bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lymphovenous Coupler-Assisted Bypass for Immediate Lymphatic Reconstruction
Authors: Spoer Daisy L. , Berger Lauren E. , Towfighi Parhom N. , Deldar Romina , Gupta Nisha , Huffman Samuel S. , Sharif-Askary Banafsheh , Fan Kenneth L. , Parikh Rajiv P. , Tom Laura K. 
Published: September 2023

Abstract
Background Breast cancer-related lymphedema is the most common cause of lymphedema in the United States and occurs in up to 50% of individuals receiving axillary lymph node dissection (ALND). Lymphovenous bypass (LVB) at the time of ALND may prevent lymphedema, but long-term results and anastomotic patency are unclear. This study evaluates the feasibility and outcomes of performing immediate lymphatic reconstruction via coupler-assisted bypass (CAB).
Methods This is a retrospective review of all patients undergoing prophylactic LVB following ALND at two tertiary care centers between 2018 and 2022. Patients were divided into cohorts based on whether they received the “standard” end-to-end (E-E) suturing or CAB technique. The primary outcome of interest was development of lymphedema. Quantitative and qualitative assessments for lymphedema were performed preoperatively and at 3, 6, 12, and 24 months postoperatively.
Results Overall, 63 LVBs were performed, of which 24 lymphatics underwent immediate reconstruction via “CAB” and 39 lymphatics via “standard” end-to-end suture. Patient characteristics, including body mass index, and treatment characteristics, including radiation therapy, did not significantly differ between groups. CAB was associated with a greater mean number of lymphatics bypassed per vein (standard 1.7 vs. CAB 2.6, p = 0.0001) and bypass to larger veins (standard 1.2 vs. CAB 2.2 mm, p < 0.0001). At a median follow-up of 14.7 months, 9.1% (1/11) of individuals receiving CAB developed lymphedema. These rates were similar to those seen following standard bypass at 4.8% (1/21), although within a significantly shorter follow-up duration (standard 7.8 vs. CAB 14.7 months, p = 0.0170).
Conclusion The CAB technique is a viable, effective technical alternative to the standard LVB technique. This comparative study of techniques in prophylactic LVB suggests that CABs maintain long-term patency, possibly due to the ease of anastomosing several lymphatics to single large caliber veins while reducing the technical demands of the procedure.
Nonabsorbable Barbed Sutures for Diastasis Recti. A Useful Device with Unexpected Risk: Two Case Reports
Authors: Giorgi Lorenzo , Ponti Veronica , Boriani Filippo , Margara Andrea 
Published: September 2023

AbstractThe introduction of nonabsorbable barbed sutures in plastic surgery has allowed the achievement of significant results in terms of efficacy and short- and long-term outcomes. However, a nonabsorbable material with no antibacterial coating could act as a substrate for subclinical bacterial colonization and thereby determine recurrent subacute and chronic infective–inflammatory processes. The authors report a clinical experience of subacute infectious complications after two cases of diastasis recti surgical correction. The authors present a two-case series in which a nonabsorbable barbed suture was used for the repair of diastasis recti. The postoperative course was complicated by surgical site infection. The origin of the infectious process was clearly localized in the fascial suture used for diastasis correction. The suture was colonized by bacteria resulting in the formation of multiple granulomas of the abdominal wall a few months postoperatively. In both the reported cases, the patients partially responded to the antibiotic targeted therapy and reoperation was required. The microbiological analyses confirmed the colonization of sutures by Staphylococcus aureus. Barbed nonabsorbable sutures should be avoided for diastasis recti surgical correction to minimize the risk of infectious suture-related complications. The paper's main novel aspect is that this is the first clinical report describing infectious complications after surgical correction of diastasis recti with barbed polypropylene sutures. The risk of microbiological subclinical colonization of polypropylene suture untreated with antibacterial coating, therefore, should be taken into account.
Total Synthesis of Marine Macrolide Natural Products by the Macrocyclization/Transannular Pyran Cyclization Strategy
Authors: Fuwa Haruhiko 
Published: September 2023

