bluuebunny/crossref_metadata_2025_split huggingface dataset:
Provision of Moderately and Highly Effective Reversible Contraception to Insured Women With Intellectual and Developmental Disabilities
Authors: Wu Justine , Zhang Jianying , Mitra Monika , Parish Susan L. , Minama Reddy Geeth Kavya 
Published: August 2018

OBJECTIVE:
To estimate provision of moderately and highly effective reversible contraceptives to women with intellectual and developmental disabilities.

METHODS:
We used data from the Massachusetts All-Payer Claims Database to identify women aged 15–44 years with and without intellectual and developmental disabilities who were continuously enrolled in a private commercial insurance plan, Medicaid, or Medicare in 2012. We calculated the percentage of women aged 15–44 years who were not medically or surgically sterile and were provided 1) highly effective, long-acting reversible contraception (LARC, the intrauterine device or subdermal implant); or 2) prescriptions for moderately effective methods (pill, patch, ring, shot, or diaphragm). Logistic regression models estimated the odds of LARC and moderately effective method provision by disability status, adjusted for age, income, and Medicaid receipt.

RESULTS:
Among 915,561 women who were not medically or surgically sterile, 13,059 women (1.4%) had at least one intellectual and developmental disability. Women with intellectual and developmental disabilities were less likely to be provided LARC (2.1% vs 4.2%, P<.001, adjusted odds ratio [OR] 0.43, 95% CI 0.38–0.48, P<.001) and moderately effective methods (21.1% vs 29.9%, P<.001, adjusted OR 0.68, 95% CI 0.65–0.71, P<.001) than women without intellectual and developmental disabilities. The one exception was the progestin shot, which was provided more often to women with intellectual and developmental disabilities than women without these disabilities (14.7% vs 4.3%, P<.001). Among a subset of women who only received moderately effective methods or LARC (n=310,344), women with intellectual and developmental disability had lower odds of receiving LARC than moderately effective methods (adjusted OR 0.59, 95% CI 0.52–0.67).

CONCLUSION:
The study findings raise concerns that the provision of LARC and moderately effective methods differs based on the presence of intellectual and developmental disabilities. Greater understanding is needed regarding factors that underlie lower provision of LARC in comparison with moderately effective methods, especially the progestin shot, among women with intellectual and developmental disabilities.
An Original Suprapannicular Incision Technique for Cesarean Delivery in the Morbidly Obese Parturient
Authors: Lakhi Nisha A. , Williamson Katherine , Moretti Michael L. 
Published: August 2018

BACKGROUND:
Obese patients are at an increased risk of cesarean delivery and its associated wound complications. We present an alternative incision technique for obese parturients that avoids making a Pfannenstiel incision under the panniculus while still providing access to the lower uterine segment.

TECHNIQUE:
For our technique, an assistant uses Allis clamps to exert caudal traction on the patient's panniculus and a transverse skin incision is made under the umbilicus, 3 cm below the line joining the anterosuperior iliac crests. On entry to the abdominal cavity, a wound retractor is placed to optimize access to the lower uterine segment so that a low transverse uterine incision can be made.

EXPERIENCE:
We have used this incision technique on 17 obese patients with no incidence of intraoperative complications, no requirement to perform a vertical hysterotomy incision, and no postoperative wound infections.

CONCLUSION:
Our technique is a feasible alternative incision for obese parturients that avoids making a subpannicular Pfannenstiel incision and still allows for good access to the lower uterine segment.
Risk of Cervical Intraepithelial Neoplasia 2 or Worse by Cytology, Human Papillomavirus 16/18, and Colposcopy Impression
Authors: Silver Michelle I. , Andrews Jeff , Cooper Charles K. , Gage Julia C. , Gold Michael A. , Khan Michelle J. , Massad L. Stewart , Parvu Valentin , Perkins Rebecca B. , Schiffman Mark , Smith Katie M. , Wentzensen Nicolas 
Published: August 2018

OBJECTIVE:
To calculate pooled risk estimates for combinations of cytology result, human papillomavirus (HPV) 16/18 genotype and colposcopy impression to provide a basis for risk-stratified colposcopy and biopsy practice.

DATA SOURCE:
A PubMed search was conducted on June 1, 2016, and a ClinicalTrials.gov search was conducted on June 9, 2018, using key words such as “uterine cervical neoplasms,” “cervical cancer,” “mass screening,” “early detection of cancer,” and “colposcopy.”

