bluuebunny/crossref_metadata_2025_split huggingface dataset:
Buprenorphine and Naloxone Versus Buprenorphine for Opioid Use Disorder in Pregnancy: A Cohort Study
Authors: Mullins Nathan , Galvin Shelley L. , Ramage Melinda , Gannon Marie , Lorenz Kathleen , Sager Brent , Coulson Carol C. 
Published: October 2019

Objective:To compare maternal and fetal outcomes among dyads prescribed buprenorphine and naloxone or buprenorphine during pregnancy.Methods:Retrospective cohort study of patients with opioid use disorder obtaining care in a comprehensive, perinatal program. Patients utilized medication for opioid use disorder: a buprenorphine and naloxone combination product or buprenorphine monotherapy. The primary outcome was neonatal abstinence syndrome requiring treatment. Maternal secondary outcomes included: negative urine drug screen at delivery, obstetrical care attendance, primary cesarean delivery, and preterm delivery. Neonatal secondary outcomes included neonatal biometry, admission to neonatal intensive care, appropriate findings on cord toxicology, and length of stay. Univariate analyses included Chi square, Fisher exact,t-, or Mann-Whitney tests, as appropriate. Multivariate binary logistic regressions examined the association of type of buprenorphine product with diagnosis of neonatal abstinence syndrome requiring treatment and adjusted for variables significantly different in between-group comparisons and correlates of treatments and the primary outcome.Results:The rate of neonatal abstinence syndrome was significantly higher (P = 0.007) among infants exposed in utero to buprenorphine versus buprenorphine and naloxone: 59/108 (54.6%) versus 30/85 (35.3%), respectively. The combined product, relative to the monoproduct, was associated with lower odds of neonatal abstinence syndrome: odds ratio (OR) = 0.453 (95% confidence interval [CI] 0.253–0.813;P = 0.008). Adjusting for dose of buprenorphine product at delivery, year of expected delivery, type of prescriber, diagnosis of hepatitis C, and preterm delivery negated these results: adjusted OR = 0.627 (95% CI 0.309–1.275). Secondary outcomes were similar.Conclusion:Compared with buprenorphine monotherapy, the combined buprenorphine and naloxone product was an acceptable alternative pharmacologic treatment for opioid use disorder during pregnancy.
The Crooked Rod Sign
Authors: Cheung Jason Pui Yin , Zhang Teng , Bow Cora , Kwan Kenny , Sze Kam Yin , Cheung Kenneth Man Chee 
Published: October 2019

Study Design.
Case report.

Objective.
To report a unique mechanical failure of magnetically controlled growing rods (MCGRs) that is related to continuous rod slippage.

Summary of Background Data.
Despite the growing popularity of MCGR in the management of patients with early onset scoliosis, postoperative complications and reoperations are not uncommon. Unique complications or unplanned reoperations are observed in patients with MCGRs that are not seen in traditional growing rods. The complications include rod slippage, mismatch between targeted and achieved distraction length, metallosis, and actuator pin fracture. We have identified an unreported failure mechanism whereby deformed threads occur in the internal distraction mechanism of the MCGR. This phenomenon may indicate increased MCGR internal screw friction and increased distraction resistance. Increased friction and resistance ultimately led to distraction failure and revision surgery.

Methods.
A girl with early onset scoliosis (EOS) was treated by dual MCGRs. She developed proximal junctional kyphosis (PJK) and continuous rod slippage. Distractions in the out-patient clinic and under sedation did not achieve successful rod lengthening. A tell-tale “crooked rod” radiological sign was identified by angulation between the actuator and the extendable portion of the rod.

Results.
Rod exchange was performed and she is now 2 years after revision surgery with successful lengthening episodes. Upon review of the extracted MCGR, distraction was not possible even after rod removal and was only resumed after the screw was manually reinserted along its correct threads.

Conclusion.
Deformed threads is a complication that cannot be reverted without rod removal and exchange. Users should be aware of this potential failure mechanism and proceed to early rod exchange rather than attempting any further distractions.

