bluuebunny/crossref_metadata_2025_split huggingface dataset:
Saphenous Vein Interposition Grafts in Lower Extremity Reconstruction: Appraisal of Technique and Case Series
Authors: Dekker Paige K. , Abdou Salma A. , Youn Richard , Bekeny Jenna C. , Kim Kevin G. , Zolper Elizabeth G. , Fan Kenneth L. , Evans Karen K. 
Published: September 2022

Summary:
Vascular microanastomosis is technically challenging in patients with calcified recipient and donor vessels. Inside-to-outside suturing can prevent plaque rupture and ensure full-thickness intimal approximation. Although this is the preferred technique for anastomosis of atherosclerotic vessels, direct connection of calcified arteries necessitates outside-to-inside suturing on one side of the anastomosis. Furthermore, it is difficult to achieve optimal vessel wall approximation in the setting of luminal size mismatch and rigid vasculature. We previously reported on the use of a saphenous vein interposition graft as a novel technique to achieve a flow-sparing anastomosis in patients with diffuse atherosclerosis who are undergoing free tissue transfer. This study further assesses outcomes of this technique in a series of patients and demonstrates a flap success rate of over 93% in patients with calcified recipient and donor microvasculature.
The treatment effect of Levofloxacin, Moxifloxacin, and Gatifloxacin contained in the conventional therapy regimen for pulmonary tuberculosis: Systematic review and network meta-analysis
Authors: He Yiyue , Li Xiaofei 
Published: September 2022

Background:
Tuberculosis (TB) is one of the serious epidemics that highly threaten the global public health. To explore the treatment effect of Levofloxacin, Moxifloxacin, and Gatifloxacin contained in the conventional therapy regimen for pulmonary tuberculosis.

Methods:
Medline, PubMed, Embase, and Cochrane Library were searched with the keyword such as “Levofloxacin,” “Moxifloxacin,” “Gatifloxacin,” and “tuberculosis”, through June 1992 to 2017. According to the inclusion and exclusion criteria, 2 researchers independently screened the literature, extracted the data, and evaluated the quality of the included studies. The Cochrane system was evaluated by RevMan5.2 and the network meta-analysis was performed by Stata 15.

Results:
A total of 891 studies were included, with a total of 6565 patients. The results of network meta-analysis showed that Moxifloxacin + conventional therapy (CT) regimen was superior to CT regimen only on the spectrum culture negative. Both Levofloxacin + CT and Moxifloxacin + CT were superior to the CT regimen in treatment success rate. For the adverse events, the Levofloxacin + CT showed much safer results than CT group, while Moxifloxacin + CT had more adverse events than CT group.

Conclusion:
Levofloxacin, Moxifloxacin, and Gatifloxacin have different superiority, comparing to CT regimen in spectrum culture negative, treatment success rate, and adverse events. Hence, combined utilization of these quinolone is important on the clinical treatment for tuberculosis.
Digital Point Solutions for Extending Contact Tracing Capacity
Authors: Santos Anicia , Nuñez Gloria , La Stacy , Dorsey Jammal H. , Patel Swati Shah , Luk Karen G. , Brillantes Kristen , Birnbaum Rebecca , Boyette Melissa , Bergquist Eleanor Peters , McClelland Amanda 
Published: September 2022

Background
Initial COVID-19 surges in the United States created a need for technology to supplement human resources to increase efficiency and efficacy.

Methods
Resolve to Save Lives worked with jurisdictions to co-design four technology solutions—Epi Viaduct data pipeline, Epi Contacts contact elicitation webform, Epi Locator contact information search plugin, and Epi Viewpoint case management system (CMS)—to expand the capacity of case investigation and contact tracing (CI/CT) teams. We assessed impact on reducing CI/CT time intervals for COVID-19 using product data and user feedback.

Results
Epi Viaduct accelerated the transfer of approximately 7,400,000 records from an electronic laboratory reporting system in a single jurisdiction to the respective CMS from more than 2.5 hours to less than 1 minute and reduced time to remove duplicate laboratory results from multiple days to less than 6 hours. Epi Contacts focused on increasing the efficacy of contact elicitation, and during a single period, 10% of index cases (9,440 of 96,319) completed Epi Contacts for a total of approximately 18,700 contacts elicited. User interviews indicated the tool increased speed of CI/CT workflows. In total, 134,410 searches were run in Epi Locator by 7320 distinct users—75% of which returned 1 or more person matches. A simple CMS, Epi Viewpoint, was developed and completed, but not deployed.

