bluuebunny/crossref_metadata_2025_split huggingface dataset:
FLOW AND GEOMETRICAL ALTERATIONS IN RETINAL MICROVASCULATURE CORRELATED WITH THE OCCURRENCE OF DIABETIC RETINOPATHY
Authors: Wang Wei , Chen Yanping , Kun Xiong , Gong Xia , Liu Hua , Wei Daheng , Wang Dongning , Liang Xiaolin , Huang Wenyong 
Published: May 2022

Purpose:
To assess the relationship between flow and geometric parameters in optical coherence tomography angiography images and the risk of incident diabetic retinopathy (DR).

Methods:
This prospective, observational cohort study recruited patients with Type 2 diabetes without DR in Guangzhou, China, and followed up annually. A commercially available optical coherence tomography angiography device (DRI OCT Triton; Topcon Inc, Tokyo, Japan) was used to obtain a variety of flow (foveal avascular zone area, vessel density, and vessel length density) and geometric (fractal dimension and blood vessel tortuosity) parameters in superficial capillary plexus (SCP) and deep capillary plexus. The odds ratio (OR) and its 95% confidence interval (CI) were calculated per 1-SD increase in each optical coherence tomography angiography parameter.

Results:
Over a follow-up of 1 year, 182 of 1,698 participants (10.7%) developed incident DR. After adjusting for conventional risk factors and image quality score, the higher risk of DR onset was significantly associated with the reduced parafoveal vessel density of SCP (OR = 0.81; 95% CI: 0.69, 0.96; P = 0.016), reduced parafoveal vessel length density of SCP (OR = 0.73; 95% CI: 0.59, 0.90; P = 0.003), reduced fractal dimension of SCP (OR = 0.73; 95% CI: 0.61, 0.87; P < 0.001), increased blood vessel tortuosity of SCP (OR = 1.39; 95% CI: 1.18, 1.64; P < 0.001), and increased blood vessel tortuosity of deep capillary plexus (OR = 1.19; 95% CI: 1.01, 1.40; P = 0.033).

Conclusion:
Reduced vessel density and impaired vessel geometry posed higher susceptibility for DR onset in patients with Type 2 diabetes, supporting the adoption of optical coherence tomography angiography parameters as early monitoring indicators of the newly incident DR.
Presenting Characteristics for Symptomatic, as Compared to Asymptomatic (assumed), Orbital Cavernous Venous Malformations
Authors: Vahdani Kaveh , Rose Geoffrey E. 
Published: May 2022

Aims:
To compare the characteristics for symptomatic and asymptomatic orbital cavernous venous malformations (OCVMs).

Methods:
A retrospective case-note review for patients with OCVMs was performed for demographics and presenting features.

Results:
Four hundred and fourteen patients (258 female; 62%) presented at a mean age of 49.4 years and all were unilateral. Ninety-two (22%) asymptomatic OCVMs were found a decade later than 322 symptomatic patients (57.8 vs. 47.0 years; p < 0.001). Patients with symptomatic OCVMs had an average symptom duration of 3.3 years with the commonest being altered vision (57%), proptosis (55%), orbital ache (21%), and diplopia (13%). Visual obscurations were reported by 11% of symptomatic patients, whereas 30% had a hyperopic shift.
Mean LogMAR was 0.39 for symptomatic OCVMs and 0.1 for asymptomatic (p < 0.001), and a relative afferent pupillary defect was detected in 38% symptomatic and 7% asymptomatic patients (p < 0.001). Mean relative exophthalmos was 3.9 mm in symptomatic patients and 1.5 mm in asymptomatic (p < 0.001), but there was no correlation between age and exophthalmos. Symptomatic lesions had higher rates of nonaxial displacement (30% vs. 7%; p < 0.00001), more palpable masses (17% vs. 2%; p = 0.0001), and more impairment of motility (29% vs. 10%; p = 0.0024). Fundal abnormalities were noted in 63% of patients with symptomatic OCVMs, as compared to 26% of asymptomatic (p < 0.0001).

