bluuebunny/crossref_metadata_2025_split huggingface dataset:
Claims-based Frailty Indices
Authors: Shashikumar Sukruth A. , Huang Kristine , Konetzka R. Tamara , Joynt Maddox Karen E. 
Published: June 2020

Objective:
The objective of this study was to evaluate claims-based frailty indices (CFIs) used to assess frailty on a population-based level.

Background:
Frailty is a key determinant of patient outcomes, independent of demographics and comorbidities. Measuring frailty in large populations has implications for targeted interventions, public reporting, and risk adjustment. Frailty indices based on administrative data in health insurance claims allow such population-level assessments of frailty.

Methods:
We used PubMed to search for studies that: (1) were development or validation studies of a CFI that predicted frailty; and (2) used only diagnosis codes within administrative claims or health services claims. We evaluated the CFIs on 6 axes: databases used to build the CFIs; variables used to designate frailty; methods used to build the CFIs; model performance for predicting frailty; model relationship to clinical outcomes; and model limitations.

Results:
We included 17 studies. They showed variation in the claims codes used to designate frailty, although themes like limited mobility and neurological and psychiatric impairment were common to most. C-statistics demonstrated an overall strong ability to predict patient frailty and adverse clinical outcomes. All CFIs demonstrated strong associations between frailty and poor outcomes.

Conclusions:
While each CFI has unique strengths and limitations, they also all had striking similarities. Some CFIs have been more broadly used and validated than others. The major takeaway from this review is that frailty is a clinically relevant, highly predictive syndrome that should be incorporated into clinical risk prediction when feasible.
Current state of the art in fat grafting: paradigm shift in surgical techniques and refinements in cleft and craniofacial reconstruction
Authors: Denadai Rafael , Lo Lun-Jou 
Published: June 2020

Purpose of review
The purpose of this review is to provide an update on current practice and trends in fat graft surgery. The present review covers postoperative fat graft survival and phases, recipient bed and fat tissue enrichment issues, the spectrum of clinical applications in the cleft-craniofacial field, surgical techniques, and predictive factors for different outcomes.

Recent findings
Current investigations have led to a better understanding of fat graft survival and postoperative clinical progress. Fat grafting has been successfully adopted in a broad spectrum of cleft-related, craniofacial contour-related, burn-related, and radiation-related indications. Many variations on harvesting, processing, and delivery techniques and the use of recipient-site preconditioning and cell-enriched methods to increase the efficiency of fat grafting have been described, but little consensus exists about which technique is optimal. The development of predictors for fat grafting-related outcomes can aid multidisciplinary teams in providing better preoperative counseling, selecting the most suitable candidates for treatment, and establishing patient-specific postoperative care profiles.

Summary
The addition of modern fat graft surgery to the surgeon's toolbox revolutionized the delivery of surgical cleft and craniofacial care. Further investigation is necessary to assist surgeons in selecting the best candidates and optimal techniques.
Optimizing speech outcomes for cleft palate
Authors: Lindeborg Michael M. , Shakya Pramila , Rai Shankar Man , Shaye David A. 
Published: June 2020

Purpose of review
Cleft lip with or without palate is one of the most common pediatric birth anomalies. Patients with cleft palate often have speech difficulties from underlying anatomical defects that can persist after surgery. This significantly impacts child development. There is a lack of evidence exploring, which surgical techniques optimize speech outcomes. The purpose of this update is to report on recent literature investigating how to optimize speech outcomes for cleft palate.

Recent findings
The two-flap palatoplasty with intravelar veloplasty (IVVP) and Furlow double-opposing Z-plasty has the strongest evidence for optimizing speech. One-stage palatal repair is favored at 10–14 months of age, while delays are associated with significant speech deficits. For postoperative speech deficits, there is no significant difference between the pharyngeal flap, sphincter pharyngoplasty, and posterior pharyngeal wall augmentation. Surgical management should be guided by closure pattern and velopharyngeal gap but few studies stratify by these characteristics.

