bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rotational Thromboelastometry (ROTEM)-guided Diagnosis and Management of Amniotic Fluid Embolism
Authors: Loughran J.A. , Kitchen T.L. , Sindhakar S. , Ashraf M. , Awad M. , Kealaher E.J. 
Published: February 2020

(Int J Obstet Anesth. 2019;38:127–145)
Amniotic fluid embolism (AFE) is rare but can be deadly, affecting 0.35 of 100,000 maternities in the United Kingdom. Diagnosis can be challenging and relies on exclusion, as this condition lacks special clinical features. Disseminated intravascular coagulation usually occurs in women with AFE and can lead to major postpartum hemorrhage. There has been increasing utilization of point-of-care viscoelastometric testing, including rotational thromboelastometry (ROTEM), during obstetric hemorrhage. This case report described a case of AFE in which ROTEM testing guided patient management.
A Multidimensional Latent Class Analysis of Harmful Alcohol Use Among Older Adults: Subtypes Within the Swedish Addiction Severity Index Registry
Authors: Jemberie Wossenseged Birhane , Padyab Mojgan , Snellman Fredrik , Lundgren Lena 
Published: February 2020

Objectives:
The present study aimed to identify multidimensional typologies of harmful alcohol use based on the Swedish Addiction Severity Index (ASI) assessment data on individuals aged 50 years and above.

Methods:
Latent class analysis examined 11 indicators from ASI data on 1747 individuals (men = 1255, women = 492) who reported they were troubled by alcohol problem at least one day in the past 30 days before their assessment. The discriminative validity of the classes was assessed by comparing other measures of individual characteristics and problem severity of other ASI dimensions.

Results:
Five subtypes of harmful alcohol use were identified. Two classes with alcohol problems varying in psychosocial functioning, age composition and ages of onset of both regular and heavy drinking. Two with psychiatric comorbidity but varying in violence, criminality, gender composition and ages of onset of regular and heavy drinking. One with high prevalence of concurrent use of other substances, psychiatric, legal, and employment problems.

Conclusions:
The analysis identified, in a national sample, heterogeneous risk groups of older adults with harmful alcohol use. These findings suggest a need for healthcare providers to assess older adults not only for their substance use but also for associated problems and needs. Given these findings, the Addiction Severity Index is a valuable assessment tool for older adults with harmful alcohol use.
Preoperative and Postoperative Sitting Radiographs for Adult Spinal Deformity Surgery
Authors: Yoshida Go , Ushirozako Hiroki , Hasegawa Tomohiko , Yamato Yu , Kobayashi Sho , Yasuda Tatsuya , Banno Tomohiro , Arima Hideyuki , Oe Shin , Mihara Yuki , Ide Koichiro , Watanabe Yuh , Yamada Tomohiro , Togawa Daisuke , Matsuyama Yukihiro 
Published: February 2020

Study Design.
Case-control study from a continuous series.

Objectives.
To study the impact of perioperative sitting radiographs in adult spinal deformity (ASD) patients and determine whether proximal junctional kyphosis (PJK) can be prevented using preoperative sitting radiograph.

Summary of Background Data.
Radiographic analysis of ASD comprises standing whole-spine radiography which cannot evaluate the relaxed posture without head-to-foot compensation.

Methods.
Preoperative and postoperative whole-spine standing and sitting radiographs and proximal mechanical complications in surgically treated spinal disorders with a minimum of 1-year follow-up were studied. Whole-spinal alignment was defined by cervical lordosis (CL), sagittal vertical axis (SVA), T1 slope (T1S), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and level of kyphotic apex (KA). Proximal mechanical complication was described as a PJK (proximal junctional angle >20°) or reoperation due to proximal junctional failure.

Results.
Surgically treated 113 patients were prospectively investigated. Patients were divided into either the ASD (thoracic to ilium posterior corrective fusion), or non-ASD groups. In the ASD group, 10 patients had postoperative PJK, and three revision surgeries were carried out due to PJF with neurological deficit. Comparing standing with sitting positions, CL, TK, and PT became larger, SVA became frontal, LL and SS became smaller, and KA became caudal particularly in the ASD group. Logistic regression analysis demonstrated that the most influenced plumb line for PJK was the upper instrumented vertebra (UIV) to C2 plumb line distance, with a cutoff value of 115 mm for predicting PJK.

