bluuebunny/crossref_metadata_2025_split huggingface dataset:
(122) Provider Attitude towards Postpartum Sexual Health
Authors: Shearer K , Khanna P 
Published: May 2023

Abstract

Introduction
The prevalence of female sexual dysfunction (FSD) worldwide is estimated to be 41% and is even more prevalent in postpartum patients. There are significant barriers to addressing FSD in a busy clinic and the use of a standardized screening questionnaire could be implemented to improve outcomes during postpartum appointments.

Objective
To assess provider knowledge and practices towards postpartum sexual health with the goal of improving postpartum sexual health.

Methods
Providers who care for postpartum patients at [institution and city obscured], were asked to complete an anonymous survey online to assess providers’ general knowledge and practices.

Results
79% of respondents answered that they felt very comfortable assessing postpartum sexual health and 88% expressed a need for continuing education on sexual medicine. The most common response for barriers to care was a lack of time. None of the respondents reported using questionnaires to assess sexual health.

Conclusions
The most significant barriers to assessing postpartum sexual health are a lack of time and provider knowledge. To overcome this, a standardized questionnaire should be created and improved continuing education should be implemented.

Disclosure
No
(126) Development of a Patient Reported Outcome Measure for Lichen Sclerosus
Authors: Pope R , Myers A , Marino J 
Published: May 2023

Abstract

Introduction
Patient-reported outcome measures (PROMs) can provide information that complements the provider-assessed clinical outcome measures of gynecologic and dermatologic diseases. As part of a larger study on lichen sclerosus (LS), genetics and the microbiome, we noted discrepancy between clinical assessment of LS and participant symptoms. Without a PROM, it is impossible to compare our results to those in the literature. Lichen sclerosus is a chronic vulvar dermatosis that affects approximately 1 in 70 women and can cause scarring, sexual dysfunction and malignancy (Krapf, 2020). However, the severity of LS symptoms may not be representative of the current clinical appearance. For example, the patient may report extreme pruritus and general irritation, yet the vulva may not appear erythematous or even consistent with active disease. On the other hand, patients may incidentally be diagnosed w lichen sclerosus after the provider noted classic characteristics including white plaques, erythema, and architectural changes of the labia and clitoral hood and yet the patient may not realize they had a vulvar skin condition with a history of only minimal to no symptoms noted.

Objective
The aim of our study is to develop patient-reported outcome measures of lichen sclerosus to incorporate patient’s experiences of LS and be able to correlate them to clinical management.

Methods
Methods: We evaluated 25 initial participants with biopsy proven lichen sclerosus and collected incidence of patient reported outcome measures as the first step of developing a larger PROM based investigation.

Results
25 participants enrolled in the study and completed questionnaires on symptoms. Many of these participants were not using topical steroid treatment for symptoms. Most commonly experienced symptoms were: prutitis (52%, n=13, burning (28%, n=7, general irritation (n=12, dryness (48%, n=8), dyspareunia (40% n=10). For many women, the symptoms radiated, woke them up from sleep and caused overall disruption of their quality of life.

Conclusions
The next step will be to create a prospective survey of women living with LS to collect the most important symptoms according to patients and not just frequency. We hope eventually therapeutic strategies can be targeted at treating these specific symptoms and managing the disease state.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Johnson and Johnson.
Deep integrative models for large-scale human genomics
Authors: Sigurdsson Arnór I , Louloudis Ioannis , Banasik Karina , Westergaard David , Winther Ole , Lund Ole , Ostrowski Sisse Rye , Erikstrup Christian , Pedersen Ole Birger Vesterager , Nyegaard Mette ,   DBDS Genomic Consortium, Banasik Karina , Bay Jakob , Boldsen Jens Kjærgaard , Brodersen Thorsten , Brunak Søren , Burgdorf Kristoffer , Chalmer Mona Ameri , Didriksen Maria , Dinh Khoa Manh , Dowsett Joseph , Erikstrup Christian , Feenstra Bjarke , Geller Frank , Gudbjartsson Daniel , Hansen Thomas Folkmann , Hindhede Lotte , Hjalgrim Henrik , Jacobsen Rikke Louise , Jemec Gregor , Kaspersen Katrine , Kjerulff Bertram Dalskov , Kogelman Lisette , Hørup Larsen Margit Anita , Louloudis Ioannis , Lundgaard Agnete , Mikkelsen Susan , Mikkelsen Christina , Nielsen Kaspar Rene , Nissen Ioanna , Nyegaard Mette , Ostrowski Sisse Rye , Pedersen Ole Birger , Henriksen Alexander Pil , Rohde Palle Duun , Rostgaard Klaus , Schwinn Michael , Stefansson Kari , Stefónsson Hreinn , Sørensen Erik , Thorsteinsdóttir Unnur , Thørner Lise Wegner , Bruun Mie Topholm , Ullum Henrik , Werge Thomas , Westergaard David , Brunak Søren , Vilhjálmsson Bjarni J , Rasmussen Simon 
Published: May 2023