METHODS OF STUDY SELECTION:
Eligible studies must have included colposcopic impression and either cytology results or HPV 16/18 partial genotype results as well as a histologic biopsy diagnosis from adult women. Manuscripts were reviewed for the following: cytology, HPV status, and colposcopy impression as well as age, number of women, and number of cervical intraepithelial neoplasia (CIN) 2, CIN 3, and cancer cases. Strata were defined by the various combinations of cytology, genotype, and colposcopic impression.

TABULATION, INTEGRATION, AND RESULTS:
Of 340 abstracts identified, nine were eligible for inclusion. Data were also obtained from three unpublished studies, two of which have since been published. We calculated the risk of CIN 2 or worse and CIN 3 or worse based on cytology, colposcopy, and HPV 16/18 test results. We found similar risk patterns across studies in the lowest risk groups such that risk estimates were similar despite different referral populations and study designs. Women with a normal colposcopy impression (no acetowhitening), less than high-grade squamous intraepithelial lesion cytology, and HPV 16/18-negative were at low risk of prevalent precancer. Women with at least two of the following: high-grade squamous intraepithelial lesion cytology, HPV16- or HPV18-positive, and high-grade colposcopic impression were at highest risk of prevalent precancer.

CONCLUSION:
Our results support a risk-based approach to colposcopy and biopsy with modifications of practice at the lowest and highest risk levels.
Anterior Subcutaneous Internal Pelvic Fixation/INFIX: A Systemic Review
Authors: Vaidya Rahul , Woodbury Derrek , Nasr Kerrelos 
Published: August 2018

Introduction:
The purpose of this article is to review the available literature on anterior subcutaneous internal pelvic fixation (ASIPF) to identify indications, clinical and radiographic outcomes, and compare these with alternative fixation methods.

Methods:
Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, a systematic search on PubMed and Google Scholar was performed. Articles included were in the English language or English translations and published between 2007 and 2018. Studies included were appraised with narrative data synthesis.

Results:
Twenty-five articles with 496 patients were included. These included 17 case series, with 3 case reports reporting adverse events.

Conclusions:
ASIPF and the appropriate posterior fixation resulted in healing of pelvic ring injuries in 99.5% of cases. Indications include unstable pelvic ring injuries with the appropriate posterior fixation. Radiographic parameters and outcome measures were infrequently reported. ASIPF is a valuable tool for reduction and fixation in unstable pelvic ring injuries. Complications include lateral femoral cutaneous nerve irritation (26.3%); heterotopic ossification (36%); infection (3%); and femoral nerve palsy (1%), which is likely related to placing the bar and screws too deep.
Sleep Disturbance in Orthopaedic Trauma Patients
Authors: Swann Matthew C. , Batty Miles , Hu Gene , Mitchell Thomas , Box Hayden , Starr Adam 
Published: August 2018

Objective:
To evaluate the prevalence and severity of sleep disturbance experienced by patients who have sustained a traumatic orthopaedic injury, how sleep disturbance affects the patient's perceived health quality, and identify factors associated with sleep disturbance.

Design:
Cross-sectional cohort study.

Setting:
Urban Level I trauma center.

Patients/Participants:
Three hundred thirty-five nonconsecutive patients who presented to clinic at various stages of treatment for their traumatic orthopaedic injuries.

Main Outcome Measurements:
Pittsburgh sleep quality index (PSQI) and 36-item short form-36 (SF-36) survey questionnaires; injury severity score (ISS).

Results:
The average PSQI score was 10.3 (±4.8). Two hundred eighty-eight (86.0%) patients had a PSQI score ≥5, indicating the presence of sleep disturbance. The PSQI score was ≥10 in 183 (54.6%) patients, which is sleep disturbance similar to the level seen in clinical depression. Patients reported an average sleep latency of 38.9 (±37.5) minutes, with a total nightly sleep time of 6.3 (±1.9) hours. Univariate statistical analysis demonstrated that age, time since injury, and all components of the SF-36 were significantly associated with increased PSQI scores. When these variables were assessed with multivariate analysis to control for confounding variables, the bodily pain, vitality, and mental health components of the SF-36 remained independently associated with PSQI (P ≤ 0.001, 0.002, and 0.001, respectively). ISS measurements at the time of presentation were not associated with PSQI scores.

