bluuebunny/crossref_metadata_2025_split huggingface dataset:
Scaling Up CareKit: Lessons Learned from Expansion of a Centralized Home HIV and Sexually Transmitted Infection Testing Program
Authors: Norelli Jenna , Zlotorzynska Maria , Sanchez Travis , Sullivan Patrick S. 
Published: May 2021

Background
Despite advances in implementing human immunodeficiency virus (HIV)/sexually transmitted infection (STI) services for men who have sex with men (MSM), many remain underserved because of barriers like stigma, low facility coverage, and provider competency. This article describes the implementation of centralized nationwide mailed HIV/STI home testing (CareKit).

Methods
The Emory Center for AIDS Research developed CareKit for research study participants to request HIV self-test kits, STI specimen collection kits, and condom/lubricant packs to be shipped to any mailing address in the United States. Sexually transmitted infection kits were customized according to study needs and could include materials to collect whole blood, dried blood spots, urine sample, and rectal and pharyngeal swab samples for syphilis, gonorrhea, and chlamydia testing. Specimens were mailed back to a central Clinical Laboratory Improvement Amendments–approved laboratory for testing, and results were returned to participants.

Results
CareKit was used by 12 MSM studies and mailed 1132 STI kits to 775 participants between January 2018 and March 2020. Participants returned 507 (45%) STI kits, which included 1594 individual specimens. Eighty-one kits (16%) had at least one positive STI test result: pharyngeal chlamydia (n = 7), pharyngeal gonorrhea (n = 11), rectal chlamydia (n = 15), rectal gonorrhea (n = 12), genital chlamydia (n = 6), genital gonorrhea (n = 1), and syphilis (n = 54). In this same 2-year period, 741 HIV self-test kits were mailed to 643 MSM.

Conclusions
CareKit successfully met studies' needs for home HIV/STI testing and diagnosed many STIs. These processes continue to be adapted for research and programs. The ability to mail home test kits has become increasingly important to reach those who may have limited access to health care services, particularly during the COVID-19 pandemic.
Human Immunodeficiency Virus and Hepatitis C Linkage-to-Care Initiative for New Orleans Residents Experiencing Homelessness During the COVID-19 Pandemic
Authors: Cironi Katherine A. , Jones Austin T. , Hauser Elizabeth M. , Olsen Joseph W. , Kissinger Patricia J. 
Published: May 2021

Background
People experiencing homelessness are disproportionately infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). In response to COVID-19, cities nationwide temporarily housed people experiencing homelessness in unused hotels. One such initiative in New Orleans also enacted a screening, counseling, and linkage-to-care model for HIV and HCV treatment for this temporarily housed population between May and July 2020.

Methods
A nonconcurrent cohort study was performed assessing follow up in the treatment of HIV and HCV for this population. Outcome data were collected on seropositive patients' electronic medical record to assess patient progression through the treatment cascade.

Results
Of 102 unhoused residents, 25 (24.5%) tested HCV seropositive. Of the HCV positive 21/25 (84%) were connected to the associated clinic for follow up care and 10 (40%) obtained HCV treatment medication. Furthermore, all 3 patients who tested seropositive for HIV either started or re-initiated antiviral treatment. The greatest barrier to providing medication for the HCV seropositive patients, once care was initiated, was loss-to-follow-up.

Conclusions
Targeting homeless persons living in temporary residences for HCV and HIV screening can be effective at promoting access to care for those infected due to this population's high HCV seropositivity especially significant if the patient has a history of intravenous drug use or is older than 40 years. However, continued outreach strategies are needed to assist patients in retention of care.
Prostate Cancer With Neuroendocrine Differentiation Recurring After Treatment With 177Lu-PSMA
Authors: Nesari Javan Farnaz , Aryana Kamran , Askari Emran 
Published: May 2021

Abstract
Prostate cancer with NED (neuroendocrine differentiation) may occur in various stages of the disease, which is associated with a poor prognosis and treatment resistance. We present a case of a patient with metastatic castration-resistant prostatic cancer, who was treated with 7 cycles of 177Lu-PSMA and a very good response. Although only few foci with PSMA uptake were remained in the last posttreatment images, PSA levels dramatically began to rise. This raised suspicion for NED, and 68Ga-DOTATATE was done showing sufficient uptake to consider a trial of 177Lu-DOTATATE. The patient reported pain response, and PSA levels dropped after 1 cycle of the treatment.
Ectopic Parathyroid Adenoma on Pectoralis Major After Endoscopic Parathyroidectomy Revealed by 99mTc-MIBI SPECT/CT
Authors: Wu Meiqi , Chen Libo , Huo Li , Jing Hongli 
Published: May 2021