AbstractPolygenic risk scores (PRSs) are expected to play a critical role in precision medicine. Currently, PRS predictors are generally based on linear models using summary statistics, and more recently individual-level data. However, these predictors mainly capture additive relationships and are limited in data modalities they can use. We developed a deep learning framework (EIR) for PRS prediction which includes a model, genome-local-net (GLN), specifically designed for large-scale genomics data. The framework supports multi-task learning, automatic integration of other clinical and biochemical data, and model explainability. When applied to individual-level data from the UK Biobank, the GLN model demonstrated a competitive performance compared to established neural network architectures, particularly for certain traits, showcasing its potential in modeling complex genetic relationships. Furthermore, the GLN model outperformed linear PRS methods for Type 1 Diabetes, likely due to modeling non-additive genetic effects and epistasis. This was supported by our identification of widespread non-additive genetic effects and epistasis in the context of T1D. Finally, we constructed PRS models that integrated genotype, blood, urine, and anthropometric data and found that this improved performance for 93% of the 290 diseases and disorders considered. EIR is available at https://github.com/arnor-sigurdsson/EIR.
Carotid intima-media thickness and atherosclerotic plaques are associated with renal function decline: a 14-year longitudinal population-based study
Authors: Goepfert Miriam , Ittermann Till , Dörr Marcus , Friedrich Nele , Völzke Henry , Dabers Thomas , Felix Stephan B , Schminke Ulf , Stracke Sylvia , von Rheinbaben Sabrina 
Published: May 2023

ABSTRACT

Background
Chronic kidney disease (CKD) leads to increased morbidity and mortality. The underlying causes of CKD are often similar to those of atherosclerosis. We investigated whether carotid atherosclerotic parameters are associated with renal function decline.

Methods
Within the population-based Study of Health in Pomerania (SHIP), Germany, 2904 subjects were observed over 14 years. The carotid intima-media thickness (cIMT) as well as carotid plaques were measured by standardized B-mode ultrasound protocol. CKD is defined as estimated glomerular filtration rate (eGFR) &lt;60 mL/min/1.73 m2 and albuminuria as urinary albumin–creatinine ratio (ACR) ≥30 mg/g. eGFR was calculated by the full age spectrum (FAS) equation and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Mixed models were applied to associate carotid parameters with change in renal function longitudinally and adjusted for confounding.

Results
The age range of the study sample was 25–86 years with a median of 54 years at baseline. In longitudinal analyses, subjects with high cIMT and the presence of plaques at baseline showed a greater decrease in eGFR (cIMT: FAS-eGFR: P &lt; .001, CKD-EPI-eGFR: P &lt; .001; plaques: FAS-eGFR: P &lt; .001, CKD-EPI-eGFR: n.s.) as well as an increased risk of developing CKD during the follow-up (cIMT: FAS-eGFR: P = .001, CKD-EPI-eGFR: P = .04; plaques: FAS-eGFR: P = .008, CKD-EPI-eGFR: P = .001). There was no association between atherosclerotic parameters and the risk of developing albuminuria.