Level of Evidence: 4
A Review of Sclerosing Foam Stability in the Treatment of Varicose Veins
Authors: Bai Taoping , Liu Yuqiu , Jiang Wentao , Li Yalan , Liu Jiche , Yu Chenhao , Fan Yubo 
Published: October 2019

BACKGROUND
Varicose veins are common clinical entities. Foam sclerotherapy is a minimally invasive and simple procedure; however, the side effects, efficacy, and stability of sclerosing foam are not ideal.

OBJECTIVE
To summarize the current studies on sclerosing foam stability and promote foam sclerotherapy development.

MATERIALS AND METHODS
We reviewed the literature before June 2018 and included only representatives studies on sclerosing foam stability. We summarized the foam half-life time (FHT) of polidocanol (POL) under 17 preparation conditions and the FHT of sodium tetradecyl sulfate under 21 preparation conditions. The preparation conditions included various combinations of temperature, liquid–gas ratio, preparation method, etc.

RESULTS
The FHT of POL varied between 40 and 4,000 seconds under different conditions. The FHT of sodium tetradecyl sulfate varied from 25.7 to 390 seconds. The higher the drug concentration, the lower the temperature required to increase foam stability. The addition of surfactant greatly increased foam stability. For different gas compositions, the FHT sequence was as follows: CO2 < CO2 + O2 < O2 < air.

CONCLUSION
Foam stability can be improved by changing the preparation conditions; therefore, the role of surfactants and predictive methods for FHT are worth investigating further.
Noncollagen Dermal Fillers: A Summary of the Clinical Trials Used for Their FDA Approval
Authors: Jiang Betty , Ramirez Mary , Ranjit-Reeves Roshni , Baumann Leslie , Woodward Julie 
Published: October 2019

BACKGROUND
Many noncollagen dermal fillers (NCDFs) have been approved by the FDA and are currently the second-most performed noninvasive cosmetic procedure.

OBJECTIVE
To summarize and compare the clinical trials reviewed by the United States FDA in the approval of NCDFs.

METHODS
The FDA Premarket Approval (PMA) site was queried, and the year of approval, indication, design, primary end points, touch-ups, retreatments, and study duration were extracted and tabulated.

RESULTS
Twenty-one FDA-approved NCDFs from 2003 to 2018 and 24 Summary of Safety and Effectiveness documents were reviewed. Differences in the trial design and in reporting of data make comparisons difficult. This article provides comparative tables to make interpreting the various trial results more straightforward.

Limitations
Primary efficacy end points and the way that filler volumes were reported varied by company. This article does not focus on secondary end points or safety data.

CONCLUSION
A comprehensive and comparative review of clinical trials of NCDFs by the FDA demonstrates that differences in data reporting, especially for touch-ups and retreatments, make filler duration difficult to compare and interpret. Understanding of the trial design will allow the clinician to become more astute and allow for better management of patient expectations in clinical practice.
Length of Fellowship Training in Population Health Research and Long-term Bibliometric Outcomes
Authors: Holland Tiffany L. , Kim Keewan , Nobles Carrie J. , Lu Ya-Ling , Seeni Indulaxmi , Mumford Sunni L. , Gilman Stephen E. , Levine Lindsay D. , Andriessen Victoria C. , Schisterman Enrique F. 
Published: October 2019

Background:
The length of research fellowships, the number of doctorates pursuing them, and the academic job market have changed dramatically in recent years. However, there is limited investigation on attributes of fellowships most relevant to future scientific achievement. We analyzed the association of a modifiable aspect of research training, fellowship length, with future achievement and differences across research discipline in the Division of Intramural Population Health Research (DIPHR), Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.

Methods:
Demographics of 88 DIPHR trainees from 1998 to 2016 were collected from publicly available annual reports. Research performance metrics, including total publication count and H index through 2016, were collected via Scopus. We used linear regression models for associations between fellowship length, including both total exposure to research training and duration of postdoctoral training alone, and research performance adjusted for start year, publications at entry, branch (e.g., Biostatistics and Bioinformatics, Epidemiology, and Health Behavior), and mentor seniority.

Results:
Each additional year of research training in DIPHR was associated with a 15% increase in H index (95% confidence interval [CI] = 3.0, 28.4) and 21% more lifetime publications (95% CI = 3.0, 41.9). Results were similar, although attenuated, when evaluating postdoctoral training alone. Differences by discipline were observed, with the strongest positive associations in the Biostatistics and Bioinformatics and Epidemiology Branches.

