bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single‐cell transcriptomics reveal temporal dynamics of critical regulators of germ cell fate during mouse sex determination
Authors: Mayère Chloé , Neirijnck Yasmine , Sararols Pauline , Rands Chris M. , Stévant Isabelle , Kühne Françoise , Chassot Anne‐Amandine , Chaboissier Marie‐Christine , Dermitzakis Emmanouil T. , Nef Serge 
Published: March 2021

AbstractDespite the importance of germ cell (GC) differentiation for sexual reproduction, the gene networks underlying their fate remain unclear. Here, we comprehensively characterize the gene expression dynamics during sex determination based on single‐cell RNA sequencing of 14 914 XX and XY mouse GCs between embryonic days (E) 9.0 and 16.5. We found that XX and XY GCs diverge transcriptionally as early as E11.5 with upregulation of genes downstream of the bone morphogenic protein (BMP) and nodal/Activin pathways in XY and XX GCs, respectively. We also identified a sex‐specific upregulation of genes associated with negative regulation of mRNA processing and an increase in intron retention consistent with a reduction in mRNA splicing in XY testicular GCs by E13.5. Using computational gene regulation network inference analysis, we identified sex‐specific, sequential waves of putative key regulator genes during GC differentiation and revealed that the meiotic genes are regulated by positive and negative master modules acting in an antagonistic fashion. Finally, we found that rare adrenal GCs enter meiosis similarly to ovarian GCs but display altered expression of master genes controlling the female and male genetic programs, indicating that the somatic environment is important for GC function. Our data are available on a web platform and provide a molecular roadmap of GC sex determination at single‐cell resolution, which will serve as a valuable resource for future studies of gonad development, function, and disease.
Isovolemic Degradation of Polycaprolactone Particles and Calculation of Their Original Size from Human Biopsy
Authors: Kim JongSeo 
Published: March 2021

Background:
Polycaprolactone (PCL) implants show isovolemic degradation during phase-1 degradation; they maintain their volume as their molecular weight decreases. Phase-2 begins with PLC volume being reduced by bulk degradation with autocatalysis. Isovolemic degradation of PCL particles during phase 1 and their longevity should be established in humans. PCL particle size can be mathematically calculated through cross-sectioned PCL particles in biopsy slides.

Methods:
Biopsy specimens were obtained from humans after giving them a subdermal injection for 4 years to measure cross-section diameters of PCL particles. In all (160) biopsy slides, all cross-sections of PCL particles were measured in size in microscopic photographs, and the real size of PCL particles was calculated through Equation of a circle (Equation

circle
) and mean value theorem for integrals (Integral

Theorem
). Diameters of Ellansé particles were measured with particle size analyzer.

Results:
On average, the calculated PCL particle size using Integral

Theorem
was 42.83 (immediately), then 43.18(1), 42.62(2), 40.90(3), and 34.46 µm(4 years), respectively. These results were similar to the diameters calculated using the Equation

circle
. PCL size remained unchanged until 3 years, which began to decrease from the fourth year, making the transition point in between. In particle size analyzer, the mean diameter was 42.42 µm.

Conclusions:
PCL particle size was mathematically calculated for 4 years in an in vivo biopsy study. Until 3 years after the injection, PCL particle diameter remained at 95.47% and showed phase-1 isovolemic degradation. From 4 years after the injection, particles decreased in size, showing phase-2 bulk degradation. PCL particles were smooth and circular for 3 years, and from the fourth year, the surface became very rough. The Ellansé-M longevity was longer than 4 years.
Multiple Thrombi during Microvascular Anastomosis Caused by Decreased Antithrombin Activity: A Case Report
Authors: Uchibori Takafumi , Takanari Keisuke , Nakamura Ryota , Kambe Miki , Ebisawa Katsumi , Nakamura Yutaka , Mogi Kousuke , Kamei Yuzuru 
Published: March 2021

