bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transverse Myelitis in Systemic Lupus Erythematosus
Authors: Chiganer Edson Hernán , Lessa Carmen Flora , Di Pace José Luis , Perassolo Mónica Beatriz , Carnero Contentti Edgar , Alessandro Lucas , Correale Jorge , Farfan María Fernanda , Galiana Graciana Lourdes , Sánchez Benavides Marvin , Pacello Franco , Stagno Mauro , Cardozo Analía , Nacimiento Cantero María Belén , Elizaur López Juan Gabriel , Delgadillo Pedro Daniel , Melgarejo Patricia , Acosta Colman Isabel , Vázquez Báez Marcos Aurelio , Correa Díaz Edgar Patricio , Jácome Sánchez Elisa Carolina , Alva Linares Magaly , Zamora Tehozol Erick Adrian , Fragoso-Loyo Hilda Esther , Quintanilla-González Lauro , Batún-Garrido José Antonio de Jesús , Sato Emilia Inoue , do Reis-Neto Edgard Torres , Carreño Nigro María Angela , Hryb Javier Pablo 
Published: February 2020

Background
Acute transverse myelitis (ATM) is an infrequent but severe complication of systemic lupus erythematosus (SLE). The purpose of study was to describe clinical features and prognostic factors of patients with SLE-related ATM.

Methods
In this medical records review study, data were collected from 60 patients from 16 centers seen between 1996 and 2017 who met diagnostic criteria for SLE and myelitis as defined by the American College of Rheumatology/Systemic International Collaborating Clinics and the Working Group of the Transverse Myelitis Consortium, respectively. Objective neurological impairment was measured with American Spinal Injury Association Impairment Scale (AIS) and European Database for Multiple Sclerosis Grade Scale (EGS).

Results
Among patients included, 95% (n = 57) were female, and the average age was 31.6 ± 9.6 years. Myelitis developed after diagnosis of SLE in 60% (n = 36). Symmetrical paraparesis with hypoesthesia, flaccidity, sphincter dysfunction, AIS = A/B, and EGS ≥ 8 was the most common presentation. Intravenous methylprednisolone was used in 95% (n = 57), and 78.3% (n = 47) received intravenous cyclophosphamide. Sensory/motor recovery at 6 months was observed in 75% (42 of 56), but only in 16.1% (9 of 56) was complete. Hypoglycorrhachia and EGS ≥ 7 in the nadir were associated with an unfavorable neurological outcome at 6 months (p < 0.05). A relapse rate during follow-up was observed in 30.4% (17 of 56). Hypoglycorrhachia and hypocomplementemia seem to be protective factors for relapse. Intravenous cyclophosphamide was associated with time delay to relapse.

Conclusions
Systemic lupus erythematosus–related ATM may occur at any time of SLE course, leading to significant disability despite treatment. Relapses are infrequent and intravenous cyclophosphamide seems to delay it. Hypoglycorrhachia, hypocomplementemia, and EGS at nadir are the most important prognostic factors.
Advanced Diffusion-Weighted Abdominal Imaging
Authors: Dreher Constantin , Kuder Tristan Anselm , König Franziska , Paech Daniel , Tavakoli Andrej , Laun Frederik Bernd , Flothow Florian , Gnirs Regula , Benkert Thomas , Strecker Ralph , Schlemmer Heinz-Peter , Bickelhaupt Sebastian 
Published: February 2020

Introduction
Magnetic resonance imaging (MRI) of the abdomen increasingly incorporates diffusion-weighted imaging (DWI) sequences. Whereas DWI can substantially aid in detecting and characterizing suspicious findings, it remains unclear to what extent the use of ultra-high b-value DWI might further be of aid for the radiologist especially when using DWI sequences with advanced processing. The target of this study was therefore to compare high and ultra-high b-value DWI in abdominal MRI examinations.

Methods
This institutional review board–approved, prospective study included abdominal MRI examinations of 70 oncologic patients (mean age, 58 years; range, 21-90 years) examined with a clinical 1.5 T MRI scanner (MAGNETOM Aera, Siemens Healthcare, Erlangen, Germany) with an advanced echo planar DWI sequence (b = 0, 50, 900, and 1500 s/mm2) after ex vivo phantom and in vivo volunteer investigations. High b900 and ultra-high b1500 DWIs were compared by a qualitative reading for image quality and lesion conspicuity using a 5-point Likert scale with 2 radiologists as readers. The ratios of apparent signal intensities of suspicious lesions/normal tissue of the same organ (LNTRs) were calculated. Appropriate methods were used for statistical analysis, including Wilcoxon signed-rank test and κ statistic for interreader agreement analysis (P < 0.05/0.0125/0.005 after Bonferroni correction).