Conclusions
Systems to mount large-scale population-based contact tracing programs were developed and implemented during the COVID-19 pandemic and can be adapted for CI/CT programs aiming to control the spread of other communicable diseases such as sexually transmitted diseases.
Previous Syphilis Not Associated With Neurocognitive Outcomes in People Living With Human Immunodeficiency Virus in Ontario, Canada
Authors: Christensen Brandon L. , Tavangar Farideh , Kroch Abigail E. , Burchell Ann N. , Rourke Sean B. , Rousseau Rodney K. , Raboud Janet M. , Light Lucia , Bekele Tsegaye , Tan Darrell H.S. ,   OHTN Cohort Study Team
Published: September 2022

Background
About 40% to 60% of people living with human immunodeficiency virus (HIV) experience neurocognitive impairments, irrespective of antiretroviral status. We hypothesized that a history of syphilis or neurosyphilis would be associated with worse neurocognitive outcomes in this population.

Methods
Among health care–engaged people living with HIV in Ontario older than 16 years enrolled in the OHTN Cohort Study, neurocognitive outcomes were as follows: (1) self-reported Medical Outcome Study–HIV Health Survey 4-item cognitive scale; (2) average T score summary scores based on objective neuropsychological testing of complex attention, speed of processing, and learning/memory; and (3) global deficit score dichotomized into impaired/unimpaired neurocognitive status. Syphilis history was determined by laboratory data or chart review. Univariable and multivariable generalized linear mixed models assessed the association between each of: syphilis, number of episodes of syphilis, and years since syphilis diagnosis with these neurocognitive outcomes controlling for age, sex, race, education, income, years of HIV, nadir and most recent CD4 count, most recent HIV viral load, substance use, depression, and number of prior neurocognitive tests.

Results
Of 1288 eligible participants, 218 (16.9%) had a history of syphilis at baseline and an additional 53 were diagnosed during follow up for a total of 271 (21.0%) at the most recent visit. Of those with past infection at baseline, 179 (82.1%) had 1 and 39 (17.9%) had 2 or more episodes of syphilis. In longitudinal multivariable models, we observed no relationship between syphilis diagnosis or years since syphilis diagnosis and any of the neurocognitive outcomes.

Conclusions
In this sample, prior syphilis was not associated with worse neurocognitive outcomes over time according to self-reported scales or objective neuropsychological testing.
Depression and Sexual Stigma Are Associated With Cardiometabolic Risk Among Sexual and Gender Minorities Living With HIV in Nigeria
Authors: Adebajo Sylvia B. , Adebiyi Ruxton , Chama John , Bello Segun , Ononaku Uche , Aka Abayomi , Lai Shenghan , Baral Stefan D. , Dyer Typhanye V. , Crowell Trevor A. , Nowak Rebecca G. , Charurat Man ,   for the TRUST/RV368 Study Group
Published: September 2022

Background:
People living with HIV are vulnerable to cardiometabolic diseases. We assessed the prevalence of cardiometabolic risk factors (CMRF) and associations with sexual stigma and depression among sexual and gender minorities (SGM) in Abuja and Lagos, Nigeria.

Methods:
The TRUST/RV368 study enrolled SGM between March 2013 and February 2020. Participants were assessed for depression, sexual stigma, and CMRF. Robust multinomial logistic regression was used to estimate adjusted odds ratio (aORs) and 95% confidence intervals (CIs) for associations of depression, sexual stigma, and other factors with increasing numbers of CMRF.

Results:
Among 761 SGM, the mean age was 25.0 ± 6.0 years; 580 (76%) identified as cisgender men, 641 (84%) had ≥1 CMRF, 355 (47%) had mild–severe depression, and 405 (53%) reported moderate–high sexual stigma. Compared with individuals without depression, those with mild (aOR 8.28; 95% CI: 4.18 to 16.40) or moderate–severe depression (aOR 41.69; 95% CI: 9.60 to 181.04) were more likely to have 3–5 CMRF. Individuals with medium (aOR 3.17; 95% CI: 1.79 to 5.61) and high sexual stigma (aOR 14.42; 95% CI: 2.88 to 72.29) compared with those with low sexual stigma were more likely to have 3–5 CMRF. Participants age 25–34 years were less likely to have 3–5 CMRF (aOR 0.41; 95% CI: 0.23 to 0.73) compared with participants age younger than 25 years.

