bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vulnerabilities for Drug Diversion in the Handling, Data Entry, and Verification Tasks of 2 Inpatient Hospital Pharmacies: Clinical Observations and Healthcare Failure Mode and Effect Analysis
Authors: de Vries Maaike , Fan Mark , Tscheng Dorothy , Hamilton Michael , Trbovich Patricia 
Published: July 2020

Objectives
Inpatient hospital pharmacies have a central role in managing controlled substances (CS) throughout the hospital medication use process (MUP). Our objectives were to identify vulnerabilities for diversion in the MUPs of 2 inpatient pharmacies, explore differences between the sites, and characterize the types of vulnerabilities identified.

Methods
We conducted clinical observations in 2 pharmacies to map their MUPs and performed a healthcare failure mode and effect analysis to proactively identify (1) the critical failure modes (CFMs) that make them vulnerable to diversion and (2) the controls that prevent, mitigate, or enhance the detectability of CFMs.

Results
We conducted 99 hours of observations between May–June and September–October 2018. We observed 36 pharmacy technicians, 4 pharmacists, and 1 clerk as they conducted tasks involving 4 processes common to both sites: procuring CS, receiving CS deliveries to the pharmacy, unit-dose packaging CS oral solids, and distributing CS to hospital units. The tasks and subtasks we mapped in the process flow diagrams led to the identification of 220 failure modes. Of these, 34 were deemed CFMs and were categorized as related to handling CS, data entry, or verification tasks. Three of the CFMs were unique to one site, given that the other site had a control for the CFM.

Conclusions
Multiple vulnerabilities for diversion exist in inpatient pharmacy processes. Our results provide some much needed detail about how specific vulnerabilities in MUP tasks and subtasks lead to an increased risk of diversion.
Physical Distancing Due to COVID-19 Disrupts Sexual Behaviors Among Gay and Bisexual Men in Australia: Implications for Trends in HIV and Other Sexually Transmissible Infections
Authors: Hammoud Mohamed A. , Maher Lisa , Holt Martin , Degenhardt Louisa , Jin Fengyi , Murphy Dean , Bavinton Benjamin , Grulich Andrew , Lea Toby , Haire Bridget , Bourne Adam , Saxton Peter , Vaccher Stefanie , Ellard Jeanne , Mackie Brent , Batrouney Colin , Bath Nicky , Prestage Garrett 
Published: July 2020

Introduction:
In March 2020, Australian state and federal governments introduced physical distancing measures alongside widespread testing to combat COVID-19. These measures may decrease people's sexual contacts and thus reduce the transmission of HIV and other sexually transmissible infections (STIs). We investigated the impact of physical distancing measures due to COVID-19 on the sexual behavior of gay and bisexual men in Australia.

Methods:
Between April 4, 2020, and April 29, 2020, 940 participants in an ongoing cohort study responded to questions to measure changes in sexual behaviors during the COVID-19 pandemic. Men reported the date they become concerned about COVID-19 and whether they engaged in sexual behavior with regular or casual partners or “fuckbuddies” in the 6 months before becoming concerned about COVID-19 (hereafter referred to as “before COVID-19”), and following the date, they become concerned about COVID-19 (hereafter referred to as “since COVID-19”). Before and since COVID-19 was based on individual participants' own perceived date of becoming concerned about COVID-19.

Results:
The mean age of was 39.9 years (SD: 13.4). Most participants (88.3%) reported sex with other men during the 6 months before COVID-19. Of the 587 men (62.4%) who reported sex with casual partners before COVID-19, 93 (15.8%) continued to do so in the period since COVID-19, representing a relative reduction of 84.2%.

