bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Immediate Implant-Based Mastectomy Reconstruction in Women with Previous Breast Radiotherapy
Authors: Olinger Thomas A. , Berlin Nicholas L. , Qi Ji , Hamill Jennifer B. , Kim Hyungjin M. , Pusic Andrea L. , Wilkins Edwin G. , Momoh Adeyiza O. 
Published: March 2020

Background:
The objective of this study was to determine whether women with a history of radiation therapy before mastectomy experience a risk for postoperative complications and patient-reported outcomes similar to those of women undergoing postmastectomy radiation therapy in the setting of immediate implant reconstruction.

Methods:
The cohort included patients undergoing immediate implant reconstruction at 11 centers across North America. Women were categorized into three groups: prior breast conservation therapy, postmastectomy radiation therapy, and no radiation therapy. Mixed effect logistic regressions were used to analyze the effects of radiation therapy status on complication rates and patient-reported outcomes.

Results: One thousand five hundred ninety-four
patients were analyzed, including 84 women with prior breast conservation therapy, 329 women who underwent postmastectomy radiation therapy, and 1181 women with no history of radiation therapy. Compared with postmastectomy radiation therapy, breast conservation was associated with lower rates of all complications and major complications (OR, 0.65; 95 percent CI, 0.37 to 1.14; p = 0.13; and OR, 0.61; 95 percent CI, 0.33 to 1.13; p = 0.12). These differences were not statistically significant. Rates of reconstructive failure between the two cohorts were comparable. Before reconstruction, satisfaction with breasts was lowest for women with prior breast conservation therapy (p < 0.001). At 2 years postoperatively, satisfaction with breasts was lower for women with postmastectomy radiation therapy compared with breast conservation patients (p = 0.007).

Conclusions:
Higher postoperative complication rates were observed in women exposed to radiation therapy regardless of timing. Although women with prior breast conservation experienced greater satisfaction with their breasts and fewer complications when compared to women undergoing postmastectomy radiation therapy, there was a similar risk for reconstruction failure.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
High-Intensity Focused Ultrasound Ablation Combined with Electrical Passive Exercise for Fast Removal of Body Fat
Authors: Tan Joo-Shin , Lin Chou-Ching , Cheng Jung-Sung , Chen Gin-Shin 
Published: March 2020

Background:
High-intensity focused ultrasound (HIFU) lipolysis still lacks treatment efficacy. The authors hypothesized that electrical stimulation of muscular groups can enhance the metabolism of free lipids released from HIFU-ablated adipocytes.

Methods:
Five-month-old, male Landrace swine, with an average initial weight of 95 kg, were divided randomly into sham, HIFU only, HIFU plus electrical stimulation I, and HIFU plus electrical stimulation II groups. Subcutaneous adipose tissue of the porcine abdomen was treated once by HIFU on days 1 of weeks 1, 3, and 5, and electrical stimulation of the quadriceps was performed once on the day 1 of weeks 1 through 6. The numbers of ultrasonic sonications were 70 per treatment for the HIFU-only and HIFU plus electrical stimulation I groups and 400 for the HIFU plus electrical stimulation II group. The measured data are expressed as medians (ranges).

Results:
The body weights of all pigs increased gradually with time. The waist circumferences below the sheath decreased from 97.7 ± 6.0 cm in week 1 and 97.9 ± 5.3 cm in week 3 to 96.4 ± 10.0 cm in week 6, and from 105.3 ± 5.1 cm and 101.2 ± 7.4 cm to 100.5 ± 6.1 cm for the HIFU plus electrical stimulation I and II groups, respectively, whereas they increased for the sham and HIFU-only groups. The reductions in the adipose tissue thickness were 0.59, 1.46, and 2.18 mm for the HIFU-only, HIFU plus electrical stimulation I, and HIFU plus electrical stimulation II groups, respectively, when the sham group increased by 1.42 mm. Follow-up blood analyses demonstrated no significant changes in lipid panel parameters from baseline values.

