bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regulation of Mitochondrial Function by Noncoding RNAs in Heart Failure and Its Application in Diagnosis and Treatment
Authors: Yang Miaomiao , Wang Xinxing , Wang Tianhui 
Published: June 2021

Abstract:
Heart failure (HF) is the terminal stage of multiple cardiovascular diseases. However, the pathogenesis of HF remains unclear and prompt; appropriate diagnosis and treatment of HF are crucial. Cardiomyocytes isolated from HF subjects frequently present mitochondrial impairment and dysfunction. Many studies have suggested that the regulation by noncoding RNAs (ncRNAs) of mitochondria can affect the occurrence and progression of HF. The regulation by ncRNAs of myocardial mitochondria during HF and the recent applications of ncRNAs in the diagnosis and treatment of HF are summarized in this review that is intended to gain keen insights into the mechanisms of HF and more effective treatments.
Vasculature-on-chip for Assessment of Bioresorbable Scaffolds and Endothelial Barrier Integrity
Authors: Tesfamariam Belay 
Published: June 2021

Abstract:
Endothelial cells adhere to one another through junctional structures formed by intercellular adhesion molecules. These intercellular proteins regulate barrier function in response to the hemodynamic shear rate and enable the selective passage of solutes and fluids across the endothelium. After endovascular device implantation, the endothelial barrier is compromised and becomes discontinuous, which increases permeability, allowing transmigration of leukocytes and lipoproteins and leading to the accumulation of lipid-laden foamy macrophages in the subendothelial space. Drug-coated bioresorbable vascular scaffold implants have been associated with unexpected thrombotic complications, which were not predicted in animals because of dissimilarities in endothelial regeneration and realignment between animals and humans. The development of a microengineered, microfluidics-based system of patterned channels lined with human endothelial and smooth muscle cells perfused with blood allows for the evaluation of endothelial function and barrier integrity. This review highlights the translational potential of vasculature-on-chip, which recreates the microphysiological milieu to evaluate the impact of drug-eluting bioresorbable vascular scaffolds on endothelial barrier integrity and to characterize polymer biodegradation behavior and drug release kinetic profiles over time.
ChartSweep: A HIPAA-compliant Tool to Automate Chart Review for Plastic Surgery Research
Authors: Chartier Christian , Gfrerer Lisa , Austen William G. 
Published: June 2021

Summary:
Retrospective chart review (RCR) is the process of manual patient data review to answer research questions. Large and heterogeneous datasets make the RCR process time-consuming, with potential to introduce errors. The authors therefore designed and developed ChartSweep to expedite the RCR process while remaining faithful to its methodological rigor. ChartSweep is an open-source tool that can be customized for use with any electronic health record system. ChartSweep was developed by the authors to extract information from electronic health records using the Python coding language. As proof-of-concept, the tool was tested in three studies: RCR1—Identification of subjects who underwent radiofrequency ablation in a cohort of patients who had undergone headache surgery (n = 172); RCR2—Identification of patients with a diagnosis of thoracic outlet syndrome in patients who underwent peripheral neuroplasty (n = 806); RCR3—Identification of patients with a history of implant illness or breast implant-associated anaplastic large cell lymphoma in patients who had undergone implant-based breast augmentation or reconstruction (n = 1133). Inter-rater reliability was assessed. ChartSweep reduced the time required to conduct RCR1 by 1315 minutes (21.9 hours), RCR2 by 1664 minutes (27.7 hours), and RCR3 by 2215 minutes (36.9 hours). Inter-rater reliability was uncompromised (k = 1.00). Open-source Python libraries as leveraged by ChartSweep significantly accelerate the RCR process in plastic surgery research. Quality of data review is not compromised. Further analyses with larger, heterogeneous study populations are required to further validate ChartSweep as a research tool.
Traumatic Flap Complications After Femtosecond LASIK
Authors: Leccisotti Antonio , Fields Stefania V. , De Bartolo Giuseppe , Malandrini Alex 
Published: June 2021

Purpose:
The purpose of this article was to evaluate the prognosis of traumatic flap dislocation or avulsion in a large series of laser-assisted in situ keratomileusis (LASIK) cases.

