bluuebunny/crossref_metadata_2025_split huggingface dataset:
Natural history and malignant potential of simple ovarian cysts in postmenopausal women: a systematic review and meta-analysis
Authors: Liu Ya-Na , Tan Xin , Xiong Wei , Dong Xue , Liu Jie , Wang Zhi-Lin , Chen Heng-Xi 
Published: February 2023

Abstract

Importance
Postmenopausal ovarian masses are not uncommon, and the incidence of ovarian cancer rises sharply after menopause.

Objective
We conducted a systematic review and meta-analysis to investigate the natural history and malignant potential of postmenopausal simple ovarian cysts.

Evidence Review
PubMed, MEDLINE, EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), ClinicalTrials.gov, and ISRCTN (International Standard Randomized Controlled Trial Number Register) were searched from inception to January 31, 2022. Meta-analyses were conducted using R software.

Findings
Twelve cohort studies with 1,672 participants and 1,513 ovarian cysts were included. The rates of simple cysts remaining unchanged (38.90%; 95% CI, 19.79%-59.85%; P < 0.01) or disappearing (34.17%; 95% CI, 19.13%-50.93%; P < 0.01) were the highest during conservative observation. The surgery rate for the simple cyst was 19.04% (95% CI, 8.19%-32.92%; P < 0.01). The malignancy rate (including borderline tumors) was very low, approximately 1/10,000 (95% CI, 0% to 0.23%; P = 0.79).

Conclusions
Simple ovarian cysts in postmenopausal women were most likely to remain unchanged or disappear during follow-up. The malignancy rate was approximately 1 in 10,000. Personal preference is the most common reason for surgery.
Fear of COVID-19 Among Japanese Workers and Exacerbation of Chronic Pain
Authors: Yoshida Tamami , Koyama Teruhide , Ishimaru Tomohiro , Minoura Akira , Mutoh Michihiro , Tabuchi Takahiro 
Published: February 2023

Objective
To evaluate the association between fear of the coronavirus disease 2019 (COVID-19) and exacerbated chronic pain among workers during the pandemic, as well as productivity loss.

Methods
We collected data using Internet-based self-reported questionnaires, on fear of COVID-19, work productivity status, exacerbation of chronic pain during the pandemic, and several confounding factors.

Results
The multivariate logistic regression analysis showed that a high level of fear of COVID-19 was associated with an increased exacerbation of chronic pain (adjusted odds ratio, 2.31; 95% confidence interval, 1.21–4.44). Meanwhile, the presence of fear of COVID-19 and exacerbated chronic pain were associated with productivity impairment (adjusted odds ratio, 2.03; 95% confidence interval, 1.44–2.85).

Conclusions
Our study shows that workers' fear of COVID-19 is correlated with exacerbated chronic pain and risk of presenteeism.
Occupational Years of Service and Leukocyte Epigenetic Aging
Authors: Nwanaji-Enwerem Jamaji C. , Cardenas Andres , Goodrich Jaclyn M. , Furlong Melissa A. , Jung Alesia M. , Collender Philip A. , Caban-Martinez Alberto J. , Grant Casey , Beitel Shawn C. , Littau Sally , Urwin Derek J. , Gabriel Jamie J. , Hughes Jeff , Gulotta John , Wallentine Darin , Burgess Jefferey L. 
Published: February 2023

ObjectiveThe aim of the study is to examine associations between years of firefighting service and eight chronological age-adjusted measures of blood leukocyte epigenetic age acceleration: Horvath, Hannum, SkinBloodClock, Intrinsic, Extrinsic, PhenoAge, GrimAge, and DNAm telomere length.MethodsThe study used a repeated measures analysis of data from 379 incumbent firefighters from eight career departments and 100 recruit firefighters from two of the departments, across the United States.ResultsIncumbent firefighters had on average greater epigenetic age acceleration compared with recruit firefighters, potentially due to the cumulative effect of occupational exposures. However, among incumbent firefighters, additional years of service were associated with epigenetic age deceleration, particularly for GrimAge, a strong predictor of mortality.ConclusionsLong-term studies with more specific occupational exposure classification are needed to better understand the relationship between years of service and aging biomarkers.
Methods for Replicating a Skater-Style Shoe Lift for People with Limb-Length Discrepancy: A Technical Note
Authors: Dutton Haley L. , Kearns Nathan , Spragg Rebecca 
Published: February 2023

ABSTRACT

Introduction
The objective of this study was to reproduce a skater-style shoe lift.

