bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comfort Levels of Outpatient Health Care Professionals When Asking About Substance Use–Related Sexual Activity: A Pilot Survey
Authors: Argenyi Michael S. , Evans Joni K. , Veach Laura J. , McNeil Candice J. 
Published: September 2023

Background
Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based intervention for substance use. Health care professionals may not receive SBIRT training or know of substance use's intersection with sexual activity. This pilot survey inquired about SBIRT training history, attitudes, and comfort among outpatient health care professionals, including assessing sexual activity–related use.

Methods
We conducted a snowball cross-sectional survey of outpatient health care professionals at a large southeastern academic medical center in June 2021 with 4-point Likert questions covering demographics, substance use attitudes, SBIRT training history, and comfort implementing SBIRT. Analysis used descriptive statistics and stratification by demographic and practice characteristics.

Results
Seventy-three professionals responded, of whom 82% were White and 66% were female. Forty-seven percent were 30 to 39 years old, 33% were internal medicine professionals, and 59% reported previous SBIRT training. All participants reported believing substance use is a significant health issue. Most reported that they were comfortable or somewhat comfortable assessing patients for substance use (85%), dropping to 60% discussing sexual activity. Advanced practice providers and physicians identified more comfort with rapport building around substance use than other health care respondents. Professionals in infectious diseases and psychiatry reported the greatest comfort assessing substance use with concurrent sexual activity.

Conclusions
There are gaps in SBIRT training and beliefs among health care professionals. Although health care workers report that assessing substance use is important, some professionals endorsed more comfort discussing substance use with patients than others, especially when inquiring about sexual activity. Future work could replicate the pilot to inform increasing comfort through training in the intersection of substance use and sexuality.
Predictive Factors of Intra-articular Corticosteroid Injections with Ultrasound-Guided Posterior Capsule Approach for Patients with Primary Adhesive Capsulitis
Authors: Lin Che-Li , Lee Yu-Hao , Chen Yi-Wen , Liao Chun-De , Huang Shih-Wei 
Published: September 2023

AbstractBackgroundAdhesive capsulitis (AC) affects the shoulder joint, causing pain and limiting motion. In clinical practice, the effectiveness of injections varies, and the factors influencing their success remain unclear. This study investigates the predictors of effective corticosteroid injections in patients with primary AC.DesignThis retrospective study enrolled AC patients aged >35 years who received intra-articular corticosteroid injections. The response was determined based on patients' pain and range-of-motion (ROM) three months after the injection. Demographic data, medical comorbidities, and radiographic parameters (critical shoulder angle [CSA] and acromial index [AI]) were compared between the effective and noneffective groups. Receiver operating-characteristic (ROC) curves and logistic regression were used to identify the predictors of injection effectiveness.ResultsThis study included 325 patients with primary AC, who were divided into responder (189 patients, 58.2%) and non-responder (136 patients, 41.8%) groups. The ROC curve revealed that the AI score indicated favorable discrimination for predicting a poor response to injections, whereas the CSA score did not. Logistic regression revealed that the pain period, diabetes mellitus, and AI are predictors of non-responders to injections.ConclusionLong pain duration, the presence of diabetes mellitus, and an AI score of >0.711 were predictors of non-response to corticosteroid injections for primary AC patients.
Ultrasound Guided Pes Anserine Bursitis Injection Choices; Prolotherapy or Oxygen-Ozone or Corticosteroid: A Randomized Multicenter Clinical Trial
Authors: Babaei-Ghazani Arash , Eftekharsadat Bina , Soleymanzadeh Hosnieh , ZoghAli Masoumeh 
Published: September 2023

Abstract

Objective
Pes anserine bursitis (PAB) is the most common cause of periarticular knee pain. The aim of the study was to evaluate the efficacy of local injection-based therapies with different materials.

Design
The enrolled patients were randomly allocated to three groups to receive different interventions. Outcome measures included pain severity using the visual analog scale (VAS) and the Western Ontario McMaster Universities osteoarthritis index (WOMAC) that was evaluated before the intervention, one and eight weeks after that.

