bluuebunny/crossref_metadata_2025_split huggingface dataset:
Artists With Anatomical Knowledge After Anathomia (1316) and Before Fabrica (1543)
Authors: Hwang Kun 
Published: August 2020

Abstract
In the Renaissance, anatomical science was a major source of inspiration for artists. By the 15th century, interest had emerged in anatomy, and the artists of the period dissected cadavers. The aim of this paper was to analyze the works of 15th century artists who had a good knowledge of human anatomy.
In PubMed and Google, "Renaissance" and "artist" and ("anatomy" or "cadaver" or "corpse") were searched. In the book Lives of the Painters, Sculptors, and Architects by Vasari, the terms "cadaver" or "dissect" or "corps" or "anatomy" were searched. Fourteen artists (Donato di Niccolò di Betto Bardi, Piero della Francesca Andrea del Castagno, Antonio del Pollaiuolo, Andrea del Verrocchio, Leonardo da Vinci, Michelangelo di Lodovico Buonarroti Simoni, Domenico di Pace Beccafumi, Baccio Bandinelli, Giovanni Antonio Lappoli, Rosso Fiorentino, Silvio Cosini of Fiesole, Jan van Calcar, and Taddeo Zucchero) who learned anatomy or performed dissections were identified, and artworks representing their knowledge of human anatomical structures were analyzed.
In this review, we identified artists who had a good knowledge of anatomy and applied anatomical knowledge of features such as muscle shape and volume in their works.
The artists sought to accurately portray facial expressions, positions, reflexive motions, and draped clothing. Observation of living subjects is the primary source of artists’ expertise. Dissection provides fixed model without flowing blood, which cannot be used as an animated model. It is thought that these artists learned about the origins of vivid expressions from the anatomy of the muscles lying beneath the skin.
Advanced Robotic Surgery of the Parapharyngeal Space: Transoral Robotic Styloidectomy in Eagle Syndrome
Authors: Rizzo-Riera Elena , Rubi-Oña Carlos , García-Wagner Miguel , Costa Ana Araujo-Da , Miralles Joan , Enchev Enrik , Rama-López Julio 
Published: August 2020

Abstract
Eagle syndrome (ES) is characterized by symptomatic elongation of the styloid process or ossification of the stylohyoid ligament causing irritation and inflammation of the trigeminal, facial, glossopharyngeal, and vagus nerves. The use of robotic surgery has been accepted as a first-line treatment for some head and neck squamous cell carcinomas but not for styloidectomy. The aim of this article is to document our experience with a transoral robotic approach to treat ES and to present the outcomes of 6 patients.
The author present the transoral robotic surgery as a successful alternative for the surgical management of ES. Our experience with this approach has been excellent, granting an optimal vision of the surgical field with the consequent safe manipulation of the instruments avoiding injuries to healthy tissue.
Surgical Ciliated Cysts in Orthognathic Surgery
Authors: Soares José Castro , Villalba Natalia Casañas , Sanromán Jacinto Fernández , Ferro Martin Fernández , Fernández Pablo López , Betancourt Annahys López , López Alberto Costas 
Published: August 2020

AbstractSurgical ciliated cysts (SCC) are rare entities that were first described in the Japanese literature after treatment for chronic maxillary sinusitis. Classically associated with surgery to the maxillary sinus, they have also been reported in association with orthognathic surgery, bone grafting, and trauma. These lesions can develop from a few months up to several years after the surgical procedure. The authors report 2 new cases of SCC after a LeFort I osteotomy for class III dentofacial deformity correction. One of them presented with bilateral lesions and suffered from a recurrence after 5 years, 2 rare events associated with SCC.A review of the literature of the past 5 years was undertaken, in order to ascertain the reported time of follow-up and recurrence. A PubMed search retrieved a total of 15 articles with 17 cases reported. Nine cases were associated with orthognathic surgery, 4 with Caldwell-Luc procedures, 2 with sinus lift and 2 with trauma. The mean follow-up after removal of the SCC was of 8.6 months. Four cases did not specify the follow up time; 1 case was lost to follow-up. No relapses were reported.Like what happens with the primary lesion, a recurrence can take place several years after removal. It is the authors’ opinion that adequate long-term follow-up must be granted for a timely diagnosis and treatment of relapsed SCC.
Cell Models for Birth Defects Caused by Chloroethyl Nitrosourea-Induced DNA Lesions
Authors: Cao Jiankun , Liu Zongjian , Wang Congxiao , Wang Jie , Pan Bo , Qie Shuyan 
Published: August 2020