Conclusions:
Our findings suggest that sleep disturbance is both highly prevalent (86% PSQI ≥5) and severe (54.6% PSQI ≥10) in patients recovering from a traumatic orthopaedic injury. The bodily pain, vitality, and mental health components of the SF-36 were independently associated with worse sleep quality. The average orthopaedic trauma patient presents with a sleep score similar to that seen in clinical sleep disorders and clinical depression. Interestingly, in our study, the severity of the overall injury burden as measured by ISS and time since injury were not independently associated with the severity of sleep disturbance, as one might expect.

Level of Evidence:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Biomechanical Assessment of Locking Plate Fixation of Comminuted Proximal Olecranon Fractures
Authors: Fantry Amanda , Sobel Andrew , Capito Nicholas , Hodax Jonathan D. , Pidgeon Tyler , Koruprolu Sarath , Rich Ryan , Fava Joseph L. , Green Andrew , Paxton Scott 
Published: August 2018

Objectives:
To determine if mean ultimate strength or failure mechanism differed between comminuted olecranon fractures created at the proximal 25% or 50% of the trochlear notch and fixed with precontoured posterior locking plates (PLPs).

Methods:
Comminuted osteotomies were created in 10 matched pairs of cadaveric upper extremities at either the proximal 25% or 50% of the trochlear notch after quantitative computed tomography scans were performed to evaluate bone mineral density. Variable-angle olecranon PLPs were fixed to the specimens. The triceps tendon of each specimen was loaded cyclically and then to failure. Comparison of mean force at failure (displacement >2 mm) was performed using the 2-tailed t test.

Results:
There were no significant differences in specimen bone mineral density within matched pairs. Nineteen specimens failed by olecranon bisection fracture in the sagittal plane. Specimens in the 25% osteotomy group failed at lower ultimate forces of 808 N (SD ± 474 N) versus 1058 N (SD ± 480 N) in the 50% osteotomy group (P = 0.044).

Conclusions:
The ultimate strength of comminuted olecranon fracture fixation with a PLP decreases significantly if the fracture is proximal to the midpoint of the trochlear notch. Fractures proximal to the midpoint of the trochlear notch may benefit from supplemental fixation or suture augmentation to prevent failure, particularly at force ranges higher than those experienced during active elbow range of motion.
Atypical Histiocytic Lesion Preceding a Peripheral T-Cell Lymphoma Involving the Skin Exhibiting the Same Molecular Alterations
Authors: Machan Salma , Córdoba Raúl , Carvajal Nerea , Requena Luis , Piris Miguel Ángel , Facchetti Fabio , Rodríguez-Pinilla Socorro María 
Published: August 2018

Abstract:
Peripheral T-cell lymphoma (PTCL), not otherwise specified (NOS) is a diagnosis of exclusion, showing extreme cytological and phenotypic heterogeneity. Skin involvement of PTCL may be primary or secondary. Diagnosis of histiocytosis may be difficult, requiring clinical–pathological correlation. We describe a laryngeal atypical histiocytic lesion (AHL) and a nasal PTCL, NOS with cutaneous involvement in the same patient presenting with peculiar histopathologic and immunophenotypic features. The laryngeal neoplasm showed morphological and immunophenotypic evidence of histiocytic differentiation and does not fit any other category of the WHO classification nor the revised classification of histiocytosis. The nasal and cutaneous lesions presented features close to natural killer/T-cell lymphoma and gamma–delta T-cell lymphoma but did not meet accurately the WHO criteria. A somatic activating Q61K mutation was found on exon 3 of the NRAS gene in both AHL and PTCL, NOS. The mutation on NRAS gene in both AHL and PTCL, NOS may suggest a common origin from a precursor cell.
Simple LC-MS/MS Methods Using Core–Shell Octadecylsilyl Microparticulate for the Quantitation of Total and Free Daptomycin in Human Plasma
Authors: Miyadera Yukari , Naito Takafumi , Yamada Takahiro , Kawakami Junichi 
Published: August 2018

Background:
Daptomycin, a cyclic lipopeptide antibiotic, displays high plasma protein binding. This study developed the simple method of liquid chromatographic separation using a core–shell octadecylsilyl microparticulate coupled to tandem mass spectrometry for the quantitation of total and free daptomycin in human plasma.

