bluuebunny/crossref_metadata_2025_split huggingface dataset:
Videographic Analysis of Blink Dynamics following Upper Eyelid Blepharoplasty and Its Association with Dry Eye
Authors: Mak Felix H. W. , Ting Michelle , Edmunds Matthew R. , Harker Anthony , Edirisinghe Mohan , Duggineni Sirisha , Murta Fabiola , Ezra Daniel G. 
Published: January 2021

Background:
This study was undertaken to characterize the effects of upper eyelid blepharoplasty on blink dynamics and to evaluate the hypothesis that changes in blink dynamics following blepharoplasty are associated with postoperative dry eye.

Methods:
The voluntary blink of 14 eyes of 7 patients with dermatochalasis undergoing upper eyelid blepharoplasty was recorded with a high-speed camera preoperatively and 6–8 months postoperatively, alongside a group of 11 controls. The images were analyzed for palpebral aperture, blink duration, and maximum velocity during opening and closing phases. Patients undergoing blepharoplasty were assessed for dry eye symptoms pre- and postoperatively at 6–8 months using the ocular surface disease index score.

Results:
Despite intraoperative orbicularis oculi resection, there was no significant compromise of blink duration or maximum velocity of eyelid opening or closure post-blepharoplasty. Postoperatively, patients had an increase in palpebral aperture compared with both preoperatively (8.71 versus 7.85 mm; P = 0.013) and control groups (8.71 versus 7.87 mm; P = 0.04). Postoperatively at 6–8 months, there was an increase in dry eye symptoms in 6 of 7 patients compared with preoperatively (ocular surface disease index, 16.6 versus 12.5; P < 0.05). There was no positive correlation between the increase in palpebral aperture and the increase in dry eye symptoms (r = –0.4; P = 0.30).

Conclusions:
Using modern videographic technology, this study demonstrates that upper eyelid blepharoplasty results in an increase in resting palpebral aperture but has no effect on dynamic blink parameters. Changes in palpebral aperture or blink dynamics are unlikely to be the cause of dry eye syndrome following blepharoplasty.
Outcome-based Comparative Study to Examine the Correction of Columella Deformities following Rhinoplasty
Authors: Uppal Rajan , Yousif Ali H. , Maheshwari Kavish 
Published: January 2021

Background:The columella is an underrepresented part of rhinoplasty. The objective of this study was to assess the outcome of columella correction following rhinoplasty and to assess any differences in the open and endonasal approach.Methods:This is a retrospective study involving 65 rhinoplasty patients, who were divided into 2 groups depending on whether they had an open or endonasal approach. Fifteen patients underwent the open procedure, and 50 patients underwent the endonasal approach. Patients who underwent endonasal rhinoplasty were compared with open rhinoplasty patients in terms of their final outcome, with a focus on the columellar correction. The classification by Rohrich and Liu and Gunter’s distance between the nasal axis and columella were used to assess the correction.Results:The overall incidence of columellar correction was 90% in the endonasal group (45 of 50 patients) and 67% in the open approach group (10 of 15 patients); a comparison shows aPvalue of 0.043 (<0.05). An estimated 49 of 50 patients (98%) from the endonasal group saw a reduction in the nasal axis–columella distance when compared with the open rhinoplasty group, who saw a reduction in 12 of 15 patients (80%); statistical analysis shows aPvalue of 0.036 (<0.05). The quantitative reduction in this distance in all patients when compared between the 2 groups had aPvalue of <0.001, suggesting a greater overall reduction using the endonasal approach. This may be related to differences in distribution of the deformities within the 2 groups.Conclusions:There is no standard way to correct the columella, but it is important to identify the deformity and the need to correct it. In our patients, we found comparable outcomes in achieving a satisfactory columella in the open and endonasal groups.
Crowd-Sourced Reliability of an Assessment of Lower Facial Aging Using a Validated Visual Scale
Authors: Kelly Jason D. , Comstock Bryan , Kowalewski Timothy M. , Smartt James M. 
Published: January 2021

Background:
Reliable and valid assessments of the visual endpoints of aesthetic surgery procedures are needed. Currently, most assessments are based on the opinion of patients and their plastic surgeons. The objective of this research was to analyze the reliability of crowdworkers assessing de-identified photographs using a validated scale that depicts lower facial aging.

