bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case Series
Authors: Nguyen Nathalie , Hayes Kari , Fenton Laura , Furuta Glenn T. , Menard‐Katcher Calies 
Published: July 2020

ABSTRACTEosinophilic esophagitis (EoE) is a chronic disease of the esophagus that leads to esophageal remodeling. Dysphagia is a common symptom that likely results from the inflammatory process or remodeling. Identifying patients that may benefit from dilation can be challenging because of difficulties in detecting subtle narrowing in patients with EoE. Here we report the benefits of a pill esophagram in the detection of esophageal narrowing in EoE. We identified a series of children with EoE and symptoms of dysphagia who underwent barium esophagram with a barium‐coated pill to assess symptoms. Three subjects had a normal fluoroscopic esophagram but had pill retention for greater than 5 minutes. Subsequent esophagoscopy and esophageal dilation revealed mucosal rent after dilation. Subtle esophageal narrowing may not be captured with barium esophagram alone in children with EoE and dysphagia. Use of the barium pill in symptomatic patients can assist in identifying patients who may benefit from esophageal dilation.
A New Domain Structure for the IMPACT‐III Health‐related Quality of life Tool for Pediatric Inflammatory Bowel Disease
Authors: Grant Amy , MacIntyre Bradley , Kappelman Michael D. , Otley Anthony R. 
Published: July 2020

ABSTRACTBackground:The IMPACT‐III measures health‐related quality of life (HRQOL) in pediatric patients with Inflammatory Bowel Disease (IBD). The original IMPACT domain structure was developed based on expert opinion and was not psychometrically validated. This study developed a new domain structure based on the current IMPACT version.Methods:Baseline data from 3 prospectively collected datasets of children and adolescents with IBD was used. Exploratory, then confirmatory factor analyses were carried out to develop a new domain structure. Internal consistency (Cronbach alpha) and construct validity with PROMIS measures (Pearson correlations, and Independent Mann‐Whitney U‐tests) were examined.Results:Data from the IBD Partners dataset alone (n = 374; 47% girls, mean age = 13.4 ± 2.5 years, median disease duration = 2.5 years, 75% were in remission, with a range of self‐reported disease activity) was used to validate the new 4‐domain IMPACT‐III model. The final domain structure was parsimonious, with factor loadings for individual items ranging from 0.39 to 0.80, and internal consistency for domains from 0.75 to 0.95. The new IMPACT‐III domains include: General well‐being, Social Functioning, Emotional functioning, and Body Image. IMPACT‐III total and domain scores were significantly lower (all P < 0.001) for participants with high (>50) versus low (<50) PROMIS anxiety, depression, fatigue, and pain T‐scores; conversely IMPACT‐III scores were higher for participants with higher peer‐relations PROMIS T‐scores.Conclusions:This valid and reliable IMPACT‐III domain structure should be used to capture pediatric self‐reported HRQOL, which will help to understand the management of IBD from the perspective of patients.
Adiponectin is Increased in Pediatric Patients With Autoimmune Hepatitis Independent of Body Weight
Authors: Cortez Ana Paula Bidutte , Mattar Regina Helena Guedes da Motta , de Azevedo Ramiro Anthero , Fisberg Mauro , Lederman Henrique Manoel , de Morais Mauro Batista 
Published: July 2020

ABSTRACTObjective:A high prevalence of obesity is reported in children and adolescents with autoimmune hepatitis (AIH). Adipokines participate in inflammatory processes. The objective of this study was to examine the relationship between excess weight and systemic inflammation, adipokines, and ghrelin in adolescents with AIH.Method:This case‐controlled study included 27 adolescents with AIH (13 with excess weight and 14 with normal weight) and a control group. Excess weight was defined by a body mass index/age Z score >+1 standard deviation. Adipokines (adiponectin, leptin, tumor necrosis factor alpha, interleukin 6 [IL‐6], and IL‐10) and ghrelin were measured with Luminex technology.Results:Adiponectin (μg/mL) was higher (P < 0.001) in AIH adolescents with and without excess weight (median: 35.0 and 42.1, respectively) than in normal‐weight (17.5) and excess‐weight (17.0) controls. Leptin was higher (P < 0.001) in excess‐weight AIH patients (18.0 ng/mL) and controls (19.8 ng/mL) than in normal‐weight AIH (7.7 ng/mL) and control (7.0 ng/mL) adolescents. IL‐6 levels were higher in excess‐weight (3.8 pg/mL) and normal‐weight (3.8 pg/mL) AIH patients than in excess‐weight (1.1 pg/mL) and normal‐weight (0.5 pg/mL) controls. IL‐10 levels were higher (5.2 pg/mL) in normal‐weight AIH patients than in excess‐weight (1.8 pg/mL) and normal‐weight (2.1 pg/mL) controls. Ferritin levels were lower in patients with AIH than in controls.Conclusions:Independent of body weight, AIH patients had higher levels of adipokines, especially adiponectin and IL‐6. Leptin levels were associated with body weight and were not influenced by AIH. IL‐10 levels were associated with lean tissue in AIH.
Factors Associated With Poor Linkage to Human Immunodeficiency Virus Care Among Index Clients and Sex Partners Receiving Human Immunodeficiency Virus Assisted Partner Services in Kenya
Authors: Wamuti Beatrice , Contesse Marielle G. , Maingi Peter , Macharia Paul , Abuna Felix , Sambai Betsy , Ng'ang'a Anne , Spiegel Hans , Richardson Barbra , Cherutich Peter , Bukusi David , Farquhar Carey 
Published: July 2020

