bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective Cohort Study of Parathyroid Function and Quality of Life After Total Thyroidectomy for Thyroid Cancer: Robotic Surgery vs. Open Surgery
Authors: Qin Xiangquan , Luo Jia , Ma Jing , Cao Xiaozheng , Zhao Jinjin , Jiang Jun , Zhang Yi , Zeng Lingjuan , Fan Linjun 
Published: September 2023

Objective:
To compare robot-assisted thyroidectomy (RT) and open thyroidectomy (OT) through a prospective cohort study focusing on the rate of postoperative hypoparathyroidism, efficacy, and quality of life (QoL).

Summary Background Data:
Hypoparathyroidism is a frequent complication after thyroidectomy. Reducing the risk of hypoparathyroidism after total thyroidectomy is a crucial and difficult task for thyroid surgeons.

Methods:
We prospectively enrolled 306 patients with papillary thyroid carcinoma(PTC) into an RT group and OT group. The former used “super-meticulous” capsular dissection (SMCD) and the latter used traditional meticulous capsular dissection. Patients were evaluated by scales [Short Form (SF)-36, Visual Impairment Scale (VIS), Swallowing Impairment Scale (SIS), Neck Impairment Scale (NIS), Scar questionnaire (SCAR-Q)].

Results:
The rates of transient hypoparathyroidism, permanent hypoparathyroidism, and transient hypocalcemia after surgery in the OT group and RT group were significantly different (P<0.001). SIS and VIS scores in the two groups were significantly different (P<0.001). SF-36 showed significant differences (P<0.001) in the subsections of “physiological function”, “body pain”, “general health”, “vitality”, “social function”, “role emotional”, and “mental health” between the two groups. SCAR-Q showed that the length and appearance of scars showed significant differences between the two groups.

Conclusions:
Robot-assisted thyroidectomy with Super-meticulous capsular dissection can protect parathyroid function and improve postoperative QoL, and could be a new option for robot-assisted surgery against thyroid cancer.
Creation of a decellularized vaginal matrix from healthy human vaginal tissue for potential vagina reconstruction – experimental studies
Authors: Sueters Jayson , Xiao Fangxin , Roovers Jan-Paul , Bouman Mark-Bram , Groenman Freek , Maas Huub , Huirne Judith , Smit Theo 
Published: September 2023

Background:
When a disorder causes absence of a healthy, full-size vagina, various neovaginal creation methods are available. Sometimes dilation or stretching of the vaginal cavity is sufficient, but intestinal or dermal flap tissue is generally required. However, different inherent tissue properties cause complications. Therefore, a lost body part should be replaced with a similar material. The use of organ-specific acellular vaginal tissue carries great potential, as its similar architecture and matrix composition make it suitable for vaginal regeneration.

Methods:
We developed an optimized protocol for decellularization of healthy, human vaginal tissue. Resected colpectomy tissue from 12 healthy transgender patients was used. Successful decellularization was confirmed by applying acellular criteria from in vivo remodeling-reports. Suitability as tissue-mimicking scaffold for vaginal reconstruction was determined by visible structural features, biocompatibility during stretching and presence of visible collagen, elastin, laminin and fibronectin.

Results:
Histological examination confirmed the preservation of structural features and minimal cellular residue was seen during fluorescence microscopy, DNA and RNA quantification and fragment-length examination. Biomechanical testing showed decreased peak load (55%, P<0.05), strain at rupture (23%, P<0.01) and ultimate tensile stress (55%, P<0.05) after decellularization, while the elastic modulus (68%) did not decrease significantly. Fluorescence microscopy revealed preserved Fibronectin-I/II/III and Laminin-I/II, while Collagen-I and Ficolin-2B were decreased but mostly retained.

Conclusions:
The absence of cellular residue, moderately altered biomechanical extracellular matrix (ECM) properties and mostly preserved structural proteins, appear to make our decellularized human vaginal matrix a suitable tissue-mimicking scaffold for vagina transplantation when tissue survival through vascularization and innervation are accomplished in the future.
Finding the minimum number of retrieved lymph nodes in Node-negative colorectal cancer using Real-world Data and the SEER database
Authors: Qiao Yihuan , Zhu Jun , Han Tenghui , Jiang Xunliang , Wang Ke , Chen Rujie , Du Yongtao , Li Jipeng , Sun Li 
Published: September 2023

Background:
Current clinical guidelines recommend the removal of at least 12 lymph nodes (LNs) in resectable colorectal cancer (CRC). With advancements in lymphadenectomy technologies, the number of retrieved lymph nodes (rLNs) has markedly increased. This study aimed to investigate the lowest number of rLNs in node-negative patients.

