bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiofrequency ablation for the management of pancreatic mass lesions
Authors: Merchant Ambreen A. , Goebel Anna M. , Willingham Field F. 
Published: April 2023

Purpose of review
Patients with pancreatic tumors may have limited treatment options. Pancreatic tumor ablation is a novel and emerging treatment modality which can now be performed using endoscopic ultrasound (EUS) guidance. This modality is well suited to guide energy delivery for radiofrequency ablation (RFA) and microwave ablation. These approaches provide minimally invasive, nonsurgical methods for delivering energy to ablate pancreatic tumors in situ. This review summarizes the current data and safety profile for ablation in managing pancreatic cancer and pancreatic neuroendocrine tumors.

Recent findings
RFA uses thermal energy to induce cell death by coagulative necrosis and protein denaturation. Studies have reported increased overall survival in patients with pancreatic tumors treated with EUS-guided RFA in a multimodality systemic approach and when used in palliative surgeries. Radiofrequency ablation may have corollary benefits in inducing an immune-modulatory effect. Tumor marker carbohydrate antigen 19–9 has been reported to decrease in response to RFA. Microwave ablation is an emerging modality.

Summary
RFA utilizes focal thermal energy to induce cell death. RFA has been applied through open, laparoscopic, and radiographic modalities. EUS-guided approaches are now allowing RFA and microwave ablation to be performed for pancreatic tumors in situ.
Practical considerations for diagnosis and treatment of polycystic ovary syndrome in adolescence – distilling guidelines into clinical practice
Authors: DiVall Sara A. 
Published: April 2023

Purpose of review
The diagnostic criteria for polycystic ovary syndrome (PCOS) in adults may overdiagnose PCOS in adolescents. Since 2015, three guidelines have developed adolescent-specific diagnostic criteria and treatment recommendations. In this review, we compare and contrast the recommendations to assist in the practical application to clinical practice.

Recent findings
The guidelines agree that hyperandrogenism with menstrual irregularity be diagnostic criteria for PCOS in adolescents yet have slight differences in how to diagnose hyperandrogenism and in the definition of menstrual irregularity. The diagnostic option of ‘at risk for PCOS’ is recommended for those girls presenting with criteria within 3 years of menarche or with hyperandrogenism without menstrual irregularity, with re-assessment later in adolescence. Lifestyle changes is first line treatment. Treatment with combined oral contraceptives or metformin is suggested, using patient characteristics and preferences to guide decision-making.

Summary
PCOS is associated with long term reproductive and metabolic complications and will present during adolescence. Yet, diagnostic features may overlap with normal adolescent physiology. The recent guidelines strove to develop criteria to accurately identify girls with PCOS allowing early surveillance and treatment yet avoid overdiagnosis of normal adolescents.
The Prevalence of Bowel and Bladder Function During Early Childhood: A Population-Based Study
Authors: Verkuijl Sanne J. , Trzpis Monika , Broens Paul M.A. 
Published: April 2023

Objectives:
Our primary aim was to determine bowel and bladder function in children aged 1 month to 7 years in the general Dutch population. Second, we aimed to identify demographic factors associated with the presence of bowel and bladder dysfunction, and their coexistence.

Methods:
For this cross-sectional, population-based study, parents/caregivers of children aged from 1 month to 7 years were asked to complete the Early Pediatric Groningen Defecation and Fecal Continence questionnaire. Different parameters of bowel and bladder function were assessed using validated scoring systems such as the Rome IV criteria.

Results:
The mean age of the study population (N = 791) was 3.9 ± 2.2 years. The mean age at which parents/caregivers considered their child fully toilet-trained was 5.1 ± 1.5 years. Prevalence of fecal incontinence among toilet-trained children was 12%. Overall prevalence of constipation was 14%, with a constant probability and severity at all ages. We found significant associations between fecal incontinence and constipation [odds ratio (OR) = 3.88, 95% CI: 2.06–7.30], fecal incontinence and urinary incontinence (OR = 5.26, 95% CI: 2.78–9.98), and constipation and urinary incontinence (OR = 2.06, 95% CI: 1.24–3.42).

