bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depot Medroxyprogesterone Acetate Use and the Development and Progression of Uterine Leiomyoma
Authors: Harmon Quaker E. , Patchel Stacy A. , Zhao Shanshan , Umbach David M. , Cooper Tracy E. , Baird Donna D. 
Published: May 2022

OBJECTIVE:
Investigate the association between use of depot medroxyprogesterone acetate (DMPA) (an injectable progestin-only contraceptive) and leiomyoma development.

METHODS:
We conducted a cohort study in the Detroit, Michigan, area that involved four clinic visits at 20-month intervals over 5 years (2010–2018) and used a standardized ultrasonography protocol to prospectively measure leiomyomas 0.5 cm or more in diameter. Participants were 1,693 self-identified Black women aged 23–35 years with no prior leiomyoma diagnosis and no hysterectomy. For this substudy, years since last use of DMPA was ascertained from questionnaire data at every visit. Leiomyoma incidence was defined as the first visit with an observed leiomyoma among women who were leiomyoma-free at enrollment. Depot medroxyprogesterone acetate associations were examined with Cox models. Leiomyoma growth was calculated as the change in log-volume for leiomyomas matched at successive visits and was modeled using linear mixed models accounting for clustered data. Leiomyoma loss, defined as a reduction in leiomyoma number in successive visits, was modeled using Poisson regression. All models used time-varying exposure and covariates.

RESULTS:
Of participants with at least one follow-up visit (N=1,610), 42.9% had ever used DMPA. Participants exposed to DMPA within the previous 2 years experienced reduced leiomyoma development during the subsequent observation interval compared with never users, including lower leiomyoma incidence (5.2% vs 10.7%), adjusted hazard ratio 0.6 (95% CI 0.4–1.0), 42.0% lower leiomyoma growth (95% CI −51.4 to −30.7) and 60% greater leiomyoma loss (adjusted risk ratio 1.6, 95% CI 1.1–2.2). Excess leiomyoma loss was also seen for those who used DMPA 2–4 years before the visit compared with never users, 2.1-fold increase (95% CI 1.4–3.1).

CONCLUSION:
Recent use of DMPA was associated with reduced leiomyoma development and increased leiomyoma loss. Such changes in early leiomyoma development in young women could delay symptom onset and reduce the need for invasive treatment.
Preoperative leukocytosis and postoperative outcomes in geriatric hip fracture patients: a retrospective cohort study
Authors: Tang Stephen Pui-Kit , Moy Lok-Tin , Wan Keith Hay-Man , Wong Hing-Cheong , Wong Kevin Kwun-Hung , Wong Kam-Kwong 
Published: May 2022

Background:
A growing amount of evidence has suggested an association between preoperative leukocytosis and postoperative complications across a variety of surgeries. The aim of this study was to evaluate the impact of preoperative leukocytosis on the prognosis of geriatric hip-fracture patients after surgery.

Methods:
This retrospective cohort included 1007 patients age 65 yr and older who underwent surgery for hip fracture between January 2016 and December 2019 at a district general hospital. Outcomes measured included surgical-site infection and 30-day and 1-year mortality. A multivariate logistic regression model was constructed in order to test whether leukocytosis was an independent predictor of morbidity and mortality in hip-fracture patients.

Results:
After adjustment for covariates, leukocytosis was not found to be a significant independent predictor of poor outcome after geriatric hip-fracture surgery. Delay of surgery longer than 48 hr and dementia were found to be independent variables associated with increased risk of surgical-site infection. The predictors of 30-day mortality were male gender and the use of anticoagulant or antiaggregant medications, whereas male gender, delay of surgery more than 48 hr, dementia and hypoalbuminemia were associated with increased 1-year mortality.

Conclusions:
Preoperative leukocytosis was not associated with adverse postoperative outcome after geriatric hip-fracture surgery. The more reliable variables for prediction of surgical outcome in geriatric hip-fracture patients were delay in surgery, gender, hypoalbuminemia, dementia, and use of anticoagulant or antiaggregant medications.

