bluuebunny/crossref_metadata_2025_split huggingface dataset:
The “Octopus Head” Dermoglandular Flap: A Novel Technique for Breast Tissue Rearranging after Implant Removal
Authors: Rossi Matteo , Cammarata Emanuele , Cipolla Calogero , Vieni Salvatore , Toia Francesca , Cordova Adriana 
Published: June 2024

Background:
Patients with previous breast augmentation may need implant removal for mechanical complications or other causes. After prosthesis removal, the residual parenchyma can be reshaped through a mastopexy with rearrangement of breast tissue. Several techniques have been described in the literature, but none of them can be considered the gold standard. In this study, we present our preliminary experience in breast tissue rearranging after implant removal through a novel technique: the “octopus head” dermoglandular flap.

Methods:
From January 2019 to October 2022, nine patients (18 breasts) underwent implant removal and simultaneous breast remodeling with the tissue obtained from the dermoglandular excess of the breast and shaped like an octopus head. Patient’s demographic and clinical characteristics, postoperative complications, and patient-reported satisfaction were recorded.

Results:
Mean age was 46.7 years. Body mass index ranged between 22.5 and 27.6 kg per m2. The majority of patients had moderate ptosis (67%). Breast implants were removed due to bilateral capsular contracture (n = 3), unilateral implant rupture with contralateral capsular contracture (n = 2), bilateral implant rupture (n = 3), and unilateral periprosthetic seroma (n = 1). We observed two minor complications: one postoperative hemorrhage with subsequent hematoma that was managed conservatively, and one nipple–areola complex malposition that underwent revision surgery. All patients were satisfied with the aesthetic and functional result.

Conclusions:
The octopus head dermoglandular flap has proved to be a safe and reliable option for breast tissue rearranging after implant removal, providing a good and stable cosmetic result, a low complication rate, and high patient-reported satisfaction.
INTRAVITREAL 0.18-mg FLUOCINOLONE ACETONIDE IMPLANT FOR PEDIATRIC UVEITIS
Authors: Wangyu Stephanie , Jung Jennifer L. , Pecen Paula E. , Palestine Alan G. , Reddy Amit K. 
Published: June 2024

Purpose:
This study reports the outcomes of the 0.18-mg intravitreal fluocinolone acetonide implant in the treatment of pediatric noninfectious uveitis.

Methods:
A retrospective cohort study was performed on patients under 18 years old who received fluocinolone acetonide implant between June 1, 2020 and March 1, 2023. Data collected included demographics, uveitis diagnosis, use of anti-inflammatory therapy, visual acuity, intraocular pressure, and grading of uveitis activity. Uveitis recurrence was defined as increased inflammation that required additional anti-inflammatory therapy.

Results:
Eleven eyes from seven patients were included in this study. One patient (one eye) had a diagnosis of immune recovery uveitis and the remaining six patients (10 eyes) had pars planitis. The rate of remaining recurrence-free was 82% at 6 months, 60% at 12 months, and 60% at 24 months. Two of the six phakic eyes at baseline required cataract extraction during follow-up. Two of the four eyes that did not have intraocular pressure-lowering surgery before implantation required surgery in follow-up.

Conclusion:
The 0.18-mg fluocinolone acetonide implant has a similar efficacy for the treatment of pediatric uveitis, particularly pars planitis, as in the adult population, although with higher rates of ocular hypertension requiring intervention.
A Quality Initiative to Improve Appropriate Medication Dosing in Pediatric Patients with Obesity
Authors: Cloyd Colleen P. , Macedone Danielle , Merandi Jenna , Pierson Shawn , Sellas Wcislo Maria , Lutmer Jeffrey , MacDonald Jennifer , Ayad Onsy , Kalata Lindsay , Thompson R. Zachary 
Published: June 2024

Introduction:
Emerging evidence supports the use of alternative dosing weights for medications in patients with obesity. Pediatric obesity presents a particular challenge because most medications are dosed based on patient weight. Additionally, building system-wide pediatric obesity safeguards is difficult due to pediatric obesity definitions of body mass index-percentile-for-age via the Center for Disease Control growth charts. We describe a quality initiative to increase appropriate medication dosing in inpatients with obesity. The specific aim was to increase appropriate dosing for 7 high-risk medications in inpatients with obesity ≥2 years old from 37% to >74% and to sustain for 1 year.