Abstract
A 45-year-old woman, who had endoscopic parathyroidectomy 5 years ago for a right inferior parathyroid adenoma, underwent 99mTc-MIBI scan for the evaluation of recurrent parathyroidism. The images did not identify any abnormal uptake in the neck. Instead, an abnormal activity in the right upper chest wall was noted, which was located in a soft tissue nodule inseparable from the right pectoralis major muscle on SPECT/CT images. Pathology confirmed parathyroid tissue.
Procedural Trends in Medicare Reimbursement and Utilization for Breast Reconstruction
Authors: Gupta Nikita , Thornburg Danielle A. , Chow Nathan A. , Haglin Jack , Kruger Erwin , Rebecca Alanna M. , Casey William J. , Teven Chad M. 
Published: May 2021

Purpose
Development of appropriate reimbursement models for breast reconstruction in the United States requires an understanding of relevant economic trends. The purpose of this study is to evaluate longitudinal patterns in Medicare reimbursement for frequently performed breast reconstruction procedures between 2000 and 2019.

Methods
Reimbursement data for 15 commonly performed breast reconstruction procedures were analyzed using the Centers for Medicare & Medicaid Services Physician Fee Schedule Look-Up Tool for each Current Procedural Terminology code. By utilizing changes to the US consumer price index, monetary data were adjusted for inflation to 2019 US dollars. Inflation-adjusted trends were used to calculate average annual and total percentage changes in reimbursement over time.

Results
From 2000 to 2019, average adjusted reimbursement for all procedures fell by 13.32%. All procedures demonstrated a negative adjusted reimbursement rate other than immediate insertion of breast prosthesis, which increased by 55.37%. The largest mean decrease was observed in breast reconstruction with other technique (−28.63%), followed by single pedicle transverse rectus abdominis myocutaneous flap (−26.02%), single pedicle transverse rectus abdominis myocutaneous flap with microvascular anastomosis (−23.33%), latissimus dorsi flap (−19.65%), and free flap reconstruction (−19.36%).

Conclusions
There has been a steady yet substantial decline in Medicare reimbursement for the majority of breast reconstruction procedures over the last 20 years. Given increasing medical costs and the financial uncertainty of the US health care system, an understanding of Medicare reimbursement trends is vital for policymakers, administrators, and physicians to develop agreeable reimbursement models that facilitate growth and economic vitality of breast reconstruction in the United States.
Efficacy of Microsurgical Treatment of Primary Lymphedema
Authors: Fallahian Fedra , Tadisina Kashyap Komarraju , Xu Kyle Y. 
Published: May 2021

Introduction
Treatment of lymphedema remains a challenging clinical problem. Lymphatic surgery has recently gained momentum as an effective method to treat both early- and late-stage disease. In particular, “physiologic” microsurgical techniques including vascularized lymph node transplant and lymphovenous bypass/anastomosis have been shown to be effective in treating even advanced lymphedema. Most published reports describe techniques and success in secondary lymphedema. Traditionally, physiologic surgery was not believed to be useful in the treatment of primary lymphedema where baseline lymphatic function is abnormal. However, recent studies have shown a benefit in these cases. The objective of this study is to evaluate outcomes and complications of physiologic microsurgical treatment for primary lymphedema.

Methods
The electronic databases of PubMed, Scopus, and MEDLINE were searched using key words “primary lymphedema” and “surgery” (also vascularized lymph node transplant, lymphovenous bypass, microsurgery). Only human studies published between 2000 and 2021 were included. Studies that only included ablative or resection surgeries were excluded.

Results
A total of 10 studies comprising 254 patients with primary lymphedema who underwent 357 physiologic microsurgical operations were included. Lymphovenous bypass comprised 88% of cases, and in the patients who underwent vascularized lymph node transplant, all but 1 flap survived. Regardless of type of operative intervention, all studies showed a statistically significant improvement in lymphedema, through either reduction in limb circumference or edema volume or improvement in quality of life.

