bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Clinical and Economic Impact of a Sustained Program in Global Plastic Surgery
Authors: Hughes Christopher D. , Babigian Alan , McCormack Susan , Alkire Blake C. , Wong Anselm , Pap Stephen A. , Vincent Jeffrey R. , Meara John G. , Castiglione Charles , Silverman Richard 
Published: January 2013

Background:
The development of surgery in low- and middle-income countries has been limited by a belief that it is too expensive to be sustainable. However, subspecialist surgical care can provide substantial clinical and economic benefits in low-resource settings. The goal of this study is to describe the clinical and economic impact of recurrent short-term plastic surgical trips in low- and middle-income countries.

Methods:
The authors conducted a retrospective review of clinic and operative logbooks from Hands Across the World's surgical experience in Ecuador. The authors calculated the disability-adjusted life-years averted to estimate the clinical impact of cleft repair and then calculated the economic impact of surgical intervention for cleft disease.

Results:
One thousand one hundred forty-two reconstructive surgical cases were performed over 15 years. Surgery was most commonly performed for scar contractures [449 cases (39.3 percent)], of which burn scars comprised a substantial amount [215 cases (18.8 percent)]. There were 40 postoperative complications within 7 days of operation (3.5 percent), and partial wound dehiscence was the most common complication [16 of 40 (40 percent)]. Cleft disorders constituted 277 cases (24.3 percent), and 102 cases were primary cleft lip and/or palate cases. Between 396 and 1042 total disability-adjusted life-years were averted through surgery for these 102 cases of primary cleft repair. This translates to an economic benefit between $4.7 million (human capital approach) and $27.5 million (value of a statistical life approach).

Conclusions:
Plastic surgical disease is a significant source of morbidity for patients in resource-limited regions. Dedicated programs that provide essential reconstructive surgery can produce substantial clinical and economic benefits to host countries.
Anaphylactic-Like Reaction to Methylene Blue
Authors: Giladi Aviram M. , Kasten Steven J. 
Published: January 2013

Background:
Anaphylaxis and anaphylactic-like reactions in the perioperative period are a significant concern for anesthesiologists and surgeons. With an incidence as high as one in 3500 and a mortality rate of 3 to 6 percent, proper management of these reactions is essential. The available surgical literature provides varied and unclear guidelines for determining the nature of these reactions and has no consensus treatment algorithm. The authors present a rare case of hypersensitivity reaction to methylene blue during cleft lip repair. A review of current literature for best-practice evaluation and management guidelines follows.

Methods:
Literature review was performed using search terms including “anaphylaxis,” “hypersensitivity,” “allergy,” “perioperative,” and “intraoperative.” Results from basic science literature, case reports, and clinical studies were used, as were personal communications with leading investigators in allergy and immunology.

Results:
Despite variations in incidence, reporting, evaluation, and management, the authors found that immediate treatment should include epinephrine, steroids, and histamine-1– and histamine-2–blocking agents. In the event of reactions with characteristics of anaphylaxis, obtaining tryptase levels 1, 4, and 24 hours after the event provides the most accurate biochemical evidence. Skin-prick and intradermal testing by an allergy specialist should be performed 6 or more weeks after the reaction.

Conclusions:
With the unique exposure risks in the perioperative period, it is the surgeon's responsibility to aid in the proper immediate and short-term treatment of anaphylaxis and anaphylactic-like reactions. Proper biochemical evaluation at the time of reaction can be critical in helping the patient avoid future reactions and should not be overlooked.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
Reconstituted Injectable Hyaluronic Acid
Authors: Fagien Steven , Cassuto Daniel 
Published: January 2013

Background:
As we currently have a better understanding of the components of facial aging, injectable filling agents have a larger role in nonsurgical facial rejuvenation. Many products are now available worldwide as options for treating the spectrum of indications that include particular agents used for the treatment of various facial rhytides and in larger quantities for regional or panfacial volumization. The latter indication has been most popularly treated with a host of agents classified as hyaluronans or injectable hyaluronic acid gels. The former had been traditionally and more successfully treated with injectable collagen or dermal matrix agents. Attempts to confuse these generalized approaches have often led to unsatisfactory results. With the precipitous disappearance of the availability of most injectable collagen substances, other methods of treating finer facial rhytides have been explored.

Methods:
Of the many options available for the treatment of facial fine lines, the authors describe a novel technique of formulating reduced concentrations of existing hyaluronic acid gels by variable dilution/reconstitution.

Results:
Over 350 of the authors' collective patients have been treated with this approach. The results have been highly satisfactory, with greater persistence, and have challenged traditional concepts of mechanism of action and biodegradation and suggest alternative options in formulations of currently available products.

