bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Detection of Cancers in the Era of Precision Oncology
Authors: Tan Wan Ying , Sharma Anup , Das Paromita , Ahuja Nita 
Published: February 2023

Purpose of review
The increasing global incidence of cancer demands innovative cancer detection modalities. The current population-based early cancer detection approaches focus on several major types of cancers (breast, prostate, cervical, lung and colon) at their early stages, however, they generally do not target high-risk individuals at precancerous stages.

Recent findings
Some cancers, such as pancreatic cancer, are challenging to detect in their early stages. Therefore, there is a pressing need for improved, accessible, noninvasive, and cost-effective early detection methods. Harnessing cell-free-based biomarker-driven strategies paves a new era of precision diagnosis for multicancer early detection. The majority of these tests are in the early stages and expensive, but these approaches are expected to become cost sensitive in the near future.

Summary
This review provides an overview of early cancer detection strategies, highlighting the methods, challenges, and issues to be addressed to revolutionize and improve global early cancer detection.
Thoracic epidural analgesia vs. patient-controlled intravenous analgesia for patients undergoing open or laparoscopic colorectal cancer surgery
Authors: Cox P. Boris W. , Pisters Tom P.R.M. , de Korte-de Boer Dianne , Pennings Christoph H. , Melenhorst Jarno , Buhre Wolfgang F.F.A. 
Published: February 2023

BACKGROUND
Thoracic epidural analgesia (TEA) is an invasive technique with potential side effects but is widely used in enhanced recovery after surgery (ERAS) programmes in colorectal cancer surgery. The effects of TEA on postoperative length of hospital stay (LOS) or morbidity is still debated.

OBJECTIVES
The main objective was to evaluate the postoperative analgesic effectiveness of TEA compared with patient-controlled intravenous analgesia (PCIA) after open or laparoscopic colorectal surgery, and whether TEA contributes to enhanced recovery.

DESIGN
A retrospective single-centre, observational study.

SETTING
Dutch tertiary-care university hospital.

PATIENTS
All consecutive adult patients undergoing colorectal cancer surgery from 1 January 2014 to 31 December 2016, with ASA status I-IV, were included. Exclusion criteria were hypersensitivity to opioid or local anaesthetic substances, or the use of multiple secondary anaesthetic techniques.

MAIN OUTCOME MEASURES
The primary outcome, postoperative pain assessed with a Numeric Rating Scale on postoperative days 1 to 3 inclusive. Secondary endpoints were LOS, the incidence of epidural related side effects, major complications and the 5-year survival rate. Using linear mixed models, pain scores were compared between patients who received TEA and PCIA.

RESULTS
Of 422 enrolled patients, 110 (32%) received TEA and 234 (68%) PCIA. Patients in the TEA group had lower pain scores: estimated NRS difference at rest; -0.79; 95% CI, -1.1 to -0.49; P < 0.001 and during movement -1.06; 95% CI, -1.39 to -0.73; P < 0.001. LOS, 30-day complication rate and overall survival at 5 years did not differ between the groups.

CONCLUSIONS
TEA in open or laparoscopic colorectal surgery is associated with moderately better postoperative pain control but does not affect LOS, postoperative morbidity, mortality nor long-term survival. The current clinical indication for TEA in colorectal surgery remains unchanged.

TRIAL REGISTRATION
International clinical trial registration number: ISRCTN11426678; retrospectively registered 26 February 2021.
‘Do-not-intubate’ orders in patients assisted by noninvasive respiratory support for acute hypoxaemic failure caused by coronavirus disease 2019; a systematic review and meta-analysis
Authors: Cammarota Gianmaria , Esposito Teresa , Simonte Rachele , Messina Antonio , Cecconi Maurizio , Vaschetto Rosanna , Vetrugno Luigi , Navalesi Paolo , Azzolina Danila , Robba Chiara , Pelosi Paolo , Longhini Federico , Maggiore Salvatore M. , De Robertis Edoardo 
Published: February 2023

BACKGROUND
Noninvasive respiratory support (NIRS) has been revealed feasible solutions to cope with the massive request for ventilatory support in patients subjected to ‘do-not-intubate’ order (DNI).

