bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sensory Reinnervation With Subcutaneously Embedded Innervated Flaps
Authors: Otani Naoya , Tomita Koichi , Taminato Mifue , Kuroda Kazuya , Yano Kenji , Kubo Tateki 
Published: August 2021

Background
In breast reconstruction, both aesthetic outcomes and sensory function are important for postoperative quality of life. Innervated flaps are useful in reconstruction after conventional mastectomy (CM), which leaves a large portion of the skin paddle exposed on the body surface. However, whether they are also useful in skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) remains unclear. This study aimed to examine the usefulness of innervated flaps in restoring sensation after SSM and NSM using a rat model.

Methods
Dorsal cutaneous nerves of rats were entirely eliminated except for the medial branch of the dorsal cutaneous nerve of thoracic segment 13, resulting in an innervated field surrounded by a denervated field. The innervated field was elevated as an innervated island flap and then subcutaneously embedded, with the skin paddle deepithelialized entirely (NSM group, n = 5) or except at the center (SSM group, n = 6). In the control model (CM group, n = 5), the flap was sutured back into its original position. Postoperative changes in the mechanonociceptive field were evaluated using the cutaneous trunci muscle reflex test. Immunohistochemical evaluation of regenerated nerves in the new mechanonociceptive field was performed at postoperative week 12.

Results
In the SSM and CM groups, the mechanonociceptive field expanded around the skin paddle. In the NSM group, a new mechanonociceptive field appeared at postoperative week 4 and expanded thereafter. Areas of the mechanonociceptive field at postoperative week 12 did not differ significantly between the SSM and NSM groups, but were significantly smaller compared with the CM group and comparable to original flap areas. Histologically, S100- and PGP9.5-positive nerve fibers were observed in the dermis of the new mechanonociceptive field and subcutaneous flap tissue.

Conclusions
Subcutaneously embedded innervated island flaps induced nerve regeneration and sensory reinnervation of the denervated skin, suggesting that innervated flaps may also be useful in reconstruction post-SSM/NSM.
Ocular Outcomes of Maxillofacial Trauma – A Decennary Descriptive Study
Authors: Singh Ishan , Shetty Premalatha , Fernandes Trishala Bhadauria , Singh Amoli 
Published: August 2021

Maxillofacial trauma is amongst the most frequently encountered trauma seen in the hospital emergency setting. It may be life-threatening on rare occasions, and with concomitant injuries, it is often severely debilitating.

Objective:
The present study was conducted to determine the occurrence of concomitant orbital and ocular injuries amongst patients with maxillofacial trauma, and also helps in deriving a correlation between different patterns of maxillofacial fractures.

Methods:
All the records of the patients with maxillofacial trauma who were admitted to our institution over a 10-year period were analyzed. The files were screened to isolate the patients with concomitant ocular and orbital injuries.

Results:
Out of a total of 686 patients, 370 had associated ocular injuries. A total of 566 (82.5%) patients were males and 120 (17.5%) females. A total of 236 patients (34.4%) were in the 3rd decade. A total of 351 cases of orbital fracture (isolated + concomitant) were reported. About 44 (12.5%) cases of isolated orbital floor fractures were seen.
Subconjunctival hemorrhage accounted for the maximum number of cases amounting to 59.19%. The least associated ocular injuries seen were of traumatic mydriasis (0.28%). Out of 370 cases of ocular injuries, 249 (67.3%) were associated with fractures of the zygomaticomaxillary complex.

Conclusions:
The present study draws attention to the concomitant orbital and ocular injuries in maxillofacial trauma patients. This study is strongly suggestive of a very high probability of concomitant ocular injury in maxillofacial trauma patients which necessitates strong interdepartmental coordination for holistic management of the maxillofacial trauma patients.
Nasal Obstruction Evaluation After LeFort I Osteotomy: A Pilot Study
Authors: Kosyk Mychajlo S. , Zapatero Zachary D. , Kalmar Christopher L. , Carlson Anna R. , Swanson Jordan W. , Bartlett Scott P. , Taylor Jesse A. 
Published: August 2021

