bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reverse Expansion for Breast Reconstruction after Skin-sparing and Nipple-sparing Mastectomy: Our First 100 Cases
Authors: Fabiocchi Luca , Lucattelli Elena , Cattin Federico , Cipriani Federico , Dellachiesa Laura , Fogacci Tommaso , Frisoni Gianluca , Semprini Gloria , Samorani Domenico 
Published: April 2023

Background:
Patients with breast cancer have experienced advancements both in oncological treatment and in aesthetics as a result of developments in reconstructive techniques. We aimed to present our experience with the reverse expansion technique, summarizing the results of our first 100 cases of reconstruction after skin-sparing mastectomy and nipple-sparing mastectomy.

Methods:
From January 2010 to September 2018, 253 breast reconstruction procedures were performed on 100 patients. The reverse expansion technique consists of autologous fat tissue transplantation requiring the combined use of a skin expander and of multiple lipofilling sessions. At the beginning of every session the breast expander was deflated by removing a saline volume similar to that of the fat to be injected.

Results:
Overall, 56 breast reconstructions after skin-sparing mastectomy and 44 after nipple-sparing mastectomy were performed. An average of 661.5 cm3 of fat per session was harvested and an average of 305.3 cm3 per breast was injected. The average number of sessions to achieve breast reconstruction was 2.53. Only four complications after 253 procedures (1.5%) were reported: one donor site hemorrhage due to genetic lack of coagulation factors, and three surgical site infections.

Conclusions:
Considering the large number of positive factors such as a fast postoperative recovery, an easy learning curve, a lack of need of a specialized surgical team, a natural look of the breast shape, and the soft consistency of the grafted tissue, we believe this technique could be the first choice for autologous reconstruction after skin-sparing mastectomy and nipple-sparing mastectomy.
Intramuscular Posterior Thigh Volumization: An Aesthetic and Harmonious Transition to the Gluteal Region (Hv-FAT)
Authors: Manzaneda Cipriani Raúl Martín , Babaitis Ricardo , Vega Héctor Duran , Viaro Mauricio , Flores Emmanuel , Adrianzen Gerardo A. 
Published: April 2023

Background:
The gluteal region remains the preferred site for fat grafting. However, the transition from the gluteal region to the thighs has not been well studied. This study aimed to describe an echographic guidance hamstring volumization procedure (Hv-FAT) as a complement to body contouring surgery.

Methods:
Hv-FAT was performed in 19 patients from four countries (Peru, Argentina, Brazil, and Mexico) from May to June 2022 by four surgeons trained in soft-tissue ultrasound and in the aforementioned technique. All the patients met the following criteria: age older than 18 years and younger than 60 years; a body mass index of 30 kg/m² or less, and a surgical risk score of 2 or less, according to the Goldman index.

Results:
A total of four men and 15 women were included in this study, whose ages ranged from 22 to 58 years (mean: 36.37 years). After fat grafting, on average, the thickness of the right biceps femoris increased by 54.07%, maintaining 95.02% of this thickness one month postoperatively, whereas the thickness of the left biceps femoris increased by 46.57%, maintaining 94.86% of this thickness in the same postoperative period. In turn, the right semitendinosus muscle thickness increased by 181.90%, maintaining 97.42% of this thickness, whereas the left semitendinosus muscle increased by 111.90%, maintaining 95.29% of this thickness 1 month postoperatively (P < 0.0001).

Conclusion:
Hv-FAT is an effective and reproducible procedure for volumizing the biceps femoris and semitendinosus muscles, maintaining significant results one month postoperatively.
Introducing e-health technology to routine cataract care: patient perspectives on web-based eye test for postoperative telemonitoring
Authors: Claessens Janneau L.J. , Maats Emma P.E. , Iacob Maria E. , Wisse Robert P.L. , Jongsma Karin R. 
Published: April 2023

Purpose:
To explore cataract patients' experiences with an e-health tool for self-assessing visual function (ie, a web-based eye test), and to formulate recommendations for its successful adoption in routine cataract care.

Setting:
Clinics in the Netherlands, Germany, and Austria.

Design:
Mixed-methods study.

