bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Race, Age, Gender, Income, and Level of Education on Motivations to Pursue Cosmetic Surgery and Surgeon Selection at an Academic Institution
Authors: Ligh Cassandra A. , Lett Elle , Broach Robyn B. , Enriquez Fabiola A. , Jordan Atasha , Percec Ivona , Serletti Joseph M. , Butler Paris D. 
Published: April 2020

Background:
Aesthetic surgery is a personal choice that appeals to a wide population of individuals. The authors investigated how race and ethnicity, age, gender, income, and education level affect patient motivation to pursue cosmetic surgery and selection of a plastic surgeon.

Methods:
One hundred seventy-two consecutive patients from two surgeons (an African American man and a Caucasian woman) completed surveys from 2016 to 2017 that assessed their decision to pursue cosmetic surgery. Univariable cumulative logit models with odds ratios and 95 percent confidence intervals were calculated with the survey data.

Results:
African American patients were more likely to be willing to travel greater than 100 miles for a surgeon who shared the same ethnicity or race, to consider international surgery, to report that social standards did not influence their decision for surgery, and to view the buttocks as the female feature that best defines attractiveness within their race or ethnicity. Patients with incomes over $125,000 and those over the age of 50 years were more likely to seek a surgeon of the same gender, think a same-gender surgeon could provide better results, be influenced by societal standards to pursue surgery, and view the face as the defining attractive female feature within their race or ethnicity. Patients with college or graduate degrees were more likely to believe a gender- and racially concordant surgeon would provide them with better a result and believed societal standards were unrealistic to obtain with diet and exercise.

Conclusions:
Plastic surgeons encounter patients of varying demographics, all of whom have differing perspectives about cosmetic surgery and motivations for its pursuit. Recognizing and defining these differences could enable surgeons to provide a more individualized cosmetic experience and inform future marketing strategies to attract a diverse patient population.
Supplementation with Extracellular Vesicles Derived from Adipose-Derived Stem Cells Increases Fat Graft Survival and Browning in Mice: A Cell-Free Approach to Construct Beige Fat from White Fat Grafting
Authors: Zhu Yuan-zheng , Zhang Jing , Hu Xuan , Wang Zhao-hui , Wu Shu , Yi Yang-yan 
Published: April 2020

Background:
Growing evidence has demonstrated that adipose-derived stem cell-derived extracellular vesicles enhance the survival of fat grafts and the browning of white adipose tissue. We evaluated whether supplementation with adipose-derived stem cell-derived extracellular vesicles promotes the survival and browning of fat grafts.

Methods:
Extracellular vesicles derived from adipose-derived stem cells were injected into fat grafts of C57BL/6 mice once per week until postgraft week 12. The grafts were collected and weighed after postgraft weeks 2, 4, and 12. The histological morphology, neovascularization, and the proportion of M2 macrophages of grafts were evaluated. The ability of extracellular vesicles to promote macrophage polarization and catecholamine secretion was detected. Whether the inducement of browning adipose differentiation is extracellular vesicles or the paracrine effect of M2 macrophages polarized by extracellular vesicles was also verified.

Results:
Grafts treated by extracellular vesicles derived from adipose-derived stem cells showed enhanced beige adipose regeneration with increased neovascularization, M2 macrophage proportion, and norepinephrine secretion at postgraft week 4. Increased retention and decreased fibrosis and necrosis were noted at postgraft week 12. The extracellular vesicles uptake by macrophages promoted M2 type polarization and catecholamine secretion while suppressing M1 type polarization. Of note, browning adipose differentiation with enhanced energy expenditure could be promoted only by the conditioned medium from extracellular vesicle–polarized M2 macrophages but not by extracellular vesicles themselves.

Conclusions:
Supplementation with extracellular vesicles derived from adipose-derived stem cells increases fat graft survival and browning by which extracellular vesicles–polarized M2 macrophages secrete catecholamines to promote beige adipose regeneration.
Revision Carpal Tunnel Release: Risk Factors and Rate of Secondary Surgery
Authors: Westenberg Ritsaart F. , Oflazoglu Kamilcan , de Planque Catherine A. , Jupiter Jesse B. , Eberlin Kyle R. , Chen Neal C. 
Published: April 2020

Background:
The first aim of this study was to determine the rate of revision carpal tunnel release in five urban hospitals over a period of 14 years. The secondary aim was to assess what demographic, condition-related, and treatment-related factors are associated with revision carpal tunnel release.