Conclusion.
Our findings highlight the usefulness of sitting spinal alignment evaluation, particularly in ASD patients, with maximum effort of thoracic spine and lower extremity compensation at standing. Mechanical complications such as PJK could be predicted using the distance from the planned UIV to the C2 plumb line in preoperative sitting radiographs.

Level of Evidence: 3
The Impact of Routinely Measuring IOP in Younger Adults to Screen for Glaucoma in a Large Eye Hospital
Authors: Garzon Catalina , Odayappan Annamalai , Kavitha Srinivasan , Venkatesh Rengaraj , Friedman David S. 
Published: February 2020

Precis:
Intraocular pressure (IOP) screening in adults 18 to 40 years of age identified 1 in 535 young adults with or at risk for developing glaucoma in India with a cost of about Indian rupee 596 (USD 8) per patient diagnosed.

Purpose:
The purpose of this study was to evaluate the outcomes of routine noncontact tonometry as a screening modality for glaucoma in young adults receiving an eye examination at Aravind Eye Hospital, Pondicherry, India.

Methods:
Retrospective chart review of adults 18 to 40 years of age screened for IOP from November 2017 to June 2018. The diagnoses were determined by a glaucoma specialist using gonioscopy, dilated fundus examination, and occasionally, Humphrey Field Analyzer, and/or optical coherence tomography. Analyses include detection of glaucoma, ocular hypertension (OHT), angle closure, and calculation of the yield of this screening paradigm.

Results:
A total of 28,369 younger adults were screened and 296 (1.05%) were referred to the glaucoma unit, 84 for an IOP >21 mm Hg and 208 for other reasons. The hypertensive group had a mean screening IOP of 29.3±8.4 mm Hg and the following diagnoses: OHT (19%), secondary raised IOP (14%), glaucoma (26%), angle closure (4%), healthy (11%) and need for further examination (26%). Fifty-five percent of those with glaucoma were previously undiagnosed. In comparison, the normotensive group had a mean IOP of 16±2.5 mm Hg and the following diagnoses: OHT (1%), glaucoma (5%), occludable angles (8%), healthy (47%) and need of further examination (33%). Nearly 40% of these patients with glaucoma were previously undiagnosed.

Conclusions:
One of every 535 young adults screened had both IOP >21 mm Hg and angle closure, OHT, secondary raised IOP or glaucoma. Given their young age and the potential to treat and delay progression, the benefits seem to outweigh the low cost of this screening.
Effect of Nonthermal Processing on Human Milk Bactericidal Activity Against Escherichia coli
Authors: Barbarska Olga , Strom Kamila , Oledzka Gabriela , Calvo Javier , Gayà Antoni , López‐Mendoza María Carmen , Rutkowska Malgorzata , Rosiak Elzbieta , Wesolowska Aleksandra Maria 
Published: February 2020

ABSTRACTNonthermal methods are more efficient at preserving various biological properties of human milk, as compared with holder pasteurization (HoP), which is the most common preservation method. This study was performed to assess the effects of nonthermal processing on bactericidal activity against Escherichia coli in human milk. Milk samples obtained from the Regional Human Milk Bank in Warsaw at Holy Family Hospital were processed by HoP, irradiated with ultraviolet‐C (UV‐C) for 5, 10, and 15 minutes (6720 J/L each minute), subjected to 2 variations of high‐pressure processing (HPP): 450 MPa for 15 minutes and 200 MPa for 10 minutes + 400 MPa for 10 min, with a 10‐minutes break. The samples were then evaluated by a bactericidal assay (raw untreated human milk was used as a control). The bactericidal capacity after HoP was preserved in 12.1% of samples, showing a significant reduction in bactericidal properties compared with in raw milk (P < 0.05). The differences between samples preserved by nonthermal methods and raw milk were not significant (P > 0.05). Nonthermal methods of human milk treatment better preserve the bactericidal capacity compared with holder pasteurisation. Those alternative technologies to HoP can be proposed after further investigation for milk processing for Human Milk Banks facilities.
Preventing Hypothermia during Cesarean Birth
Authors: Dendis Michelle , Hooven Katie 
Published: February 2020

Abstract

Purpose:
The purpose of this integrative review was to assess common warming measures used for prevention of hypothermia during the perioperative period for women having cesarean birth and to determine their efficacy.

