bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brief Report: Hospitalization Rates Among Persons With HIV Who Gained Medicaid or Private Insurance After the Affordable Care Act in 2014
Authors: Chow Jeremy Y. , Nijhawan Ank E. , Mathews W. Christopher , Raifman Julia , Fleming Julia , Gebo Kelly A. , Moore Richard D. , Berry Stephen A. 
Published: February 2021

Background:
It is unknown whether gaining inpatient health care coverage had an effect on hospitalization rates among persons with HIV (PWH) after implementation of the Affordable Care Act in 2014.

Methods:
Hospitalization data from 2015 were obtained for 1634 adults receiving longitudinal HIV care at 3 US HIV clinics within the HIV Research Network. All patients were engaged in care and previously uninsured and supported by the Ryan White HIV/AIDS Program in 2013. We evaluated whether PWH who transitioned to either Medicaid or private insurance in 2014 tended to have a change in hospitalization rate compared with PWH who remained uncovered and Ryan White HIV/AIDS Program supported. Analyses were performed by negative binomial regression with robust standard errors, adjusting for gender, race/ethnicity, age, HIV risk factor, CD4 count, viral load, clinic site, and 2013 hospitalization rate.

Results:
Among PWH without inpatient health care coverage in 2013, transitioning to Medicaid [adjusted incidence rate ratio 1.26, (0.71, 2.23)] or to private insurance [0.48 (0.18, 1.28)] in 2014 was not associated with 2015 hospitalization rates, after accounting for demographics, HIV characteristics, and prior hospitalization rates. The factors significantly associated with higher hospitalization rates include age 55–64, CD4 <200 cells/µL, viral load >400 copies/mL, and 2013 hospitalization rate.

Conclusions:
Acquiring inpatient coverage was not associated with a change in hospitalization rates. These results provide some evidence to allay the concern that acquiring inpatient coverage would lead to increased inpatient utilization.
Brief Report: Improvement in Metabolic Health Parameters at Week 48 After Switching From a Tenofovir Alafenamide–Based 3- or 4-Drug Regimen to the 2-Drug Regimen of Dolutegravir/Lamivudine: The TANGO Study
Authors: van Wyk Jean , Ait-Khaled Mounir , Santos Jesus , Scholten Stefan , Wohlfeiler Michael , Ajana Faïza , Jones Bryn , Nascimento Maria-Claudia , Tenorio Allan R. , Smith Don E. , Wright Jonathan , Wynne Brian 
Published: February 2021

Background:
In TANGO, switching to dolutegravir/lamivudine was noninferior at 48 weeks to continuing 3-/4-drug tenofovir alafenamide–based regimens in virologically suppressed individuals with HIV-1. Antiretroviral agents have been associated with weight gain and metabolic complications.

Setting:
One hundred thirty-four centers; 10 countries.

Methods:
We assessed weight; fasting lipids, glucose, and insulin; and prevalence of insulin resistance and metabolic syndrome at baseline and week 48 in TANGO participant subgroups by boosting agent use in baseline regimens (boosted and unboosted).

Results:
In each treatment group, 74% of participants used boosted regimens at baseline. In boosted and unboosted subgroups, weight and fasting glucose changes at week 48 were small and similar between treatment groups. Overall and in the boosted subgroup, greater decreases from baseline were observed with dolutegravir/lamivudine in fasting total cholesterol (P < 0.001), low-density lipoprotein cholesterol (P < 0.001), triglycerides (P < 0.001), total cholesterol/high-density lipoprotein cholesterol ratio (overall, P = 0.017; boosted, P = 0.007), and insulin (boosted, P = 0.005). Prevalence of HOMA-IR ≥2 was significantly lower at week 48 with dolutegravir/lamivudine overall [adjusted odds ratio (aOR), 0.59; 95% confidence interval (CI), 0.40 to 0.87; P = 0.008] and in the boosted subgroup [aOR, 0.56; 95% CI, 0.36 to 0.88; P = 0.012] but not in the unboosted subgroup [aOR, 0.70; 95% CI, 0.31 to 1.58; P = 0.396]. Prevalence of metabolic syndrome at week 48 was low and consistent between treatment groups overall, with differences trending to favor dolutegravir/lamivudine in the unboosted subgroup [aOR, 0.41; 95% CI, 0.15 to 1.09; P = 0.075].