Methods:
Twenty photographs of the facial nasolabial region of various non-identifiable faces were obtained for which various degrees of facial aging were present. Independent crowds of 100 crowd workers were tasked with assessing the degree of aging using a photograph numeric scale. Independent groups of crowdworkers were surveyed at 4 different times (weekday daytime, weekday nighttime, weekend daytime, weekend nighttime), once a week for 2 weeks.

Results:
Crowds assessing midface region photographs had an overall correlation of R = 0.979 (weekday daytime R = 0.991; weekday nighttime R = 0.985; weekend daytime R = 0.997; weekend nighttime R = 0.985). Bland−Altman test for test-retest agreement showed a normal distribution of assessments over the various times tested, with the differences in the majority of photographs being within 1 SD of the average difference in ratings.

Conclusions:
Crowd assessments of facial aging in de-identified photographs displayed very strong concordance with each other, regardless of time of day or week. This shows promise toward obtaining reliable assessments of pre and postoperative results for aesthetic surgery procedures. More work must be done to quantify the reliability of assessments for other pretreatment states or the corresponding results following treatment.
Combining Preservation and Structured Rhinoplasty: Septal Extension Grafts and the Interdomal Hanger
Authors: Nakamura Fernando , Luitgards Bruno Ferreira , Ronche Ferreira José C. 
Published: January 2021

Summary:
Preservation rhinoplasty is a new philosophy in the field of rhinoplasty, focusing on preserving and reshaping nasal structures. However, the authors suggest some patients are not good candidates for preservation rhinoplasty. Patients with underprojected noses and thick skin need a septal extension graft for tip support and to achieve maximum tip definition. In this article, we describe a new technique to combine septal extension graft with the preservation of tip ligaments, called interdomal hanger. It allows the surgeon to benefit from increased tip support in rotation and projection. The technique consists of the preservation of the interdomal ligament, which is then stabilized above the septal extension graft working as a suspensory sling. With this technique, the surgeon can mix important steps of preservation rhinoplasty and benefit from the support of the septal extension grafts.
Use of a Bioabsorbable Implant-Acellular Dermal Matrix Construct to Facilitate Oncoplastic Breast-conserving Surgery
Authors: Schwartz Jean-Claude D. 
Published: January 2021

Summary:
Deformity after partial mastectomy for breast cancer is not uncommon. The immediate replacement of breast volume by a bioabsorbable implant has been shown to facilitate tissue ingrowth, maintain breast contour, reduce scarring and fibrosis, and preserve cosmesis. Soft tissue coverage is critical to minimize palpability and to prevent infection and extrusion of this device, especially after radiotherapy. This coverage is often not possible after significant oncological resection or in leaner patients. Here, we describe the use of a bioabsorbable implant-acellular dermal matrix construct in patients with insufficient soft tissue coverage after wide local excision.
Non-microvascular Successful Management of Near-total Ear Avulsion
Authors: Albdour Mahammad , Ammar Hamad M. , Alnaser Mutaz M.S. , Alzaben Faisal Saud , Malek Suha 
Published: January 2021

Summary:
Traumatic ear avulsion represents a difficult challenge for all reconstructive surgeons; hence, replantation and reattachment will provide the best aesthetic outcome. However, when microsurgery is not possible, the surgeon must choose the most appropriate alternative method to address the concern. We are reporting a case of a near-total right ear external auricle amputation attached only by small skin bridge. The patient was admitted to our institute 22 hours after sustaining an injury during a motor vehicle collision. He was successfully managed by reattaching the external auricle into the anatomical place, with the repair of cartilage. This was followed by applying a daily protocol for venous congestion with the use of subcutaneous and intradermal injection of low-molecular-weight heparin daily for 10 days with gradual tapering of the dose. The external auricle survived with no complications or morbidity. Subcutaneous and intradermal low-molecular-weight heparin can be used effectively in cases of severe venous congestion of avulsed ear with adequate arterial inflow without causing any morbidity.
Combination of pembrolizumab and lenvatinib is a potential treatment option for heavily pretreated recurrent and metastatic head and neck cancer
Authors: Chen Tien-Hua , Chang Peter Mu-Hsin , Yang Muh-Hwa 
Published: January 2021

