bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are There Video Characteristics That Improve the Accuracy and Quality of Ob-Gyn Procedural Videos? [ID: 1376966]
Authors: McIlvaine Jamie , Foncham Juanita , Francis Antonia , Kayaalp Emre 
Published: May 2023

INTRODUCTION:
YouTube has emerged as a common resource used by ob-gyn residents to learn procedural skills. There has not been any research conducted that examines the relationship between video characteristics and the quality and accuracy of ob-gyn procedural videos. The purpose of this study was to assess whether YouTube video metrics, including number of likes, views, channel subscribers, geographic location, and organizational affiliations, can be used to gauge the quality and accuracy of ob-gyn procedural videos.

METHODS:
Using American College of Obstetricians and Gynecologists (ACOG) surgical curriculum topics, we conducted a search query into YouTube and sorted by relevance. Screening criteria were used to exclude videos. We then recorded video characteristics and scored the videos using the Laparoscopic Surgery Video Educational Guidelines (LAP-VEGaS) video assessment tool for quality. Additionally, we scored videos for accuracy by comparing them to the ACOG Surgical Curriculum in Obstetrics and Gynecology (SCOG) checklist.

RESULTS:
Of the 306 videos analyzed, number of likes, views, channel subscribers, and geographic location were not of high quality with LAP-VEGaS scores less than 11. The number of likes, views, and channel subscribers were not significantly associated with LAP-VEGaS or SCOG accuracy. There was a significant difference in LAP-VEGaS score and SCOG accuracy with international health care organization/specialty society with P values of .004 and .001, respectively.

CONCLUSION:
Of the characteristics studied, number of likes, views, and channel subscribers, and geographic location did not have a statistically significant difference in accuracy of educational value. Only association with international health care organizations/specialty societies was significantly associated with an increased LAP-VEGaS, indicating increased quality of video and increased percent accuracy by ACOG standards.
Provider Adherence to Edinburgh Postnatal Depression Screening [ID: 1375752]
Authors: Linfield Rachel , Marty Lindsay , Myrick Olivia 
Published: May 2023

INTRODUCTION:
As part of a quality improvement initiative at a high-volume, outpatient obstetric center, a preintervention performance metric was obtained that determined physician adherence to providing the Edinburgh Postnatal Depression Screen (EPDS), which identifies patients with perinatal mood and anxiety disorders.

METHODS:
This was a retrospective chart review conducted over a 6-month period at the outpatient offices of an academic faculty group practice in a large, urban area. Provider adherence to EPDS screening and documentation was identified as per the standard office protocol—at both 24–28 weeks of gestation and 6–8 weeks postpartum. Patient population was limited to those who presented to their postpartum visit at the designated offices from January 2021 to June 2021 and received antenatal care through this same location.

RESULTS:
Four hundred forty-five patients met the inclusion criteria for receiving both antenatal and postpartum care within the selected time frame. Antenatally, only 55% of patients received a properly scored EPDS, 12% of patients were screened but the scores were not documented, and 33% of encounters did not include depression screening. Postpartum, only 60% of patients received a properly scored EPDS, 16% of patients were screened but the scores were not documented, and 24% of postpartum encounters did not include depression screening.

CONCLUSION:
This study emphasizes the need for increased physician education and targeted changes to workflow with respect to prioritizing depression screens for patients in antenatal and postpartum periods. Further trends will highlight the need for targeted education interventions or specific patient populations that require more attention to ensure screening is performed.
Study Participants' and Clinicians' Experiences With Placement of a Novel Low-Dose Copper Intrauterine Device With a Nitinol Frame in Nulliparous Versus Parous Participants [ID: 1374840]
Authors: Turok David , Hou Melody , McNicholas Colleen , Nelson Anita , Peters Kevin , Roe Andrea 
Published: May 2023

INTRODUCTION:
Clinicians may perceive intrauterine device (IUD) placement to be more challenging for nulliparous versus parous users. This study assesses nulliparous versus parous study participants' and clinicians' experiences with placement of a novel, low-dose copper (175 mm2) IUD with a flexible nitinol frame.

