bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Preliminary Evaluation of the Kidney Function of Sugarcane Cutters From Brazil
Authors: Diniz Caíque Olegário , McKenna Zachary , Canuto Lucas , Magalhães Flávio , Machado-Moreira Christiano Antônio , Shibuya Elisa , da Cunha Irlon , Maia Paulo Alves , Roscani Rodrigo Cauduro , Rocha-Vieira Etel , Santiago de Moraes Barros Thais Maria , Bitencourt Daniel , Souza e Silva de Almeida Flávia , Amorim Fabiano Trigueiro 
Published: November 2020

Objective:
To evaluate clinical parameters, markers of kidney function, and skeletal muscle damage in a group of sugarcane cutters during harvesting season.

Methods:
Seventeen volunteers were assessed for anthropometrics and cardiorespiratory fitness. Blood and urine samples were collected 48-hours after the last work session. Blood was analyzed for glucose, creatine kinase, cholesterol, and a complete hemogram. Urine and blood samples were also analyzed for markers related to kidney function.

Results:
Volunteers were young (26 ± 6 y), had low body fat (13 ± 5%), and good cardiorespiratory fitness (41 ± 6 mL/kg/min). Classical markers of kidney function (eGFR, creatinine, cystatin C) were within the normal range. However, ten volunteers presented elevated resting serum creatine kinase (221 ± 68 U/L).

Conclusion:
Manual sugarcane harvesting is associated with sustained skeletal muscle damage which may increase the risk for kidney injury in Brazilian sugarcane cutters.
Psychosocial Impact of COVID-19 on Healthcare Workers at a Tertiary Care Cardiac Center of Karachi Pakistan
Authors: Kumar Dileep , Saghir Tahir , Ali Gulzar , Yasin Umamah , Furnaz Shumaila , Karim Musa , Hussain Muhammad , Kumari Rekha , Bai Reeta , Kumar Hitesh 
Published: November 2020

Objectives:
Aim of this study was to determine the depression, stress, and anxiety level among healthcare workers working at a tertiary care cardiac center of Karachi Pakistan during COVID-19 pandemic.

Methods:
This survey was conducted at the National Institute of Cardiovascular Disease (NICVD), Karachi, Pakistan. Participants of the study were fulltime employees of hospital. Data were collected using an online questionnaire and Depression, Anxiety and Stress - 21 (DASS-21) scale was used.

Results:
A total of 224 healthcare workers were included, 46 (20.5%) participants were screened for moderate to severe depression, 20.1% (45) for moderate to severe anxiety, and 14.7% (33) for moderate to severe stress.

Conclusion:
A significant levels of depression, anxiety, and stress were noted with the major concerns of workplace exposure, increased risk of infection, and transmission to their families and friends.
Walking Meeting Effects on Productivity and Mood Among White-Collar Workers
Authors: Kling Hannah E. , Moore Kevin J. , Brannan Debi , Caban-Martinez Alberto J. 
Published: November 2020

Objective:
Walking Meetings (WaM) have shown to be acceptable, feasible, and implementable among white-collar workers. This pilot study examines the effects of WaM on worker mood, productivity, and physical activity.

Methods:
Eighteen white-collar workers were recruited from a university in Florida. Participants wore accelerometers for 3 consecutive weeks. During baseline week, participants continued their normal seated meetings. In weeks 2 and 3, participants conducted one walking meeting in groups of two to three people.

Results:
Increased moderate occupational physical activity was correlated with increased productivity measured by decreased work time missed due to health reasons (r = –0.59; P = 0.03) and decreased impairment while working due to health reasons (r = –0.61; P = 0.02). In week 3, very vigorous physical activity was significantly correlated with negative mood (r = 0.69, P = 0.01).

Conclusion:
WaM affected worker mood and productivity and increased occupational physical activity-levels.
Before They Get to You for Gender-Related Surgery
Authors: Borek Lorraine , Selekman Janice 
Published: November 2020

Abstract
The acronym LGBT (lesbian, gay, bisexual, and transgender) has expanded to LGBTQIA (lesbian, gay, bisexual, transgender, queer or questioning, intersex, and asexual or allies). The health needs of this community are often grouped together, yet each of these letters represents a distinct population with its own health concerns. Youth who identify as transgender usually experience multiple physical, psychological, and social challenges from childhood through adolescence. Gender-affirming surgical interventions improve both one's mental health and one's quality of life for those who are transgender but often occur later in the transgender journey. This article will focus on the healthcare needs and experiences of transgender youth in the school setting before coming to the attention of the surgical team.
Professional Athletes Have Poorer Sleep Quality and Sleep Hygiene Compared With an Age-Matched Cohort
Authors: Cameron Alyse F. M. , Perera Nirmala , Fulcher Mark 
Published: November 2020

Objective:
To study sleep quality and sleep hygiene in professional athletes and an age-matched cohort.