Conclusions:
Reconstituted injectable hyaluronic acid is a highly effective and viable alternative for the aesthetic treatment of facial fine lines and other components of aging. Observations, treatment guidelines, and a rationale for this novel use and concepts to explain these finding are contained in this article.
Fat Grafting
Authors: Gir Phanette , Brown Spencer A. , Oni Georgette , Kashefi Nathalie , Mojallal Ali , Rohrich Rod J. 
Published: January 2013

Background:
Over the past 20 years, there has been a dramatic increase in the use of autologous fat grafting to treat volume and contour defects in aesthetic and reconstructive surgery. It is generally accepted that fat grafting is safe, with good patient satisfaction. However, there are many procedural variations, and in terms of objective clinical effectiveness, the major disadvantage of this technique remains the unpredictable fat resorption rates and subsequent adverse events. Because of the rapidly evolving nature of this procedure, this review article provides an update on previous reviews by looking at the current evidence base regarding fat graft techniques and their effect on clinical outcome.

Methods:
A systematic review of the scientific literature listed on PubMed was performed using 20 search terms focused on harvesting, processing, reinjection, and conservation of fat grafting. An evidence-based system was used to determine eligibility for clinical and preclinical studies.

Results:
Thirty-seven articles were selected based on inclusion and exclusion criteria: five articles were clinical trials and 32 were experimental comparative studies examining human fat grafting.

Conclusions:
This systematic review revealed a lack of high-quality data despite the increase in fat grafting over the past 20 years. At present, there is no evidence that supports specific procedural standardization. Evidence-based studies that incorporate randomized controlled, prospective, multicenter trials are required to understand which factors influence positive fat grafting clinical outcomes.
Wrist Surgery
Authors: Sammer Douglas M. , Shin Alexander Y. 
Published: January 2013

Learning Objectives:
After reading this article, the participant should be able to: 1. Recognize the clinical features of chronic scapholunate and lunotriquetral ligament injuries and their long-term sequelae. 2. Describe the current management and latest techniques for treating chronic scapholunate and lunotriquetral ligament injuries and their long-term sequelae, such as wrist arthritis.

Summary:
This article provides an update on the diagnosis, current management, and latest techniques for the treatment of chronic scapholunate and lunotriquetral ligament injuries and their long-term sequelae, such as wrist arthritis.
Reepithelialization from Stem Cells of Hair Follicles of Dermal Graft of the Scalp in Acute Treatment of Third-Degree Burns
Authors: Zakine Gilbert , Mimoun Maurice , Pham Julien , Chaouat Marc 
Published: January 2013

Background:
The scalp, an excellent donor site for thin skin grafts, presents a limited surface but is rich in keratinocyte stem cells. The purpose of this study was to double scalp harvesting in one procedure and to evaluate the capacity of the dermal layer to spontaneously reepithelialize from hair follicle stem cells.

Methods:
Two layers of 0.2-mm split-thickness skin graft, a dermoepidermal graft and a dermal graft, were harvested from scalp during the same procedure. Fifteen burn patients were included in this study. Healing of the scalp donor site and percentage of graft taken were evaluated. The Vancouver Scar Scale was used at 3 months and 1 year. Histologic studies were performed at day 0 and 3 months on grafts, and on the scalp at day 28.

Results:
Nine patients were treated on the limbs with meshed dermal graft. Six were treated on the hands with unmeshed dermal graft. Graft take was good for both types of grafts. The mean time for scalp healing was 9.3 days. Histologic study confirmed that the second layer was a dermal graft with numerous annexes and that, at 3 months, the dermis had normal thickness but with rarer and smaller epidermal crests than dermal graft. The difference between the mean Vancouver Scar Scale score of dermal graft and dermoepidermal graft was not significant.

Conclusion:
The authors' study shows the efficacy of dermal graft from the scalp and good scalp healing.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
Intensified agricultural use of grasslands reduces growth and survival of precocial shorebird chicks
Authors: Kentie Rosemarie , Hooijmeijer Jos C. E. W. , Trimbos Krijn B. , Groen Niko M. , Piersma Theunis 
Published: January 2013

