bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distribution of Bacterial Species and Resistance Patterns in Surgical Site Infection after Prior Administration of Vancomycin and Tobramycin Intrawound Powdered Antibiotic Prophylaxis
Authors: Peterson Danielle F. , McKibben Natasha S. , Lawson Michelle M. , Taylor Linh N. , Yang Qian , Working Selene , Friess Darin M. , Working Zachary M. 
Published: March 2023

Objective:
Evaluate the species distribution and resistance patterns of bacterial pathogens causing surgical site infection (SSI) after operative fracture repair, with and without the use of intrawound powdered antibiotic (IPA) prophylaxis during the index surgery.

Design:
Retrospective cohort study.

Setting:
Academic, level 1 trauma center, 2018–2020.

Patients/Participants:
Fifty-nine deep SSIs were identified in a sample of 734 patients with 846 fractures (IPA [n = 320], control [n = 526]; open [n = 157], closed fractures [n = 689]) who underwent orthopaedic fracture care. Among SSIs, 28 (48%) patients received IPA prophylaxis and 25 (42%) of the fractures were open.

Intervention:
Intrawound powdered vancomycin and tobramycin

Main Outcome Measurements:
Distribution of bacterial species and resistance patterns causing deep surgical site infections requiring operative debridement.

Results:
Zero patients developed infections caused by resistant strains of streptococci, enterococci, gram-negative enterics, Pseudomonas, or Cutibacterium species. The only resistant strains isolated were methicillin resistance (19%) and oxacillin-resistant coagulase-negative staphylococci (16%). There was no associated statistical difference in the proportion of bacterial species isolated, their resistance profiles, or rate of polymicrobial infections between the IPA and control group. Most (93%) cases using IPAs included vancomycin and tobramycin powders. There were 59 SSIs; 28 (9%) in the IPA cohort and 31 (6%) in the control cohort (P = 0.13).

Conclusion:
The use of local antibiotic prophylaxis resulted in no measurable increase in the proportion of infections caused by resistant bacterial pathogens after operative treatment of fractures. However, the small sample size and limited time frame of these preliminary data require continued investigation into their role as an adjunct to SSI prophylaxis.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
The Association Between Central Line-Associated Bloodstream Infection and Central Line Access*
Authors: Ward Andrew , Chemparathy Augustine , Seneviratne Martin , Gaskari Shabnam , Mathew Roshni , Wood Matthew , Donnelly Lane F. , Lee Grace M. , Scheinker David , Shin Andrew Y. 
Published: March 2023

OBJECTIVES:
Identifying modifiable risk factors associated with central line-associated bloodstream infections (CLABSIs) may lead to modifications to central line (CL) management. We hypothesize that the number of CL accesses per day is associated with an increased risk for CLABSI and that a significant fraction of CL access may be substituted with non-CL routes.

DESIGN:
We conducted a retrospective cohort study of patients with at least one CL device day from January 1, 2015, to December 31, 2019. A multivariate mixed-effects logistic regression model was used to estimate the association between the number of CL accesses in a given CL device day and prevalence of CLABSI within the following 3 days.

SETTING:
A 395-bed pediatric academic medical center.

PATIENTS:
Patients with at least one CL device day from January 1, 2015, to December 31, 2019.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
There were 138,411 eligible CL device days across 6,543 patients, with 639 device days within 3 days of a CLABSI (a total of 217 CLABSIs). The number of per-day CL accesses was independently associated with risk of CLABSI in the next 3 days (adjusted odds ratio, 1.007; 95% CI, 1.003–1.012; p = 0.002). Of medications administered through CLs, 88% were candidates for delivery through a peripheral line. On average, these accesses contributed a 6.3% increase in daily risk for CLABSI.

