bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perineorrhaphy Compared With Pelvic Floor Muscle Therapy in Women With Late Consequences of a Poorly Healed Second-Degree Perineal Tear: A Randomized Controlled Trial
Authors: Bergman Ida , Söderberg Marie Westergren , Ek Marion 
Published: June 2020

(Abstracted from Obstet Gynecol 2020;135:341–351)
Perineal trauma and tears during vaginal childbirth is common in primiparous women. Reported rates of perineal tears range from 47% to 78%.
Shigellosis Among Gay and Bisexual Men: A Qualitative Assessment to Examine Knowledge, Attitudes, and Practices
Authors: Caruso Elise , Wright Eric R. , Respress Ebony Townsend , Evener Steve L. , Jacobson Kathleen , Bowen Anna , Kachur Rachel , Garcia-Williams Amanda 
Published: June 2020

BackgroundShigellosis is a highly contagious enteric bacterial disease transmitted through the fecal-oral route. It is primarily transmitted through person-to-person contact and via contaminated food and water. Outbreaks of shigellosis among men who have sex with men (MSM) attributed to sexual person-to-person contact have been reported. These outbreaks are of concern because they are often caused by multidrug-resistant strains ofShigella. Little is known about shigellosis-related knowledge, attitudes, and practices among gay, bisexual, and other MSM.MethodsSix focus groups were conducted among self-identified gay or bisexual men in Atlanta, GA, in Fall 2017. Participants were asked about shigellosis-related knowledge, attitudes, and practices. Focus groups were audio recorded, and the transcribed audio was analyzed using inductive and deductive thematic coding.ResultsAmong the 24 focus group participants, most perceived that diarrheal illness was caused by contaminated food. Knowledge of shigellosis andShigellawas low, with most never having heard of the disease or bacteria. Participants did not perceive shigellosis to be a serious health concern, especially when compared with HIV; however, they did perceive gay and bisexual men to be at risk ofShigellainfection. Participants reported mixed intentions to change sexual behaviors to prevent shigellosis or talk with sexual partners about diarrhea.ConclusionsHealth communication and education efforts could be used to increase knowledge about shigellosis and shift perceptions about the severity of shigellosis among gay, bisexual, and other MSM. Additional work is needed to identify effective ways to promote shigellosis-related prevention behaviors among gay, bisexual, and other MSM.
Incidental Massive Hydrocephalus Associated With an Unruptured Choroid Plexus Arteriovenous Malformation and Complete Agenesis of the Corpus Callosum Found in an Adult at Autopsy
Authors: Conway Kyle , Smith Zachary , Nguyen Teresa , Hlavaty Leigh , Venneti Sriram , Camelo-Piragua Sandra , Webb Milad 
Published: June 2020

Abstract
Undiagnosed significant hydrocephalus is an uncommon finding at forensic autopsy as many cases present in life with complex neurological symptoms. We present a case of a 46-year-old man with no neurological deficits or history of head trauma that was incidentally found to have a massive hydrocephalus at autopsy. This was found to be associated with an unruptured arteriovenous malformation completely confined to the choroid plexus as well as complete agenesis of the corpus callosum. The arteriovenous malformation was found to form a calcified obstruction at the foramen of Monro analogous to a mass lesion, such as a colloid cyst of the third ventricle. The association of this malformation and agenesis of the corpus callosum has never been described. Histologic examination of the brain confirmed significant loss of white matter tracts and thinning of the cortical ribbon due to pressure atrophy of the ependymal lining without significant gliosis, cortical dysplasia, or evidence of other developmental malformations. Autopsy is a vital tool in the evaluation of such rare cases, enhances epidemiologic data, and increases the understanding of these pathophysiological associations.
An Inflamed, Giant, True, Extramural Duodenal Diverticulum
Authors: Sakry Rachel C. , Kemp Walter L. 
Published: June 2020

Abstract
A 53-year-old man was found to have a giant 16 × 6-cm hemorrhagic and cystic mass centered on the pancreas and duodenum. Initially diagnosed as a pancreatic pseudocyst at the time of autopsy, the cystic mass was later determined by histologic examination to be a true diverticulum of the duodenum as microscopic examination of the wall revealed 2 layers of muscle, as well as a neutrophilic infiltrate. While the cause of death of the individual was certified as methamphetamine toxicity, cardiomegaly and probable dehydration associated with a giant duodenal diverticulum were listed as contributory conditions. While duodenal diverticula in general are relatively uncommon findings, an extramural, true, giant duodenal diverticulum that is inflamed is a rare clinical or autopsy finding, with only 2 case reports identified in the clinical medical literature and none in the forensic literature.
An Illustrative Case of Suicidal Hanging Versus Accidental Hanging Associated With Autoerotic Activity
Authors: Zou Jalynn , Bauler Laura D. , Brown Theodore T. 
Published: June 2020