Summary

Intensification of agricultural use of grassland habitats has been linked to the declines of many farmland bird species, several of whom have been in decline for multiple decades despite agri‐environmental schemes. In the Netherlands, where most grasslands have been transformed into well‐drained monocultures managed for maximal dairy production, schemes that aim to protect nests from agricultural activities are the most popular. The cause of the failure of these schemes, however, seems poor recruitment of farmland birds.
Using the black‐tailed godwit Limosa limosa limosa as our model species, we tested the hypothesis underlying the most popular agri‐environmental schemes that there are no differences in condition at hatch, growth, and apparent survival rates between chicks raised on monocultures compared with chicks from herb‐rich meadows with high water tables, often managed, for the sake of grassland birds, in traditional ways. We also compare the growth rates from both habitat types with those of chicks from dairy farmland from 1976 to 1985, a time when population declines of godwits first became visible.
Hatchling mass did not differ between chicks from herb‐rich meadows and grassland monocultures, but chicks hatched on monocultures were on average 14–16% lighter at fledging, and had 4% smaller bills than chicks hatched on herb‐rich meadows. The growth rates of female chicks hatched on herb‐rich meadows were similar to those of chicks measured from 1976 to 1985. Males fledged lighter and smaller than females.
Apparent survival during the first year of life for chicks hatched on herb‐rich meadows was 2·5 times higher than that of chicks hatched on grassland monocultures. The apparent survival on herb‐rich meadows seems sufficient for a stable population.
Synthesis and applications: We found striking differences between chicks hatched on modern grassland monocultures and herb‐rich meadows. That chicks hatched on monocultures had lower growth and survival rates than chicks on meadows indicates that these chicks suffer a higher risk of starvation and/or predation. These findings imply that the most often applied agri‐environmental schemes (i.e. payments per clutch found and postponed mowing), are not effective. Instead, these schemes could even encourage maladaptive habitat choice. Conservation efforts should thus focus on the provision of herb‐rich meadows with high groundwater tables.
Exploiting pathogens' tricks of the trade for engineering of plant disease resistance: challenges and opportunities
Authors: Grant Murray R. , Kazan Kemal , Manners John M. 
Published: January 2013

SummaryWith expansion of our understanding of pathogen effector strategies and the multiplicity of their host targets, it is becoming evident that novel approaches to engineering broad‐spectrum resistance need to be deployed. The increasing availability of high temporal gene expression data of a range of plant–microbe interactions enables the judicious choices of promoters to fine‐tune timing and magnitude of expression under specified stress conditions. We can therefore contemplate engineering a range of transgenic lines designed to interfere with pathogen virulence strategies that target plant hormone signalling or deploy specific disease resistance genes. An advantage of such an approach is that hormonal signalling is generic so if this strategy is effective, it can be easily implemented in a range of crop species. Additionally, multiple re‐wired lines can be crossed to develop more effective responses to pathogens.
Impact of stepwise hyperventilation on cerebral tissue oxygen saturation in anesthetized patients: a mechanistic study
Authors: ALEXANDER B. S. , GELB A. W. , MANTULIN W. W. , CERUSSI A. E. , TROMBERG B. J. , YU Z. , LEE C. , MENG L. 
Published: January 2013

BackgroundWhile the decrease in blood carbon dioxide (CO2) secondary to hyperventilation is generally accepted to play a major role in the decrease of cerebral tissue oxygen saturation (SctO2), it remains unclear if the associated systemic hemodynamic changes are also accountable.MethodsTwenty‐six patients (American Society of Anesthesiologists I–II) undergoing nonneurosurgical procedures were anesthetized with either propofol‐remifentanil (n = 13) or sevoflurane (n = 13). During a stable intraoperative period, ventilation was adjusted stepwise from hypoventilation to hyperventilation to achieve a progressive change in end‐tidal CO2 (ETCO2) from 55 to 25 mmHg. Minute ventilation, SctO2, ETCO2, mean arterial pressure (MAP), and cardiac output (CO) were recorded.ResultsHyperventilation led to a SctO2 decrease from 78 ± 4% to 69 ± 5% (Δ = −9 ± 4%, P < 0.001) in the propofol‐remifentanil group and from 81 ± 5% to 71 ± 7% (Δ = −10 ± 3%, P < 0.001) in the sevoflurane group. The decreases in SctO2 were not statistically different between these two groups (P = 0.5). SctO2 correlated significantly with ETCO2 in both groups (P < 0.001). SctO2 also correlated significantly with MAP (P < 0.001) and CO (P < 0.001) during propofol‐remifentanil, but not sevoflurane (P = 0.4 and 0.5), anesthesia.ConclusionThe main mechanism responsible for the hyperventilation‐induced decrease in SctO2 is hypocapnia during both propofol‐remifentanil and sevoflurane anesthesia. Hyperventilation‐associated increase in MAP and decrease in CO during propofol‐remifentanil, but not sevoflurane, anesthesia may also contribute to the decrease in SctO2 but to a much smaller degree.
Self Directed Support and people with learning disabilities: a review of the published research evidence
Authors: Harkes Mary Anne , Brown Michael , Horsburgh Dorothy 
Published: January 2013

Accessible summary

Self Directed Support is the latest system of social care providing vulnerable people in the United Kingdom with a budget instead of direct service provision.

