bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combating Stigma Through HIV Self-Testing: New York State's HIV Home Test Giveaway Program for Sexual Minorities
Authors: Johnson Megan C. , Chung Rakkoo , Leung Shu-Yin J. , Edelstein Zoe , Yuan Yingchao , Flavin Susan M. 
Published: February 2020

Context:
Gay, bisexual, and men who have sex with men (MSM) are disproportionately affected by the HIV/AIDS epidemic more than any other group. In New York State (NYS) outside of New York City (NYC), MSM accounted for 57% of new HIV/AIDS diagnoses in 2017. HIV/AIDS home testing initiatives have been effective at getting priority populations tested for HIV.

Objectives:
The NYS Department of Health (NYSDOH) administered the HIV Home Test Giveaway (HHTG) program through social media and mobile applications popular among the priority populations to (1) promote HIV screening among gay and bisexual men, MSM, transgender (TG), and gender queer/gender nonconforming (GNC) individuals who have sex with men, and (2) identify individuals with undiagnosed HIV infection.

Design/Setting:
The NYSDOH recruited participants from NYS (excluding NYC) through social media campaigns between November 2016 and January 2018. Interested individuals were directed to an online eligibility survey. Eligible participants received a coupon via e-mail for a free HIV self-test (HIVST) kit through the manufacturer's Web site. Eligible participants received a $20 to $25 Amazon online gift card if they completed a voluntary online follow-up survey regarding their test results, experiences with the HHTG, and HIV/AIDS risk behaviors. Participants were also able to request assistance from the NYSDOH with further testing and various prevention and supportive services.

Participants:
In total, 6190 individuals participated and 3197 (52%) were eligible and received a coupon. Of the eligible, 2022 (63%) redeemed coupons for HIVST.

Results:
Among eligible participants, 976 (31%) reported having never been tested for HIV. On the follow-up survey, 922 (29%) participants reported having used the HIVST kit for themselves; 203 (22%) were first-time testers; and 7 (0.8%) tested HIV reactive. Of the follow-up survey participants, 761 (59%) requested assistance with various services.

Conclusions:
Media campaigns were effective in promoting HIV testing among priority populations and reaching individuals who have never been tested for HIV.
Prospective Comparison of Donor-Site Morbidity following Radial Forearm and Ulnar Artery Perforator Flap Harvest
Authors: Chang Edward I. , Liu Jun 
Published: February 2020

Background:
The forearm is a common donor site, providing thin, pliable workhorse flaps for head and neck reconstruction. There are no prospective studies comparing the donor-site morbidity of the radial forearm flap to the ulnar artery perforator flap.

Methods:
All patients undergoing forearm free flaps were included for analysis and followed for a minimum of 1 year. Grip strength, sensation to light touch, temperature sensation, and wound healing were assessed.

Results:
A total of 98 patients were enrolled (radial forearm flap, n = 50; ulnar artery perforator flap, n = 48). There were three osteocutaneous radial forearm flaps performed. The donor site was closed primarily in one radial forearm flap patient and four ulnar artery perforator flap patients. The majority of donor sites were resurfaced with full-thickness skin grafts (radial forearm flap, n = 40; ulnar artery perforator flap, n = 44), and the remaining were closed with split-thickness skin grafts. Average grip strength compared to baseline measured at 1, 3, 6, and 12 months after surgery demonstrated no significant differences. All patients returned to baseline sensation to light touch with no long-term sensory deficits at 1 year. No patients suffered significant changes in temperature sensation or cold intolerance. Seven patients suffered partial skin graft loss (radial forearm flap, n = 5; ulnar artery perforator flap, n = 2); all of them healed secondarily with local wound care. There were no flap losses in the study.

Conclusions:
The radial forearm and ulnar artery perforator flaps are equivalent in terms of success and donor-site morbidity. Selection of flap should be based on need for pedicle length, flap bulk, concerns with radial or ulnar dominance, and surgeon comfort.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
A Practical Guide for Building Collaborations Between Clinical Researchers and Engineers: Lessons Learned From a Multidisciplinary Patient Safety Project
Authors: Sankaran Roshun R. , Ameling Jessica M. , Cohn Amy E.M. , Grum Cyril M. , Meddings Jennifer 
Published: February 2020

Objectives
Engineering and operations research have much to contribute to improve patient safety, especially within complex, highly regulated, and constantly evolving hospital environments. Despite new technologies, clinical checklists, and alarm systems, basic challenges persist that impact patient safety, such as how to improve communication between healthcare providers to prevent hospital-acquired complications. Because these collaborations are often new territory for both clinical researchers and engineers, the aim of the study was to prepare research teams that are embarking on similar collaborations regarding common challenges and training needs to anticipate while developing multidisciplinary teams.

