bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hemodynamic Study of Stanford Type B Aortic Dissection Based on Ex Vivo Porcine Aorta Models
Authors: Liang Shichao , Jia Heyue , Dong Huiwu , Li Zhenfeng , Zhou Guojing , Zhang Xuehuan , Chen Duanduan , Xiong Jiang 
Published: March 2022

Background: In this study, we aimed to evaluate hemodynamic influence of the dissected aortic system via various ex vivo type B aortic dissection (AD) models. Methods: Twenty-four raw porcine aortas were harvested and randomly divided into 4 groups to create various aortic models. Model A was the control group, while models B to D indicated the AD group, where models B and C presented a proximal primary entry with the false lumen (FL) lengths of 15 and 20 cm, respectively, and model D presented a 20 cm FL with a proximal primary entry and a distal reentry. All the aortic models were connected to a mock circulation loop to attain the realistic flow and pressure status. The flow distribution rate (FDR) of the aortic branches was calculated. Doppler ultrasound was applied to visualize the AD structure and to attain the velocity of flow in both the true and false lumens. Several sections of the AD were stained with hematoxylin and eosin for histologic evaluation after the experiment. Results: This study demonstrated that higher pressures were found for the AD group compared with the control group. The mean systolic pressures at the inlet of models A to D were 113.34±0.81, 120.58±0.52, 117.76±0.82, and 115.87±0.42 mm Hg, respectively. The FDRs of the celiac artery in models A to D were 8.65%, 8.32%±0.15%, 7.87%±0.13%, and 8.03%±0.21%, respectively. By ultrasound visualization, the velocity of the flow at the entry to the FL in the AD group ranged in 10 to 92 cm/s. The dissection flap presented pulsatile movement, especially in the models B and C which contained 1 primary entry without distal reentries. Histological examinations indicated that AD was located between the intimal and medial layers. Conclusions: Our ex vivo models demonstrated that the configuration of the dissected aorta influenced the pressure distribution. Moreover, the dissection flap affected the FDR of the aortic branches that possibly inducing malperfusion syndrome.
HbA1c and Infection in Diabetic Elective Hand Surgery: A Veterans Affair Medical Center Experience 2012-2018
Authors: Coady-Fariborzian Loretta , Anstead Christy 
Published: March 2022

Background: Hemoglobin A1c (HbA1c) is an indicator of glucose control over a 3-month period. The plastic surgery service began screening HbA1c levels prior to surgery when a trend in infectious complications was noted in diabetics. We made a cutoff value of < 8% for elective hand surgery. Methods: The institutional review board approved a 7-year retrospective chart review (#201900402) 2012 through 2018 of our elective diabetic hand surgery cases. Data collected included: surgery, HbA1c levels within 3 months before surgery, glucose finger sticks day of surgery, and infectious complications up to 30 days after surgery. A Fisher exact test using a P value of < .05 and a logistic regression analysis using a P value of < .05 were used to determine statistical significance between infectious complications and screening. Results: In all, 848 cases were recorded in the data base. Infection complication rates before and after screening were not statistically significant ( P = .44). All major complications (3) requiring a return to the operating room involved surgery within the flexor sheath before screening was enforced. This was not statistically significant ( P = .25). The relative risk of an infectious complication involving the flexor sheath in unscreened patients was 3.66. A logistic regression analysis found no correlation with infectious complications based on the 3 variables of screening time ( P = .99), preoperative finger stick values ( P = .12), or HbA1c levels ( P = .29). Conclusion: The data did not support our guidelines for enforcing HbA1c cutoff levels prior to elective hand surgery. Consider enforcing levels < 8% when the flexor sheath may be violated.
On the Road Again: Return to Driving Following Minor Hand Surgery
Authors: Frazier Mary C. , Hackley Darren T. , Locklear Tonja M. , Badger Ariel E. , Apel Peter J. 
Published: March 2022

