bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Modified Design of the Pectoralis Major Myocutaneous Flap for Reconstruction of Head and Neck Defect
Authors: Lyu Xiaoming , Liu Shuming , Zheng Lei , Huang Mingwei , Zhang Jianguo , Zhang Jie 
Published: November 2020

Abstract
Even though the pectoralis major myocutaneous flap (PMMF) still has an important role in the free flaps ear, it is reported to have drawbacks such as the limited cephalad extension and high incidence of total or partial flap necrosis. Various modifications have been attempted to augment the limited cephalad extension and a stable blood supply.
The aim of this study is to describe a modified design of the skin paddle and preparation of the PMMF, to achieve stable blood circulation and sufficient pedicle length. The priority skin paddle is the medial part for its stable blood supply, and the lateral margin should be adjusted as needed. During the harvesting, the lateral thoracic artery (LTA) is preserved to protect the perforating branches, and the anterior sheath of the rectus abdominis muscle is used as a suture margin to prevent damage of the thin muscle of the PMMF. The skin paddles in this study are larger than those previously reported. All of the 21 patients in our study, the skin paddles show complete survival with no partial necrosis of skin paddle, fistula, or wound dehiscence.
It is worthwhile to consider and preserve the LTA as a major contributor to a lateral and distal PMMF. This study would be useful in future and preparation of the PMMF in head and neck reconstruction.
Chiasmatic Ridge: Incidence, Classification, and Clinical Implications
Authors: Beger Orhan , Bahşi Ilhan 
Published: November 2020

Objective:
The study aimed to identify the chiasmatic ridge (CR) morphology and to discuss its surgical significance.

Methods:
The suprasellar region of 90 adult dry skulls with unknown ages, sexes, or nationalities was examined to record the shape and incidence of the CR.

Results:
The CR was found in 14 (15.56%) of 90 dry skulls. The ridge was classified into 3 types, taking into account its shape, incidence (presence/absence), and the risk of residual tumor formation. The absence of the CR was named as Type 1 (76 cases, 84.44%). The bony extension without a hidden area was identified as Type 2 (8 cases, 8.89%), while the bony extension with a hidden area as Type 3 (6 cases, 6.67%).

Conclusion:
Type 3 CR (which has an evident hidden area beneath the ridge) should be taken into account by neurosurgeons to eliminate possible residual tumor risk during removal of tumors (eg, meningioma) with subfrontal or supraorbital approaches.
Epidemiological Research of Microtia Combined With Congenital Heart Disease
Authors: Cao Tongyu , Chen Qi , Wang Bingqing , Hu Jintian , Zou Mengxuan , Zhang Qingguo 
Published: November 2020

Summary:
Congenital heart disease (CHD) is one of the most common combined malformations of microtia. There is currently no specific study that investigates the relationship between microtia and CHD.

Methods:
This study collected microtia inpatients admitted from May 1, 2015 to July 31, 2016. The diagnosis of CHD was based on patient's symptoms, past history, and echocardiography. Pearson χ
2 test was used to analyze the correlation between CHD and microtia.

Results:
A total of 30 cases (3.35%) were documented with CHD, including atrial septal defect (12/40.00%), ventricular septal defect (7/23.30%), patent ductus arteriosus (2/6.70%), complex congenital heart disease (3/10.00%), combined CHD (2/6.70%) and other malformations (4/13.30%). Analysis showed no statistically significant relation between CHD and the side of affected ear or gender.

Conclusions:
The occurrence of CHD in microtia patients was higher than that in the general population. The relationship between them was explored mainly from the etiological perspective. Microtia and CHD were often combined in syndromes such as Goldenhar syndrome, 22q11 deletion syndrome, and CHARGE syndrome. Absence of genes or abnormal embryo development associated with these syndromes leads to the occurrence of both.
Surgical Management of Sinus Pericranii With Crouzon Syndrome
Authors: Han Tao , Ji Yi , Cui Jie , Shen Weimin 
Published: November 2020

