bluuebunny/crossref_metadata_2025_split huggingface dataset:
Butler-Sloss v The Charity Commission: ESG investment guidance in need of elaboration
Authors: Broadway Luke 
Published: October 2022

Abstract
In Butler-Sloss v The Charity Commission the High Court granted the trustees of environmental protection charities permission to enact a policy that excluded investments incompatible with the Paris Climate Agreement. Though a sound conclusion, the court’s reasoning, when taken alongside the policy proposed by the claimant charities, generates investment guidance that is unsuited for practical implementation. This article commences with an analysis of the judgment’s approach to risk and returns. Although the court’s position on reputation risk is commendable, the dicta focusing on portfolio risk, as well as the lack of distinction between income and capital returns, introduce serious liquidity threats. These difficulties undermine the institutional relevance of the charitable trust. In its second part the article advances to explore the court’s overextension of the powers of trustees to invest on moral grounds. At best this extension conflicts with a trustee’s duty to diversify their fund’s portfolio, and at worst it risks allowing trustees to completely bypass financial considerations. It is concluded that more elaborate ESG investment guidance is needed.
Ambulatory anesthesia and discharge: an update around guidelines and trends
Authors: Rohi Ayda , Olofsson Maria E.T. , Jakobsson Jan G. 
Published: October 2022

Purpose of review
Provide an oversight of recent changes in same-day discharge (SDD) of patient following surgery/anesthesia.

Recent findings
Enhanced recovery after surgery pathways in combination with less invasive surgical techniques have dramatically changed perioperative care. Preparing and optimizing patients preoperatively, minimizing surgical trauma, using fast-acting anesthetics as well as multimodal opioid-sparing analgesia regime and liberal prophylaxis against postoperative nausea and vomiting are basic cornerstones. The scope being to maintain physiology and minimize the impact on homeostasis and subsequently hasten and improve recovery.

Summary
The increasing adoption of enhanced protocols, including the entire perioperative care bundle, in combination with increased use of minimally invasive surgical techniques have shortened hospital stay. More intermediate procedures are today transferred to ambulatory pathways; SDD or overnight stay only. The traditional scores for assessing discharge eligibility are however still valid. Stable vital signs, awake and oriented, able to ambulate with acceptable pain, and postoperative nausea and vomiting are always needed. Drinking and voiding must be acknowledged but mandatory. Escort and someone at home the first night following surgery are strongly recommended. Explicit information around postoperative care and how to contact healthcare in case of need, as well as a follow-up call day after surgery, are likewise of importance. Mobile apps and remote monitoring are techniques increasingly used to improve postoperative follow-up.
The Relationship Between Sleep Traits and Tinnitus in UK Biobank: A Population-Based Cohort Study
Authors: Peng Jiajia , Dong Yijun , Luo Yaxin , Qiu Ke , Cheng Danni , Rao Yufang , Song Yao , Pang Wendu , Mu Xiaosong , Hu Chunhong , Chen Hongchang , Zhang Wei , Xu Wei , Ren Jianjun , Zhao Yu 
Published: October 2022

Objectives:
Understanding the association between sleep traits and tinnitus could help prevent and provide appropriate interventions against tinnitus. Therefore, this study aimed to assess the relationship between different sleep patterns and tinnitus.

Design:
A cross-sectional analysis using baseline data (2006–2010, n = 168,064) by logistic regressions was conducted to evaluate the association between sleep traits (including the overall health sleep score and five sleep behaviors) and the occurrence (yes/no), frequency (constant/transient), and severity (upsetting/not upsetting) of tinnitus. Further, a prospective analysis of participants without tinnitus at baseline (n = 9581) was performed, who had been followed-up for 7 years (2012–2019), to assess the association between new-onset tinnitus and sleep characteristics. Moreover, a subgroup analysis was also carried out to estimate the differences in sex by dividing the participants into male and female groups. A sensitivity analysis was also conducted by excluding ear-related diseases to avoid their confounding effects on tinnitus (n = 102,159).