Conclusion:
HIFU plus electrical stimulation can induce a substantial reduction in the waist circumference of pigs.
Who Accepts and Who Uses Community-Based Secondary Distribution HIV Self-Testing (HIVST) Kits? Findings From the Intervention Arm of a Cluster-Randomized Trial of HIVST Distribution Nested in Four HPTN 071 (PopART) Communities in Zambia
Authors: Hensen Bernadette , Schaap Albertus J. , Mulubwa Chama , Floyd Sian , Shanaube Kwame , Phiri Mwelwa M. , Bond Virginia , Bwalya Chiti , Simwinga Musonda , Fidler Sarah , Hayes Richard , Mwinga Alwyn , Ayles Helen 
Published: March 2020

Background:
HPTN 071 (PopART) was a community-randomized trial of a universal testing-and-treatment intervention on HIV incidence at population level in Zambia and South Africa. In Zambia, a trial of community-based distribution of HIV self-testing (HIVST) kits, including secondary distribution, as an option for HIV-testing was nested within 4 PopART intervention communities. We used data from the intervention arm of the nested trial to measure levels of and factors associated with acceptance and use of secondary distribution HIVST kits.

Methods:
Community HIV care providers offered the PopART combination HIV-prevention intervention door-to-door, systematically visiting all households and enumerating all household members. From 1 February to 30 April 2017, individuals aged 16 years and older consenting to PopART were offered the option to HIV self-test, if eligible for HIV-testing services. Individuals aged 18 years and older who reported a partner absent during household visits were offered an HIVST kit for secondary distribution to this partner. We used two data sources to measure acceptance and use of secondary distribution HIVST kits.

Results:
Among 9105 individuals aged 18 years and older consenting to PopART, 9.1% (n = 825) accepted an HIVST kit for secondary distribution. Approximately 55.8% reported that the kit had been used. Women were more likely to accept, and men more likely to use, secondary distribution HIVST kits. Kits were more likely to be used by individuals aged 30+ and who had not participated in a previous round of PopART. Approximately 6.8% had a reactive result.

Conclusions:
Community-based secondary distribution of HIVST kits reached men absent during community HIV care provider household visits and is a complement to facility- and community-based HIV-testing services, which often miss men.
Cumulative Burden of Depression and Neurocognitive Decline Among Persons With HIV: A Longitudinal Study
Authors: Paolillo Emily W. , Pasipanodya Elizabeth C. , Moore Raeanne C. , Pence Brian W. , Atkinson Joseph Hampton , Grelotti David J. , Grant Igor , Heaton Robert K. , Moore David J. 
Published: March 2020

Background:
Higher cumulative burden of depression among people with HIV (PWH) is associated with poorer health outcomes; however, longitudinal relationships with neurocognition are unclear. This study examined hypotheses that among PWH, (1) higher cumulative burden of depression would relate to steeper declines in neurocognition, and (2) visit-to-visit depression severity would relate to fluctuations in neurocognition within persons.

Setting:
Data were collected at a university-based research center from 2002 to 2016.

Methods:
Participants included 448 PWH followed longitudinally. All participants had >1 visit (M = 4.97; SD = 3.53) capturing depression severity (Beck Depression Inventory-II) and neurocognition (comprehensive test battery). Cumulative burden of depression was calculated using an established method that derives weighted depression severity scores by time between visits and total time on study. Participants were categorized into low (67%), medium (15%), and high (18%) depression burden. Multilevel modeling examined between- and within-person associations between cumulative depression burden and neurocognition over time.

Results:
The high depression burden group demonstrated steeper global neurocognitive decline compared with the low depression burden group (b = −0.100, P = 0.001); this was driven by declines in executive functioning, delayed recall, and verbal fluency. Within-person results showed that compared with visits when participants reported minimal depressive symptoms, their neurocognition was worse when they reported mild (b = −0.12, P = 0.04) or moderate-to-severe (b = −0.15, P = 0.03) symptoms; this was driven by worsened motor skills and processing speed.

