bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breast Surgery with Smooth Anatomical Implants with Fixation System: A Review of the World’s Largest Series of Cases
Authors: Mayo Federico 
Published: January 2023

Background:
Anatomical implants continue to be a particularly useful tool in breast surgery, offering an excellent result for certain indications. However, to ensure fixation and prevent rotation, traditional alternatives have medium to high surface roughness and have been controversial in recent years.

Methods:
A retrospective assessment of 122 prosthetic augmentation and reconstruction patients over a period of 5 years was conducted. Patients were treated with tabbed anatomical implants with a smooth surface and followed up for a period of 12 months. Demographics, complications, and patient satisfaction were captured. A subgroup of 101 patients were assessed with chest radiographs at 1-year follow-up. Technical recommendations are discussed.

Results:
Primary breast augmentation, revision augmentation, augmentation-mastopexy, and breast reconstruction were the main indications for surgery. All implants were inserted through an inframammary incision and placed in the subpectoral space using dual-plane techniques, except in one mastectomy case. Rotation of the implants was radiographically observed in only two cases of revision augmentation. None of the 122 patients developed capsular contracture, seroma, rupture, infection, hematoma, or malposition following breast surgery.

Conclusions:
Smooth anatomical implants with a fixation system offer reliable and satisfactory results for patients with various diagnoses and indications. The tab system and the fixation technique are essential to provide long-term stability, which was verified by radiographs because of the radiopaque lines present in the device for that purpose.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Anatomical Guidelines for Thigh Lipoplasty Based on Cadaveric Dissection of the Superficial Fascial System in the Thigh
Authors: Si Loubin , Li Zhijin , Li Hairui , Fu Lin , Zhang Mingzi , Qiu Zikai , Wang Xiaojun , Wang Yang 
Published: January 2023

Background:
Although widely accepted as an optimal procedure in thigh contouring, liposuction can result in complications, such as skin irregularity or aspiration inadequacy. A main cause might be insufficient knowledge of the superficial fascial system (SFS). The authors aimed to explore the characteristics of the SFS in the thigh and propose anatomical guidelines and new zoning for liposuction-assisted thigh contouring.

Methods:
A total of 20 fresh female thighs were dissected from the skin to deep fascia to observe and compare changes in the SFS from the medial to the lateral side and from the proximal to the distal end.

Results:
The thigh was divided into four units, namely, the medial (three subunits: upper, middle, and lower), anterior, posterior (three subunits: upper medial, upper lateral, and middle lower parts), and lateral thigh. The authors found that the form of the SFS has regional variations. Therefore, based on these varied features, four anatomical scenarios (degrees I to IV) and one functional section (hip-contour support) were devised from the eight subunits. Five different liposuction methods were formulated to manage these subunits: all-layer mass liposuction, normal aspiration, border feather-out, restricted lipoplasty, and anchor.

Conclusions:
The SFS of the thigh showed a regional variation pattern, based on which the authors proposed a series of new anatomy-based liposuction approaches. A well-sculpted thigh with its different sections presented in harmony can be safely obtained using these approaches.
Cyclical Stretching Induces Excess Intracellular Ca2+ Influx in Human Keloid-Derived Fibroblasts In Vitro
Authors: Mineda Kazuhide , Sato Katsuya , Nakahara Tasuku , Minami Kazuyuki , Yamashita Yutaro , Ishida Soshi , Abe Yoshiro , Hashimoto Ichiro 
Published: January 2023

