bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Botulinum Toxin A for Scar Prevention After Breast Augmentation: A Randomized Double-Blind Intraindividual Controlled Trial
Authors: Disphanurat Wareeporn , Viarasilpa Wongsiya , Thienpaitoon Peera 
Published: August 2021

BACKGROUND
Botulinum toxin A benefits postsurgical scar prevention by reducing wound edge tension and inhibiting in vitro scar tissue fibrosis.

OBJECTIVE
To investigate the efficacy of botulinum toxin Type A (BTX) in improving inframammary scar appearance after primary breast augmentation.

MATERIALS AND METHODS
A prospective, double-blinded, randomized controlled trial was performed with 27 participants receiving primary augmentation mammoplasty with inframammary incisions. After skin closure, intradermal injections of BTX were administered to 1 (treated) side of the inframammary incision. The contralateral side was the control. Scars were evaluated at 3 months, 6 months, and 9 months using the Patient and Observer Scar Assessment Scale and multispectral imaging analysis.

RESULTS
Overall, 22 patients completed the study. There were no significant subjective differences between the treated and control sides except the patient's treated side had significantly higher scores than the control side at 9 months. The treated side showed significantly smaller scar widths at 6 months and 9 months (p < .001) and better scar surface textures at 9 months (p = .003) than the control side.

CONCLUSION
Subjectively, intradermal BTX injection immediately after breast augmentation skin closure caused no significant differences. Objectively, scar width and texture significantly improved at 6 months and 9 months.
Bans on Cellphone Use While Driving and Traffic Fatalities in the United States
Authors: Zhu Motao , Shen Sijun , Redelmeier Donald A. , Li Li , Wei Lai , Foss Robert 
Published: August 2021

Background:
As of January 2020, 18 of 50 US states comprehensively banned almost all handheld cellphone use while driving, 3 states and the District of Columbia banned calling and texting, 27 states banned texting on a handheld cellphone, and 2 states had no general cellphone ban for all drivers. However, it remains unknown whether these bans were associated with fewer traffic deaths and whether comprehensive handheld bans are more effective than isolated calling or texting bans. We evaluated whether cellphone bans were associated with fewer driver, non-driver, and total fatalities nationally.

Methods:
We conducted a longitudinal panel analysis of traffic fatality rates by state, year, and quarter. Population-based rate ratios and 95% CIs were estimated comparing state–quarters with and without cellphone bans.

Results:
From 1999 through 2016, 616,289 persons including 344,003 drivers died in passenger vehicle crashes in the United States. Relative to no ban, comprehensive handheld bans were associated with lower driver fatality rates (adjusted rate ratio aRR = 0.93, 95% CI = 0.90, 0.97) but not for non-driver fatalities (aRR = 1.01, 95% CI = 0.95, 1.07) or total fatalities (aRR = 0.98, 95% CI = 0.94, 1.01). We found no differences in driver fatalities for calling-only bans (aRR = 1.00, 95% CI = 0.97, 1.03), texting-only bans (aRR = 1.02, 95% CI = 0.99, 1.05), texting plus phone-manipulating bans (aRR = 0.99, 95% CI = 0.93, 1.04), or calling and texting bans (aRR = 0.98, 95% CI = 0.88, 1.09).

Conclusions:
Comprehensive handheld bans were associated with fewer driver fatalities.
Actigraphy-derived rest--activity rhythms are associated with nocturnal blood pressure in young women
Authors: Hoopes Elissa K. , Patterson Freda , Berube Felicia R. , D’Agata Michele N. , Brewer Benjamin , Malone Susan K. , Farquhar William B. , Witman Melissa A. 
Published: August 2021

Introduction:
Misalignment between lifestyle behaviors and endogenous circadian rhythms is associated with elevated nocturnal blood pressure (BP) in experimental studies; however, less is known about free-living (i.e. nonlaboratory) circadian disruption and nocturnal BP. Additionally, sex-specific cardiovascular implications of circadian disruption are unclear.

