bluuebunny/crossref_metadata_2025_split huggingface dataset:
On Opacity: Toni Morrison’s and Paule Marshall’s Narrative Vision Therapy
Authors: Morris Johnson Nicole 
Published: February 2022

Abstract
Acknowledging an ongoing atmosphere of Black death, assault, and pain, and its relationship to a kind of ocular and imaginative distress, this article highlights the urgency of revisiting the lessons embedded in the writing of Toni Morrison (The Bluest Eye [1970]), Beloved [1987]) and Paule Marshall (“Reena” [1962], and Praisesong for the Widow [1983]). I join robust conversations in Black and literary studies in examining Marshall’s and Morrison’s crucial lessons on healing Black vision—work necessary for full command of the imagination. These lessons become more pronounced when viewed through the lens of Marshall’s and Morrison’s literary “dark sousveillance,” which Simone Browne defines as the charting of possibilities and coordination of “modes of responding to, challenging, and confronting a surveillance that [is] all encompassing.” I argue that through the use of narrative vision therapy, or the use of narrative as a healing device that realigns readers with their power to imagine and craft narratives that decenter anti-Blackness, Morrison and Marshall demonstrate that imagining otherwise futures requires intentional returns to and ongoing vigilance from opaque spaces—wherein the embrace of Black flesh, sounds, movement, and memory can help reverse distortions that our hyper-seeing of various violent forms of anti-Blackness have wrought.
Blockchain and population health
Authors: Gaynor Mark , BeLue Rhonda , Tuttle-Newhall J E , Martin Maxwell , Patejdl Frank , Vogt Clare 
Published: February 2022

Abstract

Background
Blockchain technology has made great strides in many industries but has yet to impact the world of public health. Population health issues such as outbreak surveillance and controlled substance tracking during emergencies all require a secure, easily accessible database. While the healthcare industry is typically slow to adapt to change, blockchain technology lends itself well to many healthcare issues.

Methods
We utilized a 3D framework using difficulty, novelty and necessity to examine the adoption of blockchain technology in population health, based on the 2D framework of difficulty and novelty as driving factors for the development of foundational technologies in the world of business by Iansiti and Lakhani in The Harvard Business Review.

Results
We find that by implementing the third dimension of necessity into an evaluation framework, we can better predict the adoption of technology. We found how different areas of population health fit into the evaluation framework and how necessity can eliminate barriers from implementing novel technologies.

Conclusion
The byproduct of this paper will be the extension of the Iansiti and Lakhani framework. We will show that blockchain, in all of these domains, shows promise to improve population health as we move past COVID-19 and into the future of healthcare.
Psychological impact of lung cancer screening using a novel antibody blood test followed by imaging: the ECLS randomized controlled trial
Authors: Hancox J , Ayling K , Bedford L , Vedhara K , Roberston J F R , Young B , das Nair R , Sullivan F M , Schembri S , Mair F S , Littleford R , Kendrick D 
Published: February 2022

Abstract

Background
The Early CDT®-Lung antibody blood test plus serial computed tomography scans for test-positives (TPGs) reduces late-stage lung cancer presentation. This study assessed the psychological outcomes of this approach.

Methods
Randomized controlled trial (n = 12 208) comparing psychological outcomes 1–12 months post-recruitment in a subsample (n = 1032) of TPG, test-negative (TNG) and control groups (CG).

Results
Compared to TNG, TPG had lower positive affect (difference between means (DBM), 3 months (3m: −1.49 (−2.65, − 0.33)), greater impact of worries (DBM 1m: 0.26 (0.05, 0.47); 3m: 0.28 (0.07, 0.50)), screening distress (DBM 1m: 3.59 (2.28, 4.90); 3m: 2.29 (0.97, 3.61); 6m: 1.94 (0.61, 3.27)), worry about tests (odds ratio (OR) 1m: 5.79 (2.66, 12.63) and more frequent lung cancer worry (OR 1m: 2.52 (1.31, 4.83); 3m: 2.43 (1.26, 4.68); 6m: 2.87 (1.48, 5.60)). Compared to CG, TPG had greater worry about tests (OR 1m: 3.40 (1.69, 6.84)). TNG had lower negative affect (log-transformed DBM 3m: −0.08 (−0.13, −0.02)), higher positive affect (DBM 1m: 1.52 (0.43, 2.61); 3m: 1.43 (0.33, 2.53); 6m: 1.27 (0.17, 2.37)), less impact of worries (DBM 3m: −0.27 (−0.48, −0.07)) and less-frequent lung cancer worry (OR 3m: 0.49 (0.26, 0.92)).

