bluuebunny/crossref_metadata_2025_split huggingface dataset:
Informational Efficiency in Securitization after Dodd-Frank
Authors: Flynn Sean J , Ghent Andra C , Tchistyi Alexei 
Published: January 2020

Abstract
We analyze how Dodd-Frank-mandated risk retention affects the information investors extract from issuers’ retention choices in the CMBS market. We show that the required retention level is both binding and stringent. Although this implies issuers cannot signal using the level of retention, we provide a model showing that signaling can occur by varying the retention structure. The model is consistent with spreads being empirically lower in deals with a purely first-loss retention structure. A stated concern of rulemakers is asymmetric information. However, we show that, post-crisis, the level of asymmetric information in this market is quite low.
Behavioral and neural evidence for an evaluative bias against other people’s mundane interracial encounters
Authors: Wang Yin , Schubert Thomas W , Quadflieg Susanne 
Published: January 2020

Abstract
Evaluating other people’s social encounters from a third-person perspective is an ubiquitous activity of daily life. Yet little is known about how these evaluations are affected by racial bias. To overcome this empirical lacuna, two experiments were conducted. The first experiment used evaluative priming to show that both Black (n = 44) and White Americans (n = 44) assess the same mundane encounters (e.g. two people chatting) less favorably when they involve a Black and a White individual rather than two Black or two White individuals. The second experiment used functional magnetic resonance imaging to demonstrate that both Black (n = 46) and White Americans (n = 42) respond with reduced social reward processing (i.e. lower activity in the ventral striatum) and enhanced mentalizing (e.g. higher activity in the bilateral temporal–parietal junction) toward so-called cross-race relative to same-race encounters. By combining unobtrusive measures from social psychology and social neuroscience, this work demonstrates that racial bias can affect impression formation even at the level of the dyad.
The effects of supplementing yeast fermentation products on gut permeability, hormone concentration, and growth in newborn dairy calves1
Authors: Pisoni Lucía , Relling Alejandro E 
Published: January 2020

Abstract:
The objectives of this study were to evaluate the effect of the use of yeast fermentation products (YFP) on growth, hormone concentration, and gut permeability in dairy calves. One hundred and twenty heifers were randomly assigned to one of three treatments: control group with no YFP supplementation (C), Saccharomyces cerevisiae fermentation products (SCFP) supplementation (1 g/head/d of SmartCare [Diamond V] in the milk and 0.7% on dry matter basis of NutriTek [Diamond V] on the starter feed), or Aspergillus oryzae fermentation extracts (AOFE) supplementation (3 g/head/d of LXtract1224 [Biozyme Inc.] in the milk). All calves received 6 L/d of pasteurized milk and had ad libitum access to water and dry feed along the study. Body weight (BW) was recorded at birth and on days 14, 30, and 45 and at weaning. Dry feed (starter) offered was measured daily and refusals twice a week to obtain starter intake (SI). Diarrhea events were recorded daily and fecal scores were classified by using a four-point scale. Blood was sampled on days 7 and 14 for plasma glucose, nonesterified fatty acids (NEFA), insulin, and IL-1β concentrations. Lactulose and D-mannitol were included in the morning feeding of day 14 and blood samples were taken an hour after feeding for assessment of intestinal permeability. On day 14, blood samples were taken for plasma glucagon-like peptide 2 (GLP-2) concentration. On day 30, fecal samples were collected for measurements of Salmonella and Escherichia coli concentration on feces. No treatment differences (P ≥ 0.13) were found for BW or SI. There was a time by treatment difference (P = 0.01) in average daily gain (ADG) on day 45 where C animals had a greater ADG when compared with SCFP and AOFE. Diarrhea incidence did not change between treatments (P = 0.97) and Salmonella and E. coli were not found in feces. There were no differences (P &gt; 0.60) between treatments for plasma GLP-2, glucose, insulin, lactulose, nor D-mannitol concentrations. There was a time by treatment tendency (P = 0.06) for NEFA concentration which tended to be greater on day 7 for C and AOFE when compared with day 14. Plasma IL-1β concentration showed a treatment tendency which tended (P = 0.06) to be greater for SCFP when compared with C. Under the current conditions, supplementation with YFP did not improve performance parameters. Plasma GLP-2 concentration, intestinal permeability, and plasma metabolites did not differ after yeast fermentation products supplementation.
Lung Ultrasound in Emergency and Critically Ill Patients
Authors: Arbelot Charlotte , Dexheimer Neto Felippe Leopoldo , Gao Yuzhi , Brisson Hélène , Chunyao Wang , Lv Jie , Valente Barbas Carmen Silvia , Perbet Sébastien , Prior Caltabellotta Fabiola , Gay Frédérick , Deransy Romain , Lima Emidio J. S. , Cebey Andres , Monsel Antoine , Neves Julio , Zhang Mao , Bin Du , An Youzhong , Malbouisson Luis , Salluh Jorge , Constantin Jean-Michel , Rouby Jean-Jacques ,   for the APECHO Study Group*
Published: January 2020

