bluuebunny/crossref_metadata_2025_split huggingface dataset:
DISAPPEARING CHOROIDAL MASS: OPHTHALMIC MANIFESTATIONS OF A PRESUMED KIKUCHI–FUJIMOTO DISEASE
Authors: Rodríguez-Castro Selene , Fromow-Guerra Jans , Garza-González Salvador , Pinilla-Monroy Angela , Soberon Vidal 
Published: January 2024

Purpose:
To report our findings in a patient with presumed Kikuchi–Fujimoto disease.

Methods:
Report of clinical findings, fundus images, optical coherence tomography, and ultrasonography.

Results:
A 19-year-old female patient who presented with an unusual form of symptoms that fit a disease called Kikuchi–Fujimoto disease. A large choroidal mass was observed in the posterior pole; a month later, the mass was completely gone.

Conclusion:
Large choroidal masses can occur in patients with Kikuchi–Fujimoto disease, and these do not warrant treatment as they are self-limiting.
Kytococcus schroeteri
Authors: Pandey Ishwari , Pai Sumita , Purmessur Rushmi , Kappeler Ruth , Ali Jason M. 
Published: January 2024

AbstractKytococcus schroeteriis a gram-positive coccus naturally found as part of the normal skin flora. Infection caused by this organism is not common but seems to be limited to patients with implanted prostheses. To date, there have been only 22 reported cases ofK. schroetericausing disease, of which 9 are cases of prosthetic valve endocarditis. In this review, we report on 3 further cases ofK. schroeteriprosthetic valve endocarditis and review the previously reported cases. The common theme is one of delayed diagnosis, with the organism not initially identified, often after initially being misdiagnosed as aMicrococcusspecies. Prosthetic valve endocarditis caused byK. schroeteriis commonly associated with large vegetations leading to patients often requiring surgical intervention after embolic events or to prevent them. There is currently no guidance in relation to the antimicrobial treatment, but a combination of vancomycin with rifampicin and gentamicin for 6 weeks has been noted to be efficacious.
Are Nurse-Led Eczema Clinics Effective in Reducing the Severity of Atopic Dermatitis and Its Impact on Children and Families?
Authors: Gartland Tim , Kennedy Robyn , Leins Liz , Paea Danielle , King Emma 
Published: January 2024

BACKGROUND
Initiation and expansion of nurse-led eczema clinics at a large tertiary hospital in Melbourne has improved timely access to treatment and education for many children with eczema and their families.

OBJECTIVE
The aim of this study was to determine the effectiveness of nurse-led eczema clinics in treating eczema and reducing its impact on quality of life and also the level of parent or guardian satisfaction with the clinical experience.

METHODS
All families attending two weekly community-based nurse-led eczema clinics and two weekly hospital-based nurse-led eczema clinics were invited to take part in a survey-based evaluation. A parent or guardian completed surveys at initial and follow-up clinic visits, and eczema severity was assessed at both visits using SCORAD.

RESULTS
There were 342 participants. Eczema severity was reduced by 62% (18 points), and the quality-of-life impact scores fell by at least 50% for individuals and families. More than 90% of parents rated the clinician and overall clinic experience as “excellent” or “very good.”

CONCLUSION
The nurse-led eczema clinics were effective in reducing the severity of eczema and the negative impact of eczema on the individual and the family unit. The magnitude of this reduction was clinically and statistically significant. Participants' clinic experience was highly positive.
Dermoscopy for Nurse Practitioners
Authors: Bourne Kaylyn 
Published: January 2024

ABSTRACT
Dermoscopy refers to the examination of skin by use of a dermatoscope. These devices provide a practical, noninvasive, painless, and incredibly detailed view of the skin. When used in the hands of a trained clinician, dermoscopy significantly increases diagnostic accuracy. Although most known for its role in pigmented lesion assessment, dermoscopy use has expanded to include the evaluation of nonpigmented lesions, conditions of the hair (trichoscopy), infestations (entomodermatoscopy), nail disease (onychoscopy), and cutaneous inflammatory disease (inflammatoscopy). Studies suggest that dermoscopy is valuable as it increases sensitivity for skin cancer detection. This is especially important in the setting of melanoma as it accounts for most skin-cancer-related deaths. Overall, utilization enhances diagnosis, prompts treatment, reduces morbidity and mortality, and increases healthcare cost-effectiveness. This article is written with the intent to inform dermatology nurse practitioners about this innovation. It may additionally serve as a useful resource for other advanced care providers who perform cutaneous assessment. Examples of such clinicians may include, but are not limited to, urgent care providers, pediatricians, dentists, podiatrists, and primary care providers.
Evaluation of the efficacy of using dental pulp graft in the healing of the alveolar bone after impacted canine extraction: a prospective cohort study
Authors: Aljarmakani Omar , Assad Mounzer 
Published: January 2024