AbstractIn this Account, we summarize the development of a new strategy for streamlined synthesis of tetrahydropyran-embedded macrolactones and its successful implementation to a 13-step synthesis of (–)-exiguolide and an 11-step synthesis of (+)-neopeltolide.1	Introduction2	Development of Macrocyclization/Transannular Pyran Cyclization Strategy3	Total Synthesis of (–)-Exiguolide4	Total Synthesis of (+)-Neopeltolide5	Conclusions
Cryoanalgesia: Review with Respect to Peripheral Nerve
Authors: Slavin Benjamin R. , Markowitz Moses I. , Klifto Kevin M. , Prologo Frank J. , Taghioff Susan M. , Dellon A. Lee 
Published: September 2023

Abstract
Background Cryoanalgesia is a tool being used by interventional radiology to treat chronic pain. Within a certain cold temperature range, peripheral nerve function is interrupted and recovers, without neuroma formation. Cryoanalgesia has most often been applied to the intercostal nerve. Cryoanalgesia has applications to peripheral nerve surgery, yet is poorly understood by reconstructive microsurgeons.
Methods Histopathology of nerve injury was reviewed to understand cold applied to peripheral nerve. Literature review was performed utilizing the PubMed and MEDLINE databases to identify comparative studies of the efficacy of intraoperative cryoanalgesia versus thoracic epidural anesthesia following thoracotomy. Data were analyzed using Fisher's exact and analysis of variance tests. A similar approach was used for pudendal cryoanalgesia.
Results Application of inclusion and exclusion criteria resulted in 16 comparative clinical studies of intercostal nerve for this review. For thoracotomy, nine studies compared cryoanalgesia with pharmaceutical analgesia, with seven demonstrating significant reduction in postoperative opioid use or postoperative acute pain scores. In these nine studies, there was no association between the number of nerves treated and the reduction in acute postoperative pain. One study compared cryoanalgesia with local anesthetic and demonstrated a significant reduction in acute pain with cryoanalgesia. Three studies compared cryoanalgesia with epidural analgesia and demonstrated no significant difference in postoperative pain or postoperative opioid use. Interventional radiology targets pudendal nerves using computed tomography imaging with positive outcomes for the patient with pain of pudendal nerve origin.
Conclusion Cryoanalgesia is a term used for the treatment of peripheral nerve problems that would benefit from a proverbial reset of peripheral nerve function. It does not ablate the nerve. Intraoperative cryoanalgesia to intercostal nerves is a safe and effective means of postoperative analgesia following thoracotomy. For pudendal nerve injury, where an intrapelvic surgical approach may be difficult, cryoanalgesia may provide sufficient clinical relief, thereby preserving pudendal nerve function.
The Impact of Timing of Delayed Autologous Breast Reconstruction following Postmastectomy Radiation Therapy on Postoperative Morbidity
Authors: Mirza Humza N. , Berlin Nicholas L. , Sugg Kristoffer B. , Chen Jung-Shen , Chung Kevin C. , Momoh Adeyiza O. 
Published: September 2023

Abstract
Background The ideal time to perform reconstruction after the completion of postmastectomy radiation therapy (PMRT) in patients with locally advanced breast cancer is currently unknown. We evaluate the association between the timing of delayed autologous breast reconstruction following PMRT and postoperative complications.
Methods Patients who underwent mastectomy, PMRT, and then delayed autologous breast reconstruction from 2009 to 2016 were identified from the Truven Health MarketScan Research Databases. Timing of reconstruction following PMRT was grouped 0–3, 3–6, 6–12, 12–24, and after 24 months. Multivariable models were used to assess associations between timing of reconstruction following PMRT and key measures of morbidity.
Results A total of 1,039 patients met inclusion criteria. The rate of any complications for the analytic cohort was 39.4%, including 13.3% of patients who experienced wound complications and 11.3% of patients requiring additional flaps. Unadjusted rates of complications increased from 23.4% between 0 and 3 months to 49.4% between 3 and 6 months and decreased thereafter. Need for additional flaps was highest within 3 to 6 months (14.0%). Multivariate analysis revealed higher rates of any complications when reconstruction was performed between 3 and 6 months (odds ratio [OR]: 3.04, p < 0.001), 6 and 12 months (OR: 2.66, p < 0.001), or 12 and 24 months (OR: 2.13, p = 0.001) after PMRT. No difference in complications were noted in reconstructions performed after 24 months compared with those performed before 3 months (p > 0.05). However, rates of wound complications were least likely in reconstructions after 24 months (OR: 0.34, p = 0.035).
Conclusion These findings suggest plastic surgeons may consider performing autologous breast reconstruction early for select patients, before 3 months following PMRT without increasing postoperative morbidity.
Oxidative Cyclization Reactions Catalyzed by Designed Transition-Metal Complexes: A New Strategy for the Synthesis of Flavone, Quinolone, and Benzofuran Derivatives
Authors: Ghosh Kaushik , Ahmed Naseem , Singh Apurva , Singh Sain 
Published: September 2023

