bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous Intracranial Hypotension May Be an Under-recognized Cause of Endolymphatic Hydrops
Authors: Sakano Hitomi , Jafari Aria , Allehaiby Wisam , Harris Jeffrey P. 
Published: May 2020

Objective:
We describe three rare cases of spontaneous intracranial hypotension (SIH) presenting with symptoms of endolymphatic hydrops (EH) and perform a literature review to bring attention to a rare link between SIH and EH.

Patient:
A 59-year-old female presented with postural headache, aural fullness, vertigo, hearing loss, and abnormal electrocochleography after being diagnosed with SIH by magnetic resonance imaging. The site of cerebrospinal fluid leak was identified in this individual. Two additional patients with vertigo, hearing loss, and SIH were identified by retrospective chart review.

Intervention:
All patients underwent blood patches. One patient also had diuretic treatment while another had fibrin glue injection.

Main Outcome Measures:
The outcomes of interest were resolution of headache, vertigo, aural fullness, and hearing loss.

Results:
All patients eventually improved with time. Literature review suggests that overall outcome is excellent.

Conclusions:
SIH may be an under-recognized cause of EH. We support the theory that negative intracranial pressure transmitted through the cochlear aqueduct and perilymph leads to EH. Despite the variations in treatments, the overall prognosis is excellent.
Patients With Inflammatory Bowel Diseases Are at Higher Risk for Meningitis
Authors: Kochar Bharati , Jiang Yue , Long Millie D. 
Published: June 2020

Background:
The epidemiology of meningitis is unknown in inflammatory bowel disease (IBD) patients.

Goals:
We aimed to determine the incidence of and risk factors for meningitis in IBD patients.

Study:
We conducted a retrospective cohort and nested case-control study in the Quintiles IMS Legacy PharMetrics Adjudicated Claims Database from January 2001 to June 2016. We matched IBD patients to those without IBD on age, sex, enrollment, and region. Meningitis was defined as one code for meningitis associated with an emergency department visit or hospitalization. Meningitis risk was calculated with incidence rate ratios. In a nested case-control study of IBD patients, predictors for meningitis were determined with multivariable conditional logistic regression models.

Results:
We identified 50,029 patients with Crohn’s disease (CD) and 59,830 patients with ulcerative colitis (UC) matched to 296,801 non-IBD comparators. There were 85 CD patients, 77 UC patients, and 235 comparators with meningitis. CD patients had 2.17 times the rate of meningitis and UC patients had 1.63 times the rate of meningitis as non-IBD comparators. After adjusting for relevant covariates among those with IBD, treatment with mesalamine was associated with a significantly lower odds of a meningitis claim (odds ratio: 0.40, 95% confidence interval: 0.26-0.62). Having at least one comorbidity was associated with a significantly higher odds of a meningitis claim (odds ratio: 2.21, 95% confidence interval: 1.76-2.77).

Conclusions:
Although the overall rate of meningitis is low, IBD patients are at an increased risk compared with non-IBD comparators. Comorbidities are a risk factor for meningitis in IBD patients. Pneumococcal and meningococcal vaccinations should be discussed.
On-Campus Clinical
Authors: Mannino Jennifer Emilie , Lane Mary , Siegel Victoria , Osborne Jean Marie , O'Hara Susan 
Published: June 2020

Background
Ensuring students are both confident and competent for clinical practice will lead to improved patient outcomes. Early exposure to delivering safe and effective care using knowledge, skills, and abilities that are consonant with professional practice is essential.

Problem
Caring for an increasingly complex patient population is challenging. Entry-to-practice competencies must begin early in the student's education and be developed throughout.

Approach
This educational initiative outlines an innovative and a collaborative evidence-based learning experience that prepares prelicensure nursing students to deliver safe and effective patient-centered care during their first clinical practice. Lecture and laboratory topics, clinical skills stations, and simulation scenarios were developed to promote critical thinking and clinical judgment in a complex health care environment.

Outcomes
More than 2300 first-year clinical students, instructors, and staff participated in this rigorous course-wide experience.