Background:Sinus pericranii (SP) is a rare vascular malformation which connects the intracranial dural sinuses to the extracranial venous drainage system. Although the majority of SP cases are caused by trauma, some of them are congenital. Furthermore, a few SP cases have been reported in association with craniosynostosis. The authors’ objective is to discuss the surgical management of SP with Crouzon's syndrome in children.Methods:Three-Dimensional reconstruction with enhanced CT scan was used for evaluate the condition of SP with Crouzon's syndrome in all 4 cases. Two cases with small single-hole defect on skull were only treated by cranioplasty with distraction osteogenesis. In the management of the other 2 SP patients with large skull defect, titanium mesh was used for compression of dilated venous sinus to inhabit filling and promote shrinking.Result:Four cases of SP with Crouzon's syndrome were treated in the authors’ department. With cranioplasty with distraction osteogenesis only, 2 patients with single-hole skull defect experienced SP spontaneous involution at 4 to 6 months postoperatively. With titanium mesh compression, SP with large skull defect shrank significantly without clinical recurrence, but long-term follow-up was still in need.Conclusion:For small single-hole skull defect in SP patient with Crouzon's syndrome, the only application of cranioplasty for decreasing intracranial pressure can promote SP spontaneous involution. 3D printed titanium mesh compression renders a safe and efficient approach for SP with large skull defect. Long-time follow up and further accumulation of cases may establish the efficacy of the authors’ management.
Laparoscopic Versus Open Roux-en-Y Choledochojejunostomy: A Single-institute Experience With Literature Review
Authors: Li Tao , Tuerxun Kahaer , Keyoumu Yimingjiang , Apaer Shadike , Zeng Qi , Aierken Amina , Payiziwula Jiangduosi , Ainiwaerjiang Nuerzhati , Wu Jing , Tuxun Tuerhongjiang 
Published: November 2020

Objectives:
The current clinical study aims to compare the clinical efficacy of open choledochojejunostomy (OCJ) and laparoscopic choledochojejunostomy (LCJ) in patients with benign and malignant biliary tract disorders.

Patients and Methods:
The clinical data of 40 consecutive patients who underwent either OCJ or LCJ from January 2015 to February 2017 were retrospectively analyzed. The clinical parameters analyzed include baseline information, intraoperative characteristics, and postoperative clinical outcomes. The patients were divided into OCJ group and LCJ group based on the surgical approach performed.

Results:
Of 40 patients during the study period, 15 underwent LCJ and the remaining 25 patients underwent OCJ. The mean operative time was slightly longer in the LCJ group (323.53±150.30 min) than the OCJ group (295.38±130.34 min) (P=0.945); intraoperative blood loss in 2 groups were similar (179.17 vs. 164.67 mL, P=0.839). Although hospital stay was significantly shorter in the LCJ group (8.33±2.1 d) compared with the OCJ group (19.24±4.2 d) (P<0.001). Biliary leakage is the most common complication after OCJ; no complication was experienced in the LCJ group.

Conclusions:
LCJ is a feasible and safe option for patients undergoing choledochojejunostomy.
Pros and Cons of Transoral Endoscopic Thyroidectomy Via Vestibular Approach: A Comparative Study
Authors: Zhang Guoliang , Li Bing , Zhang Guolie , Lin Yuanmei , Chen Yijun , Gao Jian 
Published: November 2020

Objective:
The objective of this study was to explore the feasibility and safety of transoral endoscopic thyroidectomy via vestibular approach (TOETVA) compared with endoscopic thyroidectomy via bilateral areola approach (ETBAA) in the treatment of patients with benign thyroid nodules.

Materials and Methods:
From January 2017 to December 2018, 60 patients who received TOETVA were enrolled as the research group; 65 patients who underwent ETBAA were included as the control group. A retrospective study was performed using the clinical data for these cases. All patients were diagnosed with benign nodules by preoperative examinations. Parameters including surgical trauma, complications, cosmetic satisfaction, and postoperative discomfort were compared between the 2 groups.

Results:
All operations were completed without incident. There were significant differences in operation time (137.8±18.7 vs. 95.7±17.2 min), intraoperative blood loss (16.8±9.1 vs. 24.6±16.6 mL), drainage volume (123.1±20.9 vs. 153.6±40.2 mL), C-reactive protein level (7.2±5.2 vs. 9.0±4.7 mg/L), drainage time (3.2±0.6 vs. 3.9±1.3 d), postoperative hospital stay (3.3±0.8 vs. 4.1±1.5 d), and sense of skin tension on the neck (0% vs. 10.8%) between the TOETVA and ETBAA groups (P<0.05). There were no significant differences in pain score, incidence of recurrent laryngeal nerve injury, transient hypoparathyroidism, infection, inadvertent parathyroidectomy, or swallow discomfort between the 2 groups. The cosmetic satisfaction score in the TOETVA group was significantly higher than that in the ETBAA group at 1 month after surgery (9.8±0.5 vs. 9.4±0.9, P<0.05), but at 3 months after the operation, the difference was not statistically significant.

