bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Satisfaction and Depression After Traumatic Brain Injury
Authors: McKee Grace B. , Perrin Paul B. , Rodriguez Agudelo Yaneth , Olivera Plaza Silvia Leonor , Quijano-Martinez Maria Cristina , Ohayagha Chimdindu , Kuzu Duygu , Cariello Annahir N. , Arango-Lasprilla Juan Carlos 
Published: May 2020

Objective
Traumatic brain injury represents a major public health concern, particularly in low- and middle-income countries like in Latin America. Family members are often caregivers for individuals with traumatic brain injury, which can result in significant stress. Research is needed to examine depression and quality of the caregiving relationship in these dyads. This study examined relationship quality and depression longitudinally after traumatic brain injury within the caregiving relationship.

Design
Dyads (N = 109) composed of individuals with traumatic brain injury and their caregivers were recruited from three hospitals in Mexico and Colombia. They self-reported depression and relationship satisfaction during hospitalization and at 2 and 4 mos after hospitalization.

Results
A 2-lag Actor Partner Interdependence Model demonstrated that patients and caregivers reporting high relationship satisfaction at baseline experienced lower depression 2 mos later, which then predicted higher caregiver relationship satisfaction at 4 mos. Moreover, patients with high relationship satisfaction at baseline had caregivers with lower depression at 2 mos, which was then associated with patients’ higher satisfaction at 4 mos.

Conclusions
Within individuals with traumatic brain injury and caregivers, depression and relationship satisfaction seem to be inversely related. Furthermore, patients’ and caregivers’ depression and relationship satisfaction impact each other over time, demonstrating interdependence within the caregiving relationship.
Is Our Effort Appropriately Valued? An Analysis of Work Relative Value Units in Immediate Breast Reconstruction
Authors: Doval Andres F. , Gratzon Andrew C. , Neese Virginia , Shuck John W. , Friedman Jeffrey , Echo Anthony 
Published: May 2020

Background:
The work relative value units system was developed as a quantifier of physician labor, technical skill, and training time required to complete surgical procedures. Thus, more complex surgical procedures that require greater technical skills and are more time consuming should yield a greater compensation. It is known that prosthetic breast reconstruction reimburses more per hour than autologous breast reconstruction. However, there are limited data comparing work relative value units and operative times in breast reconstruction procedures. Therefore, this study aims to compare mean operative times and work relative value units per minute across three different modalities of breast reconstruction.

Methods:
A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database was performed to identify all patients undergoing implant-, pedicle-, and free flap–based reconstruction over a 6-year period. Calculation and comparison of median operative times, work relative value units, and dollars per minute was performed.

Results:
A total of 3135 patients were included in the analysis: 2249 (71.7 percent) underwent immediate implant-based reconstruction, 745 (23.8 percent) underwent immediate free flap–based breast reconstruction, and 141 (4.5 percent) underwent immediate pedicle flap–based reconstruction. Patients were distributed in unilateral and bilateral cases. Consistently, median operative time was greater for free flap breast reconstruction, followed by pedicle flap– and implant-based reconstruction (p < 0.0001). However, work relative value units per minute and dollars per minute were found to be higher for prosthetic reconstruction in all comparisons (p < 0.0001).

Conclusion:
In the authors’ analysis, more complex and time-consuming procedures resulted in a lower reimbursement in dollars and work relative value units per minute for the procedure.
Development of a Patient-Based Goniometric System for the Assessment of Contracture Conditions in Dupuytren’s Disease
Authors: Baringer Magnus , Prantl Lukas , Eaton Charles , Reichert Bert 
Published: May 2020

Background:
Treatment outcomes of Dupuytren’s disease depend largely on degree of contracture and biological severity. Longitudinal assessment of each is crucial for effective care and long-term outcome assessment. Ideally, each Dupuytren’s patient should have ongoing interval evaluations. Because of the large number of Dupuytren’s patients, it would be impractical and costly for health care professionals to examine every patient in person on a regular basis. Patient-based evaluations might provide a useful and cost-effective alternative to office-based examination.

Methods:
Finger goniometry is the standard metric for office-based evaluation of Dupuytren’s disease. This study’s goal was to develop a new patient-reported goniometric system. The authors developed a completely Web-based goniometric software for patients to use without supervision and without undue effort or cost. They then evaluated the validity and precision of the core measurement system and the reliability of its patient-based application.

