bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outpatient Reduction Mammaplasty Offers Significantly Lower Costs with Comparable Outcomes: A Propensity Score–Matched Analysis of 18,780 Cases
Authors: Calotta Nicholas A. , Merola David , Slezak Sheri , Coon Devin 
Published: February 2020

Background:
Breast reduction mammaplasty is a common plastic surgery operation. Although many contemporary surgeons provide breast reduction mammaplasty as an outpatient procedure, roughly 15 percent of patients are still observed postoperatively. The authors hypothesize that observation confers no safety benefit but engenders significant cost.

Methods:
The authors reviewed cases of breast reduction mammaplasty in a commercial database and formulated three propensity score–matched cohorts: inpatient, 23-hour observation, and outpatient. Comparisons were made between inpatients and outpatients and between 23-hour observation patients and outpatients. The primary outcome variable was 14-day re-presentation rate to the emergency department or readmission. Financial data were also collected.

Results:
Comparison of inpatients and outpatients included 1237 patients each (n = 2474 total patients). The 23-hour observation–outpatient comparison included 8153 patients each (n = 16,306 total patients). For inpatients versus outpatients, the 14-day re-presentation rate was 1.4 percent for inpatients and 0.3 percent for outpatients (p < 0.01). The overall surgical complication rate was higher for inpatients (7.8 percent) than for outpatients (4.9 percent) (p < 0.01). Comparing outpatients to 23-hour observation patients, the 14-day re-presentation rate was similar (0.5 percent observation versus 0.3 percent outpatient; p = 0.10). The complication rate was higher for 23-hour observation patients (4.8 percent) than for outpatients (3.2 percent) (p < 0.01). When compared with outpatients (median, $9077), inpatients (median, $19,975) generated $10,898 more in costs. Similarly, 23-hour observation patients (median, $12,451) generated $4050 more in costs than outpatients (median, $8401) (p < 0.01).

Conclusions:
Outpatient breast reduction mammaplasty is equally safe when compared to observation or admission. Non–outpatient breast reduction mammaplasty had median costs of 148 to 220 percent that of outpatient breast reduction mammaplasty. In an era of cost consciousness, ambulatory reduction mammaplasty may offer a relatively simple method of decreasing expenditures.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Intraoperative Laser-Assisted Indocyanine Green Imaging Can Reduce the Rate of Fat Necrosis in Microsurgical Breast Reconstruction
Authors: Momeni Arash , Sheckter Clifford 
Published: February 2020

Background:
Fat necrosis following microsurgical breast reconstruction is common and problematic for patients and surgeons alike. Indocyanine green angiography provides a means of evaluating flap perfusion at the time of surgery to inform judicious excision of hypoperfused tissue. The authors hypothesized that incorporation of protocolized indocyanine green–informed flap débridement at the time of surgery would decrease the incidence of fat necrosis.

Methods:
A retrospective study of two cohorts was performed evaluating patients before and after implementation of protocolized indocyanine green–guided flap excision. Variables included demographics, procedural details, and complications. Multivariable analysis was used to determine significant differences between the cohorts and evaluate for meaningful changes in fat necrosis.

Results:
Eighty patients were included, accounting for 137 flaps. Flap type was the only significant difference between the two groups, with the indocyanine green group more likely to be deep inferior epigastric perforator flaps (43.1 percent versus 25.3 percent; p = 0.038). The overall postoperative incidence of fat necrosis was 14.6 percent (20 of 137 flaps). Comparing by cohort, the standard débridement group showed 18 of 79 flaps with fat necrosis (22.8 percent), whereas the indocyanine green–informed débridement group showed only two of 58 flaps with fat necrosis (3.4 percent; odds ratio, 0.11; 95 percent CI, 0.02 to 0.60; p = 0.011). There were no other significant differences in complication profile.