Conclusions:
TOETVA was accompanied by less surgical trauma and skin tension on the neck than ETBAA, and the cosmetic effect of this approach was better than that of ETBAA in the early postoperative period. TOETVA for benign thyroid nodules is safe and feasible. However, there are disadvantages with TOETVA, such as a long surgical period. More cases and further research are needed to delve further into this approach.
Retroperitoneoscopic Drainage of Psoas Abscess: A Systematic Review
Authors: Froiio Caterina , Bernardi Daniele , Lovece Andrea , Bonavina Giulia , Manzo Carlo Alberto , Asti Emanuele , Bonavina Luigi 
Published: November 2020

Background:
Psoas abscess is a relatively rare clinical condition that can occur worldwide, is difficult to diagnose, and has a severe clinical course. Conventional treatment ranges from antibiotic therapy alone to computed tomography (CT)-guided and/or open surgical drainage. Retroperitoneoscopic drainage represents a minimally invasive and potentially definitive therapeutic option.

Materials and Methods:
A systematic review of the literature on minimally invasive extraperitoneal access for drainage of psoas abscess was conducted through PUBMED, EMBASE, and COCHRANE databases, according to the PRISMA statement guidelines. We considered only studies in English and with a full text. The quality of all selected articles was assessed for the risk of methodological bias. Additional literature sources were used to put into context the indications and limits of retroperitoneoscopic drainage.

Results:
Seven papers published between 2004 and 2020, including a total of 56 patients, met the eligibility criteria and were included in the qualitative analysis. Causative agents of psoas abscess included Mycobacterium tuberculosis, Klebsiella pneumoniae, Enterobacter aerogenes, Staphylococcus aureus, and Streptococcus spp. Tuberculous abscess was more common than pyogenic abscess (92.8% vs. 7.2%). Main clinical findings were back pain (76.8%) and fever (53.6%). All patients were preoperatively evaluated by CT or magnetic resonance imaging. Only 4 patients (7.1%) had previously undergone CT-guided percutaneous drainage. Retroperitoneoscopic drainage was combined with antibiotic therapy in all cases. No Clavien-Dindo grade >3 complications occurred, and there was no 30-day postoperative mortality. The recurrence rate was 1.8% at a mean follow-up of 21 months.

Conclusion:
Retroperitoneoscopic surgical drainage is a safe and effective approach for the treatment of psoas abscess.
Covid-19 vaccination intentions among Canadian parents of 9-12 year old children: results from the All Our Families longitudinal cohort
Authors: Hetherington Erin , Edwards Sarah A , MacDonald Shannon E , Racine Nicole , Madigan Sheri , McDonald Sheila , Tough Suzanne 
Published: November 2020

AbstractBackgroundAcceptance of a COVID-19 vaccine is critical to achieving high levels of immunization. The objective of this study is to understand factors associated with COVID-19 vaccine intentions among parents and explore reasons underlying decision making.MethodsParticipants from a longitudinal cohort were invited to participate in a COVID-19 impact survey in May-June 2020 (n=1321). Parents were asked about the impact of the pandemic and their intention to vaccinate their child against COVID-19 should a vaccine be approved. Past infant vaccination status was validated against public health records. Multinomial regression models were run to estimate associations between demographic factors, past vaccination status, and vaccine intention. Qualitative responses regarding factors impacting decision making were analyzed thematically.ResultsSixty percent of parents (n=798) intended to vaccinate their children, but 9% (n=113) said they did not intend to vaccinate and 31% (n=410) were unsure. Lower education and income were inversely associated with intention to vaccinate. Incomplete vaccination history was associated with intention not to vaccinate but not uncertainty. Qualitative responses revealed concerns over vaccine safety and efficacy, long term effects and a rushed vaccination process.InterpretationAlmost a third of parents remain unsure about vaccinating their children against COVID-19, even within a group with historically high uptake of infant vaccines. Given the many uncertainties about future COVID-19 vaccines, clear communication regarding safety will be critical to ensuring vaccine uptake.
Maternal PrEP use in HIV-uninfected pregnant women in South Africa: Role of Stigma in PrEP initiation, retention and adherence
Authors: Moran Alexander , Mashele Nyiko , Mvududu Rufaro , Gorbach Pamina , Bekker Linda-Gail , Coates Thomas J. , Myer Landon , Davey Dvora Joseph 
Published: November 2020