Abstract

Background
Lung ultrasound is increasingly used in critically ill patients as an alternative to bedside chest radiography, but the best training method remains uncertain. This study describes a training curriculum allowing trainees to acquire basic competence.

Methods
This multicenter, prospective, and educational study was conducted in 10 Intensive Care Units in Brazil, China, France and Uruguay. One hundred residents, respiratory therapists, and critical care physicians without expertise in transthoracic ultrasound (trainees) were trained by 18 experts. The main study objective was to determine the number of supervised exams required to get the basic competence, defined as the trainees’ ability to adequately classify lung regions with normal aeration, interstitial–alveolar syndrome, and lung consolidation. An initial 2-h video lecture provided the rationale for image formation and described the ultrasound patterns commonly observed in critically ill and emergency patients. Each trainee performed 25 bedside ultrasound examinations supervised by an expert. The progression in competence was assessed every five supervised examinations. In a new patient, 12 pulmonary regions were independently classified by the trainee and the expert.

Results
Progression in competence was derived from the analysis of 7,330 lung regions in 2,562 critically ill and emergency patients. After 25 supervised examinations, 80% of lung regions were adequately classified by trainees. The ultrasound examination mean duration was 8 to 10 min in experts and decreased from 19 to 12 min in trainees (after 5 vs. 25 supervised examinations). The median training duration was 52 (42, 82) days.

Conclusions
A training curriculum including 25 transthoracic ultrasound examinations supervised by an expert provides the basic skills for diagnosing normal lung aeration, interstitial–alveolar syndrome, and consolidation in emergency and critically ill patients.

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What We Already Know about This Topic

What This Article Tells Us That Is New
Clinical Results of Acetabular Fracture Fixation Using a Focal Kocher–Langenbeck Approach Without a Specialty Traction Table
Authors: Shaath M. Kareem , Lim Philip K. , Andrews Reid , Gausden Elizabeth B. , Mitchell Phillip M. , Tissue Camden M. , “Chip” Routt Milton L. 
Published: January 2020

Objectives:
To report the clinical result of a series of patients who underwent acetabular fracture fixation using a Kocher–Langenbeck approach without a specialty traction table.

Design:
Retrospective case series.

Setting:
Level 1 trauma center.

Patients/Participants:
All patients who sustained posterior wall or posterior wall associated acetabular fractures that were treated operatively with a Kocher–Langenbeck approach over a 5-year period.

Intervention:
Surgical fixation of acetabular fractures using a flat, radiolucent table.

Main Outcome Measurements:
Outcomes included reduction quality and complications such as infection, heterotopic ossification, loss of reduction or fixation, medical complications, and neurologic injury.

Results:
We identified 172 patients. No articular malreductions of greater than 2 mm were noted on postoperative CT scans. There were 13 surgical complications observed (8.1%). There was 1 death in our cohort (0.6%), and 3 patients had nonfatal pulmonary emboli (1.9%). There were no nerve injuries observed. There were 6 acute infections (3.1%) requiring surgical intervention. Three patients had symptomatic heterotopic bone that required excision (1.9%). Four patients (2.5%) required eventual total hip arthroplasty.

