bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing Opportunities for Solar Lanterns to Improve Educational Outcomes in Off-Grid Rural Areas: Results from a Randomized Controlled Trial
Authors: Stojanovski Ognen , Thurber Mark C , Wolak Frank A , Muwowo George , Harrison Kat 
Published: January 2021

Abstract
Solar lanterns are promoted across rural Sub-Saharan Africa as a way to improve educational outcomes. A randomized controlled trial in Zimba District, Zambia, evaluates whether solar lanterns help children study and improve academic performance. The research design accounts for potential income effects from receiving a lantern and also “blinds” participants to the study's purpose. There is no relationship detected between receipt of a solar lantern and improved performance on key examinations. Impacts on self-reported study habits are also not observed. A cost-effectiveness analysis suggests that solar lanterns are not an efficient way to improve educational outcomes in developing countries relative to other available options. Two phenomena, both of which are likely observed in other developing regions, may explain these results. First, flashlights have become the dominant lighting source in rural Zambia, so solar lanterns may have only limited appeal for prospective users who no longer rely on traditional lighting options like kerosene lamps. Second, improved energy access – whether through solar lanterns or other technologies – appears to be a relatively unimportant educational input in settings like Zimba.
Suggestions for Improvement in Psychometric Corrections in Meta-analysis and Implications for Research on Worker Age and Aging
Authors: Oh In-Sue , Schmidt Frank L 
Published: January 2021

Abstract
As a vital tool for advancing cumulative science and guiding evidence-based practice, meta-analysis has advanced many research fields of the behavioral and social sciences, including worker age and aging. Nonetheless, there is still room for improvement, particularly in terms of meta-analytic methods and procedures. In this article, we overview some influential meta-analyses on worker age and aging concerning their psychometric correction methods and procedures, identify potential controversies and issues, and offer suggestions for improvement, particularly in corrections for two major methodological artifacts (i.e., range variation and measurement error). We also debunk some myths that both researchers and journal reviewers may encounter regarding how to conduct psychometric meta-analyses and discuss implications and agendas for future research on worker age and aging. We hope this article will help researchers in the field of age and aging and beyond to conduct a psychometric meta-analysis while harnessing the benefits of psychometric corrections and meta-analysis.
Systematic Review of Autonomic Nervous System Functioning in Pediatric Chronic Pain
Authors: Gibler Robert C. , Jastrowski Mano Kristen E. 
Published: January 2021

Objectives:Chronic pain is a common and debilitating health problem that impacts up to one third of children and adolescents. The pathophysiological mechanisms of chronic pain are complex, but considerable research links dysfunction of the autonomic nervous system (ANS) and chronic pain in adults. No review of ANS functioning has been conducted in pediatric chronic pain. We systematically reviewed studies examining ANS activity among youth with primary chronic pain conditions.Methods:A systematic search of PsycINFO, PubMed, and CINAHL was conducted using specific search terms. Articles were included if studies measured heart rate, blood pressure, heart rate variability, galvanic skin responses, or pupillometry among children or adolescents with a chronic pain condition. Studies examining these factors in the context of a specific disease-related pain condition were excluded.Results:Of the 1304 articles screened, 15 studies met the criteria for inclusion in this review. All included studies were cross-sectional and primarily included youth with abdominal pain. Results revealed preliminary evidence of reduced parasympathetic activity among youth with pain as measured by heart rate variability. However, results were mixed across ANS indices. Measurement and procedural differences, in addition to a lack of control groups in some studies, limit the interpretability of the reviewed findings.Discussion:Additional studies with larger and more diverse samples of youth with various chronic primary pain conditions are needed to delineate possible relationships among ANS functioning and the development and maintenance of chronic pain in children and adolescents. Clinical implications and avenues for future research are discussed.
Acetabular Coverage Decreases at the End of Skeletal Growth: A 3DCT Study of Healthy Hips
Authors: Herman Max , Krivoniak April , Ruh Ethan , Thakrar Darshit , Bosch Patrick , Wylie James D. , Ghodadra Anish , McClincy Michael P. 
Published: January 2021

Background:
Abnormalities in size and position of the acetabulum have been linked to both developmental dysplasia of the hip and femoroacetabular impingement. Owing to its 3-dimensional (3D) complexity, plain radiography and cross-sectional studies [computed tomography (CT) and magnetic resonance imaging] have limitations in their ability to capture the complexity of the acetabular 3D anatomy. The goal of the study was to use 3D computed tomography reconstructions to identify the acetabular lunate cartilage and measure its size at varying ages of development and between sexes.