Conclusion:
CMRF increased with severity of depression and sexual stigma, potentially predisposing SGM living with HIV to cardiometabolic diseases. Integrating interventions that address depression and sexual stigma in HIV care programs for SGM may improve cardiometabolic outcomes.
Weight Gain and Metabolic Effects in Persons With HIV Who Switch to ART Regimens Containing Integrase Inhibitors or Tenofovir Alafenamide
Authors: Palella Frank J. , Hou Qingjiang , Li Jun , Mahnken Jonathan , Carlson Kimberly J. , Durham Marcus , Ward Douglas , Fuhrer Jack , Tedaldi Ellen , Novak Richard , Buchacz Kate 
Published: September 2022

Background:
The timing and magnitude of antiretroviral therapy–associated weight change attributions are unclear.

Setting:
HIV Outpatient Study participants.

Methods:
We analyzed 2007–2018 records of virally suppressed (VS) persons without integrase inhibitor (INSTI) experience who switched to either INSTI-based or another non–INSTI-based ART, and remained VS. We analyzed BMI changes using linear mixed models, INSTI- and tenofovir alafenamide (TAF) contributions to BMI change by linear mixed models–estimated slopes, and BMI inflection points.

Results:
Among 736 participants (5316 person-years), 441 (60%) switched to INSTI-based ART; the remainder to non–INSTI-based ART. The mean follow-up was 7.15 years for INSTI recipients and 7.35 years for non-INSTI. Preswitch, INSTI and non-INSTI groups had similar median BMI (26.3 versus 25.9 kg/m2, P = 0.41). INSTI regimens included raltegravir (178), elvitegravir (112), and dolutegravir (143). Monthly BMI increases postswitch were greater with INSTI than non-INSTI (0.0525 versus 0.006, P < 0.001). A BMI inflection point occurred 8 months after switch among INSTI users; slopes were similar regardless of TAF use immediately postswitch. Among INSTI + TAF users, during 8 months postswitch, 87% of BMI slope change was associated with INSTI use, 13% with TAF use; after 8 months, estimated contributions were 27% and 73%, respectively. For non-INSTI+TAF, 84% of BMI gain was TAF-associated consistently postswitch. Persons switching from TDF to TAF had greater BMI increases than others (P < 0.001).

Conclusion:
Among VS persons who switched ART, INSTI and TAF use were independently associated with BMI increases. During 8 months postswitch, BMI changes were greatest and most associated with INSTI use; afterward, gradual BMI gain was largely TAF-associated.
The State of Breast Cancer Reconstruction in Virginia
Authors: Liston Jared M. , Samuel Ankhita , Camacho T. Fabian , Anderson Roger T. , Campbell Chris A. , Stranix John T. 
Published: September 2022

Background
Age, race, socioeconomic status, and proximity to plastic surgeons have been shown to impact receipt of reconstruction after mastectomy in several national studies. Given that targeted outreach efforts and programs to address these discrepancies would occur locoregionally, investigation of these reconstructive trends on a state level is warranted.

Study Design
Patients diagnosed with breast cancer in Virginia between 2000 and 2018 were identified in the Virginia Department of Health Cancer Registry. Patients who underwent mastectomy breast conservation surgery, and/or breast reconstruction at the time of oncologic surgery were identified. Patient demographics were analyzed, and logistic regression analyses were used to determine the likelihood of receipt of mastectomy, receipt of mastectomy versus breast conservation surgery, receipt of mastectomy with reconstruction versus mastectomy alone, and receipt of mastectomy with reconstruction versus breast conservation surgery with respect to the demographic variables. Geographically weighted regression analyses were also performed to determine impact of geographic location on receipt of mastectomy and reconstruction after mastectomy.

Results
A total of 78,682 patients in Virginia underwent surgical treatment for breast cancer between 2000 and 2018. Living outside a metropolitan area, increased age, lower socioeconomic status, non-White race, and lower number of plastic surgeons within 50 miles were associated with decreased rates of postmastectomy reconstruction. Rural setting, lower socioeconomic status, and lower plastic surgeon supply were also associated with decreased rates of breast conservation surgery. Reconstruction after mastectomy was lowest in the northwest, central, and southwest regions of Virginia.