Methods:
22 participants were included in this study; in-depth interviews were conducted with 12. Questionnaires and in-depth semi-structured interviews were conducted alongside a multicenter randomized controlled trial evaluating the validity, safety and cost-effectiveness of remote care after cataract surgery (Cataract Online Refraction Evaluation, a Randomized Controlled Trial). Results were analyzed thematically.

Results:
Participants reported positively about performing the web-based eye test at home. 4 overarching themes were identified in the interviews. First, participants were inventive in overcoming practical barriers encountered while conducting the test. Second, participants desired a clear presentation of test results and their meaning. Third, the ability to self-monitor visual function was appreciated. Fourth, most participants preferred to keep the option to contact their eyecare professional (ECP) postoperatively, especially when experiencing symptoms. Most would be satisfied with a phone consultation or an e-consult. Participants reported positive experiences with the web-based eye test. Barriers for successful adoption were identified, including insecurity about correctly performing the test, incomplete information on how to interpret test results, and a feeling that in-hospital assessments were superior to remote assessments.

Conclusions:
It is recommended to focus on building trust in remote eyecare delivery and that access to the ECP be retained when medically indicated or deemed necessary by the patient.
Early Postoperative Prosthesis After Transtibial Amputation: Step-By-Step Approach
Authors: Faldini Cesare , Mazzotti Antonio , Geraci Giuseppe , Zielli Simone Ottavio , Bonelli Simone , Panciera Alessandro 
Published: April 2023

ABSTRACT

Introduction
Transtibial amputation represents a definitive treatment of several pathological conditions. Historically, immediate postoperative prosthetic protocols have been developed to improve recovery; however, concerns still limit their widespread application.

Materials and Methods
The aim of this article is to present a step-by-step approach to a revised, inexpensive, and easy technique that allows early postoperative prosthetic use and rehabilitation.

Results
The technique appears to provide optimal patient care levels at reasonable costs and could be applied also in low-resource settings.

Conclusions
Early ambulation allows to avoid postoperative complications (such as thromboembolism, pneumonia, etc.) and facilitates definitive prosthetic substitution and conservation of gait patterns as well as better psychological results.

Clinical Relevance
This technique can provide a solution for allowing early ambulation in persons with amputations, facilitating the postoperative management of these patients.
Psychometric Properties of the Patient Activation Measure in Family Caregivers of Patients With Chronic Illnesses
Authors: Lin Chin-Yen , Chung Misook L. , Schuman Donna L. , Biddle Martha J. , Mudd-Martin Gia , Miller Jennifer L. , Hammash Muna , Schooler Mary P. , Rayens Mary Kay , Feltner Frances J. , Moser Debra K. 
Published: April 2023

Background
The Patient Activation Measure (PAM) is used clinically and in research to measure an individual’s knowledge, skills, and confidence related to their health management engagement. Despite the use of “patient” in the title, the instrument can be used in nonpatient populations. A group at high risk for low activation concerning their own health is family caregivers of patients with chronic illnesses. The psychometric properties of the PAM have not been established in family caregivers.

Objectives
This study aimed to examine the psychometric properties of the PAM 10-item version (PAM-10) in a sample of family caregivers of patients with chronic illnesses. Our focus was on family caregivers’ health activation of their own healthcare needs.

Methods
We evaluated the internal consistency reliability of the PAM-10 in a sample of 277 family caregivers. Item-total correlations and interitem correlations were used to assess item homogeneity. Construct validity of the PAM-10 was examined using exploratory factor analysis and testing hypotheses on known relationships.

Results
The PAM-10 demonstrated adequate internal consistency. Item-total correlation coefficients and interitem correlation coefficients were acceptable. Construct validity of the instrument was supported. Factor analysis yielded two factors that explained 62.3% of the variance in the model. Lower levels of depressive symptoms were significantly associated with better activation, providing evidence of construct validity. Caregivers with high activation levels were significantly more likely to engage in and adhere to self-care behaviors such as regular exercise, eating a healthy diet, and engaging in stress reduction strategies.

Discussion
This study demonstrated that the PAM-10 is a reliable and valid measure for family caregivers of patients with chronic illnesses to measure caregivers’ health activation of their own healthcare needs.
Are Canadian orthopaedic surgeons and American orthopaedic surgeons on par? A Canadian practice survey of orthopaedic traumatologists
Authors: Doxey Stephen , Only Arthur J. , Milshteyn Michael , Cunningham Brian P. , Cannada Lisa K. 
Published: April 2023

Abstract

Objectives:
The purpose of this study was to obtain information on Canadian orthopaedic trauma surgeon practices and salary demographics. It was hypothesized that most of the practicing surgeons recognize specific practice aspects (compensation, call schedule, operating room availability, and provided support staff) as key factors in employment opportunity evaluation.

