bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dupuytren’s disease
Authors: Milner Richard 
Published: September 2021

Abstract
Dupuytren’s disease is benign fibromatosis affecting primarily the fascia of the hand and fingers. The epidemiology, pathology, and clinical presentation are described in this chapter. Non-surgical treatments, including clostridial collagenase injection, and a variety of surgical techniques are discussed. Expected outcomes are also described together with the author’s preferred treatment algorithm.
The burned patient
Authors: Wood Fiona , Judkins Keith 
Published: September 2021

Abstract
The pathophysiology of the burn patient is complex with far-reaching effects on virtually all tissues and organ systems. Management of the many different tissue disturbances is best in a multidisciplinary team—with clinicians dealing with their particular area of expertise as part of an organized and coordinated association. An understanding of the inflammatory response is key to understanding the effect of burn injury on different organ systems, and how this can be best modulated to improve patient outcomes. The effects of burn injury are local and systemic—with growing evidence that the long-term sequelae are equally widespread and lifelong.
Fillers and dermabrasive therapies
Authors: Archer Brett 
Published: September 2021

Abstract
Facial ageing involves several key processes: loss of volume; laxity of tissues; and surface skin changes of wrinkles, pigmentation, vascular lesions, and textural changes. Surgery remains the mainstay of treating laxity or sagging of tissues. Fillers are an increasingly popular and effective method of replacing lost volume, or preventing it, and there are a myriad of options for dealing with the surface skin changes. This chapter deals with the principles of the appropriate use of fillers by looking at the patient suitability, the products available, and the proficiency of the injector. Steps to avoid complications are outlined and the management of these rare complications are discussed. A brief discussion is given of the place of chemical peels, dermabrasion, topical agents, and lasers in the improvement of the appearance of ageing skin.
Primary management of cleft lip and palate
Authors: Neil-Dwyer Jason 
Published: September 2021

Abstract
Cleft lip and palate is a condition with the potential to impact the lifetime of a patient, affecting overall health, appearance, communication, facial growth, hearing, eating, dental health, and psychological well-being. To effectively manage these multiple effects, the treatment of cleft lip and/or palate requires involvement of multiple healthcare specialists. This multidisciplinary management is difficult to coordinate so is often delivered by extended multidisciplinary healthcare teams. The early management of a child with a cleft lip and/or palate centres on the well-being of the child. The focus is on feeding, breathing, and managing medical comorbidities. Care can require extensive input from paediatric medical specialists, and needs to occur prior to any surgical management of the cleft lip or palate. This chapter discusses the surgical and perisurgical management of the primary cleft lip and/or palate including manipulation of the cleft lip prior to definitive surgery, primary lip surgery, primary palate surgery, and primary closure of the alveolar cleft with an assumption of medical well-being.
Tumours of the nasopharynx, oropharynx, and hypopharynx
Authors: Iqbal Isma Z. , Balasubramanian Anusha , Paleri Vinidh 
Published: September 2021

Abstract
The pharynx (Greek for throat) is a 12 cm fibromuscular tube extending from the base of the skull above and fusing with the oesophagus below. The pharynx is the common entrance point for respiration and digestion and is divided into the three regions based on its anterior communications—the nasopharynx, the oropharynx and the laryngopharynx. Akin to three cups stacked one on top of the other, it is composed of three constrictor muscles inserting one into the other from superior to inferior, and three longitudinal muscles enabling elevation and dilatation. The pharynx serves the dual purpose of channelling food via the oesophagus into the digestive tract and enabling air to be directed via the larynx and trachea into the respiratory system. The pharyngeal structures also assist in vocalization of sounds and equalization of pressure within the middle ear. Management of pharyngeal neoplasia is challenging and is described in greater detail in published guidelines. This chapter summarizes the management of benign and malignant neoplastic diseases of the pharynx based on its anatomical subdivisions.
Anatomy and physiology of the facial nerve and aetiology of facial nerve palsy
Authors: Gilleard Onur , Tzafetta Kalliroi 
Published: September 2021

Abstract
Facial paralysis can have significant functional and social consequences and presents a challenging reconstructive problem for plastic surgeons. Detailed knowledge of facial nerve anatomy and an understanding of the natural history of the different conditions which result in facial palsy is a prerequisite for clinicians who are involved in the management of this devastating affliction.
Aesthetic surgery of the genitalia
Authors: Mughal Maleeha , Soldin Mark 
Published: September 2021

