bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pain Acceptance Partially Mediates the Relationship Between Perceived Injustice and Pain Outcomes Over 3 Months
Authors: Ysidron Dominic W. , Slepian Peter Maxwell , Ankawi Brett , Himawan Lina K. , France Christopher R. 
Published: August 2020

Objectives:
Perceived injustice is a maladaptive cognitive appraisal of pain or injury, characterized by attributions of blame, unfairness, severity of loss, and irreparability of loss. Research suggests that perceived injustice may negatively affect pain outcomes by inhibiting the development of pain-related acceptance. The current study aimed to extend cross-sectional research by testing whether pain acceptance mediates the effects of perceived injustice on pain-related outcomes longitudinally.

Materials and Methods:
Data was analyzed from a prospective study to examine the potential mediating role of pain acceptance on recovery 3 months after an episode of low back pain. Using Mechanical Turk, we recruited participants who experienced an episode of back pain within the preceding 2 weeks, 343 of whom completed measures of perceived injustice, pain acceptance, pain ratings, and quality of life at each of 3 timepoints (recruitment, 1 mo later, and 3 mo later). Path analyses were conducted to examine pain acceptance at 1 month as a potential mediator of the relationship between perceived injustice at recruitment and pain intensity, disability, and depressive symptoms at 3 months.

Results:
Results indicated that perceived injustice at recruitment was directly related to pain intensity, disability, and depressive symptoms 3 months later, and that pain acceptance partially mediated these relationships.

Discussion:
Although these findings provide further support for pain acceptance as a buffer for the deleterious effects of perceived injustice, they also highlight that adjunctive mechanisms should be investigated to provide more comprehensive clinical insight.
Placebo Response Reduction and Accurate Pain Reporting Training Reduces Placebo Responses in a Clinical Trial on Chronic Low Back Pain
Authors: Erpelding Nathalie , Evans Kathryn , Lanier Ryan K. , Elder Harrison , Katz Nathaniel P. 
Published: August 2020

Objective:
A literature review was conducted to compare placebo responses in a recent trial—which implemented an accurate pain reporting (APR) and placebo response reduction (PRR) training program—with placebo responses in similar previous trials in chronic lower back pain (CLBP) that did not use such training.

Methods:
A literature search was performed to find parallel design, randomized, controlled trials of pharmacological treatments administered orally or through intravenous injection for CLBP. Studies were assessed for the proportion of placebo responders, defined as the proportion of patients in the placebo group with ≥30% reduction in pain intensity. A χ2 analysis was performed on the proportion of responders from the SPRINT trial and from other similar studies.

Results:
Of 844 studies identified in the initial screening process, 16 studies were included for comparison. The percentage of placebo responders was statistically significantly lower in the SPRINT study (19.1%) compared with other CLBP trials (38.0%) (P=0.003). Our results show that the placebo response was lower in the SPRINT trial than other comparable studies on CLBP.

Discussion:
These findings are consistent with results from other studies showing that neutralizing subject and study staff expectations of therapeutic benefit can decrease the placebo response in clinical trials. The results of this study suggest training participants and staff to improve pain reporting accuracy, neutralize expectations, and decrease external cues that may bias participants’ pain ratings in clinical trials may effectively decrease the placebo response leading to increased assay sensitivity.
Prevalence, Characteristics, and Clinical Course of Neuropathic Pain in Primary Care Patients Consulting With Low Back-related Leg Pain
Authors: Harrisson Sarah A. , Ogollah Reuben , Dunn Kate M. , Foster Nadine E. , Konstantinou Kika 
Published: August 2020

Objectives:
Little is known about the epidemiology of neuropathic pain in primary care patients consulting with low back-related leg pain. We aimed to describe prevalence, characteristics, and clinical course of low back-related leg pain patients with and without neuropathic pain, consulting with their family doctor in the United Kingdom.

Materials and Methods:
This was a prospective cohort study. Data were collected using a standardized baseline clinical examination and self-report questionnaires at baseline, 4, 12, and 36 months. We identified cases of neuropathic pain using 3 definitions: 2 based on clinical diagnosis (sciatica, with and without evidence of nerve root compression on magnetic resonance imaging), one on the self-report version of Leeds Assessment for Neurological Symptoms and Signs. Differences between patients with and without neuropathic pain were analyzed comparing each definition. Clinical course (mean pain intensity measured as the highest of leg or back pain intensity: mean of 3 Numerical Rating Scales, each 0 to 10) was investigated using linear mixed models over 36 months.