Materials and Methods:
A total of 1103 N0 and 208 N1a stage patients were enrolled in our cohort, while 8503 N0 and 1276 N1a patients from the Surveillance, Epidemiology, and End Results CRC database were included. Propensity score matching and multivariate Cox regression analyses were performed to mitigate the influence of selection bias and control for potential confounding variables.

Results:
The median number of rLNs in N0 patients increased from 13.5 (interquartile range [IQR]: 9-18) in 2013 to 17 (IQR: 15-20) in 2019. The restrictive cubic spline illustrated a nonlinear relationship between rLNs and prognosis (nonlinearity, P=0.009), with a threshold (N=16) influencing clinical outcomes. Patients at either N0 or N1a stage with sufficient rLNs (≥ 16) demonstrated superior prognoses to those with a limited rLNs (<16). After adjusting for clinical confounders, similar prognoses were observed in N0 limited and N1a adequate populations. Furthermore, Kaplan-Meier curves revealed N0 limited patients who received chemotherapy exhibited better outcomes than those who did not.

Conclusions:
Among patients with node-negative CRC, it is crucial to remove 16 or more LNs effectively. Fewer than 16 rLNs should be regarded as an independent risk factor, implying the need for adjuvant chemotherapy.
“Because of this rotation, this is what I want to do”: Implementation and evaluation of a telehealth opioid use disorder clinical placement for nurse practitioner students
Authors: French Rachel , Lyons Erica , Schachter Allison , Treston June A. , Marshall Ami , Lattimer Jennie , Bisaga Adam , Behar Emily , Aronowitz Shoshana V. 
Published: September 2023

ABSTRACT
The lack of clinicians comfortable prescribing buprenorphine is a barrier to access for people with opioid use disorder (OUD). Accordingly, a telehealth OUD treatment clinic, Ophelia, launched a clinical training program for nurse practitioner (NP) students. The goal of this study was to assess a telehealth-based model of OUD clinical training. To evaluate the program, we (1) identified students' knowledge related to providing OUD care to patients before and after their clinical rotation with Ophelia and (2) characterized students' attitudes about providing OUD care following their clinical rotation with Ophelia. Online pre- and postsurveys were conducted with 57 and 29 students, respectively, and semistructured interviews were conducted with 19 students who completed clinical rotations with Ophelia. We used quantitative descriptive analysis to compare presurvey and postsurvey results and conducted thematic analysis to analyze qualitative interview data. We identified three themes from the interviews: the continuum of learning opportunities, the comfort providing OUD treatment following participants' clinical rotation, and the relevance of a substance use disorder clinical rotation for all NP students. The survey also supported these findings. Of note, there were descriptive differences between presurvey and postsurvey responses related to an increase in knowledge, preparedness, and acquisition of skills to treat OUD. Using a telehealth clinical rotation for NP students to learn about OUD treatment may represent an important step in increasing the number of clinicians who can prescribe buprenorphine. These findings can inform interventions and policies that target clinician training barriers.
Pediatric Cholelithiasis in the United States: National Hospitalization Trends, 2006 to 2019
Authors: Agawu Atu , Kanagawa Christina , Wong Janeline , Shults Justine , Feudtner Chris , Bewtra Meenakshi 
Published: September 2023

Objectives:Previous studies have shown increasing hospitalizations for pediatric cholelithiasis, but recent trends are unknown. We conducted a national study of pediatric cholelithiasis to characterize recent hospitalization rate trends.Methods:Retrospective repeated cross-sectional analysis of pediatric (age < 18 years) cholelithiasis-associated hospitalizations combining data from the 2006 through 2019 Kids’ Inpatient Database releases. The primary outcome of interest was the national hospitalization rate (per 100,000 children). We examined rates stratified by age group and sex and characterized hospitalization outcomes and characteristics for pediatric cholelithiasis.Results:Twenty-nine thousand one hundred two hospital records representing 42,282 gallstone-associated hospitalizations were identified. The hospitalization rate declined from 12.9 [95% confidence interval (CI): 12.6–13.2] in 2006 to 9.1 (95% CI: 8.8–9.3) in 2019. Consistent with the literature, hospitalizations occurred most often among teenagers (71%) and individuals with female sex (72%). The proportion of hospitalizations at freestanding children’s hospitals increased significantly (from 18.2% to 35.1%). Finally, the proportion of hospitalizations involving a potentially medical predisposing condition increased significantly.Conclusions:The estimated US hospitalization rate for pediatric cholelithiasis declined by 30% between 2006 and 2019. Female patients and teenagers had the largest decline, and hospitalizations increasingly occurred at freestanding children’s hospitals. Potential explanations include potential changes in delivery of care as well as changes in population disease burden.
Determinants t of patient satisfaction with pharmacy services at Felege Hiwot comprehensive specialized hospital, Bahir Dar, Ethiopia
Authors: Yehualaw Adane , Tafere Chernet , Demsie Desalegn Getnet , Feyisa Kebede , Bahiru Bereket , Kefale Belayneh , Berihun Malede , Yilma Zewdu 
Published: September 2023

