bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is the Whole Greater than the Sum of Its Parts? The Implementation and Outcomes of a Whole Blood Program in Ecuador
Authors: Himmler Amber Nicole , Armijos Monica Eulalia Galarza , Naranjo Jeovanni Reinoso , Patiño Sandra Gioconda Peña , Altamirano Doris Sarmiento , Lazo Nube Flores , Andrade Raúl Pino , Aguilar Hernán Sacoto , de Córdova Lenin Fernández , Agurto Cecibel Cevallos , Raykar Nakul , Puyana Juan Carlos , Molina Juan Carlos Salamea 
Published: January 2021

Abstract
Background: Hemorrhagic shock is a major cause of mortality in low-and-middle-income countries (LMICs). Many institutions in LMICs lack the resources to adequately prescribe balanced resuscitation. This study aims to describe the implementation of a whole blood program in Latin America and to discuss the outcomes of the patients that received whole blood (WB).Methods: We conducted a retrospective review of patients resuscitated with WB from 2013-2019. Five units of O+ WB were made available on a consistent basis for patients presenting in hemorrhagic shock. Variables collected included: gender, age, service treating the patient, units of WB administered, units of components administered, admission vital signs, admission hemoglobin, Shock Index, Revised Trauma Score (RTS) in trauma patients, intraoperative crystalloid (lactated ringers or normal saline) and colloid (5% human albumin) administration, symptoms of transfusion reaction, length-of-stay and in-hospital mortality.Results: The sample includes a total of 101 patients, 57 of whom were trauma and acute care surgery (TACS) patients and 44 of whom were obstetrics and gynecology patients. No patients developed symptoms consistent with a transfusion reaction. Average shock index was 1.16 (±0.55). On average, patients received 1.66 (±0.80) units of whole blood. Overall mortality was 14/101 (13.86%) in the first 24 hours and 6/101 (5.94%) after 24 hours.Conclusion: Implementing a WB protocol is achievable in LMICs. Whole blood allows for more efficient delivery of hemostatic resuscitation and is ideal for resource-restrained settings. To our knowledge, this is the first description of a whole blood program implemented in a civilian hospital in Latin America.
Effects of Age, Gender, Health Status, and Political Party on COVID-19–Related Concerns and Prevention Behaviors: Results of a Large, Longitudinal Cross-sectional Survey
Authors: Naeim Arash , Baxter-King Ryan , Wenger Neil , Stanton Annette L , Sepucha Karen , Vavreck Lynn 
Published: January 2021

Background
With conflicting information about COVID-19, the general public may be uncertain about how to proceed in terms of precautionary behavior and decisions about whether to return to activity.

Objective
The aim of this study is to determine the factors associated with COVID-19–related concerns, precautionary behaviors, and willingness to return to activity.

Methods
National survey data were obtained from the Democracy Fund + UCLA Nationscape Project, an ongoing cross-sectional weekly survey. The sample was provided by Lucid, a web-based market research platform. Three outcomes were evaluated: (1) COVID-19–related concerns, (2) precautionary behaviors, and (3) willingness to return to activity. Key independent variables included age, gender, race or ethnicity, education, household income, political party support, religion, news consumption, number of medication prescriptions, perceived COVID-19 status, and timing of peak COVID-19 infections by state.

Results
The data included 125,508 responses from web-based surveys conducted over 20 consecutive weeks during the COVID-19 pandemic (comprising approximately 6250 adults per week), between March 19 and August 5, 2020, approved by the University of California, Los Angeles (UCLA) Institutional Review Board for analysis. A substantial number of participants were not willing to return to activity even after the restrictions were lifted. Weighted multivariate logistic regressions indicated the following groups had different outcomes (all P<.001): individuals aged ≥65 years (COVID-19–related concerns: OR 2.05, 95% CI 1.93-2.18; precautionary behaviors: OR 2.38, 95% CI 2.02-2.80; return to activity: OR 0.41, 95% CI 0.37-0.46 vs 18-40 years); men (COVID-19–related concerns: OR 0.73, 95% CI 0.70-0.75; precautionary behaviors: OR 0.74, 95% CI 0.67-0.81; return to activity: OR 2.00, 95% CI 1.88-2.12 vs women); taking ≥4 medications (COVID-19–related concerns: OR 1.47, 95% CI 1.40-1.54; precautionary behaviors: OR 1.36, 95% CI 1.20-1.555; return to activity: OR 0.75, 95% CI 0.69-0.81 vs <3 medications); Republicans (COVID-19–related concerns: OR 0.40, 95% CI 0.38-0.42; precautionary behaviors: OR 0.45, 95% CI 0.40-0.50; return to activity: OR 2.22, 95% CI 2.09-2.36 vs Democrats); and adults who reported having COVID-19 (COVID-19–related concerns: OR 1.24, 95% CI 1.12-1.39; precautionary behaviors: OR 0.65, 95% CI 0.52-0.81; return to activity: OR 3.99, 95% CI 3.48-4.58 vs those who did not).

