bluuebunny/crossref_metadata_2025_split huggingface dataset:
Content of an Educational Handover Letter From Medical Schools to Surgery Residencies: A Mixed Method Analysis
Authors: Lipman Jeremy M. , Park Yoon Soo , K. Papp Klara , Tekian Ara 
Published: August 2021

Purpose
To identify the content of an educational handover letter from undergraduate to graduate education in General Surgery.

Method
Expert consensus was attained on the content of an educational handover letter. A 3-stage Delphi technique was employed with 8 experts in each of 4 stakeholder groups: program directors in general surgery, medical student surgical acting internship or prep course directors, authors of medical student performance evaluations, and current categorical General Surgery residents. Data were collected from April through July 2019. A mixed method analysis was performed to quantitatively assess items selected for inclusion and qualitatively provide guidance for the implantation of such a letter.

Results
All 32 experts participated in at least one round. Of the 285 initially identified individual items, 22 were ultimately selected for inclusion in the letter. All but one expert agreed that the list represents what the content of an educational handover letter in General Surgery should be. Qualitative analysis was performed on 395 comments and identified 4 themes to guide the implementation of the letter: “minimize redundancy, optimize impact, use appropriate assessments, and mitigate risk.”

Conclusions
A framework and proposed template are provided for an educational handover letter from undergraduate to graduate medical education in General Surgery based on the quantitative and qualitative analysis of expert consensus of major stakeholders. This letter holds promise to enhance the transition from undergraduate to graduate medical education by allowing programs to capitalize on strengths and efficiently address knowledge gaps in new trainees.
Perioperative Complications in Posterior Surgeries for Cervical Ossification of the Posterior Longitudinal Ligament
Authors: Yoshii Toshitaka , Egawa Satoru , Sakai Kenichiro , Kusano Kazuo , Nakagawa Yukihiro , Hirai Takashi , Wada Kanichiro , Katsumi Keiichi , Fujii Kengo , Kimura Atsushi , Furuya Takeo , Nagoshi Narihito , Kanchiku Tsukasa , Nagamoto Yukitaka , Oshima Yasushi , Ando Kei , Takahata Masahiko , Mori Kanji , Nakajima Hideaki , Murata Kazuma , Matsunaga Shunji , Kaito Takashi , Yamada Kei , Kobayashi Sho , Kato Satoshi , Ohba Tetsuro , Inami Satoshi , Fujibayashi Shunsuke , Katoh Hiroyuki , Kanno Haruo , Imagama Shiro , Koda Masao , Kawaguchi Yoshiharu , Takeshita Katsushi , Matsumoto Morio , Yamazaki Masashi , Okawa Atsushi 
Published: August 2021

Study Design:
This was a prospective multicenter study.

Objective:
The aim of this study was to investigate the perioperative complications of posterior surgeries for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL).

Summary of Background Data:
Surgical treatment for cervical OPLL has a high risk of various complications. Laminoplasty (LAMP) and posterior decompression and instrumented fusion (PDF) are effective for multilevel cervical OPLL; however, few studies have focused on the surgical complications of these 2 procedures.

Materials and Methods:
We prospectively included 380 patients undergoing posterior surgeries for cervical OPLL (LAMP: 270 patients, PDF: 110 patients), and investigated the systemic and local complications, including neurological complications. We further evaluated risk factors related to the neurological complications.

Results:
Motor palsy was found in 40 patients (10.5%), and motor palsy in the upper extremity was most frequent (8.9%), especially in patients who received PDF (14.5%). Motor palsies involving the lower extremities was found in 6 patients (1.6%). Regarding local complications, dural tears (3.9%) and surgical site infections (2.6%) were common. In the univariate analysis, body mass index, preoperative cervical alignment, fusion surgery, and the number of operated segments were the factors related to motor palsy. Multivariate analysis revealed that fusion surgery and a small preoperative C2−C7 angle were the independent factors related to motor palsy. Motor palsy involving the lower extremities tended to be found at early time points after the surgery, and all the patients fully recovered. Motor palsy in the upper extremities occurred in a delayed manner, and 68.8% of patients with PDF showed good recovery, whereas 81.3% of patients with LAMP showed good recovery.

