bluuebunny/crossref_metadata_2025_split huggingface dataset:
External validation of the FAMISH predicting score for early gastric cancer with endoscopic submucosal dissection
Authors: Niu Zhennan , Liang Donghong , Guan Chaoyong , Zheng Yang , Meng Changjuan , Sun Xiaofang , Liu Zhuang 
Published: August 2023

Objective
To externally validate the robustness of the FAMISH predicting score designed to estimate the risk of metachronous gastric lesions (MGLs) after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC).

Methods
This multicenter, retrospective study included 618 patients with EGC who underwent curative ESD at two tertiary referral teaching hospitals between January 2014 and December 2019. FAMISH score was a composite indicator of age, sex, family history, corpus intestinal metaplasia, synchronous lesions, and H. pylori infection. Discrimination, calibration, and risk stratification of these scores were assessed. Associations between MGL characteristics and FAMISH scores were also explored.

Results
After a median follow-up period of 60 months, 83 of 618 patients (13.4%) developed MGL. The discrimination ability according to the area under the curve was 0.708 (95% CI, 0.645–0.772) for predicting the 5-year MGL. The calibration results showed good consistency between the predicted and actual MGL (Hosmer-Lemeshow, P > 0.05). In terms of risk stratification, the 5-year MGL rates were 4.1% (95% CI, 1.6%–6.5%), 10.8% (95% CI, 7.2%–14.3%), and 32.1% (95% CI, 20.9%–41.7%) in the low-, intermediate-, and high-risk groups, respectively (P < 0.001). For patients with MGL, the curative resection rate of ESD was significantly higher in the low- and intermediate-risk groups than in the high-risk group (100% vs. 80%, P = 0.037).

Conclusion
The FAMISH predicting score was externally validated and can be generalized to an independent patient population. This adjuvant tool can assist in individual clinical decision-making.
Granulocyte-colony stimulating factor in decompensated liver cirrhosis: a meta-analysis of four randomized controlled trials
Authors: Dimachkie Reem , Hamadi Rachelle , Alameddine Zakaria , Aridi Hussam , Sakr Fouad , Asmar Samer , Deeb Liliane 
Published: August 2023

Background
Decompensated liver cirrhosis (DC) has high mortality, but liver transplantation is limited due to organ scarcity and contraindications for transplantation. Granulocyte-colony stimulating factor (GCSF) shows potential for liver disease treatment with its regenerative and immunomodulatory properties. To assess the controversial use of GCSF in DC, a meta-analysis of randomized controlled trials (RCTs) compared survival benefits in patients receiving GCSF plus standard medical therapy (SMT) versus SMT alone.

Methods
A literature search was performed in four databases from data inception up to December 2022, and all registered randomized controlled (RCTs) evaluating GCSF-based therapies for cirrhotic patients were included.

Results
A study combining four RCTs assessed the impact of GCSF with SMT in 595 patients with decompensated cirrhosis. The results indicated that GCSF + SMT led to higher odds of survival compared to SMT alone [risk ratio 1.28, 95% CI (1.08–1.5)]. Heterogeneity existed among the studies, but overall, GCSF showed potential in improving survival. The intervention group exhibited improved Child-Pugh-Turcotte scores [−2.51, CI (−4.33 to −0.70)], and increased CD34 levels, but no significant improvement in MELD scores. These findings suggest GCSF may benefit patients with decompensated cirrhosis in terms of survival and liver function.

Conclusion
These results suggest that the combination of GCSF and SMT may have a positive impact on the survival rate and improvement in CPT score in patients with DC. Further RCTs are needed to shed more light on this promising modality in end-stage liver disease.
Clinicopathological profile of mastalgia in females: incidence, types, and pathological correlations. a cross-Sectional study
Authors: Ali Aqeed Abid , Faraj Faruk Hasan 
Published: August 2023

Introduction:
Mastalgia was the most common symptom in patients attending a breast clinic. The two most common types of mastalgia were (cyclical and non-cyclical). The common cause of cyclical was Physiological changes due to premenstrual tension syndrome fibrocystic changes or fibroadenosis and (Aberrations in the Normal Development and Involution of the breast ). Non-cyclical diseases are mainly benign rather than malignant. Solid masses (fibroadenomas), cysts, infections, abscesses, trauma, and nipple discharge (hormones) are rare diseases associated with breast cancer. The aim of this study is to study the incidence of mastalgia, types (cyclical and non-cyclical) and pathological types of mastalgia (benign and malignant pathologies)

Material and methods:
A cross-sectional descriptive study of mastalgia was carried out at the Breast Center Department of Maternity Teaching Hospital located in Erbil, from January 2014 to September 2015. A total of 150 breast pain cases (available clinical data) were studied in detail.

