bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strength in Numbers: A SWOT Analysis of Plastic Surgery
Authors: Blum Jessica D. , Reghunathan Meera , Bradford Perry S. , Camacho Justin , Sendek Gabriela , Jeffers Lynn , Cash Camille , Mackay Donald , Butler Paris D. , Gosman Amanda A. 
Published: December 2023

Background:
Plastic surgeons comprise the minority of practicing surgeons, with an even smaller minority practicing in an academic setting. As the practice of medicine and the systems in which we operate continue to evolve, it is essential that plastic surgeons have a say in the changing landscape. This study conducted a strengths, weaknesses, opportunities, and threats (SWOT) analysis of plastic surgery to identify unifying strengths and common threats.

Methods:
An electronic survey was distributed to American Council of Academic Plastic Surgeons’ Winter Meeting attendees on three separate occasions preceding the meeting. Respondents were asked to provide demographic information and to identify the top three strengths, weaknesses, opportunities, and threats (SWOT analysis) for the specialty. Subgroup analyses were performed based on demographic characteristics.

Results:
A total of 187 responses were received from meeting attendees, representing an 89.0% response rate. Most respondents were non-Hispanic (78.6%), White (66.8%), women (59.5%), and faculty/independent physicians (65.8%). The most identified strength in plastic surgery was our problem-solving abilities (62.0%). The most identified weakness was poor public perception of plastic surgery (54.0%). The most identified opportunity was demonstration of value to health systems (67.9%), and the most identified threat was scope of practice creep by other specialties (78.1%). The SWOT analysis identified lack of surgeon diversity as a key weakness, improvement of surgeon diversity as a key opportunity, and lack of diversity among plastic surgeons as a key threat to the specialty.

Conclusion:
Only through a diverse but united front can we effectively use our strengths to face our threats and employ opportunities to overcome our weaknesses.
The Social, Mental, and Physical Health Impacts of the COVID-19 Pandemic on People With HIV: Protocol of an Observational International Multisite Study
Authors: Cuca Yvette P. , Horvat Davey Christine , Corless Inge B. , Phillips J. Craig , Sierra-Perez Álvaro José , Solís Báez Solymar , Iwu Emilia , Sabone Motshedisi , Mulaudzi Mercy Tshilidzi , Murphey Christina , Shaibu Sheila , Chen Wei-Ti , Santa Maria Diane , Schnall Rebecca , Palmieri Patrick , Apiruknapanond Panta , Wang Tongyao , de Jesús Tania , Huang Emily , Broussard Janessa , Dawson-Rose Carol 
Published: December 2023

Abstract
As the COVID-19 pandemic spread across the world, immunocompromised individuals such as people with HIV (PWH) may have faced a disproportionate impact on their health and HIV outcomes, both from COVID-19 and from the strategies enacted to contain it. Based on the SPIRIT guidelines, we describe the protocol for an international multisite observational study being conducted by The International Nursing Network for HIV Research, with the Coordinating Center based at the University of California, San Francisco (UCSF) School of Nursing. Site Principal Investigators implement a standardized protocol to recruit PWH to complete the study online or in-person. Questions address demographics; HIV continuum of care indicators; mental and social health; COVID-19 and vaccination knowledge, attitudes, behaviors, and fears; and overall outcomes. Results of this study will contribute to knowledge that can inform responses to future public health crises to minimize their impacts on vulnerable populations such as PWH.
A novel skin grafting modality: prefabricated large sheet of postage-stamp autografts and allografts to repair extensive burn wounds; a prospective matched-control study
Authors: Shen Chuan’an , Zhang Bohan , Liu Xinzhu , Cai Jianhua , Sun Tianjun , Li Dongjie , Deng Huping , Yuan Huageng 
Published: December 2023

Background:
The excessively long operative time has been the greatest barrier to the success of transplanting postage-stamp auto- and allografts directly and piece-by-piece onto extensive burn wounds. To solve this challenge, the authors present a novel grafting modality, that is, the prefabricated-large-sheet grafting that moves the labor-intensive and time-consuming process of grafts-positioning before grafting and thereby markedly shortens the operative time.

Methods:
Twenty-one operations using the novel modality were performed on 11 patients with extensive deep burns. The grafting time using the novel modality was recorded and compared with that of the conventional piece-by-piece grafting. Eventually, the take rates of the two modalities were compared.