METHODS:
This single-arm, IRB-approved, phase 3 clinical trial recruited pregnancy-capable people aged 17–45 at 42 U.S. centers. We compared nulliparous and parous participants' experiences for first IUD placement attempt including successful placement, participant-reported pain (on an 11-point numeric pain rating scale), investigator-reported ease of IUD placement (on a 5-point Likert scale), need for mechanical cervical dilation, and uterine perforation.

RESULTS:
Of 1,620 participants enrolled, 973 (60.1%) reported nulliparity and 647 (39.9%) parity. Successful IUD placement occurred at first attempt for 929 (96.0%) nulliparous versus 625 (96.6%) parous participants. Including second attempts, successful placement occurred for 1,601 (98.8%) participants. Nulliparous participants reported a mean pain score of 5.6 (±2.19) versus 4.0 (±2.55) for parous participants (P<.001), and investigators more frequently reported hard or very hard IUD placement in 81 (8.4%) nulliparous versus 22 (3.4%) parous participants (P<.001). Among nulliparous participants, 203 (21.2%) reported pain-related adverse events associated with placement versus 65 (10.1%) in parous participants (P<.001). Mechanical dilation was required for 202 (20.8%) nulliparous versus 79 (12.2%) parous participants (P<.001). Uterine perforation occurred in 1 nulliparous (0.10%) and 1 parous participant (0.15%).

CONCLUSION:
Despite experiencing more challenging IUD placements than parous participants, nulliparous trial participants experienced similar IUD placement success with this novel, low-dose copper IUD.
Postpartum Hemorrhage: Preterm Versus Term Pregnancies [ID: 1356883]
Authors: Whelan Anna , Ciomperlik Halie , Ghose Ipsita , Mendez-Figueroa Hector , Wagner Stephen , Wiley Rachel 
Published: May 2023

INTRODUCTION:
Unlike neonatal morbidity with preterm birth (PTB; <37 weeks), maternal complications with PTB are infrequently reported. We aimed to assess the risk of postpartum hemorrhage (PPH)-related maternal morbidity among preterm versus term deliveries.

METHODS:
This was a secondary analysis of an IRB-approved retrospective cohort of all in-house singleton deliveries over 1 year. Demographics, pregnancy and delivery characteristics were abstracted from charts. Individuals who delivered preterm were compared to those who delivered at term (>37 weeks) for the primary outcome of composite maternal morbidity (CMM—blood loss >1,000 mL, uterotonic use, transfusion, uterine tamponade, surgical intervention, intensive care unit [ICU] admission, hysterectomy, and maternal death). Multivariable regression was performed to assess the adjusted relative risk (aRR) of preterm delivery on CMM with variables specified a priori.

RESULTS:
Of the 4,554 deliveries in our level 4 hospital, 4,514 (99%) met the inclusion criteria, with 1,062 (23%) delivering preterm. The overall CMM was 23.2%, with it being 30.4% in PTB and 21.0% in term births. Controlling for age, body mass index greater than 30 kg/m2, nulliparity, insurance status, race, smoking status, and cesarean delivery, preterm deliveries had a 42% higher rate of the CMM compared to term births (aRR 1.42: 95% CI, 1.27, 1.60). Transfusion, ICU admission, and hysterectomy were significantly more common among PTB than term.

CONCLUSION:
Preterm deliveries were associated with significantly higher rates of postpartum hemorrhagic CMM than those who delivered at term. Interventional trials are needed to decrease the hemorrhagic morbidity with PTB.
Evaluation of the Effect of Water-Based Lubricants on the Vaginal Microbiome of Premenopausal and Postmenopausal Women [ID: 1376703]
Authors: Krychman Michael , Hood Sarah , Palacios Santiago , Soe Jin 
Published: May 2023

INTRODUCTION:
Over-the-counter personal lubricants are available to relieve intimate discomfort associated with vaginal dryness. However, little is known about how personal lubricants may affect the vulvovaginal microbiome.

METHODS:
The present study recruited 50 premenopausal and postmenopausal women with mild-to-moderate vaginal dryness and dyspareunia. Participants were randomized to one of five lubricant treatment groups (of ranging osmolality and pH), stratified to account for menopausal status, and instructed to use their assigned lubricant during vaginal intercourse at least once a week over a 4-week period. A total of four vaginal swabs were sampled per participant pre (“baseline”)- and post (“2 hours,” “24 hours,” and “4 weeks”)-lubricant application to assess bacterial and fungal microbiome diversity via 16S (V3-V4) and ITS1 rRNA sequencing, respectively. The 301x2 paired-end reads were preprocessed to remove nonbiological and poor-quality reads using the dada2 package in RStudio. Cleaned reads were converted into Amplicon Sequence Variants (ASV) and classified using the SILVA rRNA gene database for bacteria, and the UNITE database for fungi. ASV counts were normalized to relative abundance as a function of total number of ASV per sample.

