bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coordinated Capacity Reductions and Public Communication in the Airline Industry
Authors: Aryal Gaurab , Ciliberto Federico , Leyden Benjamin T 
Published: December 2021

Abstract
We investigate the allegation that legacy US airlines communicated via earnings calls to coordinate with other legacy airlines in offering fewer seats on competitive routes. To this end, we first use text analytics to build a novel dataset on communication among airlines about their capacity choices. Estimates from our preferred specification show that the number of offered seats is 2$\%$ lower when all legacy airlines in a market discuss the concept of “capacity discipline.” We verify that this reduction materializes only when legacy airlines communicate concurrently, and that it cannot be explained by other possibilities, including that airlines are simply announcing to investors their unilateral plans to reduce capacity, and then following through on those announcements.
Obinutuzumab as treatment for ANCA-associated vasculitis
Authors: Amudala Naomi A , Boukhlal Sara , Sheridan Brittany , Langford Carol A , Geara Abdallah , Merkel Peter A , Cornec Divi 
Published: December 2021

Abstract

Objectives
Rituximab is a standard of care therapy for patients with ANCA-associated vasculitis. When rituximab is contraindicated, or in the case of refractory disease, other treatments are needed. Obinutuzumab is another anti-CD20 antibody for the treatment of haematological malignancies that may induce a deeper B cell depletion compared with rituximab. This article reviews three cases of patients with ANCA-associated vasculitis who were treated with obinutuzumab due to their history of anaphylactic reactions to rituximab.

Methods
Case series of three patients with ANCA-associated vasculitis treated with obinutuzumab.

Results
One female patient with microscopic polyangiitis and two male patients with granulomatosis with polyangiitis received obinutuzumab. The treatment was well-tolerated in all patients despite previous anaphylactic reaction to rituximab. Treatment with obinutuzumab was effective in (i) inducing disease remission, (ii) inducing total B cell depletion, and (iii) resulting in undetectable serum titres of ANCA. All three patients were re-treated with obinutuzumab for maintenance of remission.

Conclusion
Obinutuzumab appears to be a safe and efficacious therapy for patients with ANCA-associated vasculitis who have had refractory disease or a history of anaphylaxis to rituximab. Prospective studies comparing rituximab to obinutuzumab in ANCA-associated vasculitis patients are warranted.
Factors Associated with Healing Outcomes in Primary Care Patients with Diabetic Foot Ulcers: A Retrospective Study in a Multiethnic Sample
Authors: Zhu Xiaoli , Olsson Maja M. , Bajpai Ram , Lim Voon Hooi , Goh Ling Jia 
Published: December 2021

ABSTRACT

OBJECTIVE
To identify and determine patient- and ulcer-related factors associated with healing outcomes within 3 months for patients with diabetic foot ulcer (DFU) in a multiethnic primary care sample.

METHODS
Retrospective data were collected over 3 months from 520 primary care patients with a DFU between April 1, 2016 and March 31, 2017. Multivariable prevalence ratios (PRs) were calculated using Poisson regression to find associations between patient- and ulcer-related factors and healing outcomes.

RESULTS
Most patients were male (66%) and Chinese (49.8%) and had a diabetes mellitus duration longer than 5 years (81.8%). Toe ulcers (64%) were most common. Healing occurred for 33.9% of participants; 19.1% and 1.5% underwent minor and major amputation, respectively. Wound sizes between 1 and 10 cm2 (PR, 0.61; 95% confidence interval [CI], 0.46–0.76; P < .001) and over 10 cm2 (PR, 0.55; 95% CI, 0.33–0.76; P = .003), ulcer duration 6 months or longer (PR, 0.36; 95% CI, 0.19–0.53; P < .001), ischemic ulcers (PR, 0.54; 95% CI, 0.22–0.86; P = .044), and neuroischemic ulcers (PR, 0.73; 95% CI, 0.53–0.93; P = .027) were negatively associated with healing outcomes. Women were more likely to experience healing (PR, 1.18; 95% CI, 0.91–1.45; P = .157).