AbstractAn efficient and convenient synthetic protocol is reported for the synthesis of 2-phenyl-4H-chromen-4-one, 2-phenylquinolin-4(1H)-one, and 11H-benzofuro[3,2-b]chromen-11-one derivatives from 2′-hydroxychalcones, 2′-aminochalcones, and 3-hydroxyflavones, respectively, using transition-metal catalysts and TEMPO as an oxidizing agent. This catalytic heterocyclization approach involves in situ free-radical generation as phenoxyl radicals were detected by EPR spectroscopic study and H2O2 was formed. The present method has numerous advantages, such as high atom-economy, less hazardous synthesis, benign solvent and auxiliaries, easy handling, and broader substrate scope with good to excellent product yields.
Three-Dimensional Volumetric Investigation of Onodi Cells: A Multi-Slice Computed Tomography Study
Authors: Dieguez Flavia Limberg , Rosa Catharina Simioni De , Braz-Silva Paulo Henrique , Lopes Sergio Lucio Pereira de Castro , Costa Andre Luiz Ferreira 
Published: September 2023

Abstract
Introduction Onodi cells (OCs) are posterior ethmoid cells that are located above the sphenoid sinus, close to or even surrounding the carotid artery and optic nerve.
Objective To investigate and evaluate the volumetric variation of OCs through multi-slice computed tomography (MSCT) scans.
Methods We performed a retrospective review of MSCT scans of 79 subjects, 40 male and 39 female patients, Whose age ranged from 18 to 83 (mean: 39.6) years. The volumes of the OCs on the right and left sides were measured using the ITK-SNAP software (open-source) with semiautomatic segmentation. The possible relationships involving age, gender, contact with the optic nerve, extension of the pneumatization of the posterior ethmoid cells into the clinoid processes, mucous thickening in the anterior and posterior ethmoid cells, and obliteration of the sphenoethmoidal complex were analyzed with the Pearson correlation and Chi-squared tests according to the type of data compared and logistic regression models (p < 0.05).
Results We observed that an increase of one unit in the volume of OCs also increases the chance of extension of pneumatization into the clinoid processes by 0.15% (p = 0.001). No significant correlations were identified regarding age, gender, and volume of the OCs.
Conclusion The volume of the OCs has effects on the extension of pneumatization into the clinoid processes.
Wound Coverage in Extensive Necrotizing Fasciitis with Chronic Liver Disease
Authors: Choundappan M. 
Published: September 2023

AbstractChronic liver disease is characterized by lowered immunity, altered hematological parameters, and poor wound healing. Surgeons may hesitate to intervene in such patients when they present with necrotizing fasciitis (NF) or misinform the patients regarding their chances of survival. This is because of the poor nutritional state, thrombocytopaenia, and abnormal coagulation profile. However, recent guidelines show that platelet count and prothrombin time/international normalized ratio (PT-INR) do not predict postoperative bleeding. We can proceed with debridement followed by skin grafting of wounds in such patients. This will help reduce the high mortality rate of NF in cirrhotic patients.
Interosseus Membrane Reconstruction Following a Forearm Injury: A Case Report
Authors: Shine S.J. , Bamberger H.B. , Spieser C.E. , Sferrella A.M. 
Published: September 2023

