bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Amino Acids in Extremely Preterm Infants and Neurodisability at 2 Years
Authors: Bloomfield F.H. , Jiang Y. , Harding J.E. , Crowther C.A. , Cormack B.E. ,   ProVIDe Trial Group
Published: May 2023

(N Engl J Med. 2022;387:1661–1672)
Adequate fetal amino acid intake is an essential part of proper growth and development in utero. Despite its importance, the optimal protein intake for extremely low birth weight (<1000 g) infants has yet to be determined. The primary aim of this study is to determine whether an additional intake of 1 g per day of amino acids in extremely low birth weight infants beginning within 24 hours of delivery through the first 5 days of life will increase 2-year survival rates of children without neurodisability, adjusting for gestational age at the time of delivery. Secondary aims are to determine what neonatal morbidity and growth outcomes are associated with the additional intake of 1 g per day of amino acids in the same patient population.
The Incidence of Breakthrough Pain Associated With Programmed Intermittent Bolus Volumes for Labor Epidural Analgesia: A Randomized Controlled Trial
Authors: Zuo R.H. , Dang J.J. , Zhuang J.W. , Chen Q.M. , Zhang J.Y. , Zheng H.W. , Wang Z.P. 
Published: May 2023

(Int J Obstet Anesth. 2022;51:103571)
Previously, ideal programmed intermittent epidural bolus (PIEB) doses were unknown despite the wide belief that use of PIEB may reduce local anesthetic use, improve quality of analgesia and maternal satisfaction, and reduce motor block compared with continuous epidural infusion. This study compared 3 different dosages of a PIEB to determine impact on breakthrough pain and other labor analgesia factors.
Evaluation of a Quality Improvement Bundle Aimed to Reduce Opioid Prescriptions After Cesarean Delivery: An Interrupted Time Series Study
Authors: Laksono I. , Matelski J. , Flamer D. , Gold S. , Selk A. 
Published: May 2023

(Can J Anesth/J Can Anesth. 2022;69:1007–1016)
There are efforts from the medical community and the public to reduce the prescription of opioids in the United States and Canada. Quality improvement (QI) initiatives have been successfully used to reduce opioid prescriptions in patients undergoing cesarean delivery (CD). This study assessed opioid prescribing rates following a quality improvement initiative, hypothesizing there would be a lower rate of opioid prescription in post-CD patients following implementation of the QI bundle.
A 31-Year-Old Woman With Postpartum Abdominal Pain and Fever
Authors: Little S.E. , Catalano O.A. , Edlow A.G. , Shroff S.G. 
Published: May 2023

(N Engl J Med. 2022;387:2367–2375)
This case presented 15 days after the patient’s vaginal delivery of a healthy baby, when she was admitted to the hospital with abdominal pain and fever. Sixteen days prior, spontaneous labor had been augmented by artificial membrane rupture (showing clear, odorless fluid) and oxytocin infusion. An elevated white-cell count was noted (13,800/mL, 4500 to 11,000/mL reference range) and intravenous penicillin was administered. Hemoglobin was noted to be 14.0 g/dL (12.0 to 16.0 g/dL reference range). Delivery occurred 6 hours later, followed immediately by uterine atony hemorrhage with 500 mL of blood loss. Hemostasis was achieved by bimanual massage of the uterus, and administration of oxytocin and methylergonovine. A routine repair of a perineal laceration was also performed. The patient discharged from the hospital on postpartum day 1.
Correction of Breast Ptosis in Immediate Breast Reconstruction
Authors: Bushong Elizabeth E. , Komorowska-Timek Ewa D. , Parker Jessica 
Published: May 2023

Background:
Nipple-sparing mastectomy is psychologically advantageous and can result in superior cosmetic outcomes. However, nipple position adjustment is challenging, and ischemic complications may arise. For patients who require timely mastectomies and reconstructions, concurrent mastopexy may prevent nipple malposition and reduce the risk for future corrections.

Methods:
A retrospective chart review of all patients undergoing immediate prosthetic reconstruction after nipple-sparing mastectomy were analyzed. Data regarding patient characteristics; surgical indications; reconstructive modality, including presence or absence of simultaneous nipple lift; and early and late complications were examined.