OBJECTIVES
The aims of the present systematic review and meta-analysis was to estimate pooled incidence of DNI orders and the associated in-hospital mortality in patients undergoing NIRS for hypoxaemic acute respiratory failure (ARF) related to coronavirus disease 2019 (COVID-19).

DESIGN
Systematic review of observational studies and randomized-controlled trials with meta-analyses

DATA SOURCES
PUBMED, EMBASE, and Cochrane Controlled Clinical trials register were searched for observational studies and randomised-controlled trials from inception to the end of April 2022.

ELIGIBILITY CRITERIA
Inclusion criteria were: observational studies enrolling ≥50 hospitalised patients with hypoxaemic COVID-19-related ARF requiring NIRS and DNI order application. Two authors independently extracted data from enrolled investigations. Data are presented as proportions with 95% confidence interval.

RESULTS
Thirty-one observational studies were included for a total of 6645 COVID-19 patients undergoing NIRS, of whom 1590 received DNI orders. Among patients assisted by NIRS, a DNI order was expressed in a summary estimate of 25.4% [20.0–31.1] of the cases with a high between-study heterogeneity. The summary estimated of in-hospital mortality was 83.6% [75.3–90.7] for DNI patients and 20.0% [14.2–26.5] for full treatment patients, both with a high between-study heterogeneity.

CONCLUSIONS
In COVID-19 patients assisted through NIRS for hypoxaemic ARF, a DNI order was frequently issued and associated with a high in-hospital mortality

TRIAL REGISTRATION
Prospero registration number: CRD42021271313.
In utero Exposure to Maternal Diabetes and the Risk of Cerebral Palsy: A Population-based Cohort Study
Authors: Ahmed Asma , Rosella Laura C. , Oskoui Maryam , Watson Tristan , Yang Seungmi 
Published: February 2023

Background:Evidence on the effects of in utero exposure to maternal diabetes on cerebral palsy (CP) in offspring is limited. We aimed to examine the effects of pregestational (PGDM) and gestational diabetes (GDM) separately on CP risk and the mediating role of increased fetal size.Methods:In a population-based study, we included all live births in Ontario, Canada, between 2002 and 2017 followed up through 2018 (n = 2,110,177). Using administrative health data, we estimated crude and adjusted associations between PGDM or GDM and CP using Cox proportional hazards models to account for unequal follow-up in children. For the mediation analysis, we used marginal structural models to estimate the controlled direct effect of PGDM (and GDM) on the risk of CP not mediated by large-for-gestational age (LGA).Results:During the study period, 5,317 children were diagnosed with CP (187 exposed to PGDM and 171 exposed to GDM). Children of mothers with PGDM showed an increased risk (hazard ratio [HR]: 1.84 [95% confidence interval (CI): 1.59, 2.14]) after adjusting for maternal sociodemographic and clinical factors. We found no associations between GDM and CP (adjusted HR: 0.91 [0.77, 1.06]). Our mediation analysis estimated that LGA explained 14% of the PDGM-CP association.Conclusions:In this population-based birth cohort study, maternal pregestational diabetes was associated with increased risk of CP, and the increased risk was not substantially mediated by the increased fetal size.
Performance of Multiple Imputation Using Modern Machine Learning Methods in Electronic Health Records Data
Authors: Getz Kylie , Hubbard Rebecca A. , Linn Kristin A. 
Published: February 2023

Background:
Missing data are common in studies using electronic health records (EHRs)-derived data. Missingness in EHR data is related to healthcare utilization patterns, resulting in complex and potentially missing not at random missingness mechanisms. Prior research has suggested that machine learning-based multiple imputation methods may outperform traditional methods and may perform well even in settings of missing not at random missingness.

Methods:
We used plasmode simulations based on a nationwide EHR-derived de-identified database for patients with metastatic urothelial carcinoma to compare the performance of multiple imputation using chained equations, random forests, and denoising autoencoders in terms of bias and precision of hazard ratio estimates under varying proportions of observations with missing values and missingness mechanisms (missing completely at random, missing at random, and missing not at random).