Results
This trial was performed on 72 participants, with male to female ratio of 0.14 and with a mean age of 61.49 ± 9.35 years old. In the first group, corticosteroids in the second group, oxygen–ozone (O2–O3), and in the third group, dextrose 20% was injected into the pes anserine bursa under ultrasound guidance. Interaction between time and group showed a statistically significant improvement in VAS and WOMAC (P ≤ 0.05) in favor of corticosteroids and O2–O3 groups after one week and in favor of O2–O3 and prolotherapy groups after eight weeks.

Conclusion
All three treatment options are effective for patients with PAB. This study showed that the effects of O2–O3 injection and prolotherapy last longer than those of corticosteroid injection.
DELIVER: A Safety Study of a Dapivirine Vaginal Ring and Oral PrEP for the Prevention of HIV During Pregnancy
Authors: Bunge Katherine , Balkus Jennifer E. , Fairlie Lee , Mayo Ashley J. , Nakabiito Clemensia , Mgodi Nyaradzo , Gadama Luis , Matrimbira Moleen , Chappell Catherine Anne , Piper Jeanna , Chakhtoura Nahida , Szydlo Daniel W. , Richardson Barbra , Hillier Sharon L. 
Published: September 2023

Background:
Pregnancy represents a period of high HIV acquisition risk. Safety data for the monthly dapivirine vaginal ring (DVR) during pregnancy are limited. Here, we report data from the first 2 cohorts of pregnant participants in MTN-042/DELIVER, a phase 3b, randomized, open-label safety trial of DVR and oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC). MTN-042 is being conducted in 3 cohorts beginning with later gestational ages when risks of drug exposure are less.

Methods:
Eligible pregnant individuals aged 18–40 years in Malawi, South Africa, Uganda, and Zimbabwe were randomized 2:1 to monthly DVR or daily TDF/FTC. Participants in cohort 1 initiated product use between 36 weeks 0 days (36 0/7 weeks) and 37 6/7 weeks gestation; participants in cohort 2 initiated product use between 30 0/7 and 35 6/7 weeks gestation. All participants continued product use until delivery or 41 6/7 weeks gestation. Pregnancy outcomes and complications were assessed and summarized using descriptive statistics and compared with local background rates obtained through a separate chart review.

Results:
One-hundred and fifty participants were enrolled into cohort 1 with 101 randomized to DVR and 49 to TDF/FTC. One-hundred and fifty-seven participants were enrolled into cohort 2 with 106 randomized to DVR and 51 to TDF/FTC. In both cohorts, pregnancy complications were rare and similar to local background rates.

Conclusion:
In this first study of a long-acting HIV prevention agent in pregnancy, adverse pregnancy outcomes and complications were uncommon when DVR and TDF/FTC were used in the third trimester of pregnancy, suggesting a favorable safety profile for both prevention products.
Surgical site infection prophylaxis: what have we learned and are we making progress?
Authors: Ierano Courtney , Hall Lisa , James Rod 
Published: September 2023

Purpose of reviewThis review aims to discuss the current state of surgical antimicrobial prophylaxis (SAP) evidence for surgical site infection prevention. Despite decades of research, knowledge gaps persist in identifying optimal SAP regimens.Recent findingsRecent randomised controlled trials highlight ongoing heterogeneity in study design. Key new findings support the use of oral preoperative SAP for colorectal surgery and advise against the use of SAP for transperineal prostate biopsy. There is growing evidence for culture-based SAP over empiric use for transrectal prostate biopsy.Contentious issues remain regarding topical antimicrobials for cardiac procedures involving sternotomy, the necessity of SAP for wire lumpectomy and laparoscopic cholecystectomy for both mild or moderate acute cholecystitis. Procedures where SAP is not indicated, yet research is still being conducted on this topic include dental implants and clean orthopaedic procedures.SummaryResearch efforts continue with numerous trials published and registered to determine optimal SAP regimens. However, many efforts are suboptimal due to poor statistical design and redundant questions already answered by existing literature. To improve practice and influence surgeons prescribing behaviour future RCTs should be well powered, with large sample sizes across multiple sites, focusing on clinically relevant questions.
A Novel Interpretable Radiomics Model to Distinguish Nodular Goiter From Malignant Thyroid Nodules
Authors: Zhang Hao , Yang Yun-Feng , Yang Chao , Yang Yuan-Yuan , He Xin-Hong , Chen Chao , Song Xue-Lin , Ying Lei-Lei , Wang Ying , Xu Li-Chao , Li Wen-Tao 
Published: September 2023

Objectives
The purpose of this study is to inquire about the potential association between radiomics features and the pathological nature of thyroid nodules (TNs), and to propose an interpretable radiomics-based model for predicting the risk of malignant TN.