AbstractPregnant women in sub-Saharan Africa are at high risk of HIV acquisition and require effective methods to prevent HIV. In a cohort of pregnant women offered pre-exposure prophylaxis (PrEP), we evaluate the relationship between internalized and anticipated stigma and PrEP initiation at first antenatal visit, 3-month continuation and adherence using multivariable logistic regression. High internalized and anticipated PrEP stigma are associated with lower PrEP initiation at first antenatal visit (aOR internalized stigma=0.06; 95%CI=0.03-0.12 & aOR anticipated stigma=0.53; 95%CI=0.29-0.97) compared to women with low reported stigma, after controlling for covariates. Women whose partners have not been tested for HIV or whose serostatus remains unknown have 1.6-times odds of PrEP retention at 3-months compared to women whose partners have been tested (aOR=1.60; 95%CI=1.02-2.52) after adjusting for covariates. PrEP counseling and maternal PrEP interventions must consider individual- and relational-level interventions to overcome anticipated PrEP stigma and other barriers to PrEP initiation and adherence.
Pediatric Multi-Organ Dysfunction Syndrome: Analysis by an Untargeted “Shotgun” Lipidomic Approach Reveals Low-abundance Plasma Phospholipids and Dynamic Recovery Over 8-Day Period, a Single-Center Observational Study
Authors: Leimanis Laurens Mara L. , Ferguson Karen , Wolfrum Emily , Boville Brian , Sanfilippo Dominic , Lydic Todd A. , Prokop Jeremy W. , Rajasekaran Surender 
Published: November 2020

AbstractLipids are stable molecules involved in metabolism and inflammation. We investigated the plasma lipidome for markers of severity and nutritional status in critically ill children. Children with multi-organ dysfunction syndrome (MODS) (n=24) were analyzed at three time points and cross referenced to sedation controls (n = 4) for a total of N=28. Eight of the patients with MODS, needed veno-arterial extracorporeal membrane oxygenation (VA ECMO) support to survive. Blood plasma lipid profiles were quantified by nano-electrospray (nESI), direct infusion high resolution/accurate mass spectrometry (MS), and tandem mass spectrometry (MS/MS) and compared to nutritional profiles and PEdiatric Logistic Organ Dysfunction (PELOD) scores. PELOD scores were not significantly different between MODS and ECMO cases across time-points (p = 0.66). Lipid profiling provided stratification between sedation controls and all MODS patients for lysophosphatidylserine (lysoPS) (p-value = 0.004), total phosphatidylserine (PS) (p-value = 0.015), and total ether-linked phosphatidylethanolamine (PE) (p-value = 0.03). Phospholipids in patients needing ECMO were observably closer to sedation controls than other MODS patients. Nutrition intake revealed changes in lipid profiles that corresponded to calorie and protein intake. Lipid measurement in the intensive care environment shows dynamic changes over an 8-day PICU course, suggesting novel indicators for defining critically ill children.
Practical considerations for Ultraviolet-C radiation mediated decontamination of N95 respirator against SARS-CoV-2 virus
Authors: Golovkine Guillaume R. , Roberts Allison W. , Cooper Chase , Riano Sebastian , DiCiccio Angela M. , Worthington Daniel L. , Clarkson Jeffrey P. , Krames Michael , Zhang Jianping , Gao Ying , Zhou Ling , Biering Scott B. , Stanley Sarah A. 
Published: November 2020

AbstractDecontaminating N95 respirators for reuse could mitigate shortages during the COVID-19 pandemic. We tested a portable UV-C light-emitting diode disinfection chamber and found that decontamination efficacy depends on mask model, material and location on the mask. This emphasizes the need for caution when interpreting efficacy data of UV-C decontamination methods.
Overlooked bias with thermometer evaluations using quickly retaken temperatures in EHR: applications to axillary, oral, temporal artery, and tympanic thermometry
Authors: Harding Charles , Pompei Marybeth , Burmistrov Dmitriy , Pompei Francesco 
Published: November 2020