Methods:
Free daptomycin in plasma was obtained by centrifugal ultrafiltration. Deproteinized plasma specimens were directly separated using a core–shell octadecylsilyl microparticulate with isocratic elution. The mass spectrometer was run in positive-ion electrospray ionization mode. This method was applied to the quantitation of plasma samples in patients treated with intravenous daptomycin.

Results:
Daptomycin and diazepam as an internal standard were eluted with a total run time of 10 minutes. The calibration curves of total and free daptomycin in human plasma were linear over the concentration ranges of 1–100 and 0.1–10 mcg/mL, respectively. The lower limits of quantitation of the total and free daptomycin in human plasma were 1.0 and 0.1 mcg/mL, respectively. Their extraction recovery rates in nonfiltrated and ultrafiltrated plasma samples were 106.1% and 98.2%, respectively. Total and free daptomycin did not exhibit any matrix effects in human plasma. The intraday and interday accuracies and imprecisions of total daptomycin were 88.7%–106.0% and 98.7%–105.9%, and within 4.1% and 10.4%, whereas those of free daptomycin were 86.8%–101.6% and 103.0%–107.8%, and within 14.6% and 14.6%, respectively. The plasma concentration ranges of total and free daptomycin in 15 infected patients were 3.01–34.1 and 0.39–3.64 mcg/mL, respectively. The plasma protein binding rate of daptomycin ranged from 80.8% to 94.9%.

Conclusions:
The present simple method with an acceptable analytical performance can be helpful for monitoring the pharmacokinetics of daptomycin in infected patients observed in clinical settings.
Volume Retention, Metabolism, and Cellular Composition of Human Fat Xenografts
Authors: Merrifield Brittany A. , Chang Anthony , Hostetter Galen , Komorowska-Timek Ewa 
Published: August 2018

Background:
To optimize the take of transferred fat, better understanding of fat graft morphology and growth properties in vivo is critical. We aim to evaluate survival, volume retention, metabolism, and cellular composition of various aliquots of human fat xenografts.

Methods:
Twenty athymic nude mice were injected subcutaneously in opposing flanks with 0.1 ml (small) and 1.0 ml (large) aliquots of human fat graft. Volume (ultrasound) of fat aliquots was measured at baseline, 1, 3, and 12 weeks after implantation. Tissue metabolism (18F-FDG), Hematoxylin and Eosin, special stains, and immunohistochemical analysis were performed at 3 and 12 weeks to determine graft viability, cell origin, and proliferative activity.

Results:
Only 1 of 10 small grafts were detected after 12 weeks by ultrasound and 5 of 10 were found at necropsy. Volume of large grafts decreased significantly from baseline at 3 (827 ± 195 mm3 versus 953 ± 122 mm3; P = 0.004) and 12 weeks (515 ± 163 mm3 versus 953 ± 122 mm3; P = 0.0001). Metabolism increased with time in small (0.6 ± 0.4%ID/g versus 2.0 ± 1.1%ID/g, P = 0.01) and large grafts (0.4 ± 0.3%ID/g versus 1.4 ± 0.9 %ID/g; P = 0.005). Large grafts viability decreased between 3 and 12 weeks (72 ± 20% versus 31 ± 30%; P = 0.012) although small graft viability remained unchanged. Viable and proliferating human and mouse adipocytes and chimeric blood vessels were seen within grafts at both time points.

Conclusions:
Larger graft aliquot was associated with better volume retention by ultrasound but lower viability by histology. Graft metabolism increased with time irrespective of aliquot size potentially due to regenerative processes of both donor and recipient origin.
A Novel Tube-Drainage Technique of Negative Pressure Wound Therapy for Fistulae after Reconstructive Surgery
Authors: Umezawa Hiroki , Matsutani Takeshi , Yokoshima Kazuhiko , Nakamizo Munenaga , Ogawa Rei 
Published: August 2018

Background:
Patients with head and neck or esophageal cancer who undergo resection and reconstructive surgery sometimes develop fistulae that exhibit delayed wound healing. We developed a novel negative pressure wound therapy (NPWT) that employs a Penrose drain. This case series report describes its effect on the wound healing and treatment duration of cancer patients with postoperative fistulae.