Abstract
Birth defects have been linked to administration of alkylating agents during pregnancy. The anti-tumor efficacy of alkylating agents correlate with their ability to induce DNA lesions, especially interstrand crosslinks (ICLs). Yet the role of DNA damages in birth defects remains to be clarified, owing, in part, to a lack of cell models. Here we generate DNA lesions in NIH/3T3 cells to mimic defects in fetus triggered by 3-Bis(2-chloroethyl)-1-nitrosourea (BCNU, carmustine). CCK-8 assay suggests that BCNU-induced cell death was dose-dependent. Alkaline comet tests and γ-H2AX staining confirm DNA ICLs and other forms of DNA damages caused by BCNUs. The cell cycle analysis shows cells arrest in G2/M phase until crosslinks repair is complete. Taken together, all these experiments demonstrate we have successfully established normal cell models for birth defects caused by BCNU-mediated DNA damages. The model can not only guide the development of effective and low-toxicity anticancer drugs, but also be of great significance for the study of neonatal malformation triggered by BCNUs.
Orbital Floor Fractures Comparing Different Kinds of Reconstruction: A Proposal for Restoration of Physiological Anatomy
Authors: Spinzia Alessia , Renzetti Paolo , Bongiorno Antonella , Laganà Francesco 
Published: August 2020

Abstract
The most effective treatment for orbital fractures is still under debate and different strategies are proposed in the literature. All such strategies focus on reconstruction of the orbital structure, neglecting the main function of the medial and inferior walls, these latter being constructed so as to break during high energy trauma. The aim of the authors is to highlight the difference between different reconstructive techniques in an orbital fracture restoration, being inclined to favor repair over reconstruction of the orbital floor, assuming that a second trauma could happen and reconstructive material left in the orbit may damage the visual apparatus in such a scenario. Following this theme, the authors propose a reconstruction strategy using a custom made stereolithographic model and resorbable plate made of polylactic acid mesh molded onto it. The mesh is used alone or in combination with bone graft, to obtain a better reparative result. At present, this approach is best suited to sports people and the young. Even if a deeper evaluation of the method would be useful, the series of case studies presented could be of stimulus for future discussion.
Forehead Widening in Nonsyndromic Scaphocephaly Operated After 12 Months of Age
Authors: Paternoster Giovanna , Jing X.L. , Haber Samer E. , James Syril , Legros Christophe , Liu X.X. , Khonsari Hossein Roman , Zerah Michel , Meyer Philippe , Arnaud Eric 
Published: August 2020

Aim and Scope:
Our standard management is to operate isolated sagittal synostosis around 4 months of age because of morphological and cognitive outcomes. However, some patients present late and the likelihood of spontaneous remodeling is low in isolated sagittal craniosynostosis operated on after 12 months of age with a limited technique. The preliminary result of a modified technique for forehead remodeling and subtotal calvarial remodeling in nonsyndromic scaphocephalic children with late presentation is presented.

Patients and Methods:
All patients older than 1 with isolated sagittal synostosis assessed between 2011 and 2015, over 1 year of age at the time of surgery, with available pre and postoperative computed tomography-scans, were retrospectively included into the study. The following parameters were collected: (1) age at surgery, (2) duration of the procedure, (3) surgical technique, (4) fronto-nasal angle before and after surgery and (5) forehead width before and after surgery.

Results:
Ten patients aged between 15 months and 6 years were retrospectively included. Delayed surgery was due to late presentation or initial parental reluctance. All patients presented with a transversal narrowing of the forehead and an anterior bulge. Mean age at surgery was 28 months and mean follow up was 23 months (1–4 years). Measurements showed significant improvement of both the fronto-nasal angle and the width of the forehead.