Conclusions:
Even though most children are fully toilet-trained at 5 years, fecal incontinence is common. Constipation appears to be common in infants, toddlers, and older children. Fecal incontinence and constipation frequently coexist and are often accompanied by urinary incontinence. Increased awareness of bowel and bladder dysfunction in infants, toddlers, and young children is required to prevent these problems from continuing at older ages.
Trends in implementation of evidence-based hip fracture management in a major Canadian city
Authors: Vergouwen Martina , James Michael G. , You Daniel Z. , White Neil J. 
Published: April 2023

Abstract

Aims:
The importance of hip fracture care has resulted in an abundance of hip fracture management literature. The degree this evidence is incorporated into clinical practice is unknown. We examined 5 trends in hip fracture management: arthroplasty versus fixation, total hip arthroplasty (THA) versus hemiarthroplasty (HA), cemented versus uncemented femoral stem fixation, short versus long cephalomedullary nail (CMN) fixation, and time from admission to surgery. Our primary aim was to understand and assess hip fracture management trends in relation to pertinent literature.

Methods:
Data were collected from acute hip fractures in patients aged 50 years or older who presented from 2008 to 2018. ICD-10 diagnostic codes were assigned using preoperative radiographs. Surgical management was confirmed using intraoperative and postoperative radiographs and split into 6 categories: (1) short CMN, (2) long CMN, (3) cannulated screws, (4) dynamic hip screw, (5) HA, and (6) THA. Appropriate statistical tests were used to analyze trends.

Results:
In 4 assessed trends, hip fracture management aligned with high-level evidence. This was the case for a trend toward arthroplasty for displaced femoral neck fractures, increased use of THA relative to HA, increased use of short relative to long CMNs, and consistent decrease in surgical wait times. Despite the literature highlighting the disadvantages of uncemented femoral stems, our data demonstrated increased use of uncemented femoral stems.

Conclusion:
Evidence to guide orthopaedic practice is constantly emerging but may not be effectively used by clinicians. Our findings demonstrate the successes and failures of integrating evidence into hip fracture management and highlight that orthopaedic surgeons have an ongoing responsibility to strive for evidence-based practice.
Comparison of Three Different Devices for the Evaluation of Axial Length, Refractive Error, and Keratometry
Authors: Hessler Philipp , Künzel Peter , Degle Stephan 
Published: April 2023

SIGNIFICANCE
Myopia prevalence is increasing worldwide. Axial length, refractive error, and keratometry are important outcome measures in myopia management. Precise measurement methods are required for myopia management. Various devices are used to measure these three parameters, and it is not known whether their results can be used interchangeably.

PURPOSE
The aim of this study was to compare three different devices to evaluate axial length, refractive error, and keratometry.

METHODS
A total of 120 subjects (37.7 ± 15.5 years) were enrolled in this prospective study. All subjects were measured with DNEye Scanner 2 (Rodenstock GmbH, Munich, Germany), Myopia Master (Oculus Optikgeräte GmbH, Wetzlar, Germany), and IOLMaster 700 (Carl Zeiss Meditec AG, Jena, Germany). Myopia Master and IOLMaster 700 use interferometry to measure axial length. Rodenstock Consulting software (Rodenstock GmbH, Munich, Germany) was used to calculate axial length from DNEye Scanner 2 measurement. Differences were analyzed using Bland-Altman 95% limits of agreement.

RESULTS
Differences for axial length were as follows: DNEye Scanner 2 versus Myopia Master, 0.67 ± 0.46 mm; DNEye Scanner 2 versus IOLMaster 700, 0.64 ± 0.46 mm; and Myopia Master versus IOLMaster 700, −0.02 ± 0.02 mm. Differences for mean corneal curvature were as follows: DNEye Scanner 2 versus Myopia Master, −0.20 ± 0.36 mm; DNEye Scanner 2 versus IOLMaster 700, −0.40 ± 0.35 mm; and Myopia Master versus IOLMaster 700, −0.20 ± 0.13 mm. The difference in noncycloplegic spherical equivalent between DNEye Scanner 2 and Myopia Master was 0.05 ± 0.25 D.

