bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhanced Federal Collaborations in Implementation Science and Research of HIV Prevention and Treatment
Authors: Purcell David W. , Namkung Lee Ann , Dempsey Antigone , Gordon Christopher 
Published: June 2022

Abstract:
Over the past decade, national initiatives in the United States (U.S.) have focused HIV prevention and care programs and research to optimize the delivery of HIV prevention and treatment through implementation research. Although existing biomedical and behavioral prevention tools could end HIV in the U.S., the implementation of these tools has been uneven because of many factors, including organizational capacity, insufficient uptake by key populations, lack of success with prioritizing by geography or population growth, and inadequate scaling. To address these challenges, the federal government has funded programs, research, and evaluation projects aimed at improving health outcomes among people with HIV and people vulnerable to HIV acquisition. Increasingly, several special federal efforts are being conducted under the umbrella of “implementation science and research” that are essential components to scaling up evidence-based HIV prevention and treatment interventions in the U.S. This paper describes federal collaborations that have supported this increased focus on implementation from the perspective of 3 agencies in the U.S. Department of Health and Human Services; the Centers for Disease Control and Prevention, the National Institutes of Health, and the Health Resources and Services Administration. These federal collaborations have resulted in improved communication and coordination of efforts in the shaping and alignment of priorities in research and service delivery, increased implementation research conducted in real-world community and clinical settings and provided a feedback loop to expedite action in response to emerging evidence from such projects.
Acceptability and Appropriateness of Digital PrEP Interventions for Black and Latina Cisgender Women: Perspectives From Service Providers in Los Angeles County
Authors: Üsküp Dilara K. , Nieto Omar , Rosenberg-Carlson Elena , Lee Sung-Jae , Milburn Norweeta G. , Brooks Ronald A. 
Published: June 2022

Abstract:

Background:
Black and Latina cisgender women (BLCW) experience disproportionately high rates of HIV infection compared with White women. BLCW also experience disparities in uptake of pre-exposure prophylaxis (PrEP), a highly effective HIV prevention strategy. Digital technology interventions may help to improve PrEP accessibility among BLCW and address barriers to receiving PrEP services in clinical settings.

Methods:
We conducted a formative implementation research project with service providers to explore the use of digital technology interventions to improve PrEP care continuum outcomes among priority populations in Los Angeles County. A thematic analysis approach was then used to assess the perceived acceptability and appropriateness of digital PrEP interventions for BLCW.

Results:
Of the five technology products presented, service providers viewed the stand-alone telemedicine platforms as the most acceptable intervention type for BLCW. Service providers also noted perceived benefits and barriers that BLCW may experience in using stand-alone telemedicine platforms, and offered recommendations for tailoring the products to meet the individual needs of BLCW.

Conclusions:
Digital PrEP interventions may help address barriers BLCW experience in accessing PrEP in clinical settings. We offer suggestions of implementation strategies to optimize the use of digital PrEP interventions among BLCW.
Development of an Implementation Facilitation Strategy to Link Mental Health Screening and eHealth Intervention for Clients in Ryan White–Funded Clinics in Chicago
Authors: Stump Tammy K. , Ethier Kristen , Hirschhorn Lisa R. , Dakin Andrea , Bouacha Nora , Freeman Angela , Bannon Jacqueline , Gómez Walter , Moskowitz Judith T. , Bouris Alida 
Published: June 2022

Background:
To reduce the impact of depression on people living with HIV, we are implementing a clinic-based behavioral health screener and referral to Optimizing Resilience and Coping with HIV through Internet Delivery, an evidenced-based intervention. We used the Consolidated Framework for Implementation Research to identify contextual barriers and facilitators in advance of implementation.

Setting:
Sixteen Chicagoland area Ryan White Medical Case Management sites.

Methods:
We conducted a sequential mixed-methods study with medical case managers and supervisors. Participants completed an online survey assessing Consolidated Framework for Implementation Research domains, scored on a 1 (strongly disagree) to 5 (strongly agree) scale. Survey results informed a purposive sampling frame and interview protocol. Interviews were analyzed by rapid qualitative analysis.

