bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postpartum Opportunistic Salpingectomy Compared With Bilateral Tubal Ligation After Vaginal Delivery for Ovarian Cancer Risk Reduction
Authors: Wagar Matthew K. , Forlines Grayson L. , Moellman Nicholas , Carlson Anisa , Matthews Michael , Williams Makeba 
Published: March 2023

OBJECTIVE:
To compare the cost effectiveness of opportunistic salpingectomy and bilateral tubal ligation for sterilization immediately after vaginal delivery.

METHODS:
A cost-effectiveness analytic decision model was used to compare opportunistic salpingectomy with bilateral tubal ligation during vaginal delivery admission. Probability and cost inputs were derived from local data and available literature. Salpingectomy was assumed to be performed with a handheld bipolar energy device. The primary outcome was the incremental cost-effectiveness ratio (ICER) in 2019 U.S. dollars per quality-adjusted life-year (QALY) at a cost-effectiveness threshold of $100,000/QALY. Sensitivity analyses were performed to determine the proportion of simulations in which salpingectomy would be cost effective.

RESULTS:
Opportunistic salpingectomy was more cost effective than bilateral tubal ligation with an ICER of $26,150/QALY. In 10,000 patients desiring sterilization after vaginal delivery, opportunistic salpingectomy would result in 25 fewer ovarian cancer cases, 19 fewer ovarian cancer deaths, and 116 fewer unintended pregnancies than bilateral tubal ligation. In sensitivity analysis, salpingectomy was cost effective in 89.8% of simulations and cost saving in 13% of simulations.

CONCLUSION:
In patients undergoing sterilization immediately after vaginal deliveries, opportunistic salpingectomy is more cost effective and may be more cost saving than bilateral tubal ligation for reducing ovarian cancer risk.
Deliveries Among Patients With Maternal Hepatitis C Virus Infection in the United States, 2000–2019
Authors: Arditi Brittany , Emont Jordan , Friedman Alexander M. , D'Alton Mary E. , Wen Timothy 
Published: March 2023

OBJECTIVE:
To assess clinical characteristics, trends, and outcomes associated with the diagnosis of hepatitis C virus (HCV) infection during pregnancy.

METHODS:
This cross-sectional study analyzed delivery hospitalizations using the National Inpatient Sample. Temporal trends in both diagnosis of HCV infection and clinical characteristics associated with HCV infection were analyzed using joinpoint regression to estimate the average annual percent change (AAPC) with 95% CIs. Survey-adjusted logistic regression models were fit to assess the association among HCV infection and preterm delivery, cesarean delivery, and severe maternal morbidity (SMM), adjusting for clinical, medical, and hospital factors with adjusted odds ratios (aORs) as the measure of association.

RESULTS:
An estimated 76.7 million delivery hospitalizations were included, in which 182,904 (0.24%) delivering individuals had a diagnosis of HCV infection. The prevalence of HCV infection diagnosed in pregnancy increased nearly 10-fold over the study period, from 0.05% in 2000 to 0.49% in 2019, representing an AAPC of 12.5% (95% CI 10.4–14.8%). The prevalence of clinical characteristics associated with HCV infection also increased over the study period, including opioid use disorder (from 10 cases/10,000 birth hospitalizations to 71 cases/10,000 birth hospitalizations), nonopioid substance use disorder (from 71 cases/10,000 birth hospitalizations to 217 cases/10,000 birth hospitalizations), mental health conditions (from 219 cases/10,000 birth hospitalizations to 1,117 cases/10,000), and tobacco use (from 61 cases/10,000 birth hospitalizations to 842 cases/10,000). The rate of deliveries among patients with two or more clinical characteristics associated with HCV infection increased from 26 cases per 10,000 birth hospitalizations to 377 cases per 10,000 delivery hospitalizations (AAPC 13.4%, 95% CI 12.1–14.8%). In adjusted analyses, HCV infection was associated with increased risk for SMM (aOR 1.78, 95% CI 1.61–1.96), preterm birth (aOR 1.88, 95% CI 1.8–1.95), and cesarean delivery (aOR 1.27, 95% CI 1.23–1.31).

CONCLUSION:
Diagnosis of HCV infection is increasingly common in the obstetric population, which may reflect an increase in screening or a true increase in prevalence. The increase in HCV infection diagnoses occurred in the setting of many baseline clinical characteristics that are associated with HCV infection becoming more common.
Efficacy of Postpartum Pharmacologic Thromboprophylaxis
Authors: Oakes Megan C. , Reese Molly , Colditz Graham A. , Stoll Carolyn R.T. , Hardi Angela , Arnold Lauren D. , Frolova Antonina I. 
Published: March 2023

OBJECTIVE:
To evaluate the effectiveness of pharmacologic venous thromboembolism (VTE) prophylaxis in postpartum patients.