Methods:
A literature search was conducted via electronic databases EBSCO, PUBMED, Academic Search Premier, Google Scholar, and CINAHL using keyword search terms hypothermia, cesarean, and warming. Inclusion criteria were articles written in English and published between 2006 and 2018.

Results:
Seventeen articles were included in the review, covering three common warming measures; intravenous (IV) fluid warming, forced-air warming, and combined IV fluid and forced-air warming. Several other warming modalities were noted including warming mattresses and various combinations of interventions.

Clinical Implications:
Maternal hypothermia risk is increased during the perioperative period for women having cesarean birth without use of warming measures. Warming modalities that are beneficial in preventing maternal hypothermia in women having cesarean birth are IV fluid warming, upper body force-air warming, ambient OR temperature, and warming mattresses. National standards and guidelines from the American Society of PeriAnesthesia Nurses, the Association of Perioperative Registered Nurses, and the Association of Women's Health, Obstetric, and Neonatal Nurses are consistent with current evidence and should be in place and followed in every maternity unit caring for women having cesarean birth.
Geometric Measurements of Nipple Position in Breasts Reconstructed with Transverse Rectus Abdominis Musculocutaneous Flap: A 5-Year Prospective Study
Authors: Cha Han Gyu , Kim Hyung Bae , Yun Ji Young , Lee Taik Jong , Ahn Misung , Maldonado Andrés A. , Kim Eun Key 
Published: February 2020

Background:
After breast reconstruction, nipple position and other long-term changes in the reconstructed breast relative to the contralateral breast remain poorly understood. In this prospective cohort study, the authors performed serial nipple position measurements over 5 years in patients who had undergone breast reconstruction with a transverse rectus abdominis musculocutaneous (TRAM) flap. The effects of adjuvant radiotherapy on nipple position over time were also investigated.

Methods:
The authors studied 150 patients who had undergone nipple-sparing mastectomy, using radial incision followed by immediate unilateral pedicled TRAM flap breast reconstruction. Measurements of sternal notch–to-nipple, midline-to-nipple, and inframammary fold–to-nipple distances were performed 1 day before reconstruction and 6, 12, 36, and 60 months after surgery, on patients’ reconstructed and nonoperated breasts.

Results:
The average sternal notch–to-nipple distance increased in both reconstructed and nonoperated breasts at every follow-up visit, with an average difference of 0.393 cm at the 60-month visit (p < 0.0001). Comparing the pattern of distance change, reconstructed breasts tend to change more slowly than nonoperated breasts until 36 months postoperatively. In irradiated breasts, the sternal notch–to-nipple distance was significantly smaller than in nonirradiated breasts, and nipple position changed minimally between 1 and 3 years after surgery.

Conclusions:
Nipple position in TRAM flap–reconstructed breasts changed over time compared with that in nonoperated breasts, especially along the vertical axis. The pattern of nipple position change in reconstructed breasts became similar to nonoperated breasts 3 years after surgery. In patients who had undergone adjuvant radiation therapy, nipple position remained consistent for 1 to 3 years.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Opioid Prescribing and Use Patterns in Postsurgical Facial Trauma Patients
Authors: Lapidus Jodi B. , Santosa Katherine B. , Skolnick Gary B. , Som Avira , Cho Gerald J. , Waljee Jennifer F. , AuBuchon Jacob D. , Patel Kamlesh B. 
Published: February 2020

Background:
Facial fractures are painful injuries routinely managed by opioids after surgical repair. Studies have identified patient risk factors and prescribing patterns associated with opioid use in medicine and general surgery; however, little is known about these entities in the facial trauma population.

Methods:
A retrospective cohort study of opioid-naive patients undergoing surgical repair of facial fractures was conducted using the Truven Health MarketScan Commercial Claims and Encounters (2006 to 2015) and Medicaid Multi-State Databases (2011 to 2015). Eligible procedures included nasal, nasoorbitoethmoid, orbital, mandible, and Le Fort fracture repair. Opioid type, daily dosage, and prescription duration were analyzed. Multivariable logistic regression was performed to determine independent predictors of prescription refill.

