bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing Outcomes in the Therapeutic and Prophylactic Breast for Bilateral Mastectomy With Implant-Based Breast Reconstruction
Authors: Peoples Abigail E. , Waler Alexandria R. , Duet Mary L. , Prabhu Shamit S. , Katz Adam J. 
Published: February 2023

Background
Increasingly patients with unilateral breast cancer elect to undergo bilateral mastectomy with subsequent reconstruction. Studies have aimed to better identify the risks associated with performing mastectomy on the noncancerous breast. Our study aims to identify differences in complications between therapeutic and prophylactic mastectomy in patients undergoing implant-based breast reconstruction.

Methods
A retrospective analysis of implant-based breast reconstruction from 2015 to 2020 at our institution was completed. Patients with less than 6-month follow-up after final implant placement had reconstruction using autologous flaps, expander or implant rupture, metastatic disease requiring device removal, or death before completion of reconstruction were excluded. McNemar test identified differences in incidence of complications for therapeutic and prophylactic breasts.

Results
After analysis of 215 patients, we observed no significant difference in incidence of infection, ischemia, or hematoma between the therapeutic and prophylactic sides. Therapeutic mastectomies had higher odds of seroma formation (P = 0.03; odds ratio, 3.500; 95% confidence interval, 1.099–14.603). Radiation treatment status was analyzed for patients with seroma; 14% of patients unilateral seroma of the therapeutic side underwent radiation (2 of 14), compared with 25% patients with unilateral seroma of the prophylactic side (1 of 4).

Conclusions
For patients undergoing mastectomy with implant-based reconstruction, the therapeutic mastectomy side has an increased risk of seroma formation.
Quantitative Analysis on Cartilage Growth Between Ipsilateral and Contralateral Donor Sites in Microtia Patients
Authors: Lu Zijing , Hu Zhiqi , Miao Yong , Jia James , Mao Xiaoyan , Huang Wenhua 
Published: February 2023

Background
Costal cartilage harvest is required in patients with unilateral microtia when autologous reconstruction is being considered. However, whether an ipsilateral or contralateral donor site should be used remains controversial. This is the first study to compare cartilaginous growth between ipsilateral and contralateral donor sites in patients with unilateral microtia.

Methods
In this retrospective study of 58 patients, the lengths of the sixth to ninth costal cartilages and 3 position-defining measurements with respect to the sixth to ninth costochondral junctions were calculated using 3-dimensional costal cartilage imaging. Patients were divided into subgroups, and the lateral differences between isolated microtia and hemifacial microsomia and between the growing and adult age groups, were compared.

Results
In the isolated group, the sixth and seventh costal cartilages were longer on the contralateral side. The transverse dimension on the contralateral side, with respect to the sixth and seventh costochondral junctions, was also larger than that on the ipsilateral side in growing patients. However, no significant difference was observed between the 2 sides in the hemifacial microsomia group; there was also no difference between the age-related groups in this regard (P > 0.05).

Conclusions
These findings suggest that age- and side-related differences in donor sites should be considered in patients with isolated microtia.
The Use of Preoperative Antibiotics in Hardware-Based Hand Procedures Is Not Necessary
Authors: Dahmus Emma S. , Frank Katie , Jacob Glen 
Published: February 2023

Background
A survey to American Society for Surgery of the Hand members by Dunn et al showed that the use of preoperative antibiotics was random and not standardized for all hand procedures (Hand (N Y). 2020;15(4):534–541). Previous publications support that preoperative antibiotics for clean, soft-tissue procedures are not necessary, but there is minimal evidence regarding the need for preoperative antibiotics for hardware-based hand procedures. The purpose of our study is to compare infectious outcomes for patients undergoing hardware-based hand surgery between those who did and those who did not receive preoperative antibiotics.

Methods
A retrospective cohort analysis was performed on hardware-based surgical patients from the senior author's hand practice between January 2015 and October 2021. All patients either received imbedded permanent hardware or temporary percutaneous k-wire fixation. Exclusion criteria included polytrauma patients, patients with open hand wounds, and patients with less than 2 outpatient follow-up visits. Primary outcomes measured were 30- and 90-day postoperative antibiotic prescriptions and need to return to the operating room. Basic demographic information such as age, sex, body mass index, diabetes, and smoking status were recorded and compared.