Conclusion
This 1-day immersion cultivates safe practice and may be incorporated throughout the curriculum as students encounter increasingly challenging clinical practice experiences.
Noninvasive Approaches for Anxiety Reduction During Interventional Radiology Procedures
Authors: Makary Mina S. , da Silva Alexandre , Kingsbury James , Bozer Jordan , Dowell Joshua D. , Nguyen Xuan V. 
Published: May 2020

Abstract
Periprocedural anxiety is a major cause of morbidity, particularly for interventional radiology procedures that often depend on conscious sedation. Management of anxiety and pain during image-guided procedures has traditionally relied on pharmacologic agents such as benzodiazepines and opioids. Although generally safe, use of these medications risks adverse events, and newer noninvasive, nonpharmacologic techniques have evolved to address patient needs. In this review, we explore the roles of hypnosis, structured empathic attention, anodyne imagery, music, video glasses, and mobile applications in reducing procedural anxiety and pain with the goal of improving patient satisfaction, operational efficiency, and clinical outcomes.
The Influence of Obesity on Outcomes After Pediatric Reduction Mammaplasty
Authors: Fairchild Berry , Wei Shuyan , Bartz-Kurycki Marisa , Rose Jessica F. , Greives Matthew R. 
Published: May 2020

Background
Symptomatic macromastia causes negative physical and psychosocial effects, which support the need for early intervention, even in the adolescent population (Plast Reconstr Surg 2012;130:785–789). Reduction mammaplasty is a proven treatment that reliably addresses symptoms from macromastia. The National Surgical Quality Improvement Program–Pediatric is the leading nationally validated, risk-adjusted, outcomes-based program to measure and improve the quality of surgical care (Pediatrics 2012;130:e339–e346). In adults, obesity is associated with increased early postoperative complications after mammaplasty (Pediatrics 2017;140(5)). We hypothesized that obesity would increase the incidence of postoperative complications in pediatric patients undergoing reduction mammaplasty.

Methods
The National Surgical Quality Improvement Program–Pediatric database was queried for female patients 18 years or younger who underwent reduction mammaplasty from January 2012 to December 2017 using Current Procedural Terminology code 19318. Demographic, clinical, and outcomes data were abstracted from the database. A composite postoperative adverse events variable was created from a list of 21 individual adverse events. Patients were stratified by presence of obesity (body mass index ≥30 kg/m2) on univariate analyses. Multivariable logistic regression was used to determine factors associated with any postoperative adverse events.

Results
A total of 542 female patients underwent reduction mammaplasty, with 48% of the cohort being obese. Patients were similar in age (median, 17 years) and comorbidities between obese and nonobese groups. Obese patients were more likely to be African American, have higher American Society of Anesthesiologists class, and endure longer operations. Composite adverse event rates were significantly higher in the obese group (7% vs 2%, P = 0.013). Individual adverse events were similar between groups, with the exception of 30-day readmissions, which was higher in the obese group (3% vs 1%, P = 0.04). On multivariable logistic regression, obesity increased the odds of having a postoperative adverse event by 3-fold after adjusting for operative duration.

Conclusions
Obesity was significantly associated with greater postoperative adverse events in obese adolescent females after reduction mammaplasty compared with their nonobese counterparts. Although recorded rates of adverse events after reduction mammaplasty were low, preoperative weight loss programs may further improve outcomes for obese pediatric populations undergoing reduction mammaplasty.
Role, Management, and Outcome of Free Flap Reconstruction for Acute Full-Thickness Burns in Hands
Authors: Ziegler Benjamin , Hundeshagen Gabriel , Will Patrick A. , Bickert Berthold , Kneser Ulrich , Hirche Christoph 
Published: May 2020

Introduction
Severe thermal trauma to the hand can result in major impairment and reduced function due to defective healing or even extremity loss. Full-thickness injuries frequently incur exposure of tendons or bone and require an early and stable coverage with soft tissue transplants to allow for rapid induction of exercise and to preserve structures and hand function. Free tissue transfer to the hand after thermal trauma is a rare indication, and safety, management, and outcome of free flap surgery for severe acute burn injuries to the hand remains underreported.

Methods
Patients with primary reconstructions of full-thickness burn injuries to the hand undergoing microsurgical free tissue transfer surgery were retrospectively assessed in a period from 2013 to 2016. Salvage strategy of the extremity, postoperative complications, length of hospital stay, and primary reconstructive result were quantified and analyzed. Functional outcome measures (range of motion and grip strength) were assessed during clinical follow-up examinations.