Conclusions
Participants’ age, party affiliation, and perceived COVID-19 status were strongly associated with their COVID-19–related concerns, precautionary behaviors, and willingness to return to activity. Future studies need to develop and test targeted messaging approaches and consider political partisanship to encourage preventative behaviors and willingness to return to activities.
Developing an Adaptive Mobile Intervention to Address Risky Substance Use Among Adolescents and Emerging Adults: Usability Study
Authors: Coughlin Lara N , Nahum-Shani Inbal , Philyaw-Kotov Meredith L , Bonar Erin E , Rabbi Mashfiqui , Klasnja Predrag , Murphy Susan , Walton Maureen A 
Published: January 2021

Background
Substance use among adolescents and emerging adults continues to be an important public health problem associated with morbidity and mortality. Mobile health (mHealth) provides a promising approach to deliver just-in-time adaptive interventions (JITAIs) to prevent escalation of use and substance use–related consequences.

Objective
This pilot study aims to describe the iterative development and initial feasibility and acceptability testing of an mHealth smartphone app, called MiSARA, designed to reduce escalation in substance use.

Methods
We used social media advertisements to recruit youth (n=39; aged 16-24 years, who screened positive for past-month binge drinking or recreational cannabis use) with a waiver of parental consent. Participants used the MiSARA app for 30 days, with feasibility and acceptability data reported at a 1-month follow-up. We present descriptive data regarding behavior changes over time.

Results
The results show that most participants (31/39, 79%) somewhat liked the app at least, with most (29/39, 74%) rating MiSARA as 3 or more stars (out of 5). Almost all participants were comfortable with self-reporting sensitive information within the app (36/39, 92%); however, most participants also desired more interactivity (27/39, 69%). In addition, participants’ substance use declined over time, and those reporting using the app more often reported less substance use at the 1-month follow-up than those who reported using the app less often.

Conclusions
The findings suggest that the MiSARA app is a promising platform for JITAI delivery, with future trials needed to optimize the timing and dose of messages and determine efficacy.
Driving Digital Transformation During a Pandemic: Case Study of Virtual Collaboration in a German Hospital
Authors: Frick Nicholas R J , Möllmann Henriette L , Mirbabaie Milad , Stieglitz Stefan 
Published: January 2021

Background
The COVID-19 pandemic has not only changed the private lives of millions of people but has significantly affected the collaboration of medical specialists throughout health care systems worldwide. Hospitals are making changes to their regular operations to slow the spread of SARS-CoV-2 while ensuring the treatment of emergency patients. These substantial changes affect the typical work setting of clinicians and require the implementation of organizational arrangements.

Objective
In this study, we aim to increase our understanding of how digital transformation drives virtual collaboration among clinicians in hospitals in times of crisis, such as the COVID-19 pandemic.

Methods
We present the lessons learned from an exploratory case study in which we observed the introduction of an information technology (IT) system for enhancing collaboration among clinicians in a German hospital. The results are based on 16 semistructured interviews with physicians from various departments and disciplines; the interviews were generalized to better understand and interpret the meaning of the statements.

Results
Three key lessons and recommendations explain how digital transformation ensures goal-driven collaboration among clinicians. First, we found that implementing a disruptive change requires alignment of the mindsets of the stakeholders. Second, IT-enabled collaboration presupposes behavioral rules that must be followed. Third, transforming antiquated processes demands a suitable technological infrastructure.

