bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sexual Orientation–Related Disparities in Neonatal Outcomes
Authors: Chakraborty Payal , Reynolds Colleen A. , McKetta Sarah , Soled Kodiak R. S. , Huang Aimee K. , Monseur Brent , Corman Jae Downing , Obedin-Maliver Juno , Eliassen A. Heather , Chavarro Jorge E. , Austin S. Bryn , Everett Bethany , Haneuse Sebastien , Charlton Brittany M. 
Published: October 2024

OBJECTIVE:
To evaluate whether disparities exist in adverse neonatal outcomes among the offspring of lesbian, gay, bisexual, and other sexually minoritized (LGB+) birthing people.

METHODS:
We used longitudinal data from 1995 to 2017 from the Nurses' Health Study II, a cohort of nurses across the United States. We restricted analyses to those who reported live births (N=70,642) in the 2001 or 2009 lifetime pregnancy questionnaires. Participants were asked about sexual orientation identity (current and past) and same-sex attractions and partners. We examined preterm birth, low birth weight, and macrosomia among 1) completely heterosexual; 2) heterosexual with past same-sex attractions, partners, or identity; 3) mostly heterosexual; 4) bisexual; and 5) lesbian or gay participants. We used log-binomial models to estimate risk ratios for each outcome and weighted generalized estimating equations to account for multiple pregnancies per person over time and informative cluster sizes.

RESULTS:
Compared with completely heterosexual participants, offspring born to parents in all LGB+ groups combined (groups 2–5) had higher estimated risks of preterm birth (risk ratio 1.22, 95% CI, 1.15–1.30) and low birth weight (1.27, 95% CI, 1.15–1.40) but not macrosomia (0.98, 95% CI, 0.94–1.02). In the subgroup analysis, risk ratios were statistically significant for heterosexual participants with past same-sex attractions, partners, or identity (preterm birth 1.25, 95% CI, 1.13–1.37; low birth weight 1.32, 95% CI, 1.18–1.47). Risk ratios were elevated but not statistically significant for lesbian or gay participants (preterm birth 1.37, 95% CI, 0.98–1.93; low birth weight 1.46, 95% CI, 0.96–2.21) and bisexual participants (preterm birth 1.29, 95% CI, 0.85–1.93; low birth weight 1.24, 95% CI, 0.74–2.08).

CONCLUSION:
The offspring of LGB+ birthing people experience adverse neonatal outcomes, specifically preterm birth and low birth weight. These findings highlight the need to better understand health risks, social inequities, and health care experiences that drive these adverse outcomes.
Current opinion: antiretrovirals during pregnancy and breastfeeding
Authors: Nijboer Laura , van der Wekken-Pas Lena , Aebi-Popp Karoline , van Leeuwen Elisabeth , Colbers Angela 
Published: October 2024

Purpose of review
To review the most important literature from the past 2 years on the pharmacokinetics of antiretrovirals in pregnancy, placental transfer, and breastmilk.

Recent findings
Concentrations of antiretrovirals frequently used in pregnancy and their placental transfer are described, together with infant exposure through breastmilk. Also, applications of ex-vivo and in-silico studies, such as placenta perfusion studies and PBPK models, are discussed.

Summary
Great efforts were made in the past 2 years to accelerate the availability of data on antiretrovirals during pregnancy and lactation. Bictegravir showed decreased but still sufficient concentrations during pregnancy, leading to a label change by the FDA. In-silico and clinical studies on long-acting cabotegravir and rilpivirine generated information leading to cautious use of these formulations in pregnancy. Low infant exposure to antiretrovirals through breastmilk is expected for most compounds. Despite the impact of these studies, more incentives are needed for earlier implementation, for instance, during the developmental phase of drugs, to provide women antenatally with proper information on their drugs.
Road-traffic noise exposure and coronary atherosclerosis in the Swedish CArdioPulmonary bioImage Study (SCAPIS)
Authors: Murzabekov Marat , Persson Åsa , Asker Christian , Kilbo Edlund Karl , Eriksson Charlotta , Jernberg Tomas , Molnar Peter , Oudin Anna , Pyko Andrei , Lindvall Jenny , Lõhmus Mare , Persson Waye Kerstin , Nilsson Sommar Johan , Stockfelt Leo , Spanne Mårten , Svartengren Magnus , Ögren Mikael , Pershagen Göran , Ljungman Petter 
Published: October 2024

Background:
Road-traffic noise may influence the development of cardiovascular events such as stroke and myocardial infarction, but etiological mechanisms remain unclear. This study aimed to assess the relationship between long-term road-traffic noise exposure and coronary atherosclerosis in Sweden.