Conclusions
Negative psychological effects in TPG and positive effects in TNG were short-lived and most differences were small.
Three decades of organic wheat improvement: Assessing the impact and returns on investment
Authors: Grovermann Christian , Weiner Mareike , Levy Lilia , Locher Michael , Manuel Herrera Juan , Winter Eva 
Published: February 2022

Abstract
A changing regulatory environment and growing awareness are driving the need for crop improvement in organic agriculture. Contrary to conventional breeding, evidence on the economic effects of research and development in organic breeding is lacking. This study assesses adoption, economic impact, and rates of return to organic crop improvement research. The economic surplus method is used to quantify the impact of the Wiwa winter wheat variety. The standard model is enhanced by considering the economic benefits of improvements in crop nutrient and processing quality as well as resilience gains. Results show substantial economic returns of 18.6 per cent for the period from 1988 to 2019. The reduced downside risk of the organic cultivar is a key distinguishing factor in the analysis as organic breeding aims at providing farmers with resilient cultivars. Further investment in organic breeding appears as a promising element in the strategy for resilient and sustainable food systems.
Optimizing the implementation of a multisite feasibility trial of a mind–body program in acute orthopedic trauma
Authors: Bakhshaie Jafar , Doorley James , Reichman Mira , Mace Ryan , Laverty David , Matuszewski Paul E , Elwy A Rani , Fatehi Amirreza , Bowers Lucy C , Ly Thuan , Vranceanu Ana-Maria 
Published: February 2022

Abstract
The Toolkit for Optimal Recovery (TOR) is a mind–body program for patients with acute orthopedic injuries who are at risk for persistent pain/disability. In preparation for a multisite feasibility trial of TOR at three orthopedic trauma centers, we aim to qualitatively identify barriers and facilitators to study implementation and strategies to mitigate the implementation barriers and leverage facilitators.We conducted 18 live video focus groups among providers and three one-on-one interviews with department chiefs at Level 1 trauma centers in three geographically diverse sites (N = 79 participants). Using a content analysis approach, we detected the site-specific barriers and facilitators of implementation of TOR clinical trial. We organized the data according to 26 constructs of the Consolidated Framework for Implementation Research (CFIR), mapped to three Proctor implementation outcomes relevant to the desired study outcomes (acceptability, appropriateness, and feasibility). Across the three sites, we mapped six of the CFIR constructs to acceptability, eight to appropriateness, and three to feasibility. Prominent perceived barriers across all three sites were related to providers’ lack of knowledge/comfort addressing psychosocial factors, and organizational cultures of prioritizing workflow efficiency over patients’ psychosocial needs (acceptability), poor fit between TOR clinical trial and the fast-paced clinic structure as well as basic needs of some patients (appropriateness), and limited resources (feasibility). Suggestions to maximize the implementation of the TOR trial included provision of knowledge/tools to improve providers’ confidence, streamlining study recruitment procedures, creating a learning collaborative, tailoring the study protocol based on local needs assessments, exercising flexibility in conducting research, dedicating research staff, and identifying/promoting champions and using novel incentive structures with regular check-ins, while keeping study procedures as nonobtrusive and language as de-stigmatizing as possible. These data could serve as a blueprint for implementation of clinical research and innovations in orthopedic and other medical settings.
Understanding barriers and facilitators to voluntary medical male circumcision and Spear and Shield uptake in Zambian community health centers
Authors: Cristofari Nicholas V , Rodriguez Violeta J , Jones Deborah L , Weiss Stephen M 
Published: February 2022