DATA SOURCES:
On February 21, 2022, a literature search was conducted on Embase.com, Ovid-Medline All, Cochrane Library, Scopus, and ClinicalTrials.gov using terms postpartum period AND thromboprophylaxis AND antithrombin medications including heparin and low molecular weight heparin.

METHODS OF STUDY SELECTION:
Studies that evaluated the outcome of VTE among postpartum patients exposed to pharmacologic VTE prophylaxis with or without a comparator group were eligible for inclusion. Studies of patients who received antepartum VTE prophylaxis, studies in which this prophylaxis could not be definitively ruled out, and studies of patients who received therapeutic dosing of anticoagulation for specific medical problems or treatment of VTE were excluded. Titles and abstracts were independently screened by two authors. Relevant full-text articles were retrieved and independently reviewed for inclusion or exclusion by two authors.

TABULATION, INTEGRATION, AND RESULTS:
A total of 944 studies were screened by title and abstract, and 54 full-text studies were retrieved for further evaluation after 890 studies were excluded. Fourteen studies including 11,944 patients were analyzed: eight randomized controlled trials (8,001 patients) and six observational studies (3,943 patients). Among the eight studies with a comparator group, there was no difference in the risk of VTE between patients who were exposed to postpartum pharmacologic VTE prophylaxis and those who were unexposed (pooled relative risk 1.02, 95% CI 0.29–3.51); however, six of eight studies had no events in either the exposed or unexposed group. Among the six studies without a comparator group, the pooled proportion of postpartum VTE events was 0.00, likely due to five of six studies having no events.

CONCLUSION:
The current literature provided an insufficient sample size to conclude whether postpartum VTE rates differ between those exposed to postpartum pharmacologic prophylaxis and those unexposed, given the rarity of VTE events.

SYSTEMATIC REVIEW REGISTRATION:
PROSPERO, CRD42022323841.
Rare germline variants in pancreatic cancer and multiple primary cancers: an autopsy study
Authors: Fujitani Hiroo , Eguchi Hidetaka , Kochi Yuta , Arai Tomio , Muramatsu Masaaki , Okazaki Yasushi 
Published: March 2023

Background
There is a lack of information on rare germline variants of pancreatic cancer-predisposing genes. Risk genes for multiple primary cancers may overlap with those for pancreatic cancer.

Methods
A retrospective study of autopsy cases with a negative family history in the Japanese single nucleotide polymorphism for geriatric research database examined rare germline variants in the protein-coding regions of 61 genes. Targeted sequencing of these genes was performed and classified for pathogenicity using the American College of Medical Genetics and Genomics guidelines. Polyphen-2, SIFT and LoFtool algorithms were used to predict damage to protein function.

Results
Of the 189 subjects used (90 cancer and 99 non-cancer controls), 72 patients had pancreatic cancer (23 had multiple primary cancers) and 18 had no pancreatic cancer in multiple primary cancers. APC, BRCA2, BUB1B, ENG and MSH6 were associated with cancer predisposition, and pathogenic/likely pathogenic (P/LP) variants occurred in 6% [pancreatic cancer (4/72); all-cancer (5/90)] and 54% (49/90) carried only variants of uncertain significance (VUS) among cancer patients. Of these VUS, in pancreatic cancer patients, four DNA mismatch repair (MMR) genes (MLH1, MSH2, MSH6 and PMS2), and POLQ in men were significantly associated (odds ratio = 3.83; P = 0.025; P = 0.027, respectively). The most abundant predictor of functionally damaging variants was POLQ.

Conclusions
The frequency of P/LP variants in patients with sporadic pancreatic cancer suggests the need for genetic evaluation of individuals with no family history. VUS of MMR genes (MLH1, MSH2, MSH6 and PMS2) and POLQ may be useful in predicting genetic trends in the potential risk of pancreatic cancer, especially in individuals lacking P/LP.
Depth of invasion to the bladder wall as a prognostic factor and its association with circulating cell-free DNA levels in patients with muscle-invasive bladder cancer
Authors: Iemura Yusuke , Miyake Makito , Fukui Shinji , Fujii Tomomi , Ohnishi Sayuri , Hori Shunta , Morizawa Yosuke , Nakai Yasushi , Torimoto Kazumasa , Tanaka Nobumichi , Fujimoto Kiyohide 
Published: March 2023

Abstract

Background
Radical cystectomy (RC) is the standard surgical treatment for patients with muscle-invasive bladder cancer, but the prognosis is not favorable, and new prognostic factors need to be discovered. We investigated the potential of depth of invasion (DOI) as a prognostic factor in patients with muscle-invasive bladder cancer who underwent RC. Furthermore, we examined the association between preoperative levels of circulating cell-free DNA and DOI.