Results:
With a correlation of 0.992 (p < 0.01), a mean deviation of −0.25 degree, and a standard deviation of 2.74 degrees in patient-based application, the authors found their goniometric software to be comparable to practitioner-based, conventional goniometry. The authors believe patient-based goniometry to be a sufficiently accurate, valid, and reliable approach for longitudinal clinical assessment of Dupuytren’s disease.

Conclusions:
Patient-based goniometric approaches have great potential for inexpensive, accurate, and accessible longitudinal assessment of the large population of Dupuytren’s patients. Such approaches could help to substantially improve overall care of Dupuytren’s disease through early diagnosis and timely treatment. In addition, being able to collect reliable patient data on a regular basis and on a larger scale could help improve understanding of the natural history of Dupuytren’s disease.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Diagnostic, I.
Identification of High-Quality Fat Based on Precision Centrifugation in Lipoaspirates Using Marker Floats
Authors: Guan Jingyan , He Yunfan , Wang Xinhui , Yao Yao , Li Ye , Wang Zijue , Chen Yunzi , Dong Ziqing , Lu Feng 
Published: May 2020

Background:
Centrifugation creates “graded densities” of fat with varying cellular and biological compositions that influence graft retention. This study aimed to find an accurate method to identify fat fractions that are suitable for implantation.

Methods:
Five marker floats (0.925, 0.930, 0.935, 0.940, and 0.945 g/ml) were added to human lipoaspirates that were then centrifuged at 1200 g for 3 minutes to grade the density of centrifuged lipoaspirates. After centrifugation, four fat fractions divided by floats were collected for fat characteristics analysis and in vivo grafting, with Coleman fat as a control.

Results:
Fat characteristics varied significantly between the centrifuged fat fractions divided by the 0.935-g/ml marker float. Compared with low-quality fat (<0.935 g/ml), high-quality fat (>0.935 g/ml) contains more stromal vascular fraction, adipose-derived stem cells, and extracellular matrix content. Furthermore, adipocytes were found to be significantly smaller in high-quality fat than in low-quality fat, and high-quality fat persisted at a greater volume compared with low-quality fat in vivo at week 12.

Conclusions:
High-quality fat contains more stromal vascular fraction cells, extracellular matrix content, and small adipocytes, leading to the highest implant volume retention, whereas low-quality fat contains more fragile large adipocytes, leading to the least volume retention. Marker floats can be used to grade the density of lipoaspirates, with fat greater than 0.935 g/ml recommended as a suitable alternative for implantation.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
Dental Implant Survival in Vascularized Bone Flaps: A Systematic Review and Meta-Analysis
Authors: Panchal Hina , Shamsunder Meghana G. , Petrovic Ivana , Rosen Evan B. , Allen Robert J. , Hernandez Marisol , Ganly Ian , Boyle Jay O. , Matros Evan , Nelson Jonas A. 
Published: May 2020

Background:
Maxillofacial reconstruction with vascularized bone restores facial contour and provides structural support and a foundation for dental rehabilitation. Routine implant placement in such cases, however, remains uncommon. This study aims to determine dental implant survival in patients undergoing vascularized maxillary or mandibular reconstruction through a systematic review of the literature.

Methods:
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the literature was queried for implant placement in reconstructed jaws using Medical Subject Headings terms on PubMed, Embase, and Cochrane platforms. Weighted implant survivals were calculated for the entire cohort and subcohorts stratified by radiotherapy. Meta-analyses were performed to estimate effect of radiation on implant osseointegration.

Results:
Of 3965 publications identified, 42 were reviewed, including 1084 patients with 3636 dental implants. Weighted implant survival was 92.2 percent at a median follow-up of 36 months. Survival was 97.0 percent in 269 implants placed immediately in 60 patients versus 89.9 percent in 1897 delayed implants placed in 597 patients, with follow-up of 14 and 40 months, respectively. Dental implants without radiotherapy exposure had better survival than those exposed to radiation (95.3 versus 84.6 percent; p < 0.01) at a median follow-up of 36 months. Meta-analyses showed that radiation significantly increased the risk of implant failure (risk ratio, 4.74; p < 0.01) and suggested that implants placed before radiotherapy trended toward better survival (88.9 percent versus 83.4 percent, p = 0.07; risk ratio, 0.52; p = 0.14).

