bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current Trends in Prepectoral Breast Reconstruction: A Survey of American Society of Plastic Surgeons Members
Authors: Marks Jacob M. , Farmer Rebecca L. , Afifi Ahmed M. 
Published: January 2021

Background:
Prepectoral implant-based breast reconstruction has recently gained increasing popularity, but there are limited data regarding national trends in the use of this technique. Our aim was to determine practice patterns related to prepectoral breast reconstruction among plastic surgeons, as well as to identify perceived advantages and disadvantages of this technique.

Methods:
A 16-question electronic survey tool was distributed to 2535 members of the American Society of Plastic Surgeons. Survey items focused on surgeon practices related to prepectoral reconstruction, in addition to their motivations for and concerns with performing the procedure.

Results:
A total of 274 responses were received (10.8% response rate). Nearly half of respondents (48.4%) reported using prepectoral techniques in all or most of their procedures. Decreased animation deformity was identified as the most significant advantage by 76.3% of respondents. Increased rippling and potential wound healing complications were identified as the most significant disadvantages to the procedure by 49.1% and 40.4% of respondents, respectively. The majority of surgeons reported using acellular dermal matrices in their procedures, with most surgeons demonstrating preferences for cohesive and shaped devices.

Conclusions:
Prepectoral breast reconstruction is being widely adopted by plastic surgeons, with the majority of surgeons in our sample using prepectoral techniques in their practices. Responses demonstrate that this technique offers several perceived advantages, most notably the avoidance of animation deformity. However, our data also highlight that there are still many unanswered questions in the community about the complication profile and technical aspects of prepectoral techniques that warrant further investigation.
Quantifying Inequitable Access to Rapid Burn and Reconstructive Care through Geospatial Mapping
Authors: Lo Steven , Ampomah Opoku , Ankrah Levi , Darko Kwame , Bertozzi-Villa Amelia 
Published: January 2021

Summary:
Time-critical pathologies, such as the care of burn-injured patients, rely on accurate travel time data to plan high-quality service provision. Geospatial modeling, using data from the Malaria Atlas Project, together with census data, permits quantification of the huge global discrepancies in temporal access to burn care between high-income and low-resource settings. In this study, focusing on the United Kingdom and Ghana, we found that a 3-fold population difference exists with, respectively, 95.6% and 29.9% of the population that could access specialist burn care within 1-hour travel time. Solutions to such inequalities include upscaling of infrastructure and specialist personnel, but this is aspirational rather than feasible in most low- to middle-income countries. Mixed models of decentralization of care that leverage eHealth strategies, such as telemedicine, may enhance quality of local burns and reconstructive surgical care through skills transfer, capacity building, and expediting of urgent transfers, while empowering local healthcare communities. By extending specialist burn care coverage through eHealth to 8 district hospitals in rural Ghana, we demonstrate the potential to increase specialist population coverage within 1-hour travel time from 29.9% to 45.3%—equivalent to an additional 5.1 million people.
Entrapment Neuropathy Causing Persistent Headache Symptoms after Nonsurgical Rhinoplasty
Authors: Benjamin Martin , McGregor Andrew , Yousif Sarah , Shaikh Dooniya , Reish Richard G. 
Published: January 2021

Background:
The frequency of nonsurgical rhinoplasty has increased in recent years. The occurrence of headaches or migraine symptoms, and their treatment following nonsurgical rhinoplasty, have been scarcely described in the literature. Here, we present a patient who presented with subjective complaints of a new onset headache immediately after nonsurgical rhinoplasty, with subsequent reversal of her symptoms using hylauronidase. Furthermore, a literature review was conducted to establish a possible anatomical pathophysiologic mechanism of these symptoms seen in this patient.

Methods:
A case report of a patient who developed persistent headache symptoms after nonsurgical rhinoplasty, with reversal of symptoms using hylaronidase, is described. A literature review of studies on patients developing headaches or migraine-like symptoms after nonsurgical rhinoplasty was conducted, along with a review of the anatomic causes of migraines.

Results:
Of the 147 relevant citations identified in our search, only 1 individual case report describes a patient who developed a migraine headache after undergoing a nonsurgical rhinoplasty via an injection of hyaluronic acid filler. This was promptly resolved with the utilization of a hyaluronidase injection. The majority of the relevant articles in our search focused on the alarming and most feared complication of vascular compromise of the nasal tissue and intravascular embolization. Within the literature, there was no case series of nonsurgical-rhinoplasty-induced migraines taking into account our inclusion criteria.

