bluuebunny/crossref_metadata_2025_split huggingface dataset:
Initiating pre-exposure prophylaxis
Authors: Ng Yeow Chye , Mayeux Jack J. 
Published: August 2021

Abstract:
Pre-exposure prophylaxis (PrEP) is an HIV preventive service and treatment that is continuing to evolve. With the availability of in-house lab screenings and simplified testing protocols, primary care providers are in a unique position to initiate and provide the added layer of HIV protection for their patients.
Professional values and role socialization of new NPs
Authors: Hampton Debra , Parrish Evelyn , Buckler Lacey 
Published: August 2021

Abstract:
This cross-sectional study focuses on assessing factors related to role socialization of new NPs. Participants identified caring as the most important professional value, followed by activism and professionalism. Role socialization factors including a sense of belonging and forming professional identities were higher for experienced NPs.
Use of Gestational Surrogates for Women With Eisenmenger Syndrome: A Cost-Effectiveness Analysis
Authors: Clennon Emily K. , Pare Emmanuelle , Amato Paula , Caughey Aaron B. 
Published: August 2021

(Abstracted from J Matern Fetal Neonatal Med 2021;34:526–531)
One clear contraindication to pregnancy is Eisenmenger syndrome (ES), a rare complication affecting pulmonary function. Up to 50% of ES cases result in maternal deaths.
DNAH2 facilitates the homologous recombination repair of Fanconi anemia pathway through modulating FANCD2 ubiquitination
Authors: Chang Lixian , Gao Xingjie , Wang Yuxia , Huang Chunmin , Gao Min , Wang Xiaomin , Liu Chao , Wu Wenqi , An Wenbin , Wan Yang , Zhang Aoli , Zhang Yingchi , Yuan Weiping , Zhu Xiaofan 
Published: August 2021

Abstract
Fanconi anemia (FA), an X-linked genetic or autosomal recessive disease, exhibits complicated pathogenesis. Previously, we detected the mutated Dynein Axonemal Heavy Chain 2 (DNAH2) gene in 2 FA cases. Herein, we further investigated the potential association between DNAH2 and the homologous recombination repair pathway of FA. The assays of homologous recombination repair, mitomycin C (MMC) sensitivity, immunofluorescence, and ubiquitination modification were performed in U2OS and DR-U2OS cell lines. In MMC-treated U2OS cells, the downregulation of the DNAH2 gene increased the sensitivity of cells to DNA inter-strand crosslinks. We also observed the reduced enrichment of FANCD2 protein to DNA damage sites. Furthermore, the ubiquitination modification level of FANCD2 was influenced by the deficiency of DNAH2. Thus, our results suggest that DNAH2 may modulate the cell homologous recombination repair partially by increasing the ubiquitination and the enrichment to DNA damage sites of FANCD2. DNAH2 may act as a novel co-pathogenic gene of FA patients.
A Seat at the Table: Delivering Effective Infectious Diseases and Antimicrobial Stewardship Education to Advanced Practice Providers at an Academic Medical Center
Authors: Lee Matthew Shou Lun , Stead Wendy 
Published: August 2021

Introduction:
Antimicrobial Stewardship programs promote appropriate antimicrobial use through different avenues, including education. Advanced Practice Providers (APPs) provide inpatient care in a wide-range of settings. Little is known about the educational needs of APPs at academic medical centers or the effect of educational interventions directed at inpatient APPs on clinical care. Our study looked at the effect of an educational intervention on antimicrobial prescribing by APPs for asymptomatic bacteriuria (ASB) and candiduria (ASC). We also conducted a needs assessment on the opportunities and barriers to continuing medical education.

Methods:
The educational intervention consisted of in-person interactive learning accompanied by an online video. Pre-intervention and postintervention surveys included an educational needs assessment and knowledge acquisition assessment. A retrospective chart review of adult inpatients admitted to the APP services with bacteriuria or candiduria during the 3 months pre-intervention and postintervention was performed.

Results:
Our needs assessment revealed several barriers to APP-focused education including no protected time for learning, and curricula predominantly directed at the Graduate Medical Education level. Engaged APPs had improved knowledge scores, but the proportion of treated ASB or ASC episodes did not differ between the pre-intervention and postintervention.

