bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sarcopenia Best Predicts Complications in Free Flap Breast Reconstruction
Authors: Jain Nirbhay S. , Bingham Elijah , Luvisa B. Kyle , Frydrych Lynn M. , Chin Madeline G. , Bedar Meiwand , Da Lio Andrew , Roostaeian Jason , Crisera Christopher , Slack Ginger , Tseng Charles , Festekjian Jaco H. , Delong Michael R. 
Published: July 2023

Background:
Breast reconstruction remains a major component of the plastic surgeon’s repertoire, especially free-flap breast reconstruction (FFBR), though this is a high-risk surgery in which patient selection is paramount. Preoperative predictors of complication remain mixed in their utility. We sought to determine whether the sarcopenia score, a validated measure of physiologic health, outperforms the body mass index (BMI) and modified frailty index (mFI) in terms of predicting outcomes.

Methods:
All patients with at least 6-months follow-up and imaging of the abdomen who underwent FFBR from 2013 to 2022 were included in this study. Appropriate preoperative and postoperative data were included, and sarcopenia scores were extracted from imaging. Complications were defined as any unexpected outcome that required a return to the operating room or readmission. Statistical analysis and regression were performed.

Results:
In total, 299 patients were included. Patients were split into groups, based on sarcopenia scores. Patients with lower sarcopenia had significantly more complications than those with higher scores. BMI and mFI both did not correlate with complication rates. Sarcopenia was the only independent predictor of complication severity when other factors were controlled for in a multivariate regression model.

Conclusions:
Sarcopenia correlates with the presence of severe complications in patients who undergo FFBR in a stronger fashion to BMI and the mFI. Thus, sarcopenia should be considered in the preoperative evaluation in patients undergoing FFBR.
Skin Cancer: Back to Basics
Authors: Baumann John R. , Groneck Andrew D. , Martin Kari L. 
Published: July 2023

ABSTRACT
Dermatofibrosarcoma protuberans is a soft tissue tumor that arises from the dermis. This relatively rare, low-grade tumor has a high propensity for local recurrence unless it is completely excised. Dermatofibrosarcoma protuberans classically progresses slowly as a plaque on the trunk of young adults. It often resembles a scar that is slowly growing over months to years. Because of its rarity and subtle progression, this form of skin cancer will often go undiagnosed for years. Over time, dermatofibrosarcoma protuberans can become invasive into the subcutaneous fat, muscle, fascia, and chest wall. Diagnosis of dermatofibrosarcoma protuberans is made by a core needle or incisional biopsy. Once diagnosed, cure rates approach 100%. The purpose of this article is to review the epidemiology, pathophysiology, clinical features, differential diagnosis, diagnosis, staging, and treatment of dermatofibrosarcoma protuberans. Increasing healthcare providers' awareness about this rare form of skin cancer and its recognition may improve patient outcomes.
Patient Perspective Column
Authors: Johnson Tonja , Brickley Sylvana 
Published: July 2023

ABSTRACT
The Beautifully Unblemished Vitiligo Support Group is based in Florida, United States. In this article, Tonja Johnson, the founder of the Beautifully Unblemished Vitiligo Support Group, talks about her experience with having vitiligo and offers her perspective on how nurses can provide excellent care to patients with vitiligo.
A successful management of fungal peritonitis caused by Rhodotorula glutinis in CAPD patient, coincident with onychomycosis by Penicillium sp: Case report
Authors: Panggabean Steven David , Hustrini Ni Made 
Published: July 2023

Rationale:

Rhodotorula glutinis is a rare cause of fungal peritonitis in peritoneal dialysis (PD) patients. The combination treatment between aggressive PD catheter replacement and adequate antifungal treatment is crucial in managing peritonitis due to fungal infection and onychomycosis.

Patient concerns:
A 37-year-old man PD patient presented with cloudy effluent, abdominal pain, and black debris in the lumen of his PD catheter. Twelve days before admission, the patient traveled for 10 days to a high-temperature country, Saudi Arabia, for purpose of accomplishing haj. From the physical examinations, there was an onychomycosis in his right toenail.

Diagnoses:
The result of the dialysate cell count confirmed the evidence of peritonitis (i.e., cell count of 187 cells per µL, however with polymorphonuclear 31%). The dialysate culture indicated R glutinis, with no growth of bacteria. Fungal culture of his toenail scrapings was obtained and the result was Penicillium sp.