CONCLUSIONS
Ulcer healing varied by sex and was affected by wound size, wound duration, and ischemic etiology, regardless of ethnicity. Prompt attention to these risk factors may reduce healing time. Further studies are warranted to elucidate the mechanism underlying sex differences in association with DFU healing.
Reducing Hospital-Acquired Pressure Injuries through Measure-vention
Authors: Wyatt Rachel 
Published: December 2021

ABSTRACT
Evidence has shown that Braden subscale scores are independent predictors of the development of pressure injuries. However, current practice is to implement preventive measures for pressure injuries based on the total Braden Scale score. Applying evidence from the literature on Braden subscales and using “Measure-vention,” a quality improvement project using Braden subscales, was implemented in a 30-bed ICU in a Northern California level II trauma acute care hospital. The pilot study's purpose was to test whether tailoring interventions specific to the patient’s subscale risk would decrease the incidence of hospital-acquired pressure injuries (HAPIs). A 6-month pilot was launched for all patients in the ICU, regardless of Braden total score. Frontline staff collected data in real time, measuring adherence to the “Interventions by Braden Subscale” protocol, and event reports were aggregated to measure the incidence of HAPIs before and after the pilot. At the end of the pilot, the ICU noted a decrease in HAPIs by 63.5%. The results demonstrated the efficacy of using the Braden subscales to guide preventive HAPI care, preventing both HAPIs and the overutilization of resources.
How Clinical Supervisors Conceptualize Procedural Entrustment: An Interview-Based Study of Entrustment Decision Making in Endoscopic Training
Authors: Jeyalingam Thurarshen , Brydges Ryan , Ginsburg Shiphra , McCreath Graham A. , Walsh Catharine M. 
Published: December 2021

Purpose
Entrustment is central to assessment in competency-based medical education (CBME). To date, little research has addressed how clinical supervisors conceptualize entrustment, including factors they consider in making entrustment decisions. The aim of this study was to characterize supervisors’ decision making related to procedural entrustment, using gastrointestinal endoscopy as a test case.

Method
Using methods from constructivist grounded theory, the authors interviewed 29 endoscopy supervisors in the United States and Canada across multiple specialties (adult and pediatric gastroenterology, surgery, and family medicine). Semistructured interviews, conducted between April and November 2019, focused on how supervisors conceptualize procedural entrustment, how they make entrustment decisions, and what factors they consider. Transcripts were analyzed using constant comparison to generate an explanatory framework and themes.

Results
Three themes were identified from the analysis of interview transcripts: (1) entrustment occurs in varying degrees and fluctuates over time; (2) entrustment decisions can transfer within and across procedural and nonprocedural contexts; (3a) persistent static factors (e.g., supervisor competence, institutional culture, legal considerations) influence entrustment decisions, as do (3b) fluctuating, situated dynamic factors (e.g., trainee skills, patient acuity, time constraints), which tend to change from one training encounter to the next.

Conclusions
In the process of making procedural entrustment decisions, clinical supervisors appear to synthesize multiple dynamic factors against a background of static factors, culminating in a decision of whether to entrust. Entrustment decisions appear to fluctuate over time, and assessors may transfer decisions about specific trainees across settings. Understanding which factors supervisors perceive as influencing their decision making has the potential to inform faculty development, as well as competency committees seeking to aggregate faculty judgments about trainee unsupervised practice. Those leading CBME programs may wish to invest in optimizing the observed static factors, such that these foundational factors are tuned to facilitate trainee learning and achievement of entrustment.
No Recurrence in Primary Invasive Stage 1a and 1b Melanoma and Melanoma in Situ Treated With Serial Disk Staged Excision
Authors: Ahn Grace Sora , Pousti Bobak , Singh Gaurav , Elsensohn Ashley , Jiang Shang I Brian 
Published: December 2021

BACKGROUND
Optimal surgical treatment modality for invasive melanoma (IM) and melanoma in situ (MIS) has been debated with proponents for standard wide local excision (WLE), serial disk staged excision, and Mohs micrographic surgery.

OBJECTIVE
The purpose of this study is to identify the recurrence rates and surgical margins of invasive stage 1 melanoma and MIS lesions using serial disk staged excision technique with rush permanent processing and “bread loafing” microscopic analysis.