Abstract
Genital aesthetic surgery is a rapidly growing subspecialty in plastic surgery. Concerns about self-esteem and sexual identity issues have resulted in an increased demand from individuals seeking corrective or enhancing procedures. The surgeon must be able to understand the psychological, technical, and ethical issues linked with surgery to the external genitalia.
Transition of the initial mass function in the metal-poor environments
Authors: Chon Sunmyon , Omukai Kazuyuki , Schneider Raffaella 
Published: September 2021

ABSTRACT
We study star cluster formation in a low-metallicity environment using three-dimensional hydrodynamic simulations. Starting from a turbulent cloud core, we follow the formation and growth of protostellar systems with different metallicities ranging from 10−6 to 0.1 Z⊙. The cooling induced by dust grains promotes fragmentation at small scales and the formation of low-mass stars with M* ∼ 0.01–0.1 M⊙. While the number of low-mass stars increases with metallicity, when Z/Z⊙ ≳ 10−5, the stellar mass distribution is still top-heavy for Z/Z⊙ ≲ 10−2 compared to the Chabrier initial mass function (IMF). In these cases, star formation begins after the turbulent motion decays and a single massive cloud core monolithically collapses to form a central massive stellar system. The circumstellar disc preferentially feeds the mass to the central massive stars, making the mass distribution top-heavy. When Z/Z⊙ = 0.1, collisions of the turbulent flows promote the onset of the star formation and a highly filamentary structure develops owing to efficient fine-structure line cooling. In this case, the mass supply to the massive stars is limited by the local gas reservoir and the mass is shared among the stars, leading to a Chabrier-like IMF. We conclude that cooling at the scales of the turbulent motion promotes the development of the filamentary structure and works as an important factor leading to the present-day IMF.
Giant cell arteritis with spontaneous remission
Authors: Álvarez-Lario Bonifacio , Lorenzo-Martín José Andrés , Colazo-Burlato María , Macarrón-Vicente Jesús Luis , Alonso-Valdivielso José Luis 
Published: September 2021

ABSTRACT
The case of a 75-year-old woman diagnosed with polymyalgia rheumatica (PMR), treated with low doses of prednisone, and with clinical and analytical remission is reported. Two years later, she presented with a clinical picture of giant cell arteritis (GCA), including headache, diplopia, jaw pain, feeling of swelling in both temples, and elevation of acute phase reactants. Symptoms spontaneously subsided 2 weeks later, while analytical parameters improved without any treatment. A high-resolution colour Doppler ultrasound showed thickening of the intima–media complex with ‘halo’ sign in the right temporal artery. A biopsy of the right temporal artery was performed, although it was not successful, as no artery could be found, and the procedure became more complicated with an eyebrow ptosis due to a lesion in the frontal branch of the facial nerve. GCA diagnosis was based on the clinical, laboratory, and ultrasound findings. The patient was treated with prednisone and methotrexate, without clinical or analytical relapse. Comments are presented on the described cases of GCA with spontaneous remission, and the most appropriate treatments in these cases are discussed. Other peculiarities of the case, such as the progression to GCA more than 2 years after the onset of PMR, and the complications from the temporal artery biopsy are also mentioned.
A rare case of a patient with systemic lupus erythematosus who presented with Rowell syndrome responding to treatment with hydroxychloroquine and prednisone with 1 year of relapse-free survival on belimumab
Authors: Loghmani Arya , Ford Barrett , Derbes Stephen 
Published: September 2021

ABSTRACT
Rowell syndrome, first described in 1963 by Rowell et al., is an infrequently reported and unique syndrome occurring in patients with systemic lupus erythematosus (SLE). This syndrome characteristically presents with erythema-multiforme-like lesions as well as other specific immunologic and histopathological manifestations. Since Rowell’s original description, diagnostic criteria have been proposed and modified to better describe the syndrome. We describe a 32-year-old African American female patient with a previous history of SLE who presented with dermatologic, immunologic, and histopathological manifestations that fit the modified diagnostic criteria for Rowell syndrome.
A unique salvage operation strategy: implantation of the ulnar total elbow component to the radius to overcome large ulnar bone defect caused by infection after total elbow arthroplasty
Authors: Tomizawa Takuya , Ito Hiromu , Murata Koichi , Matsuda Shuichi 
Published: September 2021