Interventions:
Based on the high clinical suspicion of fungal peritonitis, fluconazole intraperitoneal (IP) was immediately given on the first day in addition to empirical antibiotics, that is, cefazolin and gentamycin IP. His peritoneal catheter was simultaneously removed and reinserted on the 4th day of treatment. Since there was a sign of fluconazole resistance, fluconazole IP was switched into oral voriconazole, without any antimicrobial treatment intraperitoneally. After 21 days of voriconazole, oral itraconazole was given until 3 months for his onychomycosis.

Outcomes:
Clinical improvement was seen on the effluent where the leucocyte count falls below 100 cells after 21 days of giving voriconazole.

Lessons:
This case report suggests the need for comprehensive evaluations of the risk for fungal infection in continuous ambulatory PD patients, especially those who live in a tropical country.
The clinical value of color ultrasound screening for fetal cardiovascular abnormalities during the second trimester: A systematic review and meta-analysis
Authors: Shi Bingye , Han Zhe , Zhang Wei , Li Wenxiu 
Published: July 2023

Background:
This meta-analysis aimed to investigate the diagnostic value of color ultrasound screening for fetal cardiovascular abnormalities during the second trimester in China.

Methods:
A literature search was conducted to evaluate the clinical value of color ultrasound screening for fetal cardiovascular abnormalities during the second trimester using English and Chinese databases. Numerical values for sensitivity and specificity were obtained from false-negative, false-positive, true-negative, and true-positive rates, presented alongside graphical representations with boxes marking the values and horizontal lines showing the confidence intervals. Summary receiver operating characteristic (SROC) curves were applied to assess the performance of the diagnostic tests. Data were processed using Review Manager 5.3.

Results:
Four studies (151 patients with fetal cardiovascular abnormalities and 3397 undiagnosed controls) met our evaluation criteria. The sensitivity was 0.91 and 0.96, respectively, and the specificity was 1.00. The Area Under the Curve (AUC) from the SROC curves was >90%; therefore, it was classified as excellent. Furthermore, there were 6 types of fetal cardiovascular abnormalities, and the pooled screening rate of atrioventricular septal defects was the highest.

Conclusion:
Our meta-analysis showed that the use of color ultrasound during the second trimester can be an excellent diagnostic tool for fetal cardiovascular abnormalities.
Effect of constraint-induced movement therapy combined with neuromuscular electrical stimulation on upper extremity function in stroke survivors: A protocol for systematic review
Authors: Dboba Mahmoud M. , Mohd Nordin Nor Azlin , Manaf Haidzir , Mohd Rasdi Hanif Farhan 
Published: July 2023

Background:
Motor impairment is common after a stroke and directly affects the function and quality of life of stroke survivors. Constraint-induced movement therapy and neuromuscular electrical stimulation are interventions that facilitate functional recovery of the upper extremities of a particular subgroup of stroke survivors. The objective of this study was to summarize the available evidence on the effects of neuromuscular electrical stimulation combined with constraint-induced movement therapy in patients with stroke.

Methods:
We conducted a comprehensive search of published articles in electronic databases, including PubMed, Scopus, PEDro, Medline (via Ovid), EMBASE, Cochrane Library, and Web of Science, using the following search terms: “stroke”; “upper extremity”; “Constraint-Induced Movement Therapy”; and “Neuromuscular Electrical Stimulation.” The search included published studies, conferences, and presentations. The article selection, data extraction, and quality evaluation will be conducted independently by 2 reviewers. The 3rd and 4th reviewers will assist in resolving any disagreements that may arise between the 2 reviewers. The risk of bias in the included studies will be assessed using the PEDro scale and Cochrane risk of bias assessment tool. Narrative synthesis and meta-analysis will be performed based on the characteristics of the included articles, including the risk of bias (if sufficient information is available).

Results:
This review summarizes the available evidence and could assist therapists in choosing the best treatment for poststroke upper extremity dysfunction.

Conclusion:
This study will provide the available evidence on the effectiveness of CIMT and NMES on upper extremity function in patients with stroke.

Ethics and dissemination:
Ethical approval is not required because the review will be based on publicly available literature. The findings of this study will be published in a peer-reviewed journal, and updates will be made depending on whether sufficient additional evidence modifies the conclusions of the review. Any changes made to the methods throughout the review will be stated in the article.