Background:
Immunotherapy has become the current standard of care for recurrent and metastatic head and neck squamous cell carcinoma (R/M HNSCC). One potential approach to improve immunotherapy efficacy is to combine pembrolizumab, an anti-PD-1 agent, with lenvatinib, a potent multikinase inhibitor. In this study, we presented our up-to-date experience with pembrolizumab/lenvatinib combination therapy in heavily pretreated R/M HNSCC.

Methods:
Patients who had R/M HNSCC, were ineligible for curative treatment, progressed after at least two lines of systemic treatment and had received pembrolizumab/lenvatinib combination therapy were enrolled in this study. The primary endpoint was the objective response rate. The secondary endpoints included the disease control rate, overall survival, progression-free survival, and the duration of response.

Results:
A total of 14 patients were enrolled in this study. All the patients had received at least two lines of systemic treatment and radiation therapy, and 71% of patients had failed previous anti-PD-1 treatment. The objective response rate of pembrolizumab/lenvatinib combination therapy was 28.6% (95% confidence interval [CI], 5.0%-52.2%). The disease control rate was 42.9% (95% CI, 17.0%-68.8%). The overall survival and progression-free survival were 6.2 months (95% CI, 2.9-9.6) and 4.6 months (95% CI, 0.05-0.9.2), respectively. Of those who had failed previous anti-PD-1 therapy, partial responses were observed in two patients. All the patients with partial responses were in the tumor proportion score <50 and combined positive score 1 to 19 groups.

Conclusion:
Our study provided up-to-date evidence that pembrolizumab/lenvatinib combination therapy achieved objective responses in both heavily pretreated and anti-PD-1 refractory R/M HNSCC patients. This study supported the use of pembrolizumab/lenvatinib combination therapy in R/M HNSCC patients without standard of care.
Exercise and Obesity: The role of exercise in prevention, weight loss, and maintenance of weight loss
Authors: Secor Mimi 
Published: January 2021

ABSTRACT
The dramatic increase in overweight and obesity rates poses a public health threat and is a mandate for nurse practitioners to address this challenge in clinical practice. Exercise plays an essential role in prevention, initial weight loss, and maintenance of weight loss and recommendations for physical activity differ for each category. Intensity of exercise, duration, and effectiveness of various types of physical activity are reviewed. Possible reasons why exercise-focused weight loss goals are not attained are also explored. Nurse practitioners are assuming an increasingly important role in combating the obesity epidemic and can make a positive impact by implementing effective, evidence-based, exercise-focused strategies for prevention, initial weight loss, and maintenance of weight loss.
Pandemics and Mental Health Through the Lens of Literature
Authors: Panayi Adriana C. , Haug Valentin 
Published: January 2021

Abstract
Depictions of pandemics presented through the lens of literary authors and poets have everlasting power. In this article, we explore the psychosocial impact of pandemics, as presented through literature and poetry, and attempt to draw similarities with the current COVID-19 pandemic. We explore topics such as fear and anxiety, hopelessness, and suicide ideation. Overall, the psychological devastation caused by epidemics has influenced many major writers and will undoubtedly impact the writers of our generation. These writings are perhaps the richest source of knowledge of humanity's remarkable capacity to endure suffering.
Algorithm-Driven Substance Use Disorder Treatment for Inner-City Clients With Serious Mental Illness and Multiple Impairments
Authors: McHugo Gregory J. , Drake Robert E. , Haslett William R. , Krassenbaum Sarah R. , Mueser Kim T. , Sweeney Mary Ann , Kline John , Harris Maxine 
Published: January 2021

