bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Systematic Review of the Impact of Patient Factors on BREAST-Q Outcomes After Reduction Mammoplasty
Authors: Liao Christopher D. , Xia Joyce , Wang Katherine , Zhao Kelley , Glickman Laurence T. , Agrawal Nikhil A. 
Published: February 2023

Background
As reduction mammoplasty rises in popularity, it will become increasingly important to understand the patient-reported outcome measurements associated with a successful operation. There has been a growing body of literature on BREAST-Q outcomes for patients undergoing reduction mammoplasty, but meta-analyses of patient factors and BREAST-Q Reduction Module scores are lacking. This study sought to ascertain which patient factors were associated with improvements in BREAST-Q scores compared with preoperative levels.

Methods
A literature review through August 6, 2021, was conducted using the PubMed database to select publications using the BREAST-Q questionnaire to evaluate outcomes after reduction mammoplasty. Studies examining breast reconstruction, breast augmentation, oncoplastic reduction, or breast cancer patients were excluded. BREAST-Q data were stratified by comorbidities, age, body mass index (BMI), complication rate, and resection weight.

Results
Among 14 articles and 1816 patients, the mean age ranged from 15.8 to 55 years, mean BMI ranged from 22.5 to 32.4 kg/m2, and bilateral mean resected weight ranged from 323 to 1845.96 g. Overall complication rate was 19.9%. On average, satisfaction with breasts improved by 52.1 ± 0.9 points (P < 0.0001), psychosocial well-being improved by 43.0 ± 1.0 points (P < 0.0001), sexual well-being improved by 38.2 ± 1.2 points (P < 0.0001), and physical well-being improved by 27.9 ± 0.8 points (P < 0.0001). The mean age was positively correlated with preoperative sexual well-being (Spearman rank correlation coefficient [SRCC]: 0.61, P < 0.05). Body mass index was negatively correlated with preoperative physical well-being (SRCC: −0.78, P < 0.01) and positively correlated with postoperative satisfaction with breasts (SRCC: 0.53, P < 0.05). The mean bilateral resected weight was significantly positively correlated with postoperative satisfaction with breasts (SRCC: 0.61, P < 0.05). No significant correlations were observed between complication rate and preoperative, postoperative, or mean change in BREAST-Q scores.

Conclusions
Reduction mammoplasty improves patient satisfaction and quality of life as reflected by the BREAST-Q. Although preoperative or postoperative BREAST-Q scores may be individually influenced by age and BMI, these variables demonstrated no statistically significant effect on the average change between these scores. This literature review suggests that reduction mammoplasty delivers high satisfaction across a diverse range of patient populations, and additional prospective cohort or comparative studies gathering robust data on other patient factors would benefit this area of research.
Osseointegration for Lower Limb Amputation
Authors: Black Grant G. , Vaeth Anna M. , Chen Yunchan , Truong Albert Y. , Reif Taylor J. , Rozbruch S. Robert , Otterburn David M. 
Published: February 2023

Purpose
Lower-limb osseointegrated prostheses are a novel alternative to traditional socket-suspended prostheses, which are often associated with poor fit, soft tissue damage, and pain. Osseointegration eliminates the socket-skin interface and allows for weight-bearing directly on the skeletal system. However, these prostheses can also be complicated by postoperative issues that can negatively impact mobility and quality of life. Little is known about the incidence of or risk factors for these complications as few centers currently perform the procedure.

Methods
A retrospective analysis was performed on all patients who underwent single-stage lower limb osseointegration at our institution between 2017 and 2021. Patient demographics, medical history, operative data, and outcomes were collected. Fisher exact test and unpaired t tests were performed to identify risk factors for each adverse outcome, and time-to-event survival curves were generated.

Results
Sixty patients met our study criteria: 42 males and 18 females with 35 transfemoral and 25 transtibial amputations. The cohort had an average age of 48 years (range, 25–70 years) and follow-up period of 22 months (range, 6–47 months). Indications for amputation were trauma (50), prior surgical complication (5), cancer (4), and infection (1). Postoperatively, 25 patients developed soft tissue infections, 5 developed osteomyelitis, 6 had symptomatic neuromas, and 7 required soft tissue revisions. Soft tissue infections were positively correlated with obesity and female sex. Neuroma development was associated with increased age at osseointegration. Neuromas and osteomyelitis were both associated with decreased center experience. Subgroup analysis by amputation etiology and anatomic location did not show significant differences in outcomes. Notably, hypertension (15), tobacco use (27), and prior site infection (23) did not correlate with worse outcomes. Forty-seven percent of soft tissue infections occurred in the 1 month after implantation, and 76% occurred in the first 4 months.