Results:
There are two types of mastalgia based on triple assessments, these are as follows, cyclical 90 cases (60%) and non-cyclical 60 cases (40%). Fibrocystic breast changes or fibroadenosis 35 cases (23.3%) and thirdly nipple discharges as part of fibrocystic (fibroadenosis) five cases (3.3%). Non-cyclical mastalgia was subdivided into benign breast pathologies, fibroadenoma 30 cases (20%), breast cyst 10 cases (6.7%), nipple discharge (hormonal) five cases (3.3%), mastitis three cases (2%) abscess two cases (1.3%), fat necrosis one case (0.7%), and malignant breast pathologies, cancer three cases (2%). Clinicopathological correlations in the current study were highly significant (P<0.005).

Conclusion:
Not all discomfort or pain can be diagnosed as mastalgia; occasionally, chest wall, referral pain, and systemic causes can mimic mastalgia. These results highlight the importance of differentiating between cyclical and non-cyclical mastalgia using clinical assessment, sonography, mammography, and blood investigations. Most mastalgia cases are benign, with cyclical mastalgia primarily related to hormonal changes during the menstrual cycle.
Lung cancer presenting with neurocognitive decline: a compelling case report highlighting healthcare seeking behavior in rural Nepal
Authors: Katwal Shailendra , Ghimire Aastha , Bhattarai Bharosha , Joshi Nishant 
Published: August 2023

Introduction:
Lung cancer is a major contributor of burden of disease globally. Early diagnosis plays a crucial role in determining the patient’s prognosis. However, diagnostic constraints and healthcare-seeking behavior in rural areas contribute to the increased mortality and morbidity associated with this disease.

Case presentation:
The authors present a case that came in with mood and personality changes who was diagnosed with lung cancer with metastasis in the brain and did not seek health care services despite a prolonged duration of her neurocognitive symptoms.

Clinical discussion:
Rural communities face multiple barriers to early diagnosis and treatment, including healthcare-seeking behavior. It is crucial to develop policies aimed at addressing these barriers in order to enhance the health status of rural Nepal.

Conclusion:
The presentation of lung cancer with atypical symptoms can contribute to delays in diagnosis and treatment, ultimately impacting the overall prognosis of the patient. Late presentation to healthcare centers further exacerbates the burden of the disease, emphasizing the critical importance of proper healthcare-seeking behavior.
A review of the safety of linezolid during pregnancy, a potential alternative syphilis treatment
Authors: Navarro Sabrina , Keith Kori , Stafylis Chrysovalantis , Konda Kelika , Klausner Jeffrey 
Published: August 2023

ABSTRACT
With growing maternal and congenital syphilis epidemics and shortages of benzathine penicillin, alternative syphilis treatments are needed. Linezolid has shown efficacy against syphilis in animal models. This review found no teratogenic effects. Some adverse effects were seen in animals, but none were reported in a small number of human studies.
Adenovirus-Associated Urethritis, a Not So Uncommon Entity. A Review of 91 Cases
Authors: Idigoras Pedro , Montes Milagrosa , López-Olaizola Maddi , de la Caba Idoia , Grandioso David , Cilla Gustavo 
Published: August 2023

Background
Human adenovirus (HAdV) is likely an underdiagnosed cause of urethritis, although it was already associated with urethritis in descriptions published more than 40 years ago. Differential clinical features of this entity, such as meatitis, conjunctivitis, and a predominance of mononuclear white blood cells in first-void urine and/or urethral smear, can be useful to increase diagnostic suspicion.

Methods
We retrospectively studied 91 episodes of HAdV-associated urethritis diagnosed for 9 years and 6 months after optimizing efforts to detect the pathogen mainly in patients with features suggestive of this condition.

