bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safe Free Tissue Transfer in Patients Older than 90 Years
Authors: Hohman Marc H. , Vincent Aurora G. , Enzi Abdul R. , Ducic Yadranko 
Published: October 2021

Abstract
Objective This study aimed to evaluate the safety of microvascular free tissue transfer in the elderly patient population.
Methods We performed a 20-year retrospective review at a tertiary care private practice of patients of ≥ 90 years of age who underwent microvascular free tissue transfer and had at least 6 months of follow-up. Similarly, we reviewed patients aged 70 to 89 years who underwent free tissue transfer between 2018 and 2020 as a control group. Records were examined for type of flap, defect site, pathology, and occurrence of complications.
Results Overall 77 patients of 90 years or older met the inclusion criteria and 77 sequential patients aged 70 to 89 years were identified to serve as a control group. The overall complication rate among patients of ≥ 90 years of age was 18%, with flap-related complications in 4% (two partial flap loss and one total loss). The mortality rate was 1.3%. All patients of ≥ 90 years of age undergoing osteocutaneous reconstruction for osteoradionecrosis experienced complications, but only one was a flap complication (partial loss). Among patients aged 70 to 89 years, the overall complication rate was also 18%, with flap-related complications in 4% (two complete flap failures and one partial loss). The mortality rate in the control group was 2.6%.
Conclusion Soft tissue free flaps are a safe option in the elderly patient population and should be offered to patients who are medically optimized prior to surgery, regardless of age. Osteocutaneous reconstruction for osteoradionecrosis must be undertaken with caution. This study reflects level of evidence 4.
Visual Outcome of Combined Descemet Stripping Endothelial Keratoplasty and Sutured Scleral Fixated Intraocular Lens in Endothelial Decompensation with Coexistent Aphakia or Intra Ocular Lens Subluxation
Authors: Kaushik Jaya , Singh Ankita , Shetty Rakesh , Parihar Jitendra Kumar Singh , Kochhar Divya , Singhal Aanchal 
Published: October 2021

Purpose
To elucidate visual outcome of patients after combined Descemet stripping endothelial keratoplasty (DSEK) with scleral fixated intra ocular lens (SFIOL) implantation in patients of endothelial decompensation with coexistent aphakia or lens subluxation.

Materials and Methods
A prospective interventional study of combined DSEK with sutured SFIOL in the patients who have undergone surgery at our center over 6-month follow-up period. Preoperative visual acuity and slit lamp findings were documented. Postoperative follow-up was done at days 1, 3, and 7 subsequently, months 1 and 3, and thereafter monthly till the sixth month.

Results
Mean age of the patients was 60.47 years. Six patients had aphakic bullous keratopathy, while 11 patients had pseudophakic bullous keratopathy with subluxated posterior chamber IOL (PCIOL). Preoperative visual acuity ranged from hand movements close to face (LogMar 2.4) with accurate projection of rays to 1/60 (LogMar 2) due to existing corneal edema and aphakia. Postoperatively uncorrected visual acuity at 6 months improved up to 6/36 (LogMar 0.8) in all cases. There was gradual improvement in corneal clarity and compactness during the follow-up. A good donor tissue endothelial count and an adequate IOP control were vital prognostic factors for the successful outcome.

Conclusion
This novel surgical merger reduces the complications of lenticule dislocation into vitreous and repeated surgeries and shows results akin to when performed in a staged manner.
Genetic factors controlling nTiO
Authors: Thabet Samar G. , Sallam Ahmed , Moursi Yasser S. , Karam Mohamed A. , Alqudah Ahmad M. 
Published: October 2021

