bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Antibiotic Prophylaxis Necessary in Small (≤20% TBSA) Burn Excisions? A Retrospective Study
Authors: Puthumana Joseph S. , Khan Iman F. , Tiongco Rafael Felix P. , Akhavan Arya A. , Khoo Kimberly H. , Qiu Cecil S. , Puthumana Joe J. , Cooney Carisa M. , Wright William F. , Caffrey Julie A. 
Published: June 2022

Background:
This study investigates the effect of prophylactic perioperative antibiotic use on patients with small burns [≤20% total body surface area (TBSA)] on rates of infection, graft loss, or readmission.

Methods:
A retrospective chart review was conducted on patients admitted to our institution’s burn center between January 2020 and July 2021. Patients were included if they had a 20% or less TBSA burn with 1 or more operating room visit for burn excision and were excluded if a preoperative infection was present. Data were gathered regarding patient demographics, burn mechanism, burn characteristics, and outcome measures including infection, graft loss, and readmission. Statistical analysis was conducted by Mann–Whitney U and Fisher exact tests, and P values reported at two-sided significance of less than 0.05.

Results:
There were no significant differences in age, body mass index, TBSA, percent third-degree burn, or comorbidities between patients who received (n = 29) or did not receive (n = 47) prophylactic perioperative antibiotics. There was a nonsignificant trend toward higher length of stay in the prophylactic antibiotic group, possibly driven by a nonsignificant trend toward higher rates of flame injuries in this group. There was no difference in infection (P = 0.544), graft loss (P = 0.494), or 30-day readmission (P = 0.584) between the two groups.

Conclusion:
This study finds no significant difference in postoperative infection, graft loss, or 30-day readmission in two similar patient cohorts who received or did not receive prophylactic perioperative antibiotics for acute excision of small (≤20% TBSA) burns.
Dual Fluorescent Tracers for Surgical Guidance: Preventing Donor-site Lymphedema in Vascularized Lymph Node Transfer
Authors: Chang Irene A. , Swanson Marco A. , Rajan Meenakshi , Schwarz Graham S. 
Published: June 2022

Introduction:
Vascularized lymph node transfer (VLNT) restores physiological lymphatic function. Although effective, postoperative impairment of donor-site lymphatic function and iatrogenic lymphedema following lymph node transfer remains a pressing concern.

Methods:
Prospective analysis of VLNT patients undergoing dual fluorescent tracers-assisted harvest was performed at our institution from September 2013 to April 2022. Reverse lymphatic mapping of the lower extremity was performed with indocyanine green (ICG). Blue dye was utilized in both white light and near-infrared spectra for visualization of donor-site lymphatic structures. Demographics, intraoperative details, and surgical outcomes were recorded.

Results:
Twenty-five patients were included. Median age was 52.9 years with a body mass index of 29.1 kg/m2 and mean follow-up of 44 months (range 24 to 90 months). Lymphedema stage ranged from Campisi 2 to 4. Inguinal VLNT was performed in 13 patients, and 12 patients received combined VLNT and free flap breast reconstruction. No patients required change in lymph node donor site intraoperatively. All ICG stained nodes were preserved in situ. No cases of iatrogenic lower extremity lymphedema were observed. Postoperative bioimpedance spectroscopy, circumferential, and volumetric measurements of the donor-site limb did not show evidence of subclinical or clinical lymphedema. The donor site healed appropriately in 92% of patients; one patient developed methylene blue-induced skin necrosis.

Conclusion:
Reverse lymphatic mapping and surgical guidance with dual ICG and blue dye fluorescent tracers provides surgeons with real-time surgical guidance without radioisotope, improves surgical visualization in both white light and near-infrared spectra, and avoids iatrogenic lymphatic dysfunction in the donor limb.
Emerging Trends in Botulinum Neurotoxin A Resistance: An International Multidisciplinary Review and Consensus
Authors: Ho Wilson W. S. , Albrecht Philipp , Calderon Pacifico E. , Corduff Niamh , Loh David , Martin Michael U. , Park Je-Young , Suseno Lis S. , Tseng Fang-Wen , Vachiramon Vasanop , Wanitphakdeedecha Rungsima , Won Chong-Hyun , Yu Jonathan N. T. , Dingley Mary 
Published: June 2022

Background:
Botulinum neurotoxin A (BoNT-A) injection is the most widely performed aesthetic procedure and a first-line therapeutic option for various medical conditions. The potential for BoNT-A immunoresistance and secondary nonresponse related to neutralizing antibody (NAb) formation warrants attention as the range of BoNT-A aesthetic applications continues to expand.

