bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge level of medical students about ionising radiation used for diagnostic purpose in radiology: a survey study
Authors: Demirtaş Meryem , Turan Arzu , Akpunar Sinan , Tafralı Şeyma , Doğan Emre , Çeliker Fatma B 
Published: June 2023

Abstract
People exposed to ionising radiation may develop harmful somatic and genetic effects in their anatomical structures. Technological advancements, particularly in radiological devices, research and examinations result in a significant increase in the number of radiological investigations. This large number of radiological examinations increased the number of patients affected by ionising radiation. This study aims to evaluate the medical students’ knowledge of ionising radiation and, examine the level of knowledge of medical students on the awareness and safety of ionising radiation exposure, emphasises the importance of radiation curricula internship programmes. This study is a survey application. The chi-square test is used. As a result, the intern’s knowledge of ionising radiation increased significantly after the internship in a radiology unit. Although it has been significantly increased, it is still insufficient. This gap can be filled by incorporating radiology unit internship programmes into the curriculum of medical faculty education programmes.
‘Its many workers and subscribers feel that their services can still be of benefit’: Hospital Leagues of Friends in the English West Midlands, c. 1948–1998
Authors: Millward Gareth 
Published: June 2023

Summary
Leagues of Friends are charities that provide ‘personal service to patients’ and ‘supply hospitals with equipment not likely to come from the budgeting of authorities’. Hundreds continue to exist, and many trace their origins to before the NHS’s foundation in 1948. Despite the rich and growing historiographies of voluntarism and the NHS, Leagues have received little attention. This article uses case studies of Leagues in the English West Midlands to show how ‘friendship’ symbolised the relationship between local NHS institutions and the communities they served. The cases show that voluntarism in British healthcare has not always been based around activism and consumerism, two areas that recent scholarship has rightly highlighted, especially from the 1960s. This allows historians to interrogate the regional and local differences within, ostensibly, a highly centralised national health system.
Going Up in Smoke: Tobacco and Government Policy in the Age of Austerity, 1945–50
Authors: Singleton John 
Published: June 2023

Abstract
This article examines the Attlee government’s performance as a crisis manager in relation to tobacco policy in the years prior to the publication in 1950 of research linking smoking and cancer. Health concerns played no role in tobacco policy before 1950, and the government hoped more teenagers would take up smoking and pay tobacco duty. Tobacco took on added significance as an economic issue because policy-makers had so little room for manoeuvre. Their task was to balance the desire of consumers to smoke as much as they liked at a reasonable price, the exchequer’s need to raise revenue from tobacco duties, and the imperative to conserve scarce dollars. Tobacco was an economic and financial rather than a health issue in the late 1940s and the authorities juggled competing demands creditably. This article examines previously neglected but important aspects of the histories of tobacco and of the Attlee government’s economic policies.
Is Microdochium maydis Associated with Necrotic Lesions in the Tar Spot Disease Complex? A Culture-Based Survey of Maize in Mexico and the Midwestern United States
Authors: Luis Jane Marian , Mehl Hillary L. , Plewa Dianne , Kleczewski Nathan M. 
Published: June 2023

Tar spot, caused by Phyllachora maydis, is an emerging disease of corn in the United States. Stromata of P. maydis are sometimes surrounded by necrotic lesions known as fisheyes and were previously reported to be caused by the fungus Microdochium maydis. The association of M. maydis with fisheye lesions has not been well documented outside of initial descriptions from the early 1980s. The objective of this work was to assess and identify Microdochium-like fungi associated with necrotic lesions surrounding P. maydis stromata using a culture-based method. In 2018, corn leaf samples with fisheye lesions associated with tar spot stromata were collected from 31 production fields across Mexico, Illinois, and Wisconsin. Cultures of pure isolates collected from Mexico believed to be M. maydis were included in the study. A total of 101 Microdochium/ Fusarium-like isolates were obtained from the necrotic lesions, and 91% were identified as Fusarium spp., based on initial ITS sequence data. Multi-gene (ITS, TEF1-α, RPB1, and RPB2) phylogenies were constructed for a subset of 55 isolates; Microdochium, Cryptostroma, and Fusarium reference sequences were obtained from GenBank. All the necrotic lesion isolates clustered within Fusarium lineages and were phylogenetically distinct from the Microdochium clade. All Fusarium isolates from Mexico belonged to the F. incarnatum-equiseti species complex, whereas >85% of the U.S. isolates grouped within the F. sambucinum species complex. Our study suggests that initial reports of M. maydis were misidentifications of resident Fusarium spp. [Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Immediate Plastic Surgery Intervention after Soft Tissue Sarcoma Resection: Examining Wound Healing, Readmission, and Reoperation
Authors: Wu Scott A. , deVries John A. , Plantz Mark A. , Dumanian Gregory , Attar Samer , Ko Jason H. , Peabody Terrance D. 
Published: June 2023