Abstract
Previous literature has documented changes in nasal obstruction after acute LeFort I osteotomy. However, there is a paucity of studies that evaluate distraction-mediated LeFort I (DO-LFI) without concomitant intranasal interventions using the nasal obstruction symptom evaluation (NOSE) scale in Class III patients. The purpose of this study is to objectively evaluate nasal obstruction quality of life through the NOSE scale in patients undergoing DO-LFI. Inclusion into the study required both a preoperative (1 year ≤ date of service) and postoperative (≥6 months and ≤2 years) NOSE scale administration. Nasal obstruction symptom evaluation scales were compared using Wilcoxon signed rank test. There was a significant difference in composite NOSE scales, x̃ = 8.0 (interquartile range: 4.0–11.0), x̃ = 1.0 (interquartile range: 1.0–3.0), P < 0.017, preoperatively and postoperatively respectfully. Additionally, when looking at individual components of the NOSE scale, nasal congestion or stuffiness, and trouble breathing through nose were significantly improved after DO-LFI (P < 0.017). Nasal blockage or obstruction (P > 0.084) and trouble breathing when exercising (P > 0.076) trended towards significant improvement, as well. Trouble sleeping did not differ, P > 0.611. We elucidate, in this pilot study, that there is an association between DO-LFI and patient reported nasal obstructive symptoms. Future prospective studies utilizing the NOSE scale are needed to determine causality.
Frontotemporal Lipofilling for Plagiocephaly Sequelae
Authors: Mendes Margarida Sofia Soares , Oliveira Ricardo José Moreira Horta , da Silva Álvaro Manuel Catarino Pereira 
Published: August 2021

Abstract
Plagiocephaly patients generally undergo corrective surgery in the first years of life, but during their growth malformative sequelae become apparent and can have a negative psychological and social impact. Volumetric filling techniques have been used to improve social balance and minimize such negative effects.
We present a case of a 25 years old male with a history of plagiocephaly corrected by 8 months of age. He kept a bilateral frontotemporal defect and we performed a lipofilling of the affected areas. The aesthetic results were very satisfactory and 6 months and 1 year after the procedure he maintained a good volumetric filling. There were no complications during or after the procedure.
Lipofilling provides good contouring results and has low complication rates. Its major inconvenient is adipose tissue resorption.
As illustrated by this case, this type of treatment significantly improves facial appearance, raising patients’ self-esteem and quality of life.
Modified Burr-Hole Craniostomy for the Treatment of Chronic Subdural Hematoma in Adults
Authors: Zhao Zhiyong , Zhang Jinglong , Zhang Guojin , Cao Yuntai , Wang Gang , Yin Hang , Zhang Jing , Zhu Miaojuan , Pan Yawen , Zhou Junlin 
Published: August 2021

Background:
Burr-hole craniostomy (BHC) is considered to be the most effective method for the treatment of chronic subdural hematoma (CSDH), and middle meningeal artery embolization is a new therapy used in clinical practice in recent years to treat CSDH. However, the optimal therapeutic effect of these 2 procedures is still controversial. This study prospectively designed a modified burr-hole craniostomy (mBHC) with drainage to treat CSDH.

Methods:
A total of 101 patients diagnosed with CSDH from January 2019 to April 2020 were prospectively included in this study. They were divided into BHC and mBHC groups. Among them, 40 selected CSDH patients received mBHC treatment. For comparison, 61 CSDH patients who received BHC treatment were used as the control group. Primary outcomes were hematoma recurrence and postoperative complications. Secondary outcomes included midline recovery, hematoma clearance, operation time, and hospital stay. The Chi-square test was used to compare the 6-month follow-up results between the 2 groups.

Results:
Among patients treated with mBHC, 39 patients had a good prognosis, and one 87-year-old patient with bilateral hematoma died of postoperative heart failure. Of the patients treated with BHC, 52 patients had good prognoses, and one 53-year-old patient with unilateral hematoma died of postoperative acute intracranial bleeding. During the 6-month follow-up period, no relapse occurred in the patients treated with mBHC, whereas 8 (13%) of the patients treated with BHC relapsed. There was a significant difference in the recurrence rate between the 2 groups (P < 0.05). In addition, midline recovery, hematoma clearance rate, operation time, and complications were found to be significantly different statistically (P < 0.05), and other characteristics of operation and outcome were not significantly different (P > 0.05) between the 2 groups.

Conclusions:
Modified burr-hole craniostomy has a positive therapeutic effect on patients with CSDH and is more effective than conventional BHC therapy.
Endoscopic-Assisted Fronto-Orbital Distraction Osteogenesis: Initial Patient Report
Authors: Kalmar Christopher L. , Carlson Anna R. , Kosyk Mychajlo S. , Zapatero Zachary D. , Heuer Gregory G. , Taylor Jesse A. 
Published: August 2021

Background:
The purpose of this manuscript is to introduce a novel endoscopic-assisted approach for creation of osteotomies and distractor hardware placement for unicoronal craniosynostosis.

