bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Evaluation of the Impact of Mental Illness on Postoperative Breast Reconstruction Revision Surgery
Authors: Saifee Jessica F. , Le Elliot L. H. , Constantine Ryan S. , Layne Jonathan E. , Kaoutzanis Christodoulos , Iorio Matthew L. 
Published: February 2023

Background:
Breast cancer impacts millions of people yearly affecting various aspects of their lives—including but not limited to mental health. Patients with a known psychiatric history, specifically generalized anxiety disorder (GAD) and/or depression, have previously been shown to have an increased number of revisions after breast reconstruction.

Methods:
A commercially available database of 91 million unique patients, PearlDiver, was used to identify patients with breast cancer who underwent autologous free flap breast reconstruction. An average number of revisions were calculated from each group of patients—those with a history of anxiety and/or depression and patients without a history of anxiety and/or depression. A logistic regression was performed to determine risk factors associated with patients undergoing revision surgery.

Results:
A total of 39,683 patients with a history of breast cancer underwent autologous breast reconstruction between 2010 and 2020, of which 6308 (15.9%) patients had a history of GAD and/or depression before autologous reconstruction. A total of 13,422 (33.8%) patients received at least one revision surgery. Patients with GAD only, depression only, and concomitant GAD and depression received 1.40 revisions each with no significant differences between the control and any of the study groups (P = 0.956). Logistic regression did not find psychiatric history to be associated with patients undergoing revision surgery (OR, 0.94; 95% CI, 0.89–1.00).

Conclusion:
Patients who underwent autologous reconstruction for breast cancer demonstrated no difference in rates of secondary surgical revision, regardless of a concurrent mental health history.
Anatomical Variations of the Pectoralis Muscle and Its Importance for Breast Implant Surgery
Authors: Montemurro Paolo , Otte Maximilian , Wagner Johannes M. , Pafitanis Georgios , Cheema Mubashir , Hedén Per 
Published: February 2023

Background:
In breast augmentation, during submuscular or dual plane dissection, anatomical variations of the inferior and costal origin of the pectoralis major muscle (PMM) play a key role to ensure optimal implant coverage. Especially, a short and narrow muscle or surgical release along the sternum increases the risk of irregularities and animation deformities of the implant.

Methods:
In 84 consecutive aesthetic breast augmentations intraoperatively, measurement of PMM dimensions was performed bilaterally. These PMM measurements were then correlated with the preoperative breast width, the inframammary fold, and the placement of the implant’s lower pole.

Results:
One hundred sixty-eight PMMs of 84 patients were dissected with a dual plane II or III technique for primary aesthetic breast augmentation. In 88% of breasts, the calculated implants’ lower pole was below the inferiomedial origin of the pectoralis muscle. In 10% of patients, a separation (more than 1 cm wide and 2 cm wide) in the inferior-medial origin of the PMM was noted. An asymmetry more than 0.5 cm in length between the left and right pectoralis major was noted in 36% of patients.

Conclusions:
In this series, the anatomy of the PMM demonstrates a substantial variability in width and length and a considerable asymmetry in its dimensions. These findings emphasize the importance of good access and visualization of the origin of the PMM fibers before its division.
The Average Facial Expressions: A Range of Motion Analysis for Different Sex and Age Groups
Authors: Schutte Hilde , Muradin Marvick S. M. , Bielevelt Freek , Seubring Karlien , Bleys Ronald L. A. W. , Rosenberg Antoine J. W. P. 
Published: February 2023

Background:
Facial expressions are ubiquitous in communication. Therefore, assessment of mimic function is essential in facial surgery, but no reference standards are currently available. This prospective study aims to create reference values of three-dimensional landmark displacement for different sex and age groups.

Methods:
Three-dimensional photographs were taken from healthy subjects in rest, maximum closed smile, and pouting. Displacement for both exercises of perioral landmarks was analyzed with MATLAB as absolute displacement and as the ratio of mouth width. Additionally, displacement in three planes was analyzed for each landmark. Averages were calculated for both genders in four age groups: 4–8, 8–12, 12–16, and >16 years.

Results:
In total, 328 subjects were included. Oral landmarks predominantly moved forward and backward for both exercises. Nasal landmarks predominantly moved vertically. Growing up, oral landmark displacement decreased for smiling, whereas nasal landmark displacement increased. For pouting, oral landmark displacement increased while growing up, whereas nasal landmark displacement decreased.