Objective:
To examine the associations between rest--activity rhythms (RAR), a field-based estimate of circadian disruption, and nocturnal BP characteristics in young men and women.

Methods:
Fifty participants (20 ± 1 years; 20 men/30 women) underwent 24-h ambulatory BP monitoring following 14 days of wrist actigraphy. RAR variables of interdaily stability (day-to-day consistency in RAR), intradaily variability (within-day fragmentation of RAR), and relative amplitude (difference between peak vs. trough activity) were derived from actigraphy. Multivariable regression models of mean nocturnal SBP, DBP, and SBP dipping were generated to test main associations with RAR variables, and sex × RAR interactions. Daytime BP, race, BMI, physical activity, sleep duration, alcohol, caffeine, and sodium intake were considered as covariates.

Results:
In the full sample, no main associations between RAR and nocturnal BP characteristics were found. Sex interacted with RAR such that in women, higher interdaily stability (β = −5.39, 95% CI = −10.04 to −0.73, P = 0.024) and relative amplitude (β = −4.78, 95% CI = −9.22 to −0.34, P = 0.036) were both associated with lower nocturnal SBP. Sex-stratified multivariable models of nocturnal BP also revealed associations between interdaily stability and relative amplitude with SBP dipping in women (all P ≤ 0.01). No associations were apparent in men.

Conclusion:
Consistent and high-amplitude RAR are favorably associated with nocturnal BP characteristics in young women.
Development and Validation of the Workplace Decisional Balance Scale for Exercise (WDBex) in a French Sample
Authors: d’Arripe-Longueville Fabienne , Hayotte Meggy , Planchard Jo-Hanna , Steiner Dirk D. , Corrion Karine 
Published: August 2021

Objective:
Despite positive effects of physical activity programs in the workplace, an appropriate measurement instrument to capture employees’ decisional balance to exercise is lacking. This study sought to develop and validate a decisional balance scale for exercise adapted to the workplace.

Methods:
Four complementary studies were carried out, with a total sample of 2398 French volunteer employees, to develop a preliminary version and examine its dimensionality, temporal stability, and construct validity.

Results:
The Workplace Decisional Balance scale for Exercise (WDBex) consists of 21 items with two subfactors, respectively composed of 12 items (facilitators) and nine items (barriers); for each subfactor, three dimensions (ie, physical, psychological, and logistic) were distinguished and presented satisfactory psychometric properties.

Conclusions:
This instrument constitutes a reliable and valid instrument for studying the psychosocial determinants of physical activity engagement in the workplace and for developing health promotion strategies.
A discussion on the ‘dispensable’ amino acids
Authors: Ennis Madeleine A. , Elango Rajavel 
Published: August 2021

Purpose of review
Recently, the concept of dietary dispensable amino acids has been increasingly challenged, as more indirect and direct (experimental) evidence has pointed to the need for them in the diet during specific life stages or disease states. Here, we discuss the classification of amino acids, methods to assess the needs for dispensable amino acids with experimental evidence from our recent studies, and highlight the role of specific dispensable amino acids in metabolism and health.

Recent findings
There exist differences among the dispensable amino acids to act as effective nitrogen sources in humans. Glycine, a dispensable amino acid is conditionally indispensable in later stages of human pregnancy.

Summary
The so-called ‘dispensable’ amino acids are quantitatively nearly 75% of the daily protein needs in humans. In certain life-stages and diseases, there is a dietary demand for the dispensable amino acids. Future well-designed studies are required to identify the dietary demand for these amino acids, which will certainly be useful for dietary management in specific diseases and to maintain health across all life-stages.
Sarcopenia and microvascular free flap reconstruction
Authors: Chen Joy , Dennis Steven K. , Abouyared Marianne 
Published: August 2021

Purpose of review
This article reviews the recent literature regarding the impact of sarcopenia on microvascular free flap reconstruction outcomes.

Recent findings
Malnutrition, and consequent muscle loss, is a prevalent issue among head and neck cancer patients. However, diagnosis remains challenging due to a paucity of reliable objective measures. Traditional markers, such as albumin, have been used in the past to assess nutritional status, but cancer-related inflammation limits their predictive value. Recently, developments in the diagnosis of sarcopenia through the novel use of computed tomography (CT) cross-sectional muscle mass indices to evaluate body composition have proven effective and accessible.