Level of Evidence:
Level III.
Application of fresh frozen plasma transfusion in the management of excessive warfarin-associated anticoagulation
Authors: Luo Yuanyuan , Ma Chunya , Yu Yang 
Published: May 2022

Abstract
Warfarin is a commonly used oral anticoagulant. Patients with artificial valve replacement, atrial fibrillation, pulmonary embolism, deep vein thrombosis, and other diseases require long-term anticoagulant oral treatment with warfarin. As warfarin exhibits prompt action with long maintenance time, it has become a key drug for the treatment of patients at risk of developing thrombosis or thromboembolism. Warfarin is a bican coumarin anticoagulant, that exhibits competitive action against vitamin K as its mechanism of action, thereby inhibiting the synthesis of coagulation factors—predominantly the vitamin K-dependent coagulation factors II, VII, IX, and X—in hepatocytes. Long-term warfarin is known to significantly increase the risk of organ bleeding in some patients, while some patients may need to reverse the anticoagulation effect. For instance, patients scheduled for emergency or invasive surgery may require rapid anticoagulation reversal. During such medical circumstances, fresh frozen plasma (FFP) is clinically used for the reversal of excess warfarin-associated anticoagulation, as it contains all the coagulation factors that can alleviate the abnormal blood anticoagulation status in such patients. Accordingly, this article aims to perform an in-depth review of relevant literature on the reversal of warfarin with FFP, and insightful deliberation of the application and efficacy of this clinical intervention.
Risk factors associated with hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation
Authors: Shen Biao , Ma Yueshen , Zhang Haixiao , Wang Mingyang , Liu Jia , Cao Jiaxin , Guo Wenwen , Feng Dan , Yang Donglin , Zhang Rongli , Chen Xin , Ma Qiaoling , Zhai Weihua , Feng Sizhou , Han Mingzhe , Pang Aiming , Jiang Erlie 
Published: May 2022

Abstract
Hemorrhagic cystitis (HC) is a common complication of allogeneic hematopoietic stem cell transplantation (HSCT). The incidence is about 7% to 68%, and some patients have to suffer a long period of frequent, urgent, and painful urination, which brings great pain. This study aimed to analyze risk factors of HC and its effect on patient survival. We collected the medical records of 859 patients who underwent HSCT at our hospital between August 2016 and August 2020. Patients with and without HC were matched using propensity score matching at a 1:1 ratio based on sex, age, and diagnosis, and logistic regression analyses were used to identify factors associated with HC. We used Kaplan–Meier curves to analyze the survival rates of patients in the HC and non-HC groups. We also analyzed the relationship between BK viral load and the occurrence of HC using receiver operating characteristic curve (ROC) analysis. After propensity score matching, there were 131 patients each in the HC and non-HC groups. In the HC group, 89 patients (67.9%) had mild HC (stage II°) and 43 (32.1%) had severe HC (stage III–IV). The median interval between stem cell transplantation and HC development was 31 (3–244) days. Univariate analysis indicated that donor age, hematopoietic stem cell source, HLA, acute graft-versus-host disease, busulfan, anti-thymocyte globulin (ATG), total body irradiation, cytomegalovirus (CMV) (urine), and BK polyomavirus (BKV) (urine) were significantly associated with HC. ATG, CMV (urine), and BKV (urine) were independent risk factors for HC based on the multivariate analysis. The Kaplan–Meier survival analysis showed no significant difference between the HC and non-HC groups (P = .14). The 1- and 2-year survival rates in the HC group were 78.4% and 69.6%, respectively, and the corresponding rates in the non-HC group were 84.4% and 80.7%, respectively. ROC analysis indicated that a urine BKV load of 1 × 107 copies/mL was able to stratify the risk of HC. In conclusion, when the BKV load is >1 × 107, we need to be aware of the potential for the development of HC.
Critical Influenza and COVID-19—A Comparative Nationwide Case-Control Study
Authors: Larsson Emma , Eriksson Jesper , Eriksson Mikael , Oldner Anders 
Published: May 2022

IMPORTANCE:
Refined knowledge of risk factors for critical influenza and COVID-19 may lead to improved understanding of pathophysiology and better pandemic preparedness.