Background:The incidence of keloids is higher in the case of darker skin. It is more common in the parts exposed to stretching (thorax, abdomen, and joints). Cyclical stretching reportedly induced each Ca2+spike through differential mechanosensitive channels in human synovial and dermal fibroblasts. Therefore, the authors hypothesized that cyclical stretching also induces a specific Ca2+spike in keloid-derived fibroblasts.Methods:This in vitro study compared the intracellular calcium dynamics induced by cyclical stretching between control (human dermal fibroblasts) and keloid (human keloid-derived fibroblasts) groups. Each group was exposed to two-dimensional stretch using an originally developed stretch microdevice. Intracellular Ca2+was observed for 5 minutes, including 30 seconds of baseline, under a fluorescent confocal laser microscope. The intracellular Ca2+concentration was evaluated every 0.5 second using the fluorescence intensity ratio. A positive cellular response was defined as a rise of the ratio by greater than or equal to 20%. The normal response cutoff value was determined by receiver operating characteristic analysis.Results:The keloid groups were significantly more responsive than the control groups (15.7% versus 8.2%;P= 0.029). In the cellular response-positive cells, the keloid groups reached significantly higher intracellular Ca2+concentration peaks than the control groups (2.20 versus 1.26;P= 0.0022). The cutoff value was 1.77, and 10.4% of the keloid-derived fibroblasts exhibited a hyper-Ca2+spike above the normal range.Conclusions:Keloid-derived fibroblasts with a hyper-Ca2+spike might constitute a keloid-specific subpopulation. Hereafter, the authors will study whether the normalization of excessive intracellular Ca2+concentration leads to keloid treatment in vivo.Clinical Relevance Statement:This study result provided a clue to the onset mechanism of keloids, which the authors hope will lead to the development of new therapy in the future.
The Implications of the Emergency Medical Treatment and Labor Act and the No Surprises Act for Plastic and Reconstructive Surgeons
Authors: Seitz Allison J. , Nicksic Peter J. , Rao Venkat K. 
Published: January 2023

Summary:
The Emergency Medical Treatment and Labor Act (EMTALA) was enacted by Congress in 1986 to protect uninsured patients against economic discrimination. Although this law has been established for several decades, recent passage of the No Surprises Act may invoke new implications for the health care system under EMTALA. Therefore, it is worthwhile to review EMTALA’s applications to the practice of plastic surgery and review EMTALA in the context of the recently passed No Surprises Act. First, providers are mandated by EMTALA to administer a medical screening examination to any patient presenting for emergent care. Second, providers must administer medical stabilization if the medical screening examination reveals an emergent condition. If the hospital lacks specialized capabilities to provide stabilizing care, they are required to transfer the patient to a facility that can provide care. Although EMTALA’s provisions protect patients and provide them with leverage to obtain emergency care, the act has been associated with out-of-network, or “surprise,” medical bills for the insured population and, ultimately, may be detrimental to plastic surgeons in emergency settings. The concerns related to EMTALA within plastic surgery involve the overburdening of surgeons at tertiary care centers because of uncompensated care and high rates of interfacility transfers. In addition, the recent passage of the No Surprises Act to end out-of-network emergency bills may further impact care provided by plastic surgeons in emergency settings under EMTALA’s mandate. Potential methods to address these concerns include increasing on-call reimbursement rates and implementation of emergency department telemedicine services.
Impact of Variations in the Nursing Care Supply-Demand Ratio on Postoperative Outcomes and Costs
Authors: Agri Fabio , Grass Fabian , Kasmi Sophie , Demartines Nicolas , Schäfer Markus , Sauvain Marc-Olivier 
Published: January 2023

Introduction
Improving surgical outcomes is a priority during the last decades because of the rising economic health care burden. The adoption of enhanced recovery programs has been proven to be part of the solution. In this context, the impact of variations in the nursing care supply-demand ratio on postoperative complications and its economic consequences is still not well elucidated. Because patients require different amounts of care, the present study focused on the more accurate relationship between demand and supply of nursing care rather than the nurse-to-patient ratio.

Methods
Through a 3-year period, 838 patients undergoing elective and emergent colorectal and pancreatic surgery within the institutional enhanced recovery after surgery (ERAS) protocol were retrospectively investigated. Nursing demand and supply estimations were calculated using a validated program called the Projet de Recherche en Nursing (PRN), which assigns points to each patient according to the nursing care they need (estimated PRN) and the actual care they received (real PRN), respectively. The real/estimated PRN ratio was used to create 2 patient groups: one with a PRN ratio higher than the mean (PRN+) and a second with a PRN ratio below the mean (PRN−). These 2 groups were compared regarding their postoperative complication rates and cost-revenue characteristics.