Conclusion:
Gay and bisexual men in Australia have dramatically reduced their sexual contacts with other men since COVID-19. These behavioral changes will likely result in short-term reductions in new HIV and STI diagnoses. If sexual health screenings are undertaken before resuming sexual activity, this could present a novel opportunity to interrupt chains of HIV and STI transmission.
Alar Base Augmentation Using Vomerine Bone Graft in Patients With Cleft Lip Nasal Deformity
Authors: Elfeki Bassem , Elhussiny Khater Amr Mohamed , Bahaa El-Din Ahmed Mohamed , Shouman Omar Ossama , Baek Rong-Min , Kim Baek-Kyu 
Published: July 2020

Background
Although many trials have been made to augment the unilateral alar base depression, the ultimate aesthetic satisfaction has proven difficult to achieve. In our study, we present a novel submucosal dissection technique to harvest the vomer bone and use it as an onlay graft to correct the alar base depression.

Methods
We collected a prospective cohort study of 11 patients with unilateral cleft lip nasal deformity. Using CorelDRAW X7 software, we obtained perioperative clinical photographs to analyze the nostril and lateral lip morphometric measurements on the cleft side. Computed tomography scans were used to assess the required graft's volume and to detect resorption. We performed vomerine ostectomy and placed and fixed the bone graft in with a lag screw over the alar base depression.

Results
The nostril width showed a significant increase, in addition to the height/width ratio. The columellar angle with the lateral lip height increased remarkably, with a general improvement in the nasal tip aesthetics.

Conclusions
The vomer bone graft has been shown to correct the lateral and inferior disorientation of the alar base and improve the nostril and nasal tip aesthetic measurements. The vomer bone is therefore a sufficient bone source for grafting with high viability and no resorption.
A Systematic Review of Breast Irrigation in Implant-Based Breast Surgery
Authors: Baker Nusaiba F. , Hart Alexandra M. , Carlson Grant W. , Losken Albert 
Published: July 2020

Background
Aesthetic and reconstructive implant-based breast surgeries are some of the most frequently performed procedures by plastic surgeons. As such, prevention of implant infection is of high importance. However, there remains no criterion-standard protocol for irrigation of the breast pocket. This review focuses on current irrigation practices in implant-based breast surgery.

Methods
Four databases were used to search for all studies, including randomized controlled trials, retrospective cohort, and prospective cohort, containing original data related to the outcomes investigated in this study. Search terms included “breast,” “irrigation,” and “infection” in different combinations to isolate studies that focused on irrigation methods in both reconstructive and augmentation surgeries. Our selection criteria specifically concentrated on those studies that explicitly related irrigation procedures to rates of clinical infection and/or capsular contracture. Each was compiled into a table in chronological order to make comparisons between the differing irrigation methods.

Results
Our search returned 239 full-text articles eligible for our review. Two independent screeners identified 9 studies that met the inclusion criteria. This included 1 prospective study and 8 retrospective studies. Two studies reported the use of chlorhexidine gluconate irrigation resulting in protection from clinical infection. Two studies investigated the role of triple antibiotic solution (TAS) either alone or combined with something else on risk of infection, and 3 reported TAS use on rates of capsular contracture. Two additional studies investigated the role of single antibiotic irrigation, concluding that some antibiotic regimen for irrigation may be sufficient in the breast pocket. Interestingly, one study noted the potential use of povidone-iodine (Betadine) as a method of irrigation.

Conclusions
These data suggest that chlorhexidine gluconate, Betadine, and TAS irrigation of the breast pocket can provide protection against infection and implant loss in both reconstruction and augmentation surgeries.
Dermatochalasis Through Decades
Authors: Kashkouli Mohsen Bahmani , Karimi Nasser , Johari-Moghadam Mohamad-Mehdi , Shayanfar Nasrin , Aghamirsalim Mohamadreza , Abdolalizadeh Parya 
Published: July 2020

Objectives
Three prior studies (2008, 2011, 2018) histopathologically compared the eyelid specimens of patients with dermatochalasis (DC, undergoing blepharoplasty) with a control group and proposed that DC may begin with subclinical inflammation leading to elastolysis and lymphostasis. With growing number of younger patients consulting for blepharoplasty, the unanswered question is whether histopathologic changes of DC differ between the younger and the older.