Abstract
The majority of hanging deaths are relatively straightforward when opining the manner of death, typically determined to be suicide. However, there are rare hanging deaths that require the forensic pathologist to seek additional information. Forensic pathologists commonly consider an accidental manner of death when the hanging death scene includes evidence of solitary sexual activity consistent with autoerotic asphyxia. Here, the authors present a case of an initially apparent suicidal hanging where important death scene details photographed by the medical examiner investigator and history provided by family members during subsequent conversations ultimately helped the forensic pathologist conclude an opinion that the hanging was accidental, likely due to autoerotic activity. The decedent, who hanged himself in the closet of his bedroom, was wearing shorts that were initially believed to be inadvertently torn; however, further investigation revealed his shorts were intentionally modified to expose his genitalia. Additional evidence documented from the death scene photographs and conversations with his mother revealed items and activities consistent with autoerotic behavior. Before opining a manner of death in hanging deaths, forensic pathologists are encouraged to consider details beyond that obtained from the initial death scene investigation and postmortem examination. A thorough medicolegal death investigation should not be viewed as introducing cognitive bias, but rather as necessary information needed to determine the most accurate cause and manner of death.
Let the EHR Talk Loudly: An EHR-Connected Verbal Surgical Safety Checklist for Medical Procedures in the Intensive Care Unit
Authors: Uppot Raul N. , Yu Alvin Yiu Chun , Samadi Katayoun , Pino Richard M. , Lee Jarone 
Published: June 2020

Objectives
The purpose of this study was to test the accuracy and user acceptance of an electronic health records (EHR)-connected verbal surgical safety checklist in the intensive care unit (ICU).

Methods
An EHR-connected verbal checklist software was deployed in our ICU between January 2019 and June 2019. The software, loaded on a mobile tablet, loudly verbalized clinical information from the EHR in the form of a time-out checklist. The accuracy of the information delivered was compared with up-to-date clinical data in the EHR in 300 patients. User acceptance was assessed using survey instruments.

Results
The software accurately verbalized patient demographics in 100% (300/300) of tested cases. Concordance rates with real-time values in the EHR for the following variables were calculated: allergies 98.6% (296/300), international normalized ratio 97.6% (293/300), and platelets 91.6% (275/300). Surveys showed that 41.2% (7/17) of users preferred current standard EHR time-outs, 17.6% (3/17) preferred verbalization software, 35.3% (6/17) preferred neither, and 5.9% (1/17) wanted both. When asked if EHR-connected verbalization software should officially replace the current standard EHR checklists, 76.5% (13/17) supported the idea.

Conclusions
An EHR-connected verbal surgical safety checklist software can leverage information in the EHR to help with workflow and patient safety. This study shows that the software can verbally deliver clinical information with great accuracy and that most ICU staff would support replacing current time-out processes.
The Effect of Padded Adhesive Dressing and Static Body Position on Sacral Interface Pressure
Authors: Seu Michelle , Bhat Deepa , Wong Alison , Wong Michael , Nojoomi Matthew , Padula William , Sacks Justin M. 
Published: June 2020

Objectives
Padded adhesive bandages are frequently used in the inpatient setting for sacral pressure injury prevention, but it is unclear whether they truly decrease interface pressure. We hypothesized such devices reduce sacral peak interface pressure in the supine position, which would be further reduced in 30-degree reclined and upright seated positions.

Methods
Study participants rested with their sacrum on a pressure-sensing mat, in 3 positions, for 30 seconds each: (1) sitting upright; (2) supine; and (3) supine against 30-degree wedge. Measurements were made with and without a padded adhesive bandage overlying the sacrum. Age, sex, and body mass index (BMI) were collected. These variables were entered sequentially, in an a priori order to construct a linear mixed-effects model.