Conclusions:
The present study creates reference values for movement of perioral structures for different sex and age groups, for two facial expressions. These data are of great value for the assessment of mimic function and give insight into the development of facial animation over time.
Five-year Follow-up Outcome of Total Omental Lymph Node Flap Transfer in Primary Lymphedema Patient
Authors: Yodrabum Nutcha , Poungjantaradej Nattanit 
Published: February 2023

Summary:
Lymphedemas are caused by the accumulation of protein-rich fluid in the interstitial space, resulting from lymphatic system obstruction. In recent years, omentum flap transfer has gained popularity as a treatment for lymphedema due to its immunogenic and lymphangiogenic properties, which aid in reducing infection rate and volume. Moreover, omental flaps have angiogenesis capabilities, which can aid in successful chronic wound covering. Using a flow-through procedure after omental flap transfer can help reduce complications including venous congestion and steal phenomenon at the recipient site. We present a long-term follow-up of a case of primary lymphedema treated with omental flap transfer with flow-through figuration, demonstrating a gradual decrease in volume, reduced infection rate, and chronic wound coverage. This case report illustrates intriguing postoperative compartment effect and vascular concerns.
Aesthetic Characteristics of the Ideal Female Breast
Authors: Bekisz Jonathan M. , Boyd Carter J. , Salibian Ara A. , Choi Mihye , Karp Nolan S. 
Published: February 2023

Background:
The female breast is a subject of significant focus within plastic surgery. Little work to date has examined public perceptions of attractiveness with respect to breast anatomy and morphology. This study provides a comprehensive assessment of anatomic and aesthetic breast characteristics valued by the general population.

Methods:
A single-institution retrospective review was conducted of patients presenting for aesthetic or reconstructive breast surgery between 2009 and 2019. A cohort of 25 patients were included in a nationwide survey designed to assess subjective impressions of overall “breast attractiveness.” Survey responses were assessed, and the five patients with the highest mean scores were identified. An in-depth analysis of this subgroup was performed, evaluating anatomic metrics on both two-dimensional photographs and three-dimensional imaging. Statistical analysis examined correlations between objective breast characteristics and subjective perceptions of “attractiveness.”

Results:
There were 1021 survey responses. Across the entire patient cohort, the mean age was 47.4 years and mean BMI was 24.9 kg/m2. On a five-point Likert scale, the mean “breast attractiveness” score for the highest-scoring subgroup patients (n = 5) was 3.1 ± 0.1. Within this group, all patients had minimal ptosis and a projected contour. Average breast size was moderate, with mean volume of 299.4 ± 115.8 cm3.

Conclusions:
This study reverse engineers the aesthetically appealing female breast, beginning with overall impressions of attractiveness and subsequently analyzing the influence of objective anatomic parameters on subjective perceptions. In surveying a large and diverse population, moderately sized, projected breasts with upper pole fullness were found to be associated with increased “attractiveness” scores.
Changes in Personal Protective Equipment Practices of Craniofacial Surgeons during COVID-19: A Cross-sectional Study
Authors: Lee James C. , Martin Alexander , Ozaki Wayne 
Published: February 2023

Background:
Surgeons who operate around nasal or oral airways are at particularly high risk for transmission of the severe acute respiratory syndrome coronavirus 2. This multipart study explores the changes in craniofacial surgeon preferences and practices for personal protective equipment (PPE) over the course of a worldwide pandemic.

Methods:
Two identical electronic survey studies, one in 2020 and one in 2022, were conducted on the use of PPE before, during, and after the pandemic among active craniomaxillofacial surgeons. Statistical changes in behaviors and preferences and differences across time points and demographic groups were evaluated.

Results:
The initial study included responses from 48 surgeons, and the follow-up study consisted of 36 responses. Although only 4.3% of surgeons wore N95 masks or powered air purifying respirator for craniomaxillofacial operations before the pandemic, 91.5% wore these measures during the early pandemic (P < 0.001). However, this fell to 74.3% 2 years later. Similarly, more than 95% of surgeons wore a mask in clinic during the pandemic at both time points compared to only 40.3% before the pandemic (P < 0.001). In 2020, 31.9% of surgeons planned to continue using N95 masks or powered air purifying respirator for craniofacial cases after the pandemic was over, but that fell to 11.4% in the follow-up study.