Systematic review registration:
PROSPERO CRD42023415645.
Early diagnosis for pulmonary embolism: A systematic review and meta-analysis
Authors: Ma Minjun , Li Yu , Xu Xiujuan , Ji Conghua 
Published: July 2023

Background:
The incidence of acute pulmonary embolism (APE) (especially early diagnosis) has increased annually in recent years, but the diagnosis of APE is a great challenge for every clinician. However, few studies have evaluated multiple diagnostic indicators simultaneously.

Methods:
A systematic search was performed using CNKI, Wan fang data, VIP, PubMed and Web of Science for studies on the diagnosis of pulmonary embolism published up to October 31, 2022. Using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2), we evaluated the risk of bias in included studies, and used a random-effects meta-analysis to obtain the summary sensitivity and specificity. The data that were extracted and calculated for this study included the first author, year of publication, country, study type, sample size, disease type, gold standard, diagnostic indicators and 4-compartment table data. We strictly followed the Preferred Reporting Items for Systematics reviews and Meta-Analysis (PRISMA) guidelines in this review.

Results:
This study included 30 articles with a total sample size of 8947 cases, involving 4 detection methods: D-dimer, Geneva rules, Wells rules, and lung imaging. The combined effect size showed that lung imaging had the highest diagnostic value (SEN = 0.95, SPE = 0.89), followed by D-dimer (SEN = 0.92, SPE = 0.60), Geneva rules (SEN = 0.78, SPE = 0.68), and Wells rules (SEN = 0.77, SPE = 0.67). The area of lung imaging was largest under the Summary Receiver Operator Characteristic (SROC) curve (AUC = 0.97), followed by Geneva rules (AUC = 0.80), Wells rules (AUC = 0.79), and D-dimer (AUC = 0.74).

Conclusion:
All 4 detection methods showed good ability to diagnose PE, and lung imaging was the best. Clinical trials are recommended to build an early decision-making model for the diagnosis of pulmonary embolism in order to increase the detection rate and improve prognosis.
Individual and Organizational Factors Associated With Nurse Manager Success
Authors: Schlotzhauer Ann E. , Cramer Emily , Grandfield Elizabeth M. , Warshawsky Nora E. 
Published: July 2023

OBJECTIVE
The aim of this study was to synthesize previous findings and provide practical guidance for maximizing nurse manager and nurse performance.

BACKGROUND
Two recent studies have linked nurse manager job design factors and individual differences to a variety of valued outcomes, but practical implications remain unclear.

METHODS
A large US sample of nurse managers was divided on the basis of nurse and patient outcomes. Various characteristics are compared across the highest and lowest performers.

RESULTS
Wider nurse manager span of control is associated with negative outcomes; the availability of support positions does not fully alleviate the consequences of wide spans. Nurse managers with fewer subordinates can effectively manage multiple units. Nurse manager experience is critical for success and cannot be fully replaced by leadership training programs.

CONCLUSIONS
Staffing and job design decisions have critical downstream implications. The present research provides guidance for effective staffing and job design.
Leveraging Multiyear, Geospatial Social Media Data for Health Policy Evaluations: Lessons From the Philadelphia Beverage Tax
Authors: Ali Shahmir H. , Lowery Caitlin M. , Trude Angela C. B. 
Published: July 2023

Context:
Public reactions to health policies are vital to understand policy sustainability and impact but have been elusively difficult to dynamically measure. The 2021 launch of the Twitter Academic Application Programming Interface (API), allowing for historical tweet analyses, represents a potentially powerful tool for complex, comprehensive policy analyses.

Objective:
Using the Philadelphia Beverage Tax (implemented January 2017) as a case study, this research extracted longitudinal and geographic changes in sentiments, and key influencers in policy-related conversations.

Design:
The Twitter API was used to retrieve all publicly available tweets related to the Tax between 2016 and 2019.

Setting:
Twitter.

Participants:
Users who posted publicly available tweets related to the Philadelphia Beverage Tax (PBT).

Main Outcome:
Tweet content, frequency, sentiment, and user-related information.

Measures:
Tweet content, authors, engagement, and location were analyzed in parallel to key PBT events. Published emotional lexicons were used for sentiment analyses.