Results:
In total, 142 patients underwent 228 nipple-sparing mastectomies and prosthetic reconstructions. Correction of ptosis (lift) was performed in 22 patients and 34 breasts. The remaining 122 patients and 194 breasts did not receive mastopexy (no-lift). Two patients received bilateral reconstructions involving both lift and no-lift. Comparing the lift and no-lift cohorts demonstrated no differences in major complications (47.1% versus 57.7%; P = 0.25) and minor complications (76.5% versus 74.7%; P = 0.83). Control for plane of implant placement also did not show differences in major (P = 0.31) or minor (P = 0.97) complications. Similarly, control of application of acellular dermal matrix found major (P = 0.25) and minor (P = 0.83) complications uniform and not affected by lift status. Nipple lift distance was not associated with increased major (P = 0.10) complications.

Conclusion:
Simultaneous correction of nipple position in immediate prosthetic breast reconstruction seem safe with uniform complications rates that are unaffected by acellular dermal matrix use or plane of implant placement.
Fertility-sparing Scrotal Reconstruction with a Superficial Circumflex Iliac Perforator Flap
Authors: Ando Nobuhiro , Akita Shinsuke , Mitsukawa Nobuyuki 
Published: May 2023

Summary:
It is believed that skin flaps should not be used to reconstruct large scrotal defects because thick flaps increase testicular temperature and decrease fertility, and those skin grafts should be used to reconstruct large scrotal defects. We report a case of extensive scrotal defect reconstructed with bilateral superficial circumflex iliac perforator (SCIP) flaps in which spermatogenesis improved postoperatively over time. A 44-year-old man underwent reconstruction of an extensive scrotal defect caused by Fournier gangrene, and bilateral SCIP flaps were used for the reconstruction. In the third postoperative month, his semen volume and sperm count after centrifugation were 1.5 mL and eight, respectively. Based on these semen findings, fertility specialists diagnosed the patient with extremely low fertility. In the ninth postoperative month, the semen volume was 2.2 mL, sperm density was 2.7 × 106/mL, sperm motility was 64%, and normal sperm morphology was 54%, indicating significant improvement. Based on the sperm findings, fertility specialists considered the patient capable of causing pregnancy. There have been no reports of preservation of spermatogenesis after scrotal reconstruction with a thinned perforator flap. In the postoperative period, we observed improvement of spermatogenesis, which suggests that scrotal reconstruction with an SCIP flap may be effective for improving both cosmetic appearance and fertility.
Trends in U.S. HIV Peer Health Worker Training Strategies and Approaches: A Scoping Review of the Literature
Authors: Gormley Maurade , Loughran Claire , Conte Jill , Dunn Navarra Ann-Margaret 
Published: May 2023

Abstract
Peer health workers (peers) are commonly engaged interventionists in the HIV care spectrum. The objective of this scoping review was to examine the range of evidence on training strategies and approaches for peer-led HIV behavioral interventions in the United States. Four electronic databases (Medline, CINAHL, EMBASE, and PsycINFO) were searched for peer-reviewed published literature (2010–2021) of peer-led HIV behavioral interventions directed to improving antiretroviral therapy adherence and/or retention in care. Eighteen studies met the inclusion criteria. Eleven studies referenced manualized training materials, and nine used role-play as part of their curricula. Peer training content and duration varied across studies, as well as evaluation of intervention fidelity, and peer competency. Findings highlight heterogeneity in peer training strategies and approaches. The expansion and sustainability of peer engagement in the HIV care continuum will require greater consensus among members of the research community on best practices for training.
Short-term outcomes following intracorporeal versus extracorporeal anastomosis after laparoscopic right and left-sided colectomy: a propensity score-matched study
Authors: Teramura Koichi , Kitaguchi Daichi , Matsuoka Hiroya , Hasegawa Hiro , Ikeda Koji , Tsukada Yuichiro , Nishizawa Yuji , Ito Masaaki 
Published: May 2023

Background:
To compare the short-term outcomes of patients undergoing intracorporeal anastomosis (IA) during laparoscopic colectomy to those undergoing extracorporeal anastomosis (EA).

Methods and Materials:
The study was a single-center retrospective propensity score-matched analysis conducted. Consecutive patients who underwent elective laparoscopic colectomy without the double stapling technique between January 2018 and June 2021 were investigated. The main outcome was overall postoperative complications within 30 days after the procedure. We also performed a sub-analysis of the postoperative results of ileocolic anastomosis and colocolic anastomosis, respectively.