Discussion
Physiologic lymphatic surgery has shown success and improvement for patients with primary lymphedema. Based on current literature, physiologic surgical treatment of primary lymphedema should be considered when treating this patient population.
Abdominal Plication for Better Cosmetic Outcomes During Deep Inferior Epigastric Perforator Flap Breast Reconstruction
Authors: Van Vliet Austin , Girardot Alexandra , Bouchez Jonathan , Kumar Ambuj , Dayicioglu Deniz 
Published: May 2021

Background
Deep inferior epigastric perforator flap (DIEP) for breast reconstruction is a widely accepted technique for breast reconstruction. Secondary benefit of this technique is abdominal contour improvement. Because of direct access, abdominal plication can be performed at the time of abdominal closure. Our goal was to investigate if this addition affected the complications.

Methods
A retrospective chart review was performed on all DIEP flap reconstructions performed by a single surgeon at a cancer center, from March 2011 through February 2020. Presence of abdominal plication, age, and body mass index were compared with reoperation due to abdominal wound or hernia, procedure length in minutes, and length of stay. The association between the dependent and independent variables for the unadjusted and adjusted analysis was performed using the binary logistic regression analysis.

Results
Three hundred fifty-eight DIEP flaps performed on 233 patients for breast reconstruction were analyzed. Flap loss was 1.7%. Abdominal plication was performed in 178 flaps (49.7%) and not performed in 180 flaps (50.3%). Thirty-nine percent were immediate; 61% were delayed. The results did not show a statistically significant association between abdominal plication and the need to reoperate (P = 0.3). Results from the adjusted analysis (age, body mass index) also did not show a significant association between the plication, need to reoperate, procedure duration, or hospital stay (P = 0.4).

Conclusions
Abdominal plication can improve cosmetic outcomes without increasing the duration of surgery, hospital stay, or reoperation rates due to abdominal complications. Therefore, it can be a valuable addition in DIEP flap breast reconstructions.
Phrenic Nerve Reconstruction for Effective Surgical Treatment of Diaphragmatic Paralysis
Authors: Kaufman Matthew R. , Chang Eric I. , Bauer Thomas , Rossi Kristie , Elkwood Andrew I. , Paulin Ethan , Jarrahy Reza 
Published: May 2021

Abstract
Diaphragmatic paralysis due to phrenic nerve injury may cause orthopnea, exertional dyspnea, and sleep-disordered breathing. Phrenic nerve reconstruction may relieve symptoms and improve respiratory function. A retrospective review of 400 consecutive patients undergoing phrenic nerve reconstruction for diaphragmatic paralysis at 2 tertiary treatment centers was performed between 2007 and 2019. Symptomatic patients were identified, and the diagnosis was confirmed on radiographic evaluations. Assessment parameters included pulmonary spirometry (forced expiratory volume in 1 second and FVC), maximal inspiratory pressure, compound muscle action potentials, diaphragm thickness, chest fluoroscopy, and Short Form 36 Health Survey Questionnaire (SF-36) survey. There were 81 females and 319 males with an average age of 54 years (range, 19–79 years). The mean duration from diagnosis to surgery was 29 months (range, 1–320 months). The most common etiologies were acute or chronic injury (29%), interscalene nerve block (17%), and cardiothoracic surgery (15%). The mean improvements in forced expiratory volume in 1 second and FVC at 1 year were 10% (P < 0.01) and 8% (P < 0.05), respectively. At 2-year follow-up, the corresponding values were 22% (P < 0.05) and 18% (P < 0.05), respectively. Improvement on chest fluoroscopy was demonstrated in 63% and 71% of patients at 1 and 2-year follow-up, respectively. There was a 20% (P < 0.01) improvement in maximal inspiratory pressure, and compound muscle action potentials increased by 82% (P < 0.001). Diaphragm thickness demonstrated a 27% (P < 0.01) increase, and SF-36 revealed a 59% (P < 0.001) improvement in physical functioning. Symptomatic diaphragmatic paralysis should be considered for surgical treatment. Phrenic nerve reconstruction can achieve symptomatic relief and improve respiratory function. Increasing spirometry and improvements on Sniff from 1 to 2 years support incremental recovery with longer follow-up.
Navigating the Gray of Academic Publication
Authors: Soteropulos Carol E. , Poore Samuel O. 
Published: May 2021