CONCLUSIONS:
The number of daily CL accesses is independently associated with risk of CLABSI in the next 3 days. In the pediatric population examined, most medications delivered through CLs could be safely administered peripherally. Efforts to reduce CL access may be an important strategy to include in contemporary CLABSI-prevention bundles.
Ultrasonic Debridement of Fournier Gangrene
Authors: Tanuma Takahiro , Ishikawa Shoichi , Saito Junpei , Kurihara Takeshi , Ichioka Shigeru 
Published: March 2023

Summary:
Ultrasonic debridement devices are minimally invasive and effective for biofilm removal, allowing for debridement of necrotic tissue while minimizing damage to normal tissues, such as the blood vessels and nerves. The use of ultrasonic debridement has been reported for foot ulcers and pressure ulcers but not Fournier gangrene. The perineal area, which is difficult to surgically debride using electrocautery, is a suitable site for the use of an ultrasonic debridement device because of its proximity to vital organs. We report here a case of Fournier gangrene that healed with testicular sparing using an ultrasonic debridement device.
Randomized Controlled Trial of a Mobile Health Application Based on Roy’s Adaptation Model on Postpartum Adaptation
Authors: Özkan Şat Sultan , Yaman Sözbir Şengül 
Published: March 2023

Abstract

Background
Mobile apps are used worldwide in nursing care, including during pregnancy, childbirth, and postpartum.

Objectives
To determine the effect of a mobile health application developed for pregnant women according to the Roy Adaptation Model on postpartum adaptation.

Methods
This was a single-center, two-arm parallel-group, randomized controlled trial. The study was conducted from March 2021 to August 2021. A mobile application was developed and offered to women in the experimental group from the 32nd–34th gestational weeks to the sixth week postpartum. The Postpartum Self-Evaluation Questionnaire (PSEQ) was administered to both experimental and control groups on the postpartum 10th day and sixth postpartum week. The generalized linear mixed-effects model and the least significant difference test were used to analyze the data.

Results
The study sample consisted of 62 pregnant women. The mean scores from the total PSEQ and the subscales decreased statistically significantly in the postpartum 10th day and postpartum sixth week in the experimental group compared to the control group (p < 0.05). The mean scores from the confidence in the ability to cope with tasks of motherhood and satisfaction with motherhood and infant care subscales indicated a statistically significant difference in group-time interaction.

Discussion
The results indicated that the mobile health application increased postpartum adaptation in women and effectively maintained adaptation until the sixth week postpartum. Use of mobile health applications may help provide practical, accessible, and quality prenatal and postpartum care.
A Randomized Controlled Trial of Listening Visits for Mothers of Hospitalized Newborns
Authors: Segre Lisa S. , McCabe Jennifer E. , Davila Rebecca Chuffo , Carter Cheryl , O’Hara Michael W. , Arndt Stephan 
Published: March 2023

Background
Emotional distress is frequently experienced by mothers whose newborns are hospitalized in a neonatal intensive care unit (NICU). Among these women, there is a critical need for emotional support conveniently delivered at the newborn’s point of care by a trusted and medically knowledgeable professional: a NICU nurse. One promising way to enhance in situ delivery of emotional care is to have a NICU nurse provide Listening Visits (LVs), a brief support intervention developed expressly for delivery by nurses to depressed postpartum women.

Objectives
This trial assessed the feasibility of having NICU nurses deliver LVs to emotionally distressed mothers of hospitalized newborns and compared depression outcomes in a small sample of participants randomized to LVs or usual care (UC).

Methods
In this pilot randomized controlled trial, emotionally distressed mothers of hospitalized newborns were randomized to receive up to six LVs from a NICU nurse or UC from a NICU social worker. To assess change in depression symptoms, women were invited to complete the Inventory of Depression and Anxiety Symptoms–General Depression Scale at enrollment and 4 and 8 weeks post-enrollment.

Results
Depression symptoms declined over time for both groups, with no difference between the two groups. A post hoc analysis of reliable change found higher rates of improvement at the 4-week assessment among recipients of LVs than UC.

Discussion
NICU nurses successfully implemented LVs during this trial. Depression symptom scores did not significantly differ in the two groups posttreatment or at follow-up. Nevertheless, post hoc analyses indicated comparatively higher rates of clinical improvement immediately after LVs, suggesting the intervention can reduce maternal depression early on when women are most distressed.
Identifying Adverse Events in Patients Hospitalized in Isolation or Quarantine Due to COVID-19
Authors: de Arriba Fernández Alejandro , Sánchez Medina Roberto , Dorta Hung María Elena , Álvarez León Eva Elisa 
Published: March 2023

Background
This study evaluated the adverse events of COVID-19 isolation or quarantine in patients with nosocomial SARS-CoV-2 infection admitted to the Hospital Universitario Insular de Gran Canaria.