Conclusions:
Longer training at DIPHR was associated with improved measures of research performance, though this relationship varied by discipline. Additional research is needed to tailor training programs to optimize success of trainees.
Weight Gain After Smoking Cessation and Lifestyle Strategies to Reduce it
Authors: Jain Priyanka , Danaei Goodarz , Manson JoAnn E. , Robins James M. , Hernán Miguel A. 
Published: October 2019

Background:
Weight gain following smoking cessation reduces the incentive to quit, especially among women. Exercise and diet interventions may reduce postcessation weight gain, but their long-term effect has not been estimated in randomized trials.

Methods:
We estimated the long-term reduction in postcessation weight gain among women under smoking cessation alone or combined with (1) moderate-to-vigorous exercise (15, 30, 45, 60 minutes/day), and (2) exercise and diet modification (≤2 servings/week of unprocessed red meat; ≥5 servings/day of fruits and vegetables; minimal sugar-sweetened beverages, sweets and desserts, potato chips or fried potatoes, and processed red meat).

Results:
Among 10,087 eligible smokers in the Nurses’ Health Study and 9,271 in the Nurses’ Health Study II, the estimated 10-year mean weights under smoking cessation were 75.0 (95% CI = 74.7, 75.5) kg and 79.0 (78.2, 79.6) kg, respectively. Pooling both cohorts, the estimated postcessation mean weight gain was 4.9 (7.3, 2.6) kg lower under a hypothetical strategy of exercising at least 30 minutes/day and diet modification, and 5.9 (8.0, 3.8) kg lower under exercising at least 60 minutes/day and diet modification, compared with smoking cessation without exercising.

Conclusions:
In this study, substantial weight gain occurred in women after smoking cessation, but we estimate that exercise and dietary modifications could have averted most of it.
A randomized clinical trial comparing vaginal laser therapy to vaginal estrogen therapy in women with genitourinary syndrome of menopause: The VeLVET Trial
Authors: Paraiso Marie Fidela R. , Ferrando Cecile A. , Sokol Eric R. , Rardin Charles R. , Matthews Catherine A. , Karram Mickey M. , Iglesia Cheryl B. 
Published: October 2019

Abstract

Objective:
The aim of the study was to compare 6-month efficacy and safety for treatment of vaginal dryness/genitourinary syndrome of menopause in women undergoing fractionated CO2 vaginal laser therapy to women using estrogen vaginal cream.

Methods:
This multicenter, randomized trial compared fractionated CO2 laser to estrogen cream at 6 institutions. We included menopausal women with significant vaginal atrophy symptoms and we excluded women with prolapse below stage 2, recent pelvic surgery, prior mesh surgery, active genital infection, history of estrogen sensitive malignancy, and other autoimmune conditions. The primary outcome was the visual analog scale vaginal dryness score. Secondary outcomes included evaluation of vaginal atrophy, quality of life symptoms, assessment of sexual function, and urinary symptoms. Adverse events (AEs) and patient global impression of improvement (PGI-I) and satisfaction were also assessed.

Results:
Sixty-nine women were enrolled in this trial before enrollment was closed due to the Federal Drug Administration requiring the sponsor to obtain and maintain an Investigational Device Exemption. Of the 69 participants enrolled, 62 completed the 6-month protocol; 30 women were randomized to the laser and 32 to estrogen cream from June 2016 to September 2017. Demographics did not differ between groups except the laser group was less parous (0 [range 0-4] vs 2 [0-6], P = 0.04). On patient global impression, 85.8% of laser participants rated their improvement as “better or much better” and 78.5% reported being either “satisfied or very satisfied” compared to 70% and 73.3% in the estrogen group; this was not statistically different between groups. On linear regression, mean difference in female sexual function index scores was no longer statistically significant; and, vaginal maturation index scores remained higher in the estrogen group (adj P value 0.02); although, baseline and 6-month follow-up vaginal maturation index data were only available for 34 participants (16 laser, 18 estrogen).