Conclusion:
Generally, switching from 3-/4-drug tenofovir alafenamide–based regimens to dolutegravir/lamivudine improved metabolic parameters, particularly when switching from boosted regimens. Because of smaller sample size in the unboosted subgroup, results warrant further investigation.
HIV Prevention Responsibility Beliefs Among Men Who Have Sex With Men in the PrEP Era
Authors: Truong Hong-Ha M. , Fatch Robin , McFarland Willi , Raymond Henry F. 
Published: February 2021

Background:
Beliefs regarding responsibility for preventing HIV transmission may differ between individuals and their sexual partners. We assessed HIV prevention responsibility beliefs among men who have sex with men (MSM) participating in the 2017 National HIV Behavioral Surveillance survey.

Methods:
MSM were recruited using time-location sampling at clubs, bars, and street locations in San Francisco. HIV prevention responsibility beliefs were assessed on a four-point scale (1 = strongly disagree to 4 = strongly agree). Associations were assessed using generalizing estimating equations to adjust for behaviors within multiple partnerships.

Results:
A total of 316 HIV-negative men and 76 HIV-positive men reported on 1336 partnerships. HIV-negative compared with HIV-positive men had higher endorsement of mutual responsibility (mean 3.7 vs. 3.5; P < 0.01). Both groups had similar levels of endorsing responsibility on the HIV-negative or HIV-positive partner. HIV-positive men endorsing equal responsibility were more likely to know their partner's HIV status (P < 0.01) and less likely to have serodiscordant condomless anal intercourse (CAI) (P < 0.01) than men who did not endorse equal responsibility. HIV-negative men in partnerships with pre-exposure prophylaxis (PrEP) use were more likely to know their partner's HIV status (P = 0.02) and have serodiscordant CAI (P = 0.04) than men not in partnerships with PrEP use.

Conclusions:
HIV-negative and HIV-positive men accept responsibility for preventing HIV. The finding that HIV-negative men in partnerships with PrEP use who engage in serodiscordant CAI is concerning because they are still at risk for other sexually transmitted infections, which are presently at elevated levels in San Francisco and other US cities.
Posttraumatic Scab on 131I Whole-Body Scan—A False-Positive Finding
Authors: Chowdhary Abdul Waheed , Kavanal Anwin Joseph , Sood Ashwani , Prashar Sarika , Upadhyay Ritesh , Bhattacharya Anish , Mittal Bhagwant Rai 
Published: February 2021

Abstract

131I scan plays a crucial role in the management of patients with differentiated thyroid cancer for the evaluation of remnant thyroid tissue, residual/recurrent metastatic disease, posttherapy tracer distribution, and response assessment to high-dose 131I therapy. Different causes secondary to physiological, pathological, and anatomical variations have been described for false-positive findings in the whole-body planar images. This case report of a patient of differentiated thyroid cancer with undocumented trauma to the left knee region a day before receiving the high-dose radioiodine therapy showed an interesting image finding of tracer uptake at unusual site in the posttherapy whole-body 131I scan.
Seasonal and Temperature-associated Effect on Infection in Implant-based Breast Reconstruction
Authors: Min Kyunghyun , Jeong Seong Su , Han Hyun Ho , Kim Eun Key , Eom Jin Sup 
Published: February 2021

Background and Objectives
Despite advances in medicine, infection at the surgical site is an impregnation problem that most surgeons confront. Although studies on the seasonality of infection have been conducted in various areas, no study has confirmed the relationship between seasonal temperature and infection after breast reconstruction.

Methods
From 2008 to 2018, a retrospective study was conducted on patients who underwent implant-based breast reconstruction. Patient demographics, intraoperative data, postoperative data, and temperature information were collected. Temperature differences between cases with and without infection were examined. The differences in the incidence and risk of infection by season were estimated according to the hot season (July to August) and the nonhot season (September to June).

Results
Of the 460 cases enrolled, 42 cases developed an infection. Among them, 15 (35.71%) cases developed infection during the hot season (P = 0.003). According to the logistic regression model, the risk of infection was 2.639 times higher in the hot season than in the nonhot season (95% confidence interval, 1.282–5.434; P = 0.008). When the temperature was higher than 25°C, the risk of infection increased by 45.2% for every 1°C increase, which was statistically significant (odds ratio, 1.452; 95% confidence interval, 1.198–1.76; P < 0.001).