Methods:
The Institute for Healthcare Improvement model for improvement was used to plan interventions and track outcomes progress. Interventions included a literature review to establish internal dosing guidance, electronic health record (EHR) functionality to identify pediatric patients with obesity, a default selection for medication weight with an opt-out, and obtaining patient heights in the emergency department.

Results:
Appropriate dosing weight use in medication ordered for patients with obesity increased from 37% to 83.4% and was sustained above the goal of 74% for 12 months.

Conclusions:
Implementation of EHR-based clinical decision support has increased appropriate evidence-based dosing of medications in pediatric and adult inpatients with obesity. Future studies should investigate the clinical and safety implications of using alternative dosing weights in pediatric patients.
Dermatofibrosarcoma Protuberans in “Slow Mohs-tion”: Multidisciplinary Approach of A Pediatric Dermatofibrosarcoma Protuberans of the Scalp with Slow Mohs Micrographic Surgery and A Double Rotational-Advancement Scalp Flap
Authors: Lindemann Cameron B. , Miladi Anis , Ortiz Kenneth 
Published: June 2024

Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft-tissue sarcoma with primary incidence of 4.1 per million person-years and accounts for 0.1% of all malignancies. In patients under the age of 19, DFSP comprises 6% of cases with an annual incidence of 1 in 1,000,000. It is a slow-growing malignancy with low metastatic potential. However, DFSP is notable for its high rates of local recurrence due to local invasion with its classic “finger-like” projections into normal tissue. We discuss a case of dermatofibrosarcoma protuberans on the scalp of a 14-year-old male with delayed diagnosis, which required extensive resection through slow Mohs Micrographic Surgery (sMMS). This resection created a sizeable scalp defect of nearly 100 cm2, which mandated creative reconstruction using a novel double rotational-advancement scalp flap to close the defect while maintaining the patient’s hairline for optimal cosmesis.
Dermoid Cysts on the Floor of the Mouth
Authors: Yeom Sujung , Lee Dong Hoon , Lim Sang Chul 
Published: June 2024

Objective:
The authors analyzed the clinical features and treatment results of surgical patients with a final diagnosis of dermoid cyst on the floor of the mouth over 14 years at our hospital.

Patients and Methods:
A total of 5 patients with a final diagnosis of dermoid cyst of the floor of the mouth from January 2010 to December 2023 were enrolled.

Results:
All patients complained of swelling in the submentum or floor of the mouth. The mean tumor size was 4.2±1.0 cm. All patients underwent complete surgical resection. A transcervical approach was performed in 3 patients, and an intraoral approach was implemented in 2 patients. There were no major complications after surgery with either method. The follow-up period was 71.4±75.7 months. There was no disease recurrence during follow-up.

Conclusion:
Dermoid cysts rarely occur on the floor of the mouth but should be considered in the differential diagnosis of other oral cavity tumors. Dermoid cysts on the floor of the mouth can be safely removed using the current transoral approach without scarring or recurrence.
Evaluating the Success of ChatGPT in Addressing Patient Questions Concerning Thyroid Surgery
Authors: Şahin Şamil , Tekin Mustafa Said , Yigit Yesim Esen , Erkmen Burak , Duymaz Yasar Kemal , Bahşi İlhan 
Published: June 2024

Objective:
This study aimed to evaluate the utility and efficacy of ChatGPT in addressing questions related to thyroid surgery, taking into account accuracy, readability, and relevance.

Methods:
A simulated physician-patient consultation on thyroidectomy surgery was conducted by posing 21 hypothetical questions to ChatGPT. Responses were evaluated using the DISCERN score by 3 independent ear, nose and throat specialists. Readability measures including Flesch Reading Ease), Flesch-Kincaid Grade Level, Gunning Fog Index, Simple Measure of Gobbledygook, Coleman-Liau Index, and Automated Readability Index were also applied.

Results:
The majority of ChatGPT responses were rated fair or above using the DISCERN system, with an average score of 45.44 ± 11.24. However, the readability scores were consistently higher than the recommended grade 6 level, indicating the information may not be easily comprehensible to the general public.