Methods:
Patients aged 10 to 18 years with asymptomatic hips and a CT pelvis for appendicitis were reviewed. Patients were stratified by sex and age: preadolescent (10 to 12), young adolescent (13 to 15), and old adolescent (16 to 18) in equal proportions. Materialise 3-matic was used to generate a 3D pelvic model, and the acetabular lunate cartilage surface area was calculated. The lunate cartilage was divided into anatomic segments: superior (11:00 to 1:00), anterior (1:00 to 4:00), and posterior (8:00 to 11:00). The femoral head surface area was calculated to control for patient size. Mixed effects models were generated predicting segment size where side was treated as a repeated measure. Absolute and relative (lunate cartilage to femoral head) models were generated.

Results:
Sixty-two patients (124 hips) were included. Females showed a significant decrease in femoral head coverage as age increased overall and in the 3 subsegments. The majority of changes occurred between the preadolescent and young adolescent groups. Males did not show an overall change, but the superior and anterior anatomic subgroups showed a significant decrease in coverage between the young and old adolescent groups. Male lunate cartilages were absolutely, but not relatively, larger than females. No clinically significant side-to-side differences were noted.

Conclusions:
The relative femoral head coverage by the acetabular lunate cartilage reduced with increasing age, suggesting the growth of the femoral head outpaces the acetabular lunate cartilage’s growth. This was more prominent in females. This study has important implications for expected acetabular coverage changes in the latter aspects of pediatric and adolescent development.

Level of Evidence:
Level III—diagnostic study.
The Five-item Modified Frailty Index is Predictive of 30-day Postoperative Complications in Patients Undergoing Spine Surgery
Authors: Pierce Katherine E. , Naessig Sara , Kummer Nicholas , Larsen Kylan , Ahmad Waleed , Passfall Lara , Krol Oscar , Bortz Cole , Alas Haddy , Brown Avery , Diebo Bassel , Schoenfeld Andrew , Raad Micheal , Gerling Michael , Vira Shaleen , Passias Peter G. 
Published: January 2021

Study Design.
Retrospective cohort study.

Objective.
This study aimed to evaluate the utility of the modified frailty index (mFI-5) in a population of patients undergoing spine surgery.

Summary of Background Data.
The original modified frailty index (mFI-11) published as an American College of Surgeons National Surgical Quality Improvement Program 11-factor index was modified to mFI-5 after variables were removed from recent renditions.

Methods.
Surgical spine patients were isolated using current procedural terminology codes. mFI-11 (11) and mFI-5 (5) were calculated from 2005 to 2012. mFI was determined by dividing the factors present by available factors. To assess correlation, Spearman rho was used. Predictive values of indices were generated by binary logistic regression. Patients were stratified into groups by mFI-5: not frail (NF, <0.3), mildly frail (MF, 0.3–0.5), severely frail (SF, >0.5). Means comparison tests analyzed frailty and clinical outcomes.

Results.
After calculating the mFI-5 and the mFI-11, Spearman rho between the two indices was 0.926(P < 0.001). Each index established significant (all P < 0.001) predictive values for unplanned readmission (11 = odds ratio [OR]: 5.65 [2.92–10.94]; 5 = OR: 3.68 [1.85–2.32]), post-op complications (11 = OR: 8.56 [7.12–10.31]; 5 = OR: 13.32 [10.89–16.29]), and mortality (11 = OR: 41.29 [21.92–77.76]; 5 = OR: 114.82 [54.64–241.28]). Frailty categories by mFI-5 were: 83.2% NF, 15.2% MF, and 1.6% SF. From 2005 to 2016, rates of NF decreased (88.8% to 82.2%, P < 0.001), whereas MF increased (9.2% to 16.2%, P < 0.001), and SF remained constant (2% to 1.6%, P > 0.05). With increase in severity, postoperative rates of morbidities and complications increased.

Conclusion.
The five-factor National Surgical Quality Improvement Program modified frailty index is an effective predictor of postoperative events following spine surgery. Severity of frailty score by the mFI-5 was associated with increased morbidity and mortality. The mFI-5 within a surgical spine population can reliably predict post-op complications. This tool is less cumbersome than mFI-11 and relies on readily accessible variables at the time of surgical decision-making.