Methods:
Retrospective, consecutive, noncomparative case series analyzes the visual and anatomical results after flap dislocation or avulsion, caused by trauma occurred at least 1 month after LASIK.

Results:
A total of 37,315 eyes of 19,602 patients were reviewed. A traumatic flap complication was observed in 9 eyes of 9 patients, with a maximum interval of 37 months after surgery. Flap dislocation with central full-thickness folds was found in 5 cases; flap lifting and repositioning achieved a full recovery of uncorrected visual acuity. In another case, a partially detached flap was repositioned by a microsponge without lifting; self-limiting localized epithelial ingrowth followed. In 3 eyes, a complete flap avulsion occurred and, after epithelialization, a moderate refractive change was observed, comprised between −0.25 and −1 diopters (D) of spherical equivalent, with astigmatism <1 D; in 1 eye, the resulting myopia was corrected by repeat femtosecond LASIK.

Conclusions:
Traumatic flap complications after femtosecond LASIK are rare but can occur even in the long term; they have a favorable anatomic and visual prognosis.
Management of Keratoconus in Down Syndrome and Other Intellectual Disability
Authors: Stephenson Kirk A. J. , Power Barry , Malata Diana , Quill Barry , Murphy Conor C. , Power William J. 
Published: June 2021

Purpose:The purpose of this study was to assess an intellectual disability (ID) cohort with keratoconus (KC) regarding ophthalmic (visual acuity and corneal tomography) and systemic characteristics and to describe an appropriate clinical algorithm for investigation and management of KC in this setting.Methods:This was the retrospective cohort study of patients with ID (Down syndrome, autism, and other) in the cornea department of a tertiary referral ophthalmic hospital in Dublin, Ireland. Retrospective chart review was conducted on people with ID undergoing examination under anesthesia or crosslinking under general anesthetic. Key outcome data included corneal examination findings, corneal tomography, visual acuity, and examination findings (eg, type of ID, general anesthetic, and cardiac status).Results:Mean age of the 24 patients was 31.9 years (66.7% male). ID type was Down syndrome (66.7%), autism (25%), and other (8.3%). KC was diagnosed in 98% of eyes, with 45.8% having untreatable advanced disease (57.1% of these bilateral), 39.6% amenable to corneal collagen crosslinking (35.7% of these bilateral), and 6.3% having corneal transplantation. Congenital heart defects were present in 37.5% of the Down syndrome group. There were no serious ocular or systemic adverse events.Conclusions:KC is strikingly prevalent in the ID population. Ireland has the highest rate of Down syndrome in Europe (26.3:10,000 live births). This group is rarely suitable for corneal transplantation, and corneal collagen crosslinking is an effective intervention to prevent progression to advanced KC in this already socially restricted group. We propose an algorithm for investigation/treatment and also recommend uniform pediatric KC screening/treatment in ID populations.
Reliability of Several Glaucoma Tests in Patients With Boston Type 1 Keratoprosthesis
Authors: Akpek Esen K. , Karakus Sezen , Yohannan Jithin , Jabbour Samir , Sotimehin Ayodeji E. , Li Gavin , Ramulu Pradeep Y. 
Published: June 2021

Purpose:
Managing glaucoma after Boston type 1 keratoprosthesis (KPro) surgery remains challenging. We herein assessed the fitness of commonly used clinical tests to evaluate glaucoma in KPro eyes versus eyes with penetrating keratoplasty (PK) as controls.

Methods:
Sixteen patients with KPro and 14 patients with PK tested in an identical manner. After the 10-2 visual field with size V stimulus, intraocular pressure (IOP) was estimated with palpation by the first observer. Then, retinal nerve fiber layer (RNFL) thickness analysis was performed twice using optical coherence tomography by an ophthalmic photographer, before and after a short break. After the second observer estimated the IOP, the visual field was repeated. Finally, color photographs of the optic disk were captured by an ophthalmic photographer. The cup-to-disk ratio was assessed by 2 masked observers, at 2 different time points, in a random manner. Agreements between and within observers and reliability of repeated measurements were evaluated using the intraclass correlation coefficient (ICC) and Bland–Altman plots.

