bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationships Among Physical Activity, Daylight Exposure, and Rest-Activity Circadian Rhythm in Patients With Esophageal and Gastric Cancer
Authors: Chen Hui-Mei , Lee Mei-Chen , Tian Jiu-Yun , Dai Mei-Fen , Wu Yu-Chung , Huang Chien-Sheng , Hsu Po-Kuei , Duong Linh Thuy 
Published: February 2023

Background
Although rest-activity circadian rhythm (RACR) disruption is associated with mortality in patients with cancer, few studies have examined the effect of RACR on patients with esophageal and gastric cancer.

Objective
The aim of this study was to identify the predictors of RACR.

Methods
This cross-sectional, single-site study included 276 patients with esophageal and gastric cancer recruited from chest-surgery and general-surgery outpatient departments. Actigraphy was used to assess objective physical activity (PA), daylight exposure, and RACR, and 3-day PA was used to indicate the subjective amount of PA. The parameter of objective PA was the up activity mean; the parameter of daylight exposure was >500 lx, and the parameters of RACR were the 24-hour correlation coefficient, in-bed less than out-of-bed dichotomy index, midline estimating statistic of rhythm, and amplitude. The subjective amount of PA was calculated as the sum of mild, moderate, and vigorous PA.

Results
The up activity mean predicted 24-hour correlation coefficient. The PA amount and up activity mean predicted in-bed less than out-of-bed dichotomy index. The up activity mean and >500-lx daylight exposure predicted midline estimating statistic of rhythm. Finally, the PA amount and up activity mean predicted the amplitude.

Conclusions
Increased PA and daylight exposure may improve RACR.

Implications for Practice
Patients with esophageal and gastric cancer should be encouraged to engage in outdoor PA during the daytime as part of their regular lifestyle to maintain a robust circadian rhythm.
Creating a Peer Review Process for Faculty-Developed Next Generation NCLEX Items
Authors: Hensel Desirée , Billings Diane M. 
Published: February 2023

Background:This article reports the findings from a pilot study of a peer review process used with a group of faculty champions who were writing items for a state-wide initiative to establish a Next Generation NCLEX item teaching test bank.Methods:Champions were oriented to the peer review process in a face-to-face session and completed reviews using theClinical Judgment Item Peer Review Formcreated for the project.Results:Eighteen faculty from 13 different schools attended the session and completed 55 reviews of 40 cases and 35 stand-alone items. Champions took approximately an hour to complete each case study and related stand-alone item review and give actionable feedback.Conclusions:The peer review process benefits reviewers and authors learning to write Next Generation NCLEX questions. The process used in this project can be replicated by other faculty in their own programs.
Added Value of Extragenital Sexually Transmitted Infection Testing in “IWantTheKit” Program Users
Authors: Yu Tong , Melendez Johan H. , Armington Gretchen S. , Silver Barbara , Gaydos Charlotte A. , Ruby Kenneth , Olthoff Glen , Greenbaum Adena , Hamill Matthew M. , Manabe Yukari C. 
Published: February 2023

Background
The 2021 Centers for Disease Control and Prevention sexually transmitted infection treatment guidelines recommend extragenital testing for gonorrhea and chlamydia in men who have sex with men and for women based on reported behaviors and exposures. The “IWantTheKit (IWTK)” program is a free online platform for specimen self-collection and mail-in for combined chlamydia/gonorrhea testing. We sought to assess the additional diagnostic value of extragenital testing compared with genital testing only for chlamydia/gonorrhea and determine factors associated with a positive extragenital test result among IWTK users.

Methods
From August 2013 to January 2022, 7612 unique IWTK users returned swabs for testing; 3407 (45%) users requested both genital and extragenital tests and were included in this analysis. Descriptive statistics were summarized for demographic characteristics, reported behaviors, and genital and extragenital test results, and data were stratified by gender and age group. A logistic regression model was used to estimate associations between factors and extragenital sexually transmitted infection positivity.

Results
Chlamydia positivity rates were 4.7%, 2.4%, and 1.5% at genital, extragenital, and both sites, respectively; for gonorrhea, 0.4%, 1.1%, and 0.4% were positive at those sites, respectively. Among women, age 25 years and younger was significantly associated with extragenital chlamydia (odds ratio [OR], 4.0; P = 0.010). Being in high-risk quiz score group was associated with extragenital chlamydia (OR, 2.6; P = 0.005) and extragenital gonorrhea in men and women (OR, 8.5; P = 0.005).