Methods:
Between 2002 and 2015, 7464 patients underwent carpal tunnel release. After manually reviewing the medical records, the authors identified 113 patients who underwent revision surgery. Multivariable logistic regression analysis was performed to study association with demographics (age, sex, and race), unilateral or bilateral treated wrist(s) (including carpal tunnel release performed simultaneously and separately), and type of surgery (open or endoscopic). To gain further insight into these factors, a matched case-control analysis in a 1:3 ratio was performed.

Results:
One hundred thirteen of 7464 patients (1.5 percent) underwent revision carpal tunnel surgery. The median (interquartile range) time to revision surgery was 1.23 years (0.47 to 3.89 years). In multivariable logistic regression analysis, older age, male sex, bilateral carpal tunnel release, and endoscopic carpal tunnel release were independently associated with higher odds for revision surgery. Multivariable conditional logistic regression of the matched case-control cohort showed that smoking and rheumatoid arthritis were independently associated with revision carpal tunnel release. Splint treatment before the initial surgery was independently associated with single carpal tunnel release.

Conclusion:
Endoscopic release, male sex, smoking, rheumatoid arthritis, and undergoing staged or simultaneous bilateral carpal tunnel release are risk factors for revision surgery.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
The Next Frontier of Outcomes Research: Collaborative Quality Initiatives
Authors: Billig Jessica I. , Kotsis Sandra V. , Chung Kevin C. ,   For the Michigan Collaborative Hand Initiative for Quality in Surgery
Published: April 2020

Summary:
Quality improvement efforts at the federal level have instituted both rewards and penalties as incentives to improve health care quality. However, neither of these methods has shown long-lasting improvements. Furthermore, many programs have focused on decreasing mortality or hospital readmissions, measurements that are not applicable to many surgical fields, including plastic surgery. One model that has been shown to be effective is a collaborative quality initiative that uses a pay-for-participation method whereby participants learn from one another and institute changes to improve patient care. Many of these changes are process measures that are easier to implement and quicker to show improvement than structural or outcome measures. Regional collaborative quality initiatives have been developed in other surgical specialties such as bariatric surgery and urology. Currently, the authors are establishing a new collaborative quality initiative for hand surgery: the Michigan Collaborative Hand Initiative for Quality in Surgery. It is a collaboration of nine sites with the goal of identifying areas that are in need of quality improvement in hand surgery and implementing measures to improve on them. The authors believe that collaborative quality initiatives will promote high-quality care and should be incorporated into the field of plastic surgery.
Unnecessary Interfacility Transfers for Craniomaxillofacial Trauma
Authors: Pontell Matthew E. , Colazo Juan M. , Drolet Brian C. 
Published: April 2020

Background:
Patients with craniomaxillofacial injuries are frequently transferred for specialist evaluation. Although transfer guidelines have improved outcomes for trauma care, no standards exist for craniomaxillofacial injuries. As a result, many patients are unnecessarily transferred emergently between facilities, resulting in high costs to patients and the health care system. This study assesses the regional frequency and necessity of transfers for isolated craniomaxillofacial injury.

Methods:
A retrospective review was conducted of all transfers with a diagnosis of “facial trauma” from 2013 to 2018. Using a previously validated framework, emergency interfacility transfers were deemed either necessary or unnecessary.

Results:
A total of 368 transfers were identified with isolated craniomaxillofacial injuries. Only 27 percent of transfers required admission. Half of transfers were unnecessary, none of which required intervention by the facial trauma service. Of 49.5 percent of necessary transfers, 38 percent required admission for surgery or management of symptoms related to facial injury, 62 percent were discharged from the emergency department, and three patients required emergency surgery.

Conclusions:
Isolated craniomaxillofacial trauma rarely requires emergency surgery; however, transferred patients occasionally require urgent and elective procedures. Unnecessary transfers result in substantial expense to the patient and the health care system, and patients ultimately experience a delay in definitive care. Unnecessary patient evaluation diverts emergency staff and resources, increasing wait times and morbidity for other patients. This study demonstrates an opportunity for transfer guidelines to improve interfacility triage of patients with facial injury.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Computer-Aided Design and Manufacturing Cutting and Drilling Guides with Prebent Titanium Plates Improve Surgical Accuracy of Skeletal Class III Malocclusion
Authors: Li Kehan , Li Jiayang , Du Wen , Xu Chunwei , Ye Bin , Luo En 
Published: April 2020

Background:
The aim of this study was to evaluate the effects of the use of computer-aided design and manufacturing cutting and drilling guides with prebent titanium plates for the correction of skeletal class III malocclusion.