Results:
Multiple imputation by chained equations and random forest methods had low bias and similar standard errors for parameter estimates under missingness completely at random. Under missingness at random, denoising autoencoders had higher bias than multiple imputation by chained equations and random forests. Contrary to results of prior studies of denoising autoencoders, all methods exhibited substantial bias under missingness not at random, with bias increasing in direct proportion to the amount of missing data.

Conclusions:
We found no advantage of denoising autoencoders for multiple imputation in the setting of an epidemiologic study conducted using EHR data. Results suggested that denoising autoencoders may overfit the data leading to poor confounder control. Use of more flexible imputation approaches does not mitigate bias induced by missingness not at random and can produce estimates with spurious precision.
Surgical Management of Hidradenitis Suppurativa: Factors Associated with Postoperative Complications and Disease Recurrence
Authors: Skorochod Ron , Margulis Alexander , Adler Neta 
Published: February 2023

Background:
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder. Treatment of HS remains challenging, and surgical procedures commonly follow attempts of conservative therapy. To date, a consensus regarding the optimal surgical technique has not been reached, and the implications of conservative therapy on future surgical outcomes have yet to be studied.

Methods:
A retrospective cohort study of 65 patients surgically treated for HS at a tertiary care center was conducted. Patients’ medical records were screened for demographical, clinical, and surgical characteristics. Statistical analysis was conducted to determine associations with postoperative complications and disease recurrence.

Results:
Fifty patients (75.8%) were treated with systemic antibiotics before opting for surgical resection. Previous treatment with systemic rifampicin was associated with higher rates of postoperative complications (P = 0.029); however, systemic cephalexin and topical clindamycin were associated with a lower rate of complications (P = 0.007 and 0.040, accordingly). Medical history of smoking and surgical management with split-thickness skin grafts were associated with higher rates of postoperative complications (P = 0.012 and 0.014, accordingly). Patients with a greater number of lesions, and those treated with split-thickness skin graft, had higher rates of disease recurrence (P = 0.0018 and 0.003, accordingly).
In a multivariate analysis a greater number of lesions (P = 0.0498) and the use of autologous split-thickness skin graft (P = 0.022) were independently associated with higher rates of disease recurrence.

Conclusions:
Previous conservative medical therapy bears the potential to modulate postoperative outcomes in HS patients, and should be taken into consideration. Despite reports of reliable results with split-thickness skin grafts, we found them to be associated with increased rates of diseases recurrence and postoperative complications.
Financial Models for an Academic Practice in Plastic Surgery
Authors: Munoz Kathrina , Evans Gregory R. D. 
Published: February 2023

Background:
In an attempt to investigate physician compensation in academic practice, financial reimbursement models of departments and/or divisions of plastic surgery within an academic university setting were evaluated.

Method:
Thirteen divisions or departments of plastic surgery were surveyed to obtain information regarding reimbursement models for plastic surgery.

Results:
Of the 13 plastic surgery groups surveyed, 11 were divisions within the department of surgery. The department chairs/chief and/or chief administrative officers were questioned regarding the following areas: (1) total compensation, 2) bonus and incentive compensation models, and (3) cosmetic and cash reimbursement. There were no regional differences that could be identified. As such, we grouped institutions into Western, Midwest, and Eastern regions. COVID-19 did not change any of the financial models that were established before the pandemic.

Discussion:
There is no ideal model for compensation, which varied among the institutions surveyed. All of these financial models were established before COVID-19 and did not significantly change with the pandemic. It appears that within this small sample size, compensation is based mainly on a $/wRVU model. Funding for research and educational teaching remains a challenge, which is not reimbursed well. Although faculty compensation may vary based on the institutions, the decision to enter and remain in academic practice includes a series of decisions. However, compensation is a significant factor, which should not be minimized.
Perspectives on the Plastic Surgery Common Application (PSCA): A Survey of 2021–2022 Integrated Plastic Surgery Applicants
Authors: Elmer Nicholas A. , Veeramani Anamika , Bustos Valeria P. , Shiah Eric , Hassell Natalie , Comer Carly D. , Manstein Samuel M. , Laikhter Elizabeth , Lin Samuel J. 
Published: February 2023

Background:
The Plastic Surgery Common Application (PSCA) was introduced as a free and specialty-specific application for plastic surgery applicants in the 2020–2021 cycle. Now in its second year, the PSCA is being piloted by all integrated residency programs with future plans to replace Electronic Residency Application Service (ERAS) in the 2022–2023 cycle. This study aimed to explore applicant perspectives related to the PSCA and ERAS applications.