Conclusions
Extragenital testing detected additional chlamydia and gonorrhea cases in the IWTK user population that would have been missed by genital-only testing, especially for women younger than 25 years and people reported to be at high risk.
Monkeypox Infection with primarily mucosal involvement
Authors: Pestana Mafalda , Caldeira Margarida Brito , Martins Inês Aparício , Valente Clara , Neves José M. , Fernandes Cândida 
Published: February 2023

ABSTRACT
Since May 2022, several non-endemic countries face a monkeypox outbreak, with clinic and epidemiological characteristics distinct from the classic ones. Primarily affecting the sexually active population, these cases present with mucocutaneous lesions mainly localized in perioral, genital, and anal areas. A retrospective study was conducted in a tertiary center in Lisbon, to characterize the population diagnosed with monkeypox infection with primarily mucosal involvement.
Defining Daily Disposable Contact Lens Wear in a Clinical Study
Authors: Wagner Heidi , Zimmerman Aaron B. , Lam Dawn , Kinoshita Beth , Rosner Bernard , Mitchell G. Lynn , Richdale Kathryn 
Published: February 2023

ABSTRACTSignificanceThe United States Food and Drug Administration regulates contact lenses as prescription medical devices and defines daily disposable lenses for single use; however, safety comparisons between daily disposable and reusable lenses rely on the lens-wearing regimen. When inappropriately discerned, studies may erroneously report replacement regimen, resulting in inaccurate risk rates.PurposeTo explore different measures for defining daily disposable wearers in the context of a clinical study.MethodsA secondary analysis of data from five multi-site fieldings (n = 1,059) from the Contact Lens Risk Survey was performed. Descriptive statistics were used to examine self-reported lens replacement, use of lens case, and manufacturer’s recommended replacement frequency as defined by the participants’ selection of their habitual lenses using a photographic aide. Daily disposable wearers were identified as reporting daily replacement (by self-report and lens identification) and not using a lens case. If there was a discrepancy among these three factors, the lens assignment was assessed as a majority response (2 of 3) or as missing if conflicting information was reported.ResultsThe cohort was approximately two-thirds (68.7%) female and ranged from 12-33 years of age. A total of 154 participants (14.5%) were classified as daily disposable wearers and 896 (84.6%) as reusable wearers. Congruence was observed among all three daily disposable assignment factors for only 106 (68.8%) wearers. The greatest discrepancy among daily disposable wearers was the report of using a lens case (n = 32; 20.8%). In contrast, reusable lens wearers were more likely to report agreement across all three factors (n = 798; 89.1%, P < .001).ConclusionsThis analysis suggests that the report of not using a lens case is a more conservative surrogate for true single-use lens wear, as one in five may be storing and reusing their daily disposable lenses.
Training Characteristics, Academic Accomplishments, and Motivation of Current Program Directors in Physical Medicine and Rehabilitation
Authors: Martinez Claudia I. , Sanchez Ashley N. , Frontera Joel , Lee Michael Y. , Escalon Miguel X. , Verduzco-Gutierrez Monica 
Published: February 2023

Abstract
This study aimed to report the training characteristics, academic accomplishments, and motivation of current US academic physical medicine and rehabilitation program directors.
A 22-question survey was developed and disseminated via email in May 2020 to 91 current residency program directors who are members of the Association of Academic Physiatrists Residency Fellowship Program Director Committee. Follow-up emails were sent 2 and 4 wks after initial distribution, and the survey was closed after 6 wks in June 2020. Data collected were deidentified. Descriptive analysis was performed.
Response rate was 49.5% (45/91); 64.4% of program directors were men, and 35.6% were women. Of the respondents, 75.4% were White/Caucasian, 6.7% were Hispanic/Latinx, 15.6% were Asian, and 2.2% were Black/African American. Moreover, 56% (9/16) of female program directors vs. 0% (0/29) of male program directors reported experiencing sex discrimination in the workplace.
Four percent of program directors were full professors in physical medicine and rehabilitation when first appointed, 17% were associate professors, and 72% were assistant professors. Thirty-four percent of program directors had at least six peer-reviewed publications when first appointed.
This survey provides insight to the training characteristics, accomplishments, and motivation of current program directors for physiatrists aspiring to enter these ranks and highlights the underrepresentation of women/minorities among leadership positions in physical medicine and rehabilitation.
Superiorly-Based Short-Scar Mastopexy Augmentation: A 10-Year Review of 1217 Consecutive Cases
Authors: Wall Simeon , Claiborne Jeffrey R , Wall Holly Casey 
Published: February 2023