Methods:
In the Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort, including 30,154 subjects aged 50–65 years, recruited between 2013 and 2018, coronary atherosclerosis was measured based on computer tomography (CT) scans as coronary artery calcium score, segment involvement score (SIS), and non-calcified plaques (NCP) at enrollment. Based on modified Nordic model, road-traffic noise exposure was modeled for 2000, 2013, and 2018 with interpolation for intermediate years. We investigated the association between time-weighted long-term exposure to road-traffic noise (Lden) and the prevalence of atherosclerosis using ordinal logistic regression models adjusting for potential socioeconomic, behavioral, and environmental confounders, including air pollution.

Results:
No clear associations were found between road-traffic noise and coronary atherosclerosis. The odds ratio for coronary artery calcium score was 1.00 (95% confidence interval [CI] = 0.96, 1.04), SIS 0.99 (0.96, 1.03), and NCP 0.98 (0.90, 1.03) per interquartile range (9.4 dB Lden) for road-traffic noise exposure during 10 years before enrollment. No consistent associations were observed in site-specific analyses or using shorter exposure periods. Furthermore, exposure-response analyses revealed no clear trends, and there were no strong interactions between road-traffic noise and cardiovascular risk factors in relation to the atherosclerosis markers.

Conclusions:
Long-term exposure to road-traffic noise was not linked to coronary atherosclerosis or calcification in relatively healthy, middle-aged populations in Sweden.
Waste not want not: the story of surgical trash
Authors: Woods Noe , Melnyk Alexandra I. , Moalli Pamela 
Published: October 2024

Purpose of review
Our escalating reliance on disposable products in the operating room has generated a large amount of waste, cost, and environmental pollution. Heath damages from the pollution caused by the US healthcare industry cause as much harm, as measured by disability-adjusted life years, as total medical errors. Our response to our own environmental impact should be proportional to that harm. Understanding the waste streams we create and the factors that contribute to our large waste generation in the operating room can help us target solutions to our most harmful practices.

Recent findings
Recent studies within the field of medical waste in ObGyn have included a systematic review analyzing most effective practices for waste reduction and environmental life cycle analyses of specific medical procedures.

Summary
Operating room waste includes regulated medical waste, pathologic waste/chemotherapy, sharps, general municipal waste, recycling, linens, and anesthetic gases. The most effective way to reduce the environmental impact from medical waste is to reduce our use of disposable supplies in favor of durable reusable materials. Other important interventions include eliminating ‘overage’ of unused supplies, optimizing use of anesthetic gas, custom pack scale backs, and proper waste segregation. This review of operative waste is intended to aid healthcare facilities in understanding and addressing their own environmental impact.
Efficacy of the Posterior Accessory Saphenous Vein as a Vein Graft in Breast Reconstruction Using Profunda Artery Perforator Flap
Authors: Tanaka Nobuyuki , Tomita Koichi , Itani Yoshihito , Kusuhara Hirohisa , Nakao Hitomi , Sueyoshi Yu , Okuda Shinnosuke , Shimizu Yuta , Hayashi Riku 
Published: October 2024