Background:
Many orthopedic and surgical oncologists use a multidisciplinary approach to soft tissue sarcoma (STS) resection. This study assesses the role of immediate plastic surgeon involvement during index soft tissue sarcoma resection.

Methods:
Adult patients who underwent index STS resection between 2005 and 2018 were queried from an institutional database. Main outcomes analyzed were 90-day same-site reoperation, any-cause readmission, and wound healing complications. Univariate and multivariate logistic regression were used to identify risk factors. Additional evaluation was then performed for the following two cohorts: patients with and without plastic surgeon involvement.

Results:
In total, 228 cases were analyzed. Multivariate regression demonstrated the following predictors for 90-day wound-healing complications: plastic surgery intervention [OR = 0.321 (0.141–0.728), P = 0.007], operative time [OR = 1.003 (1.000–1.006), P = 0.039], and hospital length of stay [OR = 1.195 (1.004–1.367), P = 0.010]. For 90-day readmission, operative time [OR = 1.004 (1.001–1.007), P = 0.023] and tumor stage [OR = 1.966 (1.140–3.389), P = 0.015] emerged as multivariate predictors. Patients whose resection included a plastic surgeon experienced similar primary outcomes despite these patients having expectedly longer operative times (220 ± 182 versus 108 ± 67 minutes, P < 0.001) and hospital length of stay (3.99 ± 3.69 versus 1.36 ± 1.97 days, P < 0.001).

Conclusions:
Plastic surgeon involvement emerged as a significant protector against 90-day wound healing complications. Cases that included plastic surgeons achieved similar complication rates in all categories relative to cases without plastic surgery intervention, despite greater operative time, hospital length of stay, and medical complications.
Magnetic Resonance Imaging Surveillance Study of Silicone Implant-based Breast Reconstruction: A Retrospective Observational Study
Authors: Kim Hyung Bae , Han Hyun Ho , Eom Jin Sup 
Published: June 2023

Background:
This study aimed to evaluate the results of magnetic resonance imaging (MRI) surveillance of implant-based breast reconstruction in patients with breast cancer.

Methods:
This retrospective observational study analyzed patients who underwent implant-based breast reconstruction and MRI surveillance by a single surgeon from March 2011 to December 2018, in a single center. All patients were informed about the recommendation of the Food and Drug Administration for MRI surveillance, and they choose to undergo MRI 3 years after surgery.

Results:
The compliance rate for MRI surveillance was 56.5% (169/299). MRI surveillance was performed at a mean of 45.8 (4.04 years) ± 11.5 months after surgery. One patient (0.6%) showed an abnormal finding of an intracapsular rupture of the silicone implant.

Conclusions:
MRI surveillance for implant rupture in implant-based breast reconstruction showed a low incidence of silent implant rupture (0.6%), whereas the compliance of MRI was relatively high (56.5%). These results raise questions about whether taking an MRI in 3–4 years is suitable for imaging surveillance of breast silicone implants. Screening recommendations should be more evidence-based, and more studies are needed to prevent unnecessary screening and patient burden.
Advances on Capsular Contracture—Prevention and Management Strategies: A Narrative Review of the Literature
Authors: Susini Pietro , Nisi Giuseppe , Pierazzi Diletta Maria , Giardino Francesco Ruben , Pozzi Mirco , Grimaldi Luca , Cuomo Roberto 
Published: June 2023

Background:
Capsular contracture (CC) is the most relevant complication of both aesthetic and reconstructive breast implant surgery. For many years, experimental and clinical trials have attempted to analyze CC risk factors, clinical features, and appropriate management strategies. It is commonly accepted that a multifactorial etiology promotes CC development. However, the heterogeneity in patients, implants and surgical techniques make it difficult to suitably compare or analyze specific factors. As a consequence, discordant data are present in literature, and a true systematic review is often limited in its conclusions. Hence, we decided to present a comprehensive review of current theories on prevention and management strategies, rather than a specific “solution” to this complication.