Conclusion:
Overall, we report on the largest cohort in the literature undergoing a prone Kocher–Langenbeck without a specialty table for acetabular fracture fixation. We found that limited extremity prepping and draping for a prone Kocher–Langenbeck on a flat, radiolucent table did not result in an increased rate of postoperative neurological complications or malreductions of acetabular fractures.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Sociodemographic patterns of pain in an urban community sample: an examination of intersectional effects of sex, race, age, and poverty status
Authors: Quiton Raimi L. , Leibel Daniel K. , Boyd Eryka L. , Waldstein Shari R. , Evans Michele K. , Zonderman Alan B. 
Published: January 2020

Abstract
Pain disparities based on race, sex, age, and socioeconomic status have been well documented. This study aimed to examine interactions among these sociodemographic factors on self-reported bodily pain in an urban community sample to assess whether membership in multiple at-risk groups confers greater risk for pain independent of depressive symptomatology. Participants (N = 1173) were enrolled in the epidemiological Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, and reported experiences of pain in various body sites. Logistic regression was used to examine independent and interactive relations of sociodemographic factors on the likelihood of reporting pain in one or more sites. A significant three-way interaction was found for race, sex, and poverty status (odds ratio [OR] = 6.04, 95% confidence interval [CI] [1.26-28.97], P = 0.025). Specifically, among Whites living in poverty, women were more likely to report pain than men (P = 0.043), suggesting a double disadvantage of being both female and living in poverty. Among those above the poverty line, African American (AA) men were less likely to report pain than White men (P = 0.024) and AA women (P = 0.019), potentially due to greater stoicism or coping skills and sources of resilience. Consistent with prior research, significant main effects revealed that older age (OR = 2.16, 95% CI [1.28-3.64], P = 0.004) and higher depressive symptoms (OR = 1.03, 95% CI [1.02-1.04], P < 0.001) were associated independently with increased likelihood of reporting pain. This study demonstrates that in an urban population, intersecting sociodemographic factors create unique social identities that impact pain, and emphasizes the need for identification of relevant mediational pathways.
Measured Performance and Vaccine Administration After Decision Support and Office Workflow Changes for Influenza Vaccination
Authors: Persell Stephen D. , Lewin Nora , Yagci Banu , Lee Ji Young , Oberoi Sonali K. , Orelind Erik , Roemer Phillip , Schachter Michael A. , Thomas Kathryn 
Published: January 2020

ABSTRACT
Influenza vaccination is underused. We examined changes in vaccination following decision support and workflow changes in a cross-sectional analysis of three vaccination seasons among adult primary care patients from 21 practices. Interventions included clinical decision support changes to facilitate documentation; changes to rooming workflow for medical assistants and licensed practical nurses to promote vaccination, prepare orders, document care done elsewhere; and record patient refusals. We measured rates for a national vaccination performance measure and receipt of onsite vaccination. Approximately 120,000 patients were eligible each season. Performance on the quality measure increased each year (40.6% to 62.5% to 76.4%). Corresponding rates of onsite vaccination were 27.7%, 28.8%, and 31.5%. The adjusted odds ratio for onsite vaccination in the second season compared with the first was 0.94 (95% confidence interval [CI] 0.92, 0.96). Onsite vaccination was more likely in the third season compared with either previous season—adjusted odds ratio for third versus second 1.14 (95% CI, 1.12, 1.16) or adjusted odds ratio for third versus first 1.07 (95% CI 1.05–1.09). Sequential changes in decision support and patient rooming process workflows were associated with large improvements in measured performance and with a significant increase in clinic-administered influenza vaccination by the third season.
Postmastectomy Breast Reconstruction: Exploring Plastic Surgeon Practice Patterns and Perspectives
Authors: Momoh Adeyiza O. , Griffith Kent A. , Hawley Sarah T. , Morrow Monica , Ward Kevin C. , Hamilton Ann S. , Shumway Dean , Katz Steven J. , Jagsi Reshma 
Published: January 2020

Background:
Within the multidisciplinary management of breast cancer, variations exist in the reconstructive options offered and care provided. The authors evaluated plastic surgeon perspectives on important issues related to breast cancer management and reconstruction and provide some insight into factors that influence these perspectives.

Methods:
Women diagnosed with early-stage breast cancer (stages 0 to II) between July of 2013 and September of 2014 were identified through the Georgia and Los Angeles Surveillance, Epidemiology, and End Results registries. These women were surveyed and identified their treating plastic surgeons. Surveys were sent to the identified plastic surgeons to collect data on specific reconstruction practices.