Abstract
Mental health clients with serious mental illness in urban settings experience multiple chronic stresses related to poverty, unemployment, discrimination, homelessness, incarceration, hospitalization, posttraumatic stress disorder, pain syndromes, traumatic brain injury, and other problems. Substance use disorder exacerbates these difficulties. This study examined the efficacy of algorithm-driven substance use disorder treatments for 305 inner-city mental health clients with multiple challenges. Researchers assessed substance use quarterly using a combination of standardized self-reports and case manager ratings. Of the 305 multiply impaired clients who began treatment, 200 (66%) completed 2 years of treatment. One fourth (n = 53) of the completers were responders who developed abstinence and improved community function; one half (n = 97) were partial responders, who reduced substance use but did not become abstinent; and one fourth (n = 50) were nonresponders. Evidence-based interventions for substance use disorder can be effective for multiply impaired, inner-city clients, but numerous complications may hinder recovery.
Navigating the Differential Diagnosis for Oncocytic Salivary Gland Lesions (Cytology and Histology)
Authors: Centeno Barbara A. , Wenig Bruce M. 
Published: January 2021

Abstract
Oncocytic lesions of the parotid gland include nonneoplastic entities and benign and malignant neoplasms. The most common benign neoplasm is Warthin tumor, which can be correctly diagnosed using fine-needle aspiration (FNA) or core biopsy in most cases. However, accurate FNA and/or biopsy preoperative diagnosis of many entities in this category is limited by sampling and overlap in morphological features among the different entities. We report the case of a 77-year-old man who presented with a right parotid mass identified on magnetic resonance imaging and computed tomography scan that was cystic with necrosis and with possible papillary growth in the cyst. The FNA smears were scantly cellular, with a few representative groups with significant nuclear crowding and overlapping in a bloody background. The cells had oncocytic cytoplasm, an increased nuclear-to-cytoplasmic ratio, and round-to-oval nuclei with prominent nucleoli. Necrosis, mitoses, and significant nuclear pleomorphism were not identified. The findings were interpreted as consistent with an oncocytoid/oncocytic salivary gland neoplasm. The cell block was acellular, so the neoplasm could not be further characterized by ancillary studies. The patient underwent a right superficial parotidectomy. The histopathological diagnosis was oncocytic carcinoma primarily based on the identification of perineural invasion. Oncocytic carcinoma is a rare, high-grade malignancy of salivary glands. This case will be used to discuss the differential diagnosis of oncocytoid/oncocytic salivary gland lesions on both cytopathology and histopathology and provide a pragmatic approach to the diagnostic evaluation. Indications for available ancillary testing will also be reviewed.
Sialadenitis of the Major Salivary Glands: A Tumor-Like Lesion of Various Etiologies and Morphological Appearances
Authors: Hernandez-Prera Juan C. 
Published: January 2021

Abstract
Inflammatory conditions of salivary glands—so-called sialadenitis—may clinically and histologically resemble a true neoplasm and result in a surgical resection. This review summarizes distinctive morphological patterns of inflammation that affect major salivary glands, and within this context, an unusual case of sialadenitis is also presented.
Essential statistical principles of clinical trials of pain treatments
Authors: Dworkin Robert H. , Evans Scott R. , Mbowe Omar , McDermott Michael P. 
Published: January 2021

Abstract
This article presents an overview of fundamental statistical principles of clinical trials of pain treatments. Statistical considerations relevant to phase 2 proof of concept and phase 3 confirmatory randomized trials investigating efficacy and safety are discussed, including (1) research design; (2) endpoints and analyses; (3) sample size determination and statistical power; (4) missing data and trial estimands; (5) data monitoring and interim analyses; and (6) interpretation of results. Although clinical trials of pharmacologic treatments are emphasized, the key issues raised by these trials are also directly applicable to clinical trials of other types of treatments, including biologics, devices, nonpharmacologic therapies (eg, physical therapy and cognitive-behavior therapy), and complementary and integrative health interventions.
Research design considerations for chronic pain prevention clinical trials: IMMPACT recommendations
Authors: Gewandter Jennifer S. , Dworkin Robert H. , Turk Dennis C. , Farrar John T. , Fillingim Roger B. , Gilron Ian , Markman John D. , Oaklander Anne Louise , Polydefkis Michael J. , Raja Srinivasa N. , Robinson James P. , Woolf Clifford J. , Ziegler Dan , Ashburn Michael A. , Burke Laurie B. , Cowan Penney , George Steven Z. , Goli Veeraindar , Graff Ole X. , Iyengar Smriti , Jay Gary W. , Katz Joel , Kehlet Henrik , Kitt Rachel A. , Kopecky Ernest A. , Malamut Richard , McDermott Michael P. , Palmer Pamela , Rappaport Bob A. , Rauschkolb Christine , Steigerwald Ilona , Tobias Jeffrey , Walco Gary A. 
Published: January 2021