Methods:
An international multidisciplinary panel reviewed published evidence on BoNT-A immunoresistance in aesthetic and therapeutic applications and discussed best practices integrating clinical, ethical, and aesthetic considerations. Consensus statements relating to awareness, assessment, and management of the risk of NAb-related secondary nonresponse in aesthetic practice were developed.

Results:
There was a consensus that, as doses used in aesthetic practice become like those in therapeutics, rates of NAb formation may be expected to increase. However, the true extent of NAb formation in aesthetics is likely underestimated due to limitations of published evidence and variability in treatment patterns of aesthetic patients. Since BoNT-A therapy is often lifelong, practitioners need to recognize immunogenicity as a potential complication that might affect future therapeutic use and strive to minimize modifiable risk factors. The selection and use of a BoNT-A product with the least immunogenic potential from the beginning may thus be advantageous, especially when treatment with high doses is planned.

Conclusions:
In view of current trends in BoNT-A aesthetic use, it is essential for practitioners to conduct thorough clinical assessments, inform patients of treatment risks, and develop BoNT-A treatment plans to minimize immunogenicity. This can help preserve the option of continued or future BoNT-A treatment with satisfactory outcomes.
Breast Cancer Among Female Flight Attendants and the Role of the Occupational Exposures
Authors: Weinmann Sandra , Tanaka Luana Fiengo , Schauberger Gunther , Osmani Vanesa , Klug Stefanie J. 
Published: June 2022

Objective
We conducted a systematic review and meta-analysis to investigate occupational exposures and their role in breast cancer (BC) risk among female flight attendants (FFAs).

Methods
We systematically searched PubMed and EMBASE and included all observational studies reporting on the outcome BC incidence among FFAs. The exposures of interest were cosmic radiation and circadian rhythm disruption. Study quality was assessed using the Newcastle-Ottawa Scale.

Results
Nine studies met the inclusion criteria, of which four were included in the meta-analysis for BC incidence (pooled standardized incidence ratio, 1.43; 95% confidence interval, 1.32 to 1.54). Three studies suggested a possible association between BC and cosmic radiation, whereas none found an association with circadian rhythm disruption.

Conclusion
Neither exposure to cosmic radiation nor circadian rhythm disruption seems to explain the elevated risk of BC among flight attendants. Further studies reporting individual information on occupational exposures are needed.
The effect of an HIV preexposure prophylaxis panel management strategy to increase preexposure prophylaxis prescriptions
Authors: Saberi Parya , Stoner Marie C.D. , Ming Kristin , Lisha Nadra E. , Hojilla J. Carlo , Scott Hyman M. , Liu Albert Y. , Steward Wayne T. , Johnson Mallory O. , Neilands Torsten B. 
Published: June 2022

Objective:
The HIV preexposure prophylaxis optimization intervention (PrEP-OI) study evaluated the efficacy of a panel management intervention using PrEP coordinators and a web-based panel management tool to support healthcare providers in optimizing PrEP prescription and ongoing PrEP care.

Design:
The PrEP-OI study was a stepped-wedge randomized clinical trial conducted across 10 San Francisco Department of Public Health primary care sites between November 2018 and September 2019. Each month, clinics one-by-one initiated PrEP-OI in random order until all sites received the intervention by the study team.

Methods:
The primary outcome was the number of PrEP prescriptions per month. Secondary outcomes compared pre- and postintervention periods on whether PrEP was discussed and whether PrEP-related counseling (e.g., HIV risk assessment, risk reduction counseling, PrEP initiation/continuation assessment) was conducted. Prescription and clinical data were abstracted from the electronic health records. We calculated incidence rate ratios (IRR) and risk ratios (RR) to estimate the intervention effect on primary and secondary outcomes.