Methods
Tracings and measurements taken from the previous skater shoe lift were used to make a reproduction of a new skater shoe lift.

Results
A successful reproduction of the skater sole lift was completed.

Clinical Relevance
This is clinically relevant due to allowing patients an additional option for large leg-length discrepancies to avoid surgery while still providing a strong, stable base and reducing overall weight.
Evaluation of the Effect of Knee Unloader Orthoses, Lateral Wedge Insoles, and Ankle Foot Orthoses on Pain, Function, and Knee Adduction Moment in Subjects with Medial Compartment Knee Osteoarthritis: A Literature Review
Authors: Mahmoodi Maede , Arazpour Mokhtar , Mousavi Mohammad Ebrahim 
Published: February 2023

ABSTRACT

Introduction
Osteoarthritis (OA) is a destructive joint disease and a major cause of pain in the elderly. The use of supportive orthoses including valgus knee brace, lateral wedged insole, and ankle-foot orthosis (AFO) is a common treatment for these people. The purpose of this review of the literature is to evaluate the effect of orthoses on pain, function, and adduction moment (AM) of individuals with medial knee OA.

Method
The search was conducted among articles published from 2010 to 2021 in bibliographic online databases including ISI Web of Science, PubMed, Scopus, and Google Scholar. The potential titles and abstracts were reviewed based on the study inclusion criteria. All randomized controlled trial (RCT) studies on the effectiveness of valgus knee brace, AFO, and lateral wedged insoles in subjects with medial knee OA were reviewed. The search terms were OA, medial knee osteoarthritis, medial joint arthritis, unloader knee brace, valgus knee brace, knee sleeve, lateral wedge insole, AFO, ankle-foot orthosis, function, pain, alignment, kinetic, kinematic, and AM.

Result
Forty-two articles were reviewed to determine the current research process. Thirteen studies evaluated the effect of lateral wedge insole on pain, function, and AM in subjects with medial compartment knee OA. Ten studies evaluated unloader knee braces. Nine studies evaluated unloader knee brace compared with lateral wedge insole, three studies evaluated AFO, and seven studies examined the combination of knee braces and lateral wedge insoles on pain, function, and AM.

Conclusion
All three orthoses in short-term follow-up reduced the AM in subjects with medial knee OA. Lateral wedge insoles did not support pain reduction in studies. The results of this study showed that knee braces may have a more lasting effect on the knee joint in the long run than lateral wedge insoles. Although the number of studies that evaluated the effect of AFOs on outcomes of subjects with knee OA is low, this intervention was found to be effective in relieving pain and reducing AM.

Clinical Relevance
In clinical studies, clinical relevance in patients with medial knee OA, orthoses effectively reduced external knee AM and pain sensation during daily activities. Thus, use of orthoses effectively supports conservative treatment in medial knee OA.
Differential Gains in Surgical Outcomes for High-Risk vs Low-Risk Pancreatoduodenectomy with Successive Refinements of Risk-Stratified Care Pathways
Authors: Ayabe Reed I , Prakash Laura R , Bruno Morgan L , Newhook Timothy E , Maxwell Jessica E , Arvide Elsa M , Dewhurst Whitney L , Kim Michael P , Ikoma Naruhiko , Snyder Rebecca A , Lee Jeffrey E , Katz Matthew H G , Tzeng Ching-Wei D 
Published: February 2023

Background:
The use of risk-stratified pancreatectomy care pathways (RSPCPs) is associated with reduced length-of-stay (LOS). This study sought to evaluate the impact of successive pathway revisions with the hypothesis that high-risk patients require iterative pathway revisions to optimize outcomes.

Study Design:
A prospectively maintained database (10/2016-12/2021) was evaluated for pancreatoduodenectomy (PD) patients managed with RSPCPs preoperatively assigned based on pancreatic fistula (POPF) risk. Launched in 10/2016 (Version 1-V1), RSPCPs were optimized in 2/2019 (V2) and 11/2020 (V3). Targeted pathway components included earlier nasogastric tube removal, diet advancement, reduced intravenous fluids and opioids, institution-specific drain fluid amylase cutoffs for early day 3 removal, and patient education. Primary outcome was LOS. Secondary outcomes included major complications (Accordion Grade III+), POPF (ISPGS Grade B/C), and delayed gastric emptying (DGE).

