bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beard and Moustache Reconstruction
Authors: Dua Kapil , Verma Vandana , Dua Aman 
Published: December 2021

AbstractBeard and moustache reconstruction has gained more popularity and acceptance over the last decade. The procedure is done for the correction of facial areas with hair density deficit and also for the cosmetic enhancement of pre-existing facial hair. The surgical technique includes the harvesting of grafts from the scalp by the follicular unit excision (FUE) or follicular unit transplantation (FUT) technique and then placing them in either premade slits or by stick and place method. The advancement and refinement of procedure over the years has aided in achieving the optimal aesthetic results, with minimal side effects.
Determinants of innovation and interactive learning in informal manufacturing enterprises in India
Authors: Shekar K Chandra , Joseph K J 
Published: December 2021

Abstract
In the context of globalization, the informal sector enterprises are also exposed to international competition; and therefore, they need to remain productive and competitive. In this regard, innovation is an obvious strategic choice at the firm level. Drawing from the data gathered through an extensive field survey in NCT-Delhi, India, this study observes that innovation activities in the informal enterprises take place mostly through non-research-and-development routes and rely more on interactive learning and learning by doing. The econometric analysis shows that formal interactions through subcontracting and membership in the industrial associations along with informal interactions with other firms, buyer–supplier interactions, and social capital are having positive and significant influence on product, process, and marketing innovation. However, this study reveals that formal interactions play a vital role in introducing marketing innovations. Further, the results show the essential role of in-house training, entrepreneurial expertise, and information communication technology usage at the firm level. Thus, the paper provides empirical evidence reiterating the importance of integrating informal manufacturing enterprises and their learning processes as the key components of the innovation system in India.
Bruise Location in Supracondylar Humerus Fractures Predicts Specific Neurovascular Injuries
Authors: Schultz Jacob D. , Rees Andrew B. , Wollenman Lucas C. , Lempert Nathaniel , Moore-Lotridge Stephanie N. , Schoenecker Jonathan G. 
Published: December 2021

Purpose:
The presence of soft tissue injury in pediatric supracondylar humerus fractures (SCHFs) has been shown to be an independent predictor of any neurovascular injury. Potentially expanding this concept, the specific neurovascular structure injured around the elbow is thought to be dependent upon the direction and magnitude of fracture displacement and subsequent soft tissue injury. Therefore, it was hypothesized that the bruise location following SCHF is indicative of the anatomic location of maximal soft tissue injury and therefore is a specific prognosticator of which neurovascular structure may be injured.

Methods:
Retrospective chart review of all SCHFs treated at a tertiary pediatric hospital from 2007 to 2017 collected information on bruise location, neurovascular injury patterns, and outcomes. Bruise location was classified as anterior, anterolateral, anteromedial, or posterior. Injury radiographs were reviewed by a blinded pediatric orthopaedic surgeon to neurovascular structure injured.

Results:
Of 2845 SCHFs identified, 267 (9.4%) had concomitant neurovascular injury—of which 128 (47.9%) met inclusion criteria. Among the vascular injuries, all bruising was anteromedial (28/45, 62.2%, P<0.05) or anterior (17/45, 37.8%, P>0.05). Fractures with anteromedial bruising correlated with median nerve injury (24/27, 88.9%, P<0.05), whereas fractures with anterolateral bruising correlated with radial nerve injuries (24/25, 96.0%, P<0.05). Bruising or radiographic evaluation correctly identified 60.2% and 64.1% of neurovascular injuries, respectively, whereas the combination identified 82.0% of neurovascular injuries correctly. Bruise location identified 23 neurovascular injuries not predicted by radiographic evaluation alone.

Conclusion:
Bruise location is an important physical examination finding that can be used as an adjunct to improve the diagnostic accuracy of neurovascular injury in SCHFs in conjunction with neurovascular physical examination and radiographic evaluation. SCHFs with anterior or anteromedial bruising should raise concern for vascular injury. In addition, anteromedial bruising is predictive of a median nerve injury and anterolateral bruising is predictive of radial nerve injury. This adjunct diagnostic is particularly helpful in a noncooperative child or if performed by a clinician with limited experience in diagnosing neurovascular injuries or interpreting pediatric elbow radiographs.

