bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brief Report: Discrepancies Between Self-Reported Adherence and a Biomarker of Adherence in Real-World Settings
Authors: Hebel Shane , Kahn-Woods Elijah , Malone-Thomas Sheryl , McNeese Marlene , Thornton Lupita , Sukhija-Cohen Adam , Patani Henna , Engeran Whitney , Daughtridge Giffin 
Published: August 2020

Background:
Pre-exposure prophylaxis (PrEP) is only effective in preventing new HIV infections when taken consistently. In clinical practice, asking a patient about their adherence (self-report) is the predominant method of assessing adherence to PrEP. Although inexpensive and noninvasive, self-report is subject to social desirability and recall biases. Several clinical trials demonstrate a discrepancy between self-reported adherence and biomarker-based recent adherence. Less is known about the accuracy of self-report in real-world clinical settings. This brief report addresses this knowledge gap and describes the concordance between self-reported adherence and biomarker-based adherence in real-world clinical settings.

Methods:
A liquid chromatography–mass spectrometry urine test for tenofovir was developed and used clinically to detect recent nonadherence (no dose in at least 48 hours) for each individual. Two clinics' standard operating procedures recommend utilization of the urine-based adherence test for patients who self-report that they are not struggling with adherence. Those who self-report struggling with adherence receive enhanced adherence support without the need for additional testing. The number of results indicating recent nonadherence from these 2 clinics were analyzed to assess the concordance between self-reported adherence and biomarker-based adherence.

Results:
Across 2 clinics, 3987 tests were conducted from patients self-reporting as “adherent,” and 564 [14.1%; 95% confidence interval (CI): 13.1% to 15.2%] demonstrated recent nonadherence with the liquid chromatography–mass spectrometry test. At clinic #1 in Florida, 3200 tests were conducted, and 465 (14.5%; 95% CI: 13.3% to 15.8%) demonstrated recent nonadherence. At clinic #2 in Texas, 787 tests were conducted, and 99 (12.6%; 95% CI: 10.4% to 14.9%) demonstrated recent nonadherence.

Conclusions:
Utilization of biomarker-based adherence monitoring at these 2 clinics resulted in 564 additional patients receiving enhanced adherence support who otherwise would not have been identified as nonadherent to their prescribed PrEP regimen. These findings suggest that objective adherence monitoring can be used clinically to enable providers to identify nonadherent patients and allocate support services accordingly.
Ranking United States Plastic Surgery Residency Programs Based on Academic Achievement of Faculty Members
Authors: Boyd Carter J. , Davis Claire , Lindsey John T. , Ananthasekar Shivani , Kurapati Srikanth , King Timothy W. 
Published: August 2020

Introduction
The Doximity Residency Navigator is currently the only resource that ranks plastic surgery residency programs. Given the paucity of objective program rankings, in this study, we devised a new algorithm to rank plastic surgery programs based on academic achievement of faculty members.

Methods
The Fellowship and Residency Electronic Interactive Database was used to obtain the following information on plastic surgery programs: the amount of 2017 National Institute of Health and Veterans Administration funding, lifetime and 5-year faculty h-indices, and the number of faculty on editorial boards of journals. Based on all of this information, an overall ranking of the top 25 plastic surgery programs was created.

Results
The top program for annual National Institutes of Health and Veteran Affairs funding was the University of Southern California (integrated and independent). The top programs for faculty lifetime h-index were the University of Michigan (integrated) and New York University (independent). The top program for faculty 5-year h-index was the University of Pennsylvania (integrated and independent). The top program for the number of faculty members who are on the editorial boards of major journals was Harvard University (integrated and independent). The top program overall was Harvard University (integrated and independent).

Conclusion
We ranked plastic surgery residency programs based on objective data related to faculty academic achievement. Academic achievement rankings are just one of numerous other factors that medical students should synthesize when making informed decisions when applying to residency.
Fractionated Ablative Carbon Dioxide Laser Therapy Decreases Ultrasound Thickness of Hypertrophic Burn Scar
Authors: Kemp Bohan Phillip M. , Cooper Laura E. , Lu Khang N. , Raper David M. , Batchinsky Maria , Carlsson Anders H. , Cancio Leopoldo C. , Chan Rodney K. 
Published: August 2020

Introduction
Carbon dioxide (CO2) laser treatment is routinely used to treat hypertrophic burn scars (HBS). Although prior research has documented subjective improvement in HBS after treatment, there is little data evaluating objective changes in scar characteristics after therapy. The aim of our process improvement project was to evaluate changes to scar thickness (ST) using high-frequency ultrasound in patients with HBS undergoing CO2 laser therapy.