Conclusions:
Late-presenting scaphocephalic patients operated on after 12 months of age require forehead remodeling to achieve satisfactory aesthetic results. Modified forehead remodeling by splitting the forehead sagittally into 2 symmetrical halves and adding a midline bone strip is a safe and feasible way to widen the forehead. Long term follow-up is needed to assess this modified technique.
Three-Dimensional Calvarial Growth in Spring-Assisted Cranioplasty for Correction of Sagittal Synostosis
Authors: Rodriguez-Florez Naiara , Borghi Alessandro , Yauwan Daniel D. , Heuntinck Pam , Bruse Jan L. , Tenhagen Maik , Göktekin Özge K. , Angullia Freida , Schievano Silvia , Dunaway David J. , Jeelani Noor Ul Owase , James Greg 
Published: August 2020

Abstract
Spring-assisted cranioplasty (SAC) is a minimally invasive technique for treating sagittal synostosis in young infants. Yet, follow-up data on cranial growth in patients who have undergone SAC are lacking. This project aimed to understand how the cranial shape develops during the postoperative period, from spring insertion to removal. 3D head scans of 30 consecutive infants undergoing SAC for sagittal synostosis were acquired using a handheld scanner pre-operatively, immediately postoperatively, at follow-up and at spring removal; 3D scans of 41 age-matched control subjects were also acquired. Measurements of head length, width, height, circumference, and volume were taken for all subjects; cephalic index (CI) was calculated. Statistical shape modeling was used to compute 3D average head models of sagittal patients at the different time points. SAC was performed at a mean age of 5.2 months (range 3.3–8.0) and springs were removed 4.3 months later. CI increased significantly (P < 0.001) from pre-op (69.5% ± 2.8%) to spring removal (74.4% ± 3.9%), mainly due to the widening of head width, which became as wide as for age-matched controls; however, the CI of controls was not reached (82.3% ± 6.8%). The springs did not constrain volume changes and allowed for natural growth. Population mean shapes showed that the bony prominences seen at the sites of spring engagement settle over time, and that springs affect the overall 3D head shape of the skull. In conclusion, results reaffirmed the effectiveness of SAC as a treatment method for nonsyndromic single suture sagittal synostosis.
The Science Behind the Springs: Using Biomechanics and Finite Element Modeling to Predict Outcomes in Spring-Assisted Sagittal Synostosis Surgery
Authors: Jeelani Noor ul Owase , Borghi Alessandro , Florez Naiara Rodriguez , Bozkurt Selim , Dunaway David , Schievano Silvia 
Published: August 2020

Abstract
Spring-assisted surgery for the correction of scaphocephaly has gained popularity over the past 2 decades. Our unit utilizes standardized torsional springs with a central helix for spring-assisted surgery. This design allows a high degree of accuracy and reproducibility of the force vectors and force distance curves. In this manuscript, we expand on the biomechanical testing and properties of these springs. Standardization of design has enabled us to study the springs on bench and in vivo and a comprehensive repository of calvarial remodeling and spring dynamics has been acquired and analyzed.
Finite element modeling is a technique utilized to predict the outcomes of spring-assisted surgery. We have found this to be a useful tool, in planning our surgical strategy and improving outcomes. This technique has also contributed significantly to the process of informed consent preoperatively. In this article, we expand on our spring design and dynamics as well as the finite element modeling used to predict and improve outcomes.
In our unit, this practice has led to a significant improvement in patient outcomes and parental satisfaction and we hope to make our techniques available to a wider audience.
Posterior Distraction Using Springs in Syndromic and Multisuture Craniosynostosis: Improving the Technique
Authors: Mathijssen Irene M.J. , Driessen Caroline , Versnel Sarah L. , Dremmen Marjolein H.G. , van Veelen Marie-Lise C. 
Published: August 2020

Introduction:
Posterior distraction is the preferred surgical treatment for particularly Apert and Crouzon syndrome in most craniofacial centers, using either external distractors or springs. The authors prefer the use of springs and have adapted their technique to further improve outcomes.

Methods:
All patients who were treated with the adapted technique for occipital expansion using springs were included. The most significant adaption that the authors introduced in 2017 is using a bony hinge at the top of the vault instead of at the caudal edge of the occiput.

Results:
A total of 8 posterior expansions with springs were performed. No complications occurred and the springs were also successfully applied in cases with extremely thin bone. If indicated, a simultaneous foramen magnum decompression was performed and this was easier to combine with a hinge at the top of the vault.

