bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retention in Care and Viral Load Improvement After Discharge Among Hospitalized Out-of-Care People With HIV Infection: A Post Hoc Analysis of a Randomized Controlled Trial
Authors: English Kellee , May Sarah B , Davila Jessica A , Cully Jeffrey A , Dindo Lilian , Amico K Rivet , Kallen Michael A , Giordano Thomas P 
Published: May 2020

Abstract

Background
Understanding factors influencing retention in care (RIC) and viral load improvement (VLI) in people with HIV (PWH) who are out of care and hospitalized will assist in intervention development for this vulnerable population.

Methods
The study was a post hoc analysis of prospectively collected data. Hospitalized participants were enrolled if they were newly diagnosed with HIV during the hospitalization or out of HIV care. Participants completed surveys at baseline and 6 months postenrollment and laboratory studies of viral load (VL). Outcomes were RIC (2 completed visits, 1 within 30 days of discharge) and VLI (VL &lt;400 or at least a 1-log10 decrease) 6 months after discharge. Univariate and multivariate regression analyses were conducted examining the contributions of predisposing, enabling, and need factors to outcomes.

Results
The study cohort included 417 participants enrolled between 2010 and 2013. The population was 73% male, 67% non-Hispanic black, 19% Hispanic, and 70% uninsured. Sixty-five percent had a baseline CD4 &lt;200 cells/mm3, 79% had a VL &gt;400 copies/mL or missing, and the population was generally poor with low educational attainment. After discharge from the hospital, 60% did not meet the definition for RIC, and 49% did not have VLI. Modifiable factors associated with the outcomes include drug use (including marijuana alone and other drugs), life instability (eg, housing, employment, and life chaos), and using avoidance coping strategies in coping with HIV.

Conclusions
Hospitalized out-of-care PWH in the United States are at high risk of poor re-engagement in care after discharge. Interventions for this population should focus on improving socioeconomic stability and coping with HIV and reducing drug use.
Assessing Molecular Point-of-Care Testing and Dried Blood Spot for Hepatitis C Virus Screening in People Who Inject Drugs
Authors: Chevaliez Stéphane , Wlassow Mélanie , Volant Johann , Roudot-Thoraval Françoise , Bachelard Antoine , Poiteau Lila , Trabut Jean-Baptiste , Hézode Christophe , Bourdel Anne , Dominguez Stéphanie 
Published: May 2020

Abstract

Background
Injecting drug use is a major driver of hepatitis C virus (HCV) spread worldwide, and the World Health Organization (WHO) has identified people who inject drugs (PWID) as a key population to target for HCV screening and care. Point-of-care (POC) hepatitis C tests and dried blood spot (DBS) sampling offer benefits for the management of patients with HCV infection by increasing HCV testing and linkage to care in different nonclinical settings. The aims of this prospective study were to evaluate the feasibility and the acceptability of use HCV ribonucleic acid (RNA) POC and fingerstick DBS testing in social-medical risk-reduction centers and to describe the cascade of care among PWID in France.

Methods
Between June 2018 and February 2019, 89 consecutive HCV-seropositive PWID attending 2 drug treatment services and 1 supervised consumption room in inner Paris were invited to participate in further evaluation, undergoing a clinical review with a liver assessment and blood tests including fingerstick capillary whole blood POC HCV RNA testing and fingerstick DBS sampling.

Results
Of the 89 participants enrolled, HCV RNA was detected in 34 (38.6%) participants. Fingerstick whole blood POC RNA testing and HCV RNA detection from DBS sample were feasible and acceptable among PWID with no major difference in terms of HCV RNA detection rate. Overall, 16 participants received pan-genotypic antiviral treatment. The proportion of PWID with sustained virologic response at 12 weeks was 81.2%, with data for 3 patients still pending.

