bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical assessment and imaging of the upper limb
Authors: Mishra Anuj 
Published: September 2021

Abstract
Clinical assessment of the upper limb and hand requires a detailed history of the symptoms, or, in cases of trauma, the circumstances of the injury. Examination should be systematic and guided by a thorough knowledge of anatomy and the likely pathology. Various modalities of imaging can be applied to confirm or characterize the pathology. Each has particular indications and should be applied carefully so as to obtain the most accurate result.
Fractures of the hand and wrist
Authors: Shewring David J. 
Published: September 2021

Abstract
Fractures of the phalanges and metacarpals are the most common fractures of the upper limb and account for 10% of all fractures. Along with fractures of the carpal bones, they represent 55% of upper extremity fractures. Although over the last few decades there has been an increased tendency to treat hand fractures with internal fixation, the vast majority of these fractures are stable and can (and should) be treated non-operatively. If surgical fixation is considered, then it must be appreciated that some hand fractures, particularly those affecting the proximal phalangeal shaft and intra-articular fractures, can be unforgiving. Fractures treated poorly, using inappropriate equipment in inexperienced hands can lead to irretrievably poor outcomes. Good or perfect results can be obtained with surgical fixation, but these demand careful planning with consideration of all the various methods in the surgical repertoire. The best, and possibly the only opportunity to obtain a good result is at the first surgical intervention and so those fractures requiring fixation should not be treated by unsupervised inexperienced surgeons. It is preferable to delay fixation by a few days until the best expertise is available.
Embryology of the upper limb
Authors: Lam Wee-Leon , Davey Megan G. 
Published: September 2021

Abstract
Recent advances in research technology have allowed a rapid progression in the understanding of upper limb embryogenesis. Limb development occurs between 4 and 8 weeks of gestation and progresses along three axes, as controlled by three centres: proximal–distal by the apical ectodermal ridge, anterior–posterior by the zone of polarizing activity, and dorsal–ventral by the dorsal ectoderm. In addition, research into molecular anatomy has revealed the central role of the sonic hedgehog protein and the complex interconnections linking all three axes of development. Despite these advances in understanding normal limb development, the field of pathembryogenesis remained limited. Recent discoveries about the roles of HOX and TBX genes, as well as bone morphogenetic proteins and GLI transcription factors, have allowed important insights into the causations of common clinical conditions. This expanding field of knowledge has facilitated the establishment of a new classification system based entirely on embryogenesis, which should catalyse closer surgeon/scientist collaborations.
Management of children’s hand disorders
Authors: Bourke Grainne , Grant Ian , Smith Gill 
Published: September 2021

Abstract
Congenital hand anomalies form a broad spectrum of conditions. The assessment of the condition requires attention to the affected part as well as the child as a whole given the incidence of associated conditions. Congenital hand anomalies are classified according to the pattern and extent of the anomaly, and its aetiology. The most significant anomalies are described in this chapter with their individual classifications and options for treatment.
Psychological assessment
Authors: Rumsey Nichola , Paraskeva Nicole 
Published: September 2021

Abstract
Although research relating to the psychology of the cosmetic surgery patient is still in its infancy, there is a consensus among researchers that various combinations of psychological factors play a key role in the recent increase in demand for cosmetic surgery, in the motivation of prospective patients to undergo surgery, in their expectations of outcome, and in their postoperative adjustment. An appreciation of the psychological aspects of cosmetic surgery is therefore crucial and places the surgeon in a stronger position to evaluate a patient’s appropriateness for surgery. Indeed, appropriate patient selection is considered a vital part of a surgeon’s role in ensuring effective care and treatment. This chapter addresses why an understanding of psychological factors contributing to all stages of the treatment process is important to the provision of appropriate care and offers a framework for pre- and postoperative assessment.
Lipomodelling
Authors: Dickson John , Mercer Nigel 
Published: September 2021