Introduction
Human immunodeficiency virus (HIV) assisted partner services (aPS) has been recommended as a strategy to increase HIV case finding. We evaluated factors associated with poor linkage to HIV care among newly diagnosed HIV-positive individuals (index clients) and their partners after receiving aPS in Kenya.

Methods
In a cluster randomized trial conducted between 2013 and 2015, 9 facilities were randomized to immediate aPS (intervention). Linkage to care—defined as HIV clinic registration, and antiretroviral therapy (ART) initiation were self-reported. Antiretroviral therapy was only offered to those with CD4 less than 500 during this period. We estimated linkage to care and ART initiation separately for index clients and their partners using log-binomial generalized estimating equation models with exchangeable correlation structure and robust standard errors.

Results
Overall, 550 index clients and 621 sex partners enrolled, of whom 46% (284 of 621) were HIV-positive. Of the 284, 264 (93%) sex partners returned at 6 weeks: 120 newly diagnosed and 144 whom had known HIV-positive status. Among the 120 newly diagnosed, only 69% (83) linked to care at 6 weeks, whereas among the 18 known HIV-positive sex partners not already in care at baseline, 61% (11) linked. Newly diagnosed HIV-positive sex partners who were younger and single were less likely to link to care (P < 0.05 for all).

Conclusion
Only two thirds of newly diagnosed, and known HIV-positive sex partners not in care linked to care after receiving aPS. The HIV aPS programs should optimize HIV care for newly diagnosed HIV-positive sex partners, especially those who are younger and single.
Provider Adherence to Syphilis Testing Guidelines Among Stillbirth Cases
Authors: Ho Yenling Andrew , Allen Katie , Tao Guoyu , Patel Chirag G. , Arno Janet N. , Broyles Andrea A. , Dixon Brian E. 
Published: July 2020

Background
The Centers for Disease Control and Prevention (CDC) recommends that all women with a stillbirth have a syphilis test after delivery. Our study seeks to evaluate adherence to CDC guidelines for syphilis screening among women with a stillbirth delivery.

Methods
We used data recorded in electronic health records for women who gave birth between January 1, 2014, and December 31, 2016. Patients were included if they were 18 to 44 years old and possessed an International Classification of Diseases, Ninth Revision or Tenth Revision, Clinical Modification diagnosis of stillbirth. Stillbirth diagnoses were confirmed through a random sample of medical chart reviews. To evaluate syphilis screening, we estimated the proportion of women who received syphilis testing within 300 days before stillbirth, women who received syphilis testing within 30 days after a stillbirth delivery, and women who received syphilis testing both before and after stillbirth delivery.

Results
We identified 1111 stillbirths among a population of 865,429 unique women with encounter data available from electronic health records. Among a sample of 127 chart-reviewed cases, only 35 (27.6%) were confirmed stillbirth cases, 45 (35.4%) possible stillbirth cases, 39 (30.7%) cases of miscarriage, and 8 (6.3%) cases of live births. Among confirmed stillbirth cases, 51.4% had any syphilis testing conducted, 31.4% had testing before their stillbirth delivery, 42.9% had testing after the delivery, and only 22.9% had testing before and after delivery.

Conclusions
A majority of women with a stillbirth delivery do not receive syphilis screening adherent to CDC guidelines. Stillbirth International Classification of Diseases codes do not accurately identify cases of stillbirth.
Cortisol Synchrony in Older Couples: Daily Socioemotional Correlates and Interpersonal Differences
Authors: Pauly Theresa , Michalowski Victoria I. , Drewelies Johanna , Gerstorf Denis , Ashe Maureen C. , Madden Kenneth M. , Hoppmann Christiane A. 
Published: July 2020

ABSTRACT

Objective
Social relationships can have positive and negative influences, and these associations are particularly pronounced in old age. This study focuses on everyday interpersonal physiological dynamics (cortisol synchrony) in older couples and investigates its associations with partner presence, positive daily partner interactions, and empathy.