Results
Forty healthy adults participated. After controlling for by-subject variation, age, and sex, BMI did not influence peak sacral pressure (P = 0.22), although the effect of body position was significant (P < 0.01). Subsequent addition of padded adhesive dressing was nonsignificant (P = 0.17); sacral peak pressure was similar with a padded adhesive dressing (247.8 ± 147.3 mm Hg) or without (mean ± standard deviation = 229.8 ± 127.7 mm Hg). Lastly, there was no significant interaction between BMI and body position (P = 0.11).

Conclusions
Padded adhesive bandages did not reduce interface pressure in any position. Sacral pressure was highest in the supine position and was not specifically affected by BMI. If padded bandages provide clinically significant reduction in pressure injury incidence, it is not simply through the reduction of interface pressure.
Pharmacokinetic and Pharmacodynamic Impacts of Depot Medroxyprogesterone Acetate Use on HIV Pre-exposure Prophylaxis in Women
Authors: Tarleton Jessica , Chen Beatrice A. , Meyn Leslie A. , Hendrix Craig W. , Marzinke Mark A. , Achilles Sharon L. 
Published: June 2020

Background:
Depot medroxyprogesterone acetate (DMPA) is a commonly used contraceptive in areas where use of tenofovir disoproxil fumarate and emtricitabine for HIV pre-exposure prophylaxis (PrEP) is increasing.

Objectives:
We aimed to investigate the impact of DMPA on PrEP drug pharmacokinetics and pharmacodynamics in women using PrEP before and after DMPA administration.

Methods:
In this pilot study, 12 HIV-negative women ages 18–45 underwent biological sample collection at 3 time points: before study drug, after 2 weeks of daily PrEP use alone, and after 2 weeks of daily PrEP and concomitant DMPA use. We measured drug and drug metabolites in plasma, peripheral blood mononuclear cells, cervicovaginal fluid, cervical tissue, and rectal fluid after each 2-week course of PrEP. We measured HIV replication ex vivo in genital tissue biopsies and innate anti-HIV activity in cervicovaginal fluid before PrEP and after both courses. We compared drug concentrations after PrEP alone to after PrEP and DMPA in the same participant using Wilcoxon signed-rank tests. We used mixed effects linear regression models to compare pharmacodynamic measures for each participant at predrug baseline, after PrEP alone, and after PrEP and DMPA.

Results:
We found no significant differences in PrEP drug and drug metabolite concentrations in any compartment during concomitant DMPA use compared with use of PrEP alone, except for a reduction in emtricitabine concentration in cervical tissue. We found no difference in HIV replication in cervical tissue or anti-HIV activity in cervicovaginal fluid during concomitant DMPA and PrEP use compared with during PrEP use alone.

Conclusions:
Concomitant use of DMPA does not clinically alter pharmacokinetics or pharmacodynamics of PrEP in women. These data support the safety of DMPA use in women using PrEP.
Surgical Complications of Skin-Sparing Mastectomy and Immediate Implant-Based Breast Reconstruction in Women Concurrently Treated With Adjuvant Chemotherapy for Breast Cancer
Authors: Kooijman Merel M. L. , Hage J. Joris , Oldenburg Hester S. A. , Stouthard Jacqueline M. , Woerdeman Leonie A. E. 
Published: June 2020

Background and Aim
To date, studies on adjuvant chemotherapy as a risk factor for the surgical outcome of combined mastectomy and breast reconstruction were hampered by the inclusion of mixed reconstructive cohorts of both delayed and immediate timing and of both autologous and implant-based techniques. Consequently, there is a paucity of data on the impact of adjuvant chemotherapy on surgical complication rates after combined skin-sparing mastectomy and immediate implant-based breast reconstruction.

Methodology
We compared the postoperative complications that occurred within 16 weeks after this combined procedure in 131 women (139 breasts) treated with adjuvant chemotherapy with those in a control group of 491 women (517 breasts) not receiving any adjuvant therapy within 16 weeks.

Results
In line with the clinically indicated selection of women to undergo adjuvant chemotherapy, the interventional group differed significantly from the control group in 7 of the 12 patient- and procedure-related characteristics. The prevalence of minor complications (13.7% and 12.4%, respectively, P = 0.68) and major complications (31.7% and 29.4%, respectively, P = 0.60) did not differ significantly between the interventional group and the controls. The fraction of breasts that needed unscheduled surgery (0.29 and 0.24, respectively, P = 0.20), the fraction of total number of interventions (0.34 and 0.33, respectively, P = 0.24), and the fraction of implants lost (0.72 and 0.67, respectively, P = 0.86) did not differ significantly between both groups. The onset of chemotherapy, furthermore, seemed not to influence the occurrence or severity of complications.