Summary:
The profunda artery perforator (PAP) flap, commonly used for small- to medium-sized breast reconstructions, offers easy harvest and inconspicuous donor-site scars. However, its shorter vascular pedicle compared with the deep inferior epigastric perforator flap limits its reach to lateral recipient vessels. This often requires strategic placement of perforators at the flap’s edge to extend reach, potentially causing congestion in the distal part of the flap. To address these challenges, using the posterior accessory saphenous vein (pASV) has proven effective. Using the pASV as a vein graft significantly extends the pedicle length of the PAP flap, enhancing anastomosis success with recipient vessels. Additionally, in cases of flap congestion, the proximal segment of the pASV can be used as an additional venous outflow pathway, while grafting the distal segment further extends its length. This dual approach improves overall flap viability and reduces venous congestion risks. This discussion highlights two cases demonstrating the innovative use of the pASV within the PAP flap. In case 1, the pASV extended the pedicle length, enhancing the flap’s placement flexibility and facilitating anastomosis with thoracodorsal vessels. In case 2, the pASV served as a secondary venous outflow pathway, with the distal segment grafted to extend the proximal portion. This adaptation provided additional venous drainage and effectively managed positioning constraints imposed by recipient vessel locations. These examples illustrate the significant benefits of utilizing the pASV in PAP flap breast reconstructions, offering a novel strategy to improve viability and expand its use in complex scenarios requiring extended vascular reach.
Anatomical Analysis of the Superior Gluteal Artery in 100 Women for Superior Gluteal Artery Perforator Flap Breast Reconstruction
Authors: Aoki Hironobu , Kamegai Mina , Inoue Mariko , Taga Marie , Hokazono Yu , Mitsuwa Hideyuki , Kurita Tomoko , Takei Hiroyuki , Ogawa Rei 
Published: October 2024

Background:
The superior gluteal artery (SGA) perforator (SGAP) flap is used more rarely for breast reconstruction with autologous tissue than other flaps because the SGA is often narrow, and the SGAP can be short. However, it provides ample fat, including in lean women. To improve its safety and utility, the preoperative SGA course in women who underwent autologous breast reconstruction was determined with three-dimensional computed tomography angiography.

Methods:
Consecutive deep inferior epigastric perforator, profunda artery perforator, and SGAP flap cases in 2019–2023 were identified. Frequencies of the following favorable preoperative SGA-anatomy variables were determined: branching of the main-SGA trunk on top/posterior of the greater sciatic foramen (designated M1/2), which allows access to a sufficiently wide SGA artery; superolateral perforating location of the superficial-SGA branch (SP3), which means the perforator is sufficiently long for uncomplicated flap placement; and nonbranching of the deep-SGA branch (D1/D2), which means this branch can used a venous and an arterial graft to extend an insufficiently long perforator.

Results:
A total of 100 cases of deep inferior epigastric perforator (n = 80), profunda artery perforator (n = 13), and SGAP flap-based breast reconstructions (n = 7) were identified. Out of 200 buttocks, 89%, 91.5%, and 62% had the favorable M1/2, SP3, and D1/D2 variables, respectively. An atypical descending branch feeding the lower buttocks (DES1/2) was observed in 34%.

Conclusions:
The branching position of the main-SGA trunk, perforating location of the SGAP, and the shape of the deep branch were classified in detail in 100 patients. By creating a surgical plan that understands the anatomy taking preoperative three-dimensional computed tomography angiography, the SGAP flap can accommodate many patterns, increasing the possibility of safe execution.
Investigation of the Optimal Age in Months for Initiation of Conservative Treatment for Congenital Auricular Deformities
Authors: Takada Asuka , Kuwahara Hiroaki , Tsuge Takuya , Ogawa Rei , Akaishi Satoshi 
Published: October 2024

Background:
The effectiveness of conservative treatment for congenital auricular deformities depends primarily on the plasticity of the auricular cartilage. However, the effect remains uncertain due to various confounding factors such as differences in the characteristics of the deformity and timing of treatment initiation. In this study, we investigated the optimal timing for initiation of conservative treatment.

Methods:
We investigated the age at treatment initiation and surgical avoidance rate among 158 children with congenital auricular deformities who were treated with corrective devices at our hospital. In addition, we conducted and analyzed questionnaires containing items assessing treatment satisfaction and characteristics.

Results:
Surgical avoidance rates decreased markedly among those starting treatment after 5 months of age, and satisfaction was significantly higher in the surgical avoidance group. Multivariate analysis showed that the only factor affecting the treatment effect was the age at treatment initiation.