Results:
In the cross-sectional analysis, participants with “current tinnitus” (OR: 1.13, 95% CI: 1.04–1.22, p = 0.004) had a higher risk of having a poor overall healthy sleep score and unhealthy sleep behaviors such as short sleep durations (OR: 1.09, 95% CI: 1.04–1.14, p < 0.001), late chronotypes (OR: 1.09, 95% CI: 1.05–1.13, p < 0.001), and sleeplessness (OR: 1.16, 95% CI: 1.11–1.22, p < 0.001) than those participants who “did not have current tinnitus.” However, this trend was not obvious between “constant tinnitus” and “transient tinnitus.” When considering the severity of tinnitus, the risk of “upsetting tinnitus” was obviously higher if participants had lower overall healthy sleep scores (OR: 1.31, 95% CI: 1.13–1.53, p < 0.001). Additionally, short sleep duration (OR: 1.22, 95% CI: 1.12–1.33, p < 0.001), late chronotypes (OR: 1.13, 95% CI: 1.04–1.22, p = 0.003), and sleeplessness (OR: 1.43, 95% CI: 1.29–1.59, p < 0.001) showed positive correlations with “upsetting tinnitus.” In the prospective analysis, sleeplessness presented a consistently significant association with “upsetting tinnitus” (RR: 2.28, p = 0.001). Consistent results were observed in the sex subgroup analysis, where a much more pronounced trend was identified in females compared with the males. The results of the sensitivity analysis were consistent with those of the cross-sectional and prospective analyses.

Conclusions:
Different types of sleep disturbance may be associated with the occurrence and severity of tinnitus; therefore, precise interventions for different types of sleep disturbance, particularly sleeplessness, may help in the prevention and treatment of tinnitus.
Analysis of Factors Contributing to Perioperative Mohs Micrographic Surgery Anxiety: Patient Survey Study at an Academic Center
Authors: Kokoska Ryan E. , Szeto Mindy D. , Steadman Laryn , Au Jeremiah H. , Somani Ally-Khan 
Published: October 2022

BACKGROUND
High perioperative patient anxiety is predictive of worse postoperative pain and quality of life. Several Mohs micrographic surgery (MMS) patient characteristics influence anxiety; however, the contributions of certain factors remain uncertain.

OBJECTIVE
Investigate factors influencing perioperative MMS patient anxiety, especially those with debated impact or unclear data.

METHODS
The authors surveyed 145 adult patients receiving MMS performed by a single MMS surgeon from 2018 to 2020. Patients self-reported demographics, history, and 10-point visual analog scale anxiety assessments at multiple stages. Health care provider (HCP)–perceived anxiety assessments were queried. A stepwise multiple regression modeling approach was used to explore potential factors.

RESULTS
Younger age, female sex, and a self-reported history of anxiety confirmed by prior HCP diagnosis were significant predictors of pre-MMS anxiety. Postoperative anxiety increased with more layers removed and higher pre-MMS anxiety. HCP–perceived patient anxiety increased with younger patient age, more layers removed, prior skin cancer removal, and HCP-perceived pre-MMS patient anxiety.

CONCLUSION
Anxiety-reducing interventions should target young female patients with a history of HCP-diagnosed anxiety, and patients with more layers removed. Prior skin cancer removal is associated with increased HCP-perceived intraoperative patient anxiety; however, it is not significant for patient-reported anxiety. Pre-MMS consultation may not be effective for anxiety reduction.
Sebaceous Carcinoma of the Face Treated With Mohs Micrographic Surgery
Authors: Meer Elana , Nguyen Brian , Luna Gabriela L. , Kim Diana , Bautista Sana , McGeehan Brendan , Giordano Cerrene , Etzkorn Jeremy , Miller Christopher , Briceño César A. 
Published: October 2022

BACKGROUND
Mohs micrographic surgery (MMS) for sebaceous carcinoma (SC) may reduce local recurrence rates, but published case series have small cohorts and limited follow-up. Mohs micrographic surgery is particularly suitable for sensitive functional and cosmetic locations, such as the face, because it facilitates tissue conservation using complete peripheral and deep margin assessment before reconstruction. Coordinated care between Mohs and oculoplastic surgeons has not been described.

OBJECTIVE
To assess rates of local recurrence and metastasis after MMS of facial SC and to describe coordinated care between Mohs and oculoplastic surgeons.