Results
Image quality was significantly increased with b900 as compared with b1500 DWI (P < 0.001) despite using an advanced DWI sequence. A total of 153 suspicious lesions were analyzed. Overall reader confidence for characterization/detection of malignant lesions and, correspondingly, the LNTR (mean, 2.7 ± 1.8 vs 2.4 ± 1.6) were significantly higher with b900 than with b1500 DWI (P < 0.001 and P < 0.001). The increased confidence of lesion recognition and LNTR in the b900 DWI remained significant qualitatively in lymphatic and hepatic lesions and quantitatively in lymphatic, pulmonal, and osseous lesions.

Conclusions
Using high b-value DWI (900 s/mm2) provided an improved image quality and also lesion conspicuity as compared with ultra-high b-value DWI (1500 s/mm2) in oncologic abdominal examinations despite using advanced processing. Consequently, the value for additional ultra-high b-value DWI in oncologic examinations should be critically evaluated in future studies.
Assessment of Low-Grade Focal Cartilage Lesions in the Knee With Sodium MRI at 7 T
Authors: Zbýň Štefan , Schreiner Markus , Juras Vladimir , Mlynarik Vladimir , Szomolanyi Pavol , Laurent Didier , Scotti Celeste , Haber Harry , Deligianni Xeni , Bieri Oliver , Nieminen Miika T. , Trattnig Siegfried 
Published: February 2020

Objectives
Several articles have investigated potential of sodium (23Na) magnetic resonance imaging (MRI) for the in vivo evaluation of cartilage health, but so far no study tested its feasibility for the evaluation of focal cartilage lesions of grade 1 or 2 as defined by the International Cartilage Repair Society. The aims of this study were to evaluate the ability of 23Na-MRI to differentiate between early focal lesions and normal-appearing cartilage, to evaluate within-subject reproducibility of 23Na-MRI, and to monitor longitudinal changes in participants with low-grade, focal chondral lesions.

Materials and Methods
Thirteen participants (mean age, 50.1 ± 10.9 years; 7 women, 6 men) with low-grade, focal cartilage lesions in the weight-bearing region of femoral cartilage were included in this prospective cohort study. Participants were assessed at baseline, 1 week, 3 months, and 6 months using morphological MRI at 3 T and 7 T, compositional 23Na-MRI at 7 T, and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. 23Na signal intensities corrected for coil sensitivity and partial volume effect (23Na-cSI) were calculated in the lesion, and in weight-bearing and non–weight-bearing regions of healthy femoral cartilage. Coefficients of variation, repeated measures analysis of covariance models, and Pearson correlation coefficients were calculated to evaluate within-subject reproducibility as well as cross-sectional and longitudinal changes in 23Na-cSI values.

Results
The mean coefficients of variation of 23Na-cSI values between the baseline and 1-week follow-up were 5.1% or less in all cartilage regions. Significantly lower 23Na-cSI values were observed in lesion than in weight-bearing and non–weight-bearing regions at all time points (all P values ≤ 0.002). Although a significant decrease from baseline 23Na-cSI values in lesion was found at 3-month visit (P = 0.015), no substantial change was observed at 6 months. KOOS scores have improved in all subscales at 3 months and 6 months visit, with a significant increase observed only in the quality of life subscale (P = 0.004).

Conclusions
In vivo 23Na-MRI is a robust and reproducible method that allows to differentiate between low-grade, focal cartilage lesions and normal-appearing articular cartilage, which supports the concept that compositional cartilage changes can be found early, before the development of advanced morphological changes visible at clinical 3-T MRI.
Burn Survivor Artist Changes Artistic Approach by Sharing How Other Survivors of Traumatic Events Can Use Art to Heal Themselves by Helping Others Heal
Authors: Hall Joel Thomas 
Published: February 2020

