bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obstetrical and Perinatal Outcomes of Patients With Methamphetamine-Positive Drug Screen on Labor and Delivery
Authors: Pham Tiffany , Tinajero Yolanda , Mo Lihong , Schulkin Jay , Schmidt Loren , Wakeman Brooke , Kremer Mallory 
Published: April 2021

(Abstracted from Am J Obstet Gynecol MFM 2020;2:100195)
Methamphetamine (Meth) is a highly addictive drug that has been recognized as a health threat. While opioid abuse and its pharmacological treatments have been well researched, there is much less on Meth addiction and its interventions.
Obstetric and Perinatal Outcomes of In Vitro Fertilization and Natural Pregnancies in the Same Mother
Authors: Herman Hadas Ganer , Mizrachi Yossi , Alon Ayala Shevach , Farhadian Yasmin , Gluck Ohad , Bar Jacob , Kovo Michal , Raziel Arieh 
Published: April 2021

(Abstracted from Fertil Steril 2020; doi: 10.1016/j.fertnstert.2020.10.060)
In vitro fertilization (IVF) has been associated with higher risks of maternal and neonatal adverse outcomes, including preeclampsia, preterm birth and neonates who are small for gestational age (SGA). It is unclear whether these outcomes are due to treatment-related factors, such as an altered implantation process, suboptimal placentation and epigenetic changes, or maternal genetic or metabolic factors of the subfertile population.
Design and Performance of a COVID-19 Hospital Recovery Model
Authors: Hu Michael , Copenhaver Martin , Langle Ana Cecilia Zenteno , Koehler Allison , Daily Bethany , Levine Wilton C. , Dunn Peter F , Safavi Kyan C. 
Published: April 2021

Objective:
To determine the accuracy of a predictive model for inpatient occupancy that was implemented at a large New England hospital to aid hospital recovery planning from the COVID-19 surge.

Background:
During recovery from COVID surges, hospitals must plan for multiple patient populations vying for inpatient capacity, so that they maintain access for emergency department (ED) patients while enabling time-sensitive scheduled procedures to go forward. To guide pandemic recovery planning, we implemented a model to predict hospital occupancy for COVID and non-COVID patients.

Methods:
At a quaternary care hospital in New England, we included hospitalizations from March 10 to July 12, 2020 and subdivided them into COVID, non-COVID nonscheduled (NCNS), and non-COVID scheduled operating room (OR) hospitalizations. For the recovery period from May 25 to July 12, the model made daily hospital occupancy predictions for each population. The primary outcome was the daily mean absolute percentage error (MAPE) and mean absolute error (MAE) when comparing the predicted versus actual occupancy.

Results:
There were 444 COVID, 5637 NCNS, and 1218 non-COVID scheduled OR hospitalizations during the recovery period. For all populations, the MAPE and MAE for total occupancy were 2.8% or 22.3 hospitalizations per day; for general care, 2.6% or 17.8 hospitalizations per day; and for intensive care unit, 9.7% or 11.0 hospitalizations per day.

Conclusions:
The model was accurate in predicting hospital occupancy during the recovery period. Such models may aid hospital recovery planning so that enough capacity is maintained to care for ED hospitalizations while ensuring scheduled procedures can efficiently return.
Simultaneous Posterolateral and Posteromedial Approaches for Fractures of the Entire Posterior Tibial Plafond: A Safe Technique for Effective Reduction and Fixation
Authors: Campbell Sean T. , DeBaun Malcolm R. , Kleweno Conor P. , Nork Sean E. 
Published: April 2021

Objective:
To determine the short-term results of surgical treatment with dual posterolateral and posteromedial approaches for fractures of the entire posterior tibial plafond and secondarily to identify common fracture characteristics.

Design:
Retrospective.

Setting:
Single academic Level 1 trauma center.

Patients:
Thirty-five patients with posterior pilon fractures followed until fracture union (minimum 3 months).

Intervention:
Surgical treatment using simultaneous combined posterolateral and posteromedial exposures for fracture reduction and internal fixation.

Main Outcome Measurement:
(1) Surgical outcomes including rate of wound complications and accuracy of the articular reduction. (2) Fracture characteristics including the incidence of articular impaction, comminution interfering with reduction, syndesmosis injury, and the type of fibula fracture.

Results:
The rate of wound problems was low (6%), and 94% of patients had an articular reduction with less than 1 mm of step or gap. There were high rates of articular comminution (83%) and posteromedial articular impaction (63%) and a 17% rate of syndesmosis injury requiring repair.