Discussion:
Although our educational intervention did not change prescribing patterns, the intervention increased knowledge around ASB and ASC. The potential hierarchical structure of interprofessional care teams may be a barrier to changing antimicrobial prescribing. Our study identified the possibility of a hidden curriculum at academic medical centers that does not prioritize APP educational needs.
Outdoor air pollution and anti-Müllerian hormone concentrations in the Sister Study
Authors: Gregoire Allyson M. , Upson Kristen , Niehoff Nicole M. , Chin Helen B. , Kaufman Joel D. , Weinberg Clarice R. , Sandler Dale P. , Nichols Hazel B. , White Alexandra J. 
Published: August 2021

Background:
Anti-Müllerian hormone (AMH) concentrations are a marker of ovarian reserve and are indicative of a woman’s reproductive lifespan. Exposure to tobacco smoke has been associated with lower AMH concentrations; however, less is known about the association between ambient air pollution and ovarian reserve.

Methods:
For 883 premenopausal Sister Study participants recruited between 2003 and 2009 in the United States, adult residential annual average concentrations of PM2.5, PM10, and NO2 were estimated using validated universal kriging models incorporating land-use regression. We estimated the distance in meters to the nearest major road for both adult enrollment and childhood residences. Serum AMH was measured using an ultrasensitive ELISA assay. Samples with AMH concentrations below the detection limit were analyzed using a picoAMH ELISA assay. Multivariable-adjusted linear regression was used to estimate the percent change in AMH in relation to ambient residential air pollution, categorized in quartiles and per interquartile range increase, and distance to a major roadway.

Results:
Overall, we observed little to no evidence of associations between AMH and air pollution concentrations or proximity to roadways. Women in the highest quartile of NO2 exposure, a traffic-related pollutant, had higher estimated AMH concentrations (Q4 vs. Q1, 42.9%; 95% CI = –3.4, 111.4) compared with the lowest quartile. However, lower mean AMH concentrations were observed for women living closer to a major roadway (<50 m to nearest roadway vs. ≥200 m = –32.9%; 95% CI = –56.1, 2.6).

Conclusions:
We saw little consistent evidence to support an association between outdoor air pollution and diminished ovarian reserve in US women ages 35–54.
Factors Influencing Patient Satisfaction with Upper Blepharoplasty in Elderly Patients
Authors: Kim Yoon Soo , Kim Byeong Seok , Kim Ho Sung , In Seok Kyung , Yi Hyung Suk , Kim Hong Il , Park Jin Hyung , Kim Hyo Young 
Published: August 2021

Background:
Upper blepharoplasty in elderly patients has characteristics that differ from those of younger patients. Blepharoptosis in elderly patients causes not only aesthetic problems but also functional problems such as entropion, visual disturbance, and sore eyes. We hypothesized that factors influencing patient satisfaction with upper blepharoplasty in elderly patients include aesthetic outcomes, functional outcomes, and personal factors.

Methods:
This study included 57 patients aged >65 years who underwent upper blepharoplasty between April 2018 and March 2019. All surgeries were performed through the “Upper Blepharoplasty Service Project” of the public health center in Geoje City. To evaluate the individual characteristics of the patients, a preoperative questionnaire (including sociodemographic characteristics, main symptoms of discomfort in the upper eyelid, and degree of expectation of surgical results) was administered to the patients. After 6 months, a satisfaction survey was conducted accordingly.

Results:
The main symptoms of discomfort were sagging of the skin of the upper eyelid. The mean score for patient satisfaction was 3.84 ± 0.40, and satisfaction with the results of surgery relative to the cost was 4.53 ± 0.63, which was the highest score. Significant verification of the regression coefficients showed that functional improvement and cognitive degree of postsurgery precautions had a significant effect on patient satisfaction, whereas aesthetic outcomes and expectations of surgical results were not correlated with patient satisfaction.

Conclusion:
The findings indicated that elderly patients tended to be satisfied with functional improvement that resolved their symptoms of discomfort and personal factors such as cost and cognitive degree of precautions after upper blepharoplasty.
Incidence of Venous Thromboembolism after Sternal Reconstruction: A Single-center Retrospective Review
Authors: Yi Allen F. , Zhang Kevin K. , Arredondo Sean D. , O’Brien Andrew L. , Kraft Casey T. , Janis Jeffrey E. , Poteet Stephen J. 
Published: August 2021

Background:
Deep sternal wound infection and mediastinitis following sternotomy are associated with significant morbidity and mortality, and often require sternal reconstruction by plastic surgeons. Despite this patient population having a substantial risk of venous thromboembolism, there are no reports of the incidence of venous thromboembolism in patients undergoing sternal reconstruction. The authors sought to evaluate the incidence of venous thromboembolism in sternal reconstruction patients and to identify common risk factors for venous thromboembolism in this patient population.

