bluuebunny/crossref_metadata_2025_split huggingface dataset:
Keratocystic odontogenic tumours (KCOT) and orthokeratinized odontogenic cysts (OKOC)
Authors: Parbhoo Alan , Simpson Mike 
Published: April 2016

Abstract
Some controversy exists regarding the naming of these jaw lesions. Reference is made to keratocystic odontogenic tumours (KCOT), orthokeratinized odontogenic cysts (OKOC), and keratocyst where the distinction is unknown. The evidence for and against marsupialisation is discussed and reference to how histological subtype affects management and outcome. We present a case of an 82-year-old patient with a recurrent KCOT in the left posterior mandible. It was initially managed with enucleation and had demonstrated appropriate bony infill radiographically. The value of adequate imaging and histological diagnosis to help make an appropriate treatment plan are highlighted. The relevance of Carnoy’s solution in treating these lesions is also discussed as a method to prevent recurrence.
Paediatric temporomandibular joint ankylosis
Authors: McMillan Kevin , Williams Rhodri 
Published: April 2016

Abstract
Ankylosis of the temporomandibular joint can be either intra- or extra-articular. It may affect bone, fibro-osseous or fibrous tissue. In addition it may be complete or incomplete. This relatively rare condition requires close management by a multidisciplinary team versed in such complex disease processes. It is acknowledged to be caused by trauma, otitis media, odontogenic and skin infections, autoimmune disease, and following radiotherapy. We present a case of a four-year-old boy with severe trismus that had developed over a period of 18 months following an ear infection. The evidence for the current management strategy of this condition is discussed and the need for close follow-up to establish early on if re-ankylosis is occurring.
Cleft palate related velopharyngeal incompetence
Authors: Sweet Christopher , Eeden Simon Van 
Published: April 2016

Abstract
Primary cleft palate repair surgery is directed at closure of the cleft without any fistulae and the subsequent development of normal speech. In cleft patients the velum is shorter than in non-cleft patients and the muscles of the soft palate are abnormally orientated. Without correction of this deformity it may lead to the development of velopharyngeal incompetence (VPI). We present a case of a female with bilateral cleft lip and palate where the primary surgery was carried out at three months for the lip, five months for the hard palate, and nine months for the soft palate. However, at three years detailed assessment demonstrated VPI. The further management is described and a comprehensive algorithm is presented.
Early Predictors of Mortality in Geriatric Patients With Trauma
Authors: Wilson Matthew S. , Konda Sanjit R. , Seymour Rachel B. , Karunakar Madhav A. ,   the Carolinas Trauma Network Research Group
Published: April 2016

Objective:
To identify variables that predict mortality in geriatric patients with trauma.

Design:
Retrospective review.

Setting:
Level I trauma center.

Patients/Participants:
A total of 147 geriatric patients with trauma (age ≥65) with a predicted probability of survival of 10%–75% based on the Trauma Score-Injury Severity Score (TRISS).

Main Outcome Measurements:
Patients were divided into 2 cohorts: survivors and nonsurvivors. The following variables available at presentation were analyzed: age, mechanism of injury, temperature, systolic blood pressure, pulse rate, shock index, respiratory rate, Glasgow Coma Scale (GCS) score, base deficit, and hematocrit (HCT). The Injury Severity Score (ISS) and TRISS were calculated for both cohorts.

Results:
Of the 147 patients analyzed, 84 (57%) died during the index hospitalization and 63 (43%) survived. The mean age of nonsurvivors was significantly higher than that of survivors (78.6 vs. 76.1 years; P < 0.04). A greater number of nonsurvivors (72.6%) sustained injuries as a result of a low-energy mechanism compared with survivors (54%; P = 0.02). GCS, temperature, and respiratory rate were significantly lower for nonsurvivors, whereas base deficit was higher (P < 0.05). The TRISS was predictive of survival (TRISS 0.27 vs. 0.53, P < 0.001), but the distinguishing capacity of the TRISS to predict mortality was limited (area under the receiver operator curve; 0.67; 95% confidence interval 0.58–0.76; P < 0.0001).