Summary
According to recent evidence, the two-flap palatoplasty with IVVP and Furlow palatoplasty result in the best speech. The pharyngeal flap, sphincter pharyngoplasty, and posterior pharyngeal wall augmentation are all viable techniques to correct residual velopharyngeal insufficiency. Future research should focus on incorporating standardized measures and more robust study designs.
Analysis of Using the Total White Blood Cell Count to Define Severe New‐onset Ulcerative Colitis in Children
Authors: Mack David R. , Saul Bradley , Boyle Brendan , Griffiths Anne , Sauer Cary , Markowitz James , LeLeiko Neal , Keljo David , Rosh Joel R. , Baker Susan S. , Steiner Steve , Heyman Melvin B. , Patel Ashish S. , Baldassano Robert , Noe Joshua , Rufo Paul , Kugathasan Subra , Walters Thomas , Marquis Alison , Thomas Sonia M. , Denson Lee , Hyams Jeffrey ,   PROTECT STUDY GROUP
Published: June 2020

ABSTRACTObjectives:The aim of this study was to assess common laboratory tests in identifying severe ulcerative colitis in children at diagnosis.Methods:A cohort of 427 children 4 to 17 years of age newly diagnosed with ulcerative colitis (UC) was prospectively enrolled. Boosted classification trees were used to characterize predictive ability of disease attributes based on clinical disease severity using Pediatric Ulcerative Colitis Activity Index (PUCAI), severe (65+) versus not severe (<65) and total Mayo score, severe (10–12) versus not severe (<10); mucosal disease by Mayo endoscopic subscore, severe (3) versus not severe (<3); and extensive disease versus not extensive (left‐sided and proctosigmoiditis).Results:Mean age was 12.7 years; 49.6% (n = 212) were girls, and 83% (n = 351) were Caucasian. Severe total Mayo score was present in 28% (n = 120), mean PUCAI score was 49.8 ± 20.1, and 33% (n = 142) had severe mucosal disease with extensive involvement in 82% (n = 353). Classification and regression trees identified white blood cell count, erythrocyte sedimentation rate, and platelet count (PLT) as the set of 3 best blood laboratory tests to predict disease extent and severity. For mucosal severity, albumin (Alb) replaced PLT. Classification models for PUCAI and total Mayo provided sensitivity of at least 0.65 using standard clinical cut‐points with misclassification rates of approximately 30%.Conclusions:A combination of the white blood cell count, erythrocyte sedimentation rate, and either PLT or albumin is the best predictive subset of standard laboratory tests to identify severe from nonsevere clinical or mucosal disease at diagnosis in relation to objective clinical scores.
The Potential Impact and Availability of Sexual Health Services During the COVID-19 Pandemic
Authors: Nagendra Gowri , Carnevale Caroline , Neu Natalie , Cohall Alwyn , Zucker Jason 
Published: June 2020

Abstract
As the COVID-19 pandemic causes upheaval in New York City (NYC), 1 consequence is the accessibility of sexual health services. The NYC STD Prevention Training Center at Columbia University administered an online provider survey to understand how the COVID-19 pandemic is affecting the availability of sexual health care services regionally.
Carriage of Neisseria meningitidis in Men Who Have Sex With Men Presenting to Public Sexual Health Clinics, New York City
Authors: Ngai Stephanie , Weiss Don , Bell Julie Anne , Majrud Difaa , Zayas Greicy , Crawley Addie , Kornblum John , Rodriguez-Rivera Lorraine D. , Quinlan Tammy , Halse Tanya A. , Retchless Adam C. , MacNeil Jessica , Pathela Preeti 
Published: June 2020

Background
We conducted a Neisseria meningitidis (Nm) carriage study among men who have sex with men (MSM) to explore possible sexual transmission.

Methods
We paired information on patient characteristics with oropharyngeal, rectal, and urethral Nm culture results to assess associations with Nm carriage among 706 MSM at New York City sexual health clinics. The Nm isolates were characterized by whole genome sequencing.

Results
Twenty-three percent (163 of 706) of MSM were Nm carriers. Oropharyngeal carriage was 22.6% (159 of 703), rectal 0.9% (6 of 695), and urethral 0.4% (3 of 696). Oropharyngeal carriage was associated with the following recent (past 30 days) exposures: 3 or more men kissed (adjusted relative risk [aRR], 1.38; 95% confidence interval [CI], 1.03–1.86), performing oral sex (aRR, 1.81; 95% CI, 1.04–3.18), and antibiotic use (aRR, 0.33; 95% CI, 0.19–0.57). Sixteen clonal complexes were identified; 27% belonged to invasive lineages.