Results
Four hundred seventy-two patients were reviewed, with 365 patients meeting inclusion and exclusion criteria. Two hundred twenty patients did not receive preoperative antibiotics and 145 patients did receive preoperative antibiotics. χ2 tests to analyze for associations between the variables were used. Thirteen patients in the no preoperative antibiotic group (5.9%), compared with 5 patients in the preoperative antibiotic group (3.4%), received a postoperative antibiotic prescription within 30 days (P = 0.288). Sixteen patients in the no preoperative antibiotic group (7.3%), compared with 8 patients in the preoperative antibiotic group (5.5%) received a postoperative antibiotic prescription within 90 days (P = 0.508). One patient in the nonantibiotic group required return to the operating room for irrigation and debridement.

Conclusions
There are no significant differences in the need for 30- and 90-day postoperative antibiotic prescriptions between those who did or did not receive preoperative antibiotics based on this single-surgeon experience.
Fluid Distribution Patterns in Early-Stage Upper Extremity Lymphedema
Authors: Friedman Rosie , Lee Clarissa , Kinney JacqueLyn R. , Salehi Betsa Parsai , Kim Geunwon , Singhal Dhruv , Tsai Leo L. 
Published: February 2023

Introduction
Magnetic resonance imaging (MRI) stage 1 (early stage) upper extremity lymphedema is characterized by fluid infiltration in the subcutaneous tissues that does not exceed 50% of the extremity circumference at any level. The spatial fluid distribution in these cases has not been detailed and may be important to help determine the presence and location of compensatory lymphatic channels. The aim of this study is to determine whether there was a pattern of distribution of fluid infiltration in patients with early-stage lymphedema that could correspond to known lymphatic pathways in the upper extremity.

Methods
A retrospective review identified all patients with MRI stage 1 upper extremity lymphedema who were evaluated at a single lymphatic center. Using a standardized scoring system, a radiologist graded the severity of fluid infiltration at 18 anatomical locations. A cumulative spatial histogram was then created to map out regions where fluid accumulation occurred most and least frequently.

Results
Eleven patients with MRI stage 1 upper extremity lymphedema were identified between January 2017 and January 2022. The mean age was 58 years and the mean BMI was 30 m/kg2. One patient had primary lymphedema and the remaining 10 had secondary lymphedema. The forearm was affected in nine cases, and fluid infiltration was predominantly concentrated along the ulnar aspect, followed by the volar aspect, while the radial aspect was completely spared. Within the upper arm, fluid was primarily concentrated distally and posteriorly, and occasionally medially.

Conclusions
In patients with early-stage lymphedema, fluid infiltration is concentrated along the ulnar forearm and the posterior distal upper arm, which aligns with the tricipital lymphatic pathway. There is also sparing of fluid accumulation along the radial forearm in these patients, suggesting a more robust lymphatic drainage along this region, possibly due to a connection to the lateral upper arm pathway.
Instantaneous gelation and non-existence of weak solutions for the Oort–Hulst–Safronov coagulation model
Authors: Rai Pooja , Kumar Giri Ankik , John Volker 
Published: February 2023

The possible occurrence of instantaneous gelation to the Oort–Hulst–Safronov (OHS) coagulation equation is investigated for a certain class of unbounded coagulation kernels. The existence of instantaneous gelation is confirmed by showing the non-existence of mass-conserving weak solutions. Finally, it is shown that for such kernels, there is no weak solution to the OHS coagulation equation at any time interval.
Pre-Post Analysis of the Impact of British Columbia Nurse Practitioner Primary Care Clinics on Patient Health and Care Experience
Authors: Contandriopoulos Damien , Bertoni Katherine , Duhoux Arnaud , Randhawa Gurprit K. 
Published: February 2023

