bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Resident Race and Ethnicity and Clinical Performance Assessment Scores in Graduate Medical Education
Authors: Klein Robin , Ufere Nneka N. , Schaeffer Sarah , Julian Katherine A. , Rao Sowmya R. , Koch Jennifer , Volerman Anna , Snyder Erin D. , Thompson Vanessa , Ganguli Ishani , Burnett-Bowie Sherri-Ann M. , Palamara Kerri 
Published: May 2022

Purpose
To assess the association between internal medicine (IM) residents’ race/ethnicity and clinical performance assessments.

Method
The authors conducted a cross-sectional analysis of clinical performance assessment scores at 6 U.S. IM residency programs from 2016 to 2017. Residents underrepresented in medicine (URiM) were identified using self-reported race/ethnicity. Standardized scores were calculated for Accreditation Council for Graduate Medical Education core competencies. Cross-classified mixed-effects regression assessed the association between race/ethnicity and competency scores, adjusting for rotation time of year and setting; resident gender, postgraduate year, and IM In-Training Examination percentile rank; and faculty gender, rank, and specialty.

Results
Data included 3,600 evaluations by 605 faculty of 703 residents, including 94 (13.4%) URiM residents. Resident race/ethnicity was associated with competency scores, with lower scores for URiM residents (difference in adjusted standardized scores between URiM and non-URiM residents, mean [standard error]) in medical knowledge (−0.123 [0.05], P = .021), systems-based practice (−0.179 [0.05], P = .005), practice-based learning and improvement (−0.112 [0.05], P = .032), professionalism (−0.116 [0.06], P = .036), and interpersonal and communication skills (−0.113 [0.06], P = .044). Translating this to a 1 to 5 scale in 0.5 increments, URiM resident ratings were 0.07 to 0.12 points lower than non-URiM resident ratings in these 5 competencies. The interaction with faculty gender was notable in professionalism (difference between URiM and non-URiM for men faculty −0.199 [0.06] vs women faculty −0.014 [0.07], P = .01) with men more than women faculty rating URiM residents lower than non-URiM residents. Using the 1 to 5 scale, men faculty rated URiM residents 0.13 points lower than non-URiM residents in professionalism.

Conclusions
Resident race/ethnicity was associated with assessment scores to the disadvantage of URiM residents. This may reflect bias in faculty assessment, effects of a noninclusive learning environment, or structural inequities in assessment.
Surfactant Protein D Influences Mortality During Abdominal Sepsis by Facilitating Escherichia coli Colonization in the Gut
Authors: Varon Jack , Arciniegas Rubio Antonio , Amador-Munoz Diana , Corcoran Alexis , DeCorte Joseph A. , Isabelle Colleen , Pinilla Vera Miguel , Walker Katherine , Brown Luke , Cernadas Manuela , Bry Lynn , Yang Haopu , Kitsios Georgios D. , McVerry Bryan J. , Morris Alison , Lee Hyunwook , Howrylak Judie , Englert Joshua A. , Baron Rebecca M. 
Published: May 2022

OBJECTIVES:
Determine the role of surfactant protein D (SPD) in sepsis.

DESIGN:
Murine in vivo study.

SETTING:
Research laboratory at an academic medical center.

PATIENTS:
SPD knockout (SPD−/−) and wild-type (SPD+/+) mice.

INTERVENTIONS:
SPD−/− and SPD+/+ mice were subjected to cecal ligation and puncture (CLP). After CLP, Escherichia coli bacteremia was assessed in both groups. Cecal contents from both groups were cultured to assess for colonization by E. coli. To control for parental effects on the microbiome, SPD−/− and SPD+/+ mice were bred from heterozygous parents, and levels of E. coli in their ceca were measured. Gut segments were harvested from mice, and SPD protein expression was measured by Western blot. SPD−/− mice were gavaged with green fluorescent protein, expressing E. coli and recombinant SPD (rSPD).

MEASUREMENTS AND MAIN RESULTS:
SPD−/− mice had decreased mortality and decreased E. coli bacteremia compared with SPD+/+ mice following CLP. At baseline, SPD−/− mice had decreased E. coli in their cecal flora. When SPD−/− and SPD+/+ mice were bred from heterozygous parents and then separated after weaning, less E. coli was cultured from the ceca of SPD−/− mice. E. coli gut colonization was increased by gavage of rSPD in SPD−/− mice. The source of enteric SPD in SPD+/+ mice was the gallbladder.