Conclusions
These data provide preliminary insights into risk factors for postoperative complications arising from lower limb osseointegration. These factors are both modifiable (body mass index, center experience), and unmodifiable (sex, age). As this procedure continues to expand in popularity, such results are necessary to inform best practice guidelines and optimize outcomes. Further prospective studies are needed to confirm the above trends.
Return of the Flap; The Empire State Mandate
Authors: Asadourian Paul A. , Chen Yunchan , Jung Wooram , Wang Marcos Lu , Koerner Anna , Qin Nancy , de Freitas Daniella , Chinta Malini , Andy Caroline , Rohde Christine H. , Otterburn David M. 
Published: February 2023

Purpose
Immediate postmastectomy breast reconstruction plays an integral role in patient care because of its psychosocial benefits. New York State (NYS) passed the 2010 Breast Cancer Provider Discussion Law with the aim of increasing patient awareness of reconstructive options through mandating plastic surgery referral at the time of cancer diagnosis. Short-term analysis of the years surrounding implementation suggests the law increased access to reconstruction, especially for certain minority groups. However, given the continued presence of disparities in access to autologous reconstruction, we aimed to investigate the longitudinal effects of the bill on access to autologous reconstruction along various sociodemographic cohorts.

Methods
Retrospective review identified demographic, socioeconomic, and clinical data for patients undergoing mastectomy with immediate reconstruction at Weill Cornell Medicine and Columbia University Irving Medical Center from 2002 to 2019. Primary outcome was receiving implant or autologous-based reconstruction. Subgroup analysis was based on sociodemographic factors. Multivariate logistic regression identified predictors of autologous reconstruction. Interrupted time series modeling analyzed differences in reconstructive trends for subgroups before and after the 2011 implementation of the NYS law.

Results
We included 3178 patients; 2418 (76.1%) and 760 (23.9%) patients underwent implant and autologous-based reconstruction, respectively. Multivariate analysis indicated that race, Hispanic status, and income were not predictors of autologous reconstruction. Interrupted time series showed that with each year leading up to 2011 implementation, patients were 19% less likely to receive autologous-based reconstruction. Following implementation, there was a 34% increase in the odds of receiving autologous-based reconstruction with each passing year. Following implementation, Asian American and Pacific Islander patients experienced a 55% greater increase in the rate of flap reconstruction than White patients. Following implementation, the highest-income quartile experienced a 26% greater increase in the rate of autologous-based reconstruction compared with the lowest-income quartile. After implementation, Hispanic patients experienced a 30% greater decrease in the rate of autologous-based reconstruction compared with non-Hispanic patients.

Conclusions
Our data indicate the long-term efficacy of the NYS Breast Cancer Provider Discussion Law in increasing access to autologous-based reconstruction, especially for certain minority groups. These findings underscore the importance of this bill and encourage its adoption into other states.
Extensive Defect Reconstruction With Pre-expanded Anterolateral Thigh Flap
Authors: Zang Mengqing , Wang Miao , Wang Danying , Du Qingyan , Zhu Shan , Chen Bo , Li Shanshan , Chen Zixiang , Liu Yuanbo 
Published: February 2023

Background
Previously reported pre-expansion techniques of the anterolateral thigh flap are mainly perforator-based. The expansion will interfere with the flap harvest if the requisite perforator is found unsuitable as a pedicle. Expansion of the peripheral territories of the flap donor site can minimize the interference from the expansion.

Methods
Forty-eight peripheral pre-expansions of the anterolateral thigh flap were retrospectively reviewed in 38 patients from 2012 to 2021. The reconstructive outcomes, including flap success, increase in flap size, donor-site closure, and complications, were assessed. In addition, subgroup analysis was performed based on the expanded territories.