Conclusions
Digital transformation is being driven by the COVID-19 pandemic. However, the rapid introduction of IT-enabled collaboration reveals grievances concerning the digital dissemination of medical information along the patient treatment path. To avoid being caught unprepared by future crises, digital transformation must be further driven to ensure collaboration, and the diagnostic and therapeutic process must be opened to disruptive strategies.
Biochemical quality of cowpea beans grown under water-deficit maintained with hydrogel
Authors: Fidelis Rodrigo Ribeiro , Da Silva Guilherme Sousa , Rauber Wagner Augusto , Rodrigues Larissa Urzêdo , Nascimento Vitor L. , Siebeneichler Susana Cristine 
Published: January 2021

Investigations related to the effects of the hydrogel use in a water-deficit conditions on the biochemical composition of the harvested products are scarce. The aim of this study was to verify the influence of hydrogel on the biochemical response of cowpea beans produced under water-deficit in southern Tocantins. The experiment was a randomized complete block design with four replications. The treatments were obtained in a 2x5 factorial scheme, being: two sources of hydrogel (Hydroplan-EB HyC and Polim-Agri PP) and five concentrations (0, 5, 10, 15, and 20kg ha-1). After harvesting, the grains of cowpea, BRS Vinagre cultivar, were ground and chemically analyzed. The oil content of the seeds agreed with the reference values. The use of Polim-Agri PP promoted the best levels of amino acids (0.38mg g-1) and proteins (243.22mg g-1) of the grains. The carbohydrate content of them (Ȳ= 81.44mg g-1) was better using Hydroplan-EB HyC, regardless of the concentration applied. The application of 6.28kg ha-1 of Polim-Agri PP provided the highest starch content (842g mg-1). The use of hydrogel improves the biochemical quality of cowpea beans produced under water deficit in southern Tocantins.
INFLUENCE OF THE SCLERAL LENS AND FLUID RESERVOIR THICKNESSES ON RESIDUAL ASTIGMATISM
Authors: Michaud Langis , Courey Gabriella 
Published: January 2021

PurposeThis study aims to determine if lens or tear fluid reservoir thicknesses (LT/FRT) may influence the presence of residual astigmatism and participant’s visual acuity.
MethodsThe study was a randomized, non-dispensing, prospective study. Empirically and randomly chosen participants were fitted with 4 combinations (350 and 250 um LT fitted with 250 and 350 um FRT) of 16 mm diameter scleral lenses, designed using a corneo-scleral profiler software (sMap 3D, Visionary Optics, US). Lenses haptics were kept spherical for all lenses. They were evaluated under a slit lamp, anterior segement OCT (objective fluid reservoir and lens thicknesses), topography over lenses and aberrometry, after 30 minutes of lens wear. Spherico-cylindrical refraction and logMar acuity were also assessed.
ResultsStudy population was composed of 24 participants aged 24.2 + 4.7 years old. Baseline refractive error was -2.3 + 1.6 D with -0.48 + 0.26 D of astigmatism. In vivo (OCT) lens A was 344.1 ± 15.4 um thick, fitted with a vault of 213.6 ± 42.4 um; Lens B was 346.2 ± 12.5/327.2 ± 44.8; Lens C was 260.3 ± 17.7/214.0 ± 40.6 um and Lens D was 262.2 ±13.2/330.8 ± 52.0 respectively. All lenses were found similarly decentered inferiorly by 0.10 to 0.15 um. BCVA was −0.32 + 0.08 (A), −0.21 + 0.10 (B), −0.28 + 0.08 (C), and −0.14 + 0.10 (D), compared to −0.25 + 0.08 (A), −0.11 + 0.10 (B), −0.23 + 0.06 (C), and −0.05 + 0.12 (D) when sphere only was compensated. Residual refractive astigmatism (RA = -0.50 to -0.75D) is found significantly higher based on the FRT (F=9.560; p=0.037) and not LT(F=0.429; p=0.522). There is no correlation be-tween RA and over-k readings (Lens A r=-0.078, p=0.773; Lens B r=−0.073, p=0.788; Lens C r=−0.345, p=0.171; Lend D r=0.019, p=0.944). Higher order aberrations, mostly vertical coma, were found clinically significant but not statistically different between lenses (A= 0.350 + 0.032; B=0.382 + 0.053, C=0.329 + 0.044 and D=0.385+ 0.062; p=0.776)
ConclusionThis study proves that low level of RA may be found when scleral lenses are fitted on normal corneas. Its occurrence is related to the presence of high-order aberrations and less likely to lens flexure.
Reflux Nephropathy
Authors: Ashoor Isa F. , Somers Michael J.G. 
Published: January 2021