CONCLUSIONS:
Enteral SPD exacerbates mortality after CLP by facilitating colonization of the mouse gut with E. coli.
Evaluation of Quality of Life (BREAST-Q) and Scar Quality (POSAS) after Breast Augmentation
Authors: Jawanrudi Pedram , Bender Richard , Pennig Dietmar , Taskin Berivan , Schäller Sebastian , Al-Malat Tarek , Mannil Lijo 
Published: May 2022

Background:
This study examines the effects of breast augmentation on women who underwent surgery in Germany regarding their quality of life (QOL) and scar quality using patient-reported surveys. The purpose of this study was to determine if there is an increase in women’s QOL after surgery compared with preoperative, and to evaluate their postoperative scar quality.

Methods:
A prospective monocentric study was conducted on 50 women who underwent breast augmentation with nanotextured silicone-filled implants between October 2018 and December 2020. Of these women, 21 (42%) participated in the preoperative survey (BREAST-Q), and 50 (100%) participated in the postoperative survey (BREAST-Q and POSAS). We used the BREAST-Q questionnaire to measure patients’ QOL and the Patient and Observer Scar Assessment Scale to determine the scar quality.

Results:
Psychosocial well-being increased by 34.3 points according to the Q-score, sexual well-being increased by 35.7, and satisfaction with breasts increased by 48.8. Physical well-being decreased by 12 points. The Patient and Observer Scar Assessment Scale mean scores, according to the patient/observer, are 3.8/2.5 for inframammary scars and 4.4/3.1 for periareolar scars.

Conclusions:
In this study, we discovered that aesthetic breast augmentation with nanotextured silicone-filled breast implants is associated with significantly higher scores for patient satisfaction, which indicates an improvement in women’s QOL.
Facial Anthropometry and Analysis in Egyptian Women
Authors: El Minawi Hisham , El Saloussy Yasmeen , Sabry Mohamed , Wahdan Wessam , El Sharkawy Omar 
Published: May 2022

Background:
Human facial analysis can be considered both an art and a science, and is used extensively to measure soft tissue proportions. Remarkable changes exist in anthropometric measures due to changes over centuries of geographical, genetic, and environmental factors, as well as waves of migration causing facial proportions to vary among the different ethnic groups. The purpose of this study was to establish facial soft tissue norms for the Egyptian female population between the ages of 18 and 50, as well as several age-related changes in facial measurements that are described fairly scarcely in the literature.

Methods:
A prospective study was carried out on 300 Egyptian women between June 2019 and December 2020. All were volunteers and between 18 and 50 years old. Facial measurements were obtained by both direct (caliper-based) and indirect (3D Crisalix software) anthropometric analysis. Anthropometric measurements used in the study included seventeen facial measurements derived from different anthropometric soft tissue landmarks from each subject and eight measurements for analysis.

Results:
Our results were able to describe the average facial and nasal measurements of the Egyptian female population, as well as the horizontal and vertical analysis of facial proportions. We also determined similarities with other Middle Eastern female measurements, with subtle differences in facial width and nasal height and width compared with Turkish and Iranian women.

Conclusions:
The current study is valuable because it delivers facial anthropometric measures for Egyptian female faces. This can provide a database for a multitude of uses, including operative planning, postoperative measurements, and forensic and ergonomic purposes.
Efficacy and Safety of the Preserflo Microshunt With Mitomycin C for the Treatment of Open Angle Glaucoma
Authors: Ibarz Barberá Marta , Martínez-Galdón Fátima , Caballero-Magro Elena , Rodríguez-Piñero Marta , Tañá-Rivero Pedro 
Published: May 2022

Précis:
The Preserflo Microshunt (PSM) is a safe and effective glaucoma microfiltering implant that significantly reduces the intraocular pressure (IOP), either alone or in combination with phacoemulsification, during the first year after surgery.

Purpose:
The purpose of this study was to assess the safety and efficacy of the PSM for the treatment of open angle glaucoma with 0.2 mg/mL mitomycin C, either alone or in combination with cataract surgery.