Conclusions
One-step screening strategy based on the detection of HCV RNA would engage people in care for treatment scale-up and HCV elimination.
What are the social and scientific benefits of participating at academic conferences? Insights from a survey among doctoral students and postdocs in Germany
Authors: Hauss Kalle 
Published: May 2020

AbstractAcademic conferences are global phenomena. As the coronavirus pandemic continues, many conferences now are being postponed or canceled. Usually, they bring together a complex network of academic and nonacademic professionals to discuss and disseminate new knowledge. The practice of ‘conferencing’ also includes activities that go far beyond the exchange of information. Conferences constitute social spaces where researchers encounter other researchers, establish new contacts, maintain old contacts, hold exploratory talks, and initiate collaborations. Academic conferences therefore can yield a plenitude of scientific and societal impacts. In the past, much progress has been made in measuring the impact of financial investments in science. There is, however, no shared understanding of how to measure the impact of academic conferences. Against the background of the time and money that is spent on both visiting and organizing conferences, it is important to understand the ways in which conferences generate impact. The coronavirus pandemic also shows that it is important to implement digital technologies like tools for virtual conferencing. This article uses qualitative and quantitative data to examine the conference activities of young scholars from German universities and to study how they profit from attending conferences. It is shown that conferences play a significant role in the qualification process. However, in terms of information and networking benefits, postdocs compared with doctoral students seem to profit more.
A Comorbidity-based Screening Tool to Predict Severe Maternal Morbidity at the Time of Delivery
Authors: Easter S.R. , Bateman B.T. , Sweeney V.H. , Manganaro K. , Lassey S.C. , Gagne J.J. , Robinson J.N. 
Published: May 2020

(Am J Obstet Gynecol. 2019;221:271.e1–271.e10)
An important strategy for improving maternal health is development of a tool that reliably identifies women at risk of severe maternal morbidity (SMM) and death. The obstetric comorbidity index (OB-CMI) summarizes the burden of maternal comorbidities and allows for the generation of a single numeric score to quantify risk assessment. While the OB-CMI was originally designed to address bias in research studies, the authors hypothesized it could be adapted for clinical use. The score is calculated from a 20-item list of comorbidities (eg, preeclampsia, multiple gestation, asthma, advanced maternal age). The comorbidities are weighted (eg, preeclampsia with severe features is 5 points, diabetes on insulin is 1 point). The points are summed for a total score. The aim of this study was to prospectively evaluate the performance of this comorbidity index as a screening tool to accurately identify laboring women at risk of SMM.
Oral Versus Intravenous Iron Therapy for Postpartum Anemia: A Systematic Review and Meta-analysis
Authors: Sultan P. , Bampoe S. , Shah R. , Guo N. , Estes J. , Stave C. , Goodnough L. , Halpern S. , Butwick A. 
Published: May 2020

(Am J Obstet Gynecol. 2019;19.e2–29.e2)
Postpartum anemia is associated with fatigue, depression, and impaired cognition. Postpartum anemia affects up to 50% of women in well-resourced countries and up to 80% of women in developing countries, which can affect maternal-child bonding. However, adverse gastrointestinal reactions to oral iron treatments (ie, nausea, vomiting, and constipation) occur in up to 40% of patients, resulting in poor compliance and persistent anemia. Intravenous (IV) iron may be ideal for these patients, as it mitigates the absorption challenges and produces a more rapid increase in hemoglobin (Hb) concentration and iron stores. The disadvantages of IV iron include increased cost and the need for treatment at a hospital or outpatient facility. This study was an updated systematic review of all randomized trials comparing oral versus IV iron therapy to treat postpartum anemia. The primary outcome measure was postpartum Hb.
Can Headache Profile Predict Future Disability
Authors: Houle Mariève , Marchand Andrée-Anne , Descarreaux Martin 
Published: May 2020

Objective:
The aim of this study was to determine if headache profile can predict future disability in patients with tension-type headache (TTH).

Materials and Methods:
Eighty-three individuals with TTH were recruited. To be included in the study participants needed to fulfill the International Headache Society classification’s criteria for episodic or chronic TTH form and to be at least 18 years old. Baseline clinical outcomes (headache and neck-related disability, kinesiophobia, self-efficacy, and anxiety) and physical outcomes (neck extensors muscles maximum voluntary contraction) were collected for all participants. A prospective data collection of headache characteristics (intensity and frequency) was conducted using daily SMS or e-mail over a 1-month period. Headache-related disability was assessed at the 3-month follow-up and was used as the disability criterion for TTH.

Results:
Correlations showed that the number of years with headache (r=0.53, P<0.001), self-reported neck pain intensity (r=0.29, P=0.025), headache frequency (r=0.60, P<0.001) and intensity (r=0.54, P<0.001), anxiety (r=0.28; P=0.031), as well as neck-related disability (r=0.64, P<0.001) were correlated to headache-related disability assessed at 3 months. Multiple regression showed that these determinants can be used to predict headache disability (R
2=0.583). Headache frequency (β=0.284) was the best individual predictor.