Conclusion
In conclusion, the hot season or average temperatures higher than 25°C increase the risk of infection in patients undergoing implant-based breast reconstruction. It is essential to focus on skin hygiene during the healing of the incision site.
The Medial Femoral Condyle Free Flap for Reconstruction of Recalcitrant Defects in the Head and Neck
Authors: Singh Kuldeep , Huang Tony C.T. , Meaike Jesse D. , Mills Andrew M. , Nathan John M. , Lettieri Salvatore C. , Arce Kevin , Moran Steven L. 
Published: February 2021

Background
Small recalcitrant defects of the mandible and maxilla may be secondary to tumor, trauma, infection, and congenital origin. Vascularized bone grafting has been shown to effectively manage these defects; however, donor sites are limited. The vascularized medial femoral condyle (MFC) provides adequate cortical cancellous bone with the option of a skin island, consistent anatomy, and minimal donor site morbidity. This article outlines the use of the MFC flap for maxillomandibular reconstruction.

Methods
A retrospective chart review of patients who required segmental maxillomandibular reconstruction with the MFC flap was conducted. A total of 9 patients (5 men and 5 women) with an average age of 45.3 years were identified. The etiology of the defects, flap sizes, and postoperative outcomes were recorded.

Results
Three patients had osteoradionecrosis of the neomandible after irradiation of the free fibula reconstruction, 3 patients had defects after cancer extirpation (1 mandible, 2 maxillary), 1 patient had a maxillary defect from trauma, and 2 patients had a residual cleft palate defect. All defects failed initial treatment with nonvascularized bone grafts. The average dimensions of the MFC flaps were 1.2 × 2.5 × 4 cm. Two of 9 flaps included a skin island. Eight flaps survived completely, but 1 patient suffered from flap failure requiring debridement and resulted in an oroantral fistula. Four patients received endosseous dental implants. Average time to union was 6.7 months, and average time to implant was 6.75 months. The average follow-up time was 24.9 months.

Conclusions
The MFC flap is useful in the reconstruction of small segmental maxillomandibular defects and for the salvage of a neomandible after osteoradionecrosis. The MFC flap provides a reliable platform for endosseous dental implants and serves as an alternative source of vascularized bone reconstruction in the head and neck.
Perforator Detection by Thermographic Imaging Augmented With Tourniquet-Reperfusion
Authors: Pan Jia-Dong , Xu Heng , Xiao Dong-chao , Hacquebord Jacques Henri , Chang Shi-Min , Wang Xin 
Published: February 2021

Background
Dynamic infrared thermography provides a new imaging method of perforator detection. This study introduces an augmented technique to improve its accuracy by tourniquet-reperfusion and reports its preliminary use in the distal lower leg reconstruction.

Methods
A tourniquet (450 mm Hg) was applied for 3 minutes on proximal thighs. After the tourniquet release, the rewarming rate and pattern of hotspots were observed by thermography to delineate the location and quality of perforators. The results were compared with those detected by computed tomographic angiography. Clinically, the local transferred posterior tibial artery or peroneal artery propeller perforator flap was performed in 9 patients for the distal lower leg reconstruction.

Results
There was a 20- to 140-second “perforator observing window” after the tourniquet release. Tourniquet-reperfusion augmented thermal imaging method (TRATIM) had a sensitivity of 90.3% and a positive predictive value of 93.3%. The TRATIM and computed tomographic angiography had an excellent concordance with a kappa index value of 0.839 (P < 0.001). Based on the TRATIM, 9 propeller perforator flaps were successfully designed and raised for the distal lower leg resurfacing. All flaps survived entirely, except one with size of 1.0 cm × 2.0 cm that had terminal necrosis.

Conclusions
The TRATIM is a quick, easy, cheap, and reliable approach for perforator detection in the lower leg. With the aid of TRATIM, a customized propeller perforator flap could be raised efficiently for the distal lower leg reconstruction.
Variations in Orofacial Clefts
Authors: Jahanbin Arezoo , Jamalinasab Abdollah , Niazi Ahmad Ehsan 
Published: February 2021

Objectives:
The main objective of this study was to report the prevalence and other relative risk factors of oral clefts among newborn infants.

Methods:
In this study, we reviewed the data regarding 234 infants with cleft anomalies as collected in questionnaires from 2004 to 2019 and demographic parameters were assessed.

Results:
Cleft lip and palate was the most common anomaly (66.7%), followed by isolated cleft palate (28.2%), isolated cleft lip (3.8%), and cleft lip and alveolus (1.3%). The study also showed that 54.3% of all cleft patients were boys and 45.7% were girls (with a rate of 1.18) and the difference between both sexes was significant (P-value = 0.010). In addition, cleft lip and palate was more common in males and isolated cleft palate was seen more in girls (P-value = 0.002, P-value = 0.001, respectively). The parents (56.4%) had consanguinity and 20% of them had a history of cleft in their family.