Methods
Using a specific patient safety project as a case study, we share lessons learned and research training tools developed in our experience from recent multidisciplinary collaborations between clinical and engineering teams, which included many nonclinical undergraduate and graduate students.

Results
We developed a practical guide to describe anticipated challenges and solutions to consider for developing successful partnerships between engineering and clinical researchers. To address the extensive clinical, regulatory, data collection, and laboratory education needed for orienting multidisciplinary team members to join research projects, we also developed and shared a checklist for project managers as well as the training materials as adaptable resources to facilitate other teams’ initiation into these types of collaborations. These resources are appropriate and tailorable for orienting both clinical and nonclinical team members, including faculty and staff as well as undergraduate and graduate students.

Conclusions
We shared a practical guide to prepare teams for new multidisciplinary collaborations between clinicians and engineers.
Early antiretroviral therapy-treated perinatally HIV-infected seronegative children demonstrate distinct long-term persistence of HIV-specific T-cell and B-cell memory
Authors: Cotugno Nicola , Morrocchi Elena , Rinaldi Stefano , Rocca Salvatore , Pepponi Ilaria , di Cesare Silvia , Bernardi Stefania , Zangari Paola , Pallikkuth Suresh , de Armas Lesley , Levy Ofer , Rossi Paolo , Pahwa Savita , Palma Paolo 
Published: February 2020

Objective:
To investigate long-term persistence of HIV-specific lymphocyte immunity in perinatally HIV-infected children treated within the first year of life.

Design:
Twenty perinatally HIV-infected children who received ART therapy within the first year of life (early treated) and with stable viral control (>5 years) were grouped according to their serological response to HIV.

Methods:
Western blot analysis and ELISA defined 14 HIV-seropositive and six seronegative patients. Frequencies of gp140-specific T-cell and B-cell, and T-cell cytokine production were quantified by flow cytometry in both seronegatives and seropositives. Transcriptional signatures in purified gp140-specific B-cell subsets, in response to in-vitro stimulation with HIV peptides was evaluated by multiplex RT-PCR.

Results:
Gp140-specific T cells and B cells persist at similar levels in both groups. A higher production of IL-21 in gp140-specific T cells was found in seropositives vs. seronegatives (P = 0.003). Gene expression in switched IgM−IgD− gp140-specific memory B cells after stimulation with HIV peptides in vitro demonstrated a differential expression of genes involved in signal transduction and activation after BCR/TLR triggering and B-cell activation. Genes relating to antibody production (PRDM1) and T–B cognate stimulation (CXCR4, IL21R) were differentially induced after in-vitro stimulation in seronegatives vs. seropositives suggesting a truncated process of B-cell maturation.

Conclusion:
HIV-specific memory B and T cells persist in early treated regardless their serological status. Seronegatives and seropositives are distinguished by gp140-specific T-cell function and by distinct transcriptional signatures of gp140-specific B cells after in-vitro stimulation, presumably because of a different antigen exposure. Such qualitative insights may inform future immunotherapeutic interventions.
Subregion Radiomics Analysis to Display Necrosis After Hepatic Microwave Ablation—A Proof of Concept Study
Authors: Bressem Keno K. , Adams Lisa C. , Vahldiek Janis L. , Erxleben Christoph , Poch Franz , Lehmann Kai S. , Hamm Bernd , Niehues Stefan M. 
Published: February 2020

Objectives
The aim of this study was to improve the visualization of coagulation necrosis after computed tomography (CT)–guided microwave ablation (MWA) in routine postablational imaging.