Materials and methods
We retrospectively reviewed patients who underwent RC between January 2007 and December 2017; those who received neoadjuvant chemotherapy were excluded. Depth of invasion was measured using hematoxylin-eosin–stained RC specimens.

Results
Of the 121 patients selected, 41 (33.9%) were eligible for analysis. The median follow-up period was 14 months and mean DOI was 17 mm (range, 2–75 mm). Long DOI (>17 mm) was significantly associated with shorter progression-free survival (hazard ratio, 14.5; 95% confidence interval, 3.9–53.97, p < 0.0001) and cancer-specific survival (hazard ratio, 18.97; 95% confidence interval, 4.04–88.99, p = 0.0002) compared with short DOI. Multivariate analysis revealed that DOI was an independent risk factor for cancer-specific survival. The levels of circulating cell-free DNA were significantly higher in patients with a longer DOI than in those with short DOI (65 vs. 20 ng/mL, respectively; p = 0.028).

Conclusions
Depth of invasion predicted with levels of circulating cell-free DNA and thus could be a useful prognostic factor.
An Index for Evaluating Exercise Capacity Improvement After Cardiac Rehabilitation in Patients After Myocardial Infarction
Authors: Nemati Sepehr , Yavari Tahereh , Tafti Fahimeh , Hooshanginezhad Zahra , Mohammadi Tanya 
Published: March 2023

Objective
We investigated relationships among predictors of improvement in exercise capacity after cardiac rehabilitation programs in patients after acute myocardial infarction.

Methods
We carried out a secondary analysis of data from 41 patients with a left ventricular ejection fraction ≥ 40% who underwent cardiac rehabilitation after the first myocardial infarction. Participants were assessed using a cardiopulmonary exercise test and stress echocardiography. A cluster analysis was performed, and the principal components were analyzed.

Results
Two distinct clusters with significantly different (P = .005) proportions of response to treatment (peak VO2 ≥ 1 mL/kg/min) were identified among patients. The first principal component explained 28.6% of the variance. We proposed an index composed of the top 5 variables from the first component to represent the improvement in exercise capacity. The index was the average of scaled O2 uptake and CO2 output at peak exercise, minute ventilation at peak, load achieved at peak exercise, and exercise time. The optimal cutoff for the improvement index was 0.12, which outperformed the peak VO2 ≥ 1 mL/kg/min criterion in recognizing the clusters, with a C-statistic of 91.7% and 72.3%, respectively.

Conclusion
The assessment of change in exercise capacity after cardiac rehabilitation could be improved using the composite index.
Psychosocial Health Factors Among Men Reporting Recent Sexual Assault
Authors: Draughon Moret Jessica , Choe Lina , Anderson Jocelyn C. 
Published: March 2023

ABSTRACT

Aim
The aim of this study was to describe psychosocial health factors in a community sample of men who sought care for sexual assault in the previous 3 months and who were recruited using Internet-based methods.

Methods
The cross-sectional survey assessed factors related to HIV postexposure prophylaxis (PEP) uptake and adherence postsexual assault: HIV risk perception, HIV PEP self-efficacy, mental health symptoms, social responses to sexual assault disclosure, PEP costs, negative health habits, and social support.

Results
There were 69 men in the sample. Participants reported high levels of perceived social support. A high proportion reported symptoms of depression (n = 44, 64%) and posttraumatic stress disorder (n = 48, 70%) consistent with cutoffs for clinical diagnoses. Just over a quarter of participants reported past 30-day illicit substance use (n = 20, 29%), and 45 people (65%) reported weekly binge drinking (six or more drinks on one occasion).

Potential Impact of This Work on Health Equity and Forensic Nursing
Men are underrepresented in sexual assault research and clinical care. We highlight similarities and differences between our sample and prior clinical samples and also outline needs for future research and interventions.

Conclusions
Men in our sample were highly fearful of acquiring HIV, initiated HIV PEP, and completed or were actively taking HIV PEP at the time of data collection despite high rates of mental health symptoms and physical side effects. These findings suggest that forensic nurses need not only to be prepared to provide comprehensive counseling and care to patients about HIV risk and prevention options but also to address the unique follow-up needs of this population.
The Association Between Shift Work Exposure and Frailty Among Middle-Aged and Older Adults
Authors: Khan Durdana , Verschoor Chris , Edgell Heather , Rotondi Michael , Tamim Hala 
Published: March 2023

Objective
To investigate the association between shift work exposure and frailty.