Conclusions:
In posterior surgeries for cervical OPLL, segmental motor palsy in the upper extremity was most frequently observed, especially in patients who received PDF. Fusion and a small preoperative C2−C7 angle were the independent risk factors for motor palsy.

Level of Evidence:
Level III.
Electrosurgery Use During Post-Mohs Micrographic Surgery Repair and Complication Rates—How Important is a Dry Field?
Authors: Juhasz Margit , Sharma Ajay N. , Lee Patrick K. , Zachary Christopher , Shive Melissa 
Published: August 2021

BACKGROUND
Electrosurgery is used to achieve hemostasis during surgery. There are no studies exploring the effects of the use or avoidance of electrodessication during Mohs micrographic surgery (MMS) repair. Given the growing concerns for tissue aerosolization, occupational smoke exposure, and spread of infectious diseases, it is important to determine the importance of electrical hemostasis.

MATERIALS AND METHODS
In this retrospective study, electronic medical records of a single, tertiary, academic dermatology practice were reviewed. All MMS cases that underwent surgical repair from January 1 to December 31, 2019, by 2 dermatologic surgeons (one who used electrodessication during repair and one who did not) were included. Patient demographic data, information regarding the procedures, and complications occurring 90 days after MMS were recorded.

RESULTS
One hundred ninety-eight cases of MMS repair used electrodessication, whereas 193 cases did not. There was no significant difference in the demographic makeup, MMS procedure, or 90-day complication rates between the 2 groups. No major adverse events were MMS-related.

CONCLUSION
The use or avoidance of electrodessication during MMS repair was not associated with increased 90-day postoperative complications, suggesting that a greater tolerance of moderate oozing at a surgical site during MMS repair is reasonable to minimize electrosurgical tissue damage and occupational smoke exposure.
Air Pollution and Autism Spectrum Disorder in Israel
Authors: Magen-Molho Hadas , Weisskopf Marc G. , Nevo Daniel , Shtein Alexandra , Chen Shimon , Broday David , Kloog Itai , Levine Hagai , Pinto Ofir , Raz Raanan 
Published: August 2021

Background:
Residual confounding is a major concern for causal inference in observational studies on air pollution-autism spectrum disorder (ASD) associations. This study is aimed at assessing confounding in these associations using negative control exposures.

Methods:
This nested case-control study included all children diagnosed with ASD (detected through 31 December 2016) born during 2007–2012 in Israel and residing in the study area (N = 3,843), and matched controls of the same age (N = 38,430). We assigned individual house-level exposure estimates for each child. We estimated associations using logistic regression models, mutually adjusted for all relevant exposure periods (prepregnancy, pregnancy, and postnatal). We assessed residual confounding using postoutcome negative control exposure at age 28–36 months.

Results:
In mutually adjusted models, we observed positive associations with ASD for postnatal exposures to NOx (odds ratio per interquartile range, 95% confidence interval: 1.19, 1.02–1.38) and NO2 (1.20, 1.00–1.43), and gestational exposure to PM2.5-10 (1.08, 1.01–1.15). The result for the negative control period was 1.04, 0.99–1.10 for PM2.5, suggesting some residual confounding, but no associations for PM2.5-10 (0.98, 0.81–1.18), NOx (1.02, 0.84–1.25), or NO2 (0.98, 0.81–1.18), suggesting no residual confounding.

Conclusions:
Our results further support a hypothesized causal link with ASD that is specific to postnatal exposures to traffic-related pollution.
Poverty, Deprivation, and Mortality Risk Among Women With HIV in the United States
Authors: Edmonds Andrew , Breskin Alexander , Cole Stephen R. , Westreich Daniel , Ramirez Catalina , Cocohoba Jennifer , Wingood Gina , Cohen Mardge H. , Golub Elizabeth T. , Kassaye Seble G. , Metsch Lisa R. , Sharma Anjali , Konkle-Parker Deborah , Wilson Tracey E. , Adimora Adaora A. 
Published: August 2021

Background:
Prior studies suggest neighborhood poverty and deprivation are associated with adverse health outcomes including death, but evidence is limited among persons with HIV, particularly women. We estimated changes in mortality risk from improvement in three measures of area-level socioeconomic context among participants of the Women’s Interagency HIV Study.