Goals/Purpose:
Mastopexy augmentation is a challenging procedure, and a technique to create desirable, consistent, predictable results with a low rate of problems has not been well standardized. The inherent difficulty lies in competing surgical maneuvers. This study sought to evaluate our experience and describe the key concepts and steps that allow safe, efficient, predictable results with a low complication and long-term reoperative rate.

Methods/Technique:
A 10-year retrospective review of all aesthetic breast surgeries between 2005 and 2015 was performed. Two senior surgeons performed 1217 one-stage, superiorly-based, short-scar mastopexy augmentation procedures. The data was evaluated in the context of other published series in the literature.

Results/Complications:
The overall revision rate was 4.8%. Patients who had undergone prior breast surgery were statistically more likely to require a revision compared with patients who had virgin breast tissue (10.4% vs 3.8%, p = 0.0005). Average follow-up was 39 months. 28% of revisions were performed more than two years after the original surgery, 16% were performed more than 6 years later. All revisions were included, regardless of procedure scope or timing. Of the 58 revision cases, 86% were purely implant or implant-pocket related, 7% were purely tissue related. There was one case of partial nipple necrosis. There were no cases of emergent reoperation, implant loss, implant exposure or major wound dehiscence.

Conclusions:
Our approach has been refined to maximize aesthetics, longevity, consistency, and surgical efficiency, and to minimize complications. This study demonstrates that safe and predictable results can be attained in one stage with low complication and reoperative rates.
Targeting the glycolytic enzyme PGK1 to inhibit the Warburg effect: a new strategy for keloid therapy
Authors: Wang Pu , Wang Qifei , Yang Xin , An Yang , Wang Jingyi , Nie Fangfei , Pan Bailin , Bi Hongsen , Qin Zelian 
Published: February 2023

Background:
Aerobic glycolysis (the Warburg effect) may play an important role in keloid pathogenesis, which may be aggravated by the hypoxic microenvironment in keloids. Phosphoglycerate kinase 1 (PGK1), a key glycolytic enzyme, is essential for cellular aerobic glycolysis, but its role in keloid formation remains unknown. This study aimed to detect PGK1 expression in keloid tissue and investigate the effects of inhibiting PGK1 expression on keloid fibroblasts (KFbs) under hypoxia and normoxia.

Methods:
Normal skin and keloid samples were separated into two parts, one was used for immunohistochemistry, and one for primary cell culture. PGK1 tissue expression was detected by immunohistochemistry. RT-PCR and Western blotting were used to detect PGK1, GLUT1, LDHA, and COL1 expression, and glucose uptake and lactate production were detected with a microplate reader. Cell proliferation and apoptosis were investigated with IncuCyte and flow cytometry. Cell migration and invasion were detected with Transwell assays. Glycolytic function was explored with the Seahorse XF96 system.

Results:
Immunohistochemistry showed PGK1 overexpression in keloid tissue compared with normal skin tissue (p<0.05). Consistently, PGK1 expression was significantly higher in KFbs than in normal skin fibroblasts (NFbs), and hypoxia stimulated PGK1 expression in KFbs and NFbs (p<0.05). PGK1 knockdown significantly inhibited KFbs glycolysis, proliferation, migration, invasion, glucose consumption, and lactate production (p<0.05). Furthermore, GLUT1, LDHA, and COL1 expression was decreased in KFbs compared to NFbs (p<0.05). Additionally, suppressing PGK1 may mediate the PI3K/AKT pathway to downregulate GLUT1, LDHA, and COL1 expression (p<0.05).

