bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Surface and Intracranial Location of Asterion
Authors: Babacan Serdar , Yildiz-Yilmaz Meriç , Kafa Ilker Mustafa , Coşkun Ihsaniye 
Published: November 2019

Background:
Asterion is identified as the connection point of sutura parietomastoidea, sutura occipitomastoidea, and sutura lambdoidea. The location of asterion, which is primarily preferred as a landmark during posterolateral surgical approach for intracranial operations, shows many variables. The aim of this study was to identify the surface location of the asterion and determine the distances between intracranial anatomical structures and asterion.

Methods:
At this present study, 11 hemicraniums (22 asterion points), situated at the laboratory of Department of Anatomy, Faculty of Medicine, Bursa Uludag University, were used. The asterion points which the sesamoid bone located were classified as type I and the ones which sesamoid bone did not locate were classified as type II. According to the proximity of asterion with sinus transversus, 3 groups were classified. About 19 parameters were measured related to asterion. The obtained data were analyzed in SPSS 22.

Results:
As a result of findings, while sesamoid bone was seen at 7 asterion points (type I), at 15 points sesamoid bone was not detected (type II) (respectively, 31.81%, 68.19%). It was identified that 15 asterion points were at the surface, 5 ones were average 3.42 ± 2.52 mm over, 2 ones average 3.21 ± 2.26 mm below of the projection of sinus transversus. Statistically significance was not seen between the measurements taken from left and right sides.

Discussion and Conclusion:
Asterion is an important landmark for the retrosigmoid approaches. The surface and intracranial location of the asterion and proximity with dural sinuses are important for surgeons not to cause fatal subdural hematomas during the approaches using “Burr Hole” technic in neurochirurgie operations.
An Objective Assessment of Orthognathic Surgery Patients
Authors: Eslamian Ladan , Borzabadi-Farahani Ali , Badiee Mohammad Reza , Le Bach T. 
Published: November 2019

Objectives:To retrospectively assess malocclusions, skeletal relationships and the functional needs of orthognathic patients treated in a University teaching hospital.Subjects and methods:This study used clinical records of 100 consecutive patients [51 female, 49 males, mean (SD) age =21.5 (2.71) years] who had orthognathic surgery in a Shahid Beheshti University of Medical Sciences affiliated hospital (9/2014–7/2017). Malocclusion type (incisor classification), sagittal skeletal pattern (ANB angle), index of orthognathic functional treatment need (IOFTN) score, and osteotomy type were recorded.Results:Overall, 66%, 31%, and 3% had Class III, II, and Class I malocclusions, respectively. Similarly, 68% and 32% had Class III and II sagittal skeletal relationships, respectively. Overall, 95% of patients scored IOFTN 4 or 5. The most prevalent IOFTN score were 4.3 (37%), 5.3 (16%), 5.4 (16%), and 4.2 (10%). There were no gender differences (P >0.05) for the distribution of malocclusions, sagittal skeletal relationships, different IOFTN scores, or when IOFTN scores were re-grouped (5, 4, and ≤3). When IOFTN scores were re-grouped (5, 4, and ≤3), they were equally distributed among patients with Class II or III skeletal relationships (P >0.05), but when the authors looked at different malocclusions, there were significant differences in IOFTN score distribution (P= 0.006). The use of genioplasty (4%) or distraction osteogenesis (2%) was limited. Single jaw surgery of either maxilla or mandible was used in 15% and 22% of patients, respectively. About 63% had undergone double-jaw surgery.Conclusion:Retrospective assessment using IOFTN identified 95% of patients as having great and very great functional needs, but prospective studies using IOFTN is needed to assess the need for orthognathic surgery. Class III malocclusions and Class III sagittal skeletal relationships were more common in this sample.
Closure of Multiple Defects From Titanium Mesh After Cranioplasty With a Super-Long Diagonal Tubed Flap of the Neck
Authors: Wang Di , Chen Wen 
Published: November 2019

Objective:
Titanium mesh is one of the most widely used materials for cranioplasty, but risk of exposure is significant. Hence, removal of implants is a routine procedure. We used a diagonal tubed flap of the neck to repair 3 defects without removal of the titanium mesh.

