bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Patient Symptomatology before and after Labiaplasty
Authors: Sorice-Virk Sarah , Li Alexander Y. , Canales Francisco L. , Furnas Heather J. 
Published: August 2020

Background:
Labiaplasty has grown in popularity, but it remains controversial. Few studies have quantified the change in specific symptomatology from before to after labiaplasty to establish its effectiveness in improving quality of life.

Methods:
In a prospective study, 62 patients undergoing labiaplasty completed written surveys privately in an examination room preoperatively and postoperatively about the presence of 11 physical and appearance-related symptoms.

Results:
Mean patient age was 33.5 years (range, 17 to 61 years). Two patients were of minority age. All patients presented with at least one symptom, averaging 6.5 (range, one to 11). Most (82.2 percent) had a trim labiaplasty, and the rest (17.7 percent) had a wedge. After labiaplasty, 93.5 percent of patients were symptom-free, with the average dropping to 0.23 of 11 symptoms. Symptom-prevalence changes from preoperatively to postoperatively included self-consciousness, dropping from 93 percent to 6.5 percent; tugging (from 66.1 percent to 0 percent); feeling less attractive (from 66.1 percent to 0 percent); negative impact on self-esteem (from 64.5 percent to 1.6 percent); negative impact on intimacy (from 62.5 percent to 0 percent); twisting (from 58.1 percent to 3.2 percent); being uncomfortable (from 56.5 percent to 4.8 percent); clothing restriction (from 54.8 percent to 3.2 percent); visible outline (from 46.8 percent to 1.6 percent); pain (from 43.5 percent to 1.6 percent); and exposure in swimsuits (from 38.7 percent to 1.6 percent). No major complications occurred. Two patients felt their labia were still too long and revision was offered. Average follow-up was 13.3 months (range, 6 to 24 months).

Conclusions:
Patients with elongated labia have a high incidence of functional and appearance-related symptoms. Labiaplasty is a safe procedure that yields significant improvement in quality of life.

CLINICAL QUESTIONS/LEVEL OF EVIDENCE:
Therapeutic, IV.
Melting the Plastic Ceiling: Where We Currently Stand on Measures to Support Women in Academic Plastic Surgery
Authors: Robinson Isabel S. , Silva Amanda K. , Abdou Salma A. , Daar David A. , Hazen Alexes , Thanik Vishal 
Published: August 2020

Background:
Previous studies have provided recommendations for increasing female leadership in academic plastic surgery. This study quantifies the extent to which these recommendations have been met in plastic surgery residency programs and identifies remaining institutional barriers to the advancement of women in academic plastic surgery.

Methods:
An electronic survey was designed to quantify select recommendations for promoting female leadership in academic plastic surgery. The survey was distributed to either a female faculty member or a male program director at each academic plastic surgery program. An optional phone interview discussing current barriers to women’s advancement followed the survey.

Results:
Forty-nine of 92 survey recipients participated (52.7 percent response rate). Women constituted 25 percent of faculty, 22 percent of program directors, and 20 percent of program leaders of participating programs. Programs on average provided three of 11 resources. Programs with female leaders provided 6.20 resources versus 2.28 resources at departments with male chairs (p = 0.015). Programs with female program directors provided 5.50 resources versus 2.18 resources at programs with male program directors (p = 0.008). Of the 49 survey respondents, nine completed the interview (18.4 percent completion rate). The most frequently identified barriers to aspiring women leaders were opaque promotion criteria (cited by 77.8 percent of interviewees), motherhood bias (77.8 percent), and unequal recruitment practices (55.6 percent).

Conclusions:
The presence of a female chair or program director is associated with a greater quantity of resources for promoting female leaders. Remaining barriers to women seeking academic leadership positions include compensation and promotion disparities, motherhood bias, and unequal recruitment practices.
Interstitial Lung Fibrosis Imaging Reporting and Data System: What Radiologist Wants to Know?
Authors: Razek Ahmed Abdel Khalek Abdel , El Badrawy Mohamed Khairy , Alnaghy Eman 
Published: August 2020

