bluuebunny/crossref_metadata_2025_split huggingface dataset:
Competing Priorities? Testing Multiple Mechanisms That Connect Adolescent Religiosity to Marriage in Young Adulthood
Authors: Hayward George M , Gilliland Claire Chipman , Denton Melinda 
Published: August 2023

AbstractReligion and family remain tightly linked institutions, but the increasingly varied period of emerging adulthood, which includes delays in marriage transition and reduced religiosity overall, calls for additional research into this relationship. Religious involvement continues to be associated with earlier age at first marriage, for example, but the specific mechanisms responsible for this connection are often only implied or untested. Accordingly, we build on prior literature and hypothesize about three mechanisms that could explain the link between adolescent religiosity and marriage transition in young adulthood: the importance of completing milestone goals prior to marriage, such as completing one’s education and establishing a career, the importance of cohabitation before marriage, and the ideal age of marriage. We use longitudinal data from the National Study of Youth and Religion to investigate each of these mechanisms for a recent cohort of young adults. Using structural equation modeling and measures for adolescent religious attendance, importance, and affiliation, we find that adolescent religiosity is related to the marriage transition primarily through the mechanism of cohabitation. Specifically, religious attendance and importance in adolescence are associated with less support for cohabitation, which in turn is associated with a higher likelihood of marriage transition during young adulthood. Findings for religious affiliation were not as consistent. In the context of demographic shifts in marriage patterns and religious involvement, these analyses provide an important illustration of how these social institutions are still connected.
Evaluating the Readability and Quality of Online Patient Education Materials for Pediatric ACL Tears
Authors: Thomas Nicholas D. , Mahler Raegan , Rohde Matthew , Segovia Nicole , Shea Kevin G. 
Published: August 2023

Background:
As the rate of anterior cruciate ligament (ACL) tears increases in children, the internet has become a major source of information and education. In the United States, the average adult reads at about an eighth grade level. The National Institutes of Health recommends that patient education materials do not exceed a sixth-grade reading level. Therefore, the most accessed resources on the internet should be created with this in mind. The purpose of this study is to assess the readability and quality of online patient resources for pediatric ACL tears.

Methods:
Google was queried using the term “Pediatric ACL Tear” on May 26, 2022. The most popular sites were identified through page one of a Google search. All content was evaluated to assure information was directed toward patients. To determine reading difficulty, the most widely accepted readability tests: Flesch Reading Ease Index, Flesch-Kincaid Grade Level, and Gunning Fog Index were calculated through plain text in Microsoft Word and URL in online readability checker Readable.io.

Results:
The average grade level for all resources was above the recommended reading level based on both Microsoft Word and Readable.io calculations. Each source exceeded the NIH recommendation by 2.6 grade levels on average (Mean grade level readability was 8.6 ± 1.9). Four of the 6 sites were above the average US reading level, exceeding the eighth grade by an average of 1.5 grade levels. All 6 sites analyzed had a mean DISCERN score of 61.9, meeting the ‘good quality’ criteria.

Conclusion:
The most readily available online materials for Pediatric ACL tears were of ‘good quality’ but above both the NIH-recommended readability level and the average US adult reading level. With the increasing need for treatment of ACL tears in pediatric and adolescent patients and greater internet accessibility in these populations, it is important to consider the readability of these resources in support of increased health literacy and improved outcomes.

Clinical Relevance:
It is important for physicians treating young patients with ACL tears to be aware of all sources of information and support, including content shared online as these platforms are increasingly utilized, especially by patients and families of lower socioeconomic status.
Circulating tumor DNA in breast cancer: a biomarker for patient selection
Authors: Agostinetto Elisa , Nader-Marta Guilherme , Ignatiadis Michail 
Published: August 2023

Purpose of review
This review aims to explore the role of circulating tumor DNA (ctDNA) as a biomarker for patient selection in breast cancer. We describe the current evidence and the main ongoing trials both in the early and metastatic setting.

Recent findings
In the metastatic setting, the analysis of ctDNA can identify specific genetic alterations amenable of molecularly targeted treatments. Several assays are now approved for the detection of genetic alterations in plasma cell-free DNA to guide treatment decision (e.g., PIK3CA mutations for PI3K inhibitors, and ESR1 mutations for the selective estrogen receptor degrader elacestrant). In the early setting, emerging evidence is demonstrating that ctDNA can identify a disease relapse with a lead-time of approximately 10 months before imaging. This could help select patients who may benefit from escalation treatment strategy, although this hypothesis needs to be first prospectively validated.

