bluuebunny/crossref_metadata_2025 huggingface dataset:
Trans-cranial Doppler predicts early neurologic deterioration in anterior circulation ischemic stroke after successful endovascular treatment
Authors: He Yan-Bo , Su Ying-Ying , Rajah Gary B. , Zhang Ying-Bo , Fan Lin-Lin , Liu Gang , Chen Hong-Bo
Published: June 2020

Background

Early neurologic deterioration (END) may occur in patients with anterior circulation ischemic stroke (ACIS) after receiving endovascular treatment (EVT). Hemodynamic insufficiency, re-occlusion, and post-re-canalization hyper-perfusion are likely to play a critical role in END. We hypothesized that hemodynamic changes can predict END in patients with ACIS post-successful EVT using trans-cranial Doppler (TCD).

Methods

We utilized a prospectively maintained database of ACIS patients treated with EVT between September 2016 and June 2018 in the Xuanwu Hospital, Capital Medical University. TCD parameters including peak systolic velocity (PSV), bilateral mean flow velocity (MFV), and pulse index (PI) were determined via the middle cerebral arteries within 72 h post-EVT. A logistic regression model was applied to detect independent predictors for END.

Results

Totally, 112 EVT patients were included in this study and 80/112 patients experienced successful re-canalization with <50% residual stenosis, while 17/80 (21.3%) patients suffered END, for which vasogenic cerebral edema (11/17) was considered as a leading role and followed by symptomatic intra-cranial hemorrhage (4/17) and ischemia progression (2/17). For the 80 patients, the PSV (median: 127 cm/s vs. 116 cm/s, P = 0.039), the ratio of ipsilateral-MFV/contra-lateral-MFV (iMFV/cMFV) (median: 1.29 vs. 1.02, P = 0.036) and iMFV/mean blood pressure (MBP) (median: 0.97 vs. 0.79, P = 0.008) in END patients were higher than those of non-END. Using the receiver-operating characteristic curve to obtain cut-off values for PSV, PI, iMFV/cMFV, and iMFV/MBP for END, we found that PI ≥0.85 (odds ratio: 11.03, 95% confidence interval: 1.92–63.46, P = 0.007) and iMFV/MBP ≥0.84 (odds ratio: 9.20, 95% confidence interval: 2.07–40.84, P = 0.004) were independent predictors of END in a multivariate logistic regression model, with a sensitivity of 82.4% and 76.5% and a specificity of 42.9% and 66.7%, respectively, and had the positive predictive values of 29.0% and 38.2%, and negative predictive values of 90.0% and 91.3%, with an area under the receiver-operating characteristic curve of 0.57 and 0.71, respectively.

Conclusion

TCD examination of EVT patients may be used as a real-time tool to detect END predictors, such as the higher PI and iMFV/MBP, allowing for better post-thrombectomy management in ACIS patients.
Evaluation of Long-Term Outcome and Patient Satisfaction Results After Tumescent Liposuction
Authors: Lipp Michael B. , Butterwick Kimberly , Angra Kunal , Chunhara Chatchadapon , Goldman Mitchel P.
Published: June 2020

BACKGROUND

Liposuction is one of the most common cosmetic surgery procedures around the world. Tumescent liposuction using local anesthesia has been shown to be the safest technique. Few long-term studies of results and satisfaction have been published on tumescent liposuction.

OBJECTIVE

To evaluate long-term results and patient satisfaction of tumescent liposuction in a single-center institution.

METHODS

Patients (n = 600) who had tumescent liposuction performed in our practice from 2002 to 2014 were contacted through letter, email, or phone to complete a questionnaire survey and in-office follow-up visit regarding their past liposuction procedures.

RESULTS

Thirty-two patients (n = 32) completed the patient questionnaire survey and followed up in the office. Surgeon and blinded evaluators saw significant differences in both the neck volume (surgeon evaluator: 2.42 vs. 0.71, p < .01; blinded evaluator: 2.8–1, p = .02) and Investigator Assessment Skin Laxity scales (blinded evaluator: 1.14 vs. 0.77, p < .01 for laxity and 1.33 vs. 0.75, p < .01 for firmness; surgeon evaluator: 1.17 vs. 0.83, p = .01 for laxity and 1.31 vs. 0.83; p < .01 for firmness). The mean follow-up period was 8.9 years overall and 9.9 years for the neck. Overall, 85.7% of the patients would recommend liposuction to their friends and family members.

CONCLUSION

Tumescent liposuction is a safe procedure with long-lasting results and high patient satisfaction.
An updated guide to the diagnosis and management of cesarean scar pregnancies
Authors: Liu Lucy , Ross Whitney T. , Chu Amanda L. , Deimling Timothy A.
Published: June 2020

Purpose of review

To review the current literature on the diagnosis and management of cesarean scar pregnancies

Recent findings

The incidence of cesarean scar pregnancies (CSPs) is increasing as a result of the increasing cesarean section rate, improved diagnostic capabilities, and a growing awareness. CSPs are associated with significant morbidity and early diagnosis is key. Diagnosis is best achieved with transvaginal ultrasound. Sonographic diagnostic criteria have been developed over decades and recently endorsed by the Society for Maternal-Fetal Medicine and other professional societies. The current categorization system differentiates CSPs that are endogenic or ‘on the scar’ from those that are exogenic or ‘in the niche’. Following diagnosis, the challenge remains in determining the optimal management as multiple modalities can be considered. Studies have demonstrated the favorable outcomes with combined local and systemic methotrexate, surgical excision through multiple routes, and adjunctive therapies, such as uterine artery embolization or uterine balloons. The current evidence is insufficient to identify a single best treatment course and a combined approach to treatment is often required.