Results:
Of 481 patients, 234 were managed by V1 (83 high-risk), 141 V2 (43 high-risk), and 106 V3 (43 high-risk). Median LOS reduction was greatest in high-risk patients with a 7d reduction (pre-RSPCP-12d, V1-9d, V2-7d, V3-5d), compared to low-risk patients (pre-pathway-10d, V1-6d, V2-5d, V3-4d). Complications decreased significantly among high-risk patients (V1-45%, V2-33%, V3-19%, p< 0.001), approaching rates in low-risk patients (V1-21%, V2-20%, V3-14%). POPF (V1-33%, V2-23%, V3-16%, p< 0.001) and DGE (V1-23%, V2-22%, V3-14%, p< 0.001) improved among high-risk patients.

Conclusions:
Risk-stratified pancreatectomy care pathways are associated with reduced LOS, major complications, Grade B/C fistula, and DGE. The easiest gains in surgical outcomes are generated from the immediate improvement in the patients most likely to be fast-tracked, but high-risk patients benefit from successive application of the learning health system model.
Better performance of deep learning pulmonary nodule detection using chest radiography with reference to computed tomography: data quality is matter
Authors: Kim Jae Yong , Ryu Wi-Sun , Kim Dongmin , Kim Eun Young 
Published: February 2023

AbstractBackgroundLabeling error may restrict radiography-based deep learning algorithms in screening lung cancer using chest radiography. Physicians also need precise location information for small nodules. We hypothesized that a deep learning approach using chest radiography data with pixel-level labels referencing computed tomography enhances nodule detection and localization compared to a data with only image-level labels.MethodsNational Institute Health dataset, chest radiograph-based labeling dataset, and AI-HUB dataset, computed tomography-based labeling dataset were used. As a deep learning algorithm, we employed Densenet with Squeeze-and-Excitation blocks. We constructed four models to examine whether labeling based on chest computed tomography versus chest X-ray and pixel-level labeling versus image-level labeling improves the performance of deep learning in nodule detection. Using two external datasets, models were evaluated and compared.ResultsExternally validated, the model trained with AI-HUB data (area under curve [AUC] 0.88 and 0.78) outperformed the model trained with NIH (AUC 0.71 and 0.73). In external datasets, the model trained with pixel-level AI-HUB data performed the best (AUC 0.91 and 0.86). In terms of nodule localization, the model trained with AI-HUB data annotated at the pixel level demonstrated dice coefficient greater than 0.60 across all validation datasets, outperforming models trained with image-level annotation data, whose dice coefficient ranged from 0.36-0.58.ConclusionOur findings imply that precise labeled data are required for constructing robust and reliable deep learning nodule detection models on chest radiograph. In addition, it is anticipated that the deep learning model trained with pixel-level data will provide nodule location information.
Antibody prevalence after 3 or more COVID-19 vaccine doses in 23,000 immunosuppressed individuals: a cross-sectional study from MELODY
Authors: Pearce Fiona A , Lim Sean H , Bythell Mary , Lanyon Peter , Hogg Rachel , Taylor Adam , Powter Gillian , Cooke Graham S , Ward Helen , Chilcot Joseph , Thomas Helen , Mumford Lisa , McAdoo Stephen P , Pettigrew Gavin J , Lightstone Liz , Willicombe Michelle 
Published: February 2023

