bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cystoscopy at the Time of Hysterectomy for Benign Indications and Delayed Lower Genitourinary Tract Injury
Authors: Barber Emma L. , Polan Rosa M. , Strohl Anna E. , Siedhoff Matthew T. , Clarke-Pearson Daniel L. 
Published: April 2019

OBJECTIVE:
To compare the rate of delayed 30-day lower genitourinary tract injury in women who underwent cystoscopy at the time of hysterectomy for benign indications to those who did not.

METHODS:
This was a retrospective cohort study of patients who underwent hysterectomy without a concomitant procedure for prolapse or incontinence for benign pathology with a general obstetrician–gynecologist (ob-gyn) recorded in the National Surgical Quality Improvement Program targeted hysterectomy file between 2015 and 2017. The primary outcome was a delayed lower genitourinary tract injury in the 30 days after hysterectomy. Secondary outcomes included urinary tract infection and operative time. The exposure of interest was cystoscopy at the time of hysterectomy. Stratified analysis was performed by route of surgery. Bivariable tests were used to examine associations.

RESULTS:
We identified 39,529 women who underwent hysterectomy for benign indications with a general ob-gyn. Surgical approach was open (26%), laparoscopic or robotic assisted laparoscopic (46%), and vaginal or vaginally assisted (28%). Overall, 25% of women underwent cystoscopy at the time of hysterectomy; cystoscopy was more commonly performed in laparoscopic or robotic (32%) and vaginal hysterectomy (25%) as compared with open hysterectomy (11%) (P<.001). There was no difference in delayed lower genitourinary tract injury between patients who underwent cystoscopy at time of hysterectomy compared with those who did not undergo cystoscopy (0.27% vs 0.24%, P=.64). Patients who underwent cystoscopy were more likely to be diagnosed with a urinary tract infection (2.6% vs 2.0%, RR 1.27 95% CI 1.09–1.47). Median operative time was increased by 17 minutes in cases where cystoscopy was performed (132 vs 115 minutes, P<.001).

CONCLUSION:
Cystoscopy at the time of hysterectomy for benign indications does not result in a lower rate of 30-day delayed lower genitourinary tract injury compared with no cystoscopy.
Reading Level of Online Patient Education Materials From Major Obstetrics and Gynecology Societies
Authors: Fahimuddin Fatimah Z. , Sidhu Sanam , Agrawal Anubhav 
Published: April 2019

OBJECTIVE:
To assess whether the readability of online patient education materials provided by eight nationally recognized obstetrics and gynecology societies is in accordance with the recommended 6th-grade reading level outlined by the American Medical Association, National Institute of Health, and United States Department of Health and Human Services.

METHODS:
An analysis of 410 online patient education materials from the American Association of Gynecologic Laparoscopists, the American College of Obstetricians and Gynecologists, the American Society for Reproductive Medicine, the American Urogynecologic Society, the Association of Reproductive Health Professionals, the Society of Gynecologic Oncology, the Society for Maternal-Fetal Medicine, and Voices for Pelvic Floor Disorders was completed, and the readability scores using the Flesch-Kincaid Grade Level, Flesch Reading Ease, Gunning Fog Scale, and Simple Measure of Gobbledygook readability scales were calculated. These scales are used to assess print and web-based written material across a wide range of medical specialties and are endorsed by the National Institutes of Health. All four scales are computer-based assessments of readability that consider word count, number of syllables, and length of sentences when calculating a score that corresponds to grade level.

RESULTS:
Majority of the patient education materials across all eight obstetrics and gynecology societies had readability scores above the recommended 6th-grade reading level. The average reading level for the 69 obstetrics-related articles ranged from 9th to 12th grade. The mean grade level for the 341 gynecology articles had a similar range across the four readability scales.

CONCLUSION:
Online patient education materials provided by major obstetrics and gynecology societies do not currently adhere to recommended readability guidelines. Continued efforts to provide accessible and informative patient education materials is recommended to help improve health literacy for women.
Herbal Medicinal Product Use During Pregnancy and the Postnatal Period
Authors: Muñoz Balbontín Yolanda , Stewart Derek , Shetty Ashalatha , Fitton Catherine A. , McLay James S. 
Published: April 2019