Results:
Responses from 134 plastic surgeons (74.4 percent response rate) were received. Immediate reconstruction (79.7 percent) was the most common approach to timing, and expander/implant reconstruction (72.6 percent) was the most common technique reported. Nearly one-third of respondents (32.1 percent) reported that reimbursement influenced the proportion of autologous reconstructions performed. Most (82.8 percent) reported that discussions about contralateral prophylactic mastectomy were initiated by patients. Most surgeons (81.3 to 84.3 percent) felt that good symmetry is achieved with unilateral autologous reconstruction with contralateral symmetry procedures in patients with small or large breasts; a less pronounced majority (62.7 percent) favored unilateral implant reconstructions in patients with large breasts. In patients requiring postmastectomy radiation therapy, one-fourth of the surgeons (27.6 percent) reported that they seldom recommend delayed reconstruction, and 64.9 percent reported recommending immediate expander/implant reconstruction.

Conclusions:
Reconstructive practices in a modern cohort of plastic surgeons suggest that immediate and implant reconstructions are performed preferentially. Respondents perceived a number of factors, including surgeon training, time spent in the operating room, and insurance reimbursement, to negatively influence the performance of autologous reconstruction.
Decreased Length of Postoperative Drain Use, Parenteral Opioids, Length of Stay, and Complication Rates in Patients Receiving Meshed versus Unmeshed Acellular Dermal Matrix in 194 Submuscular Tissue Expander–Based Breast Reconstructions: A Single-Surgeon Cohort Study
Authors: Hagarty Sarah E. , Yen Lawrence L. , Luo Jessica , Fosco Christopher R. , Gomez Kayeromi , Khare Manorama 
Published: January 2020

Background:
Studies have cited possible complications and increased fluid accumulation in implant-based breast reconstruction using acellular dermal matrix. The authors propose a novel approach, manually meshing acellular dermal matrix using a skin graft mesher before use in expander-based breast reconstruction. The authors investigated postoperative drain time, complication rates, pain, and length of hospital stay in meshed versus unmeshed acellular dermal matrix cohorts.

Methods:
One hundred fourteen patients and 194 reconstructed breasts were included overall. Of these, 99 patients were included in the pain and postoperative length of hospital stay analysis. Independent t test and chi-square analyses were used for bivariate comparisons. Multiple linear regression analyses were used to further delineate impact of meshing acellular dermal matrix on drain time, postoperative parenteral narcotic requirements, and length of stay between the two cohorts.

Results:
The meshed acellular dermal matrix cohort had lower overall complication rates compared with the unmeshed cohort. Multiple linear regression analyses showed meshing the acellular dermal matrix alone decreased drain time by 7.3 days, and decreased postoperative parenteral narcotic requirements by 77 percent (20 mg morphine). Furthermore, it was the only significant predictor for a decrease in length of stay.

Conclusions:
Meshing acellular dermal matrix significantly decreased the time needed for postoperative drains. Statistical analysis showed significantly decreased overall and minor complication rates in the meshed cohort. Meshing significantly decreased parenteral narcotic requirements and, importantly, also decreased length of stay. All of these factors have important implications regarding cost and quality of care in expander-based breast reconstruction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Calf Reduction by Partial Resection of Gastrocnemius Using a Suction-Assisted Cartilage Shaver
Authors: Jong Lih-Ren 
Published: January 2020

Background:
Long-term aesthetic reduction of the legs in Asians is gaining increasing popularity among cosmetic patients. Current treatment options include botulinum toxin injection, radiofrequency, neurectomy, and total, subtotal, or partial muscle resection of the gastrocnemius. Partial resection using Kelly forceps was introduced in 2000. This article presents the use of a suction-assisted cartilage shaver to perform partial resection, describing the procedures and shaver modifications and evaluating its use.

Methods:
A retrospective review of 71 cases with a minimum 6-month follow-up (average, 36.5 months; range, 6 to 160 months) was performed. Twenty partial calf reductions were performed with a short shaver, 27 with a long shaver, and 24 with an endoscope-guided long shaver.

Results:
Mean reduction of calf circumference was 2 cm (range, –1 to 6 cm); the mean preoperative and postoperative calf circumferences were 35.8 cm and 33.8 cm, respectively. Mean tissue reduction per calf was 110 g (range, 25 to 300 g).Two patients developed larger calves after surgery, one because of weight gain and the other because of weight training. Complications included surface irregularity (n = 4, 5.6 percent), numbness over the lateral ankle or lateral foot (n = 9, 12.7 percent), hematoma clot requiring surgical evacuation (n = 11, 15.5 percent), prolonged seroma (n = 2, 2.8 percent), and left ankle plantar-flexion contracture due to tight, sustained postsurgery bandaging (n = 1, 1.5 percent). Scar-related complications were hyperpigmentation (n = 6, 8.5 percent), depressed scars (n = 5, 7 percent), and hypertrophic scars (n = 2, 2.8 percent).