Summary:
With recent advances in microsurgical instruments and technique, microvascular anastomosis has become a universal surgical technique; however, thrombosis still presents in a number of cases. Tension, twisting, and compression to the anastomotic site are the main causes of thrombus; however, disorder of the coagulation–fibrinolysis system also need to be considered. To date, only few reports exist regarding thrombosis caused by disorder of coagulant system in microvascular anastomosis. Here we report our 3 cases in which multiple thrombus formation occurred intraoperatively caused by decrease of antithrombin (AT) activity. AT activity was measured twice a day after vascular anastomosis: after surgery and up to 3 days after surgery. Thrombosis was not observed in any of the 3 patients intraoperatively after the transfusion, or thrombosis was not observed in any of 3 patients intraoperatively after the transfusion or postoperatively, and no other complications were observed. In these 3 cases, the thrombus was not caused by technical error or other previously described factors. The observed intraoperative decrease in AT activity was thought to be caused by thrombus formation. It is important that microsurgeons are reminded that disorders of the coagulation–fibrinolysis system could cause thrombosis.
The PRS Rainbow Classification for Assessing Postbariatric Contour Deformities
Authors: de Vries Claire E. E. , van den Berg Lisa , Monpellier Valerie M. , Hoogbergen Maarten M. , Mink van der Molen Aebele B. , de Castro Steve M. M. , van der Lei Berend 
Published: March 2021

Background:
There is a need for a reliable classification system to grade contour deformities and to inform reimbursement of body contouring surgery after massive weight loss. We developed the PRS Rainbow Classification, which uses select photographs to provide standardized references for evaluating patient photographs, to classify contour deformities in postbariatric patients. To assess the reliability of the PRS Rainbow Classification to classify contour deformities in massive weight loss patients.

Methods:
Ten independent experienced plastic surgeons, 7 experienced medical advisors of the healthcare insurance company, and 10 laypersons evaluated 50 photographs per anatomical region (arms, breast, abdomen, and medial thighs). Each participant rated the patient photographs on a scale of 1–3 in an online survey. The inter-observer and the intra-observer reliabilities were determined using intra-class correlation coefficients (ICCs). The ICC analyses were performed for each anatomical region.

Results:
Inter-observer reliability was moderate to good in the body regions “arms,” “abdomen,” “medial thighs,” with mean ICC values of 0.678 [95% confidence interval (CI), 0.591–0.768], 0.685 (95% CI, 0.599–0.773), and 0.658 (95% CI, 0.569–0.751), respectively. Inter-observer reliability was comparable within the 3 different professional groups. Intra-observer reliability (test–retest reliability) was moderate to good, with a mean overall ICC value of 0.723 (95% CI, 0.572–0.874) for all groups and all 4 body regions.

Conclusions:
The moderate to good reliability found in this study validates the use of the PRS Rainbow Classification as a reproducible and reliable classification system to assess contour deformities after massive weight loss. It holds promise as a key part of instruments to classify body contour deformities and to assess reimbursement of body contouring surgery.
A Systematic Review of Tranexamic Acid in Plastic Surgery: What’s New?
Authors: Elena Scarafoni Esteban 
Published: March 2021

Background:
Blood loss associated with surgical interventions can lead to several complications. Therefore, minimizing perioperative bleeding is critical to improve overall survival. Several interventions have been found to successfully reduce surgical bleeding, including the antifibrinolytic agent. After aprotinin was withdrawn from the market in 2008, TXA remained the most commonly used medication. The safety and efficacy of TXA has been well studied in other specialties. TXA has been rarely used in plastic surgery, except in craniofacial procedures. Since the last review, the number of articles examining the use of TXA has doubled; so the aim of this systematic review is to update the readers on the current knowledge and clinical recommendations regarding the efficacy of TXA in plastic surgical procedures.

Methods:
A systematic literature search was conducted in Medline, SciELO, Cochrane, and Google Scholar to evaluate all articles that discussed the use of TXA in plastic surgery in the fields of aesthetic surgery, burn care, and reconstructive microsurgery.

Results:
A total of 233 publications were identified using the search criteria defined above. After examination of titles and abstracts, and exclusion of duplicates, a total of 23 articles were selected for analysis.