Conclusions:
These findings provide new evidence that suppressing PGK1, inhibiting glycolysis, reduces KFbs proliferation, migration, invasion, and type I collagen expression. Targeting PGK1 to inhibit the Warburg effect may be a new therapeutic strategy for keloids.
Alternate Soft Tissue Free Flaps for Head and Neck Reconstruction: The Next Generation of Workhorse Flaps
Authors: Chang Edward I. 
Published: February 2023

Introduction:
There is little debate regarding the workhorse flaps for soft tissue defects in head and neck reconstruction. However, in certain circumstances the workhorse flaps are not available or suitable, and an alternate flap is needed.

Methods:
Retrospective review of single surgeon experience with alternate soft tissue flaps performed over a 10-year period.

Results:
Overall, 156 alternate soft tissue free flaps were performed in 155 patients. The distribution of free flaps was 60 ulnar artery perforator (UAP) flaps, 28 lateral arm perforator (LAP) flaps, 33 medial sural artery perforator flaps (MSAP), and 35 profunda artery perforator (PAP) flaps with one patient who received two PAP flaps. Defects included glossectomy, facial defects following parotidectomy or resection of cutaneous malignancies, and other intraoral defects. Eleven patients suffered donor site complications: two UAP patients with partial skin graft loss, two patients with delayed wound healing in the MSAP donor site and one developed compartment syndrome with primary closure of the MSAP donor site, one patient with a radial nerve palsy following a LAP flap, and six patients with delayed wound healing in the PAP donor site which healed secondarily with conservative management. There was one total flap loss of a LAP and MSAP flap.

Conclusions:
The reconstructive microsurgeon performing high volume head and neck reconstruction may need to incorporate alternate donor sites into their armamentarium in the setting the primary workhorse flaps are not suitable or available.
SUPERIORITY OF THE SEPTAL EXTENSION GRAFT OVER THE COLUMELLAR STRUT GRAFT IN PRIMARY RHINOPLASTY: EVIDENCE FOR IMPROVED LONG-TERM TIP STABILITY
Authors: Bellamy Justin L. , Rohrich Rod J. 
Published: February 2023

PURPOSE:
Columellar strut grafts and septal extension grafts are commonly used support structures, however their relative effectiveness remains debated. The purpose of this study was to compare the long-term stability of septal extension grafts to columellar strut grafts.

METHODS:
Retrospective review of all primary rhinoplasties performed by the senior author from 2016-2019 was performed. All adult patients undergoing primary open rhinoplasty with at least year follow-up were included. Revisionary cases and those utilizing rib graft were excluded. Standardized post-operative imaging was assessed at 2-months (early) and 12-month (long-term) to measure projection/rotation change over time. Univariate and multivariable statistical comparisons were performed.

RESULTS:
Chart query yielded 133 patients. Of these, 40 patients were treated with a columellar strut and 37 with a septal extension graft. Projection loss at one-year was 4.7% for the Columellar Strut group compared to 0.2% for the Septal Extension Graft group (p<0.0001). On multivariable logistic regression, there was a 5.1-fold increased risk of >4% projection loss when using columellar strut (p<0.005).
Mean rotation loss for the columellar strut group was 4.9 degrees compared to 1.3 degrees for the septal extension graft group (p<0.0001). The independent effect of columellar strut use resulted in a 2.8-fold increased risk of rotation loss ≥5 degrees (p<0.05).

CONCLUSION:
Septal extension grafts result in effectively no loss of projection and minimal loss in rotation. A small degree of projection and rotation loss can be expected with the use of columellar strut alone. These long-term graft tendencies should be anticipated and accounted for appropriately.
Tracking Complications and Unplanned Healthcare Utilization in Aesthetic Surgery: A Nationwide Analysis of 214,504 Patients using the TOPS Database
Authors: Sergesketter Amanda R. , Shammas Ronnie L. , Geng Yisong , Levinson Howard , Matros Evan , Phillips Brett T. 
Published: February 2023

BACKGROUND:
Tracking surgical complications and unplanned healthcare utilization is essential to inform quality initiatives in aesthetic surgery. This study utilized the Tracking Operations and Outcomes for Plastic Surgeons (TOPS) database to characterize rates and predictors of surgical complications and unplanned healthcare utilization across common aesthetic surgery procedures.

METHODS:
The TOPS database was queried for all patients undergoing breast augmentation, liposuction, blepharoplasty, rhinoplasty, and abdominoplasty from 2008-2019. Incidence and risk factors for complications and unplanned readmission, reoperation, and emergency room visits were determined.