Conclusions:
Older age, lower GCS, and a low-energy mechanism of injury are associated with a higher mortality rate in this at-risk geriatric trauma population. Early identification of predictors of mortality may help care providers more accurately assess injury burden in geriatric patients.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Spontaneous Regression of Pulmonary Nodules Presenting as Epstein-Barr Virus-related Atypical Infectious Mononucleosis
Authors: Shinozuka Jun , Awaguni Hitoshi , Tanaka Shin-ichiro , Makino Shigeru , Maruyama Rikken , Inaba Tohru , Imashuku Shinsaku 
Published: April 2016

Background:
Pulmonary nodules associated with Epstein-Barr virus (EBV)-related atypical infectious mononucleosis have rarely been described.

Observations:
A 12-year-old Japanese boy, upon admission, revealed multiple small round nodules (a total of 7 nodules in 4 to 8 mm size) in the lungs on computed tomography. The hemorrhagic pharyngeal tonsils with hot signals on 18F-fluorodeoxyglucose-positron emission tomography-computed tomography were biopsied revealing the presence of EBV-encoded small nuclear RNA (EBER)-positive cells; however, no lymphoma was noted. The patient was diagnosed as having atypical EBV-infectious mononucleosis associated with primary EBV infection. Pulmonary nodules markedly reduced in numbers and sizes spontaneously over a 2-year period.

Conclusions:
Differential diagnosis of pulmonary nodules in childhood should include atypical EBV infection.
Wound Healing and Angiogenesis through Combined Use of a Vascularized Tissue Flap and Adipose-Derived Stem Cells in a Rat Hindlimb Irradiated Ischemia Model
Authors: Yoshida Shuhei , Yoshimoto Hiroshi , Hirano Akiyoshi , Akita Sadanori 
Published: April 2016

Background:
Treatment of critical limb ischemia is sometimes difficult because of the patient’s condition, and some novel approaches are needed.

Methods:
The hindlimbs of Sprague-Dawley rats, after 20-Gy x-ray irradiation and surgical occlusion, were divided into four groups: with a superficial fascial flap, 5.0 × 106 adipose-derived stromal/stem cells, and both combined. The rats were tested for laser tissue blood flow, immunohistologic blood vessel density, and foot paw punch hole wound healing. Green fluorescent protein–tagged Sprague-Dawley rats were used for further investigation by cell tracking for 2 weeks.

Results:
Laser tissue blood flow demonstrated a significant increase in the combined treatment of flap and adipose-derived stem cells at both 1 and 2 weeks. There were no significant differences between the treatment groups treated with flaps alone and those treated with adipose-derived stem cells alone. Wound healing was significantly increased following combined treatment at 1 week, and there was no wound by 2 weeks except for the no-flap and no–adipose-derived stem cell group. The number of vessels depicted by von Willebrand factor showed a significant increase in the combined treatment group, at both 1 week and 2 weeks. In the cell tracking group, at 2 weeks, the green fluorescent protein–tagged adipose-derived stem cells were significantly more positive in the no-flap group than in the flap group.

Conclusions:
Adipose-derived stem cells may be a potent cell source in irradiated and occluded limbs by enhancing tissue blood flow and blood vessel density. Adipose-derived stem cells may play an important role in some difficult ischemic conditions in terms of wound healing.
The Transverse Musculocutaneous Gracilis Free Flap: Virtual Animation–Assisted Dissection and Application in Breast Reconstruction
Authors: Gabert Pierre-Elliott , Bodin Frederic , Aljudaibi Nawaf , Duquennoy-Martinot Veronique , Guerreschi Pierre 
Published: April 2016

Summary:
The transverse musculocutaneous gracilis free flap is a valuable choice for autologous tissue, unilateral or bilateral breast reconstruction. This procedure is an excellent and customized option for immediate or delayed breast reconstruction in patients with small to moderate size breasts. Few descriptions of flap dissection and breast mound shaping are available. In this first educational video, the authors report the original dissection of the transverse musculocutaneous gracilis free flap used for breast reconstruction. Virtual animations insist on surgical key points and relevant details of the harvesting of the flap.
Promotion of Osteogenesis and Angiogenesis in Vascularized Tissue-Engineered Bone Using Osteogenic Matrix Cell Sheets
Authors: Nakano Kenichi , Murata Keiichi , Omokawa Shohei , Akahane Manabu , Shimizu Takamasa , Kawamura Kenji , Kawate Kenji , Tanaka Yasuhito 
Published: April 2016