Conclusions:
Short, long, and endoscope-guided long suction-assisted cartilage shavers for partial resection of calf muscles can be used effectively to reduce the calf. Several mostly treatable complications were noted.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Revisiting Anastomosis to the Retrograde Internal Mammary System in Stacked Free Flap Breast Reconstruction: An Algorithmic Approach to Recipient-Site Selection
Authors: Teotia Sumeet S. , Dumestre Danielle O. , Jayaraman Avinash P. , Sanniec Kyle J. , Haddock Nicholas T. 
Published: January 2020

Background:
The authors present their stacked flap breast reconstruction experience to facilitate selection of either caudal internal mammary vessels or intraflap vessels for the second recipient anastomosis.

Methods:
A retrospective review was conducted of multiflap breast reconstructions (double-pedicled deep inferior epigastric perforator, stacked profunda artery perforator, and stacked profunda artery perforator/deep inferior epigastric perforator) performed at the authors’ institution from 2011 to 2018. Data collected included demographics, recipient vessels used, and intraoperative/postoperative flap complications. Complications were compared between cranial, caudal, and intraflap anastomoses.

Results:
Four hundred stacked flaps were performed in 153 patients. Of 400 arterial anastomoses, 200 (50 percent) were to cranial internal mammary vessels, 141 (35.3 percent) were to caudal internal mammary vessels, and 59 (14.8 percent) were to intraflap vessels. Of 435 venous anastomoses, 145 (33.3 percent) were to caudal internal mammary vessels, 201 (46.2 percent) were to cranial internal mammary vessels, and 89 (20.5 percent) were to intraflap vessels. Intraoperative revision for thrombosis occurred in 12 of 141 caudal (8.5 percent), 14 of 20 cranial (7 percent), and seven of 59 intraflap (11.9 percent) arterial anastomoses (p = 0.373), and in none of caudal, three of 201 cranial (1.5 percent), and two of 89 intraflap (2.2 percent) venous anastomoses (p = 0.559). Postoperative anastomotic complications occurred in 12 of 400 flaps (3 percent) and were exclusively attributable to venous compromise; seven of 12 (58.3 percent) were salvaged, and five of 12 (41.7 percent) were lost. More lost flaps were caused by caudal [four of five (80 percent)] versus cranial [one of five (20 percent)] or intraflap (zero of five) thrombosis (p = 0.020).

Conclusion:
If vessel features are equivalent between the caudal internal mammary vessels and intraflap vessels, intraflap vessels should be used for second site anastomosis in stacked flap reconstructions.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Inhibitory regulation of calcium transients in prefrontal dendritic spines is compromised by a nonsenseShank3mutation
Authors: Ali Farhan , Shao Ling-Xiao , Gerhard Danielle M. , Sweasy Katherine , Pothula Santosh , Pittenger Christopher , Duman Ronald S. , Kwan Alex C. 
Published: January 2020

AbstractTheSHANK3gene encodes a postsynaptic scaffold protein in excitatory synapses, and its disruption is implicated in neurodevelopmental disorders such as Phelan-McDermid syndrome, autism spectrum disorder, and schizophrenia. Most studies of SHANK3 in the neocortex and hippocampus have focused on disturbances in pyramidal neurons. However, GABAergic interneurons likewise receive excitatory inputs and presumably would also be a target of constitutive SHANK3 perturbations. In this study, we characterize the prefrontal cortical microcircuit in awake mice using subcellular-resolution two-photon microscopy. We focused on a nonsense R1117X mutation, which leads to truncated SHANK3 and has been linked previously to cortical dysfunction. We find that R1117X mutants have abnormally elevated calcium transients in apical dendritic spines. The synaptic calcium dysregulation is due to a loss of dendritic inhibition via decreased NMDAR currents and reduced firing of dendrite-targeting somatostatin-expressing (SST) GABAergic interneurons. Notably, upregulation of the NMDAR subunit GluN2B in SST interneurons corrects the excessive synaptic calcium signals and ameliorates learning deficits in R1117X mutants. These findings reveal dendrite-targeting interneurons, and more broadly the inhibitory control of dendritic spines, as a key microcircuit mechanism compromised by the SHANK3 dysfunction.