Conclusions
Like other women who have to undergo mastectomy, women who need to undergo adjuvant chemotherapy can potentially benefit from combined skin-sparing mastectomy and immediate implant-based breast reconstruction.
Custom Alloplastic Temporomandibular Joint Reconstruction: Expanding Reconstructive Horizons
Authors: Humphries Laura S. , Shakir Afaaf , Figueroa Alvaro A. , Mercuri Louis G. , Dianiskova Simona , Reid Russell R. , Tragos Christina 
Published: June 2020

Abstract
Custom alloplastic temporomandibular joint (TMJ) reconstruction has been well established for the management of end-stage TMJ disease. However, its use in congenital TMJ deformities is limited. Here, the authors present initial outcomes of skeletally mature patients who underwent custom alloplastic TMJ reconstruction and simultaneous orthognathic surgery.
A retrospective case series of patients who underwent custom alloplastic TMJ reconstruction concurrent with orthognathic surgery between 2014 and 2019 was completed. Functional, aesthetic and orthodontic outcomes as well as complications were recorded.
Seven TMJs in 5 skeletally mature patients (4 female, 1 male, ages 16–30) (2 bilateral, 3 unilateral) were replaced. All but 1 patient had previous attempts at reconstructive surgery with poor results. All cases were prepared using virtual surgical planning and underwent concomitant maxillomandibular orthognathic surgery. All patients demonstrated improved post-operative occlusions. Four of 5 patients achieved >30 millimeters of post-operative MIO. Complications included ear canal perforation and facial nerve dysfunction.
There were no infections or other implant-related complications. Mean follow up was 2 years and 15 days. Alloplastic TMJ reconstruction at the time of skeletal maturity for patients with congenital mandibular TMJ defects is an alternative to existing management options. Further long-term prospective outcomes studies are ongoing.
Validation of the Hubli Grading System for Assessing Unilateral and Bilateral Cleft Lip Outcomes
Authors: Davis Matthew J. , Volk Angela S. , Desai Priya K. , Rumprecht Ewa , Hubli Eric 
Published: June 2020

Background:
When determining whether a cleft lip repair outcome is acceptable, the severity of a patient's cleft at initial presentation must be considered. Currently, there is not a widely agreed upon scale for grading the pre-operative severity or post-operative surgical outcome for patients with unilateral and/or bilateral cleft lip. The aim of this study is to validate the Hubli grading system as a reliable and reproducible system for characterizing cleft lip repair outcomes.

Methods:
Craniofacial surgeon graders independently evaluated 2489 patients from 56 different countries undergoing both unilateral and bilateral cleft lip repair from April 2004 to December 2018. Preoperative severity and postoperative surgical results were assessed, and these grades were combined to determine surgical outcome acceptability based on initial cleft severity. Intrarater and interrater reliability were calculated as percentages of agreement.

Results:
Intrarater and interrater acceptability scores had an agreement of 94.50% and 87.04%, respectively. These results indicate that using the Hubli grading system, independent raters are able to reliably and reproducibly measure the acceptability of a cleft lip repair.

Conclusions:
This study validates the use of the Hubli grading system to evaluate the acceptability of unilateral and bilateral cleft lip repairs. This is the largest study to date to evaluate cleft lip severity and repair outcomes, and the Hubli grading system is the only scale to determine the acceptability of surgical outcomes based on initial cleft severity. This system is designed to identify surgeons with sub-optimal outcomes in order to implement timely, individualized training on a global scale.
Breast Implant-associated Anaplastic Large Cell Lymphoma
Authors: Tevis Sarah E. , Hunt Kelly K. , Miranda Roberto N. , Lange Caitlin , Pinnix Chelsea C. , Iyer Swaminathan , Butler Charles E. , Clemens Mark W. 
Published: June 2020

Objective:
We sought to evaluate patients at a single academic institution in a prospective manner to report patient presentation, clinical course, treatment, and outcomes in breast implant ALCL patients.

Background:
Breast implant-associated anaplastic large cell lymphoma (breast implant ALCL) is an uncommon T cell lymphoma, which is associated with textured surface breast implants. The disease has received increasing attention over the last 20 years. Previous retrospective studies have begun to outline the clinical course of breast implant ALCL.