Results:
On average, survey respondents (n = 58) slightly agreed with positive views of team culture, learning climate, and implementation readiness (mean = 3.80–3.87). Potential barriers included intervention complexity (mean = 3.47), needed human resources (mean = 2.71–3.33), and only slight agreement with relative advantage over existing screening/referral systems (mean = 3.09–3.71). Qualitative results (n = 15) identified low advantage for clinics with robust behavioral health systems but strong advantage in clinics without these services. Respondents identified system-wide training and monitoring strategies to facilitate implementation.

Conclusions:
Ryan White Medical Case Management sites are a generally favorable context for the implementation of the interventions. As illustrated in an implementation research logic model, barriers will be addressed through deploying strategies proposed to impact clinic- and individual-level outcomes, including electronic prompts (reduce complexity), training on Optimizing Resilience and Coping with HIV through Internet Delivery as a complement to other behavioral health services (increase relative advantage), and feedback during implementation (strengthen rewards/incentives).
The Setting-Intervention Fit of Nine Evidence-Based Interventions for Substance Use Disorders Within HIV Service Organizations Across the United States: Results of a National Stakeholder-Engaged Real-Time Delphi Study
Authors: Garner Bryan R. , Knudsen Hannah K. , Zulkiewicz Brittany A. , Tueller Stephen J. , Gotham Heather J. , Martin Erika G. , Donohoe Tom , Toro Alyssa K. , Loyd Katie , Gordon Theodore 
Published: June 2022

Background:
Given substance use disorders (SUDs) among people with HIV are highly prevalent, integrating SUD services within HIV service settings is needed to help end the HIV epidemic. In this study, we assessed the setting-intervention fit (SIF) of 9 evidence-based SUD interventions: acamprosate, disulfiram, oral naltrexone, injectable naltrexone, oral buprenorphine, injectable buprenorphine, contingency management, motivational interviewing, and cognitive behavioral therapy (CBT).

Setting:
Clinical and nonclinical HIV service organizations (HSOs) in the United States.

Methods:
In May 2020, a stakeholder-engaged real-time Delphi was completed with 202 HSOs. HSO respondents rated the extent to which each SUD intervention was fundable, implementable, retainable, sustainable, scalable, and timely for their HSO, and these 6 items were summed into an SIF score (possible range of 0–18).

Results:
Motivational interviewing had the highest average SIF score (11.42), with SIF scores above the midpoint (9.5) for clinical (11.51) and nonclinical HSOs (11.36). For nonclinical HSOs, none of the other interventions were above the midpoint. For clinical HSOs, the average SIF scores were above the midpoint for CBT (10.97) and oral buprenorphine (9.51). Multivariate regression analyses, which controlled for characteristics of the HSO respondent, revealed geographic region of the United States and whether the HSO currently offered any substance use services as 2 of the best predictors of SIF scores.

Conclusions:
Notwithstanding the need to improve the SIF for the other evidence-based SUD interventions, motivational interviewing, CBT, and oral buprenorphine are currently the evidence-based SUD interventions with greatest perceived fit for integration within HSOs in the United States.
A Comparison of Handheld Doppler and Indocyanine Green Angiography for Perforator Localization
Authors: Han Tinglu , Khavanin Nima , Zhu Shan , Zang Mengqing , Chen Bo , Li Shanshan , Wu Jinlin , Liu Yuanbo 
Published: June 2022

Background
The preoperative identification of perforators is critical to the success of perforator flaps. Several technologies, including handheld Doppler (HHD) and indocyanine green angiography (ICGA), facilitate this process; however, each technology comes with unique downsides. This study directly compares the performance of HHD and ICGA in preoperative perforator identification and measures the effects of flap thickness and body mass index (BMI) on perforator localization.

Method
Data from preoperative HHD and ICGA assessments were compared with the criterion standard of intraoperative perforator localization. Sensitivity, specificity, accuracy, and positive predictive values were calculated for both and correlated with flap thickness and BMI.

Results
Thirty flaps were transferred in 30 patients across 15 different donor sites. Indocyanine green angiography had higher sensitivity, accuracy, and positive predictive value (79.2%, 74.2%, and 87.5%, respectively) than HHD (55.6%, 46.6%, and 69.4%, respectively). Perforators detected by ICGA were used as flap pedicles in 21 cases compared with 13 with HHD. There were no correlations between HHD or ICGA performance and patient BMI (both P > 0.05). Increasing flap thickness was negatively correlated with the accuracy of ICGA (P = 0.001) but not HHD (P > 0.05).