Conclusions
cIMT and carotid plaques are associated with renal function decline as well as CKD in a population-based sample. Furthermore, the FAS equation adapts best to this study population.
A Prospective Study of Key Correlates for Household Transmission of Severe Acute Respiratory Syndrome Coronavirus 2
Authors: Brown Elizabeth R , O’Brien Meagan P , Snow Brian , Isa Flonza , Forleo-Neto Eduardo , Chan Kuo-Chen , Hou Peijie , Cohen Myron S , Herman Gary , Barnabas Ruanne V 
Published: May 2023

Abstract

Background
Randomized controlled trials evaluated monoclonal antibodies for the treatment (Study 2067) and prevention (Study 2069) of coronavirus disease 2019 (COVID-19). Household contacts of the infected index case in Study 2067 were enrolled in Study 2069 and prospectively followed; these cohorts provided a unique opportunity to evaluate correlates of transmission, specifically viral load.

Methods
This post hoc analysis was designed to identify and evaluate correlates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, adjusting for potential confounding factors related to source SARS-CoV-2 viral load and risk of SARS-CoV-2 acquisition in this population. Correlates of transmission were evaluated in potential transmission pairs (any infected household member plus susceptible household contact).

Results
In total, 943 participants were included. In multivariable regression, 2 potential correlates were determined to have a statistically significant (P &lt; .05) association with transmission risk. A 10-fold increase in viral load was associated with a 40% increase in odds of transmission; sharing a bedroom with the index participant was associated with a 199% increase in odds of transmission.

Conclusions
In this prospective, post hoc analysis that controlled for confounders, the 2 key correlates for transmission of SARS-CoV-2 within a household are sharing a bedroom and increased viral load, consistent with increased exposure to the infected individual.
International trade shapes global mercury–related health impacts
Authors: Xing Zhencheng , Chang Ruirong , Song Zhengcheng , Zhang Yanxu , Muntean Marilena , Feng Kuishuang , Liu Yifan , Ma Zongwei , Wang Jigan , Zhang Jie , Wang Haikun 
Published: May 2023

Abstract
Mercury (Hg) is a strong neurotoxin with substantial dangers to human health. Hg undergoes active global cycles, and the emission sources there of can also be geographically relocated through economic trade. Through investigation of a longer chain of the global biogeochemical Hg cycle from economic production to human health, international cooperation on Hg control strategies in Minamata Convention can be facilitated. In the present study, four global models are combined to investigate the effect of international trade on the relocation of Hg emissions, pollution, exposure, and related human health impacts across the world. The results show that 47% of global Hg emissions are related to commodities consumed outside of the countries where the emissions are produced, which has largely influenced the environmental Hg levels and human exposure thereto across the world. Consequently, international trade is found to enable the whole world to avoid 5.7 × 105 points for intelligence quotient (IQ) decline and 1,197 deaths from fatal heart attacks, saving a total of $12.5 billion (2020 USD) in economic loss. Regionally, international trade exacerbates Hg challenges in less developed countries, while resulting in an alleviation in developed countries. The change in economic loss therefore varies from the United States (−$4.0 billion) and Japan (−$2.4 billion) to China (+$2.7 billion). The present results reveal that international trade is a critical factor but might be largely overlooked in global Hg pollution mitigation.
Hydrogen transfer reactions via organic radicals in gamma-irradiated chibaite
Authors: Yokoyama Yuka , Isogai Shusuke , Kusuki Kenta , Tani Atsushi , Nishido Hirotsugu 
Published: May 2023

Abstract
Chibaite, a silica-framework structure with cage-like voids occupied by gaseous molecules, was found in marine sediments. Its formation age could be evaluated using electron spin resonance (ESR) if the radicals formed by natural radiation can be assumed to accumulate over time. To investigate whether hydrogen transfer reactions, where organic radicals withdraw hydrogen atoms from other molecules in adjacent cages, occur in chibaite and affect ESR dating, gamma-irradiated chibaite was measured by ESR. Methyl, ethyl, n-propyl, isopropyl, tert-butyl radicals and hydrogen atoms were created by gamma irradiation at 77 K. The amount of tert-butyl radicals increased around 240 K and the similar amount of the other organic radicals decreased simultaneously, implying that hydrogen transfer reactions occur between isobutane and the organic radicals in chibaite around 240 K and therefore would have no influence on ESR dating because the reactions are completed at the environmental temperature.
Deploying Bots in Healthcare to Find Revenue Cycle Improvements
Authors: Dunn Rose T. 
Published: May 2023