Methods
We conducted coordinated multilevel analyses using data from two samples of older couples from Vancouver, Canada, and Berlin, Germany (study 1: n = 85 couples aged 60–87 years; study 2: n = 77 couples aged 66–85 years), who completed questionnaires and provided salivary cortisol samples five to seven times daily for 7 days.

Results
Significant dyadic covariation in cortisol (synchrony) was present across studies (study 1/2: b = 0.04/0.03, p < .001/.001). Partner presence was only associated with greater cortisol synchrony in study 1 (b = 0.06, p = .003) but not in study 2 (b = 0.02, p = .187). Cortisol synchrony was higher when partners reported prior positive socioemotional partner interactions (study 1: b = 0.09, p = .005; study 2: b = 0.04, p = .005). There was no statistically significant association between cortisol synchrony and empathic concern (b = 0.01, p = .590) or perspective taking (b = 0.02, p = .065).

Conclusions
Moments of social bonding are intertwined with physiological synchrony in everyday life. The implications of potential repeated transmission of stress in the context of high synchrony for individual health and relationship functioning warrant further investigation.
Returning to Elective Orthopedic Surgery During the COVID-19 Pandemic: A Multidisciplinary and Pragmatic Strategy for Initial Patient Selection
Authors: Vles Georges F. , Ghijselings Stijn , De Ryck Iris , Meyfroidt Geert , Sweeney Nicola A. , Oosterlinck Wouter , Casteels Minne , Moke Lieven 
Published: July 2020

Objective
The aim of the study was to design an objective, transparent, pragmatic, and flexible workflow to assist with patient selection during the initial phase of return to elective orthopedic surgery during the COVID-19 pandemic with the main purpose of enhancing patient safety.

Methods
A multidisciplinary working group was formed consisting of representatives for orthopedics, epidemiology, ethics, infectious diseases, cardiovascular diseases, and intensive care medicine. Preparation for upcoming meetings consisted of reading up on literature and testing of proposed methodologies on our own waiting lists.

Results
A workflow based on 3 domains, that is, required resources, patient fitness, and time sensitivity of the procedure, was considered most useful. All domains function as standalones, in a specific order, and no sum score is used. The domain of required resources demands input from the surgical team, results in a categorical (yes or no) outcome, and generates a list of potential patients who can be scheduled for surgery under these particular circumstances. The (weighted) items for the domain of patient fitness are the same for every patient, are scored on a numerical scale, but are likely to change during the pandemic as more data become available. Time sensitivity of the procedure is again scored on a numerical scale and becomes increasingly important when returning to elective surgery proves to be acceptably safe. After patient selection, an augmented informed consent, screening, and testing according to local guidelines will take place.

Conclusions
A workflow is proposed for patient selection aiming for the safest possible return to elective orthopedic surgery during the COVID-19 pandemic.
Choroidal Thickness Is a Biomarker Associated With Response to Treatment in Ankylosing Spondylitis
Authors: Steiner Martina , del Mar Esteban-Ortega Maria , Thuissard-Vasallo Israel , García-Lozano Isabel , García-González Alejandro Javier , Pérez-Blázquez Eugenio , Sambricio Javier , García-Aparicio Ángel , Casco-Silva Bruno Francisco , Sanz-Sanz Jesús , Valdés-Sanz Nuria , Fernández-Espartero Cruz , Díaz-Valle Teresa , Gurrea-Almela María , Fernández-Melón Julia , Gómez-Resa María , Pato-Cour Esperanza , Díaz-Valle David , Méndez-Fernández Rosalía , Navío Teresa , Moriche-Carretero Manuel , Muñoz-Fernández Santiago ,   on behalf of the ChOroidal Thickness in ESpondylitis (COnTEST) Study Group
Published: July 2020

Objective
Choroidal thickness (CT) has been evaluated as a marker of systemic inflammation in ankylosing spondylitis (AS). This study evaluates the CT of AS patients before and after 6 months of biological treatment.

Methods
This longitudinal multicenter study evaluated CT in 44 AS patients. The correlations between CT and C-reactive protein (CRP) with disease activity indices were calculated. The concordance between CT and CRP was determined. We assessed factors associated with response to treatment. Clinically important improvement was defined as a decrease in Ankylosing Spondylitis Disease Activity Score of 1.1 points or greater.