ABSTRACT
The elbow joints of patients with rheumatoid arthritis (RA) are often destroyed, and total elbow arthroplasty (TEA) is one treatment for these patients. However, patients with RA tend to develop surgical site infections due to immunosuppression. Once an implant is infected, reoperation may be difficult because of the risk of reinfection. In such patients, the infected site must be debrided thoroughly, although this might reduce the bone scaffold needed for re-TEA. We used a unique method to manage a large ulnar bone defect and an infected implant. The patient with RA had undergone TEA 15 years earlier. Etanercept was initiated to control disease activity; however, this treatment led to infection of the elbow prosthesis. Several surgical debridements were performed to eradicate the bacteria, which improved the symptoms of infection. However, most of the proximal ulna was lost, and it seemed impossible to fix the prosthesis using the remaining small ulna after debridement. Therefore, we planned to implant the ulnar component into the radius as a salvage technique. With this procedure, we provided the patient with elbow mobility and eradicated the infection. This is an alternative method for restoring function in an elbow with a massive bone defect in the ulna.
Factors associated with cognitive impairment and cognitive concerns in patients with metastatic non-small cell lung cancer
Authors: Eggen Annemarie C , Richard Nadine M , Bosma Ingeborg , Jalving Mathilde , Leighl Natasha B , Liu Geoffrey , Mah Kenneth , Higazy Randa , Shultz David B , Reyners Anna K L , Rodin Gary , Edelstein Kim 
Published: September 2021

Abstract

Background
Knowledge regarding cognitive problems in metastatic non-small cell lung cancer (mNSCLC) is limited. Such problems may include both patient-reported cognitive concerns and demonstrable cognitive impairment. Greater understanding of these outcomes is needed to inform rehabilitation strategies for these difficulties. We aimed to identify the frequency of cognitive problems and associated factors in patients with mNSCLC.

Methods
In this cross-sectional study, adults with mNSCLC completed validated neuropsychological tests and self-report questionnaires measuring cognitive concerns, neurobehavioral concerns, depression, demoralization, illness intrusiveness, self-esteem, and physical symptoms. Cognitive impairment (performance based) was defined according to International Cancer and Cognition Task Force criteria. Clinically significant cognitive concerns were defined by a score ≥1.5 SD below the normative mean on the Functional Assessment of Cancer Therapy-Cognitive Function Perceived Cognitive Impairment (FACT-Cog PCI). Univariate and multivariate logistic regression analyses were performed to identify associated factors.

Results
Of 238 patients approached, 77 participated (median age: 62 years; range: 37-82). Brain metastases were present in 41 patients (53%), and 23 (29%) received cranial irradiation. Cognitive impairment and cognitive concerns were present in 31 (40%) and 20 patients (26%), respectively. Cognitive impairment and cognitive concerns co-occurred in 10 patients (13%), but their severity was unrelated. Cognitive impairment was associated with cranial irradiation (odds ratio [OR] = 2.89; P = .04), whereas cognitive concerns were associated with greater illness intrusiveness (OR = 1.04; P = .03) and lower self-esteem (OR = 0.86; P = .03).

Conclusions
Cognitive impairment and cognitive concerns are both common in patients with mNSCLC but are not necessarily related, and their risk factors differ. The association of illness intrusiveness and self-esteem with cognitive concerns can inform therapeutic interventions in this population.
Two plastid POLLUX ion channel-like proteins are required for stress-triggered stromal Ca2+release
Authors: Völkner Carsten , Holzner Lorenz Josef , Day Philip M , Ashok Amra Dhabalia , Vries Jan de , Bölter Bettina , Kunz Hans-Henning 
Published: September 2021

