bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravenous Tranexamic Acid in Implant-Based Breast Reconstruction Safely Reduces Hematoma without Thromboembolic Events
Authors: Weissler Jason M. , Banuelos Joseph , Jacobson Steven R. , Manrique Oscar J. , Nguyen Minh-Doan T. , Harless Christin A. , Tran Nho V. , Martinez-Jorge Jorys 
Published: July 2020

Background:
Antifibrinolytic medications, such as tranexamic acid, have recently garnered increased attention. Despite its ability to mitigate intraoperative blood loss and need for blood transfusion, there remains a paucity of research in breast reconstruction. The authors investigate whether intravenous tranexamic acid safely reduces the risk of hematoma following implant-based breast reconstruction.

Methods:
A single-center retrospective cohort study was performed to analyze all consecutive patients undergoing immediate two-stage implant-based breast reconstruction following mastectomy between 2015 and 2016. The incidence of postoperative hematomas and thromboembolic events among all patients was reviewed. The patients in the intervention group received 1000 mg of intravenous tranexamic acid before mastectomy incision and 1000 mg at the conclusion of the procedure. Fisher’s exact test and the Mann-Whitney-Wilcoxon test were used. Multivariate logistic regression models were performed to study the impact of intravenous tranexamic acid after adjusting for possible confounders.

Results:
A total of 868 consecutive breast reconstructions (499 women) were reviewed. Overall, 116 patients (217 breasts) received intravenous tranexamic acid, whereas 383 patients (651 breasts) did not. Patient characteristics and comorbidities were similar between the two the groups. Patients who received tranexamic acid were less likely to develop hematomas [n = 1 (0.46 percent)] than patients who did not [n = 19 (2.9 percent)] after controlling for age, hypertension, and type of reconstruction (prepectoral and subpectoral) (p = 0.018). Adverse effects of intravenous tranexamic acid, including thromboembolic phenomena were not observed. Multivariate analysis demonstrated that age and hypertension independently increase risk for hematoma.

Conclusions:
Intravenous tranexamic acid safely reduces risk of hematoma in implant-based breast reconstruction. Further prospective randomized studies are warranted to further corroborate these findings.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Cosmetic Surgery Safety: Putting the Scientific Data into Perspective
Authors: Rohrich Rod J. , Avashia Yash J. , Savetsky Ira L. 
Published: July 2020

Summary:
Optimizing patient safety and outcomes remains at the forefront of cosmetic surgery today. The five most commonly performed procedures are breast augmentation, liposuction, rhinoplasty, blepharoplasty, and abdominoplasty. Safety of all cosmetic surgery is a necessity for its successful, continued practice. This article seeks to elucidate the current literature detailing the major and minor complication profiles of the five most practiced areas in cosmetic surgery.
Trigger Finger Treatment: Identifying Predictors of Nonadherence and Cost
Authors: Nasser Jacob S. , Speth Kelly A. , Billig Jessica I. , Wang Lu , Chung Kevin C. 
Published: July 2020

Background:
Evidence-based practices in medicine are linked with a higher quality of care and lower health care cost. For trigger finger, identifying patient factors associated with nonadherence to evidence-based practices will aid physicians in treatment decisions. The objectives were to (1) determine patient factors associated with treatment nonadherence, (2) examine the success rates of steroid injections, and (3) evaluate the economic consequences of nonadherence to treatment recommendations.

Methods:
The authors used data from the Clinformatics DataMart database from 2010 to 2017 to conduct a population-based analysis of patients with single-digit trigger finger. The authors calculated rates of steroid injection success and examined associations between injection success and patient factors using chi-square tests. In addition, the authors analyzed differences in the cost to the insurer, the cost to the patient, and total cost.

Results:
A total of 29,722 patients were included in this analysis. Injection success rates were similar for diabetic (72 percent) and nondiabetic patients (73 percent), women (73 percent), and men (73 percent). Nonetheless, diabetics (OR, 1.4; 95 percent CI, 1.4 to 1.5; p < 0.001) and women (OR, 1.2; 95 percent CI, 1.1 to 1.2; p < 0.001) were significantly more likely to receive nonadherent treatment. In total, $23 million (U.S. dollars) were spent on nonadherent trigger finger care.