AbstractObjectivesTo investigate the prevalence of spike-protein antibodies following at least 3 COVID-19 vaccine doses in immunocompromised individuals.DesignCross-sectional study using UK national disease registries of individuals with solid organ transplants (SOT), rare autoimmune rheumatic diseases (RAIRD) and lymphoid malignancies (LM).SettingParticipants were identified, invited and recruited at home by accessing the NHS Blood and Transplant Registry for those UK individuals who had received a SOT; and the National Disease Registration Service at NHS Digital for identifying individuals within England with RAIRD or LM.Participants101972 people were invited, 28411 recruited, and 23036 provided serological data, comprising 9927 SOT recipients, 6516 with RAIRD, and 6593 with LM.InterventionsParticipants received a lateral flow immunoassay for spike-protein antibodies to perform at home together with an online questionnaire.Main outcome measuresOdds of detectable IgG spike-protein antibodies in immunosuppressed cohorts following at least three COVID-19 vaccine doses by participant demographic, disease type, and treatment related characteristicsResultsIgG spike-protein antibodies were undetectable in 23.3%, 14.1% and 20.7% of the SOT, RAIRD and LM cohorts, respectively. Participants had received three, four or ≥five vaccine doses at the time of testing in 28.5%, 61.8%, and 9.6%, respectively. In all groups, seropositivity was associated with younger age, higher number of vaccine doses and previous COVID-19 infection. Immunosuppressive medication reduced the likelihood of seropositivity: the lowest odds of seropositivity were found in SOT recipients receiving an anti-proliferative agent, calcineurin inhibitor and steroid concurrently, and those treated with anti-CD20 in the RAIRD and LM cohorts.ConclusionsApproximately one in five individuals with SOT, RAIRD and LM have no detectable IgG spike-protein antibodies despite three or more vaccines, but this proportion reduces with sequential booster doses. Choice of immunosuppressant and disease-type is strongly associated with serological response. Antibody testing could enable rapid identification of individuals who are most likely to benefit from additional COVID-19 interventions.Trial registrationClinicaltrials.gov,NCT05148806
Impact of the COVID-19 pandemic on tuberculosis control in Indonesia: a nationwide analysis of programme data and health system vulnerabilities
Authors: Surendra Henry , Elyazar Iqbal RF , Puspaningrum Evelyn , Darmawan Deddy , Pakasi Tiffany T , Lukitosari Endang , Sulistyo Sulistyo , Deviernur Shena M , Fuady Ahmad , Thwaites Guy , van Crevel Reinout , Shankar Anuraj H , Baird J Kevin , Hamers Raph L 
Published: February 2023

AbstractBackgroundThere are limited measures of the impact of the COVID-19 pandemic on tuberculosis (TB) control in high-burden countries like Indonesia.MethodsWe analysed district-level data of reported TB cases, treatment and deaths, COVID-19 incidence and mortality, health care capacity, economic status, education level, and public health development index from all 514 districts in Indonesia. We compared data before (2016-2019) and during (2020-2021) the pandemic.FindingsCompared to the preceding year (2019), in the first pandemic year (2020) the TB case notification declined by 31% (from median 172 [IQR 129-244] in 2019 to 119 [IQR 87-170] in 2020 per 100,000 population; 565,669 vs 393,323 cases, respectively); mortality increased by 8% (from median 4·2 [IQR 2·0-7·4] to 5·0 (IQR 3·1-7·5) per 100,000 population; 13,059 vs 14,148 deaths, respectively); and the overall proportion of cases who started treatment declined by 7% (from 98% to 91%). The second pandemic year (2021) saw a partial recovery of case notifications (median 142 [IQR 99-204]; 473,006) and deaths (4·1 [IQR 2·5-6·8]; 12,016), but a persistently reduced treatment coverage (84%). Reductions in TB notifications between districts were associated with higher COVID-19 incidence and fewer per capita GeneXpert machines for TB diagnosis. Likewise, reduced TB treatment coverage was associated with fewer per capita doctors, and increased reported TB deaths was associated with fewer per capita primary health centres, lower per capita domestic expenditure and higher education.InterpretationThe COVID-19 pandemic significantly, yet unevenly, impacted the national TB control programme across Indonesia, with the greatest impacts in districts with the least resilient health systems.FundingWellcome Africa Asia Programme Vietnam
Clinical Value Of CT-Derived Simulations Of Transcatheter-Aortic-Valve-Replacement In Challenging Anatomies The PRECISE-TAVR Trial
Authors: Hokken Thijmen W , Wienemann Hendrik , Dargan James , van Ginkel Dirk-Jan , Dowling Cameron , Unbehaun Axel , Bosmans Johan , Bader-Wolfe Andreas , Gooley Robert , Swaans Martin , Brecker Stephen J. , Adam Matti , Van Mieghem Nicolas M. 
Published: February 2023