Abstract
Voluntary medical male circumcision (VMMC) has been an effective method for reducing the risk of HIV transmission by 50%–70% in Eastern and Southern Africa. The Spear and Shield (S&S) program is a community health center (CHC)-based biobehavioral VMMC HIV prevention intervention that increased VMMC uptake in male CHC attendees in Lusaka, Zambia. Qualitative data organized using the Consolidated Framework for Implementation Research (CFIR) has been used to characterize factors that may impact S&S/VMMC implementation. This manuscript uses the CFIR to examine S&S implementation across 96 CHCs in four Zambian provinces using a mixed-methods approach to (a) quantify successful S&S implementation; (b) understand how CFIR domains might provide insight into the degree of implemental success; (c) identify major themes among least and most successful CHCs; and (d) help guide future prevention efforts and policy related to VMMC promotion in the Zambian CHC context. In contrast with CFIR quantitative analyses, 12 major qualitative themes associated with the least and most successful CHCs provided unique insight into S&S and VMMC implementation and guidance for future implementation studies. Themes included lack of resources (staff, space, transportation) for the former and strong staff relationships and active community engagement for the latter. The CFIR framework appears extremely useful for the identification of qualitative themes related to intervention implementation, and reduction of qualitative data for quantitative analyses may sacrifice more nuanced information. Consideration of CFIR themes may be useful to inform HIV prevention strategies in Zambia and similar contexts.
Applying the Nightingale Pledge in Reducing Health Disparities: A Hospital-Acquired Pressure Injury Case Study
Authors: Green Cheryl 
Published: February 2022

ABSTRACT
Professional nurses, by virtue of their training, pledge to care for individuals who are sick or infirm. This commitment is confirmed via the Nightingale Pledge, which focuses on public health and equity and deems the nurse to be a missioner of health. Health disparities exist in direct conflict with the nursing responsibility of caritas, or love. Accordingly, it is imperative that nurse educators create learning environments that are conducive to comfortably discussing differences in physical assessments performed on diverse populations as part of their work to eliminate health disparities and in accordance with the Nightingale Pledge.
Consistent Practices in Pressure Injury Prevention at Long-term Care Facilities
Authors: Haavisto Elina , Kielo-Viljamaa Emilia , Hjerppe Anna , Puukka Pauli , Stolt Minna 
Published: February 2022

ABSTRACT

OBJECTIVE
To examine the use of consistent practice in pressure injury (PI) prevention based on international guidelines at long-term care facilities in Finland.

METHODS
A correlational cross-sectional design was used. The authors collected data from 84 contact persons within 62 participating long-term care facilities in Finland using the Pressure Ulcer Prevention Practice instrument.

RESULTS
According to the respondents, the PI prevention strategies practiced most often were skin assessment and skin care; nutrition was the prevention used least often. Consistent practices relating to repositioning were most frequently agreed upon, whereas those relating to risk assessment were least frequently agreed upon. Some of the demographic factors of respondents, including knowledge level and reading of PI prevention guidelines and articles, were associated with the frequency of prevention practices.

CONCLUSIONS
Although respondents reported a moderate level of PI prevention based on international guidelines, there were often no consistent practices in the units. Further education about PI prevention might improve the consistent practice of evidence-based PI prevention.
Patient Characteristics Associated With Phone Versus Video Telemedicine Visits for Substance Use Treatment during COVID-19
Authors: Chang Ji Eun , Lindenfeld Zoe , Thomas Tatiana , Waldman Justine , Griffin Judith 
Published: February 2022

Objectives
Although video visits may offer some benefits over the telephone, not all patients may be equipped to access video telemedicine, raising questions surrounding access disparities. The aim of this study is to examine patient characteristics associated with the use of phone versus video-enabled tele-medication for opioid use disorders (MOUD) during COVID-19.

Methods
This study uses data from a nonurban integrated substance use disorder treatment site in New York to examine patient characteristics associated with the modality of tele-MOUD care. The provider did not offer in-person care. Multivariable regression models were used to assess the association between patient’s primary mode of tele-MOUD and patient demographic characteristics. Additional analysis of new patient inductions examined associations between mode of tele-MOUD induction and 30-day follow-up receipt.

Results
Of the 4557 tele-MOUD encounters, 76.92% were video and 23.08% were telephone visits. Older patients had significantly higher odds of primarily using telephone (odds ratio [OR]: 0.580; 95% confidence interval [CI]: 0.045, 1.115). Patients with higher education (OR: –0.791; 95% CI: –1.418, –0.168), recent overdose (OR: –0.40; 95% CI: –0.793, –0.010), and new patients (OR: 0.484; 95% CI: –0.945, 0.023) were significantly less likely to rely on telephone. Of 336 new patient initiations, 31 were conducted by telephone while 305 were conducted through video. The mode of new patient initiation was not associated with a follow-up visit within 30 days of initiation.