Results
During the investigated period, 13 patients were identified undergoing reconstruction of 14 hands via free flap transplantation after severe burn injury in the acute phase. Nine anteriolateral thigh flaps (64%), 3 latissimus dorsi flaps (18%), 1 serratus anterior flap, and 1 tensor fasciae lata flap (7%) were performed. In all cases, salvage of the affected extremity was achieved, although 1 flap (7%) was lost during the early postoperative period requiring secondary reconstruction via pedicled groin flap. Further complications were venous thrombosis (n = 2; 14%) and hematoma (n = 2; 14%). Mean length of hospital stay was 51 days. Functional outcome during follow-up examination after an average of 9.3 months was inhomogeneous depending on the pattern of injury and ranged from complete recovery to nearly entire loss of hand function.

Conclusions
Free flap transfer can be a mandatory and valuable tool to cover full-thickness burn injuries of the hand early in the clinical course of thermal trauma and may provide extremity salvage by favorable means of reconstruction to achieve acceptable functional outcomes, in the most severe cases. Although microsurgical failure rates in burn patients are slightly higher than in free flap transfer to the upper extremity in general, it can be performed with reasonable risk-to-benefit ratio.
SECg Staging System: A New Approach to the Management of Arteriovenous Malformations of the Head and Neck
Authors: Colletti Giacomo , Biglioli Federico , Ierardi Anna Maria , Dessy Margherita , Tombris Stavros , Mattassi Raul , Stillo Francesco , Dionisio Ambra , Rozell-Shannon Linda , Carrafiello Gianpaolo , Waner Milton 
Published: May 2020

Objectives:
Arteriovenous malformations (AVM) are the most troublesome vascular malformations to deal with. They tend to behave like low-grade malignancies with infiltrative and disruptive growth. Crucially, the clinical course of an AVM that has been improperly managed is usually characterized by a recurrence that is much more aggressive than the original disease. As in oncology, a comprehensive staging system is highly desirable and is to date lacking in the literature. The authors present a new comprehensive staging system.

Methods:
A multicentric multidisciplinary team of experts in the field of vascular anomalies has created this new staging system. The SECg staging system defines the local extension of the disease (S1–S4), the vascular architecture of the malformation (E1, E2, E3), the severity of the symptoms (C0–C3) and the presence or absence of growth of the AVM (g+, g−).

Results:
This staging system allows to address all the aspects of AVMs and, more importantly, to help building an appropriate, individualized treatment plan for affected patients. After being staged an AVM can be defined as (a) healable, (b) healable with predicted sequelae, or (c) unhealable. Then, the SECg system allows to outline (a) absolute indications, (b) relative indications, and (c) no indications for treatment. The purpose of the treatment (radical, palliative) is furthermore taken into consideration.

Conclusions:
This multicentric, the SECg staging system that this multidisciplinary group of Authors has defined allows for a comprehensive staging of the disease which in turn has enabled to outline an algorithm to properly manage AVMs.
Modified Medial and Lateral Platysmaplasty
Authors: Choi Jeongho , Hwang Kun 
Published: May 2020

Abstract
In our previous anatomic study, the authors could pull the platysma effectively in the medial direction, lateral direction, or both the medial and lateral directions. In this paper, the authors analyzed the results of our series of modified medial and lateral platysmaplasties, in which the technique was based on Hamra's platysmaplasty, modified in light of Feldman's corset platysmaplasty and Mendelson's concepts.
In medial platysmaplasty, subcutaneous dissection was performed from the mandibular border to 2 or 3 finger breadths above the xiphoid process. Lateral platysmaplasty required only peri-lobular subcutaneous dissection for exposing and anchoring the lateral border of the platysma to the preauricular platysma auricular fascia (PAF). Lateral dissection does not go beyond the occipital hairline. During dissection, the zygomatic retaining ligaments were detached and repositioned and anchored to the lateral side of the PAF using 4–0 sutures. One hundred sixty-eight patients underwent platysmaplasty (87 medial platysmaplasty, 76 lateral platysmaplasty, 3 isolated neck lift).
The follow-up period ranged from 1 month to 156 months. In general, medial platysmaplasty was more efficacious than simple lateral pulling back for various conditions involving neck deformities, especially midline bands and severe submental fullness with skin laxity. The complications were 1 case of neuropraxia of the cervical branch (0.6%), 3 cases of hematoma (1.8%), 2 cases of seroma (1.2%), and 2 cases of submental depression (1.2%). All patients had temporary paresthesia around the periauricular area, but fully recovered by 6 months.
Using this modified medial and lateral platysmaplasty, we obtained satisfactory results with low complications.
Pediatric Otoplasty: Does Surgical Specialty Training Affect Safety and Rates of Adverse Perioperative Events?
Authors: Kalmar Christopher L. , Patel Vijay A. , Humphries Laura S. , Zimmerman Carrie E. , Vu Giap H. , Swanson Jordan W. , Taylor Jesse A. 
Published: May 2020