Patients and Methods
In this prospective case series, 20 right upper eyelid skin of 20 nonsmoker, class 3 Fitzpatrik skin type women (30–68 years old) were histopathologically examined. Patients were divided into 2 age groups of 50 years or older and older than 50 years. Upper eyelid skin was preoperatively marked, intraoperatively removed, postoperatively divided into 3 sections: lateral (lateral limbus to lateral canthus), central (between medial and lateral limbi), and medial (medial limbus to medial canthus), and separately (totally 60 specimens) sent for histopathological examination. A masked pathologist recorded skin thickness in all specimens (60) as well as lymphatic vessels diameter and density, elastic fiber density, macrophage number, collagen intrafibril edema, and depth of collagen stromal bed in central sections (20 specimens).

Results
There were 10 patients at each age group. Histopathological measurements were not significantly different between the 2 age groups except mean lymphatic vessel diameter (P = 0.034) that was larger in the second group (>50 years). A significant positive correlation was also observed between the age and lymphatic vessel diameter (r
s = 0.3, P = 0.009).

Conclusions
Lymphangiectasia progresses significantly by age. Histopathological characteristics of DC are the same in the 2 age groups.
Industry Payments by Allergan, Inc to Plastic Surgery and Related Specialties in 2018
Authors: Isbester Kelsey , Boas Samuel , Summerville Lesley , Wee Corinne , Kumar Anand 
Published: July 2020

Abstract
In 2014, payments to medical providers from drug/device manufacturers were made public through the Open Payments Database. Although previous studies have used the Open Payments Database to describe relationships between specialties and industry, few have evaluated specific companies and the effect of their contributions. As a large contributor to industry payments in plastic surgery, Allergan, Inc represents a significant source of potential financial conflicts of interest in the field. In this study, we aimed to describe the quantity, type, and specific products associated with Allergan's payments to both plastic surgeons and physicians of other specialties. In 2018, Allergan paid a total of $48,484,163 in 397,225 payments to 90,386 physicians. Psychiatry and neurology received $11,867,861 in payments, the largest of any specialty, whereas internal medicine received the largest number of individual payments. Plastic surgeons made the most per physician ($3025). Most payments made to plastic surgeons were categorized as “gifts.” Payments made in relation to Botox were predominantly made to neurologists, whereas most payments attributed to Natrelle breast implants were made to plastic surgeons (74.4%). Surprisingly, 18.2% of Natrelle payments were made to family medicine physicians. Further study is needed to fully understand the implications of the financial contributions revealed in this study.
Rhinoplasty With Hyaluronic Acid
Authors: Chen Bo , Ma Li , Ji Kai , Lu Hui , Hu Xiaogen , Qi Yanwen , Qi Huijie , Gao Zhanwei 
Published: July 2020

Objective
To explore the clinical effect of rhinoplasty with a standard 5-step injection procedure of hyaluronic acid using sharp needle in correction of deficient features of the Chinese nose.

Methods
Between January 2016 and December 2018, hyaluronic acid was injected with the sharp needle by a standard procedure in the anterior nasal spine, nasal columella, nasal tip, nasal root, and dorsum, as well as the junction region of nasal root and brow in 198 Chinese patients. The postoperative curative effect was analyzed, and the adverse reactions were observed.

Results
The nasal shape in all patients was significantly improved, obtaining the stereoscopic appearance, and satisfactory results. During a 6-month follow-up, 4 patients developed local subcutaneous congestion and bruising in the nasal dorsum after treatment, which disappeared within 2 weeks. No patients suffered from complications such as infection, embolism, necrosis, transparent nasal dorsum, and widened nasal roots.

Conclusions
Injection of hyaluronic acid with the sharp needle by a standard 5-step procedure is a safe technique that can effectively correct the deficient features of the Chinese nose.
Determining the period of communicability of SARS-CoV-2: A rapid review of the literature
Authors: Park Mina , Pawliuk Colleen , Nguyen Tribesty , Griffitt Amanda , Dix-Cooper Linda , Fourik Nadia , Dawes Martin 
Published: July 2020