Successful outcomes while minimizing complications can be achieved with a multidisciplinary, collaborative effort. Guidelines for cesarean scar pregnancies will continue to evolve as the published reports grow.
Modified Intrascleral Fixation for Repositioning the Dislocated Single-Piece, Rigid PMMA Intraocular Lens
Authors: Zong Yuan , Wu Kaicheng , Fang Wangyi , Yu Jian , Jiang Chunhui , Xu Gezhi
Published: June 2020

Purpose:

To describe a modified intrascleral fixation technique for repositioning single-piece rigid polymethyl methacrylate intraocular lenses (IOLs).

Methods:

Four patients with dislocated IOLs were enrolled. Surgical modifications included using ≤1-mm scleral incision for haptic externalization, placing the IOL haptic placement in scleral tunnels, and using 8-0 absorbable sutures. Patients were followed up for 6 months with routine ophthalmic examinations, corneal endothelial cell counts, and ultrasound biomicroscopy (UBM).

Results:

The mean follow-up time was 13.5 ± 5.45 months. The IOL was well centered and the spherical refraction improved (+10.25 ± 2.21 vs. −0.81 ± 1.59 D, P < 0.05), whereas the best-corrected visual acuity (pre 20/43 Snellen, 0.42 ± 0.33 logarithm of the minimum angle of resolution equivalent and post 20/36 Snellen, 0.31 ± 0.22 logarithm of the minimum angle of resolution equivalent; P = 0.235), intraocular pressure (pre 13.8 ± 3.21, post 13.55 ± 5.14 mmHg), corneal endothelium density (pre 2,423.8 ± 279.6/mm2, post 2,280.25 ± 350.7/mm2), and total astigmatism (pre −1.94 ± 0.43, post −1.69 ± 0.59 D) remained unchanged. The average horizontal and vertical IOL tilt was 0.33 ± 0.22° and 0.81 ± 0.38°, respectively. Intraocular lens decentration was 0.10 ± 0.03 mm horizontally and 0.13 ± 0.06 mm vertically.

Conclusion:

The modified intrascleral fixation technique shows encouraging midterm results in patients with dislocated single-piece, rigid polymethyl methacrylate IOLs. Larger samples and longer follow-up are required to confirm the outcomes of this technique.
In Vivo Confocal Microscopy Morphometric Analysis of Meibomian Glands in Patients With Graves Ophthalmopathy
Authors: Vagge Aldo , Bernabei Federico , Del Noce Chiara , Pellegrini Marco , Giannaccare Giuseppe , Senni Carlotta , Scotto Riccardo , Traverso Carlo E.
Published: June 2020

Purpose:

To characterize meibomian glands (MGs) features in patients with Graves ophthalmopathy (GO) by in vivo confocal microscopy (IVCM) and to further investigate possible correlations with ocular surface characteristics.

Methods:

Consecutive patients with GO and controls were enrolled. The following ocular surface parameters were measured: tear break-up time, Schirmer test, and corneal fluorescein staining (Oxford score) were performed on each subject. IVCM of MGs was performed, and the scans were analyzed with ImageJ software for the calculation of the following: acinar unit density, total gland area, total lumen area (TLA), acinar longest diameter, and acinar shortest diameter. A nonparametric Mann–Whitney U test was used to compare variables between patients with GO and controls. The Spearman correlation analysis was used to evaluate the correlations between ocular surface and IVCM parameters.

Results:

Twenty-one patients with GO and 24 sex- and age-matched healthy controls were included. Acinar unit density was significantly lower in patients with GO compared with controls (24.5 ± 8.1 vs. 34.2 ± 7.5 U/mm2; P < 0.001). In addition, patients with GO showed significantly higher values of TLA, acinar longest diameter, and acinar shortest diameter compared with controls (respectively, 3104.7 ± 1713.3 vs. 1393.8 ± 448.0 μm2, 94.4 ± 21.2 vs. 64.3 ± 10.1 µm and 56.6 ± 15.3 vs. 42.2 ± 12.3 μm; always P < 0.05). In patients with GO, TLA showed a significant inverse correlation with Schirmer test (Rs = −0.467; P = 0.038).

Conclusions:

IVCM allowed to detect distinctive features of MGs in patients with GO and could represent a surrogate tool for the assessment of MG status in these patients.
Visian Implantable Collamer Lens Behavior in Descemet Membrane Endothelial Keratoplasty Surgery
Authors: Alió del Barrio Jorge L. , D'Oria Francesco , Alió Jorge L.
Published: June 2020

Endothelial damage is one of the leading causes for anterior chamber phakic intraocular lens (AC-pIOL) explantation. In young patients, where the pIOL is explanted alone without lensectomy, an important anisometropia is left, unless an exchange with a posterior chamber (PC) pIOL is performed. However, in the event of corneal decompensation, there is no published evidence about the potential influence of a collamer-based PC-pIOL [implantable collamer lens (ICL)] on endothelial keratoplasty surgery. We report a case of severe endothelial damage after AC-pIOL implantation managed by the exchange of the AC-pIOL by an ICL, followed by Descemet membrane endothelial keratoplasty. Collamer-based PC-pIOLs seem to not affect Descemet membrane endothelial keratoplasty outcomes. ICL did not show any transparency loss. These results cannot be extrapolated to other non-collamer–based PC-pIOLs. Further studies with larger samples are necessary to confirm these outcomes.
DSAEK Centration and Interface Folds: Surgical Management
Authors: Gadhvi Kunal , Pagano Luca , Menassa Nardine , Borroni Davide , Kaye Stephen B. , Levis Hannah J. , Romano Vito
Published: June 2020

Purpose:

To describe a method to center a Descemet stripping automated endothelial keratoplasty lamellar graft and address interface folds.