Background:
Otoplasty remains an overlapping clinical domain of plastic surgery and otolaryngology. The purpose of this study is to objectively analyze the safety of otoplasty and determine if there are any risk factors, such as surgical training, associated with increased patient morbidity.

Methods:
Retrospective cohort study was conducted of otoplasty procedures performed in North America by plastic surgeons and otolaryngologists between 2012 and 2017 using the American College of Surgeons National Surgical Quality Improvement Program Pediatric dataset. Statistical analysis was performed to analyze the relationships between comorbidities, congenital malformations, and postoperative complications.

Results:
There were 777 otoplasty procedures performed during the study period. Median age at time of surgery was 8.3 years (95% CI 7.9–8.7 years). Plastic surgeons performed 75.8% (n = 589) procedures and otolaryngologists performed 23.4% (n = 182). No significant (P = 0.952) difference in the occurrence of postoperative complications between surgical specialties was appreciated despite the fact that operative time was significantly longer in procedures performed by otolaryngologists (121 minutes versus 94 minutes, P < 0.001). Overall, 1.3% (n = 10 of 777) children experienced a complication, with the most common complication being superficial surgical site infection, occurring in 0.9% (n = 7 of 777) patients. There was no association of comorbidities (P all > 0.324) or congenital malformations (P all > 0.382) contributing to postoperative complications. Reoperation (0.8%, n = 6 of 777) and readmission (0.4%, n = 3 of 777) were uncommon; nevertheless, these adverse events were significantly associated with multiple inherent patient risk factors on multivariate regression.

Conclusions:
Otoplasty is a relatively safe surgical procedure with similarly low complication and readmission rates when performed by plastic surgeons and otolaryngologists. Surgical site infection remains the most prevalent complication after otoplasty. Readmission and reoperation after otoplasty were significantly correlated to prematurity, structural pulmonary abnormality, alimentary tract disease, and seizure disorder.
Metabolomic Profiling for Diagnosis and Prognostication in Surgery: A Scoping Review
Authors: Khan Tabassum A. , Loftus Tyler J. , Filiberto Amanda C. , Ozrazgat-Baslanti Tezcan , Ruppert Matthew M. , Bandyopadhyay Sabyasachi , Laiakis Evagelia C. , Arnaoutakis Dean J. , Bihorac Azra 
Published: June 2020

Objective:
This review assimilates and critically evaluates available literature regarding the use of metabolomic profiling in surgical decision-making.

Background:
Metabolomic profiling is performed by nuclear magnetic resonance spectroscopy or mass spectrometry of biofluids and tissues to quantify biomarkers (ie, sugars, amino acids, and lipids), producing diagnostic and prognostic information that has been applied among patients with cardiovascular disease, inflammatory bowel disease, cancer, and solid organ transplants.

Methods:
PubMed was searched from 1995 to 2019 to identify studies investigating metabolomic profiling of surgical patients. Articles were included and assimilated into relevant categories per PRISMA-ScR guidelines. Results were summarized with descriptive analytical methods.

Results:
Forty-seven studies were included, most of which were retrospective studies with small sample sizes using various combinations of analytic techniques and types of biofluids and tissues. Results suggest that metabolomic profiling has the potential to effectively screen for surgical diseases, suggest diagnoses, and predict outcomes such as postoperative complications and disease recurrence. Major barriers to clinical adoption include a lack of high-level evidence from prospective studies, heterogeneity in study design regarding tissue and biofluid procurement and analytical methods, and the absence of large, multicenter metabolome databases to facilitate systematic investigation of the efficacy, reproducibility, and generalizability of metabolomic profiling diagnoses and prognoses.