Conclusions:
Intraoperative use of indocyanine green angiography was associated with significantly lower odds of fat necrosis. This technology may reduce additional revision operations and improve patient satisfaction. Additional studies are needed to determine whether this innovation is cost-effective and generalizable to the entire autologous breast reconstruction population.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
The Effect of Omega-3 Fatty Acids on Capsular Tissue around the Breast Implants
Authors: Lombardo Giuseppe A. G. , Tamburino Serena , Magano Katia , Fagone Paolo , Mammana Santa , Cavalli Eugenio , Basile Maria S. , Salvatorelli Lucia , Catalano Francesca , Magro Gaetano , Nicoletti Ferdinando 
Published: February 2020

Background:
One of the most common complications of the use of foreign material, in both reconstructive and cosmetic breast surgery, is capsular contracture. Historically, research on capsular contracture has focused mainly on reducing bacterial contamination through antibiotic solutions. Only secondary studies have focused on pharmacological control of the inflammation process, with particular attention paid to the main inflammation pathway, the arachidonic acid cascade. An important role in the arachidonic acid cascade is played by the omega-3 fatty acids, which are found mainly in oily fish and food supplements. The goal of the present study was to investigate the effects of omega-3 supplements on capsule contraction.

Methods:
Female C57BL/6 mice were implanted with custom-made silicone gel implants and divided into two groups. The treated group received omega-3 oil daily while the control group received water daily by gavage. After mice were euthanized, samples of capsules were collected to evaluate thickness and transforming growth factor (TGF)-β expression.

Results:
The results showed that capsules in the omega-3 group were thinner and more transparent than those found in the control group. In addition, a significant downregulation of the TGF-β2 gene transcript was observed in the omega-3 group.

Conclusions:
Omega-3 supplementation seems to be effective in reducing the occurrence of capsular formation, mainly through inhibition of the TGF-β pathway and impairment of collagen deposit. Omega-3 supplementation is a simple and promising method that could be used to prevent or at least reduce capsular contracture after silicone implant surgery.
Abbe Flap Reconstruction of the Upper Lip
Authors: Luce Edward A. , Jing Xi Lin , Carlson Terri 
Published: February 2020

Summary:
Reconstruction of substantial-sized upper lip defects may require an Abbe flap reconstruction to avoid excessive tightness and deformity. The design of the Abbe or lip switch flap harvested from the lower lip is important for a satisfactory aesthetic and functional result. Harvest of the flap is performed to enable a definitive inset into the defect. The video that accompanies this article depicts rotation of an Abbe flap into a philtral defect created by basal cell carcinoma excision.
Rhinoplasty Refinements: Addressing the Pollybeak Deformity
Authors: Rohrich Rod J. , Shanmugakrishnan R. Raja , Mohan Raja 
Published: February 2020

Summary:
Pollybeak deformity represents one of the most common complications of rhinoplasty that require revision rhinoplasty for correction. This article helps to understand the basis behind the deformity, which helps us to prevent and to treat this deformity. This article and video also reiterate that systematic facial analysis is important to look for imperfections and asymmetries in other parts of the face and show how a chin augmentation is performed to correct microgenia.
Lacrimal Canalicular Reconstruction With Canalicular Transposition
Authors: Park Sang Min , Kim Chang Yeom 
Published: February 2020

Abstract
Medial eyelid defects often damage the lacrimal drainage system, and reconstruction for these patients is challenging. The purpose of this report is to describe a new surgical technique for canalicular reconstruction using canalicular transposition. A 67-year-old female patient presented with an eyelid tumor diagnosed as a sebaceous cell carcinoma at the medial left lower eyelid. The tumor along with the lacrimal punctum and canaliculus was excised. The remnant of the canaliculus was transpositioned to the eyelid margin, and the eyelid was reconstructed by direct closure with cantholysis. Transpositioned canaliculus was patent and functioned well at 1-year postoperative follow-up. A novel technique of reconstruction of medial eyelid defect involving the lacrimal drainage system is described.
Effects of Oxytocin for Induction and Augmentation of Labor on Pelvic Floor Symptoms and Support in the Postpartum Period
Authors: Nicola Lauren , Yang Jingye , Egger Marlene J. , Nygaard Ingrid E. 
Published: February 2020

Objective
The aim of the study was to determine whether oxytocin for induction or augmentation of labor impacts the incidence or persistence of pelvic floor symptoms and support 5 to 10 weeks after first vaginal delivery.

