem impacts of long COVID. Long COVID, including its late cognitive, cardiovascular, embolic, and diabetic complications, disproportionately impacts frontline workers, many of whom are of lower socioeconomic status and represented by ethnic minorities.
Natural infection and current vaccines do not provide durable protection for reinfection. Herd immunity is not possible at this time. Although SARS-CoV-2 is unlikely to be eliminated, decreasing spread is imperative to slow the rate of mutations, decrease the number of reinfections, and lower the chances of developing long COVID. The primary mode of spread is through aerosolization. Both routine breathing and talking aerosolizes the virus. With the extremely high infectivity of SARS-CoV-2, it is unlikely that central building ventilation alone will be enough to satisfactorily mitigate spread. Additional safe active air cleaning technology, such as upper-room germicidal UV-C lighting, needs to be deployed.
Misinformation and disinformation have inhibited response effectiveness. Examples include downplaying the benefit of well-fitted masks and the risks that COVID-19 and long COVID pose to children, along with believing children cannot spread the disease. The engagement of local community leaders is essential to educate the community and drive social change to accept vaccinations and other public health interventions. Vaccinations and natural immunity alone are unlikely to adequately prevent community spread and do not provide durable protection against the risk of long COVID.
Frontline workers must keep their immunity as high as possible and work in settings with clean air, along with wearing N95 masks when they are in contact with the public. Finally, there needs to be a financial safety net for frontline workers and their families in the event of incapacitation or death from COVID-19.
Radioguided Occult Lesion Localization for Gynecologic Tumor Relapses
Authors: Bebia Vicente , Mast Richard , Villasboas-Rosciolesi Diego , Franco-Camps Silvia , Pérez-Benavente María Asunción , Gil-Moreno Antonio , Cabrera Silvia 
Published: May 2023

Purpose of the Report
Excision of peritoneal or nodal isolated recurrences frequently involves performing a surgery on a previously operated area, which is more difficult to achieve with minimally invasive approaches. Our aim was to describe the technical aspects, feasibility, and complications derived from the application of the radioguided occult lesions localization (ROLL) in gynecologic oncology recurrence excision.

Patients and Methods
All consecutive patients bearing localized relapses of a gynecologic tumor that were considered candidates for surgical excision were assessed to undergo a ROLL procedure. Radiotracer (99mTc-albumin macroaggregate) injection of the lesions was performed by ultrasonography or CT guidance. Relapses were localized using a gamma probe by minimally invasive surgery when located in the abdomen, or percutaneously when located in the groin. Intraoperative and early (up to postoperative day 30) complications were prospectively recorded.

Results
A total of 8 patients underwent the procedure. The median age was 59 years (range, 35–87 years). Four patients had abdominal relapses, whereas 4 patients presented groin relapses. The mean operative time was 120 minutes (range, 30–190 minutes), whereas the median estimated blood loss was 5 mL (range, 0–150 mL). All the targeted lesions were successfully removed. No intraoperative complications were reported. One postoperative complication (inguinal lymphocele) was recorded.

Conclusions
ROLL surgery constitutes a new approach for isolated recurrences in gynecological tumors.
Testicular Metastasis From Prostate Cancer Demonstrated on PSMA PET/CT
Authors: Mamaliga Tatiana , Obando Jose Antonio , Liu Yiyan 
Published: May 2023

Abstract
Testicular metastasis from prostate cancer is rarely reported in radiology literature. We present the case of an 84-year old man with history of prostate cancer, who obtained an 18F-Pylarify PET/CT for biochemical recurrence, with an incidentally detected prostate-specific membrane antigen–avid large right testicular mass. The 18F-Pylarify PET/CT showed no evidence of local prostate tumor recurrence in the prostate bed, but demonstrated small right common and external lymph node metastases in addition to the incidentally noted large right testicular mass. The patient underwent orchiectomy with subsequent histopathologic examination confirming metastasis from prostate cancer.