Results:
A total of 20,191 patients undergoing surgical repair of facial fractures were identified. Of these, 15,861 patients (78.6 percent) filled a perioperative opioid prescription. Refill (58.7 percent) and potentially inappropriate prescribing (39.4 percent) were common among this population. Patient factors including prior substance use (adjusted OR, 1.84; 95 percent CI, 1.63 to 2.07) and history of mental health disorder (adjusted OR, 1.43; 95 percent CI, 1.06 to 1.91) were independent predictors of refill. Increased odds of refill were seen in patients prescribed tramadol (OR, 1.98; 95 percent CI, 1.48 to 2.66) and those who underwent multiple surgical repairs (OR, 3.38; 95 percent CI, 2.54 to 4.50).

Conclusions:
Refill and potentially inappropriate prescribing occurred at high rates in facial trauma patients undergoing surgical repair. Additional studies are needed to develop guidelines for proper opioid prescribing in this population.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
A Novel Hump Reinsertion Technique to Reconstruct the Nasal Dorsum
Authors: Öztürk Güncel 
Published: February 2020

Abstract
Nasal hump removal and modification is a commonly performed procedure in rhinoplasty. The spreader flap is most commonly used in the reconstruction technique and involves suturing the medial end of the upper lateral cartilage (ULC) onto the septum. In this study, author presents a new hump removal technique that includes a novel procedure for hump reinsertion and suturing that is easy and comfortable to apply in hump removal operations. The records of the patients were assessed retrospectively from private practice. Patients who had undergone hump removal operations using a hump reinsertion graft were included. In total, 54 patients met the inclusion and exclusion criteria, and their records were assessed. The hump was divided into 3 parts longitudinally. The septum, which is a part of the nasal hump, was prepared as a strut graft, and the ULCs were prepared as spreader grafts. A novel suturing technique was used while the spreader grafts were fixed. This technique was used if the ULC was larger than 3 mm. The patients were evaluated using the “Rhinoplasty Outcome Evaluation” (ROE) 12 months after surgery. The initial median ROE score was 40.5; after surgery, it increased to 88.5. The ROE score changed significantly (P < .001). The postoperative results were satisfactory. After assessments, no asymmetry or functional problems were found in all participants. This technique allows for closed rhinoplasty without the need for an additional graft from the septum, enhancing the prevention of displacement and improving functionality.
Resuscitation From Hemorrhagic Shock With Fresh and Stored Blood and Polymerized Hemoglobin
Authors: Williams Alexander T. , Lucas Alfredo , Muller Cynthia R. , Munoz Carlos , Bolden-Rush Crystal , Palmer Andre F. , Cabrales Pedro 
Published: February 2020

ABSTRACT

Background:
Hemoglobin (Hb)-based oxygen carriers (HBOCs) have been proposed as alternatives to blood for decades. Previous studies demonstrated that large molecular diameter HBOCs based on polymerized bovine Hb (PolybHb) attenuate Hb side-effects and toxicity. The objective of this study was to test the safety and efficacy of tense state PolybHb after long-term storage.

Methods and Results:
PolybHb was subjected to diafiltration to remove low molecular weight (< 500 kDa) species and stored for 2 years. PolybHb was studied in parallel with blood, collected from rats and stored leukodepleted under blood bank conditions for 3 weeks. Rats were hemorrhaged and resuscitated to 90% of the blood pressure before the hemorrhage with fresh blood, stored blood, fresh PolybHb, or 2-year-stored PolybHb. Hemorrhagic shock impaired oxygen delivery and cardiac function. Resuscitation restored blood pressure and cardiac function, but stored blood required a significantly larger transfusion volume to recover from shock compared with fresh blood and PolybHb (fresh and stored). Stored blood transfusion elevated markers of organ damage compared with all other groups.

Conclusions:
These studies indicate that large molecular diameter PolybHb is as efficacious as fresh blood in restoring cardiac function and confirm the lack of degradation of PolybHb's safety or efficacy during long-term storage.
Deciding Our Future: Consensus Conference Summary Report
Authors: Siddiqui Nazema Y. , Dunivan Gena C. , Chermansky Christopher J. , Bradley Catherine S. 
Published: February 2020

Objectives
There are few quality measures that allow for optimization of care for pelvic organ prolapse (POP). In coordination with the American Urogynecologic Society (AUGS), a prior group agreed upon health care provider–reported data elements that are important for large-scale quality measurement. The primary objective was to review existing patient-reported outcome (PRO) measurement tools for POP and consider where improvements are needed for inclusion in a quality measurement tool. A secondary objective was to discuss enhanced strategies to improve the quality of care for women with mesh complications.