Results
Dysuria was the main symptom (84%), whereas meatitis was observed in 34% of cases. Furthermore, 40% of patients had conjunctivitis. Human adenovirus type D was the most prevalent HAdV (56%), although HAdV-C6, a type not previously associated with urethritis, was observed in 12 patients (13%).

Conclusions
Urethritis due to HAdV is not uncommon, and it is important to screen for it to avoid unnecessary treatments, contact tracing studies, and checkups. The use of multiplex polymerase chain reaction assays that include HAdV, for the diagnosis of urethritis, would raise awareness of its role in this entity.
Facilitated Asynchronous Online Learning to Build Public Health Strategic Skills
Authors: Meredith Genevive R. , Leong Donna , Frost Cheyanna , Travis Alexander J. 
Published: August 2023

Context:
The COVID-19 pandemic spurred significant government investments for hiring public health workers. There are clear opportunities to help build capacities among both current and incoming public health workers, closing well-elucidated skill gaps.

Objective:
To report on the development process, methods used, and outcomes seen from a point-in-time public health workforce capacity-building initiative, Public Health Essentials (PHE).

Design:
Capacity-building outcomes evaluation using pre/postintervention measures.

Setting:
The United States.

Participants:
A total of 512 learners working in roles (government or adjacent to) that support public health.

Intervention:
PHE, a cohort-based facilitated asynchronous online course comprising 5 units, 18 modules, 54 learning outcomes, and 266 teaching and applied assessment elements designed to build public health strategic skills.

Main Outcome Measure(s):
Two outputs and 3 outcomes were used to assess and improve progress in achieving our goal of building generalizable and transferrable public health ability and confidence among diverse public health workers: Use of PHE, PHE completion rate, Learner competence, Change in self-assessed ability, and Benefits of PHE.

Results:
From September 2021 to December 2022, 4 agencies used PHE for fellowship training or employee capacity building. Some 79% (n = 512) of learners completed the training, demonstrating competence in all 54 areas assessed by expert course facilitators. Of those, 79% (n = 321) completed both optional pre- and post-PHE surveys, reporting statistically significant gains in all strategic skill domains assessed (n = 9), regardless of demographics and public health experience. Learners gained new skills and knowledge (92%), developed a better understanding of public health (86%), and broadened their public health skill base (84%). A majority can apply the knowledge and skills gained directly to their work (94%), which benefits their team (92%), and have increased their confidence as public health practitioners (49%).

Conclusions:
PHE can significantly improve learners' ability across 9 strategic skill areas in as few as 15 weeks, regardless of their demographics, training, or experience.
Cervical Cancer Screening Positivity Among Women Living With HIV in CDC-PEPFAR Programs 2018–2022
Authors: McCormick Laura J. , Gutreuter Steve , Adeoye Oluwatosin , Alger Sarah X. , Amado Celeste , Bay Zurnaid , Chirwa Catherine Motswere , Chituwo Omega , Correia Della , Deus Maria , Dirlikov Emilio , Efuntoye Tim , Gunde Laurence , Kabaghe Alinune , Kalamya Julius N. , Lorenzoni Cesaltina , Magesa Daniel , Mate Celina , Mulokoshi Theopolina , Ninsiima Josephine Connie , Nyangasi Mary , Nyika Ponesai , Pasipamire Munyaradzi , Ssali Mina , Tefera Fana , Torre Lindsey A. , Urso Marilena , Wandira Ronald , Zemburuka Brigitte , Montandon Michele 
Published: August 2023

Background:
The US President's Emergency Plan for AIDS Relief aims to address the higher risk of cervical cancer among women living with HIV by offering high-quality screening services in the highest burden regions of the world.

Methods:
We analyzed the US President's Emergency Plan for AIDS Relief Monitoring, Evaluation, and Reporting data from Centers for Disease Control and Prevention–supported sites in 13 countries in sub-Saharan Africa for women living with HIV aged older than 15 years who accessed cervical cancer screening services (mostly visual inspection, with ablative or excisional treatment offered for precancerous lesions), April 2018–March 2022. We calculated the positivity by age, country, and clinical visit type (first lifetime screen or routine rescreening). We fitted negative binomial random coefficient models of log-linear trends in time to estimate the probabilities of testing positive and any temporal trends in positivity.