OBJECTIVES:
To compare risk-factor profiles of patients admitted to intensive care with critical influenza and COVID-19.

DESIGN, SETTING, AND PATIENTS:
A nationwide retrospective matched case-control study, including all adults admitted to an ICU in Sweden with influenza or COVID-19 between 2014 and September 2020 and a matched control population (ratio 1:5, patients:controls).

MEASUREMENTS AND MAIN RESULTS:
Admission to an ICU. The study included 1,873 influenza and 2,567 COVID-19 ICU patients, and 9,365 and 12,835 controls, respectively, matched on sex, age, and geographical region. Influenza patients were older and less likely male, and carried a larger burden of comorbidity and a higher Simplified Acute Physiology Score III score, whereas short-term mortalities were similar when compared to COVID-19 patients. The risk-factor profiles at ICU admission were largely comparable including socioeconomic, psychiatric, and several somatic variables. Hypertension was a strong risk factor in critical COVID-19 patients compared with influenza. Nonglucocorticoid immunosuppressive therapy was associated with critical influenza but not COVID-19. Premorbid medication with statins and renin-angiotensin-aldosterone system inhibitors reduced the risk for both conditions, the opposite was a seen for glucocorticoid medication. Notably, medication with betablockers, oral anticoagulation, and platelet inhibitors reduced the risk of critical COVID-19 but not influenza.

CONCLUSIONS:
The risk-factor profiles for critical influenza and COVID-19 were largely comparable; however, some important differences were noted. Hypertension was a stronger risk factor for developing critical COVID-19, whereas the use of betablockers, oral anticoagulants, and platelet inhibitors all reduced the risk of ICU admission for COVID-19 but not influenza. Findings possibly reflected differences in pathophysiological mechanisms between these conditions.
Exploring the Experience of Nurses in Providing Care to Patients With COVID-19: A Qualitative Study
Authors: SHAHOEI Roonak , NEMATI Syede Mona , VALIEE Sina 
Published: May 2022

ABSTRACT

Background
The COVID-19 pandemic has caused conflicts in the world health system. The role of nurses is prominent because of their close contact with patients.

Purpose
The aim of this study was to explore the experiences of nurses in providing care to patients with COVID-19.

Methods
This phenomenological study was conducted in 2020. Purposive sampling was used and continued until data saturation. Semistructured interviews were conducted with 14 nurses at Tohid Hospital, Sanandaj, Iran, all of whom had experience providing care to patients with COVID-19. Interviews were transcribed verbatim and analyzed using Colaizzi's phenomenological method.

Results
The participants included four men and 10 women. Data analysis revealed four main themes (14 subthemes) related to the experience of the participants in providing care to patients with COVID-19. These themes included (a) fear (fear of being infected, fear of being a carrier, fear of the disease, and high mortality of patients), (b) compulsion (compulsion to care, being under pressure), (c) distinct experience (need for self-care, working with personal protective equipment, and ambiguity in care/treatment), and (d) sacrifice (altruism, compassion, self-sacrifice, and being proud of yourself).

Conclusions/Implications for Practice
The experience of participants in caring for patients with COVID-19, in addition to the unique experience of care, was associated with fear, compulsion, and sacrifice. Because of the ongoing COVID-19 pandemic and the unique experience of nurses serving in COVID-19 units, it is necessary to educate and support nurses to deal effectively with this situation.
BarberED then screened: Disrupting the colorectal cancer disparity in urban Black men
Authors: Sizer Wilhelmina , Conyers Yvette 
Published: May 2022

ABSTRACT

Background:
Colorectal cancer (CRC) is the third most common diagnosed cancer among non-Hispanic Black people in the United States. Alarmingly, this population is also 40% more likely to succumb to the disease. Black men get diagnosed younger, present with late-stage disease, and have poor 5-year survival rates. In total, 42% of the racial disparity is due to differences in screening.