Abstract
When creating art, the mind becomes free of physical barriers, no longer feeling broken or different. These same results can be sustained long term over large populations of survivors of traumatic events by grouping individuals into teams to create art of all types with the focus being on helping others. Long-term sustainability can occur with the concept of dedicated centers such as art studios and performing art centers with others that believe in art's healing potential. The simple activity of healing yourself while helping others heal, in whatever large or small way, can help us thrive beyond just surviving. No matter how long ago a traumatic event occurred in someone's life, those lessons learned should be shared with new burn survivors as they go through the long and difficult healing process by having a place that they can go and be with others who have been through the same process.
Lipofilled Mini Dorsi Flap
Authors: Piat Jean-Marc , Tomazzoni Gabriela , Giovinazzo Vincenzo , Dubost Valentine , Maiato Anna Paula , Ho Quoc Christophe 
Published: February 2020

Introduction
The traditional extended latissimus dorsi flap technique, in addition to lipofilling, has been one of the main procedures used for breast reconstruction after mastectomy. However, to obtain excellent results, this technique requires a large muscle harvest and further lipofilling sessions. The lipofilled mini dorsi flap technique, performed in a single operation, appealed to us as a way to improve the traditional technique.
We present our experience with the lipofilled mini dorsi flap technique in a new scenario.

Materials and Methods
We performed breast reconstruction with a lipofilled mini dorsi flap in female patients with breast cancer who underwent mastectomy and immediate breast reconstruction with a lipofilled mini dorsi flap. The operative technique is detailed in this article. The results were evaluated by the patients and the surgical team.

Results
We performed 72 lipofilled mini dorsi flap procedures during breast reconstruction surgery from May 2017 to January 2019. Fifty-nine (81.9%) cases were immediate reconstructions. Complications, such as infection or necrosis of the flap, were not observed in this study. We noticed seroma and 1 case of infected lymphocele, which was drained.
Body mass index (BMI) was directly related to postoperative dorsal seroma. The authors reported that greater BMI was associated with a higher seroma volume.
Most patients evaluated their reconstruction as satisfactory. The surgical team evaluated most of the results as very satisfactory or satisfactory. There were no cases of unsatisfactory results reported either by the patients or the surgical team.

Conclusions
The lipofilled mini dorsi flap technique is an efficient, elegant, and less invasive solution that is more easily and quickly performed and achieves excellent long-term results in the immediate breast reconstruction scenario. For the first time to our knowledge, lipofilling was used to reduce the extent of latissimus dorsi dissection. The postoperative follow-up was better tolerated by patients. This technique may be offered to patients regardless of oncological treatment. In our experience, the lipofilled mini dorsi flap method has become the primary technique for immediate breast reconstruction.
A Comparative Analysis of Outcomes After Reduction of Zygomatic Fractures Using the Carroll-Girard T-bar Screw
Authors: Choi Bong Gyu , Kang Chan-Su , Kim Yong-Ha , Chung Kyu-Jin 
Published: February 2020

Purpose
Several approaches are available for managing zygomatic fractures; however, each approach has its complications. Use of the Carroll-Girard T-bar screw (CGTS) can reduce complications because it reduces the number of approaches needed for reduction. This study aimed to analyze the efficiency of the CGTS compared with the 3-point approach.

Methods
A retrospective study was conducted by reviewing the computed tomography scans of 204 patients who underwent reduction surgery of Knight and North type 3, 4, or 5 zygomatic fractures from March 2009 to August 2017. Facial asymmetry, operative time, and complications were evaluated to compare 2 groups of patients: those who underwent CGTS and those who did not. Bilateral differences in the distance from the reference plane to the malar eminence in 3 dimensions based on computed tomography scans were used to calculate facial asymmetry.

Results
Among 204 patients, 91 were treated with CGTS whereas 113 patients underwent a 3-point approach. Bilateral differences in the position of the malar eminence and facial asymmetry were not statistically different in both groups. Operative time was not different in both groups. However, when patients with type 4 fracture were independently compared, the mean operative time was significantly shorter for the CGTS group. Wound dehiscence occurred in 11 patients (9.7%) in the 3-point approach group, compared with none in the CGTS group. None of the patients in the CGTS group complained of postoperative cheek scars over their incision sites.

Conclusions
This study revealed that CGTS is a useful and feasible instrument that can reduce the number of approaches for zygomatic bone reduction and help clinicians achieve satisfactory outcomes.
Reconstruction of Traumatic Defects of the Tibia With Free Fibula Flap and External Fixation
Authors: Bibbo Christopher , Bauder Andrew R. , Nelson Jonas , Ahn Jaimo , Levin L. Scott , Mehra Samir , Kovach Stephen J. 
Published: February 2020

Introduction
Traumatic intercalary defects of the tibia may be effectively managed with the free fibula flap. However, any alteration of limb alignment with residual bony angular deformity of the tibia must be also addressed. We describe the use of the free fibula flap in conjunction with external fixation to allow residual deformity correction and patient mobilization ambulation during healing of the free flap.