Methods:
The PubMed database was searched for literature regarding CC prevention and management strategies. Pertinent articles in English, published before December 1, 2022, were compared with selection criteria and eventually included in this review.

Results:
Through the initial search, 97 articles were identified, of which 38 were included in the final study. Several articles explored different medical and surgical preventive and therapeutic strategies, showing numerous controversies on appropriate CC management.

Conclusions:
This review provides a clear overview of the complexity of CC. The wide variety of clinical situations in term of patients, implants, and surgical techniques prevent the standardization of CC management strategies. By contrast, a patient-customized approach should be preferred, and different strategies should be considered depending on the specific case. Further research is desirable to better ascertain evidence-based protocols with regard to CC prevention and treatment.
Questioning the Utility of Temporal Artery Biopsy in Giant Cell Arteritis: A Negative Biopsy May Facilitate Decision-making
Authors: Lafreniere Ann-Sophie , Ponich Brett , Hartley Rebecca , Temple-Oberle Claire F. 
Published: June 2023

Background:
Plastic surgeons are frequently consulted to perform temporal artery biopsy (TAB), even though patients meet the American College of Rheumatology diagnostic criteria for giant cell arteritis (GCA) and are already treated. This study aimed to analyze the impact of TAB on steroid duration in patients undergoing TAB.

Methods:
We undertook a prospective study of adult patients undergoing TAB for GCA in Calgary. Consecutive, multicenter recruitment was performed over 2 years. Primary outcomes included initiation or discontinuation and duration of corticosteroids.

Results:
Twenty-one TABs were performed in 20 patients. Nineteen percent of TABs were positive, and 71.4%, negative. In 9.5% of patients, accidental sampling of a vessel other than the superficial temporal artery occurred. Fifty-two percent of patients received steroids before TAB, of which the mean duration was 8.0 days for TAB+ (postive temporal artery biopsy result) patients and 8.4 days for TAB− (negative temporal artery biopsy result; P = 0.22) patients. Before TAB, the American College of Rheumatology score was 2.5 for TAB+ patients and 2.4 for TAB− (P = 0.74). Postbiopsy, the American College of Rheumatology score was 3.5 for TAB+ patients (therefore reaching diagnostic threshold of 3) but remained 2.4 for TAB− (P = 0.02). TAB+ patients were treated for 352.3 days, whereas TAB− patients for 16.7 days (P = 0.29). Complications were more likely with long-term (>6 weeks) steroids (P = 0.17).

Conclusion:
In patients with a low suspicion of GCA, a negative TAB helps bolster physician confidence and leads to a shorter steroid duration.
The Effect of Obesity on Distal Radius Fractures: An Analysis from the NSQIP Database
Authors: Gonuguntla Rishi , Ghali Abdullah , Prabhakar Gautham , Momtaz David , Ahmad Farhan , Slocum Dean , Kotzur Travis , Cushing Tucker , Saydawi Adnan , Wu Chia 
Published: June 2023

Introduction:
The rate and severity of obesity has risen over the past 40 years, and class III (formerly morbid) obesity presents additional sequelae. The effect of obesity on the incidence and recovery of hand and wrist fractures remains unclear. We sought to quantify the relationship between class III obesity and postoperative distal radius fracture (DRF) complications.

Methods:
We performed a retrospective analysis of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database for surgical DRF patients more than 50 years old from 2015 to 2020. We then stratified patients into class III obese (BMI > 40) and compared the rates of postoperative complications to a control group with BMI less than 40.