Methods
Longitudinal secondary data analyses were performed using Canadian Longitudinal Study on Aging. Individuals aged 45 to 85 years were included at baseline (N = 47,740). Primary shift work (SW) variables were derived at baseline: ever exposed to SW, SW exposure in longest job, and SW exposure in current job. Multinomial regression models were constructed to evaluate the association between SW and frailty at 3 years of follow-up.

Results
Participants ever exposed to SW were associated with frailty compared with those who worked only daytime. Particularly, females worked in rotating shifts in their longest jobs were more likely to be classified as frail compared with those who worked only daytime.

Conclusions
This study suggests that SW may play a role in development of frailty and this warrants further investigation.
Lisfranc and Chopart amputation: A systematic review
Authors: van der Wal Gesiena E. , Dijkstra Pieter U. , Geertzen Jan H.B. 
Published: March 2023

Background:
Lisfranc and Chopart amputations are historically controversial procedures. To obtain evidence for the pros and cons we performed a systematic review to analyze wound healing, the need for re-amputation at a higher level, and ambulation after a Lisfranc or Chopart amputation.

Methods:
A literature search was performed in 4 databases (Cochrane, Embase, Medline, and PsycInfo), using database-specific search strategies. Reference lists were studied to include relevant studies that were missed in the search. Of the 2881 publications found, 16 studies could be included in this review. Excluded publications concerned editorials, reviews, letters to the editor, no full text available, case reports, not meeting the topic, and written in a language other than English, German, or Dutch.

Results:
Failed wound healing occurred in 20% after Lisfranc amputation, in 28% after modified Chopart amputation, and 46% after conventional Chopart amputation. After Lisfranc amputation, 85% of patients were able to ambulate without prosthesis for short distances, and after modified Chopart 74%. After a conventional Chopart amputation, 26% (10/38) had unlimited household ambulation.

Conclusions:
The need for re-amputation because wound healing problems occurred most frequently after conventional Chopart amputation. All 3 types of amputation levels do, however, provide a functional residual limb, with the remaining ability to ambulate without prosthesis for short distances. Lisfranc and modified Chopart amputations should be considered before proceeding to a more proximal level of amputation. Further studies are needed to identify patient characteristics to predict favorable outcomes of Lisfranc and Chopart amputations.
Efficacy of catheter ablation for atrial fibrillation in patients with significant functional mitral regurgitation
Authors: Zhao Danqing , Zhang Futao , Liu Xiaojie , Li Muzhang , Zhang Leiming , Hu Juan , Li Feifei , Wu Jintao 
Published: March 2023

Background:
Catheter ablation has been established to be an effective therapy for paroxysmal atrial fibrillation (AF) and is recommended as the treatment of choice for many patients, including those with clinically significant functional mitral regurgitation (MR). However, there is little information available about the clinical efficacy of catheter ablation for paroxysmal AF in patients with significant functional MR.

Methods:
We performed a retrospective study of 247 patients with paroxysmal AF who underwent AF ablation. The study included 28 (11.3%) patients with significant functional MR and 219 (88.7%) without significant functional MR. AF recurrence was defined as the occurrence of confirmed atrial tachyarrhythmia lasting >30 seconds beyond 3 months after catheter ablation.

Results:
During a mean follow-up of 20.1 ± 7.4 months (range, 3–36 months), 45 (18.2%) patients developed recurrence of AF. The recurrence rate of AF was higher in patients with significant functional MR than in those without significant functional MR (42.9% vs 15.1%; P < .001). Univariable Cox proportional hazards regression analysis showed that significant functional MR (hazard ratio [HR], 3.46; 95% confidence interval [CI], 1.78–6.72; P < .001), age (HR, 1.04; 95% CI, 1.01–1.08; P = .009), the CHA2DS2-VASc score (HR, 1.28; 95% CI, 1.05–1.56; P = .017), and heart failure (HR, 4.71; 95% CI, 1.85–11.96; P = .001) were associated with the risk of recurrence. Multivariable analysis showed that significant functional MR (HR, 2.48; 95% CI, 1.21–5.05; P = .013), age (HR, 1.04; 95% CI, 1.00–1.07; P = .031), and heart failure (HR, 3.39; 95% CI, 1.27–9.03; P = .015) were independent predictors of AF recurrence.