Conclusion:
While ChatGPT exhibits potential in answering patient queries related to thyroid surgery, its current formulation is not yet optimally tailored for patient comprehension. Further refinements are necessary for its efficient application in the medical domain.
Optimal Timing for Initiation of Thromboprophylaxis After Hepatic Angioembolization
Authors: Collie Brianna L. , Lyons Nicole B. , Goddard Logan , Cobler-Lichter Michael D. , Delamater Jessica M. , Shagabayeva Larisa , Lineen Edward B. , Schulman Carl I. , Proctor Kenneth G. , Meizoso Jonathan P. , Namias Nicholas , Ginzburg Enrique 
Published: June 2024

Objective:
To evaluate the optimal timing of thromboprophylaxis (TPX) initiation after hepatic angioembolization in trauma patients.

Background:
TPX after hepatic trauma is complicated by the risk of bleeding, but the relative risk after hepatic angioembolization is unknown.

Methods:
Patients who underwent hepatic angioembolization within 24 hours were retrospectively identified from the 2017 to 2019 American College of Surgeons Trauma Quality Improvement Project data sets. Cases with <24-hour length of stay and other serious injuries were excluded. Venous thromboembolism (VTE) included deep venous thrombosis and PE. Bleeding complications included hepatic surgery, additional angioembolization, or blood transfusion after TPX initiation. Differences were tested with univariate and multivariate analyses.

Results:
Of 1550 patients, 1370 had initial angioembolization. Bleeding complications were higher in those with TPX initiation within 24 hours (20.0% vs 8.9%, P<0.001) and 48 hours (13.2% vs 8.4%, P=0.013). However, VTE was higher in those with TPX initiation after 48 hours (6.3% vs 3.3%, P=0.025). In the 180 patients with hepatic surgery before angioembolization, bleeding complications were higher in those with TPX initiation within 24 hours (72% vs 20%, P <0.001), 48 hours (50% vs 17%, P<0.001), and 72 hours (37% vs 14%, P=0.001). Moreover, deep venous thrombosis was higher in those with TPX initiation after 96 hours (14.3% vs 3.1%, P =0.023).

Conclusions:
This is the first study to address the timing of TPX after hepatic angioembolization in a national sample of trauma patients. For these patients, initiation of TPX at 48 to 72 hours achieves the safest balance in minimizing bleeding while reducing the risk of VTE.

Level of Evidence
Level III—retrospective cohort study.
Tumor Mutational Burden From Circulating Tumor DNA Predicts Recurrence of Hepatocellular Carcinoma After Resection
Authors: Wehrle Chase J. , Hong Hanna , Kamath Suneel , Schlegel Andrea , Fujiki Masato , Hashimoto Koji , Kwon David Choon Hyuck , Miller Charles , Walsh R. Matthew , Aucejo Federico 
Published: June 2024

Objective:
Describe the utility of circulating tumor DNA in the postoperative surveillance of hepatocellular carcinoma (HCC).

Background:
Current biomarkers for HCC like alpha-fetoprotein (AFP) are lacking. Circulating tumor DNA (ctDNA) has shown promise in colorectal and lung cancers, but its utility in HCC remains relatively unknown.

Methods:
Patients with HCC undergoing curative-intent resection from November 1, 2020, to July 1, 2023, received ctDNA testing using the Guardant360 platform. Tumor mutational burden (TMB) is calculated as the number of somatic mutations-per-megabase of genomic material identified.

Results:
Forty-seven patients had postoperative ctDNA testing. The mean follow-up was 27 months, and the maximum was 43.2 months. Twelve patients (26%) experienced recurrence. Most (n=41/47, 87.2%) had identifiable ctDNA postoperatively; 55.3% (n=26) were TMB-not detected versus 45.7% (n=21) TMB-detectable. Postoperative identifiable ctDNA was not associated with RFS (P=0.518). Detectable TMB was associated with reduced RFS (6.9 vs 14.7 mo, P=0.049). There was a higher rate of recurrence in patients with TMB (n=9/21, 42.9%, vs n=3/26, 11.5%, P=0.02). Area under the curve for TMB-prediction of recurrence was 0.752 versus 0.550 for AFP. ROC analysis established a TMB cutoff of 4.8mut/mB for predicting post-operative recurrence (P=0.002) and RFS (P=0.025). AFP was not correlated with RFS using the lab-normal cutoff (<11 ng/mL, P=0.682) or the cutoff established by ROC analysis (≥4.6 ng/mL, P=0.494). TMB-high was associated with poorer RFS on cox-regression analysis (hazard ratio=5.386, 95% CI: 1.109–26.160, P=0.037), while microvascular invasion (P=0.853) and AFP (P=0.439) were not.