Results:
All patients were healed and discharged. The average grafting time per unit area (100 cm2) of prefabricated-large-sheet grafting and piece-by-piece grafting were (0.41±0.09) min and (7.46±1.07) min, respectively, and the difference is statistically significant(P<0.001). The average take rate of the prefabricated sheets was (85.43±6.14)% and that of the piece-by-piece transplanted grafts was (87.29±5.23)% and there is no significant difference(P>0.05).

Conclusions:
The prefabricated-large-sheet grafting significantly reduces the intraoperative grafting time while ensures uniformity of the skin grafts and secures good outcomes, thereby making the intermingled transplantation of postage-stamp auto- and allografts, which has been an excellent modality per se but limited to repair small residual wounds, now feasible to repair extensive deep burn wounds. It is worth wider understanding and application in the treatment of extensive deep burns.
Association of systemic inflammatory markers and tertiary lymphoid structure with pathological complete response in gastric cancer patients receiving preoperative treatment: a retrospective cohort study
Authors: Wu Yingying , Zhao Junjie , Wang Zhaoming , Liu Dan , Tian Chenyu , Ye Botian , Sun Yihong , Li Haojie , Wang Xuefei 
Published: December 2023

Background:
Assessment of systemic and local immune responses is crucial in determining the efficacy of cancer interventions. The identification of specific factors that correlate with pathological complete response (pCR) is essential for optimizing treatment decisions.

Methods:
In this retrospective study, a total of 521 patients diagnosed with gastric adenocarcinoma who underwent curative gastrectomy following preoperative treatment were reviewed. Of these patients, 463 did not achieve pCR (non-pCR) and 58 achieved pCR. Clinicopathological factors were evaluated to identify predictors for pCR using a logistic regression model. Additionally, a smaller cohort (n=76) was derived using propensity score matching to investigate local immune response, specifically the features of tertiary lymphoid structure (TLS) using H&E staining, immunohistochemistry, and multiplex immunofluorescence.

Results:
The multivariate regression analysis demonstrated a significant association between low systemic inflammatory status and pCR, as evidenced by reduced levels of the combined systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) (SII+NLR) (odds ratio: 3.33, 95% CI: 1.79–6.17, P<0.001). In the smaller cohort analysis, distinct TLS characteristics were correlated with the presence of pCR. Specifically, a higher density of TLS and a lower proportion of PD1+ cells and CD8+ cells within TLS in the tumor bed were strongly associated with pCR.

Conclusion:
Both systemic and local immune profile were associated with pCR. A low level of SII+NLR served as an independent predictor of pCR, while distinct TLS features were associated with the presence of pCR. Focusing on the immune profile was crucial for optimal management of gastric cancer patients receiving preoperative treatment.
Perioperative and long-term survival outcomes of pancreatectomy with arterial resection in borderline resectable or locally advanced pancreatic cancer following neoadjuvant therapy: a systematic review and meta-analysis
Authors: Xue Kang , Huang Xing , Zhao Pengcheng , Zhang Yi , Tian Bole 
Published: December 2023

Background:
Pancreatic cancer frequently involves the surrounding major arteries, preventing surgeons from making a radical excision. Neoadjuvant therapy (NAT) can lessen the size of local tumors and eliminate potential micrommetastases. However, systematic and evidence-based recommendations for the treatment of arterial resection (AR) after NAT in pancreatic cancer are scarce.

Method:
A computerized search of the Medline, Embase, Cochrane Library databases, and Clinicaltrials was performed to identify studies reporting the outcomes of patients who underwent pancreatectomy with AR and NAT for pancreatic cancer. Studies that reported perioperative and/or long-term results after pancreatectomy with AR and NAT were eligible for inclusion. The quality of the evidence was assessed with Newcastle–Ottawa Quality Assessment Form of bias tool. Data were pooled and analyzed by Stata 14.0 software.

Result:
Nine studies with an overall sample size of 215 met our eligibility criteria and were included in the meta-analysis. All studies were retrospective studies, and the methodological quality was moderate. The pooled morbidity and mortality rates were 51% (95% CI: 41–61%; I²= 0.0%) and 2% (95% CI: 0–0.08; I²=33.3%), respectively. Meta-analysis showed that the overall R0 resection rate was 79% (CI: 70–86%, I²=15.5%). Comparative data on R0 rates of patients who underwent pancreatectomy with and without NAT showed a significant difference in favor of the former group with moderate statistical heterogeneity (Relative risk=1.21; 95% CI: 0.776–1.915; I²=48.0%). The median 1-, 2-, 3-, and 5-year survival rates of patients who had AR were 92.3% (range: 72.7–100%), 64.8% (range: 25–78.8%), 51.6% (range: 16.7–63.6%), and 14% (range: 0–41.1%), respectively. Data on median progression-free survival ranged from 5.25 to 36.3 months, and the median overall survival ranged from 17 to 44.9 months.