ABSTRACTObjectiveThis study aims to evaluate the impact of a primary care nurse-practitioner-led clinic model piloted in British Columbia (Canada) on patients’ health and care experience.DesignThe study relies on a quasi-experimental longitudinal design based on a pre-and-post survey of patients receiving care in NP-Led clinics. The pre-rostering survey (T0) was focused on patients’ health status and care experiences preceding being rostered to the NP clinic. One year later, patients were asked to complete a similar survey (T1) focused on the care experiences with the NP clinic.SettingTo solve recurring problems related to poor primary care accessibility, British Columbia opened four pilot NP-led clinics in 2020. Each clinic has the equivalent of approximately six full-time NPs, four other clinicians plus support staff. Clinics are located in four cities ranging from core urban to peri rural.ParticipantsRecruitment was conducted by the clinic’s clerical staff or by their care provider. A total of 437 usable T0 surveys and 254 matched and usable T1 surveys were collected.Primary outcome measuresThe survey instrument was focused on five core dimensions of patients’ primary care experience (accessibility, continuity, comprehensiveness, responsiveness, and outcomes of care) as well as on the SF-12 Short-form Health Survey.ResultsScores for all dimensions of patients’ primary care experience increased significantly: Accessibility (T0=5.9, T1=7.9, p<0.000), Continuity (T0=5.5, T1=8.8, p<0.000), Comprehensiveness (T0=5.6, T1=8.4, p<0.000), Responsiveness (T0=7.2, T1=9.5, p<0.000), Outcomes of care (T0=5.0, T1=8.3, p<0.000). SF-12 Physical health T-scores also rose significantly (T0=44.8, T1=47.6, p<0.000) but no changes we found in the mental health T scores (T0=45.8, T1=46.3 p=0.709).ConclusionsOur results suggest that the NP-Led primary care model studied here likely constitutes an effective approach to improve primary care accessibility and quality.Strengths and limitationsThis study evaluates the impact of a primary care nurse-practitioner-led clinic model piloted in British Columbia (Canada) on patients’ health and care experienceThe study rests on a pre-post survey without a control group therefore the differences observed could be caused by external factorsData collection took place between 2020 and 2022, during the Covid-19 pandemic.Only four NP-PCC clinics exist and participation in the survey was voluntary and uncompensated limiting the number of respondents
Old tools, new applications: use of environmental bacteriophages for typhoid surveillance and evaluating vaccine impact
Authors: Hooda Yogesh , Islam Shuborno , Kabiraj Rathin , Rahman Hafizur , da Silva Kesia E. , Raju Rajan Saha , Luby Stephen P , Andrews Jason R , Saha Samir K , Saha Senjuti 
Published: February 2023

ABSTRACTTyphoid-conjugate vaccines (TCVs) provide an opportunity to reduce the burden of typhoid fever, caused bySalmonellaTyphi, in endemic areas. As policymakers design vaccination strategies, accurate and high-resolution data on disease burden is crucial. However, traditional blood culture-based surveillance is resource-extensive, prohibiting its large-scale and sustainable implementation.SalmonellaTyphi is a water-borne pathogen, and here, we tested the potential of Typhi-specific bacteriophage surveillance in surface water bodies as a low-cost tool to identify whereSalmonellaTyphi circulates in the environment. In 2021, water samples were collected and tested for the presence ofSalmonellaTyphi bacteriophages at two sites in Bangladesh: urban capital city, Dhaka, and a rural district, Mirzapur.SalmonellaTyphi-specific bacteriophages were detected in 66 of 211 (31%) environmental samples in Dhaka, in comparison to 3 of 92 (3%) environmental samples from Mirzapur. In the same year, 4,620 blood cultures at the two largest pediatric hospitals of Dhaka yielded 215 (5%) culture-confirmed typhoid cases, and 3,788 blood cultures in the largest hospital of Mirzapur yielded 2 (0.05%) cases. 75% (52/69) of positive phage samples were collected from sewage. All isolated phages were tested against a panel of isolates from differentSalmonellaTyphi genotypes circulating in Bangladesh and were found to exhibit a diverse killing spectrum, indicating diverse bacteriophages were isolated. These results suggest an association between the presence of Typhi-specific phages in the environment and the burden of typhoid fever, and the potential of utilizing environmental phage surveillance as a low-cost tool to assist policy decisions on typhoid control.Highlights-Typhi-specific bacteriophages can be isolated from surface waters in endemic countries using low-cost methods-More Typhi-specific bacteriophages are obtained in areas with higher typhoid cases-Typhi-specific bacteriophages exhibit diverse activity spectrum against a panel ofSalmonellaTyphi isolates circulating in Bangladesh-Environmental surveillance can be used as a tool to predict typhoid burdenGraphical abstract
Synthesising environmental, epidemiological, and genetic data to assist decision making for onchocerciasis elimination
Authors: Shrestha Himal , McCulloch Karen , Chisholm Rebecca H , Armoo Samuel , Vierigh Francis , Sirwani Neha , Crawford Katie E , Osei-Atweneboana Mike , Grant Warwick N , Hedtke Shannon M 
Published: February 2023