Conclusions:
Posterior distraction with springs is a safe and effective procedure and allows a simultaneous foramen magnum decompression. Planning the hinge at the vault allows intracranial volume gain at the site of the posterior skull base.
Open Reduction, Internal Fixation of Isolated Mandible Angle Fractures in Growing Children
Authors: Yesantharao Pooja S. , Lopez Joseph , Reategui Alvaro , Najjar Omar , Yu Jason W. , Pourtaheri Navid , Redett Richard J. , Manson Paul N. , Dorafshar Amir 
Published: August 2020

Background:
Mandible angle fractures can result in significant, long-term morbidity in children. However, management of this particular mandibular fracture type is not well-characterized in the pediatric population. This study investigated isolated mandibular angle fractures in the pediatric patients.

Methods:
This was a 30-year retrospective, longitudinal cohort study of pediatric patients presenting to a single institution with mandibular angle fractures. Patient data were abstracted from electronic medical records. Subgroup analyses were completed by dentition stage.

Results:
Seventeen patients met inclusion criteria, of whom 6 (35.3%) had deciduous, 4 (23.5%) had mixed, and 7 (41.2%) had permanent dentition. Deciduous/mixed dentition patients with mobile, displaced fractures underwent ORIF, whereas those with nondisplaced fractures underwent treatment with soft diet. Among permanent dentition patients, most patients (71.4%) underwent ORIF regardless of fracture severity. The post-ORIF complication rate was 55.6%; no complications were reported after soft diet or closed treatment (Fischer exact: P
= 0.05). The most common post-ORIF complication was alveolar nerve paresthesia (17.6%) and post-ORIF complication rates did not vary by age (deciduous: 16.7%, mixed: 25.0%, permanent: 42.9%, Fischer exact: P
= 0.80). ORIF patients who received a single upper border miniplate had a lower complication rate (42.9%) than other plating methods (upper and lower miniplates—100%). Fracture severity was predictive of post-ORIF complications (odds ratio: 2.23, 95% confidence interval: 2.22–2.24, P < 0.0001).

Conclusions:
Isolated mandible angle fractures were relatively rare in children, and treatment requirements varied by injury severity and dentition stage. Although isolated angle fractures had substantial associated morbidity, this fracture pattern did not result in notable growth limitations/deformity.
Endoscopic Spring-Mediated Distraction for Unilambdoid Craniosynostosis
Authors: Mittermiller Paul A. , Rochlin Danielle H. , Menard Robert M. 
Published: August 2020

Background:
Craniosynostosis treatment modalities have changed over time. These have included open calvarial remodeling, suturectomy with helmet molding, hand-powered distraction devices, and spring-mediated distraction. Implantable springs were first described for their use in treatment of craniosynostosis in 1998 (Lauritzen et al, Plast Reconstr Surg 121;2008:545-554). They have been used for the correction of craniosynostosis involving single and multiple sutures and have been placed through both endoscopic and open approaches. Their use for correction of lambdoid synostosis has been previously only described using an open approach (Arnaud et al, Child Nerv Syst 28;2012:1545-1549). The senior author has performed spring-mediated distraction for treating unilambdoid craniosynostosis using an endoscopic approach, which is described below and has not previously been reported by other authors.

Methods:
A retrospective analysis of our series of endoscopic unilambdoid synostosis repairs is included in this article. Patients were analyzed based on patient characteristics, operative details, and outcomes. The operation commences by approaching the lambdoid suture endoscopically through a 2- to 3-cm incision lateral to the lambdoid suture. Burr holes are placed on either side of the suture and a suturectomy is performed. Springs are bent preoperatively to a predetermined force. Two springs are placed across the suturectomy defect and the skin is closed. The patient is monitored for improvement in head shape and cranial X-rays are performed to measure the degree of distraction.

Results:
Seven patients underwent endoscopic spring-mediated distraction for unilambdoid craniosynostosis. The average age at the time of operation was 9.4 months. The median force of each spring placed was 7.0 N. The median length of hospital stay after spring placement was 2 days. Springs were removed at 5.6 months on average. Five patients had X-rays immediately after placement and prior to removal. Each spring expanded an average distance of 15.3 mm. There were no surgical complications. Three patients had both preoperative and postoperative computed tomography scans available. The angle of the cranial base, calculated by comparing foramen magnum to cribriform plate angles, improved 5.8° (12.3 preoperatively to 6.6 postoperatively).