Conclusion:
Cleft lip and palate in boys and cleft palate in girls was more common. Parents’ consanguinity and history of cleft in their family are also important factors to consider. Further studies on cleft anomalies along with or without genetic factors are required.
Morphometric Analysis of Cleft Lip Palate and Prognathic Mandibles in Relation to Mandibular Canal Course
Authors: Sancar Bahadir , Dedeoğlu Numan 
Published: February 2021

Introduction:
This study aimed to evaluate the mandibular canal course in individuals with cleft lip palate (CLP) and mandibular prognathism in terms of the sagittal split-ramus osteotomy using cone-beam computed tomography.

Materials and Methods:
Individuals with CLP older than 16 years of age and planned to undergo Le fort I + SSR osteotomies and those with class III occlusion planned to undergo Le fort I + SSR osteotomies were included. The measurements on the cleft side of CLP patients were compared with both their noncleft sides and those with class III occlusion. The course of the inferior alveolar nerve and its position in the mandible were evaluated starting from the mandibular foramen, the first entrance to the mandible, to the mental foramen, the exit from the mandible.

Results:
The distance between the mandibular canal and the buccal surface of the mandible (B3) on the plane tangent to the distal of the mandibular first molar and perpendicular to the occlusal plane was found to be greater in individuals with CLP (P = 0.011). Buccal cortex thickness (C4) at the level of the mandibular canal on the plane tangent to the distal of the mandibular second molar and perpendicular to the occlusal plane was found to be lower in individuals with CLP (P = 0.021).

Conclusions:
The buccal cortex thickness of the mandible corpus and the distance of the mandibular canal to the buccal surface is different in patients with CLP compared to class III individuals’ posterior to the mandible. Surgeons should take these differences into consideration during mandibular osteotomy.
The Effect of Smoking on the Postoperative Course After Head and Neck Reconstruction With a Vascularized Free Flap: A Retrospective Study
Authors: Garip Melisa , Croonenborghs Tomas-Marijn , Bila Michel , Vranckx Jan Jeroen , Politis Constantinus 
Published: February 2021

Objectives:
The objective of the present study is to determine the impact of smoking on hospital and intensive care unit stay, need for surgical reintervention, Portsmouth Physiological and Operative Severity Score for the enumeration of Mortality and morbidity, and surgical complications after head and neck reconstructions.

Methods:
All 153 patients who underwent head and neck reconstructions with free tissue transfer at the department of oral and maxillofacial surgery at the University Hospitals of Leuven between January 1, 2015 and December 31, 2018 were enrolled in this retrospective cohort study. Data from medical charts were extracted. Univariate and multiple regression analyses were performed. A level of significance of P < 0.05 (α = 0.05) was used.

Results:
Smoking was not associated with Portsmouth Physiological and Operative Severity Score for the enumeration of Mortality and morbidity, hospital or ICU stay, the incidence of postoperative complications in both flap and donor site, or surgical reintervention.

Conclusions:
Regarding the outcomes included in this study, smoking status should not be considered as a critical factor in patient selection for head and neck reconstructions with a vascularized free flap.
A Giant Diving Ranula Extending to the Skull Base in Pediatric Age
Authors: Kumbul Yusuf Çağdaş , Okur Nazan , Çiriş Ibrahim Metin , Okur Erdoğan , Sivrice Mehmet Emre , Akin Vural 
Published: February 2021

Abstract
Ranula is a retention cyst that develops from the salivary glands. It has 2 subtypes, oral and diving. There are differences in the clinical features of ranula subtypes. In particular, diving ranula is more prone to extend in the neck spaces than oral ranula. The enlargement of the diving ranula is generally downward in the neck. If the opposite occurs, we may encounter very interesting and difficult cases. Diving ranula should be kept in mind in the differential diagnosis of cystic neck masses in the pediatric age group and its treatment should be done surgically.
A 15-year-old girl admitted to our clinic with the complaint of swelling in the floor of the mouth and neck. In physical examination of the patient, a mass with cystic content was observed adjacent to the left Wharton canal. In addition, a 4 × 3 cm, soft, fluctuant, nonfixed, painless mass was palpated in the left submandibular area. Magnetic resonance imaging revealed that the neck mass was a diving ranula extending from the parapharyngeal space to the skull base. In the surgery, submandibular and sublingual salivary glands were removed together with the diving ranula. We observed no complications in the postoperative period.
Magnetic resonance imaging should be used to confirm the diagnosis of diving ranula. In the treatment of diving ranula, excision of the ranula alone is not enough surgically. We also recommend excision of the submandibular and/or sublingual salivary glands associated with ranula to reduce the recurrence rate.
Association of Plasma Levels of Fas Ligand with Severity and Outcome of Sepsis
Authors: Yoo Hongseok , Lee Jin Young , Park Junseon , Suh Gee Young , Jeon Kyeongman 
Published: February 2021