RESULTS:
Nonparametric ordination methods and multivariate analysis of variance showed that repeated application of all lubricants tested, did not significantly alter the vaginal microbiome for up to 4 weeks after product application. Microbiome diversity and relative abundance differed significantly between premenopausal and postmenopausal women but remained unchanged before and after lubricant application.

CONCLUSION:
Overall, lubricant use was associated with maintenance of the vaginal microbiome, regardless of the participant's menopausal status.
A 20-Year Analysis Assessing the Competitiveness of Obstetrics and Gynecology Residency Programs and Medical School Applicants [ID: 1365966]
Authors: Michelotti Ali , Schenken Claire , Schenken Robert , Stansbury Nicholas , Treffalls Rebecca 
Published: May 2023

INTRODUCTION:
The competitiveness of obstetrics and gynecology residency programs in the last two decades is not well described in the literature. As such, we aimed to assess the change in competitiveness of obstetrics and gynecology programs over a 20-year period using a normalized competitive index (NCI).

METHODS:
Obstetrics and gynecology match data was obtained from the National Resident Matching Program (NRMP) (2003–2022). Applicant metrics (USMLE scores, research output and experiences, and work and volunteer experiences) were obtained from the NRMP and the Association of American Medical Colleges (AAMC) (2007–2021). The competitive index (CI) was assessed using the average number of programs ranked per applicant divided by match rate each year. The NCI was normalized by dividing the yearly CI by averaged CI over 20 years. Data were analyzed using univariate analysis and linear regression.

RESULTS:
When comparing the two decades (2003–2012 versus 2013–2022), applicants (1,539±77 versus 1,902±46, P<.001), positions (1,173±10 versus 1,345±31, P<.001), and number of programs ranked per applicant (13±0.04 versus 15±0.02, P<.001) have increased. While the match rate did not significantly change from 2003 to 2022 (76±3 versus 71±1, P=.14), the NCI increased (R2=0.92, P<.001), indicating increased competitiveness. Applicant metrics increased over time, including step 1 scores (212±3 versus 229±1, P=.01), step 2 scores (232± 4 versus 245±1, P=.002), and research output (2.5±0.4 versus 5.0±0.3, P=.002).

CONCLUSION:
Despite an increase in obstetrics and gynecology applicants and applicant metrics, match rates remain unchanged. However, the competitiveness of programs has significantly increased, as demonstrated by the NCI. The NCI may be a useful metric for applicants to determine competitiveness in comparison to match rates.
Efficacy of immune checkpoint inhibition in metastatic uveal melanoma: a systematic review and meta-analysis
Authors: Pham James P. , On Lawrence , Ardolino Luke , Hurwitz Joshua , Salaun Helene , Sim Hao-Wen , Joshua Anthony M. 
Published: May 2023

Introduction
Metastatic uveal melanoma (mUM) has historically been associated with short survival and limited effective treatments. Immune checkpoint inhibitors (ICIs) have been trialed in mUM; however, robust conclusions regarding their efficacy are difficult to draw given small study sizes and heterogeneous patient populations.

Methods
Five databases were searched using a combination of ‘ICI’ and ‘mUM’ headings, and data on patient demographics, objective response rate (ORR), overall survival (OS) and progression-free survival
(PFS) were extracted. Pooled ORR was calculated using a random effects model and the inverse variance method. Available Kaplan–Meier OS and PFS curves were used to construct summary OS and PFS plots, from which median values were derived.

Results
Pooled ORR was 9.2% overall (95% CI 7.2–11.8) [4.1% for anti-CTLA4 (95% CI 2.1–7.7), 7.1% for anti-PD(L)1 (95% CI 4.5–10.9) and 13.5% for anti-CTLA4 plus anti-PD1 (95% CI 10.0–18.0)]. Median OS was 11.5 months overall (95% CI 9.5–13.8) [8.0 months for anti-CTLA4 (95% CI 5.5–9.9), 11.7 months for anti-PD(L)1 (95% CI 9.0–14.0) and 16.0 months for ipilimumab plus anti-PD1 (95% CI 11.5–17.7) (P <0.001)]. Median PFS was 3.0 months overall (95% CI 2.9–3.1).