Conclusions:
Pancreatectomy with major AR following NAT has the potential to enhance the survival rate of patients with unresectable pancreatic cancer involving the arteries by achieving R0 resection, despite a significant risk of postoperative complications. However, to validate the feasibility and effectiveness of this procedure, prospective controlled studies are necessary to address limitations arising from small sample sizes and potential biases inherent in retrospective studies.
Role of tumor necrosis factor alpha-induced protein 6 (TNFAIP6) in tumors: a pan-cancer analysis
Authors: Yang Yang , Liu Zhi-Gang , Yang Yan-Qi , Zhang Zhi-Gang , Wang Xiao-Li , Li Yu-Long , Sun Rui-Fang 
Published: December 2023

Abstract

Background
There is growing evidence that the gene named tumor necrosis factor α–induced protein 6 (TNFAIP6) has an important role in various tumors. However, a systematic pan-cancer analysis of TNFAIP6 is lacking. Here we aimed to analyze the expression of TNFAIP6 across multiple cancers and verify its expression during the progression of colon cancer.

Methods
We performed a comprehensive bioinformatics analysis to examine the expression of TNFAIP6 across 27 tumor types. GEPIA2 was used to evaluate the effect of TNFAIP6 on clinical cancer prognosis. cBioportal was used to assess TNFAIP6 mutations. The correlation between TNFAIP6 and cancer immune infiltrates was explored using TIMER2.0. The CancerSEA database was used to perform functional analysis of TNFAIP6. Metascape was used to identify TNFAIP6-related gene enrichment pathways. Immunohistochemistry was performed to detect TNFAIP6 protein expression in the colon cancer. In addition, the Comparative Toxicogenomics Database was searched for known and possible antitumor drugs that may be associated with TNFAIP6.

Results
We found that, in most of the cancers included in this analysis, TNFAIP6 was highly expressed, and there is a distinct relationship between TNFAIP6 expression and cancer prognosis. TNFAIP6 expression is associated with cancer-associated fibroblasts, neutrophils, and endothelial cells. TNFAIP6 and similar genes may also be involved in the PID_VEGF_VEGFR_ pathway. Immunohistochemistry revealed an increasing trend of TNFAIP6 protein expression in normal, adenoma, and colon cancer tissues. Several known and possible antitumor drugs that may be associated with TNFAIP6 were identified in the Comparative Toxicogenomics Database. These results suggest that a number of drugs may target TNFAIP6 during cancer treatment, including cisplatin, irinotecan, resveratrol, U 0126, NSC689534, genistein, NSC668394, oxaliplatin, plerixafor, topotecan, vincristine, flutamide, doxorubicin, MRK 003, folic acid, demecolcine, tunicamycin, zoledronic acid, and schizandrin B.

Conclusions

TNFAIP6 may function as an oncogene in certain cancers. Furthermore, this study provides evidence that TNFAIP6 is an important factor in colon cancer progression.
The relationship between alcohol consumption and risk of HIV in married men in Sub-Saharan Africa
Authors: König Lukas , Petersen Williams Petal , Shuper Paul A. , Probst Charlotte 
Published: December 2023

Objective:
A key factor for incidence of HIV is alcohol consumption. It impacts judgment and the probability to overlook risk-relevant information, which creates a pathway to reduced adherence to biomedical prevention and engagement in condomless sex. We strengthen the understanding of the link between alcohol consumption and risk of HIV among married men in sub-Saharan Africa (SSA), as we use comprehensive population-level data to provide robust evidence with high external validity.

Design:
Cross-sectional data analysis.

Methods:
Based on data from Demographic and Health Surveys (DHS) from 20 countries and over 30 000 observations, a minimally and a fully adjusted model with country fixed effects examined the relationship between the men's alcohol consumption (observed by wife) and HIV status (blood test) while accounting for survey weights and controlling for potential confounders.

Results:
The data comprised a total of 35 108 men. Minimally adjusted [risk ratio (RR) 1.25; 95% confidence interval (CI) 1.14–1.37; P < 0.001] and fully adjusted (RR 1.26; 95% CI 1.15–1.38; P < 0.001) models showed a positive association between the men's alcohol consumption and HIV status. Two sensitivity analyses confirmed the association.