Abstract
The aim of this work is to review interstitial lung fibrosis Imaging Reporting and Data System (ILF-RADS) that was designed for reporting of interstitial lung fibrosis (ILF). Findings include pulmonary and extrapulmonary findings and is subsequently designed into 4 categories. Pulmonary findings included lung volume, reticulations, traction bronchiectasis, honeycomb, nodules, cysts, ground glass, consolidation, mosaic attenuation and emphysema, and distribution of pulmonary lesions; axial (central, peripheral and diffuse), and zonal distribution (upper, middle, and lower zones). Complications in the form of acute infection, acute exacerbation, and malignancy were also assessed. Extrapulmonary findings included mediastinal, pleural, tracheal, and bone or soft tissue lesions. The lexicon of usual interstitial pneumonia (UIP) was classified into 4 categories designated as belonging in 1 of 4 categories. Lexicon of ILF-RADS-1 (typical UIP), ILF-RADS-2 (possible UIP), ILF-RADS-3 (indeterminate for UIP), and ILF-RADS-4 (inconsistent with UIP).
Conventional and Advanced Magnetic Resonance Imaging Features of Supratentorial Extraventricular Ependymomas
Authors: Jabeen Shumyla , Konar Subhas K. , Prasad Chandrajit , Mahadevan Anita , Beniwal Manish , Sadashiva Nishanth , Santosh Vani , Saini Jitender 
Published: August 2020

Objective
To describe the magnetic resonance imaging characteristics of supratentorial ependymomas.

Methods
The magnetic resonance imaging and computed tomography imaging characteristics of 49 cases of supratentorial ependymomas were analyzed retrospectively. The location, size, degree of perilesional edema, gross appearance, computed tomography attenuation characteristics, T1 and T2 signal intensity characteristics, degree of diffusion restriction, presence of calcification, and hemorrhage were documented for each lesion. The intratumoral susceptibility scores (ITSS), apparent diffusion coefficient (ADC) values, relative cerebral blood volume, and choline/N-acetyl aspartate ratios were documented where available.

Results
The frontal lobe was the most common location with a mean size of 6.37 × 4.8 cm. Severe perilesional edema was evident in 30%. Heterogenous, solid-cystic appearance was present in 96% lesions, with 95% of extraventricular lesions extending from pial surface to the ventricular margin. Calcification was seen in 55% of cases. The ITSS was 3 in 85.7% of lesions. The mean ADC value calculated was 600 × 10−6 mm2/s. The mean relative cerebral blood volume on dynamic susceptibility contrast perfusion was 4.83. The mean choline/N-acetyl aspartate ratio was 5.87. Leptomeningeal dissemination was demonstrable in 5 lesions. Four lesions were abutting the dura with frank dural invasion in one. One patient presented with disseminated disease without evidence of a primary lesion.

Conclusions
A large lesion with relatively well-defined margins, heterogeneous solid cystic appearance, extending from the pial surface to the ventricular margin, presence of calcification, and ADC values approaching those of white matter should raise a suspicion of supratentorial ependymoma. High ITSS, MR perfusion parameters, and magnetic resonance spectroscopy characteristics are similar to those of other high-grade gliomas.
Differentiation of Crystals Associated With Arthropathies by Spectral Photon-Counting Radiography
Authors: Huber Florian Alexander , Becce Fabio , Gkoumas Spyridon , Thüring Thomas , Steinmetz Sylvain , Letovanec Igor , Guggenberger Roman 
Published: August 2020

Objectives
The aims of this study were to test whether spectral photon-counting radiography (SPCR) is able to identify and distinguish different crystals associated with arthropathies in vitro and to validate findings in a gouty human third toe ex vivo.

Materials and Methods
Industry-standard calibration rods of calcium pyrophosphate, calcium hydroxyapatite (HA), and monosodium urate (MSU) were scanned with SPCR in an experimental setup. Each material was available at 3 different concentrations, and a dedicated photon-counting detector was used for SPCR, whereas validation scans were obtained on a clinical dual-energy computed tomography (DECT) scanner. Regions of interest were placed on SPCR images and consecutive DECT images to measure x-ray attenuation characteristics, including effective atomic numbers (Z
eff). Statistical tests were performed for differentiation of Z
eff between concentrations, materials, and imaging modalities. In addition, a third toe from a patient with chronic gouty arthritis was scanned with SPCR and DECT for differentiation of MSU from HA.

Results
In both SPCR and DECT, significant differences in attenuation and Z
eff values were found for different concentrations among (P < 0.001) and between different materials (P < 0.001). Overall, quantitative measurements of Z
eff did not differ significantly between SPCR- and DECT-derived measurements (P = 0.054–0.412). In the human cadaver toe, gouty bone erosions were visible on standard grayscale radiographic images; however, spectral image decomposition revealed the nature and extent of MSU deposits and was able to separate it from bone HA by Z
eff.