Conclusions:
Overall implant survival was 92.2 percent; however, radiotherapy adversely impacted outcomes. Implants placed before radiotherapy may demonstrate superior survival than implants placed after.
Restoration of Spinopelvic Continuity with the Free Fibula Flap after Limb-Sparing Oncologic Resection Is Associated with a High Union Rate and Superior Functional Outcomes
Authors: Mericli Alexander F. , Boukovalas Stefanos , Roubaud Margaret S. , Kai-Cheng Chu Carrie , Bird Justin , Lewis Valerae O. , Rhines Laurence D. , Chang Edward I. , Adelman David M. , Hanasono Matthew M. 
Published: May 2020

Background:Type 1 internal hemipelvectomies and total sacrectomies cause significant biomechanical instability, demanding pelvic ring reconstruction for ambulation and torso support. Previously described methods include autografts, allografts, and implants, commonly with poor long-term outcomes. The authors hypothesized that the free fibula flap for spinopelvic reconstruction is safe and effective, and associated with a high bony union rate and superior functional outcomes.Methods:The authors performed a retrospective review of all patients who underwent free fibula flap surgery after internal hemipelvectomy or total sacrectomy at M. D. Anderson Cancer Center from 2003 to 2018. The primary outcome was radiographic evidence of bony union. Secondary outcomes included surgical-site occurrence and lower extremity function. Univariate and multivariate logistic regression analyses were performed.Results:Forty-seven patients were included (internal hemipelvectomy,n= 38; total sacrectomy,n= 9). The mean follow-up was 3.3 years and the most common abnormality was chondrosarcoma (30.4 percent). The nonunion rate was 9.7 percent and the surgical-site occurrence rate was 34 percent; there were no flap losses. Greater age was significantly associated with nonunion (OR, 1.1; 95 percent CI, 1 to 1.2;p= 0.003), whereas obesity was the only independent predictor of surgical-site occurrence (OR, 9.2; 95 percent CI, 1.2 to 71.3;p= 0.03). Functional metrics approached those of adult norms by 3 years postoperatively. Compared to internal hemipelvectomy patients, patients undergoing total sacrectomy had more comorbidities, a higher complication rate, and a worse functional outcome.Conclusion:The free fibula flap for spinopelvic reconstruction is safe and effective, and is associated with a high bony union rate and superior functional outcomes.CLINICAL QUESTION/LEVEL OF EVIDENCE:Risk, III.
18F-FDG PET/CT Imaging of Adrenal Liposarcoma
Authors: Wang Rang , Fan Qiuping , Tian Rong 
Published: May 2020

Abstract
Liposarcoma is a common soft tissue sarcoma in retroperitoneum, but adrenal liposarcoma is rare. We here described a 61-year-old man with left-upper-quadrant pain, hypertension, and weight loss. Abdominal CT showed a large, heterogeneously enhanced mass on the left adrenal area, which compressed the surrounding pancreas, spleen, and left kidney. Subsequent FDG PET/CT demonstrated heterogeneous uptake by the lesion. Postoperative pathological findings confirmed the diagnosis of adrenal liposarcoma.
Cost-effectiveness of Intestinal Transplantation Compared to Parenteral Nutrition in Adults
Authors: Canovai Emilio , Ceulemans Laurens J. , Peers Guido , De Pourcq Lutgart , Pijpops Marleen , Hoffman Ilse , De Hertogh Gert , Hiele Martin , Jochmans Ina , Monbaliu Diethard , Vanuytsel Tim , Pirenne Jacques 
Published: May 2020

Background.
Intestinal transplantation (ITx) is the most expensive abdominal organ transplant. Detailed studies about exact costs and cost-effectiveness compared to home parenteral nutrition (HPN) therapy in chronic intestinal failure are lacking. The aim is to provide an in-depth analysis of ITx costs and evaluate cost-effectiveness compared to HPN.

Methods.
To calculate costs before and after ITx, costs were analyzed in 12 adult patients. To calculate the costs of patients with uncomplicated chronic intestinal failure, 28 adults, stable HPN patients were studied. Total costs including surgery, admissions, diagnostics, HPN therapy, medication, and ambulatory care were included. Median (range) costs are given.

Results.
Costs before ITx were €69 160 (€60 682–90 891) in year 2, and €104 146 (€83 854–186 412) in year 1. After ITx, costs were €172 133 (€122 483–351 407) in the 1st year, €40 619 (€3905–113 154) in the 2nd year, and dropped to €15 743 (€4408–138 906) in the 3rd year. In stable HPN patients, the costs were €83 402 (€35 364–169 146) in the 1st year, €70 945 (€31 955–117 913) in the 2nd year, and stabilized to €60 242 (€29 161–238 136) in the 3rd year.

