bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genioglossus Advancement: Technique Modification for Improved Chin Contour
Authors: Emanuelli Elisa , O’Connor Michaela K. , Garg Ravi K. 
Published: March 2023

Summary:
Genioglossus advancement plays an important role in the armamentarium of the obstructive sleep apnea surgeon and has gone through many iterations over several decades. A recently described technique involves creating a box osteotomy, which is carried through the inferior border of the mandible in order to increase recruitment of the suprahyoid musculature. Here we introduce a further modification of the technique that uses virtual planning to improve the safety and accuracy of genial tubercle capture. In addition, angulation of the lateral osteotomies enhances bone to bone contact. Before the osteotomy, the surgeon has the opportunity to drill the buccal plate to reduce the chin profile. This approach is particularly valuable in the patient who is prognathic at baseline or who becomes prognathic after simultaneous maxillomandibular advancement. Here we discuss this unique approach, demonstrating how the patient profile may be balanced even as the genial tubercle is advanced.
Nipple Shield Made from a Thermoplastic with Aluminum Properties
Authors: Soyano Haruka , Matsumine Hajime 
Published: March 2023

Summary:
Here, we report the preparation of a nipple shield from an inexpensive and re-formable thermoplastic with metallic properties as well as its favorable outcomes when used for patients who had undergone nipple reconstruction. The nipple shield was prepared from a material made of a mixture of a thermoplastic resin and special aluminum pellets (aluminum content, 70%). Each patient wore the nipple shield for 3 months after nipple reconstruction. The material was re-softened for re-forming into an adequate shape as required during this 3-month period. All reconstructed nipples were securely protected, with no complications (eg, ulceration, wound dehiscence, and wound infections) during the 3-month period. Also, there were no skin complications such as contact dermatitis or cellulitis in the area where the nipple shield was in contact with the skin. None of the patients stopped using the nipple shield because it came off frequently, or was uncomfortable or painful to wear, and there were no cases in which the nipple shield had to be remade due to damage. The thermoplastic material used in this study appeared to be extremely useful as a nipple protection material because of its good breathability, attributed to its nonwoven form, its low thermal conductivity and resulting cooling effect attributed to its aluminum content, its suitability for rapid re-forming, and its washability.
Subclinical atherosclerosis and risk factors in relation to autonomic indices in the general population
Authors: Zambach Christian , Fedorowski Artur , Gerward Sofia , Johansson Madeleine , Engström Gunnar , Hamrefors Viktor 
Published: March 2023

Objective:
Orthostatic hypotension and resting heart rate (RHR) are associated with cardiovascular disease (CVD). However, it is unknown how these factors relate to subclinical CVD. We examined the relationship between orthostatic blood pressure (BP) response, RHR and cardiovascular risk factors, including coronary artery calcification score (CACS) and arterial stiffness, in the general population.

Methods:
We included 5493 individuals (age 50–64 years; 46.6% men) from The Swedish CArdioPulmonary-bio-Image Study (SCAPIS). Anthropometric and haemodynamic data, biochemistry, CACS and carotid-femoral pulse wave velocity (PWV) were retrieved. Individuals were categorized into binary variables that manifest orthostatic hypotension and in quartiles of orthostatic BP responses and RHR, respectively. Differences across the various characteristics were tested using χ2 for categorical variables and analysis of variance and Kruskal–Wallis test for continuous variables.

Results:
The mean (SD) SBP and DBP decrease upon standing was -3.8 (10.2) and -9.5 (6.4) mmHg, respectively. Manifest orthostatic hypotension (1.7% of the population) associated with age (P = 0.021), systolic, diastolic and pulse pressure (P < 0.001), CACS (<0.001), PWV (P = 0.004), HbA1c (P < 0.001) and glucose levels (P = 0.035). Age (P < 0.001), CACS (P = 0.045) and PWV (P < 0.001) differed according to systolic orthostatic BP, with the highest values seen in those with highest and lowest systolic orthostatic BP-responses. RHR was associated with PWV (P < 0.001), SBP and DBP (P < 0.001) as well as anthropometric parameters (P < 0.001) but not CACS (P = 0.137).