Conclusion:
Symptomatic OCVMs may present with reduced visual function, either due to the globe or optic nerve compression, or proptosis. Asymptomatic (presumed) OCVMs— representing 22% of all OCVMs—are usually found a decade later than symptomatic lesions, and a few may have only mild functional impairment.
Functional Versus Anatomical Nasolacrimal Obstruction: Are There Differences in Epiphora Severity, Symptoms, or Effects on Quality of Life?
Authors: Shapira Yinon , Macri Carmelo , Selva Dinesh 
Published: May 2022

Purpose:
To elucidate whether the specific cause of nasolacrimal duct drainage impairment impacts the severity, symptoms, and implications on visual tasks and quality of life (QOL) in epiphora.

Methods:
A retrospective review of consecutive adult patients with epiphora attending a tertiary lacrimal clinic from June 2011 to March 2021 was conducted. Cases with evidence of canalicular stenosis, a mucocele, or other identifiable causes of epiphora were excluded. A structured interview assessed the epiphora severity (Munk), symptomatology, precipitating factors, and effects on visual tasks and QOL. Following lacrimal syringing, all eyes were investigated with dacryocystography and dacryoscintigraphy. The domains of the interview were compared between nasolacrimal duct obstruction (NLDO), stenosis (NLDS), and nonanatomical functional delay (FNLDO).

Results:
One hundred twenty-two symptomatic eyes (63 patients; mean age 63.3 ± 17.2 years; 59% females) were included. There was no difference in Munk score between the groups (NLDO = 3.71 ± 0.18, NLDS = 3.79 ± 2.0, FNLDO = 3.85 ± 0.15; p = 0.82). In all 3 groups, most cases had a Munk >2 (86.8%, 75.9%, and 89.1%, respectively; p = 0.25). Discharge was more common in NLDO (65.7%) compared with NLDS (30.0%) and FNLDO (36.4%, p = 0.006). Worsening in the cold/wind was more frequent in FNLDO (77.1%) compared with NLDO (48.5%, p = 0.029). Effects on visual tasks and QOL were not significantly different.

Conclusions:
FNLDO patients experience a high severity of epiphora, comparable to patients with NLDS and those with complete NLDO. The distinction between FNLDO and NLDS had little consequence on reported symptoms, precipitating factors, visual tasks, and QOL. Discharge may be more specific to NLDO, whereas precipitating cold or wind is more specific to FNLDO.
Qualitative evidence synthesis using meta-ethnography to understand the experience of living with osteoarthritis pain
Authors: Toye Francine , Seers Kate , Barker Karen Louise 
Published: May 2022

Abstract
Osteoarthritis pain affects the lives of a large number of people around the world. Understanding other people's experience is integral to effective care, and qualitative research can have an important part to play in education and good clinical practice. We aimed to systematically search for, identify, and synthesise qualitative research exploring the experience of living with osteoarthritis to incorporate this knowledge into an educational resource. We comprehensively searched 4 bibliographic databases and used the methods of meta-ethnography to synthesise qualitative research findings. We screened 10,123 titles, 548 abstracts, and 139 full texts. We included findings from 118 reports (105 unique samples) of at least 2534 adults living with osteoarthritis around the world. We developed 7 themes from more than 600 findings: it is part of my life's tapestry; (yet) it is consuming me; it constrains my body and my occupations; I am becoming separated, yet dependent; I accept, but I will not let it define me; and (yet) this makes me feel less than the person I was. Our findings highlight the profound impact that osteoarthritis can have on people's lives and the struggle to hold onto a sense of self. They indicate that recognising these losses, and taking osteoarthritis seriously, is an integral part of effective health care. This finding may be transferable beyond this condition.
Efficacy and safety of S-1 based adjuvant chemoradiotherapy for resected pancreatic ductal adenocarcinoma with high-risk pathological feature: a prospective, single-arm, interventional study
Authors: Wu Lili , Xu Yaolin , Zeng Zhaochong , Chen Yixing , Zhou Yuhong , Wang Dansong , Sun Jing , Lv Minzhi , Du Shisuo , Lou Wenhui 
Published: May 2022

Abstract

Objective:
It remains unclear whether adjuvant chemoradiotherapy (CRT) improves survival outcome of pancreatic ductal adenocarcinoma (PDAC) patients after surgery. This study aimed to investigate the efficacy and safety of tegafur/gimeracil/oteracil (S-1)-based adjuvant concurrent chemoradiotherapy in resected PDAC patients with defined high-risk pathological features.