Conclusions
Our findings suggest that oral sex and the number of recent kissing partners contribute to Nm carriage in MSM.
An Unusual Method of Suicide
Authors: Jackson Nicole R. , Paul Ian D. 
Published: June 2020

Abstract
Suicidal ligature strangulation is a relatively rare event—far more common is suicide by hanging or homicidal ligature strangulation. With the increasing rate of suicide in the United States, use of atypical ligatures is likely to increase as well. Herein, we present such a rare case, a man who died by tightening cable ties around his own neck, and discuss the necessity of full scene and autopsy investigation to ensure proper certification of manner of death.
Association Between Changes in Subjective and Objective Measures of Mobility in People With Lower Limb Amputations After Inpatient Rehabilitation
Authors: Cieslak Gabrielle , Omana Humberto , Madou Edward , Frengopoulos Courtney , Viana Ricardo , Payne Michael W. , Hunter Susan W. 
Published: June 2020

Abstract
Functional recovery for people with lower limb amputations is quantified using objective or subjective measures of performance. In this brief report, the prospective relationship between objective and subjective mobility after rehabilitation was evaluated in people with lower limb amputations. Adults undergoing inpatient prosthetic rehabilitation for a first unilateral transtibial or transfemoral level lower limb amputation were recruited. Assessment times: discharge and 4-mo follow-up. Gait velocity and the L Test under single- and dual-task conditions measured objective mobility. The Prosthetic Evaluation Questionnaire (section 4 and question 5b) measured subjective mobility. Paired t tests and Pearson correlation analysis evaluated change over time and the association between mobility types, respectively. Twenty-one people with lower limb amputations (61.6 ± 8.2 yrs) participated. Gait velocity significantly improved (single- and dual-task: P < 0.001). L Test significantly improved for single-task (P = 0.002) but not dual-task conditions. No statistically significant Prosthetic Evaluation Questionnaire changes were observed. One subjective mobility question (sidewalk walking) correlated with objective mobility at follow-up (L Test single- and dual-task: r = −0.77; P < 0.001). Objective mobility improved after discharge; however, subjective reporting had no change. Lack of association may represent a mismatch between quantitative outcomes and subjective self-assessment. Both subjective and objective measures of mobility should be collected to provide a holistic picture of clinical and patient-relevant outcomes in people with lower limb amputations.
The Effect of Extracorporeal Shock Wave Therapy on Pain Intensity and Neck Disability for Patients With Myofascial Pain Syndrome in the Neck and Shoulder
Authors: Jun Ji Hyun , Park Geun-Young , Chae Choong Sik , Suh Dong-Churl 
Published: June 2020

Objective
The aim of the study was to investigate the efficacy of extracorporeal shock wave therapy on myofascial pain syndrome in the neck and shoulder compared with that of other treatments.

Data Sources
PubMed, Embase, and Web of Science were systematically searched until May 30, 2019, to select randomized controlled trials.

Review Methods
The randomized controlled trials comparing extracorporeal shock wave therapy with sham extracorporeal shock wave therapy or other treatments for patients with myofascial pain syndrome in the neck and shoulder patients were included. Two reviewers independently identified eligible studies. The Cochrane Handbook was used to evaluate the methodological quality of the included randomized controlled trials. Main outcomes associated with pain intensity, pressure pain threshold, and neck disability were selected. The study was registered with PROSPERO (Registration Number CRD 42019137459).

Results
A total of 11 randomized controlled trials were finally included. The results indicated that extracorporeal shock wave therapy had a large effect size on improving pain intensity (standardized mean difference [SMD] = 0.67, 95% confidence interval = 0.11 to 1.23, P = 0.02) and pressure pain threshold (SMD = 1.19, 95% confidence interval = 0.27 to l2.12, P = 0.01) at postintervention. However, there was no significant effect on neck disability at postintervention (SMD = 0.03, 95% confidence interval = −0.76 to 0.83, P = 0.93). After the subgroup analyses on the type of extracorporeal shock wave therapy, focused extracorporeal shock wave therapy had a significant effect on improving pain intensity (SMD = 0.75, 95% confidence interval = 0.13 to 1.36, P = 0.02) and pressure pain threshold (SMD = 1.70, 95% confidence interval = 0.21 to 3.18, P = 0.03) at postintervention in comparison with that of other treatments.

Conclusions
Extracorporeal shock wave therapy is superior to other treatments in terms of alleviating the pain intensity and pressure pain threshold of patients with myofascial pain syndrome in the neck and shoulder at postintervention. In particular, focused extracorporeal shock wave therapy shows significant improvement in pain relief. However, radical extracorporeal shock wave therapy for myofascial pain syndrome treatment still remains unclear.
Natural History of Serum Enzyme Levels in Duchenne Muscular Dystrophy and Implications for Clinical Practice
Authors: Rodríguez-Cruz Maricela , Almeida-Becerril Tomas , Atilano-Miguel Salvador , Cárdenas-Conejo Alan , Bernabe-García Mariela 
Published: June 2020

Objective
In Duchenne muscular dystrophy, creatine kinase and transaminases are released into the circulation, indicating muscle injury. Their usefulness in monitoring muscle injury or disease progression has not yet been fully evaluated. Thus, this study examined serum creatine kinase and transaminase concentrations at different ages in patients with Duchenne muscular dystrophy and evaluated their association with muscle injury.