Conclusion:
Patients with significant functional MR have an increased risk of AF recurrence after catheter ablation.
Metabolic and ventilatory changes during postural change from the supine position to the reclining position in bedridden older patients
Authors: Yamada Yoji , Mitani Yuji , Yamamoto Akio , Miura Kazumo , Yamada Kanji , Oki Yukari , Oki Yutaro , Maejima Yasumichi , Kurumatani Yoko , Ishikawa Akira 
Published: March 2023

The prevention of pneumonia in bedridden older patients is important, and its recurrence in these patients is a relevant issue. Patients who are bedridden and inactive, and have dysphagia are considered to be at risk for pneumonia. Efforts to reduce the bedridden state and low activity may be necessary to reduce the risk of developing pneumonia in bedridden older patients. This study aimed to clarify the effects of postural change from the supine position to the reclining position on metabolic and ventilatory parameters and on safety in bedridden older patients. Using a breath gas analyzer and other tools, we assessed the following 3 positions: lying on the back (supine), resting in the Fowler position (Fowler), and resting in an 80° recline wheelchair (80°). Measurements were oxygen uptake, carbon dioxide output, gas exchange ratio, tidal volume (VT), minute volume, respiratory rate, inspiratory time, expiratory time, total respiratory time, mean inspiratory flow, metabolic equivalents, end-expiratory oxygen, and end-expiratory carbon dioxide as well as various vital signs. The study analysis included 19 bedridden participants. The change in oxygen uptake driven by changing the posture from the supine position to the Fowler position was as small as 10.8 mL/minute. VT significantly increased from the supine position (398.4 ± 111.2 mL) to the Fowler position (426.9 ± 106.8 mL) (P
= .037) and then showed a decreasing trend in the 80° position (416.8 ± 92.5 mL). For bedridden older patients, sitting in a wheelchair is a very low-impact physical activity, similar to that in normal people. The VT of bedridden older patients was maximal in the Fowler position, and the ventilatory volume did not increase with an increasing reclining angle, unlike that in normal people. These findings suggest that appropriate reclining postures in clinical situations can promote an increase in the ventilatory rate in bedridden older patients.
Red Blood Cell Vitamin C Concentration and Its Effect on Deformability in Pediatric Sickle Cell Disease
Authors: Choi Daniel H. , Violet Pierre-Christian , Majumdar Suvankar , Levine Mark 
Published: March 2023

Red cell rigidity is common in sickle cell disease (SCD). The contribution of oxidative stress on deformability remains unknown. This study investigated red blood cell (RBC) vitamin C concentrations in pediatric SCD (n=43) compared with healthy controls (n=23) and developed a protocol to raise RBC vitamin C concentrations to measure the effect on deformability. Sickle cell RBC vitamin C concentrations seem low (20.5 μM, SD: 16.2 vs. 51.7 μM, SD: 15.8; P<0.0001). Vitamin C can be successfully loaded into sickle cell RBCs but seems to have minimal effect on deformability. Future studies are needed to understand the clinical implications of vitamin C deficiency in pediatric SCD.
Significance of CEBPE Gene Promoter Polymorphism (Rs2239630 G > A) Assessment in Childhood B-cell Acute Lymphoblastic Leukemia
Authors: Aref Salah , El-Ghonemy Mohamed , Shimaa Hendawy , Darwish Ahmad , Abdelmabood Suzy , Khaled Nada 
Published: March 2023

Background:
A significant association has been reported between CEBPE gene promoter polymorphisms (rs2239630 G > A) and the incidence of B-cell acute lymphoblastic leukemia (B-ALL). However, no previous study on this issue has been included among the Egyptian cohort of pediatric patients with B-ALL. Therefore, this study was designed to address the associations between CEBPE polymorphisms and susceptibility to B-ALL, as well as its impact on the outcome of B-ALL Egyptian patients with B-ALL.

Patients and Methods:
In the current study, we evaluated the rs2239630 polymorphism in 225 pediatric patients and 228 controls to assess the association of different rs2239630 genotypes with childhood susceptibility to B-ALL and the impact on the outcome of the patients.

Results:
The frequency of the A allele was significantly higher in the cases of B-ALL compared with the control group (P = 0.004). By analyzing different genotypes for the predictive value of disease development, the GA and AA genotypes have been identified to be the highest among multivariate factors with an odds ratio of 3.330 (95% CI: 1.105-10.035). Likewise, the A allele was significantly associated with the shortest overall survival.

Conclusions:

CEBPE gene promoter polymorphism (rs2239630 G > A) AA is frequently associated with B-ALL; and has the worst overall survival among the 3 genotypes, followed by the GA and GG genotypes (P < 0.001)