Level of Evidence: 3
Multimodal Radiofrequency Application for Lower Face and Neck Laxity
Authors: Dayan Erez , Rovatti Paolo , Aston Sherell , Chia Christopher T. , Rohrich Rod , Theodorou Spero 
Published: January 2021

Background:
Nonexcisional facial skin tightening has long been an elusive goal in aesthetic surgery. The “treatment gap” includes cases who are not “severe” enough for excisions surgery but not “mild” enough for most traditional noninvasive aesthetic modalities. In this retrospective review, we present the largest evaluation to date of radiofrequency (RF) skin tightening technology combination including bipolar RF (FaceTite; InMode) and fractional bipolar RF (Fractora modified to Morpheus8; InMode).

Methods:
A multicenter retrospective study was conducted between January 2013 and December 2018 using a combination of bipolar RF and fractional bipolar RF for the treatment of facial aging. Data collection included demographic information, Baker Face/Neck Classification, amount of energy used, adverse events, and patient satisfaction. Four cadaver dissections were also conducted to correlate the underlying neuromuscular anatomy with RF treatment of the lower face and neck.

Results:
Two hundred forty-seven patients (234 women and 13 men) were included in the study. Average age was 55.1 years (SD, ±8), body mass index was 24.3 (±2.4), and 9% (23/247) of patients were active smokers at the time of treatment. Patients had an average Baker Face/Neck Classification score of 3.1 (SD, ±1.4). The procedure was performed under local anesthesia in 240/247 cases (97.2%). Patients objectively improved their Baker Face/Neck Classification score by 1.4 points (SD, ±1.1). Ninety-three percent of patients indicated that they were pleased with their results and would undergo the procedure again. Complications recorded for our cohort included prolonged swelling >6 weeks (4.8%, 12/247), hardened area >12 weeks (3.2%, 8/247), and marginal mandibular neuropraxia (1.2%, 3/247), which all resolved without further intervention. When considering possible control variables, age seems to be a significant factor. That is, older patients were more likely to benefit from a larger magnitude of the treatment effect (as demonstrated by a decrease in the Baker rating from pre- to posttreatment) when compared with younger patients. However, both groups did demonstrate significant improvements across time.

Conclusion:
While this combination RF treatment (FaceTite bipolar RF and fractional bipolar RF) does not aim to replace a facelift/necklift in appropriate candidates, it does broaden the plastic surgeons’ armamentarium to potentially fill a treatment gap.
Use of Pericranial Flaps with Dermal Substitute for Scalp Reconstruction: A Case Series
Authors: Chaiyasate Kongkrit , Oliver Lauren N. , Kreitzberg Scott A. , Lyons Mitchell , Goldman Joshua , Lu Stephen M. , Bastiaans Tracey , Lumley Christopher , Sachanandani Neil S. 
Published: January 2021

Background:
Skin cancer incidence has been rapidly increasing over the past 2 decades, and the resulting defects from excision have significant aesthetic and functional implications. In particular, wound coverage for large scalp and forehead defects with calvarial exposure can lead to hairline distortion, contour irregularities, and alopecia. We describe a 2-stage technique for scalp reconstruction, which preserves the normal hairline, covers exposed bone with vascularized tissue, and restores an aesthetic soft-tissue contour.

Methods:
This is a retrospective case series of 13 adults with ages ranging from 50 to 89 years. All patients underwent Mohs surgery on the forehead or scalp between July 2014 and April 2017. Patients underwent a 2-staged reconstruction with an initial pericranial flap and dermal substitute placement followed by the placement of a split-thickness skin graft within 4–6 weeks.

Results:
Over a 3-year period, 13 patients had successful reconstruction of the scalp defect without alteration of the hairline or contour irregularity. Two patients had minor complications after the first-stage procedure with successful aesthetic reconstruction.