Conclusions
Indocyanine green angiography was more sensitive, specific, and accurate than HHD in identifying perforators across various donor sites; however, its performance suffered in thicker flaps, whereas HHD did not. Patient BMI was not correlated with the performance of either technology. Additional research can further delineate the interrelationships of flap thickness and technologies for perforator localization.
Treatment Strategies for Acute Seymour Fractures in Children and Adolescents
Authors: Cha Soo Min , Lin Yu-Te 
Published: June 2022

Purpose
We aimed to suggest treatment strategies for Seymour fractures (SFs) with varying clinical manifestations, based on the retrospective outcomes of patients seen at our institute.

Methods
Between March 2000 and December 2019, a total of 26 SF patients were categorized into 3 groups: acute typical SF (category 1; open fracture/exposed germinal matrix and physis), acute injuries but delayed presentation (category 2; presented to our institute more than 24 hours after the injury with misdiagnosis as simple nail injuries), and direct crush injuries (category 3; the most severe injury type, characterized by nail loss, nail bed lacerations, or maceration of the germinal matrix). In category 1, reduction was maintained using K-wire fixation without nail plate sutures. In 2, massive irrigation/debridement was followed by reduction and nail plate suturing without K-wire fixation. Finally, in 3, nail bed repair, reinsertion of the extracted nail plate after creating a penetration hole for drainage, K-wire fixation, and nail plate suturing were sequentially performed.

Results
The mean age of the patients was 8.92 years. At the final follow-up, the mean dorsal angulation was 1.73 degrees, and the length ratio was 97.88%; no significant differences were observed compared with the contralateral normal side (P = 0.498 and P = 0.341, respectively). The final visual analog scale pain score; the Disabilities of the Arm, Shoulder, and Hand score; and the active range of motion ratio were 0.50, 1.52, and 96.92%, respectively. There were no significant complications requiring revision surgery. Although the overall outcomes were satisfactory, category 3 patients had slightly worse visual analog scale pain scores; Disabilities of the Arm, Shoulder, and Hand scores; and range of motion compared with those in the other categories (P = 0.003, P = 0.002, and P < 0.001, respectively).

Conclusions
Satisfactory clinical outcomes were obtained by applying different surgical treatments to the different SF categories. We have suggested appropriate treatment strategies for acute SF varying in severity.
Gliomas of the Optic Nerve: A SEER-Based Epidemiologic Study
Authors: Dihowm Fatma , Alvarado Luis A. , Margo Curtis E. 
Published: June 2022

Background:
To determine whether patients with biopsy-confirmed optic nerve glioma differ in clinical features and outcomes from those diagnosed by neuroradiologic imaging alone.

Methods:
Retrospective comparative analysis. Pilocytic astrocytomas (PAs) and gliomas of the optic nerve were identified through ICD-O codes in the Surveillance, Epidemiology, and End Results (SEER) cancer registry from 1975 through 2017. Demographics, clinical features, and outcomes were compared according to the method of diagnosis (biopsy-confirmed and radiologic only) and by age (birth through 19 years and 20 years of age and older). Differences in proportions were tested with the chi-square test. Associations with tumor-related death were evaluated with logistic regression. Statistical significance: α < 0.01.

Results:
Over 42 years, 313 PAs and 720 gliomas of the optic nerve were identified. The young age distributions were similar between the 2 groups. PAs were biopsied more often than gliomas (54% vs 13.2% [P < 0.001]). Tumor-attributable death occurred more often among PAs and gliomas that were biopsied than those that were not (7.1% vs 0.7% [P < 0.01]; 7.4% vs 1.1% [P < 0.01], respectively). Roughly 15% of both PAs and gliomas were diagnosed in persons 20 years and older.