Methods
Participants in this prospective cohort study were nulliparous women 18 years or older that delivered vaginally at 37 weeks gestation or more and completed the Epidemiology of Prolapse and Incontinence Questionnaire (EPIQ) and the Pelvic Organ Prolapse Quantification examination in third trimester and 5 to 10 weeks postpartum. We compared the incidence and persistence of symptomatic EPIQ domains and worse vaginal support (maximal vaginal descent ≥0 cm) between women who received oxytocin with those that did not (with or without prostaglandin or mechanical methods in both groups). We performed modified binomial regression to calculate adjusted relative risks of each outcome with 95% confidence intervals.

Results
The mean (SD) age of the 722 participants was 28.3 (5.2) years; 20% were Hispanic. There were no significant differences according to oxytocin exposure in either incidence or persistence of symptomatic EPIQ domains or worse vaginal support. We found similar results in sensitivity analyses comparing women who received oxytocin as the sole pharmacologic agent to women who received no pharmacologic agent. After adjusting for demographic and obstetric factors associated with incidence and persistence of symptoms and support, oxytocin exposure continued to have no effect.

Conclusions
Oxytocin during labor does not significantly increase the risks for the incidence or persistence of pelvic floor symptoms or worse vaginal support in the early postpartum period, although power for less frequent outcomes was limited.
Bone Mineral Density in Relation to Chronic Kidney Disease After Heart Transplantation: A Retrospective Single-center Study at Skåne University Hospital in Lund 1988–2016
Authors: Löfdahl Eveline , Haggård Carl , Rådegran Göran 
Published: February 2020

Background.
Our aim was to investigate the bone mineral density (BMD) evolution and incidence of osteoporosis in relation to chronic kidney disease (CKD) up to 10 years after heart transplantation (HT).

Methods.
A retrospective analysis was performed on 159 HT patients at Skåne University Hospital in Lund 1988–2016.

Results.
The median follow-up time was 6.1 years (interquartile range = 7.5 y). HT patients with CKD stage <3 or normal kidney function before HT exhibited a greater mean BMD loss in the lumbar spine, compared to patients with CKD stage ≥3 before HT, at the first (−6.6% versus −2.5%, P = 0.029), second (−3.7% versus 2.1%, P = 0.018), and third (−2.0% versus 4.1%, P = 0.047) postoperative years, respectively. All included HT patients exhibited a BMD loss in the femoral neck at the first postoperative year (−8.8% [−10.3 to −7.3] in patients with CKD stage <3 or normal kidney function and −9.3% [−13.2 to −5.5] in patients with CKD stage ≥3 before HT), which was not fully reversed up to 10 years after HT. In adjusted models, CKD stage <3 before HT did not predict osteopenia and osteoporosis in the lumbar spine or femoral neck.

Conclusions.
CKD before HT did not predict BMD loss or osteoporosis development after HT. The study is, however, limited by a lack of data on fractures, and further studies on the relationship between CKD and postoperative bone strength are encouraged.
Rapid colorimetric detection of COVID-19 coronavirus using a reverse transcriptional loop-mediated isothermal amplification (RT-LAMP) diagnostic platform: iLACO
Authors: Yu Lin , Wu Shanshan , Hao Xiaowen , Li Xuelong , Liu Xiyang , Ye Shenglong , Han Heng , Dong Xue , Li Xin , Li Jiyao , Liu Na , Liu Jianmin , Zhang Wanzhong , Pelechano Vicent , Chen Wei-Hua , Yin Xiushan 
Published: February 2020

