bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender Disparities in Preoperative Resource Use for Wrist Arthroscopy
Authors: Billig Jessica I. , Sterbenz Jennifer M. , Zhong Lin , Chung Kevin C. 
Published: October 2018

Background:
Although national efforts to minimize gender biases exist, gender differences in surgery persist. This study aims to investigate gender differences in preoperative resource use of patients undergoing wrist arthroscopy for nontraumatic wrist pain.

Methods:
Patients who underwent a wrist arthroscopy for nontraumatic pain from 2009 to 2015 were selected from the Truven MarketScan databases. Demographic and preoperative resource use data were recorded. Multivariable regression models were performed to examine the relationship between gender and preoperative resource use and to investigate the cost of these services.

Results:
A total of 8792 patients, 3805 men and 4987 women, met our inclusion criteria. Women were less likely to use imaging modalities preoperatively (OR, 0.08; 95 percent CI, 0.07 to 1.00; p = 0.02). However, women used more occupational therapy (OR, 1.2; 95 percent CI, 1.1 to 1.3; p = 0.002), nonnarcotic analgesia (OR, 1.2; 95 percent CI, 1.1 to 1.3; p = 0.001), and narcotic analgesia (OR, 1.6; 95 percent CI, 1.5 to 1.8; p < 0.001). Preoperative costs during the 12 months before surgery were similar between genders ($1308 versus $1367, respectively; p = 0.07). However, women accrued more costs from occupational therapy ($130 versus $93; p = 0.003), and nonnarcotic ($65 versus $46; p < 0.001) and narcotic medications ($568 versus $197; p < 0.001).

Conclusions:
Significant gender differences exist in the preoperative care for patients undergoing wrist arthroscopy. Men use more imaging, implying more intense preoperative investigation for wrist pain, whereas women use more conservative measures, highlighting possible implicit provider biases in preoperative management and potential gender differences in disease presentation.
CRISPR Craft: DNA Editing the Reconstructive Ladder
Authors: Roh Danny S. , Li Edward B.-H. , Liao Eric C. 
Published: October 2018

Summary:
The clustered regularly interspaced short palindromic repeats (CRISPR) system of genome editing represents a major technological advance spanning all areas of genetics and downstream applications. CRISPR’s potential impact on treating human disease encompasses all clinical specialties, including areas important to the plastic surgeon such as oncology, wound healing, immunology, and craniofacial malformations. Plastic surgeons should gain familiarity with this gene editing technology, and become active contributors and leaders in applying CRISPR to their respective areas of expertise. This review describes the history and basic mechanism of CRISPR genome editing, highlights current and future applications, and discusses limitations. The authors will consider CRISPR’s potential impact and use in plastic and reconstructive surgery.
Regional Variation and Trends in the Timing of Lower Extremity Reconstruction: A 10-Year Review of the Nationwide Inpatient Sample
Authors: Sheckter Clifford C. , Pridgen Brian , Li Alexander , Curtin Catherine , Momeni Arash 
Published: October 2018

Background:
The ideal timing of soft-tissue coverage for open lower extremity fractures remains controversial. Using U.S. national data, this study aims to characterize secular trends and regional variation in the timing of soft-tissue coverage.

Methods:
Using discharge data from the Nationwide Inpatient Sample (2002 to 2011), the authors identified 888 encounters admitted from the emergency department with isolated open lower extremity fractures treated with pedicled or free tissue transfer. Soft-tissue coverage timing was assessed by patient factors, hospital characteristics, and fracture patterns. Statistical significance and secular trends were analyzed with generalized linear models.

Results:
The mean day of soft-tissue reconstruction was at 6.64 days. Over the 10-year period, the day of reconstruction increased significantly (from 6.12 days in 2002 to 12.50 days in 2011; coefficient, 0.09; 95 percent CI, 0.05 to 0.12; p < 0.001). Demographic and facility factors did not significantly impact timing. Elixhauser comorbidity scores greater than 2 were associated with later coverage (10.13 days versus 6.29 days; p = 0.001) along with multisite fractures (8.35 days; p = 0.022) and external fixators (8.78 days; p < 0.001). The U.S. Census division showed significant variation in timing ranging from 0.94 days (East North Central) to 9.84 days (Pacific).