Local Problem:
In Rochester, New York, there are eight zip codes where less than 47% of the population completed CRC screening and six zip codes where men have 15% to 49% above expected cases of CRC.

Methods:
This qualitative improvement project took place in a barbershop in a zip code with subpar screening rates and higher-than-expected cases of CRC. Black men, 45–75 years of age, not current with CRC screening guidelines were recruited to participate after they received barber services. CRC screening was considered complete once a colonoscopy was scheduled.

Interventions:
Colorectal cancer education was provided by a nurse practitioner to barbers, who then provided education to their eligible patrons. After the education, patrons who decided to undergo screening were connected to a local gastroenterology group where a colonoscopy was scheduled.

Results:
Thirteen participants agreed to participate in the project. Nine participants scheduled CRC screening, and seven completed the colonoscopy evaluation.

Conclusions:
Barbers and nurse practitioners are an ideal partnership when seeking to disrupt the CRC health care disparity. Members of the Black community who may not routinely participate in preventive care can be innovatively educated to improve their health status.
Perceived Age and Personality Profiling after Orthognathic Surgery
Authors: Pourtaheri Navid , Peck Connor J. , Gowda Arvind , Parsaei Yassmin , Allam Omar , Patel Visha K. , Park Eric , Yu Jason , Lopez Joseph , Steinbacher Derek M. 
Published: May 2022

Background:
Recent studies suggest that orthognathic surgery can improve facial age and personality profiling. The authors expand on these findings by assessing the role of patient facial profile and sociodemographics on perceived changes following surgery.

Methods:
Preoperative and postoperative images of 65 patients operated on by a single surgeon were randomly assorted and rated by 30 respondents. Patient facial profiles were categorized as convex, concave, or straight. Paired and unpaired t tests were used to assess differences preoperatively and postoperatively. Multivariate regression and post hoc receiver operating characteristic curve analyses were used to quantify the influence of various patient factors.

Results:
Significant decreases in perceived age were seen following orthognathic surgery overall (−1.31 years; p < 0.01) and in the straight (−1.10 years; p = 0.02) and convex (−1.80 years; p ≤ 0.01) subgroups. After controlling for patient sociodemographics, there were no significant differences in age change based on facial profile. Older age at the time of surgery was independently associated with greater perceived age changes (p = 0.04); older patients (>26.5 years, determined by receiver operating characteristic curve) experienced greater net decreases in perceived age in comparison to younger patients (−2.0 years versus −1.2 years; p < 0.01). Improvements were seen in overall attractiveness (p < 0.01) and in each tested personality characteristic following surgery (p < 0.01). These differences were not significantly associated with different patient sociodemographics or facial profile.

Conclusions:
The authors’ data add to the growing base of evidence that orthognathic surgery improves patient-perceived age and personality. Significant decreases in perceived age are more likely to be gained by patients undergoing surgery at an older age.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, II.
Undibacter mobilis gen. nov., sp. nov. isolated from an artificial wetland in Okcheon, Korea
Authors: Jung Gi-Yong , Nam In-Hyun , Kim So-Jeong 
Published: May 2022

Strain GY_HT was isolated from an artificial wetland in Okcheon, Chungcheongbuk-do Province, Republic of Korea. Strain GY_HT was closely related to

Pseudolabrys taiwanensis

CC-BB4T based on 16S rRNA gene sequences (94.7 % similarity) and clustered within the family

Nitrobacteraceae

. Cells of the isolate were Gram-stain-negative, catalase-negative and oxidase-positive, and colonies were white or pale transparent. A flagellum was observed, and the isolate could respire both aerobically and anaerobically. Growth of GY_ HT was observed in the following conditions: 10–45 °C, pH 5–11 and 0–4 % NaCl. The optimal conditions for growth were 25 °C, pH 6.5–7.5 and 0.5–1.5 % NaCl. The major fatty acids were C19 : 0 cyclo ω8c (35.8 %) and summed feature 8 (C18 : 1
ω7c/C18 : 1
ω6c; 27.4 %). The major quinone was found to be ubiquinone-10. Diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol and phosphatidylcholine were the major polar lipids. The G+C content of the genome of GY_HT was 63.3 mol%. Based on its phylogenomic, physiological and biochemical attributes, strain GY_HT represents a novel species of a novel genus of the family