AbstractThe recent outbreak of a novel coronavirus SARS-CoV-2 (also known as 2019-nCoV) threatens global health, given serious cause for concern. SARS-CoV-2 is a human-to-human pathogen that caused fever, severe respiratory disease and pneumonia (known as COVID-19). By press time, more than 70,000 infected people had been confirmed worldwide. SARS-CoV-2 is very similar to the severe acute respiratory syndrome (SARS) coronavirus broke out 17 years ago. However, it has increased transmissibility as compared with the SARS-CoV, e.g. very often infected individuals without any symptoms could still transfer the virus to others. It is thus urgent to develop a rapid, accurate and onsite diagnosis methods in order to effectively identify these early infects, treat them on time and control the disease spreading. Here we developed an isothermal LAMP based method-iLACO (isothermal LAMP based method for COVID-19) to amplify a fragment of the ORF1ab gene using 6 primers. We assured the species-specificity of iLACO by comparing the sequences of 11 related viruses by BLAST (including 7 similar coronaviruses, 2 influenza viruses and 2 normal coronaviruses). The sensitivity is comparable to Taqman based qPCR detection method, detecting synthesized RNA equivalent to 10 copies of 2019-nCoV virus. Reaction time varied from 15-40 minutes, depending on the loading of virus in the collected samples. The accuracy, simplicity and versatility of the new developed method suggests that iLACO assays can be conveniently applied with for 2019-nCoV threat control, even in those cases where specialized molecular biology equipment is not available.
DISPERSE – A trait database to assess the dispersal potential of aquatic macroinvertebrates
Authors: Sarremejane Romain , Cid Núria , Stubbington Rachel , Datry Thibault , Alp Maria , Cañedo-Argüelles Miguel , Cordero-Rivera Adolfo , Csabai Zoltán , Gutiérrez-Cánovas Cayetano , Heino Jani , Forcellini Maxence , Millán Andrés , Paillex Amael , Pařil Petr , Polášek Marek , de Figueroa José Manuel Tierno , Usseglio-Polatera Philippe , Zamora-Muñoz Carmen , Bonada Núria 
Published: February 2020

AbstractDispersal is an essential process in population and community dynamics, but is difficult to measure in the field. In freshwater ecosystems, information on biological traits related to organisms’ morphology, life history and behaviour provides useful dispersal proxies, but information remains scattered or unpublished for many taxa. We compiled information on multiple dispersal-related biological traits of European aquatic macroinvertebrates in a unique resource, the DISPERSE database. DISPERSE includes 39 trait categories grouped into nine dispersal-related traits for 480 taxa, including Annelida, Mollusca, Platyhelminthes, and Arthropoda such as Crustacea and Insecta, generally at the genus level. Information within DISPERSE can be used to address fundamental questions in metapopulation ecology, metacommunity ecology, macroecology and evolutionary ecology research. Information on dispersal proxies can be applied to improve predictions of ecological responses to global change, and to inform improvements to biomonitoring and conservation management strategies. The diverse sources used in DISPERSE complement existing trait databases by providing new information on dispersal traits, most of which would not otherwise be accessible to the scientific community.
Targeting lateral inhibition to improve vision following macular degeneration
Authors: Rizzi M , Powell K , Robinson MR , Matsuki T , Hoke J , Maswood RN , Georgiadis A , Georgiou M , Jones PR , Ripamonti C , Michaelides M , Rubin GS , Smith AJ , Ali RR 
Published: February 2020

AbstractMacular degeneration is the leading cause of blindness in the developed world. Whilst most patients lose sight owing to atrophic changes, no treatments currently exist that improve the vision deficit due to atrophy. Here, we identify loss of lateral inhibition as a specific mechanism by which photoreceptor degeneration reduces visual function beyond the atrophic area. We find that this inhibition is adaptive, and that if modulated can improve visual function, making inhibitory circuits an unexpected therapeutic target for age related macular degeneration and related disorders.
Intensity and dose of neuromuscular electrical stimulation influence sensorimotor cortical excitability
Authors: Insausti-Delgado Ainhoa , López-Larraz Eduardo , Omedes Jason , Ramos-Murguialday Ander 
Published: February 2020

AbstractNeuromuscular electrical stimulation (NMES) of the peripheral nervous system has been largely used in the field of neurorehabilitation to decrease muscle atrophy and to restore motor function in paralyzed patients. The rehabilitative effects of NMES rely on the direct or indirect efferent effect on muscle tone and afferent volleys that induce cortical excitation. Although different neuroimaging tools suggested the capability of NMES to regulate the excitability of sensorimotor cortex and corticospinal circuits, to date how intensity and dose of NMES can neuromodulate the brain oscillatory activity measured with electroencephalography (EEG) is yet to be clarified. In the present study, we quantify the effect of NMES parameters on brain oscillatory activity of twelve healthy participants who underwent stimulation of wrist extensors during rest while EEG was recorded. Three different NMES intensities were included: (1) low, inducing slight sensory perception, (2) medium, inducing moderate sensory perception, and (3) high, generating a functional movement. Firstly, we efficiently removed stimulation artifacts from the sensorimotor brain oscillatory activity. Secondly, we analyzed the effect of amplitude and dose on the latter. On the one hand, we observed significant NMES amplitude-dependent brain SMR modulation, demonstrating the direct effect of afferent receptors recruitment. On the other hand, our results revealed a significant NMES amplitude-based dose-effect on SMR modulation over time. While at low and medium intensities the NMES produced a significant cortical inhibitory effect in time, at high intensity a significant cortical facilitatory effect was induced. These results highlight the functionally relevant role of muscle contraction and proprioception in sensorimotor processes, which should be carefully considered for the design and development of NMES based neuromodulation.
Models of primate ventral stream that categorize and visualize images
Authors: Christensen Elijah , Zylberberg Joel 
Published: February 2020