Methods:
A retrospective, open-label study of 64 eyes with primary open angle glaucoma that underwent PSM implantation and were followed up for at least 9 months. Success was defined as IOP 6–17 mm Hg and a reduction of at least 20%, complete without hypotensive medication, and qualified with medication. Safety was assessed by the incidence of adverse events. Secondary endpoints included mean hypotensive medications, visual acuity, and incidence of needling and surgical revision.

Results:
A total of 51 eyes underwent PSM alone and 13 underwent PSM+phacoemulsification. In the overall population of the study, the mean IOP was significantly reduced from 22.03±0.7 mm Hg at baseline to 12.7±0.4 mm Hg at the final visit, P<0.0001 (mean follow-up: 11±1.4 mo). The IOP was significantly reduced in both groups (P<0.0001). Ocular hypotensive medication was reduced significantly from 2.7±0.7 to 0.2±0.5 (P<0.0001). No significant differences were found in IOP-lowering medication between groups (PSM alone, 0.2±0.08; PSM+phacoemulsification, 0.1±0.1; P=0.2). At the final visit, 70.3% were considered as complete success and 12.5% as qualified success. The most common adverse event was clinical hypotony (7.8%) followed by hyphema (4.7%), and anterior chamber reformation (1.6%). Overall, 1.6% required needling and 15.6% surgical revision to restore the flow.

Conclusion:
Glaucoma surgery with the PSM and mitomycin C was efficacious and safe in the short term, either alone or in combination with cataract surgery, and may be considered a surgical option for lowering IOP in primary open angle glaucoma.
Glioneuronal tumor with neuropil-like islands in the spinal cord
Authors: Liu Honglei , Wang Can , Lou Lei , Li Yuehong , Yi Li 
Published: May 2022

Abstract

Rationale:
Glioneuronal tumor with neuropil-like islands (GTNI) is a distinctive neoplasm located in the cerebrum. Moreover, spinal GTNI is extremely rare. Herein, we present a case of spinal GTNI and review the related literature.

Patient concerns:
A 38-year-old Chinese woman presented to our hospital with a 6-month history of neck pain and a 1-month history of dizziness.

Diagnoses:
Magnetic resonance imaging revealed a large intramedullary mass spanning the length of the spinal cord from C1 to C4. Microscopic and immunohistochemical examinations of the tumor tissue revealed findings typical of GTNI.

Interventions:
The patient underwent C1 to C4 intraspinal gross tumor resection.

Outcomes:
Follow-up results showed that the patient had no recurrence 6 months after tumor resection.

Lessons:
GTNI in the spinal cord is a highly rare neoplasm with poor prognosis. Therefore, clinicians and pathologists should differentiate GTNI from other benign glioneuronal tumors, and long-term follow-up of patients with spinal GTNI is necessary.
Anatomical breast imaging-derived parameters do not provide incremental information in prediction of nonvisualization of sentinel lymph nodes on lymphoscintigraphy
Authors: Chahid Youssef , Verberne Hein J. , Poel Edwin , Hendrikse N. Harry , Booij Jan 
Published: May 2022

Objective
Accurate sentinel lymph node (SLN) staging is essential for both prognosis and treatment in patients with breast cancer. However, the preoperative lymphoscintigraphy may fail to visualize the SLN. The aim of this retrospective study was to investigate whether parameters derived from anatomical breast imaging can predict SLN nonvisualization on lymphoscintigraphy.

Methods
For this retrospective study, all data of mammography, breast MRI, and lymphoscintigraphy of SLN procedures from January 2016 to April 2021 were collected and reviewed from the Amsterdam UMC database.

Results
A total of 758 breast cancer patients were included in this study. SLN nonvisualization on planar lymphoscintigraphy at 2-h postinjection (pi) was 29.7% and was reduced after a second injection to 7.5% at late lymphoscintigraphy 4-h pi. Multivariable analysis showed that age ≥ 70 years (P = 0.019; OR, 1.82; 95% CI, 1.10–3.01), BMI ≥ 30 kg/m2 (P = 0.031; OR, 1.59; 95% CI, 1.04–2.43), and nonpalpable tumors (P = 0.034; OR, 1.54; 95% CI, 1.03–2.04) were independent predictors of SLN nonvisualization. Differences in tumor size, Breast Imaging-Reporting and Data System classification, or breast density were not significantly associated with SLN nonvisualization.