Conclusions:
The literature shows a clear benefit of using TXA to decrease blood loss regardless of the administration route, with no risk of thrombosis events. Also, TXA elicits a potent anti-inflammatory response with a decrease in postoperative edema and ecchymosis, which improves recovery time. Further investigations are needed to standardize the optimal administration route and dosage of TXA.
Pilonidal Cyst Excision: Primary Midline Closure with versus without Closed Incision Negative Pressure Therapy
Authors: Gabor Silvio , de Lima Favaro Murillo , Pimentel Pedroso Ruy Francisco , Duarte Bárbara Henriqueta Ferreira , Novo Rafaela , Iamarino Ana Paula , Ribeiro Marcelo Augusto Fontenelle 
Published: March 2021

Background:
Pilonidal cysts are a painful condition that primarily affect young adult men. In the literature, numerous operative techniques for resolving pilonidal cysts are described, with variable outcomes. The objective of this study was to compare primarily closed midline incisions managed with or without the use of closed incision negative pressure therapy after pilonidal cyst excision.

Methods:
Twenty-one patients underwent excision and midline primary closure. Postoperative care composed of closed incisional negative pressure therapy (study group; n = 10) or gauze dressings (control group; n = 11). In both groups, the sutures were partially removed on day 14 and completely removed on day 21. Compared outcomes included the duration of hospitalization, pain on the day of surgical procedure, and on postoperative day 7, and time-to-healing.

Results:
The median hospital stay was about 9 hours and 23 hours in the study and control groups, respectively (P < 0.05). The median pain scores on the day of operation were 1.20/10 in the study group and 3.36/10 in the control group (P < 0.05). On day 7, study group showed median pain score 0.9/10 and control group showed 2.63/10 (P < 0.05). The mean healing time was 23.8 and 57.9 days in the ciNPT group and gauze group, respectively (P < 0.05).

Conclusion:
These outcomes supported the incorporation of closed incision negative pressure therapy into our surgical treatment protocol for pilonidal cysts.
Building a Multidisciplinary Academic Surgical Gender-affirmation Program: Lessons Learned
Authors: Manrique Oscar J. , Bustos Samyd S. , Bustos Valeria P. , Mascaro Andres A. , Ciudad Pedro , Forte Antonio J. , Del Corral Gabriel , Kim Esther A. , Langstein Howard N. 
Published: March 2021

Background:
Every day, we see more patients present to hospitals and clinics seeking gender-affirmation care to ameliorate the symptoms of gender dysphoria. However, to provide a multidisciplinary approach, it is important to offer an integrated clinical program that provides mental health assessment, endocrine therapy, physical therapy, research, and the full spectrum of surgical services devoted to transgender patients. This article describes our experience on building a specialized, multidisciplinary, academic state-of-the-art gender-affirmation program.

Methods:
Herein, we describe the main and critical components on how to build a multidisciplinary academic gender-affirmation program. We share our lessons learned from this experience and describe how to overcome some of the obstacles during the process.

Results:
Building a multidisciplinary academic gender-affirmation program requires an invested team, as each and every member is essential for feedback, referrals, and to improve patient’s experience. Institutional support is essential and by far the most important component to overcome some of the obstacles during the process. Having all team members working under the same institution provides all the critical components needed to improve outcomes and patient satisfaction. In addition, the collection of prospective data with a well-structured research team will provide information needed to improve clinical services and standardize clinical protocols, while leaving space for innovation.

Conclusions:
This article describes the steps and experience needed to build a multidisciplinary holistic academic gender-affirmation program. We provide our lessons learned during the process that will help guide those who intend to start an academic gender-affirmation program.
Treatment of Trichiasis by Releasing Follicle Roots of Eyelashes: A New Technique
Authors: Karademir Sacit , Agaoglu Galip 
Published: March 2021