AbstractAn open question in systems neuroscience is which objective function (or computational “goal”) best describes the computations performed by the ventral stream (VS) of primate visual cortex. Substantial past research has suggested that object categorization could be such a goal. Recent experiments, however, showed that information about object positions, sizes, etc. is encoded with increasing explicitness along this pathway. Because that information is not necessarily needed for object categorization, this motivated us to ask whether primate VS may do more than “just” object recognition. To address that question, we trained deep neural networks, all with the same architecture, with three different objectives: a supervised object categorization objective; an unsupervised autoencoder objective; and a semi-supervised objective that combined autoencoding with categorization. We then compared the image representations learned by these models to those observed in areas V4 and IT of macaque monkeys using canonical correlation analysis (CCA). We found that the semi-supervised model provided the best match the monkey data, followed closely by the unsupervised model, and more distantly by the supervised one. These results suggest that multiple objectives – including, critically, unsupervised ones – might be essential for explaining the computations performed by primate VS.
FTO intronic SNP strongly influences human neck adipocyte browning determined by tissue and PPARγ specific regulation: a transcriptome analysis
Authors: Tóth Beáta B. , Arianti Rini , Shaw Abhirup , Vámos Attila , Veréb Zoltán , Póliska Szilárd , Győry Ferenc , Bacso Zsolt , Fésüs László , Kristóf Endre 
Published: February 2020

AbstractBrown adipocytes, abundant in deep-neck (DN) area in humans, are thermogenic with anti-obesity potential. FTO pro-obesity rs1421085 T-to-C SNP shifts differentiation program towards white adipocytes in subcutaneous fat. Human adipose-derived stromal cells were obtained from subcutaneous neck (SC) and DN fat of 9 donors, of which 3-3 carried risk-free (T/T), heterozygous or obesity-risk (C/C) FTO genotypes. They were differentiated to white and brown (long-term PPARγ stimulation) adipocytes, then global RNA sequencing was performed and differentially expressed genes (DEGs) were compared. DN and SC progenitors had similar adipocyte differentiation potential but differed in DEGs. DN adipocytes displayed higher browning features according to ProFAT or BATLAS scores and characteristic DEG patterns revealing associated pathways which were highly expressed (thermogenesis, interferon, cytokine, retinoic acid, with UCP1 and BMP4 as prominent network stabilizers) or downregulated (particularly extracellular matrix remodelling) compared to SC ones. Part of DEGs in either DN or SC browning was PPARγ-dependent. Presence of the FTO obesity-risk allele suppressed the expression of mitochondrial and thermogenesis genes with a striking resemblance between affected pathways and those appearing in ProFAT and BATLAS, underlining the importance of metabolic and mitochondrial pathways in thermogenesis. Among overlapping regulatory influences which determine browning and thermogenic potential of neck adipocytes, FTO genetic background has a so far not recognized prominence.
Single cell sequencing of the small and AT-skewed genome of malaria parasites
Authors: Liu Shiwei , Huckaby Adam C. , Brown Audrey C. , Moore Christopher C. , Burbulis Ian , McConnell Michael J. , Güler Jennifer L. 
Published: February 2020

AbstractSingle cell genomics is a rapidly advancing field; however, most techniques are designed for mammalian cells. Here, we present a single cell sequencing pipeline for the intracellular parasite,Plasmodium falciparum, which harbors a relatively small genome with an extremely skewed base content. Through optimization of a quasi-linear genome amplification method, we achieve better targeting of the parasite genome over contaminants and generate coverage levels that allow detection of relatively small copy number variations on a single cell level. These improvements are important for expanding accessibility of single cell approaches to new organisms and for improving the study of adaptive mechanisms.