Conclusions:
Diabetics and women have increased odds of having surgery without a prior steroid injection, despite similar success rates of steroid injections compared to nondiabetics and men. Because performing surgical release before any steroid injections may represent a higher cost treatment option, providers should provide steroid injections before surgery for all patients regardless of diabetes status or sex to minimize overtreatment.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
Low-Dose Computed Tomographic Scans for Postoperative Evaluation of Craniomaxillofacial Fractures: A Pilot Clinical Study
Authors: Elegbede Adekunle , Diaconu Silviu , Dreizin David , Li Guang , Dunlow Ryan , Ngaage Ledibabari M. , Rasko Yvonne , Liang Fan , Grant Michael P. , Nam Arthur J. 
Published: July 2020

Summary:
Computed tomographic scans are frequently obtained following craniomaxillofacial fracture reconstruction. The additive radiation from such scans is not trivial; cumulative radiation exposure poses stochastic health risks. In this article, the authors postulate that a low-dose computed tomography protocol provides adequate image quality for postoperative evaluation of reconstructed craniomaxillofacial fractures. This study included patients for whom a computed tomographic scan was indicated following craniomaxillofacial fracture repair at a Level I trauma center. Postoperative craniomaxillofacial computed tomography was performed using a low-dose protocol, rather than standard protocols. A craniomaxillofacial surgeon and a radiologist interpreted the images to determine whether they were of sufficient quality. It was decided a priori that any inadequate low-dose computed tomography would require repeated scanning using standard protocols. The primary endpoint was the need for repeated computed tomography. In addition, the clarity of clinically significant anatomical landmarks on the images was graded on a five-point Likert scale. Twenty patients were scanned postoperatively using the low-dose protocol. Mean radiation dose (total dose-length product) from the low-dose protocol was 71 mGy · cm versus 532 mGy · cm for the preoperative computed tomographic scans that were obtained using conventional protocols (p < 0.001). All 20 low-dose computed tomographic scans were determined to provide satisfactory image quality. No patients required repeated computed tomography secondary to poor image quality. Low-dose computed tomography received high image-quality scores. A low-dose computed tomography protocol that delivers approximately 7.5-fold less radiation than the standard protocols was found to be adequate for postoperative evaluation of craniomaxillofacial fractures. Larger prospective studies may be warranted.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Abdominoplasty with Scarpa Fascia Preservation: Randomized Controlled Trial with Assessment of Scar Quality and Cutaneous Sensibility
Authors: Novais Catarina S. , Carvalho Jorge , Valença-Filipe Rita , Rebelo Marco , Peres Helena , Costa-Ferreira António 
Published: July 2020

Background:
Scarpa fascia preservation during abdominoplasty has been shown to reduce complications associated with the traditional technique. As an extension of a previously published randomized controlled trial, this study aims to clarify whether preservation of Scarpa fascia during abdominoplasty has an influence on scar quality or sensibility recovery.

Methods:
This was a single-center clinical trial, involving 160 patients randomly assigned to one of two surgical procedures: classic full abdominoplasty (group A) and abdominoplasty with preservation of Scarpa fascia (group B). Patients were later convoked to assess scar quality and abdominal cutaneous sensibility. Scar quality was evaluated through the Patient and Observer Scar Assessment Scale. Cutaneous sensibility was measured on the upper and lower abdomen, using light touch, Semmes-Weinstein testing (5.07/10-g monofilament), and a 25-gauge needle.

Results:
A total of 99 patients (group A, 54 patients; group B, 45 patients) responded to contact, with a mean follow-up time of 44 months. Concerning scar quality, Patient and Observer Scar Assessment Scale scores were similar between groups. On the upper abdomen, there was a statistically significant difference between groups on cutaneous sensibility, on the examination with the Semmes-Weinstein 5.07/10-g monofilament (group A, 79.6 percent; group B, 93.3 percent; p = 0.046) and pain (group A, 90.7 percent; group B, 100 percent; p = 0.044). No statistically significant differences were found between groups on the lower abdomen. A considerable proportion of patients (two-thirds) still presented sensibility alterations in the subumbilical area 3½ years after abdominoplasty.

