bluuebunny/crossref_metadata_2025_split huggingface dataset:
Real Effects of Search Frictions in Consumer Credit Markets
Authors: Argyle Bronson , Nadauld Taylor , Palmer Christopher 
Published: November 2022

Abstract
We show that search frictions in credit markets affect accepted interest rates and loan sizes and distort consumption. Using data on car loan applications and originations not intermediated by car dealers, we isolate quasi-exogenous variation in both the costs and benefits to searching for credit. After identifying lender-specific policies that price risk discontinuously, we study the differential response to offered interest rates by borrowers who face high and low search costs. High-search-cost borrowers are 10$\%$ more likely to accept loan offers with higher markups, consequently originating smaller loans and purchasing older and less expensive cars than lower-search-cost borrowers.
Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Recent Alcohol Use Is Associated With Increased Pre-exposure Prophylaxis (PrEP) Continuation and Adherence Among Pregnant and Postpartum Women in South Africa
Authors: Miller Amanda P. , Shoptaw Steven , Moucheraud Corrina , Mvududu Rufaro , Essack Zaynab , Gorbach Pamina M. , Myer Landon , Davey Dvora L. Joseph 
Published: November 2022

Background:
South African women experience high levels of alcohol use and HIV infection during the perinatal period. Oral pre-exposure prophylaxis (PrEP) is highly effective at reducing HIV risk. We examined associations between alcohol use and PrEP use during pregnancy and postpartum.

Methods:
The PrEP in Pregnant and Postpartum women study is a prospective observational cohort of 1200 HIV-negative pregnant women enrolled at first antenatal care visit and followed through 12 months' postpartum in Cape Town, South Africa. The analytic sample comprised pregnant women who initiated PrEP at baseline and were not censored from study follow-up before 3-month follow-up. We examined associations between any or hazardous alcohol use (Alcohol Use Disorders Identification Test—Consumption score ≥3) in the year before pregnancy and PrEP continuation and adherence during pregnancy (self-report of missing <2 doses in past 7 days and biomarker-confirmed with tenofovir diphosphate in dried blood spots).

Results:
Of 943 women on PrEP (median age of 26 years), 50% reported alcohol use before pregnancy, and 33% reported hazardous use. At 3-month follow-up, 58% of women were still using PrEP; 41% reported recent adherence, and 23% were biomarker-confirmed adherent. In multivariable models, hazardous alcohol use was associated with increased odds of continuing PrEP [adjusted odds ratio (aOR) = 1.54, 95% confidence interval (CI): 1.16–2.06], self-reported PrEP adherence (aOR = 1.41, 95% CI: 1.07–1.87), and biomarker-confirmed PrEP adherence (aOR = 1.35 95% CI: 0.98, 1.87). Associations were similar in models of any alcohol use and PrEP continuation/adherence.

Conclusions:
Pregnant and postpartum women who reported recent alcohol use had increased odds of continuing to take PrEP, indicating that higher risk women may continue on oral PrEP.
Pulmonary Embolism Risk After Cosmetic Abdominoplasty and Functional Panniculectomy
Authors: Kalmar Christopher L. , Thayer Wesley P. , Kassis Salam , Higdon Kent K. , Perdikis Galen 
Published: November 2022

Background
Tighter abdominal wall reconstruction may increase intra-abdominal pressure, which can decrease lower extremity venous return. Decreased venous return through the inferior vena cava has been demonstrated to increase risk of deep vein thrombosis.

Objectives
Tighter abdominal wall plication during cosmetic abdominoplasty compared with functional panniculectomy may increase these risks. The purpose of this study was to determine whether cosmetic abdominoplasty increases risk for thromboembolic events compared with functional panniculectomy.

Methods
Retrospective cohort study was conducted using the National Surgical Quality Improvement Program database for excision of excessive subcutaneous infraumbilical skin and soft tissue at participating hospitals between 2015 and 2019. Procedures performed for cosmetic abdominoplasty versus functional panniculectomy were compared for occurrences of postoperative pulmonary embolism (PE).

Results
During the study interval, 11,137 patients underwent excision of excessive infraumbilical abdominal skin, including 57.4% (n = 6397) patients undergoing functional panniculectomy and 42.6% (n = 4740) patients undergoing cosmetic abdominoplasty. Patients undergoing functional panniculectomy were significantly more likely to have comorbidities than those undergoing cosmetic abdominoplasty (P < 0.001). The risk for postoperative PE was independently associated with cosmetic abdominoplasty (P < 0.001), elevated body mass index (P = 0.001), preoperative recent weight loss (P = 0.006), and concurrent hernia repair (P = 0.049). Most PE events occurred outpatient after discharge (87.2%), and the average postoperative time from surgery until PE was 10.5 ± 6.7 days.