Conclusions
Telemedicine may increase access to MOUD, though certain patients may rely on different forms of telemedicine. Attention must be paid to policies that promote equitable access to both video and telephone tele-MOUD visits.
Verification of Resectability Status for Pancreatic Cancer
Authors: Makino Isamu , Tajima Hidehiro , Kitagawa Hirohisa , Gabata Ryosuke , Okazaki Mitsuyoshi , Shinbashi Hiroyuki , Ohbatake Yoshinao , Nakanuma Shinichi , Saito Hiroto , Yamaguchi Takahisa , Terai Shiro , Okamoto Koichi , Sakai Seisho , Kinoshita Jun , Nakamura Keishi , Ninomiya Itasu , Fushida Sachio , Ohta Tetsuo 
Published: February 2022

Objectives
Resectability status is considered an important indicator for progression of pancreatic cancer. We verified the superior mesenteric artery (SMA) factors of resectability status by radiological and pathological analysis in patients who underwent pancreatoduodenectomy with combined resection of the SMA.

Methods
We enrolled 22 patients who underwent pancreatoduodenectomy with combined resection of the SMA. Patients were divided into 3 groups according to the contact angle between the tumor and the SMA in preoperative computed tomography images (no contact, R-sma; contact within 180 degrees, BR-sma; contact more than 180 degrees, UR-sma). We pathologically evaluated cancer progression toward the SMA.

Results
There were 3 patients with R-sma, 12 with BR-sma, and 7 with UR-sma. The median distance (mm) between the cancer and the SMA was 7.0 with R-sma, 1.0 with BR-sma, and 0 with UR-sma (P = 0.0003). Invasion to the superior mesenteric nerve plexus was positive in none with R-sma, 11 with BR-sma, and 7 with UR-sma (P < 0.0001). Invasion to the SMA was positive in none with R-sma and BR-sma, and 7 with UR-sma (P < 0.0001).

Conclusions
Superior mesenteric artery factors of resectability status are reliable indicator for cancer progression toward the SMA.
The Fate of Resectable Pancreatic Adenocarcinoma After Neoadjuvant Chemotherapy
Authors: Irfan Ahmer , Rose J. Bart , Wang Thomas N. , Vickers Selwyn M. , Dudeja Vikas , Gbolahan Olumide , Reddy Sushanth 
Published: February 2022

Objectives
Pancreatic cancer continues to be a major cause of cancer-related mortality. There has been a greater implementation of up-front chemotherapy for pancreatic adenocarcinoma patients. Although there are many theoretical benefits to neoadjuvant chemotherapy, its clinical impact is uncertain. We sought to understand the outcomes of patients with resectable and borderline-resectable pancreatic adenocarcinoma who underwent neoadjuvant chemotherapy.

Methods
Patients were collected in a secure database from September 2018 to May 2020. Patients were excluded if they presented with locally advanced or metastatic disease, inability to complete chemotherapy, or if they were not a surgical candidate.

Results
Sixty-six patients with resectable disease underwent chemotherapy. Folinic acid/5-fluorouracil/irinotecan/oxaliplatin was used in 41 patients (62.1%) and gemcitabine-based regimens in 28 patients (42.4%, greater than 100% as some patients underwent both regimens). After restaging, 47 patients (71.2%) were thought to have resectable disease. Of these patients, 36 have been successfully resected to date. Metastatic disease was found in 12 patients (18.2%) and 6 patients (9.1%) had locally advanced disease.

Conclusions
Most patients with resectable pancreatic cancer are resected after neoadjuvant chemotherapy, but a subset will develop local or distant progression. Further studies will be needed to determine which patients will progress locally and may benefit from an up-front surgical approach.
Surgery-First Orthognathic Approach to Correct Facial Asymmetry: Artificial Intelligence–Based Cephalometric Analysis
Authors: Choi Jong Woo , Park Hojin , Kim, B.S. In-Hwan , Kim Namkug , Kwon Soon-Man , Lee Jang Yeol 
Published: February 2022

Background:
The surgery-first orthognathic approach has been applied at our institution since 2007. However, its indications remain debated. The aim of this study was to investigate the reliability of the surgery-first approach to correct facial asymmetry compared to the traditional orthodontics-first approach using a novel artificial intelligence–based cephalometric analysis.

Methods:
Intervention outcomes of surgery-first (n = 33) and orthodontics-first (n = 26) approaches to correct facial asymmetry were examined. Patients with facial asymmetry who had undergone orthognathic surgery from January of 2006 to January of 2019 were included in the study. In the surgery-first approach, the novel preoperative simulation process on the dental model was performed to determine the final occlusion without presurgical orthodontic treatment. Changes in cephalometric landmarks were compared using the supervised deep learning process developed at our institution.