AbstractIntroductionHow long individuals may transmit virus after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear. Understanding the communicability period of SARS-CoV-2 is important to inform the period of isolation required to prevent nosocomial and community spread. The objective of this study was to identify the reported communicable period of SARS-CoV-2, based on a rapid review of existing literature.MethodsStudies reporting empirical data on the period of communicability of SARS-CoV-2 through investigations of duration of communicability based on in-person contact (“contact transmission”), isolation and culture of virus (“viral isolation”), and viral shedding by detection of nucleic acids by RT-PCR (“viral shedding”) were identified through searches of peer-reviewed and pre-print health sciences literature databases (Ovid MEDLINE, Embase, Google Scholar, medRxiv and arXiv) and the grey literature. Articles were screened for relevance, then data were extracted, analyzed, and synthesized.ResultsOut of the 165 studies included for qualitative analysis, one study investigated contact transmission, three investigated viral isolation, 144 investigated viral shedding, and 17 studies focused on both viral shedding and viral isolation. The median length of time until viral clearance across all viral isolation studies was nine days; however, the maximum identified duration was 32 days. Studies with data on both viral isolation and viral shedding showed a prolonged maximum time until viral clearance for viral shedding (9 days vs 24 days).DiscussionFindings from this review support a minimum 10-day period of isolation; however, additional observation should be considered for individuals being released into high-risk settings.
Efficacy of chloroquine and hydroxychloroquine in treating COVID-19 infection: a meta-review of systematic reviews and an updated meta-analysis
Authors: Chivese Tawanda , Musa Omran A. H. , Hindy George , Al-Wattary Noor , Badran Saif , Soliman Nada , Aboughalia Ahmed T. M. , Matizanadzo Joshua T. , Emara Mohamed M. , Thalib Lukman , Doi Suhail A. R. 
Published: July 2020

AbstractObjectiveTo synthesize findings from systematic reviews and meta-analyses on the efficacy and safety of chloroquine (CQ) and hydroxychloroquine (HCQ) with or without Azithromycin for treating COVID-19, and to update the evidence using a meta-analysis.MethodsA comprehensive search was carried out in electronic databases for systematic reviews, meta-analyses and experimental studies which investigated the efficacy and safety of CQ, HCQ with or without Azithromycin to treat COVID-19. Findings from the reviews were synthesised using tables and forest plots and the quality effect model was used for the updated meta-analysis. The main outcomes were mortality, the need for intensive care services, disease exacerbation, viral clearance and occurrence of adverse events.ResultsThirteen reviews with 40 primary studies were included. Two meta-analyses reported a high risk of mortality, with ORs of 2.2 and 3.0, and the two others found no association between HCQ and mortality. Findings from two meta-analyses showed that HCQ with Azithromycin increased the risk of mortality, with similar ORs of 2.5. The updated meta-analysis of experimental studies showed that the drugs were not effective in reducing mortality (RR 1.1, 95%CI 1.0-1.3, I2 =0.0%), need for intensive care services (OR 1.1, 95%CI 0.9-1.4, I2 =0.0%), virological cure (OR 1.5, 95%CI 0.5-4.4, I2 =39.6%) or disease exacerbation (OR 1.2, 95%CI 0.3-5.9, I2 =31.9%) but increased the odds of adverse events (OR 12,3, 95%CI 2.5-59.9, I2 =76.6%).ConclusionThere is conclusive evidence that CQ and HCQ, with or without Azithromycin are not effective in treating COVID-19 or its exacerbation.RegistrationPROSPERO: CRD42020191353
Developmental PCB exposure disrupts synaptic transmission and connectivity in the rat auditory cortex, independent of its effects on peripheral hearing threshold
Authors: Lee Christopher M. , Sadowski Renee N. , Schantz Susan L. , Llano Daniel A. 
Published: July 2020