Conclusions
Cosmetic abdominoplasty has greater than 4 times the risk of postoperative PE than functional panniculectomy. Risk of PE is further increased by concurrent hernia repair, elevated body mass index, and rapid weight loss in the immediate preoperative period. It may be advisable to caution patients to delay abdominal excisional body contouring procedures until their weight has plateaued.
A Cohort Study on Neuropathic Pain of the Sural Nerve—Can Neurectomy Be Considered a Valid Treatment Option?
Authors: Besmens Inga S. , Brackertz Sophie , Schiller Andreas , Knipper Sophie , Giovanoli Pietro , Calcagni Maurizio 
Published: November 2022

Background
Sural nerve neuroma is often caused by an injury during prior surgery, for example, osteosynthesis or ligament refixations at ankle level. Different surgical techniques to treat neuroma have been described. Neurectomy of an injured symptomatic sural nerve has been described as a treatment option for neuropathic pain. The aim of this study was to evaluate the outcomes of this technique to operatively treat sural nerve neuroma in our department.

Methods
From 2010 to 2020, a total of 30 consecutive patients with neuropathic pain and suspected neuroma of the sural nerve underwent sural nerve neurectomy. A medical chart review was performed to collect patient-, pain-, and treatment-specific factors. Outcomes were registered.

Results
After neurectomy, 22 patients (73.3%) had persisting pain. In logistic regression models evaluating the risk of persisting pain after sural nerve neurectomy, no independent predictor of higher risk of persisting pain could be identified.

Conclusion
For sural nerve neuromas, neurectomy remains an option as the surgical morbidity is minor, but patients need to be counseled that only a fourth of those undergoing surgery will be pain-free afterward.
Secondary Surgery in Facial Feminization
Authors: Rochlin Danielle H. , Chaya Bachar F. , Rodriguez Colon Ricardo , Onuh Ogechukwu , Rojas Allison , Rodriguez Eduardo D. 
Published: November 2022

Background
As facial feminization surgery (FFS) continues to grow in access and popularity, the need for secondary FFS can be expected to increase. The purpose of this study was to identify reasons for FFS reoperation and offer recommendations to minimize secondary surgery.

Methods
A retrospective cohort study of patients who underwent FFS from October 2017 to 2021 was performed. Patients who underwent nonstaged secondary surgery were identified and sorted in 2 non–mutually exclusive surgical cohorts: additional surgery, defined as unplanned additional feminization surgery on previously unoperated facial units, and revision surgery, defined as redo surgery on previously operated facial units. Reasons for secondary surgery were examined in the context of the senior author's experience.

Results
Of 161 patients who underwent FFS, 41 (25.5%) underwent secondary surgery consisting of additional surgery (n = 32) and/or revision surgery (n = 30). There were no significant differences in clinical or demographic data between the secondary surgery and total FFS cohorts. Among additional surgery patients, facial units that had been previously operated on were as follows: nose (46.3%), trachea (31.7%), forehead/brow (22.0%), chin (12.2%), lips (9.8%), and cheeks (7.3%). Among revision patients, facial units revised were as follows: nose (36.6%), forehead/brow (26.8%), cheeks (17.1%), chin (17.1%), lips (12.5%), and trachea (2.4%). The main indication for revision for all facial units was undercorrection to feminine ideals.

Conclusions
One-quarter of patients who underwent FFS had prior FFS and/or sought revision. Keeping in mind that the dominant indication for revision was undercorrection, FFS surgeons can minimize the need for secondary surgery in the future.
Literature Review
Authors: Khan Mustafa T.A. , Won Brian Wong , Baumgardner Kyle , Lue Melinda , Montorfano Lisandro , Hosein Rayaad C. , Wang Howard T. , Martinez Roberto A. 
Published: November 2022

Introduction
Robotic-assisted surgery is gaining popularity because of reported improvement in aesthetic outcomes while reducing the occurrence of complications compared with conventional surgical methods. Deep inferior epigastric perforator (DIEP) flap harvesting has a long track record as a viable procedure for autologous reconstruction of the breast. In this literature review, we describe the feasibility of using the robotic platform in DIEP flap harvest.

