bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Ventilated Patients With Sepsis Who Undergo Interhospital Transfer: A Nationwide Linked Analysis*
Authors: Rush Barret , Tyler Patrick D. , Stone David J. , Geisler Benjamin P. , Walley Keith R. , Celi Leo Anthony 
Published: October 2017

Objectives:The outcomes of critically ill patients who undergo interhospital transfer are not well understood. Physicians assume that patients who undergo interhospital transfer will receive more advanced care that may translate into decreased morbidity or mortality relative to a similar patient who is not transferred. However, there is little empirical evidence to support this assumption. We examined country-level U.S. data from the Nationwide Readmissions Database to examine whether, in mechanically ventilated patients with sepsis, interhospital transfer is associated with a mortality benefit.Design:Retrospective data analysis using complex survey design regression methods with propensity score matching.Setting:The Nationwide Readmissions Database contains information about hospital admissions from 22 States, accounting for roughly half of U.S. hospitalizations; the database contains linkage numbers so that admissions and transfers for the same patient can be linked across 1 year of follow-up.Patients:From the 2013 Nationwide Readmission Database Sample, 14,325,172 hospital admissions were analyzed. There were 61,493 patients with sepsis and on mechanical ventilation. Of these, 1,630 patients (2.7%) were transferred during their hospitalization. A propensity-matched cohort of 1,630 patients who did not undergo interhospital transfer was identified.Interventions:None.Measurements and Main Results:The exposure of interest was interhospital transfer to an acute care facility. The primary outcome was hospital mortality; the secondary outcome was hospital length of stay. The propensity score included age, gender, insurance coverage, do not resuscitate status, use of renal replacement therapy, presence of shock, and Elixhauser comorbidities index. After propensity matching, interhospital transfer was not associated with a difference in in-hospital mortality (12.3% interhospital transfer vs 12.7% non–interhospital transfer;p= 0.74). However, interhospital transfer was associated with a longer total hospital length of stay (12.8 d interquartile range, 7.7–21.6 for interhospital transfer vs 9.1 d interquartile range, 5.1–17.0 for non–interhospital transfer;p< 0.01).Conclusions:Patients with sepsis requiring mechanical ventilation who underwent interhospital transfer did not have improved outcomes compared with a cohort with matched characteristics who were not transferred. The study raises questions about the risk-benefit profile of interhospital transfer as an intervention.
Efficacy of IncobotulinumtoxinA for the Treatment of Glabellar Frown Lines in Male Subjects: Post-Hoc Analyses From Randomized, Double-Blind Pivotal Studies
Authors: Jones Derek H. , Kerscher Martina , Geister Thorin , Hast Michael A. , Weissenberger Petra 
Published: October 2017

BACKGROUND
Males are increasingly seeking minimally invasive cosmetic procedures such as botulinum toxin injection. However, few studies have specifically examined the efficacy of such procedures among men.

OBJECTIVE
To assess the efficacy of incobotulinumtoxinA for treating glabellar frown lines (GFLs) in men.

METHODS
Three incobotulinumtoxinA studies were included in post hoc analyses of responder rates: 2 pivotal Phase 3 US registration studies for GFLs (n = 55 males in a pooled analysis) and a European pivotal Phase 3 study for upper facial lines (UFLs; n = 21 males).

RESULTS
In the pooled analysis of Phase 3 GFL studies, 55.9% of males and 81.4% of females were responders on the Facial Wrinkle Scale (FWS) at 30 days. Similarly, 54.5% and 88.0% of males and females, respectively, treated for GFLs in the upper facial line study were responders on the Merz Aesthetics Scales (MAS) at 30 days. Lower proportions of male responders on the Facial Wrinkle Scale /Merz Aesthetics Scales were consistent with results from onabotulinumtoxinA and abobotulinumtoxinA GFL studies.

CONCLUSION
Compared with females, males demonstrate lower response rates on wrinkle severity scales in studies on all 3 available botulinum toxins. Variations in treatment response are potentially associated with key male anatomic differences (e.g., muscle mass). Results emphasize the need for customized treatment plans.
Hair Transplantation Controversies
Authors: Avram Marc R. , Finney Robert , Rogers Nicole 
Published: October 2017

BACKGROUND
Hair transplant surgery creates consistently natural appearing transplanted hair for men. It is increasingly popular procedure to restore natural growing hair for men with hair loss.