Methods:
We conducted a single-arm, prospective, and interventional study at Zhongshan Hospital Fudan University from December 2012 to December 2019 and the last follow-up was conducted in December 2021. This study was approved by the Ethics Committee of Zhongshan Hospital Fudan University on December 27, 2012 (approval No. B2012-139). Resected PDAC patients with high-risk pathological features, including positive resection margin, pathological T3-4N1-2M0 disease, peripancreatic fat invasion, microvascular invasion, and perineural invasion, were recruited. Primary endpoint was overall survival and secondary endpoints were disease-free survival, treatment toxicity, and 2-, 5-year survival rates.

Results:
A total of 54 patients were recruited. Mean age was 63.6 years old (±7.2). The distribution of T and N stages were 24.1% for T1, 46.3% for T2, 27.8% for T3, 1.9% for T4, 33.3% for N1, and 11.1% for N2. Seven patients had R1 resection. The median overall survival and disease-free survival were 27.1 and 13.7 months, respectively, while no fatal adverse events were recorded. Subgroup analyses showed differences in survival outcomes among patients with microvascular invasion, different N stages, and preoperative CA 19-9 levels. Further, a Cox proportional hazard model demonstrated associations of lymph node metastases, CA 19-9 level, and microvascular invasion with overall survival and disease-free survival.

Conclusion:
S-1-based adjuvant CRT showed promising efficacy and manageable toxicity in resected PDAC patients with high-risk pathological features.
Acute venous thromboembolism in acute pancreatitis based on the severity: a retrospective cohort study
Authors: Ali Hassam , Manickam Swethaa , Pamarthy Rahul , Farooq Muhamad Fahd , Leland William 
Published: May 2022

Abstract

Objective:
Acute pancreatitis (AP) results in systemic inflammatory responses and activates coagulation pathways. We intend to investigate the risk and hospital outcomes of acute venous thromboembolisms (VTE) in patients with AP.

Methods:
We retrospectively analyzed patients with AP from 2016 to 2019 using the National Inpatient Sample database. Primary outcome was the effect of VTE on the length of stay, inpatient costs, and mortality. Hierarchical multivariate logistic regression models were built using univariate screens.

Results:
The study included 909,354 weighted discharges with AP. 2.1% of cases had an acute VTE. The length of stay was 5.9 days longer in the hospital of AP patients with VTE compared to AP with no VTE (P < 0.001). Total hospital charge per patient was $71,914 in patients with VTE compared to AP with no VTE (P < 0.001). Mortality was higher in AP patients with VTE compared to AP with no VTE (adjusted odds ratio [AOR] 4.2, 95% confidence interval [CI]: 3.4–5.3, P < 0.001). AP was associated with an increased VTE risk during inpatient stay (AOR 1.06, 95% CI 1.04–1.1, P < 0.001) There was an increased association of lower and upper extremity deep venous thrombosis with AP without necrosis (AOR 6.9, 95% CI 6.4–7.4, P < 0.001) and AP with infected necrosis (AOR 12.2, 95% CI 10.6–14.1, P < 0.001) but not in AP without necrosis (AOR 0.77, 95% CI 0.74–0.81, P < 0.001).

Conclusion:
VTE in AP increases length of stay and inpatient costs. The prognosis is poor in such patients, with increased inpatient mortality compared to no VTE. AP with necrosis can increase chances of all VTE subtypes; however, AP without necrosis does not increase upper and lower extremity VTE risk.
The Essential Elements of the Clinical Reasoning Process
Authors: Joplin-Gonzales Pamela , Rounds Linda 
Published: May 2022

Background:
Clinical reasoning is an important skill that enables health care professionals to identify and evaluate patients' real or potential problems, implement appropriate interventions, solve clinical problems, and improve the quality of health care and patient outcomes.

Purpose:
The goal of this study was to go beyond individual professions and seek consensus across health care professions on the essential elements of the clinical reasoning process.

Methods:
This study used a traditional Delphi methodology to seek consensus from clinical reasoning experts from the fields of nursing, medicine, and physical and occupational health.

Results:
The experts reached a consensus on 56 essential elements identified from the clinical reasoning literature. This is the first time health care professions have reached a consensus on the essential elements of the clinical reasoning process using a Delphi study.