Summary:
The purpose of this study was to evaluate the radiographic density of the alveolar bone of the maxilla after extraction of the impacted canines and using the pulp tissue as an autogenous graft.

Materials and methods:
This prospective cohort study recruited 14 patients (8 females and 6 males) between 2021 and 2023, with an average age of 35 years. All participants had palatally impacted maxillary canines. The impacted teeth were extracted surgically. The extracted teeth were then used for autogenous grafting. The pulp tissue was removed, cut into small pieces, and placed on an absorbable gelatin sponge before being inserted into the extraction socket. The wound was subsequently closed meticulously. After 4 months, the bone density was assessed radiographically using the Hounsfield Scale on cone beam computed tomography scans.

Results:
After 4 months, the mean radiographic bone density value in the extraction area was (652.77 ± 56.13 HU), while the average density of the original bone was (659.7 ± 39.6 HU).

Conclusions:
Within the limits of this study, dental pulp tissue can be used to restore bony defects of the alveolar bone in the maxilla. However, further research is needed to confirm these findings.
Research and Practice in Quality Improvement and Implementation Science
Authors: Dolansky Mary A. , Horvat Davey Christine , Moore Shirley M. 
Published: January 2024

Background:
Nurses play an essential role in the achievement of quality depicted by the Quintuple Aim to improve clinical outcomes, patient experience, equity, provider well-being, and reduction of costs. When quality gaps occur, practice change is required and is facilitated by quality improvement (QI) and implementation science (IS) methods. QI and IS research are required to advance our understanding of the mechanisms that explain how evidence is implemented and improvements are made.

Problem:
Despite past efforts of the evidence-based practice and QI movements, challenges persist in sustaining practice improvements and translating research findings to direct patient care.

Approach:
The purpose of this article is to describe the Synergy for Change Model that proposes that both QI and IS research and practice be used to accelerate improvements in health care quality.

Conclusions:
Recognizing the synergy of QI and IS practice and research will accelerate nursing's contributions to high-quality and safe care.
The LIMB-Q: Reliability and Validity of a Novel Patient-Reported Outcome Measure for Patients with Lower Extremity Trauma
Authors: Mundy Lily R. , Klassen Anne F. , Pusic Andrea L. , deJong Tim , Hollenbeck Scott T. , Gage Mark J. ,   LIMB-Q Development Team
Published: January 2024

Background:
The LIMB-Q is a novel patient-reported outcome measure for patients with lower extremity trauma. The aim of this study was to perform a psychometric validation of the LIMB-Q based on the Rasch measurement theory.

Methods:
An international, multisite convenience sample of patients with lower extremity traumatic injuries distal to the midfemur was recruited from clinical sites in the United States and the Netherlands and online platforms (in English; Trauma Survivors Network patient support group and the Prolific academic research platform). A cross-sectional survey of the LIMB-Q was conducted with test–retest reliability analysis performed 1 to 2 weeks after initial completion in a subgroup of patients.

Results:
The LIMB-Q was field-tested in 713 patients. The mean age was 41 years (SD, 17 years; range, 18 to 85 years), the mean time from injury was 7 years (SD, 9 years; range, 0 to 58 years), and there were various injury and treatment characteristics (39% fracture surgery only, 38% flap or graft, 13% amputation, 10% amputation and flap or graft). Out of 382 items tested, 164 were retained across 16 scales. Reliability was demonstrated with person separation index values of 0.80 or greater in 14 scales (0.78 to 0.79 in the remaining 2 scales), Cronbach alpha values 0.83 or greater, and intraclass correlation coefficient values 0.70 or greater. Each scale was unidimensional, measurement invariance was confirmed across clinical and demographic factors, test–retest analysis showed adequate reliability, and construct validity was demonstrated.