Background:
Patients have explicit desire for quality services when they visit health institutions. Patient satisfaction is a primary means of measuring the effectiveness of healthcare delivery. However, inadequate discovery of their needs may result in patient dissatisfaction. Patients who are satisfied with pharmaceutical care are likely to adherence, seeking for medical attentions and take medications properly. Providing better access to quality pharmacies is a way to improve patient satisfaction with healthcare services.

Study objective:
The study was aimed to assess patient satisfaction with pharmacy services at Felege Hiwot Comprehensive Specialized Hospital (FHCSH).

Methods and materials:
An institution-based cross-sectional study design was conducted at FHCSH from 1 May 2021 to 30 October 2021. Data were collected by interview with structured questionnaires. Then the data were coded, entered, and then analyzed by SPSS version 23. The association between predictors and outcome was measured using bivariate logistic regression.

Result:
In this study, 384 study participants were included. Majority of the participants were males (55.37%, N=227). The overall satisfaction score of the participants of this study was 65.37%. In our study, clients showed greater satisfaction towards pharmacists’ commitment to correct myths (92%), pharmacist availability (88.78), and cleanliness (87.8%). Multivariate analysis indicated physical restriction [adjusted odds ratio (AOR)=6:95%; 95% CI (2.98, 25.9)] and rural residence [AOR=2.43; 95% CI (1.71, 9.6)] had significant association with pharmacy service dissatisfaction. Among the quality pharmacy service indicators, counselling on how medications work [AOR=9; 95% CI (1.48, 8.85)], keeping to dosage regimen [AOR=7.3; 95% CI (5.49, 11.06)], and advice on the current medical condition had greater odds of client dissatisfaction.

Conclusion:
The findings of the current study showed that patients’ satisfaction towards outpatient pharmacy services provided by FHCSH is very low as it is indicated in their perception towards revealing written information about medication use, medication availability, medication storage, and instructions about medication side effects.
Endemic mycoses – are we making progress in management?
Authors: Bahr Nathan C. , Thompson George R. 
Published: September 2023

Purpose of review
The endemic fungi are a significant cause of morbidity and mortality in effected patients. The range of endemicity for these are expanding with infections observed outside of traditional locations. Enhanced diagnostic and treatment practices may significantly alter patient outcomes.

Recent findings
Recently completed clinical trials have focused on an assessment of improving efficacy while minimizing patient toxicity. Practice changing trials have been completed in histoplasmosis showing the utility of a single up-front liposomal amphotericin B dose followed by standard itraconazole dosing. The recent evaluation of several antifungal options including isauvconazole in the treatment of coccidioidomycosis also show promise for additional therapeutic agents. A recently conducted trial has also shown the superiority of amphotericin B therapy over itraconazole in the treatment of talaromycosis.

Summary
The increased range of endemic mycoses coupled with the growing immunocompromised patient population mandates continued investigation of improved diagnostic and therapeutic options. Advances in these areas have led to more rapid diagnosis and more efficacious antifungal therapy.
Diagnostic Utility of 99mTc-MDP Bone Scintigraphy for Nivolumab-Induced Inflammatory Arthritis
Authors: Araki Yoshihiro , Misaki Tomonori , Ueda Yasuhiro , Matsumoto Naoyuki , Takaso Yuji 
Published: September 2023