Conclusions:
This article demonstrates the paucity of literature regarding nonsurgical-rhinoplasty-induced headaches. Although a causation effect cannot be linked, our study highlights a rare phenomenon associated with this ever-increasing aesthetic procedure.
Pediatric Ectopic Nail Formation following Fingertip Trauma: A Case Report and Literature Review
Authors: Fleury Christopher M. , Nasser Jacob S. , Aivaz Marudeen , Mantilla-Rivas Esperanza , Manrique Monica , Oh Albert K. , Boyajian Michael J. , Rogers Gary F. 
Published: January 2021

Summary:
Post-traumatic ectopic nail is an uncommon entity that is occasionally observed after trauma to the fingertip and nail, resulting in aesthetic and functional morbidity. We report a case of post-traumatic ectopic nail in a 3-year-old girl following trauma to her index finger and subsequent surgical intervention to remove an inclusion cyst. The unusual clinical sequence is presented to highlight the etiology and treatment of this rare lesion.
Associations of the nocturnal blood pressure fall and morning surge with cardiovascular events and mortality in individuals with resistant hypertension
Authors: Cardoso Claudia R.L. , Salles Gil F. 
Published: January 2021

Objective:
The prognostic importance of the nocturnal blood pressure (BP) fall and early-morning surge were scarcely investigated in patients with resistant hypertension (RHT). We investigated them in a prospective cohort of 1726 RHT individuals.

Methods:
The nocturnal fall and morning surge were calculated from the baseline ambulatory BP monitoring (ABPM) and also as mean cumulative values using all ABPMs performed during follow-up. Dipping patterns (normal, extreme, reduced, and reverse) were defined by classic cut-off values of the night-to-day ratio, while MS (difference between early-morning and night-time BP) was categorized into quartiles and at the extremes of its distribution (5th, 10th, 90th, and 95th percentiles). The primary outcomes were total cardiovascular events (CVEs), major adverse cardiovascular events (MACEs), all-cause and cardiovascular mortalities. Multivariate Cox analyses examined the associations between nocturnal BP fall and morning surge and outcomes.

Results:
Over a median follow-up of 8.3 years, 417 CVEs occurred (358 MACEs), and 391 individuals died (233 cardiovascular deaths). Reduced and reverse dipping patterns were significant predictors of CVEs and MACEs, with hazard ratios between 1.6 and 2.5, whereas extreme dipping was a protective factor in younger individuals (hazard ratios 0.3--0.4) but a hazardous factor in elderly (hazard ratios 3.7--5.0) and in individuals with previous cardiovascular diseases (hazard ratios 2.6--4.4). No morning surge parameter was predictive of any outcome in fully adjusted analyses.

Conclusion:
Abnormal dipping patterns but not the early-morning BP surge, were important prognostic markers for future cardiovascular morbidity in RHT patients. The prognosis of extreme dippers depended on age and the presence of cardiovascular diseases.
COMPARISON OF SINGLE DRUSEN SIZE ON COLOR FUNDUS PHOTOGRAPHY AND SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY
Authors: Kim Dong Yoon , Loo Jessica , Farsiu Sina , Jaffe Glenn J. 
Published: January 2021

Purpose:
To determine the relationship of drusen size as determined by spectral-domain optical coherence tomography (SD-OCT) with that measured on registered color fundus photography (CFP) images and to derive an OCT-based classification system that was comparable with that determined by CFP.

Methods:
Custom software was developed to register CFP images to the scanning laser ophthalmoscopy fundus images obtained simultaneously with the corresponding SD-OCT images, so that individual drusen observed on CFP could be matched with those seen on SD-OCT. Single druse size (diameter, area, volume, and height) on CFP and SD-OCT images from a phase two clinical trial was determined with the Duke OCT Retinal Analysis Program.