OBJECTIVE:To report the incidence and nature of herbal medicinal products' adverse events and herb–drug interactions used by some pregnant and postnatal women.DATA SOURCES:The Allied and Complementary Medicine Database, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, the Cochrane Library, MEDLINE, Scopus, Web of Science, and ClinicalTrials.gov were searched from inception until August 2018.METHODS OF STUDY SELECTION:Any studies reporting adverse events, herb–drug interactions or absence thereof associated with herbal medicinal products used during pregnancy or the postnatal period were included. Conference abstracts, pilot studies, and nonhuman studies were excluded. All included studies were critically appraised by two independent reviewers.TABULATION, INTEGRATION AND RESULTS:Database searches retrieved 3,487 citations. After duplicate removal and review of titles, abstracts, and full-text, 115 articles were critically appraised. After excluding irrelevant and low-quality articles, 74 articles were included for data extraction and synthesis. Adverse drug reactions, congenital malformations, fetal growth retardation or herb–drug interactions were the primary study objective reported by 19 of the 74 included studies, 16 cohort studies, one cross-sectional survey, and two randomized controlled trials. A total of 47 herbal medicinal products and 1,067,071 women were included in this review. Use of almond oil was associated with preterm birth (odds ratio 2.09, 95% CI 1.07–4.08), oral raspberry leaf was associated with cesarean delivery (adjusted odds ratio [AOR] 3.47, 95% CI 1.45–8.28); heavy licorice use was associated with early preterm birth by 3.07-fold (95% CI 1.17–8.05). African herbal medicine mwanaphepo was associated with maternal morbidity (AOR 1.28; 95% CI 1.09–1.50), and neonatal death or morbidity. Fourteen studies reported absence of adverse events. Four studies reported herb–drug interactions, but none studied adverse events arising from them.CONCLUSION:The use of herbal medicinal products during pregnancy and the postnatal period should be discouraged until robust evidence of safety is available.SYSTEMATIC REVIEW REGISTRATION:PROSPERO, CRD42017081058.
Robotic Sacrocolpopexy Simulation Model and Associated Hierarchical Task Analysis
Authors: Myers Erinn M. , Anderson-Montoya Brittany L. , Fasano Heather T. , Vilasagar Smitha , Tarr Megan E. 
Published: April 2019

BACKGROUND:
There are limited robotic dry lab training resources that include presacral dissection with vaginal and sacral mesh attachment for robotic sacrocolpopexy. Our objective was to create a simulation model to resemble the anatomy encountered during robotic sacrocolpopexy. Additionally, we sought to outline the steps required to complete a robotic sacrocolpopexy by performing a hierarchical task analysis. With the results of the hierarchical task analysis, we assessed the model's ability to provide an adequate platform for completion of robotic sacrocolpopexy procedural steps.

METHOD:
This observational simulation study was divided into two phases. Phase 1 included model development. Phase 2 involved development of the hierarchical task analysis and assessment of the model.

EXPERIENCE:
After model creation, six experts each performed a robotic sacrocolpopexy using the model. Overall, experts agreed that the model replicated opening the peritoneum, presacral dissection, suturing on the anterior and posterior vagina, and presacral mesh attachment.

CONCLUSION:
We demonstrate construction and use of a robotic sacrocolpopexy simulation model to aid surgeons in training. Further, the hierarchical task analysis provides a method to assess the model's ability to replicate each step of robotic sacrocolpopexy.
Sexual Minority Women's Experiences With Sexual Identity Disclosure in Contraceptive Care
Authors: Greene Madelyne Z. , Carpenter Emma , Hendrick C. Emily , Haider Sadia , Everett Bethany G. , Higgins Jenny A. 
Published: April 2019

OBJECTIVE:
To describe a group of young sexual minority women's experiences with and preferences for sexual identity disclosure in the context of contraceptive care.

METHODS:
In Chicago, Illinois, Salt Lake City, Utah, and Madison, Wisconsin, investigators conducted five focus groups (n=22) and 11 interviews with women aged 20–30 years who identified as something other than heterosexual. Focus groups explored social norms regarding contraceptive care; interviews documented individual experiences with contraceptive care. Using a qualitative descriptive approach and combined deductive and inductive content analysis, investigators coded transcripts for themes related to disclosing sexual orientation to contraceptive providers.

RESULTS:
Participants described the process of sexual identity disclosure in contraceptive care in three stages: 1) listening for whether, when, and how health care providers asked about sexual orientation, 2) deciding whether or not to disclose sexual identity to providers, and 3) evaluating responses from providers after disclosure. Participants wanted providers to: avoid assumptions and ask about both sexual identity and sexual behaviors, signal their openness and competence around the health of sexual minority women during contraceptive encounters, and focus discussions on the individual patient's priorities and needs for contraceptive care.