Methods:

A novel technique to center a Descemet stripping automated endothelial keratoplasty graft without undue manipulation of endothelial surface using a STC-6 needle passed obliquely through the anterior corneal surface to engage and progress the lenticule along the posterior surface after injection of air.

Result:

Centration of graft achieved and macroscopic folds resolved.

Conclusions:

Here, we describe an atraumatic and reproducible method for graft centration.
Questionnaire Development of a Good Nurse and Better Nursing From Korean Nurses' Perspective
Authors: PARK Mihyun , PARK Eun-Jun
Published: June 2020

Background

The concepts of “good nurse” and “better nursing” have changed over time and should be investigated from the perspective of nurses.

Purpose

The aim of this study was to develop and assess the psychometric properties of two questionnaires used to assess “good nurse” and “better nursing.”

Methods

The interview data of 30 registered nurses (RNs) from a previous study were reviewed to develop the questionnaire items, and content validity was examined. One hundred seventeen RNs participated in a pilot survey for pretesting the constructs, 469 RNs participated in a main survey to explore these constructs using exploratory factor analysis (EFA), and 468 RNs participated in model refining and validation using confirmatory factor analysis.

Results

After a critical review of RN interview data and content validity evaluation, 73 of 124 statements on “good nurse” and 56 of 57 statements on “better nursing” were selected. In the pilot survey, the number of items was reduced to 45 for both questionnaires using an EFA. In the main survey, EFA was used to load 34 items on the five factors of the good nurse questionnaire and 26 items on the three factors of the better nursing questionnaire. In the confirmatory factor analysis, to obtain better fitting models, the good nurse questionnaire consisted of 17 items on the five factors of collaboration, professional competency, self-efficacy, a sense of achievement, and compassion, whereas the better nursing questionnaire consisted of 16 items on the three factors of person-centered nursing, proactive nursing, and expertise in caring. The construct reliability, convergent validity, and discriminant validity of the questionnaires were achieved.

Conclusions/Implications for Practice

The concept of “good nurse” from the perspectives of the nurses in this study was similar with those of patients in previous studies, while including individual traits such as sense of achievement. Better nursing is conceptualized with the exemplary performance of nursing focusing on the nature of nursing and leading excellence and power in clinical practice. The study findings inform what nursing education and workforce development should focus on for nursing to continuously progress. Furthermore, it is recommended that the concepts of a good nurse and better nursing be compared across different countries using the questionnaires.
Ice Capades
Authors: Seashore Justin , Nishi Shawn P.E.
Published: June 2020

Background:

Transbronchial lung cryobiopsy (TBLC) has been proposed as a potentially safer alternative in the diagnosis of interstitial lung disease. The current practice of TBLC is unknown as most published data come from case reports, case series, and a few trials. The authors report the practice patterns of TBLC on the basis of survey responses.

Methods:

The authors created an anonymous online survey to assess how proceduralists evaluate patients, perform, and manage complications of TBLC. Surveys were distributed through social media and e-mail distribution lists from the American Association of Bronchology and Interventional Pulmonology and the Society of Advanced Bronchoscopists. Aggregated responses are reported as counts, percentages, and averages.

Results:

Surveys show significant variation in parameters providers use to assess appropriate patients for procedures, how specific aspects of TBLC are performed, and how complications and results are managed.

Conclusion:

This is the first and largest survey of providers describing the current large variation in the use of cryobiopsy for the evaluation of interstitial lung disease. The standardized practice is essential to understand the true diagnostic accuracy or rate of complications related to TBLC.
Serum HBV RNA Dynamic and Drug Withdrawal Predictor Value in Patients With Chronic HBV Infection on Long-term Nucleos(t)ide Analogue (NA) Therapy
Authors: Liu Yayun , Xue Jianya , Liao Wei , Yan Hongli , Liang Xuesong
Published: June 2020

Aims:

This study aimed to investigate the dynamic pattern of serum hepatitis B virus (HBV) RNA in chronic hepatitis B (CHB) patients on long-term nucleos(t)ide analogue (NA) therapy and evaluate predictor value of end-of-treatment (EOT) serum HBV RNA status on drug-withdrawal durability.

Methods:

We carried out a real-life cohort study of 326 CHB patients on NA treatment between February 12, 2016 and February 21, 2018. Thirty of these patients discontinued NA treatment after enrollment, and were included in 2-year off-therapy follow-up. Serum HBV RNA levels were determined using the RNA simultaneous amplification testing method.

Results:

Both serum HBV RNA and DNA levels declined significantly in long-term antiviral progress. When the treatment duration was longer than 3 years, the undetectable rates of HBV RNA and DNA were 55.10% and 97.0%, respectively. The serum HBV RNA-negative rate was 39.5%. The cumulative 2-year off-therapy viral and clinical relapse rate was 40.56%; 95% confidence interval (95% CI), 21.51-59.61 and 31.31%; 95% CI, 11.32-51.29 in all patients, respectively. Patients with EOT hepatitis B surface antigen (HBsAg)≤1000 IU/mL plus HBV RNA negativity had a relatively lower cumulative 2-year off-therapy viral relapse rate (23.01%; 95% CI, 0.17-45.99). EOT HBsAg≤1000 IU/mL plus HBV RNA negativity showed obvious superiority for the EOT HBsAg≤1000 IU/mL single in drug withdrawal durability prediction, with better specificity (18.18% vs. 72.73%, P=0.03), and the positive predictive value and negative predictive value were 76.92% and 47.06%, respectively.