Results:
The sizes of 213 individual drusen were measured on CFP and SD-OCT. The drusen diameter measured on CFP was significantly correlated with those determined on SD-OCT (R: 0.879, P < 0.001). Based on the corresponding formula: drusen diameter on SD-OCT = 0.77 × (drusen diameter on CFP) + 50.67 µm, large drusen defined as ≥125 µm on CFP had a diameter ≥145 µm on OCT, medium drusen defined as 63 µm to 124 µm on CFP had diameters 100 µm to 144 µm on OCT, and small drusen defined as <63 µm on CFP had diameters <100 µm on OCT.

Conclusion:
With our registration software and imaging processing algorithms, we were able to correlate individual druse sizes measured on CFP with those determined on SD-OCT. These data can be used to develop an SD-OCT-based grading scale, analogous to the CFP Age-Related Eye Disease Study drusen scale that may be useful in the clinic and in clinical trials.
Subretinal Injection Under Perfluorocarbon Liquids to Avoid Foveal Dehiscence
Authors: Steel David H. , Geraghty Brendan , Kearns Victoria , Stanzel Boris , Wong David 
Published: January 2021

summary:
We describe a novel technique modification of subretinal injection to reduce the risk of foveal dehiscence during subretinal tissue plasminogen activator delivery for submacular haemorrhage, using a perfluorocarbon liquid filled vitreous cavity and an eccentric injection point, with a viscous fluid injector system controlled injection.

Purpose:
To describe a novel method of subretinal injection to reduce the risk of foveal dehiscence during subretinal tissue plasminogen activator delivery for submacular hemorrhage.

Method:
Description of technique with illustrative case description and details of four cases treated. The subretinal injection is delivered under a perfluorocarbon liquid bubble filling 80% of the vitreous cavity. An eccentric injection point is used and the tissue plasminogen activator injected under a pneumatically controlled viscous fluid injection system with a 38-g polyimide cannula and low injection pressure.

Results:
Four cases have been treated with controlled subretinal injection extending under the fovea without dehiscence, including one case with apparent preexisting foveal dehiscence and a preretinal clot.

Conclusion:
The technique allows the creation of a low more diffuse subretinal bleb compared with without perfluorocarbon liquid, minimizing hydraulic stress on the fovea during injection and could be applied to other subretinal injection scenarios where the fovea is at risk of hydraulic blowout. Further experience of the technique is needed to validate this initial report.
Corneal Edema Visualization With Optical Coherence Tomography Using Deep Learning: Proof of Concept
Authors: Zéboulon Pierre , Ghazal Wassim , Gatinel Damien 
Published: January 2021

Purpose:
Optical coherence tomography (OCT) is essential for the diagnosis and follow-up of corneal edema, but assessment can be challenging in minimal or localized edema. The objective was to develop and validate a novel automated tool to detect and visualize corneal edema with OCT.

Methods:
We trained a convolutional neural network to classify each pixel in the corneal OCT images as “normal” or “edema” and to generate colored heat maps of the result. The development set included 199 OCT images of normal and edematous corneas. We validated the model's performance on 607 images of normal and edematous corneas of various conditions. The main outcome measure was the edema fraction (EF), defined as the ratio between the number of pixels labeled as edema and those representing the cornea for each scan. Overall accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve were determined to evaluate the model's performance.

Results:
Mean EF was 0.0087 ± 0.01 in the normal scans and 0.805 ± 0.26 in the edema scans (P < 0.0001). Area under the receiver operating characteristic curve for EF in the diagnosis of corneal edema in individual scans was 0.994. The optimal threshold for distinguishing normal from edematous corneas was 6.8%, with an accuracy of 98.7%, sensitivity of 96.4%, and specificity of 100%.

Conclusions:
The model accurately detected corneal edema and distinguished between normal and edematous cornea OCT scans while providing colored heat maps of edema presence.
Immunogenicity of Vero Cell Culture-derived Japanese Encephalitis Vaccine in Pediatric and Young Hematopoietic Stem Cell Transplantation Recipients
Authors: Assawawiroonhakarn Surapat , Apiwattanakul Nopporn , Pakakasama Samart , Hongeng Suradej , Anurathapan Usanarat , Yoksan Sutee , Klinmalai Chompunuch , Sae-Chew Pattarana , Techasaensiri Chonnamet 
Published: January 2021

Background:
Children and young adults undergoing hematopoietic stem cell transplantation (HSCT) typically lose their immunity to vaccine-preventable diseases, including Japanese encephalitis (JE). Revaccination against JE in this population has not been well characterized.