Abstract
Immune checkpoint inhibitors can revive exhausted helper T-cells, and inflammatory cell reactivation may cause autoimmune disease–like conditions. Drug-induced arthritis is an immune-related adverse event, but the diagnostic approach is undefined. We present the diagnostic utility of 99mTc-MDP bone scintigraphy for nivolumab-induced inflammatory arthritis. A 67-year-old man with hypopharyngeal carcinoma presented bilateral multiple metacarpophalangeal joint pain and swelling at each nivolumab administration. Regular imaging findings were atypical for inflammatory arthritis and did not fulfill the criteria for rheumatoid arthritis. We diagnosed nivolumab-induced inflammatory arthritis based on clinical symptoms and the symmetrical moderate uptake of the affected joints on 99mTc-MDP bone scintigraphy.
Somatostatin Receptor–Directed PET/CT Can Differentiate Between Different Subtypes of Head and Neck Paragangliomas
Authors: Zhi Yingjun , Gerhard-Hartmann Elena , Hartrampf Philipp E. , Weich Alexander , Higuchi Takahiro , Bley Thorsten A. , Hackenberg Stephan , Hagen Rudolf , Rosenwald Andreas , Scherzad Agmal , Remde Hanna , Fassnacht Martin , Werner Rudolf A. , Serfling Sebastian E. 
Published: September 2023

Background
Given their neuroendocrine origin, head and neck paragangliomas (HNPGLs) can be imaged with somatostatin receptor (SSTR)–directed PET/CT. We aimed to determine whether the in vivo PET signal can differentiate between varying HNPGL subtypes.

Patients and Methods
Fourteen patients with HNPGL received pretherapeutic SSTR-PET/CTs using 68Ga-DOTATOC. Six (42.9%) patients had a jugular paraganglioma (PGL-J), 5 (35.7%) were diagnosed with carotid paraganglioma (PGL-Cs), and the remaining 3 patients (21.4%) had PGL-C with pathogenic SDHx germline variants (PGL-C-SDH). A visual and quantitative assessment of the primary tumor on SSTR-PET was performed, including SUVmax and target-to-background ratio (TBR). Quantitative values were then compared between subgroups of patients affected with different HNPGL entities.

Results
On visual assessment, all primary HNPGLs could be identified on SSTR-PET/CT. Quantification of HNPGL revealed substantially elevated SUVmax in PGL-J (101.7 ± 58.5) when compared with PGL-C-SDH (13.4 ± 5.6, P < 0.05), but not when compared with PGL-C (66.7 ± 27.3, P = 0.4; PGL-C vs PGL-C-SDH, P = 0.2). TBR of PGL-J (202.9 ± 82.2), however, further differentiated between PGL-C (95.7 ± 45.4, P < 0.05) and PGL-C-SDH (20.4 ± 12.2, P < 0.01; PGL-C vs PGL-C-SDH, P = 0.3). Moreover, whole-body readout revealed metastases in 2/3 (66.7%) of PGL-C-SDH patients, with a single SSTR-expressing skeletal lesion in one subject and bipulmonary lesions in the other patient.

Conclusions
In patients with HNPGL, SSTR-PET/CT identified the primary and metastatic disease and provides substantially elevated TBR, indicating excellent image contrast. PET-based quantification can also differentiate between varying HNPGL subtypes.
Unilateral Chronic Parotitis With 68Ga-DOTA-FAPI-04 PET/CT and 18F-FDG PET/CT Imaging in a Case of a Patient With Papillary Thyroid Carcinoma
Authors: Roshanravan Vahid , Sadeghi Ramin , Zakavi Seyed Rasoul , Norouzbeigi Nasim , Aghaee Atena 
Published: September 2023

AbstractThe68Ga-FAPI (fibroblast activation protein inhibitor) radiotracer is a novel and versatile tool in nuclear medicine, exhibiting potential for use in various conditions due to its significant upregulation in cancerous and inflammatory conditions, particularly those involving fibrotic and infectious processes. In this report, we present the case of a patient with papillary thyroid carcinoma who underwent total thyroidectomy and iodine therapy. He was referred because of high thyroglobulin despite negative diagnostic radioiodine imaging (TENIS syndrome). The patient underwent18F-FDG and68Ga-DOTA-FAPI-46 PET/CT imaging for metastatic workup and treatment planning. FAPI uptake was observed in the right parotid gland (with no FDG uptake), prompting a99mTcO4−salivary scintigraphy. Subsequently, a diagnosis of chronic sialadenitis was made.
Impact of Different Training Methods on Daily Use of Point-of-Care Ultrasound
Authors: De Carvalho Hugo , Godiveaux Nicolas , Javaudin Francois , Le Bastard Quentin , Kuczer Vincent , Pes Philippe , Montassier Emmanuel , Le Conte Philippe 
Published: September 2023

