bluuebunny/crossref_metadata_2025_split huggingface dataset:
Salvaging Exposed Cochlear Implants
Authors: Arab Khalid , Altamimi Lamees , Al-Otaibi Haya , Kattan Abdullah , Gelidan Adnan G. 
Published: October 2021

Background:
The cochlear implant (CI) procedure is one of the most efficient surgical options for the management of patients suffering from severe bilateral sensorineural hearing loss. Notably, CI exposure is one of the most commonly reported complications. Herein, we report our experience in the management of three patients with CIs complicated by implant exposure.

Methods:
We present a retrospective review-based case series of three patients with exposed CIs requiring soft tissue coverage who were referred to plastic surgery care. These patients underwent their CI procedures at a university hospital specializing in ear, nose, and throat, after which they were referred for plastic surgery care at our university hospital for reconstruction after exposure. Each patient was managed through different surgical techniques based on the size, site, and condition of the surrounding tissue. The management options are discussed in this article.

Results:
Three patients with exposed cochlear implants were treated with different surgical techniques. During the 1-year follow-up period, the patients made an uneventful recovery with fully functional cochlear implants.

Conclusions:
The management of CI extrusion with local scalp flaps can constitute an effective and reliable option to salvage CI with a good prognosis and a lower incidence of exposure recurrence. Optimal results for establishing effective soft tissue coverage can be achieved by choosing the appropriate technique according to the clinical presentation.
Reconstruction of Completely Circumferentially Degloved Thumb Using Omental Flap and Tubular Split-thickness Skin Graft
Authors: Suito Motomu , Abe Naoki , Hirasawa Chihiro , Aisaka Tetsuya , Sakai Hiroshi 
Published: October 2021

Summary:
Various types of thin flaps have been used for reconstruction in cases of complete circumferential degloving injuries of digits (Urbaniak classification class III). The omental flap has extensive, pliable, and well-vascularized tissue and helps prevent bone resorption of the distal phalange that can result from avascular necrosis. A 31-year-old right-handed man with class III left thumb injury and compartment syndrome of the left forearm was treated successfully with a free omental flap wrapped around the thumb and then covered with a tubular split-thickness skin graft. The postoperative course was good, except that the distal third of the phalange of the thumb was resected because of insufficient omentum volume transplanted to the thumb tip resulting from omental volume bias in the distal part of the thumb. Bone scintigraphy 1 year after injury showed technetium-99m accumulation in the remaining two-thirds of the distal phalange, although there was no blood supply before the reconstruction. The advantages of our treatment method are that the thickness of the reconstructed digits can be adjusted by the amount of the omental flap. Skin grafting can be simplified; and with multiple digital injuries, separated fingers can be reconstructed in a single operation by wrapping each digit with a divided omental flap. Use of the free omental flap and tubular split-thickness skin graft is a therapeutic reconstruction option for Urbaniak class III injury.
Antibacterial action mechanisms of trypsin inhibitors
Authors: de Souza Nascimento Amanda Maria , Rodrigues Matias Lídia Leonize , de Oliveira Segundo Victor Hugo , Piuvezam Grasiela , Passos Thaís Souza , Damasceno Karla Suzanne Florentino da Silva Chaves , Morais Ana Heloneida de Araújo 
Published: October 2021

Abstract

Introduction:
Infectious diseases caused by bacteria represent one of the challenges in human healthcare, mostly caused by resistant bacteria, increasing the treatment cost, and fatal health complications. Researchers worldwide seek new therapeutic strategies to combat these highly resistant bacteria. Trypsin inhibitor peptides or proteins have innumerous bioactivities, such as antibacterial activity, which makes them potential candidates to treat diseases caused by bacteria. Thus, this study protocol describes a systematic review concerning the action mechanisms related to these molecules’ antibacterial activity.