SUMMARY
Doing more with less has been a business mantra for decades. Healthcare leaders have implemented flex scheduling and job sharing, streamlined workflows, committed to process improvement techniques such as Lean, hired retirees, gained efficiencies from remote work ... and the list goes on. Each tactic has yielded productivity improvements, yet the need to do more with less continues. Postpandemic challenges include staff recruitment and retention, labor inflation, and dwindling margins, all of which must be addressed while maintaining corporate cultures. The journey with bots described here started in this dynamic environment, and the work has not been single-threaded. The organization featured here—an integrated delivery network—has digital front-door and back-end robotic process automation (RPA) projects underway. The digital front-door initiative supports patient self-registration and automates authorizations and insurance verification processes. The back-end patient financial services RPA project replaces and enhances existing technology. Revenue cycle as a multidepartment function is leadership's poster child for RPA, and the revenue cycle team is tasked to demonstrate the value of the technology. This article covers the initial steps and lessons learned in the process.
How An Established Health System Ventures Forth: Ochsner Invests in the Future
Authors: Quirk Aimee 
Published: May 2023

SUMMARY
The founding of Ochsner Ventures followed the natural evolution of more than a decade of growth and expansion of Ochsner Health's offerings and capabilities beyond traditional patient care. This growth has enabled the health system to bring critical services to underserved communities across the Gulf South. Ochsner Ventures supports promising companies both in and beyond the region while bringing forward new solutions to healthcare sector challenges and improving health outcomes, access, and equity. In a dynamic healthcare environment amid the persistent effects of the COVID-19 pandemic, Ochsner Health is executing a multiyear strategic plan to reinforce its mission and maintain a position of strength in the region. One aspect of the strategy focuses on the diversification and pursuit of new value by creating new revenue, additional savings, cost reductions, innovations, and amplifying existing assets and capabilities.
Programming Levels and Speech Perception in Pediatric Cochlear Implant Recipients With Enlarged Vestibular Aqueduct or GJB2 Mutation
Authors: Jahn Kelly N. , Morse-Fortier Charlotte , Griffin Amanda M. , Faller David , Cohen Michael S. , Kenna Margaret A. , Doney Elizabeth , Arenberg Julie G. 
Published: May 2023

Objective
To determine the relationship between hearing loss etiology, cochlear implant (CI) programming levels, and speech perception performance in a large clinical cohort of pediatric CI recipients.

Study Design
Retrospective chart review.

Setting
Tertiary care hospitals.

Patients
A total of 136 pediatric CI recipients (218 ears) were included in this study. All patients had diagnoses of either enlarged vestibular aqueduct (EVA) or GJB2 (Connexin-26) mutation confirmed via radiographic data and/or genetic reports. All patients received audiologic care at either Boston Children's Hospital or Massachusetts Eye and Ear in Boston, MA, between the years 1999 and 2020.

Main Outcome Measures
Electrode impedances and programming levels for each active electrode and speech perception scores were evaluated as a function of etiology (EVA or GJB2 mutation).

Results
Children with EVA had significantly higher impedances and programming levels (thresholds and upper stimulation levels) than the children with GJB2 mutation. Speech perception scores did not differ as a function of etiology in this sample; rather, they were positively correlated with duration of CI experience (time since implantation).

Conclusions
Differences in electrode impedances and CI programming levels suggest that the electrode-neuron interface varies systematically as a function of hearing loss etiology in pediatric CI recipients with EVA and those with GJB2 mutation. Time with the CI was a better predictor of speech perception scores than etiology, suggesting that children can adapt to CI stimulation with experience.
Safety and Effectiveness of Vedolizumab in Elderly Patients with Inflammatory Bowel Disease
Authors: Dahiya Dushyant Singh , Chandan Saurabh , Bapaye Jay , Mohan Babu P. , Ramai Daryl , Kassab Lena L. , Chandan Ojasvini C. , Dulai Parambir S. , Kochhar Gursimran S. 
Published: May 2023

Background:
There is limited data on Vedolizumab utilization in elderly patients. Our study aims to assess the effectiveness and safety of Vedolizumab in this subset population.