Conclusions.
ITx, although initially very expensive, is cost-effective compared to HPN in adults by year 4, and cost-saving by year 5.
Outdoor PM2.5 Concentration and Rate of Change in COVID-19 Infection in Provincial Capital Cities in China
Authors: Han Yang , Lam Jacqueline CK , Li Victor OK , Crowcroft Jon , Fu Jinqi , Downey Jocelyn , Gozes Illana 
Published: May 2020

AbstractMotivated by earlier findings that exposure to daily outdoor PM2.5 (P) may increase the risk of influenza infection, our study examines if immediate exposure to outdoor P will modify the rate of change in the daily number of COVID-19 infections (R), for (1) the high infection provincial capital cities in China and (2) Wuhan, China, using regression modelling. A multiple linear regression model was constructed to model the statistical relationship between P and R in China and in Wuhan, from 1 January to 20 March 2020. We carefully accounted for potential key confounders and addressed collinearity. The causal relationship between P and R, and the interaction effect between key variables were investigated. A causal relationship between P and R across the high infection provincial capital cities in China was established via matching. A higher P resulted in a higher R in China. A 10 µg/m3 increase in P gave a 1.5% increase in R (p < 0.001). An interaction analysis between P and absolute humidity (AH) showed a statistically significant negative relationship between P × AH and R (p < 0.05). When AH was $ 5.8 g/m3, a higher P and AH gave a higher R. In contrast, when AH ≥ 5.8 g/m3, the effect of a higher P was counteracted by the effect of a higher AH, resulting in a lower R. Given that P can exacerbate R, we recommend the installation of air purifiers and better air ventilation to reduce the effect of P on R. Further, given the increasing discussions/observations that COVID-19 can be airborne, we highly recommend the wearing of surgical masks to keep one from contracting COVID-19 via the viral-particulate transmission pathway.
Does Heat Thermotherapy Improve Cardiovascular and Cardiometabolic Health? A Systematic Review and Narrative Synthesis of the Literature
Authors: Price Ben S. , Lucas Samuel J.E. , Gifford Rachel E. , Cable Nigel T. , Lucas Rebekah A.I. 
Published: May 2020

Objective: To assess the efficacy of heat thermotherapy to improve cardiovascular and cardiometabolic health, and to compare potential heat thermotherapy moderating factors.
Design: Systematic review and narrative synthesis.
Data Sources: Electronic databases (MEDLINE, EMBASE and Web of Science) were searched up to 6th February 2020.
Eligibility criteria for selecting studies: Journal articles with adult participants, a controlled trial study design, and a passive heating stimulus with a cardiovascular or cardiometabolic health outcome were included.
Results: From 1036 articles, 39 articles met the inclusion criteria. Heat thermotherapy was delivered acutely (one bout; n=19), short term (2-15 bouts; n=6) and chronically (>15 bouts; n=14), via either hot water immersion (n=26; water temperature 38-43 °C) or heated air exposure (n=11; air temperature 31-90 °C), or water perfused suit/handheld device (n=2). Heat exposure ranged from 10 to 240 minutes. Cardiovascular and cardiometabolic measurement techniques varied across studies, alongside participant age (≤35 years, n=376; >35 ≤60 years, n=335 and >60 years, n=350) and health status. 21/27 studies measuring cardiovascular outcomes reported positive health benefits, including increased flow-mediated dilation (1.3-5.3%) and lower systolic blood pressure (4-16 mm Hg). 15/22 studies measuring cardiometabolic outcomes reported positive health benefits, including reduced postprandial glucose (-0.89 to -0.5 mmol.L	-1) and C-reactive protein concentrations (-0.9 to -10.94 mg.L-1).
Conclusion: Overall, 29/39 studies demonstrated significant positive cardiovascular or cardiometabolic health benefits from heat thermotherapy across various population demographics, despite varied study design and modality. Heat thermotherapy is an efficacious treatment for cardiovascular disease alongside pharmaceutical and exercise-based interventions.
“Subtherapeutic concentrations of first-line antitubercular agents in pediatric patients and its association with tuberculosis treatment outcome: protocol for a systematic review and meta-analysis”
Authors: Chachaima-Mar Jorge , Sánchez-Velazco Diana , Ugarte-Gil Cesar 
Published: May 2020