Methods:
Only three small incisions are performed, one at the anterior fontanelle, pterional region, and upper lateral blepharoplasty location. Unicoronal strip craniectomy and osteotomies in temporal bone, nasofrontal junction, lateral orbital rim, sphenoid wing, orbital roof, and contralateral frontal bone are performed through these incisions with the assistance of a 30° 5-mm endoscope. One linear cranial distractor is inserted through the pterional incision and fixated across the unicoronal suturectomy.

Results:
Endoscopic-assisted fronto-orbital distraction osteogenesis has been performed on 3 patients with unicoronal craniosynostosis. Median age at surgery was 5.4 months (95%CI 5.0–6.1). Median operative duration was 98 minutes (95%CI 91–112), and estimated blood loss was 25 mL (95%CI 15–150). Median length of distraction achieved was 25.7 mm (95%CI 21.9–28.0), based on lateral skull x-rays obtained on the last day of activation. Distractors were removed 2.3 months postoperatively (95%CI 2.1–3.1), and operative duration of distractor removal was 20 minutes (95%CI 19–29). There was 1 complication, a transient cerebrospinal fluid leak thought to have been caused by a pinpoint injury to the dura at the nasofrontal junction, which was managed expectantly and resolved spontaneously by the fourth postoperative day.

Conclusions:
Endoscopic-assisted fronto-orbital distraction osteogenesis is a promising treatment modality for children with unicoronal craniosynostosis combining the benefits of distraction osteogenesis with a minimally invasive approach. Additional experience and follow-up are needed to determine its utility, safety, and longevity.
Pediatric Aggressive Benign Mandibular Tumors: Clinical Features and Management
Authors: Koraitim Mohamed , Medra Ahmed Mohamed , Salloum Ahmed M. , Shehata Ehab A. 
Published: August 2021

Introduction:
Aggressive benign mandibular tumors are uncommon in the pediatric population, and there is few publishing in the literature specifically dealing with them. Aggressive tumors can be defined based on known biologic behavior and/or histologic type and/or clinical characteristics.

Aim of the Study:
To review the clinical features and management of lower jaw pediatric aggressive benign tumor.

Patients and Methods:
Medical records review of pediatric patients presented with aggressive benign mandibular tumors to the Maxillofacial and Plastic Surgery Department, University of Alexandria, Egypt between 2011 and 2019.

Results:
Fifty-eight patients were included in this study, aged between 2 and 16 years (average = 11.8). Ameloblastoma was the commonest pathological diagnosis (n = 18) followed by central giant cell granuloma (n = 11) and juvenile ossifying fibroma (n = 10). Patients with central giant cell granuloma were treated by en-block resection (n = 4) or curettage after interferon alfa injection (n = 7). All other benign tumors were treated by en-block resection. The length of follow-up ranged from 1 to 8 years. Successful reconstruction was accomplished in 45 patients (88.2%).

Conclusions:
Aggressive lesion should be treated in an aggressive manner and immediate reconstruction is advocated. However, pharmacotherapy combined with enucleation is a more conservative approach for management of aggressive central giant cell tumors.
Destructive Frontonasal Mucocele Following Facial Trauma and Surgery
Authors: Moore Warner , Cohn Jason E. , Bundrick Paige 
Published: August 2021

Abstract
Mucoceles are fluid filled cysts with numerous etiologies that can erode bone and if left untreated, can lead to infraorbital and intracranial complications. With limited cases published in the medical literature, our patient with a frontonasal mucocele expanding from the frontal sinus to the nasal dorsum with erosion of the nasal bones and upper lateral cartilages, provides an opportunity for evidence-based diagnosis and treatment. We present a 24-year-old female with a nasal mass destroying numerous nasal structures. Three surgical approaches were considered: open rhinoplasty, bicoronal approach, and Lynch excision; the latter executed with subsequent total nasal reconstruction. Bone, septal cartilage, and temporalis fascia were utilized to provide structural support and a posterior nasal septal flap was incorporated to maintain a blood supply. integrity of nasal structure and cosmesis as well as recurrence of disease were monitored during postoperative visits.
Efficacy and Safety of Low Molecular Weight Heparin Versus Unfractionated Heparin for Prevention of Venous Thromboembolism in Trauma Patients
Authors: Tran Alexandre , Fernando Shannon M. , Carrier Marc , Siegal Deborah M. , Inaba Kenji , Vogt Kelly , Engels Paul T. , English Shane W. , Kanji Salmaan , Kyeremanteng Kwadwo , Lampron Jacinthe , Kim Dennis , Rochwerg Bram 
Published: August 2021

Purpose:
Trauma patients are at high risk of VTE. We summarize the efficacy and safety of LMWH versus UFH for the prevention of VTE in trauma patients.