Methods:
An anonymous survey was distributed to integrated plastic surgery residency applicants from the 2021–2022 application cycle. Participants were asked to provide basic demographic information, their perspectives of the PSCA, and overall application preference.

Results:
One hundred forty (43.1%) applicants completed the survey. Nearly, 63% of applicants responded “slightly well” or “not well at all” regarding their ability to highlight at least one aspect of their application. Forty-one percent of applicants believed ERAS best highlighted the strengths of their application compared with 27% who believed their strengths were better highlighted by the PSCA. Seventy-nine percent reported the cost savings associated with the PSCA were “very” or “extremely important.” Overall, 63% of respondents reported a preference to apply with the PSCA alone.

Conclusions:
This is the first study to provide insight on applicants' perspectives of the PSCA. Although the majority preferred applying with the PSCA, there may be challenges with transitioning to this application solely. Future iterations of the PSCA may aim to ameliorate functionality concerns, optimize application content, and incorporate plastic surgery-specific information that may be important to selection committees.
Reducing Opioid Overprescribing through Procedure-specific Prescribing Guidelines
Authors: Zhang Kevin K. , Blum Kevin M. , Chu Jacqueline J. , Sharma Shuchi , Skoracki Roman J. , Moore Amy M. , Janis Jeffrey E. , Barker Jenny C. 
Published: February 2023

Background:
Despite advances in opioid-sparing pain management, postdischarge opioid overprescribing in plastic surgery remains an issue. Procedure-specific prescribing protocols have been implemented successfully in other surgical specialties but not broadly in plastic surgery. This study examined the efficacy of procedure-specific prescribing guidelines for reducing postdischarge opioid overprescribing.

Methods:
A total of 561 plastic surgery patients were evaluated retrospectively after a prescribing guideline, which recommended postdischarge prescription amounts based on the type of operation, was introduced in July 2020. Prescription and postdischarge opioid consumption amounts before (n = 428) and after (n = 133) guideline implementation were compared. Patient satisfaction and prescription frequency of nonopioid analgesia were also compared.

Results:
The average number of opioid pills per prescription decreased by 25% from 19.3 (27.4 OME) to 15.0 (22.7 OME; P = 0.001) after guideline implementation, with no corresponding decrease in the average number of postdischarge opioid pills consumed [10.6 (15.1 OME) to 8.2 (12.4 OME); P = 0.147]. Neither patient satisfaction with pain management (9.6‐9.6; P > 0.99) nor communication (9.6‐9.5; P > 0.99) changed. The rate of opioid-only prescription regimens decreased from 17.9% to 7.6% (P = 0.01), and more patients were prescribed at least two nonopioid analgesics (27.5% to 42.9%; P = 0.003). The rate of scheduled acetaminophen prescription, in particular, increased (54.7% to 71.4%; P = 0.002).

Conclusions:
A procedure-specific prescribing model is a straight-forward intervention to promote safer opioid-prescribing practices in plastic surgery. Its usage in clinical practice may lead to more appropriate opioid prescribing.
M-shaped Genioplasty: New Findings after 10 Years of Experience
Authors: Fariña Rodrigo , Valladares-Pérez Salvador , Navarro-Cuellar Carlos , Torrealba Ramón , Fariña-Silva Antonia , Fariña-Silva Gabriel 
Published: February 2023

Background:
This study aimed to evaluate changes of the M-shaped genioplasty in sagittal and vertical planes in a group of 34 patients and describe other indications, such as the increase of the mentolabial angle, decrease in the depth of the mentolabial fold, and the centering of the chin.