Conclusion
This study shows that, by using a multivariable analysis, risk factors for SLN nonvisualization in breast cancer patients during preoperative lymphoscintigraphy at 2-h pi are age ≥ 70 years, BMI ≥ 30 kg/m2, and nonpalpable tumors. Parameters derived from mammography or breast MRI, however, are not useful to predict SLN nonvisualization on lymphoscintigraphy.
Effect of Group Logotherapy on Anxiety About Death and Existential Loneliness in Patients With Advanced Cancer
Authors: Heidary Maedeh , Heshmati Rasoul , Hayes Joseph 
Published: May 2022

Background
Although logotherapy has been shown to relieve other psychological symptoms of patients with cancer, no studies have specifically investigated the effect of logotherapy on anxiety about death and existential loneliness in these patients.

Objective
The aim of this study was to determine the effect of group logotherapy on anxiety about death and existential loneliness in patients with advanced cancer.

Methods
Sixty-three patients who were in the advanced stage of cancer were recruited from 2 hospital oncology services and were randomly assigned to either experimental (n = 31) or control group (n = 32). The intervention group received 10 weekly 2-hour group logotherapy. Templer’s Death Anxiety Scale and ELQ were completed pre- and posttreatment.

Results
A 2 × 2 mixed analysis of variance was used to determine the effect of the treatment on each of the dependent variables. The analyses revealed that patients in the logotherapy group reported a significant decrease in anxiety about death and existential loneliness after (vs before) the treatment. No significant decreases were observed in the waitlist control group.

Conclusions
These results have implications for treating death anxiety and feelings of existential loneliness among patients with advanced cancer. They suggest that group logotherapy is highly effective in reducing these existential concerns. Limitations and avenues for future research are discussed.

Implications for Practice
The study emphasizes that group logotherapy can be considered in oncology care programs by healthcare professionals and in educational curriculums and is suggested for use among caregivers and patients with advanced cancer.
Ultrasound-guided lumbar medial branch blocks and intra-articular facet joint injections: a systematic review and meta-analysis
Authors: Ashmore Zachary M. , Bies Michael M. , Meiling James B. , Moman Rajat N. , Hassett Leslie C. , Hunt Christine L. , Cohen Steven P. , Hooten W. Michael 
Published: May 2022

Abstract
There is great interest in expanding the use of ultrasound (US), but new challenges exist with its application to lumbar facet–targeted procedures. The primary aim of this systematic review and meta-analysis was to determine the risk of incorrect needle placement associated with US–guided lumbar medial branch blocks (MBB) and facet joint injections (FJI) as confirmed by fluoroscopy or computerized tomography (CT). An a priori protocol was registered, and a database search was conducted. Inclusion criteria included all study types. Risk of bias was assessed using the Cochrane risk of bias tool for randomized controlled trials and the National Heart, Lung, and Blood tool for assessing risk bias for observational cohort studies. Pooled analysis of the risk difference (RD) of incorrect needle placement was calculated. Pooled analysis of 7 studies demonstrated an 11% RD (P < 0.0009) of incorrect needle placement for US-guided MBB confirmed using fluoroscopy with and without contrast. Pooled analysis of 3 studies demonstrated a 13% RD (P < 0.0001) of incorrect needle placement for US-guided FJI confirmed using CT. The time to complete a single-level MBB ranged from 2.6 to 5.0 minutes. The certainty of evidence was low to very low. Ultrasound-guided lumbar MBB and FJI are associated with a significant risk of incorrect needle placement when confirmed by fluoroscopy or CT. The technical limitations of US and individual patient factors could contribute to the risk of incorrect needle placement.
A Longitudinal Mixed-Methods Examination of Positive Health Check: Implementation Results From a Type 1 Effectiveness-Implementation Hybrid Trial
Authors: Garner Bryan R. , Burrus Olivia , Ortiz Alexa , Tueller Stephen J. , Peinado Susana , Hedrick Haley , Harshbarger Camilla , Galindo Carla , Courtenay-Quirk Cari , Lewis Megan A. 
Published: May 2022

Background:
Positive Health Check is an evidence-based video doctor intervention developed for improving the medication adherence, retention in care, and viral load suppression of people with HIV receiving clinical care.

Setting:
Four HIV primary care clinics within the United States.