CONCLUSIONS
The results for axial length and keratometry from Myopia Master and IOLMaster were comparable. The axial length calculated by DNEye Scanner 2 was significantly different from interferometry devices and is not appropriate for myopia management. The differences in keratometry readings were clinically not significant. All refractive outcomes were comparable.
An Observational Study on Pattern of Empirical Acyclovir Therapy in Children With Acute Encephalitis From Northern India
Authors: Adarsha Naik , Samprathi Madhusudan , Sankhyan Naveen , Singh Mini P. , Bansal Arun , Jayashree Muralidharan , Angurana Suresh Kumar , Nallasamy Karthi 
Published: April 2023

Objectives:
To identify the prevalence of herpes simplex encephalitis (HSE), factors influencing the duration of empirical acyclovir and frequency of acute kidney injury (AKI) in children with acute encephalitis syndrome (AES).

Design:
Prospective observational study.

Setting:
Pediatric Emergency Department and PICU of a tertiary hospital in Northern India.

Patients:
All consecutive, eligible children between 1 month and 12 years old presenting with AES, defined as altered consciousness for greater than 24 hours (including lethargy, irritability, or a change in personality) and two or more of the following signs: 1) fever (temperature ≥ 38°C) during the current illness, 2) seizures or focal neurological signs, 3) cerebrospinal fluid (CSF) pleocytosis, 4) electroencephalogram, and/or 5) neuroimaging suggesting encephalitis, who received at least one dose of acyclovir.

Interventions:
None.

Measurements and Main Results:
Of the 101 children screened, 83 were enrolled. The median (interquartile range [IQR]) age was 3 years (1–6 yr). Thirty-one children (37.3%) were diagnosed with AES, of which four were labeled as probable HSE (three based on MRI brain, one based on serology). Scrub typhus, dengue, Japanese encephalitis, and mumps were the other infective causes. The median (IQR) duration of acyclovir therapy was 72 hours (24–264 hr); 21 children (25.3%) received acyclovir for less than 24 hours and 11 (13.3%) for greater than or equal to 14 days. New-onset AKI was seen in 18 children (21.7%) but was mostly transient. Death (n = 8, 9.6%) and discontinuation of care due to futility or other reasons (n = 15, 18%) were noted in 23 children (28%). Factors associated with duration of acyclovir greater than 7 days, on univariable analysis, were lower modified Glasgow Coma Score at admission, requirement of invasive ventilation, invasive intracranial pressure monitoring, and CSF pleocytosis (5–500 cells). On multivariable analysis, only CSF pleocytosis of 5–500 cells was associated with duration of acyclovir greater than 7 days.

Conclusions:
Given the low prevalence of HSE, and the risk of AKI, this study sensitizes the need to review our practice on initiation and stopping of empirical acyclovir in children with acute encephalitis.
Impact of COVID-19 Pandemic on the Influenza Vaccination and Predictors of Influenza Vaccination in Japan: A Cross-sectional Study
Authors: Shojima Kensaku , Kobayashi Taiichiro , Tabuchi Takahiro 
Published: April 2023

Objective:
With the current global pandemic of COVID-19, there is concern that an influenza outbreak could exacerbate the health care burden. Improving the influenza vaccination rate is becoming more critical because controlling the spread of influenza is essential for reducing excess mortality. Therefore, we investigated whether the influenza vaccination rate changed during the COVID-19 pandemic in Japan and identified the factors associated with influenza vaccination uptake.

Design:
This cross-sectional study used data from an Internet survey with adjustments to approximate a nationally representative estimate using inverse probability weighting.

Setting:
A total of 23 142 respondents, aged 15 to 80 years, were evaluated to estimate weighted percentages and prevalence ratios with 95% confidence intervals of influenza vaccination in the period 2020-2021.

Results:
Overall, in the period 2020-2021, the influenza vaccination rate rose from 38.1% before the COVID-19 pandemic to 44.6%. “Using traditional media” was a positive predictor of influenza vaccination uptake. “Using social media,” “COVID-19 vaccine hesitancy,” and “living in a prefecture with a high proportion of COVID-19 cases” were negative predictors.