Design:
Cross-sectional study.

Setting:
Professional athletes and a sport medicine center.

Participants:
Professional rugby, netball and football athletes (n = 184) and attendees to a sport medicine center (n = 101).

Interventions:
Participants completed an online survey.

Main Outcome Measures:
Sleep Hygiene Index (SHI) and Pittsburgh Sleep Quality Index (PSQI).

Results:
Forty-five percent (n = 128) of respondents were aged between 18 and 24 years, 54% (n = 154) were men and 65% (n = 184) were professional athletes. The sleep duration of the professional athletes (mean rank 134.3, n = 181) was greater than the age-matched cohort (mean rank = 154.4, n = 101), U = 7835.0, z = −2.3, P = 0.02; however, they reported more sleep disturbance (mean ranking = 148.0, n = 181) than the age-matched cohort (mean rank = 129.8, n = 101), U = 7960.5 z = −2.5, P = 0.01, 2–tailed. Professional athletes had worse sleep regularity (mean rank = 152.3, n = 183) compared with the age-matched cohort (mean rank = 124.6, n = 101), U = 7448.5, z = −2.7, P = 0.006, 2-tailed, had an inferior sleep environment (mean rank = 149.5, n = 183) compared with the age-matched cohort (mean rank = 129.8, n = 101), U = 7959.5, z = −2.0, P = 0.047, and had more naps (mean rank = 156.2, n = 183) compared with the age-matched cohort (mean rank = 117.6, n = 101), U = 6729.0, z = −4.2, P = 0.00 0, 2-tailed.

Conclusions:
Professional athletes reported poorer sleep quality and sleep hygiene compared with an age-matched cohort, and difficulty falling asleep following competition. It is likely this is due to the stress of competition, training, and traveling. Because sleep plays an important role in postexercise recovery and has an impact on injury and athletic performance, it is important to have strategies to support better sleep quality and sleep hygiene in athletes.
Safety and efficacy of switching from infliximab biosimilar CT-P13 to infliximab biosimilar SB2 in patients with inflammatory bowel disease
Authors: Lovero Rosa , Losurdo Giuseppe , La Fortezza Rosa Federica , Terracciano Fulvia , Biscaglia Giuseppe , Martino Giuseppina , Nardella Marianna , Di Leo Alfredo , Principi Mariabeatrice , Andriulli Angelo , Bossa Fabrizio 
Published: November 2020

Introduction
For patients with inflammatory bowel diseases, switching from infliximab originator to biosimilars is effective and safe. Few data on single switch have been published, and data on multiple switches of different infliximab are unavailable.

Methods
A retrospective analysis of patients who switched from CT-P13 to SB2, and of those with multiple switches among different infliximab compounds was conducted. Clinical activity, C reactive protein (CRP), adverse events (AE) and loss of response (LOR) were recorded.

Results
Thirty-six patients (26 males, 14 Crohn’s disease and 22 ulcerative colitis) were enrolled and followed up for >6 months. All patients switched from CT-P13 to SB2; 12 of them (33.3%) had already switched from reference Infliximab to CT-P13, and for the remaining patients CT-P13 was the first infliximab. The clinical remission rate six months before and three months after SB2-switch was the same (58.3%) and the rate of mild activity varied from 27.8 to 33.3% (P = 0.68); the percentage of patients with normal CRP values passed from 94.4 to 91.7% (P = 1). Two patients (5.5%) had AE and 11 (30.5%) a LOR. At univariate analysis, patients with a single switch had a non-significant risk of LOR during SB2 [odds ratio (OR) = 7.86; 95% confidence interval (CI) 0.87–71, P = 0.06]. SB2-LOR was associated with previous AE under CT-P13 (OR = 9.1, 95% CI 0.82–100, P = 0.07). None of such factors was significant at multivariate analysis.