Background: Patient return-to-driving following minor hand surgery is unknown. Through daily text message surveys, we sought to determine return-to-driving after minor hand surgery and the factors that influence return-to-driving. Methods: One hundred five subjects undergoing minor hand surgery received daily text messaging surveys postoperatively to assess: (1) if they drove the day before and if so; (2) whether they wore a cast, sling, or splint. Additional patient-, procedure-, and driving-related data were collected. Results: More than half of subjects, 54 out of 105, returned to driving by the end of postoperative day #1. While patient-related factors had no effect on return-to-driving, significant differences were seen in anesthesia type, procedure laterality, driving assistance, and distance. Return-to-driving was significantly later for subjects who had general anesthetic compared to wide awake local anesthetic with no tourniquet (4 ± 4 days vs 1 ± 3 days, P = 0.020), as well as for bilateral procedures versus unilateral procedures (5 ± 5 days vs 1 ± 3 days, P = 0.046). Lack of another driver and driving on highways led to earlier return-to-driving ( P = 0.040 and, P = 0.005, respectively). Conclusions: Most patients rapidly return to driving after minor hand surgery. Use of general anesthetic and bilateral procedures may delay return-to-driving. Confidential real-time text-based surveys can provide valuable information on postoperative return-to-driving and other patient behaviors.
Impact of aneurysm diameter, angulation, and device sizing on complete occlusion rates using the woven endobridge (WEB) device: Single center United States experience
Authors: Fortunel Adisson , Javed Kainaat , Holland Ryan , Ahmad Samuel , Haranhalli Neil , Altschul David 
Published: March 2022

Background The Woven EndoBridge device is a novel treatment option for wide-necked bifurcation intracranial aneurysms (WNBA). While this device has had good results, there remains a subset of WNBA that fail this treatment. The main objective of this study is to identify risk factors that are associated with incomplete occlusion of WEB treated aneurysms at short-term follow up. Methods This was a retrospective study of 31 patients with intracranial aneurysms who were treated with WEB at a single institution in the USA in 2019–2021. Data was collected via chart review on patient demographics, aneurysm characteristics, procedural details, and occlusion status at six months follow up. Bivariate analyses were performed comparing completely occluded aneurysms with neck remnants and residual aneurysms. Results 16 (52%) had completely occluded aneurysms while 11 (35%) patients had a neck remnant, and 4 (13%) patients had a residual aneurysm at follow up. Patients with neck remnants and residual aneurysms had aneurysms with a larger diameter. A large aneurysm diameter is an independent risk factor for incomplete occlusion (OR 4.23 95% CI 1.08–16.53 P value = 0.038). Patients with residual aneurysms had an average difference between the aneurysm width and WEB diameter of −0.08mm compared to 1.2 mm in patients with occluded aneurysms. 75% of patients with a residual aneurysm presented with a ruptured aneurysm. Lastly, more patients with a residual aneurysm had an immediate angiographic outcome of incomplete occlusion. Conclusion Larger aneurysms are at risk for incomplete occlusion status post WEB treatment. Larger, ruptured aneurysms with minimal difference in aneurysm and WEB diameter that fail to occlude immediately post-treatment are more likely to present as residual aneurysms at short-term follow up.
Variability of Glycemic Outcomes and Insulin Requirements Throughout the Menstrual Cycle: A Qualitative Study on Women With Type 1 Diabetes Using an Open-Source Automated Insulin Delivery System
Authors: Mewes Darius , Wäldchen Mandy , Knoll Christine , Raile Klemens , Braune Katarina 
Published: March 2022