Methods:
As part of a type 1 hybrid trial, a mixed-methods approach was used to longitudinally assess the following 3 key implementation constructs over a 23-month period: innovation-values fit (ie, the extent to which staff perceive innovation use will foster the fulfillment of their values), organizational readiness for change (ie, the extent to which organizational members are psychologically and behaviorally prepared to implement organizational change), and implementation climate (ie, the extent to which implementation is expected, supported, and rewarded). Quantitative mixed-effects regression analyses were conducted to assess changes over time in these constructs. Qualitative analyses were integrated to help provide validation and understanding.

Results:
Innovation-values fit and organizational readiness for change were found to be high and relatively stable. However, significant curvilinear change over time was found for implementation climate. Based on the qualitative data, implementation climate declined toward the end of implementation because of decreased engagement from clinic champions and differences in priorities between research and clinic staff.

Conclusions:
The Positive Health Check intervention was found to fit within HIV primary care service settings, but there were some logistical challenges that needed to be addressed. Additionally, even within the context of an effectiveness trial, significant and nonlinear change in implementation climate should be expected over time.
Assessment of Functional Outcomes of an Autospreader Flap and Spreader Graft in Rhinoplasty
Authors: Aydoğdu Imran , Bayram Ali Alper , Aydoğdu Zeynep 
Published: May 2022

Objective:
Nasal obstruction after rhinoplasty occurs due to narrowing of the internal nasal valve. Narrowing is due to osteotomy performed to close the open roof of nose after dorsum hump resection. Spreader grafts and autospreader flaps are used to prevent such narrowing. in this study, we aimed to compare the effects of these 2 rhinoplasty techniques on olfactory function, nasal air passage opening, quality of life, and patient satisfaction.

Methods:
In this prospective study, 48 rhinoplasty patients were randomly divided into 2 groups according to graft technique used, either spreader graft or autospreader flap. These 2 groups were compared for patient satisfaction. The sinonasal outcome test-22, peak nasal flowmetry, and Connecticut Chemosensory Clinical Research Center test were applied to all patients before and 8 weeks after surgery.

Results:
The study enrolled 48 patients. Nasal airflow increased in both groups postoperatively. in the preoperative and postoperative comparison of odor functions, postoperative odor functions were similar in both groups. In the autospreader flap group, the preoperative rhinoplasty outcome evaluation questionnaire score was 4.1 ± 2.2 versus 21.3 ± 2.6 in the third postoperative month. The preoperative rhinoplasty outcome evaluation score was 3.9 ± 2.1 in the spreader graft group and 19.7 ± 1.9 in the third postoperative month.

Conclusions:
In the present study, postoperative nasal airflow improved in the patients in both the spreader graft and autospreader flap groups. in the patient satisfaction surveys after rhinoplasty, the satisfaction of the patients in the autospreader flap group was higher than that of the patients in the spreader graft group.
New Technology: Compound Abnormal Muscle Response During Microvascular Decompression for Hemifacial Spasm
Authors: Zhong Wenxiang , Ying Tingting , Li Shiting , Zhu Jin , Tang Yinda , Yuan Yan 
Published: May 2022

Objective:
To discuss effect of intraoperative compound abnormal muscle response (AMR) in patients undergoing microvascular decompression (MVD) for hemifacial spasm (HFS).

Methods:
Eighty-six HFS patients were underwent single or compound AMR monitoring during MVD. Single AMR recording was from the frontal muscle by stimulation of the marginal mandibular branch. Compound AMR recordings were obtained from the orbicularis oris and mentalis muscles by electrical stimulation of the temporal branch of the facial nerve, and from the frontal and orbicularis oculi muscles by stimulation of the marginal mandibular branch. Clinical outcome was compared with compound AMR results at the completion of MVD.

Results:
Forty-two of 45 patients’ AMR were recorded by compound AMR monitoring and 34 of 41 patients’ AMR were recorded by single AMR monitoring during MVD. Hemifacial spasm resolved completely in 41 patients whose compound AMR was recorded and in 26 patients whose single AMR was recorded. Compound AMR gained a sensitivity of 96.3% and a specificity of 97.2%. Correspondingly, single AMR gained a sensitivity of 97.1% and a specificity of 86.3%.

Conclusions:
Our results suggest that compound AMR is more suitable than single AMR in MVD for HFS.