Conclusion:
The LIMB-Q is a patient-reported outcome measure with 16 independently functioning scales (6 to 15 items per scale) developed and validated specifically for patients with lower extremity trauma with fractures, reconstruction, or amputation.
Objective Assessment of the Repeated Botox Treatment to the Synkinesis of Facial Paralysis by the Integrated Electromyography
Authors: Homma Tsutomu , Uemura Noriko , Tanaka Kentaro , Mori Hiroki , Okazaki Mutsumi 
Published: January 2024

Background:
The widely used botox type A (BTX-A) is effective against synkinesis in facial palsy sequelae. Repeated injections are necessary and permanent improvements have been reported. We objectively evaluated the changes in synkinesis at >6 months after BTX-A injection, including changes over time with the number of administrations.

Methods:
In 48 patients who received multiple BTX-A injections, evaluation by the Sunnybrook Facial Grading System (FGS) and integrated electromyography (iEMG) was performed before treatment and at least 6 months after the first, second, and third BTX-A injection. The iEMG ratio on the affected and healthy sides was calculated for each mimetic muscle and mimic motion.

Results:
There was no significant difference in the FGS synkinesis score before treatment and after the third injection, although an improvement was observed. The iEMG ratio was significantly improved in the orbicularis oculi with open-mouth smile and lip pucker after the third dose compared to before treatment. The orbicularis oris showed a significant improvement when the eyelids were closed, while the platysma showed a significant improvement when the eyelids were closed and when the lip was pursed. Multiple regression analysis revealed that the orbicularis oculi and platysma had a greater effect on the iEMG ratio for the number of treatments than other factors.

Conclusions:
Repeated BTX-A injections showed improvements in synkinesis for the orbicularis oculi, orbicularis oris, and platysma, even after >6 months, compared to before treatment.
Analysis of Sexual Dimorphic Features of the Jawline and Chin in White Celebrity Faces
Authors: Salinas Cristina A. , Liu Alice , Sharaf Basel A. 
Published: January 2024

Background:
The jawline greatly influences facial shape and contributes to facial dimorphism. Analysis of lower facial shape and sexual dimorphic differences in contemporary attractive white faces can advance the goals of lower facial aesthetics and facial gender–affirming surgery (FGAS).

Methods:
Full-face, front-view photos of 47 white female and 21 white male celebrities were included from a list generated using GQ magazine’s Highest Paid Models issue, People Magazine’s Beautiful issue (1991–2022), and celebrities featured on lifestyle websites. Facial landmarks were detected through a facial analysis program using Vision framework and MATLAB. After converting pixel distances to absolute distances, lower face measurements were compared between males and females.

Results:
The mean lower facial height was 6.08 cm in females and 7.00 cm in males (P value<0.001). The mean bigonial width was 11.21 cm in females and 12.30 cm in males (P value<0.001). The ratio of facial height to lower facial height was 2.98 in females and 2.76 in males (P value<0.001), signifying that symmetry in facial thirds is more prevalent in attractive female faces, while a longer lower face is more common in attractive male faces. The greatest differences in female and male facial contours were at gonial angles and chin.

Conclusions:
Analysis of contemporary white celebrity faces demonstrated significantly wider and longer lower facial measurements in males. The overall contour of the female lower face was more tapered at the gonial angles and chin compared to males. These results are important when planning lower facial rejuvenation or FGAS, as lower face size and proportions influence perceived gender and attractiveness.
Complete Extensive Heterotopic Ossification of the Entire Free Fibula Flap Vascular Pedicle in Maxillary Reconstruction
Authors: Abou Ghanem Odette , O’Sick Nicholas Robert , Kalmar Christopher L. , Golinko Michael 
Published: January 2024

Introduction:
Heterotopic ossification is a pathologic extra-skeletal bone formation as a form of aberrant repair process with acquired or genetic etiologies. In plastic surgery, it has been well-described in the burn and trauma patients. Rarely, it can happen along the vascular pedicle of free tissue transfer, and when it happens, it is most commonly in head and neck reconstruction.

Case Presentation:
Here we present a case of complete extensive heterotopic ossification of the entire vascular pedicle from the anastomosis to the bone in an osteocutaneous free fibula flap (FFF). The fibula was used as a 2-segment reconstruction for a maxillary defect resulting from a self-inflicted gunshot wound. The skin paddle was used to reconstruct the anterior palatal defect.