Conclusions:
Full-thickness defects of the scalp and forehead with bone exposure provide a reconstructive challenge for plastic surgeons. Reconstructive algorithms continue to evolve and should be tailored to best suit patients’ needs and medial comorbidities. Two-staged reconstruction with local pericranial flap provides a safe and efficacious reconstruction that minimizes hairline distortion, contour irregularity, and donor site morbidity.
Outcomes of Poly-4-hydroxybutyrate Mesh in Ventral Hernia Repair: A Systematic Review and Pooled Analysis
Authors: Mellia Joseph A. , Othman Sammy , Naga Hani I. , Messa Charles A. , Elfanagely Omar , Byrnes Yasmeen M. , Basta Marten N. , Fischer John P. 
Published: January 2021

Background:
Within the past decade, poly-4-hydroxybutyrate (P4HB) biosynthetic mesh has been introduced as a potential alternative to traditional biologic and synthetic mesh in ventral hernia repair (VHR). The aim of this study was to systematically assess clinical outcomes with the P4HB in VHR.

Methods:
A literature search identified all articles published in 2000 involving the use of P4HB in VHR. Descriptive statistics were used to synthesize collective data points, including postoperative outcomes. A pooled analysis of postoperative outcomes was performed using chi-square test and Fisher exact test.

Results:
Across 7 studies, the P4HB was used in 453 patients. The mean rate of surgical site infection (SSI) was 6.8% (31/453), reoperation 10.7% (30/281), and recurrence 9.1% (41/453). At an average follow-up of 26.8 months, the incidence of recurrence was 10.4% (28/270). Onlay was significantly associated with increased recurrence (14.2% versus 4.4%, P = 0.001). Among sublay placements, there was no difference in recurrence in clean (Center for Disease Control [CDC] 1) or contaminated (CDC >1) wounds (2.7% versus 6.1%, P = 0.585), but contaminated wounds were associated with increased SSI (2.7% versus 15.2%, P = 0.028). Ventral Hernia Working Group grade 2 and 3 did not have different incidences of recurrence (8.0% versus 5.1%, P = 0.526) nor SSI (5.1% versus 14.6%, P = 0.265).

Conclusions:
Overall, clinical outcomes of the P4HB mesh in VHR are acceptable. The P4HB mesh serves as a reliable alternative to traditional synthetic and biologic mesh across a range of defect characteristics and patient health conditions. Further research is needed to better understand the conditions in which it may provide a clinical benefit over traditional mesh types.
Middle-retroauricular Island Flap: A New Axial Flap for Reconstruction of Non-helical Ear Defects
Authors: Papa Giovanni , Stocco Chiara , Arnež Zoran Marij 
Published: January 2021

Background:
Surgical treatment of ear carcinomas needs the selection of the appropriate reconstructive techniques, which depends on the location and the dimensions of the defect after excision of the cancer and the quality of blood supply to the peri-lesional skin.
The aim of this study was to evaluate the efficacy and reliability of a new axial island retroauricular flap (middle-retroauricular island flap M-RIF) for coverage of non-helical ear defects with direct donor site closure.

Methods:
All patients, from January 2013 to January 2020, with skin tumors of the non-helix region and undergoing a combined skin-cartilage excision with M-RIF local flap reconstruction under local anesthesia, were enrolled in the study.

Results:
18 patients (14 men and 4 women) underwent auricle skin-cartilage excision and M-RIF flap reconstruction. The mean age was 65 years (range, 60–85); the type of primary lesions were 12 BCC and 6 SCC. One flap wound dehiscence and one donor site infection and partial necrosis of the posterior auricular skin occurred; no other complications were recorded.

Conclusions:
The M-RIF flap is a valid surgical option when dealing with non-helical defects of the anterior pinna. It allows the reconstruction of the defect of the entire anterior surface of the auricle apart from the helix and the lobe and primary donor site closure.
Development and Validation of Scoring System to Predict Secondary Amputations in Free Flap Reconstruction
Authors: Karamanos Efstathios , Ahmad Hassan , Makhani Ahmed A. , Dev Ameesh N. , Saad Noah , Julian Bao-Quynh , AlQattan Husain , Wang Howard , Cromack Douglas 
Published: January 2021

Background:
Need for amputation is a potential complication when limb salvage is attempted. The present study aimed to develop a risk assessment tool to predict the risk of future amputation when counseling patients about their reconstructive options.

Methods:
All patients undergoing a free flap lower extremity soft tissue reconstruction by the senior author from 2005 to 2019 were retrospectively identified. Patient’s demographics, comorbidities, and technical aspects of the operation were extracted. Logistic regressions were used to create a predictive scoring system for future amputation.