Abstract
Academic publishing has undergone a transition from print-based, subscription access journals targeted toward physicians and scientists to the widely accessible, open access (OA) format made possible by the Internet. The objectives of OA broadly include audience expansion and improved public access to publicly funded research, reduction of limitations on content reuse and alteration, and prompt turnaround from submission to publication. Despite well-intended founding principles, unexpected disadvantages of the OA model have arisen including the emergence of predatory journals, which exploit the author-pays publishing model with the deceptive promise of reputable publishing platforms. Predatory journals can be difficult to discern from the legitimate yet unsophisticated novice journal, which represents a destructive influence on the credibility of surgeons and scientists within many specialties. As an author, when the highly reputable, “whitelisted” journals in our field are not available or interested in the scope of our work, how can we ensure authenticity of those journals that exist in the gray area between legitimate and illegitimate? Given these questions, the goal of this article is to demystify the history and selected issues that surround academic publication including content access, licensing, indexing, and journal metrics. With this background, we then evaluate highly visible OA journals in plastic and reconstructive surgery and build a basic framework, which authors can use to evaluate a journal for legitimacy and visibility.
Standardization of the Rat Dorsal Random Pattern (McFarlane) Flap Model and Evaluation of the Pharmacological Agents Aiming to Salvage Partial Flap Necrosis
Authors: Üstün Galip Gencay , Öztürk Semih , Koçer Uğur 
Published: May 2021

Introduction
Partial flap necrosis is a common complication after surgery. McFarlane flap model has been used for assessment of various agents' effects on random flap survival. The aim of this study was to review the methodology of studies using this flap model and reveal the most successful agents.

Materials and Methods
PubMed, Scopus, and Web of Science databases were screened for words “McFarlane flap,” “flap survival,” and (“flap” and “rat”) by using time limits between 1965 and 2019. A total of 71 original articles were reviewed. Dimensions and base (cranial/caudal) of the flap, treatment protocol, follow-up period, and survival rates were extracted. Modified survival rates were calculated. Coefficients of variation of cranial/caudally based control group flaps and most commonly used flap models were calculated to assess interstudy variability.

Results
A total of 165 different treatment regimens were studied. One-hundred twelve regimens (67.9%) were found to increase flap survival. Most common flap dimensions were 9 cm × 3 cm, followed by 10 cm × 3 cm, 8 cm × 2 cm and 6 cm × 2 cm. Studies using caudally based flaps showed less interstudy variability, but survival rates were similar. Pentoxifylline, sildenafil, chlorpromazine, phenoxybenzamine, and phentolamine were reported to be successful in multiple studies.

Conclusions
There are numerous agents found to be effective for treatment of partial flap necrosis, but further clinical research is needed. To overcome standardization problems, use of commonly used flap dimensions with a caudal base and interpretation of results after 7 days of follow-up seems appropriate.
Laparoscopic Sutureless Rectopexy Using a Fixation Device for Complete Rectal Prolapse
Authors: Tomochika Shinobu , Suzuki Nobuaki , Yoshida Shin , Fujii Toshiyuki , Tokumitsu Yukio , Shindo Yoshitaro , Iida Michihisa , Takeda Shigeru , Hazama Shoichi , Nagano Hiroaki 
Published: May 2021

Background:
Complete rectal prolapse (CRP) commonly affects the daily life of older people and has no established operative treatment approach. We describe our simple method of laparoscopic, sutureless rectopexy, involving rectal mobilization (along with its peritoneum bilaterally) and fixation to the sacral promontory using a fixation device. We also present an analysis of short-term outcomes in patients treated using this procedure.

Materials and Methods:
We retrospectively evaluated 62 patients with CRP, who underwent a laparoscopic rectopexy via tack fixation, between 2004 and 2017. The peritoneum was widely attached near the site of peritoneal reflection, as in rectal cancer surgery. The hypogastric nerve was carefully detached from the front of the sacrum. Keeping the nerve intact, we lifted and mobilized the dissected rectum cranially towards the promontory, and the rectal peritoneum was affixed to the sacrum by applying 2 to 3 fixed tacks bilaterally, using a fixation device.

Results:
The median age of the study group was 80 (10 to 91) years. All procedures were successful without serious intraoperative complications; only 1 patient required conversion to open surgery. Median values for operative duration, intraoperative blood loss, and postoperative period of hospitalization were 177 (125 to 441) minutes, 5 (0 to 275) mL, and 7 (3 to 17) days, respectively. Only 6 (9.7%) patients experienced recurrence during the follow-up period.