Abstract
Background Essex-Lopresti injuries are complex, frequently missed forearm/elbow injuries consisting of a fracture of the radial head with disruption of both the distal radioulnar joint (DRUJ) and the interosseous membrane (IOM). Ideal management of these injuries remains controversial, especially in relation to the IOM, due in part to underdiagnosis of IOM injury and incomplete understanding of the IOM role.
Methods A 43-year-old man sustained an open radial shaft fracture with associated radial head subluxation, coronoid base fracture, and DRUJ injury with ulnar head subluxation. He was taken for surgery, where elbow instability with near complete disruption of the IOM was observed. Persistent gross rotational instability was noted following radius fixation, so braided suture and button reconstruction of the central band of the IOM was performed. This restored rotational and longitudinal stability to the radiocapitellar joint and DRUJ. Over 1 year out from the index surgery, the patient's elbow and DRUJ have remained stable, and he is back working as a laborer.
Results While little literature exists on outcomes of acute IOM reconstruction in these injuries, recent biomechanical studies have shown the importance of the central band on rotational elbow stability.
Conclusion This case supports the importance of the central band of the IOM by demonstrating the impact of its repair on the longitudinal and rotational stability of the elbow and DRUJ. IOM repair has the potential to improve our treatment of this complicated injury by better restoring forearm stability and function of the elbow, which future studies could help further elucidate.
The Effect of Working Length, Fracture, and Screw Configuration on Plate Strain in a 3.5-mm LCP Bone Model of Comminuted Fractures
Authors: Wainberg S.H. , Moens N.M.M. , Ouyang Z. , Runciman J. 
Published: September 2023

Abstract
Introduction This study provides a comprehensive examination of plate strain under realistic fracture configurations. The effect of plate working length, plate contact, fracture length, and position on strain was evaluated using bone surrogates subjected to “load-controlled,” nondestructive conditions.
Materials and Methods Five 3.5-mm locking compression plates (LCP) were instrumented with six strain gauges. The gauges were glued between holes in predetermined locations marked by laser engraving. Nine fracture models were created using bone surrogate, each representing a combination of the criteria under study: long versus short working length, degree of plate compression, fracture location, and fracture length. All five plates were tested under each of the nine configurations. The constructs were mounted in an Instron testing machine with a 5-kN load cell. Each specimen was cyclically loaded at a rate of 5 mm/min to 50, 100, and 200 N.
Results Decreased plate strain was noted with a short plate working length in all fracture configurations (p < 0.05). Increasing the plate working length increased the strain at higher loads and on the plate adjacent to the fracture gap. The size of the fracture gap and fracture location had minimal effects on plate strain (p < 0.05). Elevation of the plate off the bone (1.5 mm) resulted in increased plate strain under all loading conditions (p < 0.05).
Conclusion Our null hypothesis was rejected in that a short plate working length resulted in decreased plate strain in all comminuted fracture configurations. Our secondary hypothesis was validated in that elevation of the plate from the bone resulted in increased strain in all configurations. As plate strain identifies regions of mechanical weakness whereby a construct may prematurely fail by acute overload or cyclic fatigue, identifying factors that may increase plate strain allows the surgeon to reduce these variables as much as possible to reduce the incidence of implant failure and subsequent fracture failure.
Spatial-Semantic Transformer for Spatial Relation Recognition
Authors: Peng Huilin , Wang Yang , Ge Hao 
Published: September 2023

Abstract
Spatial relation recognition, which aims to predict a spatial relation predicate, has attracted increasing attention in the computer vision study. During tackling this problem, modeling spatial relation of the subjects and objects is of great importance. We find that only using spatial features leads to poor results in predicting the spatial relation. To overcome these challenges, we propose an effective spatial attention module to enhance spatial features using semantic features. After identifying the importance of spatial attention mechanism, we propose a spatial transformer module with encoder layers to recognize unseen spatial relation based on spatial attention mechanism. Extensive experiments on the benchmark dataset (SpatialSense) show that, by using refined spatial feature, our spatial transformer model and spatial attention model achieve state-of-the-art performance on overall accuracy.
The Redesigning Icons to Reduce User Confusion
Authors: Satcharoen Kleddao , Bunyanuson Boonyawat , Siripreechawat Panassava , Tangtisanon Pikulkaew 
Published: September 2023