OBJECTIVE
To review some current controversies in hair transplant surgery.

MATERIALS AND METHODS
Review of the English PubMed literature and specialty literature in hair transplant surgery.

RESULTS
Some of the controversies in hair transplant surgery include appropriate donor harvesting technique including elliptical donor harvesting versus follicular unit extraction whether manual versus robotic, the role of platelet-rich plasma and low-level light surgery in hair transplant surgery.

CONCLUSION
Hair transplant surgery creates consistently natural appearing hair. As with all techniques, there are controversies regarding the optimal method for performing the procedure. Some of the current controversies in hair transplant surgery include optimal donor harvesting techniques, elliptical donor harvesting versus follicular unit extraction, the role of low-level light therapy and the platelet-rich plasma therapy in the procedure. Future studies will further clarify their role in the procedure.
Optimizing Male Periorbital Rejuvenation
Authors: Scheuer Jack F. , Matarasso Alan , Rohrich Rod J. 
Published: October 2017

BACKGROUND
Facial rejuvenation continues to be an increasing trend among males. The periorbital region deserves special mention given the overall differences in aesthetics between sexes.

OBJECTIVE
To examine the aesthetics of the upper eyelid, lower eyelid, lateral canthus, and brow with respect to male periorbital rejuvenation.

METHODS
The upper eyelid, lower eyelid, lateral canthus, and brow are examined, highlighting aesthetic differences in males and females.

RESULTS
The authors outline principles so as to maintain a masculine appearance when treating the male upper eyelid, lower eyelid, lateral canthus, and brow.

CONCLUSION
With guiding principles, the male upper lid, lower lid, brow, and lateral canthus can be managed to achieve optimal, consistent results.
Male Surgical Neck Rejuvenation: [RETRACTED]
Authors: Moy Ronald L. , Moy Lauren 
Published: October 2017

BACKGROUND
Patients who are aging, with weight gain, and increased skin laxity, request dermatologists to improve their neck area. Surgical and nonsurgical options are reviewed as well as benefits and side effects. This article will focus on how surgical techniques can be applied for male patients in particular.

OBJECTIVE
To review surgical neck rejuvenation therapies available currently to find the best option for male patients.

CONCLUSION
Surgical treatment of the male neck to improve mandibular contour and loose neck skin requires tightening of the platysmal muscle and usually skin removal in the postauricular sulcus and into the hairline. Most patients choose to have this performed underline tumescent anesthesia when given the choice of sedation versus local anesthesia. The other surgical variations of improving the neck contour on a male include using a direct excision by a midline incision starting in the submental crease and extending down the anterior neck. This approach allows for maximum tightening of the platysmal bands. The incision line can be minimized using intraoperative laser resurfacing immediately after suturing. Chin implants are necessary in some patients to give good neck improvement. The isolated neck lift is one the most common procedures requested by men asking for neck improvement.
Aesthetic Treatment With Botulinum Toxin: Approaches Specific to Men
Authors: Green Jeremy B. , Keaney Terrence C. 
Published: October 2017

BACKGROUND
Men are increasingly seeking aesthetic treatment with neuromodulators.

OBJECTIVE
To successfully treat the male patient, it is imperative to understand anatomical and dosing differences from his, perhaps more familiar, female counterpart.

CONCLUSION
After reading this review including male-specific botulinum toxin technique tips derived from their own practices, the authors hope injectors are able to approach their male patients with increased confidence to deliver superior outcomes.
Considerations When Treating Cosmetic Concerns in Men of Color
Authors: Awosika Olabola , Burgess Cheryl M. , Grimes Pearl E. 
Published: October 2017

BACKGROUND
Men of color include a diverse population encompassing individuals with Fitzpatrick skin Types IV through VI. Yet, there is a paucity of data describing the cosmetic concerns of this population.

OBJECTIVE
To review the basic science of advantages and disadvantages of skin of color and pathophysiology, incidence, and treatment of disorders of cosmetic concern in men of color.

METHODS
A MEDLINE search was performed for publications on sex and racial differences in basic science of skin, common disorders in men of color, and evidence-based treatments.