Conclusions:
Craniofacial surgeon practices have shifted significantly toward more protective PPE over the course of the coronavirus disease 2019 pandemic. However, this effect was dampened over the course of a protracted pandemic. Despite this, our studies indicate a long-term shift in surgeon preference that is likely to persist after the pandemic is over.
Transcription factor AP-2 gamma/Krüppel-like factor 10 axis is involved in miR-3656-related dysfunction of endothelial cells in hypertension
Authors: Ren Yaxuan , Shi Jikang , Liu Sainan , Zhu Wenfei , Shao Aiyu , Qiao Yichun , Li Yong , Liu Yunkai , Cheng Yi , Liu Yawen 
Published: February 2023

Background:
Dysfunction of endothelial cells links to microvascular rarefaction, reflecting the pathogenesis of hypertension. Our previous studies found that miR-3656 reduces nitric oxide generation and von Willebrand factor (vWF) cleavage, thereby retarding blood flow and potentially increasing blood pressure. In this paper, we investigated mechanism of transcription regulation contributing to miR-3656-damaged endothelial cells in hypertension.

Methods:
The effects of miR-3656 on function of endothelial cells were analyzed on the basis of proliferation, migration, tube formation, and apoptosis. The mRNA level and protein level of genes were examined using quantitative real-time polymerase chain reaction (qRT-PCR) and western blot. Dual-luciferase reporter assay was performed to confirm the binding between miR-3656 and 3’ untranslated region (UTR) of transcription factor AP-2 gamma (TFAP2C). The binding between TFAP2C and the promoter region of Krüppel-like factor 10 (KLF10) was confirmed by chromatin immunoprecipitation-qPCR assay.

Results:
miR-3656 impaired the cell proliferation, migration, tube formation, and apoptosis of endothelial cells. miR-3656 inhibited the expression of TFAP2C by directly targeting 3’UTR of TFAP2C; moreover, miR-3656-induced injury of endothelial cells was rescued by TFAP2C overexpression. Furthermore, downregulated TFAP2C decreased KLF10 expression by binding to KLF10 promoter region, and upregulated KLF10 reversed the effects of silencing TFAP2C on endothelial cells. These inhibitory processes led to interference of miR-3656 to KLF10-promoted function of endothelial cells.

Conclusion:
TFAP2C/KLF10 axis is involved in miR-3656-related dysfunction of endothelial cells in hypertension. The 3’UTR of TFAP2C and KLF10 promoter region are the hubs of the TFAP2C/KLF10 axis.
MAP2K1 Mutation in Zebrafish Endothelial Cells Causes Arteriovenous Shunts Preventable by MEK Inhibition
Authors: Sudduth Christopher L. , Blum Nicola , Smits Patrick J. , Cheng Yu Sheng , Vivero Matthew P. , Harris Matthew P. , Lawson Nathan D. , Greene Arin K. 
Published: February 2023

Objectives:
Arteriovenous malformation (AVM) is a congenital lesion with a nidus of irregular blood vessels connecting arteries to veins instead of a normal capillary bed. Somatic MAP2K1 activating mutations in endothelial cells cause extracranial AVM. The purpose of this study was to create a MAP2K1 AVM animal model using zebrafish and to test pharmacotherapy.

Methods:
Single-cell casper Tg(gata1a:DsRed) zebrafish embryos were injected with plasmid DNA (control [pTol2-Fli:GFP]; mutant [pTol2-Fli:GFP-kdrl:MAP2K1K57N]) and Tol2 transposase mRNA to mosaically express activated MAP2K1 in endothelial cells. Two cohorts of fish were examined: group 1 (n = 161) established phenotypes and group 2 (n = 126) tested MEK inhibition. Blood flow was visualized using DsRed fluorescence of erythrocytes. Embryos were imaged 72 hours postfertilization.

Results:
Group 1 exhibited abnormal arteriovenous shunts in 58 of 96 (60%) embryos expressing MAP2K1K57N in endothelial cells. Shunts occurred between the proximal aorta and common cardinal vein (n = 39; 67%) or between the major artery and vein within the trunk or tail (n = 19; 33%). Shunts were not present in control zebrafish (n = 65). MEK inhibition reduced shunt frequency caused by endothelial MAP2K1K57N expression in group 2 from 84% to 55% (0.2 μM) or 25% (0.4 μM) (P = .006).