Abstract
Two decades ago, large cation currents were discovered in the envelope membranes of Pisum sativum L. (pea) chloroplasts. The deduced K+-permeable channel was coined fast-activating chloroplast cation channel but its molecular identity remained elusive. To reveal candidates, we mined proteomic datasets of isolated pea envelopes. Our search uncovered distant members of the nuclear POLLUX ion channel family. Since pea is not amenable to molecular genetics, we used Arabidopsis thaliana to characterize the two gene homologs. Using several independent approaches, we show that both candidates localize to the chloroplast envelope membrane. The proteins, designated PLASTID ENVELOPE ION CHANNELS (PEC1/2), form oligomers with regulator of K+ conductance domains protruding into the intermembrane space. Heterologous expression of PEC1/2 rescues yeast mutants deficient in K+ uptake. Nuclear POLLUX ion channels cofunction with Ca2+ channels to generate Ca2+ signals, critical for establishing mycorrhizal symbiosis and root development. Chloroplasts also exhibit Ca2+ transients in the stroma, probably to relay abiotic and biotic cues between plastids and the nucleus via the cytosol. Our results show that pec1pec2 loss-of-function double mutants fail to trigger the characteristic stromal Ca2+ release observed in wild-type plants exposed to external stress stimuli. Besides this molecular abnormality, pec1pec2 double mutants do not show obvious phenotypes. Future studies of PEC proteins will help to decipher the plant’s stress-related Ca2+ signaling network and the role of plastids. More importantly, the discovery of PECs in the envelope membrane is another critical step towards completing the chloroplast ion transport protein inventory.
Biochemical and molecular properties of LHCX1, the essential regulator of dynamic photoprotection in diatoms
Authors: Giovagnetti Vasco , Jaubert Marianne , Shukla Mahendra K , Ungerer Petra , Bouly Jean-Pierre , Falciatore Angela , Ruban Alexander V 
Published: September 2021

Abstract
Light harvesting is regulated by a process triggered by the acidification of the thylakoid lumen, known as nonphotochemical “energy-dependent quenching” (qE). In diatoms, qE is controlled by the light-harvesting complex (LHC) protein LHCX1, while the LHC stress-related (LHCSR) and photosystem II subunit S proteins are essential for green algae and plants, respectively. Here, we report a biochemical and molecular characterization of LHCX1 to investigate its role in qE. We found that, when grown under intermittent light, Phaeodactylum tricornutum forms very large qE, due to LHCX1 constitutive upregulation. This “super qE” is abolished in LHCX1 knockout mutants. Biochemical and spectroscopic analyses of LHCX1 reveal that this protein might differ in the character of binding pigments relative to the major pool of light-harvesting antenna proteins. The possibility of transient pigment binding or not binding pigments at all is discussed. Targeted mutagenesis of putative protonatable residues (D95 and E205) in transgenic P. tricornutum lines does not alter qE capacity, showing that they are not involved in sensing lumen pH, differently from residues conserved in LHCSR3. Our results suggest functional divergence between LHCX1 and LHCSR3 in qE modulation. We propose that LHCX1 evolved independently to facilitate dynamic tracking of light fluctuations in turbulent waters. The evolution of LHCX(-like) proteins in organisms with secondary red plastids, such as diatoms, might have conferred a selective advantage in the control of dynamic photoprotection, ultimately resulting in their ecological success.
Riboswitch-mediated inducible expression of an astaxanthin biosynthetic operon in plastids
Authors: Agrawal Shreya , Karcher Daniel , Ruf Stephanie , Erban Alexander , Hertle Alexander P , Kopka Joachim , Bock Ralph 
Published: September 2021

Abstract
The high-value carotenoid astaxanthin (3,3′-dihydroxy-β,β-carotene-4,4′-dione) is one of the most potent antioxidants in nature. In addition to its large-scale use in fish farming, the pigment has applications as a food supplement and an active ingredient in cosmetics and in pharmaceuticals for the treatment of diseases linked to reactive oxygen species. The biochemical pathway for astaxanthin synthesis has been introduced into seed plants, which do not naturally synthesize this pigment, by nuclear and plastid engineering. The highest accumulation rates have been achieved in transplastomic plants, but massive production of astaxanthin has resulted in severe growth retardation. What limits astaxanthin accumulation levels and what causes the mutant phenotype is unknown. Here, we addressed these questions by making astaxanthin synthesis in tobacco (Nicotiana tabacum) plastids inducible by a synthetic riboswitch. We show that, already in the uninduced state, astaxanthin accumulates to similarly high levels as in transplastomic plants expressing the pathway constitutively. Importantly, the inducible plants displayed wild-type–like growth properties and riboswitch induction resulted in a further increase in astaxanthin accumulation. Our data suggest that the mutant phenotype associated with constitutive astaxanthin synthesis is due to massive metabolite turnover, and indicate that astaxanthin accumulation is limited by the sequestration capacity of the plastid.
Impact of Nerve Surgery on Opioid and Medication Use in Patients with Chronic Nerve Injuries
Authors: Felder John M. , Ducic Ivica 
Published: September 2021