CONCLUSION:
Decisions made by sexual minority women about sexual identity disclosure in contraceptive contexts are influenced by previous and current interactions with health care providers. Contraceptive providers should ask all patients about sexual identity and sexual behavior, avoid assumptions about use of and need for contraception, and acknowledge the prevalence of marginalization, discrimination, and stigma experienced by sexual minority women and their communities in health care contexts.
Uterine Rupture at Term in a Patient With Abdominal Cerclage
Authors: Dandapani Monica , Pflugner Lindsey P. , Fanning Nicole S. 
Published: April 2019

BACKGROUND:
When labor ensues in the setting of transabdominal cerclage, uterine rupture is a potential complication associated with significant morbidity and mortality for both mother and fetus.

CASE:
A woman with a transabdominal cerclage presented at 39 2/7 weeks of gestation with contractions, tachycardia, abdominal pain, and fetal bradycardia. Emergent cesarean delivery revealed a ruptured uterus with fetus and placenta floating in the abdomen. Neonatal Apgar scores were 2, 2, and 5 at 1, 5, and 10 minutes of life respectively, with cord pH less than 6.8. After transfusion for the mother and rehabilitation for the neonate, both made a good recovery.

CONCLUSION:
Uterine rupture can be catastrophic, and prevention is paramount. In addition to individualized delivery planning, women with transabdominal cerclage in place should be counseled to present to the hospital immediately in the presence of contractions to prevent poor outcomes.
Accuracy of Three Screening Tools for Prenatal Substance Use
Authors: Coleman-Cowger Victoria H. , Oga Emmanuel A. , Peters Erica N. , Trocin Kathleen E. , Koszowski Bartosz , Mark Katrina 
Published: April 2019

OBJECTIVE:
To compare and evaluate the accuracy of three screening tools in identifying illicit drug use and prescription drug misuse among a diverse sample of pregnant women.

METHODS:
This prospective cross-sectional study enrolled a consecutive sample of 500 pregnant women, stratified by trimester, receiving care in two prenatal clinical settings in Baltimore, Maryland, from January 2017 to January 2018. All participants were administered three index tests: 4P's Plus, NIDA Quick Screen-ASSIST (Modified Alcohol, Smoking and Substance Involvement Screening Test), and the SURP-P (Substance Use Risk Profile-Pregnancy) scale, and administered reference tests (urine and hair drug testing) at the in-person baseline visit. To assess test–retest reliability of the index tests, screening tool administrations were repeated 1 week later by telephone. For each screening tool, sensitivity, specificity, positive predictive value, negative predictive value and test–retest reliability were computed. Results were stratified by age, race, and trimester of pregnancy.

RESULTS:
Of the 500 enrolled pregnant women, 494 completed the index screening tools, 497 completed reference testing, and 453 underwent test–retest analysis. For the 4P's Plus, sensitivity=90.2% (84.5, 93.8), and specificity=29.6% (24.4, 35.2). For the NIDA Quick Screen-ASSIST, sensitivity=79.7% (71.2, 84.2), and specificity=82.8% (78.1, 87.1). For the SURP-P, sensitivity=92.4% (87.6, 95.8) and specificity=21.8% (17.4, 27.2). Test–retest reliability (phi correlation coefficients) was 0.84, 0.77, and 0.79 for the 4P's Plus, NIDA Quick Screen-ASSIST and the SURP-P, respectively. For all screening tools, there were differences in validity indices by age and race, but no differences by trimester.

CONCLUSION:
The SURP-P and 4P's Plus had high sensitivity and negative predictive values, making them more ideal screening tests than the NIDA Quick Screen-ASSIST. A clear recommendation for a clinically useful screening tool for prenatal substance use is crucial to allow for prompt and appropriate follow-up and intervention.
Midterm and Long-term Follow-up After Surgical Reconstruction for Lateral Polydactyly of the Foot With Mosaic-like Alignment of the Phalanx Bones
Authors: Iba Kousuke , Ozasa Yasuhiro , Hanaka Megumi , Hayakawa Hikaru , Kanaya Kohei , Yamashita Toshihiko 
Published: April 2019

Background:
The phalanx bones in several cases of lateral polydactyly of foot revealed complicated alignment with radiographic findings revealing medial-protrusion and lateral deviation of the middle phalanx. We previously defined such cases as showing “mosaic-like alignment” and demonstrated favorable postoperative outcomes using our surgical procedure. The aim of this study was to evaluate the midterm and long-term postoperative outcomes in such cases.