Methods
This is a retrospective cohort study with 30-day follow-up of 126 patients diagnosed with nosocomial COVID-19 through polymerase chain reaction test, between May 1 and June 30, 2022, in a 500-bed university hospital in the island of Gran Canaria.

Results
Between May 1 and July 30, 2022, a total of 2250 patients were admitted to the Hospital Universitario Insular de Gran Canaria; 126 of them were diagnosed with nosocomial COVID-19 through a polymerase chain reaction test. The rate of nosocomial COVID-19 infection was 5.6%. From the 126 patients of the study population, 27 experienced an adverse event (21.4%) and 2 experienced 2 adverse events (1.6%) due to COVID-19 isolation or quarantine. Thus, a total of 31 adverse events occurred in 29 patients. These events included the following: delay in transfer to other centers of 11 patients who were pending of receiving a negative COVID-19 test result (35.5%), delay or cancellation of diagnostic tests in 9 patients (29%), delay or cancellation of doctor visit in 7 patients (22.6%), and delay or cancellation of surgical or other interventions in 4 patients (12.9%).

Conclusions
Because of the adverse consequences of nosocomial COVID-19 infection in hospitalized patients, measures should be observed for the prevention and control of nosocomial infection transmission, and adverse events related to patient safety issues in health care in isolated or quarantined COVID-19 patients should be prevented.
Pulmonary Vein Sign on Computed Tomography Pulmonary Angiography in Proximal and Distal Chronic Thromboembolic Pulmonary Hypertension With Hemodynamic Correlation
Authors: Gopalan Deepa , Riley Jan Y.J. , Leong Kai’en , Guo Haiwei Henry , Zamanian Roham T. , Hsi Andrew , Auger William , Lindholm Peter 
Published: March 2023

Background:
Pulmonary vein sign (PVS) indicates abnormal pulmonary venous flow on computed tomography pulmonary angiography (CTPA) is a frequent finding in proximal chronic thromboembolic pulmonary hypertension (CTEPH). PVS’s occurrence in distal CTEPH and correlation to disease severity is unknown. Using right heart catheterization data, we evaluated the relationship between PVS and CTEPH disease distribution and severity.

Materials and Method:
A total of 93 consecutive CTEPH cases with both CTPA and right heart catheterization were identified in this retrospective multi-institutional study. After excluding 17 cases with suboptimal CTPA, there were 52 proximal and 24 distal CTEPH cases. Blood flow in the major pulmonary veins was graded qualitatively. Subgroup analysis of PVS was performed in 38 proximal CTEPH cases before and after pulmonary endarterectomy.

Results:
PVS was more frequent in proximal (79%) than distal CTEPH (29%) (P<0.001). No significant difference was noted in invasive mean pulmonary artery pressure (46±11 and 41±12 mm Hg) or pulmonary vascular resistance (9.4±4.5 and 8.4±4.8 WU) between the 2 groups. In the subgroup analysis, PVS was present in 29/38 patients (76%) before surgery. Postoperatively, 33/38 cases (87%, P<0.001) had normal venous flow (mean pulmonary artery pressure 46±11 and 25; pulmonary vascular resistance 9.2±4.3 and 2.6 WU preop and postop, respectively).

Conclusion:
PVS is a common feature in proximal but infrequent findings in distal CTEPH. PVS does not correlate with hemodynamic severity. PVS resolution was seen in the majority of patients following successful endarterectomy.
Psychosocial Burden of Pediatric and Adult Patients With Congenital Versus Traumatic Facial Differences
Authors: Leung Karen L. , Yang Jason J. , Chen Frank R. , Kim Erinn , Gosman Amanda A. 
Published: March 2023

Background
Psychiatric distress and its effects on healthcare utilization in pediatric patients with congenital and traumatic facial differences remain poorly understood. This study analyzes the psychosocial burden along with mental health and reconstructive surgery services utilization of this patient population in comparison with adult patients with such facial differences.

Methods
The 2004–2012 Medical Expenditures Panel Survey was queried for all patients with facial differences. Socioeconomic variables, Patient Health Questionnaire 2 and Kessler 6 scores, responses from validated screening surveys, and utilization of mental health and reconstructive surgery (ie, plastic surgery and otolaryngology) services were compared between pediatric and adult patients with congenital and traumatic facial differences.