Conclusions:
Achieving consensus on the essential elements of the clinical reasoning process is essential to better understanding, improved teaching, and evaluation of clinical reasoning skills.
Randomized Controlled Trial of Healthy Divas: A Gender-Affirming, Peer-Delivered Intervention to Improve HIV Care Engagement Among Transgender Women Living With HIV
Authors: Sevelius Jae M. , Dilworth Samantha E. , Reback Cathy J. , Chakravarty Deepalika , Castro Danielle , Johnson Mallory O. , McCree Breonna , Jackson Akira , Mata Raymond P. , Neilands Torsten B. 
Published: May 2022

Background:
Transgender women are disproportionately affected by HIV and are less likely to be optimally engaged in care than other groups because of psychosocial challenges. With community collaboration, we developed Healthy Divas, an individual-level intervention to increase healthcare empowerment and gender affirmation to improve engagement in HIV care. Healthy Divas comprises 6 peer-led individual sessions and one group workshop facilitated by a healthcare provider with expertise in HIV care and transgender health.

Setting/Methods:
To test the intervention's efficacy, we conducted a randomized controlled clinical trial in San Francisco and Los Angeles among transgender women living with HIV; control was no intervention. Transgender field staff conducted recruitment. Assessments occurred at baseline and 3, 6, 9, and 12 months postrandomization. The primary outcome was engagement in HIV care, defined as the sum of (1) self-reported HIV care provider visit, past 6 months, (2) knowledge of most recent CD4 count, (3) self-reported antiretroviral therapy adherence ≥90%, and (4) self-reported antiretroviral therapy adherence ≥80%.

Results:
We enrolled 278 participants; almost half (46%) were African American/Black and one-third (33%) were Hispanic/Latina. At 6 months, participants in the intervention arm had over twice the odds of being in a higher HIV care engagement category than those in the control arm (aOR = 2.17; 95% CI: 1.06 to 4.45; P = 0.04); there were no significant study arm differences in the outcome at the other time points.

Conclusions:
This trial demonstrates the short-term efficacy of an urgently needed behavioral intervention to improve engagement in HIV care among transgender women living with HIV; ongoing intervention may be needed to maintain positive impact over time.

Trial Registration:
Clinicaltrials.gov identifier: NCT03081559.
Opioid Prescribing Practices Among Plastic Surgeons
Authors: Oberhofer Haley M. , Rao Adityanarayan , Carlson Jacob T. , Mast Bruce A. , Simmons Christopher J. , Gutowski Karol A. , Satteson Ellen S. 
Published: May 2022

Background
Health care providers play an important role in the national opioid crisis with 40% of opioid-related deaths being attributed to prescription medications (Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. 2018) and as many as half of the opioid pills prescribed after outpatient plastic surgery may go unused (Plast Reconstr Surg 2019;143:929-938). The purpose of this study was to provide broad foundational data regarding postoperative analgesic prescribing patterns among members of the American Society of Plastic Surgeons (ASPS) to facilitate inclusion of opioid data fields in the ASPS Tracking Operations and Outcomes for Plastic Surgeons database for longitudinal evaluation.

Methods
A survey regarding opioid prescribing practices was electronically distributed to a representative cohort of 2555 ASPS members. Two hundred seventy-nine responses (11% response rate) were received.

Results
The majority of respondents reported prescribing opioids following 1 or more types of cosmetic and reconstructive procedures (90.2% and 81.7%, respectively; p = 0.0057), most commonly oxycodone and hydrocodone. Most (61.9%) reported less than 5% of patients request an opioid refill. Nonopioid medications, most commonly acetaminophen and ibuprofen/naproxen, were also prescribed but less commonly so for cosmetic (80.7–85.8%) than reconstructive (86.3–91.5%) procedures. Local anesthetic was less commonly used for mastopexy (83.7%) than augmentation (91.8%, p = 0.02).

Conclusions
Based on survey responses, potential areas of improvement to reduce opioid prescribing and use include provider education on the use of multimodal pain regimens including nonopioid medication and “as needed” rather than scheduled dosing, use of local anesthetic blocks, as well as patient education on opioid safety and proper disposal of unused medication.
Is Routine Imaging Necessary for the Management of Pediatric Hand Fractures Postoperatively?
Authors: Sleiwah Aseel , Al-Jabir Ahmed , Mughal Maleeha , Syed Mobinulla 
Published: May 2022

Background
Pediatric hand fractures heal remarkedly well, and clinically significant displacement after operative fixation is rare. Radiation exposure in medical practice is regulated by the Ionizing Radiation Medical Exposure Regulations 2017, and unnecessary radiation should be avoided. In the literature, there is paucity of information regarding the number of radiographs required in the postoperative period and guidelines are lacking.