Patient and Methods:
An outpatient, who suffered from three fistulas on the scalp after titanium cranioplasty received a super-long diagonal tubed flap of the neck surgery. The entire procedure was performed in the outpatient operating room.

Results:
All the 3 fistulas were completely covered by the tubed flap, and no complications were observed. In the 5-year follow-up, the color, thickness and texture were satisfactory, and the scars were inconspicuous.

Conclusion:
The surgery using a super-long diagonal tubed flap of the neck was innovative, flexible and economical, and is recommended as a suitable choice for reconstruction of local multiple defects, especially the rounded ones.
Oncologic Outcomes After Robotic Pancreatic Resections Are Not Inferior to Open Surgery
Authors: Girgis Mark D. , Zenati Mazen S. , King Jonathan C. , Hamad Ahmad , Zureikat Amer H. , Zeh Herbert J. , Hogg Melissa E. 
Published: November 2019

Objective:
Compare oncologic outcomes after open and robotic pancreatic resections for pancreatic adenocarcinoma (PDAC).

Summary of Background Data:
Receipt of adjuvant chemotherapy improves survival after resected PDAC. Complications after pancreatectomy have been shown to prohibit the administration of adjuvant chemotherapy and survival. We examined the effect of surgical approach on receipt of adjuvant chemotherapy, complications, and overall survival after pancreatectomy.

Methods:
A single-institution retrospective review of all patients with PDAC who underwent robotic or open pancreatectomy from 2011 to 2016 with 24-month follow-up.

Results:
Four hundred fifty-six patients underwent resection: 226 robotic and 230 open. No significant difference was identified in major complications or receipt of adjuvant chemotherapy between robotic and open pancreatectomy, nor was approach an independent predictor of these outcomes. Robotic pancreatectomy patients had a shorter length of stay than patients who underwent open pancreatectomy (7 days vs 9 days; P < 0.001). Additionally, wound infection rate (32.3% vs 12.4%, P < 0.0001) and transfusion (39.6% vs 12.4%, P < 0.0001) was improved in robotic pancreatectomy group with no differences in perioperative mortality. Improved median overall survival approached statistical significance for the robotic cohort (25.6 months vs 23.9 months; P = 0.055); however, on multivariable analysis the robotic approach predicted overall survival, (hazard ratio 0.77, P = 0.041). Robotic approach was an independent predictor of decreased blood loss and less transfusions than the open approach.

Conclusions:
Robotic pancreatectomy was not inferior compared to open pancreatectomy in a high-volume experienced center for oncologic outcomes and due to decreased blood loss and transfusion may have improved survival.
The 100 Most Cited Papers in the History of the American Surgical Association
Authors: Landreneau Joshua P. , Weaver Matthew , Delaney Conor P. , Aminian Ali , Dimick Justin B. , Lillemoe Keith D. , Schauer Philip R. 
Published: November 2019

Objective:
The aim of this study was to determine characteristics of the most cited publications in the history of the American Surgical Association (ASA).

Summary Background Data:
The Annals of Surgery has served as the journal of record for the ASA since 1928, with a special issue each year dedicated to papers presented before the ASA Annual Meeting.

Methods:
The top 100 most cited ASA publications in the Annals of Surgery were identified from the Scopus database and evaluated for key characteristics.

Results:
The 100 most cited papers from the ASA were published between 1955 and 2010 with an average of 609 citations (range: 333–2304) and are included among the 322 most cited papers in the Annals of Surgery. The most common subjects of study included clinical cancer (n = 43), gastrointestinal (n = 13), cardiothoracic/vascular (n = 9), and transplant (n = 9). Ninety-three institutions were included lead by Johns Hopkins University (n = 9), University of Pittsburgh (n = 8), Memorial Sloan-Kettering (n = 7), John Wayne Cancer Institute (n = 7), University of Texas (n = 7), and 5 each from Brigham and Women's Hospital, Mayo Clinic, and University of Chicago. The majority of manuscripts came from the United States (n = 85), followed by Canada (n = 7), Germany (n = 5), and Italy (n = 5). Study design included randomized controlled trials (n = 19), retrospective matched cohort studies (n = 11), retrospective nonmatched studies (n = 46), and other (n = 24).

