bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes After Central Wedge Labiaplasty Performed Under General Versus Local Anesthesia
Authors: Nwaoz Basil , Sinnott Catherine J. , Kuruvilla Annet , Natoli Noel B. 
Published: April 2021

Purpose
Interest in labiaplasty as a way to alter and improve genital appearance has been on the rise. Labiaplasty procedures can be performed in the office setting under local anesthesia. However, these procedures are often performed under general anesthesia for patient comfort and to facilitate the operative technique and to potentially improve outcomes. Outcomes after labiaplasty performed under general anesthesia as compared with that performed under local anesthesia in the office setting have not been well-defined. This article aimed to compare outcomes after central wedge labiaplasty performed under general anesthesia versus that performed under local anesthesia.

Methods
A retrospective chart review identified patients who underwent central wedge labiaplasty performed by a single surgeon from 2011 to 2019. Demographic, clinical, and operative information were reviewed and recorded. Outcomes were assessed by evaluating postoperative complications and the need for revision surgery.

Results
Thirty-two women with a mean age of 32.8 ± 11.2 years and a mean body mass index of 22.0 ± 3.5 kg/m2 underwent central wedge or extended central wedge labiaplasty during the study period. Ten (31.2%) labiaplasties were performed under local anesthesia in an office setting, and 22 (68.8%) were performed under general anesthesia. Demographic, clinical, and operative characteristics were comparable between labiaplasties performed under local anesthesia and those performed under general anesthesia. Postoperative asymmetry and wound dehiscence were the most common complications. Outcomes after labiaplasty performed under general anesthesia were comparable to those performed under local anesthesia, with regard to asymmetry (27.3% vs 10.0%; P = 0.387), dehiscence (27.3% vs 40.0%; P = 0.683), scarring (4.5% vs 0.0%; P = 1.000), and the need for revision surgery (31.8% vs 40.0%; P = 0.703), respectively. There were no cases of infection, hematoma, decreased sensation, or dyspareunia.

Conclusions
Postoperative asymmetry and dehiscence were the most common complications after labiaplasty performed under general or local anesthesia. Outcomes after labiaplasty performed under general anesthesia were comparable to those performed under local anesthesia. Further studies are needed to assess outcomes after labiaplasty performed under general anesthesia versus that performed under local anesthesia.
Trends in Peripheral Nerve Epidemiology and Reconstruction
Authors: Bellaire Christopher P. , Inglesby Dani C. , Marayati Naoum Fares , Warburton Andrew J. , Melamed Eitan 
Published: April 2021

Background
Peripheral nerve injuries (PNIs) are most commonly treated with direct nerve repair procedures or nerve autografts. However, recent advancements in synthetic and vein conduits have led to their increased utilization. The present study quantifies the incidence of these procedures over time and geography and identifies differences in complication rates, illustrating the current epidemiologic climate regarding conduit use for PNI repair.

Methods
A query was conducted using the State Ambulatory Surgery and Services Databases data from 2006 to 2011 in both Florida and California for patients undergoing nerve repair, nerve grafting, synthetic conduits, and vein conduits. Patient zip code data were analyzed to determine the geographic distribution of various types of repair. In addition, text-mining algorithms were used to identify trends in PNI-related publications.

Results
In the 6-year period investigated, direct nerve repair was the most frequently used procedure for PNIs. However, the utilization of direct repairs declined significantly from 2006 to 2011. Synthetic and vein conduits demonstrated a significant increase over the same period. There were significantly higher rates of complications for autologous grafts (3.3%), vein conduits (3.5%), and synthetic conduits (2.4%), as compared with direct nerve repairs (1.4%). There was a nonsignificant difference in infection rates between these types of nerve repair.

Conclusions
From an epidemiologic perspective, both graft and synthetic conduit-based PNI repairs are increasing in prevalence both in clinical practice and in the academic literature. This will likely continue in the future with the development of advancements in biologic and synthetic nerve conduit PNI repair options.
Three-Dimensional Computed Tomography Reconstruction and Measurement of Nasal End Deformity in Complete Unilateral Cleft Lip and Palate
Authors: Wang Binqing , Xu Meng , Yin Ningbei , Wang Yongqian , Song Tao 
Published: April 2021

Background
The repair of nasal deformities secondary to cleft lip and palate is complex and requires reliable preoperative nasal 3-dimensional assessment. This study explored nasal end (defined as the lower third of the external nasal and vestibular parts of the nasal cavity) deformities secondary to unilateral complete cleft lip and palate.