Conclusions:
A progressive delay in the timing of soft-tissue reconstruction was noted and may be attributed to negative-pressure wound therapy. The timing of soft-tissue coverage varied by region after adjusting for patient and hospital factors. Additional studies are needed to understand the impact of delayed soft-tissue coverage on patient outcomes and health services utilization.
Amputation-Site Soft-Tissue Restoration Using Adipose Stem Cell Therapy
Authors: Bourne Debra A. , Thomas R. Dallin , Bliley Jacqueline , Haas Gretchen , Wyse Aaron , Donnenberg Albert , Donnenberg Vera S. , Chow Ian , Cooper Rory , Coleman Sydney , Marra Kacey , Pasquina Paul F. , Rubin J. Peter 
Published: October 2018

Summary:
Soft-tissue deficits in amputation stumps can lead to significant pain and disability. An emerging treatment option is stem cell–enriched fat grafting. This is the first study assessing the potential for this treatment modality in lower extremity amputation sites. In this prospective cohort study, five injured military personnel suffering from pain and limited function at amputation sites were recruited. Fat grafting enriched with stromal vascular fraction was performed at amputation sites to provide additional subcutaneous tissue padding over bony structures. Outcomes measures included complications, demographic data, physical examination, cellular subpopulations, cell viability, graft volume retention, pain, Lower Extremity Functional Scale, Functional Mobility Assessment, 36-Item Short-Form Health Survey, and rates of depression. Follow-up was 2 years. There were no significant complications. Volume retention was 61.5 ± 24.0 percent. Overall cell viability of the stromal vascular fraction was significantly correlated with volume retention (p = 0.016). There was no significant correlation between percentage of adipose-derived stem cells or number of cells in the stromal vascular fraction and volume retention. There was a nonsignificant trend toward improvement in pain scores (3.0 ± 2.5 to 1.2 ± 1.6; p = 0.180 at 2 years). There were no significant changes in disability indexes. Results from this pilot study demonstrate that stromal vascular fraction–enriched fat grafting is a safe, novel modality for the treatment of symptomatic soft-tissue defects in traumatic lower extremity amputations. Volume retention can be anticipated at slightly over 60 percent. Further studies are needed to assess efficacy.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Management of Fat Necrosis after Autologous Fat Transplantation for Breast Augmentation
Authors: Lin Jeng-Yee , Song Ping , Pu Lee L. Q. 
Published: October 2018

Background:
Palpable lumps as sequelae of fat necrosis after fat grafting to the breast may not only cause physical or psychological symptoms to patients but also potentially complicate breast cancer screening. In this article, the authors present their experience in management of fat necrosis following fat grafting for breast augmentation.

Methods:
Over a 5-year period, a total of 685 Asian women (age range, 20 to 58 years) underwent autologous fat transplantation to the breasts. The average volume of fat graft to each breast was 205 ± 45 cc. The preoperative and postoperative photographs and the breast volume were recorded. Detection of fat necrosis was based on clinical examinations and imaging studies. The mean follow-up was 208 ± 36 days.

Results:
The mean volume increase was 135 ± 20 cc in a single breast, with a mean graft retention rate of 65 percent. Sixty-six patients (9.6 percent) were found to have fat necrosis in the form of solitary or multiple cysts, sclerotic nodules, or calcifications in either one or both breasts postoperatively. The average time before first detection of the breast lump was 108 ± 45 days. Management of fat necrosis included aspiration or excision based on the authors’ treatment algorithm. The symptoms related to fat necrosis such as discomfort on palpation, pain, or possible skin reaction were significantly improved in 54 of 57 patients (94.7 percent).