Conclusions:
High cumulative burden of depression is associated with worsening neurocognition among PWH, which may relate to poor HIV-related treatment outcomes. Intensive interventions among severely depressed PWH may benefit physical, mental, and cognitive health.
Is HIV Self-Testing a Strategy to Increase Repeat Testing Among Pregnant and Postpartum Women? A Pilot Mixed Methods Study
Authors: Oyaro Patrick , Kwena Zachary , Bukusi Elizabeth A. , Baeten Jared M. 
Published: March 2020

Introduction:
Repeat HIV testing among pregnant and postpartum women enables incident HIV infection identification for targeted interventions. We evaluated oral HIV self-testing (HIVST) for repeat HIV testing among pregnant and postpartum women attending busy public clinics in East Africa.

Methods:
Between October 2018 and January 2019, we conducted a pilot mixed methods study to evaluate the acceptability of oral-based HIVST among pregnant and postpartum women within 3 public health facilities in Kisumu County, Kenya. We invited 400 seronegative pregnant and postpartum women to choose between clinic-based oral HIVST and the standard finger prick provider-initiated testing and counseling for repeat HIV testing. We measured the frequency of each choice and described the participants' experiences with the choices, including data from 3 focus group discussions.

Results:
Slightly over half of the women [53.8%, 95% confidence interval (CI): 48.7 to 58.7] chose oral HIVST. Unmarried women were more likely to use HIVST (prevalence ratio: 1.26, 95% CI: 1.01 to 1.57, P < 0.05). The most frequent reason for oral HIVST selection was the fear of the needle prick (101/215, 47.0%). More HIVST than provider-initiated testing and counseling users indicated lack of pain (99.1% vs 34.6%, P < 0.001) and the need for assistance (18.1% vs 1.1%, P < 0.001) as reflective of their HIV testing experiences. Participants choosing HIVST cited privacy, ease, and speed of the procedure as the main reasons for their preference.

Conclusions:
The use of HIVST in Kenyan antenatal and postpartum settings seems to be feasible and acceptable for repeat HIV testing. Future work should explore the practical mechanisms for implementing such a strategy.
A Predictor for Defects in Filling of the Left Atrial Appendage on Cardiac Computed Tomography in Patients With Atrial Fibrillation
Authors: Ouchi Kotaro , Sakuma Toru , Ojiri Hiroya 
Published: March 2020

Purpose
The aim of this study was to identify possible predictors for findings of left atrial appendage (LAA) filling defects in patients with atrial fibrillation (AF) on cardiac computed tomography (CT).

Materials and Methods
We retrospectively evaluated findings of LAA filling defects on the early phase of cardiac CT of 63 patients with history of AF and compared those images with those of 63 control subjects. We investigated potential predictors for LAA filling defects.

Results
Filling defects of the LAA correlated significantly with patient history of persistent AF (P = 0.045; odds ratio [OR], 3.17), chicken wing morphology (P = 0.013; OR, 4.12), and with LAA volume (P = 0.0032; OR, 1.19) of 12.53 cm3 or greater (sensitivity, 87.3%; specificity, 69.8%).

Conclusions
We observed persistent AF, the chicken wing type of LAA morphology, and LAA volume as independent predictors of LAA filling defects on cardiac CT. These findings might improve cardiac CT scanning protocol.
Diagnostic Accuracy of Single-Phase Computed Tomography Texture Analysis for Prediction of LI-RADS v2018 Category
Authors: Puttagunta Srikanth , van der Pol Christian B. , Ferri Melanie , Sy Wat Josephine , Kulkarni Ameya , Carrion-Martinez Ivan 
Published: March 2020

Objective
The aim of this study was to determine if texture analysis can classify liver observations likely to be hepatocellular carcinoma based on the Liver Imaging Reporting and Data System (LI-RADS) using single portal venous phase computed tomography.

Methods
This research ethics board–approved retrospective cohort study included 64 consecutive LI-RADS observations. Individual observation texture analysis features were compared using Kruskal-Wallis and 2 sample t tests. Logistic regression was used for prediction of LI-RADS group. Diagnostic accuracy was assessed using receiver operating characteristic curves and Youden method.

Results
Multiple texture features were associated with LI-RADS including the mean HU (P = 0.003), median (P = 0.002), minimum (P = 0.010), maximum (P = 0.013), standard deviation (P = 0.009), skewness (P = 0.007), and entropy (P < 0.001). On logistic regression, LI-RADS group could be predicted with area under the curve, sensitivity, and specificity of 0.98, 96%, and 100%, respectively.