Discussion:
Results showed that TTH frequency and intensity and the presence of concomitant infrequent migraine are predictors of future disability over a 3-month period. Further studies are needed to evaluate the contribution of other potential physical outcomes on headache-related disability.
Relapsing Bickerstaff Brainstem Encephalitis After Autologous Stem Cell Transplant
Authors: Malhotra Ashwin , Latov Norman 
Published: May 2020

Abstract
Bickerstaff brainstem encephalitis, widely considered to be associated with Miller Fisher and Guillain–Barré syndromes, is a rare disease state defined by the triad of ophthalmoplegia, ataxia, and decreased consciousness. The presence of central nervous system involvement, commonly in the form of impaired arousal, solidifies it as a unique entity. We present a case of this rare syndrome after autologous stem cell transplant.
BAG3 Myopathy Presenting With Prominent Neuropathic Phenotype and No Cardiac or Respiratory Involvement: A Case Report and Literature Review
Authors: Malatesta Lindsay , Arya Kapil , Gokden Murat , Stefans Vikki , Veerapandiyan Aravindhan 
Published: May 2020

Abstract
Bcl-2–associated athanogene 3 (BAG3) myopathy is a rare myofibrillar myopathy characterized by toe walking and clumsiness in the first decade with rapid progression to cardiomyopathy and restrictive lung disease in the second decade. Most patients (18 patients) have the c.626C >T (p.Pro209Leu) mutation. We describe BAG3 myopathy due to p.Pro209Leu in a 13-year-old girl with initial prominent neuropathic phenotype and no cardiac or respiratory involvement. Parents reported toe walking and clumsiness since 3 years old. Examination at the age of 13 years showed findings suggestive of Charcot–Marie–Tooth disease. Nerve conduction studies revealed demyelinating polyneuropathy. Next-generation sequencing panel for inherited neuropathies was unrevealing. Whole exome sequencing identified a de novo mutation in BAG3. Muscle biopsy confirmed myofibrillar myopathy. No cardiac involvement or symptoms of respiratory involvement at the age of 14 years. This case emphasizes the phenotypic variability of BAG3 myopathy and the importance of thorough electrophysiological examination and muscle pathology for establishing a precise diagnosis.
ACR–ASTRO Practice Parameter for Image-guided Radiation Therapy (IGRT)
Authors: Luh Join Y. , Albuquerque Kevin V. , Cheng Cheewai , Ermoian Ralph P. , Nabavizadeh Nima , Parsai Homayon , Roeske John C. , Weiss Stephanie E. , Wynn Raymond B. , Yu Yan , Rosenthal Seth A. , Hartford Alan 
Published: May 2020

Aim/Objectives/Background:
The American College of Radiology (ACR) and the American Society for Radiation Oncology (ASTRO) have jointly developed the following practice parameter for image-guided radiation therapy (IGRT). IGRT is radiation therapy that employs imaging to maximize accuracy and precision throughout the entire process of treatment delivery with the goal of optimizing accuracy and reliability of radiation therapy to the target, while minimizing dose to normal tissues.

Methods:
The ACR–ASTRO Practice Parameter for IGRT was revised according to the process described on the ACR website (“The Process for Developing ACR Practice Parameters and Technical Standards,” www.acr.org/ClinicalResources/Practice-Parametersand-Technical-Standards) by the Committee on Practice Parameters of the ACR Commission on Radiation Oncology in collaboration with the ASTRO. Both societies then reviewed and approved the document.

Results:
This practice parameter is developed to serve as a tool in the appropriate application of IGRT in the care of patients with conditions where radiation therapy is indicated. It addresses clinical implementation of IGRT including personnel qualifications, quality assurance standards, indications, and suggested documentation.