Methods
The Preferred Reporting Items for Systemic Reviews and Meta-Analysis methodology was to guide the literature review. PubMed and Scopus databases were searched from inception to June 6, 2022. The Medical Subject Heading terms and keywords used to conduct this search are as described: “Robotic AND deep inferior epigastric perforator AND Breast reconstruction.”

Results
Seven publications, detailing a total of 56 robotic-assisted DIEP flap harvest procedures, were selected for review. Four publications used the transabdominal preperitoneal approach, whereas 2 exclusively used a totally extraperitoneal approach, and 1 compared the 2 approaches. The measured outcomes included technical feasibility of flap harvest in cadavers, viable flap harvest in live patients, harvest time and pedicle dissection time, pedicle length, fascial incision length, donor site pain, need for postoperative narcotic, donor site morbidity, and hernia formation. Overall, the reviewed articles demonstrated successful DIEP flap harvesting without the need for conversion to the conventional open procedure. Postoperative complications were minimal. Robotic DIEP flap harvest was shown to be safe and there were no reports of donor-site morbidity in the studies reviewed. The main advantages of the robotic approach include decreased postoperative pain and length of hospital stay, along with improved aesthetic outcomes. The main disadvantages are increased operative time and cost.

Conclusions
Although at its current iteration, the robotic-assisted DIEP flap is feasible, it may not be practical in all settings. Furthermore, the true benefit of the robotic platform is yet to be determined, as more long-term studies are necessary.
An Updated Definition of Plastic Surgery
Authors: Li Qingfeng , Wang Wenjin , Zan Tao , Xiang MengPing , Pu Lee L. Q. , Schaefer Dirk J. , Ohjimi Hiroyuki 
Published: November 2022

Abstract
Modern medicine tends to provide comprehensive medical services based on disease or pathological features. As a result, the overlap between plastic surgery and other surgical departments greatly deepened. What was exclusively done by plastic surgeons are nowadays frequently practiced by other surgeons as well. Thus, generating confusion as to whether plastic surgery is an independent subject or a tool. Therefore, in this new era of modern medicine, it is necessary to reconsider the definition of plastic surgery.
Obstructive Sleep Apnea in Men With Idiopathic Intracranial Hypertension: A Prospective Case–Control Study
Authors: Kabanovski Anna , Chan Aaron , Shapiro Colin , Margolin Edward 
Published: November 2022

Background:
Idiopathic intracranial hypertension (IIH) is uncommon in men. Previous studies reported on high frequency of obstructive sleep apnea (OSA) in men with IIH, but the pathophysiology of this association remains unclear. One possible culprit for increased intracranial pressure in patients with OSA is hypercapnia. The purpose of this study was to compare the rate of hypercapnia during polysomnography (PSG) study in men with and without IIH and to report on the rate and severity of OSA in men with IIH compared with control subjects of similar age and body mass index (BMI).

Methods:
Prospective case–control study of male patients diagnosed with IIH underwent PSG with continuous oxygen and carbon dioxide monitoring overnight. Healthy control subjects with similar age and BMI also underwent PSG. The incidence of OSA diagnosis, rate of hypercapnia and hypoxia, and apnea hypopnea index (AHI) were compared between 2 groups.

Results:
Eleven subjects with IIH and 10 controls underwent PSG. Both groups were similar regarding age and BMI on the Mann–Whitney U test (P = 0.072 for age, P = 0.251 for BMI). Subjects for whom carbon dioxide data were not available for more than 50% of total sleep time were excluded from hypercapnia analysis. The mean age was 41.9 years, and the mean BMI was 33.8 kg/m2 in subjects and controls. OSA was diagnosed in 9 of 11 men with IIH and 4 of 10 controls. There was no statistically significant difference in the rate of hypercapnia and hypoxia between 2 groups for whom the data were available. All patients with BMI over 30 kg/m2 (7 of 7) and 50% (2 of 4) controls with BMI over 30 kg/m2 were diagnosed with OSA compared with 50% (2 of 4) of cases and 33% (2 of 6) of controls with BMI less than 30 kg/m2. BMI was a significant predictor of total AHI (P = 0.042) and OSA severity (P = 0.023), but IIH diagnosis was not (P > 0.05).