Methods:
A single-center retrospective review was completed of all patients who underwent sternal reconstruction by plastic surgeons between January 2012 and July 2020. Demographic data, antiplatelet and anticoagulant use, 2005 Caprini score, operative time, bleeding events, and postoperative venous thromboembolism events were recorded.

Results:
A total of 44 patients were identified for analysis. The average 2005 Caprini score for the cohort was 10.9. In total, 93.2% of patients received perioperative antiplatelet and anticoagulant therapy (either chemoprophylaxis or systemic). Two patients developed postoperative venous thromboembolism events, for a total venous thromboembolism rate of 4.6%. Four patients had bleeding events requiring reoperation. No deaths were reported from either of these complications.

Conclusions:
Patients undergoing sternal reconstruction are at a high risk for venous thromboembolism and postoperative bleeding events. Despite the growing body of literature on venous thromboembolism in various surgical populations, the optimal management of thromboembolic risk in patients with high Caprini scores undergoing sternal reconstruction requires additional investigation.
Body Contouring in Massive Weight Loss Patients Receiving Venous Thromboembolism Chemoprophylaxis: A Systematic Review
Authors: Yin Christine , McAuliffe Phoebe B. , Marquez Jocellie E. , Liao Christopher D. , Vasilakis Vasileios , Estrella Jewel , Labropoulos Nicos , Khan Sami U. 
Published: August 2021

Background:
Venous thromboembolism (VTE) events are the leading cause of morbidity and mortality in plastic surgery. Currently, there is no consensus regarding the use of VTE chemoprophylaxis in the context of the risk for bleeding following specific body contouring procedures. Furthermore, there is increasing popularity of these procedures in the massive weight loss (MWL) patient population, who may be at higher risk due to multiple risk factors. The purpose of this study was to stratify the incidence of VTE and bleeding events among individual, specific body contouring procedures in MWL patients receiving chemoprophylaxis.

Methods:
A systematic review was designed according to PRISMA guidelines. We screened all articles published between 1988 and 2018 reporting chemoprophylaxis status, VTE, and bleeding events in MWL patients undergoing body contouring procedures.

Results:
Thirty-one publications were reviewed. The VTE incidence for any procedure was too low to reach significance. Overall, hematoma incidence in single-procedure patients (8.7%) was significantly higher than concomitant-procedure patients (4.2%, P < 0.01). However, when stratified into operative and nonoperative hematomas, no significant difference between single- and concomitant-procedure groups overall was demonstrated for either category. Individually, only thighplasty patients had a higher rate of operative hematomas when undergoing thighplasty alone (5.3%) compared with thighplasty with concomitant procedures (0.6%, P < 0.05).

Conclusions:
Overall, MWL patients undergoing single body contouring procedures (among abdominoplasty, belt lipectomy, thighplasty) were found to have a higher risk of hematoma compared with those undergoing combined contouring procedures. However, stratified hematoma data revealed no differences in overall risk between single- and multiple-procedure operations.
Successful Treatment of Rheumatoid Lymphedema with Lymphatic Venous Anastomosis
Authors: Imai Hirofumi , Yoshida Shuhei , Uchiki Toshio , Sasaki Ayano , Nagamatsu Shogo , Koshima Isao 
Published: August 2021

Summary:
Rheumatoid lymphedema is a rare but severely disabling condition caused by reduced lymphatic drainage. Most treatment methods are conservative and may lead to the exacerbation of lymphedema. Lymphatic venous anastomosis (LVA) is an effective treatment for lymphedema after surgery involving the lymphatic system, such as lymph node dissection for cancer treatment. LVA has not been used to treat rheumatoid lymphedema. We present a case of rheumatoid lymphedema treated with surgical procedures, including LVA. Following LVA, objective and subjective symptom relief was noted, along with decreased swelling and pain in the affected area. The postoperative course was uneventful. LVA for the treatment of rheumatoid lymphedema may provide definitive clinical improvements.
Utility of Viscoelastic Tests to Predict Flap Thrombosis: A Systematic Review
Authors: Malapati Harsha , Hanwright Philip J. , Tuffaha Sami H. 
Published: August 2021

Background:
Flap thrombosis is a rare but devastating complication in microsurgery. Preoperative identification of patients at increased risk for microvascular thrombosis remains challenging. Viscoelastic testing (VET) provides a comprehensive evaluation of the clotting process and can effectively identify hypercoagulability. However, the utility of VET in microvascular reconstruction remains unclear.