Results:
Prevalence of neuropathic pain varied from 48% to 74% according to definition used. At baseline, patients with neuropathic pain had more severe leg pain intensity, lower pain self-efficacy, more patients had sensory loss than those without. Distinct profiles were apparent depending on neuropathic pain definition. Mean pain intensity reduced after 4 months (6.1 to 3.9 [sciatica]), most rapidly in cases defined by clinical diagnosis.

Discussion:
This research provides new information on the clinical course of neuropathic pain and a better understanding of neuropathic pain in low back-related leg pain patients consulting in primary care.
Endothelial Injury and Glycocalyx Degradation in Critically Ill Coronavirus Disease 2019 Patients: Implications for Microvascular Platelet Aggregation
Authors: Fraser Douglas D. , Patterson Eric K. , Slessarev Marat , Gill Sean E. , Martin Claudio , Daley Mark , Miller Michael R. , Patel Maitray A. , dos Santos Claudia C. , Bosma Karen J. , O’Gorman David B. , Cepinskas Gediminas 
Published: August 2020

Objectives:
Coronavirus disease 2019 is caused by the novel severe acute respiratory syndrome coronavirus 2 virus. Patients admitted to the ICU suffer from microvascular thrombosis, which may contribute to mortality. Our aim was to profile plasma thrombotic factors and endothelial injury markers in critically ill coronavirus disease 2019 ICU patients to help understand their thrombotic mechanisms.

Design:
Daily blood coagulation and thrombotic factor profiling with immunoassays and in vitro experiments on human pulmonary microvascular endothelial cells.

Setting:
Tertiary care ICU and academic laboratory.

Subjects:
All patients admitted to the ICU suspected of being infected with severe acute respiratory syndrome coronavirus 2, using standardized hospital screening methodologies, had daily blood samples collected until testing was confirmed coronavirus disease 2019 negative on either ICU day 3 or ICU day 7 if the patient was coronavirus disease 2019 positive.

Interventions:
None.

Measurement and Main Results:
Age- and sex-matched healthy control subjects and ICU patients that were either coronavirus disease 2019 positive or coronavirus disease 2019 negative were enrolled. Cohorts were well balanced with the exception that coronavirus disease 2019 positive patients were more likely than coronavirus disease 2019 negative patients to suffer bilateral pneumonia. Mortality rate for coronavirus disease 2019 positive ICU patients was 40%. Compared with healthy control subjects, coronavirus disease 2019 positive patients had higher plasma von Willebrand factor (p < 0.001) and glycocalyx-degradation products (chondroitin sulfate and syndecan-1; p < 0.01). When compared with coronavirus disease 2019 negative patients, coronavirus disease 2019 positive patients had persistently higher soluble P-selectin, hyaluronic acid, and syndecan-1 (p < 0.05), particularly on ICU day 3 and thereafter. Thrombosis profiling on ICU days 1–3 predicted coronavirus disease 2019 status with 85% accuracy and patient mortality with 86% accuracy. Surface hyaluronic acid removal from human pulmonary microvascular endothelial cells with hyaluronidase treatment resulted in depressed nitric oxide, an instigating mechanism for platelet adhesion to the microvascular endothelium.

Conclusions:
Thrombosis profiling identified endothelial activation and glycocalyx degradation in coronavirus disease 2019 positive patients. Our data suggest that medications to protect and/or restore the endothelial glycocalyx, as well as platelet inhibitors, should be considered for further study.
Progress of mechanical power in the intensive care unit
Authors: Chi Yi , He Huai-Wu , Long Yun 
Published: August 2020