Methods
Retrospective medical record review was conducted of patients with segmental tibial defects greater than 7 cm who underwent reconstruction with fibula free flap and simple pin-bar external fixation, followed by conversion to 6-axis computer-assisted multiplanar circular ring external fixation to correct residual bony deformity. Outcomes analyses included free flap complications, return to the operating room, complications associated with the external fixation, bony union, correction of residual deformity, amputation rate, visual analog pain scales, and patient satisfaction.

Results
Eight patients (8 tibiae) underwent reconstruction. Mean tibial bone defect was 10.2 cm; all limbs had soft-tissue defects (mean size, 138 cm2). Free fibula grafts were harvested as osteocutaneous or osteomyocutaneous flaps (average length, 12 cm). Complications included 1 delayed union and 3 (37.5%) patients readmitted for graft fracture. Ultimately, 100% of patients achieved graft union with satisfactory correction of residual limb deformity. Limb salvage rate was 100%.

Discussion
Management of segmental tibial bone loss utilizing initial simple external fixation and microsurgical reconstruction followed by application of computer-assisted circular external fixator may provide a reliable reconstructive protocol for posttraumatic tibial defects with residual bone malalignment.
Geriatric Patients Carry Increased Risk for Deep Venous Thrombosis and Pulmonary Embolism in Reduction Mammaplasty
Authors: Davé Dattesh R. , Arora Aman , Zeiderman Matthew R. , Wong Michael S. 
Published: February 2020

Introduction
Reduction mammaplasty is one of the most common plastic surgery procedures performed. No study has evaluated whether geriatric patients are at greater risk for developing postoperative complications relative to nongeriatric patients.

Methods
The American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database was reviewed for reduction mammaplasty procedures from 2005 to 2017. Hypothesis testing for demographics, comorbidities, and postoperative complications between geriatric and nongeriatric patients was performed. Statistically significant differences were then evaluated with multivariate logistic regression analysis.

Results
A total of 25,909 reduction mammaplasties were collected by NSQIP from 2005 to 2017, with 1897 patients older than 64 years (8% of all cases). The average age for geriatric breast reduction patients was 69 years versus 41.5 years for nongeriatric patients. Rates of comorbidities including diabetes, smoking status, dyspnea status, and hypertension medication were statistically different between the groups. Rates of deep venous thrombosis (DVT) and pulmonary embolism (PE) were significantly higher in geriatric versus nongeriatric patients, respectively (0.32 vs 0.06, P < 0.001 and 0.37 vs 0.09, P < 0.001). Multivariate analysis demonstrated geriatric patients had a 4.2 and 3.9 times higher risk of developing a DVT and PE than nongeriatric patients (C.I. 1.5–11.6, P = 0.006 and C.I. 1.6–9.8, P = 0.004).

Discussion
This study represents the largest evaluation of geriatric reduction mammaplasties in the United States. Although rare, geriatric age confers a 4 times increased risk for developing DVT and PE relative to nongeriatric patients all while adjusting for preoperative risk factors in reduction mammaplasty. Plastic surgeons should consider counseling their geriatric patients regarding these increased risks.
Artificial Intelligent Virtual Assistant for Plastic Surgery Patient's Frequently Asked Questions
Authors: Boczar Daniel , Sisti Andrea , Oliver Jeremie D. , Helmi Haytham , Restrepo David J. , Huayllani Maria T. , Spaulding Aaron C. , Carter Rickey , Rinker Brian D. , Forte Antonio Jorge 
Published: February 2020

Background
Artificial Intelligent Virtual Assistants (AIVA) is a segment of artificial intelligence that is rapidly developing. However, its utilization to address patients' frequently asked questions remains unexplored.

Methods
We developed an AIVA to answer questions related to 10 frequent topics asked by plastic surgery patients in our institution. Between July 27, 2018, and August 10 of 2018, we recruited subjects with administrative positions at our health care institution to chat with the virtual assistant. They asked, with their own words, 1 question for each topic and filled out a satisfaction questionnaire. Postsurvey analysis of questions and answers allowed assessment of the virtual assistant's accuracy.