Methods
Ultrasound measurements of ST were obtained from patients with HBS before initial and at each subsequent treatment. ST, reduction in ST per treatment, and percentage reduction in ST from baseline were tabulated. Post hoc analyses examining the effect of initial ST and scar maturity on outcome were performed. First, patients were grouped by baseline ST into thicker (group 1, initial ST ≥ median value) and thinner (group 2, initial ST < median value) scar groups. Second, patients were divided into quartiles based on time from injury to treatment. Outcomes at each time point were compared with either Mann-Whitney U or Kruskal-Wallis tests, with Bonferonni corrections performed for post hoc subgroup analyses. Significance was set at P < 0.05.

Results
Twenty-one consecutive patients with HBS treated with CO2 laser were included. All patients completed 1 or more treatment, 48% completed 2 or more treatments, and 28% completed 3 treatments. Median initial ST was 0.71 cm (0.44–0.98 cm), and median scar maturity was 7.5 months (4.9–9.8 months). Overall, ST decreased over the treatment course (P < 0.001), with post hoc analysis demonstrating that 2 treatments were required to achieve a significant ST reduction (P < 0.01). On subgroup analysis comparing initial ST, ST decreased significantly in group 1 (thicker scars) overall (P < 0.001) but not in group 2 (P = 0.109). ST reduction was greatest after 1 treatment in group 1 (P = 0.022) and group 2 (P = 0.061). Percent reduction was greater in group 1 relative to group 2 after 1 treatment (P = 0.016). On subgroup analysis of scar maturity, there were no significant differences in either baseline ST or ST at any subsequent visit.

Conclusions
Fractionated ablative CO2 laser treatment improved ST after 1 to 2 treatments. Patients with thicker scars demonstrated greater ST reduction than those with thinner scars. Ultrasound adequately assessed treatment response.
Mitigating Ischemia-Reperfusion Injury Using a Bilobed Partial REBOA Catheter: Controlled Lower-Body Hypotension
Authors: Necsoiu Corina , Jordan Bryan S. , Choi Jae H. , Moon James J. , Espinoza Mark D. , Gremmer Brandon J. , Batchinsky Andriy I. , Cancio Leopoldo C. 
Published: August 2020

ABSTRACT

Background:
Non-compressible torso hemorrhage (NCTH) is the leading cause of potentially preventable death on the battlefield. Resuscitative endovascular balloon occlusion of the aorta (REBOA) aims to restore central blood pressure and control NCTH below the balloon, but risks ischemia-reperfusion injury to distal organs when prolonged. We tested a bilobed partial REBOA catheter (pREBOA), which permits some of the blood to flow past the balloon.

Methods:
Female swine (n = 37, 6 groups, n = 5–8/group), anesthetized and instrumented, were exponentially hemorrhaged 50% of estimated blood volume (all except time controls [TC]). Negative controls (NC) did not receive REBOA or resuscitation. Positive controls (PC) received retransfusion after 120 min. REBOA groups received REBOA for 120 min, then retransfusion. Balloon was fully inflated in the full REBOA group (FR), and was partially inflated in partial REBOA groups (P45 and P60) to achieve a distal systolic blood pressure of 45 mm Hg or 60 mm Hg.

Results:
Aortic occlusion restored baseline values of proximal mean arterial pressure, cardiac output, and carotid flow in pREBOA groups. Lactate reached high values during occlusion in all REBOA groups (9.9 ± 4.2, 8.0 ± 4.1, and 10.7 ± 2.9 for P45, P60, and FR), but normalized by 6 to 12 h post-deflation in the partial groups. All TC and P60 animals survived 24 h. The NC, PC, and P45 groups survived 18.2 ± 9.5, 19.3 ± 10.6, and 21.0 ± 8.4 h. For FR animals mean survival was 6.2 ± 5.8 h, significantly worse than all other animals (P < 0.01, logrank test).