Background:
The regeneration of large, poorly vascularized bone defects remains a significant challenge. Although vascularized bone grafts promote osteogenesis, the required tissue harvesting causes problematic donor-site morbidity. Artificial bone substitutes are promising alternatives for regenerative medicine applications, but the incorporation of suitable cells and/or growth factors is necessary for their successful clinical application. The inclusion of vascular bundles can further enhance the bone-forming capability of bone substitutes by promoting tissue neovascularization. Little is known about how neovascularization occurs and how new bone extends within vascularized tissue-engineered bone, because no previous studies have used tissue-engineered bone to treat large, poorly vascularized defects.

Methods:
In this study, the authors developed a novel vascularized tissue-engineered bone scaffold composed of osteogenic matrix cell sheets wrapped around vascular bundles within β-tricalcium phosphate ceramics.

Results:
Four weeks after subcutaneous transplantation in rats, making use of the femoral vascular bundle, vascularized tissue-engineered bone demonstrated more angiogenesis and higher osteogenic potential than the controls. After vascularized tissue-engineered bone implantation, abundant vascularization and new bone formation were observed radially from the vascular bundle, with increased mRNA expression of alkaline phosphatase, bone morphogenetic protein-2, osteocalcin, and vascular endothelial growth factor-A.

Conclusion:
This novel method for preparing vascularized tissue-engineered bone scaffolds may promote the regeneration of large bone defects, particularly where vascularization has been compromised.
Increased Osteoid Formation in BMP-2–Loaded Silk-Based Screws
Authors: Koolen Pieter G. L. , Haas Dylan , Kim Kuylhee , Fox Sharon , Ibrahim Ahmed M. S. , Kim Peter , Kaplan David L. , Lin Samuel J. 
Published: April 2016

Background:
Resorbable osteosynthesis systems are used to treat craniofacial fractures. However, conventional synthetic polyester materials are potentially associated with inflammatory reaction and negative host response and may result in incomplete bone remodeling. The authors have developed a resorbable silk fibroin–based osteosynthesis system and propose that silk screws loaded with bone morphogenetic protein-2 (BMP-2) may exhibit biocompatibility and promote bone remodeling.

Methods:
Resorbable silk screws were prepared and loaded with BMP-2. The BMP-2–loaded and nonloaded silk screws were inserted into the distal femora in 15 Sprague-Dawley rats by self-tapping, similar to conventional metal systems. Animals were euthanized after 1, 3, and 6 months. The femora were explanted at the designated time points, dissected for histologic evaluation, and compared regarding osteoid formation and inflammatory response.

Results:
Increasing organization of newly formed bone tissue was observed over time in both groups. No appreciable difference in inflammation was noted between the BMP-2–loaded and nonloaded silk screws. Notably, mineralized collagen around the periphery of the screw appears to be greatest and more organized in the BMP-2–loaded samples. There was greater recruitment of osteoclasts and osteoblasts around the perimeter of the BMP-2–loaded screws at 3 and 6 months.

Conclusions:
The BMP-2–loaded silk-based fixation device in this study exhibited characteristics comparable to the current nonloaded silk screws with regard to integration and biocompatibility. However, functionalization of silk screws with BMP-2 appeared to allow for more organized collagen and osteoid deposition after 3 and 6 months and may increase the potential of successful remodeling.
The Efficacy of Intense Pulsed Light Therapy in Postoperative Recovery from Eyelid Surgery
Authors: Linkov Gary , Lam Vincent B. , Wulc Allan E. 
Published: April 2016

Background:
The purpose of this study was to evaluate the efficacy of postoperative intense pulsed light therapy on patients who undergo bilateral eyelid surgery.

Methods:
Patients presenting over a 3-month period for bilateral eyelid surgery were asked to participate in an institutional review board–approved study. Intense pulsed light therapy was administered three times to the same randomly assigned side on postoperative days 1 to 2, 5 to 7, and 10 to 12. Sham light therapy was administered to the contralateral side. Patient surveys and physician ratings were obtained based on photographic evaluation of ecchymosis, edema, and erythema. Three physicians, including the senior author (A.E.W.), submitted ratings, and these ratings were assessed for interobserver reliability.