Methods:
This prospective study evaluated the immunogenicity of inactivated Vero cell culture-derived JE vaccine in children and young adults (<25 years of age) who had completed HSCT >1 year prior. Each patient received inactivated Vero cell culture-derived JE vaccine at enrollment and 1 month after enrollment, as well as a booster dose 13 months after enrollment. Serum JE plaque reduction neutralization test and JE-specific T lymphocyte count assay were performed at baseline, 1 month after the second dose, on the day of the booster dose, and 1 month after the booster dose.

Results:
Thirty-seven patients were enrolled. At baseline, 15 patients (40.5%) had plaque reduction neutralization titer >10, which is considered protective. Among 22 seronegative patients, 15 (68.2%) and 19 (86.4%) exhibited seroconversion after revaccination and booster dose, respectively. Median JE-specific T lymphocyte counts also increased. Twenty of 111 (18.0%) vaccination doses resulted in self-limiting side effects.

Conclusions:
The inactivated Vero cell culture-derived JE vaccine may be safe and effective for immunization against JE virus in children and young adults who have undergone HSCT.
Just4Us: Development of a Counselor-Navigator and Text Message Intervention to Promote PrEP Uptake Among Cisgender Women at Elevated Risk for HIV
Authors: Teitelman Anne M. , Koblin Beryl A. , Brawner Bridgette M. , Davis Annet , Darlington Caroline , Lipsky Rachele K. , Iwu Emilia , Bond Keosha T. , Westover Julie , Fiore Danielle , Tieu Hong-Van 
Published: January 2021

Abstract
In the United States, pre-exposure prophylaxis (PrEP) uptake among eligible cisgender women has been slow, despite the availability of oral PrEP since 2012. Although women make up nearly 20% of those living with HIV, there are currently few PrEP uptake interventions for cisgender women at elevated risk for acquiring HIV. Here we describe the process used to design and pre-pilot test Just4Us, a theory-based behavioral intervention to promote PrEP initiation and adherence among PrEP-eligible cisgender women. This work was part of a multiphase study conducted in New York City and Philadelphia, two locations with HIV rates higher than the national average. The counselor-navigator component of the intervention was designed to be delivered in a 60- to 90-min in-person session in the community, followed by several phone calls to support linkage to care. An automated text messaging program was also designed for adherence support. Just4Us addressed personal and structural barriers to PrEP uptake using an empowerment framework by building on women's insights and resources to overcome barriers along the PrEP cascade. Usability pre-pilot testing results were favorable and provided valuable feedback used to refine the intervention.
Depressive Symptoms Predict Delayed Ambulation After Traumatic Injury
Authors: Higgins Jacob T. , Lennie Terry A. , Frazier Susan K. 
Published: January 2021

Background:
Impaired psychological state, such as anxiety and depressive symptoms, occurs in up to 40% of patients hospitalized for traumatic injury. These symptoms, in the acute period, may delay engagement in activity, such as ambulation, following injury. The purpose of this study was to determine whether baseline anxiety and depressive symptoms predicted delayed (>48 hr from admission) ambulation in patients hospitalized for major traumatic injury.

Methods:
Adults (n = 19) admitted for major trauma (Injury Severity Score [ISS] = 15) provided a baseline measure of anxiety and depressive symptoms (Hospital Anxiety and Depression Scale [HADS]). Logistic regression was used to determine the predictive power of baseline HADS Anxiety and HADS Depression subscale scores for delayed ambulation while controlling for ISS.

Results:
At baseline, anxiety was present in 32% of patients; 21% reported depressive symptoms. Baseline HADS Anxiety score did not predict the ambulation group. However, for each 1 point increase in baseline HADS Depression score, the likelihood of patients ambulating after 48 hr from admission increased by 67% (odds ratio = 1.67; 95% CI [1.02, 2.72]; p = .041).

Conclusion:
Worsening depressive symptoms were associated with delayed ambulation in the acute period following injury. Future, larger scale investigations are needed to further elucidate the relationship between psychological symptoms and the acute recovery period from trauma to better inform clinicians and guide development of interventions to improve patient outcomes.
Desmopressin for Antiplatelet-Associated Intracranial Hemorrhage: A Concise Review
Authors: Geiger Haden , Samai Kathryn 
Published: January 2021

Objective
To provide a concise review of the literature on desmopressin use for antiplatelet reversal in patients with intracranial hemorrhage.