Conclusion:
Subclinical abnormalities in cardiovascular autonomic function, such as impaired and exaggerated orthostatic BP response and increased resting heart rate, are associated with markers of increased cardiovascular risk in the general population.
Arterial stiffness and blood pressure in treated hypertension: a longitudinal study
Authors: Wu Shouling , Tian Xue , Chen Shuohua , Zhang Yijun , Zhang Xiaoli , Xu Qin , Wang Anxin 
Published: March 2023

Objectives:
It has been reported that an increase in arterial stiffness precedes an increase in blood pressure (BP) in the general population. Whether BP lowering results from of reducing arterial wall or vice versa in antihypertensive treatment is unclear. This study aimed to investigate the association between arterial stiffness and BP in patients with treated hypertension.

Methods:
This study included 3277 participants who were treated with antihypertensive agents and with repeated measurements of branchial-ankle pulse wave velocity (baPWV) and BP during 2010–2016 from the Kailuan study. Temporal relation between baPWV and BP was assessed by cross-lagged path analyses.

Results:
After adjustment for potential confounders, the standard regression coefficient from baseline baPWV to follow-up SBP was 0.14 [95% confidence interval (95% CI), 0.10–0.18], which was significantly greater than that from baseline SBP to follow-up baPWV (0.05; 95% CI, 0.02–0.08) (P < 0.0001 for difference). Similar results were observed for the cross-lagged analysis with changes of baPWV and mean arterial pressure. Further analysis showed that the yearly rate of change in SBP during the follow-up period significantly varied across increasing quartiles of baseline baPWV (P < 0.0001), whereas the yearly rate of change in baPWV showed a nonsignificantly varied trend across quartiles of baseline SBP (P = 0.2443).

Conclusion:
These findings provided strong evidence that reduction in arterial stiffness through antihypertensive treatment could precede BP lowering.
The sustainable antihypertensive and target organ damage protective effect of transcranial focused ultrasound stimulation in spontaneously hypertensive rats
Authors: Li Dapeng , Zhang Siyuan , Cao Fangyuan , Han Jie , Wang Mengke , Lai Chunhao , Zhang Jingjing , Xu Tianqi , Bouakaz Ayache , Wan Mingxi , Ren Pengyu 
Published: March 2023

Objective:
In this study, we aimed to investigate the sustainable antihypertensive effects and protection against target organ damage caused by low-intensity focused ultrasound (LIFU) stimulation and the underlying mechanism in spontaneously hypertensive rats (SHRs) model.

Methods and results:
SHRs were treated with ultrasound stimulation of the ventrolateral periaqueductal gray (VlPAG) for 20 min every day for 2 months. Systolic blood pressure (SBP) was compared among normotensive Wistar–Kyoto rats, SHR control group, SHR Sham group, and SHR LIFU stimulation group. Cardiac ultrasound imaging and hematoxylin–eosin and Masson staining of the heart and kidney were performed to assess target organ damage. The c-fos immunofluorescence analysis and plasma levels of angiotensin II, aldosterone, hydrocortisone, and endothelin-1 were measured to investigate the neurohumoral and organ systems involved. We found that SBP was reduced from 172 ± 4.2 mmHg to 141 ± 2.1 mmHg after 1 month of LIFU stimulation, P < 0.01. The next month of treatment can maintain the rat's blood pressure at 146 ± 4.2 mmHg at the end of the experiment. LIFU stimulation reverses left ventricular hypertrophy and improves heart and kidney function. Furthermore, LIFU stimulation enhanced the neural activity from the VLPAG to the caudal ventrolateral medulla and reduced the plasma levels of ANGII and Aldo.