Level of Evidence:
Level IV, case series.
Unplanned Return to the Operating Room (UpROR) After Pediatric Diaphyseal Femoral Fractures
Authors: Baghdadi Soroush , Mahmoud Mahmoud A.H. , Flynn John (Jack) M. , Arkader Alexandre 
Published: December 2021

Background:
Femoral fractures are the most common cause of fracture-related admissions. Unplanned return to the operating room (UpROR) is a major event and imposes a substantial burden on the family and health care system. The purpose of this study was to determine the incidence of complications and early UpROR during the first 6 months following treatment of femoral fractures and their risk factors.

Methods:
In an institutional review board–approved study, a retrospective review of all patients who were treated for a femoral fracture during a 10-year period at a pediatric tertiary care center was performed. Patients less than 18 years old with a diaphyseal fracture and complete records were included, and nondiaphyseal or pathologic fractures, as well as underlying metabolic or genetic disorders, were excluded. All clinic visits in the first 6 months after treatment were reviewed, and all complications and UpRORs were extracted. Patients were grouped based on their age (below 5, 5 to 11, above 11 y old) at initial treatment, and statistical tests were used to infer differences between groups.

Results:
Overall, 841 fractures in 832 patients were included, with a mean age of 5.5±4.8 years fracture, of which 72% were male. A total of 106 complications (12.6%) and 45 UpRORs (5.3%) were encountered during the study period. Patients with and without UpROR had similar demographics and injury and treatment characteristics. Loss of reduction was the most common reason for UpROR (58%), followed by implant-related complications. Flexible nails had the highest risk of UpROR among patients who were initially treated surgically (P=0.03).

Conclusions:
Our findings indicate that children under the age of 5 years have a 5% risk of UpROR in the first 6 months after the fracture, mainly for repeat spica casting due to loss of reduction. Patients aged 5 years or older have an ∼6% risk of UpROR, mainly related to complications of flexible nails. The findings of this study are important when consulting families on different treatments of diaphyseal femoral fractures.

Level of Evidence:
Therapeutic level III—retrospective cohort study.
Evidence-based cataract surgery teaching milestones: guide to evaluate resident achievement
Authors: Milovanova Ekaterina , Rudnisky Christopher J. 
Published: December 2021

Purpose:
To develop evidence-based milestones for cataract surgery teaching and identify performance indicators.

Setting:
Royal Alexandra Hospital, Edmonton, Alberta, Canada.

Design:
Retrospective cohort study.

Methods:
Operative records from a single surgeon were reviewed for resident participation when learning cataract surgery over a 14-year period. Time to complete a resident's first complete case was the primary outcome. Secondary outcomes included mean time to perform each categorical step of the procedure, number of cases participated in, rate of participation, complex case involvement, and complications. Strong resident performance was defined as time to first complete a case 1 SD quicker than mean performance; weak performance was the opposite.

Results:
Residents (n = 13) performed beginner steps for 3.1 ± 3.2 months and intermediate steps until month 4.3 ± 3.3, and by month, 5.1 ± 3.4 residents were able to do complete cases. Time to perform a complete case increased with lower case participation (P = .02); mean proportion of complex cases that a resident participated in was 7.9% (n = 17.6 ± 10.0); less than 1% of resident cases resulted in posterior capsular rupture (PCR; n = 1.4 ± 1.3 cases). Based on these data, weaker achievement was defined as failure to achieve beginner-step competency by month 6.3, intermediate step competency by month 7.6, or inability to perform a complete case by month 8.5. In this dataset, 23.1% of residents (n = 3) met this definition.

Conclusions:
Residents who train with multiple teachers during a focused cataract surgery rotation can perform complete cases after a mean of 5.1 ± 3.4 months with a low PCR rate.
“Worse Than Disappointing”: Prediagnostic Health Care Challenges of Women With Inflammatory Vulvar Dermatoses
Authors: Rivera Sydney , Dykstra Chandler , Flood Anna , Herbenick Debby , DeMaria Andrea L. 
Published: December 2021

Objective
The purpose of this study was to investigate challenges women face before inflammatory vulvar dermatosis diagnosis to guide interventions for improving time to diagnosis and health care experiences.