Methods:
A systematic review of the association between VET and pedicle thrombosis and free flap loss was performed in accordance with Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Identified studies were reviewed independently by two authors for pertinent data.

Results:
Six studies met inclusion criteria. Heterogenous study design and outcome reporting complicated direct comparisons and precluded a formal meta-analysis. Four studies found a statistically significant relationship between VET results and flap thrombosis or flap loss. The maximum clot strength and the fibrinogen-to-platelet ratio (FPR) were key viscoelastic parameters in these studies, both representing a measure of maximal clot strength. Specifically, an elevated FPR (>42%) generated a sensitivity and specificity for flap loss ranging from 57% to 75% and 60% to 82%, respectively. Notably, the negative predictive value for flap failure with a normal preoperative FPR was greater than 90% in all studies reporting a correlation. The remaining two studies reported no predictive value for VET with respect to flap failure or pedicle thrombosis.

Conclusion:
The results of this review suggest that VET, particularly parameters relating to clot strength, may help clinicians identify patients at risk for flap thrombosis. However, uncontrolled and heterogenous reporting limit definitive conclusions, and high-quality diagnostic studies are needed to better determine the clinical utility of viscoelastic testing for free flap patients.
PERIPAPILLARY MICROVASCULATURE OF THE RETINA AND CHORIOCAPILLARIS IN UNINVOLVED FELLOW EYES OF UNILATERAL RETINAL VEIN OCCLUSION PATIENTS
Authors: Park Young Joo , Kim Jiah , Lee Eun Ji , Park Kyu Hyung 
Published: August 2021

Purpose:
To investigate peripapillary microvascularity of the retina and choriocapillaris in uninvolved fellow eyes of patients with branch retinal vein occlusion (RVO) compared with that of healthy controls.

Methods:
Peripapillary optical coherence tomography angiography bilateral eye scans of 46 patients with unilateral RVO and 46 age-matched control eyes were reviewed. Microvascular density in radial peripapillary capillary plexus (RPCP), superficial capillary plexus, and deep capillary plexus and signal void parameters in choriocapillaris were assessed. Data were statistically adjusted for hypertension.

Results:
Microvascular densities in the RPCP and superficial capillary plexus were lower in the fellow eyes of patients with RVO than in the controls (RPCP, P = 0.021; superficial capillary plexus, P = 0.040). There were fewer choriocapillaris signal voids in the fellow eyes than in the control (P = 0.043). In patients with a duration of RVO onset >12 months (n = 27), all signal void parameters were lower in the fellow eyes than in the control eyes (size, P = 0.03; number, P = 0.046; proportion of the total area, P = 0.029).

Conclusion:
Uninvolved fellow eyes of patients with unilateral RVO showed microvascular impairment in the retina and choriocapillaris, even after adjusting for age and hypertension, suggesting that an unknown systemic factor might affect both the affected and unaffected eyes.
RECURRENCE RATE OF CYSTOID MACULAR EDEMA WITH TOPICAL DORZOLAMIDE TREATMENT AND ITS RISK FACTORS IN RETINITIS PIGMENTOSA
Authors: Shimokawa Shotaro , Murakami Yusuke , Fujiwara Kohta , Funatsu Jun , Nakatake Shunji , Koyanagi Yoshito , Akiyama Masato , Yoshida Noriko , Takeda Atsunobu , Ikeda Yasuhiro , Sonoda Koh-Hei 
Published: August 2021

Purpose:
To investigate the rate of the recurrence of cystoid macular edema (CME) secondary to retinitis pigmentosa (RP) after the initiation of topical dorzolamide and the recurrence risk factors.

Methods:
We retrospectively analyzed the data of RP patients at Kyushu University Hospital. We included patients who showed a treatment response to 1.0% topical dorzolamide. The day of treatment initiation was set as the baseline. Topical dorzolamide treatment was continued during the follow-up. The recurrence of CME (defined as a >20% increase in central subfield thickness compared to previous visit, or a central subfield thickness value that exceed baseline value) was evaluated at each follow-up visit. Risk factors for RP-CME recurrence were analyzed by Cox proportional hazards modeling. A Kaplan–Meier survival analysis was used to evaluate the time to recurrent RP-CME.