Titanium dioxide nanoparticle (nTiO2) is one of the most produced nanoparticles worldwide. Its mechanism on crop development and performance is unclear as it is hard to predict their toxicity or benefit. Therefore, understanding the genetics of crop development under nTiO2 is a prerequisite for their applications in agriculture and crop improvement. Here, we aimed to examine the influnce of 300 ppm nTiO2 on seed germination, seedling morphology, root-related traits in 121 worldwide spring barley (Hordeum vulgare L.) accessions. Results show that nTiO2 significantley affected all traits scored in this study. Response to nTiO2 treatment, clear wide natural variation among accesions was detected. Remarkably, 10 genotypes showed increased root length under nTiO2 at the seedling stage indicating that nTiO2 enhanced the root elongation. Genome-wide association scan (GWAS) was applied using 9K single nucleotide polymorphism (SNPs) in a mixed-linear model that revealed 86 significant marker-trait associations with all traits scored in this study. Many significant SNPs were physically located near candidate genes, of which 191 genes were detected within the linkage disequilibrium and distributed over all barley chromosomes. Mostly, the genes harboured by chromosome 2H, specially calcium-binding genes family, regulate the variation of seedling length-related traits. Candidate genes on 7H encode zinc finger protein that controls the rate of germination. Therefore, these genomic regions at 2H and 7H can be targeted to select for improved seedling development and seed germination under nTiO2 stress in soils. These results improve understanding the genetic control of seed germination and seedling development under high levels of nTiO2 that can support plant breeding and crop improvement programmes.
A log-log speedup for exponent one-fifth deterministic integer factorisation
Authors: Harvey David , Hittmeir Markus 
Published: October 2021

Building on techniques recently introduced by the second author, and further developed by the first author, we show that a positive integer

N
N

may be rigorously and deterministically factored into primes in at most
\[

O

(

N

1

/

5

log

16

/

5

⁡
N

(
log
⁡
log
⁡
N

)

3

/

5

)

O\left ( \frac {N^{1/5} \log ^{16/5} N}{(\log \log N)^{3/5}}\right )

\]
bit operations. This improves on the previous best known result by a factor of

(
log
⁡
log
⁡
N

)

3

/

5

(\log \log N)^{3/5}

.
Translation, production, and distribution of the Bible
Authors: Riches John 
Published: October 2021

Abstract
‘Translation, production, and distribution of the Bible’ examines the translation, production, and distribution of the Bible. For centuries, the religious texts were preserved in Hebrew on scrolls. By the 4th century ce, the whole of the Bible would be found in codex form. Later, the 15th century saw the growth of lay movements based on private prayer and bible reading. It also saw the development of printing using movable type, which made possible the production of cheaper bibles. This prepared the way for the Protestant Reformation with its powerful desire to make the Bible available to all. New methods of producing cheap bibles were developed in the 19th century and led to a remarkably dynamic process of distributing bibles across the world. In this the Bible societies played a vital role.
Galatians through history
Authors: Riches John 
Published: October 2021

Abstract
‘Galatians through history’ studies the rich reception history of Paul’s letter to the Galatians, which is one of the shorter works in the Bible. At the turn of the 4th century, it helped shape the new worlds which would emerge as the Roman Empire embraced Christianity. At the Reformation, it was one of the central texts for Martin Luther. Luther’s commentary was a key text for John Bunyan and for the Wesleys. It is important to look at how Paul deals in his letter with the central issue of Law observance and consider how later interpreters of his letter used his ideas and images to shape the life of the Churches in their very different situations.
Wavelet spectra for multivariate point processes
Authors: Cohen E A K , Gibberd A J 
Published: October 2021

SummaryWavelets provide the flexibility for analysing stochastic processes at different scales. In this article we apply them to multivariate point processes as a means of detecting and analysing unknown nonstationarity, both within and across component processes. To provide statistical tractability, a temporally smoothed wavelet periodogram is developed and shown to be equivalent to a multi-wavelet periodogram. Under a stationarity assumption, the distribution of the temporally smoothed wavelet periodogram is demonstrated to be asymptotically Wishart, with the centrality matrix and degrees of freedom readily computable from the multi-wavelet formulation. Distributional results extend to wavelet coherence, a time-scale measure of inter-process correlation. This statistical framework is used to construct a test for stationarity in multivariate point processes. The methods are applied to neural spike-train data, where it is shown to detect and characterize time-varying dependency patterns.
Personal Independence Payment Forms, a De/Re/Constructive Reading: Re/Positioning Claimants, Social Workers and Social Work Practice ‘through’ Policy Discourse
Authors: Cockain Alex 
Published: October 2021