Results
Rate of successful flap elevation of 100% and flap survival rate of 97.9% were achieved. One patient had total flap necrosis, which was salvaged with skin grafting. Peripheral expansion attained a mean 55.5% ± 19.6% increase in flap width. Primary donor-site closure was accomplished in 95.8% of flaps and fascial restoration in 97.9% of the donor sites. Three patients developed major expansion-related complications, which required surgical intervention. One patient had wound dehiscence in the donor site, which healed by secondary intention. Compared with other subgroups, the lateral-and-medial-side expansion provided a larger flap for reconstruction (P = 0.001).

Conclusions
If time is not of the essence, peripheral pre-expansion permits direct donor-site closure with size augment of the anterolateral thigh flap. In addition, it preserves the reliability and versatility of the anterolateral thigh flap.
Aortic balloon occlusion in distal zone 3 reduces blood loss from obstetric hemorrhage in placenta accreta spectrum
Authors: Kluck Sarah L. , Russo Rachel M. , Appel Noah B. , Frankfurt Alan I. , Weltge Craig , Shimer Tricia , Feagins Brian , Frotan Amin , Rinehart Brian , Cohen Robert A. 
Published: February 2023

BACKGROUND
Peripartum hemorrhage is a significant cause of maternal death. We developed a standardized, multidisciplinary cesarean hysterectomy protocol for placenta accreta spectrum (PAS) using prophylactic resuscitative endovascular balloon occlusion of the aorta (REBOA). We initially placed the balloon in proximal zone 3, below the renal arteries. An internal review revealed more bleeding than expected, and we subsequently changed our protocol to occlude the origin of the inferior mesenteric artery (distal zone 3), to decrease blood flow through collateral circulation. We hypothesized that distal zone 3 occlusion would reduce blood loss and transfusion volume and may permit a longer duration of occlusion compared with proximal zone 3 occlusion without increasing ischemic complications.

METHODS
We conducted a single-center retrospective cohort study of patients with suspected PAS who underwent REBOA-assisted cesarean hysterectomy from December 2018 to March 2022. Medical records of all patients with PAS were reviewed. Data were extracted from hospital admission through 3 months postpartum.

RESULTS
Forty-four patients met the inclusion criteria. Nine never had the balloon inflated. Eighteen patients had placement in proximal zone 3, whereas twenty-six patients had placement in distal zone 3. Background and clinical characteristics were similar in both groups. Placental pathology was obtained in every case. After adjusting for relevant risk factors, multivariate analysis revealed that distal occlusion was associated with a 45.9% (95% confidence interval, 23.8–61.6%) decrease in estimated blood loss, 41.5% (13.7–60.4%) decrease in red blood cell transfusion volume, and 44.9% (13.5–64.9%) reduction in total transfusion volume. There were no vascular access or resuscitative endovascular balloon occlusion of the aorta–related complications in either group.

CONCLUSION
This study highlights the safety of prophylactic REBOA in planned cesarean hysterectomy for PAS and provides a rationale for distal zone 3 positioning to reduce blood loss. Resuscitative endovascular balloon occlusion of the aorta should be considered at other institutions with placenta accreta programs, especially in patients with extensive collateral flow.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level IV.
Improving in silico prediction of influenza vaccine effectiveness by genome analysis incorporating epitope information
Authors: Cao Lirong , Lou Jingzhi , Li Qi , Zheng Hong , Mok Chris Ka Pun , Chen Zigui , Chan Renee Wan Yi , Cheung Peter Pak Hang , Chong Marc Ka Chun , Yeoh Eng Kiong , Wu William Ka Kei , Yu Jun , Chan Paul Kay Sheung , Zee Benny Chung-Ying , Wang Maggie Haitian 
Published: February 2023

AbstractFast evaluation of vaccine effectiveness (VE) is valuable for facilitating vaccine development and making vaccination strategy. In previous studies, we developed the computational model linking molecular variations and VE for the influenza and COVID-19, through which VE prediction prior to mass vaccination and infection is possible. In this study, we perform a complete survey of the predictive effect of major functional regions of the influenza virus for VE. Interestingly, we found that the genetic distance measured on the antigenic sites being also the effective mutations for epidemics is a strong predictor for influenza VE. Based on the identified optimal predictor codon set, we develop the improved VE-Genetic Distance model for influenza (VE-GD flu). The prediction accuracy of the new model is R-square 87.1% for H3N2 (p-value < 0.001) on VE data of the United States. Leave-one-out cross validation shows that the concordance correlation coefficient of the predicted and observed VE is 90.6% (95% CI: 73.8-96.9). Significant prediction improvement is also found for pH1N1. Accurate prediction of influenza VE before vaccine deployment may facilitate reverse vaccinology to optimize vaccine antigen design and government preparedness of influenza epidemics.
State switching and high-order spatiotemporal organization of dynamic Functional Connectivity are disrupted by Alzheimer’s Disease
Authors: Arbabyazd Lucas , Petkoski Spase , Breakspear Michael , Solodkin Ana , Battaglia Demian , Jirsa Viktor 
Published: February 2023