Conclusions:
Surgical fixation using simultaneous, combined posterolateral and posteromedial approaches for posterior pilon fractures had a low rate of wound complications and was an effective strategy for obtaining an accurate reduction. The rate of syndesmotic instability requiring fixation was lower than previous work reporting on fixation using a single approach. This may be a useful technique for surgeons who treat these injuries. Careful assessment of the preoperative imaging is required in patients with posterior pilon fractures.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Intramedullary Screw Fixation of Olecranon Fractures Reduces the Risk of Early Unplanned Reoperation: A Retrospective Review of 556 Patients
Authors: Meals Clifton , Johnson Christopher , Reitz Logan , Hannan Zachary , Mulliken Alexandra , O'Hara Nathan N. , Pensy Raymond 
Published: April 2021

Objectives:
To determine the effect of intramedullary screw–based fixation on early postoperative complications after olecranon fractures. We hypothesized that intramedullary screw–based fixation results in decreased need for reoperation compared with plate and screw–based and tension band–based fixation.

Design:
Retrospective cohort.

Setting:
Two academic Level-1 trauma centers.

Patients/Participants:
Five hundred fifty-six patients treated with a tension band–based, plate and screw–based, or intramedullary screw–based construct for an olecranon fracture over a 10-year period.

Intervention:
Open reduction and internal fixation.

Main Outcome Measurement:
Unplanned reoperation. Demographic, injury type and severity, supplemental fixation, and length of follow-up data were viewed as potential confounders and analyzed as such.

Results:
We identified 556 relevant patients. One hundred ninety-nine patients were treated with an intramedullary screw–based construct, 229 with a plate and screw–based construct, and 128 with a tension band–based construct. We observed significant differences in the age, fracture type, percentage of open fractures, use of supplemental fixation, and treating institution between the treatment groups. Ninety-five patients (17.1%) had an unplanned reoperation. When we adjusted for confounders, intramedullary screw–based fixation reduced the odds of an unplanned reoperation by 54% compared with plate and screw–based treatment. In the adjusted analysis, we did not observe a difference between plate and screw–based treatment and tension band–based fixation.

Conclusions:
Intramedullary screw–based fixation of olecranon fractures results in decreased need for early reoperation compared with more common olecranon fixation strategies.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Pathological and Immunohistochemical Characteristics of Granuloma and Lymphatics in Cheilitis Granulomatosa
Authors: Ramassamy Sivaranjini , Van Hoang Thi Ai , Chuang Jen-Yu , Wu Yu-Hung 
Published: April 2021

Abstract:
Cheilitis granulomatosa (CG) is an idiopathic, rare, and chronic granulomatous disorder involving the lips. We characterized the pathological and immunohistopathological findings of these granulomas and their relationship with the lymphatic vessels. Pathologically confirmed cases of primary CG from 2001 to 2016 were collected. Cases of inflammatory cheilitis without the presence of granuloma were included in the control group. Demographic data, clinical presentation, response to therapy, and pathological differences were compared. Periodic acid–Schiff and acid-fast stains excluded patients having infections. CD68, CD163, and D2-40 stains demonstrated features of granuloma, macrophage polarization, and the relationship between granuloma and lymphatic vessels. Thirteen patients diagnosed with CG were enrolled. Thirteen people were enrolled in the control group. The granulomas were either mononuclear or sarcoidal. They were predominantly positive for CD68 but negative for CD163. Perilymphatic granulomas were found in all patients. Intralymphatic histiocytosis and lymphatic dilatation were more commonly observed in patients diagnosed with CG than those in controls (54% vs. 15%, P = 0.03 and 92% vs. 23%, P < 0.01). TH1 immune response due to CD68+ M1 macrophages results in CG. Perilymphatic aggregation of macrophages and intralymphatic histiocytosis were important pathological clues for diagnosis.
The Conjoined TUGPAP Flap for Breast Reconstruction: Systematic Review and Illustrative Anatomy
Authors: Karir Aneesh , Stein Michael J. , Zhang Jing 
Published: April 2021

Background:
Although abdominally based flaps continue to be the gold standard for autologous breast reconstruction, alternative donor sites are necessary when the abdominal region is unavailable or inadequate for flap harvest. In this case, thigh-based flaps, such as the profunda artery perforator (PAP), transverse upper gracilis (TUG), or newly described TUGPAP, are thought to be reliable with low morbidity and satisfactory cosmesis. The objective of this study was to perform a systematic review of breast reconstruction with PAP, TUG, or TUGPAP, and present anatomy and surgical techniques through illustrative examples.