Background: The impact of hormone dynamics throughout the menstrual cycle on insulin sensitivity represents a currently under-researched area. Despite therapeutic and technological advances, self-managing insulin therapy remains challenging for women with type 1 diabetes (T1D). Methods: To investigate perceived changes in glycemic levels and insulin requirements throughout the menstrual cycle and different phases of life, we performed semi-structured interviews with 12 women with T1D who are using personalized open-source automated insulin delivery (AID) systems. Transcripts were analyzed using thematic analysis with an inductive, hypothesis-generating approach. Results: Participants reported significant differences between the follicular phase, ovulation, and luteal phase of the menstrual cycle and also during puberty, pregnancy, and menopause. All participants reported increased comfort and safety since using AID, but were still required to manually adjust their therapy according to their cycle. A lack of information and awareness and limited guidance by health care providers were frequently mentioned. Although individual adjustment strategies exist, achieving optimum outcomes was still perceived as challenging. Conclusions: This study highlights that scientific evidence, therapeutic options, and professional guidance on female health-related aspects in T1D are insufficient to date. Further efforts are required to better inform people with T1D, as well as for health care professionals, researchers, medical device manufacturers, and regulatory bodies to better address female health needs in therapeutic advances.
Development and Feasibility of a Multidisciplinary Approach to AKI Survivorship in Care Transitions: Research Letter
Authors: Barreto Erin F. , May Heather P. , Schreier Diana J. , Meade Laurie A. , Anderson Brenda K. , Rensing Megan E. , Ruud Kari L. , Kattah Andrea G. , Rule Andrew D. , McCoy Rozalina G. , Finnie Dawn M. , Herges Joseph R. , Kashani Kianoush B. ,   For the ACT Study Group
Published: March 2022

Background: Acute kidney injury (AKI) survivors are at heightened risk for poor short- and long-term health outcomes. Even among those who recover after an AKI episode, the risk for chronic kidney disease is 4- to 6-fold higher than in patients without AKI, underscoring the importance of identifying methods to improve AKI survivorship. Objective: The purpose of this report was to describe the development and feasibility of a novel multidisciplinary approach to caring for AKI survivors at care transitions (ACT). Design: Observational process improvement initiative. Setting: Single academic medical center in the United States. Patients: The studied population was adults with stage 3 AKI not discharging on dialysis who were established with a primary care provider (PCP) at our institution. Methods: An electronic health record tool was developed prior to implementation to identify AKI survivors. The ACT program encompassed engaging patients in the hospital, delivering education by nephrology-trained nurses before discharge, completing recommended laboratory testing after discharge, and conducting structured kidney-focused follow-up with a pharmacist and a PCP within 7 to 14 days after discharge. Patients could be referred for nephrology evaluation at the discretion of the PCP. Results: Preliminary data demonstrated that most AKI survivors of interest could be identified, educated, and followed up with this model. This strategy appeared feasible, scalable, and maximized the unique expertise of each member of the multidisciplinary team. Limitations: Small sample size, future assessment of process, clinical, and patient-reported outcomes needed. Conclusions: The multidisciplinary ACT workflow supported by clinical decision support was feasible and addressed gaps in existing care transition models. Team-based care delivery in primary care appears to be a mechanism to extend the capacity for kidney health monitoring for AKI survivors.
A national teledentistry study on the knowledge, attitudes, training and practices of private dentists
Authors: Giraudeau Nicolas , Bauer Mathieu , Tramini Paul , Inquimbert Camille , Toupenay Steve 
Published: March 2022

Objectives Nationally examine the self-perceived knowledge, attitudes and practices of TeleDentistry (TD) among dentists in private practice in France. Methods A descriptive questionnaire-based survey was conducted nationwide from 10 November 2020 to 13 December 2020. The national scale survey was both anonymous and voluntary and was sent by the National Board of Dentists to 42,464 private dentists that were officially registered in France. The questionnaire included 36 questions divided into various sections: (i) general profile (gender, age range, and university, where respondents completed their dental studies), (ii) general knowledge of telemedicine, and (iii) familiarity with current regulations on telemedicine and activities that qualify as telemedicine. Results Only 57.1% of dentists in private practice stated that they had never heard nor knew about TD (n=2,887). Only 1.5% (n=76) stated they had attended a training module on telemedicine and/or TD during their studies at university. Only 1.3% (n=26) of dentists who practised a TD activity stated that they knew about telemedicine regulations. Only 65.7% (n=2,020) of those who had never practised and 74.8% (n=1,485) who had practised TD acknowledged that they would like to practice TD. Conclusions In conclusion, this study found a significant need for TD education and training as well as on regulations. It may be necessary in the future to ensure that all stakeholders in the field of dentistry work together to improve these two topics for dental practitioners. It is also worth noting that TD and telemedicine are public health tools and that they could provide inequitable access to medical care. However, TD must be implemented to decrease inequality and ensure it does not do the opposite.
Perspectives and experiences with COVID-19 vaccines in people with MS
Authors: Ciotti John R. , Perantie Dana C. , Moss Brandon P. , Fitzgerald Kathryn C. , Cohen Jeffrey A. , Mowry Ellen M. , Naismith Robert T. , Chahin Salim 
Published: March 2022