Methods
In this retrospective study, computed tomography (CT) imaging and pathological data from 141 patients with TN were collected. The data were randomly stratified into a training group (n = 112) and a validation group (n = 29) at a ratio of 4:1. A total of 1316 radiomics features were extracted by using the pyradiomics tool. The redundant features were removed through correlation testing, and the least absolute shrinkage and selection operator (LASSO) or the minimum redundancy maximum relevance standard was used to select features. Finally, 4 different machine learning models (RF Hybrid Feature, SVM Hybrid Feature, RF, and LASSO) were constructed. The performance of the 4 models was evaluated using the receiver operating characteristic curve. The calibration curve, decision curve analysis, and SHapley Additive exPlanations method were used to evaluate or explain the best radiomics machine learning model.

Results
The optimal radiomics model (RF Hybrid Feature model) demonstrated a relatively high degree of discrimination with an area under the receiver operating characteristic curve (AUC) of 0.87 (95% CI, 0.70–0.97; P < 0.001) for the validation cohort. Compared with the commonly used LASSO model (AUC, 0.78; 95% CI, 0.60–0.91; P < 0.01), there is a significant improvement in AUC in the validation set, net reclassification improvement, 0.79 (95% CI, 0.13–1.46; P < 0.05), and integrated discrimination improvement, 0. 20 (95% CI, 0.10–0.30; P < 0.001).

Conclusion
The interpretable radiomics model based on CT performs well in predicting benign and malignant TNs by using quantitative radiomics features of the unilateral total thyroid. In addition, the data preprocessing method incorporating different layers of features has achieved excellent experimental results.

Clinical relevance statement
As the detection rate of TNs continues to increase, so does the diagnostic burden on radiologists. This study establishes a noninvasive, interpretable and accurate machine learning model to rapidly identify the nature of TN found in CT.
Head-to-Head Comparison of 18F-FDG and 68Ga-FAPI-04 PET/CT for Radiological Evaluation of Cervical Cancer
Authors: Shu Qiaoqiao , He Xubing , Chen Xi , Liu Mengna , Chen Yue , Cai Liang 
Published: September 2023

Purpose
We aimed to compare the potential value of 68Ga-FAPI-04 and 18F-FDG PET/CT in primary cervical cancer and lymph node metastases.

Methods
Patients with cervical cancer underwent both 68Ga-FAPI-04 and 18F-FDG PET/CT. Histopathology and follow-up CT or MRI results (at least 3 months of follow-up) were used as reference criteria. Paired-sample t test was used to compare the SUVmax of 18F-FDG and 68Ga-FAPI-04 PET/CT for cervical cancer primary lesions and metastatic lymph nodes.

Results
A total of 35 patients with a mean age of 53 ± 11 years (range, 30–76 years) were included. The detection rate of both tracers for primary tumors was 100%. There was no significant correlation between 18F-FDG and 68Ga-FAPI-04 for SUVmax (14.5 ± 5.7 vs 15.1 ± 6.2; P = 0.645). In addition, the detection rates of 68Ga-FAPI-04 and 18F-FDG for lymph node metastasis were 100% and 98%, respectively. No significant difference was found in SUVmax between 18F-FDG and 68Ga-FAPI-04 groups (7.6 ± 4.0 vs 7.0 ± 3.5; P = 0.572). Twelve false-positive lymph nodes were detected in 8 patients with 18F-FDG PET/CT, none of which were developed on 68Ga-FAPI-04 PET/CT.