Conclusions:
Fat necrosis following autologous fat grafting for breast augmentation can be managed successfully and its related symptoms can be relieved in 94.7 percent of patients. It can be approached safely based on a sound algorithm developed by the authors.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
A New Paradigm in Cleft Lip Procedural Excellence: Creation and Preliminary Digital Validation of a Lifelike Simulator
Authors: Rogers-Vizena Carolyn R. , Saldanha Francesca Y. L. , Hosmer Andrew L. , Weinstock Peter H. 
Published: October 2018

Summary:
Simulation is becoming an increasingly important tool for hands-on surgical education in a no-risk environment. Cleft lip repair is a common procedure where precise technique is needed to achieve optimal outcome, making it an ideal candidate for simulation. A digital simulated patient with a typical unilateral complete cleft lip and alveolus was constructed using existing three-dimensional imaging studies. Key surface and internal anatomical elements were characterized in detail. A prototype high-fidelity simulator was constructed with silicone and synthetic polymers over a supportive scaffold, piloted by three surgeons using multiple techniques, and digitally compared to real patients. All surgeons completed key steps of a cleft lip repair on the simulator and found it approximated the haptics and anatomy of a cleft lip. Surface change and anthropometric movements accomplished on the simulator were similar for all three surgeons. In digital comparison to analogous real patient data, the simulator anthropometric movements and topographic change were similar to real nasolabial movement. A high-fidelity cleft lip simulator provides “on-demand” opportunity to realistically practice all steps of a cleft lip repair, with implications for overcoming volume-outcome relationship challenges of diminishing operative experience for resident surgeons.
Altered Hypothalamus-Pituitary-Adrenal Axis Function: A Potential Underlying Biological Pathway for Multiple Concurrent Symptoms in Patients With Advanced Lung Cancer
Authors: Oh In-Jae , Kim Kyu-Sik , Kim Young-Chul , Park Jai-Young , Yoo Keun-Young , Do Sang-Hwan , Ahn Ryun-Sup 
Published: October 2018

ABSTRACT

Objective
Patients with advanced cancer commonly experience multiple symptoms that present as groups or clusters. The present study aimed to examine whether hypothalamus-pituitary-adrenal (HPA) axis dysfunction underlies the concurrent multiple symptoms in patients with advanced cancer.

Methods
Patients' cortisol levels were determined in saliva samples collected after awakening (0, 30, and 60 minutes after awakening) and at nighttime (21:00–22:00 PM) from 46 patients with lung cancer (15.2% women), with a mean (standard deviation) age of 64.3 (9.2) years and 47 healthy participants (53.2% women; age = 62.0 [4.6] years). Cancer-related symptoms were measured using the M.D. Anderson Symptom Inventory (MDASI).

Results
Compared with healthy participants, patients showed a significantly reduced cortisol awakening response (F(1,364) = 46.2, p < .001) and had flatter diurnal slope of cortisol (larger β values) (mean [standard error of the mean] = −0.64 [0.06] versus −0.18 [0.05], p < .001). Altered HPA axis function was significantly and adversely associated with performance status and burden of symptoms (all p values < .01). However, each MDASI item varied widely in the degree of association with the HPA axis function. Hierarchical clustering analysis based on Spearman's rank correlation with complete linkage identified that nausea was clustered with vomiting, numbness, and dry mouth, whereas the other nine MDASI core symptoms associated with altered HPA axis function were clustered together.

Conclusions
Altered HPA axis function may be a possible biological pathway that can explain the concurrence of core symptoms in patients with advanced lung cancer.
Incidence of Infectious Adverse Events in Patients With Rheumatoid Arthritis and Spondyloarthritis on Biologic Drugs—Data From the Brazilian Registry for Biologics Monitoring
Authors: Cecconi Mariana , Ranza Roberto , Titton David C. , Moraes Júlio C. B. , Bertolo Manoel , Bianchi Washington , Brenol Claiton , Carvalho Hellen M. , de Castro Glaucio R. W. , Costa Izaias P. , Cunha Maria F. L. , Duarte Ângela , Fernandes Vander , Freire Marlene , Louzada-Junior Paulo , Macieira José C. , Miranda José R. S. , Pereira Ivanio A. , Pinheiro Geraldo R. C. , Stadler Barbara , Toledo Roberto A. , Valim Valeria , Descalzo Miguel A. , Pinto Rogerio M. C. , Laurindo Ieda 
Published: October 2018

Background
The safety profile of biologic drugs might present substantial regional differences. Since 2009, the Brazilian Society of Rheumatology has maintained BIOBADABRASIL (Brazilian Registry for Biologic Drugs), a registry for monitoring of biologic therapies in rheumatic diseases.