Conclusions:
Zebrafish endothelial cells expressing mutant MAP2K1 form abnormal arteriovenous shunts supporting the causality of the variant in human AVMs. MEK inhibition reduced shunt formation validating its potential efficacy as a pharmacotherapeutic option for AVM. This zebrafish model may be used for further study of the etiopathogenesis of AVM as well as to test drugs.
Adhesive capsulitis following COVID-19 vaccination: A case series
Authors: Ghosh Srutarshi , Pandey Sanjay Kumar , Biswas Anurug , Pandey Jyoti 
Published: February 2023

Abstract
Of the many bizarre complications of administration of the COVID 19 vaccine, adhesive capsulitis is almost unheard-of, although Shoulder Injury following Vaccine Administration (SIRVA), which by definition has symptom onset within 48 hours and is caused by faulty injection technique, has been rarely reported. Nine cases of adhesive capsulitis, five males and four females with a mean age of 48.7 ± 12.7 years, presenting within one month of intramuscular Covishield™ vaccine on the ipsilateral deltoid and fulfilling the standard UK FROST Multicenter Study diagnostic criteria are reported. The mean time interval from vaccination till symptom onset was 12.3 ± 3.1 days, and mean symptom duration was 9.4 ± 2.4 weeks. Conventional treatment with Non-Steroidal Anti Inflammatory Drugs, followed by intra-articular steroid injection coupled with suprascapular nerve steroid block improved the pain score and range of movement in 8 weeks. The exact pathogenesis remains an enigma, although mechanisms such as local spread via deltoid muscle microvasculature, nerves, or SIRVA causing secondary adhesive capsulitis have been hypothesized. While adhesive capsulitis is a very common diagnosis in the physiatric outpatient setting, the possible association with Covishield™ vaccination, the Indian version of the Oxford AstraZeneca recombinant ChAdOx1 nCoV-19 vaccine, is almost absent in existing literature and hence likely to be missed by clinicians, which necessitates this report.
The PRINCOVID retrospective study – a predictive model of pressure injuries for critical COVID-19 patients
Authors: Teixeira-Vaz Ana , Rocha José Afonso , Oliveira Mafalda , Almeida e Reis David , Simões Moreira Tiago , Silva Ana Isabel , Paiva José Artur 
Published: February 2023

ABSTRACT

Objective
To characterize pressure injuries (PI), identify risk factors, and develop a predictive model for PI at intensive care unit (ICU) admission for critical COVID-19 patients.

Design
Retrospective analysis of a consecutive sample of patients admitted to ICU between May/2020 and September/2021. Inclusion criteria encompassed the diagnosis of Acute Respiratory Distress Syndrome due to SARS-CoV-2, requiring invasive mechanical ventilation >48 h. Several predictors were evaluated: socio-demographic characteristics, comorbidities, clinical and laboratory findings at ICU admission. The primary outcome was the presence of PI.

Results
205 patients were included, mostly males (73%) with a mean age of 62 years old. PI prevalence was 58%. On multivariable analysis, male gender, hypertension, hemoglobin, and albumin at ICU admission were independently associated with PI, constituting the PRINCOVID model. The model reached an AUC-ROC of 0.71, surpassing the Braden Scale(p = 0.0015). The PRINCOVID score ranges from 0-15, with two risk groups: “at-risk”(≤7 points) and “high-risk”(>7 points).

Conclusions
This study proposes PRINCOVID as a multivariable model for developing PI in critical COVID-19 patients. Based on four parameters (gender, hypertension, hemoglobin and albumin at ICU admission), this model fairly predicts the development of PI. The PRINCOVID score allows patients’ classification into two groups, facilitating early identification of high-risk patients.
Secondary Breast Reconstruction in Irradiated Patients - Prospective Trial Comparing DIEP to Brava Expansion + Fat Transplantation
Authors: Begic Anadi , Tolli Jukka , Hegard Wenche , Stark Birgit 
Published: February 2023

Background:
Autologous tissue reconstruction of the breast is preferable after irradiation. Fat transplantation is a possible alternative. The aim of this prospective trial was to compare outcomes of deep inferior epigastric perforator (DIEP) flaps to BRAVA® expansion + fat grafting, after mastectomy and irradiation.

Methods:
Patients were recruited among the candidates for delayed breast reconstruction after mastectomy and irradiation and were given the same information on both methods. Twenty-six patients underwent DIEP reconstructions and 31 patients had multiple fat grafting sessions after BRAVA® external tissue expansion. Outcomes were evaluated using Breast-Q questionnaire and Telemark Breast Score (TBS).