AbstractPolychlorinated biphenyls (PCBs) are enduring environmental toxicants and exposure is associated with neurodevelopmental deficits. The auditory system appears particularly sensitive, as previous work has shown that developmental PCB exposure causes both hearing loss and gross disruptions in the organization of the rat auditory cortex. However, the mechanisms underlying PCB-induced changes are not known, nor is it known if the central effects of PCBs are a consequence of peripheral hearing loss. Here, we study changes in both peripheral and central auditory function in rats with developmental PCB exposure using a combination of optical and electrophysiological approaches. Female rats were exposed to an environmental PCB mixture in utero and until weaning. At adulthood, auditory brainstem responses were measured, and synaptic currents were recorded in slices from auditory cortex layer 2/3 neurons. Spontaneous and miniature inhibitory postsynaptic currents (IPSCs) were more frequent in PCB-exposed rats compared to controls and the normal relationship between IPSC parameters and peripheral hearing was eliminated in PCB-exposed rats. No changes in spontaneous EPSCs were found. Conversely, when synaptic currents were evoked by laser photostimulation of caged-glutamate, PCB exposure did not affect evoked inhibitory transmission, but increased the total excitatory charge, the number and distance of sites that evoke a significant response. Together, these findings indicate that early developmental exposure to PCBs causes long-lasting changes in both inhibitory and excitatory neurotransmission in the auditory cortex that are independent of peripheral hearing changes, suggesting the effects are due to the direct impact of PCBs on the developing auditory cortex.Significance StatementThe mechanisms by which developmental exposure to polychlorinated biphenyls (PCBs) disrupt the central nervous system are not yet known. Here we show that developmental PCB exposure is associated with long-lasting dysregulation of both excitatory and inhibitory neurotransmission in the rodent brain. We further find that, unlike controls, synaptic parameters in the auditory cortex of PCB-exposed rats are independent of peripheral hearing changes. These data suggest that PCB-related changes in the auditory cortex are independent of their effects on the auditory periphery and that PCB exposure may disrupt the plastic mechanisms needed to restore normal processing in the auditory cortex after peripheral hearing loss.
From plants to ants: Fungal modification of leaf lipids for nutrition and communication in the leaf-cutter ant fungal garden ecosystem
Authors: Khadempour Lily , Kyle Jennifer E. , Webb-Robertson Bobbie-Jo M. , Nicora Carrie D. , Smith Francesca B. , Smith Richard D. , Lipton Mary S. , Currie Cameron R. , Baker Erin S. , Burnum-Johnson Kristin E. 
Published: July 2020

AbstractLipids are essential to all living organisms, as an energy source, as an important cellular structural component, and as a communication tool. In this study, we used global lipidomic methods to evaluate the lipids in leaf-cutter ant fungal gardens. Leaf-cutter ants and their coevolved fungal cultivar,Leucoagaricus gongylophorus, are a model mutualistic system. The fungus enzymatically digests fresh plant material that the ants cut and deliver, converting energy and nutrients from plants, and providing them to the ants through specialized hyphal swellings called gongylidia. Using combined liquid chromatography, ion mobility spectrometry, and tandem mass spectrometry we evaluated differences between the molecular speciation of lipids in the leaf-cutter ant fungal garden ecosystem. This lipidomic study characterized leaves that are fed to the gardens, gongylidia that are produced by the fungus to feed the ants, and spatially resolved regions of the fungal garden through stages of leaf degradation. Lipids containing alpha-linolenic acid (18:3) were enriched in leaves and the top of the gardens, but not dominant in the middle or bottom regions. Gongylidia were dominated by lipids containing linoleic acid (18:2). To evaluate the communicative potential of the lipids in fungal gardens we conducted a behavioral experiment that showedAttaleaf-cutter ants responded differently to 18:3 and 18:2 fatty acids, with aggression towards 18:3 and attraction for 18:2. This work demonstrates the role of lipids in both the transfer of energy and as an inter-kingdom communication tool in leaf-cutter ant fungal gardens.ImportanceIn this work we examined the role of lipids in the mutualism between leaf-cutter ants and fungus. These ants cut fresh leaf material, which they provide to their fungal cultivar, that converts energy and nutrients from the plants and provides it to the ants in specialized hyphal swellings called gongylidia. This work constitutes the first example of a global lipidomics study of a symbiotic system and provides insights as to how the fungus modifies plant lipids into a usable source for the ants. Through a behavioral experiment, this work also demonstrates how lipids can be used as an inter-kingdom communication tool, in this case an attractant, rather than as a repellant, which is more often seen.