Conclusions:

In the long-term antiviral process, both serum HBV RNA and DNA levels declined significantly. EOT serum HBV RNA negativity was not an independent drug withdrawal marker, but can complement the HBsAg titer to monitor drug withdrawal in CHB patients on long-term NA therapy.
Considerations for the otolaryngologist in the era of COVID-19: a review of the literature
Authors: Miller Lauren E. , Shaye David A. , Lee Linda N.
Published: June 2020

Purpose of review

The SARS-CoV-2 coronavirus pandemic, referred to as COVID-19, has spread throughout the globe since its first case in China in December 2019, leaving a significant number of people infected and clinically ill. The purpose of this review is to provide the current known clinical characteristics of and management for COVID-19 as it relates to otolaryngology.

Recent findings

COVID-19 is a highly transmissible respiratory disease with common presenting symptoms of fever, cough, and fatigue. In the absence of available vaccines or antiviral therapies, symptomatic and respiratory support is the current standard of therapy. Measures to prevent further transmission have been enacted globally including social distancing and cancellation of public events. Given elevated viral load in the upper aerodigestive tract, extra precautions in patients with otolaryngology needs have been recommended for protection of both healthcare workers and patients.

Otolaryngologists face unique risk from COVID-19. Maintaining appropriate preventive health measures and remaining updated on institutional clinical guidelines is paramount for both caretaker safety and patient care.
Gender affirming and aesthetic cranioplasty: what's new?
Authors: Spiegel Jeffrey H.
Published: June 2020

Purpose of review

Esthetic cranioplasty is an important part of facial feminization surgery. Additionally, it is an often underappreciated procedure for facial beautification. This chapter reviews current trends in esthetic cranioplasty for transgender women and others. Valuable techniques and innovations that do not advance the field are reviewed.

Recent findings

Although promoted in recent literature, among the key concepts discussed in this review are the limitations of cutting guides, the rare indications for preoperative imaging, and when burring the glabellar area is appropriate rather than doing a full osteoplastic flap setback.

Forehead feminization cranioplasty is a highly dependent upon the surgeon's artistic ability. Modeling and guides are potentially helpful for the novice surgeon but better is to learn appropriate anatomy for a more refined result.
Fatal Acute Pancreatitis in an Adolescent
Authors: Hade Allison L. , Zumwalt Ross E.
Published: June 2020

Acute pancreatitis is uncommon in children and adolescents, and when it does occur, it is rarely fatal. The cause of death may be misdiagnosed as a death due to diabetic ketoacidosis or an infectious disease if an autopsy is not performed. Because these deaths are often unexpected and may occur before medical care, the forensic pathologist may be contacted to determine the cause of death. Even deaths that occur after hospitalization may be referred to the medical examiner because of the concern for drug involvement, the unusual age of the decedent, or the decreased availability for a hospital autopsy. We report a fatal case of acute pancreatitis in a 14-year-old adolescent girl who was brought unresponsive to the emergency room of a university hospital and died after unsuccessful resuscitation efforts.
Acquired Cystic Kidney Disease–associated Renal Cell Carcinoma (ACKD-RCC) Harbor Recurrent Mutations in KMT2C and TSC2 Genes
Authors: Shah Abhishek , Lal Priti , Toorens Erik , Palmer Matthew B. , Schwartz Lauren , Vergara Norge , Guzzo Thomas , Nayak Anupma
Published: June 2020

Individuals with acquired cystic kidney disease (ACKD) in the setting of end-stage renal disease (ESRD) have a high risk of developing renal cell carcinoma (RCC). ACKD-RCC is considered a distinct renal neoplasm in the International Society of Urologic Pathologists (ISUP)-World Health Organization (WHO) classification of kidney tumors which may behave aggressively. Since its original description, there have been multiple case reports and series published; however, the pathogenesis of this neoplasm is uncertain and there is limited data on the genetic aberrations of this tumor. Herein, we present our experience with ESRD kidneys, with emphasis on ACKD-RCC, associated cysts, and the somatic mutation analysis of a subset of ACKD-RCCs using next-generation sequencing. Our data on 59 cases with ESRD that underwent nephrectomy, shows that ACKD-RCC represents more than half of the tumors (25/46; 54%) developing in ESRD, followed by papillary RCC (13; 28%). History of dialysis, male sex, and African American race were potential risk factors for developing ACKD-RCCs. Further, ACKD-RCC–like cysts are possible precursors of RCCs in the ACKD setting noted in 40 of 46 (87%) cases with tumors. Next-generation sequencing analysis revealed recurrent mutations in the KMT2C gene in 4 of 5 ACKD-RCCs (80%), exclusively exhibiting cribriform “sieve-like” morphology; whereas the case negative for KMT2C mutations exhibited “type 2” papillary RCC morphology and lacked “sieve-like” growth pattern. Pathogenic mutations in TSC2 were the second common abnormality (3/5; 60%), often coexisting with KMT2C mutations. Deleterious mutations in additional genes such as CBL, PDGFRA, and SYNE1, etc. were noted but were nonrecurrent and always coexisted with mutations in KMT2C or TSC2. To conclude, our study highlights that mutations in a chromatin-modifying gene KMT2C may potentially be oncogenic drivers for the development of ACKD-RCC with classic sieve-like morphology. In addition, pathogenic mutations in TSC2 possibly play a role in the development of cysts/tumors in a subset of ACKD patients. If corroborated in larger cohorts, these findings would be useful in planning surveillance and early intervention in ESRD patients developing ACKD.
Hemifacial Microsomia Review: Recent Advancements in Understanding the Disease
Authors: Paul Marek A. , Opyrchał Jakub , Knakiewicz Michał , Jaremków Paweł , Bajtek Jan , Chrapusta Anna
Published: June 2020