MATERIALS AND METHODS
Recurrence rates and surgical margins of 63 IM and 207 MIS at the University of California Dermatology Surgery Unit were retrospectively reviewed.

RESULTS
No recurrences were observed with average follow-up of 34 and 36 months for IM and MIS, respectively (range, 10–92 months). Average surgical margins were 19.8 mm (SD 9.7) for IM and 12.1 mm (SD 12.2) for MIS.

CONCLUSION
This SSE technique for the treatment of IM and MIS is comparable in efficacy to other SSE techniques, and it offers physicians a simple and accessible alternative to WLE and MMS.
Early Endothelialization of Ab Interno Stromal Tectonic Patch in the Management of Corneal Perforation Secondary to Bacterial Keratitis
Authors: Roberts Harry W. , Davidson Max , Thaung Caroline , Myerscough James 
Published: December 2021

Purpose:
The purpose of this study was to describe a novel surgical technique using an ab interno stromal patch to treat corneal perforation and to present the histological findings of the patch after its removal during definitive mushroom keratoplasty.

Methods:
The endothelium had already been removed with the submerged cornea using backgrounds away (SCUBA) technique.

Results:
The patient was managed successfully with a sutureless ab interno stromal tectonic patch. Two months later, definitive mushroom keratoplasty was performed and the patch was sent for histological examination. Immunohistochemistry revealed a reactive endothelium covering the posterior surface of the graft. Nine months later, her best-corrected visual acuity was 6/9.

Conclusions:
This is the first case to our knowledge demonstrating that stromal tectonic grafts without the endothelium can successfully attach to the host tissue and seal a perforation. The stroma may undergo reendothelialization and begin to restore vision, even before penetrating keratoplasty.
Effects of Carbapenem Restriction on the Prevalence of Carbapenem-Resistant Acinetobacter baumannii Infection in Adult General Wards
Authors: Alotaibi Meshal Saud , Alzayed Mohammed Saud , Alhabeeb Yasser Mohammed , Tawfic Nader Ahmad , Rakha Ehab Badran 
Published: December 2021

Background
Recently, there has been a significant increase in the number of nosocomial infections caused by the carbapenem-resistant Acinetobacter baumannii (CRAB) pathogen, subsequently increasing mortality and morbidity. This infection is usually observed in intensive care units. However, in our hospital, we have experienced an increasing number of CRAB infection cases in adult general wards. Carbapenem use is considered a contributing factor. Therefore, we examined the restriction of carbapenem use in adult general wards as a strategy to decrease the prevalence of CRAB infection.

Methods
The study was divided into 2 periods: carbapenem-nonrestricted period and carbapenem-restricted period. During the carbapenem-nonrestricted period, data of CRAB infection cases and carbapenem consumption were collected retrospectively between February 1, 2016, and January 31, 2017. During the carbapenem-restricted period, the same data were collected prospectively from February 1, 2017, to January 31, 2018. The amount of carbapenem consumed was measured as daily defined doses per 1000 patient days.

Results
The numbers of admitted patients during the carbapenem-nonrestricted and carbapenem-restricted periods were 7501 and 8062, respectively. The average amount of carbapenem consumption reduced from 1.35 defined daily doses/1000 to 0.125 defined daily doses/1000 patient days. During the carbapenem-nonrestricted period, 31 CRAB infection cases exhibited isolated CRAB. After the carbapenem-restricted period, only 14 CRAB infection cases were reported (P = 0.005).

Conclusions
Implementing carbapenem restriction can be an effective strategy to decrease the prevalence of CRAB infection, subsequently decreasing mortality. However, the stewardship of other groups of antibiotics, which can be used as alternatives to carbapenems, is important to avoid the emergence of other bacterial strains.
Subcutaneous Dirofilariasis in the United States
Authors: Houston Peter M. , Parks Amanda L. 
Published: December 2021