Summary:Trichiasis is an acquired condition in which eyelashes are misdirected toward the ocular surface, resulting in eye irritation and ocular morbidities. Different treatment modalities have been described, including surgical and non-surgical methods. The goal of this article is to present a novel technique for treatment of trichiasis, with a brief review of treatment options. Through a supratarsal incision, each misdirected eyelash follicle root was reached and freed from surrounding tissues by meticulous dissection. Then, hair shafts on the lid margin were redirected upward and glued to 2 bars extending horizontally across the upper eyelid. Two years after operation, the corrected eyelashes maintained their normal upward direction. To the best of our knowledge, this is the first reported case of chronic trichiasis treated by this technique. The main advantage of the technique, unlike most of the other treatment methods, is that follicles of the affected eyelashes are not removed or destroyed, which is appreciated from the aesthetic point of view, especially in female patients. We believe that any plastic surgeon with basic knowledge of blepharoplasty and hair transplantation can perform this technique without much difficulty. So far, there is no recurrence; however, long-term follow-up with a large series of patients is required for drawing better conclusions.
The effect of NSAIDs on postfracture bone healing: a meta-analysis of randomized controlled trials
Authors: Al Farii Humaid , Farahdel Leila , Frazer Abbey , Salimi Ali , Bernstein Mitchell 
Published: March 2021

Objectives:
To determine whether nonsteroidal anti-inflammatory drugs (NSAIDs) have an adverse effect on bone healing by evaluating all available human randomized controlled trials (RCTs) on this subject.

Data Sources:
A comprehensive search of electronic databases (PubMed, MEDLINE, and Cross-References) until October 2018 comparing the occurrence of nonunion in patients who received NSAIDs to the control group through RCTs.

Study Selection:
Inclusion criteria were English-only studies, and the type of studies was restricted to RCTs.

Data Extraction:
Two authors independently extracted data from the selected studies, and the data collected were compared to verify agreement.

Data Synthesis:
Nonunion was the main outcome evaluated in each study. Regression analysis was used to estimate the relative risk comparing the duration and the type of NSAIDs by calculating the odds ratio (OR) for dichotomous variables. Studies were weighed by the inverse of the variance of the outcome, and a fixed-effects model was used for all analyses.

Conclusions:
Six RCTs (609 patients) were included. The risk of nonunion was higher in the patients who were given NSAIDs after the fracture with an OR of 3.47. However, once the studies were categorized into the duration of treatment with NSAIDs, those who received NSAIDs for a short period (<2 weeks) did not show any significant risk of nonunion compared to those who received NSAIDs for a long period (>4 weeks). Indomethacin was associated with a significant higher nonunion rate and OR ranging from 1.66 to 9.03 compared with other NSAIDs that did not show a significant nonunion risk.
Gravettian hand stencils as sign language formatives
Authors: Etxepare Ricardo , Irurtzun Aritz 
Published: March 2021

Several Upper Palaeolithic archaeological sites from the Gravettian period display hand stencils with missing fingers. On the basis of the stencils that Leroi-Gourhan identified in the cave of Gargas (France) in the late 1960s, we explore the hypothesis that those stencils represent hand signs with deliberate folding of fingers, intentionally projected as a negative figure onto the wall. Through a study of the biomechanics of handshapes, we analyse the articulatory effort required for producing the handshapes under the stencils in the Gargas cave, and show that only handshapes that are articulable in the air can be found among the existing stencils. In other words, handshape configurations that would have required using the cave wall as a support for the fingers are not attested. We argue that the stencils correspond to the type of handshape that one ordinarily finds in sign language phonology. More concretely, we claim that they correspond to signs of an ‘alternate’ or ‘non-primary’ sign language, like those still employed by a number of bimodal (speaking and signing) human groups in hunter–gatherer populations, like the Australian first nations or the Plains Indians. In those groups, signing is used for hunting and for a rich array of ritual purposes, including mourning and traditional story-telling. We discuss further evidence, based on typological generalizations about the phonology of non-primary sign languages and comparative ethnographic work, that points to such a parallelism. This evidence includes the fact that for some of those groups, stencil and petroglyph art has independently been linked to their sign language expressions.This article is part of the theme issue ‘Reconstructing prehistoric languages’.
Vascular Inflammation in Lungs of Patients with Fatal Coronavirus Disease 2019 (COVID-19) Infection: Possible role for the NLRP3 inflammasome
Authors: Paul Oindrila , Tao Jian Qin , Litzky Leslie , Feldman Michael , Montone Kathleen , Rajapakse Chamith , Bermudez Christian , Chatterjee Shampa 
Published: March 2021