Nitrobacteraceae

. We propose the name as Undibacter mobilis gen. nov., sp. nov. The type strain is GY_HT (=KCTC 62792T=JCM 32856T).
The influence of corporate governance and corporate social responsibility on corporate performance: an Iberian panel data evidence
Authors: Neves Maria Elisabete , Santos Adriana , Proença Catarina , Pinho Carlos 
Published: May 2022

PurposeThe main goal of this paper is to study the influence of some corporate governance, corporate social responsibility (CSR), and corporate-specific characteristics on the performance of Iberian-listed companies.Design/methodology/approachTo achieve the paper's aim, the authors have used data from 33 Portuguese-listed companies, and 60 Spanish-listed companies, for the period 2011 to 2018. To test the hypotheses, the authors employed the generalized method of moments (GMM) estimation method, developed by Arellano and Bover (1995) and Blundell and Bond (1998).FindingsThe results point out that the performance determinants vary depending on the country under analysis and the variable used to measure performance. Despite being neighbors and historically commercially close, these countries have differences in their governmental, social and economic structure that lead to different stakeholder perceptions on the determinants of corporate performance. Specifically, when the authors use Tobin's Q as a market performance variable, board independence and the existence of a CSR committee have different signs in the two countries. The same happens when return on assets (ROA) is used as an accounting variable for internal management, implying that both, managers and potential investors of the two countries have different understandings about the variables that influence their performance.Originality/valueTo the best of the authors' knowledge, this is the first study to comparatively analyze the two countries of the Iberian Peninsula, analyzing the effect of corporate governance and social responsibility characteristics on the performance. The authors' results show that managers and potential investors have different points of view regarding the importance of corporate governance and social responsibility characteristics in corporate performance.
The impact of military expenditures on out of pocket healthcare payments: international evidence based on a dynamic panel data analysis
Authors: Grigorakis Nikolaos , Galyfianakis Georgios 
Published: May 2022

PurposeThe empirical analysis dealt in this paper emphasizes on the impact of military expenditures on out of pocket (OOP) healthcare payments. A sizeable body of defence economics literature has investigated the trade-off between military and public health expenditure, by testing the crowding-out or growth-stimulating hypothesis; does military expenditure scaling up crowd-out or promote governmental resources for social and welfare programs, including also state health financing?Design/methodology/approachIn this study, panel data from 2000 to 2018 for 129 countries is used to examine the impact of military expenditure on OOP healthcare payments. The dataset of countries is categorized into four income-groups based on World Bank's income-group classification. Dynamic panel data methodology is applied to meet study objectives.FindingsThe findings of this study indicate that military expenditure positively affects OOP payments in all the selected groups of countries, strongly supporting in this way the crowding-out hypothesis whereby increased military expenditure reduces the public financing on health. Study econometric results are robust since different and alternative changes in specifications and samples are applied in our analysis.Practical implicationsUnder the economic downturn backdrop for several economies in the previous decade and on the foreground of a potential limited governmental fiscal space related to the Covid-19 pandemic adverse economic effects, this study provides evidence that policy-makers have to adjust their government policy initiatives and prioritize Universal Health Coverage objectives. Consequently, the findings of this study reflect the necessity of governments as far as possible to moderate military expenditures and increase public financing on health in order to strengthen health care systems efficiency against households OOP spending for necessary healthcare utilization.Originality/valueDespite the fact that a sizeable body of defence economics literature has extensively examined the impact of military spending on total and public health expenditures, nevertheless to the best of our knowledge there is no empirical evidence of any direct effect of national defence spending on the main private financing component of health systems globally; the OOP healthcare payments.