AbstractBackgroundPopulation genetics is crucial for understanding the transmission dynamics of diseases like onchocerciasis. Landscape genetics identifies the ecological features that impact genetic variation between sampling sites. Here, we have used a landscape genetics framework to understand the relationship between environmental features and gene flow of the filarial parasiteOnchocerca volvulusand of its intermediate host and vector, blackflies in the genusSimulium. We analysed samples from the ecological transition region separating the savannah and forest ecological regions of Ghana, where the transmission ofO. volvulushas persisted despite almost half a century of onchocerciasis control efforts.MethodsWe generated a baseline microfilarial prevalence map from the point estimates of pre-ivermectin microfilarial prevalence from 47 locations in the study area. We analysed mitochondrial data from 164 parasites and 93 blackflies collected from 15 communities and four breeding sites, respectively. We estimated population genetic diversity and identified correlations with environmental variables. Finally, we compared baseline prevalence maps to movement suitability maps that were based on significant environmental variables.ResultsWe found that the resistance surfaces derived from elevation (r = 0.793, p = 0.005) and soil moisture (r = 0.507, p = 0.002) were significantly associated with genetic distance between parasite sampling locations. Similarly, for the vector populations, the resistance surfaces derived from soil moisture (r = 0.788, p = 0.0417) and precipitation (r = 0.835, p = 0.0417) were significant. The correlation between the baseline parasite prevalence map and the parasite resistance surface map was stronger than the correlation between baseline prevalence and the vector resistance surface map. The central parts of the transition region which were conducive for both the parasite and the vector gene flow were most strongly associated with high baseline onchocerciasis prevalence.ConclusionsWe present a framework for incorporating environmental, genetic, and prevalence data for identifying when ecological conditions are favourable for onchocerciasis transmission between communities. We identified areas with higher suitability for parasite and vector gene flow, which ultimately might help us gain deeper insights into defining transmission zones for onchocerciasis. Furthermore, this framework is translatable to other onchocerciasis endemic areas and to other vector-borne diseases.
PRACTICES OF OCCUPATIONAL HEALTH AND SAFETY AND EXPERIENCE OF OCCUPATIONAL HAZARDS AMONG SOLID WASTE MANAGERS IN PORT HARCOURT METROPOLIS OF RIVERS STATE
Authors: Amadi Stanley Nyemahame , Clement Emmanuel , Pelebo Emmanuel Tamunobelema , Apugo Uchechukwu Ifeanyichukwu 
Published: February 2023

AbstractBackgroundWaste generation is a daily occurrence and requires a proper system of collection, management, and disposal. This function lies on municipal solid waste managers (MSWM) who use manual methods of waste collection and management in the conduct of their activities. This exposes them to various forms of occupational health risks.AimThe study investigated the occupational risk exposure of waste managers in Port Harcourt metropolis.Materials and MethodThis descriptive cross-sectional survey collected data from solid waste collectors or managers who have worked for over a year in the Rivers state, using a researcher-administered semi-structured questionnaire. The data was analysed using SPPS version 23.ResultsA total of 317 were recruited, with the majority as males (68.5%), aged between 30 – 39 years (56.5%), married (55.5%), permanent staff (54.3%), educated to the tertiary level (31.2%), have over 5 years of experience (52.1%) and earn between 30,000 – 39,000 Naira monthly (44.8%). Also, 87.1% of the respondents had good practice of occupational health and safety, while 61.5% and 32% of the waste managers have been exposed to work-related accidents and diseases respectively in course of carrying out their job within the last 12 months. Cuts (30.0%), puncture wounds (20.5%), and road accidents (20.2%) as the most experienced hazards by the workers, while allergies (23.2%) and rash/other skin diseases (22.1%) were the most experienced type of illness.ConclusionThe high prevalence of occupational hazards can be attributed to poor working conditions and lack of adequate safety gear. Hence, there is a need for increased governmental budgetary allocation for the provision safety gear and training
Dynamics of Influenza A and SARS-CoV-2 coinfections during the COVID-19 pandemic in India
Authors: Ravikumar Sandhra , Tamboli Ekant , Rahangdale Shefali , Salsekar Lekha , Tomar Siddharth Singh , Khairnar Krishna 
Published: February 2023