Conclusions
Texture analysis features on portal venous phase computed tomography can identify liver observations likely to be hepatocellular carcinoma, which may preclude the need to recall some patients for additional multiphase imaging.
Deep Breathing Increases Heart Rate Variability in Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus
Authors: Rovsing Cecilie , Rovsing Helene , Liboriussen Caroline Hundborg , Jensen Mette Kjeldsgaard , Andersen Sally Søgaard , Andersen Stine Søgaard , Kristensen Salome , Jochumsen Mads 
Published: March 2020

Background/Objective
Autoimmune diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have been associated with an impaired function of the autonomic nervous system and reduced vagus nerve (VN) tone measured through lower heart rate variability (HRV). Targeting the VN through electrical stimulation has been proposed as a treatment strategy with promising results in patients with RA. Moreover, it has been suggested that the VN can be stimulated physiologically through deep breathing. In this study, the aim was to investigate if the VN can be stimulated through deep breathing in patients with RA and SLE, as measured by HRV.

Methods
Fifty-seven patients with RA and SLE performed deep breathing exercises for 30 minutes in this explorative study. Before the breathing exercise, 2 electrocardiogram recordings were obtained to determine the patient's baseline HRV during rest. After the 30-minute breathing exercise, 5 minutes of electrocardiogram recordings were obtained to determine postintervention HRV and used as a measure of vagal activity.

Results
No change was observed in the HRV between the 2 recordings prior the exercise, but the heart rate and HRV significantly decreased and increased, respectively, after the deep breathing exercise.

Conclusions
HRV can be modulated in patients with RA and SLE; this may have implications for future treatment with medications in conjunction with deep breathing. However, the biological and clinical effect of deep breathing must be investigated in future studies.
Catgut and its Use in Plastic Surgery
Authors: Kim Hun , Hwang Kun , Yun Seon Mi 
Published: March 2020

Abstract
The aim of this paper is to review the origin, physical properties, advantages, and usage of catgut in plastic surgery and oral surgery.
In PubMed search, the search terms (“catgut” AND [“plastic surgery” OR “facelift”]) and (“catgut” AND “oral surgery”) were used, resulting in 28 and 30 papers, respectively. Of those 58 papers, 31 papers were excluded. Eight other papers were added; therefore, 35 papers were analyzed.
Catgut has been used in cleft palate surgery since 1938. In 1976, it was used in a superficial wound with anti-tension taping. In the 1970s, 1980s, and 1990s, catgut was used in otoplasty, scrotoplasty, hemostasis of neurofibroma, blepharoplasty, ptosis surgery, and rhytidectomy. From the 2000s until the present day, it has been preferred in many fields of plastic surgery, including pediatric lacerations and conjunctiva sutures. In oral wound repairs and tonsillectomy, catgut has been used from the 1970s to the present. Many studies have compared catgut with other suture materials in terms of wound healing, inflammatory reaction, and longevity, and their respective advantages and disadvantages continue to be discussed.
The advantages of catgut as a suture material are as follows: 1, The fundamental advantage of catgut is its absorbability. 2, Catgut has excellent tensile strength. 3, Sterility, when catgut is taken from a sealed tube, is assured. 4, Hardened, or ‘chromed,’ catgut is preferable to the ‘plain’ variety. 5, The finest possible size should be used in preference to thicker sizes.
Catgut sutures are still widely used in plastic surgery and oral surgery.
The Lima Surgical Protocol for Cleft Palate Repair
Authors: Rossell-Perry Percy , Luque-Tipula Margot 
Published: March 2020

Background:
A cleft team experience addressing non-syndromic cleft palate and cleft lip and palate is presented. The purpose of the present study is to compare surgical outcomes using 2 different protocols for cleft palate repair provided by a cleft team in Lima, Perú.

Methods:
This is a comparative study between 2 groups of patients with non-syndromic cleft palate who were operated using different surgical protocols from 1999 to 2014. One hundred twenty-four children with non-syndromic isolated cleft palate and cleft lip and palate treated from 2007 to 2014 using a surgical protocol developed by our cleft team in Lima, Perú were compared with 145 children with cleft palate and cleft lip and palate treated by the same team using different protocol from 1999 to 2007. Data collection was accomplished by evaluation of symptomatic oronasal fistulas, presence of velopharyngeal insufficiency (VPI) and postoperative complications.