Abstract
Mechanical power of ventilation, currently defined as the energy delivered from the ventilator to the respiratory system over a period of time, has been recognized as a promising indicator to evaluate ventilator-induced lung injury and predict the prognosis of ventilated critically ill patients. Mechanical power can be accurately measured by the geometric method, while simplified equations allow an easy estimation of mechanical power at the bedside. There may exist a safety threshold of mechanical power above which lung injury is inevitable, and the assessment of mechanical power might be helpful to determine whether the extracorporeal respiratory support is needed in patients with acute respiratory distress syndrome. It should be noted that relatively low mechanical power does not exclude the possibility of lung injury. Lung size and inhomogeneity should also be taken into consideration. Problems regarding the safety limits of mechanical power and contribution of each component to lung injury have not been determined yet. Whether mechanical power-directed lung-protective ventilation strategy could improve clinical outcomes also needs further investigation. Therefore, this review discusses the algorithms, clinical relevance, optimization, and future directions of mechanical power in critically ill patients.
Neuro-oncology Multidisciplinary Clinic and Improvements in Patient Outcome
Authors: Kubicek Gregory J. , Yocum Nora , Thomas Christina , Goldman Howard W. 
Published: August 2020

Background:
Neuro-oncology care is becoming increasingly complex and patients often see multiple specialists. Multidisciplinary clinic (MDC) is a patient-centric option to allow multiple specialists to be involved where patients see multiple providers on the same day.

Objective:
The objective of this study was to evaluate the role of a neuro-oncology MDC on patient outcomes.

Materials and Methods:
Retrospective study was performed on consecutive patients who received radiosurgery for central nervous system (CNS) disease. We evaluated patients 2 years before and 2 years after the implementation of a MDC.

Results:
A total of 351 patients were analyzed, 163 patients before MDC and 188 after implementation of MDC. Before MDC the median follow-up was dependent on which department ordered follow-up radiographic imaging. This discrepancy decreased after the MDC. Overall survival for patients with CNS metastatic disease improved in the MDC cohort (median survival of 248 before MDC and 315 d after, P<0.027).

Conclusion:
We found that neuro-oncology MDC improved follow-up across disciplines and improved overall survival for patients with CNS metastatic disease.
Posterior and total corneal astigmatism measured with optical coherence tomography–based biometer and dual Scheimpflug analyzer
Authors: Wang Li , Cao Danmin , Vilar César , Koch Douglas D. 
Published: August 2020

Purpose:
To compare corneal astigmatism obtained from an optical coherence tomography-based biometer (OCT) and dual Scheimpflug analyzer (DSA).

Setting:
Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA.

Design:
Retrospective case series.

Methods:
Consecutive cases with both OCT and DSA measurements were reviewed. Three parameters were analyzed with OCT and DSA: (1) standard keratometric astigmatism (K vs simulated keratometry [SimK]), (2) posterior corneal astigmatism, and (3) total corneal astigmatism (total keratometry [TK] vs total corneal power [TCP]). The magnitudes of corneal astigmatism obtained from the 2 devices were compared. Vector analysis was used to assess differences in corneal astigmatism between devices.

Results:
In this study 530 corneas in 530 patients were measured. Compared with the DSA, the OCT produced a lower mean magnitude of posterior corneal astigmatism (−0.19 vs −0.29 diopter [D]) and a higher percentage of eyes with magnitude ≤0.25 D (75.5% vs 41.9%) (P < .05). Comparing TK and TCP, (1) TK was greater in magnitudes (1.03 vs 0.98 D); (2) 84.3% of eyes had differences in magnitude of ≤0.50 D; (3) in eyes with TK astigmatism ≥0.5 D, 34.5% and 60.1% of eyes had differences in steep meridian of ≤5 degrees and ≤10 degrees, respectively, and (4) 59.2% of eyes had vector differences of ≤0.50 D. In with-the-rule and against-the-rule eyes, respectively, the vector differences between TK and TCP were 0.16 D @ 83 degrees and 0.17 D @ 12 degrees, and in posterior corneal astigmatism, 0.06 D @ 173 degrees; and 0.15 D @ 175 degrees.