Abstract
Lipomodelling refers to the transfer of fat, as an autologous graft. The technique is now widely performed for a great variety of conditions. It can be used to correct both congenital and acquired deformities and also for cosmetic enhancement at various sites around the body. The technique has become especially popular for treating contour deformities that can occur following breast surgery and also for facial deformities. Although increasingly popular, there remain many unknowns. Outcomes are difficult to predict and the optimal method of harvest and distribution is yet to be defined. There is concern that fat grafting in and around a site that has previously been treated for cancer may contribute to the development of new or recurrent disease. However, there is currently no evidence to support this in follow-up studies.
Genetics of craniofacial anomalies
Authors: Wilkie Andrew O.M. 
Published: September 2021

Abstract
The birth of a child with a craniofacial malformation is usually an unexpected and devastating event for the parents. One of the first questions asked is ‘Why did this happen?’ Later, they may go on to ask ‘Could this happen again and if so, can it be avoided?’ A clinical genetics assessment can make an important contribution to answering these and other questions. In general, craniofacial malformations represent defects in embryogenesis, which can arise either from altered genetic information (abnormal developmental programming of the embryo), environmental insult (disruption of development), or a combination of adverse genetic and environmental factors. The clinical geneticist’s approach is primarily directed towards deciding which of these scenarios is most likely to be correct and, if a specific genetic cause is suspected, to advising on the most appropriate genetic tests to perform.
Syndromic craniosynostosis
Authors: Dover Stephen , Evans Martin 
Published: September 2021

Abstract
Syndromic craniosynostoses result from a complex interaction between genetic factors, molecular and cellular events, as well as mechanical and deformational forces. They can all have secondary effects on growth and development. Approximately 180 craniofacial syndromes have been identified and it is thought that about 15% of all craniosynostoses are syndromic. They are due to genetic mutations and among the most common are mutations in the fibroblast growth factor receptor 2 gene (FGFR2). Multidisciplinary care for craniofacial patients is considered the optimal model of care and is based on the concept of management during childhood, the transition into adulthood, and finally support and treatment throughout adulthood.
Hypertelorism and orbital dystopia
Authors: Greig Aina V.H. , Dunaway David J. 
Published: September 2021

Abstract
Orbital hypertelorism is defined as an abnormally wide distance between the orbits. It is a physical finding often associated with other cranial and facial malformations. Orbital dystopia refers to an abnormal position or shape of the orbits. These orbital abnormalities can be associated with visual problems including amblyopia, astigmatism, squints, and loss of vision. Patients are managed by a multidisciplinary team.
Velopharyngeal dysfunction
Authors: Sainsbury David C.G. , Williams Caroline C. , Mehendale Felicity V. 
Published: September 2021

Abstract
This chapter explores velopharyngeal dysfunction (VPD), its impact, aetiology, assessment, and management. VPD may cause hypernasal, weak, and unintelligible speech, facial grimacing, nasal turbulence and nasal regurgitation, middle ear problems, and sinusitis. Such manifestations may be distressing for the patient, be associated with poor academic outcomes, be negatively perceived by others, lead to bullying and withdrawal, and result in relationship and employment difficulties. Like the effect of a visible difference on psychosocial confidence and self-esteem, the manifestations of VPD on emotional well-being and social interaction do not necessarily correlate with the amount of speech, language, or communication dysfunction. Normal anatomy, neuromotor function, and speech learning are prerequisites for effective velopharyngeal function. A problem with any of these components may result in a velopharyngeal mechanism that fails to efficiently and fully close throughout oral speech sound formation leading to VPD and an ensuing speech disorder. Perceptual speech evaluation is used to diagnose VPD. Lateral videofluoroscopy and nasoendoscopy are commonly deployed to assess velopharyngeal function and determine management strategies. Surgical interventions include pharyngoplasty, pharyngeal flaps, and velopharyngeal augmentation. Non-surgical interventions include speech prostheses and nasal obturators for speech improvement.
Anatomy and embryology of the head and neck
Authors: Loh Charles Y.Y. , Wallace Christopher G. 
Published: September 2021

Abstract
An overview of the anatomy and embryology of the face, head, and neck that is most relevant to the plastic surgeon is presented in this chapter. Subsections focus on the scalp, forehead, cheek, nose, ears, eyelid, lips, oral cavity, oropharynx, mandible, muscles of mastication, nasopharynx, hypopharynx, and larynx.
Tumours of the oral cavity
Authors: Dunne Jonathan A. , Matteucci Paolo L. 
Published: September 2021