Results:
Twenty-four of 31 patients in the fat graft group completed the study. Six to nine operative sessions were required to gain a mean volume of about 490 ml. The mean total operation time was 11.5 hours. Four patients in this group developed a new primary or metastatic cancer disease during the study. Twenty-four of 26 patients in the DIEP-group completed the study. The mean total operation time was 8 hours. The mean volume of the reconstructed breast was 523 ml. TBS scores showed similar improvements in both groups at short terms of 3 months in Brava and 6 in DIEP group.

Conclusion:
Supplementary surgical procedures are often needed in breast reconstruction after mastectomy with irradiation using Brava external expansion + fat grafting. Even though the aesthetic results evaluated by surgeons were comparable, patients were more satisfied with outcomes after DIEP reconstructions compared to BRAVA® + fat grafting.
The Male Eyebrow and Eyelid: An Anthropometric Analysis of Caucasian Professional Models.”
Authors: Pietruski Piotr , Majak Marcin 
Published: February 2023

Background:
Surgical lift of eyebrows is one of the most efficient facial rejuvenation methods. Although the popularity of those procedures seems to be increasing among men, little is known about esthetically pleasant male eyebrow shape and position.

Methods:
Semi-automatic photogrammetric analysis of three-hundred professional Caucasian male models of assumed age of 18-39 years old was performed. The assessment was conducted in two sessions, using A.I.D. software. A set of linear, angular, and surface area morphometric parameters of the periorbital region was measured.

Results:
A total of six-hundred periorbital regions were quantitatively evaluated. Statistical analysis showed high inter-rater reliability for all three types of measurements. The mean width of the eyebrow was found to be 47.28 + 4.55 mm. The male eyebrow was flat and low-located, overlying the orbital rim. The apex was located at the lateral two-thirds of the brow's width. The vertical distance between the eyebrow's peak and the hairline was 51.3 ± 7.15 mm. In addition, an Averaged Body Contours (ABC) was generated using the A.I.D. software, enabling graphical summarization of facial outline and periorbital contours of all analyzed subjects in the form of a single figure.

Conclusions:
Based on the esthetical preferences of several leading modeling agencies, a concept of the ideal eyebrow for Caucasian males was created. The collected morphometric data on the periorbital region may guide the surgical rejuvenation attempts of achieving youthful and natural brow contours. It may also aid its reconstruction using hair transplant techniques.
Carbon dioxide laser transconjunctival lower blepharoplasty: an objective and quantitative comparison to monopolar electrosurgery
Authors: Chen Chia-Fang , Mao Shih-Hsuan , Yen Cheng-I , Yang Shih-Yi , Hsiao Yen-Chang , Yang Jui-Yung , Chang Shu-Yin , Chuang Shiow-Shuh , Chen Hung-Chang 
Published: February 2023

Background:
The ability of simultaneous cutting and hemostasis with low lateral thermal injury makes CO2 laser a useful tool in blepharoplasty. Monopolar electrosurgery is another commonly used cutting tool that improves the quality of hemostasis and cutting speed. This study aimed to objectively and quantitatively assess the intraoperative and postoperative outcomes of transconjunctival lower blepharoplasty using either a CO2 laser or monopolar electrosurgery.

Methods:
Between August 2018 and March 2021, 78 patients who underwent transconjunctival lower blepharoplasty were randomly assigned to the CO2 laser group or monopolar electrosurgery group. Patient related parameters were recorded. Periorbital bruises were objectively and quantitatively assessed using the ecchymosis evaluation score. Analyses were performed using the independent sample t-test, the Mann-Whitney U test, the chi-square test, and the Fisher exact test.

Results:
Sex, age, local anesthesia injection volume, and fat removal volume were not different between the groups. Patients’ subjective intraoperative heat sensation was significantly higher in the monopolar electrosurgery group than in the CO2 laser group. The CO2 laser group had a significantly lower incidence of postoperative chemosis than the monopolar electrosurgery group. All patients had uncomplicated wound healing, except three (7.89%) patients in the monopolar electrosurgery group who developed conjunctival granuloma. Operation time, intraoperative pain sensation, intraoperative blood pressure, postoperative ecchymosis, conjunctivitis, and patients’ esthetic satisfaction did not differ between the groups.

Conclusion:
Our findings revealed that CO2 laser is a useful technique for reducing intraoperative heat sensation and postoperative chemosis and may prevent conjunctival wound complications.