Conclusions:
It is crucial to use predictors of influenza vaccination, such as how to use the media, for promoting a more widespread influenza vaccination uptake. The results of this study may be helpful in improving influenza vaccination rates, which could reduce the burden on health care services during outbreaks of influenza and COVID-19.
Effectiveness of music therapy within community hospitals: an EMMPIRE retrospective study
Authors: Rodgers-Melnick Samuel N. , Rivard Rachael L. , Block Seneca , Dusek Jeffery A. 
Published: April 2023

Abstract

Introduction:
Given the challenges health systems face in providing effective nonpharmacologic treatment for pain and psychological distress, clinical effectiveness studies of evidence-based strategies such as music therapy (MT) are needed.

Objectives:
This study examined changes in patient-reported outcomes (PROs) after MT and explored variables associated with pain reduction of ≥2 units on a 0 to 10 numeric rating scale (NRS).

Methods:
A retrospective review was conducted on initial MT interventions provided to adults receiving community hospital care between January 2017 and July 2020. Sessions were included if participants reported pre-session pain, anxiety, and/or stress scores of ≥4 on the NRS. Data analysis included a bootstrap analysis of single-session changes in PROs and a logistic regression exploring variables associated with pain reduction (ie, ≥2 units vs <2 units).

Results:
Patients (n = 1056; mean age: 63.83 years; 76.1% female; 57.1% White; 41.1% Black/African American) reported clinically significant mean reductions in pain (2.04 units), anxiety (2.80 units), and stress (3.48 units). After adjusting for demographic, clinical, and operational characteristics in the model (c-statistic = 0.668), patients receiving an MT session in which pain management was a goal were 4.32 times more likely (95% confidence interval 2.26, 8.66) to report pain reduction of ≥2 units than patients receiving an MT session in which pain management was not a session goal.

Conclusion:
This retrospective study supports the clinical effectiveness of MT for symptom management in community hospitals. However, additional research is needed to determine which characteristics of MT interventions and patients influence pain change.
Challenges and Solutions for Monitoring Alcohol Use in Patients with Alcohol Related Liver Disease: Pilot Study of a Wearable Alcohol Biosensor
Authors: DiMartini Andrea , Behari Jaideep , Dunn Michael , Bataller Ramon A. , Jakicic John M. , McNulty Mary , Young Ryan C. , Dew Mary Amanda 
Published: April 2023

ABSTRACT

Objectives
Early alcohol use identification can prevent morbidly/mortality for alcohol-associated liver disease (ALD). Innovative wearable alcohol biosensors (biosensors) that identify alcohol use through perspiration are an emerging technology with potential application for Patients with ALD. Our primary aim was to determine biosensor acceptability and feasibility for Patients with ALD. We describe participant acceptance and challenges using biosensor technology in a pilot study of biosensors with Patients with ALD.

Design
Participants had a recent diagnosis or hospitalization for decompensated ALD, had to be drinking within the past three months and be followed at our center. Participants wore the biosensor daily for 3 months. Quantitative data using the Technology Acceptance Model 2 (TAM2) measure were collected at intake and study conclusion. The TAM2’s 13 items cover 4 scales; perceived usefulness, ease of use, attitude towards technology and intention to use on a 7-point Likert scale. Lower scores indicate higher acceptance. Participants were asked open-ended questions about issues wearing the biosensor.

Results
Among 27 participants, 60% were women, average age 45 + 10, and 89% were white. TAM2 subscales indicated initially high acceptance (mean scores 1.2-2.2) and remained high (mean scores 1.3-2.3) without statistically significant decline at study conclusion. From open-ended questions, several themes regarding problems with device wear emerged: a) uncomfortable or cumbersome to wear, b) problems with biosensor appearance, and c) issues with useability. Challenges to biosensor usage included data being lost when devices were damaged and devices being lost during the study.

Conclusions
Alcohol biosensors appear to be acceptable to ALD participants. However, improving the appearance, comfort, durability and functionality of biosensor devices is critical to clinical deployment.

Clinicaltrials.gov
identifier NCT03533660: Alcohol biosensor monitoring for alcohol liver disease
Childhood Trauma and Adult Somatic Symptoms
Authors: Eilers Hanna , aan het Rot Marije , Jeronimus Bertus F. 
Published: April 2023

ABSTRACT

Objective
Childhood trauma is a key public health risk factor for developing physical illness. This study examined how childhood abuse and neglect predict adult somatic symptoms assessed retrospectively and in real time.