Methods:
We searched 6 databases from inception through March 12, 2021. We included randomized controlled trials (RCTs) or observational studies comparing LMWH versus UFH for thromboprophylaxis in adult trauma patients. We pooled effect estimates across RCTs and observational studies separately, using random-effects model and inverse variance weighting. We assessed risk of bias using the Cochrane tool for RCTs and the Risk of Bias in Non-Randomized Studies (ROBINS)-I tool for observational studies and assessed certainty of findings using Grading of Recommendations, Assessment, Development and Evaluations methodology.

Results:
We included 4 RCTs (879 patients) and 8 observational studies (306,747 patients). Based on pooled RCT data, compared to UFH, LMWH reduces deep vein thrombosis (RR 0.67, 95% CI 0.50 to 0.88, moderate certainty) and VTE (RR 0.68, 95% CI 0.51 to 0.90, moderate certainty). As compared to UFH, LMWH may reduce pulmonary embolism [adjusted odds ratio from pooled observational studies 0.56 (95% CI 0.50 to 0.62)] and mortality (adjusted odds ratio from pooled observational studies 0.54, 95% CI 0.45 to 0.65), though based on low certainty evidence. There was an uncertain effect on adverse events (RR from pooled RCTs 0.80, 95% CI 0.48 to 1.33, very low certainty) and heparin induced thrombocytopenia [RR from pooled RCTs 0.26 (95% CI 0.03 to 2.38, very low certainty)].

Conclusions:
Among adult trauma patients, LMWH is superior to UFH for deep vein thrombosis and VTE prevention and may additionally reduce pulmonary embolism and mortality. The impact on adverse events and heparin induced thrombocytopenia is uncertain.
Long-term Mental Health Trajectories of Injured Military Servicemembers
Authors: Dalton Michael K. , Manful Adoma , Jarman Molly P. , Koehlmoos Tracey P. , Weissman Joel S. , Cooper Zara , Schoenfeld Andrew J. 
Published: August 2021

Objective:
We sought to quantify the impact of injury characteristics and setting on the development of mental health conditions, comparing combat to noncombat injury mechanisms.

Background:
Due to advances in combat casualty care, military service-members are surviving traumatic injuries at substantial rates. The nature and setting of traumatic injury may influence the development of subsequent mental health disorders more than clinical injury characteristics.

Methods:
TRICARE claims data was used to identify servicemembers injured in combat between 2007 and 2011. Controls were servicemembers injured in a noncombat setting matched by age, sex, and injury severity. The rate of development, and time to diagnosis [in days (d)], of 3 common mental health conditions (post-traumatic stress disorder, depression, and anxiety) among combat-injured servicemembers were compared to controls. Risk factors for developing a new mental health condition after traumatic injury were evaluated using multivariable logistic regression that controlled for confounders.

Results:
There were 3979 combat-injured servicemember and 3979 matched controls. The majority of combat injured servicemembers (n = 2524, 63%) were diagnosed with a new mental health condition during the course of follow-up, compared to 36% (n = 1415) of controls (P < 0.001). In the adjusted model, those with combat-related injury were significantly more likely to be diagnosed with a new mental health condition [odds ratio (OR): 3.18, [95% confidence interval (CI): 2.88–3.50]]. Junior (OR: 3.33, 95%CI: 2.66–4.17) and senior enlisted (OR: 2.56, 95%CI: 2.07–3.17) servicemem-bers were also at significantly greater risk.

Conclusions:
We found significantly higher rates of new mental health conditions among servicemembers injured in combat compared to service-members sustaining injuries in noncombat settings. This indicates that injury mechanism and environment are important drivers of mental health sequelae after trauma.
The Impact of COVID-19 on Electroconvulsive Therapy
Authors: Kwan Elaine , Le Brandon , Loo Colleen K. , Dong Vanessa , Tor Phern-Chern , Davidson Don , Mohan Titus , Waite Susan , Branjerdporn Grace , Sarma Shanthi , Hussain Salam , Martin Donel M. 
Published: August 2021

Objectives
The coronavirus disease 2019 (COVID-19) pandemic has led to reported change in electroconvulsive therapy (ECT) services worldwide. However, minimal data have been published demonstrating tangible changes across multiple ECT centers. This article aimed to examine changes in ECT patients and ECT service delivery during the pandemic.