Conclusions
Identification and differentiation of different crystals related to arthropathies are possible with SPCR at comparable diagnostic accuracy to DECT. Further research is needed to assess diagnostic accuracy and clinical usability in vivo.
MRI-Guided Focused Ultrasound of Osseous Metastases
Authors: Bitton Rachel R. , Rosenberg Jarrett , LeBlang Suzanne , Napoli Alessandro , Meyer Joshua , Butts Pauly Kim , Hurwitz Mark , Ghanouni Pejman 
Published: August 2020

Background
A phase 3 multicenter trial demonstrated that magnetic resonance imaging (MRI)–guided focused ultrasound (US) is a safe, noninvasive treatment that alleviated pain from bone metastases. However, outcomes varied among institutions (from 0%–100% treatment success).

Purpose
The aim of this study was to identify patient selection, technical treatment, and imaging parameters that predict successful pain relief of osseous metastases after MRI-guided focused US.

Materials and Methods
This was a secondary analysis of a phase 3 clinical study that included participants who received MRI-guided focused US treatment for painful osseous metastases. Noncontrast CT was obtained before treatment. T2-weighted and T1-weighted postcontrast MRIs at 1.5 T or 3 T were obtained before, at the time of, and at 3 months after treatment. Numerical Rating Scale pain scores and morphine equivalent daily dose data were obtained over a 3-month follow-up period. At the 3-month endpoint, participants were categorized as pain relief responders or nonresponders based on Numerical Rating Scale and morphine equivalent daily dose data. Demographics, technical parameters, and imaging features associated with pain relief were determined using stepwise univariable and multivariable models. Responder rates between the subgroup of participants with all predictive parameters and that with none of the parameters were compared using Fisher exact test.

Results
The analysis included 99 participants (mean age, 59 ± 14 years; 56 women). The 3 variables that predicted successful pain relief were energy density on the bone surface (EDBS) (P = 0.001), the presence of postprocedural periosteal devascularization (black band, BB+) (P = 0.005), and female sex (P = 0.02). The subgroup of participants with BB+ and EDBS greater than 5 J/mm2 had a larger decrease in mean pain score (5.2; 95% confidence interval, 4.6–5.8) compared with those without (BB−, EDBS ≤ 5 J/mm2) (1.1; 95% confidence interval, 0.8–3.0; P < 0.001). Participants with all 3 predictive variables had a pain relief responder rate of 93% compared with 0% in participants having none of the predictive variables (P < 0.001).

Conclusions
High EDBS during treatment, postprocedural periosteal devascularization around the tumor site (BB+), and female sex increased the likelihood of pain relief after MRI-guided focused US of osseous metastasis.
Uncovering the Hidden Penis
Authors: Ngaage Ledibabari Mildred , Lopez Joseph , Wu Yinglun , Nam Arthur , Boyle Karen , Rasko Yvonne , Goldberg Nelson 
Published: August 2020

Introduction
A hidden penis can interfere with normal hygiene, prevent effective voiding, restrict sexual activity, and cause great embarrassment to the patient. The terms “hidden,” “buried,” and “trapped” penis are used interchangeably. To date, there is no classification system that adequately characterizes the spectrum of this condition. In this study, we propose a simplified nomenclature and classification system for adult-acquired hidden penis.

Methods
We performed a retrospective review of all adult patients treated surgically for hidden penis by the senior author from 2009 to 2019. Patients were classified into either “buried” or “trapped” categories. A “buried” penis was defined as a hidden penis concealed by suprapubic fat without fibrous tethering. These patients were managed with panniculectomy, monsplasty, or both. In contrast, those with a “trapped” penis presented with scarred or fibrous tissue, which required surgical lysis, phalloplasty, and penile skin resurfacing.