Results:
Inter-rater agreement of palpation IOP estimate was moderate for eyes with KPro (ICC = 0.47) and fair for eyes with PK (ICC = 0.27). Visual field and RNFL thickness showed high test–retest reliability in both KPro and PK eyes (ICC > 0.80 for both). Inter-rater agreement of cup-to-disk ratio assessments was substantial in eyes with both KPro (ICC = 0.62) and PK (ICC = 0.70).

Conclusions:
The 10-2 visual field and RNFL thickness seem sufficiently repeatable and might allow the detection of glaucoma progression in KPro eyes. Such testing is important, given limited inter-rater agreement regarding the palpation IOP estimate.
Evaluation of Self-efficacy in Children and Adolescents With Thalassemia Major
Authors: Baghersalimi Adel , Darbandi Bahram , Kazemnezhad Leyli Ehsan , Kamran Mavardiani Zahra , Ahmad Sharbafi Monireh , Rezasefat Balesbaneh Azar 
Published: June 2021

Background:
The survival of thalassemia patients has increased, but there are still challenges regarding the complications of cardiac or endocrine dysfunction and the psychological problems of these patients. Many patients with chronic disease, including thalassemia major (TM), have shown a reduction in communication skills and self-efficacy.

Objective:
The aim of this study was to investigate the self-efficacy among TM patients and determine the related factors among them.

Materials and Methods:
This research was a cross-sectional study and consisted of 40 TM patients 7 to 19 years of age. The control group was 80 nonthalassemia patients. Data were gathered using a 2-part questionnaire. The collected data was entered into the SPSS (version 21) and were analyzed using descriptive and analytical statistics (Mann-Whitney U, and multiple linear regression model).

Results:
According to the Mann-Whitney test, there was no significant difference between self-efficacy score among the affected and nonthalassemia groups (P=0.62). According to the regression model, only, the frequency of monthly blood transfusion was significantly correlated with self-efficacy score, so that by 1 U increase in frequency of monthly blood transfusion, we will have 11 U decrease in self-efficacy score (β=−11, P=0.011).

Conclusions:
The results of this study showed that the rate of self-efficacy in children with thalassemia was moderate (52.5%) to good (45%). The allocation of a specific ward, easy access to health care staff, and social support for patients may seem to justify the moderate to good self-efficacy in these patients.
A New Concept of Narrowing Genioplasty: Home Plate–Shaped Sliding Osteotomy
Authors: Hirohi Toshitsugu 
Published: June 2021

Background:
Narrowing genioplasty is commonly performed among East Asian populations, as a broad and/or square chin can be aesthetically unappealing. This study was aimed to introduce the home plate–shaped sliding osteotomy technique for narrowing genioplasty and to evaluate the results of this technique.

Methods:
A retrospective chart review of 117 patients who underwent home plate–shaped sliding osteotomy alone between 2011 and 2019 was performed. The angles of oblique osteotomy lines and measurements of caudal repositioning, which significantly affect the postoperative chin shape, were evaluated.

Results:
The home plate–shaped sliding osteotomy technique was successfully accomplished for narrowing genioplasty as an isolated procedure. The mean distance of caudal repositioning was 3.9 ± 0.8 mm, and the mean angles of oblique osteotomy lines were 23.3 ± 4.8 degrees on the right and 21.8 ± 3.5 degrees on the left. This produced an aesthetically pleasing rounded and proportionately narrow chin. The incidence of minor complications was 6.0 percent. There were no major complications. In particular, the risk of inferior alveolar nerve injury was obviated, as an additional mandibular border osteotomy was not typically used with this technique.

Conclusions:
This new surgical procedure for narrowing genioplasty provides improved aesthetic results by altering the chin shape, rather than reducing the transverse width of the chin. The versatility of this procedure allows the chin shape to be adjusted with respect to narrowing, vertical lengthening, anterior advancement, and asymmetric or cleft chin correction. The present study suggests that home plate–shaped sliding genioplasty may be an excellent alternative for correcting broad and/or square chins and more complex chin deformities.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Financial Analysis of Operating a Resident Aesthetic Clinic
Authors: Wagner Ryan D. , Raj Sarth , Davis Matthew J. , Bush Matthew , Perdanasari Aurelia Trisliana , Izaddoost Shayan A. , Reece Edward M. , Winocour Sebastian 
Published: June 2021

Background:
Recent changes to the plastic surgery residency training requirements along with a general call for expanded education in cosmetic surgery have encouraged many institutions to incorporate resident aesthetic clinics into their curricula. Although the safety and satisfaction rates of resident aesthetic clinics have been well-studied, their financial viability has not. This study reviews the financial viability of the resident aesthetic clinic at the authors’ institution through a cost analysis.