Results:
The surgery-first approach without presurgical orthodontic treatment corrected facial asymmetry and yielded results similar to those of the traditional orthognathic approach. The statistical analysis revealed that changes in skeletal cephalometric landmarks were similar in the two groups.

Conclusions:
The surgery-first orthognathic approach without presurgical orthodontic treatment treated facial asymmetry, possibly suggesting a possible paradigm shift in treatment. In addition, artificial intelligence–based cephalometric analysis was an effective tool.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
A Novel Technique for Muscle Flap Preservation in Posterolateral Muscle-Sparing Thoracotomy
Authors: O’Neill Rebecca C. , Mentz James A. , Reece Edward , Ripley Taylor , Coster Jenalee , Winocour Sebastian J. 
Published: February 2022

Summary:
The muscle-sparing thoracotomy offers several benefits over the traditional posterolateral thoracotomy approach for surgically accessing the chest cavity. Some of the potential advantages of preserving the latissimus dorsi and serratus anterior muscles include both functional benefits and potential use of these muscles for future flap reconstruction. Nevertheless, the muscle-sparing thoracotomy technique has traditionally been described with a wide exposure and, as a result, a theoretically higher risk of seroma and hematoma formation due to the increased dead space. The authors propose a new approach to muscle-sparing thoracotomy to avoid the disadvantages of each technique. By defining two subcutaneous anatomical triangles that can be safely lifted without disrupting the latissimus dorsi and serratus anterior muscles’ blood supply, this novel approach provides good exposure, preserves muscle flaps for future use, and minimizes dead space. As a result, this novel muscle-sparing thoracotomy technique has the potential to minimize postoperative complications and maximize patient outcomes.
Training Surgery Residents to be Leaders: Construction of a Resident Leadership Curriculum
Authors: Stein Matthew K. , Kelly John D. , Useem Michael , Donegan Derek J. , Levin L. Scott 
Published: February 2022

Summary:
Historically, the traditional pathways into plastic surgery required board eligibility in a surgical specialty such as general surgery, orthopedics, urology, neurosurgery, otolaryngology, or ophthalmology. This requirement resulted in plastic surgery residents who had served as chief residents before plastic surgery training. Their maturity emotionally and surgically allowed them to immediately concentrate on the new language and principles of plastic surgery. They had led others and were capable of leading themselves in a new surgical discipline. Today, medical students typically match into surgical specialties directly out of medical school and need to spend their time learning basic surgical skills and patient care because of the contracted time afforded to them. Formal leadership training has historically been limited in surgical training. The authors set out to delineate the creation, implementation, and perceptions of a leadership program within a surgical residency and provide guideposts for the development of engaged, conscious, and dedicated leaders within the residencies they lead.
Vein Grafts in Free Flap Reconstruction: Review of Indications and Institutional Pearls
Authors: Langdell Hannah C. , Shammas Ronnie L. , Atia Andrew , Chang Edward I. , Matros Evan , Phillips Brett T. 
Published: February 2022

Summary:
Vein grafts enable soft-tissue reconstruction in cases of insufficient pedicle length, a lack of nearby recipient vessels, and a wide zone of injury caused by trauma or radiation therapy. The purpose of this article is to provide a comprehensive review of vein grafts in free flap reconstruction focusing on the timing of arteriovenous loops, complications, and surgical technique. Vein graft indications, types of vein grafts, and location-specific considerations are also reviewed. Three reconstructive microsurgeons at high-volume centers were asked to offer institutional pearls on the order of anastomosis, selection of donor veins, and timing of arteriovenous loops. In terms of gap length, vessel gaps less than 10 cm may be reconstructed with an interposition or transposition vein graft. For longer gaps, surgeons should consider the use of arteriovenous loops, transposition arteriovenous loops, or flow-through flaps. Both one and two-stage arteriovenous loops are used, depending on patient comorbidities, potential exposure of critical structures, and surgeon preference. Although one-stage arteriovenous loops expedite the reconstructive process, two-stage arteriovenous loops require shorter operations and help identify patients at risk of flap failure. Although whether the use of vein grafts increases flap failure rates is controversial, complications are highest in lower extremity reconstruction, cases of a prolonged interval between stages in two-stage arteriovenous loops, and unplanned vein grafts.