RESULTS
There are intrinsic differences in skin and hair of darker-complexioned men, particularly in Hispanics, African Americans, Asians, and Afro-Caribbeans. Advantages of darker skin include increased photoprotection, slowed aging, and a lower incidence of skin cancer. However, the increased content of melanin is associated with myriad dyschromias including melasma and postinflammatory hyperpigmentation (PIH). Additional common skin conditions of concern in men of color include pseudofolliculitis barbae, acne keloidalis nuchae, and keloids.

CONCLUSION
A skin color conscious approach should be administered in caring for the cosmetic concerns of men of color that is cognizant of differences in biology of the skin and hair, associated PIH of disorders, and cultural/social practices among this population.
Preconditioning and Postconditioning by Cardiac Glycosides in the Mouse Heart
Authors: Duan Qiming , Xu Yunhui , Marck Pauline V. , Kalisz Jennifer , Morgan Eric E. , Pierre Sandrine V. 
Published: October 2017

Abstract:
Ouabain preconditioning (OPC) initiated by low concentrations of the cardiac glycoside (CG) ouabain binding to Na/K-ATPase is relayed by a unique intracellular signaling and protects cardiac myocytes against ischemia/reperfusion injury. To explore more clinically applicable protocols based on CG properties, we tested whether the FDA-approved CG digoxin could trigger cardioprotective effects comparable with those of ouabain using PC, preconditioning and PostC, postconditioning protocols in the Langendorff-perfused mouse heart subjected to global ischemia and reperfusion. Ouabain or digoxin at 10 μmol/L inhibited Na/K-ATPase activity by approximately 30% and activated PKCε translocation by approximately 50%. Digoxin-induced PC (DigPC), initiated by a transient exposure before 40 minutes of ischemia, was as effective as OPC as suggested by the recovery of left ventricular developed pressure, end-diastolic pressure, and cardiac Na/K-ATPase activity after 30 minutes of reperfusion. DigPC also significantly decreased lactate dehydrogenase release and reduced infarct size, comparable with OPC. PostC protocols consisting of a single bolus injection of 100 nmoles of ouabain or digoxin in the coronary tree at the beginning of reperfusion both improved significantly the recovery of left ventricular developed pressure and decreased lactate dehydrogenase release, demonstrating a functional and structural protection comparable with the one provided by OPC. Given the unique signaling triggered by OPC, these results suggest that DigPostC could be considered for patients with risk factors and/or concurrent treatments that may limit effectiveness of ischemic PostC.
The Delay Phenomenon: Is One Surgical Delay Technique Superior?
Authors: Gersch Robert P. , Fourman Mitchell S. , Dracea Cristina , Bui Duc T. , Dagum Alexander B. 
Published: October 2017

Background:
Surgical delay remains a common method for improving flap survival. However, the optimal surgical technique has not been determined. In this article, we compare flap perfusion, viable surface area, and flap contraction of 2 surgical delay techniques.

Methods:
Male Sprague-Dawley rats were divided into 3 groups. In the incisional surgical delay group (n = 9), a 9 × 3 cm dorsal flap was incised on 3 sides without undermining, leaving a cranial pedicle. In the bipedicle surgical delay group (BSD, n = 9), a 9 × 3 cm dorsal flap was incised laterally and undermined, leaving cranial and caudal pedicles. Control group (n = 16) animals did not undergo a delay procedure. Ten days following surgical delay, all flaps for all groups were raised, leaving a cranial pedicle. A silicone sheet separated the flap and the wound bed. On postoperative day (POD) 7, viable surface area was determined clinically. Contraction compared to POD 0 was measured with ImageJ software. Perfusion was measured with Laser Doppler Imaging. The Kruskal-Wallis with Dunn’s multiple comparisons test was performed for group comparisons.

Results:
BSD preserved significantly more viable surface area on POD 7 (13.7 ± 4.5 cm2) than Control (8.7 ± 1.8 cm2; P = 0.01). BSD also showed significantly less contraction (21.0% ± 13.5%) than Control (45.9% ± 19.7%; P = 0.0045). BSD and incisional surgical delay showed significantly increased perfusion compared with Control on POD 0 (P = 0.02 and 0.049, respectively), which persisted on POD 3. This trend resolved by POD 7.