Results:
The number of PrEP prescriptions across clinics increased from 1.85/month (standard deviation [SD] = 2.55) preintervention to 2.44/month (SD = 3.44) postintervention (IRR = 1.34; 95% confidence interval [CI] = 1.05–1.73; P = 0.021). PrEP-related discussions during clinic visits (RR = 1.13; 95% CI = 1.04–1.22; P = 0.004), HIV risk assessment (RR = 1.40; 95% CI = 1.14–1.72; P = 0.001), and risk reduction counseling (RR = 1.16; 95% CI = 1.03–1.30; P = 0.011) increased from the pre- to the postintervention period. Assessment of PrEP initiation/continuation increased over time during the postintervention period (RR = 1.05; 95% CI = 0.99–1.11; P = 0.100).

Conclusions:
A panel management intervention using PrEP coordinators and a web-based panel management tool increased PrEP prescribing and improved PrEP-related counseling in safety-net primary care clinics.
Impact of COVID19 on Maxillofacial Fractures in the Province of L’Aquila, Abruzzo, Italy. Review of 296 Patients Treated With Statistical Comparison of the Two-Year Pre-COVID19 and COVID19
Authors: Giovannetti Filippo , Lupi Ettore , Di Giorgio Danilo , Scarsella Secondo , Oliva Antonio , Di Fabio Desiderio , Prata Paolo , Petricca Giada , Valentini Valentino 
Published: June 2022

Abstract
The aim of this study was to understand the impact of the COVID-19 pandemic on the epidemiology of maxillofacial trauma in a regional trauma center in L’Aquila, Abruzzo, Italy, during the first wave of the pandemic and comparted it to an equivalent period from 2015 to 2018. The authorshave retrospectively analyzed personal data, site of trauma, etiology, and mechanism of injury. Statistical analysis has been carried out utilizing IBM SPSS Statistics software (IBM Corp., Armonk, NY) and significance was accepted for P values of <0.05. From January 2015 to December 2020, a total of 296 were analyzed. In Pre-COVID era, 195 patients were evaluated, 130 males (66.6%) and 65 females (33.4%). Zygomatic-malar complex fractures were the most common site of trauma in both genders (53%), followed by mandibular fractures (23%) and orbital ones (15%). The highest incidences of injuries were recorded between 15 and 34 years (21%) with the most common etiology attributed to road accidents traumas (49%). In COVID19 era, the authors recorded 101 traumas, 58 males (57.4%), 43 females (42.6%). Zygomatic-malar complex fractures were confirmed as the most common ones in both genders (41%). The most common etiology was related to casual domestic accident and assaults (37% and 30%, respectively). There was no statistically significant difference in terms of incidence in the comparison of Pre-COVID19 and COVID19 periods (P > 0.05) as opposed to the etiology in which the road traffic accidents decreased in favor of domestic accidents and interpersonal assaults (P < 0.05). Our scientific study represents the first epidemiologic study related to the impact of COVID-19 on maxillo-facial trauma in the Province of L’Aquila, Abruzzo, Italy. A decrease in the number of Maxillofacial injuries related to road traffic accidents can be demonstrated as the benefit of lockdown, however, a significant increase in the number of physical assaults shows how isolation and restrictions have had a highly negative psychological impact on society.
Performance metrics for models designed to predict treatment effect
Authors: Maas C.C.H.M. , Kent D.M. , Hughes M.C. , Dekker R. , Lingsma H.F. , van Klaveren D. 
Published: June 2022

ABSTRACTBackgroundMeasuring the performance of models that predict individualized treatment effect is challenging because the outcomes of two alternative treatments are inherently unobservable in one patient. The C-for-benefit was proposed to measure discriminative ability. However, measures of calibration and overall performance are still lacking. We aimed to propose metrics of calibration and overall performance for models predicting treatment effect.MethodsSimilar to the previously proposed C-for-benefit, we defined observed pairwise treatment effect as the difference between outcomes in pairs of matched patients with different treatment assignment. We redefined the E-statistics, the cross-entropy, and the Brier score into metrics for measuring a model’s ability to predict treatment effect. In a simulation study, the metric values of deliberately “perturbed models” were compared to those of the data-generating model, i.e., “optimal model”. To illustrate these performance metrics, different modeling approaches for predicting treatment effect are applied to the data of the Diabetes Prevention Program: 1) a risk modelling approach with restricted cubic splines; 2) an effect modelling approach including penalized treatment interactions; and 3) the causal forest.ResultsAs desired, performance metric values of “perturbed models” were consistently worse than those of the “optimal model” (Eavg-for-benefit≥0.070 versus 0.001, E90-for-benefit≥0.115 versus 0.003, cross-entropy-for-benefit≥0.757 versus 0.733, Brier-for-benefit≥0.215 versus 0.212). Calibration, discriminative ability, and overall performance of three different models were similar in the case study. The proposed metrics were implemented in a publicly available R-package “HTEPredictionMetrics”.ConclusionThe proposed metrics are useful to assess the calibration and overall performance of models predicting treatment effect.
Association between Bisphosphonate use and COVID-19 related outcomes: a retrospective cohort study
Authors: Thompson Jeffrey , Wang Yidi , Dreischulte Tobias , Barreiro Olga , Gonzalez Rodrigo J. , Hanč Pavel , Matysiak Colette , Neely Harold R. , Rottenkolber Marietta , Haskell Tom , Endres Stefan , von Andrian Ulrich H. 
Published: June 2022