Methods:
We prospectively followed women with cytologically proven breast implant ALCL from 2014 to 2019. Demographic, clinical, treatment, and outcome data were collected and descriptive statistics were performed on variables of interest.

Results:
We identified 52 women with pathologically confirmed breast implant ALCL. Implants were placed for augmentation in 61.5% of women and reconstruction in 36.5% of women. All of the 41 patients with known implant information had implants with textured surface. The majority of patients presented with delayed seroma (69.2%) and without systemic symptoms (86.5%). Most patients with staging information presented with Stage IA disease. Patient outcomes were excellent with 2 disease recurrence (3.8%) and all patients ultimately achieved complete remission.

Conclusions:
Further evaluation of the prospective and growing database of patients with breast implant ALCL will further improve our understanding of the disease and its clinical course. Robust participation in the breast implant ALCL PROFILE registry will improve our knowledge of long-term outcomes after implant placement. Finally, increasing awareness for patients and providers will lead to earlier diagnosis and improved outcomes for patients.
Methylenetetrahydrofolate reductase gene C677T polymorphism and risk of alcohol dependence
Authors: Rai Vandana , Kumar Pradeep 
Published: June 2020

AbstractAlcohol dependence is a complex neuropsychiatric disorder. Numerous studies investigated association between MTHFR gene C677T polymorphism and alcohol dependence (AD), but the results of this association remain conflicting. Accordingly, authors conducted a meta-analysis to further investigate such an association. PubMed, Elsevier Science Direct and Springer Link databases were searched for studies on the association between the MTHFR C677T polymorphism and AD. Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated using the fixed- or random-effects model. Statistical analysis was performed with the software program MetaAnayst and MIX.A total of 11 articles were identified through a search of electronic databases, up to February 28, 2020. The results of the present meta-analysis did not show any association between MTHFR C677T polymorphisms and AD risk (for T vs. C: OR = 1.04, 95% CI = 0.88-1.24; CT vs. CC: OR=1.02, 95%CI= 0.62-1.68; for TT + CT vs. CC: OR = 1.10, 95% CI = 0.94-1.29; for TT vs. CC: OR = 1.01, 95% CI = 0.66-1.51; for TT vs. CT + CC: OR = 0.97, 95% CI = 0.66-1.40). Results of subgroup analysis showed no significant association between MTHFR C677T polymorphism with AD in Asian as well as in Caucasian population. In conclusion, C677T polymorphism is not a risk factor for alcohol dependence.
Are Suboptimal in utero Conditions Associated with Obesity and Cardiometabolic Risk Factors in Caucasian children?
Authors: Saidj Soraya , Henderson Melanie , Ruchat Stephanie-May , Paradis Gilles , Hulst Andraea Van , Zappitelli Michael , Mathieu Marie-Eve 
Published: June 2020

AbstractObjectiveTo explore the association between in utero exposure to suboptimal gestational factors (SGFS; gestational diabetes mellitus, hypertensive disorders during pregnancy, maternal smoking during pregnancy), childhood obesity, and cardiometabolic risk factors.MethodsData were obtained from the “QUebec Adiposity and Lifestyle InvesTigation in Youth” longitudinal study (QUALITY) composed of 630 Caucasian children recruited at age 8–10 (first visit V1; n=619) and followed-up 2 years later (second visit V2; n=557). Multivariate logistic regression models were used.ResultsIn the cohort, maternal smoking during pregnancy was associated with higher odds of obesity (OR1=2.00, 95% CI 1.25-3.20, OR2=2.29, 95% CI 1.26-4.16) at both visit and with higher odds of high waist circumference (OR1=1.96, 95% CI 1.24-3.1) at V1. Hypertensive disorders during pregnancy were associated with higher odds of obesity (OR1=2.37, 95% CI 1.17-4.80) at visit 1. Joint exposure to SGFS was associated with higher odds of: high waist circumference (OR1=1.42, 95% CI 1.06-1.91) at V1, obesity (OR2= 1.63, 95% CI 1.153-2.32) at V2 and low levels of HDL cholesterol (OR2=1.45, 95% CI 1.04-2.03) at V2. Analysis stratification by sex revealed that boys were more adversely affected by exposure to combined SGFS while girls were more affected by exposure to maternal smoking during pregnancy.ConclusionIn utero exposure to an independent or combined SGFS is associated with adverse adipose and cardiometabolic profiles in children, with sex specificities.