Materials and Methods
Ten MWAs were performed in 8 pigs under CT guidance. After each ablation, we obtained contrast-enhanced CT scans in venous phase. Ablations were then resected as a whole, and histologic slices were obtained orthogonally through the ablation center. Subsequently, a vital stain was applied to the sections for visualization of coagulation necrosis. Computed tomography images were reformatted to match the histologic slices. Afterwards, quantitative imaging features were extracted from the subregions of all images, and binary classifiers were used to predict the presence of coagulation necrosis for each subregion. From this, heatmaps could be created, which visually represented the extent of necrosis in each CT image. Two independent observers evaluated the extent of coagulative necrosis between the heat maps and histological sections.

Results
We applied 4 different classifiers, including a generalized linear mixed model (GLMM), a stochastic gradient boosting classifier, a random forest classifier, and a k-nearest neighbor classifier, out of which the GLMM showed the best performance to display coagulation necrosis. The GLMM resulted in an area under the curve of 0.84 and a Jaccard index of 0.6 between the generated heat map and the histologic reference standard as well as a good interobserver agreement with a Jaccard index of 0.9.

Conclusions
Subregion radiomics analysis may improve visualization of coagulation necrosis after hepatic MWA in an in vivo porcine model.
Preoperative Evaluation of the Superficial Fascial System Can Predict Wound Complications in Body Contouring Surgery
Authors: Straughan David M. , McCarthy Michelle E. , Guidry Richard F. , Chaffin Abigail E. , St. Hilaire Hugo , Dancisak Michael , Lindsey John T. 
Published: February 2020

Background
The demand for body contouring surgery continues to rise. The inclusion of the superficial fascial system (SFS) during closure of such procedures has been shown to improve outcomes; however, currently reported wound complication rates remain high. The authors assess whether decreased quantities of SFS are associated with wound complications in these patients.

Methods
A retrospective study of patients undergoing body contouring surgery was performed. Preoperatively, ultrasound images were obtained of the SFS. Using Cellprofiler, the mean gray values (MGVs) of the SFS were calculated to quantify this structure. Chart review was performed to identify postoperative wound complications.

Results
Thirty-six patients were included: 30 abdominoplasties, 3 bilateral medial thigh lifts, and 3 bilateral brachioplasties. The overall wound complication rate was 22.5%. There were no significant differences in body mass index, age, smoking status, weight of resected specimen, or diabetes when comparing the complication and noncomplication groups. However, the MGV was significantly greater in the noncomplication group compared with the complication group (0.135 ± 0.008 vs 0.099 ± 0.005, respectively, P = 0.03). The average MGV for the entire cohort was 0.127. Patients with an MGV of greater than 0.127 had a wound complication rate of 0% compared with that of 39% for patients with an MGV of 0.127 or less (P = 0.005).

Conclusions
Poor quantities of SFS identified by ultrasound were associated with increased wound complications in patients undergoing body contouring surgery. Furthermore, patients with better than average SFS seem to be protected from such complications.
Portable Color-Flow Ultrasound Facilitates Precision Flap Planning and Perforator Selection in Reconstructive Plastic Surgery
Authors: Homsy Christopher , McCarthy Michelle E. , Lim Soobin , Lindsey John T. , Sands Thomas T. , Lindsey John T. 
Published: February 2020

Background
Precise flap planning and perforator selection are paramount for successful perforator flap surgery. Portable color-flow ultrasound (PCFU) is a convenient, low-cost, easily accessible imaging modality that is pivotal in the planning of perforator flaps where anatomic variability is the rule.

Methods
Perforator mapping was performed using an L12–4 linear-array ultrasound probe connected to an Android tablet. Images were obtained with the Lumify app (Philips Lumify, usa.philips.com). Perforator characteristics were recorded (arterial diameter, emergence points from fascia, subcutaneous course, and projection onto the skin surface) using still images and real-time videos.

Results
Thirty consecutive patients had 40 perforator or musculocutaneous flap reconstructions over a 2-year period. For the 15 flaps that had preoperative computed tomographic angiography (CTA) imaging, the preoperative sonographic measurements correlated with CTA and intraoperative findings. Portable color-flow ultrasound allowed perforator flap design and selection based on the largest available perforator, the most appropriate flap thickness, and comparison of multiple donor sites including left versus right. Two deep inferior epigastric perforator patients required take-back to the operating room for debridement of devitalized nonflap tissue. The superior gluteal artery perforator flap was abandoned intraoperatively due to proximal vascular anomalies. Overall flap success rate was 98% (39/40 flaps).