Results:
We included 10,022 patients (570 class III obese vs. 9,452 not class III obese). Patients with class III obesity had significantly increased odds of experiencing any complication (OR 1.906, p<0.001), adverse discharge (OR 2.618, p<0.001), delayed hospital stay of longer than three days (OR 1.91, p<0.001), and longer than seven days (OR 2.943, p<0.001) than controls. They also had increased odds of unplanned reoperation (OR 2.138, p = 0.026) and readmission (OR 2.814, p < 0.001) than non–class III obese patients. Class III obese patients had a significantly longer average operation time (79.5 min vs. 72.2 min, p < 0.001). They also spent more time in the hospital postoperatively (0.86 days vs. 0.57 days, p = 0.001).

Conclusion:
Class III obese patients undergoing DRF repair are more likely to experience postoperative complications than non–class III obese patients.
Professional Liability in Plastic Surgery: A Change of Scenario in Medical Professional Liability in Spain
Authors: Martin-Fumadó Carles , Benet-Travé Josep , Güerri-Fernández Robert , López-Ojeda Anna , Bermejo-Segú Oriol , Arimany-Manso Josep 
Published: June 2023

Background:
The epidemic of complaints and/or litigation, both in and out of court, for cases of alleged malpractice has increased dramatically. In Spain, claims related to plastic surgery are gaining more and more interest.

Methods:
The Council of Medical Associations of Catalonia database was used to analyze claims related to plastic surgery from 1986 to 2021.

Results:
1039 claims (9.8% over 10,567 total claims) were studied. Both the total number of claims (P = 0.016; R2=0.16) and the number of claims for plastic surgery (P < 0.0005; R2=0.732) showed an upward trend during the period of study. In the period from 2000 to 2021, the behavior was different; while the number of total claims stabilized (P = 0.352; R2 = 0.043), plastic surgery claims continued to show a time-related tendency to increase (P < 0.0005; R2=0.484). The distribution was 50.12% out of court. Ten unique procedures accounted for 84.5% of the total number of claims. Liability was observed in 21.46% of the closed claims, with differences between civil (20.34%), criminal (6.89%), and out-of-court (25.53%) procedures. Regarding compensation amounts, out-of-court cases had an average of 33,169.44 euros paid; civil cases, 29,153.37 euros; and criminal cases, 37,186.88 euros.

Conclusions:
The increase in the number of cases can only be related to an increase in the activity carried out by plastic surgeons. There has been a change in Spain in terms of the most sought-after medical specialty, with plastic surgery having displaced the perennially most sought-after specialty, orthopedic surgery and traumatology.
Surgical strategy for colorectal cancer with synchronous liver and extrahepatic metastases: A scoring system and decision tree model
Authors: Tseng Chan-Wei , Teng Hao-Wei , Lin Chun-Chi , Lei Hao-Jan , Hung Jung-Jyh , Liang Wen-Yih , Hsia Cheng-Yuan , Chou Shu-Cheng , Lin Hung-Hsin , Huang Sheng-Chieh , Cheng Hou-Hsuan , Lan Yuan-Tzu , Wang Huann-Sheng , Yang Shung-Haur , Chen Wei-Shone , Lin Jen-Kou , Jiang Jeng-Kai , Chang Shih-Ching , Chau Gar-Yang 
Published: June 2023

Background:
The role of hepatectomy in a specific group of patients with synchronous colorectal cancer with liver metastases (SCRLM) and synchronous extrahepatic disease (SEHD) is still unclear. The aim of this study was to evaluate the efficacy of liver surgery and define the selection criteria for surgical candidates in patients with SCRLM + SEHD.

Methods:
Between July 2007 and October 2018, 475 patients with colorectal cancer with liver metastases (CRLM) who underwent liver resection were retrospectively reviewed. Sixty-five patients with SCRLM + SEHD were identified and included in the study. Clinical pathological data of these patients were analyzed to evaluate the influence on survival. Important prognostic factors were identified by univariate and multivariate analyses. The risk score system and decision tree analysis were generated according to the important prognostic factors for better patient selection.

Results:
The 5-year survival rate of patients with SCRLM + SEHD was 21.9%. The most important prognostic factors were SCRLM number of more than five, site of SEHD other than the lung only, inability to achieve SCRLM + SEHD R0 resection, and BRAF mutation of cancer cells. The proposed risk score system and decision tree model easily discriminated between patients with different survival rates and identified the profile of suitable surgical patients.