Design:
Cross-sectional survey study.

Setting:
Orthopaedic Trauma Association (OTA) practice surveys.

Participants:
All active Canadian members of the OTA were eligible to participate.

Main Outcome Measurement:
A 50-question survey was sent through email to OTA members assessing physician, practice, and compensation metrics of Canadian orthopaedic traumatologists.

Results:
Fifty-two of 113 Canadian OTA members participated giving a response rate of 46%. All surgeons worked in an academic practice, either for a university (83%) or community hospital (17%). Only 2% of surgeons have changed jobs in the last 5 years, and over 73% of surgeons maintain the same place of employment during their careers. Most had an available dedicated orthopaedic trauma operating room (73%). The majority indicated having residents (71%) and fellows (63%) as support staff. Many reported completing 300–500 cases per year (42%), which decreased during COVID-19 for 50% of surgeons. The most common reported compensation was between $400,000 and $600,000 US dollars (25%) with many working 4–6 call shifts a month (48%) and 51–70 hours a week (48%).

Conclusion:
This study demonstrated the varying practice and physician economic variables currently in Canada. The identification and continued surveillance of these employment variables will allow for transparency in job market evaluation by applicants.

Level of Evidence:
Level V.
“Prevention of postoperative complications by prepectoral versus subpectoral breast reconstruction: A systematic review and meta-analysis”
Authors: Kim Yo-Han , Yang Yun-Jung , Lee Dong-Won , Song Seung-Yong , Lew Dae-Hyun , Yang Eun-Jung 
Published: April 2023

Background:
Implant-based breast reconstruction has evolved over time. However, the effects of prepectoral breast reconstruction (PBR) compared with those of subpectoral breast reconstruction (SBR) have not been clearly defined. Therefore, this study aimed to compare the occurrence of surgical complications between PBR and SBR to determine the procedure that is effective and relatively safe.

Methods:
PubMed, Cochrane Library, and EMBASE databases were searched for studies published until April 2021 comparing PBR and SBR postmastectomy. Two authors independently assessed the risk of bias. General information on the studies and surgical outcomes were extracted. Among 857 studies, 34 and 29 were included in the systematic review and meta-analysis, respectively. Subgroup analysis was performed to clearly compare the results of patients who underwent postmastectomy radiation therapy (PMRT).

Results:
Pooled results showed that prevention of capsular contracture (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.41–0.79) and infection control (OR 0.73, 95% CI 0.58–0.92) were better with PBR than with SBR. Rates of hematoma, implant loss, seroma, skin-flap necrosis, and wound dehiscence were not significantly different between PBR and SBR. PBR considerably improved postoperative pain, BREAST-Q score, and upper arm function compared with SBR. Among PMRT patients, the incidence rates of capsular contracture were significantly lower in the PBR group than in the SBR group (OR 0.14, 95% CI 0.05–0.35).

Conclusions:
The results showed that PBR had fewer postoperative complications than SBR. Our meta-analysis suggests that PBR could be employed as an alternative technique for breast reconstruction in appropriate patients.
“Needle micro-cores: can they pose an occlusive threat with non-particulate injections?”
Authors: Soares Danny J. , Bowhay Alexis , von Haven Haley N. , Ugarte Angela J. , Blevins Larry W. , Birusingh Rhea J. , Kechriotis Chris , Yi Christina H. 
Published: April 2023