Results:
A total of 45 891 tweets were retrieved (1311 with geolocation data). Changes in the tweet volume and sentiment were strongly driven by Tax-related litigation. While anger and fear increased in the months prior to the policy's implementation, they progressively decreased after its implementation; trust displayed an inverse trend. The 50 tweeters with the highest positive engagement included media outlets (n = 24), displaying particularly high tweet volume/engagement, and public personalities (n = 10), displaying the greatest polarization in tweet sentiment. Most geo-located tweets, reflecting 321 unique locations, were from the Philadelphia region (55.2%). Sentiment and positive engagement varied, although concentrations of negative sentiments were observed in some Philadelphia suburbs.

Conclusions:
Findings highlighted how longitudinal Twitter data can be leveraged to deconstruct specific, dynamic insights on public policy reactions and information dissemination to inform better policy implementation and evaluation (eg, anticipating catalysts for both heightened public interest and geographic, sentiment changes in policy conversations). This study provides policymakers a blueprint to conduct similar cost and time efficient yet dynamic and multifaceted health policy evaluations.
Facial Contour Features Measured on CT Reflects Upper Airway Morphology in Patients With OSA
Authors: Zhang Zishanbai , Sun Dance , Jia Yajie , Fei Nanxi , Li Yanru , Han Demin 
Published: July 2023

Objective:
To determine facial contour features, measured on computed tomography (CT), related to upper airway morphology in patients with obstructive sleep apnea (OSA); certain phenotype of facial abnormalities implying restriction of craniofacial skeleton and adipose tissue nimiety has predicted the value of the severity of OSA.

Materials and Method:
Sixty-four male patients with OSA [apnea-hypopnea index (AHI) ≥10/h] who had upper airway CT were randomly selected to quantitatively measure indicators of facial contour and upper airway structures. Pearson correlation analyses were performed. Partial correlation procedure was used to examine correlations while controlling body mass index (BMI).

Results:
Upper airway anatomy can nearly all be reflected in the face, except retroglossal airway. Upper face width can be measured to assess the overall skeletal structures of the airway. Lower face width can be used to represent how much adipose tissue deposited. Hard palate, retropalatal, and hypopharyngeal airways have corresponding face indicators respectively. Midface width is a better predictor of AHI severity and minimum blood oxygen even than neck circumference because it contains the most anatomical information about the airway, including RP airway condition, soft palate length, tongue volume, etc. These correlations persisted even after correction for BMI.

Conclusions:
All anatomical features of the upper airway except retroglossal airway can be reflected in the face, and midface width is the best predictor of AHI severity and minimum blood oxygen, even better than neck circumference and BMI.
Clinical and neuroimaging features of the progressive supranuclear palsy- corticobasal degeneration continuum
Authors: Whitwell Jennifer L. 
Published: July 2023

Purpose of review
The aim of this study was to discuss how recent work has increased our understanding of progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). The investigation of large and autopsy-confirmed cohorts, imaging modalities to assess different aspects of pathophysiology, clinical phenotypes and the application of advanced machine learning techniques, have led to recent advances in the field that will be discussed.

Recent findings
Literature over the past 18 months will be discussed under the following themes: studies assessing how different neuroimaging modalities can improve the diagnosis of PSP and CBD from other neurodegenerative and parkinsonian disorders, including the investigation of pathological targets such as tau, iron, neuromelanin and dopamine and cholinergic systems; work improving our understanding of clinical, neuroanatomical and pathological heterogeneity in PSP and CBD; and work using advanced neuroimaging tools to investigate patterns of disease spread, as well as biological mechanisms potentially driving spread through the brain in PSP and CBD.

Summary
The findings help improve the imaging-based diagnosis of PSP and CBD, allow more targeted prognostic estimates for patients accounting for phenotype or disease, and will aid in the development of appropriate and better-targeted disease biomarkers for clinical treatment trials.
Exploring the Association between Contraceptive Use and Women’s tolerance towards Domestic Violence: Evidence from MICS 2019 Survey
Authors: Haider Tanvir , Al Fidah Md Fuad , Hossain Md Emam , Mahdee Syed Nafi , Efa Syeda Sumaiya 
Published: July 2023