Materials and Methods
The present analysis was part of a larger study exploring sexual health and quality of life of women with vulvar and nonvulvar inflammatory dermatoses, evaluated via a 20-minute web-based survey. One open-response item asked participants to “briefly describe any challenges you faced with regards to health care or health care providers in the time when you were seeking a diagnosis”; this item informed the present study. Eligible participants were women older than 18 years, living in the United States, with diagnosis of an inflammatory vulvar dermatosis persisting at least 1 month. Participants (n = 118) had a mean age of 46.55 ± 15.35 years, and 64% (n = 75) had lichen sclerosus.

Results
Provider-based challenges consisted of insensitive communication and ascribing physical symptoms to mental health issues, self-harm, or other factors. System-based challenges included confusing referral networks, limited specialist access, and widespread lack of provider education. Personal challenges for participants seeking care included feelings of embarrassment and reduced health care efficacy. Challenges led to emotional response and impact for participants, characterized by negative (e.g., distrust in the medical system) or positive (e.g., self-advocacy efforts, strong social media communities) outcomes.

Conclusions
Findings provide unique insights into the challenges women experience before inflammatory vulvar dermatosis diagnosis. This study creates new knowledge exploring the diagnostic journey accompanying inflammatory vulvar dermatoses and contributes practically to clinical and research needs of this understudied population.
The Vaginal Microbiome: V. Therapeutic Modalities of Vaginal Microbiome Engineering and Research Challenges
Authors: Vieira-Baptista Pedro , De Seta Francesco , Verstraelen Hans , Ventolini Gary , Lonnee-Hoffmann Risa , Lev-Sagie Ahinoam 
Published: December 2021

Objective
This series of articles, titled The Vaginal Microbiome (VMB), written on behalf of the International Society for the Study of Vulvovaginal Disease, aims to summarize the recent findings and understanding of the vaginal bacterial microbiota, mainly regarding areas relevant to clinicians specializing in vulvovaginal disorders.

Materials and Methods
A search of PubMed database was performed, using the search terms “vaginal microbiome” with “treatment,” “diagnosis,” and “research.” Full article texts were reviewed. Reference lists were screened for additional articles.

Results
The currently available approaches for treating vaginitis or attempting to modulate the VMB are often insufficient. It has traditionally relied on the use of antibiotics, antiseptics, and antifungals. The fifth and last article of this series discusses the new and/or alternative therapeutic modalities. It addresses the role of probiotics, prebiotics and symbiotics, activated charcoal, biofilm disrupting agents, acidifying agents, phage therapy, and the concept of vaginal microbiome transplant. The challenges facing the research of VMB, including the clinical impact of microbiome manipulation, classification, and new diagnostic approaches are discussed.

Conclusions
Microbiome research has grown dramatically in recent years, motivated by innovations in technology and decrease in analysis costs. This research has yielded huge insight into the nature of microbial communities, their interactions, and effects with their hosts and other microbes. Further understanding of the bacterial, fungal, phage, and viral microbiomes in combination with host genetics, immunologic status, and environmental factors is needed to better understand and provide personalized medical diagnostics and interventions to improve women's health.
Case Report: Recurrent Transient Monocular Vision Loss Secondary to Protein C Deficiency
Authors: Zeng Tina , Malloy Kelly A. 
Published: December 2021

SIGNIFICANCE
Protein C deficiency is a thrombophilic condition that increases the risk of venous and arterial thrombi, the latter of which can cause transient monocular vision loss. In cases of recurrent transient monocular vision loss, in which the typical stroke workup has been unrevealing, investigation for hypercoagulable states is warranted.

PURPOSE
This study reports a case of transient monocular vision loss secondary to protein C deficiency in a patient with no known personal or family history of venous thromboembolism and highlights the eye care provider's role in helping with diagnosis of this condition.