Methods:
In this prospective, randomized, controlled clinical trial, 46 patients with skeletal class III malocclusion were randomly assigned into two groups. The patients underwent bimaxillary surgery with computer-aided design and manufacturing cutting and drilling guides with prebent titanium plates (experimental group) or computer-aided design and manufacturing splints (control group). Preoperative and postoperative imaging data were collected and then analyzed using Mimics Research 19.0, Geomagic Studio, and IBM SPSS Version 21.0.

Results:
Deformity evaluation and posttreatment assessment were performed for all patients. The experimental group had fewer postoperative complications. Comparison of the linear and angular differences to facial reference planes revealed more accurate repositioning of the mandible and condyles in the experimental group, although the position of several landmarks still requires small adjustments.

Conclusion:
Computer-aided design and manufacturing cutting and drilling guides with prebent titanium plates effectively corrected skeletal class III malocclusion, providing positional control of segments with reasonable surgical accuracy.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
Technical Refinements of Vulvar Reconstruction in Gender-Affirming Surgery
Authors: Dy Geolani W. , Kaoutzanis Christodoulos , Zhao Lee , Bluebond-Langner Rachel 
Published: April 2020

Summary:
Penile inversion vaginoplasty involves creation of vulva and a vaginal canal. Few studies describe techniques for creating aesthetic vulvar components, particularly the clitoral hood and labia minora. The authors present their approach to primary vulvoplasty, aiming to achieve the following: (1) labia minora that are well-defined and three-dimensional; (2) labia minora that frame the introitus; (3) sufficient clitoral hooding; (4) a patent introitus that appears closed at rest; and (5) prominent labia majora. In this technique, the labia majora are created by first pulling the superolateral scrotal skin inferiorly and medially toward the perineum. The labia majora incisions may be made laterally, medially, or both laterally and medially, dependent on the amount of penile and scrotal skin available. Initial approximating sutures are placed to anchor the labia inferiorly, and then excess skin is removed medially. The surgeon should avoid excess defatting of the labia majora, which are subject to initial edema and often atrophy with time. The preputial or distal penile shaft skin is used for the clitoral hood and medial aspect of the labia minora, with proximal penile shaft skin used for the lateral surface. The penile skin used for the lateral aspect of the labia minora must be pulled inferomedially toward the perineum, to create a narrow, tapered appearance and avoid effacement of the labia minora. Interrupted horizontal mattress quilting sutures are used to define the labia minora as distinct subunits. By considering homologous structures and anatomical subunits, we are able to create well-defined, aesthetic vulva in trans women and nonbinary individuals.
Constrictive (Obliterative) Bronchiolitis as Presenting Manifestation of Connective Tissue Diseases
Authors: Arcadu Antonella , Ryu Jay H. 
Published: April 2020

Background
Constrictive (obliterative) bronchiolitis (CB) is an uncommon form of obstructive lung disease that can occur in patients with identifiable causes including connective tissue diseases (CTDs) as a form of lung involvement. We explored whether CB can be the presenting manifestation of CTD.

Methods
We identified 44 patients with cryptogenic CB and examined the presenting clinical, laboratory, and radiologic features, as well as their clinical course.

Results
The mean age at presentation was 60.5 (SD, 13.8) years and included 38 women (86%); 32 (73%) were never smokers. All patients presented for evaluation of dyspnea, commonly associated with cough. An obstructive pattern on pulmonary function testing was demonstrated in 86% of patients. On chest high-resolution computed tomography, nearly all patients manifested a mosaic attenuation pattern with air trapping on expiratory views, characteristic of CB. Bronchoscopic lung biopsy (n = 10) was usually nondiagnostic (90%), whereas all 5 surgical lung biopsies yielded evidence of CB. Serologic testing for CTD was positive in 19 patients (43%) and most commonly included antinuclear antibody, rheumatoid factor, and anti–cyclic citrullinated antibodies. Seven of these patients with positive serologic results were eventually diagnosed to have CTD. Connective tissue diseases included rheumatoid arthritis in 4 patients, Sjögren syndrome in 2, and undifferentiated CTD in 1 patient.