Results
Thirty participants completed the survey. The majority was female (70%), and the mean age was 27.76 years (SD, 8.68 [19–51] years). The overall accuracy of the plastic surgery AIVA was 92.3% (277/294 questions), and participants considered the answer correct in 83.3% of the time (250/294 answers). Most of the participants considered the AIVA easy to use, answered adequately, and could be helpful for patients. However, when asked if this technology could replace a human assistant, they stayed neutral.
Platelet-Rich Plasma for Skin Graft Storage
Authors: Gökkaya Ali , Görgü Metin , Kızılkan Jehat , Karanfil Ertuğrul , Doğan Ali , Astarcı Hesna Müzeyyen 
Published: February 2020

Background
Storage of surplus grafts for later use is one of the standard procedures used in plastic surgery. For the delayed use of skin grafts, various methods and media have been investigated for short-term storage. This study aimed to investigate the effect of platelet-rich plasma (PRP) skin graft storage on the survival of skin grafts obtained from rabbit ears.

Materials and Methods
Twelve rabbits were used in this study. A total of 12 skin grafts measuring 1 × 1 cm2 were obtained from the inner surfaces of the rabbits' ears. The grafts were stored at +4°C in saline, Hartmann's, and PRP media. On days 3, 7, 10, and 14, the grafts were implanted into the ears in areas measuring 1 × 1 cm2 where the skin, cartilage, and perichondria were excised. After the implantation of the grafts, the survival rates were evaluated by measuring the graft areas on day 0, day 10, and day 30.

Results
The graft survival rate decreased as the storage period increased in all 3 of the media. The decrease in survival rate was higher in the grafts that were stored in the Hartmann's media in comparison with the saline and PRP media, and the difference was statistically significant. The decrease in graft survival was similar between the storage in saline and PRP media; however, the differences were statistically insignificant.

Conclusions
Although in vitro criteria are important for evaluating graft survival, in vivo studies showing the graft take rate in the recipient area are required. When the in vivo criteria are evaluated, the use of PRP is not superior to the use of saline for graft storage. However, additional studies are required to evaluate the effects of PRP media on graft quality.
Determination of the Ratio of the Decantation Time and the Separation of Components in Lipoaspirate
Authors: Mecott Gabriel A. , Cueto-Ramos Rubén G. , González-Martínez Adrian , Perez-Trujillo José J. , Chacon-Martinez Hernán , de Oca Roberto Montes , Garcia-Perez Mauricio M. 
Published: February 2020

Abstract
Decantation of the lipoaspirate is one of the most common techniques used to prepare the fat graft. The aim of the study was to determine the ideal time of decantation that provides the best separation of the components without compromising the viability of the adipocytes.

Methods
Thirty milliliters of fat were obtained from 11 healthy adults and decanted at room temperature for 0, 30, and 60 minutes. After decantation, the infiltration liquid and the remnant fat were measured with a volumetric pipette. Once the solution was removed, the remnant fat was centrifuged at 3000 rpm for 5 minutes to separate any residual solution, to measure the amount of actual fat obtained at that time point. Viability was determined with trypan blue staining for all the samples.

Results
After decantation, 9.4 ± 0.79 mL of fat was obtained at time 0, whereas 7.7 ± 1.56 mL was obtained at 30 minutes and 6.9 ± 0.92 mL at 60 minutes. Actual fat volume was 6.6 ± 1.56 mL, 5.5 ± 1.39, and 5.26 ± 1.3 mL, respectively. Viability at time 0 was 73.33 ± 0.06%, 72.57 ± 0.1% at 30 minutes, and 59.3 ± 0.09% at 60 minutes (P = 0.004).

Results
The fat grafting, processed by decantation, will have the best performance within a period of 30 minutes after harvesting, where the best rate of viability and separation of components will be achieved.
Clinical Applications of Allograft Skin in Burn Care
Authors: Wang Chunyang , Zhang Feng , Lineaweaver William C. 
Published: February 2020

Abstract
Allograft skin has been widely used for wound management in burn centers. Functional as biologic dressing, it can not only provide ideal temporary wound coverage in extensive burns when autograft is not immediately available but also prepare the wound bed for definitive autografting. In this article, the up-to-date clinical application of allograft in burn care was reviewed, including coverage of extensive burn wounds, combined use with meshed autograft, template for delayed application of cultured epidermal autografts, and the use of human acellular dermal matrix. Although it has potential disadvantages of rejection and disease transmission, allograft skin remains a workhorse in treatment of severe burn wounds.