Results:
Among the 2.8 million completed cancer screens, 5.4% identified precancerous lesions, and 0.8% were positive for suspected invasive cervical cancers (6.1% overall). The positivity rates declined over the study period among those women screening for cervical cancer for the first time and among those women presenting to antiretroviral therapy clinics for routine rescreening.

Conclusions:
These positivity rates are lower than expectations set by the published literature. Further research is needed to determine whether these lower rates are attributable to the high level of consistent antiretroviral therapy use among these populations, and systematic program monitoring and quality assurance activities are essential to ensure women living with HIV have access to the highest possible quality prevention services.
The Capacity of HIV Care Facilities to Implement Strategies Recommended by the Ending the HIV Epidemic Initiative: The Medical Monitoring Project Facility Survey
Authors: Beer Linda , Williams Dustin , Tie Yunfeng , McManus Timothy , Yuan Anne (Xin) , Crim Stacy M. , Demeke Hanna B. , Creel Darryl , Blackwell Angela D. , Craw Jason A. , Weiser John 
Published: August 2023

Background:
Data are needed to assess the capacity of HIV care facilities to implement recommended Ending the HIV Epidemic activities.

Setting:
US HIV care facilities.

Methods:
We analyzed 2021 survey data from 514 facilities that were recruited from a census of facilities providing care to a national probability sample of US adults with HIV. We present weighted estimates of facility characteristics, services, and policies and estimates of the proportion of all US HIV patients attending these facilities.

Results:
Among HIV care facilities, 37% were private practices, 72% were in areas with population >1 million, and 21% had more than 1000 HIV patients. Most provided preexposure prophylaxis (83%) and postexposure prophylaxis (84%). More than 67% of facilities provided HIV-specific stigma or discrimination training for all staff (covering 70% of patients) and 66% provided training on cultural competency (covering 74% of patients). A majority of patients attended facilities that provided on-site access to HIV/sexually transmitted infection (STI) transmission risk reduction counseling (89%); fewer had on-site access to treatment for substance use disorders (35%). We found low provision of on-site assistance with food banks or meal delivery (14%) and housing (33%). Approximately 71% of facilities reported using data to systematically monitor patient retention in care. On-site access to adherence tools was available at 58% of facilities; 29% reported notifying patients of missed prescription pickups.

Conclusion:
Results indicate some strengths that support Ending the HIV Epidemic–recommended strategies among HIV care facilities, such as high availability of preexposure prophylaxis/postexposure prophylaxis, as well as areas for improvement, such as provision of staff antistigma trainings and adherence supports.
IgG4 Positivity in Chronic Tonsillitis: A New Component of IgG4-Related Disease?
Authors: Sahin Murat S. , Gundogdu Baris , Vural Gurcan , Dogantekin Betul 
Published: August 2023

Objective:
Immunoglobulin G4-related disease (IgG4-RD) and chronic tonsillitis are both chronic fibroinflammatory diseases in which tissue atrophy is sometimes observed. In this study, the authors aimed to investigate the pathologic IgG4 positivity in tonsillectomy specimens and hypothesized to name it as a new clinical component of IgG4-RD if there is significant IgG4 positivity in chronic tonsillitis.

Methods:
A total of 73 patients who underwent tonsillectomy for chronic tonsillitis were included in this study. Of these, 31 patients had atrophic form chronic tonsillitis. Pathologic examinations and specific IgG4 immunohistochemical staining were performed by the same experienced pathologist in terms of IgG4-RD.

Results:
Sixty-three percent (n=46) of the cases were male, 37% (n=27) were female, their ages ranged from 3 to 51, and the mean age was 19.11±14.82. It was determined that 23.3% (n=17) of the cases participating in the study were IgG4-positive. When the pathologic grades of the cases were examined; it was observed that 13.7% (n=10) were Grade I, 65.8% (n=48) were Grade II, and 20.5% (n=15) were Grade III. A statistically significant difference was found between the pathology degrees of the cases according to the IgG4 groups (P=0.001; P<0.01).