AbstractSpontaneous activity during the resting state, tracked by BOLD fMRI imaging, or shortly rsfMRI, gives rise to brain-wide dynamic patterns of inter-regional correlations, whose structured flexibility relates to cognitive performance. Here we analyze resting state dynamic Functional Connectivity (dFC) in a cohort of older adults, including amnesic Mild Cognitive Impairment (aMCI,N= 34) and Alzheimer’s Disease (AD,N= 13) patients, as well as normal control (NC,N= 16) and cognitively “super-normal” (SN,N= 10) subjects. Using complementary state-based and state-free approaches, we find that resting state fluctuations of different functional links are not independent but are constrained by high-order correlations between triplets or quadruplets of functionally connected regions. When contrasting patients with healthy subjects, we find that dFC between cingulate and other limbic regions is increasingly bursty and intermittent when ranking the four groups from SNC to NC, aMCI and AD. Furthermore, regionsaffected at early stages of AD pathologyare less involved in higher-order interactions in patient than in control groups, while pairwise interactions are not significantly reduced. Our analyses thus suggest that the spatiotemporal complexity of dFC organization is precociously degraded in AD and provides a richer window into the underlying neurobiology than time-averaged FC connections.Author SummaryBrain functions emerge from the coordinated dynamics of many brain regions. Dynamic Functional Connectivity (dFC) analyses are a key tool to describe such dynamic complexity and have been shown to be good predictors of cognitive performance. This is particularly true in the case of Alzheimer’s Disease (AD) in which an impoverished dFC could indicate compromised functional reserve due to the detrimental effects of neurodegeneration. Here we observe that in healthy ageing dFC is indeed spatiotemporally organized, as reflected by high-order correlations between multiple regions. However, in people with aMCI or AD, dFC becomes less “entangled”, more random-like, and intermittently bursty. We speculate that this degraded spatiotemporal coordination may reflect dysfunctional information processing, thus ultimately leading to worsening of cognitive deficits.
LiteRev, an Automation Tool to Support Literature Reviews: A Case Study on Acute and Early HIV Infection in Sub-Saharan Africa
Authors: Orel Erol , Ciglenecki Iza , Thiabaud Amaury , Temerev Alexander , Calmy Alexandra , Keiser Olivia , Merzouki Aziza 
Published: February 2023

AbstractBackgroundLiterature Reviews (LRs) identify, evaluate, and synthesise relevant papers to a particular research question to advance understanding and support decision making. However, LRs, especially traditional systematic reviews are slow, resource intensive, and are outdated quickly.ObjectiveUsing recent Natural Language Processing (NLP) and Unsupervised Machine Learning (UML) methods, this paper presents a tool named LiteRev that supports researchers in conducting LRs.MethodsBased on the user’s query, LiteRev can perform an automated search on different open-access databases and retrieve relevant metadata on the resulting papers. Papers (abstracts or full texts) are text processed and represented as a Term Frequency-Inverse Document Frequency (TF-IDF) matrix. Using dimensionality reduction (PaCMAP) and clustering (HDBSCAN) techniques, the corpus is divided into different topics described by a list of keywords. The user can select one or several topics of interest, enter additional keywords to refine their search, or provide key papers to the research question. Based on these inputs, LiteRev performs an iterative nearest neighbours search, and suggests a list of potentially interesting papers. The user can tag the relevant ones and trigger a new search until no additional paper is suggested for screening. To assess the performance of LiteRev, we ran it in parallel to a manual LR on the burden and care for acute and early HIV infection in sub-Saharan Africa. We assessed the performance of LiteRev using True and False Predictive Values, recall and Work Saved over Sampling.ResultsWe extracted, text processed and represented into a TF-IDF matrix 631 unique papers from PubMed. The topic modelling module identified 5 main topics and 16 topics (ranging from 13 to 98 papers) and extracted the 10 most important keywords for each. Then, based on 18 key papers, we were able to identify 2 topics of interest with 7 key papers in each of them. Finally, we ran the k-nearest neighbours module and LiteRev suggested first a list of 110 papers for screening, among which 45 papers were confirmed as relevant. From these 45 papers, LiteRev suggested 26 additional papers, out of which 8 were confirmed as relevant. At the end of the iterative process (4 iterations), 193 papers out of 613 papers in total (31.5% of the whole corpus) were suggested by LiteRev. After title/abstract screening, LiteRev identified 64 out of the 87 relevant papers (i.e., recall of 73.6%). After full text screening, LiteRev identified 42 out of the 48 relevant papers (i.e., recall of 87.5%, and Work Saved over Sampling of 56.0%).ConclusionsWe presented LiteRev, an automation tool that uses NLP and UML methods to streamline and accelerate LRs and to support researchers in getting quick and in-depth overviews on any topic of interest.
Splenic T follicular helper cells compromiseMycobacterium tuberculosisclearance in aged C57BL/6 mice
Authors: Pahwa Falak , Chaudhary Shweta , Chaturvedi Shivam , Nanda Ranjan Kumar 
Published: February 2023