Hemifacial microsomia (HFM) is the second most common congenital disability of the face, with a prevalence of 1 in 3000 to 5600 live births. Although etiology is still not fully understood, including both genetics and environmental factors, the latest reports indicate the prominence of premature loss of the neural crest cells. What is more, a deficit of muscles of mastication, except the masseter, correlates in the pathomechanism of mandibular underdevelopment. Due to the significant phenotypic diversification, the typical picture of HFM cannot be determined. It may present as an esthetic concern—minor asymmetry with deformed auricle, and on the contrary, as microtia/anotia with conductive type hearing loss, hypoplastic mandible, and microphthalmia, impairing patient's daily activities. Referring to psychosocial problems, it has been proved that in population with HFM, there is a modestly elevated risk for behavior problems, social competence, and less acceptance. Over the years, more comprehensive methods of assessing the extent and severity of the HFM as the OMENS (+) classification have emerged. The authors like to summarize and present for plastic surgery resident and plastic surgeons the critical features of HFM, including the epidemiology, clinical presentation, pathogenesis, and innovative management reported in the current literature.
Primary Observation of the Causes of Temporal Hypertrophy Secondary to Fat Grafting and the Effect of Liposuction on the Hypertrophy
Authors: Lei Hua , Ma Gui-e
Published: June 2020

Objective:

In Asia, the temporal hollowing is considered to be a sign of bad fortune and aging. Many people demand to correct the temporal hollowing with fat grafting. Subsequently, the temporal hypertrophy secondary to fat grafting become more and more. This study attempted to preliminarily explore the causes of temporal hypertrophy and observe the safety and effectiveness of liposuction in correcting temporal hypertrophy.

Methods:

A diagnostic criteria for temporal hypertrophy was established, and 55 of 78 patients who complained of temporal swelling were defined as temporal hypertrophy, and filled out a questionnaire which included patients’ basic information, preoperative, intraoperative, and postoperative problems related to fat grafting, as well as their acceptance of liposuction. Analyze the results of the questionnaire to explore which factors are associated with hypertrophy. Practice liposuction on patients who are willing to try liposuction. Postoperative complications were observed to determine the safety of liposuction. The patients, doctors, and bystanders were followed up 3 months postoperative to investigate the satisfaction of the operation for analyzing the effectiveness of liposuction for temporal hypertrophy.

Results:

Before fat grafting, 13 (23.6%) patients without significant temporal hollowing and 42 (76.4%) patients with obvious temporal hollowing; 28 (50.9%) patients with 1 fat grafting, 20 (36.4%) with 2 fat gratings, 7 (12.7%) with 3 fat grafting. The mean time between 2 fat gratings was 4.8 months. The fat donor sites: 50 (90.9%) patients in thigh, 4 (7.3%) in abdomen, and in 1 (1.8%) in waist. The average onset time of hypertrophy in 55 patients was 13.1 months after the last fat grafting. The average onset time of temporal hypertrophy of the weight-gain group (25.7 months) was significant later than that of the weight-invariant group (7 months) (P < 0.01).

No irregularities, skin necrosis, hematoma, or infection was found in all patients. One patient showed the damage to temporal branch of facial nerve on right side, which fully recovered at 1 week postoperative. 7 (22.6%) patients, 10 (32.3%) doctors, and 8 (25.8%) laypersons reported satisfactory results; 14 (45.2%) patients, 15 (48.4%) doctors, and 14 (45.2%) laypersons reported mostly satisfactory results; 10 (32.3%) patients, 6 (19.4%) doctors, and 9 (29.0%) laypersons reported dissatisfactory results.

Conclusions:

To prevent temporal hypertrophy, the following points are important: to rationally choose of indication of temporal fat grafting, to wait 1 to 2 years before next fat grafting, to maintain weight stability after fat grafting, to practice conservative fat grafting, to prudently choose fat donor site. Liposuction is safe for temporal hypertrophy, but it is not easy to operate and difficult to correct all cases. Therefore, a superior treatment plan should be explored.
The Impact of Fibrin Sealant Volume on Skin Graft Contraction in a Full-Thickness Skin Graft Model
Authors: Kim Ara , Lee Sanghun , Lee Hojune , Lim Ha Seong , Lim So Young
Published: June 2020

Background:

Fibrin sealant has been used for skin grafting in anatomically difficult facial areas. Although biodegradable, an excess of fibrin sealant may inhibit skin graft healing by inhibiting diffusion at the graft-recipient bed interface. The impact of fibrin sealant volume on graft healing was examined in a rat full-thickness skin graft model.

Methods:

Seventy-two full-thickness 2.5 × 2.5-cm2 skin grafts were used on the dorsum of male Sprague-Dawley rats. The grafts were treated with three different volumes of fibrin sealant placed onto the recipient bed: 0.0 mL or normal saline (group 1), 0.1 mL (group 2), and 0.4 mL (group 3). Graft healing and complications were assessed using digital photographs and necropsies on postoperative days 3, 7, and 21.

Results:

Group 3 showed the greatest graft contraction on days 3 and 21, while group 2 showed the least contraction on all 3 postoperative days (P = 0.002, 0.004, and <0.001, respectively). Histopathologic analysis showed inflammatory foreign body reactions in group 3 on days 3 and 7, and less vascular density on day 21 (P = 0.003). Group 1 showed the highest incidence of hematoma (P = 0.004).