Methods
Three-dimensional nasal end morphometric measurements were obtained from 48 patients who had undergone Millard cleft lip repair and reached skeletal maturity (cleft group) and from 36 age- and ethnicity-matched normal subjects (control group). For the cleft group, paired t tests and 1-way analysis of covariance were used to evaluate the internal and external morphological characteristics of the cleft and noncleft sides of the nasal end, and correlation analysis was done to evaluate the relationship between cleft-side measurements.

Results
In the cleft group, the cleft side showed significantly smaller nasal vestibular volume and skin area, nostril area, nasal column length, and nostril height and greater nostril base length and nasal alar length than the noncleft side (all P < 0.05). Controlling for sex, there were significant differences in the nasal vestibular volume and skin area, internal nasal valve area, long nostril diameter, nostril base length, columella length, nostril height, and nasal alar length between the cleft and control groups (all P < 0.05). On the cleft side, the area of the skin lining of the nasal vestibule positively correlated with the alar length (r = 0.67, P < 0.05).

Conclusions
Three-dimensional nasal end reconstruction provides a more detailed preoperative nasal end morphological evaluation than previously available techniques.

Level of Evidence
Level III, case-control study
High-Pressure Injection Injuries of the Hand
Authors: Nichols Georgina , Gallegos Jose , Tavana M. Lance , Armstrong Milton B. , Herrera Fernando A. 
Published: April 2021

Introduction
The incidence of high-pressure injection injuries of the hand is low. Although the occurrence is rare, the precarious progression of the injury exacts prompt surgical evaluation in order to avoid complications and amputation. The current study was devised in order to make comparisons to the current data, in addition to supplementing the literature with observations regarding clinical course and management.

Methods
A multisurgeon, retrospective chart review from a single institution was performed. Inclusion criteria included cases involving a high-pressure injection injury to the hand that underwent surgical management. Patient demographics, injury details, and hospital course were all reviewed and recorded.

Results
This retrospective review identified 20 cases meeting criteria, all of which involved males. The average age at time of injury was 39.7 years (range, 21–71 years). The incidence of injection injuries over a 10-year time period was 2.1 cases per year. The nondominant hand was injured in 11 cases (63%). The most common site of injury was the index finger with 11 recorded incidents (55%). Other reported locations included the metacarpal (40%) and small finger (5%). Occupational data included 10 construction workers, 5 painters, and 2 cleaning crew members, and 3 had nonmanual occupations. Paint was the most commonly injected substance with 17 reported cases (85%). On average, the delay until surgery was observed to be 21.9 hours (n = 16). Only 1 patient underwent surgery at 6 hours after surgery. The average number of procedures performed was 1.8 (range, 1–4). Hospitalization duration was on average 3.9 days (range, 1–9 days), and the average follow-up length was 69 days (range, 7–112 days). There were no identified cases that necessitated amputation.

Conclusions
This form of injury most commonly affects male, middle-aged laborers. Our study found very low amputation rates when compared with the current literature, despite observing longer delays to surgery according to current recommendations. Limited comparisons can be made from data regarding clinical course and management because of the small sample size of the current study and the limited published data. This indicates a need for further exploration and collection of data involving parameters such as clinical course and management.
Neutralization of SARS-CoV-2 variants by convalescent and vaccinated serum
Authors: Bates Timothy A. , Leier Hans C. , Lyski Zoe L. , McBride Savannah K. , Coulter Felicity J. , Weinstein Jules B. , Goodman James R. , Lu Zhengchun , Siegel Sarah A. R. , Sullivan Peter , Strnad Matt , Brunton Amanda E. , Lee David X. , Curlin Marcel E. , Messer William B. , Tafesse Fikadu G. 
Published: April 2021

AbstractWe tested human sera from large, demographically balanced cohorts of BNT162b2 vaccine recipients (n=51) and COVID-19 patients (n=44) for neutralizing antibodies against SARS-CoV-2 variants B.1.1.7 and B.1.351. Although the effect is more pronounced in the vaccine cohort, both B.1.1.7 and B.1.351 show significantly reduced levels of neutralization by vaccinated and convalescent sera. Age is negatively correlated with neutralization in vaccinee, and levels of variant-specific RBD antibodies are proportional to neutralizing activities.
Using Machine Learning to Classify Schizophrenia Based on Retinal Images
Authors: Joseph Diana , Lai Adriann , Silverstein Steven , Ramchandran Rajeev , Bernal Edgar A. 
Published: April 2021