Conclusions
Nearly one-half of patients with cryptogenic CB manifest positive CTD serology, and some of these patients have CTD not previously diagnosed. These results suggest that CB can be the presenting manifestation of a CTD.
Association of Dickkopf-1 Polymorphisms With Radiological Damage and Periodontal Disease in Patients With Early Rheumatoid Arthritis
Authors: Cardona-Rincón Alex Dario , Acevedo-Godoy Mónica Alexandra , Bello-Gualtero Juan Manuel , Valle-Oñate Rafael , Chalem-Choueka Philippe , Perdomo Sandra Janeth , Miyared Arias-Arias Angela , Chila-Moreno Lorena , Bautista-Molano Wilson , Romero-Sánchez Consuelo 
Published: April 2020

Background
Rheumatoid arthritis (RA) is a systemic autoimmune disease that increased bone resorption. Periodontal disease (PD) is an associated risk factor of RA. Studies suggest an association between bone markers such as the dickkopf-related protein 1 (DKK-1) and progression of radiological damage. We aimed to evaluate the marker DKK-1, its polymorphisms in patients with early rheumatoid arthritis (eRA), and its association with rheumatic, radiological, and periodontal variables.

Methods
This is a cross-sectional study. Samples were obtained from 63 patients with eRA. Radiographs of hands and feet were evaluated by Sharp–van der Heijde score (SHS) and Simple Erosion Narrowing Score (SENS). Serum DKK-1 levels and high-resolution fusion analysis was used for polymorphisms (rs1896368, rs1896367, rs1528873). Bivariate analyses were performed.

Results
Individuals heterozygous for rs1896367 had more frequent erosions (p = 0.026) and joint space narrowing (p = 0.005) in the feet, higher SHS (p = 0.016), and higher SENS (p ≤ 0.001). Patients homozygous for rs1896368 had less frequent joint space narrowing in hands and feet as assessed by SHS and less presence of erosions by SENS (odds ratio, 0.04; 95% confidence interval, 0.00–0.93; p < 0.05). The presence of PD was associated with the homozygous of rs1896367 (p = 0.009) and the heterozygous of rs1896368 (p = 0.033).

Conclusions
Polymorphism rs1896367 seems to be associated with greater radiological compromise; rs1896368 confers protection against bone damage in Colombian eRA patients.
The Influence of Hand Dominance on the Degree of Deformities in Patients With Systemic Lupus Erythematosus and Jaccoud Arthropathy
Authors: Loureiro Galvão Verena , Ferreira Vasconcelos dos Santos Daiane , Santiago Mittermayer B. 
Published: April 2020

Background/Objective
Joint deformities in Jaccoud arthropathy (JA), associated with systemic lupus erythematosus (SLE), can lead to a reduction in articular function and an impaired quality of life. There is controversy in the literature as to whether hand dominance contributes to deformities observed in rheumatoid arthritis and other forms of rheumatism. The purpose of this study was to assess whether hand dominance has any influence on the degree of deformity or joint range of motion in patients with JA associated with SLE.

Methods
This was a pilot cross-sectional study of 22 female patients (mean age, 46.18 ± 12.61 years) with both SLE and JA. Each patient's hand grip and hand and wrist joint range of motion were assessed by the same examiner. The Wilcoxon test was used to compare the median values of the angles and muscular strength found between the sides.

Results
All the study participants were right-side dominant. The median muscle strength of the right and left hands was 13.25 kilogram-force (KgF) (range, 7.00–18.00 KgF) and 10.50 KgF (range, 7.50–17.25 KgF), respectively. Both the fingers of the right and left hands had a median ulnar drift of 10.00°; however, their ranges differed (right, 4.50° to 20.00°; left: 0.00° to 15.50°). No statistically significant differences were found in the extension angulation of the proximal interphalangeal joints or the flexion of the distal interphalangeal joints of the second to fifth fingers, between the dominant and nondominant hands.