Abstract
Oral tumours are a common malignancy, with smoking and alcohol the principal aetiological factors. Squamous cell carcinoma is the commonest pathology, most frequently affecting the anterior tongue and floor of the mouth. Surgery is the mainstay of T1/T2 tumour management, and tracheostomy may be required. Sentinel node biopsy is an effective staging procedure; however, there is a high rate of occult nodal metastasis which may warrant elective supraomohyoid neck dissection. Macroscopic nodal disease requires modified radical neck dissection, preferably with adjuvant chemoradiotherapy. For unresectable tumours, radical external beam radiotherapy with cisplatin should be given. Reconstruction of soft tissue involves a range of skin grafts and local, regional, and free flaps, while bony reconstruction includes obturators and non-vascularized and vascularized bone grafts. Postoperative rehabilitation aims to restore speech, mastication, swallow, and dentition. Three-year survival is greater than 90% for stage I/II disease, with excellent functional outcomes.
Tumours of the salivary glands
Authors: Wokes James , McLean Neil 
Published: September 2021

Abstract
Malignant salivary gland tumours are rare and histologically diverse. The most common tumour site is the parotid gland and most tumours are benign. The aetiological factors are numerous. Presentation of a painless swelling of a salivary gland is always considered as suspicious. Ultrasonography, computed tomography, and magnetic resonance imaging are all useful imaging modalities. Fine-needle aspiration cytology and core biopsy are valuable diagnostic tools. Surgical excision represents the mainstay of treatment for resectable tumours. Radiotherapy, chemotherapy, and immunotherapy all have roles in management.
Scalp, forehead, and calvarial reconstruction
Authors: Rahman Kaz M.A. 
Published: September 2021

Abstract
Reconstruction of the scalp and forehead fall broadly into two categories: trauma and malignancy. Traumatic injuries include lacerations, avulsions, burns, and penetrating injuries. Excisional surgery is predominately due to cutaneous malignancies such as squamous and basal cell carcinomas. In both groups of patients, it is important to understand both the anatomical subunits requiring reconstruction and which layers are deficient in the soft tissues and bone. This can be further complicated by previous surgery and radiotherapy.
Lower body lift and abdominal surgery after massive weight loss
Authors: Richter Dirk F. , Schwaiger Nina 
Published: September 2021

Abstract
Following the establishment of modern body lift procedures by Ted Lockwood, who sadly passed away in 2005, other innovative approaches are also now available. The main idea behind these operations, similar to modern face-lifting procedures, is to reconstruct the superficial and deep tissue layers (comparable to the superficial musculoaponeurotic system of the face) and the overlying skin. Large areas of tissue undermining and separation are, however, necessary to allow sufficient mobilization and tightening to achieve improvement in function and form. At the same time, it should not be forgotten that patients who have undergone major weight loss often have intrinsic medical problems such as diabetes mellitus, high blood pressure, nicotine abuse, and hormonal changes. These factors must be considered when planning the reconstruction. The problems and solutions derive from the authors’ experience over the last 15 years at the Department of Plastic Surgery at the Dreifaltigkeits-Hospital in Wesseling, Germany. These surgical procedures create great wound cavities but have associated risks that are manageable when planning and surgery are carried out meticulously.
Chemical burns
Authors: Murray Alexandra 
Published: September 2021

Abstract
Chemical burn injuries represent a small proportion of all burns. They are, however, a unique and challenging subset with over 25,000 potential causative agents. Their management, requiring specialist knowledge and expertise, is ideally performed by specialist burns services. A large proportion of these injuries occur in the workplace, with significant socioeconomic implications. Health and safety standards are therefore paramount for prevention, particularly through ensuring adequate eye protection and clothing. The increasing numbers of acid-related assaults, chemical warfare, and terrorism comprise a complex part of burn care internationally. This chapter highlights the key features of chemical burns, the most commonly encountered agents, and their pathophysiology. A thorough and safe plan for assessment and acute management of these injuries is provided, emphasizing the importance of cross-speciality involvement when appropriate.
Granulomatous nephritis: A rare presentation of juvenile-onset sarcoidosis
Authors: Chotalia Prashant , Pandya Sapan , Srivastava Puja 
Published: September 2021