Conclusions:
In this porcine model of hemorrhagic shock, animals undergoing partial REBOA for 120 min survived longer than those undergoing full occlusion.
Immunomodulatory and Therapeutic Effects of Mesenchymal Stem Cells on Organ Dysfunction in Sepsis
Authors: Khosrojerdi Arezou , Soudi Sara , Hosseini Ahmad Zavaran , Eshghi Fateme , Shafiee Abbas , Hashemi Seyed Mahmoud 
Published: August 2020

ABSTRACT
Sepsis is a life-threatening disorder that is caused by a dysregulated inflammatory response during an infection. The disease mostly affects pregnant women, newborns, and patients in intensive care units. Sepsis treatment is a significant part of a country's health budgets. Delay in the therapy causes irreversible failure of various organs due to the lack of blood supply and reduction of oxygen in the tissues and eventually increased mortality. The involvement of four or five organs by sepsis has been attributed to an increased risk of death to over 90%. Although antibiotics are at the first line of sepsis treatment, they do not possess enough potency to control the disease and prevent subsequent organ failure. The immunomodulatory, anti-inflammatory, anti-apoptotic, and anti-microbial properties of mesenchymal stem cells (MSCs) have been reported in various studies. Therefore, the application of MSCs has been considered a potentially promising therapeutic strategy. In preclinical studies, the administration of MSCs has been associated with reduced bacterial load and decreased levels of pro-inflammatory factors as well as the improved function of the different vital organs, including heart, kidney, liver, and lungs. The current study provides a brief review of sepsis and its pathophysiology, and then highlights recent findings in the therapeutic effects of MSCs and MSC-derived secretome in improving sepsis-induced organ dysfunction. Besides, eligible sepsis candidates for MSC-therapy and the latest clinical findings in these areas have been reviewed.
Whole-exome Sequencing Reveals New Potential Susceptibility Genes for Japanese Familial Pancreatic Cancer
Authors: Takai Erina , Nakamura Hiromi , Chiku Suenori , Kubo Emi , Ohmoto Akihiro , Totoki Yasushi , Shibata Tatsuhiro , Higuchi Ryota , Yamamoto Masakazu , Furuse Junji , Shimizu Kyoko , Takahashi Hideaki , Morizane Chigusa , Furukawa Toru , Yachida Shinichi 
Published: August 2020

Objective:
The primary objective of this study was to identify novel genes that predispose people in the Japanese population to FPC.

Summary of Background Data:
Familial history of pancreatic cancer is an important risk factor but, to date, few genes predisposing individuals to increased risk of developing FPC have been identified.

Methods:
We performed whole-exome sequencing of germline DNA from 81 Japanese FPC patients. We also investigated somatic gene alterations in 21 matched tumor tissues through whole-exome sequencing and copy number analysis.

Results:
Our germline variants identified previously known FPC susceptibility genes such as ATM and BRCA2, and several novel tumor suppressor genes with potentially deleterious variants for FPC. Interestingly, somatic whole-exome analysis demonstrated that most tumor samples with suspicious loss of heterozygosity of candidate genes were KRAS wild-types, implying that these cases may not have required KRAS activation as a driver event for carcinogenesis.

Conclusions:
Our findings indicate that FPC patients harbor potentially deleterious causative germline variants in tumor suppressor genes, which are known to acquire somatic mutations in pancreatic cancer, and that somatic loss of heterozygosity of some FPC susceptibility genes may contribute to the development of FPC in the absence of somatic KRAS-activating mutation. Genetic testing for a wider variety of FPC-predisposition genes could provide better screening approach for high-risk groups of pancreatic cancer.
A Novel Technique for Bile Duct Division During Laparoscopic Living Donor Hepatectomy to Overcome Biliary Complications in Liver Transplantation Recipients: “Cut and Clip” Rather Than “Clip and Cut”
Authors: Rhu Jinsoo , Kim Mi Seung , Choi Gyu-Seong , Jeong Woo Kyoung , Kim Jong Man , Joh Jae-Won 
Published: August 2020

Background.
This study was designed to analyze the clinical impact of a new bile duct division technique during laparoscopic living donor hepatectomy.

Methods.
Laparoscopic donor right hepatectomies performed by a single surgeon between December 2016 and August 2019 were included. Magnetic resonance cholangiopancreatography of the donors was reconstructed, and the length of the common channel of the dividing intrahepatic duct was measured. Patients were divided into 2 groups based on the bile duct division techniques of “clip and cut” versus “cut and clip.” Outcome of bile duct division was categorized based on the graft and bile duct type and number of bile duct openings.

Results.
A total of 147 transplantations were included. Outcomes in the “cut and clip” group were better than those in the “clip and cut” group with regard to obtaining an adequate division point (94.2% versus 78.8%; P = 0.019). The “cut and clip” showed superior biliary stricture-free survival than the “clip and cut” group (hazard ratio [HR], 0.456; confidence interval [CI], 0.217-0.957; P = 0.038) whereas recipients with hepaticojejunostomy (HR, 3.358; CI, 1.090-10.350; P = 0.035) and bile duct type other than type I (HR, 2.214; CI, 1.143-4.289; P = 0.018) showed increased risk for biliary stricture-free survival. Better outcome in terms of obtaining a single opening was also obtained in the “cut and clip” group (68.2% versus 84.6%; P = 0.040), and this difference was significant especially with a common channel shorter than 10 mm (45.5% versus 81.2%; P = 0.043).