Summary:
The incidence of vascular occlusion injuries has risen substantially due to the increasing popularity of cosmetic injectables. Among these occurrences, instances of soft tissue ischemic events following the injection of non-particulate solutions, such as botulinum, represent an enigmatic etiology that has yet to be fully understood. One hypothesized mechanism of injury underlying these events relates to the accidental capture and intravascular ejection of needle micro-cores, defined as submillimeter tissue fragments trapped by the beveled lumen of a needle during conventional injections. To test this hypothesis, we conducted a cytologic evaluation of dermal remnants incidentally captured by 31G tuberculin needles following repeated injections into post-rhytidectomy skin fragments. Our findings revealed the presence of dermal tissue micro-cores ranging from 100-275 μm in diameter with an overall micro-coring incidence of 0.7%. These findings confirm the ability of ultra-fine needles, commonly employed in botulinum injections, to produce tissue micro-cores that may serve as causative agents of vascular occlusion with non-particulate solutions. Awareness of this additional mechanism of injury may be of benefit in the early recognition and management of these rare occurrences.
177Lu-DOTATATE Theranostics
Authors: Peterson Avery B. , Wang Chang , Wong Ka Kit , Frey Kirk A. , Muzik Otto , Schipper Matthew J. , Dewaraja Yuni K. 
Published: April 2023

Purpose
Pretreatment predictions of absorbed doses can be especially valuable for patient selection and dosimetry-guided individualization of radiopharmaceutical therapy. Our goal was to build regression models using pretherapy 68Ga-DOTATATE PET uptake data and other baseline clinical factors/biomarkers to predict renal absorbed dose delivered by 177Lu-DOTATATE peptide receptor radionuclide therapy (177Lu-PRRT) for neuroendocrine tumors. We explore the combination of biomarkers and 68Ga PET uptake metrics, hypothesizing that they will improve predictive power over univariable regression.

Patients and Methods
Pretherapy 68Ga-DOTATATE PET/CTs were analyzed for 25 patients (50 kidneys) who also underwent quantitative 177Lu SPECT/CT imaging at approximately 4, 24, 96, and 168 hours after cycle 1 of 177Lu-PRRT. Kidneys were contoured on the CT of the PET/CT and SPECT/CT using validated deep learning–based tools. Dosimetry was performed by coupling the multi–time point SPECT/CT images with an in-house Monte Carlo code. Pretherapy renal PET SUV metrics, activity concentration per injected activity (Bq/mL/MBq), and other baseline clinical factors/biomarkers were investigated as predictors of the 177Lu SPECT/CT-derived mean absorbed dose per injected activity to the kidneys using univariable and bivariable models. Leave-one-out cross-validation (LOOCV) was used to estimate model performance using root mean squared error and absolute percent error in predicted renal absorbed dose including mean absolute percent error (MAPE) and associated standard deviation (SD).

Results
The median therapy-delivered renal dose was 0.5 Gy/GBq (range, 0.2–1.0 Gy/GBq). In LOOCV of univariable models, PET uptake (Bq/mL/MBq) performs best with MAPE of 18.0% (SD = 13.3%), and estimated glomerular filtration rate (eGFR) gives an MAPE of 28.5% (SD = 19.2%). Bivariable regression with both PET uptake and eGFR gives LOOCV MAPE of 17.3% (SD = 11.8%), indicating minimal improvement over univariable models.

Conclusions
Pretherapy 68Ga-DOTATATE PET renal uptake can be used to predict post-177Lu-PRRT SPECT-derived mean absorbed dose to the kidneys with accuracy within 18%, on average. Compared with PET uptake alone, including eGFR in the same model to account for patient-specific kinetics did not improve predictive power. Following further validation of these preliminary findings in an independent cohort, predictions using renal PET uptake can be used in the clinic for patient selection and individualization of treatment before initiating the first cycle of PRRT.
Roseomonas fluvialis sp. nov., an aerobic bacteriochlorophyll a-containing freshwater bacterium isolated from river epilithic biofilm
Authors: Hirose Setsuko , Asano Tomomi , Hamada Moriyuki , Morohoshi Sho , Kunihiro Tadao , Hanada Satoshi 
Published: April 2023

A strictly aerobic bacteriochlorophyll a-containing alphaproteobacterium, designated strain S08T, was isolated from a biofilm sampled at Tama River in Japan. The non-motile and rod-shaped cells formed pink-beige pigmented colonies on agar plates containing organic compounds and showed in vivo absorption maxima at 798 and 866 nm in the near-infrared region, typical for the presence of bacteriochlorophyll a. The new bacterial isolate is Gram-negative, oxidase-negative and catalase-positive. Phylogenetic analysis based on 16S rRNA gene sequences showed that strain S08T was closely related to species in the genus