Background People with MS may have unique perspectives on COVID-19 vaccines due to their condition and/or medications. Objective Assess perspectives and experiences with COVID-19 vaccination, and quantify variables impacting COVID-19 vaccine willingness in people with MS. Methods A survey captured demographics, MS characteristics, and COVID-19 infection and exposures data; opinions on COVID-19 vaccine safety, side effects, and efficacy; and experiences following vaccination. Chi-square tests and a logistic regression model were used to denote between-group differences and variables predicting vaccine willingness, respectively. Results Most (87.8%) of the 237 participants were willing to receive the vaccine. Fifteen percent held or delayed a DMT dose for vaccination. MS symptoms worsened in a minority (7.6% first/only dose; 14.7% second dose), and most side effects were mild (80.0%; 55.3%). Those not planning to receive the vaccine were primarily concerned with long-term safety (70.4%). Medical comorbidities (adjusted odds ratio [aOR]=5.222; p=0.04) and following infection prevention precautions (aOR=6.330; p=0.008) were associated with vaccine willingness. Conclusion Most individuals with MS surveyed plan to receive the COVID-19 vaccine. People with MS experience similar side effects to the general population, and few experience transient MS symptom worsening. These results can inform conversations on vaccination between providers and people with MS.
Association of Perinatal Factors With Severe Obesity and Dyslipidemia in Adulthood
Authors: Tadese Kristene , Ernst Vivian , Weaver Amy L. , Thacher Tom D. , Rajjo Tamim , Kumar Seema , Kaufman Tara , Wi Chung-Il , Lynch Brian A. 
Published: March 2022

Background: Perinatal factors including gestational age, birthweight, size for gestational age, delivery route, maternal parity, maternal age, maternal education, socioeconomic status, race, and sex, are associated with the future risk of obesity and co-morbid conditions. This study evaluated the relationship of birthweight for gestational age and perinatal factors with severe obesity and dyslipidemia in adulthood. Methods: We conducted a population-based, retrospective birth cohort study of infants born to residents of Olmsted County, MN between 1976 and 1982. Outcomes were assessed after age 18 years until October 2020, including severe obesity (BMI ≥ 40 kg/m2) and dyslipidemia (total cholesterol ≥200 mg/dL, non-high density lipoprotein [non-HDL] cholesterol ≥145 mg/dL or HDL cholesterol <40 mg/dL). We obtained mother’s age, education level, and parity as well as newborn sex, race, type of delivery, single/multiple birth, gestational age, and birthweight from birth certificate data. Individual-level socioeconomic status (SES) of the household at birth was determined with the HOUSES index. Results: Of 10 938 birth cohort subjects, 7394 had clinic visits after age 18 years and were included, with 2630 having severe obesity (n = 798) or dyslipidemia (n = 2357) as adults. In multivariable models, female sex, singleton birth, less maternal education, and lower SES defined by HOUSES were independently associated with an increased risk of severe obesity in adulthood. Non-white race, singleton birth, and lower birthweight were independently associated with adult dyslipidemia. Birthweight for gestational age was not associated with severe obesity or dyslipidemia. Conclusion: Perinatal factors were associated with both severe obesity and dyslipidemia in adulthood. Lower SES at birth was predictive of severe obesity in adulthood, highlighting the opportunity to investigate modifiable perinatal social determinants to reduce the risk of severe obesity.
Return to Play and Performance After Anterior Cruciate Ligament Reconstruction in National Football League Players
Authors: Mody Kush S. , Fletcher Amanda N. , Akoh Craig C. , Parekh Selene G. 
Published: March 2022