Conclusions:
Identifiable TMB on postoperative ctDNA predicts HCC recurrence and outperformed AFP in this cohort. Perioperative ctDNA may be a useful surveillance tool following curative-intent hepatectomy. Larger-scale studies are needed to confirm this utility and investigate additional applications in HCC patients, including the potential for prophylactic treatment in patients with residual TMB after resection.
Executive Function as an Underlying Mechanism of Alcohol Use, Aggression, and ADHD
Authors: Spychala Kellyn M. , Friedman Naomi P. , Gizer Ian R. 
Published: June 2024

AbstractBackgroundExecutive functioning (EF) has been proposed as a transdiagnostic risk factor for externalizing disorders and behavior more broadly, including attention-deficit/hyperactivity disorder (ADHD), aggression, and alcohol use. Previous research has demonstrated both phenotypic and genetic overlap among these behaviors, but has yet to examine EF as a common causal mechanism. The current study examined reciprocal causal associations between EF and several externalizing behaviors using a Mendelian randomization (MR) approach.MethodsTwo-sample MR was conducted to test causal associations between EF and externalizing behaviors. Summary statistics from several genome-wide association studies (GWASs) were used in these analyses, including GWASs of EF, ADHD diagnostic status, drinks per week, aggressive behavior, and alcohol use disorder (AUD) diagnostic status. Multiple estimation methods were employed to account for horizontal pleiotropy (e.g., inverse variance weighted, MR-PRESSO, MR-MIX).ResultsEF demonstrated significant causal relationships with ADHD (P < 0.01), AUD (P < 0.03), and alcohol consumption (P < 0.01) across several estimation methods. Reciprocally, ADHD showed a significant causal influence on EF (P < 0.03). Nonetheless, caution should be used when interpreting these findings as there was some evidence for horizontal pleiotropy in the effect of EF on ADHD and significant heterogeneity in variant effects in the other relations tested. There were no significant findings for aggression.ConclusionsFindings suggest that EF may be a causal mechanism underlying some externalizing behaviors, including ADHD and alcohol use, and that ADHD may also lead to lower performance on EF tasks.
Fostering inclusivity: Navigating loneliness and wellbeing among Nigerian international students in the UK Higher Education
Authors: Ajibade Benjamin O. , Mwalillanda Petronella 
Published: June 2024

AbstractBackgroundLoneliness is a state of solitude or being alone. Research addressing loneliness has increased dramatically over the past two decades; however, despite the psychological state risks related to being lonely, the connection between loneliness and mental health disorders still needs to be sufficiently explored. Loneliness is when one’s relationships do not meet the psychosocial needs and expectations. Loneliness is a state of emotion that can be a barrier to social development and, at the same time, impact physical health and mental state. However, loneliness may be a distressing and pervasive experience, defined as the feeling that one’s desired quantity or quality of the social connection is unfulfilled.MethodA qualitative primary research study was conducted for this study. The participants were selected using the purposive sampling method, and 8 participants of Nigerian origin were interviewed for this research. The participants interviewed were of Yoruba, Benin and Igbo origin; therefore, the results cannot represent the entire Nigerian population because it is missing the Hausa tribe. The data were analysed using the thematic analysis method. Ethical approval was obtained from the institution.ResultsThe most salient themes were Voices of Loneliness: International Students’ Coping Strategies and Personal Journeys; Building Bridges: The Role of Community and Social Networks in Overcoming Loneliness; Exploring the Emotional Turmoil and Coping Mechanisms in a Foreign Landscape; Navigating New Realities: The Integration and Adaptation Challenges of International Students and Navigating Loneliness and Seeking Connection. The results showed that feelings of loneliness could result from emotional, psychological, or mental health and the problematic aspect of adaptation to the UK weather, as this greatly impacted their studies. Therefore, emphasis should be placed on understanding each student’s cultural background, assisting international students in examining their bicultural realities to recognise how clients internalise and adhere to culture considering their Nigerian cultural identities and values.
Galápagos yellow warblers differ in behavioural plasticity in response to traffic noise depending on proximity to road
Authors: Hohl Leon , Yelimlieş Alper , Akçay Çağlar , Kleindorfer Sonia 
Published: June 2024