Summary
Liquid biopsy for ctDNA detection represents an exciting new field in rapid evolution. Several trials are ongoing to validate the clinical utility of ctDNA in daily practice in the early setting and to expand its current indications in the metastatic one.
Early Sleep Differences in Young Infants with Autism Spectrum Disorder
Authors: Foster Miranda , Federico Alexis , Klaiman Cheryl , Bradshaw Jessica 
Published: August 2023

ABSTRACT:

Objective:
Children with autism spectrum disorder (ASD) experience greater sleep challenges than their neurotypical peers, but sleep patterns for infants later diagnosed with ASD are unknown. This study examined differences in total sleep duration and proportion of sleep experienced at night within the first 6 months of life among infants later diagnosed with ASD, infants who demonstrated subclinical characteristics of ASD and were classified as exhibiting the broad autism phenotype (BAP), and their typically developing (TD) peers. In addition, associations between infant sleep variables and developmental outcomes at 24 months were explored.

Methods:
Participants included 79 infants enrolled in a prospective, longitudinal study of the early development of ASD. Between ages 1 week and 6 months, participants completed a monthly retrospective 24-hour sleep log. At 24 months, participants received a comprehensive diagnostic evaluation, including the Autism Diagnostic Observation Schedule-2 and Mullen Scales of Early Learning and Vineland-II and were clinically characterized as ASD, BAP, or TD.

Results:
When accounting for the influence of age, infants later diagnosed with ASD slept less within the 24-hour period than infants in TD or BAP groups from 0 to 6 months (p = 0.04). Percentage of sleep experienced during nighttime hours did not significantly differ between groups from 0 to 6 months (p = 0.25). Greater nighttime sleep percentage at 6 months predicted higher receptive language (p < 0.001) and fine motor scores (p < 0.0001) at 24 months. Total sleep duration at 6 months did not predict any developmental outcomes at 24 months.

Conclusion:
Findings suggest that differences in sleep may occur among autistic individuals earlier in life than previously documented and have cascading effects on development.
Feasibility of Implementing a Total Worker Health ® Intervention During the COVID-19 Pandemic in Small and Medium Businesses
Authors: McAden Emily P. , Leff Maija S. , Staley John A. , Greenberg Rosa W. , Nylander-French Leena A. , Linnan Laura A. 
Published: August 2023

Objective
In response to the COVID-19 pandemic’s disruptive effect on employers and workers, an interdisciplinary team launched the Carolina Promoting Safe Practices for Employees’ Return study to assess the feasibility of providing tailored technical assistance to small and medium North Carolina businesses using a Total Worker Health (TWH)® approach.

Methods
Feasibility of the approach was assessed via surveys and interviews of business representatives from four participating businesses ranging in size from 3 to 110 employees.

Results
The TWH approach is feasible, that is, in demand, practical, and acceptable to protect and promote worker safety, health, and well-being. Potential challenges include implementation cost, difficulty engaging all employees, and difficulty accessing tailored health and safety materials in a timely manner.

Conclusions
Additional refinement and testing of the TWH approach postpandemic with more worksites is warranted.
Effectiveness of Internet-Based Cognitive Behavioral Therapy for Patients With Cancer
Authors: Yu Shuanghan , Liu Yantong , Cao Minglu , Tian Qi , Xu Mengmeng , Yu Lin , Yang Shu , Zhang Wei 
Published: August 2023

Background
Internet-based cognitive behavioral therapy (ICBT) is a relatively new therapy with unknown effectiveness in patients with cancer. In addition, therapist-guided and self-guided ICBT patient-specific outcomes for cancer patients remain to be explored.

Objective
To explore the effects of ICBT on psychological outcomes, physical outcomes, and daily life outcomes in patients with cancer.

Methods
Electronic databases such as PubMed, Web of Science, Cochrane Library, EMBASE, APA PsycINFO, ProQuest, and ClinicalTrials.gov were searched for relevant studies published from their inception to October 2022. Five GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) considerations were used to assess the quality of relevant evidence. Data analysis was performed via RevMan 5.4 (The Cochrane Collaboration, London, United Kingdom) and Stata 15.0 (StataCorp, College Station, Texas).