Abstract
Point-of-care ultrasound (POCUS) curriculum varies among countries. However, the length of training required for physicians is still under debate. We investigated the impact of different training methods: short hands-on courses (STS), long academic training sessions (LTS), or both (mixed training [MTS]), for POCUS daily use and self-reported confidence overall and specific to specific clinical situations. This was a descriptive study conducted over a 3-month period through a Web-based survey designed to assess the influence of different methods of POCUS training among physicians and residents on their daily practice. The survey was sent to 1212 emergency physicians with prior POCUS training; 515 answers (42%) could be analyzed. Participants in the STS group performed POCUS less frequently than physicians in the LTS or MTS group. Daily use in the STS group was 51% versus 82% in the LTS group and 83% in the MTS group (P < 0.01). The overall self-reported confidence in POCUS was lower in the STS group (P < 0.01) in all studied clinical situations. There was no significant difference between LTS and MTS groups (P > 0.05). Method of POCUS training significantly influenced POCUS daily use. Physicians who underwent long training sessions used POCUS more frequently in their routine practice and were significantly more confident in their ability to perform and interpret a POCUS examination.
Oxygen Consumption as an Early Warning System in the Critically ill
Authors: Hoeyer-Nielsen Anne Kirstine , Holmberg Mathias J. , Grossestreuer Anne V. , Yankama Tuyen , Berg Katherine M. , Donnino Michael W. 
Published: September 2023

Abstract

Introduction
In this study, we assessed whether changes in oxygen consumption (VO2) and other metabolic parameters could be used as an early warning system for detecting clinical deterioration in mechanically ventilated patients.

Methods
This was a prospective cohort study of adult patients requiring mechanical ventilation between February 2016 and March 2019. We looked for changes in VO2, carbon dioxide production (VCO2), respiratory quotient (RQ), and end-tidal carbon dioxide (EtCO2), occurring prior to clinical deterioration. Clinical deterioration was pre-defined as a requirement of vasopressor, an increase in serum lactate by 20% where at least one value was above 3 mmol/L, or a decrease in hemoglobin by 20% in the four hours prior to clinical deterioration.

Results
A total of 141 patients were included. There were no detectable changes in VO2, VCO2, and EtCO2 within the four hours prior to any clinical deterioration. RQ increased significantly within the four hours prior to an increase in lactate as compared to no increase in lactate but there were no detectable changes prior to other clinical deteriorations.

Conclusions
RQ has the potential to be an early marker of tissue hypoperfusion or mitochondrial dysfunction. However, future studies are necessary to evaluate the use of RQ as a bedside monitor in critical care settings.
Preoperative Prediction of Postoperative Infections Using Machine Learning and Electronic Health Record Data
Authors: Zhuang Yaxu , Dyas Adam , Meguid Robert A. , Henderson William , Bronsert Michael , Madsen Helen , Colborn Kathryn 
Published: September 2023

Objective:
Estimate preoperative risk of postoperative infections using structured electronic health record (EHR) data.

Summary Background Data:
Surveillance and reporting of postoperative infections is primarily done through costly, labor-intensive manual chart review on a small sample of patients. Automated methods using statistical models applied to postoperative EHR data have shown promise to augment manual review as they can cover all operations in a timely manner. However, there are no specific models for risk-adjusting infectious complication rates using EHR data.

Methods:
Preoperative EHR data from 30,639 patients (2013-2019) were linked to American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) preoperative data and postoperative infection outcomes data from five hospitals in the University of Colorado Health System. EHR data included diagnoses, procedures, operative variables, patient characteristics, and medications. Lasso and the knockoff filter was used to perform controlled variable selection. Outcomes included surgical site infection (SSI), urinary tract infection (UTI), sepsis/septic shock, and pneumonia up to 30 days post-operatively.

Results:
Among >15,000 candidate predictors, seven were chosen for the SSI model and six for each of the UTI, sepsis, and pneumonia models. Important variables included preoperative presence of the specific outcome, wound classification, comorbidities, and American Society of Anesthesiologists physical status classification (ASA Class). Area under the receiver operating characteristic curve for each model ranged from 0.73-0.89.

Conclusion:
Parsimonious preoperative models for predicting postoperative infection risk using EHR data were developed and showed comparable performance to existing ACS-NSQIP risk models that use manual chart review. These models can be used to estimate risk-adjusted postoperative infection rates applied to large volumes of EHR data in a timely manner.