Conclusions:
At 6 months, fractionated CO2 vaginal laser and vaginal estrogen treatment resulted in similar improvement in genitourinary syndrome of menopause symptoms as well as urinary and sexual function. Overall, 70% to 80% of participants were satisfied or very satisfied with either treatment and there were no serious adverse events.

Video Summary:

http://links.lww.com/MENO/A470.
An Ideal Female Breast Shape in Balance with the Body Proportions of Asians
Authors: Lee Hun Joo , Ock Jae Jin 
Published: October 2019

Background:
Defining an ideal breast shape is one of the most fundamental and essential parts for a breast surgery. To propose a set of criteria for determining an ideal breast shape of Asians, the authors performed a survey using a questionnaire based on important esthetic elements of a breast.

Methods:
The authors created a 11-item questionnaire, asking breast shape preference in the frontal and the lateral views. Each question had multiple options, each of which was accompanied by adequate illustrations.

Results:
A total of 1,012 Asian responses were collected. In the frontal view, preferences converged for position of the nipple to be at 45% of the SU (distance from the sternal notch to the umbilicus) and the inframammary fold at 60% of the SU. For lateral bulging of the breast, the respondents preferred it to be 100% of the upper buttock, and 100% of the interacromion width. As for the lower pole height, breast width ratio of 50% was the most preferred. In the lateral view, straight slope of the upper breast was the most preferred, along with a 1.0 projection ratio and a front-facing nipple. The most ideal vertical proportion of the breast footprint was selected as 65:35, and for the anterior breast as 55:45.

Conclusion:
The authors used a questionnaire analysis, which considers a proportional balance between the breast and the whole body shape, and proposed that an ideal breast shape can be used effectively in planning for and assessing the outcomes of breast surgery
Levels of Evidence in Plastic and Reconstructive Surgery Research: Have We Improved Over the Past 10 Years?
Authors: Sugrue Conor M. , Joyce Cormac W. , Carroll Sean M. 
Published: October 2019

Summary:
Levels of evidence (LOE) aid in the critical appraisal of evidence by ranking studies based on limitation of its design. Analyzing LOE provides insight into application of evidence-based medicine. The aim of this study is to determine if the quality of evidence in plastic surgery research has improved over the past 10 years. Systematic review of research published in Plastics and Reconstructive Surgery journal over the years, 10-year period (2008, 2013, 2018), was performed. LOE for each article was determined using the American Society of Plastic Surgeons (ASPS) guidelines. Each level was calculated as percentage of publications per year and compared yearly and between different topics. Eight hundred eighty-four studies were included in the final analysis. The LOE of the research improved over the study period. Level 4 evidence was the most frequent published (50.6%, 447/884), with a decline from 63.2% in 2008 to 41.3% in 2018. Level 1 evidence improved each year and accounted for 2.1% of all research in 2018. Aesthetic surgery was the most frequent published topic with upper limb research demonstrating an 18.5% increase in high-quality evidence over the study period. Increased awareness of evidence-based medicine has improved the quality of plastic surgery research over the past decade. It is vital this continues to provide gold standard patient care.
Restoration of Bilateral Cranial Defects by Hybridization of Microvascular Free Flaps and Artificial Bones
Authors: Mashiko Takanobu , Minabe Toshiharu , Ohnishi Fumio , Momosawa Akira 
Published: October 2019

Summary:
Although treatment methods for cranial reconstruction have significantly improved over the past decades, patients having potentially negative influences, such as a history of infection, epidural dead space, or inadequate scalp, remain at high risk of postoperative failure from implant infection and exposure necessitating removal. A 41-year-old male patient sustained severe craniofacial injuries in a traffic accident. Cranioplasty with titanium mesh implants failed due to implant infection, leading to implant removal and debridement. Following repeated local infections and a craniectomy, the patient developed large bilateral complex cranial defects. We then performed a multistage operation, consisting of vascularized free-flap transfers to cover the intracranial dead spaces, and bony reconstruction using hydroxyapatite implants, which achieved full restoration of the defects. We believe that this is the better operative plan for treatment of cranial defects in patients with high-risk factors.
Revisiting the Safety of the Corneal Collagen Crosslinking Procedure: Evaluation of the Effect of Ultraviolet A Radiation on Retinal Function and Structure
Authors: Lazaridis Apostolos , Tsamassiotis Spiros , Droutsas Konstantinos , Besgen Volker , Sekundo Walter , Schroeder Frank Michael , Wenner Yaroslava 
Published: October 2019

Purpose:
To evaluate the effect of ultraviolet A radiation on retinal function and structure after the corneal collagen crosslinking procedure.