Conclusions:
Biopsy-confirmed cases of PA and glioma of the optic nerve were associated with more therapeutic interventions and worse outcomes compared with patients who were diagnosed radiologically. Clinical variables relevant to clinical decision-making not captured by SEER likely explain the inability to meaningfully interpret outcome from the registry database. Cancer registries should avoid coding specific histopathologic diagnoses when tissue is not obtained.
Postpartum Depression in Surgeons and Workplace Support for Obstetric and Neonatal Complication: Results of a National Study of US Surgeons
Authors: Castillo-Angeles Manuel , Atkinson Rachel B , Easter Sarah Rae , Gosain Ankush , Hu Yue-Yung , Cooper Zara , Kim Eugene S , Fromson John A , Rangel Erika L 
Published: June 2022

BACKGROUND:
Postpartum depression has well-established long-term adverse effects on maternal and infant health. Surgeons with rigorous operative schedules are at higher risk of obstetric complications, but they rarely reduce their workload during pregnancy. We evaluated whether lack of workplace support for work reductions during difficult pregnancies or after neonatal complications is associated with surgeon postpartum depression.

STUDY DESIGN:
An electronic survey was sent to practicing and resident surgeons of both sexes in the US. Female surgeons who had at least one live birth were included. Lack of workplace support was defined as: (1) disagreeing that colleagues/leadership were supportive of obstetric-mandated bedrest or time off to care for an infant in the neonatal intensive care unit; (2) feeling unable to reduce clinical duties during pregnancy despite health concerns or to care for an infant in the neonatal intensive care unit. Multivariate logistic regression was used to determine the association of lack of workplace support with postpartum depression.

RESULTS:
Six hundred ninety-two surgeons were included. The 441 (63.7%) respondents who perceived a lack of workplace support had a higher risk of postpartum depression than those who did not perceive a lack of workplace support (odds ratio 2.21, 95% CI 1.09 to 4.46), controlling for age, race, career stage, and pregnancy/neonatal complications. Of the surgeons with obstetric-related work restrictions, 22.6% experienced loss of income and 38.5% reported >$50,000 loss.

CONCLUSION:
Lack of workplace support for surgeons with obstetric or neonatal health concerns is associated with a higher risk of postpartum depression. Institutional policies must address the needs of surgeons facing difficult pregnancies to improve mental health outcomes and promote career longevity.
Multidisciplinary Project to Prevent Postoperative Urinary Tract Infection
Authors: Wilson Spencer B , Shaikh Shamsh P , Rosenkranz Pam , Rush Ingrid , Kandadai Padma , Wang David S , McAneny David 
Published: June 2022

BACKGROUND:
Postoperative urinary tract infections (UTIs) are associated with increased lengths of stay, inpatient costs, and mortality. Review of institutional data from the American College of Surgeons (ACS) NSQIP revealed opportunities to improve practices with respect to urinary catheter (Foley) insertion, catheter care, adherence to diagnosis and prevention protocols, and ACS NSQIP reporting.

STUDY DESIGN:
A multidisciplinary quality improvement team convened and implemented interventions based on a literature review and analysis of institutional drivers of postoperative UTI. The team educated the ACS NSQIP surgical clinical reviewers and clinical teams about UTI diagnostic criteria and prevention, trained staff in proper catheterization technique, and provided performance feedback. The team also developed kits with supplies and instructions for patients who were discharged home with catheters, along with an instructional video. The investigators evaluated project effectiveness by comparing pre- and postintervention process measures and rates of postoperative UTI.

RESULTS:
After interventions, compliance rates improved for hand hygiene (62% to 83%, p = 0.04), precleansing of the periurethral area (66% to 97%, p = 0.001), and catheter positioning (41% to 93%, p < 0.001), and the composite performance (10% to 73%, p < 0.001). Surgery residents’ scores on a UTI knowledge assessment improved from 71% to 81% (p = 0.005). The majority of residents and staff strongly agreed that the training sessions would change their practice (57% and 69%, respectively). The unadjusted rate of postoperative UTIs at our institution decreased from 1.55% to 0.69% (p = 0.016), corresponding to an improvement in the ACS NSQIP odds ratio from 1.51 to 0.86.