Conclusions
Our experience with PCFU has rapidly improved, allowing individualized perforator flap selection and design based on each patient's unique perforator anatomy, reconstructive requirements, and donor site characteristics. In our practice, PCFU has supplemented CTA and in many cases has supplanted CTA as the primary imaging modality of choice in the planning of perforator flap reconstruction.
Clinical Research of the Remanent Diplopia Correction Operation After Orbital Fracture Repair
Authors: Liu Shaorui , Shen Qin , Shi Wodong , He Jie , Fan Xianqun 
Published: February 2020

Objective:
To investigate the occasion, method and effectiveness of the diplopic correction after the orbital fracture repair in Chinese patients with orbital fracture.

Methods:
This was a retrospective observational study of 64 patients with remanent diplopia after the reconstructions of orbital fracture were studied between January 2014 and June 2017. The different cause, operational occasions, and surgical techniques analyzed. All patients were followed for 6 months after the surgeries.

Results:
After treatment, 64 patients with III degree diplopia were all performed the operations on extraocular muscles. Different operation was selected to different patients according to the examinational results of the extraocular muscles and passive drawer test, including rectos retropulsion, suspension, excise, Jensen's connection, and fixation to periorbital membrane. During the surgery, 25 patients had no diplopia in mainly functional visual fields, while 15 patients still had III degree diplopia. After 6 months, 27 patients had no diplopia in mainly functional visual fields, while 13 patients still had II degree diplopia. Among these 13 patients with III degree diplopia, 7 patients had no the diplopia of primary position of eye, and 6 patients had the diplopia of primary position. These 6 patients were suggested to wear the triangular prisms for improvement of the diplopia.

Conclusion:
The operations should be selected according to the examining results about eye movements and diplopia before and during the surgeries. Reasonable operations could correct diplopia and improve the eye movements effectually.
Usage of Epinephrine Mixed With Lidocaine in Plastic Surgery
Authors: Kim Hun , Hwang Kun , Yun Seon Mi , Kim Dae Joong 
Published: February 2020

Abstract
Plastic surgeons commonly administer subcutaneous epinephrine to reduce intraoperative blood loss. The authors hypothesized that there are safe and effective concentration of epinephrine for vasoconstriction and their durations. The aim of this study is to summarize the existing literatures for the usage of epinephrine mixed with lidocaine in plastic surgical field.
In 1903, Braun reported that adrenaline prolonged the local anesthetic effects of cocaine. The Parke-Davis Company began selling cocaine with adrenaline, as well as combining adrenaline with new synthetic local anesthetics.
Based on a review of the literature, concentrations between 1:50,000 and 1:400,000 are equally effective and provide superior vasoconstriction compared with more dilute solutions. If epinephrine is further diluted, its onset and time to peak serum concentration are delayed, and its duration of action is shortened. When lidocaine is used without epinephrine, duration of anesthesia is shortened reverse proportionally to the lidocaine concentration. When lidocaine is used with epinephrine, duration of anesthesia is prolonged proportionally to the lidocaine concentration. With slow injection rate in the soft tissue, the maximum safe dose of lidocaine is approximately 3 mg/kg plain and 7 mg/kg when mixed with epinephrine. Lidocaine may protect the myocardium because of its antiarrhythmic activity, which is the rationale for infiltrating lidocaine mixed with epinephrine in general anesthesia.
In plastic surgery, subcutaneous infiltration of epinephrine-lidocaine solution is performed to reduce intraoperative blood loss. Even in general anesthesia, infiltrating lidocaine mixed with epinephrine may protect the myocardium because of its antiarrhythmic activity.
Disastrous Complications Following Rhinoplasty: Soft Tissue Defects
Authors: Bilgen Fatma , Ince Bilsev , Ural Alper , Bekerecioğlu Mehmet 
Published: February 2020

Background:
Rhinoplasty has become one of the most frequently performed worldwide aesthetic procedures thanks to the successful results obtained by plastic surgeons. In this study, soft tissue defects, encountered as an undesirable and fearsome complication following rhinoplasty, its causes and precautions are presented by authors.