ABSTRACT
Sarcoidosis is rare in children. Incidence and prevalence of sarcoidosis in India are not known. Renal involvement in childhood sarcoidosis is further rare with no clear data about prevalence. Here we report a case of a 13-year-old girl who presented with sarcoidosis with multi-system involvement including renal sarcoidosis. She initially presented with pyrexia of unknown origin and cervical lymphadenopathy – evaluation of which led to diagnosis of sarcoidosis. Later, after development of pulmonary involvement, she was treated with oral prednisolone and azathioprine. She again defaulted on medicines and later presented with renal failure and was diagnosed with a renal sarcoidosis. She was treated with oral prednisolone and mycophenolate mofetil with which she gradually improved with normal renal functions.
The effect of macropore size of hydroxyapatite scaffold on the osteogenic differentiation of bone mesenchymal stem cells under perfusion culture
Authors: Shi Feng , Xiao Dongqin , Zhang Chengdong , Zhi Wei , Liu Yumei , Weng Jie 
Published: September 2021

Abstract
Previous studies have proved that dynamic culture could facilitate nutrients transport and apply mechanical stimulation to the cells within three-dimensional scaffolds, thus enhancing the differentiation of stem cells towards the osteogenic phenotype. However, the effects of macropore size on osteogenic differentiation of stem cells under dynamic condition are still unclear. Therefore, the objective of this study was to investigate the effects of macropore size of hydroxyapatite (HAp) scaffolds on osteogenic differentiation of bone mesenchymal stem cells under static and perfusion culture conditions. In vitro cell culture results showed that cell proliferation, alkaline phosphate (ALP) activity, mRNA expression of ALP, collagen-I (Col-I), osteocalcin (OCN) and osteopontin (OPN) were enhanced when cultured under perfusion condition in comparison to static culture. Under perfusion culture condition, the ALP activity and the gene expression of ALP, Col-I, OCN and OPN were enhanced with the macropore size decreasing from 1300 to 800 µm. However, with the further decrease in macropore size from 800 to 500 µm, the osteogenic related gene expression and protein secretion were reduced. Computational fluid dynamics analysis showed that the distribution areas of medium- and high-speed flow increased with the decrease in macropore size, accompanied by the increase of the fluid shear stress within the scaffolds. These results confirm the effects of macropore size on fluid flow stimuli and cell differentiation, and also help optimize the macropore size of HAp scaffolds for bone tissue engineering.
Ambient air pollution and inflammatory effects in a Canadian pregnancy cohort
Authors: Gogna Priyanka , King Will D , Villeneuve Paul J , Kumarathasan Premkumari , Johnson Markey , Lanphear Bruce , Shutt Robin H , Arbuckle Tye E , Borghese Michael M 
Published: September 2021

Background:
Epidemiologic studies have consistently reported associations between air pollution and pregnancy outcomes including preeclampsia and gestational diabetes. However, the biologic mechanisms underlying these relationships remain unclear as few studies have collected relevant biomarker data. We examined relationships between ambient PM2.5 and NO2 with markers of inflammation during pregnancy in a prospective cohort of Canadian women.

Methods:
We analyzed data from 1170 women enrolled in the Maternal-Infant Research on Environmental Chemicals study. Daily residential PM2.5 and NO2 exposures during pregnancy were estimated using satellite-based and land-use regression models and used to create 14-day and 30-day exposure windows before blood-draw. Inflammatory markers C-reactive protein, interleukin-6, interleukin-8, and tumor necrosis factor-α were measured in third trimester plasma samples. Multivariable linear regression was used to estimate associations for an interquartile range (IQR) increase in PM2.5 and NO2 and markers of inflammation, while adjusting for individual-level confounders.