Results:
Twenty-eight patients who underwent bilateral eyelid surgery followed by intense pulsed light therapy were enrolled. The mean age of the patients was 66 years (range, 44 to 81 years). Eighty-six percent of patients were female. The change in ratings between postoperative days 1 to 2 and 10 to 12, in the treatment and control groups, was statistically significant for severity of bruising by both patient and physician assessment and for color of bruising only by patient assessment. The interobserver reliability reached the greatest agreement in the ecchymosis category at each time point for the treatment group.

Conclusion:
In a series of patients who underwent eyelid surgery, intense pulsed light therapy decreased the degree of ecchymosis compared with sham treatment in postoperative eyelid surgery patients.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
An Algorithm for Managing Syndromic Craniosynostosis Using Posterior Vault Distraction Osteogenesis
Authors: Swanson Jordan W. , Samra Fares , Bauder Andrew , Mitchell Brianne T. , Taylor Jesse A. , Bartlett Scott P. 
Published: April 2016

Background:
The authors hypothesize that early posterior vault distraction osteogenesis safely confers considerable cranial vault remodeling, sufficient to enable fronto-orbital advancement to be delayed to a later age, with improved outcomes.

Methods:
The authors conducted a retrospective cohort study of children with syndromic craniosynostosis treated before (2003 to 2008) or after (2009 to 2014) implementation of posterior vault distraction osteogenesis.

Results:
Sixty children with syndromic craniosynostosis presented during the study period. Forty met inclusion criteria with care continuity and complete records: 22 before and 18 after implementation of posterior vault distraction osteogenesis. Only 11 patients (61 percent) who underwent initial posterior vault distraction osteogenesis required frontal advancement, at a mean follow-up of 4.0 years of age, compared with 22 patients (100 percent) before implementation of posterior vault distraction osteogenesis. Kaplan-Meier survival analysis indicated significant delay of first fronto-orbital advancement in the posterior vault distraction osteogenesis cohort compared with the pre–posterior vault distraction osteogenesis cohort (p = 0.011). Comparing treatment in the first 5 years of life among posterior vault distraction osteogenesis versus non–posterior vault distraction osteogenesis subcohorts of patients older than 5 years, there were significantly fewer fronto-orbital advancements performed (0.6 versus 1.5 per patient; p = 0.023).

Conclusion:
Using early posterior vault distraction osteogenesis for patients with syndromic craniosynostosis significantly reduces the average number of fronto-orbital advancement procedures in the first 5 years of life, delays initial fronto-orbital advancement, and is likely to reduce the total number of major craniofacial procedures.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Current Applications of Facial Volumization with Fillers
Authors: Wilson Anthony J. , Taglienti Anthony J. , Chang Catherine S. , Low David W. , Percec Ivona 
Published: April 2016

Learning Objectives:
After reading this article and watching the accompanying videos, the participant should be able to: 1. Assess patients seeking facial volumization and correlate volume deficiencies anatomically. 2. Identify appropriate fillers based on rheologic properties and anatomical needs. 3. Recognize poor candidates for facial volumization. 4. Recognize and treat filler-related side effects and complications.

Summary:
Facial volumization is widely applied for minimally invasive facial rejuvenation both as a solitary means and in conjunction with surgical correction. Appropriate facial volumization is dependent on patient characteristics, consistent longitudinal anatomical changes, and qualities of fillers available. In this article, anatomical changes seen with aging are illustrated, appropriate techniques for facial volumization are described in the setting of correct filler selection, and potential complications are addressed.
Rilpivirine and Doravirine Have Complementary Efficacies Against NNRTI-Resistant HIV-1 Mutants
Authors: Smith Steven J. , Pauly Gary T. , Akram Aamir , Melody Kevin , Ambrose Zandrea , Schneider Joel P. , Hughes Stephen H. 
Published: April 2016

Background:
Rilpivirine (RPV) is the latest non-nucleoside reverse transcriptase inhibitor (NNRTI) to be approved by Food and Drug Administration to combat HIV-1 infections. NNRTIs inhibit the chemical step in viral DNA synthesis by binding to an allosteric site located about 10 Å from the polymerase active site of reverse transcriptase (RT). Although NNRTIs potently inhibit the replication of wild-type HIV-1, the binding site is not conserved, and mutations arise in the binding pocket. Doravirine (DOR) is a new NNRTI in phase III clinical trials.