Methods:
This systematic review protocol was elaborated according to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). The databases PubMed, ScienceDirect, Scopus, Web of Science, and Virtual Health Library will be used. Experimental studies carried out with rats and/or mice of both sexes, without water or diet restriction and in vitro (bacterial culture) studies and in cell, treated with trypsin inhibitor-type peptides or proteins that have a possible antibacterial action will be included. If at least two studies present clinical and/or methodological and/or statistical homogeneity, a meta-analysis will be carried out at the end of the analysis. The selection of studies, data extraction, and methodological quality assessment will be performed independently by two reviewers.

Results:
This protocol will be the basis for a systematic review. It is expected to identify several manuscripts highlighting the mechanisms related to the action of trypsin inhibitor peptides or proteins on bacteria.

Conclusion:
The systematic review based on this protocol will gather knowledge about trypsin inhibitor peptides or proteins’ antibacterial action mechanisms. It will provide subsidies for new research involving these molecules’ application against infectious diseases caused by bacteria.

Ethics and dissemination:
The present work does not involve any humans or animals; therefore, ethical approval is not needed.

Prospero Registration Number:
This review was registered with the International Register of Prospective Systematic Reviews on Jun 11, 2020 (registration: CRD42020189069). Available at: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=189069.
Vocal fold sulci – what are the current options for and outcomes of treatment?
Authors: Avellaneda Juan Carlos , Allen Jacqueline E. 
Published: October 2021

Purpose of review
Sulcus vocalis is a benign condition of the vocal folds that, according to its severity, can affect the quality of the voice of those who have it. Voice symptoms can range from mild to severe, affecting the quality of life of patients with this condition. Although different surgical and no surgical options have been described, no gold standard treatment has been described.

Recent findings
New evidence supports congenital, inflammatory, and acquired theories for sulcus vocalis. Also, recent literature demonstrated the role of the epithelium in the pathogenesis, which makes the absence of superficial lamina propria no longer the only accepted hypothesis. Technological developments improved the in-office diagnostics capabilities for this condition, but vocal fold palpation remains the gold standard. Different benign laryngeal conditions are associated with sulcus vocalis and knowing when to treat those is very important. Different treatment options are available for sulcus vocalis, however, results are diverse and no strong recommendations for one over the other can be made.

Summary
Progress continues to be made in our understanding of sulcus vocalis from diagnosis to treatment. Novel and promising therapeutic strategies have been recently developed for this condition; however, more data and investigations are needed to improve their accuracy and reproducibility.
Global Burden of Orofacial Clefts and the World Surgical Workforce
Authors: Massenburg Benjamin B. , Hopper Richard A. , Crowe Christopher S. , Morrison Shane D. , Alonso Nivaldo , Calis Mert , Donkor Peter , Kreshanti Prasetyanugraheni , Yuan Jie 
Published: October 2021

Background:
Orofacial clefts are one of the most common congenital anomalies, but this disease burden is unevenly distributed worldwide. The authors hypothesize that this burden falls disproportionately on the countries with the smallest surgical workforce or lowest Socio-Demographic Index, rather than those with the highest prevalence of disease.

Methods:
The authors estimated the prevalence and disease burden of orofacial clefting from 1990 to 2017 in 195 countries using the Global Burden of Disease methodology. Prevalence and disability-adjusted life-years were compared geographically, temporally, and against the size of the national surgical workforce, Socio-Demographic Index, and income status. Linear and logarithmic regressions were performed.

Results:
In 2017, the prevalence of orofacial clefting was estimated to be 10.8 million people, representing a disease burden of 652,084 disability-adjusted life-years, with most of this disease burden experienced by low- and middle-income countries (94.1%). From 1990 to 2017, there was a decrease in disease burden (-70.2%) and prevalence (-4.9%). There was negative logarithmic association between surgical workforce size and disease burden, with a surgical workforce of greater than six providers per 100,000 population (3.6 disability-adjusted life-years versus 22.4 disability-adjusted life-years per 100,000 population; p < 0.0001).