CASE REPORT
A 59-year-old woman presented with recurrent transient monocular vision loss of the right eye. Her history was remarkable for suffering an ischemic stroke with hemorrhagic conversion shortly after experiencing episodes of transient monocular vision loss. These episodes initially waned but recurred 3 months later. Extensive workup at the time of recurrence of her visual symptoms was unrevealing. Given the timing of her visual symptoms and history of stroke, her presentation was suggestive of transient ischemic attacks. Her previous extensive workup and chronicity of symptoms did not necessitate emergent evaluation. However, additional workup for hypercoagulable conditions was initiated. The testing revealed protein C deficiency, which prompted initiation of oral anticoagulants for stroke prophylaxis.

CONCLUSIONS
Transient monocular vision loss is a symptom commonly encountered by eye care providers, which necessitates emergent evaluation to reduce stroke risk if the symptom appears vascular in origin. Testing for hypercoagulable conditions is indicated in patients demonstrating recurrent transient monocular vision loss, even if there is no known personal or family history of venous thromboembolism. Eye care providers need to be aware of this association between hypercoagulable conditions and transient vision loss to aid in prompt diagnosis and treatment with the goal of preventing stroke and permanent vision loss.
Malignant Sarcomatous Degeneration of Craniofacial Fibrous Dysplasia
Authors: Hussaini Adnan S. , Swanson Daniel D. , Nguy Peter L. , Pan Kristen S. , de Castro Luis F. , Boyce Alison M. , Collins Michael T. , DeKlotz Timothy R. 
Published: December 2021

Background:
Fibrous dysplasia (FD) is an uncommon bone disease characterized by the replacement of normal bone architecture with abnormal fibro-osseous connective tissue. Here, we discuss 2 cases of craniofacial FD, with malignant sarcomatous degeneration - a rare and morbid complication of the disease.

Case History:
Two cases of craniofacial FD with malignant degeneration are presented. In the first, a 68-year-old male with a history of FD presented with acutely worsening left-sided facial pain and V2 and V3 hypoesthesia. Imaging findings suggested a large infratemporal fossa mass with biopsy demonstrating sarcomatous degeneration. Radical craniofacial resection achieved a gross total resection with likely microscopic disease. The patient was unable to tolerate adjuvant chemotherapy or radiation and succumbed to his disease 13 months following surgery.
In the second case, a 36-year-old male with McCune-Albright Syndrome and craniofacial FD presented with acutely worsening left-sided headaches and midface hypoesthesia. Imaging revealed a heterogenous and expansile lesion with erosive changes in the left nasal cavity and infratemporal fossa. Pathology was suggestive of low grade sarcomatous degeneration. Given the extensive involvement of the skull base, the tumor was deemed unresectable, and the patient soon died following initiation of chemotherapy.

Clinical Relevance:
Malignant sarcomatous transformation is a rare and challenging complication of craniofacial FD. Indolent onset, advanced spread at time of presentation, and close relationship with vital neurovascular structures are all hurdles for the treating clinician. The entity poses a diagnostic dilemma, as pathological analysis can be equivocal and may mimic nonmalignant processes, such as locally aggressive FD.
A Multicentric Prospective Study on Maxillofacial Trauma Due to Road Traffic Accidents: The World Oral and Maxillofacial Trauma Project
Authors: Romeo Irene , Roccia Fabio , Aladelusi Timothy , Rae Euan , Laverick Sean , Ganasouli Dimitra , Zanakis Stelios N. , de Oliveira Gorla Luis Fernando , Pereira-Filho Valfrido Antonio , Gallafassi Daniel , Faverani Leonardo Perez , Alalawy Haider , Kamel Mohammed , Samieirad Sahand , Jaisani Mehul Raiesh , Rahman Sajjad Abdur , Rahman Tabishur , Goetzinger Maximilian , Bottini Gian Battista , Carlaw Kirsten , Aquilina Peter , Duran-Valles Francesc , Bescos Coro , Hassanein Ahmed Gaber 
Published: December 2021