Conclusions
Within the state of Virginia, programs to improve access to breast reconstruction for patients residing in rural regions, as well as non-White patients, older patients, and those in lower socioeconomic groups should be implemented. Future studies would implement and study the efficacy of such outreach programs, which could then be applied and tailored to other states or regions to address sociodemographic disparities in access to breast reconstruction.
Reconstruction of Quadriceps Function Using a Single Functional Gracilis Muscle Transfer With an Adductor Longus Nerve to Femoral Nerve Branch of the Rectus Femoris Nerve Transfer
Authors: Donaldson Elsa K. , Chandler Rowan M. , Clark Tod A. , Hayakawa Thomas E.J. , Giuffre Jennifer L. 
Published: September 2022

BackgroundA femoral nerve injury may result in cutaneous sensory disturbances of the anteromedial thigh and complete paralysis of the quadriceps femoris muscles resulting in an inability to extend the knee. The traditional mainstay of treatment for femoral neuropathy is early physiotherapy, knee support devices, and pain control. Case reports have used the anterior division of the obturator nerve as a donor nerve to innervate the quadriceps femoris muscles; however, a second nerve transfer or nerve grafting is often required for improved outcomes. We suggest a novel technique of combining an innervated, pedicled gracilis transfer with an adductor longus to rectus femoris nerve transfer to restore the strength and stability of the quadriceps muscles.MethodsThis is a case series describing the use of a pedicled gracilis muscle transposed into the rectus femoris position with a concomitant nerve transfer from the adductor longus nerve branch into the rectus femoris nerve branch to restore quadriceps function after iatrogenic injury (hip arthroplasty) and trauma (gunshot wound).ResultsWith electrodiagnostic confirmation of severe denervation of the quadriceps muscles and no evidence of elicitable motor units, 2 patients (average age, 47 years) underwent a quadriceps muscle reconstruction with a pedicled, innervated gracilis muscle and an adductor longus to recuts femoris nerve transfer. At 1 year follow-up, the patients achieved 4.5/5 British Medical Research Council full knee extension, a stable knee, and the ability to ambulate without an assistive aid.ConclusionsThe required amount of quadriceps strength necessary to maintain quality of life has not been accurately established. In the case of femoral neuropathy, we assumed that a nerve transfer alone and a gracilis muscle transfer alone would not provide enough stability and strength to restore quadriceps function. We believe that the restoration of the quadriceps function after femoral nerve injury can be achieved by combining an innervated, pedicled gracilis transfer with an adductor longus to rectus femoris nerve transfer with low morbidity and no donor defects.
Hyperosmolar Hyperglycemic Crisis After Burn Injury in a Patient With Advanced Amyotrophic Lateral Sclerosis
Authors: Lin Meng-Wei , Chang Yu-Tzu , Hsueh Yuan-Yu 
Published: September 2022

Abstract
Metabolic disturbance in patients of amyotrophic lateral sclerosis is a rare presentation that might be related to disease progression and outcomes. Hypermetabolic status after major burn injury remains a critical issue in the modern medical care. Here, we present a rare case of a patient sporadic amyotrophic lateral sclerosis who suffered from minor burn injury (8% total body surface area), developing critical hyperosmolar hyperglycemic state during early hospitalization. Newly diagnosed diabetes is established and found related to the underlying disease of this patient. The accumulative metabolic alteration among vulnerable patients of amyotrophic lateral sclerosis and burn injury is noteworthy. Judicious monitoring of fluid and metabolic status helps to prevent the occurrence of acute hyperosmolar hyperglycemic state.
Preliminary Study of the Treatment Strategy for Retaining Traumatic Foreign Bodies Involving the Carotid Artery
Authors: Zhang Chuxi , Wu Jinyang , Zhang Wenbin , Yuan Hao , Yang Chengshuai , Zhang Yong , Zhang Shilei 
Published: September 2022

Purpose:
Craniomaxillofacial trauma is usually accompanied by indwelling foreign bodies, and some of those are close to the carotid artery, which increases the risks and difficulties of surgical treatment. The introduction of interventional radiology combined with image-guided surgical navigation may be a good solution for precise surgery to remove foreign bodies.