Abstract
Redesigning icons to reduce user confusion was created to solve the problems of Icons that are modelled on objects that are not popular for nowadays or are confusing to convey the meaning to the user to gain more effectively, increased accuracy and convenience for the user. A new icon design project to reduce user confusion. It arises from researching design-related information such as Affordance theory, image processing, color and mood theory, or even in terms of pixel size Which affects the use. Bring knowledge to design icons to better solve problems and respond to the needs of the user. This was done by collecting user data through questionnaires on the website with random questions and options. To take into account the performance of icons that are designed to find a suitable design for the use of that function.
Simulation and Optimization of the Operation Efficiency of Heat Exchange Units in Intelligent Heating Systems Based on Entransy Dissipation Thermal Resistance
Authors: Jia Zile , Sun Hao , Liu Dan , Zhao Meng , Lan Xingbo 
Published: September 2023

Abstract
So as to investigate heat exchange efficiency of heat exchange units under different operating conditions, this paper builds a simulation analysis model for heat exchange units in the framework of intelligent district heating systems based on the Modelica unified modeling language and the MWorks platform. Analyze the real-time operating efficiency of heat exchange units using entransy dissipation thermal resistance as an evaluation indicator of heat exchange efficiency. This paper analyzes the trend of heat exchange efficiency changes of heat exchange units when the primary side flow rate, secondary side flow rate, primary side inlet temperature, secondary side inlet temperature, and secondary side bypass pipeline valve opening change. The simulation results verify that when the primary side and the secondary side flow match, the entransy dissipation thermal resistance is the smallest, and its heat transfer efficiency is the highest. Under the simulation condition where the convective heat transfer coefficient is constant, the entransy dissipation thermal resistance is independent of the inlet temperature changes on the primary and secondary sides. The minimum entransy dissipation thermal resistance could be achieved, which represents the optimal real-time heat exchange efficiency state, when the valve opening of the mixed water heat exchange unit is 45% under the specific flow conditions.
Application of Acid Fracturing Technology to Improve Water Yield of Deep Carbonate Geothermal Wells
Authors: Zhang Zhiyong , Yang Beibei , Lv Xiaolan 
Published: September 2023

Abstract
To achieve the “carbon peak” goal, green and low-carbon energy development is the key. The development and utilization of geothermal resources and the development of deep carbonate geothermal wells in China are analyzed. Based on the principle of chemical reaction between hydrochloric acid and the main components of carbonate rock, four rock samples from geothermal wells were dissolved with 15% and 20% hydrochloric acid, respectively. The comparison showed that 15% hydrochloric acid was more economical and effective. The percolation capacity of acid dissolution fractures was tested through percolation capacity experiments, and the optimal amount of acid solution was determined to be 2-8 PV. It was verified that acid dissolution helps improve fracture percolation capacity. Through the on-site testing of acid fracturing technology in the Xiong’an New Area, it has been verified that the on-site implementation of multi-stage acid fracturing has a significant effect on increasing production. Finally, conclusions are drawn. The method of using acid solution dissolution to increase the water yield of deep carbonate geothermal wells is feasible, and the multi-stage acid fracturing technology is suitable for deep wells and can increase the water output of geothermal wells, which has good promotion value.
The effect of porous media on the thermal storage performance of salinity-gradient solar pond
Authors: Shao Zhengri , Wu Dan , Liang Jinguang , Cong Wei , Liang Kaijie 
Published: September 2023

Abstract
A solar pond is a system that uses a salt concentration gradient to store heat. The application of the system is conducive to solving the problems of long production cycles, low brine temperature, and salt algae in the solar pond lithium extraction process and the solar pond potassium enrichment process. Based on this, our research group laid porous media at the bottom of the solar pond and utilized the heat storage and adsorption capacity of porous media to improve the thermal storage performance of the solar pond. The experimental results show that foam ceramics have good thermal storage performance and the ability to reduce turbidity. Laying foam ceramics on the bottom of the solar pond can not only increase the thermal storage performance of LCZ but also help reduce the turbidity of the pool water. After adding porous media, the heat extraction position of the solar pool moves from the junction of LCZ and NCZ to the bottom of LCZ. In addition, adding transparent film on the upper surface of the solar pond is also conducive to improving the thermal storage performance of the solar pond and reducing the turbidity of the solar pond.