Conclusions
Hand dominance does not seem to influence the degree of JA deformities in patients with SLE.
18F-PSMA 1007 Uptake in a Man With Metastatic Breast Cancer
Authors: Marafi Fahad , Sasikumar Arun , Alfeeli Mahamoud , Thuruthel Sanjay 
Published: April 2020

Abstract
A 72-year-old man, who is known with a case of metastatic carcinoma of the breast, was referred for 18F-PMSA 1007 PET/CT with clinical suspicion of synchronous prostate cancer. 18F-PSMA 1007 PET/CT scan detected no abnormal tracer concentrating lesion in the prostate gland; however, abnormal tracer concentration was noted in soft tissue lesions in left breast, metastatic lymph nodes, and skeletal lesions. Compared with 18F-FDG PET/CT, more bone lesions were detected on 18F-PSMA 1007 imaging. The findings of our case open the possibility of imaging metastatic breast cancer with 18F-PSMA 1007 in men.
68Ga-FAPI PET/CT in Assessment of Liver Nodules in a Cirrhotic Patient
Authors: Zhao Liang , Gu Jianwei , Fu Kaili , Lin Qin , Chen Haojun 
Published: April 2020

Abstract

68Ga-FAPI PET/CT was performed in a 56-year-old cirrhotic patient with multiple liver nodules, which were suspected of hepatocellular carcinoma by contrast-enhanced magnetic resonance but were not visualized by 18F-FDG PET/CT. Increased 68Ga-FAPI liver uptake was observed in this cirrhotic patient. However, the nodules had no pathological 68Ga-FAPI uptake and were clearly visualized due to the low activity compared with surrounding liver parenchyma. The 68Ga-FAPI PET/CT features, suggestive of benign nodules, have been later confirmed by histopathological examination. This case suggested that 68Ga-FAPI PET/CT may be useful in the differentiation between benign nodules and hepatocellular carcinoma in the patient with liver cirrhosis.
Obscured Meckel’s Diverticulum by the Urinary Bladder
Authors: Pirayesh Elahe 
Published: April 2020

Abstract
We describe a case of a 5-year-old boy with a history of intermittent melena underwent 99mTcO4
− scintigraphy. On dynamic images, no abnormal activity was noted. After voiding and also in the lateral view, the focus of activity was noted in the superior and anterior aspect of the urinary bladder, compatible with a Meckel's diverticulum, which was confirmed pathologically as well.
Primary Central Nervous System Lymphoma With Diffuse Neurolymphomatosis Involving Multiple Cranial and Spinal Nerve Roots
Authors: Singh Shashank Shekhar , Mittal Bhagwant Rai , Kumar Rajender , Singh Harmandeep , Balaini Neeraj , Goyal Manoj 
Published: April 2020

Abstract
Primary central nervous system lymphoma is an extranodal lymphoma originating in the brain, spinal cord, and leptomeninges, which rarely spreads outside the nervous system. Neurolymphomatosis is the term used to describe lymphomatous involvement of the cranial nerves (except optic nerve) and peripheral nerve roots or plexus. We report a case of a 23-year-old man presented with progressive weakness of all 4 limbs. 18F-FDG PET/CT revealed FDG-avid thickening along the multiple cranial nerve roots, spinal nerve roots, and brain parenchymal lesion. Core biopsy from the peripheral nerve root demonstrated the lymphomatous involvement.
Intraosseous Medullary Fat Necrosis on 99mTc-MDP Bone Scan of Patient With Acute Pancreatitis
Authors: Tupalli Avinash , Angamuthu Meivel , Prashanth Arun , Singh Roma , Kumar Rakesh 
Published: April 2020

Abstract
Pancreatic disease can be associated with polyarthritis and panniculitis in a small number of patients, and this triad constitutes PPP syndrome. Early diagnosis is critical as it has high morbidity and mortality. Panniculitis can occur in fat present anywhere in the body. Involvement of fat in bone marrow is relatively uncommon, and radiologic imaging shows osteolytic lesions involving long bones. Here we present a case of acute pancreatitis, referred to our department for evaluation of severe joint pain and multiple bone pain. 99mTc-MDP scan with SPECT/CT has been done, which showed medullary expansion with heterogenous tracer uptake, that is, moth-eaten appearance.
Radiation Recall Myositis Detected With 18F-FDG PET/CT After a Treatment of Cervical Cancer
Authors: Lemay Joanie , Bouchard Myriam , Rousseau Étienne 
Published: April 2020

Abstract
A 34-year-old woman, after being treated for cervical cancer, presented with severe pain in the inguinal and the upper abdominal region with restriction in range of motion of the trunk 71 days after radiation therapy and 19 days after receiving adjuvant gemcitabine and cisplatin chemotherapy. The 18F-FDG PET/CT showed complete response to cancer treatment, but also revealed a localized inflammatory process that was delimited by radiation fields rather than anatomical structures, suggesting a radiation recall phenomenon.