Conclusion

68Ga-FAPI-04 PET/CT has a high tracer rate for the diagnosis of primary cervical cancer and lymph node metastases. Moreover, 68Ga-FAPI-04 PET/CT also showed good results in distinguishing metastatic lymph nodes from reactive lymph nodes of cervical cancer.
Increased Uptake in Microcystic Serous Cystadenoma Mimicking Pancreatic Neuroendocrine Tumor on 68Ga-DOTATATE PET/MRI
Authors: Gao Jing , Liu Chang , Zhou Jinxin , Lin Xiaozhu , Zhang Yifan 
Published: September 2023

Abstract
A 2.6-cm solid cystic lesion in the pancreatic head was found in a 51-year-old woman on CT. A pancreatic neuroendocrine tumor was suspected, and a 68Ga-DOTATATE PET/MRI was performed, which showed increased tracer uptake in the lesion. However, postsurgical pathologic examination indicated a pancreatic serous cystadenoma. Here, we reported a case of microcystic pancreatic serous cystadenoma that could be misdiagnosed as a pancreatic neuroendocrine tumor on a 68Ga-DOTATATE PET/MRI.
A Retrospective Analysis of Ultrasonic Diagnosis of Neonatal Respiratory Distress Syndrome
Authors: Hu Ling , Zhu Shuo 
Published: September 2023

Abstract
The aim of the study was to investigate ultrasound's diagnostic capabilities for infant respiratory distress syndrome. Retrospective analysis was performed on the clinical information of 96 newborns with respiratory distress syndrome who were treated at our hospital between July 2015 and October 2017. The patients were split into the mild group (n = 55) and the severe group based on the findings of the chest x-ray examinations (n = 41). All neonates underwent an ultrasound examination at baseline, 12 hours after treatment and 24 hours after treatment of pulmonary surfactant (PS). Between the 2 groups, ultrasonographic characteristics and imaging scores were compared between infants with and without PS treatment. When compared with the severe group, the ultrasound score in the mild group was lower (P < 0.05). Before treatment, there was no statistically significant difference in ultrasound score between the PS treatment group and the non-PS treatment group (P > 0.05). At each time point after treatment, the ultrasonography score of the non-PS treatment group was greater than that of the PS treatment group (P < 0.05). Neonatal respiratory distress syndrome severity may be accurately assessed using ultrasound technology. Furthermore, the results of ultrasonography examinations may serve as a significant marker for assessing and measuring the severity of newborn respiratory distress syndrome.
New Sarculator Prognostic Nomograms for Patients with Primary Retroperitoneal Sarcoma
Authors: Callegaro Dario , Barretta Francesco , Raut Chandrajit P , Johnston Wendy , Strauss Dirk C , Honoré Charles , Bonvalot Sylvie , Fairweather Mark , Rutkowski Piotr , van Houdt Winan J. , Gladdy Rebecca A. , Tirotta Fabio , Tzanis Dimitiri , Skoczylas Jacek , Haas Rick L. , Miceli Rosalba , Swallow Carol J. , Gronchi Alessandro 
Published: September 2023

Objective:
To update the current Sarculator retroperitoneal sarcoma (RPS) prognostic nomograms considering the improvement in patient prognosis and the case volume effect.

Summary Background Data:
Survival of patients with primary RPS has been increasing over time, and the volume-outcome relationship has been well recognized. Nevertheless, the specific impact on prognostic nomograms is unknown.

Methods:
All consecutive adult patients with primary localized RPS treated at 8 European and North American sarcoma reference centers between 2010 and 2017 were included. Patients were divided in two groups: high volume centers (HVC, ≥13 cases/year) and low volume centers (LVC, <13 cases/year). Primary endpoints were overall survival (OS) and disease free-survival (DFS). Multivariable analyses for OS and DFS were performed. The nomograms were updated by recalibration. Nomograms performance was assessed in terms of discrimination (Harrell C index) and calibration (calibration plot).

Results:
The HVC and LVC groups comprised 857 and 244 patients, respectively. Median annual primary RPS case volume (interquartile range) was 24.0 in HVC (15.0-41.3) and 9.0 in LVC (1.8-10.3). Five-year OS was 71.4% (95% CI 68.3-74.7%) in the HVC cohort and 63.3% (56.8-70.5%) in the LVC cohort (P=0.012). Case volume was associated with both OS (LVC vs. HVC HR 1.40, 95%CI 1.08-1.82, P=0.011) and DFS (HR 1.93, 95%CI 1.57-2.37, P<0.001) at multivariable analyses. When applied to the study cohorts, the Sarculator nomograms showed good discrimination (Harrell C index between 0.68 and 0.73). The recalibrated nomograms showed good calibration in the HVC group while the original nomograms showed good calibration in the LVC group.