Conclusion:
The authors concluded that as the histopathologic grades of chronic lymphoplasmacytic inflammation in tonsils specimen increase, IgG4 positivity rates also increase. Therefore, this clinical entity may be a new IgG4-related disease state in cases with chronic tonsillitis.

Level of Evidence:
Level II.
Quality of Life and Real-Time Patient Experience During Neoadjuvant Therapy
Authors: Shannon Alexander H , Sarna Angela , Bressler Luke , Monsour Christina , Palettas Marilly , Huang Emily , D’Souza Desmond M , Kneuertz Peter J , Ejaz Aslam , Pawlik Timothy M , Santry Heena , Cloyd Jordan M 
Published: August 2023

Background:
Neoadjuvant therapy (NT) is increasingly used for patients with localized gastrointestinal (GI) cancers. There is little data assessing patient experience and quality of life (QOL) during NT for GI cancers.

Objective:
To use a customized smartphone application to prospectively measure QOL and the real-time patient experience during NT.

Methods:
Patients with GI cancers receiving NT were instructed on using a customized smartphone application through which the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire, a validated measure of health-related (HR) QOL, was administered at baseline, every 30 days, and at completion of NT. Participants also tracked their mood, symptoms, and used free-text journaling functionalities in the application. Mean overall and sub-section HRQOL scores were calculated during NT.

Results:
Among 104 enrolled patients, mean age was 60.5±11.5 years and 55% were male. Common cancer diagnoses were colorectal (40%), pancreatic (37%), and esophageal (15%). Mean overall FACT-G scores did not change during NT (P=0.987). While functional wellbeing scores were consistently the lowest and social wellbeing scores the highest, FACT subscores similarly did not change during NT (all P>0.01). The most common symptoms reported during NT were fatigue, insomnia, and anxiety (39.3%, 34.5%, and 28.3% of patient entries, respectively). Qualitative analysis of free-text journaling entries identified anxiety, fear, and frustration as the most common themes, but also the importance of social support systems and confidence in health care providers.

Conclusions:
While patient symptom burden remains high, results of this prospective cohort study suggest QOL is maintained during NT for localized GI cancers.
Health care utilization outcomes in patients with blunt chest wall trauma following discharge from the emergency department: A retrospective, observational data-linkage study
Authors: Battle Ceri , Hutchings Hayley , Rafferty James , Toghill Hannah , Akbari Ashley , Watkins Alan 
Published: August 2023

BACKGROUND
Although much is published reporting clinical outcomes in the patients with blunt chest wall trauma who are admitted to hospital from the ED, less is known about the patients’ recovery when they are discharged directly without admission. The aim of this study was to investigate the health care utilization outcomes in adult patients with blunt chest wall trauma, discharged directly from ED in a trauma unit in the United Kingdom.

METHODS
This was a longitudinal, retrospective, single-center, observational study incorporating analysis of linked datasets, using the Secure Anonymised Information Linkage databank for admissions to a trauma unit in the Wales, between January 1, 2016, and December 31, 2020. All patients 16 years or older with a primary diagnosis of blunt chest wall trauma discharged directly home were included. Data were analyzed using a negative binomial regression model.

RESULTS
There were 3,205 presentations to the ED included. Mean age was 53 years, 57% were male, with the predominant injury mechanism being a low velocity fall (50%). 93% of the cohort sustained between 0 and 3 rib fractures. Four percent of the cohort were reported to have chronic obstructive pulmonary disease, and 4% using preinjury anticoagulants. On regression analysis, inpatient admissions, outpatient appointments and primary care contacts all significantly increased in the 12-week period postinjury, compared with the 12-week period preinjury (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.33–1.99; p < 0.001; OR, 1.28; 95% CI, 1.14–1.43; p < 0.001; OR, 1.02; 95% CI, 1.01–1.02; p < 0.001, respectively). Risk of health care resource utilization increased significantly with each additional year of age, chronic obstructive pulmonary disease and preinjury anticoagulant use (all p < 0.05). Social deprivation and number of rib fracture did not impact outcomes.

CONCLUSION
The results of this study demonstrate the need for appropriate signposting and follow-up for patients with blunt chest wall trauma presenting to the ED, not requiring admission to the hospital.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level IV.