CONCLUSIONS:
A series of interventions, including provider training, patient education, and audits of practice with performance feedback, are associated with improvements in both practice and the incidence of postoperative UTI.
Patient Factors Associated with High Opioid Consumption after Common Surgical Procedures Following State-Mandated Opioid Prescription Regulations
Authors: Sacklow Autumn , Malhotra Ajai K , Jones Ethan , Callas Peter , Fujii Mayo , Colovos Christos 
Published: June 2022

BACKGROUND:
State regulations have decreased prescribed opioids with more than 25% of patients abstaining from opioids. Despite this, 2 distinct populations of patients exist who consume “high” or “low” amounts of opioids. The aim of this study was to identify factors associated with postoperative opioid use after common surgical procedures and develop an opioid risk score.

STUDY DESIGN:
Patients undergoing 35 surgical procedures from 7 surgical specialties were identified at a 620-bed tertiary care academic center and surveyed 1 week after discharge regarding opioid use and adequacy of analgesia. Electronic medical record data were used to characterize postdischarge opioids, complications, demographics, medical history, and social factors. High opioid use was defined as >75th percentile morphine milligram equivalents for each procedure. An opioid risk score was calculated from factors associated with opioid use identified by backward multivariate logistic regression analysis.

RESULTS:
A total of 1,185 patients were enrolled between September 2017 and February 2019. Bivariate analyses revealed patient factors associated with opioid use including earlier substance use (p < 0.001), depression (p = 0.003), anxiety (p < 0.001), asthma (p = 0.006), obesity (p = 0.03), migraine (p = 0.004), opioid use in the 7 days before surgery (p < 0.001), and 31 Clinical Classifications Software Refined classifications (p < 0.05). Significant multivariates included: insurance (p = 0.005), employment status (p = 0.005), earlier opioid use (odds ratio [OR] 2.38 [95% CI 1.21 to 4.68], p = 0.01), coronary artery disease (OR 0.38 [95% CI 0.16 to 0.86], p = 0.02), acute pulmonary embolism (OR 9.81 [95% CI 3.01 to 32.04], p < 0.001), benign breast conditions (OR 3.42 [95% CI 1.76 to 6.64], p < 0.001), opioid-related disorders (OR 6.67 [95% CI 1.87 to 23.75], p = 0.003), mental and substance use disorders (OR 3.80 [95% CI 1.47 to 9.83], p = 0.006), headache (OR 1.82 [95% CI 1.24 to 2.67], p = 0.002), and previous cesarean section (OR 5.10 [95% CI 1.33 to 19.56], p = 0.02). An opioid risk score base was developed with an area under the curve of 0.696 for the prediction of high opioid use.

CONCLUSIONS:
Preoperative patient characteristics associated with high opioid use postoperatively were identified and an opioid risk score was derived. Identification of patients with a higher need for opioids presents an opportunity for improved preoperative interventions, the use of nonopioid analgesic therapies, and alternative therapies.
Lower Social Support is Associated with Accelerated Epigenetic Aging: Results from the Health and Retirement Study
Authors: Rentscher Kelly E. , Klopack Eric T. , Crimmins Eileen M. , Seeman Teresa E. , Cole Steve W. , Carroll Judith E. 
Published: June 2022

AbstractGrowing evidence suggests that social relationship quality can influence age-related health outcomes, although how the quality of one’s relationships directly relates to the underlying aging process is less clear. We hypothesized that lower social support and higher relationship strain would be associated with an accelerated epigenetic aging profile among older adults in the Health and Retirement Study. Adults (N = 3,647) aged 50-96 years completed ratings of support and strain in relationships with their spouse, children, other family, and friends. They also provided a blood sample and DNA methylation profiling derived epigenetic aging measures: Horvath, Hannum, PhenoAge, GrimAge, and Dunedin Pace of Aging methylation (PoAm). Generalized linear models adjusting for age, sex, and race/ethnicity revealed that lower support from one’s spouse, children, other family, and friends and higher strain with one’s spouse, children, and friends was associated with an accelerated epigenetic aging profile. In secondary analyses that further adjusted for socioeconomic and lifestyle factors and following false discovery rate correction, support from other family members and friends was associated with epigenetic aging. Findings suggest that lower support within close relationships relates to epigenetic aging acceleration, offering one mechanism through which relationship quality might influence risk for age-related disease.