Methods:
Starting in October 2013, we linked geocoded residential census block groups to the 2015 Area Deprivation Index (ADI) and two 2012–2016 American Community Survey poverty variables, categorized into national tertiles. We used parametric g-computation to estimate, through March 2018, impacts on mortality of improving each income or poverty measure by one and two tertiles maximum versus no improvement.

Results:
Of 1596 women with HIV (median age 49), 91 (5.7%) were lost to follow-up and 83 (5.2%) died. Most women (62%) lived in a block group in the tertile with the highest proportions of individuals with income:poverty <1; 13% lived in areas in the tertile with the lowest proportions. Mortality risk differences comparing a one-tertile improvement (for those in the two highest poverty tertiles) in income:poverty <1 versus no improvement increased over time; the risk difference was −2.2% (95% confidence interval [CI] = −3.7, −0.64) at 4 years. Estimates from family income below poverty level (−1.0%; 95% CI = −2.7, 0.62) and ADI (−1.5%; 95% CI = −2.8, −0.21) exposures were similar.

Conclusions:
Consistent results from three distinct measures of area-level socioeconomic environment support the hypothesis that interventions to ameliorate neighborhood poverty or deprivation reduce mortality risk for US women with HIV. See video abstract at, http://links.lww.com/EDE/B863.
Association between higher serum uric acid levels within the normal physiological range and changes of lumbar spine bone mineral density in healthy Chinese postmenopausal women: a longitudinal follow-up study
Authors: Han Wen , Bai Xiaojuan , Han Lulu , Sun Xuefeng , Chen Xiangmei 
Published: August 2021

Abstract

Objectives:
The aim of this study was to investigate whether higher serum uric acid (SUA) levels within the physiological range were associated with changes in lumbar spine bone mineral density (LBMD) in postmenopausal women without existing lumbar spine osteoporosis after a longitudinal follow-up of 3.09 years, and to further confirm the relationship between SUA and bone mineral density (BMD) in other sites such as femoral neck, total hip, and trochanter at follow-up.

Methods:
A longitudinal study of 175 healthy postmenopausal women without osteoporosis was conducted in Shenyang, China. BMD of the lumbar spine, femoral neck, total hip, and trochanter were measured using dual-energy x-ray absorptiometry at each visit. Pearson's correlation analysis and regression analyses were performed to determine any associations.

Results:
There were positive correlations between baseline SUA and BMD of the lumbar spine (P = 0.03), total hip (P = 0.04), and trochanter (P = 0.04). Moreover, higher baseline SUA levels were independently associated with LBMD decline and the odds ratio of the baseline SUA of the third quartile group was 0.12 (95% confidence interval, 0.02-0.70, P < 0.05), with P = 0.23 for the trend in baseline SUA when compared with participants in the lowest, first quartile group after adjustment for many potential confounding variables.

Conclusions:
Higher SUA levels within the normal physiological range were independently associated with decreased LBMD, and SUA levels were positively related to the BMD of the lumbar spine, total hip, and trochanter in healthy Chinese postmenopausal women.
Factors related to age at natural menopause in China: results from the China Kadoorie Biobank
Authors: Wang Meng , Kartsonaki Christiana , Guo Yu , Lv Jun , Gan Wei , Chen Zheng-Ming , Li Li-Ming , Hu Chong-Gao , Yang Ling , Yu Min 
Published: August 2021

Abstract

Objectives:
The aim of this study was to investigate the potentially modifiable factors affecting age at natural menopause (ANM) in Chinese women.

Methods:
We used cross-sectional data from the China Kadoorie Biobank study which that recruited 0.5 million (0.3 million women) Chinese adults aged 30 to 79 from 2004 to 2008. Multinomial logistic regression models were used to examine the relationships between ANM and various factors recorded at baseline.

Results:
Among 87,349 postmenopausal women, the mean ANM (SD) was 48.7 (4.3) years. Older age, being a housewife, earlier menarche, and passive smoking were associated with both premature menopause (PM, ie, ANM <40 years) and early menopause (EM, ie, ANM between 40 and 44 years). A higher odds for EM was observed in women who were widowed (odds ratio: 1.10, 95% confidence interval: 1.04-1.16), had spontaneous abortions (1.33 [1.05-1.69]), current regular smoking (1.19 [1.07-1.37]), and frequent spicy food intake (1.11 [1.05-1.08]). Higher socioeconomic status; later first birth; more live births and induced abortions; longer breastfeeding; tea drinking, as well as intakes of meat, fruits, dairy, and soybean products; and increased body mass index gain were inversely associated with PM and/or EM. In contrast, women who had more pregnancies, occasional alcohol drinking, higher levels of physical activity or body mass index, vitamin intake, and hypertension were more likely to have a later age at menopause (LM, ie, ANM ≥53 years).