Conclusions.
The “cut and clip” technique showed superior outcomes to the “clip and cut” technique in terms of fewer bile duct openings and biliary stricture-free survival of the recipients.
Increased Intracranial Pressure Without Hydrocephalus Associated With Spinal Cord Tumor: Literature Review
Authors: Zhou Yujia , McClelland Collin M. , Lee Michael S. 
Published: August 2020

Abstract:
Spinal cord tumors (SCTs) may rarely cause increased intracranial pressure without hydrocephalus (IICPWH). A review of the English literature published after 1970 revealed 29 cases of IICPWH secondary to SCT. The following data were acquired: demographics, tumor characteristics, ophthalmic and neurological manifestations, and cerebral spinal fluid (CSF) features. We summarize the existing literature regarding various theories of pathophysiology, spinal imaging recommendations, and treatment modalities used in managing such patients. Patients with papilledema who also have neurological signs or symptoms of myelopathy or elevated CSF protein particularly in the setting of an atypical demographic for pseudotumor cerebri should raise a suspicion for a spinal tumor and prompt further investigation with a spinal MRI.
Idiopathic Intracranial Hypertension Triggering Hemifacial Spasm
Authors: Garcia Maria D. , Mansukhani Sasha A. , Chen John J. , Bhatti M. Tariq 
Published: August 2020

Abstract:
Idiopathic intracranial hypertension (IIH) is a syndrome associated with increased intracranial pressure without a clear underlying cause that is classically seen in young women. Patients typically present with headache and ocular findings, including disc edema and, less frequently, an abduction deficit. To make a diagnosis of IIH, other than cranial nerve 6 or 7 dysfunction, patients must have a normal neurologic examination. When cranial nerve 7 is affected patients can present with hemifacial spasm. We present the case of a young woman with IIH who had hemifacial spasm as one of the presenting symptoms. Her symptoms resolved once she was treated for IIH with acetazolamide.
Pseudo-Gaze Deviation Resulting From Positive Angle Kappa and Esotropia
Authors: Rateaux Maxence , Espinasse-Berrod Marie-Andrée , Couret Chloé , Bremond-Gignac Dominique , Robert Matthieu P. 
Published: August 2020

Abstract:
A 6-year-old boy was referred for constant right gaze deviation. Rather than a gaze deviation, he constantly seemed to look on the left side of any displayed target. Examination revealed the association of a highly positive angle Kappa and an esotropia of equal values. He also exhibited signs of ocular albinism with no associated infantile nystagmus syndrome. The X-linked ocular albinism was confirmed genetically, explaining the presence of a positive angle Kappa. A highly positive angle Kappa can be associated with a convergent strabismus; in case both values offset each other, this can result in a constant “sidelooking,” which should not be confused with a gaze deviation.
Androgen receptor-reduced sensitivity is associated with increased mortality and poorer glycaemia in men with type 2 diabetes mellitus: a prospective cohort study
Authors: Heald Adrian H. , Yadegar far Ghasem , Livingston Mark , Fachim Helene , Lunt Mark , Narayanan Ram Prakash , Siddals Kirk , Moreno Gabriela , Jones Richard , Malipatil Nagaraj , Rutter Martin , Gibson Martin , Donn Rachelle , Hackett Geoff , Jones Hugh 
Published: August 2020

Introduction
Hypogonadism is associated with poorer glycaemic outcomes/increased all-cause and cardiovascular morbidity/mortality in type 2 diabetes mellitus (T2DM). Increasing CAG repeat number within exon-1 of the androgen receptor (AR) gene is associated with increased AR resistance/insulin resistance.

Methods
We determined in a long-term 14-year follow-up cohort of 423 T2DM Caucasian men, the association between baseline androgen status/CAG repeat number (by PCR then Sequenom sequencing) and metabolic/cardiovascular outcomes.