Methods
This study aims to examine whether routine imaging or the lack of it influences functional outcome and time to discharge from the clinic. A retrospective data of pediatric hand fractures requiring intervention between 2014 and 2018 at our institution were conducted before and after elimination of routine postoperative imaging. A total of 230 patients were included in the study.

Results
Two cohorts of patients were identified. The first had routine postoperative radiographs, whereas the second did not have routine radiographs. There was no change in management and difference in the range of motion at discharge between the 2 groups (P = 0.74). Patients without routine imaging were discharged earlier from clinic (74.4 vs 108.2 days, P = 0.012).

Conclusions
This study shows that clinically significant fracture displacement is rare after operative reduction and fixation in pediatric age group. It demonstrates our experience in refraining from routine postoperative radiographs. The overall benefit is to avoid unnecessary radiation and subsequent costs implicated.
To Decline or Accept
Authors: Warden Aleah M. , Soteropulos Carol E. , Eftekari Sahand C. , Nicksic Peter J. , Dingle Aaron M. , Poore Samuel O. 
Published: May 2022

Importance
After the rise of predatory journals characterized by false claims of legitimacy and a pay-to-publish model, similar “predatory conferences” have become increasingly common. The email inbox of an academic physician can be filled with daily announcements encouraging conference attendance, abstract submission, and often panel or keynote speaker invitations. It therefore becomes important for the plastic surgeon to be able to discern whether these invitations are from “predatory” conferences or legitimate career advancement opportunities, especially early in practice.

Objective
To aid the invited physician in determining the legitimacy of a conference, we aimed to characterize objective features of conferences for which email invitations have been received and use this information to build a decision-making guide.

Design
We analyzed all conference invitations received by the email of one academic plastic surgeon in a 4-month period. These conferences were organized into 3 groups based on affiliation with known professional societies. The following information was collected if available: affiliation with a professional society, type of invitation, conference location, conference format (in-person, virtual, or hybrid), conference title, conference fees, conference organizer, associated journals or publishers, abstract journal submission, grammar, headshots, time to abstract review, and acceptance.

Results
There were 56 unique conference invitations. These were categorized into 15 affiliated conferences, 28 unaffiliated conferences, and 17 conferences of undetermined affiliation. Unaffiliated conferences were more likely to solicit speaker invitations (P < 0.001), claim to be “international” (P = 0.001), send emails with grammatical errors (P < 0.001), use unprofessional headshots on the conference Web site (P < 0.001), and have reduced virtual conference fees (P = 0.0032) as compared with conferences affiliated with known professional societies. When comparing the attendance and presenter fees of in-person venues, there was no significant difference between affiliated and unaffiliated conferences (P = 0.973, P = 0.604). Affiliated conferences were more likely to take place in the United States (P = 0.014).

Conclusions and Relevance
We present a method to quickly assess the legitimacy of an academic meeting by way of a few important questions. Based on our findings, emails soliciting conference speakers, claims of international presence, grammatical errors, unprofessional headshots, and reduced virtual conference fees are all characteristics that should raise red flags.
Intraosseous Lipoma of the Carpus
Authors: Park Il-Jung , Lee Jiwon , Lee Heejeong , Kang Soo-Hwan 
Published: May 2022

Abstract
Intraosseous lipoma is a very rare benign lipoma, accounting for less than 0.1% of primary bone tumors. Incidentally found in most cases, it frequently involves the metaphysis of the long bones of the lower extremity or calcaneus but rarely occurs in the upper extremity. Intraosseous lipoma of the carpal bones, especially, has yet to be reported, except for 3 cases of scaphoid and capitate involvement. Herein, we report 2 cases of intraosseous lipoma in the capitate and hamate bones with a literature review. Two patients complained of wrist discomfort despite conservative treatment and were diagnosed by computed tomography, magnetic resonance imaging, and surgical biopsy. They were treated with intralesional curettage and autologous bone graft, and their symptoms improved and showed no evidence of recurrence, both clinically and radiologically.