Conclusions:
The top 100 most cited publications from the ASA are highly impactful, landmark studies representing a diverse array of subject matter, investigators, study design, institutions, and countries. These influential publications have immensely advanced surgical science over the decades and should serve as inspiration for all surgeons and surgical investigators.
Multicenter Study of the Treatment of Appendicitis in America
Authors: Yeh Daniel Dante , Eid Ahmed I. , Young Katelyn A. , Wild Jeffrey , Kaafarani Haytham M. A. , Ray-Zack Mohamed , Kana’an Tala , Lawless Ryan , Cralley Alexis L. , Crandall Marie 
Published: November 2019

Objective:
We sought to describe contemporary presentation, treatment, and outcomes of patients presenting with acute (A), perforated (P), and gangrenous (G) appendicitis in the United States.

Summary Background Data:
Recent European trials have reported that medical (antibiotics only) treatment of acute appendicitis is an acceptable alternative to surgical appendectomy. However, the type of operation (open appendectomy) and average duration of stay are not consistent with current American practice and therefore their conclusions do not apply to modern American surgeons.

Methods:
This multicenter prospective observational study enrolled adults with appendicitis from January 2017 to June 2018. Descriptive statistics were performed. P and G were combined into a “complicated” outcome variable and risk factors were assessed using multivariable logistic regression.

Results:
A total 3597 subjects were enrolled across 28 sites: median age was 37 (27–52) years, 1918 (53%) were male, 90% underwent computed tomography (CT) imaging, 91% were initially treated by appendectomy (98% laparoscopic), and median hospital stay was 1 (1–2) day. The 30-day rates of Emergency Department (ED) visit and readmission were 10% and 6%. Of 219 initially treated with antibiotics, 35 (16%) required appendectomy during index hospitalization and 12 (5%) underwent appendectomy within 30 days, for a cumulative failure rate of 21%. Overall, 2403 (77%) patients had A, whereas 487 (16%) and 218 (7%) patients had P and G, respectively. On regression analysis, age, symptoms >48 hours, temperature, WBC, Alvarado score, and appendicolith were predictive of “complicated” appendicitis, whereas co-morbidities, smoking, and ED triage to appendectomy >6 hours or >12 hours were not.

Conclusion:
In the United States, the majority of patients presenting with appendicitis receive CT imaging, undergo laparoscopic appendectomy, and stay in the hospital for 1 day. One in five patients selected for initial non-operative management required appendectomy within 30 days. In-hospital delay to appendectomy is not a risk factor for “complicated” appendicitis.
Prevalence of Nocturia in United States Women: Results From National Health and Nutrition Examination Survey
Authors: Daugherty Michael , Ginzburg Natasha , Byler Timothy 
Published: November 2019

Introduction
Nocturia can be one of the most bothersome lower urinary tract symptoms that can significantly affect quality of life. In both sexes, nocturia has been associated with decreased overall health. We aim to assess the prevalence of nocturia in US females and identify factors associated with significant nocturia.

Methods
A cross-sectional, US population-based database (National Health and Nutrition Examination Survey) was queried for females surveyed during the years 2009 to 2014. Nocturia information was obtained from the question, “how many times do you urinate at night?” Significant nocturia was defined as those women who urinated 2 or more times per night. Demographic characteristics, information on urinary incontinence, and gynecologic/obstetrical history were analyzed. Multivariable logistic regression was performed to identify factors associated with significant nocturia.

Results
A total of 7620 adult women were available for analysis. Of all women, 28.8% (95% confidence interval, 27.3–30.3) reported significant nocturia. Nocturia rates increased with increasing age (P < 0.0001). For those women who underwent childbirth, delivery type had no association with nocturia (P = 0.23). On multivariable analysis, only increasing age, black race, body mass index of 30 or greater, urge incontinence, and poor overall health were associated with increased rates of nocturia. Higher levels of education and increased household income were associated with lower rates of nocturia.