Conclusions:
This practice parameter is a tool to guide clinical use of IGRT and does not make recommendations on site-specific IGRT directives. It focuses on the best practices and principles to consider when using IGRT effectively, especially with the significant increase in imaging data that is now available with IGRT. The clinical benefit and medical necessity of the imaging modality and frequency of IGRT should be assessed for each patient.
Dislocation rates of perineural catheters placed either perpendicular or parallel to the femoral nerve
Authors: Kalimeris Konstantinos , Rupnik Barbara , Allenspach Kathrin , Fucentese Sandro F. , Götschi Tobias , Aguirre José , Eichenberger Urs 
Published: May 2020

BACKGROUND
Ultrasound has increased the efficacy of femoral nerve catheters but their postoperative dislocation still remains a common problem. Although catheter placement parallel to the nerve seems to reduce dislocation rates in other nerves and plexuses, the possible advantage for femoral nerve catheter placement remains unclear.

OBJECTIVE
To compare the dislocation rates of femoral catheters when placed perpendicular or parallel to the femoral nerve.

DESIGN
Randomised controlled study.

SETTING
University orthopaedic hospital. Duration of study: October 2018 to June 2019.

PATIENTS
Eighty patients scheduled for major knee surgery with femoral catheter were enrolled and randomly allocated in two groups. Data from 78 patients could be analysed.

INTERVENTIONS
The femoral nerve catheters was placed perpendicular to the nerve in Group 1 (n=40), whereas in Group 2 (n=38) parallel to it. For Group 1 the short-axis view of the nerve and an in-plane puncture was used. For Group 2 we used the short-axis view of the nerve and an out-of-plane puncture technique combined with rotation of the transducer to the long-axis view with the needle in-plane.

MAIN OUTCOME MEASURES
Primary outcome was the catheter dislocation rate in the first 48 h. Secondary outcomes were pain scores and sensory blockade.

RESULTS
There was no statistically significant difference between the two techniques regarding dislocation of the catheters at 24 or 48 h (at 48 h, Group 1: 15%, Group 2: 2.6%, P = 0.109). Also pain scores, sensory blockade and rescue doses of ropivacaine did not differ between the groups. However, in Group 2 the technique took longer.

CONCLUSION
Rotating the ultrasound probe to the long-axis in-plane view enabled examination of the catheter position when it was placed parallel to the nerve. The parallel placement of the catheter required more time, but did not significantly improve dislocation rate, pain scores or sensory blockade.

TRIAL REGISTRATION
Clinicaltrials.gov identifier: NCT03693755.
Feasibility of Dried Blood Spots in Children with Behavioral Problems
Authors: Kloosterboer Sanne M. , van Eijk Estelle , van Dijk Monique , Dieleman Gwen C. , Hillegers Manon H. J. , van Gelder Teun , Koch Birgit C. , Dierckx Bram 
Published: May 2020

Background:Minimally invasive sampling methods are important to facilitate therapeutic drug monitoring and pharmacokinetic research in children with behavioral problems. This study assessed the feasibility and pain of dried blood spot (DBS) sampling in this population.Methods:Repeated DBS sampling was performed in children with autism spectrum disorder (ASD) and severe behavioral problems using antipsychotic drugs, aged between 6 and 18 years. The child, guardian, and DBS performer assessed pain using the numeric rating scale (NRS-11) or 5-face Faces Pain Scale. The influence of age, sex, and the fingerprick performer on the child's pain intensity was analyzed using linear mixed models.Results:Overall, 247 fingerpricks were performed in 70 children. Seven children refused all DBS sampling. The median (interquartile range) NRS-11 pain scores were 2 (3) rated by children, 3 (2.5) by guardians, and 2 (2) by fingerprick performers. The child's age and sex, and fingerprick performer had no significant influence on pain intensity.Conclusions:DBS sampling could be performed in most children with ASD and severe behavioral problems. However, 1 in 5 children refused one or more DBS fingerpricks owing to distress. Most expressed minimal pain (NRS < 4). Repeated sampling with DBS is feasible in children with ASD and severe behavioral problems.
Ultra HD Liposuction: Enhancing Abdominal Etching Using Ultrasound-Guided Rectus Abdominis Fat Transfer (UGRAFT)
Authors: Viaro Mauricio S. S. , Danilla Stefan , Cansanção Alvaro Luiz , Viaro Paloma Salomone 
Published: May 2020

Background:
High-definition (HD) liposuction has allowed surgeons to sculpt the abdomen, enhancing abdominal etching. To create a more athletic abdomen, fat grafting has been used subcutaneously, and rectus abdominis fat grafting has been performed in patients undergoing lipoabdominoplasty. With the objective of increasing muscle volume to obtain a natural-looking abdomen in patients who are not suitable for abdominoplasty, we propose the use of ultrasound-guided rectus abdominis fat grafting (UGRAFT) in association with HD liposuction.