VII.AbstractObjectivesThinning of retinal layers has been documented in patients with chronic schizophrenia using standard metrics of optical coherence tomography (OCT) devices. We demonstrate the effectiveness of machine learning (ML) techniques to differentiate between schizophrenia patients and healthy controls using OCT images.MethodsFeatures extracted from a convolutional neural network (CNN) designed to segment retinal layers from OCT images represented abstracted data from the OCT images of 14 first episode (FEP) and 18 chronic schizophrenia patients, and their respective 20 and 18 age-matched controls. The abstracted data and OCT machine metrics were used separately to train support vector classification (SVC) models to differentiate between control and schizophrenia samples and test them.ResultsSVCs operating on OCT machine metrics did not classify unseen samples of FEP schizophrenia patients and controls with performance better than chance, while those looking at chronic schizophrenia did, paralleling results obtained using parametric statistics. In contrast, SVCs operating on OCT image data extracted from the CNN classified unseen samples from both populations with performance greater than chance.ConclusionThese results suggest that ML techniques can detect patterns in patients with FEP schizophrenia with greater performance using features extracted from OCT images than metrics provided by OCT machines.
Using flexible carbon fiber insoles for 1st metatarsophalangeal arthritis lead to pain reduction and high compliance rate: A Randomized Controlled Trial
Authors: Sornsakrin Pongpanot , Bhimani Rohan , Vrolyk Michael Drew , Lubberts Bart , Guss Daniel , DiGiovanni Christopher W , Waryasz Gregory 
Published: April 2021

AbstractIntroductionShoe modification and orthotics play an important role in non-operative management for 1st metatarsophalangeal (MTP) arthritis. However, compliance can be low due to pain and discomfort. We hypothesized that patients who wear a flexible carbon fiber insole for 1st metatarsophalangeal arthritis will report reduced pain, and higher physical function and compliance rate when compared with a rigid Morton’s extension insole.MethodsFour males and nine females (mean age of 56 years; range 35-79) diagnosed with 1st metatarsophalangeal arthritis were included in this randomized controlled trial. Participants randomly received either bilateral flexible carbon fiber insoles (VKTRY®) (n=7) or unilateral Morton’s extension insole (n=6). Outcome measures included patient compliance, comfort rate, and Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires Global Health, pain interference, v1.0 pain intensity, v2.0 Physical Function, and v1.0 Depression. Participants filled out questionnaires at baseline and at two, six, and twelve weeks follow-up.ResultsCompared to Morton’s extension insole, use of flexible carbon fiber insole led to reduction of pain interference score at 6 and 12 weeks (median ⍰ −9.5 vs 0.0 p=0.015; and median ⍰ −15.1 vs −2.3 p=0.015, respectively), as well as reduction of pain intensity score at 6 and 12 weeks (median ⍰ −11.9 vs −2.3 p=0.018; and median ⍰ −11.9 vs −2.3 p=0.010, respectively). The compliance rate in flexible carbon fiber insole group was 100% at 2, 6 and 12 weeks, compared to 83%, 83% and 50% in the Morton group. In addition, patients wearing carbon fiber insoles experienced higher comfort levels (p-values ranging from <0.001 to p=0.007). There were no differences between the comparison groups at 2, 6, and 12 weeks in terms of the global health, physical function, and depression scores.ConclusionPatients diagnosed with 1st metatarsophalangeal arthritis may benefit from wearing flexible carbon fiber insoles, compared to commonly used rigid orthotic insoles, such as the Morton’s extension. This insert can be used safely for nonoperative treatment of hallux rigidus and is another option for nonoperative treatment.LEVEL OF EVIDENCELevel I, randomized clinical trial.
Cost-Effectiveness Threshold for Healthcare and Safety: Justification and Quantification
Authors: Yanovskiy Moshe , Levy Ori Nissim , Shaki Yair Y. , Zigdon Avi , Socol Yehoshua 
Published: April 2021