Methods:
A systematic review of the literature was conducted using PubMed, Embase, and Cochrane Library. Articles were included if they used a PAP, TUG, or TUGPAP flap for oncologic, traumatic, or congenital breast reconstruction in patients 18 years or older.

Results:
Forty-nine studies met inclusion criteria. Seven hundred five patients underwent 906 breast reconstructions with 1037 flaps (755 TUG, 230 PAP, and 52 TUGPAP). Mean patient age was 45.9 years. The mean flap weight for TUG, PAP, and TUGPAP flaps were 323.4, 346.9, and 437.0 g, respectively. The most common recipient vessel was the internal mammary artery in 821 flaps. The overall flap survival rate was 97.2% (1008/1037). TUG flaps had a significantly higher recipient and donor complication rate compared with both PAP (recipient: 18.1% versus 7.8%, P = 0.0001; donor: 25.8% versus 7.0%, P < 0.00001) and TUGPAP flaps (recipient: 18.1% versus 2.0%, P < 0.001; donor: 25.8% versus 7.7%, P < 0.01).

Conclusion:
The TUGPAP flap is a safe and effective alternative for autologous breast reconstruction when the abdominal donor site is unavailable.
Secondary Vulvar Reconstruction Using Bilateral Gluteal Fold Flaps after Radical Vulvectomy with Direct Closure
Authors: Roh Solji , Miyamoto Shimpei , Kitamura Yutaro , Mito Daisuke , Okazaki Mutsumi 
Published: April 2021

Summary:
Although primary vulvovaginal reconstruction after vulvectomy has high potential to improve patients’ outcomes, flap reconstruction is not an established part of the current standard treatment for vulvar cancer. We report a patient with successful secondary vulvar reconstruction 3 years after radical vulvectomy with direct wound closure. A 69-year-old woman presented with chronic, burning vulvar pain 3 years after radical vulvectomy without reconstruction for stage IB vulvar cancer. Her urethral orifice had everted because of the direct wound closure, which resulted in severe pain on contact. We performed secondary vulvar reconstruction using bilateral 14 × 5 cm2 gluteal fold flaps. Postoperative pain management and overall aesthetic outcomes were satisfactory. Secondary vulvar reconstruction with gluteal fold flaps can avoid the sequelae resulting from inadequate direct wound closure after radical vulvectomy. Thus, we strongly advocate immediate vulvar reconstruction to prevent such situations.
Carbon Fiber Two-Pull Solid Ankle-Foot Orthoses versus Serial Casting in the Treatment of Idiopathic Toe Walking with Ankle Equinus Contracture
Authors: Hoffman Nicole A. , Dallum Joanna R. , Hinshon Scott , Finch Michael D. 
Published: April 2021

ABSTRACT

Introduction
Idiopathic toe walking (ITW) is a common pediatric diagnosis. Serial casting, a common treatment used for an ankle equinus contracture, may not be appropriate for all children. This pilot study investigated whether carbon fiber two-pull solid ankle-foot orthoses (CTP-AFOs) would have similar outcomes as serial casting in the treatment of children with a diagnosis of ITW and ankle equinus contracture.

Materials and Methods
Children with ITW (n = 35) were randomized to receive CTP-AFOs or serial casting. Assessments were at initial, posttreatment, and 4-month follow-up with therapy protocols until posttreatment.

Results
There was no statistical difference in active (<0.001) and passive (<0.001) dorsiflexion range of motion, the Observational Gait Scale (<0.001), the Pediatric Reach Test (<0.01) popliteal range of motion (<0.001), strength in dorsiflexion (<0.001) and plantarflexion (0.21), and the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (0.31). Both groups demonstrated significant improvement over time with therapeutic intervention performed by a physical therapist.

Conclusions
Carbon fiber two-pull solid ankle-foot orthoses are a noninferior alternative to serial casting in a population with ITW and ankle equinus contracture. Therapeutic interventions for treatment of ITW and ankle equinus contracture have demonstrated improvements in motor outcomes.
The Utilization of Consensus Techniques in Education and Research in Medical Professions
Authors: Block Zachary A. , Brinkmann John T. , Gard Steven A. 
Published: April 2021

ABSTRACT

Study Design
This is a narrative review.