Conclusions:
Burden of orofacial clefting has a strong negative association with the size of the surgical workforce, suggesting that strengthening the surgical workforce will help alleviate this burden. Epidemiologic data on countries and regions with inadequate surgical workforces and high disease burden should guide future research efforts and allocation of resources, and guide the treatment and educational goals of international charitable organizations.
The Incidence of Occult Malignant and High-Risk Pathologic Findings in Breast Reduction Specimens
Authors: Razavi Seyed Amirhossein , Hart Alexandra M. , Betarbet Udayan , Li Xiaoxian , Carlson Grant W. , Losken Albert 
Published: October 2021

Background:
The goal of this study was to determine the incidence of occult malignancy and high-risk breast pathologic findings in patients who undergo breast reduction procedures.

Methods:
Medical records of consecutive patients who underwent reduction mammaplasty performed by the senior authors (A.L. and G.W.C.) at Emory University Hospital between 1997 and 2018 were reviewed. Data regarding patient demographics, personal or family history of malignancy, operative technique, pathologic findings, and follow-up were extracted. Patients were categorized into two groups, those with and those without breast cancer. Group A patients underwent reduction for symptomatic macromastia, and group B underwent contralateral reduction for unilateral breast cancer treated with oncoplastic partial or total breast cancer reconstruction. Pathologic findings were divided into four groups; normal, benign, high-risk, and malignant.

Results:
A total 1014 patients (1419 breast reductions) were included in the study. Comparing groups A and B, mean age was 37.8 ± 16.2 years versus 54.5 ± 11.1 years (p < 0.001), mean body mass index was 34.1 ± 7.6 kg/m2 versus 33.3 ± 7.4 kg/m2 (p = 0.2), and average reduction weight was 875.6 ± 491 g versus 723.7 ± 438 g (p < 0.001). The incidence of high-risk or malignant lesions was 1.8 percent (n = 15) in group A and 8 percent (n = 49) in group B (p < 0.001). On multivariable logistic regression analysis, age and personal history of breast cancer were positive predictors for high-risk and malignant lesions.

Conclusions:
The incidence of abnormal pathologic findings in breast reduction specimens is not uncommon, and occult malignancy or high-risk lesions can be found, especially in patients with contralateral breast cancer. Appropriate specimen orientation, diligence with checking the pathologic findings, and open communication with the pathologist are crucial.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, II.
The Goldilocks Procedure with and without Implant-Based Immediate Breast Reconstruction in Obese Patients: The Mayo Clinic Experience
Authors: Bustos Samyd S. , Nguyen Minh-Doan , Harless Christin A. , Tran Nho V. , Martinez-Jorge Jorys , Lin Jason , Forte Antonio J. , Casey William J. , Boughey Judy C. , McLaughlin Sarah A. , Gray Richard , Manrique Oscar J. 
Published: October 2021

Background:
Obesity is a risk factor for complications in breast reconstruction. Thus, implant-based immediate breast reconstruction in obese women may be controversial. The authors analyzed obese patients who underwent skin-sparing mastectomy using Wise-pattern incisions (Goldilocks procedure) and compared outcomes between two groups: Goldilocks with immediate breast reconstruction and Goldilocks only.

Methods:
A retrospective review was performed of patients with a body mass index of 30 kg/m2 or higher who underwent the Goldilocks procedure at the Mayo Clinic Health System from 2012 to 2019. Data were extracted from electronic medical records. Minor complications (partial-thickness wound dehiscence or flap necrosis, or tissue expander/implant malposition) and major complications (full-thickness wound dehiscence or flap necrosis, capsular contracture, tissue expander/implant explantation, or unplanned reoperation or readmission) were compared between groups. Patient-reported outcomes using BREAST-Q questionnaires were also assessed.