Results
The mean PRN ratio was 0.81. A total of 710 patients (84.7%) had a PRN+ ratio, and 128 (15.3%) had a PRN− ratio. Multivariable analysis focusing on overall complications, severe complications, and prolonged length of stay revealed no significant impact of the PRN ratio for all outcomes (P > 0.2). The group PRN− had a mean margin per patient of U.S. dollars 1426 (95% confidence interval, 3 to 2903) compared with a margin of U.S. dollars 676 (95% confidence interval, −2213 to 3550) in the PRN+ group (P = 0.633).

Conclusions
A PRN ratio of 0.8 may be sufficient for patients treated following enhanced recovery after surgery guidelines, pending the adoption of an accurate nursing planning system. This may contribute to better allocation of nursing resources and optimization of expenses on the long run.
Type 1 Fuzzy Logic Classification of Pain Severity (Pain Assessment)
Authors: Bundalian Linnaeus T. , M. Pariño Rhendell John , Caldo Rionel B. 
Published: January 2023

AbstractFuzzy logic has given man a vast range of opportunities in different field of practice. Fuzzy logic applications are often used in automated systems, robotics and even in medicine. Medical applications of fuzzy logic has greatly improved some gray areas in medical practices especially when considering factors that has no direct unit of measurement to define its degree or magnitude and this includes pain assessment. Assessing pain has become a challenge for medical practitioners since the degree of its severity varies among people. There are number of tools to assess the severity of pain, but none of these have described a constant scale for each corresponding degree of severity. This paper applies the concepts of fuzzy logic in assessing the severity of pain. The goal of the study is to come up with a type 1 fuzzy logic classification of pain assessment in Excel VB macro program platform.
Mechanistic insights into the interactions between cancer drivers and the tumour immune microenvironment
Authors: Misetic Hrvoje , Keddar Mohamed Reda , Jeannon Jean-Pierre , Ciccarelli Francesca D. 
Published: January 2023

ABSTRACTThe crosstalk between cancer and the tumour immune microenvironment (TIME) has attracted significant interest because of its impact on cancer evolution and response to treatment. Despite this, cancer-specific tumour-TIME interactions and their mechanisms of action are still poorly understood. Here we identified the interactions between cancer-specific genetic drivers and anti- or pro-tumour TIME features in individual samples of 32 cancer types. The resulting 477 TIME drivers are multifunctional genes whose alterations are selected early in cancer evolution and recur across and within cancer types. Moreover, the anti-tumour TIME driver burden is predictive of overall response to immunotherapy. Focusing on head and neck squamous cancer (HNSC), we rebuilt the functional networks linking specific TIME driver alterations to the TIME state. We showed that TIME driver alterations predict the immune profiles of HNSC molecular subtypes, and that deregulation of keratinization, apoptosis and interferon signalling underpin specific driver-TIME interactions. Overall, our study provides a comprehensive resource of TIME drivers giving mechanistic insights into their immune-regulatory role.
The Impact of Multiple Sequence Alignment Error on Phylogenetic Estimation under Variable-Across-Phylogeny Substitution Models
Authors: Doko Rei , Liu Kevin J. 
Published: January 2023

AbstractIn many different species, it has been observed that nucleotide compositions are not identical on the genic and even genomic scale. This observation contradicts a commonly held assumption in most maximum likelihood based phylogenetic estimation methods - that the process governing DNA evolution is identical across lineages. We show that when DNA evolution is nonhomogeneous, topological estimation and continuous parameter estimation are impacted both by alignment quality and model misspecification due to the homogeneity-across-lineages assumption.
Circadian rhythm disruption is associated with skeletal muscle dysfunction within the blind Mexican Cavefish
Authors: Olsen Luke , Krishnan Jaya , Banks Charles , Hassan Huzaifa , Rohner Nicolas 
Published: January 2023