Conclusions:
New nomograms for patients with primary RPS treated with surgery at high-volume versus low-volume sarcoma reference centers are available in the Sarculator app.
Survival bias in pediatric hemorrhagic shock: Are we misrepresenting the data?
Authors: Sullivan Travis M. , Sippel Genevieve J. , Gestrich-Thompson Waverly V. , Jensen Aaron R. , Burd Randall S. 
Published: September 2023

BACKGROUND
Studies of hemorrhage following pediatric injury often use the occurrence of transfusion as a surrogate definition for the clinical need for a transfusion. Using this approach, patients who are bleeding but die before receiving a transfusion are misclassified as not needing a transfusion. In this study, we aimed to evaluate the potential for this survival bias and to estimate its presence among a retrospective observational cohort of children and adolescents who died from injury.

METHODS
We obtained patient, injury, and resuscitation characteristics from the 2017 to 2020 Trauma Quality Improvement Program database of children and adolescents (younger than 18 years) who arrived with or without signs of life and died. We performed univariate analysis and a multivariable logistic regression to analyze the association between the time to death and the occurrence of transfusion within 4 hours after hospital arrival controlling for initial vital signs, injury type, body regions injured, and scene versus transfer status.

RESULTS
We included 6,063 children who died from either a blunt or penetrating injury. We observed that children who died within 15 minutes had lower odds of receiving a transfusion (odds ratio, 0.1; 95% confidence interval, 0.1–0.2) compared with those who survived longer. We estimated that survival bias that occurs when using transfusion administration alone to define hemorrhagic shock may occur in up to 11% of all children who died following a blunt or penetrating injury but less than 1% of all children managed as trauma activations.

CONCLUSION
Using the occurrence of transfusion alone may underestimate the number of children who die from uncontrolled hemorrhage early after injury. Additional variables than just transfusion administration are needed to more accurately identify the presence of hemorrhagic shock among injured children and adolescents.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
Diagnostic Value of Intermittent Photic Stimulation Among Adult Patients in a Tertiary Referral Epilepsy Center: A Retrospective Study
Authors: Steinhoff Bernhard J. , Intravooth Tassanai , Gupta Jitender , Bernedo-Paredes Viviane , Mahn Patricia , Stockinger Jakob , Martin Peter , Staack Anke M. 
Published: September 2023

Purpose:
Photosensitivity is a phenomenon that may be elicited by standardized intermittent photic stimulation during EEG recording and is detected more frequently in children and adolescents. Nevertheless, at our Epilepsy Center, we routinely assess photosensitivity in all newly referred adult patients. In this investigation, we sought to address the diagnostic yield under the prerequisites described.

Methods:
We reanalyzed all routine EEG recordings among referrals to the department of adults during the first six months of 2019, including a simultaneous video that is always coregistered in our center. The prevalence of abnormal findings during photic stimulation was assessed.

Results:
Intermittent photic stimulation was performed on 344 patients. Photoparoxysmal response were detected in five subjects (1.5%). All patients were female. Four patients were diagnosed with idiopathic generalized epilepsy, and one with Doose syndrome. Photomyogenic responses were recorded in 1.1% and only in patients with psychogenic nonepileptic seizures. In two subjects with psychogenic nonepileptic seizures, the typical seizure was provoked by intermittent photic stimulation (8.7% of all subjects with psychogenic nonepileptic seizures in this cohort). Photoparoxysmal response was not detected in any subject with focal epilepsy, syncope, or other nonepileptic paroxysmal events. In every case of photoparoxysmal responses, increased photosensitivity had already been reported before recording.

Conclusions:
In our study, photoparoxysmal responses was a rare phenomenon among adults with a preponderance of females and idiopathic generalized epilepsies. Intermittent photic stimulation may be helpful in provoking typical psychogenic nonepileptic seizures and thus abbreviate the diagnostic process. Provided a careful history, routine intermittent photic stimulation in adults with epilepsy does not appear to be mandatory.