Results:
Forty RP-CME patients showed a treatment response to topical dorzolamide. During the mean 3.9-year follow-up, 14 patients exhibited recurrence; its rate was 15.6%, 34.7%, and 48.7% at 1, 3, and 5 years, respectively. A high baseline central subfield thickness was significantly associated with recurrent (hazard ratio 1.11, 95% CI: 1.05–1.18, P = 0.0004).

Conclusion:
The recurrence rate of RP-CME increased with time. A high baseline central subfield thickness value was a risk factor for recurrence.
Utilization of Forearm Crutches to Avoid Lymphedema After Breast Cancer Lymph Node Surgery: A Case Report
Authors: Curfman Sue E. , Austin Gary P. , Radack Ben 
Published: August 2021

Background:
Despite many patients with breast cancer being advised to limit upper extremity (UE) use, there is growing evidence that UE use is not associated with lymphedema. Subsequently, clinicians may be unsure of how to advise patients with a history of breast cancer who need assistive devices to ambulate.

Study Design/Case Description:
A 51-year-old woman who had recently undergone treatment for breast cancer sustained a knee injury requiring the use of crutches. Forearm crutches were used instead of axillary crutches to minimize the potential for irritation to the axillary lymphatic vessels and thus reduce the risk for lymphedema. L-Dex measures were used to monitor for lymphedema.

Outcomes:
L-Dex scores did not exceed the change of more than +7.1 to indicate the presence of lymphedema. Furthermore, there were no clinical signs or symptoms of lymphedema while using crutches and in the 7 months following.

Discussion:
Prolonged rigorous UE use by ambulating non-weight-bearing with forearm crutches within 1 to 2 months of treatment for breast cancer did not result in UE lymphedema. This case report reinforces the growing body of evidence that avoiding aggressive UE activity may not be necessary in those at low risk of lymphedema and informs assistive device prescription for patients with breast cancer.
Written scholarship as a foundation for professional practice: Similarities and differences between writing coaches and editors
Authors: Hicks Rodney (Rod) W. 
Published: August 2021

ABSTRACT
Scholarship forms the scientific basis of advanced practice registered nurse (APRN) practice. Although the number of manuscripts from APRNs has grown, the vast majority of APRNs do not publish works that affect practice, education, research, or policy. Many APRNs are unaware of resources, such as a writing coach and an editor, that facilitate producing publishable scholarship. This article describes the similarities and differences of the two resources.
Decentralized Cochlear Implant Programming Network Improves Access, Maintains Quality, and Engenders High Patient Satisfaction
Authors: Bourn Stephanie , Goldstein Mary Rose , Knickerbocker Alissa , Jacob Abraham 
Published: August 2021

Objective:
Cochlear implants have become a powerful tool in managing patients with moderate to profound sensorineural hearing loss and lack of benefit from hearing aids. Currently, less than 10% of people who would benefit from a CI receive the treatment. This lack of access is multi-factorial yet largely due in part to an inadequate referral system. The purpose of the current study was to evaluate speech outcomes and patient satisfaction for adult cochlear implant (CI) recipients in a single-surgeon, high volume CI center that uses a decentralized network (DCN) of private practice programming audiologists.

Study Design:
Retrospective case series.

Setting:
Tertiary otology/neurotology practice.

Patients:
Adult CI recipients implanted between April 2017 and August 2019.

Intervention(s):
Surgical/rehabilitative.

Main Outcome Measure(s):
Speech outcomes (AzBio quiet) were evaluated 6-months post implantation. Patients were surveyed to determine satisfaction with programming services, surgical services, and CI benefit.

Results:
The senior author (A.J.) performed 223 CI operations: 136 (61%) were programmed at the CI center and 84 (38%) at outside audiology clinics through a DCN. The 6-month speech outcomes (AzBio, quiet) revealed similar scores regardless of where programming services were received; CI center: 25% pre-op versus 55% post-op; DCN: 24% pre-op versus 59% post-op. Additionally, patients reported high-levels of satisfaction with programming services, surgical services, and CI benefit.

Conclusion:
A decentralized network of well-trained private practice audiologists who identify CI candidates and program their devices after surgery 1) improves patient access to cochlear implantation, 2) maintains excellent speech outcomes, and 3) engenders high levels of patient satisfaction.