AbstractThis article critically reads a Personal Independence Payment Claim Form. All agents implicated in this form (e.g. the Department of Work and Pensions, assessors, an Office Manager and health professionals) are contemplated although of central concern is the positioning of claimants—or the persons filling in the form on their behalf—and social workers, and the constructions of social work practice resulting from such positioning. This article investigates discourse in the form itself, the discourse claimants are obliged to supplement and the discursive formations this text registers/generates. To read this form, I distinguish between overt, declarative and manifest content and the covert, descriptive, latent, perhaps unintentional but violent content, accessing the latter through a symptomatic reading, which draws upon my interpretation of principles associated with deconstruction, critical discourse analysis, decentering and positioning. Conceiving of PIP-related practice as possessing the dynamic qualities of an ‘episode’, this article argues that although the text provides help with costs, a corollary or side-effect, is that claimants and social workers are made to inhabit problematic positions within discourse/practice. Textual analysis may, nevertheless, unsettle, and re/position and de/re/construct relations, thereby decentering institutionalised ways of being.
Information Asymmetry, Financial Intermediation, and Wealth Effects of Project Finance Loans
Authors: Ferguson Andrew , Lam Peter 
Published: October 2021

Abstract
Using a unique hand-collected sample, we study market reactions to mining developers announcing project finance loans. We document a significant three-day abnormal return of 2.6% and a 3.4% reduction in abnormal bid-ask spread around loan approvals, consistent with information transfer from private lenders to equity holders and reduction in asymmetric information. Cross-sectional analysis reveals a negative association between announcement return and hedging requirements specified in loan contracts, which becomes insignificant after controlling for treatment effects of hedging. Specialist banks do not charge lower rates but are more likely to impose hedging requirements, consistent with rent extraction due to bargaining power. (JEL G30, G32)
Defining Enhanced Recovery Pathway with or without Liposomal Bupivacaine in DIEP Flap Breast Reconstruction
Authors: Haddock Nicholas T. , Garza Ricardo , Boyle Carolyn E. , Liu Yulun , Teotia Sumeet S. 
Published: October 2021

Background:
Enhanced recovery after surgery (ERAS) includes multiple interventions that have yielded positive outcomes in a number of surgical fields. The authors evaluated whether an ERAS protocol and the subsequent addition of liposomal bupivacaine affect patient outcomes specifically in deep inferior epigastric perforator (DIEP) flap breast reconstruction.

Methods:
All patients treated with DIEP flaps from January of 2016 to December of 2019 were reviewed retrospectively. The ERAS protocol was implemented midway through 2017; halfway through 2018, intraoperative transversus abdominis plane blocks with liposomal bupivacaine were added to the protocol. Such interventions allowed for comparison of three patient groups: before ERAS, during ERAS, and after ERAS plus liposomal bupivacaine. Primary outcomes observed were postoperative opioid consumption and length of stay. The p values were obtained using the Wilcoxon test for pairwise comparisons.

Results:
After adjusting for ERAS group compliance, 216 patients were analyzed. The pre-ERAS group was composed of 67 patients, the ERAS group was composed of 69 patients, and the ERAS plus liposomal bupivacaine group was composed of 80 patients. Postoperative opioid consumption was reduced when comparing the pre-ERAS and ERAS groups (from 275.7 oral morphine equivalents to 146.7 oral morphine equivalents; p < 0.0001), and also reduced with the addition of liposomal bupivacaine (115.3 oral morphine equivalents; p = 0.016). Furthermore, hospital length of stay was decreased from 3.6 days in the pre-ERAS group to 3.2 days (p = 0.0029) in the ERAS group, and to 2.6 days (p < 0.0001) in the ERAS group plus liposomal bupivacaine groups.