There is a lack of evidence underpinning the strategy of Self Directed Support.

There is a need to learn more about how well the policies are working.

Barriers need to be identified and overcome to ensure that people who are eligible can access Self Directed Support.

SummaryA systematic literature review was undertaken to determine the evidence base underpinning the strategy of Self Directed Support and whether evidence demonstrates that this policy is accessible to everyone with a learning disability. It also sought to identify whether there were any barriers to Self Directed Support for people with severe or profound learning disabilities and, if so, how these barriers could be overcome. Four mixed‐method research papers, two quantitative studies, seven qualitative studies and four literature reviews were identified. The findings indicated that very few studies pertain specifically to people with learning disabilities, and little account has been taken of their range of ability or the distinction between adults with legal capacity and those without. It is evident from the literature that Self Directed Support is not, as yet, attainable for everyone with a learning disability but those able to access it have reported an improvement in their quality of life. There is a need for further research to determine the extent of awareness and understanding of the policy of Self Directed Support, and the implications it will have on the future care of people with a wide range of learning disabilities.
Gaining employment: the experience of students at a further education college for individuals with learning disabilities
Authors: Skellern Joanne , Astbury Geoff 
Published: January 2013

Accessible summary

People with learning disabilities can feel excluded from society; employment can help to improve social inclusion.

Everyone needs to be creative in their approach to facilitate work‐based placements and employment opportunities for students at further education colleges.

Students with learning disabilities, parents, education staff and employers need to work together to make sure everyone has the best work experience possible.

SummaryEmployment is widely acknowledged as a key factor to social inclusion, but it is estimated that <7% of people with learning disabilities are in paid employment. It was the aim of the research study to critically examine the experience of gaining employment from the perspectives of students with learning disabilities, parents, education staff and employers. All participants were recruited from one collaborating UK organisation, a college offering further education for young people with learning disabilities. Twenty‐three interviews were conducted. Analysis of the data identified three themes surrounding the perceived roles of: Protector, Rescuer and Worker. Recommendations are discussed to improve collaborative working between student, parent, education staff and employer to overcome some of the difficulties influencing employment rates and contribute to the empowerment and inclusion of people with learning disabilities in society.
The Impact of Board Interlocks on Auditor Choice and Audit Fees
Authors: Johansen Thomas Riise , Pettersson Kim 
Published: January 2013

AbstractManuscript TypeEmpiricalResearch Question/IssueThis paper uses uniqueDanish data to examine whether non‐executive directors draw on both direct and indirect ties in the network of interlocking directorates to impact auditor choice, and whether this impact has consequences for audit fees.Research Findings/InsightThe paper finds clear evidence that non‐executive directors draw on their networks to impact auditor choice, and evidence that clients pay an audit fee premium when non‐executive directors are connected to audit firms outside the focal company. The relationship between non‐executive directors and auditors is well established inDenmark and exhibits features that currently emerge in international debates and regulations. Therefore, the national context offers an interesting setting for empirical evidence of whether international aspirations are likely to be realized.Theoretical/Academic ImplicationsAudit‐related corporate governance research has predominantly adopted the agency theory paradigm and has only drawn on alternative theoretical perspectives to a limited extent. We draw on the literature about board interlocks and social network theory in order to develop a study that aims to increase our understanding of the non‐executive director–auditor relationship and the role that board networks have in governing auditor choice decisions. The study identifies interlocks as an infrastructure for differentiation in the audit market and determines that such differentiation is associated with an audit fee premium for audit firms. The findings indicate that personal experiences with auditors are shared among non‐executive directors and that audit attributes other than low cost audit, auditor size, and industry specialism, are important in the audit market.Practitioner/Policy ImplicationsOur findings support continued efforts to strengthen the relationship between non‐executive directors and auditors. Our findings also indicate that board interlocks may constitute a mechanism that mitigates the audit market failure that arises because of a lack of auditor differentiation.
Small animal positron emission tomography imaging and in vivo studies of atherosclerosis
Authors: Hag Anne Mette Fisker , Ripa Rasmus Sejersten , Pedersen Sune Folke , Bodholdt Rasmus Poul , Kjaer Andreas 
Published: January 2013

SummaryAtherosclerosis is a growing health challenge globally, and despite our knowledge of the disease has increased over the last couple of decades, many unanswered questions remain. As molecular imaging can be used to visualize, characterize and measure biological processes at the molecular and cellular levels in living systems, this technology represents an opportunity to investigate some of these questions in vivo. In addition, molecular imaging may be translated into clinical use and eventually pave the way for more personalized treatment regimes in patients. Here, we review the current knowledge obtained from in vivo positron emission tomography studies of atherosclerosis performed in small animals.