Results
Three thousand two hundred forty-nine participants from 20 studies were included in the meta-analysis. Statistically significant effects of ICBT were found on psychological distress, quality of life (QOL), anxiety, and depression, after the intervention. A separate analysis of follow-up data showed that ICBT had a sustainable effect on psychological distress, anxiety, and depression. Subgroup analyses showed that therapist-guided ICBT was more effective for psychological distress and QOL.

Conclusion
Internet-based cognitive behavioral therapy can improve symptom management for patients with cancer.

Implications for Practice
Internet-based cognitive behavioral therapy effectively improves psychological distress, anxiety, and depression in patients with cancer after intervention and at follow-up. Internet-based cognitive behavioral therapy improved QOL for cancer patients postintervention but not during follow-up. Internet-based cognitive behavioral therapy did not relieve fatigue or fear of recurrence in cancer patients. Therapist-guided ICBT is recommended for its superior outcomes in alleviating psychological distress and improving overall QOL in adults with cancer when compared with self-guided ICBT.
Assessment of Cognitive and Mood Changes in Older Survivors of COVID-19
Authors: Ozdemir Cagla , Tastemur Mercan 
Published: August 2023

Abstract
The long-term effects of coronavirus disease 2019 (COVID-19) infection are not fully known. In this study, we aimed to evaluate cognitive function and mood changes with 1-year follow-up in the elderly after COVID-19 disease. Ninety COVID-19 survivors and 90 healthy controls were included in the study between April 2022 and 2023. The patients were evaluated at the 1st, 6th, and 12th months for cognition, depression, and sleep quality. Cognitive function is assessed by the Montreal Cognitive Assessment (MoCA), sleep quality by the Pittsburgh Sleep Quality Index, and depression by the Yesavage Geriatric Depression Scale. COVID-19 survivors secured lower scores in certain domains of the MoCA in comparison with the controls at the first and sixth months. However, at the 12th month, no difference was observed in total MoCA (p = 0.100), Yesavage Geriatric Depression Scale (p = 0.503), and Pittsburgh Sleep Quality Index (p = 0.907) between survivors and controls. Older patients who recovered from COVID-19 have lower cognitive function compared with controls up to 12 months. However, cognitive function scores were similar at the end of the first year except for memory scores.
Associations Between Cumulative Social Adversities and Substance Use Comorbidity in a Statewide Sample of Individuals in Treatment for Mental Illnesses
Authors: Compton Michael T. , Frimpong Eric Y. , Fu En , Ehntholt Amy , Chaudhry Sahil , Ferdousi Wahida , Rowan Grace A. , Swetnam Hannah , Radigan Marleen , Smith Thomas E. , Rotter Merrill 
Published: August 2023

Abstract
We sought to investigate associations of cumulative social adversities in four areas (low education, unemployment, homelessness, and criminal/legal involvement) with presence of comorbid alcohol and drug use disorders among individuals in treatment for mental illnesses. Using data from 103,416 adults in mental health treatment, generalized estimating equation modified Poisson models were used to estimate increased risk of having comorbid substance use disorders based on individual and/or cumulative number of social adversities present. Controlling for effects of sex, race/ethnicity, and region (New York City vs. the rest of the State), as well as for the other social adversities, each of four social adversities was associated with presence of substance use comorbidity. Relative to having none of the social adversities, the presence of one, two, three, or four was associated with an increased prevalence ratio (PR) of having substance use comorbidity: 1.44, 2.10, 2.66, and 2.92; all p's < 0.0001. PRs were greater among female patients, and among Hispanics and those classified as other or multiracial compared with non-Hispanic Whites or non-Hispanic Blacks. Findings indicate substantial associations between four social adversities and presence of substance use comorbidity; the strength of association with the four social adversities is cumulative.
Computed Tomography–Based Predictive Model for the Probability of Lymph Node Metastasis in Gastric Cancer: A Meta-analysis
Authors: Teng Fei , Fu Yu-Fei , Wu An-Le , Xian Yu-Tao , Lin Jia , Han Rui , Yin Yong-Fang 
Published: August 2023

Objectives
Whether or not a gastric cancer (GC) patient exhibits lymph node metastasis (LNM) is critical to accurately guiding their treatment and prognostic evaluation, necessitating the ability to reliably predict preoperative LNM status. The present meta-analysis sought to examine the diagnostic value of computed tomography (CT)–based predictive models as a tool to gauge the preoperative LNM status of patients with GC.