Results:
Fourteen-day (IQR: 6.85 µg/m3) and 30-day (IQR: 6.15 µg/m3) average PM2.5 exposures before blood-draw were positively associated with C-reactive protein after adjustment for covariates (24.6% [95% CI = 9.4, 41.9] and 17.4% [95% CI = 1.0, 35.0] increases, respectively). This association was found to be robust in several sensitivity analyses. Neither PM2.5 nor NO2 exposures were associated with interleukin-6, interleukin-8, or tumor necrosis factor-α.

Conclusion:
Exposure to ambient PM2.5 is positively associated with maternal inflammatory pathways in late pregnancy. This may contribute to positive associations between ambient PM2.5 and risk of adverse pregnancy outcomes.
Association of Lifetime History of Traumatic Brain Injury With Prescription Opioid Use and Misuse Among Adults
Authors: Adams Rachel Sayko , Corrigan John D. , Ritter Grant A. , Hagemeyer Abby , Pliskin Madeline B. , Reif Sharon 
Published: September 2021

Objective:
To investigate associations of lifetime history of traumatic brain injury (TBI) with prescription opioid use and misuse among noninstitutionalized adults.

Participants:
Ohio Behavioral Risk Factor Surveillance System (BRFSS) participants in the 2018 cohort who completed the prescription opioid and lifetime history of TBI modules (n = 3448).

Design:
Secondary analyses of a statewide population-based cross-sectional survey.

Main Measures:
Self-report of a lifetime history of TBI using an adaptation of the Ohio State University TBI-Identification Method. Self-report of past year: (1) prescription pain medication use (ie, prescription opioid use); and (2) prescription opioid misuse, defined as using opioids more frequently or in higher doses than prescribed and/or using a prescription opioid not prescribed to the respondent.

Results:
In total, 22.8% of adults in the sample screened positive for a lifetime history of TBI. A quarter (25.5%) reported past year prescription opioid use, and 3.1% met criteria for prescription opioid misuse. A lifetime history of TBI was associated with increased odds of both past year prescription opioid use (adjusted odds ratio [AOR] = 1.52; 95% CI, 1.27-1.83; P < .01) and prescription opioid misuse (AOR = 1.65; 95% CI, 1.08-2.52; P < .05), controlling for sex, age, race/ethnicity, and marital status.

Conclusion:
Results from this study support the “perfect storm” hypothesis—that persons with a history of TBI are at an increased risk for exposure to prescription opioids and advancing to prescription opioid misuse compared with those without a history of TBI. Routine screening for a lifetime history of TBI may help target efforts to prevent opioid misuse among adults.
Evaluation of Patient Information Material in the Consent Process for Surgical Stabilization of Rib Fractures
Authors: Hung Gary S. L. , Gardiner Ben , Patel Bhavik M. 
Published: September 2021

Background:
Surgical stabilization of rib fractures is a procedure carried out in most trauma centers; however, data on evaluation of patient information material regarding this procedure are limited. The trauma service at our hospital implemented slide presentation as an adjunct tool to the consenting process for patients undergoing this procedure.

Objective:
The aim was to evaluate information material for patients undergoing surgical stabilization of rib fractures procedure and subjective outcomes from education on components of knowledge, emotion, and behavior for patients undergoing this procedure.

Methods:
A one-group posttest prospective design study was conducted over 18 months at a Level I trauma center. Supplementary visual material was provided as an adjunct to the consent process of surgical rib fixation. Evaluation from the patient's perspective was undertaken utilizing the usefulness scale for patient information material. This tool was based on a tripartite model of reading, evaluating, and responding to patient information material.

Results:
Over the period of 18 months, 60 patients underwent surgical stabilization of rib fractures. Fifty-two (91.7%) patients reviewed the information material, and 41 (78.8%) patients completed the feedback. The results reflect that the majority of patients perceived positive responses in emotional support (M = 8.42, SD = 6.6); behavioral motivation (M = 8.57, SD = 6.4); and education on knowledge (M = 9.09, SD = 4.6).

Conclusion:
In this novel study, visual aids as an adjunct to the informed consent process augmented patient knowledge regarding surgical stabilization of rib fractures and received positive subjective patient feedback on knowledge about the procedure.