MATERIALS AND METHODS
Retrospective review identified facial SC cases treated with MMS at a single institution from January 2005 to August 2020. Tumor characteristics and outcomes were recorded. Descriptive and predictive analyses were performed.

RESULTS
Forty-nine cases were reviewed with a mean follow-up of 51 months. The most common sites were periorbital, infraorbital cheek, and nasal ala. No patients experienced regional recurrence after MMS. One patient with Muir–Torre syndrome developed metastatic recurrence (at 82.9 months). All patients underwent 2-stage reconstruction with dermatology-performed MMS and oculoplastic reconstruction.

CONCLUSION
Collaboration between Mohs and oculoplastic surgeons with a tissue-sparing approach of MMS can reduce recurrence and optimize cosmesis and function for central facial SC.
Rate and Characteristics of Incompletely Excised Cutaneous Squamous Cell Carcinoma: A Dermatological Daily Practice Multicenter Prospective Cohort Study
Authors: van Lee Charlotte B. , Kouloubis Nina , Wakkee Marlies , Kelleners-Smeets Nicole W.J. , Nellen Ruud G.L. , van Rengen Annik , de Vijlder Hanke C. , Wijne Leon C.C. , Nijsten Tamar , van den Bos Renate R. 
Published: October 2022

BACKGROUND
Incomplete excision of squamous cell carcinoma (cSCC) is associated with an increased risk of recurrence, metastasis, and mortality.

OBJECTIVE
To determine the rate and characteristics of incompletely excised cSCC in a dermatological daily practice setting.

METHODS
Prospective study of all patients who gave informed consent, with a cSCC treated with standard excision (SE) at 1 of 6 Departments of Dermatology in the Netherlands between 2015 and 2017. Pathological reports were screened to detect all incompletely excised cSCCs.

RESULTS
A total of 592 patients with 679 cSCCs were included, whereby most cases were low risk cSCC (89%). The rate of incompletely excised cSCC was 4% (n = 26), and the majority were high-risk cSCCs of which 24 invaded the deep excision margin.

CONCLUSION
This prospective study showed that in a dermatological setting, the risk of an incompletely excised cSCC is low (4%) for a cohort that was dominated by low-risk cSCCs. Most incompletely excised cSCCs were of high risk, and incompleteness was almost always at the deep margins. These results suggest that for high-risk cSCC, one should pay attention especially to the deep margin when performing SE, and/or microscopic surgery should be considered.
Perimenopause meets life: observations from the Women Living Better Survey
Authors: Woods Nancy Fugate , Coslov Nina , Richardson Marcie K. 
Published: October 2022

Abstract

Objective
The purpose of these analyses was to test a predictive quantitative model relating personal characteristics, reproductive aging stages, health behaviors, roles, stressors, and satisfaction with life roles to bothersome symptoms experienced during the late reproductive stage and the menopausal transition (MT).

Methods
Participants (N = 2,406) aged 35 to 55 years completed the Women Living Better Survey online between March to August 2020, and 1,529 met the inclusion criteria and provided menstrual cycle data for staging reproductive aging. They were recruited from the Women Living Better newsletter and from other online groups of midlife women. Hierarchical regression analysis using a two-stage model tested the effect of several factors on each of five bothersome symptom groups: brain fog, volatile mood, fatigue/pain, vasomotor/sleep disruption, and anxiety/vigilance symptoms. In stage I, personal characteristics, reproductive aging stage, and health behaviors were examined, and in stage II roles (ie, caregiver, partner, employment-related), satisfaction with life roles and stressors associated with roles were added.

Results
More bothersome brain fog symptoms were associated with less education, MT (vs late reproductive stage), low satisfaction with life roles, and greater health-related and overcommitment stress (all P < 0.005). More bothersome volatile mood symptoms were associated with health-related, partner relationship, and other relationship stress. More bothersome fatigue/pain symptoms were associated with less education and greater difficulty paying for basics and health-related and other relationship stress. Vasomotor/sleep-onset symptoms were associated with less education, MT, and health-related and work stress. More bothersome anxiety/vigilance symptoms were associated with less education, more difficulty paying for basics, and health and work stress.