AbstractEvery public expenditure, including saving lives or extending life expectancy of particular persons (target population), has unwanted but unavoidable side effects of statistical shortening of life expectancy of the general public. Therefore, cost-effectiveness analysis in making decisions regarding health and safety is an ethical necessity. We report here cost-effectiveness estimation based on comparison of three independent methods: (1) by analyzing salaries in risky occupations, (2) by assuming that people value their lives twice more than the wealth they earn, and (3) by comparing with the U.S. current legal practice. To the best of our knowledge, nobody applied method (2) to cost-effectiveness analysis. Our result is that the cost-effectiveness threshold for the developed countries is about US$60,000 ± 25,000 per life-year (LY), or about 1.0 ± 0.4 GDP (gross domestic product) per capita per LY. Therefore, a sum of not higher than US$85,000 (1.4 GDP per capita) is statistically sufficient to “purchase” an additional year of life – or, alternatively, to “rob” one year of life if taken away. So, 140% GDP per capita per life-year should be considered as the upper limit of prudent expenditure on healthcare and safety. The result is in excellent correspondence with the existing healthcare policies.HighlightsSafety consumes resources; resources are limitedTherefore, excessive safety expenditure claims more life than it savesPrudent safety expenditure is up to 140% GDP per capita per life-year
Exploring the genetic overlap of suicide-related behaviors and substance use disorders
Authors: Colbert Sarah M.C. , Hatoum Alexander S. , Shabalin Andrey , Coon Hilary , Nelson Elliot C. , Agrawal Arpana , Docherty Anna R. , Johnson Emma C. 
Published: April 2021

AbstractBackgroundSuicide-related behaviors are heterogeneous and transdiagnostic, and may demonstrate varying levels of genetic overlap with different substance use disorders (SUDs).MethodsWe used linkage disequilibrium score regression, genomic structural equation models, and Mendelian Randomization to examine the genetic relationships between several SUDs and suicide-related behaviors. Our analyses incorporated summary statistics from the largest genome-wide association studies (GWAS) of problematic alcohol use (PAU), the Fagerström Test for Nicotine Dependence (FTND), cannabis use disorder (CUD), and opioid use disorder (OUD; Ns ranging from 46,213-435,563) and GWAS of ever self-harmed, suicide attempt, and suicide death (Ns ranging from 18,223-117,733). We also accounted for genetic liability to depression (N=500,199) and risk tolerance (N=315,894).ResultsSuicide-related behaviors were significantly genetically correlated with each other and each SUD, but there was little evidence of causal relationships between the traits. Simultaneously correlating a common SUD factor with each specific suicide indicator while controlling for depression and risk tolerance revealed significant, positive genetic correlations between the SUD factor and suicide-related behaviors (rg = 0.26-0.45, se=0.08-0.09). In the model, depression’s association with suicide death (β = 0.42, se = 0.06) was weaker compared to ever-self harmed and suicide attempt (β = 0.58, se=0.05 and β = 0.50, se=0.06, respectively).DiscussionWe identify a general level of genetic overlap between SUDs and suicide-related behaviors which is independent of depression and risk tolerance. Additionally, our findings suggest that genetic and behavioral contributions to suicide death may somewhat differ from non-lethal suicide-related behaviors.
mRNA vaccination compared to infection elicits an IgG-predominant response with greater SARS-CoV-2 specificity and similar decrease in variant spike recognition
Authors: Röltgen Katharina , Nielsen Sandra C. A. , Arunachalam Prabhu S. , Yang Fan , Hoh Ramona A. , Wirz Oliver F. , Lee Alexandra S. , Gao Fei , Mallajosyula Vamsee , Li Chunfeng , Haraguchi Emily , Shoura Massa J. , Wilbur James L. , Wohlstadter Jacob N. , Davis Mark M. , Pinsky Benjamin A. , Sigal George B. , Pulendran Bali , Nadeau Kari C. , Boyd Scott D. 
Published: April 2021