Abstract
The purpose of this prospective multicenter study was to analyze the epidemiology, patterns, and management of maxillofacial fractures due to road traffic accidents (RTAs) worldwide.
Between Monday September 30, 2019 and Sunday October 4, 2020,1066 patients with RTAs related fractures were admitted to 14 maxillofacial surgery departments. The following data were analyzed: age, gender, mechanism of injury, alcohol or drug abuse at the time of trauma, maxillofacial fracture site, facial injury severity scale (FISS) score, associated injuries, day and month of trauma, time of treatment, type of treatment and length of hospital stay. Data were analyzed using bivaried and multivaried statistical analysis.
Eight hundred seventy patients were male, and 196 were female. The most common mechanism of injury was motorcycle accidents (48%). More than half of the patients had fractures of the middle third of the maxillofacial skeleton. In total, 59% of the study sample underwent open reduction internal fixation. The median facial injury severity scale (3 points) and the medial hospital stay (3 days) were significantly lower in patients with seatbelts and helmet (P
< 0.001).
This first prospective, multicenter epidemiological study shows that motorcycle accidents are the leading cause of RTAs related fractures, mostly in young males. Particularly in Australia and Europe, the incidence of RTAs was significantly lower. Moreover, this study found that the severity of maxillofacial lesions was significantly higher in patients without safety devices, with consequent longer hospital stay demonstrating the efficacy of road safety policies in preventing maxillofacial injury.
Effect of Maxillary Skeletal Expansion on Airflow Dynamics of the Upper Airway
Authors: Liu Zhenggang , Zhang Nan , Chen Shuai , Lei Li 
Published: December 2021

Abstract:
Maxillary skeletal expansion (MSE) provides a new nonsurgical method for the treatment of patients with insufficient maxillary arch expansion width. In this study the aerodynamic changes of the upper airway after MSE in adult patients were explored based on three-dimensional reconstruction technology of cone-beam computed tomographic data and the numerical simulation technology of computational fluid dynamics. An upper airway experimental model was then created based on three-dimensional printing technology and tested in vitro to verify the reliability of the numerical simulation method. The comparison between numerical simulation and experimental results shows that the 2 results are in good agreement. The results of numerical simulation showed that the cross-sectional area of the upper airway was increased after MSE, the pressure and velocity of the upper airway were reduced, and airway resistance was also reduced during exhalation and inhalation. This study shows that MSE can effectively improve the airway dynamics of patients.
The Long-Term Clinical Outcomes of Selectively Extracranial Radiofrequency Thermocoagulation for Trigeminal Neuralgia Guided by Three-Dimensionally Printed Personalized Template
Authors: Jiang Ziyan , Jiang Shengchao , Meng Qinggong , Cai Hengxing , Ke Jin 
Published: December 2021

Abstract:
The purpose of this study was to assess the long-term pain relief and the complications of selectively extracranial radio-frequency thermocoagulation (RFT) for trigeminal neuralgia (TN) guided by a three-dimensionally (3D) printed personalized template. The authors conducted a retrospective study of 117 TN patients, who were treated with selectively extracranial RFT under 3D printed personalized template guidance between September 2014 and January 2019. The mean follow-up duration was 42.8 months (range: 28–83 months). Favorable pain relief of patients was 100% at discharge, 86.3% at 1 year, 80.3% at 2 years, 78.6% at 3 years, and 75.4% at 5 years. No complication associated with a puncture or intracranial complication was observed during or after RFT. Postoperative complications included facial numbness in 91 patients (77.8%), masticatory muscle weakness in 15 patients (12.8%), ear paresthesia in 3 patients (2.6%), limited mouth opening in 2 patients (1.7%), and taste hypesthesia in 2 patients (1.7%). Most of these symptoms were improved during the visits and their life was not severely affected. Selectively extracranial RFT guided by a 3D printed personalized template is a clinically practical, effective, and safe approach for TN patients.
Nevoid Basal Cell Carcinoma Syndrome: Clinical Features, Treatment, and Diagnostic Criteria
Authors: Zhang Ting , Chen Renji , Guo Siyuan 
Published: December 2021

Abstract:
Nevoid basal cell carcinoma syndrome is a rare genetic disorder that has an impact on the body’s organs, such as skin and skeletal. Clinical features, physical and pathological examinations, surgical treatment, and diagnostic criteria have been explicated by means of describing the medical experience of a patient with nevoid basal cell carcinoma syndrome in this report.