Objectives
The aim of this study was to verify the incidence rate (IR) of serious infections in rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients on biologic drugs.

Methods
BIOBADABRASIL prospectively included patients with rheumatic diseases who started the first biologic drug or a synthetic disease-modifying antirheumatic drug as a parallel control group. This study focuses on serious infectious adverse events (SIAEs) in RA and SpA patients on biologic drugs compared with controls, from January 2009 to June 2015. Time of exposure was set from initiation of the drug to the date of last administration or censorship. Serious infectious adverse events IR was calculated per 1000 patient/years with 95% confidence interval (CI).

Results
A total of 1698 patients (RA, 1121; SpA, 577) were included, 7119 patient/years. Serious infectious adverse events were more common among patients on tumor necrosis factor inhibitors (TNFi's) than controls (adjusted IR ratio, 2.96 [95% CI, 2.01–4.36]; p < 0.001). Subsequent TNFi was associated with a higher SIAEs incidence when compared with first TNFI (adjusted IR ratio, 1.55 [95% CI, 1.15–2.08]; p = 0.004). Serious infectious adverse events were associated with age and corticosteroids intake. Serious infectious adverse events were more frequent in the respiratory tract in all subgroups.

Conclusions
In BIOBADABRASIL, biologic drugs, especially the subsequent TNFi, were associated with a higher risk of serious infections compared with synthetic DMARDs. Corticosteroid intake and age represented risk factors for SIAEs. Constant monitoring is required to follow the safety profile of drugs in the clinical setting of rheumatic conditions in Brazil.
Translating surveillance data into incidence estimates
Authors: Bourhis Yoann , Gottwald Timothy R. , van den Bosch Frank 
Published: October 2018

AbstractMonitoring a population for a disease requires the hosts to be sampled and tested for the pathogen. This results in sampling series from which to estimate the disease incidence,i.e. the proportion of hosts infected. Existing estimation methods assume that disease incidence is not changing between monitoring rounds, resulting in underestimation of the disease incidence. In this paper we develop an incidence estimation model accounting for epidemic growth with monitoring rounds sampling varying incidence. We also show how to accommodate the asymptomatic period characteristic to most diseases. For practical use, we produce an approximation of the model, which is subsequently shown accurate for relevant epidemic and sampling parameters. Both the approximation and the full model are applied to stochastic spatial simulations of epidemics. The results prove their consistency for a very wide range of situations.
Epigenome-wide Analysis Identifies Genes and Pathways Linked to Neurobehavioral Variation in Preterm Infants
Authors: Everson Todd M. , Marsit Carmen J. , O’Shea T. Michael , Burt Amber , Hermetz Karen , Pastyrnak Steven L , Neal Charles R , Carter Brian S , Helderman Jennifer , McGowan Elisabeth C. , Smith Lynne M , Soliman Antoine , Hofheimer Julie A , DellaGrotta Sheri A , Dansereau Lynne M , Padbury James F , Lester Barry M 
Published: October 2018

AbstractBackground & ObjectivesNeonatal neurobehavioral performance measures, such as the NICU Network Neurobehavioral Scale (NNNS), have been developed to assess the neurobehavioral characteristics of infants and provide insights into future developmental trajectories. The identification of molecular biomarkers of very early life neurobehavioral experiences could lead to better predictions of the long-term developmental outcomes of high-risk infants including preterm infants. To this end, we aimed to examine whether variability in DNA methylation (DNAm) or epigenetic age from surrogate tissues are associated with NNNS profiles in a cohort of infants born less than 30 weeks postmenstrual age (PMA).MethodsThis study was performed within the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study and included those infants with complete NNNS assessment data and DNAm measured from buccal cells, collected at near term-equivalent age using the Illumina EPIC array (N=536). We tested whether epigenetic age and age acceleration differed between infants based on their NNNS profile classifications. Then we performed an epigenome-wide association study, to test whether DNAm at individual epigenetic loci varied between these NNNS profile groupings. Models were adjusted for recruitment site, infant sex, postmenstrual age, and estimated tissue heterogeneity.ResultsWe found that infants with an optimal NNNS profile had slightly older epigenetic age than other NOVI infants (β1 = 0.201, p-value = 0.026), and that infants with an atypical NNNS profile had differential methylation at 29 CpG sites (FDR < 10%). The genes annotated to these differentially methylated CpGs included PLA2G4E, TRIM9, GRIK3, and MACROD2, which have previously been associated with neurological structure and function, or with neurobehavioral disorders.ConclusionsGreater epigenetic age is associated with optimal NNNS responses while altered DNAm of multiple genes are associated with an atypical neurobehavioral profile at near-term equivalent age. These findings build upon the existing evidence that epigenetic variations in buccal cells may serve as markers of neonatal neurobehavior and might facilitate early identification of children at risk for abnormal developmental outcome.
Spatial and Temporal Analysis of the Stomach and Small Intestinal Microbiota in Fasted Healthy Humans
Authors: Seekatz Anna M. , Schnizlein Matthew K. , Koenigsknecht Mark J. , Baker Jason R. , Hasler William L. , Bleske Barry E. , Young Vincent B. , Sun Duxin 
Published: October 2018