Conclusion:
Scarpa fascia preservation during abdominoplasty does not influence scar quality, but it improves sensibility recovery in the supraumbilical area.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
The Outcome of COVID-19 Patients with Acute Myocardial Infarction
Authors: Tamimi Hassan Al , Alhamad Yasser , Khazaal Fadi , ElHassan Mowahib , AlBinali Hajar , Arabi Abdul rahman , Al-Qahtani Awad , Asaad Nidal , Al-Hijji Mohammed , Hamid Tahir , Rafie Ihsan , Omrani Ali , Kaabi Saad Al , Alkhal Abdullatif , Maslamani Muna Al , Ali Mohamed , Alkhani Murad , AlNesf Mariam , Jalala Salem Abu , Arafa Salaheddine , ElSousy Reem , Tamimi Omar Al , Soaly Ezeldine , Khalil Charbel Abi , Suwaidi Jassim Al 
Published: July 2020

AbstractObjectivesCoronavirus Disease 2019 (COVID-19) is a rapidly expanding global pandemic resulting in significant morbidity and mortality. COVID-19 patients may present with acute myocardial infarction (AMI). The aim of this study is to conduct detailed analysis on patients with AMI and COVID-19.MethodsWe included all patients admitted with AMI and actively known or found to be COVID-19 positive by PCR between the 4th February 2020 and the 11th June 2020 in the State of Qatar. Patients were divided into ST-elevation myocardial infarction (STEMI) and Non-STE (NSTEMI).ResultsThere were 68 patients (67 men and 1 woman) admitted between the 4th of February 2020 and the 11th of June 2020 with AMI and COVID-19. The mean age was 49.1±9 years, 46 patients had STEMI and 22 had NSTEMI. 38% had diabetes mellitus, 31% had hypertension, 16% were smokers, 13% had dyslipidemia, and 14.7% had prior cardiovascular disease. Chest pain and dyspnea were the presenting symptoms in 90% and 12% of patients, respectively. Fever (15%) and cough (15%) were the most common COVID-19 symptoms, while the majority had no viral symptoms. Thirty-nine (33 STEMI and 6 NSTEMI) patients underwent coronary angiography, 38 of them had significant coronary disease. In-hospital MACE was low; 1 patient developed stroke and 2 died.ConclusionContrary to previous small reports, in-hospital adverse events were low in this largest cohort of COVID-19 patients presenting with AMI. We hypothesize patient’s demographics and profile including younger age contributed to these findings. Further studies are required to confirm this observation.Key questionsWhat is already known on this subject?COVID-19 patients may present with acute myocardial infarction (AMI).What might this study add?Contrary to previous small reports, most COVID-19 patients presenting with AMI have significant obstructive coronary artery disease and favorable in-hospital outcome.How might this impact on clinical practice?COVID-19 patients presenting with AMI should be treated according to the standard practice.
Incorporating human mobility data improves forecasts of Dengue fever in Thailand
Authors: Kiang Mathew V , Santillana Mauricio , Chen Jarvis T , Onnela Jukka-Pekka , Krieger Nancy , Engø-Monsen Kenth , Ekapirat Nattwut , Areechokchai Darin , Prempree Preecha , Maude Richard J. , Buckee Caroline O 
Published: July 2020

AbstractOver 390 million people worldwide are infected with dengue fever each year. In the absence of an effective vaccine for general use, national control programs must rely on hospital readiness and targeted vector control to prepare for epidemics, so accurate forecasting remains an important goal. Many dengue forecasting approaches have used environmental data linked to mosquito ecology to predict when epidemics will occur, but these have had mixed results. Conversely, human mobility, an important driver in the spatial spread of infection, is often ignored. Here we compare time-series forecasts of dengue fever in Thailand, integrating epidemiological data with mobility models generated from mobile phone data. We show that long-distance connectivity is correlated with dengue incidence at forecasting horizons of up to three months, and that incorporating mobility data improves traditional time-series forecasting approaches. Notably, no single model or class of model always outperformed others. We propose an adaptive, mosaic forecasting approach for early warning systems.
Incidence, risk factors and impact of seasonal influenza in pregnancy: A national cohort study
Authors: Vousden Nicola , Bunch Kathryn , Knight Marian ,   the UKOSS influenza Co-Investigators Group
Published: July 2020