Results
Children ages 5 to 12 years were more likely to be affected by facial trauma, whereas adolescents aged 13 to 17 years were more affected by congenital facial conditions. Pediatric patients with congenital facial conditions had higher rates of medical care, education, and special therapy utilization (P < 0.0001), although their facial trauma counterparts used mental health services more often (P < 0.0001). In adults, more facial trauma patients reported poorer perceived mental health status (P = 0.01). Among patients with any facial difference, distressed adult patients were less likely to see a reconstructive surgeon even when controlling for socioeconomic variables (0.55 [0.31–0.97], P = 0.04).

Conclusions
In the pediatric population, psychosocial considerations should include both age and etiology of facial differences to best optimize care. Among adults with facial trauma, poor mental health may contribute to lower rates of surgical follow-up, highlighting a potential benefit for provision of mental health services earlier for these patient populations.
A Simple and Effective Intraoperative Technique for Correction of Severe Congenital Breast Asymmetry
Authors: Pu Lee L.Q. 
Published: March 2023

Background
One severe type of congenital breast asymmetry, with a hypoplastic breast on one side and a hyperplastic breast on the other side, has been recognized in the author's practice. Although breast augmentation, mastopexy, and breast reduction used separately or in combination are the most common procedures performed to correct congenital asymmetrical breasts, an effective approach for the correction of such a congenital breast asymmetry has not been established in the literature. In this article, a simple and effective intraoperative approach is described for correction of severe congenital breast asymmetry.

Method
Breast augmentation with an implant for the hypoplastic side and mastopexy or small breast reduction for the hyperplastic side were performed. Symmetry was achieved intraoperatively by an implant for breast augmentation on the hypoplastic side and mastopexy or small reduction, determined by a tailor-tacking technique, on the hyperplastic side.

Results
In the past 2 years, a total of 4 patients with severe congenital breast asymmetry was operated on by the author with this established approach. All patients were pleased about their symmetry and cosmetic outcome without any surgical complications. The resulted breast scars are minimal and well tolerated by patients. No revision or subsequent surgery has even been needed during follow-op.

Conclusion
Correction of severe congenital breast asymmetry is not an easy task and can be difficult. This simple and effective intraoperative approach provides a relatively easy and logical way as a 1-stage procedure for this subgroup of patients with symmetrical and cosmetically pleasing outcome.
Incidence of Complications Associated With Lipectomy Techniques and Patient Body Mass Index
Authors: Mansour Ahmed , Steele Andrew , Terrasse Weston , Butte Zara , Kincaid Hope , Wallace Sean , Miller Nathan , Miles Marshall , Wojcik Randolph , Murphy Robert X. 
Published: March 2023

IntroductionAn evaluation of complication rates in different abdominal lipectomy techniques with relationship to body mass index (BMI) and other risk factors.MethodsWe identified patients who underwent an abdominal lipectomy at our institution from January 2015 to July 2020. Those with concurrent hernia repair were excluded. Patients were classified into 2 groups: (1) horizontal lipectomy with or without umbilical translocation and (2) inverted-T lipectomy with translocation. Demographics, operative details, and postoperative complications were collected for 1 year postoperatively. Bivariate analyses were conducted to determine factors associated with type of procedure and complications. Crude and stratum-specific (based on BMI) odds ratios for complications were calculated for the inverted T as compared with the horizontal group. A replicate analysis using the national Tracking Operations and Outcomes for Plastic Surgeons (TOPS) as a single cohort was performed.ResultsAt our institution, 362 patients (group 1 = 196, group 2 = 166) were included. A total of 40.9% of patients experienced at least one complication at 1 year postoperatively with the complication rate decreasing to 28.0% when analyzed at the 30-day postoperative period. Specifically, wound disruption rates were highest in group 2 (39.8%) compared with group 1 (15.6%;P< 0.0001). The odds of experiencing a complication were greater in the inverted-T group overall and within each stratum of BMI. When dividing the cohort based on BMI class (normal weight, overweight, class I, class II, and class III obesity), the incidence of wound disruption increased as did BMI (2.6%, 22.2%, 27.2%, 48.2%, and 56.3%, respectively;P< 0.0001). The TOPS data set included 23,067 patients and showed an overall complication rate of 13.1% at 30-day postop. Overall, wound disruption rate was 4.6%. Compared with normal weight patients, the odds of experiencing a complication trended higher with each stratum of BMI. Other factors associated with complications included BMI, tobacco use, diabetes, American Society of Anesthesiology, prior massive weight loss, and LOS.ConclusionsThe increasing complication rate within each BMI stratum of the large sample size of the TOPS patient cohort, in addition to our similar institutional trends, suggests that a staged procedure may be more appropriate for higher BMI patients. Surgical technique modification with limited flap undermining in patients undergoing inverted-T lipectomy to preserve flap perfusion may also decrease overall complication rates.
Glycome profiling and immunohistochemistry uncover spaceflight-induced changes in non-cellulosic cell wall components inArabidopsis thalianaseedling roots
Authors: Nakashima Jin , Pattathil Sivakumar , Avci Utku , Chin Sabrina , Sparks J. Alan , Hahn Michael G. , Gilroy Simon , Blancaflor Elison B. 
Published: March 2023