Methods:
The study included 17 feet from 16 patients; 5 male and 11 female, with one bilateral case. The radiographic findings in all cases revealed a mosaic-like alignment of phalanges. Average age of the patients at the initial surgery was 12 months and average duration of post-operative follow-up was 89 months (60 to 132 mo). The surgical procedures were focused on the alignment between the distal and proximal phalanges independent of the middle phalanx alignment. Ligamentous joint stability was restored using collateral ligament reconstruction. We retrospectively evaluated post-operative outcomes, and subjective evaluation by the patients and parents was carried out.

Results:
No cases revealed either varus or valgus deformities, pigmentation of the grafted skin, or functional disturbance. As for postoperative complications, we observed visible thickening in 7 toes, 3 of which further underwent partial resection of the middle phalanx. Subjective evaluation of the postoperative results by the patients and parents was “very satisfied” or “satisfied” in 15 of 16 cases.

Conclusion:
On the basis of our midterm to long-term postoperative outcomes, we believe that our method of surgical reconstruction provides a new option for the treatment of lateral polydactyly of the foot with mosaic-like alignment of the phalanx bones.

Level of Evidence:
Level IV—therapeutic studies.
Assessing the Quality of Evidence Presented at Annual General Meetings: A 5-Year Retrospective Study
Authors: Zamir Nasim , Gholami Arian , Jajarmi Yasmin , Jackson Chornenki Nicholas L. , Patel Ameen , Dore Kelly L. 
Published: April 2019

Introduction:
Health care professionals rely on annual general meetings (AGMs) to obtain up-to-date information and practice guidelines relevant to their specialty. The majority of such information at meetings is presented through abstract sessions. However, the quality of the evidence presented during such abstract sessions is unclear. Standardized measures were applied to assess the quality of evidence of abstracts presented at the Canadian Society of Nephrology AGM over a 5-year period.

Methods:
Two authors independently reviewed all CSN AGM abstracts presented from 2012 to 2016. Using a schema published in 2011 by the Oxford Centre for Evidence-Based Medicine (OCEBM), each abstract was subsequently ranked based on the quality of evidence. Schema categories ranged from level I, representing the highest evidence quality, to level V, representing the lowest. The number of authors and the authors' institution affiliations were also collected from the abstracts, where available, or if affiliations were unclear, an internet search of the author was performed.

Results:
Six hundred forty-two articles were screened. In total, 70% (n = 450) met the inclusion criteria. When assessed, 15% of articles were level I (highest quality), 17% level II, 53% level III, 12% level IV, and 3% level V (lowest quality). A Jonckheere–Terpstra test demonstrated a significant trend of increasing quality of evidence (P < .05) and collaboration (P < .005) over the 5-year study period. There was a significant correlation between level of evidence and collaboration across years reviewed in the study, rs(98) = −0.226, P < .001.

Discussion:
The results indicate a consistent increase in quality of evidence and collaborative submissions over time. To the authors' knowledge, this is the first assessment and analysis of AGM presentation quality within internal medicine and its subspecialties. Documenting and monitoring changes in the quality of evidence with a standardized framework may offer valuable insight pertaining to the medical field and the research community.
Ectopic Ocular Surface Calcification in Patients With Hypophosphatasia Treated With Asfotase Alfa
Authors: Gospe Sidney M. , Santiago-Turla Cecilia , DeArmey Stephanie M. , Cummings Thomas J. , Kishnani Priya S. , Bhatti M. Tariq 
Published: April 2019

Purpose:
To assess for ectopic ocular calcification in a series of patients with hypophosphatasia (HPP) treated with asfotase alfa, a recombinant tissue-nonspecific alkaline phosphatase.

Methods:
This is a retrospective analysis of subjects enrolled at Duke University Medical Center in ENB-009-10 (ClinicalTrials.gov: NCT01163149), a randomized controlled trial of asfotase alfa in adolescents and adults with HPP. Seven patients between the ages of 45 and 66 years diagnosed with HPP based on clinical features and low serum alkaline phosphatase levels were enrolled at our site. Subjects were randomized to receive either daily subcutaneous injections of asfotase alfa or no treatment. After 24 weeks, during the open-label extension phase, all subjects received treatment for at least 4 years. All subjects underwent comprehensive eye examinations at baseline and at 24-week intervals throughout the study to assess for development of ocular calcifications.