Design
This is a prospective cohort study that included 110 patients with Duchenne muscular dystrophy categorized by age groups. Creatine kinase and transaminases were quantified in the serum; the Vignos scale evaluated the muscle function.

Results
Creatine kinase and transaminase levels were higher in ambulatory than that in nonambulatory patients, which significantly decreased as age increased. Serum creatine kinase and transaminase concentrations were elevated in all ages, and those aged 3–4 yrs had the highest concentrations. Age and Vignos Scale were significantly correlated with creatine kinase and transaminase concentrations. Age, creatine kinase, and transaminases explained the 42.5% of loss of muscle function.

Conclusions
This study added the knowledge on the natural history of Duchenne muscular dystrophy at different ages and confirmed that creatine kinase and transaminases decrease with age and loss of muscle function, making them generally inappropriate for monitoring response to therapy, although they are useful for the clinical diagnosis.
Assessing Patient-Reported Outcomes After Female Cosmetic Genital Surgery
Authors: Sinnott Catherine J. , Glickman Laurence T. , Natoli Noel B. , Dobryansky Michael , Veeramachaneni Haritha B. 
Published: June 2020

Purpose
Patient-reported outcomes after female cosmetic genital surgery (FCGS) have been well documented; however, methods vary widely between studies and are often very detailed, time-consuming, and difficult to reproduce. The purpose of this study was to assess patient-reported outcomes after FCGS using a novel method and survey as well as to present the results of a pilot study aimed at validating this survey.

Methods
A retrospective chart review identified patients who underwent FCGS. Demographic, clinical, operative, and outcome characteristics were recorded. A novel survey, including 14 items administered by telephone interview, was developed and extrapolated from the BREAST-Q for augmentation mammaplasty, to assess patient-reported outcomes after FCGS with regard to satisfaction with outcome and physical, psychosocial, and sexual well-being.

Results
The survey response rate was 50.6% (39 patients). Over a mean time after surgery of 56 months, 14 complications occurred in 11 patients (28.2%), and 10 complications required revision surgery. Postoperative asymmetry and dehiscence were the most common complications. Despite the higher complication and revision surgery rates, 97.4% agreed that the surgery was a good experience and were satisfied with the results after surgery. In addition, patient-reported outcomes after FCGS showed significant improvement in physical well-being, psychosocial well-being, and sexual well-being (P < 0.001).

Conclusions
This novel survey can be used to assess patient-reported outcomes after FCGS in an efficient approach. Despite the potential complications and need for revision surgery, the vast majority of patients who undergo FCGS feel that it is a good experience, are satisfied with the results after surgery, and show significant improvement in physical, psychosocial, and sexual well-being after surgery.
Outcomes, Techniques, and Risk Factors for Dehiscence in Central Wedge Labiaplasty
Authors: Sinnott Catherine J. , Glickman Laurence T. , Natoli Noel B. , Dobryansky Michael , Veeramachaneni Haritha B. 
Published: June 2020

Purpose
Outcomes after female cosmetic genital surgery (FCGS) performed by plastic surgeons working in a group practice setting have not been well documented. This article aimed to assess outcomes and to describe FCGS techniques used in a large group private plastic surgery practice.

Methods
A retrospective chart review identified patients who underwent FCGS from 2009 to 2018. Demographic, clinical, and operative information was reviewed and recorded. Outcomes were assessed by evaluating postoperative complications and the need for revision surgery.

Results
Seventy-seven women between the ages of 14 and 53 years underwent FCGS performed by 1 of 6 surgeons. Forty-five patients underwent central wedge excision for labia minora hypertrophy, whereas 32 patients underwent extended central wedge excision for labia minora and clitoral hood hypertrophy. Four patients underwent liposuction of the mons pubis as an additional procedure. Over a mean follow-up of 37.4 months, postoperative asymmetry/redundancy occurred in 12 patients, requiring revision in 10. Wound dehiscence occurred in 12 patients, requiring revision in 9. There was one hematoma postoperatively requiring evacuation, one case of dyspareunia, and one case of decreased sensation. A single-layer wound closure (P = 0.050) and mons liposuction (P = 0.011) were risk factors for wound dehiscence.