Conclusions:
There were clinically significant differences in total corneal astigmatism obtained from OCT and DSA devices. Compared with DSA, OCT produced lower values for posterior corneal astigmatism.
Willingness to Use HIV Self-Testing With Online Supervision Among App-Using Young Men Who Have Sex With Men in Bangkok
Authors: Samoh Nattharat , Peerawaranun Pimnara , Jonas Kai J. , Lim Sin How , Wickersham Jeffrey A. , Guadamuz Thomas E. 
Published: August 2020

Abstract
An online assessment among social media–using young men who have sex with men found that 87% were willing to use HIV self-testing with online supervision. Correlates included never tested, having higher numbers of sexual partners, and seeking partners online. HIV self-testing with online supervision may be appropriate for young men who have sex with men who have high risks and may not access venue-based settings.
Clinical and Personal Lubricants Impact the Growth of Vaginal Lactobacillus Species and Colonization of Vaginal Epithelial Cells: An in Vitro Study
Authors: Łaniewski Paweł , Owen Kimberley A. , Khnanisho Michael , Brotman Rebecca M. , Herbst-Kralovetz Melissa M. 
Published: August 2020

Background
Vaginal lubricants are commonly used during gynecological examinations, during sexual activities, or to alleviate vaginal dryness. Many lubricants contain potentially bacteriostatic or bactericidal agents (parabens, chlorhexidine gluconate, nonoxynol-9). Our objective was to evaluate the impact of lubricants that vary in formulation on the growth and viability of vaginal Lactobacillus species and vaginal epithelial cell (VEC) colonization in an in vitro model.

Methods
Growth curve, disk diffusion, and minimal inhibitory assays were used to determine the impact of lubricants or excipients on the growth of Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus jensenii, and Lactobacillus iners. L. crispatus strain was used in VEC colonization assays. Statistical differences were determined by analysis of variance.

Results
Lubricants containing chlorhexidine gluconate or nonoxynol-9 (N-9; Conceptrol, K-Y Jelly, and Surgilube) significantly inhibited Lactobacillus species growth (P < 0.05). In contrast, other clinical lubricants (E-Z Lubricating Jelly, McKesson Lubricating) and personal lubricants (Astroglide Liquid, Good Clean Love Almost Naked, K-Y Warming Jelly) did not exhibit this effect. Chlorhexidine gluconate had a detrimental effect on Lactobacillus growth and exhibited stronger antimicrobial activity compared with methylparaben and propylparaben (P < 0.0001). There were lubricants that did not induce cytotoxicity in VEC (Good Clean Love Almost Naked, E-Z Lubricating Jelly, McKesson Lubricating Jelly), but these products did substantially decrease the attachment of L. crispatus to VEC, particularly when VEC were preexposed to lubricants before inoculation with bacteria (P < 0.0001).

Conclusions
This in vitro model indicates that select vaginal lubricants, particularly those with chlorhexidine gluconate, have potentially adverse effects on women’s health by reducing growth and recolonization of vaginal Lactobacillus species.
Intravaginal Practices Among Women Attending a Sexually Transmitted Disease Clinic—Philadelphia, 2017
Authors: Lewis Felicia M.T. , Diesel Jill 
Published: August 2020

Abstract
We conducted a survey among women attending an urban public sexually transmitted disease clinic to determine the type and frequency of intravaginal cleansing practices. Both intravaginal washing and douching were frequent, performed mostly for routine hygiene, and associated with self-report of sexually transmitted infection and bacterial vaginosis (douching and intravaginal washing).
Comparison of Neurocognitive Outcomes in Postoperative Adolescents with Unilateral Coronal Synostosis
Authors: Wu Robin T. , Gabrick Kyle S. , Singh Anusha , Landi Nicole , Taylor Jesse A. , Bartlett Scott P. , Persing John A. , Alperovich Michael 
Published: August 2020