Introduction:
Limited information is available regarding the ability of nerve surgery to affect medication use patterns in patients with chronic pain or neuropathy due to nerve injury.

Methods:
A retrospective survey was distributed to all operative patients (N = 767) from a single nerve surgeon’s practice between 2014 and 2020. Data collected included demographics, specifics of the injury and symptoms, medication and opioid use before surgery, and medication/opioid use following surgery.

Results:
Out of the 767 patients, 209 (27.2%) completed the survey. Average age was 48.8 (SD = 19.1) years; 68.9% female and 31.1% male. More than 50% of the patients took at least three medications. More than 50% of the patients after surgery did not need medication or had significant reduction; 54.1% of the patients took opioid medication daily, and 97.3% of patients reported that narcotic medications did not resolve their problem. Patients rated the effectiveness (Likert scale 0–10) of opioid medications in general at an average 3.25 ± 2.03. Of patients who took opioids regularly, 61.6% reported a negative effect of these medications on daily or professional activities. After surgery, more than 50% of the patients did not need opioids or had a significant reduction in opioid usage.

Conclusions:
Untreated nerve injuries lead to ongoing chronic pain, explaining why medications are mostly ineffective in eliminating symptoms. In this study, nerve surgery targeting the anatomical source of symptoms effectively reduced both opioid and nonopioid medication use.
Effects of Prescription Opioid Use on Traumatic Brain Injury Risk in Older Adults
Authors: Herrera Anthony V. , Wastila Linda , Brown Jessica P. , Chen Hegang , Gambert Steven R. , Albrecht Jennifer S. 
Published: September 2021

Objective:
The objective of this study was to estimate the risk of traumatic brain injury (TBI) associated with opioid use among older adult Medicare beneficiaries.

Setting:
Five percent sample of Medicare administrative claims obtained for years 2011-2015.

Participants:
A total of 50 873 community-dwelling beneficiaries 65 years and older who sustained TBI.

Design:
Case-crossover study comparing opioid use in the 7 days prior to TBI with the control periods of 3, 6, and 9 months prior to TBI.

Main Measures:
TBI cases were identified using ICD-9 (International Classification of Diseases, Ninth Revision) and ICD-10 (International Classification of Diseases, Tenth Revision) codes. Prescription opioid exposure and concomitant nonopioid fall risk–increasing drug (FRID) use were determined by examining the prescription drug event file.

Results:
The 8257 opioid users (16.2%) were significantly younger (mean age 79.0 vs 80.8 years, P < .001). Relative to nonusers, opioid users were more likely to be women (77.0% vs 70.0%, P < .001) with a Charlson Comorbidity Index of 2 or more (43.7% vs 30.9%, P < .001) and higher concomitant FRID use (94.0% vs 82.7%, P < .001). Prescription opioid use independently increased the risk of TBI compared with nonusers (OR = 1.34; 95% CI, 1.28-1.40). In direct comparisons, we did not observe evidence of a significant difference in adjusted TBI risk between high- (≥90 morphine milligram equivalents) and standard-dose opioid prescriptions (OR = 1.01; 95% CI, 0.90-1.14) or between acute and chronic (≥90 days) opioid prescriptions (OR = 0.93; 95% CI, 0.84-1.02).

Conclusions:
Among older adult Medicare beneficiaries, prescription opioid use independently increased risk for TBI compared with nonusers after adjusting for concomitant FRID use. We found no significant difference in adjusted TBI risk between high-dose and standard-dose opioid use, nor did we find a significant difference in adjusted TBI risk between acute and chronic opioid use. This analysis can inform prescribing of opioids to community-dwelling older adults for pain management.