Results:
By week 120, all 7 subjects developed asymptomatic white refractile deposits in the interpalpebral perilimbal conjunctiva. Biopsy of the conjunctival lesions in 2 subjects revealed elastosis with subepithelial calcification. The lesions were nonprogressive and in 5 subjects exhibited some degree of regression.

Conclusions:
Asfotase alfa was invariably associated with development of mild focal conjunctival calcification, likely through disinhibition of hydroxyapatite crystal propagation. The calcifications were not symptomatic or vision-threatening and should not preclude enzyme replacement therapy for patients with this rare and often debilitating disease.
Outcomes of Corneal Transplantation Using Donor Corneas Retrieved From Snakebite Victims
Authors: Donthineni Pragnya Rao , Chaurasia Sunita , Garg Prashant 
Published: April 2019

Purpose:
To report the outcomes of corneal transplantation using donor corneas retrieved from snakebite victims.

Methods:
This study was a retrospective analysis of 30 corneal transplants performed from 2014 to 2016 using donor corneas retrieved from snakebite victims. The details of the donor corneal characteristics and the transplant recipients were collected from the eye bank and the medical records department.

Results:
The mean age of the donors was 30.4 ± 17.5 years. The median death-to-preservation time was 3.3 hours [interquartile range: 1.3–5.6 hours]. Ninety percent (27/30) of the corneas were evaluated as optical grade, and 10% (3/30) of the corneas were deemed as therapeutic grade. The mean endothelial cell density on specular microscopy of the donor corneas was 2943 ± 615 cells/mm2, and median corneal thickness was 514 μm (interquartile range: 506–520). Seventy-five percent of the corneas transplanted had cleared, with a mean follow-up duration of 1.5 ± 1.0 years (range: 0.4–3.7) years and mean logarithm of the minimum angle of resolution (LogMAR) visual acuity of 0.51 ± 0.27 (range: 0–1.2) at the last follow-up.

Conclusions:
The donor corneas retrieved from snakebite victims are apparently safe and suitable for transplantation, and screening for such donor corneas should include a thorough examination of ocular adnexa to rule out local envenomation before corneal retrieval in addition to the routine evaluation protocol.
Three-Year Outcome Comparison Between Femtosecond Laser-Assisted and Manual Descemet Membrane Endothelial Keratoplasty
Authors: Sorkin Nir , Mednick Zale , Einan-Lifshitz Adi , Trinh Tanya , Santaella Gisella , Telli Alexandre , Chan Clara C. , Rootman David S. 
Published: April 2019

Purpose:
To evaluate 3-year outcomes of femtosecond laser-assisted Descemet membrane endothelial keratoplasty (F-DMEK) compared with manual Descemet membrane endothelial keratoplasty (M-DMEK) in patients with Fuchs endothelial corneal dystrophy (FECD).

Methods:
A retrospective, interventional study, including eyes with FECD and cataract that underwent either F-DMEK or M-DMEK combined with cataract extraction at either the Toronto Western Hospital or Kensington Eye Institute, and that had at least 18 months' follow-up was conducted. Exclusion criteria: complicated anterior segments, previous vitrectomy, previous keratoplasty, corneal opacity, or any other visually significant ocular comorbidity.

Results:
Included were 16 eyes of 15 patients in the F-DMEK group (average follow-up 33.0 ± 9.0 months) and 45 eyes of 40 patients in the M-DMEK group (average follow-up 32.0 ± 7.0 months). There were no issues with the creation of femtosecond descemetorhexis (in the F-DMEK group)—all descemetorhexis cuts were complete. Best spectacle-corrected visual acuity improvement did not differ significantly between the groups at 1, 2, and 3 years (P = 0.849, P = 0.465 and P = 0.936, respectively). Rates of significant detachment in F-DMEK and M-DMEK were 1 of 16 eyes (6.25%) and 16 of 45 eyes (35.6%) (P = 0.027). Rebubbling rates were 1 of 16 eyes (6.25%) and 15 of 45 eyes (33.3%) (P = 0.047). Cell-loss rates following F-DMEK and M-DMEK were 26.8% and 36.5% at 1 year (P = 0.042), 30.5% and 42.3% at 2 years (P = 0.008), 37% and 47.5% at 3 years (P = 0.057), respectively. Graft failure rate was 0% in F-DMEK and 8.9% in M-DMEK (all were primary failures; P = 0.565).

Conclusions:
F-DMEK showed good efficacy with reduced detachment, rebubble, and cell-loss rates, compared with M-DMEK.