ABSTRACTThe SARS-CoV-2 exhibits similar aetiology, mode of transmission and clinical presentation as the H1N1pdm09 (a subtype of Influenza A) and Influenza A (other subtypes), and can exist as a coinfection in the same patient. It is essential to understand the coinfection dynamics of these viruses for effective management of the disease. This study examined 959 SARS-CoV-2 positive samples collected from the six states and three union territories in India from May to December 2022. The clinical data was accessed from the Integrated Health Information Platform (IHIP) and the Indian council of medical research (ICMR) COVID-19 data portal. The samples were tested for SARS-CoV-2, H1N1pdm09 and Influenza A using Reverse Transcriptase Real-Time Polymerase Chain Reaction q(RT-PCR). All 959 samples were subjected to SARS-CoV-2 whole genome sequencing (WGS) using Oxford Nanopore Next Generation Sequencing (NGS). From the 959 SARS-CoV-2 positive samples, 17.5% were co-infected with H1N1pdm09, 8.2% were co-infected with Influenza A, and 74.2% were only positive for SARS-CoV-2. The comparative analysis of viral load among the coinfected cases revealed that Influenza A and H1N1pdm09 had higher viral loads than SARS-CoV-2 in the studied samples. Out of 959 samples subjected to WGS, 815 and 144 were considered quality control (QC) passed, and QC failed, respectively, for SARS-CoV-2 variant calling. SARS-CoV-2 WGS identified 46 different variants belonging to the Omicron lineage. The SARS-CoV-2 and Influenza A coinfection group; and the SARS-CoV-2 and H1N1pdm09 coinfection group showed a higher proportion of symptomatic cases. This work demonstrates the need for coinfection analysis for the H1N1pdm09 virus, Influenza A virus and SARS-CoV-2 while studying the etiological agent in individuals with ILI/SARI symptoms. It is recommended that, in addition to determining the aetiology of ILI/SARI, an examination for H1N1pdm09 and Influenza A be conducted concurrently utilising molecular tools such as WGS and RT-PCR to understand the variant dynamics and the viral load for taking an informed decision during the patient management and treatment discourse.
ASYMPTOMATIC MONKEY POX VIRUS INFECTION: A SELF-SAMPLING SCREENING INTERVENTION ADRESSED TO GAY, BISEXUAL AND OTHER MEN WHO HAVE SEX WITH MEN AND TRANS WOMEN IN SPAIN
Authors: Agustí Cristina , Martínez-Riveros Héctor , Hernández-Rodríguez Àgueda , Casañ Cristina , Díaz Yesika , Alonso Lucía , Martró Elisa , Muñoz-Basagoiti Jordana , Gallemí Marçal , Folch Cinta , Sönmez Ibrahim , Adell Héctor , Villar Marta , de León Alexia París , Martinez-Puchol Sandra , Pelegrin A.C , Perez-Zsolt Daniel , Raïch-Regué Dàlia , Mora Rubén , Villegas Luis , Clotet Bonaventura , Izquierdo-Useros Nuria , Cardona Pere-Joan , Casabona Jordi 
Published: February 2023

AbstractWe aimed to assess the prevalence of asymptomatic cases of monkeypox virus (MPXV) infection among gay, bisexual, and other men who have sex with men and trans women (TW), using a self-sampling strategy. Anal and pharyngeal swabs were tested by MPXV real-time PCR and positive samples inoculated into Vero E6 cells, which were subsequently checked for cytopathic effect (CPE).Seven out 113 participants were MPXV positive (6.19% (95% CI: 1.75%-10.64%)). Five tested positive in pharyngeal swabs, one in anal swab and one in both. Six did not present symptoms recognized as MPXV infection. Three samples were positive for CPE, and showed anti-vaccinia pAb staining by FACS and confocal microscopy.We describe Mpox cases that remain undiagnosed and show reproductive virus despite low viral loads and who might be able to infect others. Restricting testing to individuals reporting Mpox symptoms may not be enough to contain outbreaks.