Conclusion:
Endoscopic spring-mediated distraction is a safe and effective method of treatment for unilambdoid craniosynostosis. The series represents the largest experience with this technique. The approach can be considered in all patients with unilambdoid synostosis given the efficacious improvement in vault remodeling, low patient morbidity, short operating time, and minimal inpatient stay.
Respiratory and Gastrointestinal COVID-19 Phenotypes in Kidney Transplant Recipients
Authors: Crespo Marta , Mazuecos Auxiliadora , Rodrigo Emilio , Gavela Eva , Villanego Florentino , Sánchez-Alvarez Emilio , González-Monte Esther , Jiménez-Martín Carlos , Melilli Edoardo , Diekman Fritz , Zárraga Sofía , Hernández Domingo , Pascual Julio 
Published: August 2020

Background.
Coronavirus infectious disease 2019 (COVID-19) pandemic has posed at risk the kidney transplant (KT) population. We describe clinical pictures, risk factors for death, and chances to recovery in a large cohort of KT recipients with COVID-19.

Methods.
Inclusion in a Spanish prospectively filled registry was allowed for KT cases with confirmed COVID-19. Outcomes were assessed as in-hospital mortality or recovery.

Results.
The study population comprised of 414 patients. Fever, respiratory symptoms, and dyspnea were the most frequent COVID-19-related symptoms, and 81.4% of them had pneumonia. More than one-third of patients showed digestive symptoms at diagnosis, combinations of nausea, vomiting, and diarrhea. Most patients were hospitalized, 12.1% in intensive care units, and 17.6% needed ventilator support. Treatment for COVID-19 included frequently hydroxychloroquine, azithromycin, high-dose steroids, lopinavir/ritonavir, and tocilizumab. After a mean follow-up of 44 days, the fatality rate was 26.3%. Pneumonia without gastrointestinal symptoms was associated with a 36.3% mortality (respiratory phenotype), and gastrointestinal symptoms without pneumonia with a 5.3% mortality (gastrointestinal phenotype). The mixed pneumonia and gastrointestinal phenotype showed an intermediate mortality of 19.5% (mixed phenotype). Multivariate Cox regression analysis showed that age and pneumonia were independently associated with death, whereas the gastrointestinal phenotype was associated with recovery.

Conclusions.
COVID-19 is frequent among the KT population. Advanced age and pneumonia are the main clinical features associated with a high-mortality rate. Gastrointestinal disease is associated with a more benign course and lower mortality.
Extracorporeal Membrane Oxygenation in Pediatric Liver Transplantation: A Multicenter Linked Database Analysis and Systematic Review of the Literature
Authors: Ziogas Ioannis A. , Johnson Wali R. , Matsuoka Lea K. , Rauf Muhammad A. , Thurm Cary , Hall Matt , Bacchetta Matthew , Godown Justin , Alexopoulos Sophoclis P. 
Published: August 2020

Background.
Extracorporeal membrane oxygenation (ECMO) can be used to maintain oxygen delivery and provide hemodynamic support in case of circulatory and respiratory failure. Although the role of ECMO has emerged in the setting of adult liver transplantation (LT), data in children are limited. We aimed to describe the characteristics and outcomes of children receiving ECMO support at the time of or following LT.

Methods.
All pediatric LT recipients (≤20 y) requiring ECMO support peri-/post-LT were identified from a linked Pediatric Health Information System/Scientific Registry of Transplant Recipients dataset (2002–2018). The Kaplan-Meier method and Cox regression analysis were used to assess post-ECMO survival. A systematic literature review was conducted in accordance with the PRISMA statement.

Results.
Thirty-four children required ECMO peri-/post-LT. The median time from LT to ECMO was 5 d (interquartile range, 0.0–12.3), and the median ECMO duration was 1 d (interquartile range, 1.0–6.3). Children started on ECMO within 1 d of LT exhibited superior survival compared with those started on ECMO later (P = 0.03). When adjusting for recipient weight, increasing time from LT to ECMO initiation was associated with increased risk of mortality (hazard ratio, 1.03; 95% confidence interval, 1.00-1.06; P = 0.049). Overall, 55.9% (n = 19 of 34) of the patients survived. Twenty-two children receiving ECMO in the peri-/post-LT period were systematically reviewed, and 15 of them survived (68.2%).

Conclusions.
With an encouraging >55% patient survival at 6 mo, ECMO should be considered as a viable option in pediatric LT recipients with potentially reversible severe respiratory or cardiovascular failure refractory to conventional treatment.