Conclusion:

An excess volume of fibrin sealant may produce pathologic wound contraction in skin grafting because a skin graft lacks a vascular pedicle and is highly dependent on diffusion from the host environment. Before using fibrin sealant for skin grafting in facial areas where the aesthetic outcome is important, the appropriate volume to use can be determined.
Surgical Treatment of Bilateral Atrophic Mandible Fracture
Authors: Florentino Vinícius Gabriel Barros , Abreu Diego Feijão , Ribeiro Ney Robson Bezerra , Silva Leonardo de Freitas , Gondin Ricardo Franklin , Mello Manoel de Jesus Rodrigues , Aguiar Andréa Silvia Walter de
Published: June 2020

Poor proprioception, weakness, and impaired reflexes increase the incidence of facial fracture in the elderly. Mandibular fractures in these people range from 10.1% to 56%. Fragment reduction and fracture consolidation are difficult due to bone atrophy, decreased capacity for bone regeneration, and lack of anatomical landmarks to guide the alignment of the fragments. This study reports 2 patients with different conducts regarding the treatment of bilateral fractures in atrophic mandible. The first patient refers to the removal of plates of the 2.4 mm system with low profile, which failed during the mandibular function, being replaced by the 2.4 mm system with high profile. The 2nd clinical reports the use of the 2.0 mm system only to simplify the mandibular fracture, and then reconstructing that with a 2.4-mm system with high profile, using the load bearing principles. Regarding mandibular fractures, an important goal is to neutralize the muscle action aiming the bone stability. There are several methods to treat that the indication should consider the load bearing and load sharing concepts. The incorrect fixation choice in these patients can result in complications as bad union, material failure, infection, and consequent treatment failure.
Barrel Stave Osteotomy Decompression for Acute Brain Injury in Infants: Technical Note
Authors: Beez Thomas , Munoz-Bendix Christopher , Hänggi Daniel , Beseoglu Kerim , Cornelius Jan F.
Published: June 2020

Decompressive craniectomy (DC) is rarely required in infants, but when performed several aspects should be considered: These youngest patients are vulnerable to blood loss and cranial reconstruction can be challenging due to skull growth and bone flap resorption. On the other hand, infants have thin and flexible bone and osteogenic potential. The authors propose a technique which makes use of these unique aspects by achieving decompression with the craniofacial method of barrel stave osteotomy, aiming to achieve adequate DC, limit perioperative risks and facilitate subsequent cranial reconstruction.
Cartilage-Sparing Otoplasty: The Effects of Adipo-Perichondrial Flap-Assisted Posterior Auricular Muscle Complex Flap Technique on the Repair of Prominent Ear Deformities
Authors: Ünverdi Ömer Faruk , Demir Ahmet
Published: June 2020

Background:

In the repair of prominent ear deformities, the main objectives are to recreate the antihelical fold, reduce projection in patients with a large concha, and normalize the distance between the ear and the cranium. This study evaluated the efficacy of the adipo-perichondrial flap-assisted posterior auricular muscle complex (PAMC) flap technique, which involves a new approach to the repair of prominent ear deformities.

Materials and Methods:

A medially based PAMC flap and a laterally based adipo-perichondrial flap were elevated in 22 patients with prominent ear deformities. In order to shape the ear, the PAMC flap was sutured to the transition zone between the helix and antihelix, and the adipo-perichondrial flap to the periosteum of the mastoid bone. The ear-cranium distances were measured preoperatively and at postoperative first and sixth months.

Results:

Thirteen patients were female and 9 were male. The mean age of the patients was 19.4 years, and the mean follow-up period was 10.6 months. The ear-cranium distance significantly decreased in the postoperative first-month and sixth-month evaluations compared to the preoperative values (P < .05). No relapse, suture exposition, hematoma, keloid scar, or infection was observed.

Conclusion:

Posterior auricular muscle complex is a strong anatomical structure that includes the trapezius muscle, occipital muscle, extrinsic ear muscles, temporal fascia, and sternocleidomastoid fascia. By elevating this structure as a flap and combining it with an adipo-perichondrial flap, successful results can be achieved in the repair of prominent ear deformities, which prevents relapses and maintains the shape of the ear in the long term.
Dentoalveolar Fractures: New Orthodontic Protocol Proposal and Pilot Study
Authors: Dell’Aversana Orabona Giovanni , Perrotta Stefania , Lo Giudice Giorgio , Bocchino Tecla , Valletta Rosa , Abbate Vincenzo , Califano Luigi
Published: June 2020

The goal of fracture treatment that includes the dentoalveolar process is to obtain the anatomic bone healing and the pre-injury occlusion restoration with functional and aesthetic recovery, avoiding dental or periodontal lesions. Fractures activates, in the damaged tissue, the Regional Acceleratory Phenomenon, a physiological healing process that can also be activated during orthodontic overloads. Orthodontic treatment in the traumatized area could exploit this phenomenon in order to sustain the cellular activity.

The aim of this study is to propose a treatment protocol for dentoalveolar fractures based on the use of orthodontics in order to sustain the physiological healing process known as Regional Acceleratory Phenomenon.

The authors present 2 cases of an 18 year old woman and 23 year old man affected by dentoalveolar fracture. The operative protocol the authors applied foresaw three steps of treatment: orthodontic brackets application, surgery, orthodontic treatment.

The patients showed complete healing at the 3 months follow-up and were treated up to 18 months for further orthodontic treatment.