AbstractPediatric tuberculosis is a neglected disease that is receiving more attention lately. Some studies found that serum levels of first line antituberculosis drugs do not reach reference concentrations in children. However, these reference ranges were validated in an adult sample. Thus, we do not know if subtherapeutic concentrations of antitubercular agents in children are associated with negative outcomes.ObjectiveTo estimate the association between subtherapeutic concentrations of first-line antitubercular drugs with clinical outcomes of treatment.MethodsWe propose to do a systematic review and meta-analysis. In order to do so, we will perform an electronic search in Medline, SCOPUS, Web of Science and Global Index Medicus. There will be no restriction of language nor date of publication. First, we will screen titles and abstracts; then we will screen through the full text of the article. Both phases will be done by 2 independent authors. Data extraction will be performed using a data abstraction form by two independent authors. The quality of the studies will be checked with standardized tools according to the design of the study, and will also be performed by duplicate. We will present the main characteristics of each included study through tables. The heterogeneity between studies will be assessed through the I2 statistic. If appropriate, we will use the random-effects model to calculate the pooled estimate. We will evaluate the publication bias through visual inspection of the funnel plot and Egger’s test. Pre-arranged subgroup and sensitivity analysis will be performed.ResultsWe will publish the results of this systematic review in a peer-reviewed journal.ConclusionsThis systematic review will provide up-to-date evidence regarding serum concentration in pediatric patients and its association with outcomes. With the analysis we plan, we will offer important recommendations regarding the dosage of the first line antitubercular agents in children, and the modifications that may be needed.Conflicts of interestAll the authors declare to have no conflict of interest.FundingThis study did not receive funding from the public, commercial or not-for-profit sectors.
Identification of severity zones for mitigation strategy assessment COVID-19 outbreak in Malaysia
Authors: Ahmad Tahir , Ashaari Azmirul , Awang Siti Rahmah , Mamat Siti Salwana , Mohamad Wan Munirah Wan , Fuad Amirul Aizad Ahmad , Hassan Nurfarhana 
Published: May 2020

AbstractThe objective of this research is to identify severity zones for the COVID-19 outbreak in Malaysia. The technique employed for the purpose is fuzzy graph that can accommodate scarcity, quantity, and availability of data set. Two published sets of data by the Ministry of Health of Malaysia are used to implement the technique. The obtained results can offer descriptive insight, reflection, assessment, and strategizing actions in combating the pandemic.
Syndromic Surveillance for COVID-19 in Canada
Authors: Lapointe-Shaw Lauren , Rader Benjamin , Astley Christina M. , Hawkins Jared B. , Bhatia Deepit , Schatten William J. , Lee Todd C. , Liu Jessica J. , Ivers Noah M. , Stall Nathan M. , Gournis Effie , Tuite Ashleigh R. , Fisman David N. , Bogoch Isaac I. , Brownstein John S. 
Published: May 2020

ABSTRACTBackgroundSyndromic surveillance through web or phone-based polling has been used to track the course of infectious diseases worldwide. Our study objective was to describe the characteristics, symptoms, and self-reported testing rates of respondents in three different COVID-19 symptom surveys in Canada.MethodsData sources consisted of two distinct Canada-wide web-based surveys, and phone polling in Ontario. All three sources contained self-reported information on COVID-19 symptoms and testing. In addition to describing respondent characteristics, we examined symptom frequency and the testing rate among the symptomatic, as well as rates of symptoms and testing across respondent groups.ResultsWe found that 1.6% of respondents experienced a symptom on the day of their survey, 15% of Ontario households had a symptom in the previous week, and 44% of Canada-wide respondents had a symptom in the previous month over March-April 2020. Across the three surveys, SARS-CoV-2-testing was reported in 2-9% of symptomatic responses. Women, younger and middle-aged adults (versus older adults) and Indigenous/First nations/Inuit/Métis were more likely to report at least one symptom, and visible minorities were more likely to report the combination of fever with cough or shortness of breath.InterpretationThe low rate of testing among those reporting symptoms suggests significant opportunity to expand testing among community-dwelling residents of Canada. Syndromic surveillance data can supplement public health reports and provide much-needed context to gauge the adequacy of current SARS-CoV-2 testing rates.