Materials and Methods:
Eight patients operated between December 2015 and December 2018 were enrolled in this study. According to the causes of soft tissue defects observed following rhinoplasty; patients were examined in 5 groups consisting of excessive subcutaneous adipose tissue defatting, improper dissection plane, compression of cast, splint and strip materials, pressure applied to skin by cartilage grafts, and overresection.

Results:
Herein, while subcutaneous excessive defatting and intense cigarette smoking was responsible of the necrosis in the first patient we defined, high pressure on skin due to tight bandaging or external splint materials lead to skin necrosis in our patients 2, 3, and 4. The 5th and 6th patients were candidates of a revision rhinoplasty; however, both resulted with necrosis probably by reason of inaccurate dissection and/or possible diminished vascularity by previous rhinoplasty operations. In the 8th patient, necrosis was observed due to the compression of the bulky autologous cartilage graft used in the skin.

Conclusion:
In conclusion, skin necrosis is a rare but bothersome complication of rhinoplasty. The importance of atraumatic techniques and appropriate dissection plane during the rhinoplasty operation as well as the importance of the effect and control of the postoperative applied splint and bandage materials is so obviously seen.
Is There an Increasing Interest in Facial Feminization Surgery? A Search Trends Analysis
Authors: Teixeira Jeffrey C. , Morrison Shane D. , Brandstetter Kathleyn A. , Nuara Michael J. 
Published: February 2020

Abstract
Facial feminization surgery (FFS) has increased in prevalence and recent studies show that transgender women are just as likely to want facial feminization surgery compared to genital affirmation surgery. While previous research has demonstrated an increase in individuals seeking gender affirmation surgery, little is known on the prevalence of facial feminization surgery. Categorizing the number of facial feminization surgeries performed is difficult given lack of reimbursement rates and paucity of centers of excellence which publish data on their case numbers. Research has also shown a general increase in the information that patients seek on the internet with respect to gender affirmation surgery as procedures have become more prevalent. However, to date, there have been no studies looking at the overall interest in individuals seeking information on facial feminization surgery on the internet. Therefore, this study looks for the first time at an analysis of Google Trends data with respect to global interest in facial feminization surgery.
Consensus Recommendations for the Use of Simulation in Therapeutic Patient Education
Authors: Penneçot Christelle , Gagnayre Remi , Ammirati Christine , Bertin Éric , Capelle Delphine , Cheraitia Elisabeth , Chiniara Gilles , David Valérie , De La Tribonnière Xavier , Decelle Béatrice , Derambure Philippe , Gignon Maxime , Greffier Catherine , Gross Olivia , Lalande Anne , Lartiguet Patrick , Letallec Claire , Mahé Claude , Mero Yannette , Mohammed Roland , Pétré Benoit , Picchiottino Patricia , Pougheon-Bertrand Dominique , Secheresse Thierry , Vaillant Geneviève , Van der Schueren-Etévé Marie , Verdier Jocelyne , Benhaberou-Brun Dalila , Bardou Marc , Marchand Claire 
Published: February 2020

Introduction
Simulation is rarely used to help individuals with chronic diseases develop skills. The aim of the study was to provide recommendations for the use of simulation in therapeutic patient education (S-TPE).

Methods
Expert consensus was achieved with the participation of the following 3 groups of experts: (a) expert patients and caregivers; (b) health professionals specialized in therapeutic patient education (TPE); and (c) simulation experts. Each expert received a list of questions by e-mail in 3 iterations. The synthesis of the 2 first questionnaires resulted in 34 first recommendations voted during the consensus conference meeting. Each recommendation was subject to an extensive literature review. The quality of the evidence and the strength of the recommendations were assessed through the evaluation, development, and evaluation criteria categories (GRADE criteria). The third questionnaire selected and illustrated recommendations more specific to the use of S-TPE.

Results
At the end of the process, the experts identified 26 recommendations specific to the use of S-TPE. They proposed examples of skills in different diseases and stressed the importance of adapting the conditions of use (location, equipment, time of the care) to the circumstances of the patient learner and skills to be developed. Experts should exercise great caution as this technique presents ethical considerations related to patient care.

Conclusions
These recommendations underline the fact that simulation could bring added value to TPE. They provide a framework and examples for the experimental use of simulation in TPE. Research into feasibility and acceptability is needed.