Conclusion:
BSD showed improved early perfusion, increased viable surface area, and reduced contraction compared to control, suggesting that BSD is the superior flap design for preclinical modeling.
The Reconstruction of the Donor Site of DP Flap Using Thoracodorsal Artery Perforator Flap
Authors: Okochi Masayuki , Okochi Hiromi , Sakaba Takao , Ueda Kazuki 
Published: October 2017

Summary:
We performed a new procedure for reconstruction of donor site of a deltopectoral (DP) flap. A 58-year-old man presented with a wide subcutaneous abscess, which was caused by acute mandibular osteomyelitis due to dental caries. On admission, the patient received a neck incision for drainage. However, necrosis of the neck skin was observed after drainage. The patient had an 8 × 10 cm skin and soft-tissue defect, which we covered with a DP flap (15 × 7 cm). The DP flap donor site was reconstructed using a 16 × 8 cm pedicled thoracodorsal artery perforator (TDAP) flap. There was no flap necrosis, abscess formation, or scar contracture of the DP region. Debulking of the TDAP flap was not required. The pedicled TDAP flap is useful for the reconstruction of the donor site of DP flap. In this report, we describe our operative procedure.
YOUNGER AGE AT PRESENTATION IN CHILDREN WITH COATS DISEASE IS ASSOCIATED WITH MORE ADVANCED STAGE AND WORSE VISUAL PROGNOSIS
Authors: Daruich Alejandra , Matet Alexandre , Munier Francis L. 
Published: October 2017

Purpose:
To determine the age distribution of children with Coats disease and the impact of age at diagnosis on the visual prognosis.

Methods:
Consecutive Coats disease cases aged 18 years or younger at diagnosis were retrospectively included. Clinical and imaging parameters were analyzed by comparative, correlation, survival, univariate, and multivariate statistics.

Results:
Ninety-eight patients were included. At diagnosis, mean age was 5.4 years ± 4.3 years (1 month-18 years). Younger age at diagnosis was correlated with more severe disease stage (P < 0.0001, r = −0.52), which was confirmed by survival analysis (P < 0.0001). Comparative analysis was performed between patients younger and older than 4 years at diagnosis. Leukocoria or strabismus was more frequent at presentation in patients younger than 4 years (P < 0.0001). Areas of peripheral nonperfusion and peripheral telangiectasia were more extensive at presentation in younger than older patients (P = 0.0003 and P = 0.039). Foveal sparing at diagnosis was less frequent in younger than older patients (2% vs. 23%, P = 0.002). The incidence of structural complications or enucleation during follow-up (mean duration: 5.9 years ± 4.5 years) was higher, and last-recorded visual acuity was lower in younger than older patients (P = 0.001 and P = 0.0009). Final logarithm of the minimal angle of resolution visual acuity was negatively correlated with age at diagnosis (P = 0.001, Spearman r = −0.42). Multivariate analysis indicated that disease stage (P < 0.0001), but not age at diagnosis (P = 0.07), independently influenced the last-recorded visual acuity.

Conclusion:
Onset of Coats disease in children of younger age is associated with more severe manifestations, more advanced stage, and worse visual outcome. Age, correlated with disease stage, should be considered a prognostic marker in Coats disease.
VISUAL ACUITY IN PATIENTS WITH STARGARDT DISEASE AFTER AGE 40
Authors: Collison Frederick T. , Fishman Gerald A. 
Published: October 2017

Purpose:
To better define visual acuity loss in patients with Stargardt disease later in life.

Methods:
The most recent best-corrected visual acuities in the better-seeing eye of 221 patients with Stargardt disease over 40 years of age were recorded. Also included were the age at subjective onset for symptoms and duration of symptoms. Juvenile onset was defined as onset before age 21; adult onset was defined as onset between 21 and 40 years; and late onset was defined as onset at age 41 or later.

Results:
The median age of the patients with Stargardt disease was 53.1 years. Twenty-four patients (10.9%) had worse than 20/400 best-corrected visual acuity, and none had either light perception or no light perception vision. Whereas 17 of the 52 juvenile onset patients had best-corrected visual acuity worse than 20/400, only 4 of 80 adult-onset patients and 1 of 70 late-onset patients reached this level of acuity loss.

Conclusion:
Although many patients with Stargardt disease lose visual acuity to the 20/200 to 20/400 range, and some lose visual acuity beyond 20/400, none of these patients reached either light perception or no light perception. The numbers found in this study will be valuable in counseling patients with Stargardt disease and could have value in planning treatment trials.
“Recognize and Remove”: A Universal Principle for the Management of Sports Injuries
Authors: Fuller Colin W. 
Published: October 2017

Objective:
To identify the locations and types of injury that result in players not being immediately removed from the field of play when injured and to quantify the magnitude of the situation.