Results:
Statistical significant differences were observed between the 2 groups regarding the development of flap necrosis in favor of the Lima protocol. No significant difference in palatal fistula and VPI rate between the 2 protocols was found.

Conclusions:
The Lima Surgical Protocol for cleft palate repair is an alternative strategy which uses the strengths of different surgical techniques based on the severity of the cleft. We observed better surgical outcomes using the Lima protocol with regards to postoperative complications in patients with non-syndromic cleft palate.
Systemic and Cardiac Alterations After Long Bone Fracture
Authors: Weber Birte , Lackner Ina , Knecht Deborah , Braun Christian Karl , Gebhard Florian , Huber-Lang Markus , Hildebrand Frank , Horst Klemens , Pape Hans-Christoph , Ignatius Anita , Schrezenmeier Hubert , Haffner-Luntzer Melanie , Kalbitz Miriam 
Published: March 2020

ABSTRACTThe purpose of this study was to reveal possible consequences of long-bone fracture on cardiac tissue and to analyze the role of systemically elevated danger associated molecular patterns, complement anaphylatoxins and cytokines. Blood samples of mice, pigs, and humans after a fracture were analyzed by ELISAs for complement component 5a (C5a), tumor necrosis factor (TNF), and extracellular histones.In vivoresults were completed byin vitroexperiments with human cardiomyocytes treated with TNF and extracellular histones. The influence of histones and human plasma after fracture on isolated human polymorphonuclear leukocytes (PMNs) was investigated. An elevation of TNF, C5a, and extracellular histones after long bone fracture was measured. Moreover, the appearance of systemic troponin I levels was observed and structural changes in connexin 43 and desmin were detected. Further, the presence of TNF leads to elevation of reactive oxygen species, troponin I release, and histone appearance in supernatant of human cardiomyocytes. Incubation of human PMNs with histones and plasma of patients after fracture lead to formation of neutrophil extracellular traps. Present results suggest that structural alterations in the heart might be consequences of the complement activation, the release of extracellular histones, and the systemic TNF elevation in the context of a long bone fracture.
Halomonas montanilacus sp. nov., isolated from hypersaline Lake Pengyanco on the Tibetan Plateau
Authors: Lu Huibin , Xing Peng , Zhai Lei , Li Huabing , Wu Qinglong 
Published: March 2020

A Gram-stain-negative, catalase- and oxidase-positive, aerobic, rod-shaped, motile strain (PYC7WT) was isolated from Lake Pengyanco on the Tibetan Plateau. Comparisons based on 16S rRNA gene sequences showed that strain PYC7WT belongs to the genus

Halomonas

, with

Halomonas malpeensis

YU-PRIM-29T and

Halomonas johnsoniae

T68687T as its closest neighbours (96.8 and 96.6 % 16S rRNA gene sequence similarity, respectively), and only 93.1 % 16S rRNA gene sequence similarity to

Halomonas elongata

ATCC 33173T. The predominant respiratory quinone of strain PYC7WT is Q-9, with Q-8 as a minor component. The major fatty acids are C18 : 1
ω6c and / or C18 : 1
ω7c, C16 : 0, C16 : 1
ω6c and/or C16 : 1
ω7c, and C12 : 0 3OH. The polar lipids of strain PYC7WT include phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol, phosphatidylinositol and two unidentified phospholipids. Genome sequencing revealed a genome size of 4.79 Mbp and a G+C content of 62.9 mol%. DNA–DNA hybridization values of strain PYC7WT showed 45, 30 and 38 % relatedness with

Halomonas johnsoniae

DSM 21197T,

Halomonas hamiltonii

DSM 21196T and

Halomonas stevensii

DSM 21198T, respectively. Combining phenotypic, biochemical, genotypic and DNA–DNA hybridization data, we propose that strain PYC7WT represents a novel species within the genus

Halomonas

and to have the name Halomonas montanilacus sp. nov.; PYC7WT (=CICC 24506T= KCTC 62529T) is the type strain.