Methods:
A retrospective analysis was performed on 34 patients between 2010 and 2019. All studies were conducted at T0 (preoperative), T1 (a month after surgery), and T2 (1 year after surgery). The position of the bone pogonion (Pg) was measured vertically and horizontally at T0, T1, and T2; the mentolabial angle and the depth of the mentolabial fold were measured at T0 and T2.

Results:
The average sagittal advancement at T1 was 6.6 mm and at T2 was 6.4 mm. The inferior movement was an average of 5.6 mm at T1 and T2, showing both movements excellent stability. The mentolabial angle increased at T2 an average of 28.2 degrees (5 degrees per each millimeter of inferior movement), whereas the depth of the mentolabial fold decreased an average of 2.8 mm (decreased 49% from the initial depth and decreased 0.56 mm per each mm of inferior movement). The average increase of the lower third of the face was 5 mm. No complications were observed in any patient.

Conclusions:
M-shaped genioplasty is an anterior osteotomy of the mandible, which allows the chin to move forward and downward. Additionally, it allows an increase of the mentolabial angle and decreases the mentolabial fold.
Distraction Osteogenesis to Treat the Sequel of Early Undiagnosed Childhood Trauma
Authors: Al-Tamimi Bouthayna , Patel Brijesh , Mills Caroline 
Published: February 2023

Summary:
Undiagnosed trauma to the condylar head can later cause growth deficits secondary to mechanical restrictions created by scarring and loss of motion. This case illustrates how through a multidisciplinary team effort, distraction osteogenesis was successfully used with a hybrid functional appliance to correct a mandibular asymmetry caused by early undiagnosed childhood trauma. An intra-oral distraction device was placed to lengthen the mandibular ramus and body. Following distraction, a hybrid functional orthodontic appliance was used during growth to correct the cant of the occlusal plane. The patient’s growth potential was advantageous in this case because it allowed for selective and controlled eruption on the deficient side using the hybrid functional appliance while impeding further vertical development on the left side by using a bite plane. This bite plane was serially reduced to achieve gradual eruption of the maxillary teeth and alveolar process. In this way, the patient’s own growth potential was harnessed to correct the maxillary cant, which, if left uncorrected, would have necessitated orthognathic surgery once skeletal growth was complete. Through liaison with the surgeon and the orthodontist, there was substantial improvement in facial symmetry and occlusion.
Predicting Final Implant Volume in Two-stage Prepectoral Breast Reconstruction
Authors: Atia Andrew N. , Sergesketter Amanda R. , Morris Miranda X. , Biswas Sonali , Zhang Gloria , Langdell Hannah C. , Hollins Andrew W. , Phillips Brett T. 
Published: February 2023

Background:
Two-stage implant-based breast reconstruction remains the most commonly performed reconstructive modality following mastectomy. Although prior studies have explored the relationship between tissue expander (TE) features and permanent implant (PI) size in subpectoral reconstruction, no such study exists in prepectoral reconstruction. This study aims to identify pertinent TE characteristics and evaluate their correlations with PI size for prepectoral implant-based reconstruction.

Methods:
This study analyzed patients who underwent two-stage prepectoral tissue expansion for breast reconstruction followed by implant placement. Patient demographics and oncologic characteristics were recorded. TE and PI features were evaluated. Significant predictors for PI volume were identified using linear and multivariate regression analyses.

Results:
We identified 177 patients and 296 breast reconstructions that met inclusion criteria. All reconstructions were performed in the prepectoral plane with the majority using acellular dermal matrix (93.8%) and primarily silicone implants (94.3%). Mean TE size was 485.4 cm3 with mean initial fill of 245.8 cm3 and mean final fill of 454.4 cm3. Mean PI size was 502.9 cm3 with a differential fill volume (PI-TE) of 11.7 cm3. Multivariate analysis identified significant features for PI size prediction, including TE size (R2 = 0.60; P < 0.0001) and TE final fill volume (R2 = 0.57; P < 0.0001). The prediction expression for TE final fill and TE size was calculated as 26.6 + 0.38*(TE final fill) + 0.61*(TE size).

Conclusions:
TE size and final expansion volume were significant variables for implant size prediction. With prepectoral implant placement gaining popularity, the predictive formula may help optimize preoperative planning and decision-making in prepectoral reconstructions.