AbstractDuring the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, new vaccine strategies including lipid nanoparticle delivery of antigen encoding RNA have been deployed globally. The BioNTech/Pfizer mRNA vaccine BNT162b2 encoding SARS-CoV-2 spike protein shows 95% efficacy in preventing disease, but it is unclear how the antibody responses to vaccination differ from those generated by infection. Here we compare the magnitude and breadth of antibodies targeting SARS-CoV-2, SARS-CoV-2 variants of concern, and endemic coronaviruses, in vaccinees and infected patients. We find that vaccination differs from infection in the dominance of IgG over IgM and IgA responses, with IgG reaching levels similar to those of severely ill COVID-19 patients and shows decreased breadth of the antibody response targeting endemic coronaviruses. Viral variants of concern from B.1.1.7 to P.1 to B.1.351 form a remarkably consistent hierarchy of progressively decreasing antibody recognition by both vaccinees and infected patients exposed to Wuhan-Hu-1 antigens.
Detecting Pathogen-Associated RNA via Piecewise Isothermal Testing achieving Sample-to-Result Integration
Authors: Banerjee Saptarshi , Biswas Sujay Kumar , Kedia Nandita , Sarkar Rakesh , De Aratrika , Mitra Suvrotoa , Roy Subhanita , Bandopadhyay Aditya , Banerjee Indranath , Goswami Ritobrata , Dutta Shanta , Chawla-Sarkar Mamta , Chakraborty Suman , Mondal Arindam 
Published: April 2021

AbstractWe report a novel piece-wise isothermal nucleic acid test (PINAT) for diagnosing pathogen-associated RNA that embeds an exclusive DNA-mediated specific probing reaction with the backbone of an isothermal reverse-transcription cum amplification protocol as a unified single-step procedure. This single step sample-to-result test method has been seamlessly integrated in an inexpensive, scalable, pre-programmable and portable instrument, resulting in a generic platform technology for detecting nucleic acid from a wide variety of pathogens. The test exhibited high sensitivity and specificity of detection when assessed using 200 double-blind patient samples for detecting SARS-CoV-2 infection conducted by the Indian Council of Medical Research (ICMR), reporting a positive and negative percent agreement of 94.6% and 98% respectively. We also established its efficacy in detecting influenza-A infection, performing the diagnosis at the point of collection with uncompromised detection rigor. The envisaged trade-off between advanced laboratory-based procedures with the elegance of common rapid tests renders the innovation to be ideal for deployment in resource-limited settings towards catering the needs of the underserved.
Evidence for increased breakthrough rates of SARS-CoV-2 variants of concern in BNT162b2 mRNA vaccinated individuals
Authors: Kustin Talia , Harel Noam , Finkel Uriah , Perchik Shay , Harari Sheri , Tahor Maayan , Caspi Itamar , Levy Rachel , Leschinsky Michael , Dror Shifra Ken , Bergerzon Galit , Gadban Hala , Gadban Faten , Eliassian Eti , Shimron Orit , Saleh Loulou , Ben-Zvi Haim , Amichay Doron , Ben-Dor Anat , Sagas Dana , Strauss Merav , Avni Yonat Shemer , Huppert Amit , Kepten Eldad , Balicer Ran D. , Nezer Doron , Ben-Shachar Shay , Stern Adi 
Published: April 2021

SummaryThe SARS-CoV-2 pandemic has been raging for over a year, creating global detrimental impact. The BNT162b2 mRNA vaccine has demonstrated high protection levels, yet apprehension exists that several variants of concerns (VOCs) can surmount the immune defenses generated by the vaccines. Neutralization assays have revealed some reduction in neutralization of VOCs B.1.1.7 and B.1.351, but the relevance of these assays in real life remains unclear. We performed a case-control study that examined the distribution of SARS-CoV-2 variants observed in infections of vaccinated individuals (“breakthrough cases”) and matched infections of unvaccinated individuals. We hypothesized that if there is lower vaccine effectiveness against one of the VOCs, its proportion among the breakthrough cases should be higher than among unvaccinated cases. Our results show that vaccinees that tested positive at least a week after the second dose were indeed disproportionally infected with B.1.351, as compared with unvaccinated individuals (odds ratio of 8:1). Those who tested positive between two weeks after the first dose and one week after the second dose, were disproportionally infected by B.1.1.7 (odds ratio of 26:10), suggesting reduced vaccine effectiveness against both VOCs at particular time windows following vaccination. Nevertheless, the B.1.351 incidence in Israel to-date remains low and vaccine effectiveness remains high among those fully vaccinated. These results overall suggest that vaccine breakthrough infection may be more frequent with both VOCs, yet a combination of mass-vaccination with two doses coupled with non-pharmaceutical interventions control and contain their spread.