Methods
Relevant articles were identified in the PubMed, Web of Science, and Wanfang databases. These studies were used to conduct pooled analyses examining sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) values, and area under the curve values were computed for summary receiver operating characteristic curves.

Results
The final meta-analysis incorporated data from 15 studies, all of which were conducted in China, enrolling 3,817 patients with GC (LNM+: 1790; LNM−: 2027). The developed CT-based predictive model exhibited respective pooled sensitivity, specificity, PLR, and NLR values of 84% (95% confidence interval [CI], 0.79–0.87), 81% (95% CI, 0.76–0.85), 4.39 (95% CI, 3.40–5.67), and 0.20 (95% CI, 0.16–0.26). The identified results were not associated with significant potential for publication bias (P = 0.071). Similarly, CT-based analyses of LN status exhibited respective pooled sensitivity, specificity, PLR, and NLR values of 62% (95% CI, 0.53–0.70), 77% (95% CI, 0.72–0.81), 2.71 (95% CI, 2.20–3.33), and 0.49 (95% CI, 0.40–0.61), with no significant risk of publication bias (P = 0.984).

Conclusions
Overall, the present meta-analysis revealed that a CT-based predictive model may outperform CT-based analyses alone when assessing the preoperative LNM status of patients with GC, offering superior diagnostic utility.
Metastatic Pulmonary Calcification: Single-Center Review of Typical and Atypical Imaging Features
Authors: Chen Tina , Hossain Rydhwana , Jeudy Jean , Chelala Lydia , White Charles 
Published: August 2023

Purpose
The purpose of this study is to bring attention to an atypical form of metastatic pulmonary calcification, which is conventionally described as a metabolic process with upper lobe predominance in patients with a specific clinical history, which has not been reported as a distinct entity.

Methods
Patients with metastatic pulmonary calcification (MPC) were first identified with mPower keyword search, including MPC or metastatic calcifications on computed tomography chest radiological reports. Patients were then filtered on likelihood of MPC based off imaging reports. Images were then reviewed by three senior radiologists for pertinent characteristics such as location of MPC, degree of calcifications and pleural effusions. Based on the predominant location of MPC, cases were labeled as either typical or atypical. Clinical and imaging characteristics relevant to MPC were noted and compared across typical and atypical cases.

Results
In our study, we describe 25 patients with MPC, 13 defined as typical MPC and 12 with atypical MPC. Through consensus of senior radiologists, MPC was deemed to be mild (52%), moderate (44%), or severe (4%). Twenty-three patients (92%) had underlying renal disease including 21 requiring dialysis at the time of diagnosis. Outside of age at diagnosis, there was no significant clinical difference between the two groups. Evaluation of imaging characteristics (average HU attenuation, 267; range, 186–295), pattern and distribution of calcification, and clinical history strongly supported a diagnosis of atypical MPC.

Conclusion
This study presents several cases of lower lobe subpleural MPC associated with pleural effusions, which has not been reported as a distinct entity, despite comprising a significant portion of MPC cases at our institution.
Accuracy of Orbital Shape Reconstruction—Comparative Analysis of Errors in Implant Shape Versus Implant Positioning: A Cadaveric Study
Authors: Hardisty Michael , Wei Yuan Tao , Hontscharuk Rayisa , Ibrahimi Amani , Antonyshyn Oleh , Edwards Glenn , Mainprize James G. , Whyne Cari M. 
Published: August 2023

Introduction:
Orbital blowout fractures are commonly reconstructed with implants shaped to repair orbital cavity defects, restore ocular position and projection, and correct diplopia. Orbital implant shaping has traditionally been performed manually by surgeons, with more recent use of computer-assisted design (CAD). Accuracy of implant placement is also key to reconstruction. This study compares the placement accuracy of orbital implants, testing the hypothesis that CAD-shaped implants indexed to patient anatomy will better restore orbit geometry compared with manually shaped implants and manually placed implants.