Conclusions:
There was no difference in hypercapnia rate between men with IIH and controls; thus, hypercapnia is an unlikely causative factor in pathophysiology of IIH. OSA on PSG was almost 2 times as prevalent in patients with IIH compared with controls; however, BMI was the strongest predictor of OSA diagnosis, and most patients (9 of 11) with BMI over 30 kg/m2 had OSA on PSG. In men with BMI less than 30, the rate of OSA on PSG study was higher in men with IIH. Based on these data, we recommend that all men with the diagnosis of IIH should undergo PSG study.
It Has Become a Part of Me: Living With Low Anterior Resection Syndrome After Ostomy Reversal
Authors: Buergi Catherine 
Published: November 2022

PURPOSE:
The purpose of this study was to explore challenges of individuals living with low anterior resection syndrome (LARS) 1 year or more after ostomy reversal and formulate a greater understanding of their needs.

DESIGN:
Qualitative study with a phenomenological approach.

SUBJECTS AND SETTING:
The sample comprised 2 women and 5 men. All participants had undergone low anterior resection in the Comprehensive Cancer Center of a Swiss university hospital. The mean age of participants was 66 years (range, 61-71 years).

METHODS:
Interviews were conducted 12 to 42 months after ostomy reversal. Data were collected from one-on-one in-depth interviews using a standardized interview guide with open-ended questions. An interpretative phenomenological analysis was used to interpret data.

RESULTS:
Analysis revealed 3 central categories addressing the burden of living with LARS: “Internalizing new living conditions”; “Actively planning a new everyday life”; and “Knowing the body and controlling symptoms.” “Unpredictability” emerged as the key challenge. Being informed in advance about the problems expected to arise, having the possibility to talk about problems, as well as receiving peer support and structured aftercare were identified as means to ease patients' challenges when living with LARS.

CONCLUSIONS:
Twelve to 42 months after stoma reversal, participants had internalized their new living conditions. Their level of acceptance of their situation was substantial. There are indications that a culture of open information before ostomy reversal contributed to being mentally prepared for the situation after surgery. Talking openly about their problems helped participants organize their everyday life.
Peristomal Necrosis Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Authors: van Kessel Charlotte S. , Mendes Colleen , Young Christopher J. 
Published: November 2022

BACKGROUND:
Peristomal necrosis is a rare but challenging condition requiring multidisciplinary management involving surgical debridement and intensive WOC nurse management.

CASE:
Mr T was a 56-year-old man who underwent cytoreductive surgery with intraperitoneal chemotherapy for a high-grade appendiceal neoplasm. As part of the procedure, an Abcarian stoma (end-ileostomy with a distal lumen from the transverse colon brought out flush with skin beside the proximal stoma) was created. Postoperatively there was leakage of effluent under the subcutaneous skin resulting in full-thickness necrosis of the peristomal area requiring surgical debridement. Consequently, a large peristomal skin defect occurred, resulting in difficulty achieving a good seal of the ostomy pouching system. To overcome these challenges, a multidisciplinary approach with WOC nurses, colorectal surgeons, and plastic surgeons was implemented. Initially, the defect was managed with a negative pressure wound therapy system, followed by a primary closure of the peristomal skin by the plastic surgeons. Mr T was discharged to home 58 days after his initial surgery; by that time, the peristomal skin was healed and he was able to manage ostomy pouching changes independently. Eight months later his ileostomy was successfully reversed.

CONCLUSIONS:
Large peristomal defects are challenging but can be managed successfully via a multidisciplinary approach including WOC nurses, colorectal surgeons, and plastic surgeons.
Preventive Nail Care Among Diabetic Patients
Authors: Williams O'Braint ZaKeia , Stepter Catherine R. , Lambert Brandi 
Published: November 2022

PURPOSE:
The purpose of this quality improvement initiative was to increase adherence to follow-up appointments in patients with diabetes mellitus for prevention of diabetic foot ulcers.

PARTICIPANTS AND SETTING:
The sample comprised 33 adults with diabetes mellitus being cared for at an outpatient wound care clinic affiliated with a large metropolitan hospital in the state of Mississippi, located in the Southern United States.

APPROACH:
This quality improvement approach used the Plan-Do-Study-Act method. Educational flyers and verbal instruction were provided to enhance adherence to preventive nail care and follow-up appointments. The goal for this quality improvement initiative was to increase adherence with preventive nail care and follow-up care.

OUTCOMES:
Participants were provided with educational flyers and verbal instruction that emphasized the importance of follow-up clinic appointments, which promoted increased attendance at follow-up appointments. The proportion of patients who did not attend follow-up appointments fell from 9.2% prior to the intervention to 5.8% after its introduction.