Discussion
ICIs have limited efficacy in mUM and a recommendation for their use must consider the balance of benefit and risk for individual patients if no other options are available. Further biomarker profiling studies may be helpful in assessing which patients will benefit from ICIs, in particular the addition of ipilimumab to anti-PD1 therapy.
Minority Student Perspectives of Barriers, Supports, and Christian Virtues in an Undergraduate Christian Nursing Program
Authors: Kunnen Katherine E. E. , Miller Katherine , Oh Yehyeon 
Published: May 2023

ABSTRACT:
Diversity and inclusion are critical priorities in nursing education programs. Literature has focused on minority student experiences of barriers and supports—but not through a Christian worldview. This qualitative study using a phenomenological-hermenuetic approach gave voice to the experiences of 15 self-identified minority student graduates from a Christian baccalaureate nursing program. Data analysis revealed opportunities for growth in providing a supportive climate within the program and how Christian virtues of hospitality, humility, and reconciliation can be employed to achieve this goal.
Stability of 10 Beta-Lactam Antibiotics in Human Plasma at Different Storage Conditions
Authors: Bahmany Soma , Ewoldt Tim M.J. , Abdulla Alan , Koch Birgit C.P. 
Published: May 2023

Background:
Recently, several studies have assessed the effects of therapeutic drug monitoring of frequently prescribed beta-lactam antibiotics, for which they were quantified in human plasma samples. Beta-lactams are considered unstable, leading to extra challenges in quantification. Therefore, to ensure sample stability and minimize sample degradation before analysis, stability studies are crucial. This study investigated the stability of 10 frequently used beta-lactam antibiotics in human plasma at relevant storage conditions for clinical use.

Methods:
Amoxicillin, benzylpenicillin, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, flucloxacillin, imipenem, meropenem, and piperacillin were analyzed using ultraperformance convergence chromatography tandem mass spectrometry and liquid chromatography tandem mass spectrometry. Their short-term and long-term stabilities were investigated by measuring quality control samples at low and high concentrations against freshly prepared calibration standards. Measured concentrations at each time point were compared with the concentrations at T = 0. Antibiotics were considered stable if recovery results were between 85% and 115%.

Results:
Short-term stability results indicated ceftriaxone, cefuroxime, and meropenem to be stable up to 24 hours at room temperature. All evaluated antibiotics, except imipenem, were stable on ice in a cool box for 24 hours. Amoxicillin, benzylpenicillin, and piperacillin were stable for 24 hours at 4–6°C. Cefotaxime, ceftazidime, cefuroxime, and meropenem were stable at 4–6°C up to 72 hours. Ceftriaxone and flucloxacillin were stable for 1 week at 4–6°C. Long-term stability results showed that all antibiotics were stable up to 1 year at −80°C, except imipenem and piperacillin, which were stable for 6 months at −80°C.

Conclusions:
Plasma samples for amoxicillin, benzylpenicillin, cefotaxime, ceftazidime, flucloxacillin, and piperacillin may be stored for a maximum of 24 hours in a cool box. Refrigeration is suitable for plasma samples of amoxicillin, benzylpenicillin, meropenem, and piperacillin for up to 24 hours and cefotaxime, ceftriaxone, ceftazidime and cefuroxime for 72 hours. Plasma samples for imipenem should be frozen directly at −80°C. For long-term storage, plasma samples can be stored at −80°C for a maximum of 6 months for imipenem and piperacillin and 12 months for all other evaluated antibiotics.
Long-Term Corneal Refractive Power Changes Two Decades After Radial Keratotomy With Microperforations
Authors: Iwamoto Yuri , Koh Shizuka , Inoue Ryota , Soma Takeshi , Oie Yoshinori , Maeda Naoyuki , Nishida Kohji 
Published: May 2023