Conclusions:
Enhanced recovery after surgery protocols decrease postoperative opioid consumption and hospital length of stay in DIEP flap breast reconstruction. The addition of liposomal bupivacaine further strengthens the impact of the protocol.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Cost-Effectiveness of Lower Extremity Nerve Decompression Surgery in the Prevention of Ulcers and Amputations: A Markov Analysis
Authors: Rinkel Willem D. , Franks Billy , Birnie Erwin , Castro Cabezas Manuel , Coert J. Henk 
Published: October 2021

Background:
The costs and health effects associated with lower extremity complications in diabetes mellitus are an increasing burden to society. In selected patients, lower extremity nerve decompression is able to reduce symptoms of neuropathy and the concomitant risks of diabetic foot ulcers and amputations. To estimate the health and economic effects of this type of surgery, the cost-effectiveness of this intervention compared to current nonsurgical care was studied.

Methods:
To estimate the incremental cost-effectiveness of lower extremity nerve decompression over a 10-year period, a Markov model was developed to simulate the onset and progression of diabetic foot disease in patients with diabetes and neuropathy who underwent lower extremity nerve decompression surgery, compared to a group undergoing current nonsurgical care. Mean survival time, health-related quality of life, presence or risk of lower extremity complications, and in-hospital costs were the outcome measures assessed. Data from the Rotterdam Diabetic Foot Study were used as current care, complemented with information from international studies on the epidemiology of diabetic foot disease, resource use, and costs, to feed the model.

Results:
Lower extremity nerve decompression surgery resulted in improved life expectancy (88,369.5 life-years versus 86,513.6 life-years), gain of quality-adjusted life-years (67,652.5 versus 64,082.3), and reduced incidence of foot complications compared to current care (490 versus 1087). The incremental cost-effectiveness analysis was −€59,279.6 per quality-adjusted life-year gained, which is below the Dutch critical threshold of less than €80,000 per quality-adjusted life-year.

Conclusions:
Decompression surgery of lower extremity nerves improves survival, reduces diabetic foot complications, and is cost saving and cost-effective compared with current care, suggesting considerable socioeconomic benefit for society.
Objectifying High-Definition Brazilian Buttock Lift Results Using the Buttock Assessment Tool
Authors: Mowlavi Arian , Berri Mariam , Talle Armin , Talle Mehdi 
Published: October 2021

Background:
The buttock is an essential feature of the female silhouette. This has led to the rise of the Brazilian butt lift as one of the most popular plastic surgery procedures in recent years. Despite this popularity, there remains no prevailing standard for the ideal buttock size and shape. In fact, a wide range of preferred sizes and shapes among the authors’ patients has been observed. The authors hypothesized that age, religious affinity, and ethnic differences may demonstrate different buttock size and shape preferences.

Methods:
The authors designed the buttock assessment tool, which utilizes digitally altered buttock sizes and shapes to determine desired buttock shape (upper, middle, and lower pole maximum fullness) and buttock size (waist-to-hip width ratio) for both the posteroanterior and lateral views. A survey of 422 patients was completed, evaluating variation of desired buttock size and shape based on patient age, cultural, and ethnic differences.

Results:
There were significant differences in buttock size and buttock shape based on age, ethnicity, and religion. Hispanics and African Americans were twice as likely as Caucasians to request lower pole fullness in the posteroanterior view. Older respondents preferred a smaller buttock in both views. African Americans preferred a larger buttock compared to Caucasians in both views. Hispanics preferred a larger buttock in only the lateral view. Muslim respondents preferred a smaller buttock in the posteroanterior view.