Results
Thirteen patients met the inclusion criteria. The cohort was aged 53 ± 15.7 years with a mean body mass index of 37.4 ± 4.3 kg/m2. Two patients required repeat operations, yielding a total of 15 operative encounters. Six were defined as buried, and 9 as trapped. Inability to achieve erection was the most common preoperative complaint in those with buried penis (67%), whereas difficulties in voiding were most common with trapped penis (78%). Patients with trapped penises had a significantly larger body habitus than those with a buried penis (39.8 vs 34.2 kg/m2, P = 0.0088). Operative duration and length of hospital stay were comparable between the trapped and buried penis groups (206 vs 161 minutes, P = 0.3664) (5 vs 1 day, P = 0.0836). One third experienced wound complications, but this was not significantly different between buried and trapped penises (17% vs 44%, P = 0.5804). Postoperatively, 5 patients experienced spontaneous erections, and 7 were able to void while standing.

Conclusions
Patients with a trapped penis present with a different preoperative symptom profile and body type than those with a buried penis. Our nomenclature and classification system offer a simple and clear algorithm for the management of hidden penis. Large cohort studies are warranted to assess differences in clinical outcomes between trapped and buried penises.
FEIBA® Reversal for Apixaban and Rivaroxaban in Patients with Intracranial and Non-intracranial Hemorrhages
Authors: Hunt Aleah R. , Coffeen Shawn N. , Shiltz Dane L. , Ice Calvin , Parker Jessica 
Published: August 2020

AbstractBackgroundSince FDA approvals, apixaban and rivaroxaban use has steadily increased. Currently, FEIBA® has been used off-label for factor Xa inhibitor reversal yet there are limited studies to support this practice. Therefore, additional safety and effectiveness data is needed for apixaban and rivaroxaban reversal in patients with an associated bleeding event.MethodsThe following retrospective study evaluated patients who received at least one dose of FIEBA® for the reversal of apixaban or rivaroxaban. One hundred forty-seven patients with an acute bleed were evaluated. The primary study outcome sought to determine the percentage of patients who achieved excellent or good hemostatic effectiveness within 12 hours of FEIBA® administration. The primary safety outcomes assessed the percent of patients who experienced an inpatient adverse event defined by thrombosis or mortality during hospital admission post-FEIBA® administration.ResultsAmong the 147 patients evaluated, 58 experienced an intracranial hemorrhage (ICH) and 89 experienced a non-ICH bleeding event. One hundred fifteen patients (78%) achieved excellent or good hemostasis. Three patients (2%) experienced a thrombotic complication while another 3 patients (2%) had a hemorrhagic complication. A total of 15 patients (10%) experienced in-hospital mortality following FEIBA® administration.ConclusionThis retrospective study supports the safety and effectiveness of FEIBA® for the management of acute bleeding events secondary to apixaban and rivaroxaban. FEIBA® achieved excellent or good (collectively defined as effective) hemostasis similarly for ICH and non-ICH bleeding events in patients receiving apixaban or rivaroxaban. Furthermore, the thromboembolism outcomes associated with FEIBA® were minimal. The effectiveness and safety outcomes support FEIBA® as a plausible apixaban and rivaroxaban reversal agent, notably among patients experiencing ICH.
IntracellularStaphylococcus aureusperturbs the host cell Ca2+-homeostasis to promote cell death
Authors: Stelzner Kathrin , Winkler Ann-Cathrin , Chunguang Liang , Ade Carsten P. , Dandekar Thomas , Fraunholz Martin J. , Rudel Thomas 
Published: August 2020

AbstractThe opportunistic human pathogenStaphylococcus aureuscauses serious infectious diseases ranging from superficial skin and soft tissue infections to necrotizing pneumonia and sepsis. While classically regarded as extracellular pathogen,S. aureusis able to invade and survive within human cells. Host cell exit is associated with cell death, tissue destruction and spread of infection. The exact molecular mechanism employed byS. aureusto escape the host cell is still unclear. In this study, we performed a genome-wide shRNA screen and identified the calcium signaling pathway to be involved in intracellular infection.S. aureusinduced a massive cytosolic Ca2+-increase in epithelial host cells after invasion and intracellular replication of the pathogen. This was paralleled by decrease in endoplasmic reticulum Ca2+-concentration. Additionally, calcium ions from the extracellular space contributed to the cytosolic Ca2+-increase. As a consequence, we observed that the cytoplasmic Ca2+-rise led to increase in mitochondrial Ca2+-concentration, the activation of calpains and caspases and eventually to cell lysis ofS. aureus-infected cells. Our study therefore suggests that intracellularS. aureusdisturbs the host cell Ca2+-homeostasis and induces cytoplasmic Ca2+-overload, which results in both apoptotic and necrotic cell death in parallel or succession.ImportanceDespite being regarded as an extracellular bacterium, the pathogenStaphylococcus aureuscan invade and survive within human cells. The intracellular niche is considered as hide-out from the host immune system and antibiotic treatment and allows bacterial proliferation. Subsequently, the intracellular bacterium induces host cell death, which may facilitate spread of infection and tissue destruction. So far, host cell factors exploited by intracellularS. aureusto promote cell death are only poorly characterized. We performed a genome-wide screen and found the calcium signaling pathway to play a role inS. aureusinvasion and cytotoxicity. The intracellular bacterium induces a cytoplasmic and mitochondrial Ca2+-overload, which results in host cell death. Thus, this study firstly showed how an intracellular bacterium perturbs the host cell Ca2+-homeostasis.
Biophysical characterization of the ETV6 PNT domain polymerization interfaces
Authors: Gerak Chloe A. N. , Cho Sophia Y. , Kolesnikov Maxim , Okon Mark , Murphy Michael E. P. , Sessions Richard B. , Roberge Michel , McIntosh Lawrence P. 
Published: August 2020