Conclusion:
We concluded that LIFU stimulation has a sustainable antihypertensive effect and protects against target organ damage by activating antihypertensive neural pathways from VLPAG to the caudal ventrolateral medulla and further inhibiting the renin–angiotensin system (RAS) activity, thereby supporting a novel and noninvasive alternative therapy to treat hypertension.
Remembering Paul E. Meehl: Historical Contributions to Predictive Modeling in Human Behavior
Authors: Ryu Jihan 
Published: March 2023

Abstract
This article briefly examines the life and work of the late clinical psychologist and philosopher of science Paul E. Meehl. His thesis in Clinical versus Statistical Prediction (1954) that the data combination performed by mechanical operations, as compared to clinicians, achieves higher accuracy in predicting human behavior is one of the earliest theoretical works that laid the groundwork for utilizing statistics and computational modeling in research in psychiatry and clinical psychology. For today’s psychiatric researchers and clinicians grappling with the challenges of translating the ever-increasing data of the human mind into practice tools, Meehl’s advocacy for both accurate modeling of the data and their clinically relevant use is timely.
Hikikomori Syndrome and Digital Technologies: A Systematic Review
Authors: Sales-Filho Gabriel S. , Bandeira Igor D. , Argollo Nayara , Lucena Rita 
Published: March 2023

Abstract
Hikikomori syndrome (HS) is a voluntary prolonged social isolation associated with personal and community impact. Previous evidence pointed out a possible relationship between this syndrome with addiction to digital technologies. Here we aim to understand the relationship between HS and digital technology use, overuse, and addictive behaviors, as well as potential therapeutic approaches.
We conducted a systematic review of observational and intervention studies available in PubMed/MEDLINE, LILACS, IBECS, Embase, PsycINFO, and SciELO databases, following the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA 2020) criteria. The risk of bias was assessed with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and Consensus-based Clinical Case Reporting Guideline Development (CARE). Eligibility criteria were pre-, at-risk populations, or those with HS diagnosis, and any kind of technological overuse. Seventeen studies were included in the review, of which eight were cross-sectional, eight were case reports, and one was quasi-experimental. Hikikomori syndrome was associated with addition to digital technologies; no cultural differences were found. Environmental factors, such as a history of bullying, low self-esteem, and grief were identified as precursors of addictive behaviors. The included articles addressed addiction to digital technologies, electronic games, and social networks, among others, in HS. HS is cross-culturally associated with such addiction. The management of these patients remains challenging, and no target evidence-based treatments have been developed. The studies included in this review had several limitations, and more studies with a higher level of evidence are needed to support the results.
Effect of combined procedural pain interventions during neonatal intensive care on sleep, cognitive development, and internalizing behavior: a follow-up analysis of a randomized controlled trial
Authors: Gao Haixia , Li Mei , Gao Honglian , Xu Guihua , Wang Danwen , Lv Hui 
Published: March 2023

Abstract
Repeated procedural pain can cause preterm infants to spend excessive time awake at the cost of sleep and can have a detrimental impact on later cognitive and behavioral development. What's more, poor sleep may be correlated with worse cognitive development and more internalizing behaviors in infants and toddlers. In a randomized controlled trial (RCT), we found that combined procedural pain interventions (sucrose, massage, music, nonnutritive sucking, and gentle human touch) during neonatal intensive care could improve preterm infants' early neurobehavioral development. Here, we followed up the participants who were enrolled in the RCT to evaluate the effect of combined pain interventions on later sleep, cognitive development, and internalizing behavior and to determine whether sleep may moderate the effect of combined pain interventions on the cognitive development and internalizing behavior. Total sleep time and night awakenings at 3, 6, and 12 months old; the cognitive development (adaptability, gross motor, fine motor, language, and personal–social domains) at 12 and 24 months old measured by the Chinese version of Gesell Development Scale; and the internalizing behavior at 24 months old measured by the Chinese version of Child Behavior Checklist were assessed. Our findings showed the potential benefits of combined pain interventions during neonatal intensive care for preterm infant's later sleep, motor and language development, and internalizing behavior, and the effect of combined pain interventions on motor development and internalizing behavior might be moderated by the mean total sleep duration and night awakenings at 3, 6, and 12 months old.
Work-Related Factors Associated With Health and Well-Being of Early Care and Education Workers
Authors: Quinn Emilee L. , Otten Jennifer J. , Stover Bert , Peckham Trevor , Seixas Noah S. 
Published: March 2023

Objective
We assessed and examined relationships between the health and working conditions of early care and education workers.