Summary
Literature shows compelling evidence that sarcopenia is associated with higher rates of surgical complications that delay recovery and increase mortality. The use of CT imaging to quantify muscle loss offers an objective way to evaluate nutritional status, which is predictive of postoperative rates of complications. Research on ways to optimize muscle mass prior to surgery is limited, however, immunonutrition is emerging as a promising intervention that can attenuate sarcopenia-related inflammation to improve outcomes.
Bilateral Sagittal Split Mandibular Ramus Osteotomy Alters the Temporomandibular Joint
Authors: Wang Xiangshen , Sun Xiumei , Wu Guomin 
Published: August 2021

Abstract
In this retrospective analysis, we examined temporomandibular joint space volume and condyle position in 10 patients undergoing bilateral sagittal split mandibular ramus osteotomy plus Le Fort I osteotomy to correct mandibular asymmetry. Cone beam computed tomography was used to map temporomandibular joint prior to (T0), immediately after (T1), and at 1 year after surgery (T2). In the deviated side, we detected significant lateral shift of the condyle in 5 patients at T1, and the shift disappeared at T2. In the non-deviated side, we detected significant medial shift of the condyle in all 10 patients at T1; the shift continued in 9 patients at T2. Temporomandibular joint space volume increased significantly at T1 and returned to presurgical volume at T2. In conclusion, there is significant shift in position of condyle in majority of the patients after bilateral sagittal split mandibular ramus osteotomy. The most consistent and persisting change was medial shift on the nondeviated side.
Long-Term Results After Head Orthosis Therapy for Early Childhood Position-Related Cranial Deformities: Stability of Treatment Outcome and Parental Satisfaction
Authors: Grandoch Andrea , Lentzen Max-Philipp , Seikel Hanna , Wetzel Christian , Zoeller Joachim E. 
Published: August 2021

Abstract
The purpose of this study was to determine whether different types of position-related cranial deformities show changes after completion of head orthosis therapy. We investigated how children's age at the begin of molding helmet therapy affects the duration and long-term stability of treatment. In addition, parental satisfaction with helmet therapy has been investigated.
Between 2012 and 2019, 47 patients have been analyzed after undergoing helmet therapy. At the beginning of treatment different disease pattern were classified. Posterior deformational Plagiocephalus defined by a cranial vault index (CVA) > 1 cm and a cranial index (CI) ≤ 90%. Posterior deformational Brachycephalus defined by CVA ≤ 1 cm and CI > 90%. Posterior deformational combined Plagio- and Brachycephalus defined by CVA > 1 cm and CI > 90%. At the beginning of therapy, the end of therapy and within 5-year-follow-up CI and CVA was measured by three-dimensional photogrammetry for 2 age groups (4–6 and 7–12 months). Additionally, parents completed a standardized questionnaire to evaluate the personal assessment of treatment outcome.
During treatment CI and CVA of all children decreased significantly (P < 0.001). Furthermore, CI significantly decreased after ending helmet therapy (P < 0.001). Cranial vault index decreased not significantly in the same period (P = 0.361). For the 4 to 6 months old group treatment time was significantly shorter than for the older group. Before starting helmet therapy nearly half of the parents graded the scull as moderate and one-third as severe deformed. After ending treatment, the majority of parents report satisfaction and compliance. However, one-third of parents noted a slight scull deformation and personal load during therapy.
After completion of therapy an improvement of head shape can be expected for the majority of children. This is particularly evident for improvement of the CI and a shorter treatment time until the age of 6 months at the beginning of therapy. Parents reported satisfaction and child compliance. Almost all parents were convinced that treatment was useful and would repeat it again.
Functionality Assessment of Patients With Cleft Hands
Authors: Rosa Marco Felipe Franco , do Monte Thais Miguel , Raposo-Amaral Cassio Eduardo , Raposo-Amaral Cesar Augusto , de Abreu Marcos Felipe Marcatto 
Published: August 2021

Background:
Ectrodactyly, commonly referred to as cleft hand, is a rare pathology characterized by a deficiency and/or complete absence of the central ray in each hand. In order to customize treatment and improve the patient's quality of life, a more detailed functional evaluation is required. Although several studies evaluate functionality in different types of cleft hands, there are only a few studies that show self-reported evaluations. The objective of this study is to assess the hand function of cleft hand patients.