Conclusions
Recognizing that midlife stress comes from many role- and relationship-related sources and that several of these stressors are associated with greater symptom bother supports the importance of proactive identification and management of sources of stress.
The effect of Mitomycin-C in neoadjuvant concurrent chemoradiotherapy for rectal cancer
Authors: Wang Ling-Wei , Liu Yu-Shih , Jiang Jeng-Kai 
Published: October 2022

Background:
Neoadjuvant concurrent chemoradiotherapy (nCCRT) followed by total mesorectal excision has become the standard of care for advanced rectal cancer, but the most effective regimen of chemotherapeutic agents has not yet been determined. The purpose of this study is to determine the effect of Mitomycin-C (MMC) in nCCRT for rectal cancer.

Methods:
From 2000 to 2017, patients with rectal adenocarcinoma who received nCCRT followed by radical surgery were enrolled in our study. The patients were retrospectively separated into two groups according to nCCRT regimens (with or without MMC). Other factors related to cancer down-staging after nCCRT, disease-free survival (DFS) and overall survival (OS) were analyzed.

Results:
One hundred ninety-five patients received radiotherapy (RT) + MMC + oral tegafur-uracil (UFUR), and 191 patients received RT + UFUR without MMC as neoadjuvant CCRT. Adding MMC might increase the down-staging rate (odds ratio [OR] = 1.520, p = 0.058), and down-staging had significant effect to improve OS (OR = 1.726, p = 0.002) and DFS (OR = 2.185, p < 0.001). The OS and DFS were improved in patients who received MMC, although this result did not reach a statistically significant difference. There was a higher incidence of low-grade toxicities in the MMC group, especially neutropenia, genitourinary side effects, and dermatological side effects (p < 0.001).

Conclusion:
Adding MMC to the regimen of nCCRT for rectal adenocarcinoma is shown to increase tumor down-staging rate and improve disease-free and OS, although these benefits come at the cost of increased low-grade toxicities. Prospective randomized studies are needed to explore the role of MMC in nCCRT for rectal cancer.
A Critical Appraisal of Evidence on the Efficacy and Safety of Serotonergic Psychedelic Drugs as Emerging Antidepressants
Authors: Ledwos Nicole , Rosenblat Joshua D. , Blumberger Daniel M. , Castle David J. , McIntyre Roger S. , Mulsant Benoit H. , Husain M. Ishrat 
Published: October 2022

Abstract

Purpose/Background
There has been resurgence of interest in the therapeutic use of serotonergic (“classic”) psychedelics in major depressive disorder (MDD) and end-of-life distress. This commentary offers a critical appraisal of current evidence for antidepressant effects of classic psychedelics from contemporary clinical trials and highlights pitfalls that should be addressed before clinical translation.

Methods/Procedures
A narrative review was conducted to identify clinical trials of serotonergic psychedelics for the treatment of MDD and end-of-life distress. Trials published between January 1990 and May 2022 were identified on PubMed using combinations of search terms.

Findings/Results
Psilocybin, lysergic acid diethylamide, and ayahuasca have clinical trials to evaluate antidepressant effects. Two studies showed preliminary positive effects of single-dose ayahuasca for treatment-resistant depression. Similar results were seen in lysergic acid diethylamide for end-of-life distress. Small randomized clinical trials (RCTs) of psilocybin combined with psychotherapy showed superiority to waitlist controls and comparable efficacy and safety to an active comparator in MDD, with additional RCTs showing efficacy in end-of-life distress. Adverse events associated with psychedelics were reported as mild and transient. Small homogenous samples, expectancy bias, functional unblinding, and lack of consensus and standardization of psychotherapy are major limitations of all studies.