Design:
Prospective cohort epidemiological study with definitions and procedures compliant with the international consensus statement for studies in rugby.

Setting:
Sevens World Series (SWS) (2008-2016) and Rugby World Cup (RWC) (2007, 2011, 2015).

Participants:
Players from 17 countries taking part in the SWS and 22 countries taking part in the RWC.

Main Outcome Measures:
Location, type, and mean severity of injury, period of match when the injury occurred and whether players were removed from the field of play when injured.

Results:
Injured players (51.5%) in the SWS and 33.1% of injured players in the RWC were immediately removed from the field of play at the time of injury. The percentages of players immediately removed varied from 16.7% for hand fractures (severity: 71 days) to 96.7% for shoulder dislocations/subluxations (severity: 105 days) during the SWS and from 4.5% for shoulder ligament sprains (severity: 25 days) to 65.9% for concussions (severity: 9 days) during the RWC. The percentage of players immediately removed from play when injured was not related to the severity of the injury sustained.

Conclusions:
A high proportion of players continue to play (in the same game) after sustaining an injury although the likelihood of being removed from play is not dependent on injury severity.
High Incidence of Bell's Palsy After Mastoidectomy: A Longitudinal Follow-up Study
Authors: Choi Hyo Geun , Sim Songyong , Hong Sung Kwang , Park Su-kyoung , Lee Hyo-Jeong , Chang Jiwon 
Published: October 2017

Objective:
The objective of this study was to compare the prevalence of Bell's palsy in participants who underwent mastoidectomy (to treat chronic otitis media) and nonmastoidectomy participants (control).

Methods:
Using the national cohort study from the Korean Health Insurance Review and Assessment Service, mastoidectomy patients (2,045) and control participants (8,180) were matched 1:4 for age, sex, income, and region of residence. The prevalence of Bell's palsy in both the groups was measured from 0 to 10 years postoperation.

Results:
In a sample of 1,025,340 Korean individuals, 7,070 were diagnosed or treated with Bell's palsy between 2002 and 2013; the annual incidence of Bell's palsy was 0.057%. The overall prevalence of Bell's palsy was three times higher in the mastoidectomy group (1.27%) than control group (0.49%) (p < 0.001). The prevalence of Bell's palsy was different between the two groups in postoperative 0 year: 0.78% for the mastoidectomy group versus 0.01% for the control group (p < 0.001).

Conclusion:
Although we could not verify the laterality, the prevalence of Bell's palsy was increased in chronic otitis media patients treated with mastoidectomy patients compared with controls, especially within a year after surgery.
The outcome of transanal endoscopic microsurgery in obese patients
Authors: Fenig Yaniv , Khoury Mansour , Schmilovitz-Weiss Hemda , Gingold-Belfer Rachel , Nissim Bachar Gil , Issa Nidal 
Published: October 2017

Background
The prevalence of obesity is as high as one-third of the adult population in the ultrasound. Obese patients operated for rectal cancer are less likely to undergo sphincter-preserving surgery, and have an increased morbidity and mortality. We aim to report the outcomes of transanal-endoscopic-microsurgery (TEM) in obese patients with benign and malignant neoplasms.

Materials and methods
An analysis was carried out of all patients undergoing TEM at a single institution between 2004 and 2015. Clinical, demographic, and pathologic data were analyzed in respect to BMI; a dichotomous variable was created categorizing the patients in this retrospective case series as either obese (BMI≥30) or nonobese (BMI<30).

Results
Of the 158 patients who underwent TEM during the study period, 51 (32%) were obese and 107 (68%) were nonobese. No significant differences were found in terms of patients’ demographics and tumor characteristics. There were no significant differences in operative time [105 min (range: 75–170) and 98 (range: 56–170), respectively, P=0.2], hospital length of stay [3 days (range: 2–6) and 4 (range: 2–12), respectively, P=0.48], or complication rates (20 and 23%, respectively, P=0.68).

Conclusion
TEM is a safe procedure for rectal neoplasms in the obese population. We found no difference in surgical time and completeness of specimen resection, and no increase in complications or length of stay in the hospital in obese versus nonobese patients. As for selected high risk patients, the TEM may be of benefit in obese patients with T1/T2N0M0 rectal cancer.