ABSTRACTBackgroundAlthough there are several efficacious vaccines against COVID-19, vaccination rates in many regions around the world remain insufficient to prevent continued high disease burden and emergence of viral variants. Repurposing of existing therapeutics that prevent or mitigate severe COVID-19 could help to address these challenges. The objective of this study was to determine whether prior use of bisphosphonates is associated with reduced incidence and/or severity of COVID-19.MethodsA retrospective cohort study utilizing payer-complete health insurance claims data from 8,239,790 patients with continuous medical and prescription insurance from 1-1-2019 to 6-30-2020 was performed. The primary exposure of interest was use of any bisphosphonate from 1-1-2019 to 2-29-2020. Outcomes of interest included: (a) testing for SARS-CoV-2 infection; (b) COVID-19 diagnosis; and (c) hospitalization with COVID-19 diagnosis between 3-1-2020 and 6-30-2020.Results7,906,603 patients for whom continuous medical and prescription insurance information was available were selected. 450,366 bisphosphonate users were identified and 1:1 propensity score-matched to bisphosphonate non-users by age, gender, insurance type, primary-care-provider visit in 2019, and comorbidity burden. Bisphosphonate users had lower odds ratios (OR) of testing for SARS-CoV-2 infection (OR=0.22; 95%CI:0.21-0.23; p<0.001), COVID-19 diagnosis (OR=0.23; 95%CI:0.22-0.24; p<0.001), and COVID-19-related hospitalization (OR=0.26; 95%CI:0.24-0.29; p<0.001). Sensitivity analyses yielded results consistent with the primary analysis. Bisphosphonate-use was also associated with decreased odds of acute bronchitis (OR=0.23; 95%CI:0.22-0.23; p<0.001) or pneumonia (OR=0.32; 95%CI:0.31-0.34; p<0.001) in 2019, suggesting that bisphosphonates may protect against respiratory infections by a variety of pathogens, including but not limited to SARS-CoV-2.ConclusionsPrior bisphosphonate-use was associated with dramatically reduced odds of SARS-CoV-2 testing, COVID-19 diagnosis, and COVID-19-related hospitalizations. Prospective clinical trials will be required to establish a causal role for bisphosphonate-use in COVID-19-related outcomes.
Ventilation Requirements and Recommendations for Controlling SARS-CoV-2 and Variants Outbreaks in Indoor Gathering Places with Close Contact
Authors: Chow W.K. 
Published: June 2022

AbstractUnexpected rapid infection involving SARS-CoV-2 variant Omicron known as the fifth wave of outbreak occurred since early January 2022 in Hong Kong. Almost 1.2 million citizens were infected in three months. Ventilation provisions in some gathering places with close contact such as restaurants were found to be lower than requirements, believed to be one of the main causes of transmission in these indoor spaces. At the end of the fifth outbreak in mid-May 2022, group infections were still found in several such gathering places including restaurants and pubs due to inadequate ventilation provisions. There are worries about triggering the sixth wave of outbreak.Key points related to ventilation requirements in such gathering places are discussed in this paper. Adequate ventilation of 6 air changes per hour minimum must be provided to avoid direct air transmission of virus. Indoor aerodynamics induced by ventilation system must be considered too. However, it is difficult to measure ventilation rate quickly and accurately. A control scheme on virus outbreaks is proposed on installing mechanical ventilation energy use meters and carbon dioxide sensors for checking ventilation provisions adequacy quickly.
Breathlessness in a virtual world: An experimental paradigm testing how discrepancy between VR visual gradients and pedal resistance during stationary cycling affects breathlessness perception
Authors: Finnegan Sarah L. , Dearlove David J. , Morris Peter , Freeman Daniel , Sergeant Martin , Taylor Stephen , Pattinson Kyle T.S. 
Published: June 2022