Conclusions:
This study suggests that the initiation of conservative treatment with corrective devices within 5 months of age for congenital auricular deformities may lead to avoidance of surgery and increased satisfaction. However, we should not judge the indication for conservative treatment solely based on age in months. Bearing in mind the effectiveness of initiating treatment within the first 5 months of age, we should initiate treatment at the earliest appropriate age with consideration of the individual patient's type and severity of deformity and cartilage elasticity.
Pilot Study: Single-depth Superficial Ultrasound with Subdermal Injections of Diluted Calcium Hydroxylapatite for Improving Lower Face Skin Quality
Authors: Ramirez Sylvia , Scherz Gunther , Leprince Rémi 
Published: October 2024

Background:
The lower face can be challenging to treat. We assessed the effectiveness of combining single-depth superficial microfocused ultrasound with visualization (MFU-V, Ultherapy; Merz North America, Inc. Raleigh, N.C.) and subdermal injections of diluted calcium hydroxylapatite (CaHA, Radiesse; Merz North America, Inc. Raleigh, N.C.) in a single session for improving skin quality in the lower face.

Methods:
This study enrolled women with moderate-to-severe fine lines and skin unevenness on the lower face who desired nonsurgical intervention. Single-depth MFU-V treatment (10 MHz/1.5 mm) was followed by subdermal injections of diluted (1:1) CaHA. Subjects were followed up for 24 weeks posttreatment. Objective skin quality assessments (Rv: wrinkle depth; R3z: skin unevenness) were performed using LifeViz Micro (QuantifiCare, Sophia Antipolis, France). Subjective assessments included the modified Fitzpatrick Wrinkle Scale visual analog scale, Global Aesthetic Improvement Scale, and global satisfaction scale.

Results:
Twelve subjects completed the study. The mean Rv value, mean R3z value, and mean modified Fitzpatrick Wrinkle Scale visual analog scale score improved significantly from baseline to week 24 (mean differences: −0.0321 mm, −0.0684 mm, −1.1667; all P < 0.001). All subjects were rated by the investigators as having demonstrated improvement in their overall aesthetic appearance as early as week 4. All subjects were “very satisfied” or “satisfied” with their treatment from week 12 onwards. No unexpected adverse events were reported.

Conclusions:
Combination treatment with single-depth superficial MFU-V and diluted CaHA in a single session significantly improved lower facial skin quality, as assessed by both objective and subjective outcome measures.
Is it feasible to treat atrial fibrillation at the time of minimally invasive coronary artery bypass grafting?
Authors: Waterford Stephen D. , Ad Niv 
Published: October 2024

Purpose of review
Coronary artery bypass grafting remains the most common operation performed by cardiac surgeons. As a result, a cardiac surgeon with a typical practice will most commonly encounter atrial fibrillation when performing coronary artery bypass grafting. In this review, we first emphasize the importance of treating atrial fibrillation in patients undergoing coronary bypass grafting. We review benefits of concomitant surgical ablation and its importance relative to complete coronary revascularization. We then discuss options to treat atrial fibrillation in a more minimally invasive manner in these patients, while still preserving treatment efficacy.

Recent findings
Surgical ablation at the time of coronary artery bypass grafting surgery could be as important as complete revascularization. Bi-atrial ablation provides superior rhythm control compared to left-sided ablation only.

Summary
We highlight various options for surgical ablation at the time of coronary artery bypass grafting surgery, and provide an algorithm for ablation in individual patients.
Validation of a French Version of the Visual Function and Corneal Health Status Instrument and Correlation With Vision and Glare Measurements in Fuchs Endothelial Corneal Dystrophy
Authors: Mullie Guillaume A. , Juarez Alejandro , Etcheverry Antoine , Natchev Paul , Taleb Nassima , Boutin Tanguy , Choremis Johanna , Mabon Michèle , Talajic Julia , Giguère Charles-Édouard , Brunette Isabelle 
Published: October 2024

Purpose:
To validate a French version of the Visual Function and Corneal Health Status (V-FUCHS) instrument in Fuchs endothelial corneal dystrophy (FECD) and to correlate questionnaire scores with objective measurements of best-corrected visual acuity (BCVA) and intraocular straylight.