Patients and Methods:
Four patients were included in the study. All patients underwent digital subtraction angiography and enhanced computed tomography before surgery. The patients were divided into 3 categories (A, B, and C) according to the presence of carotid artery damage and its positional relationship with the foreign body, and 3 corresponding treatment strategies were developed. Treatments were completed using interventional radiology and surgical navigation systems.

Results:
All foreign bodies were completely removed, except for 1 remaining in the jugular foramen in a patient. The prognosis of all patients was good, and no systemic complications occurred.

Conclusion:
The combined interventional radiology and surgical navigation method proposed in this study is an effective method to improve the accuracy and safety of foreign body removal surgery.
Preoperative Fibrinogen Level and Bleeding in Liver Transplantation for End-stage Liver Disease: A Cohort Study
Authors: Carrier François Martin , Deshêtres Annie , Ferreira Guerra Steve , Rioux-Massé Benjamin , Zaouter Cédrick , Lee Nick , Amzallag Éva , Joosten Alexandre , Massicotte Luc , Chassé Michaël 
Published: September 2022

Background.
Liver transplantation is a high-risk surgery associated with important perioperative bleeding and transfusion needs. Uncertainties remain on the association between preoperative fibrinogen level and bleeding in this population.

Methods.
We conducted a cohort study that included all consecutive adult patients undergoing a liver transplantation for end-stage liver disease in 1 center. We analyzed the association between the preoperative fibrinogen level and bleeding-related outcomes. Our primary outcome was intraoperative blood loss, and our secondary outcomes were estimated perioperative blood loss, intraoperative and perioperative red blood cell transfusions, reinterventions for bleeding and 1-y graft and patient survival. We estimated linear regression models and marginal risk models adjusted for all important potential confounders. We used restricted cubic splines to explore potential nonlinear associations and reported dose-response curves.

Results.
We included 613 patients. We observed that a lower fibrinogen level was associated with a higher intraoperative blood loss, a higher estimated perioperative blood loss and a higher risk of intraoperative and perioperative red blood cell transfusions (nonlinear effects). Based on an exploratory analysis of the dose-response curves, these effects were observed below a threshold value of 3 g/L for these outcomes. We did not observe any association between preoperative fibrinogen level and reinterventions, 1-y graft survival or 1-y patient survival.

Conclusions.
This study suggests that a lower fibrinogen level is associated with bleeding in liver transplantation. The present results may help improving the selection of patients for further studies on preoperative fibrinogen administration in liver transplant recipients with end-stage liver disease.
Separating Signal from Noise in Wastewater Data: An Algorithm to Identify Community-Level COVID-19 Surges
Authors: Keshaviah Aparna , Huff Ian , Hu Xindi C. , Guidry Virginia , Christensen Ariel , Berkowitz Steven , Reckling Stacie , Noble Rachel T. , Clerkin Thomas , Blackwood Denene , McLellan Sandra , Roguet Adélaïde , Mussa Isabel 
Published: September 2022

AbstractWastewater monitoring has shown promise in providing an early warning for new COVID-19 outbreaks, but to date, no approach has been validated to reliably distinguish signal from noise in wastewater data and thereby alert officials to when the data show a need for heightened public health response. We analyzed 62 weeks of data from 19 sites participating in the North Carolina Wastewater Monitoring Network to characterize wastewater metrics before and around the Delta and Omicron surges. We found that, on average, wastewater data identified new outbreaks four to five days before case data (reported based on the earlier of the symptom start date or test collection date). At most sites, correlations between wastewater and case data were similar regardless of how wastewater concentrations were normalized, and correlations were slightly stronger with county-level cases than sewershed-level cases, suggesting that officials may not need to geospatially align case data with sewershed boundaries to gain insights into disease transmission. Wastewater trend lines showed clear differences in the Delta versus Omicron surge trajectories, but no single wastewater metric (detectability, percent change, or flow-population normalized viral concentrations) adequately indicated when these surges started. After iteratively examining different combinations of these three metrics, we developed a simple algorithm that identifies unprecedented signals in the wastewater to help clarify changes in communities’ COVID-19 burden. Our novel algorithm accurately identified the start of both the Delta and Omicron surges in 84% of sites, potentially providing public health officials with an automated way to flag community-level COVID-19 surges.