Results
Forty-four eyes in patients aged 18 to 65 years were included. Mean CT values were significantly higher at baseline than after 6 months of treatment (baseline: 355.28 ± 80.46 μm; 6 months: 341.26 ± 81.06 μm; p < 0.001). There was a 95% concordance between CT and CRP at baseline and 6 months. Clinically important improvement was associated with lower baseline CT and age as independent factors (odds ratios, 0.97 [95% confidence interval, 0.91–0.93; p = 0.009] and 0.81 [95% confidence interval, 0.7–0.95; p = 0.005]), with baseline CT of less than 374 μm (sensitivity 78%, specificity 78%, area under the curve 0.70, likelihood ratio 3.6).

Conclusions
Choroidal thickness decreased significantly after 6 months of biological treatment in all treatment groups. Choroidal thickness and CRP had a 95% concordance. A high CT was associated with a risk of biological treatment failure. Choroidal thickness can be considered a useful biomarker of inflammation and a factor associated with response to treatment in AS.
Transversus Abdominis Plane Block With Liposomal Bupivacaine Versus Thoracic Epidural for Postoperative Analgesia After Deep Inferior Epigastric Artery Perforator Flap–Based Breast Reconstruction
Authors: Clary Zachary , Nazir Niaman , Butterworth James 
Published: July 2020

Purpose
Autologous breast reconstruction with abdominally based free flaps has traditionally been associated with a longer hospital stay and higher initial cost relative to other reconstructive methods. One important component of this course is postoperative pain control. Thoracic epidural anesthesia is considered among the most effective methods for pain control in the immediate postoperative period following these procedures. Recently, our institution began using 4 quadrant transversus abdominis plane (TAP) blocks with liposomal bupivacaine. Encouraging trends were observed with utilization of TAP blocks; however, we sought to quantify this effect compared with that of thoracic epidural anesthesia. This study would contribute to a growing body of evidence supporting an enhanced recovery pathway for microvascular breast reconstruction.

Method
Thirty patients who underwent deep inferior epigastric artery perforator flap–based breast reconstruction from January 2016 to April 2017 were evaluated. Fifteen patients received thoracic epidural anesthesia, and 15 received 4 quadrant TAP blocks with liposomal bupivacaine. Opioid consumption was evaluated and compared for the first 3 days postoperatively. All opioids were converted to oral morphine equivalents (OMEs) for standardization. Day of discharge, day of Foley removal, and several traditionally opioid-related adverse effects were also recorded and compared.

Result
On postoperative days 0, 1, 2, and 3, opioid consumption among those given epidural anesthesia compared with those who received TAP blocks with liposomal bupivacaine was 34.9 versus 32.6 OMEs (P = 0.81), 98.9 versus 92.4 OMEs (P = 0.78), 59.7 versus 56.0 OMEs (P = 0.79), and 59.6 versus 24.5 OMEs (P = 0.005*), respectively. Total opioid consumption for the epidural group was 253.1 versus 205.4 OMEs for the TAP block group (P = 0.2743). Time until removal of Foley was 2.7 days for patients with an epidural and 2.1 days for those receiving TAP blocks (P = 0.0056*). Length of stay for those receiving epidural was 4.33 days compared with 3.53 days for those receiving TAP blocks (P = 0.0002*).

Conclusion
When using TAP blocks with liposomal bupivacaine, a statistically significant effect on postoperative day 3 and decreased opioid utilization overall were observed. Patients also had their Foley removed sooner and were discharged from the hospital earlier.
Translucent Customized Cranial Implants Made of Clear Polymethylmethacrylate
Authors: Shay Tamir , Mitchell Kerry-Ann , Belzberg Micah , Zelko Ian , Mahapatra Smruti , Qian Jason , Mendoza Luis , Huang Judy , Brem Henry , Gordon Chad 
Published: July 2020

Background
Large skull reconstruction, with the use of customized cranial implants, restores cerebral protection, physiologic homeostasis, and one's preoperative appearance. Cranial implants may be composed of either bone or a myriad of alloplastic biomaterials. Recently, patient-specific cranial implants have been fabricated using clear polymethylmethacrylate (PMMA), a visually transparent and sonolucent variant of standard opaque PMMA. Given the new enhanced diagnostic and therapeutic applications of clear PMMA, we present here a study evaluating all outcomes and complications in a consecutive patient series.

Methods
A single-surgeon, retrospective, 3-year study was conducted on all consecutive patients undergoing large cranioplasty with clear PMMA implants (2016–2019). Patients who received clear PMMA implants with embedded neurotechnologies were excluded due to confounding variables. All outcomes were analyzed in detail and compared with previous studies utilizing similar alloplastic implant materials.