Introduction
Consensus techniques are an increasingly common research tool used to define levels of expert agreement on a topic where evidence is inconsistent or lacking. An assessment of commonly used consensus techniques can inform future education and research.

Objective
The aim of this study was to describe the use of various consensus techniques used in education and research in orthotics and prosthetics and closely related medical professions, to aid in choosing the most appropriate consensus technique for future research.

Methods
A systematic search of the literature was conducted using specific terms and keywords related to various consensus techniques, applications of consensus techniques in research and education, and medical disciplines related to orthotics and prosthetics. Studies were included if they described the use of a consensus technique for medical education or research and explained why the specific technique was used.

Results
Common consensus techniques were identified in the literature. To allow comparison of the techniques, the advantages, disadvantages, limitations, and previous applications of each were extracted from the literature.

Conclusion
Using the information from the literature, the most prevalent consensus techniques can be compared, aiding educators and researchers in choosing the technique most suitable for their topic of inquiry.
Clinical implications of arterial hypertension in patients with spontaneous coronary artery dissection
Authors: Alfonso Fernando , García-Guimaraes Marcos , Alvarado Teresa , Sanz-Ruiz Ricardo , Roura Gerard , Amat-Santos Ignacio J. , Abdul-Jawad Altisent Omar , Tizón-Marcos Helena , Flores-Ríos Xacobe , Masotti Mónica , Pérez-de Prado Armando , Ferre Georgina Fuentes , Ruiz-Poveda Fernando Lozano , Valero Ernesto , Portero-Portaz Juan José , Diez-Villanueva Pablo , Salamanca Jorge , Bastante Teresa , Rivero Fernando 
Published: April 2021

Background
Spontaneous coronary artery dissection (SCAD) is a rare but increasingly recognized cause of acute coronary syndrome. Many patients with SCAD have associated coronary risk factors. However, the implications of arterial hypertension in SCAD patients remain unknown.

Objective
This study sought to assess the clinical implications of arterial hypertension in a nationwide cohort of patients with SCAD.

Methods
The Spanish SCAD registry (NCT03607981) prospectively enrolled 318 consecutive patients. All coronary angiograms were centrally analyzed to confirm the diagnosis of SCAD. Patients were classified according to the presence of arterial hypertension.

Results
One-hundred eighteen patients (37%) had a diagnosis of arterial hypertension. Hypertensive SCAD patients were older (60 ± 12 vs. 51 ± 9 years old) and had more frequently dyslipidemia (56 vs. 23%) and diabetes (9 vs. 3%) but were less frequently smokers (15 vs. 35%) than normotensive SCAD patients (all P < 0.05). Most patients in both groups were female (90 vs. 87%, NS) and female patients with hypertension were more frequently postmenopausal (70 vs. 47%, P < 0.05). Hypertensive SCAD patients had more severe lesions and more frequently multivessel involvement (15 vs. 7%, P < 0.05) and coronary ectasia (19 vs. 7%, P < 0.05) but showed a similar prevalence of coronary tortuosity (34 vs. 26%, NS). Revascularization requirement was similar in both groups (17 vs. 26%, NS) but procedural success was significantly lower (65 vs. 88%, P < 0.05) and procedural-related complications more frequent (65 vs. 41%, P < 0.05) in SCAD patients with hypertension.

Conclusion
Patients with SCAD and hypertension are older, more frequently postmenopausal and have more coronary risk factors than normotensive SCAD patients. During revascularization SCAD patients with hypertension obtain poorer results and have a higher risk of procedural-related complications (NCT03607981).
Menstrual patterns and disorders among Chinese women of reproductive age
Authors: Mao Lele , Xi Sisi , Bai Wenpei , Yao Chen , Zhou Yingfang , Chen Xing , Sun Yu 
Published: April 2021