ABSTRACT

Introduction:
Levels of the apoptosis regulator Fas ligand (FasL) are associated with severity of sepsis, but its association with the mortality of sepsis and necroptosis, a regulated cell death mechanism, is not yet clear. We aimed to assess the association of FasL level with outcomes of sepsis and receptor interacting protein kinase-3 (RIPK3), an essential necroptosis mediator, for determining the relationship between FasL and necroptosis.

Methods:
Plasma FasL and RIPK3 levels were measured by ELISA from prospectively enrolled critically ill adult patients. The best cut-off level of FasL for 28-day mortality prediction was determined by Youden's index. The association between plasma levels of FasL and RIPK3 was assessed by a linear regression method.

Results:
Among 188 patients, 58 (30.9%) were diagnosed with sepsis and 84 (44.7%) with septic shock, respectively. Plasma levels of FasL increased in the group order of control, sepsis, and septic shock groups (P for trend < 0.001). For 142 patients with sepsis, organ dysfunction and septic shock were more prevalent in the group with plasma FasL levels that were higher than the best cut-off level. A significant difference in mortality between high and low FasL patients was observed up to 90 days (Log-rank P = 0.013). FasL levels did not significantly change over day 3 and day 7. FasL levels were not correlated with those of RIPK3.

Conclusions:
The plasma level of FasL was associated with severity of sepsis and was predictive of mortality. However, it was not correlated with RIPK3 level.
Center-level Utilization of Hepatitis C Virus–positive Donors for Orthotopic Heart Transplantation
Authors: Huckaby Lauren V. , Seese Laura M. , Handzel Robert , Wang Yisi , Hickey Gavin , Kilic Arman 
Published: February 2021

Background.
The use of hepatitis C virus–positive (HCV+) donors has expanded the donor pool for orthotopic heart transplantation (OHT). This study evaluated center-level trends and utilization of HCV+ donors for OHT.

Methods.
Data were extracted from the Scientific Registry of Transplant Recipients on adults (≥18 y) undergoing OHT between January 1, 2016 and December 31, 2019. Centers performing <10 OHTs during the study period were excluded. Donor utilization rates were evaluated at the center level. Center-level characteristics were compared between centers performing HCV+ donor hepatitis C virus–negative (HCV−) recipient OHTs and those not utilizing HCV+ donors for HCV− recipients.

Results.
A total of 10 134 patients underwent OHT, including 613 (6.05%) HCV+ donors transplanted into HCV− recipients. The number of HCV+ OHTs increased from 15 of 2512 (0.60%) in 2016 to 285 of 2490 (11.45%) in 2019 (P < 0.001). In 2016, among 105 centers performing OHTs, 7 (6.67%) utilized HCV+ donors compared to 2019 during which 55 (52.89%) of 104 centers utilized HCV+ donors (P < 0.001). In total, 57 of 107 (53.27%) centers utilized HCV+ donors during the study period. Centers utilizing HCV+ donors had higher overall donor utilization rates (7376/24 378 [30.26%] versus 3463/15 335 [22.58%], P < 0.001) and were higher volume as compared to nonutilizing centers (mean annual OHT volume 30.72 ± 1.21 versus 16.2 ± 1.40, P < 0.001).

Conclusions.
Although the use of HCV+ donors for OHT is rapidly expanding in the United States, almost half of transplant centers remain nonutilizers. Broader education and implementation of HCV+ donor protocols may be important in expanding OHT to more patients with end-stage heart failure.
Excessive Masturbation Successfully Treated With Methylphenidate in a 6-Year-Old Child With Autism Spectrum Disorder Accompanied by Attention Deficit Hyperactivity Disorder
Authors: Ferahkaya Hurşit , Bilgiç Ayhan 
Published: February 2021

Abstract
Children with autism spectrum disorder frequently exhibit inappropriate sexual behaviors, such as excessive masturbation. However, research on the control and management of excessive masturbation in these children is very limited. In this presentation, excessive masturbation that responded to treatment with methylphenidate is described in a young boy diagnosed with autism spectrum disorder and comorbid attention deficit hyperactivity disorder.