The operative protocol proposed by the Authors appears to be a rational choice since it allows a single orthodontic device to be an “active splinting system”, with fast application time, good acceptance by the patient, low complications rate; moreover, it produces any planned dental movements for further orthodontic treatments.
Chondroma in the Area of the Spheno-Ethmoid Junction
Authors: Liu Jinfeng , Hao Qingqing , Wu Wei , Wang Ningyu
Published: June 2020

Chondroma in the area of the spheno-ethmoidal junction is very rare. A 29-year-old male patient with chronic rhinosinusitis with nasal polyps was arranged for a preoperative computed tomography scan, and a lesion was accidentally found in his spheno-ethmoidal junction and involved the skull base. Combined with MRI, the lesion was misdiagnosed as fungal sinusitis. However, no fungal lesions were found during the operation, and cartilage tissue was confirmed only after some bone was ground away under the guidance of a surgical navigation system. Our case indicates that chondroma is easily misdiagnosed as fungal sinusitis when it appears in the sinuses and should be carefully distinguished from fungal sinusitis. Moreover, when lesions involve the skull base, surgical navigation systems are useful in accurately locating lesions.
Craniofacial Injuries Seen Among Electric-Motorized Bicycle Riders
Authors: Frenkel Boaz , Bahouth Hany , Abu Shqara Fadi , Rachmiel Adi
Published: June 2020

The popularity of electric-motorized bicycles (E-bikes) has increased dramatically over the past few years. As a result, E-bike--associated injuries are quickly becoming a substantial issue. The aim of the present study was to evaluate the epidemiology and general nature of these injuries, with special attention to craniofacial trauma. This was a retrospective study of 84 E-bike riders who suffered from trauma and treated at our level 1 trauma center between the years 2014 and 2018. The information consisted of demographics, characteristics of injury, Injury Severity Score, and number of hospitalization days.

Regarding craniofacial trauma, the mean age was 22.7 years. Data about helmet usage was missing. The most common cause of injuries in maxillofacial region, was falling (80%). The most prevalent injury in the maxillofacial region was fractures of the zygomatic complex with the orbit (33%) and soft tissue lacerations.

There is little data regarding craniofacial trauma attributed to electric-motorized bicycle accidents. In Israel there are a lot of young adults and teenagers that use E-bikes as an economical solution for mobility. Education regarding road behavior and the proper use of protective measures such as wearing a helmet can reduce significantly overall injuries and cranio-facial trauma in particular.
Evaluation of Awareness, Adherence, and Barriers of Pelvic Floor Muscle Training in Pregnant Women: A Cross-sectional Study
Authors: Bayat Masoumeh , Eshraghi Narjes , Naeiji Zahra , Fathi Marzieh
Published: June 2020

Introduction

Adherence to pelvic floor muscle training (PFMT) may be enhanced when the women become aware of its preventive/therapeutic role in pelvic floor disorders.

Objective

This study is conducted to evaluate the PFMT awareness, adherence, and barriers in pregnant women.

Method

We studied the awareness, adherence, and barriers of PFMT in 200 pregnant women attended in prenatal care clinic in their third trimester of pregnancy using semistructured interviews with open and closed questions derived from recent literature review on PFMT.

Result

Fifty-four (27%) of studied women were familiar with PFMT, 175 (87.5%) of patients thought that the UI is normal during pregnancy, and 25 (32.05%) had experienced UI episodes and had consulted with their obstetrician. Twenty-one (10.5%) of patients did the PFMT exercises before their pregnancy, 14 (66.6%) of them continued their PFMT exercises during their pregnancy, and 7 (33.4%) stopped it. Concerns about miscarriage were the main reason of discontinuing the exercises during pregnancy. Routes of knowledge acquisition were the Internet in 24 cases (44.4%), health system in 13 cases (24.07%), family and friends in 11 cases (20.3%), and books/magazines in 6 cases (11.1%). Main means of mass communication (including TV, radio, and newspapers) had no role in knowledge distribution in this filed.

Conclusions

Pregnant women require more health education regarding PFMT. Health care professionals should be more involved in patient education process. Internet resources are used widely by women and need more academic/scientific supervision.
The Sensitivity of Scalp EEG at Detecting Seizures—A Simultaneous Scalp and Stereo EEG Study
Authors: Casale Marc J. , Marcuse Lara V. , Young James J. , Jette Nathalie , Panov Fedor E. , Bender H. Allison , Saad Adam E. , Ghotra Ravi S. , Ghatan Saadi , Singh Anuradha , Yoo Ji Yeoun , Fields Madeline C.
Published: June 2020

Purpose:

Compare the detection rate of seizures on scalp EEG with simultaneous intracranial stereo EEG (SEEG) recordings.

Methods:

Twenty-seven drug-resistant epilepsy patients undergoing SEEG with simultaneous scalp EEG as part of their surgical work-up were included. A total of 172 seizures were captured.

Results:

Of the 172 seizures detected on SEEG, 100 demonstrated scalp ictal patterns. Focal aware and subclinical seizures were less likely to be seen on scalp, with 33% of each observed when compared with focal impaired aware (97%) and focal to bilateral tonic–clonic seizures (100%) (P< 0.001). Of the 72 seizures without ictal scalp correlate, 32 demonstrated an abnormality during the SEEG seizure that was identical to an interictal abnormality. Seizures from patients with MRI lesions were statistically less likely to be seen on scalp than seizures from nonlesional patients (P= 0.0162). Stereo EEG seizures not seen on scalp were shorter in duration (49 seconds) compared with SEEG seizures seen on scalp (108.6 seconds) (P< 0.001).