Discussion:
Heterotopic ossification of the FFF vascular pedicle is most reported in the head and neck reconstruction cases. It is rare, but when it happens, it occurs earlier, more commonly, and more extensively in cases of maxillary reconstruction than in cases of mandibular reconstruction. Flap loss due to this sequela has not been reported, and surgical debridement is indicated only when symptomatic.

Conclusion:
Heterotopic ossification of an FFF vascular pedicle is a rare but well-described entity. The periosteal bone formation capacity preservation after revascularization of the flap is thought to be one of the major etiologies of this phenomenon. Hence, some have suggested a modification in the harvesting technique of the FFF that could mitigate return to the operating room, especially when it is for maxillary reconstruction in the trauma patient. Keywords: Keywords: free fibula flap, heterotopic ossification, maxillary reconstruction, mandibular reconstruction.
Factors Associated With Complications and Failure in Transoral, Mandible Fracture Repair
Authors: Cohn Jason E. , Othman Sammy , Zaransky Sydney , Zwillenberg Seth 
Published: January 2024

Objective:
Open reduction internal fixation (ORIF) of the mandible has been a well-studied topic. However, there has not been a study investigating the relationship between suture type and complications.

Methods:
A retrospective chart review of patients who sustained mandibular fractures was conducted at an urban level I trauma center (2010–2018). Descriptive statistics were used to categorize the sociodemographic data. χ2 and Mann-Whitney U testing were used to compare variables between the polyglactin 910 (vicryl) and chromic sutured groups.

Results:
The study cohort consisted of 102 patients who underwent ORIF of the mandible through the transoral approach. Fifty-nine (57.8%) patients were closed with vicryl suture, whereas 43 (42.2%) with chromic gut suture. There were no differences in sociodemographics, immune status, substance abuse status, fracture type, time to repair, and managing care team between the two groups. Both groups had similar rates of wound dehiscence, infection, and revision surgery. Patients who were operated on earlier were more likely to experience a postoperative infection and dehiscence compared with patients operated on later (P = 0.029 and P = 0.008, respectively). Smokers were more likely to experience dehiscence compared with nonsmokers (P = 0.001). Females and immunocompromised patients were more likely to require revision surgery (P < 0.001).

Conclusion:
Suture type for transoral, ORIF of the mandible does not impact the rate of infection, wound dehiscence, and revision surgery. However, risk factors for complications can include early operative repair, smoking, female sex, and immunosuppression.
Pancreatic Serous Cystadenoma
Authors: Assawasirisin Charnwit , Qadan Motaz , Aimprasittichai Satita , Kambadakone Avinash , Servin-Rojas Maximiliano , Warshaw Andrew L. , Lillemoe Keith D. , Fernández-del Castillo Carlos 
Published: January 2024

Objective:
To understand the natural history of serous cystadenoma (SCA), and the diagnostic accuracy of SCA and identify possible factors that lead to the correct diagnosis.

Background:
SCA is a benign cystic pancreatic neoplasm of the pancreas, accounting for ~15% of resected pancreatic cysts. Current recommendations are to proceed with surgical resection in symptomatic patients or when there is uncertainty regarding diagnosis. The latter continues to be a challenge since intentional resection of an SCA accounts for only a minority of resected cases.

Methods:
Retrospective single-institution review of patients who on final pathology had a diagnosis of pancreatic SCA and of patients who had this diagnosis and were managed nonoperatively. Demographic data, cyst characteristics, and growth rate were collected for analysis.

Results:
A total of 250 patients were analyzed. Median age was 62 (range: 22–89), 65% were females, and 34% had symptoms. Tumor size ranged from 0.6 to 20, with a median of 3.4 cm. The morphologic appearance was microcystic in 58%, macrocystic in 16%, mixed-type in 23%, and solid in 3%. Pancreatic duct dilation and pancreatic atrophy were found in 22% and 14%, respectively. The average growth rate was 1.8 mm/year regardless of tumor size. Of the 172 patients who underwent surgery, SCA was the preoperative diagnosis in only 33%. A correct diagnosis was independently associated with large tumors and cyst fluid carcinoembryonic antigen analysis. Pancreatic duct dilation was independently associated with an in-growing cyst and the presence of calcification.