Results
Fifty-five patients underwent cranioplasty with customized clear PMMA implants. Twenty-one (38%) were performed using a single-stage cranioplasty method (ie, craniectomy and cranioplasty performed during the same operation utilizing a prefabricated, oversized design and labor-intense, manual modification), whereas the remaining 34 (62%) underwent a standard, 2-stage reconstruction (craniectomy with a delayed surgery for cranioplasty and minimal-to-no implant modification necessary). The mean cranial defect size was 101.8 cm2. The mean follow-up time was 9 months (range, 1.5–39). Major complications requiring additional surgery occurred in 7 patients (13%) consisting of 2 (4%) cerebrospinal fluid leaks, 2 (4%) epidural hematomas, and 3 (4%) infections. In addition, 3 patients developed self-limiting or nonoperative complications including 2 (4%) with new onset seizures and 1 (2%) with delayed scalp healing.

Conclusions
This is the first reported consecutive case series of cranioplasty reconstruction using customized clear PMMA implants, demonstrating excellent results with regard to ease of use, safety, and complication rates well below published rates when compared with other alloplastic materials. Clear PMMA also provides additional benefits, such as visual transparency and sonolucency, which is material specific and unavailable with autologous bone. Although these early results are promising, further studies with multicenter investigations are well justified to evaluate long-term outcomes.
Prophylactic Bronchial Stump Support With Intrathoracic Muscle Flap Transposition
Authors: Asaad Malke , Van Handel Amelia , Akhavan Arya A. , Huang Tony C. T. , Rajesh Aashish , Shen K. Robert , Allen Mark A. , Sharaf Basel , Moran Steven L. 
Published: July 2020

Background
Bronchopleural fistula (BPF) is a dreaded complication of pulmonary resection. For high-risk patients, bronchial stump coverage with vascularized tissue has been recommended. The goal of this study was to report our experience with intrathoracic muscle transposition for bronchial stump coverage.

Methods
A retrospective review of all patients who underwent intrathoracic muscle flap transposition as a prophylactic measure at our institution between 1990 and 2010 was conducted. Demographics, surgical characteristics, and complication rates were abstracted and analyzed.

Results
A total of 160 patients were identified. The most common lung resections performed were pneumonectomy (n = 69, 43%) and lobectomy (n = 60, 38%). A total of 168 flaps were used where serratus anterior was the most common flap (n = 136, 81%), followed by intercostal (n = 14, 8%), and latissimus dorsi (n = 12, 7%). Ten patients (6%) developed BPF, and empyema occurred in 13 patients (8%). Median survival was 20 months, and operative mortality occurred in 7 patients (4%).

Conclusions
Reinforcement of the bronchial closure with vascularized muscle is a viable option for potentially decreasing the incidence of BPF in high-risk patients. Further randomized studies are needed to determine the efficacy of this technique for BPF prevention.
The Evolving Trends in the Impact Factor of Plastic Surgery Journals
Authors: Asaad Malke , Shamoun Feras , Rajesh Aashish , Meaike Jesse , Tran Nho V. 
Published: July 2020

Background
The journal impact factor (IF) is one of the most widely adopted metrics to assess journal value. We aimed to investigate the trends in the IF and ranking of plastic surgery journals (PSJs) over a 22-year period.

Methods
The Journal Citation Report 2018 was used to identify all journals within the field of plastic surgery from 1997 to 2018. We analyzed the IF of PSJs and that of the category surgery.

Results
A total of 34 PSJs were identified. The mean IF increased from 0.584 (median, 0.533) in 1997 to 1.58 (median, 1.399) in 2018 (P < 0.0001). Over the same time, the median IF of the journals in the category surgery increased from 0.914 to 1.883. The mean journal IF percentile of PSJs within surgery remained fairly stable (P = 0.999). A strong positive correlation was identified between the IF of PSJs and both the 5-year IF (r = 0.943, P < 0.0001) and the immediacy index (r = 0.736, P < 0.0001). The percentage of self-citations across the study period was fairly stable at a mean of 19.2%. A weak positive correlation was found between the IF and the percentage of self-citations (r = 0.171, P < 0.0001).

Conclusions
The mean journal IF in PSJs has been trending upward over the last 22 years. Ranking of PSJs IF within the category surgery has remained unchanged. The self-citation rate has been fairly stable and correlated weakly with the IF. A strong positive correlation exists between the IF and both the immediacy index and the 5-year IF.