Methods:
An observational retrospective study was performed on 12 cleft hand patients who were treated between 2008 and 2018. There were 8 male patients and 4 female patients. Patients were divided into 2 groups according to their ages: (Group 1) 6 patients between 1 and 7 years of age, and (Group 2) 6 patients between 8 and 18 years of age, respectively. Each group was sub-stratified into 5 subgroups according to the classification system created by Manske and Halikis.

Results:
Regardless of age, intragroup hand type comparisons within Groups 1 and 2 did not demonstrate statistically significant differences (P > 0.05) between hand outcomes according to Manske and Halikis classification. Comparison between cleft hand patients and their age matched controls demonstrated statistically significant differences (P < 0.05), as the patients in the control group had higher outcome scores.

Conclusions:
Regardless of cleft hand type and patient age, patients with cleft hands experience impaired hand function and present lower outcome scores in comparison to their age matched controls.
Influence of Bone-Borne Trans-Sutural Distraction Osteogenesis Therapy on the Hard Palate of Growing Children With Cleft Lip and Palate
Authors: Li Sijia , Zhang Peiyang , Chen Yujie , Fang Lin , Bai Yanjie , Zhao Zhenmin 
Published: August 2021

Abstract
The efficacy of trans-sutural distraction osteogenesis therapy (TSDO) in treating midfacial hypoplasia in children with cleft lip and palate has been confirmed. However, few studies have reported that changes occur in the palate after TSDO treatment. To study the effect of TSDO on palatal morphology and its relative position in the craniofacial region, we retrospectively collected and measured the computed tomography images of 29 growing children with cleft lip and palate and midfacial hypoplasia, before and after TSDO. The results showed that the length and height of the palate did not change significantly, but the width and arch length increased, and the anterior area was more pronounced than the posterior area, with the median palatine suture still centered without obvious deviation. This suggests lateral palate growth after distraction, most likely around the median palatine suture. The distance from the palate to the cranial base also increased after distraction, and the anterior nasal spine moved forward, whereas the palate rotated by an average of 10.04° downward from the center of the anterior nasal spine. The increasing distance between the palate and cranial base may result from the growth of the nasal bone or the skull base. The oropharyngeal airway volume was also increased by an average of 2256.36 mm3, which may be beneficial to children's ventilatory function. In conclusion, TSDO therapy has influence on patients’ palatal morphology and position, which should be considered before surgery.
Total Customized Alloplastic Reconstruction for Treatment of Severe Temporomandibular Joint Pathologic Conditions: A Case Series of Combined Intraoral and Extraoral Approach
Authors: de Sousa Gil Ariane Paredes , Velasques Bibiana Daldasso , Uzun Nelson , Haas Orion Luiz , de Oliveira Rogério Belle 
Published: August 2021

Abstract
Temporomandibular joint (TMJ) reconstruction with customized alloplastic implants has become a safe and effective treatment option of TMJ end-stage pathology with excellent outcomes reported in the literature. The purpose of this study is to report 5 cases of severe TMJ pathology and customized alloplastic reconstruction using a combined intraoral approach and extraoral approach. Four patients with TMJ involved for benign tumor and one patient with severe TMJ resorption were enrolled. Compromised joints were replaced with customized prosthesis under general anesthesia using an association of intraoral approach/extraoral approach. An implant handpiece with adapted drills for bone drilling and the insertion of screws was used to fixate the mandibular component intraorally; the fossa component was inserted via preauricular approach. The hemimandibulectomies/codilectomy with safety margin were successfully performed and for 2 patients Orthognathic Surgery was also required. Follow-up period was from 15 to 28 months (average 22 months), with no history of surgical site infection or damage to the prostheses. Occlusal relationship and function, as well as facial symmetry were kept stable in all patients. The combination of an intraoral and extraoral approach for total TMJ replacement with customized prosthesis may be an alternative and reliable strategy for pathologic reconstruction, keeping function and reducing aesthetic damage.
Le Fort I Osteotomy in Cleft Patients: Maxillary Advancement and Articulation
Authors: Harjunpää Roni , Alaluusua Suvi , Leikola Junnu , Heliövaara Arja 
Published: August 2021