Minimally invasive surgical techniques including robotic-assisted laparoscopic ureteral reimplantation and endoscopic transurethral injection are becoming increasingly prevalent. They are associated with a high success rate, shorter hospital stay, and an excellent safety profile.
This review contains 6 figures, 5 tables, 1 video, and 90 references.
Key words: congenital reflux nephropathy, acquired reflux nephropathy, robotic-assisted laparoscopic ureteral reimplantation, reflux nephropathy, primary vesicoureteral reflux, urinary tract infection
Spine and Spinal Cord Injury
Authors: Arribas Miguel , Cole Michael A. 
Published: January 2021

Spinal injury has the potential to dramatically change a patient’s life. Prompt diagnosis, appropriate supportive medical care, early transfer to a spinal injury center and, if necessary, surgical intervention within 24 hours are essential to optimizing outcomes. Clinical decision rules aid in determining the need for imaging. When needed, non-contrast enhanced CT is the initial imaging test of choice with MRI being used in patients with neurologic findings, significant pathology on CT, and/or high suspicion for injury. CT or MRI with intravenous contrast is preferred in penetrating trauma. Radiographs are of limited utility in evaluating spinal injury in adults. Classification of spinal injury based on appearance on imaging and neurologic exam is important for surgical management decisions. Cervical injury may lead to respiratory distress requiring early intubation. Hypotension is most often a result of hemorrhage from concomitant traumatic injuries to other organ systems. Crystalloid, blood products, atropine and norepinephrine should be used as needed to avoid systolic BP< 90 mm Hg or heart rate< 60 BPM and maintain a MAP of 85-90 mm Hg. Steroid administration within the first 8 hours of significant spinal injury is controversial and the decision to administer steroids should be made through consultation with patient, family and spinal specialist.
The review contains 8 figures, 2 videos, 13 tables, and 59 references.
Keywords: blunt trauma, neurologic assessment, penetrating trauma, spinal anatomy, spinal cord injury, spinal injury, steroid use, vertebrae, vertebral anatomy, vertebral injury
Distraction Osteogenesis in Plastic Surgery
Authors: Zellner Elizabeth G , Steinbacher Derek M 
Published: January 2021

Distraction osteogenesis (DO), the gradual controlled movement of osteotomized bone to create native bone de novo, is a powerful tool in the reconstructive surgeon’s armamentarium. Originally developed by Ilizarov in the early twentieth century in Russia for use on the long bones of the leg, Snyder, McCarth, and other craniofacial pioneers popularized the technique in the well-vascularized bones of the facial skeleton. DO involves making a planned osteotomy perpendicular to the desired vector of skeletal growth and then applying incremental traction across this opening to encourage the growth of new osteogenic matrix. With adequate stabilization, this bony regenerate becomes ossified and remodels into a new bone. Although the original studies used distraction n the mandible, applications can now be found in the maxilla, midface, and cranial vault. Established bony flaps or grafts can also be distracted to allow for more creative solutions. In the past few decades, device technology has rapidly advanced with new simplified external devices and smaller buried internal distraction devices. In the absence of adequate bone stock, distraction offers a unique opportunity to create new bone and shape overlying the soft tissue.

This review contains 7 figures, 2 tables and 69 references
Keywords: Distraction osteogeneis, mandible, craniofacial, craniosynostosis, micrognathia, Robin Sequence, glossoptosis, regenerate, consolidation, distraction device.
Compression Neuropathies
Authors: Theman Todd A. , Azari Kodi 
Published: January 2021

Compression neuropathies result from entrapment at specific anatomic locations. They are a common clinical problem, particularly in the upper extremity, where a patient’s underlying medical conditions can affect the likelihood of symptoms. Early recognition from the clinical history and a detailed examination, including provocative maneuvers, combined with electrodiagnostic testing or imaging modalities is imperative to guide treatment and prevent permanent dysfunction.