Conclusions:

Scalp EEG is not a sensitive tool for the detection of focal aware and subclinical seizures but is highly sensitive for the detection of focal impaired aware and focal to bilateral tonic–clonic seizures. Longer duration of seizure and seizures from patients without MRI lesions were more likely to be apparent on scalp. Abnormalities seen interictally may at times represent an underlying seizure. The cognitive, affective, and behavioral long-term effects of ongoing difficult-to-detect seizures are not known.
Calculation on surface energy and electronic properties of CoS
2
Authors: Zhu Yan-li , Wang Cong-Jie , Gao Fei , Xiao Zhi-xia , Zhao Peng-long , Wang Jian-yong
Published: June 2020

Density functional theory was employed to investigate the (111), (200), (210), (211) and (220) surfaces of CoS
2
. The surface energies were calculated with a sulfur environment using first-principle-based thermodynamics. It is founded that surfaces with metal atoms at their outermost layer have higher energy. The stoichiometric (220) surface terminated by two layer of sulfur atoms is most stable under the sulfur-rich condition, while the non-stoichiometric (211) surface terminated by a layer of Co atoms has the lower energy under the sulfur-poor environment. The electric structure results show that the front valence electrons of (200) surface are active, indicating that there may be some active sites on this face. There is an energy gap between the stoichiometric (220) and (211), which has low Fermi energy, indicating that their electronic structures are dynamically stable. Spin-polarized bands are calculated on the stoichiometric surfaces, and these two (200) and (210) surfaces are predicted to be noticeably spin-polarized. The Bravais–Friedel–Donnay–Harker (BFDH) method is adopted to predict crystal growth habit. The results show that the most important crystal planes for the CoS
2
crystal growth are (111) and (200) planes, and the macroscopic morphology of CoS
2
crystal may be spherical, cubic, octahedral, prismatic or plate-shaped, which have been verified by experiments.
Exploring the corrosion inhibition capability of FAP-based ionic liquids on stainless steel
Authors: Tiongson Julius Kim A. , Aganda Kim Christopher C. , Bruzon Dwight Angelo V. , Guevara Albert P. , Basilia Blessie A. , Tapang Giovanni A. , Martinez Imee Su
Published: June 2020

Corrosion is clearly one of the more common causes of materials failure in stainless steel. To manage corrosion, chemical inhibitors are often used for prevention and control. Ionic liquids due to their hydrophobic and corrosion-resistant property are being explored as alternative protective coatings and anti-corrosion materials. In this particular study, ionic liquids containing functionalized imidazolium cations and tris(pentafluoroethyl)trifluorophosphate (FAP) anions were investigated for their ability to inhibit corrosion on stainless steel surfaces in acidic environment. Using surface characterization techniques, specifically scanning electron microscopy and energy-dispersive X-ray (EDX), the morphology and the elemental composition of the steel surfaces before and after corrosion were determined. Contact angle measurements were also performed to determine how these ionic liquids were able to wet the stainless steel surface. In addition, potentiodynamic studies were carried out to ensure that corrosion inhibition has occurred. Results show that these ionic liquids were able to inhibit corrosion on the stainless steel surfaces. This indicates promise in the use of these FAP-based ionic liquids for corrosion management in stainless steel.
Variational analysis of landscape elevation and drainage networks
Authors: Hooshyar Milad , Anand Shashank , Porporato Amilcare
Published: June 2020

Landscapes evolve towards surfaces with complex networks of channels and ridges in response to climatic and tectonic forcing. Here, we analyse variational principles giving rise to minimalist models of landscape evolution as a system of partial differential equations that capture the essential dynamics of sediment and water balances. Our results show that in the absence of diffusive soil transport the steady-state surface extremizes the average domain elevation. Depending on the exponentmof the specific drainage area in the erosion term, the critical surfaces are either minima (0 < m < 1) or maxima (m > 1), withm = 1 corresponding to a saddle point. We establish a connection between landscape evolution models and optimal channel networks and elucidate the role of diffusion in the governing variational principles.
High precision numerical approach for Davey–Stewartson II type equations for Schwartz class initial data
Authors: Klein Christian , McLaughlin Ken , Stoilov Nikola
Published: June 2020

We present an efficient high-precision numerical approach for Davey–Stewartson (DS) II type equa- tions, treating initial data from the Schwartz class of smooth, rapidly decreasing functions. As with previous approaches, the presented code uses discrete Fourier transforms for the spatial dependence and Driscoll’s composite Runge–Kutta method for the time dependence. Since DS equations are non-local, nonlinear Schrödinger equations with a singular symbol for the non-locality, standard Fourier methods in practice only reach accuracy of the order of 10−6or less for typical examples. This was previously demonstrated for the defocusing integrable case by comparison with a numerical approach for DS II via inverse scattering. By applying a regularization to the singular symbol, originally developed for D-bar problems, the presented code is shown to reach machine precision. The code can treat integrable and non-integrable DS II equations. Moreover, it has the same numerical complexity as existing codes for DS II. Several examples for the integrable defocusing DS II equation are discussed as test cases. In an appendix by C. Kalla, a doubly periodic solution to the defocusing DS II equation is presented, providing a test for direct DS codes based on Fourier methods.
Pear-shaped atomic nuclei
Authors: Butler P. A.
Published: June 2020

This review presents the current status of experimental evidence for the occurrence of reflection-asymmetric or ‘pear’ shapes in atomic nuclei, which arises from the presence of strong octupole correlations in the nucleon–nucleon interactions. The behaviour of energy levels and electric octupole transition moments is reviewed, with particular emphasis on recent measurements. The relevance of nuclear pear shapes to measurements of fundamental interactions is also discussed.