Results:
A total of 283 patients were initially extracted; after propensity score matching, there were 113 patients in each of the IA and EA groups. There were no differences in patient characteristics between the two groups. The IA group had a significantly longer operative time than the EA group (208 vs. 183 min, P=0.001). The rate of overall postoperative complications was significantly lower in the IA group (n=18, 15.9%) than in the EA group (n=34, 30.1%; P=0.02), especially in colocolic anastomosis after left-sided colectomy (IA: 23.8% vs. EA: 59.1%; P=0.03). Postoperative inflammatory marker levels were significantly higher in the IA group on postoperative day 1 but not on postoperative day 7. There was no difference in the postoperative lengths of hospital stay between the two groups, and no deaths occurred.

Conclusion:
The data suggest that performing IA during laparoscopic colectomy can potentially reduce the risk of postoperative complications, especially in colocolic anastomosis after left-sided colectomy.
The Rate of Eustachian Tube Dysfunction in Adult Patients With Chronic Inflammatory Middle Ear Disease Is Low
Authors: Gey Alexandra , Reiber Julia , Honigmann Robert , Zirkler Jonas , Rahne Torsten , Plontke Stefan K. 
Published: May 2023

Objective
To assess the rate of dilatory (chronic obstructive) eustachian tube dysfunction (ETD) in adult patients scheduled for surgery for chronic inflammatory middle ear disease.

Patients
We included adult patients with chronic inflammatory middle ear disease (chronic suppurative otitis media, adhesive otitis media [middle ear atelectasis], cholesteatoma). We excluded patients with pathologies that do not stem from ETD (e.g., noninflammatory chronic middle ear disease [e.g., otosclerosis], tumors, solely external auditory canal conditions), patients scheduled for implantable electronic hearing devices independent of disease, patients with otitis media with effusion and scheduled paracentesis or ventilation tubes only, patients with previous radiotherapy or previous balloon eustachian tuboplasty, and children and patients unable to complete questionnaires.

Intervention(s)
We evaluated ETD with Valsalva maneuver and in case of negative or unclear Valsalva with the eustachian tube score (ETS). A negative Valsalva maneuver and an ETS score of 5 or lower were used to define dilatory (chronic obstructive) ETD.

Main Outcome Measure(s)
Rate of ETD in the included patients.

Results
From a total of 482 consecutive patients, 350 patients had positive Valsalva maneuver or ETS score higher than 5. From the 193 patients with negative or unclear Valsalva maneuver, 77 patients had an ETS score of 5 or lower, and 55 rejected further diagnostics with ETS.

Conclusions
Based on a large cohort of adult patients with chronic inflammatory middle ear disease scheduled for middle ear surgery, the majority (82%) seems to have no dilatory (chronic obstructive) ETD that can be detected with current routine clinical methods and tubomanometry. Common pathophysiological explanations should be questioned critically, especially in the context of communication with patients.
Using Stapes Velocity to Estimate the Efficacy of Mechanical Stimulation of the Round Window With an Active Middle Ear Implant
Authors: Tollin Daniel J. , Koka Kanthaiah , Peacock John 
Published: May 2023

Objective
To test a method to measure the efficacy of active middle ear implants when coupled to the round window.

Methods
Data previously published in Koka et al. (Hear Res 2010;263:128–137) were used in this study. Simultaneous measurements of cochlear microphonics (CM) and stapes velocity in response to both acoustic stimulation (forward direction) and round window (RW) stimulation (reverse direction) with an active middle ear implant (AMEI) were made in seven ears in five chinchillas. For each stimulus frequency, the amplitude of the CM was measured separately as a function of intensity (dB SPL or dB mV). Equivalent vibrational input to the cochlea was determined by equating the acoustic and AMEI-generated CM amplitudes for a given intensity. In the condition of equivalent CM amplitude between acoustic and RW stimulation-generated output, we assume that the same vibrational input to the cochlea was present regardless of the route of stimulation.

Results
The measured stapes velocities for equivalent CM output from the two types of input were not significantly different for low and medium frequencies (0.25–4 kHz); however, the velocities for AMEI-RW drive were significantly lower for higher frequencies (4–14 kHz). Thus, for RM stimulation with an AMEI, stapes velocities can underestimate the mechanical input to the cochlea by ~20 dB for frequencies greater than ~4 kHz.

Conclusions
This study confirms that stapes velocity (with the assumption of equivalent stapes velocity for forward and reverse stimulation) cannot be used as a proxy for effective input to the cochlea when it is stimulated in the reverse direction. Future research on application of intraoperative electrophysiological measurements during surgery (CM, compound action potential, or auditory brainstem response) for estimating efficacy and optimizing device coupling and performance is warranted.
Cochlear Implantation for Rudimentary Otocysts: Two Case Reports
Authors: Lu Simeng , Wei Xingmei , Kong Ying , Yang Bentao , Dhanasingh Anandhan , Li Yongxin 
Published: May 2023

Objective
Rudimentary otocyst (RO) is characterized by an otic capsule without an internal auditory canal, which is considered a contraindication to cochlear implantation (CI). In this study, we were the first to report two patients with ROs who underwent CI.