Methods:
This consecutive case series consisted of all patients from February 2014 to February 2017 who underwent resection and reconstruction for head and neck or esophageal cancer and who then developed a fistula that was treated with either NPWT or a second flap that did not resolve the fistula or led to fistula recurrence and was then treated with NPWT. A Penrose drainage tube was inserted into the fistula, and a NPWT device was applied.

Results:
Eleven patients (10 males, 1 female; mean age, 67.4 years) underwent NPWT for fistulae that arose after tumor resection and reconstruction (n = 6) or after fistula reconstruction (n = 5). The resection was for esophageal (n = 4), laryngeal (n = 3), oral (n = 2), and hypopharyngeal (n = 2) cancer. In 9 cases, 1 week of NPWT led to rapid and complete wound healing. In 2 cases, complete healing occurred after 3–4 weeks of NPWT.

Conclusions:
Our NPWT applies continuous negative pressure inside the fistula only and dramatically promoted fistula healing. This approach may work by cleaning the fistula and promoting mucosal surface adhesion. It is particularly effective when the tissue surrounding the fistula is soft due to fresh tissue transfer.
Evaluating Medical Spanish Proficiency: A Comparison of Physician Assistant Student Self-Assessment to Standardized Patient and Expert Faculty Member Ratings
Authors: Lie Désirée A. , Forest Christopher P. , Richter-Lagha Regina 
Published: August 2018

Purpose
Whether physician assistant (PA) students' self-assessment or standardized patient (SP) evaluations of students' medical Spanish proficiency accurately reflect their language proficiency is unclear. This study compares PA student and SP ratings with an expert faculty member's rating to determine whether student or SP ratings can be used to evaluate language proficiency.

Methods
Fifty-eight students participated in a single-station Spanish Objective Structured Clinical Examination (OSCE) at the midpoint of a medical Spanish curriculum. Using the Interagency Language Roundtable (ILR)—a 6-point, single-item language proficiency scale previously validated among physicians—PA students and SPs evaluated students' medical Spanish proficiency. Their scores were then compared with the scores derived by an expert faculty rater who had viewed a video of each student–SP encounter. The faculty's score was considered the gold standard. Correlation between scores was calculated using Spearman's rank correlation coefficient.

Results
Mean student scores were highest when rated by SPs (M = 3.8, SD = 0.9), followed by self (M = 3.0, SD = 0.9), and then faculty (M = 2.5, SD = 1.2). Spearman's rank correlation coefficient showed a strong positive correlation between students and the expert faculty rater (r

s
= 0.67, P < .001) and between SPs and the expert faculty rater (r

s
= 0.72, P < .001). The correlation was stronger for high- than for low-proficiency students. Students' self-rated scores showed significant improvement from baseline to the OSCE.

Conclusions
PA students participating in a medical Spanish curriculum and SPs show good correlation with an expert faculty rater in assessing Spanish proficiency during an OSCE. Standardized patients demonstrate scoring leniency. The ILR has potential for tracking aggregate student progress and curriculum effectiveness. With training, student self-rating could be used for interval assessment of medical Spanish communication.
Assessing the Impact of a Professional Development Program for Physician Assistant Program Directors
Authors: Alexander Lisa Mustone , Auth Patrick , Carlson Rachel , Davison Meredith 
Published: August 2018

Purpose
The growth of physician assistant (PA) programs nationally has stretched the available capacity of experienced PA program directors. To address this need, a professional developmental program was designed to provide new program directors with the knowledge, skills, and resources necessary to succeed in the role. This study sought to characterize the impact of program attendance over time. Data were collected from individuals representing 5 cohorts that participated in the annual Physician Assistant Education Association New Program Directors Retreat between 2011 and 2015.

Methods
An electronic survey was developed and sent to all 5 cohorts (n = 139). Anonymous responses were collected and quantitative data were analyzed in the aggregate and also by year of participation. Qualitative data were analyzed, and a thematic analysis was conducted. Results were compared with baseline data collected during the program registration process and with published national data on program director characteristics.

Results
Seventy-five program participants completed the survey, for a response rate of 57%. Program director stability, educational achievement, and involvement in leadership and service activities were found to be positive outcomes for individuals who had participated in the professional development program.

Conclusion
Survey respondents reported positive outcomes after attending a professional development program; these outcomes are consistent with research on similar programs published in the literature. Our findings suggest that new program directors who participated in this professional development program not only derived career-stabilizing benefits but also succeeded in creating supportive peer networks while gaining greater confidence in their new academic role.