Summary:
Unilateral coronal nonsyndromic craniosynostosis is associated with asymmetric skull growth, which may influence cerebral long-term function. Twenty affected adolescents who underwent cranial vault remodeling at a mean age of 8.2 months (12 from the Yale Craniofacial Clinic and eight from the Children’s Hospital of Philadelphia) all completed a double-blinded neurodevelopmental assessment at an average age of 12.1 years. The study cohort included 55 percent female and 50 percent right-sided craniosynostosis. Mean verbal intelligence quotient was highest at 117.3, and mean performance intelligence quotient was 106.4, for a mean full-scale intelligence quotient of 112.5. Patients performed above the national average on all academic achievements except for numerical operations, which was significantly lower than word reading (p = 0.022). Patients performed below average on all Beery-Buktenica visual motor tests; motor-coordination was poorer than both visual motor integration and visual perception (p = 0.027 and p = 0.005). Significant positive correlations existed between paternal education/visual perception (r = 0.450; p = 0.046) and household income/verbal intelligence quotient (r = 0.628; p = 0.004). Patients with right unilateral coronal nonsyndromic craniosynostosis had improved spelling compared with left-sided patients on multivariate regression (p = 0.033). Female patients had higher motor coordination (p = 0.024). Breast-fed patients had better performance intelligence quotient (p = 0.024), visual motor integration (p = 0.014), and visual perception (p = 0.031). Adolescents who underwent cranial vault remodeling at two institutions had above average intelligence quotient scores, but worse mathematical and visual motor achievement compared with control subjects. Left-side craniosynostosis patients performed worse in spelling than right-side patients. Breast-feeding was an independent predictor for improved performance intelligence quotient, visual motor achievement, and visual perception performance. Study findings are limited by the cohort size. A larger population study is required, which could validate or modify the study conclusions.
The Glass Ceiling in Plastic Surgery: A Propensity-Matched Analysis of the Gender Gap in Career Advancement
Authors: Ngaage Ledibabari M. , Ngadimin Cleo , Harris Chelsea , Rawes Catherine , Wu Yinglun , Landford Wilmina , Slezak Sheri , Rasko Yvonne M. 
Published: August 2020

Background:
Gender parity remains elusive in academic plastic surgery. It is unknown whether this disparity is attributable to differences in qualifications or to the glass ceiling of gender bias. To parse this, the authors compared academic titles and departmental leadership of female academic plastic surgeons to a matched group of their male counterparts.

Methods:
The authors conducted a cross-sectional analysis of academic plastic surgeons. The authors identified faculty, sex, academic rank, and leadership positions from plastic surgery residency program websites. The authors then collected details on training institution, advanced degrees, years in practice, and h-index for use as independent variables. The authors performed a propensity score analysis to 1:1 match male and female academic plastic surgeons.

Results:
A total of 818 academic plastic surgeons were included. The cohort was predominately male [n = 658 (81 percent)], with a median 12 years in practice and a median h-index of 9. Before matching, men had more years in practice (13 years versus 9 years; p < 0.0001), a greater h-index (11 versus 5; p < 0.0001), were more likely to be professors (34 percent versus 13 percent; p < 0.0001), and held more leadership positions than women (41 percent versus 30 percent; p = 0.0221). Following matching, gender parity was demonstrated in academic rank and departmental leadership.

Conclusions:
Differences in training, qualifications, career length, and academic productivity may account for the leadership gap in academic plastic surgery. Gendered difficulties in reaching qualification benchmarks must be addressed before gender parity in promotion can be achieved.
Comparing the Lumbar and SGAP Flaps to the DIEP Flap Using the BREAST-Q
Authors: Opsomer Dries , Vyncke Tom , Ryx Michelle , Stillaert Filip , Van Landuyt Koenraad , Blondeel Phillip 
Published: August 2020

Background:
The deep inferior epigastric artery perforator (DIEP) flap is the gold standard in autologous breast reconstruction. When the abdomen is not available, alternative donor sites can be found at the buttock, the lumbar region, or the thighs. These flaps are referred to as second-choice flaps. This study compares the superior gluteal artery perforator (SGAP) flap and the lumbar artery perforator (LAP) flap to the DIEP flap using patient-reported outcomes.

Methods:
A retrospective study was performed reviewing the records of 417 women who underwent a free flap breast reconstruction with either a DIEP, an LAP, or an SGAP flap, between 2006 and 2018. Patients were asked to fill out the BREAST-Q questionnaire, and patient-reported outcomes were analyzed and correlated to the demographic information.

Results:
The response rate was 54.5 percent, with 50 LAP, 153 DIEP, and 25 SGAP flap patients participating. When questioned about their satisfaction with breasts and satisfaction with outcome, all three procedures were rated similarly high. When comparing the physical well-being of the donor site and appearance of the donor site, LAP flap patients reported significantly lower scores than DIEP and SGAP flap patients.

Conclusions:
Patients who undergo LAP or SGAP flap breast reconstruction seem similarly satisfied with the appearance and outcome of their free flap breast reconstruction compared with DIEP flap patients. The donor-site morbidity and its impact on the patient’s well-being in SGAP and LAP flap patients have been underestimated. Despite more donor-site discomfort, the LAP and SGAP flaps are feasible alternatives whenever the DIEP flap is not possible.