Results:
One hundred five patients (181 breasts) were included. Mean ± SEM age and body mass index were 57.1 ± 10.4 years and 37.9 ± 5.8 kg/m2 for the Goldilocks-only group and 51.5 ± 1.1 years and 35.5 ± 0.4 kg/m2 for the Goldilocks with immediate breast reconstruction group, respectively. Median follow-up time was 15.1 months (interquartile range, 10.0 to 28.6 months). Overall, 96 breasts underwent the Goldilocks-only procedure and 85 Goldilocks with immediate breast reconstruction. Multivariable analyses revealed a higher rate of minor complications (adjusted hazard ratio, 2.83; 95 percent CI, 1.22 to 7.02) and major complications (adjusted hazard ratio, 2.26; 95 percent CI, 1.25 to 4.24) in the Goldilocks with immediate breast reconstruction group compared with the Goldilocks-only group, at any given time. Patient satisfaction was not statistically different between groups.

Conclusions:
The Goldilocks procedure is a feasible breast reconstructive option in obese patients; however, when it is performed with immediate breast reconstruction, it is associated with higher rates of complications. For patients with a body mass index of 40 kg/m2 or greater, the authors recommend the Goldilocks-only procedure or delayed reconstruction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Expanded Role of Alar Contour Grafts
Authors: Rohrich Rod J. , Durand Paul D. 
Published: October 2021

Summary:
Alar rim deformities are among the most common problems affecting patients undergoing both primary and secondary rhinoplasty. They can be caused by several factors such as congenital hypoplasia or malpositioning of the lateral crura, and from acquired surgical weakening during rhinoplasty. Even though altering the structure of the lower lateral cartilage complex can help prevent and correct alar rim deformities, this may not always allow for sufficient control of the alar rim. Alar contour grafts have been proven efficacious not just in the treatment of specific rim deformities but also in their prevention. In this article, the authors present four types of alar contour grafts and discuss their expanded role in the prevention and treatment of alar rim deformities.
Compliance to kangaroo mother care best practice: an evidence-based implementation project
Authors: Siraneh Yibeltal , Berhane Melkamu , Abraham Gelila , Feyissa Garumma Tolu , Morankar Sudhakar 
Published: October 2021

ABSTRACT

Background:
Worldwide about 13 million babies are born prematurely every year. Kangaroo mother care (KMC) is a proven, acceptable and feasible method to decrease the mortality rate of premature infants. Reviewing current KMC practices, implementing in the context and auditing the compliance would benefit the promotion evidence-based practice (EBP), which was not well known in the study area.

Objectives:
The main objective of the study was to increase awareness of EBP for KMC in the neonatal care unit of a public hospital through identifying local barriers and facilitators, and to measure compliance with best practice recommendations.

Methods:
The current KMC best practice quality improvement project was conducted between March and May 2018. The project team was established for this implementation project. Six KMC best practice audit criteria were used to evaluate the compliance at baseline and endline using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool. All (20) clinical staff who were working in the neonatal care unit were included in the study. Based on the baseline audit result, gaps and barriers were identified and discussed, and implementation strategies specific to the local setting were developed to mitigate the gaps. Baseline results were compared with the final follow-up audit result to measure change in compliance. Again, these data were compared with other studies to identify the sustainability of the project in a clinical setting.

Results:
A total of 80 cases (baseline 20 and implementation 60) were observed demonstrating KMC procedures. Study found that follow-up compliance rates for all criteria improved compared with baseline audit; for example, criterion 5 (assessment of infant's condition) improved from 20% during baseline to 90% during follow-up and criterion 3 (parent/family received counselling) improved from 30 to 95%.

Conclusion:
The current study demonstrated that EBP training and frequent supportive supervision translated in improved compliance to best available evidence to KMC in a resource-limited setting.
Management of nipple pain or trauma in breastfeeding mothers in a hospital setting: a best practice implementation project
Authors: Yang Lixia , Wang Xiaoyang , Luo Yin , Sun Fengjiao , Wu Minyan , Huang Yacui , Zhang Qian , Liu Yawei , Xiao Lin , Wang Ning 
Published: October 2021

ABSTRACT

Introduction and aims:
Breastfeeding is one of the best ways to ensure healthy growth and development of an infant. Nipple pain and trauma are common complications associated with breastfeeding, which render it difficult for the mother to continue breastfeeding. The aim of this project was to promote evidence-based practice in the management of nipple pain or trauma for breastfeeding mothers in a large tertiary hospital in China.