AbstractAlthough the microbiota in the proximal gastrointestinal (GI) tract has been implicated in health and disease, much of these microbes remains understudied compared to the distal GI tract. This study characterized the microbiota across multiple proximal GI sites over time in healthy individuals.As part of a study of the pharmacokinetics of oral mesalamine administration, healthy, fasted volunteers (N=8; 10 observation periods total) were orally intubated with a four-lumen catheter with multiple aspiration ports. Samples were taken from stomach, duodenal, and multiple jejunal sites, sampling hourly (≤7 hours) to measure mesalamine (administered at t=0), pH, and 16S rRNA gene-based composition.We observed a predominance of Firmicutes across proximal GI sites, with significant variation compared to stool. The microbiota was more similar within individuals over time than between subjects, with the fecal microbiota being unique from that of the small intestine. The stomach and duodenal microbiota displayed highest intra-individual variability compared to jejunal sites, which were more stable across time. We observed significant correlations in the duodenal microbial composition with changes in pH; linear mixed models identified positive correlations with multipleStreptococcusoperational taxonomic units (OTU) and negative correlations with multiplePrevotella and PasteurellaceaeOTUs. Few OTUs correlated with mesalamine concentration.The stomach and duodenal microbiota exhibited greater compositional dynamics compared to the jejunum. Short-term fluctuations in the duodenal microbiota was correlated with pH. Given the unique characteristics and dynamics of the proximal GI tract microbiota, it is important to consider these local environments in health and disease states.
Reliability and Generalizability of Similarity-Based Fusion of MEG and fMRI Data in Human Ventral and Dorsal Visual Streams
Authors: Mohsenzadeh Yalda , Mullin Caitlin , Lahner Benjamin , Cichy Radoslaw , Oliva Aude 
Published: October 2018

AbstractTo build a representation of what we see, the human brain recruits regions throughout the visual cortex in cascading sequence. Recently, an approach was proposed to evaluate the dynamics of visual perception in high spatiotemporal resolution at the scale of the whole brain. This method combined functional magnetic resonance imaging (fMRI) data with magnetoencephalography (MEG) data using representational similarity analysis and revealed a hierarchical progression from primary visual cortex through the dorsal and ventral streams. To assess the replicability of this method, here we present results of a visual recognition neuro-imaging fusion experiment, and compare them within and across experimental settings. We evaluated the reliability of this method by assessing the consistency of the results under similar test conditions, showing high agreement within participants. We then generalized these results to a separate group of individuals and visual input by comparing them to the fMRI-MEG fusion data of Cichy et al (2016), revealing a highly similar temporal progression recruiting both the dorsal and ventral streams. Together these results are a testament to the reproducibility of the fMRI-MEG fusion approach and allows for the interpretation of these spatiotemporal dynamic in a broader context.
Insomnia and problematic gaming: a study in 9 low-and middle-incomes countries
Authors: Sosso FAE , Kuss Daria J. 
Published: October 2018

Withdrawal Statements: The authors have withdrawn their manuscript as they have discovered some potential inconsistencies in the analysis of the data. Therefore, the authors do not wish this work to be cited as reference for the project.The second author has data integrity concerns and wishes to distance herself unequivocally from the lead author.