Conclusion
Switching from CT-P13 to SB2 seems to be safe and effective either in patients with a single than in those with multiple switches.
The Costs of Breast Reconstruction and Implications for Episode-Based Bundled Payment Models
Authors: Berlin Nicholas L. , Chung Kevin C. , Matros Evan , Chen Jung-Sheng , Momoh Adeyiza O. 
Published: November 2020

Background:
Implementation of payment reform for breast reconstruction following mastectomy demands a comprehensive understanding of costs related to the complex process of reconstruction. Bundled payments for services to women with breast cancer may profoundly impact reimbursement and access to breast reconstruction. The authors’ objectives were to determine the contribution of cancer therapies, comorbidities, revisions, and complications to costs following immediate reconstruction and the optimal duration of episodes to incentivize cost containment for bundled payment models.

Methods:
The cohort was composed of women who underwent immediate breast reconstruction between 2009 and 2016 from the MarketScan Commercial Claims and Encounters database. Continuous enrollment for 3 months before and 24 months after reconstruction was required. Total costs were calculated within predefined episodes (30 days, 90 days, 1 year, and 2 years). Multivariable models assessed predictors of costs.

Results:
Among 15,377 women in the analytic cohort, 11,592 (75 percent) underwent tissue expander, 1279 (8 percent) underwent direct-to-implant, and 2506 (16 percent) underwent autologous reconstruction. Adjuvant therapies increased costs at 1 year [tissue expander, $39,978 (p < 0.001); direct-to-implant, $34,365 (p < 0.001); and autologous, $29,226 (p < 0.001)]. At 1 year, most patients had undergone tissue expander exchange (76 percent) and revisions (81 percent), and a majority of complications had occurred (87 percent). Comorbidities, revisions, and complications increased costs for all episode scenarios.

Conclusions:
Episode-based bundling should consider separate bundles for medical and surgical care with adjustment for procedure type, cancer therapies, and comorbidities to limit the adverse impact on access to reconstruction. The authors’ findings suggest that a 1-year time horizon may optimally capture reconstruction events and complications.
Best New Flaps and Tips for Success in Microsurgery
Authors: Brown Erin , Suh Hyunsuk Peter , Han Hyun Ho , Pak Changsik John , Hong Joon Pio 
Published: November 2020

Learning Objectives:
After reviewing this article, the participant should be able to: 1. Understand the trends in reconstruction using flaps. 2. Understand the surgical anatomy and elevation of the three best flaps: superficial circumflex iliac artery perforator, profunda artery perforator, and thin anterolateral thigh perforator. 3. Understand the core principle and the modern evolution of microsurgery. 4. Be acquainted with new microsurgical tips to maximize outcomes.

Summary:
Plastic surgery has a long history of innovation expanding the conditions we can treat, and microsurgical reconstruction has played a pivotal role. Freestyle free flaps now create another paradigm shift in reconstructive surgery, relying on a better understanding of anatomy and physiology, opening the door to patient-specific customized reconstruction. This article aims to provide information regarding useful and practical new advances in the field of microsurgery.
Psychological Characteristics, Female Sex, and Opioid Use Predict Acute Postoperative Pain in Patients Surgically Treated for Thumb Base Osteoarthritis: A Cohort Study
Authors: Wouters Robbert M. , Porsius Jarry T. , van der Oest Mark J. W. , Slijper Harm P. , Souer J. Sebastiaan , Selles Ruud W. , MacDermid Joy C. 
Published: November 2020

Background:
It is unclear which factors predict acute postoperative pain in patients surgically treated for thumb base osteoarthritis. The authors investigated the influence of type of surgery, preoperative sociodemographics, preoperative patient-reported outcome measures, psychological characteristics, and postoperative opioid use on acute postoperative pain 24 hours postoperatively following surgery for thumb carpometacarpal osteoarthritis. In addition, preoperative and acute postoperative pain were compared.

Methods:
In this prospective cohort study, 215 patients surgically treated for thumb carpometacarpal osteoarthritis were included. Data were collected in 16 clinics for hand surgery and therapy in The Netherlands. Hierarchical regression was used to identify whether type of surgery, preoperative sociodemographics, preoperative patient-reported outcome measures, psychological characteristics (including treatment credibility and expectations, illness perception, pain catastrophizing, anxiety, and depression), and postoperative opioid use predicted acute postoperative pain 24 hours postoperatively, measured using the Numeric Pain Rating Scale (range, 0 to 10).

Results:
Female sex, opioid use, higher preoperative satisfaction with hand, and higher self-reported consequences and coherence predicted greater postoperative pain, with 31 percent explained variance in the final model including psychological factors. Mean postoperative Numeric Pain Rating Scale score was lower (5.1 ± 2.4) than preoperative pain, measured using visual analogue scales (during the past week, 6.7 ± 1.7; physical load, 7.5 ± 1.7) and the Michigan Hand Outcomes Questionnaire (6.4 ± 1.4; p < 0.001).