Implications/Conclusions
Given the methodological limitations of published RCTs, the evidence supporting the efficacy and safety of serotonergic psychedelics for depression is currently of low level. Future research should assess the role of expectancy and psychedelic effects in moderating and mediating treatment response. Innovative trial designs are needed to overcome functional unblinding. For now, psychedelics should remain experimental interventions used within clinical trials.
The Role of HIV Partner Services in the Modern Biomedical HIV Prevention Era: A Network Modeling Study
Authors: Jenness Samuel M. , Le Guillou Adrien , Lyles Cynthia , Bernstein Kyle T. , Krupinsky Kathryn , Enns Eva A. , Sullivan Patrick S. , Delaney Kevin P. 
Published: October 2022

ABSTRACT

Background
HIV partner services can accelerate the use of antiretroviral-based HIV prevention tools (ART and PrEP), but its population impact on long-term HIV incidence reduction is challenging to quantify with traditional PS metrics of partner identified or HIV-screened. Understanding the role of partner services within the portfolio of HIV prevention interventions, including using it to efficiently deliver antiretrovirals, is needed to achieve HIV prevention targets.

Methods
We used a stochastic network model of HIV/STI transmission for men who have sex with men (MSM), calibrated to surveillance-based estimates in the Atlanta area, a jurisdiction with high HIV burden and suboptimal partner services uptake. Model scenarios varied successful delivery of partner services cascade steps (newly diagnosed “index” patient and partner identification, partner HIV screening, and linkage or reengagement of partners in PrEP or ART care) individually and jointly.

Results
At current levels observed in Atlanta, removal of HIV partner services had minimal impact on 10-year cumulative HIV incidence, as did improving a single partner services step while holding the others constant. These changes did not sufficiently impact overall PrEP or ART coverage to reduce HIV transmission. If all index patients and partners were identified, maximizing partner HIV screening, partner PrEP provision, partner ART linkage, and partner ART reengagement would avert 6%, 11%, 5%, and 18% of infections, respectively. Realistic improvements in partner identification and service delivery were estimated to avert 2–8% of infections, depending on the combination of improvements.

Conclusions
Achieving optimal HIV prevention with partner services depends on pairing improvements in index patient and partner identification with maximal delivery of HIV screening, ART, and PrEP to partners if indicated. Improving the identification steps without improvement to antiretroviral service delivery steps, or vice versa, is projected to result in negligible population HIV prevention benefit.
Presumptive and Follow-Up Treatment Associated With Gonorrhea and Chlamydia Testing Episodes in Sexually Transmitted Disease Clinics: Impact of Changing Treatment Guidelines for Gonorrhea, Sexually Transmitted Disease Surveillance Network, 2015–2018
Authors: Llata Eloisa , Braxton Jim , Asbel Lenore , Huspeni Dawn , Tourdot Laura , Kerani Roxanne P. , Cohen Stephanie , Kohn Robert , Schumacher Christina , Toevs Kim , Torrone Elizabeth , Kreisel Kristen 
Published: October 2022

Background
Centers for Disease Control and Prevention recommendation for treatment of uncomplicated gonorrhea (NG) were revised in December 2020 and include ceftriaxone monotherapy when chlamydial infection was excluded. We evaluated the impact of these revised treatment recommendations using data from a network of sexually transmitted disease (STD) clinics before the change in guidelines.

Methods
We performed a cross-sectional analysis from 8 STD clinics participating in the STD Surveillance Network from January 2015 to June 2018 assessing NG/chlamydia (CT) testing episodes, nucleic acid amplification test results, CT only and NG/CT treatment records, and timing of treatment. We describe the frequency of NG and CT treatment practices and what proportion of patients treated would not have had to receive an antichlamydial agent.

Results
Of 190,589 episodes that occurred during the study period, 67,895 (35.6%) episodes were associated with a treatment record consistent with NG or chlamydia (CT only [n = 37,530] or NG/CT [n = 30,365]), most (~86%) were prescribed on the same-day as initial testing. Of the 67,895 episodes with corresponding treatment record(s), 42.1% were positive for either NG or CT compared with 3.7% were positive for NG or CT for those not associated with treatment records (n = 122,694 episodes). Among 30,365 episodes associated with NG/CT treatment records, monotherapy would only have been indicated for 10.1% (3081/30,365) of the episodes as they were treated on follow-up and were NG positive and CT negative.

Conclusions
Treatment was prescribed in one-third of NG/CT testing episodes, with the majority provided same day. Despite changes in NG treatment guidelines to ceftriaxone monotherapy, majority of patients would continue to receive an antichlamydia agent when treated for NG in these settings.