Data Sources
Source data were obtained from a PubMed literature review.

Study Selection:
Studies addressing desmopressin for antiplatelet reversal.

Data Extraction:
Relevant studies were reviewed and included through consensus of the authors. The following aspects of each study were identified, abstracted, and analyzed: study population, study design, methods, results, and relevant implications for practice.

Data Synthesis
A growing body of evidence continues to provide mixed results for the use of desmopressin in patients presenting with antiplatelet-associated intracranial hemorrhage. The potential benefit outweighs the possible risks associated with a one-time dose. In addition to desmopressin, platelets should only be considered in patients undergoing a neurosurgical procedure until further and superior evidence is available. Guidelines recommend a weight-based approach for desmopressin dosing at 0.4 mcg/kg over 30 min.

Conclusions
The available evidence supports desmopressin as potentially beneficial with minimal risk for use in patients with antiplatelet-associated intracranial hemorrhage.
Genomics of aging: Genes, adducts, and telomeres
Authors: Wysocki Kenneth , Seibert Diane 
Published: January 2021

ABSTRACT
Genomics influences the aging process in many different ways. This 10-part series of articles describes what is known about genetics and aging, including genes, adducts, and telomeres, decreased immune defenses, oxidation and inefficient mitochondria, toxins and radiation, glycosylation, caloric intake and sirtuin production, neurotransmitter imbalance, hormone mechanisms, reduced nitric oxide, and stem cell slowdown. This first article explores gene adducts as an epigenetic “sludge,” the influence of telomeres and other mutations that contribute to DNA dysfunction, cell stress, and premature aging. Factors that contribute to adduct formation and reduced telomere length are presented along with some changes in behavior, environmental exposure, food/supplement use, weight, sleep, and exercise that have been found to reduce damage, potentially increasing longevity. Adherence to a Mediterranean diet that contains fruits and whole grains along with fiber, antioxidants (e.g., beta-carotene, vitamins C and E), omega-3 fatty acids, and soy protein may reduce DNA adducts and protect telomeres. So providers may want to recommend these simple but key clinical and individual changes to enhance DNA health, wellness, and longevity.
Assessment and management of agitation, sleep, and mental illness in the surgical ICU
Authors: Ortiz Damaris 
Published: January 2021

Purpose of review
Increased focus on patient-centered outcomes, mental health, and delirium prevention makes this review timely and relevant for critical care.

Recent findings
This review focuses on patient-centered outcomes in the ICU, highlighting the latest research to promote brain health and psychological recovery during and after perioperative critical illness. Topics include sedation in the obese patient, delirium severity assessments, the role of the Psychiatry Consultation-Liaison in the ICU, Post-intensive care syndrome, and the importance of family engagement in the COVID era.

Summary
Highlighting new research, such as novel implementation strategies in addition to a lack of research in certain areas like sleep in the ICU may lead to innovation and establishment of evidence-based practices in critical care. Perioperative brain health is multifaceted, and an increase in multidisciplinary interventions may help improve outcomes and decrease morbidity in ICU survivors.
The limitations of evidence: increasing data and increasing doubt in the treatment of cardiac arrest
Authors: Berg Katherine M. 
Published: January 2021

Purpose of review
Cardiac arrest is one of the most challenging disease processes to study with clinical trials due to the emergent and unpredictable nature of these events and complexity of the patient population. In recent years, there has been a major push to complete more large, multicentre trials. In many cases, however, there remains little certainty on what treatments are most efficacious, in spite of the recent increase in evidence. This review was undertaken to address some of the unique barriers to address answering research questions in cardiac arrest with clinical trials.

Recent findings
Multiple examples of trials that have failed to reach definitive conclusions, and potential reasons for this, are discussed.

Summary
Trials on multiple major cardiac arrest interventions, including temperature management, drugs during cardiopulmonary resuscitation (CPR) and airway management, now have high-quality randomized trials, but significant questions on efficacy and best practices remain. Common pitfalls and reasons for this are explored, including heterogeneity of patients and providers, variability in exact interventions studied, delay in starting research interventions and lack of consistency across systems in decision making around appropriateness for resuscitation.