AbstractAgeing increases susceptibility to infectious diseases like tuberculosis (TB), however limited reports are available on the cellular and molecular details in aged (>60 years) patients. In this study, we asked how low aerosol dose ofMycobacterium tuberculosisH37Rv (Mtb) affects aged (17/19 months; M) C57BL/6 mice in their bacterial clearance, liver micronutrient levels, circulatory cytokines and T cell distribution compared to younger (2/4M) controls. Till 6 weeks post infection, aged mice showed similar tissue (lung, spleen, and liver) Mtb load as young mice. Interestingly, aged mice showed a delayed lung Mtb clearance at 2 weeks post rifampicin (RIF) - isoniazid (INH) treatment compared to younger mice. Aged mice showed unregulated liver Fe levels upon Mtb infection while young mice had lower Fe levels. Aged Mtb infected mice revealed a lower proportion of splenic T-follicular helper (TFH) like CD4+T cells, which provides B cell help in generating high affinity antibodies and immune memory. Aged mice had higher basal circulatory IL-6 levels. Circulatory IFN-γ levels in aged (19M) C57BL/6 mice failed to resolve upon RIF-INH treatment. Splenic CD4+CD44+T cells of aged mice showed deregulated levels of mitochondrial proteins (4-hydroxy-2-oxoglutarate aldolase and aspartate aminotransferase). Overall, while filling in knowledge gaps on the host age-related responses to Mtb infection and during treatment, this study provides new perspectives for T cell distribution and function, which opens avenue for adjunct therapeutic development for geriatric TB patients.
Advanced marker-assisted selection versus genomic selection in breeding programs
Authors: Degen Bernd , Müller Niels 
Published: February 2023

AbstractAdvances in DNA sequencing technologies allow the sequencing of whole genomes of thousands of individuals and provide several million single nucleotide polymorphisms (SNPs) per individual. These data combined with precise and high-throughput phenotyping enable genome-wide association studies (GWAS) and the identification of SNPs underlying traits with complex genetic architectures. The identified causal SNPs and estimated allelic effects could then be used for advanced marker-assisted selection (MAS) in breeding programs. But could such MAS compete with the broadly used genomic selection? This question is of particular interest for the lengthy tree breeding strategies. Here, with our new software SNPscan we simulated a simple tree breeding program and compared the impact of different selection criteria on genetic gain and inbreeding. Further, we assessed different genetic architectures and different levels of kinship among individuals of the breeding population. Interestingly, apart from progeny-testing, genomic selection (GS) using gBLUP performed best under almost all simulated scenarios. MAS based on GWAS results outperformed GS only if the allelic effects were estimated in large populations (ca. 10,000 individuals) of unrelated individuals. Notably, GWAS using 3,000 extreme phenotypes performed as good as the use of 10,000 phenotypes. Genomic selection increased inbreeding and thus reduced genetic diversity more strongly compared to progeny testing and GWAS-based selection. In conclusion, our analyses further support the potential of genomic selection for forest tree breeding and improvement although MAS may gain relevance with decreasing sequencing costs in the future.