Conclusions:
This large epidemiological study found a wide range of sociodemographic, lifestyle, dietary, and reproductive factors related to PM, EM, and LM in Chinese women.
The aortic-femoral arterial stiffness gradient is blood pressure independent in older adults: the atherosclerosis risk in communities (ARIC) study
Authors: Stone Keeron , Fryer Simon , Faulkner James , Meyer Michelle L. , Heffernan Kevin , Kucharska-Newton Anna , Zieff Gabriel , Paterson Craig , Matsushita Kunihiro , Hughes Timothy M. , Tanaka Hirofumi , Stoner Lee 
Published: August 2021

Background:
Aortic arterial stiffness is a strong independent predictor of cardiovascular disease (CVD); however, its dependence on mean arterial pressure (MAP) limits its clinical utility. The aortic-femoral arterial stiffness gradient (af-SG), a novel marker of CVD risk, may be a promising alternative, but its dependence on MAP is not known. The aim of this study was to determine the relationship between MAP and the af-SG in healthy older adults and those with established disease, including hypertension and diabetes.

Method:
We evaluated the dependency of the af-SG on MAP in healthy older adults (n = 694, aged 74 ± 5 years), and adults with hypertension (n = 2040, aged 76 ± 5 years), and diabetes (n = 1405, aged 75 ± 5 years) as part of the community-based Atherosclerosis Risk in Communities (ARIC) Study. Carotid-femoral pulse-wave velocity (cfPWV), femoral-ankle PWV (faPWV) and blood pressure were measured using standardized protocols. The af-SG was calculated as faPWV divided by cfPWV. Multivariable regression analysis was performed to test the independent association of MAP with af-SG, with adjustments for known confounders, including age, sex, BMI, blood glucose and heart rate.

Results:
There was no significant relationship between the af-SG and MAP in healthy (β = 0.002, P = 0.301), hypertension (β = −0.001, P = 0.298) or diabetes (β = −0.001, P = 0.063) population groups, with MAP explaining less than 0.1, less than 0.1 and 0.2% of the variance in the af-SG, respectively.

Conclusion:
These findings suggest that the af-SG may be regarded as a MAP independent index of arterial health and CVD risk in older adults.
A Case of Laryngeal Infection Secondary to Mycobacterium mageritense in an Immunocompetent Patient
Authors: Lehman David E. , Delman Mark 
Published: August 2021

Abstract

Mycobacterium mageritense is a rare rapidly growing nontuberculous mycobacterium classified as a member of the Mycobacterium fortuitum group. It has been described in the literature in case reports as causing varied types of infections, primarily in patients with an identifiable predisposition such as direct inoculation or immunosuppression. Here we describe the first known case of this bacteria causing a laryngeal infection. The patient in this case did not have any identifiable exposures or immunosuppression leading to the infection.
A case of COVID-19 Reinfection and Systematic Review of Patterns of Reinfection
Authors: Chamblain Melissa , Dawkins Elissa , Lane Jason , Ghany Reyan , Tamariz Leonardo , Palacio Ana , Guzman-Suarez Belisa 
Published: August 2021

Abstract
We present a case of a middle age Hispanic patient with COVID-19 reinfection. We conducted a systematic review of the literature of reinfection cases and found that women represent the majority of the cases and that reinfection usually presents with more severe disease, particularly among healthcare workers.
Use of Industrial Filters by Health Care Workers During Shortages of N95 Respirators in Pandemic Times
Authors: Lin Belle K. , Munter Bryce , Pascavis Katie , Nakaji Peter , Nicolasora Nelson 
Published: August 2021

Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to a significant shortage of personal protective equipment in multiple health care facilities around the world, with the highest impact on N95 respirator masks. The N95 respirator is a mask that blocks at least 95% of very small (0.3 μm) particles and is considered a standard for enhanced respiratory precautions. The N95 mask shortage has created a need for other options for nasal and oral respiratory protection with similar filtration efficiency and “medical-grade” clearance, which can be used in health care settings. However, the literature around various filter types, their filtration capabilities, and the organizations certifying their use is dense, confusing, and not easily accessible to the public. Here, we synthesize relevant literature to analyze and disseminate information on (1) alternative viable filter options to N95s, (2) the National Institute for Occupational Safety and Health certification process, (3) the relationship of National Institute for Occupational Safety and Health certification to Food and Drug Administration certification of filtration devices and surgical masks, and (4) how this relationship may affect future filtration usage in the medical community during a pandemic. Analysis of these standards is meant to inform regarding evidence of respirator efficacy but does not imply any official endorsement of these alternatives. With this article, we illuminate viable alternative respirator options during the COVID-19 pandemic to help alleviate the dependency on N95 face masks.
Family Caregiver and Provider Perspectives on Inclusive Care
Authors: Shepherd-Banigan Megan E. , Boucher Nathan A. , McKenna Kevin , Delgado Roxana E. , Whitaker Coleton , Christensen Leah , Sperber Nina R. 
Published: August 2021

Background:
Home-based and community-based health care for individuals with complex medical conditions is often provided by family caregivers. Yet caregivers often are not meaningfully included in interactions with clinical health care teams. Inclusive care means inviting the caregiver to participate in shared decision-making and treatment planning. For aging or medically vulnerable adults, caregiver inclusion is an important facet of patient-centered care.

Methods:
We apply a mixed-methods approach using a survey (n=50) and semistructured interview data (n=13) from a national sample of caregivers of veterans and semistructured interview data from (n=24) providers from 3 Veterans Affairs regional networks. We elicited data from caregivers about their experiences with inclusive care and how providers communicate with them and assess their capacity. We juxtaposed these data with provider perspectives to see where there was alignment.

Findings:
We determined that caregivers play important roles in trust-building, communications management, implementation of care plans at home or in the community, and improving the care of care recipients—while maintaining a balance between competing tensions.

Conclusions:
Our findings suggest that expanding inclusive care could improve care quality and health outcomes of individuals with complex health care needs. Further, our findings bolster recent policy efforts at the federal and state levels to increase recognition of caregivers as key members of the health care team.
Intensity of bone involvement: a quantitative 18F-FDG PET/CT evaluation for monitoring outcome of multiple myeloma
Authors: Takahashi Maria Emilia Seren , Mosci Camila , Duarte Gislaine O. , Pericole Fernando V. , Metze Konradin , Lorand-Metze Irene G.H. , Ramos Celso D. 
Published: August 2021

Purpose
The parameter intensity of bone involvement (IBI) was recently proposed to quantitatively assess patients with multiple myeloma using 18F-fluorodeoxyglucose-PET combined with computed tomography (18F-FDG PET/CT) images. Here, we aimed to calculate IBI variation (ΔIBI) between two consecutive PET/CT of the same patient and verified its relationship with a subjective visual analysis of the images and with clinical outcome.

Methods
Consecutive whole-body 18F-FDG PET/CT performed to assess the outcomes of 29 patients diagnosed with multiple myeloma were retrospectively evaluated. ΔIBI was calculated after bone segmentation, using liver standardized uptake value as a threshold to determine metabolically active volumes in the skeleton. For each pair of consecutive PET/CTs, two nuclear medicine physicians classified visually the most recent image as PET-remission, PET-progression or PET-stable when compared to the previous examination.

Results
The lowest ΔIBI was –1.27 and the highest was 0.29. PET-remission was related to ΔIBI <0 (median = –0.10; –1.27 to +0.03), while PET-progression was related to ΔIBI >0 (median = 0.02; –0.07 to +0.29). ΔIBI around zero was found in images classified as PET-stable (median = 0.00; –0.08 to +0.06). Significant difference in ΔIBI was found between the three groups. Multivariate stepwise analysis showed that IBI value at diagnostic PET/CT, serum calcium and percentage of plasma cells in the bone marrow are independent prognostic factors.

Conclusion
Delta IBI provides quantitative data for variations of 18F-FDG uptake in the bone marrow during the follow-up of the patients. In addition, higher IBI values at diagnosis are associated with a higher risk of patient’s death.