Methods
We surveyed early care and education workers (n = 2242) about their socioeconomic characteristics; work organization; psychosocial, physical, and ergonomic exposures; coping behaviors; and health.

Results
Nearly half of respondents reported chronic health conditions. Most worked full time, half earned less than $30,000 a year, and many reported unpaid hours or inability to take breaks. One-quarter reported economic strain. Numerous exposures were prevalent. Workers' general health was poorer than normed averages, although their physical functioning was slightly better. Sixteen percent of workers reported work-related injuries, and 43% reported depressive symptoms. Factors associated with health included socioeconomic characteristics, having a chronic condition, job type, access to benefits, eight psychosocial stressors, four physical exposures, sleep, and alcohol consumption.

Conclusions
Findings support the need for attention to this workforce's health.
Effect of Surface Decalcification With Hydrochloric Acid on the Determination of Estrogen Receptor, Progesterone Receptor, Ki67, and Human Epidermal Growth Factor Receptor 2 Expressions in Invasive Breast Carcinoma Based on Immunohistochemistry and Fluorescence In Situ Hybridization
Authors: Ping Wu , Xin Rao , Li Zhang , Yupeng Chen , Fangling Song , Caihong Ren , Shun Hu , Sheng Zhang 
Published: March 2023

Background:
Bone is the most common site of metastatic breast cancer (MBC). EDTA is often used to decalcify bony tissue samples to ensure the accurate assessment of antigenicity in MBC. It takes ~24 to 48 hours to decalcify small bone tissues such as bone marrow, which is considered unacceptable given the priority that is often placed on the rapid processing of bone marrow trephine cores. Thus, an effective decalcification method that preserves genetic material is needed.

Aim:
We performed immunohistochemical studies on surface decalcification (SD) in breast tumors and evaluated the effect of SD on receptor status and human epidermal growth factor receptor 2 (HER2). Fluorescence in situ hybridization was performed on a subset of these tumors to establish a protocol for handling bone specimens for MBC.

Materials and Methods:
Forty-four cases of invasive breast tumors were studied. We compared the immunohistochemical expressions of estrogen receptor (ER), progesterone receptor (PR), Ki67, and HER2 between control tissue (nondecalcified) and parallel tissue subjected to SD with hydrochloric acid. We also evaluated the effect of SD on the fluorescence in situ hybridization expression of HER2.

Results:
Categorical decreases in ER and PR expression were identified in 9/31 (29.0%) cases without SD and 10/26 (38.5%) cases with SD. HER2 expression changed from equivocal to negative in 4/12 (33.4%) cases. Among the HER2-positive cases, all remained positive after SD. The most significant declines in immunoreactivity occurred with Ki67, with an average decrease from 22% to 13%. The average HER2 copy numbers were 5.37 and 4.76 in the control and SD groups, respectively, and the average HER2/CEP17 ratios were 2.35 and 2.08, respectively.

Conclusions:
Overall, SD is an alternative decalcification method in bony metastases to assess ER, PR, and HER2 in MBC.
Factors Associated With Weight Loss After Laparoscopic Adjustable Gastric Banding in Adolescents With Severe Obesity
Authors: Levaillant Lucie , Levaillant Mathieu , Sfeir Nathalie , Bouhours-Nouet Natacha , Amsellem-Jager Jessica , Beaumesnil Marion , Coutant Régis , Riquin Élise , Schmitt Françoise 
Published: March 2023

Background:
Childhood obesity is associated with many comorbidities. Bariatric surgery is known to be efficient for reducing weight in adolescents.