ABSTRACTHyperinflammation is a key event that occurs with SARS-CoV-2 infection. In the lung, hyperinflammation leads to structural damage to tissue. To date, numerous lung histological studies have shown extensive alveolar damage, but there is scarce documentation of vascular inflammation in postmortem lung tissue. Here we document histopathological features and monitor the NLRP3 inflammasome in fatal cases of disease caused by SARS Cov2 (COVID-19). We posit that inflammasome formation along the vessel wall is a characteristic of lung inflammation that accompanies COVID-19 and that it is a probable candidate that drives amplification of inflammation post infection.
The presence of SARS-CoV-2 RNA in different freshwater environments in urban settings determined by RT-qPCR: implications for water safety
Authors: Mahlknecht Jürgen , Alonso-Padilla Diego , Ramos Edrick , Reyes Luisa Ma. , Álvarez Mario Moises 
Published: March 2021

AbstractThis study is the first focused on the presence of SARS-CoV-2 in different freshwater environments in an urban setting. Groundwater and surface water reservoirs for drinking water as well as water from receiving rivers of the Monterrey Metropolitan Area were sampled repeatedly during a SARS-CoV-2 peak phase between October 2020 and January 2021, and viral RNA was measured by quantitative reverse transcription polymerase chain reaction. Forty-four percent of the groundwater samples had detectable viral loads between 2.6 and 38.3 copies/ml. A significant correlation between viral load and sucralose concentration in groundwater reaffirmed the hypothesis of leaching and infiltrating effluent from surface and/or failing sewage pipes and emphasized the importance of water disinfection. Twelve percent of the surface water dam samples tested positive for viral RNA, with values varying between 3.3 and 3.8 copies/ml. Finally, 13% of the river samples were positive for viral RNA, with concentrations ranging from 2.5 to 7.0 copies/ml. Untreated wastewater samples taken in the same period showed viral loads of up to 3535 copies/ml, demonstrating a dilution effect and/or wastewater facilities efficiency of three orders of magnitude. Variations in the viral loads in the groundwater and surface water over time and at the submetropolitan level generally reflected the reported trends in infection cases for Monterrey. The viral loads in the freshwater environments of Monterrey represent a low risk for recreational activities according to a preliminary risk assessment model. However, this result should not be taken lightly due to uncertainty regarding data and model constraints and the possibility of situations where the infection risk may increase considerably.
Lives Saved from Age-Prioritized Covid-19 Vaccination
Authors: Goldstein Joshua R. , Cassidy Thomas , Mahmud Ayesha S. 
Published: March 2021

AbstractBACKGROUNDThe criteria used to allocate scarce COVID-19 vaccines are hotly contested. While some are pushing just to get vaccines into arms as quickly as possible, others advocate prioritization in terms of risk.OBJECTIVEOur aim is to use demographic models to show the enormous potential of vaccine risk-prioritization in saving lives.METHODSWe develop a simple mathematical model that accounts for the age distribution of the population and of COVID-19 mortality. This model considers only the direct live-savings for those who receive the vaccine, and does not account for possible indirect effects of vaccination. We apply this model to the United States, Japan, and Bangladesh.RESULTSIn the United States, we find age-prioritization would reduce deaths during a vaccine campaign by about 93 percent relative to no vaccine and 85 percent relative to age-neutral vaccine distribution. In countries with younger age structures, such as Bangladesh, the benefits of age-prioritization are even greater.CONTRIBUTIONFor policy makers, our findings give additional support to risk-prioritized allocation of COVID-19 vaccines. For demographers, our results show how the age-structures of the population and of disease mortality combine into an expression of risk concentration that shows the benefits of prioritized allocation. This measure can also be used to study the effects of prioritizing other dimensions of risk such as underlying health conditions.