Methods:
Billing data were analyzed for all patient visits to the resident aesthetic clinic of the authors’ institution during calendar year 2018. Data were extracted, including type and anatomical location of each procedure, charges collected, and supplies used. A financial analysis was performed based on fixed and variable costs and gross revenue.

Results:
A total of 100 unique patients were seen in the clinic over a 1-year period, resulting in 53 operations. This included 15 face, four breast, and 34 body contouring procedures. In addition, 160 cosmetic injections were performed. The gross revenue was $69,955 and the net revenue was $36,600.

Conclusions:
The resident aesthetic clinic at the authors’ institution proved to be financially viable. The authors encourage other institutions to more closely examine the financial state of their resident aesthetic clinics as well. Furthermore, the authors hope that this analysis demonstrates to other programs that, with certain practice models, cost should not be a barrier to initiating and maintaining this valuable training tool.
Clinical Effect of Systemic Steroids in Patients with Cirrhosis and Septic Shock
Authors: Piccolo Serafim Laura , Simonetto Douglas A. , Anderson Alexandra L. , Choi Dae Hee , Weister Timothy J. , Hanson Andrew C. , Kamath Patrick S. , Gajic Ognjen , Gallo de Moraes Alice 
Published: June 2021

ABSTRACT

Purpose:
Evidence regarding the utility of systemic steroids in treating patients with cirrhosis and septic shock remains equivocal. This study aimed to evaluate and elucidate the association of steroid use with outcomes and adverse effects in a cohort of patients with cirrhosis and septic shock.

Patients and methods:
Retrospective cohort study of patients with cirrhosis and septic shock admitted to a tertiary hospital intensive care unit (ICU) from January 2007 to May 2017, using a validated ICU Datamart. Patients who received vasopressors within 6 h of ICU admission were included in the multivariate analysis. The effect of steroids on outcomes was evaluated using multivariable regression, adjusting for confounding variables.

Results:
Out of 179 admissions of patients with cirrhosis and septic shock, 56 received steroids during the ICU admission. Patients who received steroids received a higher total dose of vasopressors (91.2 mg vs. 39.1 mg, P = 0.04) and had a lower initial lactate level (1.8 mmol/L vs. 2.6 mmol/L, P = 0.007). The multivariate analysis included 117 patients and showed no significant differences in mortality, length of ICU admission, or length of hospital stay. Bleeding events, delirium, and renal-replacement therapy requirements were also not associated with the use of steroids.

Conclusion:
The use of systemic steroids was more prevalent in cirrhotic patients with higher vasopressor requirements. It was not associated with decreased mortality or increased ICU- and hospital-free days, or to adverse effects.
Duodenal-Jejunal Bypass Liner for the management of Type 2 Diabetes Mellitus and Obesity
Authors: Ruban Aruchuna , Miras Alexander D. , Glaysher Michael A. , Goldstone Anthony P. , Prechtl Christina G. , Johnson Nicholas , Chhina Navpreet , Al-Najim Werd , Aldhwayan Madhawi , Klimowska-Nassar Natalia , Smith Claire , Lord Joanne , Li Jia V. , Flores Lilliam , Al-Lababidi Moaz , Dimitriadis Georgios K. , Patel Mayank , Moore Michael , Chahal Harvinder , Ahmed Ahmed R. , Cousins Jonathan , Aldubaikhi Ghadah , Glover Ben , Falaschetti Emanuela , Ashrafian Hutan , Roux Carel W. le , Darzi Ara , Byrne James P. , Teare Julian P. 
Published: June 2021