AbstractBackgroundPregnant women are particularly vulnerable to severe infection from influenza resulting in poor neonatal outcomes. The majority of evidence relates to pandemic 2009 A/H1N1 influenza. The objective of this study was to describe the characteristics and outcomes of pregnant women hospitalised with seasonal influenza.MethodsThis national, prospective, observational cohort study used the UK Obstetric Surveillance System (UKOSS) to identify all pregnant women admitted to hospital between 01/11/2016 and 31/10/2018 with laboratory confirmed influenza together with a comparison group of pregnant women. Baseline characteristics, immunisation status, maternal and perinatal outcomes were compared.ResultsThere were 405 women admitted to hospital with laboratory confirmed influenza in pregnancy: 2.7 per 10,000 maternities. Compared to 694 comparison women, women with influenza were less likely to be professionally employed (aOR 0.59, 95%CI 0.39-0.89) or immunised in the relevant season (aOR 0·59, 0·39-0·89) and more likely to have asthma (aOR 2.42, 1.30-4.49) or have had a previous pregnancy complication (aOR 2·47, 1·33-4·61). They were more likely to be admitted to intensive care (aOR 21.3, 2.78-163.1) and to have a caesarean birth (aOR 1·42, 1·02-1.98). Their babies were more likely to be admitted to neonatal intensive care (aOR 1.86, 1·01-3·42).ConclusionsImmunisation reduces the risk of hospitalisation with influenza in pregnancy which is associated with increased risk of morbidity for both the mother and baby. There is a continued need to increase awareness of safety and effectiveness of immunisation in pregnancy and provision within antenatal care settings, especially for high risk groups.Key pointsThe incidence of hospital admission with seasonal influenza in pregnancy in the UK is 2.7 per 10,000 maternities. Lack of immunisation increases risk of hospitalisation. Influenza in pregnancy increases risk of caesarean birth and neonatal admission to intensive care.
Accounting for body mass effects in the estimation of field metabolic rates from body acceleration
Authors: Byrnes Evan E. , Lear Karissa O. , Brewster Lauran R. , Whitney Nicholas M. , Smukall Matthew J. , Armstrong Nicola J. , Gleiss Adrian C. 
Published: July 2020

ABSTRACTLife history, reproduction, and survival are fundamentally linked to energy expenditure and acquisition. Dynamic Body Acceleration (DBA), measured through animal-attached data-loggers or transmitters, has emerged as a powerful method for estimating field metabolic rates of free-ranging individuals. After using respirometry to calibrate oxygen consumption ratewith DBA in captive settings, predictive models can be applied to DBA data collected from free-ranging individuals. However, laboratory calibrations are generally performed on a narrow size range of animals, which may introduce biases when predictive models are applied to differently sized individuals in the field. Here, we tested the influence of scale effects on the ability of a single predictive model to predictover a range of body sizes. We performed respirometry experiments with individuals spanning one order of magnitude in body mass (1.74–17.15 kg) and used a two-step modelling process to assess the intra-specific scale dependence of the-DBA relationship and incorporate such dependencies into the covariates ofpredictive models. The final predictive model showed scale dependence; the slope of the-DBA relationship was strongly allometric (M1.55), whereas the intercept term scaled closer to isometry (M1.08). Using bootstrapping and simulations, we tested the performance of this covariate-corrected model against commonly used methods of accounting for mass effects on the-DBA relationship and found lowest error and bias in the covariate-corrected approach. The strong scale dependence of the-DBA relationship indicates that caution must be exercised when models developed using one size class are applied to individuals of different sizes.Summary statementThe relationship between oxygen consumption rate and dynamic body acceleration is allometrically dependent, and models incorporate different slope and intercept scaling rates estimate metabolic rates more accurately than mass-specific approaches.
Therapeutic use of cannabis, cannabis-derived products and synthetic cannabinoids for rheumatoid arthritis: Protocol for a systematic review
Authors: Schulze Clara , Durán Josefina , Bravo-Jeria Rocío , Verdugo-Paiva Francisca , Morel Macarena , Rada Gabriel 
Published: July 2020