RESULTS:
A total of 214,504 patients were identified. Overall, 94,618 breast augmentations, 56,756 liposuction procedures, 29,797 blepharoplasties, 24,946 abdominoplasties, and 8,387 rhinoplasties were included. A low incidence of peri-operative complications was found, including seroma (1.1%), hematoma (0.7%), superficial wound complication (0.9%), deep surgical site infection (0.2%), need for need for blood transfusion (0.05%), and DVT/PE (0.1%). Incidence of unplanned readmission, emergency room visits, and reoperation were 0.34%, 0.25%, and 0.80%, respectively. Patients who underwent an abdominoplasty more commonly presented to the emergency room and had unplanned readmissions or reoperations compared to other studied procedures. Furthermore, an increased age, diabetes, higher BMI, ASA class, longer operative times, and pursuit of combined aesthetic procedures were associated with increased risk for unplanned healthcare utilization.

CONCLUSIONS:
There is a low incidence of perioperative complications and unplanned healthcare utilization following common aesthetic surgery procedures. Continued entry into large national databases in aesthetic surgery is essential for internal benchmarking and quality improvement.
Branding a Plastic Surgery Group Practice: A Case Study
Authors: Bank Jonathan , Feingold Randall S. , Korn Peter , Light David , Israeli Ron 
Published: February 2023

Background:
You only get one opportunity to make a first impression. In today’s era, that first impression is frequently a digital one. Our old digital brand “face” was stale and not a true representation of how we view ourselves as a practice. In an evolving arena of competition and surgical scope, we felt compelled to engage in rebranding our practice.

Methods:
This article details the steps we took to launch a new website, generate collateral branded material, and execute a social media marketing plan. We attempt to keep the outline general enough to be applicable to the range of practice types of the journal’s readership, and present relevant results of the process.

Results:
Sample of “creative” products are shown. Quantifiable outcomes were direct website traffic (91% increase), website sessions (82% increase), unique users (55% increase), page views (118% increase), time spent browsing (100% increase). We experienced a 21% increase in new patient volume and a similar increase in total cases performed.

Conclusions:
This article outlines steps we took to rebrand our practice, in the face of current challenges in the plastic surgery landscape and how prospective patients seek surgeons. Benchmarking the steps of a successful branding process is crucial and informative to developing and executing a plan. While there are many potential contributors to the growth of a practice, the impact of our branding appears to be a significant factor.
“Reconstruction of Forequarter and Extended Forequarter Amputations: Indications and Outcomes.”
Authors: Roubaud Margaret S. , Mericli Alexander F. , Adelman David M. , Hanasono Matthew M. , Lewis Valerae O. , Moon Bryan S. 
Published: February 2023

BACKGROUND:
Forequarter amputations (FQAs) and extended forequarter amputations (EFQAs) are rare procedures with high morbidity that often require significant soft tissue and/or bony reconstruction. We describe the largest series of oncologic FQAs and EFQAs to date with associated reconstructive and oncologic outcomes.

METHODS:
We retrospectively reviewed data from all patients who underwent FQA or EFQA at The University of Texas MD Anderson Cancer Center from January 1, 2008, to January 1, 2019. Surgical outcomes, survival, and local recurrence rates were summarized and compared.

RESULTS:
Forty-seven patients met the inclusion criteria, including 14 with EFQAs. Most patients (53%) were male; the median age was 58 years (range, 2-74). The most common tumor type was sarcoma (79%) and most common presentation was recurrent (34%). Nineteen patients (40%) had distant metastases. The median defect size was 351 cm 2; flap reconstruction was required in 30 patients (64%). Eight patients (17%) experienced immediate complications and 12 (26%) experienced delayed complications. The median overall survival (OS) time was 21 months, and the 5-year OS rate was 28.1%. OS and disease-free survival (DFS) were superior in the EFQA group (69.8% vs 11.6%, p=0.017; 58.9% vs 9.8%, p=0.014, respectively). However, metastases at presentation was the most important predictor of survival on multivariate analysis (OR= 3.98, p=0.004).

CONCLUSIONS:
EFQA patients had better OS and DFS than FQA patients, owing to a lower incidence of metastatic disease. This study suggests a benefit to more aggressive resection and reconstruction when disease is locally confined.