ABSTRACTA large and diverse library of glycan-directed monoclonal antibodies (mAbs) was used to determine if plant cell walls are modified by low-gravity conditions encountered during spaceflight. This method called glycome profiling (glycomics) revealed global differences in non-cellulosic cell wall epitopes inArabidopsis thalianaroot extracts recovered from RNA purification columns between seedlings grown on the International Space Station-based Vegetable Production System and paired ground (1-g) controls. Immunohistochemistry on 11-day-old seedling primary root sections showed that ten of twenty-two mAbs that exhibited spaceflight-induced increases in binding through glycomics, labeled space-grown roots more intensely than those from the ground. The ten mAbs recognized xyloglucan, xylan, and arabinogalactan epitopes. Notably, three xylem-enriched unsubstituted xylan backbone epitopes were more intensely labeled in space-grown roots than in ground-grown roots, suggesting that the spaceflight environment accelerated root secondary cell wall formation. This study highlights the feasibility of glycomics for high-throughput evaluation of cell wall glycans using only root high alkaline extracts from RNA purification columns, and subsequent validation of these results by immunohistochemistry. This approach will benefit plant space biological studies because it extends the analyses possible from the limited amounts of samples returned from spaceflight and help uncover microgravity-induced tissue-specific changes in plant cell walls.
Assignment of the somatic A/B compartments to chromatin domains in giant transcriptionally active lampbrush chromosomes
Authors: Krasikova Alla , Kulikova Tatiana , Rodriguez Ramos Juan Sebastian , Maslova Antonina 
Published: March 2023

AbstractThe three-dimensional configuration of the eukaryotic genome is an emerging area of research. Chromosome conformation capture outlined genome segregation into large scale A and B compartments corresponding mainly to transcriptionally active and repressive chromatin. It remains unknown how the compartmentalization of the genome changes in growing oocytes of animals with hypertranscriptional type of oogenesis. In this type of oogenesis, highly elongated chromosomes, called lampbrush chromosomes, acquire a characteristic chromomere-loop appearance, representing one of the classical model systems for studying the structural and functional organization of chromatin domains. Here, we compared the distribution of A/B compartments in chicken somatic cells with chromatin domains in lampbrush chromosomes. We found that in lampbrush chromosomes, the extended chromatin domains, restricted by compartment boundaries in somatic cells, disintegrate into individual chromomeres. Next, we performed FISH-mapping of the genomic loci, which belong to A or B chromatin compartments as well as to A/B compartment transition regions in embryonic fibroblasts on isolated lampbrush chromosomes. We established, that in chicken lampbrush chromosomes, clusters of dense compact chromomeres bearing short lateral loops and enriched with repressive epigenetic modifications generally correspond to constitutive B compartments in somatic cells. These results suggest that gene-poor regions tend to be packed into chromomeres. Clusters of small loose chromomeres with relatively long lateral loops show no obvious correspondence with either A or B compartment identity. Some genes belonging to facultative B (sub-) compartments can be tissue-specifically transcribed during oogenesis, forming distinct lateral loops.