Patient
Two patients (18 months old and 2 years old) presenting with bilateral congenital hearing loss were diagnosed with ROs.

Intervention
CI was performed. The transmastoid slotted labyrinthotomy approach was used with customized MED-EL electrode arrays.

Main Outcome Measures
Categorical auditory performance, infant-toddler meaningful auditory integration of sound, the speech intelligibility rating, and meaningful use of speech scale.

Results
Both children could understand common phrases and had intelligible, connected speech 2 years after CI.

Conclusion
With proper indication, surgical approach and postoperative training, a child with an RO may benefit from CI.
Ultrasonographic Identification of Shell Surface Types in Commercially Available Silicone Gel-Filled Breast Implants
Authors: Herrera-Mora Giovanni , Solis-Chaves Pablo , Hernandez-Aviles Georgina , Graham Emma-Jane M. , Clausen-Oreamuno Christine , Castro-Cespedes Jose Andres , Haupt Jennifer , Jamiel Morgan , Veiseh Omid , Sforza Marcos , Hancock John , Kinney Brian , De Mezerville Roberto , Langer Robert , Doloff Joshua C. , Chacon-Quiros Manuel 
Published: May 2023

Background
Breast implant safety issues have resulted in the need for global product recalls and medical device tracing. Conventional methods of breast implant tracing, have to date proven to be unsuccessful. This study aims to evaluate the effectiveness of HRUS screening in identifying implanted breast devices.

Methods
Data from 113 female patients undergoing pre-operative ultrasound screening for secondary breast surgery between 2019 and 2022 was prospectively reviewed to evaluate the effectiveness of HRUS imaging with the aid of a Sonographic Surface Catalog to identify the surface and brand type of implanted breast devices.
To corroborate the findings and assess the reproducibility of the approach, further evaluations were replicated in New Zealand white rabbits and compared to the results found in humans.

Results:
In the human recipients, implant surface and brand types were correctly identified by ultrasound imaging in 99% (112/113) and 96% (69/72) of the cases, either consultation-only or revision, respectively. This constituted an overall success rate of 98% (181/185). Further, in a corroborating New Zealand White rabbit model where full-scale commercial implants were introduced and monitored over many months, from the total 28 analyzed, the surface was accurately identified in a total of 27 cases (the one failure being prior to generation of an SSC), demonstrating an overall success rate of 96.4%.

Conclusions
HRUS is, therefore, a valid and first-hand tool for breast implant imaging that can correctly evaluate both surface type and brand type alongside other variables such as implant placement, positioning, flipping, or rupture.

Clinical Relevance Statement:
High-resolution ultrasound is a valid and first-hand tool for the identification and traceability of breast implants that evaluates surface type and brand type. These low-cost, accessible, and reproducible practice provides patients with peace of mind and surgeons with a promising diagnostic tool.
Outcomes of Primary Furlow Double-Opposing Z-plasty for the Treatment of Symptomatic Submucous Cleft Palate
Authors: Pitkänen Veera , Szwedyc Anika , Alaluusua Suvi , Geneid Ahmed , Vuola Pia , Saarikko Anne 
Published: May 2023

Background:
Submucous cleft palate (SMCP) requires surgical repair if symptomatic. The Furlow double-opposing Z-plasty is the preferred method in Helsinki cleft center.

Aims:
To assess the efficacy and complications of Furlow Z-plasty in the treatment of symptomatic SMCP.

Methods:
This retrospective study reviewed documentation of 40 consecutive patients with symptomatic SMCP who underwent primary Furlow Z-plasty by 2 high-volume cleft surgeons at a single center between 2008 and 2017. Patients underwent perceptual and instrumental evaluation of velopharyngeal function (VPF) by speech pathologists preoperatively and postoperatively.

Results:
The median age at Furlow Z-plasty was 4.8 years (SD 2.6, range 3.1–13.6). The overall success rate, including postoperative competent or borderline competent VPF, was 83%, and 10% required secondary surgery for residual velopharyngeal insufficiency. The success rate was 85% in nonsyndromic, and 67% in syndromic patients with no significant difference (P=0.279). Complications arose in only 2 (5%) patients. No children were found to have obstructive sleep apnea postoperatively.