Conclusion:
In line with previous experimental studies and theoretical framework, this study confirms a risk relationship between alcohol consumption and HIV. Thus, modern HIV/AIDS programs must continue to address the relationship in implementation of prevention and treatment programs.
Chest Computed Tomography Findings in Unilateral Pulmonary Fibrosis Secondary to Chronic Hypoperfusion
Authors: Marrocchio Cristina , Humphries Stephen M. , Lynch David A. 
Published: December 2023

Purpose:
Unilateral lung fibrosis is uncommon and few cases secondary to parenchymal hypoperfusion have been reported, requiring further understanding of this entity. This study aims to report the chest computed tomography (CT) findings of patients with unilateral lung fibrosis related to parenchymal hypoperfusion observed in our institution.

Patients and Methods:
Patients with a chest CT between 2004 and 2022 showing a condition causing hypoperfusion of either lung and ipsilateral unilateral lung fibrosis were retrospectively identified. Clinical and scintigraphic data were collected. Pattern and distribution of fibrosis were recorded, and its progression was evaluated when follow-up was available. In adequate CTs, fibrosis was quantified using data-driven textural analysis (DTA). Affected and contralateral lungs and baseline and follow-up data were compared using the Wilcoxon signed-rank test.

Results:
Thirteen patients (male: 7, female: 6, median age: 61 y) were included; 5 with congenital unilateral absence of a pulmonary artery and 8 with fibrosing mediastinitis. The mean scintigraphic perfusion of affected lungs was 3.3% ± 1.1 compared with 96.7% ± 1.1 contralaterally (n = 7, P = 0.017). Fibrosis had a UIP pattern in one case, indeterminate in the others, and was most commonly diffuse craniocaudally and peripheral or central axially. DTA in 12 patients showed a mean fibrotic score of 32% ± 24.6 compared with 0.5% ± 0.4 in the contralateral lungs (P = 0.002). Median follow-up was 4.5 years (minimum to maximum: 1 to 13 y). Of 10 patients, fibrosis was progressive in 60%. DTA of 5 follow-up CTs showed increased reticulations (P = 0.043).

Conclusion:
In patients with lung hypoperfusion, the possible complication of lung fibrosis should be considered.
The Efficacy of Acupressure for Nausea and Vomiting After Laparoscopic Cholecystectomy: A Meta-analysis Study
Authors: Zhao Bufei , Zhao Tianshi , Yang Hua , Fu Xiaojuan 
Published: December 2023

Objectives:
This meta-analysis aims to explore the impact of acupressure on nausea and vomiting for patients undergoing laparoscopic cholecystectomy (LC).

Background:
Acupressure may have some potential in managing nausea and vomiting after LC.

Patients and Methods:
PubMed, Embase, Web of Science, EBSCO, and Cochrane library databases were systematically searched, and we included randomized controlled trials assessing the effect of acupressure on nausea and vomiting for LC.

Results:
Six randomized controlled trials were finally included in the meta-analysis. Overall, compared with control intervention for LC, acupressure was associated with significantly reduced incidence of nausea at 2 hours [odds ratio (OR) = 0.37; 95% CI = 0.21-0.67; P = 0.001] and nausea at 6 hours (OR = 0.38; 95% CI = 0.22-0.66; P = 0.0006; Fig. 4), and decreased need of rescue antiemetic (OR = 0.41; 95% CI = 0.20-0.85; P = 0.02; Fig. 8), but demonstrated no obvious impact on vomiting at 2 hours (OR = 0.76; 95% CI = 0.28-2.10; P = 0.60), vomiting at 6 hours (OR = 0.49, 95% CI = 0.20-1.20; P = 0.12), nausea at 24 hours (OR = 0.71; 95% CI = 0.37-1.35; P = 0.30), or vomiting at 24 hours (OR = 0.81; 95% CI = 0.28-2.35; P = 0.69).

Conclusions:
Acupressure is effective in controlling nausea and decreasing rescue antiemetics for LC.
Breaking the Status Quo in Heart Failure: Leveraging Remote Patient Monitoring to Effectively Put the Heart Failure Guidelines to Practice
Authors: Feldman David I. , Campbell Marcus L , Feldman Theodore , Curnow Randall , Fudim Marat 
Published: December 2023