Background:
Maxillary advancement may affect speech in cleft patients.

Aims:
To examine whether the amount of maxillary advancement and preoperativecephalometric skeletal and dentoalveolar relationships are associated with articulation errors of the Finnish alveolar consonants /s/, /l/, and /r/ in cleft patients.

Materials and Methods:
Fifty-seven nonsyndromic cleft patients who underwent Le Fort I or bimaxillary osteotomies were evaluated retrospectively. Pre- and post-operative lateral cephalometric radiographs and standardized speech video recordings were analyzed. The Aspin-Welch unequal variance t test, Student t test sign test, intraclass correlation and Kappa statistics were used in the statistical analyses.

Results:
The mean advancement of the maxilla (point A) was 4.65 mm horizontally (range −2.80 to 11.30) and −3.82 mm vertically (range −14.20 to 3.90). The overall articulation (especially the sounds /s/ and /l/) improved significantly postoperatively, but the amount of maxillary advancement did not affect the articulation. The preoperative mean percentages of /s/, /l/, and /r/ errors were 32%, 33%, 46% and the postoperative percentages 23%, 19%, 40%, respectively. Preoperative articulation errors of /s/ were related to palatal inclination of the upper incisors.

Conclusions:
Orthognathic surgery may improve articulation errors. The amount of maxillary advancement is not related to the improvement.
Design and Implementation of an Emergency Undocking Curriculum for Robotic Surgery
Authors: Melnyk Rachel , Saba Patrick , Holler Tyler , Cameron Katherine , Mithal Prabhakar , Rappold Philip , Wu Guan , Cubillos Jimena , Rashid Hani , Joseph Jean V. , Ghazi Ahmed E. 
Published: August 2021

Introduction
Current training for robotic surgery crisis management, specifically emergency robotic undocking protocol (ERUP), remains limited to anecdotal experience. A curriculum to impart the skills and knowledge necessary to recognize and complete a successful ERUP was developed using an education approach then evaluated.

Methods
Baseline knowledge and confidence regarding ERUP were established for 5 robotic teams before completing 2 full-immersion simulations separated by an online self-paced learning module. In each simulation, teams operated on a perfused hydrogel model and were tasked to dissect a retroperitoneal tumor abutting a major vessel. During vascular pedicle ligation, a major vascular bleed and nonrecoverable robotic fault were remotely induced, necessitating ERUP with open conversion. After the simulation, participants completed surgery task load index (cognitive load assessment) and realism surveys. Weighted checklists scored participants' actions during each simulation. Surgical metrics including estimated blood loss, time to control bleeding, and undocking time were recorded. Curriculum retention was assessed by repeating the exercise at 6 months.

Results
Participants experienced high levels of cognitive demand and agreed that the simulation's realism and stress mimicked live surgery. Longitudinal analysis showed significant knowledge (+37.5 points, p = 0.004) and confidence (+15.3 points, p < 0.001) improvements from baseline to completion. Between simulations, checklist errors, undocking time, and estimated blood loss decreased (38⇾17, −40 seconds, and −500 mL, respectively), whereas action scores increased significantly (+27 points, p = 0.008). At 6 months, insignificant changes from curriculum completion were seen in knowledge (−4.8 points, p = 0.36) and confidence (+3.7 points, p = 0.1).

Conclusions
This simulation-based curriculum successfully improves operative team's confidence, knowledge, and skills required to manage robotic crisis events.