Conclusion:
The Brazilian buttock assessment tool has become critical to understanding and delivering prospective Brazilian butt lift patients’ goals by objectifying buttock size and shapes.
Collagenase Tenotomy for Dupuytren Boutonniere
Authors: Denkler Keith A. , Vaughn Carolyn J. , Park Keon M. , Hansen Scott L. 
Published: October 2021

Summary:
Treatment of boutonniere Dupuytren disease is rare and is resistant to treatment because of altered tendon dynamics. The authors used a small dose of collagenase clostridium histolyticum for an enzymatic tenotomy of the distal interphalangeal joint and showed that hyperextension at the distal interphalangeal joint improved significantly. Fifteen patients with boutonniere Dupuytren disease with severe proximal interphalangeal joint contractures averaging −69 degrees of extension were included in the study. Ten patients had at least one previous intervention, including surgical fasciectomy, Digit Widget treatment, and needle aponeurotomy. Collagenase clostridium histolyticum enzymatic tenotomy was performed in-office as a wide-awake procedure. All patients received varying doses of collagenase clostridium histolyticum for volar Dupuytren disease enzymatic fasciotomy and 0.1 mg of collagenase clostridium histolyticum into the distal extensor tendon for tenotomy to treat boutonniere deformity at the same time. Collagenase clostridium histolyticum enzymatic tenotomy significantly improved total active motion of the finger by 41.0 degrees (p = 0.001). Loss of extension at both the metacarpophalangeal joint and the proximal interphalangeal joint also improved with gains of 11.7 (p = 0.04) and 20.7 degrees (p = 0.0005) of extension, respectively. The average distal interphalangeal joint hyperextension was improved from 29.7 degrees to 14.0 degrees (p = 0.002). The authors show that collagenase injection led to significant average improvement in joint contracture at all finger joints and significantly increased the arc of motion at the proximal interphalangeal joint and metacarpophalangeal joint. Although collagenase has been previously used for flexion contractures in Dupuytren disease, we believe it has a role in treating the distal interphalangeal joint hyperextension deformity associated with boutonniere deformity in Dupuytren disease as well.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Physiologic Timeline of Cranial-Base Suture and Synchondrosis Closure
Authors: Vu Giap H. , Xu Wen , Go Beatrice C. , Humphries Laura S. , Kalmar Christopher L. , Taylor Jesse A. , Bartlett Scott P. , Vossough Arastoo , Nah-Cederquist Hyun-Duck , Swanson Jordan W. 
Published: October 2021

Background:
Fusion of cranial-base sutures/synchondroses presents a clinical conundrum, given their often unclear “normal” timing of closure. This study investigates the physiologic fusion timelines of cranial-base sutures/synchondroses.

Methods:
Twenty-three age intervals were analyzed in subjects aged 0 to 18 years. For each age interval, 10 head computed tomographic scans of healthy subjects were assessed. Thirteen cranial-base sutures/synchondroses were evaluated for patency. Partial closure in greater than or equal to 50 percent of subjects and complete bilateral closure in less than 50 percent of subjects defined the fusion “midpoint.” Factor analysis identified clusters of related fusion patterns.

Results:
Two hundred thirty scans met inclusion criteria. The sutures’ fusion midpoints and completion ages, respectively, were as follows: frontoethmoidal, 0 to 2 months and 4 years; frontosphenoidal, 6 to 8 months and 12 years; and sphenoparietal, 6 to 8 months and 4 years. Sphenosquamosal, sphenopetrosal, parietosquamosal, and parietomastoid sutures reached the midpoint at 6 to 8 months, 8 years, 9 to 11 months, and 12 years, respectively, but rarely completed fusion. The occipitomastoid suture partially closed in less than or equal to 30 percent of subjects. The synchondroses’ fusion midpoints and completion ages, respectively, were as follows: sphenoethmoidal, 3 to 5 months and 5 years; spheno-occipital, 9 years and 17 years; anterior intraoccipital, 4 years and 10 years; and posterior intraoccipital, 18 to 23 months and 4 years. The petro-occipital synchondrosis reached the midpoint at 11 years and completely fused in less than 50 percent of subjects. Order of fusion of the sutures, but not the synchondroses, followed the anterior-to-posterior direction. Factor analysis suggested three separate fusion patterns.

Conclusions:
The fusion timelines of cranial-base sutures/synchondroses may help providers interpret computed tomographic data of patients with head-shape abnormalities. Future work should elucidate the mechanisms and sequelae of cranial-base suture fusion that deviates from normal timelines.