Conclusions:
Metabolomic profiling research would benefit from standardization of study design and analytic approaches. As technologies improve and knowledge garnered from research accumulates, metabolomic profiling has the potential to provide personalized diagnostic and prognostic information to support surgical decision-making from preoperative to postdischarge phases of care.
MegaLMM: Mega-scale linear mixed models for genomic predictions with thousands of traits
Authors: Runcie Daniel E , Qu Jiayi , Cheng Hao , Crawford Lorin 
Published: May 2020

ABSTRACTLarge-scale phenotype data can enhance the power of genomic prediction in plant and animal breeding, as well as human genetics. However, the statistical foundation of multi-trait genomic prediction is based on the multivariate linear mixed effect model, a tool notorious for its fragility when applied to more than a handful of traits. We presentMegaLMM, a statistical framework and associated software package for mixed model analyses of a virtually unlimited number of traits. Using three examples with real plant data, we show thatMegaLMMcan leverage thousands of traits at once to significantly improve genetic value prediction accuracy.
Sex hormones underlying 17a-Estradiol effects on neuroinflammation
Authors: Debarba Lucas K. , Jayarathne Hashan , Miller Richard A. , Garratt Michael , Sadagurski Marianna 
Published: May 2020

Abstract17-α-estradiol (17aE2) treatment extends lifespan in male mice and can reduce neuroinflammatory responses in the hypothalamus of 12-month-old males. Although 17aE2 improves longevity in males, female mice are unaffected, suggesting a sexually dimorphic pattern of lifespan regulation. We tested whether the sex-specific effects of 17aE2 on neuroinflammatory responses are mediated by sex hormones and whether hypothalamic changes extend to other brain regions in old age. Manipulating sex hormone levels through gonadectomy, we show that sex-specific effects of 17aE2 on age-associated gliosis are brain region-specific and are partially dependent on gonadal hormone production. 17aE2 treatment started at 4 months of age protected 25-month-old males from hypothalamic inflammation. Castration prior to 17aE2 exposure reduced the effect of 17aE2 on hypothalamic astrogliosis. By contrast, sex-specific changes in microgliosis with 17aE2 were not significantly affected by castration in males. While 17aE2 treatment had no effect of hypothalamic astrocytes or microglia in intact females, ovariectomy significantly increased the occurrence of hypothalamic gliosis evaluated in 25-month-old females, which was partially reduced by 17aE2. In the hippocampus, both male and female gonadally-derived hormones influenced the severity of gliosis and the responsiveness to 17aE2 in a regiondependent manner. The male-specific effects of 17aE2 correlate with changes in hypothalamic ERα expression, highlighting a receptor through which 17aE2 could act. The results of this study demonstrate that neuroinflammatory responses to 17aE2 are partially controlled by the presence of sex-specific gonads. Interactions between sex-steroids and neuroinflammation could, therefore, influence late-life health and disease onset, leading to sexual dimorphism in aging.
Understanding the genetics of important traits in quality protein maize (Zea maysL.) by Line × Tester analysis
Authors: Bharti Baudh , Dubey R.B. , Kumar Arun , Pal Lalit , Kaushik Prashant 
Published: May 2020

AbstractMaize (Zea maysL.) is among the top ten most valuable crops and livestock products. Maize demand and production are continuously rising. The nutritionally rich quality proteins maize (QPM) has almost two times as much lysine as well as tryptophan, amino acids which then the conventional maize varieties. In this study, genetics of important traits in quality protein maize were determined using a Line by Tester matting design. The 45 hybrids were obtained via Line by Tester crossing of 15 lines and 3 testers. The parents and their hybrids were evaluated under two environments. A significant amount of variation was recorded for most of the traits studied. Parental genotypes L2, L6, T2, L8, L7 and L14, exhibited negative and considerable general combining ability (GCA) effects for days to flowering and maturity. L7 × T2, L13 × T3, L10 × T1, L1 × T1, L9 × T2, L5 × T1, L12 × T2, L11 × T3, L10 × T3, L14 × T1 and L6 × T1 were identified with suitable yield and component traits. Crosses L5 × T1, L3 × T1, L12 × T2, L7 × T3, L1 × T2 and L13 × T1 were identified for quality traits. Heterosis over the mid parent crosses L13 × T1 showed highest negative and significant followed by L6 × T1, L12 × T2, L14 × T2 and L2 × T1 for days to 50 per cent tasselling. A significant correlation for the lysine content was determined between F1 mean and specific combining ability (SCA) effects. Overall, this work provides the useful insights into the genetics of important agronomical and biochemical traits of quality protein maize.