Methods:
In the present prospective, single-center cohort study 17 eyes of 17 patients who underwent collagen crosslinking (Dresden protocol) for the treatment of corneal ectasia were examined preoperatively and at 2 and 6 weeks postoperatively with multifocal electroretinogram and optical coherence tomography. The P1 amplitude density (P1-AD) of the central retinal response was documented in 5 concentric rings, with ring 1 (R1) representing the foveal response and rings 2 to 5 (R2–R5) corresponding to successive annuli of stimulation. Visual acuity, corneal densitometry at the 0 to 2 mm zone and at the 2 to 6 mm annulus, and macular thickness (MT; central, 1 mm, 3 mm, and 5 mm zones) were recorded.

Results:
The preoperative values of P1-AD were R1 = 109.96 ± 28.96, R2 = 49.8 ± 14.46, R3 = 29.85 ± 8.9, R4 = 19.33 ± 6.3, and R5 = 16.39 ± 5.48 nV/deg2. At 2 weeks, these values were R1 = 77.54 ± 24.47, R2 = 36.55 ± 12.53, R3 = 21.53 ± 7.71, R4 = 15.3 ± 6.13, and R5 = 13.32 ± 5.48, showing a significant reduction for R1-R4 (P ≤ 0.026). The 6-week P1-AD was R1 = 99.8 ± 31.23, R2 = 40.67 ± 16.39, R3 = 24.98 ± 7.13, R4 = 16.35 ± 4.84, and R5 = 13.76 ± 3.98, showing no significant differences compared with preoperative values (P ≥ 0.054). Corneal densitometry increased significantly at 2 weeks (P < 0.001) and remained increased at 6 weeks (P < 0.001), showing statistically insignificant correlations with 2-week P1-AD (P ≥ 0.553). The central MT increased (P = 0.787), whereas MT at 1 mm (P = 0.444), 3 mm (P = 0.039), and 5 mm (P < 0.001) zones decreased.

Conclusions:
The return of P1-AD to preoperative (physiologic) values at 6 weeks confirms the safety standards of the duration and intensity of ultraviolet A radiation, as proposed by the Dresden protocol. However, temporary postoperative retinal dysfunction cannot be excluded.
Exploratory Investigation into Energy Expenditure Using Tuned versus Nontuned Ankle-Foot Orthoses–Footwear Combinations in Children with Cerebral Palsy
Authors: Eddison Nicola , Chockalingam Nachiappan , Healy Aoife , Needham Robert , Unnithan Vish 
Published: October 2019

ABSTRACTIntroductionChildren with cerebral palsy (CP) commonly expend two to three times as much energy to walk as typically developing children. Research shows that the effects of nontuned ankle-foot orthoses (AFOs) on energy expenditure are inconclusive. Tuning of an ankle-foot orthosis–footwear combination (AFO-FC) has demonstrated an improvement in the kinetics and kinematics of pathological gait, particularly knee flexion during stance phase, which are key determinants of an energy-efficient gait. The objective of this study was to compare the submaximal energy expenditure via indirect calorimetry and speed and distance walked of tuned and nontuned AFO-FCs and barefoot gait in children with CP.MethodsThis study is a performance assessment of four children aged between 7 and 10 years with a diagnosis of CP (one hemiplegic and three diplegic participants, two female and two male, with a Gross Motor Function Classification System [GMFCS] of 2) at a gait analysis laboratory.ResultsThere was a reduction in gross submaximal energy expenditure and energy efficiency index (EEI) based on O2in three of the four participants tested when wearing tuned compared with a nontuned AFO-FC. The reduction ranged from 9.2% to 33.7%. Speed and distance covered also showed improvement in the tuned condition.ConclusionsTuning the AFO-FC of children with CP has the potential to decrease energy expenditure and increase speed and distance compared with providing a nontuned AFO-FC.