Materials and Methods:
Databases including Cochrane Central, Embase, Medline (via Ovid), Scopus, and Web of Science were searched in August 2022 to identify studies that assessed Vedolizumab therapy in elderly patients. Pooled proportion and risk ratios (RR) were calculated.

Results:
Total 11 studies with 3546 IBD patients (1314 elderly and 2232 young) were included in the final analysis. Pooled rate of overall and serious infections in the elderly cohort was 8.45% (95% CI=6.27-11.29; I223%) and 2.59% (95% CI=0.78-8.29; I276%), respectively. However, there was no difference in overall infection rates between elderly and young patients. Pooled rate of endoscopic, clinical, and steroid-free remission for elderly IBD patients was 38.45% (95% CI=20.74-59.56; I293%), 37.95% (95% CI=33.08-43.06; I213%), and 38.8% (95% CI=31.6-46.4; I277%), respectively. Elderly patients had lower steroid-free remission rates [RR 0.85, 95% CI=0.74-0.99; I20%, P=0.03]; however, there was no difference in rates of clinical (RR 0.86, 95% CI=0.72-1.03; I20%, P=0.10) or endoscopic remission (RR 1.06, 95% CI=0.83-1.35; I20%, P=0.63) compared with younger patients. Pooled rate of IBD-related surgery and IBD-related hospitalizations was 9.76% (95% CI=5.81-15.92; I278%) and 10.54% (95% CI=8.37-13.2; I20%), respectively for the elderly cohort. There was no statistical difference in IBD-related surgeries between elderly and young IBD patients, RR 1.20 (95% CI=0.79-1.84; I216%), P=0.4.

Conclusions:
Vedolizumab is equally safe and effective for clinical and endoscopic remission in elderly and younger populations.
A Safe and Efficient Technique for Pedicled TRAM Flap Breast Reconstruction
Authors: Semple John L. , Viezel-Mathieu Alex , Alshaqsi Sultan , Armstrong Kathleen 
Published: May 2023

Learning Objectives:
After studying this article, the participant should be able to: 1. Understand the indications for a unilateral pedicled transverse rectus abdominis (TRAM) flap-based breast reconstruction. 2. Understand the different types and designs of pedicled TRAM flap used in both immediate and delayed breast reconstruction. 3. Understand the essential landmarks and relevant anatomy of the pedicled TRAM flap. 4. Understand the steps of raising the pedicled TRAM flap, the subcutaneous transfer, and the insetting of the flap on the chest wall. 5. Understand the nature of donor-site management and closure of the defect. 6. Develop a postoperative plan for continuing care and pain management.

Summary:
This article focuses primarily on the unilateral, ipsilateral pedicled TRAM flap. Although the bilateral pedicled TRAM flap may be a reasonable option in some cases, they have been shown to have a significant impact on abdominal wall strength and integrity. Other types of autogenous flaps using the same lower abdominal tissue, such as a free muscle-sparing TRAM or a deep inferior epigastric flap, can be performed as a bilateral procedure with less impact on the abdominal wall. Breast reconstruction with a pedicled transverse rectus abdominis flap has persisted for decades as a reliable and safe form of autologous breast reconstruction leading to a natural and stable breast shape.
A Nasal Columellar Base Stabilizing Suture Technique
Authors: Baldini Nicolas , Alomani Mohammad , Fonseca Eduardo , Saban Yves 
Published: May 2023

Summary:
When seeking to achieve a more aesthetic and narrower columella, most of the required changes concern the middle and base of the columella. Narrowing and reshaping the columellar base require a sequential approach with a good anatomical knowledge and aesthetics analysis. The columellar base is a three-dimensional structure that must be analyzed following 3 axes: transverse (thickness or width), frontal (height), sagittal (nasolabial angle). Frequently, sutures that aim to close the distance between the medial crura footplates result in modifying the nasolabial angle, as a side effect, due to caudal protrusion of the columellar soft tissue. The question is: how to keep an adequate nasolabial angle? A transverse columellar base stabilizing suture acting on these 3 axes, that enables to maintain the result after the columellar base management, is described in this article.