Methods
We retrospectively assessed data collected on ECT patients within the Clinical Alliance and Research in Electroconvulsive Therapy and Related Treatments (CARE) Network during a 3-month period starting at the first COVID-19 restrictions in 2020 and compared data with predicted values based on the corresponding 3-month period in 2019. Mixed-effects repeated-measures analyses examined differences in the predicted and actual number of acute ECT courses started and the total number of acute ECT treatments given in 2020. Sociodemographic, clinical, treatment factors, and ECT service delivery factors were compared for 2020 and 2019.

Results
Four Australian and 1 Singaporean site participated in the study. There were no significant differences between the predicted and actual number of acute ECT courses and total number of acute ECT treatments administered in 2020. During 2020, there were statistically significant increases in the proportion of patients requiring ECT under substitute consent and receiving ECT for urgent reasons compared with 2019.

Conclusions
This multisite empirical study is among the first that supports anecdotal reports of changes in the triaging and delivery of ECT during COVID-19. Results suggest that ECT was prioritized for the most severely ill patients. Further data assessing the impacts of COVID-19 on ECT are needed.
Using ultraviolet absorption spectroscopy to study nanoswitches based on non-canonical DNA structures
Authors: McCarte Blair , Yeung Owen T. , Speakman Alexander J. , Elfick Alistair , Dunn Katherine E. 
Published: August 2021

AbstractNon-canonical forms of DNA are attracting increasing interest for applications in nanotechnology. It is frequently convenient to characterize DNA molecules using a label-free approach such as ultraviolet absorption spectroscopy. In this paper we present the results of our investigation into the use of this technique to probe the folding of quadruplex and triplex nanoswitches. We confirmed that four G-quartets were necessary for folding at sub-mM concentrations of potassium and found that the wrong choice of sequence for the linker between G-tracts could dramatically disrupt folding, presumably due to the presence of kinetic traps in the folding landscape. In the case of the triplex nanoswitch we examined, we found that the UV spectrum showed a small change in absorbance when a triplex was formed. We anticipate that our results will be of interest to researchers seeking to design DNA nanoswitches based on quadruplexes and triplexes.HighlightsUltraviolet absorption spectroscopy can probe non-canonical DNA structures.Absorbance at 295nm tends to increase as G-quadruplexes form.Four G-quartets are needed to form a quadruplex with less than 1mM potassium.Formation of DNA triplexes can also yield a small change in UV spectra.UV absorption is a cheap label-free method for studying DNA nanoswitches.
Widespread cell stress and mitochondrial dysfunction in early Alzheimer’s Disease
Authors: Venkataraman Ashwin V , Mansur Ayla , Rizzo Gaia , Bishop Courtney , Lewis Yvonne , Kocagoncu Ece , Lingford-Hughes Anne , Huiban Mickael , Passchier Jan , Rowe James B , Tsukada Hideo , Brooks David J. , Martarello Laurent , Comley Robert A. , Chen Laigao , Schwarz Adam J. , Hargreaves Richard , Gunn Roger N. , Rabiner Eugenii A. , Matthews Paul M 
Published: August 2021

AbstractCell stress and impaired oxidative phosphorylation are central to mechanisms of synaptic loss and neurodegeneration in the cellular pathology of Alzheimer’s disease (AD). We quantified the in vivo density of the endoplasmic reticulum stress marker, the sigma 1 receptor (S1R) using [11C]SA4503 PET, as well as that of mitochondrial complex I (MC1) with [18F]BCPP-EF and the pre-synaptic vesicular protein SV2A with [11C]UCB-J in 12 patients with early AD and in 16 cognitively normal controls. We integrated these molecular measures with assessments of regional brain volumes and brain perfusion (CBF) measured with MRI arterial spin labelling. 8 AD patients were followed longitudinally to estimate rates of change with disease progression over 12-18 months. The AD patients showed widespread increases in S1R (≤ 27%) and regional decreases in MC1 (≥ -28%), SV2A (≥ -25%), brain volume (≥ -23%), and CBF (≥ -26%). [18F]BCPP-EF PET MC1 density (≥ -12%) and brain volumes (≥ -5%) were further reduced at follow up in brain regions consistent with the differences between AD patients and controls at baseline. Exploratory analyses showing associations of MC1, SV2A and S1R density with cognitive changes at baseline and longitudinally with AD, but not in controls, suggested a loss of metabolic functional reserve with disease. Our study thus provides novel in vivo evidence for widespread cellular stress and bioenergetic abnormalities in early AD and that they may be clinically meaningful.