Conclusions
Nocturia is prevalent in the United States with almost 30% of all women reporting significant nocturia. Importantly, nocturia does not affect only older individuals, as 1 in 6 women under the age of 40 years report waking 2 or more times per night to urinate.
Use of ketamine for prehospital pain control on the battlefield: A systematic review
Authors: de Rocquigny Gaël , Dubecq Christophe , Martinez Thibault , Peffer John , Cauet Amandine , Travers Stéphane , Pasquier Pierre 
Published: November 2019

BACKGROUND
Intravenous ketamine is commonly used for pain management in the civilian prehospital setting. Several studies have evaluated its effectiveness in the military setting. To date, there has been no report reviewing the published data on the use of ketamine in this context. The objective of this systematic review was to analyze the content and quality of published data on the use of ketamine for prehospital pain management in military trauma.

METHODS
The MEDLINE database was searched for studies on ketamine use in combat prehospital settings, at point of injury or during evacuation, published between 2000 and 2019. The systematic review was conducted following PRISMA guidelines, and the protocol was registered on PROSPERO (CRD42019115728). Civilian reports and case series lacking systematic data collection were excluded.

RESULTS
Eight studies were included with 2029 casualties receiving ketamine. All but one were American reports from Afghanistan and Iraq conflicts. Studies implied retrospective cohorts or prospective observational analysis. Ketamine use rose from 3.9% during the period preceding its addition to the Tactical Combat Casualty Care guidelines in 2012 to 19.8% thereafter. It was the most common analgesic administered (up to 52% of casualties) in one of the studies. Ketamine was more likely given during tactical medical evacuation when no analgesic was provided at the point of injury. The median total intravenous dose was 50 mg. Pain intensity decreased from moderate or severe to mild or none, sometimes after only one dose. In one study, ketamine administration during tactical evacuation was associated with increased systolic blood pressure as opposed to morphine. Incoherent speech, extremity movements, and hallucinations were the main adverse events reported.

CONCLUSION
Published data on ketamine use in military trauma are rare and heterogeneous. Though, all studies tend to strengthen the belief in the efficacy and safety of ketamine when given at 50-mg to 100-mg intravenous for prehospital analgesia in combat casualties.

LEVEL OF EVIDENCE
Systematic Review, Level IV.
Prevalence and prognostic impact of inhalation injury among burn patients: A systematic review and meta-analysis
Authors: Galeiras Rita , Seoane-Quiroga Leticia , Pértega-Díaz Sonia 
Published: November 2019

BACKGROUND
The objective of our study was to perform a systematic review and meta-analysis aimed at assessing the prevalence of inhalation injury in burn patients and its prognostic value in relation to in-hospital mortality.

METHODS
We searched the PubMed and EMBASE databases for noninterventional studies published between 1990 and 2018 investigating in-hospital mortality predictors among burn patients.
The primary meta-analysis evaluated the association between inhalation injury and mortality. A secondary meta-analysis determined the global estimate of the prevalence of inhalation injury and the rate of mortality. Random effects models were used, and univariate meta-regressions were used to assess sources of heterogeneity. This study is registered in the PROSPERO database with code CRD42019127356.

FINDINGS
Fifty-four studies including a total of 408,157 patients were selected for the analysis. A pooled inhalation prevalence of 15.7% (95% confidence interval, 13.4%–18.3%) was calculated.
The summarized odds ratio of in-hospital mortality secondary to an inhalation injury was 3.2 (95% confidence interval, 2.5–4.3). A significantly higher odd of mortality was found among the studies that included all hospitalized burn patients, those that included a lower proportion of male patients, those with a lower mean total body surface area, and those with a lower prevalence of inhalation injury.

CONCLUSION
Despite our study's limitations due to the high risk of bias and the interstudy heterogeneity of some of our analyses, our results revealed a wide range of prevalence rates of inhalation injury and a significant association between this entity and in-hospital mortality in burn patients. However, this association is not significant if adjusted for disease severity.