This review contains 7 figures, 2 tables, and 45 references.
Keywords: carpal tunnel syndrome, cubital tunnel syndrome, radial tunnel syndrome, ulnar tunnel syndrome, pronator syndrome, anterior interosseous syndrome, entrapment neuropathy, electrodiagnostic studies
Mastopexy
Authors: Arnautovic Aska , Broyles Justin M. 
Published: January 2021

Mastopexy and mastopexy-augmentation are commonly performed surgeries to lift ptotic breasts while improving breast shape and volume. Factors that cause breast ptosis include aging, hormonal changes, and weight loss. Common surgical approaches for mastopexy utilize the periareolar, vertical, and wise techniques. All of these techniques incorporate parenchymal rearrangement in addition to skin envelope resection in order to achieve the patient’s aesthetic goals. A plastic surgeon should carefully select the appropriate mastopexy technique based on a patient’s preoperative grade of ptosis, breast shape/volume, and aesthetic goals. Many of these mastopexy techniques can be combined with implant augmentation, either as a single or two-stage procedure in appropriate patients with volume concerns. Revisions tend to be more common after implant-augmentations and may be necessary based on patient concerns and surgeon discretion.
This review contains 5 figures, 5 tables, and 14 references
Keywords: mastopexy, mastopexy-augmentation, breast lift, breast ptosis, vertical mastopexy, periareolar mastopexy, wise pattern mastopexy, breast surgery
Uroneurology
Authors: Seth Jai H , Panicker Jalesh N. 
Published: January 2021

The function of the pelvic organs, including the lower urinary tract (LUT), is controlled by a complex network of nerves. This leaves patients with neurologic disease vulnerable to LUT and pelvic organ dysfunction. Physicians often come across urogenital complaints in their patients with neurologic disease, the symptoms of which can result in significant distress and loss of dignity and quality of life. Due to the health and economic burden that accompanies neurogenic pelvic organ dysfunction, it is important for clinicians to understand the common forms of dysfunction, essential investigations, and modes of management. This chapter covers bladder dysfunction from a physician’s perspective. Topics include neurologic control of the LUT, large bowel, and sexual functions; male and female sexual response; neurogenic bladder dysfunction and its management; diagnostic evaluation; management of neurogenic sexual dysfunction; management of erectile dysfunction; ejaculatory dysfunction; sexual dysfunction in women; and fecal incontinence. Figures illustrate efferent innervation of the LUT, neurologic detrusor overactivity, a urethral pressure profile in a patient with Fowler syndrome, an example bladder diary, an example bladder scan, and normal and obstructed flow patterns. Tables list common causes of injury at the suprapontine, suprasacral, and infrasacral levels and storage and voiding systems.

This chapter contains 6 highly rendered figures, 2 tables, 53 references, 1 teaching slide set, and 5 MCQs.
Morphometric Study of Suprascapular Notch and Its Variations in Dried Human Scapulae
Authors: Pawar Kamal D. , Chavan Sushama. K. , Joshi Mohini M. 
Published: January 2021

The study was undertaken to see the variation of the suprascapular notch. The notch is present on the superior border of the scapula near the root of coracoid process. It is roofed by the superior transverse ligament and is converted into foramen for the passage of suprascapular nerve. The study was carried out on 121 scapulae in the department of Anatomy RMC Loni, Ahmednagar. The parameters included in the study were presence of notch, shape of notch, transvers length of notch, edge of notch, ossification of transverse ligament and other finding were also noted. The parameters were measured by Vernier calliper and appropriate statistical tests were applied.
The supra-scapular notch was present in 82.64% of scapulae. U Deep shaped notch was most common shape followed by J shallow shaped notch. Round edge at the depth of the notch was more common.
The knowledge of suprascapular notch variations is of great importance for surgeons performing suprascapular nerve decompression especially by means of endoscopic techniques. Our anatomical study helps the clinicians before planning a surgery.
The Second Wave of COVID-19 in Italy: What’s Going On?
Authors: Cornelli Umberto , Belcaro Giovanni , Cesarone Maria Rosaria , Recchia Martino , Cotellese Roberto 
Published: January 2021

Background: a second wave (W2) of COVID-19 is affecting Italy.
Objective: to analyze the ratio between deaths and positive cases in two different 36-day periods of W2.
Methods: data were retrieved by the Official Bulletin of the Italian Protezione Civile. The analysis was based on mobile averages.
Results: The ratios deaths/positive cases in the first 35-day period form October 9th and November 13th were of 2.45 ± 0.482 and in the second 36-day period from November 14th and December 19th was 2.37 ± 0.416. There is no statistical difference between the periods (p> 0.05). The differences are significant (p<0.01) in terms of trends, since in the first period the curve is flat, while in the second is growing.
Conclusions: the reason of the different trends are several, such as the starting of the colder season, the delay in providing with the common flu vaccination. the confusion about the initiative of lockdown, and the poor care for the older people.