AbstractStudies related to COVID-19 increasingly use electronic health records (EHR) to obtain large-scale evidence. However, EHR-based research must be performed with care because it can involve new study design problems that are unfamiliar to much of the medical community. Haimovich et al. (2020) sought to inform COVID-19 practice by evaluating temporal artery thermometers (TATs). They retrospectively searched EHR for temperatures measured twice within 15 minutes, including once with a TAT. The TAT often disagreed with reference measurements, so Haimovich et al. concluded TATs perform poorly. Here, we extended Haimovich et al.’s study design to all other major thermometer types using the eICU Collaborative Research Database. We retrospectively identified 80,065 pairs of quickly retaken temperatures from 24,765 adult U.S. critical care patients treated in 2014-2015. We found that oral, tympanic, and axillary thermometers disagreed with reference measurements as much as TATs did. Moreover, all thermometer types showed unprecedentedly worse agreement than observed in research using other study designs: every thermometer type broke ±0.9°F (±0.5°C) limits of clinically acceptable agreement by >2-fold and no type satisfied basic standards for repeatability. A natural explanation for these findings is that clinicians often retook temperatures within minutes because of user or patient errors during measurement, such as probe misplacement or patient movement. This means that quickly retaken EHR measurements do not reflect device accuracy or precision in correct use and, contrary to Haimovich et al.’s conclusions, should not be used to evaluate thermometer performance or revise COVID-19 fever thresholds. Our study provides an illustrative example of unexpected study design problems that can undermine EHR-based research.
Multiday cycles of heart rate are associated with seizure likelihood
Authors: Karoly Philippa J. , Stirling Rachel E. , Freestone Dean R. , Nurse Ewan S. , Maturana Matias , Halliday Amy , Neal Andrew , Gregg Nicholas M. , Brinkmann Benjamin , Richardson Mark P. , Dumanis Sonya B. , Gerche Andre La , Grayden David B. , D’Souza Wendyl , Cook Mark J. 
Published: November 2020

AbstractCircadian and multiday rhythms are found across many biological systems, including cardiology, endocrinology, neurology, and immunology. In people with epilepsy, epileptic brain activity and seizure occurrence have been found to follow circadian, weekly, and monthly rhythms. Understanding the relationship between these cycles of brain excitability and other physiological systems can provide new insight into the causes of multiday cycles. The brain-heart link is relevant for epilepsy, with implications for seizure forecasting, therapy, and mortality (i.e., sudden unexpected death in epilepsy).We report the results from a non-interventional, observational cohort study, Tracking Seizure Cycles. This study sought to examine multiday cycles of heart rate and seizures in adults with diagnosed uncontrolled epilepsy (N=31) and healthy adult controls (N=15) using wearable smartwatches and mobile seizure diaries over at least four months (M=12.0, SD=5.9; control M=10.6, SD=6.4). Cycles in heart rate were detected using a continuous wavelet transform. Relationships between heart rate cycles and seizure occurrence were measured from the distributions of seizure likelihood with respect to underlying cycle phase.Heart rate cycles were found in all 46 participants (people with epilepsy and healthy controls), with circadian (N=46), about-weekly (N=25) and about-monthly (N=13) rhythms being the most prevalent. Of the participants with epilepsy, 19 people had at least 20 reported seizures, and 10 of these had seizures significantly phase locked to their multiday heart rate cycles.Heart rate cycles showed similarities to multiday epileptic rhythms and may be comodulated with seizure likelihood. The relationship between heart rate and seizures is relevant for epilepsy therapy, including seizure forecasting, and may also have implications for cardiovascular disease. More broadly, understanding the link between multiday cycles in the heart and brain can shed new light on endogenous physiological rhythms in humans.
The economic value of quarantine is higher at lower case prevalence, with quarantine justified at lower risk of infection
Authors: Petrie James , Masel Joanna 
Published: November 2020

1.AbstractSome infectious diseases, such as COVID-19, are so harmful that they justify broad scale social distancing. Targeted quarantine can reduce the amount of indiscriminate social distancing needed to control transmission. Finding the optimal balance between targeted vs. broad scale policies can be operationalized by minimizing the total amount of social isolation needed to achieve a target reproductive number. Optimality is achieved by quarantining on the basis of a risk threshold that depends strongly on current disease prevalence, suggesting that very different disease control policies should be used at different times or places. Aggressive quarantine is warranted given low disease prevalence, while populations with a higher base rate of infection should rely more on social distancing by all. The total value of a quarantine policy rises as case counts fall, is relatively insensitive to vaccination unless the vaccinated are exempt from distancing policies, and is substantially increased by the availability of modestly more information about individual risk of infectiousness.