Abstract
Menstruation is an important indicator of women's health. Identification of abnormal menstrual patterns in adolescence may improve early diagnosis of potential health concerns in adulthood. This study aimed to evaluate menstrual patterns and disorders of Chinese women of reproductive age based on an APP.
From December 2015 to January 2016, a cross-sectional study was conducted. We utilized a mobile application (APP) to collect information about participants’ age at menarche, length of menstruation, duration of menstruation, amount of menstrual flow, regularity of menstrual cycle, prevalence of abnormal uterine bleeding and dysmenorrhoea.
A total of 156,055 women (25,716 from the questionnaire survey and 130,000 from the mobile APP users) participated in the study. The average age of the subjects was 26.32 ± 6.97 years (median age, 25 years). Mean age at menarche was 13.08 ± 1.87 years; average length of menstrual cycle, 30.9 ± 4.28 days (median 30 days); and average duration of menstruation, 5.01 ± 1.13 days (median 5 days). Women with irregular menstrual cycles accounted for 36.41%. Women aged < 18 years and > 30 years were more likely to experience irregular menstrual cycles. The prevalence of secondary amenorrhoea was 4.07%. More than 20% of women reported abnormal menstrual flow. About 20.11% of women had abnormal uterine bleeding, and 77.65% had dysmenorrhoea. A hot compress was the most commonly used approach to ameliorate dysmenorrhoea. Women with low education and low income and those with high education and high income tended to have menstrual problems.
A mobile APP as a survey tool has the advantages of large sample size, low cost, and high efficiency. The use of a mobile APP is an emerging approach for collecting big data in the field of health research. The results showed that the prevalence of menstrual disorders among Chinese reproductive women was high. Healthcare providers should educate girls and their caregivers about menstrual physiology, normal menstrual pattern, and reproductive health to prevent long-term diseases.
Complementary and alternative therapies for tension-type headache
Authors: Zhai Xixi , Zhang Sishuo , Li Chuancheng , Liu Fei , Huo Qing 
Published: April 2021

Abstract

Background:
Tension-type headache (TTH) is the most common form of primary headache with high prevalence, which affects the quantity of life seriously. The pharmacological treatment of TTH is not the most effective. Meanwhile, complementary therapies and alternative therapies play an essential role in the treatment of TTH, and there is an absence of comparison between various interventions. Therefore, we propose the network meta-analysis protocol to compare the efficacy and safety of various complementary therapies and alternative therapies for TTH.

Methods:
From the beginning to February 2021, we will search the database to collect randomized controlled trials of complementary and alternative therapies for TTH. Two researchers will be responsible for screening retrieve documents, extracting data. The risk of bias will be assessed based on the Cochrane bias risk tool. We will use STATA16.0 and WinBUGS1.4.3 for paired meta-analysis and Bayesian network meta-analysis. The quality of evidence will be assessed using the grading of recommendations assessment development and evaluation.

Results:
This study will compare and rank the efficacy and safety of various complementary and alternative treatments for TTH.

Conclusions:
This study will provide more extensive evidence for the complementary and alternative therapies of TTH. We expect to assist clinicians and patients in choosing the optimum treatment.

Protocol registration number:
INPLASY202130088.
Long interspersed nuclear element-1 hypomethylation is associated with poor outcomes via the activation of ST18 in human hepatocellular carcinoma
Authors: Lee Yu Rim , Kim Gyeonghwa , Lee Hye Won , Tak Won Young , Park Soo Young , Jang Se Young , Kweon Young Oh , Park Jung Gil , Han Young Seok , Chun Jae Min , Han Ja Ryung , Hur Keun 
Published: April 2021

Abstract
The level of long interspersed nuclear element-1 (LINE-1) methylation, representing the global deoxyribonucleic acid methylation level, could contribute to the prognosis of cancer via the activation of oncogenes. This study was performed to evaluate the prognostic implications of LINE-1 hypomethylation in patients with hepatocellular carcinoma (HCC) and the possible mechanisms related to oncogene activation.
Seventy-seven HCC patients between October 2014 and September 2015 were enrolled in this prospective study. Quantitative pyrosequencing was performed to assess the LINE-1 methylation level of HCC and matched non-HCC tissue samples. The expression of suppression of tumorigenicity 18 was measured by immunohistochemistry and its correlation with LINE-1 methylation levels was examined.
LINE-1 was significantly hypomethylated in the HCC tissue compared with the matched nontumor tissue (64.0 ± 11.6% vs 75.6 ± 4.0%, P < .001). LINE-1 hypomethylation was an independent risk factor for overall survival (hazard ratio = 27.291, P = .032) and disease progression (hazard ratio = 5.298, P = .005). The expression of suppression of tumorigenicity 18 was higher in the hypomethylated LINE-1 HCC tissue than the hypermethylated LINE-1 tumor tissue (P = .030).
LINE-1 hypomethylation may serve as a potential prognostic marker for patients with HCC.