SummaryCircadian control of physiology and metabolism is pervasive throughout nature, with circadian disruption contributing to premature aging, neurodegenerative disease, and type 2 diabetes (Musiek et al. 2016; Panda, 2016). It has become increasingly clear that peripheral tissues, such as skeletal muscle, possess cell-autonomous clocks crucial for metabolic homeostasis (Gabriel et al. 2021). In fact, disruption of the skeletal muscle circadian rhythm results in insulin resistance, sarcomere disorganization, and muscle weakness in both vertebrates and non-vertebrates – indicating that maintenance of a functional muscle circadian rhythm provides an adaptive advantage. We and others have found that cavefish possess a disrupted central circadian rhythm and, interestingly, a skeletal muscle phenotype strikingly similar to circadian knock-out mutants; namely, muscle loss, muscle weakness, and insulin resistance (Olsen et al. 2022; Riddle et al. 2018; Mack et al. 2021). However, whether the cavefish muscle phenotype results from muscle-specific circadian disruption remains untested. To this point, we investigated genome-wide, circadian-regulated gene expression within the skeletal muscle of theAstyanax mexicanus– comprised of the river-dwelling surface fish and troglobitic cavefish – providing novel insights into the evolutionary consequence of circadian disruption on skeletal muscle physiology.
The role of accounting regulation on good news recognition and conditional conservatism: evidence from China’s 2006 accounting regulation
Authors: Barhamzaid Zuhair 
Published: January 2023

Purpose
This study aims to investigate the impact of accounting regulation (AR) on good news (GNs) recognition and conditional conservatism (CC), using the Chinese experiment in the 2006 AR.

Design/methodology/approach
The current study applies the Basu (1997) model to a sample of 26,755 firm-year observations from 1997 to 2017.

Findings
The study finds that GNs recognition is significantly reduced and becomes significantly less than bad news recognition under China’s 2006 AR, suggesting that CC is enhanced under China’s 2006 AR.

Research limitations/implications
This paper excludes the financial sector from the sample. Thus, generalizing results on the financial sector is not appropriate. In addition, the available literature on this topic is limited as it deals with convergence with IFRS, not the full adoption of IFRS.

Practical implications
The study findings are expected to benefit policymakers and accounting standard setters in controlling GNs recognition and CC as well.

Originality/value
Whereas prior studies on this topic report their results on CC only, without considering the role of AR on GNs recognition, this paper highlights the role of AR on both GNs recognition and CC as well.
Explicating the contextuality of corporate governance through ownership structure and family management: evidence from an emerging economy
Authors: Hasan Arshad , Riaz Zahid , Nakpodia Franklin 
Published: January 2023

Purpose
This study aims to investigate the impact of family management and ownership structure, including foreign ownership and business group ownership, on corporate performance.

Design/methodology/approach
Using an agency perspective and a quantitative research methodology, this study examines listed firms in Pakistan from 2009 to 2018.

Findings
The results suggest that family management and concentrated leadership constrain, whereas family leadership, foreign ownership and group ownership strengthen monitoring effectiveness and corporate performance. These findings imply that the shareholder governance logic offers optimal solutions in an emerging economy, as relational governance may activate agency problems.

Originality/value
The findings are consistent with the relevance of relational governance mechanisms in the form of family leadership. However, the results suggest that emerging economies require a hybrid governance model to address their unique agency problems, thereby underlining context relevance in corporate governance scholarship. Furthermore, this research adopts a thick view of institutions to clarify institutional embeddedness and corporate governance contextuality in an emerging economy.
The impact of job insecurity on job burnout among hospitality employees during COVID-19 pandemic: the moderating role of supervisor and co-worker support
Authors: Chong Chin Ann , Ng Lee Peng , Chen I-Chi 
Published: January 2023