AbstractBackgroundPre-procedural computed tomography planning improves procedural safety and efficacy of transcatheter aortic valve replacement(TAVR). However, contemporary imaging modalities do not account for device-host interactions. This study evaluates the value of pre-procedural computer simulation with FEops HEARTguide™ on overall device success in patients with challenging anatomies undergoing TAVR with a contemporary self-expanding supra-annular transcatheter heart valve.MethodsThis prospective multicenter observational study included patients with a challenging anatomy defined as bicuspid aortic valve, small annulus or severely calcified aortic valve. We compared the heart team’s transcatheter heart valve(THV) planning decision based on 1) conventional multislice computed tomography(MSCT) and 2) MSCT imaging with FEops HEARTguide™ simulations. Clinical outcomes and THV performance were followed up to 30 days.ResultsA total of 77 patients were included(Median age 79.9 years (IQR 74.2-83.8), 42% male). In 35% of the patients, pre-procedural planning changed after FEops HEARTguide™ simulations(change in valve size selection(12%) or target implantation height(23%)). A new permanent pacemaker implantation(PPI) was implanted in 13% and >trace paravalvular leakage (PVL) occurred in 28.5%. The contact pressure index(i.e. simulation output indicating the risk of conduction abnormalities) was significantly higher in patients with a new PPI, compared to those without(16.0%(25th-75thpercentile 12.0-21.0) vs. 3.5%(25th-75th percentile 0−11.3), p<0.01) The predicted PVL was 5.7mL/s(25th-75thpercentile 1.3-11.1) in patients with none-trace PVL, 12.7(25th-75th percentile 5.5-19.1) in mild PVL and 17.7(25th-75thpercentile 3.6-19.4) in moderate PVL(p=0.04).ConclusionFEops HEARTguide™ simulations may provide enhanced insights in the risk for PVL or PPI after TAVR with a self-expanding supra-annular THV in complex anatomies.
Role of genetics in capturing racial disparities in cardiovascular disease
Authors: Bose Aritra , Platt Daniel E. , Kartoun Uri , Ng Kenney , Parida Laxmi 
Published: February 2023

AbstractThe role of race in medical decision-making has been a contentious issue. Insights from history and population genetics suggest considering race as a differentiating marker for medical practices can be influenced by systemic bias, leading to serious errors. This may negatively impact treatment of complex diseases such as cardiovascular disease (CVD). We seek to identify instrumental variables and independently verifiable epidemiological tests of whether diagnoses and treatments impacting severe cardiovascular conditions are racially linked. Using data from the UK Biobank (UKB), we found minimal, non-significant racial differences in log odds ratio (OR) between a range of cardiovascular outcomes such as atrial fibrillation, coronary artery disease, coronary thrombosis, heart failure and cardiac fatality. Genetics classification with respect to principal components vs. racial identification of Black British showed no significant differences in diagnoses or therapeutics for CVD related diseases and their associated comorbidities. However, Black British had significant risk of association with genetically predisposed risk of CVD as captured by polygenic risk scores (PRS) of CVD (OR=1.12; 95%CI:1.034-1.223;p <0.006) as well as in 14 related traits. We used a sub-population based feature selection method to find Townsend Deprivation Index, smoking history, hypertension, PRS for ischemic stroke, low density lipoprotein cholesterol, and type II diabetes as the top features predicting the ethnographic category of Black British with an AUC of 79.5%. Therefore, PRS can be used to understand racial disparities in disease outcome which is otherwise not reflected in clinical factors such as diagnoses outcome status or therapeutics in large observational cohorts such as UKB. PRS yield better predictive power with underrepresented minorities and can improve clinical decision-making.
Modelling the impact of vaccination and sexual behavior change on reported cases of mpox in Washington D.C
Authors: Clay Patrick A. , Asher Jason M. , Carnes Neal , Copen Casey E. , Delaney Kevin P. , Payne Daniel C. , Pollock Emily D. , Mermin Jonathan , Nakazawa Yoshinori , Still William , Mangla Anil T. , Spicknall Ian H. 
Published: February 2023

AbstractBackgroundThe 2022 mpox outbreak infected over 30,000 people in the United States. Infections were commonly associated with sexual contact between men. Interventions included vaccination and reductions in sexual partnerships. We estimated the averted infections attributable to each intervention using mathematical modeling.MethodsWe fit a dynamic network transmission model to mpox cases reported by the District of Columbia through January 2023. We incorporated vaccine administration data and reported reductions in sexual partnerships among gay, bisexual, or other men who have sex with men (MSM). Model output consisted of predicted cases over time with or without vaccination and/or behavior change.ResultsWe estimated initial case reductions were due to behavior change. Vaccination alone averted 64% [IQR:57%-72%] and behavior change alone averted 21% [IQR:11%-29%] of cases. Vaccination and behavior change together averted 80% [IQR:74%-85%] of cases. In the absence of vaccination, behavior change reduced cumulative cases but also prolonged the outbreak.ConclusionsInitial case declines were likely caused by behavior change, but vaccination averted more cases overall. Overall, this indicates that encouraging individuals to protect themselves was vital in the early outbreak, but that combination with a robust vaccination program was ultimately required for control.