Methods
The AUGS Scientific Committee convened a 1-day meeting titled “Deciding our Future: Consensus Conference on Prolapse Outcomes and Best Practices for Mesh Complications.” Speakers discussed the current state of POP outcome measurement and meaningful ways of measuring and improving quality. Furthermore, past and future work for standardization of care regarding mesh complications was discussed.

Results
Conference participants included invited speakers, representatives from AUGS and partner societies, 5 patient representatives from the AUGS Patient Advisory Committee, and 38 registered participants from academic institutions, community practices, and industry. Participants developed a roadmap for incorporating PROs into a national POP quality improvement registry. Participants also discussed important gaps in our knowledge of treatment of mesh complications and previewed proposed terminology and treatment algorithms.

Conclusions
Using appropriate methodology, existing PRO measurement tools can be collapsed into one concise tool for POP quality measurement. Over the next year, work will continue toward this goal. Proposed updates to mesh terminology and treatment algorithms will be published separately.
Incidence and Outcomes of Significant Weight Changes After Pancreas Transplant Alone
Authors: Swanson Kurtis J. , Joachim Emily , Arunachalam Annamalai , Aziz Fahad , Garg Neetika , Mohamed Maha , Djamali Arjang , Redfield Robert R. , Kaufman Dixon B. , Odorico Jon , Mandelbrot Didier , Parajuli Sandesh 
Published: February 2020

Background.
Weight change, primarily weight gain, is a common problem among solid organ transplant recipients. The incidence of weight gain or loss after successful pancreas transplant alone (PTA) and the effect on graft survival is unknown.

Methods.
This was a single-center observational study among PTA recipients, transplanted at our center between January 1, 2005, and July 31, 2017, who had a functional pancreas graft for at least 1 year and documented weight change at the 1-year clinic visit.

Results.
In this cohort study of 105 PTA recipients, 28 had significant weight gain, 27 had significant weight loss, and the remaining 50 did not have significant weight change at 1-year posttransplant. When comparing the weight gain and no weight change groups, the weight gain cohort started to gain weight at 3 months posttransplant to 5 years or last follow up. Similarly, the weight loss group lost weight at 3 months posttransplant up to last follow up. Clinically significant weight gain or weight loss were not associated with uncensored or death censored graft failure in univariate regression and Kaplan-Meier survival analysis. Also, there were no significant differences between the groups in the glycated hemoglobin at last follow up.

Conclusions.
Approximately 50% of PTA recipients had a significant weight change at 1-year posttransplant, of which 25% gained significant weight and 25% loss. There was no significant difference in graft survival due to the significant weight changes. Further research is needed in this field.
Leveraging Heterogeneous Network Embedding for Metabolic Pathway Prediction
Authors: Basher Abdur Rahman M. A. , Hallam Steven J. 
Published: February 2020

AbstractMetabolic pathway reconstruction from genomic sequence information is a key step in predicting regulatory and functional potential of cells at the individual, population and community levels of organization. Although the most common methods for metabolic pathway reconstruction are gene-centric e.g. mapping annotated proteins onto known pathways using a reference database, pathway-centric methods based on heuristics or machine learning to infer pathway presence provide a powerful engine for hypothesis generation in biological systems. Such methods rely on rule sets or rich feature information that may not be known or readily accessible. Here, we present pathway2vec, a software package consisting of six representational learning based modules used to automatically generate features for pathway inference. Specifically, we build a three layered network composed of compounds, enzymes, and pathways, where nodes within a layer manifest inter-interactions and nodes between layers manifest betweenness interactions. This layered architecture captures relevant relationships used to learn a neural embedding-based low-dimensional space of metabolic features. We benchmark pathway2vec performance based on node-clustering, embedding visualization and pathway prediction using MetaCyc as a trusted source. In the pathway prediction task, results indicate that it is possible to leverage embeddings to improve pathway prediction outcomes.Availability and implementationThe software package, and installation instructions are published ongithub.com/pathway2vecContactshallam@mail.ubc.ca