AbstractIntroductionThe sensation of breathlessness is often attributed to perturbations in cardio-pulmonary physiology, leading to changes in afferent signals. New evidence suggests that these signals are interpreted in the light of prior “expectations”. A misalignment between afferent signals and expectations may underly unexplained breathlessness. Using a novel immersive virtual reality (VR) exercise paradigm, we investigated whether manipulating an individual’s expectation of effort (determined by a virtual hill gradient) may alter their perception of breathlessness, independent from actual effort (the physical effort of cycling).MethodsNineteen healthy volunteers completed a single experimental session where they exercised on a cycle ergometer while wearing a VR headset. We created an immersive virtual cycle ride where participants climbed up 100 m hills with virtual gradients of 4%, 6%, 8%, 10% and 12%. Each virtual hill gradient was completed twice: once with a 4% cycling ergometer resistance and once with a 6% resistance, allowing us to dissociate expected effort (virtual hill gradient) from actual effort (physical effort of pedalling). At the end of each hill, participants reported their perceived breathlessness. Linear mixed effects models were used to examine the independent contribution of actual effort and expected effort to ratings of breathlessness (0-10 scale).ResultsExpectation of effort (effect estimate ± std. error, 0.63 ± 0.11,p<0.001) and actual effort (0.81 ± 0.21,p<0.001) independently explained subjective ratings of breathlessness, with comparable contributions of 19% and 18%, respectively. Additionally, we found that effort expectation accounted for 6% of participants’ physical effort of pedalling and was a significant, independent predictor (0.09 ± 0.03;p=0.001).ConclusionsAn individuals’ expectation of effort is equally important for forming perceptions of breathlessness as the actual effort required to cycle. A new VR paradigm enables this to be experimentally studied and could be used to re-align breathlessness and enhance training programmes.
Three Imaging Endophenotypes Characterize Neuroanatomical Heterogeneity of Autism Spectrum Disorder
Authors: Hwang Gyujoon , Wen Junhao , Sotardi Susan , Brodkin Edward S. , Chand Ganesh B. , Dwyer Dominic B. , Erus Guray , Doshi Jimit , Singhal Pankhuri , Srinivasan Dhivya , Varol Erdem , Sotiras Aristeidis , Dazzan Paola , Kahn Rene S. , Schnack Hugo G. , Zanetti Marcus V. , Meisenzahl Eva , Busatto Geraldo F. , Crespo-Facorro Benedicto , Pantelis Christos , Wood Stephen J. , Zhuo Chuanjun , Shinohara Russell T. , Shou Haochang , Fan Yong , Koutsouleris Nikolaos , Gur Raquel E. , Gur Ruben C. , Satterthwaite Theodore D. , Wolf Daniel H. , Davatzikos Christos 
Published: June 2022

AbstractAutism spectrum disorder (ASD) is associated with high structural heterogeneity in magnetic resonance imaging (MRI). This work uncovers three neuroanatomical dimensions of ASD (N=307) using machine learning methods and constructs their characteristic MRI signatures. The presence of these signatures, along with their clinical profiles and genetic architectures, are investigated in the general population. High expression of the first dimension (A1, “aging-related”) is associated with globally reduced brain volume, cognitive dysfunction, and aging-related genetic variants. The second dimension (A2, “schizophrenia-like”) is characterized by enlarged subcortical volume, antipsychotic medication use, and partially overlapping genetic underpinnings to schizophrenia. The third dimension (A3, “classical ASD”) is distinguished by enlarged cortical volume, high non-verbal cognitive performance, and genes and biological pathways implicating brain development and abnormal apoptosis. Thus, we propose a three-dimensional endophenotypic representation to construe the heterogeneity in ASD, which can support precision medicine and the discovery of the biological mechanisms of ASD.