Methods
Participants in the HowNutsAreTheDutch project completed the Childhood Trauma Questionnaire—Short Form and, to assess somatic symptoms, the cross-sectional Patient Health Questionnaire (n = 406) or a longitudinal ecological momentary assessment protocol that included responding to an item on physical discomfort 3 times a day for 30 days (n = 290).

Results
As hypothesized, childhood trauma was positively associated with adult somatic symptoms assessed using the Patient Health Questionnaire (d = 0.30) and assessed using the ecological momentary assessment item (d = 0.31), also after adjustment for age, sex, educational level, and relationship status. Longitudinally, we also explored whether interpersonal context moderated abuse outcomes, and observed that social company dampened momentary physical discomfort among people with a history of more physical neglect (d = 0.04).

Conclusions
Childhood trauma, especially emotional and sexual abuse, predicts specific adult somatic symptoms. Future work may examine how symptom expression is influenced by the social lives of traumatized individuals.
Trait Hostility Moderates the Relationships between Work Environments and Ambulatory Blood Pressure and Momentary Affect
Authors: Small Amanda K. , Zawadzki Matthew J. 
Published: April 2023

Abstract

Objective
Hostility is a risk factor for cardiovascular disease and mortality, but less is known about when hostility poses greatest risk. Work environments can be characterized by features that are reactive for high hostile individuals. Using a person by environment approach, this paper tested whether hostility interacted with work location to predict the cardiovascular disease risk factors of ambulatory blood pressure (ABP) and momentary affect.

Method
Community participants (n = 108; aged 20-68, M = 36.52, SD = 11.96; 66.06% men; primarily 35.62% non-Hispanic Black, 31.51% non-Hispanic White, and 15.07% Latino/Hispanic) completed a measure of trait hostility followed by two 24-hour ABP monitoring sessions. After each ABP reading, ecological momentary assessment was used to capture participants’ current location and ratings of anger, sadness, happiness, and anxiety.

Results
4,321 observations were recorded. Multilevel models tested the relationship between work location, trait hostility, and their interaction on ABP and momentary affect. Participants higher on hostility had higher systolic ABP, diastolic ABP, anger, and sadness (but not happiness nor anxiety) when at work compared to when not at work; no differences were observed for those lower on hostility. A more consistent pattern of results was found for the William hostility subscale than a traditional measure.

Conclusions
Results suggest mechanisms for how trait hostility can lead to cardiovascular disease and mortality and highlight the importance of studying traits like hostility within context. Future research should consider the role of social determinates of health like socioeconomic status and features of the work environment to better understand this relationship.
Microsurgical Reconstruction of Extensive Lower Lip Defects
Authors: Ribeiro Luis Mata , Peng Chi , Cheong David Chon-Fok , Hung Shao-Yu , Tsao Chung-Kan 
Published: April 2023

Background
Large defects of the lower lip pose a difficult challenge for any reconstructive surgeon. When there is limited local tissue available to resurface the defects, free flaps are the preferred option.

Aim and Objectives
We reported our experience in the reconstruction of extensive lower lip defects. The authors propose a new algorithm for microsurgical technique selection and assessment of the functional outcomes obtained.

Materials and Methods
A retrospective review of all microsurgical reconstructions of extensive lower lip defects by the senior author for 10 years was performed. The functional outcomes assessed included speech, feeding, and oral continence. Patients were stratified according to their status of simultaneous mandible resection (none, marginal, segmental).

Results
Fifty-one patients were included in this study. Almost all patients (96.1%) achieved intelligible speech. Only 1 patient experienced severe drooling. Most patients could eat a solid or soft diet (72.5%). Mandible resection was associated with the worst feeding outcomes.

Conclusions
Microsurgical reconstruction of extensive lip defects is safe and provides good results. Free flap selection should take into account the location of the defect, the resected structures, and the body mass index of the patient. Feeding status seems to be inversely correlated with the amount of mandibular resection.