Abstract
Although certain risk factors can identify individuals who are most likely to develop chronic pain, few interventions to prevent chronic pain have been identified. To facilitate the identification of preventive interventions, an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain. We present general design considerations for prevention trials in populations that are at relatively high risk for developing chronic pain. Specific design considerations included subject identification, timing and duration of treatment, outcomes, timing of assessment, and adjusting for risk factors in the analyses. We provide a detailed examination of 4 models of chronic pain prevention (ie, chronic postsurgical pain, postherpetic neuralgia, chronic low back pain, and painful chemotherapy-induced peripheral neuropathy). The issues discussed can, in many instances, be extrapolated to other chronic pain conditions. These examples were selected because they are representative models of primary and secondary prevention, reflect persistent pain resulting from multiple insults (ie, surgery, viral infection, injury, and toxic or noxious element exposure), and are chronically painful conditions that are treated with a range of interventions. Improvements in the design of chronic pain prevention trials could improve assay sensitivity and thus accelerate the identification of efficacious interventions. Such interventions would have the potential to reduce the prevalence of chronic pain in the population. Additionally, standardization of outcomes in prevention clinical trials will facilitate meta-analyses and systematic reviews and improve detection of preventive strategies emerging from clinical trials.
Local Triamcinolone Treatment Affects Inflammatory Response in Seroma Exudate of Abdominoplasty Patients: A Randomized Controlled Trial
Authors: Anker Alexandra M. , Felthaus Oliver , Prantl Lukas , Geis Sebastian , Brébant Vanessa , Kehrer Andreas , Strauss Catharina , Ruewe Marc , Vykoukal Jody , Klein Silvan M. 
Published: January 2021

Background:
As the leading complication of abdominoplasty, seroma formation might represent an inflammatory process in response to surgical trauma. This prospective randomized trial investigated whether local administration of the antiinflammatory agent triamcinolone could prevent seroma accumulation.

Methods:
Weekly and cumulative seroma volumes were compared between the study groups A, B, and C over a 4-week follow-up (group A, with drain, without triamcinolone; group B, without drain, without triamcinolone; group C, without drain, with triamcinolone). Aspirated seroma samples were analyzed by enzyme-linked immunosorbent assay for selective inflammatory mediators.

Results:
Triamcinolone significantly reduced cumulative seroma volume (n = 60; mA 845 ± SDA 578 ml, mC 236 ± SDC 381 ml, p = 0.001). The most accentuated suppressive effect of triamcinolone was observed shortly after the treatment (week 1) (mA1 616 ± SDA1 457 ml, mB1 153 ± SDB1 161 ml, mC1 22 ± SDC1 44 ml, p
A1/C1 < 0.001, p
B1/C1 = 0.014). Local triamcinolone administration resulted in a differential concentration of interleukin-6 (IL-6) and matrix metalloproteinase-9 (MMP-9 (week 1) in seroma exudate as measured by enzyme-linked immunosorbent assay (mIL-6A1 1239 ± SDA1 59 pg/ml, mIL-6C1 848 ± SDC1 80 pg/ml, p < 0.001; mMMP-9A1 2343 ± SDA1 484 pg/ml, mMMP-9C1 376 ± SDC1 120 pg/ml, p = 0.001).

Conclusions:
Local administration of 80 mg of triamcinolone reduced postabdominoplasty seroma accumulation significantly. Under triamcinolone treatment, suppressed levels of IL-6 and MMP-9 in seroma fluid were observed. Notably, inflammatory marker suppression correlated clinically with a decrease in seroma accumulation.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.