Abstract:
We retrospectively examined corneal refractive power in three patients who had been followed up for more than 20 years after radial keratotomy (RK) with microperforations (MPs). All patients underwent RK in both eyes and were referred to our clinic because of postoperative decreased vision. MP was observed in five of the six eyes at the initial visit. The corneal refractive power of the anterior and posterior surfaces of the 6-mm-diameter cornea was examined using Fourier analysis based on corneal shape analysis using anterior segment optical coherence tomography. The spherical components decreased in all three cases. The asymmetry and higher-order irregularity components and fluctuations in corneal refractive power were markedly greater in the two cases with MP in both eyes. Fluctuations in corneal refractive power were observed at more than 20 years after RK with MP. Therefore, careful observation is necessary, even after a long-term postoperative follow-up period.
Pediatric Laryngeal Coccidioidomycosis: A Case Series in an Endemic Region
Authors: Naeem Fouzia , McCarty James , Rowe Mark R , Davis Amy W. , Tablizo Mary Anne , Hady Kelly Kathleen , Vijayan Vini 
Published: May 2023

Background:
Laryngeal coccidioidomycosis is a rare but life-threatening manifestation of coccidioidomycosis. Data in children are sparse and limited to case reports. We conducted this study to review the characteristics of laryngeal coccidioidomycosis in children.

Methods:
We performed a retrospective review of patients ≤21 years of age with laryngeal coccidioidomycosis who were treated from January 2010 to December 2017. We collected demographic data, clinical and laboratory studies and patient outcomes.

Results:
Five cases of pediatric laryngeal coccidioidomycosis were reviewed. All children were Hispanic and 3 were female. The median age was 1.8 years and the median duration of symptoms before diagnosis was 24 days. The most common symptoms included fever (100%), stridor (60%), cough (100%) and vocal changes (40%). Airway obstruction requiring tracheostomy and/or intubation for airway management was present in 80%. The most frequent location of lesions was the subglottic area. Coccidioidomycosis complement fixation titers were frequently low and culture/histopathology of laryngeal tissue was necessary to make a definitive diagnosis. All patients required surgical debridement and were treated with antifungal agents. None of the patients had recurrence during the follow-up period.

Conclusions:
This study suggests that laryngeal coccidioidomycosis in children presents with refractory stridor or dysphonia and severe airway obstruction. Favorable outcomes can be achieved with a comprehensive diagnostic work-up and aggressive surgical and medical management. With the rise in cases of coccidioidomycosis, physicians should have a heightened awareness regarding the possibility of laryngeal coccidioidomycosis when encountering children who have visited or reside in endemic areas with stridor or dysphonia.
Return to Sport After Operative Fixation of Midshaft Clavicle Fractures in Professional Jockeys
Authors: Fahy Stephen , Ó Doinn Tiarnán , Peters Nina , Pugh Jennifer , Fox Ciara , Kenny Patrick 
Published: May 2023

Objective:
Clavicle fractures are the most commonly observed fracture sustained in professional horse racing. This study is the first to report on time lost from injury and functional recovery after surgical fixation of midshaft clavicle fractures in professional jockeys.

Design:
Retrospective cohort study.

Setting:
Professional Horse Racing Ireland; Patients (or Participants): Professional Jockeys in Ireland with midshaft clavicular fractures managed with Open Reduction Internal Fixation. Interventions (or Assessment of Risk Factors or Independent Variables): Operative fixation with Open Reduction Internal Fixation.

Main Outcome Measures:
Assessment of postoperative Quick Disabilities of Arm Shoulder and Hand (QuickDASH) score and Patient Reported Outcome Measures assessing for associated complications and time to return to competition among professional athletes.

Results:
Between 07/06/2013 and 29/09/2022, 22 patients met the predetermined inclusion criteria. Ninety-five percent of patients returned to competition at their preinjury level, one patient failed to return to competition for reasons unrelated to his injury. The mean time for return to competition was 68.14 days postinjury. Few complications were reported, whereas functional recovery was excellent across the cohort, with an average QuickDASH score of 0.85 (0.0-2.3).

Conclusions:
Plate fixation of midshaft clavicle fractures is effective and safe in the setting of professional horse racing. Ninety-five percent of patients can be expected to return within 14 weeks of injury. Patients returning at less than 7 weeks after injury had no adverse outcomes, suggesting a potential role for more aggressive rehabilitation postoperatively and ultimately, a quicker return to competition.