AbstractAcoustic communication between animals is increasingly disrupted by noise in human-altered environments making signals less effective. Birdsong is a signal used in agonistic interactions between territorial rivals, and birds may modify their song and singing behaviour in response to noise. However, if these modifications are still ineffective, this can lead to increased conflict between rivals. Here, we asked whether experimental traffic noise induces immediate changes in acoustic characteristics of song and aggressive behaviour in populations and territories that differ greatly in traffic noise exposure. We conducted simulated territorial intrusions on Galápagos yellow warblers (Setophaga petechia aureola) living on Santa Cruz (high traffic) and Floreana (low traffic) islands. Territories were either adjacent to the nearest road or at least 100 m away from it. We assessed the focal birds’ physical response levels and recorded their vocalisations in response to playback of conspecific song (control) and conspecific song coupled with traffic noise (noise treatment). We found that physical response levels mostly depended on treatment and distance to the nearest road: on both islands, birds living adjacent to the nearest road increased their aggression levels with experimental noise compared to control, while birds living farther away decreased their aggression levels. Birds on all islands irrespective of their distance to a road increased minimum frequency of their songs during the noise treatment. However, change in peak frequency and duration of their songs depended on the habitat they live in. Our results suggest behavioural flexibility in territorial responses and birdsong in response to traffic noise, which appears to depend at least in part on prior experience with traffic noise.HighlightsGalápagos yellow warblers modified their behaviour in response to traffic noise.Behavioural plasticity depended on the island and distance to the nearest road.Birds living close to a road increased their aggression in response to an intruderBirds living farther away from a road decreased their aggression.
Landmark knowledge overrides optic flow in honeybee waggle dance distance estimation
Authors: Menzel Randolf , Galizia C. Giovanni 
Published: June 2024

AbstractHoneybees encode in their waggle dances the vector (distance and direction) of an outbound flight to a food source or a new nest side. Optic flow has been identified as the major source of information in the distance estimation. Additional components of distance estimation were also identified, e.g. the sequence of experienced landmarks. Here we address the question of whether bees also use the landscape memory developed during exploratory orientation flights to estimate distance. We took advantage of the fact that flights in a narrow tunnel lead to further distance measures due to higher optic flow. We find that this effect is lost when bees had explored the area in which the tunnel is located and when they have somewhat restricted visual access to the surrounding environment through the mesh on top of the tunnel. These data are interpreted in the context of other findings about the structure of navigational memory in bees that develops during exploratory orientation flights. In particular, the data suggest that bees embed distance measures into a representation of navigational space that stores previously experienced landscape features.Summary statementThe distance code in the honeybee waggle dance is embedded in the landscape memory that bees establish during their exploratory and their foraging flights.
Pro-oxidant influence of quercetin supplementation inSaccharomyces cerevisiae
Authors: Carrillo-Garmendia Andres , Vaca-Martinez Ana Leticia , Carmona-Moreno Blanca Lucia , González-Hernández Juan Carlos , Granados-Arvizu Jose Angel , Arvizu-Medrano Sofia Maria , Gracida Jorge , Nava Gerardo M. , Regalado-Gonzalez Carlos , Madrigal-Perez Luis Alberto 
Published: June 2024

AbstractHow could quercetin exert a pro-survival phenotype (antioxidant) in mammalian cells while toxic to other eukaryotic cells? The redox capacity of quercetin may explain its antioxidant and toxic effects, based on the idea that quercetin impairs the electron transport chain, affecting ATP production and forming quercetin-derived free radicals. Herein, we provide evidence that quercetin supplementation: 1) depolarizes the mitochondrial membrane and augments the ADP/ATP ratio; 2) increases superoxide anion cellular levels; 3) changes the cellular response to H2O2challenge associated with the antioxidant cellular response; 4) sensitizes the cellular response to lipoperoxidation challenge, and 5) augments cardiolipin levels. These events suggest that the quercetin pro-oxidant effect is related to mitochondrial respiration dysfunction and could induce cellular antioxidant response.