Conclusions:
Psychological factors, female sex, and opioid use enhance the prediction of acute postoperative pain beyond surgery type, preoperative sociodemographics, and patient-reported outcome measures. Female sex and opioid use were the strongest predictors, even after controlling for psychological factors. Future studies may investigate sex-based approaches and patient education for reducing acute postoperative pain.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, II.
Shear Force Processing of Lipoaspirates for Stem Cell Enrichment Does Not Affect Secretome of Human Cells Detected by Mass Spectrometry In Vitro
Authors: Prantl Lukas , Eigenberger Andreas , Klein Silvan , Limm Katharina , Oefner Peter J. , Schratzenstaller Thomas , Felthaus Oliver 
Published: November 2020

Background:
Lipofilling is one of the most often performed surgical procedures in plastic and reconstructive surgery. Lipoaspirates provide a ready source of stem cells and secreted factors that contribute to neoangiogenesis and fat graft survival. However, the regulations about the enrichment of these beneficial cells and factors are ambiguous. In this study, the authors tested whether a combination of centrifugation and homogenization allowed the enrichment of viable stem cells in lipoaspirates through the selective removal of tumescent solution, blood, and released lipids without significantly affecting the cell secretome.

Methods:
Human lipoaspirate was harvested from six different patients using water jet–assisted liposuction. Lipoaspirate was homogenized by first centrifugation (3584 rpm for 2 minutes), shear strain (10 times intersyringe processing), and second centrifugation (3584 rpm for 2 minutes). Stem cell enrichment was shown by cell counting after stem cell isolation. Lipoaspirate from different processing steps (unprocessed, after first centrifugation, after homogenization, after second centrifugation) was incubated in serum-free cell culture medium for mass spectrometric analysis of secreted proteins.

Results:
Lipoaspirate homogenization leads to a significant 2.6 ± 1.75-fold enrichment attributable to volume reduction without reducing the viability of the stem cells. Protein composition of the secretome did not change significantly after tissue homogenization. Considering the enrichment effects, there were no significant differences in the protein concentration of the 83 proteins found in all processing steps.

Conclusions:
Stem cells can be enriched mechanically without significantly affecting the composition of secreted proteins. Shear-assisted enrichment of lipoaspirate constitutes no substantial manipulation of the cells’ secretome.
Examining the Correlation between Altmetric Score and Citations in the Plastic Surgery Literature
Authors: Boyd Carter J. , Ananthasekar Shivani , Kurapati Srikanth , King Timothy W. 
Published: November 2020

Background:
Social media are transforming the dissemination of published research. This influence brought the advent of a new metric, altmetrics, which seeks to quantify the influence of research in real time based on an article’s attention online. This study aims to determine the correlation between altmetrics ratings for articles with traditional bibliometrics of impact factor and citation rate.

Methods:
The 10 most cited articles in the top 15 plastic surgery journals were determined for 2013 and 2016. The 2013 articles allow for a 5-year lag time, whereas 2016 data provide another timepoint for comparison. Altmetric scores and citation count were collected for each article. Impact factor and Twitter account age were determined for each journal. Statistical analysis was completed using descriptive statistics, and Pearson and Spearman correlation coefficients.

Results:
In both 2013 and 2016, there was a weak positive correlation between citations and Altmetric score (r = 0.2620, p = 0.0012; r = 0.3564, p < 0.0001, respectively) and between impact factor and the Altmetric score (r = 0.2419, p = 0.0040; r = 0.3887, p = < 0.0001, respectively). Twitter was the main contributor to the Altmetric score in both 2013 and 2016.

Conclusions:
Altmetric scores and traditional bibliometrics are not strongly correlated with one another in the plastic surgery literature at this point in time. Still, the short- and long-term impact of a publication might be determined through the combined analysis of citation count, impact factor, and Altmetric scores.
Upper Eyelid Ptosis Correction with Levator Advancement in Asian Patients using the Musculoaponeurotic Junction of the Levator as the Key Reference Point
Authors: Wong Chin-Ho , Hsieh Michael Ku Hung , Mendelson Bryan 
Published: November 2020