Patients:
A prospective study with 10 consecutive patients undergoing UGRAFT was conducted. After HD liposuction, UGRAFT was performed from an incision in the umbilical region, using a blunt 2.5-mm cannula assisted by ultrasound. Fat injection was done closer to the anterior rectus sheath in the lower and middle muscle bellies.

Results:
UGRAFT was performed in 10 patients. The mean age was 34.8 years (range, 24–51 years). The mean body mass index was 23.83 kg/m2 (range, 20.58–28.39 kg/m2). The mean volume of fat injected per “pack” was 34 cm3 (range, 20–40 cm3). UGRAFT added a mean time of 20 minutes (range, 15–30 minutes) to HD liposuction. Comparing the rectus abdominis muscle thickness pre-UGRAFT and post-UGRAFT, average muscle thickness increase was 5.1 mm (55.7% ± 37%), with P < 0.0001.

Conclusion:
UGRAFT showed to be helpful for obtaining muscle expansion and a more natural abdominal contour, avoiding that unnatural appearance that HD liposuction may provide in patients who gain weight or have skin laxity.
Transfeminine Gender Confirmation Surgery with Penile Inversion Vaginoplasty: An Initial Experience
Authors: Loree John T. , Burke Mark S. , Rippe Bridgett , Clarke Sarah , Moore Samuel H. , Loree Thom R. 
Published: May 2020

Background:
To detail the early experience with and results of a transfeminine (TF) genital reconstruction at an established plastic surgery practice in Western New York.

Methods:
Between June 2016 and June 2019, 30 patients underwent penile inversion vaginoplasty for TF gender reassignment. All patients fulfilled World Professional Association for Transgender Health and NY State criteria for reassignment surgery. All surgeries were carried out at a large, government-owned tertiary care center.

Results:
There were 30 patients in this retrospective study, with a mean age of 37 years (SD 5.4) and a mean body mass index of 27.3 kg/m2 (SD 3.2 kg/m2). Nineteen patients never smoked, 4 were former smokers, and 7 were current smokers. Primary surgery was an orchiectomy and modified single-stage penile inversion vaginoplasty. Mean operative time was 6.0 hours. Mean initial hospital stay was 8.2 days. Three of the 30 (10%) patients required transfusion. There were 6 (20%) complications. Three complications (10%) required reoperation: 1 patient for wound dehiscence on postoperative day 7, 1 for rectal perforation identified on postoperative day 10, and 1 for urethrovaginal fistula. All complications were addressed without sequalae. Twenty of the 30 (66%) patients have undergone revision surgery. Indications for revision were prolapse correction/deepening, labiaplasty, clitoral hood construction/revision, meatal asymmetry, urinary fistula repair, and posterior vaginal flap revision. Twenty-one of 28 (75%) revisions were outpatient surgeries. There were no complications from these procedures. Overall satisfaction via survey was 92% (24 respondents).

Conclusions:
TF gender reassignment is a novel, challenging set of procedures for the specialty of plastic surgery. With appropriate consideration and technique, penile inversion vaginoplasty is a safe, effective means of achieving this goal.
Three Perspectives on a Successful Succession
Authors: Lancaster Tim , Hibbs Scott , Holland Brad 
Published: May 2020

SUMMARY
Leadership succession does not need to be extremely difficult. However, it does require time, a carefully planned process, well-defined roles, and the intent of all parties to achieve a successful transition—along with the trust to make these various aspects come together. In a CEO succession, the work does not begin at the time of an announced retirement or departure but rather well in advance. The outgoing CEO must want to make the upcoming transition as smooth as possible for everyone involved. The organization must already be committed to the ongoing education of its board, medical staff, and administrators so that all stakeholders are well prepared to execute the transition. Candidates for the CEO role in transition also must be confident in the knowledge of their own needs as well as the needs of the organization. When everyone’s best interests come together to create a good fit, the succession can be successful.
In this article, the leadership transition at one healthcare system is recounted from the perspectives of three principal players: the outgoing president and CEO, the chair of the board of trustees search committee, and the incoming president and CEO.