Methods:
The placement accuracy of orbital implants was assessed within a cadaveric blowout fracture model (3 skulls, 6 orbits) via 3-dimensional CT analysis. Defects were repaired with 4 different techniques: manually placed-manually shaped composite (titanium-reinforced porous polyethylene), manually placed CAD composite, indexed placed CAD composite, and indexed placed CAD titanium mesh.

Results:
Implant placement accuracy differed significantly with the implant preparation method (P=0.01). Indexing significantly improved the placement accuracy (P=0.002). Indexed placed titanium mesh CAD implants (1.42±0.33 mm) were positioned significantly closer to the intact surface versus manually placed-manually shaped composite implants (2.12±0.39 mm).

Discussion:
Computer-assisted design implants indexed to patient geometry yielded average errors below the acceptable threshold (2 mm) for enophthalmos and diplopia. This study highlights the importance of adequately indexing CAD-designed implants to patient geometry to ensure accurate orbital reconstructions.
Systematic Reviews and Meta-analyses of the Procedure-specific Risks of Thrombosis and Bleeding in General Abdominal, Colorectal, Upper-Gastrointestinal and Hepatopancreatobiliary Surgery
Authors: Lavikainen Lauri I. , Guyatt Gordon H. , Sallinen Ville J. , Karanicolas Paul J. , Couban Rachel J. , Singh Tino , Lee Yung , Elberkennou Jaana , Aaltonen Riikka , Ahopelto Kaisa , Beilmann-Lehtonen Ines , Blanker Marco H. , Cárdenas Jovita L. , Cartwright Rufus , Craigie Samantha , Devereaux P.J. , Garcia-Perdomo Herney A. , Ge Fang Zhou , Gomaa Huda A. , Halme Alex L.E. , Haukka Jari , Karjalainen Päivi K. , Kilpeläinen Tuomas P. , Kivelä Antti J. , Lampela Hanna , Mattila Anne K. , Najafabadi Borna Tadayon , Nykänen Taina P. , Pandanaboyana Sanjay , Pourjamal Negar , Ratnayake Chathura B. B. , Raudasoja Aleksi R. , Vernooij Robin W. M. , Violette Philippe D. , Wang Yuting , Xiao Yingqi , Yao Liang , Tikkinen Kari A. O. ,   ROTBIGGS Investigators
Published: August 2023

Objective:
To provide procedure-specific estimates of symptomatic venous thromboembolism (VTE) and major bleeding following abdominal surgery.

Summary Background Data:
Use of pharmacological thromboprophylaxis represents a trade-off that depends on VTE and bleeding risks that vary between procedures; their magnitude remains uncertain.

Methods:
We identified observational studies reporting procedure-specific risks of symptomatic VTE or major bleeding after abdominal surgery; adjusted the reported estimates for thromboprophylaxis and length of follow-up; and estimated cumulative incidence at 4 weeks post-surgery, stratified by VTE risk groups; and rated evidence certainty.

Results:
After eligibility screening, 285 studies (8,048,635 patients) reporting on 40 general abdominal, 36 colorectal, 15 upper-gastrointestinal, and 24 hepatopancreatobiliary surgery procedures proved eligible. Evidence certainty proved generally moderate or low for VTE and low or very low for bleeding requiring reintervention. The risk of VTE varied substantially between procedures: in general abdominal surgery from a median of <0.1% in laparoscopic cholecystectomy to a median of 3.7% in open small bowel resection; in colorectal from 0.3% in minimally-invasive sigmoid colectomy to 10.0% in emergency open total proctocolectomy; and in upper-gastrointestinal/hepatopancreatobiliary from 0.2% in laparoscopic sleeve gastrectomy to 6.8% in open distal pancreatectomy for cancer.

Conclusions:
VTE thromboprophylaxis provides net benefit through VTE reduction with small increase in bleeding in some procedures (e.g., open colectomy, open pancreaticoduodenectomy), whereas the opposite is true in others (e.g., laparoscopic cholecystectomy, elective groin hernia repairs). In many procedures, thromboembolism and bleeding risks are similar, and decisions depend on individual risk prediction and values and preferences regarding VTE and bleeding.