IMPLICATIONS FOR PRACTICE:
This quality improvement initiative positively impacted practice at a local wound care clinic in Mississippi resulting in a clinically relevant reduction in no-show follow-up visits when compared to the previous year.
Prevalence of Friction Skin Injury on the Buttocks and/or Posterior Thighs in an Acute Care Setting
Authors: Berke Christine Thies 
Published: November 2022

PURPOSE:
The prevalence of friction skin injury (FcI) in an acute care hospital was evaluated as part of a quality improvement initiative.

PARTICIPANTS/SETTING:
The setting for this quality improvement project was an academic medical center with 728 licensed beds in the central plains of the United States. Data were collected by 33 clinicians: 28 were RN staff members and 5 were patient care technicians. Six of the 28 nurses (21%) were board-certified wound nurses and 2 (7%) were in training but not yet certified. Prevalence data were collected on 354 hospitalized patients.

APPROACH:
Friction skin injuries were measured in conjunction with the institution's quarterly skin survey for the NDNQI PUPS (National Database of Nursing Quality Indicators Pressure Ulcer Prevalence Survey) in August 2019. The prevalence of FcI was calculated using the number of patients with FcI divided by the total number of patients surveyed.

OUTCOMES:
Three hundred fifty-four patients completed the survey in this PUPS; FcI was diagnosed in 8 patients, yielding a prevalence rate of 2.3%. Clinical manifestations of FcI such as lichenification, skin/soft tissue discoloration, skin/soft tissue deformation and/or callus formation, and skin ulceration were also documented. In addition, a majority of patients with FcI were found to have fecal or urinary incontinence (n = 5/8, 63%; 2 had both fecal and urinary incontinence, 25%). Braden Scale for Pressure Sore Risk subscales scores were analyzed; the mean subscale score for moisture was 3.4; the mean subscale score for friction/shear was 1.4; the mean subscale score for activity was 2.6; and the mean subscale score for mobility was 2.9.

IMPLICATIONS FOR PRACTICE:
To the best of my knowledge, this is the first published article documenting FcI prevalence in any care setting. Additional prevalence studies are needed to establish the epidemiology of FcI across care settings and in the community.
Reducing Mask-Related Pressure Injuries in Pediatric Patients During Noninvasive Ventilation by Targeting Patient Mask Leak
Authors: Lauderbaugh Denise L. , Popien Toni L. , Lesser Daniel J. , Bhattacharjee Rakesh , Pfrommer Puleo Cheryl 
Published: November 2022

PURPOSE:
To compare outcomes following implementation of patient mask leak range of 25 to 55 liters per minute (lpm) to guide strap tension of sleep masks during noninvasive ventilation against baseline data with no patient mask leak range on number of noninvasive mask-related pressure injuries (PIs).

PARTICIPANTS AND SETTING:
All noninvasively ventilated pediatric acute care patients admitted to general wards and intensive care units between February 1, 2018, and February 1, 2019, in a quaternary hospital in the southwest United States.

APPROACH:
Using the Plan Do Study Act model, we employed an intervention to examine the rate of PIs per noninvasive positive pressure ventilation (NIPPV) days and patient-days before and after implementation of patient mask leak parameters between 25 and 55 lpm to guide mask strap tension. Since patients are at an increased risk of sleep mask-related PIs only when on NIPPV, we sought to describe that as number or PIs per number of days at risk, described as NIPPV days, and patient days which is the traditional denominator for wounds and hospital-acquired conditions.

OUTCOMES:
Preintervention, 6 out of 115 subjects (5.2 %) incurred PI at a rate of 0.51 per 100 NIPPV days or 0.26 per 1000 patient-days. Of the 1932 NIPPV days since education was completed, only 1 subject out of 87 (1.1%) incurred a high-stage PI (0.05/100 NIPPV days—a 96.79% reduction or 0.05/1000 patient-days—a 92.86% reduction). Upon reaching more than 90% compliance with patient mask leak range in December 2018, 1221 NIPPV days resulted in 0 noninvasive mask-related PIs. Greater than 90% compliance with a patient mask leak of 25 to 55 lpm allowed us to successfully achieve our hospital's operating plan goal of 0.15 of 1000 patient-days within this group.

IMPLICATIONS FOR PRACTICE:
Maintaining a patient mask leak range between 25 and 55 lpm should be considered as part of proper fit for pediatric patients using NIPPV with a mask. Additional work is needed to assess this leak range in more children and in studies conducted at multiple sites.