Methods:
The original V-FUCHS 15-item instrument was designed to assess VA and glare in patients with FECD. It was translated from English to French and back translated to English by independent translators. The questionnaire was administered on 2 occasions (4 weeks apart), and BCVA, modified Krachmer grade, and straylight were measured. Construct validity, internal consistency, test–retest reliability, and predictive validity were assessed.

Results:
A total of 159 subjects, aged 41 to 86 years, were prospectively recruited from July 2019 to October 2020 and classified into 6 groups: mild, moderate, or advanced FECD; unilateral or bilateral Descemet membrane endothelial keratoplasty for FECD; and healthy controls (n = 35). Construct validity was confirmed by item response theory model. Cronbach alpha demonstrated excellent internal consistency (VA: 0.91, glare: 0.88), and intraclass correlations showed good test–retest reliability (VA: 0.75 and glare: 0.82). Significant correlations were observed between both VA and glare factors and the modified Krachmer grade, BCVA, and straylight.

Conclusions:
The proposed French version of the V-FUCHS instrument provides a valid and reliable tool for the assessment of visual disability in patients with FECD. This questionnaire bridges the gap between self-reported FECD symptoms and objective clinical measurements, which may prove useful to optimize the timing of surgery and to assess postoperative improvement in symptoms.
New Nurse Turnover Intention and Related Factors in Japan and China: Focusing on Nursing Practice Environment and Burnout
Authors: JIANG Dan , KIRA Junko 
Published: October 2024

ABSTRACT

Background
With rapidly declining birth rates and aging populations worldwide, the demand for nursing care has increased in recent years. High turnover, an important cause of nurse staffing shortages, directly affects the quality of nursing care. However, no comparison studies on turnover intention in East Asia have been published.

Purpose
The purpose of this study was to clarify the relationships among turnover intention, the work environment, and related factors among new nurses in Japan and China.

Methods
A self-administered questionnaire survey was used to collect data from nurses employed for < 2 years. This questionnaire included participant characteristics, assessment of desire to become a nurse at the start of employment, current turnover intention, the Practice Environment Scale of the Nursing Work Index, and the Maslach Burnout Inventory-Human Services Survey. The relationship between current turnover intention and, respectively, number of hospital beds, strength of desire to become a nurse at the start of employment, level of participation in hospital affairs, emotional exhaustion (EE), personal achievement, and demographic variables was assessed.

Results
The number of nurses who intended to leave the hospital was higher in Japan (74.1%) than in China (42.4%). However, of those expressing intention to leave, 46.6% of the nurses in China and only 5.0% of those in Japan indicated intention to quit the nursing profession altogether. In Japan, collegial nurse–physician relations and EE were related to turnover intention, whereas in China, number of hospital beds, strength of desire to become a nurse at the start of employment, participation in hospital affairs, EE, and personal achievement were all related to turnover intention.

Conclusions
To enhance retention and reduce turnover intention among nurses, the strength of desire to become a nurse in China and the nurse–physician relationship and EE in Japan should be taken into particular consideration when designing retention strategies and nurse education programs.
Lethal Self-Administration of Atracurium: A Rarely Reported Case with Review of Literature
Authors: Galoria Darshan , Shukla Srushti , Datta Arijit , Das Abhishek , Goswami Dhara , Rana Pradip , Tiwari Preeti 
Published: October 2024

Abstract
Atracurium besylate is a nondepolarizing skeletal muscle relaxant first introduced in 1980. It is used during endotracheal intubation. It causes muscle relaxation during surgery or mechanical ventilation. When people consider suicide, they employ drugs found in their surroundings but not usually injectable muscle relaxants, which are not widely available. Studies on their use in suicide are rarely reported worldwide. This was a case of a 34-year-old male nursing staff, working in the general surgery department's operation theater complex, who was found unconscious in bed in his room in the morning with an empty syringe by the bedside. He was declared dead when brought to the emergency department. Forensic autopsy was conducted, and during the external examination, a needle puncture wound was found over the left cubital fossa. No other external other injuries were observed throughout the body. The toxicological analysis report indicated the presence of laudanosine in the vitreous humor, blood, urine, and skin from the puncture site and underneath vein. Also, the toxicological analysis of the empty syringe found at the crime scene revealed the presence of atracurium, confirming that the victim had administered a lethal dose of atracurium.