AbstractETV6 is an ETS family transcriptional repressor that self-associates by its PNT domain to facilitate cooperative DNA binding. Chromosomal translocations frequently generate constitutively active oncoproteins with the ETV6 PNT domain fused to the kinase domain of one of many protein tyrosine kinases. Although an attractive target for therapeutic intervention, the propensity of the ETV6 PNT domain to polymerize via the tight head-to-tail association of two relatively flat interfaces makes it challenging to identify suitable small molecule inhibitors of this protein-protein interaction. Herein we provide a comprehensive biophysical characterization of the ETV6 PNT domain interaction interfaces to aid future drug discovery efforts and help define the mechanisms by which its self-association mediates transcriptional repression. Using NMR spectroscopy, X-ray crystallography, and molecular dynamics simulations, we demonstrate that ETV6 PNT domain variants with monomerizing mutations adopt very stable helical bundle folds that do not change in conformation upon self-association. Amide hydrogen exchange and surface plasmon resonance-monitored alanine scanning mutagenesis studies identified hot spot regions within the self-association interfaces. These regions include both central hydrophobic residues and flanking salt-bridging residues. Collectively, these studies indicate that small molecules targeted to these hydrophobic or charged regions within the relatively rigid interfaces could potentially serve as orthosteric inhibitors of ETV6 PNT domain polymerization.
Dementia Risk and Dynamic Response to Exercise: Methodology for an Acute Exericise Clinical Trial
Authors: White Dreu , John Casey S , Kucera Ashley , Truver Bryce , Lepping Rebecca J , Lee Phil , Martin Laura , Billinger Sandra A , Burns Jeffrey M , Morris Jill K , Vidoni Eric D 
Published: August 2020

AbstractBackgroundExercise likely has numerous, meaningful benefits for brain and cognition. However, those benefits and their causes remain imprecisely defined, especially in the context of cognitive disorders associated with aging, such as Alzheimer’s disease (AD). If the brain does benefit from exercise it does so primarily through exposure to brief, “acute” exposures to exercise over a lifetime. Methods: The Dementia Risk and Dynamic Response to Exercise (DYNAMIC) clinical trial seeks to characterize the acute exercise response in cerebral perfusion, and circulating neurotrophic factors in older adults with and without the apolipoprotein e4 genotype (APOE4), the strongest genetic predictor or sporadic, late onset AD. DYNAMIC will enroll 60 older adults into a single moderate intensity bout of exercise intervention. We will measure pre- and post-exercise cerebral blood flow using arterial spin labeling, and neurotrophic factors. We expect that APOE4 carriers will have poor CBF regulation, i.e. slower return to baseline perfusion after exercise, and will demonstrate blunted neurotrophic response to exercise, with concentrations of neurotrophic factors positively correlating with CBF regulation. If exercise-induced changes in perfusion and circulating factors can be detected, DYNAMIC will contribute to our understanding of exercise-induced brain change and potential biomarker outcomes of exercise interventions. Results: Preliminary proof-of-concept findings on 7 older adults and 9 younger adults. We have found that this experimental method can capture CBF and neurotrophic response over a time course, and best practices following exercise. Conclusions: This methodology will provide important insight into acute exercise response and potential directions for clinical trial outcomes. ClinicalTrials.govNCT04009629