AbstractBackgroundAccess to contraception is crucial for preventing unintended pregnancies and promoting reproductive rights. In Bangladesh, the contraceptive prevalence rate (CPR) has increased over the decades. However, domestic violence (DV) remains a major concern. Women who experience DV are more likely to have unintended pregnancies and abortions. They are also more likely to live in poverty and experience depression and anxiety.ObjectiveThis study aimed to assess the relationship between contraceptive use and women’s tolerance of DV in Bangladesh.MethodsData from the Bangladesh Multiple Indicator Cluster Survey (MICS) 2019 was used for the study. The sample size was 47,692 women aged 15-49; data were analyzed using Jamovi software (version 2.3.26). Ethical considerations were strictly followed.ResultsThe study found a contraception utilization rate of 66.5% among Bangladeshi women of reproductive age. Factors associated with contraceptive use included age, residence, education level of the woman, marital structure, wealth index, and tolerance for domestic violence. Women with high tolerance towards domestic violence had higher odds (AOR: 1.1; 95% CI: 1.017-1.189; p = 0.017) of using contraception than women with no tolerance.ConclusionThe study’s result suggest a complex relationship between contraceptive use, women’s tolerance of domestic violence, and other factors such as age, education, wealth, location, etc. Programs and policies are needed to promote contraceptive use in Bangladesh. Efforts should target socioeconomic, cultural, and psychological factors and barriers which are faced by women exposed to domestic violence. By tackling these challenges, programs, and policies can effectively promote contraception use and improve women’s reproductive health.
The Cardiovascular Impact and Genetics of Pericardial Adiposity
Authors: Rämö Joel T , Kany Shinwan , Hou Cody R , Friedman Samuel F , Roselli Carolina , Nauffal Victor , Koyama Satoshi , Karjalainen Juha ,   FinnGen, Maddah Mahnaz , Palotie Aarno , Ellinor Patrick T , Pirruccello James P 
Published: July 2023

AbstractBackgroundWhile previous studies have reported associations of pericardial adipose tissue (PAT) with cardiovascular diseases such as atrial fibrillation and coronary artery disease, they have been limited in sample size or drawn from selected populations. Additionally, the genetic determinants of PAT remain largely unknown. We aimed to evaluate the association of PAT with prevalent and incident cardiovascular disease and to elucidate the genetic basis of PAT in a large population cohort.MethodsA deep learning model was trained to quantify PAT area from four-chamber magnetic resonance images in the UK Biobank using semantic segmentation. Cross-sectional and prospective cardiovascular disease associations were evaluated, controlling for sex and age. A genome-wide association study was performed, and a polygenic score (PGS) for PAT was examined in 453,733 independent FinnGen study participants.ResultsA total of 44,725 UK Biobank participants (51.7% female, mean [SD] age 64.1 [7.7] years) were included. PAT was positively associated with male sex (β = +0.76 SD in PAT), age (r= 0.15), body mass index (BMI;r= 0.47) and waist-to-hip ratio (r= 0.55) (P < 1×10-230). PAT was more elevated in prevalent heart failure (β = +0.46 SD units) and type 2 diabetes (β = +0.56) than in coronary artery disease (β = +0.22) or AF (β = +0.18). PAT was associated with incident heart failure (HR = 1.29 per +1 SD in PAT [95% CI 1.17–1.43]) and type 2 diabetes (HR = 1.63 [1.51–1.76]) during a mean 3.2 (±1.5) years of follow-up; the associations remained significant when controlling for BMI. We identified 5 novel genetic loci for PAT and implicated transcriptional regulators of adipocyte morphology and brown adipogenesis (EBF1,EBF2andCEBPA) and regulators of visceral adiposity (WARS2andTRIB2). The PAT PGS was associated with T2D, heart failure, coronary artery disease and atrial fibrillation in FinnGen (ORs 1.03–1.06 per +1 SD in PGS, P < 2×10-10).ConclusionsPAT shares genetic determinants with abdominal adiposity and is an independent predictor of incident type 2 diabetes and heart failure.Clinical PerspectiveWhat is new?In a large, prospective and uniformly phenotyped cohort, pericardial adipose tissue was independently predictive of incident heart failure and type 2 diabetes when adjusted for body mass index.In contrast, pericardial adipose tissue was not independently predictive of atrial fibrillation.A genome-wide association study of pericardial adipose tissue identified five novel loci, implicating genes influencing adipocyte morphology, brown-like adipose tissue differentiation and abdominal adiposity.What are the clinical implications?Pericardial adipose tissue accumulation may reflect a metabolically unhealthy adiposity phenotype similarly to abdominal visceral adiposity.