Conclusion:
Laparoscopic tacking rectopexy performed using a fixation device for repairing CRP is a simple, safe, and sutureless procedure with no severe complications or mortality.
Urinary Retention Following Inguinal Herniorrhaphy: Role of Neuromuscular Blockade Reversal
Authors: Valencia Morales Diana J. , Stewart Brody R. , Heller Stephanie F. , Sprung Juraj , Schroeder Darrel R. , Ghanem Omar M. , Weingarten Toby N. 
Published: May 2021

Background:
Nondepolarizing neuromuscular blockade is reversed with neostigmine/glycopyrrolate or sugammadex. Anticholinergic glycopyrrolate decreases bladder detrusor muscle contractility, potentially leading to postoperative urinary retention (POUR). POUR commonly complicates inguinal herniorrhaphy. In this study we assess association between reversal technique and POUR.

Methods:
Records of adult patients undergoing unilateral inguinal herniorrhaphy with neuromuscular blockade from January 2013 to September 2020 were reviewed for POUR (unplanned postoperative insertion of urinary catheter). A propensity-adjusted analysis was performed to assess POUR in neostigmine/glycopyrrolate versus sugammadex using inverse probability of treatment weighting (IPTW) to adjust for potential confounding.

Results:
We identified 181 patients who underwent herniorrhaphy with amnio-steroidal neuromuscular blockers, 75 (41.4%) who received sugammadex and 106 (58.6%) neostigmine/glycopyrrolate. Compared with sugammadex, neostigmine/glycopyrrolate group had longer surgical course [unweighted standardized difference (USTD)=0.38, P=0.004], received more intraoperative opioids (USTD=0.704, P<0.001), more often performed via laparoscopic approach (USTD=0.407, P=0.012), and less often with periprocedural urinary catheter insertion (USTD=0.452, P=0.003). POUR was observed in 2 (3%) of patients in the sugammadex group, and 16 (15%) in neostigmine/glycopyrrolate [unadjusted odds ratio (OR)=0.15; 95% confidence interval (CI): 0.03-0.69; P=0.015, and IPTW OR=0.13; 95% CI: 0.03-0.64; P=0.012]. Results remained similar with further analysis adjusted for opioid administration in the postanesthesia care unit (adjusted IPTW OR=0.18; 95% CI: 0.04-0.88; P=0.034). Of the POUR patients, 9 required unplanned overnight admission and 4 emergency room visit.

Conclusion:
These results suggest that neuromuscular blockade reversal with sugammadex is associated with lower rates of POUR following unilateral inguinal herniorrhaphy. Our results need to be reconfirmed in a randomized prospective study.
Ninjin’yoeito, a traditional Japanese Kampo medicine, suppresses the onset of anhedonia induced by dysfunction in the striatal dopamine receptor type 2-expressing medium spiny neurons
Authors: Oizumi Hiroaki , Imai Ryota , Suzuki Toru , Omiya Yuji , Tanaka Kenji F , Mimura Masaru , Mizoguchi Kazushige 
Published: May 2021

Objective
Recent studies have suggested that ninjin’yoeito (NYT), a traditional Japanese Kampo medicine, improves diminished motivation in humans and animals, rendering it a novel therapeutic option for impaired motivation. To better characterize the effect of NYT on motivation, we examined its effect on motivated behaviors in mice.

Methods
Mouse models of neurodegeneration-related apathy, in which striatal dopamine receptor type 2-expressing medium spiny neurons (D2-MSNs) were progressively damaged by diphtheria toxin expression, were chosen.

Results
The decrease in effort-based operant responding for rewards (sucrose pellets), indicative of the mouse’s motivated behavior, in the affected mice was not suppressed by chronic treatment with NYT suspended in drinking water at 1% (w/v). Mice were then subjected to a sucrose preference test, wherein they freely chose to ingest tap water and a sucrose solution without being required to exert effort. The affected mice showed a decline in preference for sucrose over tap water, relative to nonaffected controls, indicating anhedonia-like traits. In contrast to the diminished operant behavior, the anhedonic behavior in the affected mice was prevented by the NYT administration. Furthermore, NYT did not affect the size of Drd2 mRNA disappearance in the striatum of affected mice, suggesting that the NYT effect was unrelated to DTA-mediated neurodegeneration.

Conclusion
These results demonstrate that the beneficial effect of NYT on motivation is mediated, at least in part, through the potentiation of hedonic capacity by certain neuromodulatory pathways.