Objective:The aim of this study was to examine the clinical efficacy and safety of the duodenal-jejunal bypass liner (DJBL) while in situ for 12 months and for 12 months after explantation.Summary Background Data:This is the largest randomized controlled trial (RCT) of the DJBL, a medical device used for the treatment of people with type 2 diabetes mellitus (T2DM) and obesity. Endoscopic interventions have been developed as potential alternatives to those not eligible or fearful of the risks of metabolic surgery.Methods:In this multicenter open-label RCT, 170 adults with inadequately controlled T2DM and obesity were randomized to intensive medical care with or without the DJBL. Primary outcome was the percentage of participants achieving a glycated hemoglobin reduction of ≥20% at 12 months. Secondary outcomes included weight loss and cardiometabolic risk factors at 12 and 24 months.Results:There were no significant differences in the percentage of patients achieving the primary outcome between both groups at 12 months [DJBL 54.6% (n = 30) vs control 55.2% (n = 32); odds ratio (OR) 0.93, 95% confidence interval (CI): 0.44–2.0;P= 0.85]. Twenty-four percent (n = 16) patients achieved ≥15% weight loss in the DJBL group compared to 4% (n = 2) in the controls at 12 months (OR 8.3, 95% CI: 1.8–39;P = .007). The DJBL group experienced superior reductions in systolic blood pressure, serum cholesterol, and alanine transaminase at 12 months. There were more adverse events in the DJBL group.Conclusions:The addition of the DJBL to intensive medical care was associated with superior weight loss, improvements in cardiometabolic risk factors, and fatty liver disease markers, but not glycemia, only while the device was in situ. The benefits of the devices need to be balanced against the higher rate of adverse events when making clinical decisions.Trial Registration:ISRCTN30845205. isrctn.org; Efficacy and Mechanism Evaluation Programme, a Medical Research Council and National Institute for Health Research (NIHR) partnership reference 12/10/04.
Overall Volume Trends in Esophageal Cancer Surgery Results From the Dutch Upper Gastrointestinal Cancer Audit
Authors: Voeten Daan M. , Gisbertz Suzanne S. , Ruurda Jelle P. , Wilschut Janneke A. , Ferri Lorenzo E. , van Hillegersberg Richard , van Berge Henegouwen Mark I. 
Published: June 2021

Objective:
In the pursuit of quality improvement, this study aimed to investigate volume-outcome trends in oncologic esophagectomy in the Netherlands.

Summary of Background Data:
Concentration of Dutch esophageal cancer care was dictated by introducing an institutional minimum of 20 resections/yr.

Methods:
This nationwide cohort study included all esophagectomy patients registered in the Dutch Upper Gastrointestinal Cancer Audit in 2016–2019 from hospitals currently still performing esophagectomies. Annual esophagectomy hospital volume was assigned to each patient and categorized into quartiles. Multivariable logistic regression investigated short-term surgical outcomes. Restricted cubic splines investigated if volume-outcome relationships eventually plateaued.

Results:
In 16 hospitals, 3135 esophagectomies were performed. First volume quartile hospitals performed 24–39 resections/yr; second, third, and fourth quartile hospitals performed 40–53, 54–69, and 70–101, respectively. Compared to quartile 1, in quartiles 2 to 4, overall/severe/technical complication, anastomotic leakage, and prolonged hospital/intensive care unit stay rates were significantly lower and textbook outcome and lymph node yield were higher. When raising the cut-off from the first to second quartile, higher-volume centers had less technical complications [Adjusted odds ratio (aOR): 0.82, 95% confidence interval (CI): 0.70–0.96], less anastomotic leakage (aOR: 0.80, 95% CI: 0.66–0.97), more textbook outcome (aOR: 1.25, 95% CI: 1.07–1.46), shorter intensive care unit stay (aOR: 0.80, 95% CI: 0.69–0.93), and higher lymph node yield (aOR: 3.56, 95% CI: 2.68–4.77). For most outcomes the volume-outcome trend plateaued at 50–60 annual resections, but lymph node yield and anastomotic leakage continued to improve.

Conclusion:
Although this study does not reflect on individual hospital quality, there appears to be a volume trend towards better outcomes in high-volume centers. Projects have been initiated to improve national quality of care by reducing hospital variation (irrespective of volume) in outcomes in The Netherlands.