Roseomonas

. The closest phylogenetic relative of strain S08T was

Roseomonas lacus

TH-G33T (98.2 % sequence similarity). The major cellular fatty acids were C16 : 0, C18 : 1 2-OH and summed feature 8 (C18 : 1
ω7c/C18 : 1
ω6c). The predominant respiratory quinone was ubiquinone-9. The major polar lipids contained diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylcholine and an aminolipid. The G+C content of the genomic DNA was 70.6 mol%. The average nucleotide identity and digital DNA–DNA hybridization values between strain S08T and the related

Roseomonas

type strains were all far lower than the cut-off value for the delineation of species. The results of polyphasic comparisons showed that strain S08T was clearly distinguishable from other members of the genus

Roseomonas

. Therefore, we propose a new species in the genus

Roseomonas

, namely, Roseomonas fluvialis sp. nov. The type strain is S08T (=DSM 111902T=NBRC 112025T).
SLC26A2-mediated sulfate metabolism is essential for the tooth development
Authors: Yoshida Y. , Inubushi T. , Yokoyama M. , Nag P. , Oka A. , Murotani T. , Kani R. , Shiraishi Y. , Kurosaka H. , Takahata Y. , Nishimura R. , Papagerakis P. , Yamashiro T. 
Published: April 2023

AbstractThe sulfate transporter gene SLC26A2 is responsible for diastrophic dysplasia, which represents skeletal dysplasia in humans. This highlights the importance of sulfate metabolism in skeletal formation. SLC26A2-related chondrodysplasia is also known to exhibit abnormalities in craniofacial and tooth development. Although the function of SLC26A2 in mammals has been investigated using genetic mouse models, the essential role of SLC26A2 during craniofacial and tooth development has not been elucidated.In this study, we demonstrate the pivotal roles of SLC26A2-mediated sulfate metabolism during tooth development. Analysis ofSlc26a2expression reveals that it is predominantly expressed in dental tissues, including odontoblasts and ameloblasts, during tooth development.Slc26a2knockout mice (Slc26a2-KO-Δexon2) exhibit a retrognathic upper jaw, small upper incisors, and hypoplasia of upper molars. Additionally, upper incisors and molars inSlc26a2-KO-Δexon2mice display flattened odontoblasts and nuclei that lack intracellular polarity. In contrast, tooth phenotype is not remarkable in lower incisors and molars.Furthermore, the expression of odontoblast differentiation markers,DsppandDmp1, is significantly decreased in the upper molars ofSlc26a2-deficient mice.Ex vivoorgan culture of tooth germs by implantation ofSlc26a2-deficient tooth germs under the kidney capsule reveals hypoplasia of the dentin matrix as well as tooth root shortening.In vitrostudies using human dental pulp stem cells (hDPSCs) show that the expression levels ofDsppandDmp1inshSlc26a2knockdown cells are significantly decreased compared to control cells.Collectively, our data demonstrate that SLC26A2-mediated sulfate metabolism is essential for tooth development. This study may provide insight into the mechanisms underlying tooth abnormalities in patients with recessively inherited chondrodysplasias caused by mutations in the SLC26A2 gene.
Short time diffusive fluxes over membrane receptors yields the direction of a signaling source
Authors: Lindsay Alan E. , Bernoff Andrew. J. , Hernández Adrián Navarro 
Published: April 2023

AbstractAn essential ability of many cell types is to detect stimuli in the form of shallow chemical gradients. Such cues may indicate the direction that new growth should occur, or the location of a mate. Amplification of these faint signals is due to intra cellular mechanisms while the cue itself is generated by the noisy arrival of signaling molecules to surface bound membrane receptors. We employ a new hybrid numerical-asymptotic technique coupling matched asymptotic analysis and numerical inverse Laplace transform to rapidly and accurately solve the parabolic exterior problem describing the dynamic diffusive fluxes to receptors. We observe that equilibration occurs on long timescales, potentially limiting the usefulness of steady state quantities for localization at practical biological timescales. We demonstrate that directional information is encoded primarily in early arrivals to the receptors, while equilibrium quantities inform on source distance. We develop a new homogenization result showing that complex receptor configurations can be replaced by a uniform effective condition. In the extreme scenario where the cell adopts the angular direction of the first impact, we show this estimate to be surprisingly accurate.