Methods:
Using a single round HIV-1 infection assay, we tested RPV and DOR against a broad panel of NNRTI-resistant mutants to determine their respective activities. We also used molecular modeling to determine if the susceptibility profile of each compound was related to how they bind RT.

Results:
Several mutants displayed decreased susceptibility to DOR. However, with the exception of E138K, our data suggest that the mutations that reduce the potency of DOR and RPV are non-overlapping. Thus, these 2 NNRTIs have the potential to be used together in combination therapy. We also show that the location at which DOR and RPV bind with the NNRTI binding pocket of RT correlates with the differences in their respective susceptibility to the panel of NNRTI-resistance mutations.

Conclusions:
This shows that (1) DOR is susceptible to a number of well-known NNRTI resistance mutations and (2) an understanding of the mutational susceptibilities and binding interactions of NNRTIs with RT could be used to develop pairs of compounds with non-overlapping mutational susceptibilities.
Expanding the measurement of police integrity
Authors: Hickman Matthew J. , Piquero Alex R. , Powell Zachary A. , Greene Jack 
Published: April 2016

Purpose– Klockarset al.use scenario methodology to measure perceived seriousness, level of discipline warranted, and willingness to report fellow officers engaged in various negative behaviors. These data are used to characterize the occupational culture of integrity in a given agency, relative to other agencies. What remains unclear is whether these agency-level findings mask important meso- and micro-level variation in the data (i.e. at the precinct/district and officer levels) that may contribute to a more complete understanding of an agency’s culture of integrity. The paper aims to discuss these issues.Design/methodology/approach– This study replicates and extends Klockarset al.’s work using data from a survey administered to 499 Philadelphia police officers, with the goal of both validating their methodological approach and exploring the need for multi-level theory in the study of police integrity. In addition to comparing the results from Philadelphia to those obtained by Klockarset al., the authors test for differences across officer demographics, and explore variance in the willingness to report various behaviors at both the officer- and district-levels.Findings– Results indicate that bivariate relationships between officer-level demographics and willingness to report fellow officers are negated when controlling for theoretically relevant attitudinal variables such as cynicism and, consistent with Klockarset al., perceived seriousness of the underlying behavior. In addition, there is significant district-level variation in the average willingness to report fellow officers, and this variation can be explained by both organizational and environmental variables. On balance, the findings provide support for a multi-level approach to the study of police integrity.Originality/value– While the Klockarset al.approach addresses macro-level variation in police integrity, this study contributes important findings at the meso- and micro-levels.
Exploring the viability of an attitudes toward ethical behavior scale in understanding police integrity outcomes
Authors: Hickman Matthew J. , Powell Zachary A. , Piquero Alex R. , Greene Jack 
Published: April 2016

Purpose– Relying on a moral development theoretical framework, the purpose of this paper is to argue that the perceived seriousness of a particular behavior is a reflection of one’s broader attitudes toward ethical behaviors. Attitudes toward ethical behavior should provide both an elaborated explanation for the relationship between the perceived seriousness of a behavior and the likelihood of reporting a fellow officer for that behavior, as well as an alternative approach to the measurement and assessment of police integrity outcomes.Design/methodology/approach– Using data from a sample of 499 Philadelphia police officers, the current study uses a modified fifteen item ethics scale first developed by Hyams (1990) and used by others, in order to examine its relation to integrity outcomes. The paper provides a full descriptive and measurement analysis of the scale and then explores its utility in understanding integrity outcomes through a variety of hypothetical scenarios.Findings– While the perceived seriousness of a behavior is strongly predictive of the likelihood of reporting a fellow officer who engages in that behavior, the findings suggest that seriousness may be a proxy for attitudes toward ethical behaviors.Originality/value– While Klockarset al.’s approach to the measurement of police integrity has been an important contribution to integrity research, other measures of police integrity such as attitudes toward ethical behavior are also useful as they move us conceptually from assessing attitudes toward ethical behavior to their antecedents – the strength of underlying value premises shaping subsequent attitudes.