Results:
A total of 277 patients were identified. Of these patients, two-thirds (183) were used to derive the scoring system and one-third (94) were used to validate the score. In total, 25 of 183 patients (14%) underwent an amputation. A stepwise forward logistic regression identified age > 55 years, smoking, acute wound, aggressive fluid resuscitation intra-operatively, inability to use a superficial vein for drainage, and inability to use the posterior tibialis artery for anastomosis as independent predictors of need for future amputations. The beta co-efficients were used to create the scoring system, and the patients were categorized into mild, moderate, and severe risk based on their cumulative score. The validity of the scoring system was verified by using the one-third validation cohort.

Conclusions:
In patients undergoing free flap reconstruction of the lower extremity, the need for future amputation is 14%. The use of a scoring system can guide the surgeon’s and patient’s decision regarding limb salvage.
Is Tissue Expansion Worth It? Comparative Outcomes of Skin-preserving versus Delayed Autologous Breast Reconstruction
Authors: Phillips Brett T. , Mercier-Couture Genevieve , Xue Amy S. , Chu Carrie K. , Schaverien Mark V. , Liu Jun , Garvey Patrick B. , Baumann Donald P. , Butler Charles E. , Largo Rene D. 
Published: January 2021

Background:
The requirement for postmastectomy radiation therapy (PMRT) at the time of mastectomy is often unknown. Autologous reconstruction is preferred in the setting of radiotherapy by providing healthy vascularized tissue to the chest. To maximize mastectomy skin preservation, tissue expander (TE) placement maintains the breast pocket until definitive reconstruction. This study aims to compare outcomes of skin-preserving delayed versus standard delayed autologous breast reconstruction in the setting of PMRT.

Methods:
A retrospective review of a prospective database was performed of two patient cohorts at a single center between 2006 and 2016. Inclusion criteria were locally advanced breast cancer patients who completed PMRT and free autologous reconstruction. Primary outcomes were major intraoperative and postoperative TE and flap complications.

Results:
Over 10 years, 241 patients underwent mastectomy and PMRT. Standard delayed autologous breast reconstruction was performed in 131 breasts (non-TE group). Skin-preserving delayed autologous reconstruction was performed in 113 breasts (TE group). The TE group was associated with a higher incidence of intraoperative complications during flap reconstruction (P = 0.002) and had a higher venous thrombosis incidence than the non-TE cohort (P = 0.007). Other major postoperative complications were not significantly different between the two groups. TE patients had 7.5 times higher risk of intraoperative complications and an 18.6% TE loss rate.

Conclusions:
We identified higher intraoperative flap complications and a high rate of TE loss in patients who underwent skin-preserving delayed autologous breast reconstruction. The benefit of mastectomy skin preservation needs to be weighed against the increased risk of TE loss and higher rates of flap thrombosis.
Surgeon-administered Ultrasound-guided Peripheral Nerve Blocks in Outpatient Procedures of the Upper Extremity
Authors: Winter Jessica , McLeod Graham , Quaife Tanis , Petropolis Christian 
Published: January 2021

Summary
Outpatient hand surgery is often performed in the operating room, which can result in prolonged waiting times for patients when operating room resources are limited. Few studies have explored the application of ultrasound-guided nerve blocks in the setting of outpatient hand surgery. Fifty patients were enrolled in this prospective study. Ultrasound-guided peripheral nerve blocks were performed at the level of the elbow and proximal forearm for outpatient hand surgeries. A timer was used to record the time to administer the block and time to affect. A post-procedure survey was administered, which included a numerical analogue scale (0–10) and Likert rating scale questions to characterize the patients’ pain experience for receiving the block and pain during the procedure: pain experienced by patients receiving the ultrasound-guided nerve block(s) (0–10), mean: 1.84; pain experienced by patients during a procedure (0–10), mean: 0.56; surgeon satisfaction during the procedure (0–10), mean 9.78. Average time to perform the ultrasound-guided nerve block(s) was 4 minutes 58 seconds; average time from completion of the block to effect reported by patients, 5 minutes 42 seconds; the average time for performing the procedure, 21 minutes 30 seconds. Our study shows that the use of ultrasound to block peripheral nerves of the forearm is effective; <10% of patients required additional local anesthetic. The technique is safe; no complications were reported. The technique is efficient in an outpatient hand surgery setting.