BackgroundDespite guideline directed medical therapy (GDMT) being recognized to improve outcomes in patients with heart failure with reduced ejection fraction (HFrEF), optimization has been limited resulting in worse outcomes and exorbitant costs. Although remote patient monitoring (RPM) has proven to help improve patient care, implementation of RPM at scale leading to healthcare cost savings has not been demonstrated.MethodsPatients from 11 states were enrolled from August 2021 to April 2023 in a virtual heart failure (HF) program offered by Cadence. Eligible patients were Medicare beneficiaries with a history of an ejection fraction (EF) <40%. A clinical team monitored patient daily vitals measured on a cellular enabled blood pressure (BP) cuff, heart rate monitor and weight scale. Clinical visits using technology enabled clinical protocols were also conducted on a regular basis to facilitate guideline directed clinical interventions including symptom, vital and medication optimization. Cost analysis used 5 years of de-identified healthcare claims data from an Accountable Care Organization (ACO) and calculated average monthly healthcare costs using the 4-month period of January-April for each year. We then used a Differences-in-Differences analysis to estimate the effect of Cadence on average monthly healthcare costs compared to ACO patients who were ordered for Cadence but did not enroll.ResultsTotal of 367 patients (mean [SD]: age 74 [11] years; EF 45 [2] %; systolic BP (SBP) 131 [19] mmHg; n [%]: 122 women [33%]; 260 white (71%)) were followed for a median of 294 days. There was a significant decrease in patients’ BP (SBP -6.9, Diastolic BP -4.9 mmHg; p<0.001) and weight (−2.1 lbs; p=0.010) but not heart rate. Patients experienced significant increases in the use of sodium glucose co-transporter 2 inhibitors (92 [26%] to 165 [45%]; p<0.001) and mineralocorticoid receptor antagonists (120 [33%] to 144 [39%]; p=0.002) but not β-blockers or renin-angiotensin system antagonists. The percentage of patients on ≥50% target dose significantly increased for all pillars of GDMT. There was also a significant increase in the percentage of patients on all 4 pillars of GDMT at follow (84 [23%] vs. 26 [7%]; p<0.001). A total of 70 enrolled and 42 ordered but not enrolled HF patients were included in the ACO analysis. Compared to ordered but not enrolled patients, enrollment in Cadence resulted in a 52% (-$1,076.64 per HF patient per month) cost reduction, with the most significant reductions related to hospitalizations and hospital associated spending.ConclusionsWe present the first evidence to support the use of a remote patient intervention program that leverages RPM and technology supported clinical interventions to not only improve the use and dose of GDMT for HFrEF patients but also reduce total and hospital associated costs.
Factors associated with knowledge, attitudes, and behaviors regarding antiviral medications for COVID-19 among US adults
Authors: Oyegun E. Ivy , Ategbole Muyiwa , Jorgensen Cynthia , Fisher Allison , Briggs Hagen Melissa , Gutekunst Lindsay , Roberts Eric , Koumans Emilia H. 
Published: December 2023

AbstractBackgroundLittle is known about public perceptions of antivirals for the treatment of mild-to-moderate COVID-19 in the United States (US). Our objective was to explore adult perceptions toward COVID-19 antivirals with the goal of improving outreach communications about antivirals for COVID-19.MethodsDuring July 2022, potential respondents 18 years and older were randomly sampled from a national opt-in, non-representative, cross-sectional internet panel, with oversampling of African Americans, Hispanics, and adults 65 years and older. Respondents were asked about sociodemographic factors, and knowledge, attitudes, and perceptions regarding COVID-19 antivirals. Results were weighted to represent the non-institutionalized US adult population.ResultsAmong 1,155 respondents, 51% were female, 60% were 18-49 years, 21% were 50-64 years, and 19% were 65 years or older. Compared to those aged 18-49 years and 50-64 years, a greater proportion of adults 65 years and older were knowledgeable about COVID-19 antivirals and would take them if they tested positive or their doctor recommended them. Adults 65 years and over and those reporting immunosuppression or disability had the highest rates of willingness to take antivirals. For all groups, the proportion of people willing to take antivirals increased by >20% if recommended by their doctor. Respondents in the 50-64 and 65+ groups who were sure they would take COVID-19 antivirals were more likely to be fully vaccinated and less likely to be living in isolation.ConclusionGroups that are less likely to have been vaccinated, those living in isolation, and those not sure about whether they would take an antiviral or not may be at risk for not receiving treatment to prevent severe COVID-19 outcomes. However, trust in doctor recommendations may be enough to overcome individual patient concerns about COVID-19 antivirals. Targeted initiatives to educate those at risk for severe COVID-19 outcomes about the effectiveness of antivirals, including those who are unvaccinated given their increased risk of severe disease, may be needed to further lower this population’s risk of severe COVID-19.