LEVEL OF EVIDENCE
Systematic review/meta-analysis, level III.
Is all plasma created equal? A pilot study of the effect of interdonor variability
Authors: Chipman Amanda M. , Pati Shibani , Potter Daniel , Wu Feng , Lin Maximillian , Kozar Rosemary A. 
Published: November 2019

BACKGROUND
Clinical benefits of plasma as an adjunct for treatment of hemorrhagic shock (HS) have been well established. However, its use is not without risk. Little is understood regarding the clinical implications of plasma variability. We hypothesized there to be interdonor variability in plasma that would impact endothelial and organ function postinjury.

METHODS
Pulmonary endothelial cells (ECs) were incubated with plasma from 24 random donors, and transendothelial electrical resistance was measured. Plasma units with a more or less protective effect on reducing EC permeability were selected for testing in vivo. Syndecan-1 and cytokines were measured. Mice underwent laparotomy and then HS followed by resuscitation with the selected plasma units and were compared with mice receiving no resuscitation and shams. Lung tissue was sectioned and stained for myeloperoxidase and pulmonary syndecan-1 and scored for lung histopathologic injury.

RESULTS
Plasma from 24 donors revealed variability in the reversal of EC monolayer hyperpermeability; transendothelial electrical resistance for the more protective plasma was significantly higher than that for the less protective plasma (0.801 ± 0.022 vs. 0.744 ± 0.035; p = 0.002). Syndecan-1 was also markedly increased in the less protective compared with the more protective plasma (38427 ± 1257 vs. 231 ± 172 pg/mL, p < 0.001), while cytokines varied. In vivo, the more protective plasma mitigated lung histopathologic injury compared with the less protective plasma (1.56 ± 0.27 vs. 2.33 ± 0.47, respectively; p = 0.005). Similarly, myeloperoxidase was significantly reduced in the more protective compared with the less protective plasma group (2.590 ± 0.559 vs. 6.045 ± 1.885; p = 0.02). Lastly, pulmonary syndecan-1 immunostaining was significantly increased in the more protective compared with the less protective plasma group (20.909 ± 8.202 vs. 9.325 ± 3.412; p = 0.018).

CONCLUSION
These data demonstrate significant interdonor variability in plasma that can adversely influence the protective effects of plasma-based resuscitation on HS-induced lung injury. This may have important implications for patient safety and clinical outcomes.
Spontaneous, Voluntary, and Reflex Blinking in Clinical Practice
Authors: Valls-Sole Josep 
Published: November 2019

Summary:
Blinking is one of the motor acts performed more frequently by healthy human subjects. It involves the reciprocal action of at least two muscles: the orbicularis oculi shows a brief phasic activation while the levator palpebrae shows transient inhibition. In clinical practice, noninvasive recording of the orbicularis oculi activity is sufficient to obtain useful information for electrodiagnostic testing. Blinking can be spontaneous, voluntary, or reflex. Although the analysis of spontaneous blinks can already furnish interesting data, most studies are based on reflex blinking. This article is a review of some of the alterations that can be observed in blinking, focusing in four patterns of abnormality that can be distinguished in the blink reflex: (1) afferent versus efferent, which allows characterization of trigeminal or facial lesions; (2) peripheral versus central, which distinguishes alterations in nerve conduction from those involving synaptic delay; (3) upper versus lower brainstem lesions, which indicates the lesions involving specific circuits for trigeminal and somatosensory blink reflexes; and (4) asymmetric abnormal excitability pattern, which shows a unilateral alteration in the descending control of excitability in brainstem circuits. The blink reflex excitability recovery curve to paired stimuli may provide information about other modulatory inputs to trigemino-facial circuits, such as those proposed for the connection between basal ganglia and trigeminal neurons. Finally, prepulse inhibition of blink reflex reflects the motor surrogate of subcortical gating on sensory volleys, which is still another window by which electrodiagnosis can document motor control mechanisms and their abnormalities in neurologic diseases.