PurposeThis study evaluates the moderating role of work-based social supports (i.e. supervisor support and co-worker support) in the relationship between job insecurity and job burnout among hospitality employees in Malaysia. Besides, the direct effect between job insecurity and job burnout is examined.Design/methodology/approachThe cross-sectional data of this study were based on a total of 220 self-administered questionnaires that have been completed by hospitality employees from three different states in Malaysia. Respondents were recruited based on a snowball sampling approach. The data were collected during the COVID-19 pandemic, which was from October 2020 to January 2021.FindingsPartial least square-structural equation modeling (PLS-SEM) was performed via SmartPLS software. The finding confirmed that job insecurity significantly intensifies employees' job burnout. Supervisor support and co-worker support were found to moderate the link between job insecurity and burnout. As anticipated, the relationship between job insecurity and job burnout increased when supervisor support is low. But high co-worker support was found to strengthen the impact of job insecurity on job burnout instead of the reverse.Originality/valueThis study supplements the existing literature by clarifying which sources of work-based social support (i.e. co-worker support or supervisor) is more salient in alleviating the adverse impact of job insecurity on job burnout during the COVID-19 pandemic among hospitality employees in Malaysia.
Critical reflection on VUCA in tourism and hospitality marketing activities
Authors: Lubowiecki-Vikuk Adrian , Budzanowska-Drzewiecka Małgorzata , Borzyszkowski Jacek , Taheri Babak 
Published: January 2023

PurposeThis paper aims to provide an interpretative synthesis and critical reflection on the concept of “volatility, uncertainty, complexity and ambiguity” (VUCA) and its implementation in tourism and hospitality marketing activities and explain why it is useful and necessary.Design/methodology/approachThis paper is based on a critical reflection research methodology which allows for a synthesis of data from the traditional narrative review and on the authors’ experiences and observations.FindingsThe volatile environments in which entities from the tourism and hospitality industry (T&HI) operate necessitate a redefinition of the rules for designing marketing activities. The VUCA concept may serve as the basis for these changes. Its implementation requires specific managerial skills enabling T&HI entities to use an agile marketing strategy. The latter should be based on a flexible and customer-centric approach.Practical implicationsThis paper provides a VUCA framework for adapting marketing mix instruments to the rapidly changing hospitality and tourism industry. This paper also offers several useful guides for practitioners on different aspects of VUCA within the industry.Originality/valueTo the best of the authors’ knowledge, this paper is one of the first attempts to reflect critically on the possibilities of using the VUCA concept in marketing by the T&HI and contributes to the discussion about the conditions for its implementation. This paper offers suggestions about the dynamic competencies of tourism and hospitality managers (enterprise and leader oriented), which are essential when designing marketing mix instruments in line with the VUCA concept, and indicates directions for future research.
Talent orchestration and boomerang talent: seasonally employed chefs’ evaluation of talent management practices
Authors: Magrizos Solon , Roumpi Dorothea , Rizomyliotis Ioannis 
Published: January 2023

PurposeThe aim of this study is to shed light on the talent management practices in the unique context of seasonal work in professional kitchens. Acknowledging that in the context of seasonal work in the hospitality industry it is rather difficult to rely on mainstream strategic talent management practices (e.g. training and development), the authors draw on resource orchestration, an extension of the resource-based view and propose a conceptual model of talent management tactics that could potentially increase seasonal employees’ likelihood of returning to the same employer.Design/methodology/approachGiven the uniqueness of the context of this study and the dearth of prior relevant research, this study uses a grounded theory approach. Specifically, this study analyses and draws conclusions from 25 interviews with employees in commercial kitchens.FindingsThis study develops a “talent orchestration model”, which places emphasis on management of talented employees across three dimensions: structuring, leveraging and developing talent.Research limitations/implicationsExtant literature in human capital management focusses mostly on the development of human capital, but the results place more emphasis on using or leveraging human capital.Originality/valueThis study moves beyond the well-researched context of hotels and focusses on talent management behind closed doors as in the case of kitchen chefs and, drawing on resource orchestration, this study further examines talent management practices with shorter time frame targeted on seasonal employees.