Abstract
Dirofilariasis is a filarial infection of domestic and sylvatic vertebrates such as canines, felines, raccoons, and bears (the definitive hosts) and is transmitted mostly by mosquitoes (the vector) with the exception being Dirofilaria ursi that is transmitted by the black fly. At least 60 cases of subcutaneous dirofilariasis in humans have been reported; however, the overall incidence of dirofilarial infection has increased, and dirofilariasis is considered an emerging zoonosis. Here, we present a case of subcutaneous Dirofilaria in an otherwise healthy woman in her sixth decade who presented with a painless, mobile, nonerythematous pea-sized nodule of the right upper extremity of 1 month's duration. Evaluation regarding possible disseminated infection, microfilaremia, filarial serology, pulmonary, and central nervous system involvement was negative. She reported no travel outside of South Carolina. Her only risk factor was exposure to mosquitoes 5 months prior in her backyard, composed primarily of wetlands, a common habitat in coastal southeastern United States. No antihelminthics were given. She had complete resolution of the lesion after surgical excision, with no sequelae. This is the second case reported in Charleston, South Carolina.
Positive, Mildly Positive, and Uncertain Nasopharyngeal Swab and Outcome in COVID-19 Patients
Authors: Malerba Paolo , Boari Gianluca E. M. , Nardin Matteo , Tomasi Cesare , Chiarini Giulia , Bonetti Silvia , Bianco Gianluca , Faustini Cristina , Braglia-Orlandini Federico , De Ciuceis Carolina , Rizzoni Damiano 
Published: December 2021

Introduction and Aim
Diagnosis of SARS-CoV-2 infection is mainly based on gene detection through polymerase chain reaction analysis on nasopharyngeal swab. The Allplex TM 2019-nCoV assay targets 3 different viral genes: RNA-dependent RNA polymerase, envelope, and nucleocapside. A coding system was developed based on different number of genes expressed: a nasopharyngeal swab was considered “positive” if all 3 genes tested underwent amplification, “mildly positive” if only 2 out of 3 genes were detected, “uncertain” if only 1 gene and “negative” if none resulted amplified from the test. Our aim was to assess whether this classification correlates with clinical outcome in a cohort of COVID-19 patients.

Methods
This is a retrospective study including patients admitted with diagnosis of SARS-CoV-2 infection to a medical ward at the Montichiari Hospital, Brescia, Italy, from February 28 to April 30, 2020. All patients underwent the nasopharyngeal swab upon admission.

Results
A total of 204 patients were included in this study. Patients with full positive nasopharyngeal swab showed higher values of C-reactive protein and neutrophiles/lymphocytes ratio compared with patients with mildly positive or uncertain nasopharyngeal swab. Mortality did not differ between the 2 groups. A Cox multivariate analysis showed that age, male sex, and CRP values are independent predictors of in-hospital mortality.

Conclusions
Our study demonstrated that patients with a complete SARS-CoV-2 gene detection nasopharyngeal swab show a higher inflammatory profile, and this can be an indirect measurement of viral load in COVID-19 patients.
Analysis of the Main Groups Victimized by Familiar Violence and by Violence by a Known Person in Brazil
Authors: Rodrigues Nádia Cristina Pinheiro , Andrade Mônica Kramer de Noronha , O'Dwyer Gisele , Monteiro Denise Leite Maia , Reis Inês do Nascimento , Lino Valéria Teresa Saraiva 
Published: December 2021

Abstract
This study aims to evaluate the ratio of the number of cases of family violence and violence by a known person, over the four surveys that took place in 2006, 2007, 2009, and 2011, within the population treated in the Brazilian health services, according to demographic and socioeconomic characteristics. Data from the Vigilância de Violências e Acidentes survey was used. The variables age, victim sex, aggressor sex, race, and schooling level were considered in the analysis. This study pointed out decreasing trend in the number of violence-related care within the older age group. The number of familial violence-related care per victim sex was higher for male victims when the aggressor was female, and conversely, it was higher for female victims when the aggressor was male. The number of violence-related care was mostly higher in non-White people than in White. People with low schooling levels showed the highest ratio of the number of violence-related care.
Thirty-Minute Psychiatric Management Visits in Academic Medical Centers
Authors: Yager Joel , MacPhee Edward R. , Ritvo Alexis D. , Salamander Rakel M. 
Published: December 2021