Conclusion:
Furlow primary Z-plasty is a safe and effective operation for symptomatic SMCP with a success rate of 83% with only 5% rate of complications.
Low C-reactive Protein and Urea Distinguish Primary Nonfunction From Early Allograft Dysfunction Within 48 Hours of Liver Transplantation
Authors: Halle-Smith James M. , Hall Lewis , Hann Angus , Arshad Asif , Armstrong Matthew J. , Bangash Mansoor N. , Murphy Nick , Cuell James , Isaac John L. , Ferguson James , Roberts Keith J. , Mirza Darius F. , Perera M. Thamara P. R. 
Published: May 2023

Background.
Primary nonfunction (PNF) is a life-threatening complication of liver transplantation (LT), but in the early postoperative period, it can be difficult to differentiate from early allograft dysfunction (EAD). The aim of this study was to determine if serum biomarkers can distinguish PNF from EAD in the initial 48 h following LT.

Materials and Methods.
A retrospective study of adult patients that underwent LT between January 2010 and April 2020 was performed. Clinical parameters, absolute values and trends of C-reactive protein (CRP), blood urea, creatinine, liver function tests, platelets, and international normalized ratio in the initial 48 h after LT were compared between the EAD and PNF groups.

Results.
There were 1937 eligible LTs, with PNF and EAD occurring in 38 (2%) and 503 (26%) patients, respectively. A low serum CRP and urea were associated with PNF. CRP was able to differentiate between the PNF and EAD on postoperative day (POD)1 (20 versus 43 mg/L; P < 0.001) and POD2 (24 versus 77; P < 0.001). The area under the receiver operating characteristic curve (AUROC) of POD2 CRP was 0.770 (95% confidence interval [CI] 0.645-0.895). The urea value on POD2 (5.05 versus 9.0 mmol/L; P = 0.002) and trend of POD2:1 ratio (0.71 versus 1.32 mmol/L; P < 0.001) were significantly different between the groups. The AUROC of the change in urea from POD1 to 2 was 0.765 (95% CI 0.645-0.885). Aspartate transaminase was significantly different between the groups, with an AUROC of 0.884 (95% CI 0.753-1.00) on POD2.

Discussion.
The biochemical profile immediately following LT can distinguish PNF from EAD; CRP, urea, and aspartate transaminase are more effective than ALT and bilirubin in distinguishing PNF from EAD in the initial postoperative 48 h. Clinicians should consider the values of these markers when making treatment decisions.
Steroid Avoidance After Adult Living Donor Liver Transplant: A Cohort Analysis
Authors: Nunez Miguel , Praglin Claudia R. , Torres Ana M. , Agudelo Eliana Z. , Braun Hillary J. , Huang Chiung-Yu , Syed Shareef , Roberts John P. , Roll Garrett R. 
Published: May 2023

Background.
Although steroid avoidance (SA) has been studied in deceased donor liver transplant, little is known about SA in living donor liver transplant (LDLT). We report the characteristics and outcomes, including the incidence of early acute rejection (AR) and complications of steroid use, in 2 cohorts of LDLT recipients.

Methods.
Routine steroid maintenance (SM) after LDLT was stopped in December 2017. Our single-center retrospective cohort study spans 2 eras. Two hundred forty-two adult recipients underwent LDLT with SM (January 2000–December 2017), and 83 adult recipients (December 2017–August 2021) underwent LDLT with SA. Early AR was defined as a biopsy showing pathologic characteristics within 6 mo after LDLT. Univariate and multivariate logistic regressions were performed to evaluate the effects of relevant recipient and donor characteristics on the incidence of early AR in our cohort.

Results.
Neither the difference in early AR rate between cohorts (SA 19/83 [22.9%] versus SM 41/242 [17%]; P = 0.46) nor a subset analysis of patients with autoimmune disease (SA 5/17 [29.4%] versus SM 19/58 [22.4%]; P = 0.71) reached statistical significance. Univariate and multivariate logistic regressions for early AR identified recipient age to be a statistically significant risk factor (P < 0.001). Of the patients without diabetes before LDLT, 3 of 56 (5.4%) on SA versus 26 of 200 (13%) on SM needed medications prescribed for glucose control at the time of discharge (P = 0.11). Patient survival was similar between SA and SM cohorts (SA 94% versus SM 91%, P = 0.34) 3 y after transplant.

Conclusions.
LDLT recipients treated with SA do not exhibit significantly higher rates of rejection or increased mortality than patients treated with SM. Notably, this result is similar for recipients with autoimmune disease.