Conclusions
Central wedge excision and extended central wedge excision labiaplasty were the techniques used in a large group plastic surgery practice. Postoperative asymmetry and dehiscence were the most common complications, and the revision surgery rate was high. A single-layer wound closure and additional mons liposuction were risk factors for dehiscence after central wedge labiaplasty.
Satisfaction and Regret Following Uterosacral Ligament Suspension and Sacrocolpopexy: A Prospective Multicenter Analysis From the Fellows’ Pelvic Research Network
Authors: Bastawros Dina , Rabon Hannah , Noor Nabila , Florian-Rodriguez Marian E. , Hobson Deslyn , Tarr Megan E. 
Published: June 2020

Objectives
The primary objective was to compare levels of satisfaction, regret, and Patient Global Impression of Improvement (PGI-I) scores between women who underwent vaginal uterosacral ligament suspension (USLS) and minimally invasive sacrocolpopexy (SCP). Secondary objectives were to identify which preoperative counseling resources were most useful.

Methods
This was a multicenter, retrospective cohort study through the Fellows’ Pelvic Research Network that included women who underwent a USLS or SCP between January 2013 and January 2016 with 1-year follow-up. Women completed the Decision Regret Scale for Pelvic Floor Disorders, Satisfaction with Decision Scale for Pelvic Floor Disorders, and PGI-I. Data were also collected on usefulness of various educational preoperative resources.

Results
A total of 175/367 (47.6%) women participated; 45 (25.7%) and 130 (74.3%) in the USLS and SCP groups, respectively. Mean Decision Scale for Pelvic Floor Disorders scores were 4.6 ± 0.8 and 4.5 ± 0.7 (P = 0.30) in the USLS and SCP groups, respectively, indicating a high level of satisfaction with surgical decision. The mean Decision Regret Scale for Pelvic Floor Disorders score was 1.5 ± 0.8 in USLS and 1.6 ± 0.8 in SCP (P = 0.53). The SCP group had higher PGI-I scores (1.7 ± 1.4 vs 2.0 ± 1.3, P = 0.02), indicating lower perceived postoperative improvement. Most women (151 [86.3%] of 175) reported that verbal counseling was sufficient and would not have found additional resources helpful.

Conclusions
Women have high satisfaction and low regret with their decision to pursue surgical correction with USLS or SCP. Most are satisfied with only verbal preoperative counseling.
Feasibility and Learning Curve of Transvaginal Natural Orifice Transluminal Endoscopic Surgery for Hysterectomy and Uterosacral Ligament Suspension in Apical Compartment Prolapse
Authors: Lowenstein Lior , Matanes Emad , Lauterbach Roy , Mor Omer , Burke Yechiel Z. , Weiner Zeev , Baekelandt Jan 
Published: June 2020

Objective
The aim of this study was to describe our experience with transvaginal natural orifice transluminal endoscopic surgery (vNOTES) uterosacral ligament suspension (USLS) and to evaluate the learning curve of mastering the skills to operate this procedure.

Methods
This is a prospective study of the first 35 vNOTES hysterectomy and USLS surgeries performed between October 2018 and April 2019 at Rambam Health Care Campus (Israel) (n = 26) and Imelda Hospital (Belgium) (n = 9). The primary outcome was surgical time. Secondary outcomes included intraoperative bleeding, length of hospitalization, pain during the first 24 hours postoperative pain, and the need for analgesia, intraoperative, and postoperative adverse events.

Results
The median age was 55 years (range, 40–81). The median operative time was 113 minutes (range, 89–233). For the procedures performed at Rambam, total operative time decreased from the first 13 to the following 13: from 149 minutes (range, 89–233 minutes) to 103 (89–170) (<0.001); Pearson correlation demonstrated a moderate negative significant correlation of surgery duration with surgeon experience (rho = −0.445, P < 0.001). The median estimated blood loss was 30 mL (20–200). The median hospital stay was 2 days (1–3). There were no intraoperative adverse events. The median visual analogue scale score for pain assessment during the first 24 hours after surgery was 1 (range, 1–3).

Conclusions
vNOTES USLS is a feasible procedure that showed marked improvement in surgical performance in a short period, as evidenced by the decrease in surgical time and the low rate of minor associated perioperative complications. Outcomes of long-term follow-up should be investigated.