Summary:
Upper eyelid ptosis correction is a complex procedure. The ethnic differences in the Asian upper eyelid anatomy are compounded by the technical challenges of primary and revision ptosis correction. The authors present a technique of upper eyelid ptosis correction that estimates the exact location of suture fixation that uses the musculoaponeurotic junction of the levator as the reference point. The preoperative considerations in determining the fixation point relative to the musculoaponeurotic junction include the following: A, the extent of ptosis correction needed; B, the degree of compensatory brow elevation with eye opening; and C, eye dominance. The benefits of this approach are the shortened operative time because of more precise preoperative planning and greater predictability and reproducibility of the results. The authors have found that this technique produced consistent and superior results for ptosis correction in Asian patients.
Task Shifting for Initiation and Monitoring of Antiretroviral Therapy for HIV-Infected Adults in Uganda: The SHARE Trial
Authors: Sekiziyivu Brian Arthur , Bancroft Elizabeth , Rodriguez Evelyn M. , Sendagala Samuel , Nasirumbi Muniina Pamela , Najjengo Marjorie Sserunga , Kiragga Agnes N. , Musaazi Joseph , Musinguzi Joshua , Sande Enos , Brad Bartholow , Dalal Shona , Byakika-Jayne Tusiime , Kambugu Andrew 
Published: November 2020

Background:
With countries moving toward the World Health Organization's “Treat All” recommendation, there is a need to initiate more HIV-infected persons into antiretroviral therapy (ART). In resource-limited settings, task shifting is 1 approach that can address clinician shortages.

Setting:
Uganda.

Methods:
We conducted a randomized controlled trial to test if nurse-initiated and monitored ART (NIMART) is noninferior to clinician-initiated and monitored ART in HIV-infected adults in Uganda. Study participants were HIV-infected, ART-naive, and clinically stable adults. The primary outcome was a composite end point of any of the following: all-cause mortality, virological failure, toxicity, and loss to follow-up at 12 months post-ART initiation.

Results:
Over half of the study cohort (1,760) was women (54.9%). The mean age was 35.1 years (SD 9.51). Five hundred thirty-three (31.6%) participants experienced the composite end point. At 12 months post-ART initiation, nurse-initiated and monitored ART was noninferior to clinician-initiated and monitored ART. The intention-to-treat site-adjusted risk differences for the composite end point were −4.1 [97.5% confidence interval (CI): = −9.8 to 0.2] with complete case analysis and −3.4 (97.5% CI: = −9.1 to 2.5) with multiple imputation analysis. Per-protocol site-adjusted risk differences were −3.6 (97.5% CI: = −10.5 to 0.6) for complete case analysis and −3.1 (−8.8 to 2.8) for multiple imputation analysis. This difference was within hypothesized margins (6%) for noninferiority.

Conclusions:
Nurses were noninferior to clinicians for initiation and monitoring of ART. Task shifting to trained nurses is a viable means to increase access to ART. Future studies should evaluate NIMART for other groups (e.g., children, adolescents, and unstable patients).
Effect of Statin Therapy on Age-Associated Changes in Physical Function Among Men With and Without HIV in the Multicenter AIDS Cohort Study
Authors: Abdo Mona , Langan Susan J. , MaWhinney Samantha , Sun Jing , Lake Jordan E. , Palella Frank J. , Kingsley Lawrence , Brown Todd T. , Erlandson Kristine M. 
Published: November 2020

Background:
The longer-term risks of statins on physical function among people with HIV are unclear.

Methods:
Longitudinal analysis of Multicenter AIDS Cohort Study men between 40 and 75 years of age with ≥2 measures of gait speed or grip strength. Generalized estimating equations with interaction terms between (1) statin use and age and (2) HIV serostatus, age, and statin use were considered to evaluate associations between statin use and physical function. Models were adjusted for demographics and cardiovascular risk factors.

Results:
Among 2021 men (1048 with HIV), baseline median age was 52 (interquartile range 46–58) years; 636 were consistent, 398 intermittent, and 987 never statin users. There was a significant interaction between age, statin, and HIV serostatus for gait speed. Among people with HIV, for every 5-year age increase, gait speed (m/s) decline was marginally greater among consistent versus never statin users {−0.008 [95% confidence interval (CI) −0.017 to −0.00007]; P = 0.048}, with more notable differences between intermittent and never users [−0.017 (95% CI −0.027 to −0.008); P < 0.001]. Similar results were observed among men without HIV. Significant differences in grip strength (kg) decline were seen between intermittent and never users [−0.53 (95% CI −0.98 to −0.07); P = 0.024] and differences between consistent and never users [−0.28 (95% CI −0.63 to 0.06); P = 0.11] were not statistically significant.

Conclusions:
Among men with and without HIV, intermittent statin users had more pronounced declines in physical function compared with consistent and never users. Consistent statin use does not seem to have a major impact on physical function in men with or without HIV.