ABSTRACTOBJECTIVETo assess the therapeutic effects of cannabis, cannabis-derived products and synthetic cannabinoids for rheumatoid arthritis.DESIGNThis is the protocol of a systematic review. DATA SOURCES: Searches will be conducted in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), trial registries, grey literature and in a centralized repository in L-OVE (Living OVerview of Evidence). L-OVE is a platform that maps PICO questions to evidence from Epistemonikos database.ELIGIBILITY CRITERIA FOR SELECTING STUDIES AND METHODSWe will include randomized controlled trials evaluating therapeutic use of cannabis, cannabis-derived products and synthetic cannabinoids for rheumatoid arthritis. Our primary interest will be in trials comparing the intervention with placebo or no treatment (intervention plus optimal treatment vs placebo plus optimal treatment or optimal treatment alone) in patients receiving optimal treatment for rheumatoid arthritis. Optimal treatment will be defined as disease modifying anti-rheumatic drugs. Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will perform random-effects meta-analyses and use Grading of Recommendations Assessment, Development and Evaluation (GRADE) to assess the certainty of the evidence for each outcome.ETHICS AND DISSEMINATIONThe Scientific Ethics Committee of the Pontificia Universidad Católica de Chile granted ethical exemption for the realization of this study. Results of this review will be widely disseminated via peer-reviewed publications, social networks and traditional media and will be sent to relevant international organizations discussing this topic.
AutoSEIR: Accurate Forecasting from Real-time Epidemic Data Using Machine Learning
Authors: Rizzo Stefano Giovanni , Vantini Giovanna , Saad Mohamad , Chawla Sanjay 
Published: July 2020

AbstractSince the SARS-CoV-2 virus outbreak has been recognized as a pandemic on March 11, 2020, several models have been proposed to forecast its evolution following the governments’ interventions. In particular, the need for fine-grained predictions, based on real-time and fluctuating data, has highlighted the limitations of traditional SEIR models and parameter fitting, encouraging the study of new models for greater accuracy. In this paper we propose a novel approach to epidemiological parameter fitting and epidemic forecasting, based on an extended version of the SEIR compartmental model and on an auto-differentiation technique for partially observable ODEs (Ordinary Differential Equations). The results on publicly available data show that the proposed model is able to fit the daily cases curve with greater accuracy, obtaining also a lower forecast error. Furthermore, the forecast accuracy allows to predict the peak with an error margin of less than one week, up to 50 days before the peak happens.
Impact of climatic parameters on COVID-19 pandemic in India: analysis and prediction
Authors: Deyal Namrata , Tiwari Vipin , Bisht Nandan S. 
Published: July 2020

ABSTRACTThe COVID-19 is spreading very fast globally and various factors of it have to be analysed. The aim of this study is to analyze the effect of climatic parameters (Average Temperature (AT), Atmospheric Pressure (AP), Relative Humidity (RH), Solar Radiation (SR) and Wind Speed (WS)) on the COVID-19 epidemic during 25 March 2020 to 15 June 2020 in most affected states of India i.e. Maharashtra, Delhi and Tamilnadu. We quantitatively establish the correlation between these parameters by using Kendall & Spearman rank correlation test. The results indicate that the numbers of cases are highly correlated with the AT (r2 > 0.6, p < 0.001) in Delhi where as a moderate correlation (r2 > 0.6, p < 0.001) has been estimated for Maharashtra and Tamilnadu. Similarly, an intermediate range of correlation coefficient has been observed for other climatic parameters. A comparative study of climatic parameters in the current COVID-19 period with previous two years (2018-2019) has been carried out. Corresponding results imply a substantial trend for all three states. The range of climatic parameters have been found corresponding to maximum number of cases results as AT (25∼ 40 ° C), RH (40∼70%), AT (740∼965 mmHg), SR (200-250 W/mt 2) and WS (.5∼14 m/sec). Time series analysis depicts that the number of cases and mortality are increasing rapidly. COVID-19 epidemic peak has been predicted by SIR model for capital of India (New Delhi) and it would be around October 2020. The outcomes of this study will be helpful for the containment of COVID- 19 not only in India but globally.