Background: Considerable variability exists in return-to-play rates after anterior cruciate ligament (ACL) injury and reconstruction (ACLR) among National Football League (NFL) players of different positions. Purpose/Hypothesis: The purpose of this study was to compare return-to-play and performance levels by position in NFL players after ACLR. It was hypothesized that (1) ACL injuries have significant effects on the careers of NFL players, including return to play and performance, and (2) players of certain positions that involve relatively less pivoting and cutting perform better after ACLR. Study Design: Descriptive epidemiology study. Methods: All NFL players who underwent ACLR between 2013 and 2018 were identified using the FantasyData injury database. Player characteristics, snap count, games played, games started, and performance metrics were collected for 3 years before and after injury using the Pro Football Reference database. Performance was measured using an approximate value (AV) algorithm to compare performance across positions and over time. Nonparametric tests were used to compare the pre- and postinjury data and the percentage change in performance between different positions. Results: Overall, 312 NFL players were included in this study, and 174 (55.8%) returned to play. Of the eligible players, only 28.5% (n = 59/207) remained in the league 3 years postinjury. Within the first 3 years postinjury, players played in fewer games (8.7 vs 13.7; P < .0001), started in fewer games (3.0 vs 8.3; P < .0001), had lower AVs (1.5 vs 4.3; P < .0001), and had decreased snap counts (259.0 vs 619.0; P < .0001) compared with preinjury. Quarterbacks were most likely to return to play (92.9% vs 53.7%; P = .0040) and to return to performance (2% vs 50% decrease in AV; P = .0165) compared with the other positions. Running backs had the largest decrease in AV (90.5%), followed by defensive linemen (76.2%) and linebackers (62.5%). Conclusion: The study findings indicated that NFL players are severely affected by ACL injury, with only 28.5% still active in the league 3 years after the injury. Running backs, defensive linemen, and linebackers performed the worst after injury. Quarterbacks were most likely to return to play and had superior postinjury performance compared with the other positions.
Prenatal Ultrasound Utilization and Its Associated Factors among Pregnant Women in Jimma Town Public Health Institutions, Ethiopia
Authors: Yetwale Aynalem , Kabeto Tola , Biyazin Tsegaw , Fenta Belete 
Published: March 2022

Background Ultrasound scanning is an integral part of antenatal care worldwide. However, little is known about the utilization of obstetric ultrasound in Ethiopia. This study aimed to assess prenatal ultrasound utilization and its associated factors among pregnant women attending antenatal care in Jimma town public health care facilities. Methods An institutional-based cross-sectional study was conducted on 303 pregnant women attending antenatal care (ANC) from July to August 2021 in Jimma town public health care facilities. A systematic sampling technique was used to select study participants who attended the ANC service during the data collection period. Logistic regression analysis was performed to determine the association between the explanatory and response variables. The strength of association of dependent and independent variables was presented as crude and adjusted odds ratio (AOR) at a 95% confidence interval. The level of significance was declared at a P-value of less than .05 in multivariable logistic regression. Narratives, figures, and tables were used to obtain the results. Findings The proportion of prenatal ultrasound utilization in this study was 60.7% [(95% CI); (55.4%-66%)]. Residency AOR = 6.09 (95%CI: 2.35-15.78), household monthly income less than 1000 AOR = 0.159(0.035-0.73), mother's history of at least one abortion AOR = 5.78 (95% CI: 1.89– 17.64), and knowledge towards prenatal ultrasound AOR = 15.77 (95% CI: 6.39-38.92) were found statistically significant association with prenatal ultrasound utilization. Conclusions In the current study, the proportion of prenatal ultrasound utilization during pregnancy was lower than the world health organization (WHO) recommendation. Therefore, the author recommended that educating mothers on the purposes of obstetric ultrasound and/ or including a prenatal ultrasound screening as part of antenatal care is needed.