Abstract
To address high clinical demand and manage workflow, some university-based practice settings are tending to replace traditional hour-long outpatient appointments with 30-minute psychiatric management visits, which must comply with multiple regulatory requirements for documentation and billing. This care model can significantly shape the culture of psychiatric treatment and education. Based on the limited published literature on this topic and pooled experiences of faculty, residents, and administrators, this article offers observations and raises questions concerning 1) clinical, educational and administrative benefits, limitations, and challenges for conducting 30-minute psychiatric visits in training contexts; 2) how administrative impositions affecting resident and faculty time and attention impact clinical encounters; 3) how various teaching settings manage regulatory requirements differently; and 4) considerations for education needs and opportunities, research gaps, and policy implications. Quality of care and education could be improved by judicious overhaul of administrative requirements to minimize burdens offering little clinical or educational value.
Cost-Effectiveness Analysis Between Sacral Neuromodulation and OnabotulinumtoxinA for the Treatment of Refractory Overactive Bladder in Women: A Systematic Review
Authors: Gerjevic Kristen A. , Ahmad Sophia , Strohbehn Kris , Riblet Natalie 
Published: December 2021

(Abstracted from Female Pelvic Med Reconstr Surg 2021;27:481–487)
Sacral neuromodulation (SNM) and onabotulinumtoxinA (BONT/A) are well-established treatments for refractory overactive bladder (OAB) syndrome. SNM inhibits urination by stimulating the sacral portion of the spinal court, and BONT/A inhibits acetylcholine by causing detrusor muscle paralysis.
Frontline Reporting from the Epicenter of a Global Pandemic: A Survey of the Impact of COVID-19 on Plastic Surgery Training in New York and New Jersey
Authors: Shah Jinesh , Zhao Ruya , Yi Joseph , Otterburn David , Patel Ashit , Szpalski Caroline , Tanna Neil , Taub Peter J. , Weichman Katie E. , Ricci Joseph A. 
Published: December 2021

Background:
Since the first documented case of coronavirus disease of 2019 (COVID-19), the greater New York City area quickly became the epicenter of the global pandemic, with over 500,000 cases and 50,000 deaths. This unprecedented crisis affected all aspects of health care, including plastic surgery residency training. The purpose of this study was to understand the specific impact of the COVID-19 pandemic on plastic surgery residencies.

Methods:
A survey of all plastic surgery residency training programs in the greater New York City area was conducted. The impact to training during the peak months of infection (March and April of 2020) was evaluated using resident education as measured by case numbers, need for redeployment, and staff wellness as primary outcome variables.

Results:
A total of 11 programs were identified in the region, and seven programs completed the survey, with a response rate 63.6 percent. When comparing productivity in March and April of 2019 to March and April of 2020, a total decrease in surgical volume of 64.8 percent (range, 19.7 to 84.8 percent) and an average of 940 (range, 50 to 1287) cancelled clinic visits per month were observed. These decreases directly correlated with the local county’s COVID-19 incidence rates (p = 0.70). A total of 83 percent of programs required redeployment to areas of need, and correlation between local incidence of COVID-19 and the percentage of residents redeployed to non–plastic surgical clinical environments by a given program (ρ = 0.97) was observed.

Conclusion:
As the first COVID-19 wave passes the greater New York area and spreads to the rest of the country, the authors hope their experience will shed light on the effects of the ongoing COVID-19 pandemic, and inform other programs on what to expect and how they can try and prepare for future public health crises.
An Update on the Surgical Management of the Bulbous and Boxy Tip
Authors: Rohrich Rod J. , Avashia Yash J. , Savetsky Ira L. 
Published: December 2021

Summary:
The bulbous and box tips are two common morphologies encountered in rhinoplasty. Nasal tip reshaping is a challenging aspect of rhinoplasty. Understanding the classifications of nasal tip morphologies aids when performing a nasal-facial analysis. The management algorithm for both tip morphologies shares various techniques. These techniques include but are not limited to cephalic trim, transdomal sutures, and interdomal sutures. A graduated approach to managing the variations in bulbous and boxy tips will help in achieving consistent results. New concepts applied to the management include supporting alar rims with alar contour grafts, closing dead space through a series of techniques, and managing the soft-tissue envelope, which is often in excess.