Results

Metabolic outcomes: Lower total testosterone was associated with higher BMI (kg/m2) at 14-year-follow-up: regression coefficient −0.30 (95% confidence interval −0.445 to −0.157), P = 0.0001. The range of CAG repeat number was 9-29 repeats. Higher CAG repeat number in exon-1 of the AR gene was associated with higher follow-up HbA1c2016 – each unit increase in CAG repeat-associated with an increment of 0.1% in HbA1C2016 (P = 0.04), independent of baseline testosterone. Cardiovascular outcomes and mortality: At an average of 14-year-follow-up, 55.8% of hypogonadal men had died vs 36.1% of eugonadal men (P = 0.001). There was a ‘u’ shaped relation between number of CAG repeats and mortality. Twenty-one CAG repeats were associated with an up to nearly 50% lower mortality rate than <21 CAG repeats and >21 CAG repeats – independent of baseline testosterone level.

Conclusion
A higher number of CAG repeats at the AR gene associates with higher future HbA1c. There was a ‘u’ shaped relation between CAG repeat number and mortality rate. Determination of CAG repeat number may become part of assessment of androgen status/its consequences for men with T2DM.
Pediatric surgical services in Bangladesh during the COVID 19 pandemic: How they are affected and how to overcome the backlog, keeping healthcare professionals safe
Authors: Hannan Md Jafrul , Parveen Mosammat Kohinoor , Hasan Md Samiul 
Published: August 2020

AbstractBackgroundSevere Acute Respiratory syndrome coronavirus 2 (SARS-CoV-2), which originated in Wuhan, China, has turned into a pandemic. All countries have implemented multiple strategies to try mitigating the losses caused by this virus. To stop the rapid spread of the disease and in compliance with the World Health Organization’s social distancing policy, the government of Bangladesh has implemented a number of strategies, one of which is to limit the spread of the virus in hospitals by postponing elective procedures and providing only emergency services in the hospitals.The objective of this survey was to assess the current status of pediatric surgical procedures in different hospitals in Bangladesh and assess the effects of the current restrictions along with their implications in the long run.Materials and MethodsA survey was performed among doctors from public and private hospitals in Bangladesh to evaluate the status on pediatric surgery.ResultsThe results clearly revealed the lack of a significant reduction in doctors’ exposure to SARS-CoV-2 by postponing elective procedures.ConclusionKeeping in mind the socioeconomic and health care conditions of the country, the author recommend resuming elective surgical procedures.
Complement C3 vs C5 inhibition in severe COVID-19: early clinical findings reveal differential biological efficacy
Authors: Mastellos Dimitrios C. , Pires da Silva Bruno G. P. , Fonseca Benedito A. L. , Fonseca Natasha P. , Martins Maria A. , Mastaglio Sara , Ruggeri Annalisa , Sironi Marina , Radermacher Peter , Skendros Panagiotis , Ritis Konstantinos , Manfra Ilenia , Iacobelli Simona , Huber-Lang Markus , Nilsson Bo , Yancopoulou Despina , Connolly E. Sander , Garlanda Cecilia , Ciceri Fabio , Risitano Antonio M. , Calado Rodrigo T. , Lambris John D. 
Published: August 2020

AbstractGrowing clinical evidence has implicated complement as a pivotal driver of COVID-19 immunopathology. Deregulated complement activation may fuel cytokine-driven hyper-inflammation, thrombotic microangiopathy and NET-driven immunothrombosis, thereby leading to multi-organ failure. Complement therapeutics have gained traction as candidate drugs for countering the detrimental consequences of SARS-CoV-2 infection. Whether blockade of terminal complement effectors (C5, C5a, or C5aR1) can elicit similar outcomes to upstream intervention at the level of C3 remains debated. Here we have compared the clinical efficacy of the C5-targeting mAb eculizumab with that of the compstatin-based C3-targeted drug candidate AMY-101 in small independent cohorts of severe, mainly non-intubated COVID-19 patients. Our exploratory study indicates that therapeutic complement inhibition abrogates COVID-19 hyper-inflammation. Both C3 and C5 inhibitors elicit a robust anti-inflammatory response, reflected by a steep decline in CRP and IL-6 levels, associated with marked lung function improvement and resolution of SARS-CoV-2-associated ARDS. C3 inhibition afforded broader therapeutic control in COVID19 patients by attenuating both C3a and sC5b-9 generation and preventing FB consumption. This broader inhibitory profile of anti-C3 treatment was associated with a more robust decline of neutrophil counts, a greater decline of median LDH levels and more prominent lymphocyte recovery within the first 7 days of treatment. These early clinical results offer important insight into the differential mechanistic basis and underlying biology of C3 and C5 inhibition in COVID-19. They point to a broader pathogenic involvement of C3-mediated pathways and set the stage for larger prospective trials that will benchmark these complement-targeting agents in COVID-19.