Conclusions:
SCA is a slow-growing pancreatic cystic neoplasm that is mostly asymptomatic but can lead to pancreatic duct dilation and atrophy in some patients. A surprisingly small number of correct preoperative diagnoses confirms that this entity continues to be a diagnostic challenge. A more thorough preoperative workup that includes endoscopic ultrasonography should improve the rate of misdiagnosis.
Use of Preoperative Endoscopic Capsule-Based pH Testing Before Bariatric Surgery
Authors: Scott John , Blackhurst Dawn , Hodgens Brian D , Carbonell Alfredo M , Cobb William S , Richardson Emily S , Dahlgren Nicholas JP , Kothari Shanu N 
Published: January 2024

BACKGROUND:
Vertical sleeve gastrectomy is the most performed bariatric operation in the US; however, a significant number of patients suffer from persistent or new-onset reflux. No consensus for objective preoperative evaluation in these patients exists. We compared capsule-based pH testing vs GERD symptom scoring to determine extent of preoperative GERD to aid in procedure selection for bariatric surgery.

STUDY DESIGN:
An IRB-approved retrospective review of consecutive patients at a single institution was performed from April 2021 to December 2022. During initial consultation for bariatric surgery, a validated GERD symptom subjective survey was administered. All patients demonstrating interest in sleeve gastrectomy or had a history of reflux underwent upper endoscopy with capsule-based pH testing.

RESULTS:
Sixty-two patients underwent preoperative endoscopy with capsule-based pH testing and completed GERD symptom assessment survey(s). Median BMI was 43.4 kg/m2 and 66.1% of patients were not taking a proton-pump inhibitor before performance of pH testing. There was negligible linear association between the objective DeMeester score obtained by capsule-based pH probe and GERD symptom survey scores. Median GERD symptom survey scores did not differ between patients with and without a diagnosis of GERD based on pH testing (all p values >0.11).

CONCLUSIONS:
An objective method for identifying severe GERD in the preoperative assessment may aid in the decision tree for procedure selection and informed consent process. Patients with significant preoperative GERD may be at higher risk for future GERD-related sleeve complications. Capsule-based pH testing may prove to be superior to subjective symptom scoring systems in this patient population.
Increasing Injury Intensity among 6,500 Violent Deaths in the State of Maryland
Authors: Sakran Joseph V , Lunardi Nicole , Mehta Ambar , Ezzeddine Hiba M , Chammas Majid , Fransman Ryan , Byrne James P , Stevens Kent , Efron David 
Published: January 2024

BACKGROUND:
Anecdotal evidence strongly suggests there has been a rise in violent crimes. This study sought to examine trends in injury characteristics of homicide victims in Maryland. We hypothesized that there would be an increase in the severity of wound characteristics.

STUDY DESIGN:
The Office of the Chief Medical Examiner is a statewide agency designated by law to investigate all homicides, suicides, or unusual or suspicious circumstances. Using individual autopsy reports, we collected data among all homicides from 2005 to 2017, categorizing them into 3 time periods: 2005 to 2008 (early), 2009 to 2013 (mid), and 2014 to 2017 (late). Primary outcomes included the number of gunshots, stabs, and fractures from assaults. High-violence intensity outcomes included victims having 10 or more gunshots, 5 or more stabs, or 5 or more fractures from assaults.

RESULTS:
Of 6,500 homicides (annual range 403 to 589), the majority were from firearms (75%), followed by stabbings (14%) and blunt assaults (10%). Most homicide victims died in the hospital (60%). The average number of gunshots per victim was 3.9 (range 1 to 54), stabs per victim was 9.4 (range 1 to 563), and fractures from assaults per victim was 3.7 (range 0 to 31). The proportion of firearm victims with at least 10 gunshots nearly doubled from 5.7% in the early period to 10% (p < 0.01) in the late period. Similarly, the proportion with 5 or more stabbings increased from 39% to 50% (p = 0.02) and assault homicides with 5 or more fractures increased from 24% to 38% (p < 0.01).

CONCLUSIONS:
In Maryland, the intensity of violence increased across all major mechanisms of homicide. Further follow-up studies are needed to elucidate the root causes underlying this escalating trend.