Methods:
The project was conducted using the Joanna Briggs Institute framework and Practical Application of Clinical Evidence System. Six audit criteria were applied in baseline and follow-up audits to assess compliance in practice with best practice recommendations. The Getting Research into Practice tool was used to help analyze barriers to the fulfillment of each audit criterion based on the baseline audit results. Implementation strategies were discussed and then undertaken to overcome the barriers and bring changes to the current practice.

Results:
The baseline audit results demonstrated poor compliance in nipple pain or trauma management practice with all of the six criteria. Significant improvements were achieved in the follow-up audit. Specifically, the compliance rate increased from 15 to 100% for criterion 1 and from 2 to 93% for criterion 2. For criteria 3, 4, 5 and 6, the compliance rate increased from 0 to 90, 85, 100 and 86%, respectively.

Conclusion:
The current evidence-based implementation project was successfully conducted and achieved great improvement in the management of nipple pain or trauma associated with breastfeeding. Continuous effort is required to maintain changes and further improve practice.
Regional probabilistic situational awareness and forecasting of COVID-19
Authors: Engebretsen Solveig , Palomares Alfonso Diz-Lois , Rø Gunnar , Kristoffersen Anja Bråthen , Lindstrøm Jonas Christoffer , Engø-Monsen Kenth , Hin Chan Louis Yat , Dale Ørjan , Eriksson Midtbø Jørgen , Stenerud Kristian Lindalen , Di Ruscio Francesco , White Richard , Frigessi Arnoldo , de Blasio Birgitte Freiesleben 
Published: October 2021

AbstractMathematical models and statistical inference are fundamental for surveillance and control of the COVID-19 pandemic. Several aspects cause regional heterogeneity in disease spread. Individual behaviour, mobility, viral variants and transmission vary locally, temporally and with season, and interventions and vaccination are often implemented regionally. Therefore, we developed a new regional changepoint stochastic SEIR metapopulation model. The model is informed by real-time mobility estimates from mobile phone data, laboratory-confirmed cases, and hospitalisation incidence. To estimate locally and time-varying transmissibility, case detection probabilities, and missed imported cases, we present a new sequential Approximate Bayesian Computation method allowing inference in useful time, despite the high parametric dimension. We test our approach on Norway and find that three-week-ahead predictions are precise and well-calibrated, suitable for real-time surveillance.SignificanceWe developed a regional infectious disease spread model focussing on operational usefulness in real time. The model is informed by near real-time mobile phone mobility data, laboratory-confirmed cases, and hospitalisation incidence. The model is used to estimate reproduction numbers and provide regional predictions of future hospital beds. Regional reproduction numbers are important due spatio-temporal heterogeneity due to for example local interventions. We assume different regional reproduction numbers for different periods of the epidemic. We propose a new calibration method to estimate the reproduction numbers and other parameters of the model, tailored to handle the increasingly high dimension of parameters over time. The model has been successfully used for local situational awareness and forecasting for the Norwegian health authorities during COVID-19.
Parallel functional subnetworks embedded in the macaque face patch system
Authors: Park Soo Hyun , Koyano Kenji W. , Russ Brian E. , Waidmann Elena N. , McMahon David B. T. , Leopold David A. 
Published: October 2021

AbstractDuring normal vision, our eyes provide the brain with a continuous stream of useful information about the world. How visually specialized areas of the cortex, such as face-selective patches, operate under natural modes of behavior is poorly understood. Here we report that, during the free viewing of videos, cohorts of face-selective neurons in the macaque cortex fractionate into distributed and parallel subnetworks that carry distinct information. We classified neurons into functional groups based on their video-driven coupling with fMRI time courses across the brain. Neurons from each group were distributed across multiple face patches but intermixed locally with other groups at each recording site. These findings challenge prevailing views about functional segregation in the cortex and underscore the importance of naturalistic paradigms for cognitive neuroscience.One-Sentence SummaryNatural visual experience reveals parallel functional subnetworks of neurons embedded within the macaque face patch system