Conclusion:
Liver surgery should not be a contraindication for patients with SCRLM + SEHD. Patients with complete SCRLM + SEHD R0 resection, SCRLM number less than or equal to five, SEHD confined to the lung only, and wild-type BRAF could have favorable survival outcomes. The proposed scoring system and decision tree model may be beneficial to patient selection in clinical use.
A case report: Catatonic symptoms secondary to systemic lupus erythematosus with multiple infections: neuropsychiatric or “mimickers?”
Authors: Lv Lizeyu , Lin Yong , Zhang Yu , Xiao Wen , Li Mingquan , Zhao Liangbin 
Published: June 2023

Rationale:
Systemic lupus erythematosus (SLE) is frequently accompanied by neuropsychiatric (NP) manifestations. However, typical symptoms of catatonia are uncommon. Neuropsychiatric SLE or its “mimickers” may cause NP symptoms, making differential diagnosis a significant challenge in clinical practice.

Patient concerns:
A 68-year-old female with SLE was hospitalized for edema, lung infection, and recurrent fungal mouth ulcers after multiple courses of cortisol and immunosuppressive therapy. Five days after admission, stupor, immobility, mutism, and rigidity were observed.

Diagnosis:
“Mimickers”: catatonic disorder due to a general medical condition.

Intervention:
Initially, relevant laboratory tests, imaging studies, and the disease activity index score were performed. A survey of the causes of the disease was conducted among the patient’s relatives. Subsequently, we discontinued moxifloxacin, corticosteroids, fluconazole, and other medications and inserted a gastric tube for nutritional support. During this process, traditional Chinese medicine and acupuncture have been utilized.

Outcomes:
After 3 days, the patient recovered and only complained of fatigue.

Conclusion:
When SLE presents with NP symptoms, it is essential to make a correct diagnosis in order to guide appropriate treatment by actively searching for inducers and clinical, laboratory, and neuroradiological characteristics that can aid in the differential diagnosis. When treatment options are limited, it can be beneficial to try a variety of combination strategies, such as traditional Chinese medicine and acupuncture.
Pathological discrimination between luteinized thecoma associated with sclerosing peritonitis and thecoma
Authors: Liu Jia , Wei Jia , Yang Yiqun , Wei Juncheng 
Published: June 2023

Background:
Similarities between luteinized thecoma associated with sclerosing peritonitis (LTSP) and thecoma, cause difficulty in clinical differential diagnoses. To improve the situation, we selected 10 specified molecular pathological markers that are frequently used in clinical pathology of ovarian sex cord-stromal tumors to determine whether they exert a discriminatory effect.

Methods:
Applying immunohistochemistry, we analyzed the expression of alpha-1,6-mannosylglycoprotein 6-beta-n-acetylglucosaminyltransferase B (MGAT5B), nuclear receptor coactivator 3 (NCOA3), proliferation marker protein Ki-67 (MKI67), estrogen receptor, progesterone receptor, Vimentin, receptor tyrosine-protein kinase erbB-2, Catenin beta-1 (β-Catenin), CD99 antigen (CD99) and Wilms tumor protein (WT1) in 102 cases of diseases containing 11 LTSP and 91 thecoma. Whole-exome sequencing and fluorescence in situ hybridization were used to examine the MGAT5B-NCOA3 fusion gene in LTSP. Statistical analysis was performed using t test, one-way analysis of variance test, and post hoc test.

Results:
Six significant markers were verified for the discrimination between LTSP and thecoma, containing 4 upregulating indicators MGAT5B, NCOA3, MKI67, β-Catenin, and 2 downregulating markers CD99 and WT1 in luteinized cells. In addition, the MGAT5B-NCOA3 fusion gene was identified in LTSP for the first time with significantly rich expression compared to thecoma.

Conclusions:
We verified 6 significant molecular pathological markers containing MGAT5B, NCOA3, MKI67, β-Catenin, CD99, and WT1 and identified MGAT5B-NCOA3 fusion gene in LTSP; this work will help clinicians to discriminate between medical conditions and treat patients accurately.