Objectives:
The primary outcome was to identify somatic or psychosocial factors associated with success at 24 months after a laparoscopic adjustable gastric banding (LAGB) procedure in our cohort of adolescents with severe obesity. Secondary endpoints were to describe weight loss outcomes, comorbidity resolution, and complications.

Methods:
We have retrospectively reviewed medical records of patients who had LAGB placed between 2007 and 2017. Factors associated with success at 24 months after LAGB were researched, with success being defined as positive percentage of excess weight loss (%EWL) at 24 months.

Results:
Forty-two adolescents underwent a LAGB procedure, the mean %EWL was 34.1% at 24 months, with improvement in most comorbidities and without major complications. Having lost weight before surgery was associated with success, whereas a high body mass index at surgery was associated with a higher risk of failure. No other factor was found to be associated with success.

Conclusion:
Comorbidities mostly improved 24 months after LAGB and no major complication occurred. Having lost weight before surgery was associated with a successful surgery, whereas a high body mass index at surgery increases the risk of failure.
Baseline depressive symptoms do not moderate the association between baseline symptom severity and time to recovery in individuals with grade I-II whiplash-associated disorders: A secondary analysis of a randomised controlled trial
Authors: Marchand Andrée-Anne , Hogg-Johnson Sheilah , Côté Pierre 
Published: March 2023

Abstract

Objective
This study investigated the moderating role of baseline depressive symptoms on the association between baseline pain severity and time to recovery in individuals with acute grade I-II whiplash-associated disorders (WAD).

Design
This is a secondary analysis of a randomised controlled trial investigating the effectiveness of a government-regulated rehabilitation guideline for the management of grade I-II WAD. Participants who completed baseline questionnaires for neck pain intensity and depressive symptoms and follow-up questionnaire on self-reported recovery were included in the analysis. Cox proportional hazards models were built, and hazard rate ratios were reported to describe the association between baseline neck pain intensity and time to self-reported recovery and to assess the effect modification of baseline depressive symptoms.

Results
303 participants provided data for this study. Despite baseline level of depressive symptoms and neck pain intensity being independently associated with delayed recovery, the association between baseline neck pain intensity and time to recovery was not stronger for individuals with significant post-collision depressive symptoms (HRR = 0.91 (95%CI 0.79–1.04)) than for those without depressive symptoms (HRR = 0.92 (95%CI 0.83-1.02)).

Conclusion
Baseline depressive symptoms are not an effect modifier of the association between baseline neck pain intensity and time to self-reported recovery in acute WAD.
Frailty education: promoting geriatric competencies among Physical Medicine and Rehabilitation residents
Authors: Maccarone Maria Chiara , Masiero Stefano , Papathanasiou Jannis , Panayotov Kiril , Kashilskah Yana , Prokopidis Konstantinos , Papanastasiou Christina , Tyllianakis Minos , Dionyssiotis Yannis 
Published: March 2023

Abstract
Frailty, a geriatric syndrome of growing importance in recent years, has been shown to be associated with increased risk of disability, adverse health and socio-economic outcomes. Therefore, there is a need for new educational strategies for Physical Medicine and Rehabilitation (PMR) residents to promote greater geriatric competencies, with a focus on developing customized evaluation and management plans. With this paper, we aimed at offering a quick reference tool summarizing the latest evidence on the rehabilitative management of frailty. Indeed, a comprehensive geriatric evaluation is needed before developing an evidence-based and individually tailored rehabilitation program including physical activity, educative strategies, nutritional interventions and proposals for social reintegration. In the future, appropriate educational training may allow a more careful management of these patients, with consequent improvements in quality of life and functionality.
Harmonic Scalpel-Assisted Endonasal Endoscopic Resection of the Vascular Tumors of the Anterior Skull Base
Authors: Jurlina Martin , Pupić-Bakrač Jure , Pupić-Bakrač Ana 
Published: March 2023

Vascular tumors represent a challenging pathologic subset for surgical treatment as they show a propensity for profuse bleedings. This is especially applicable to the skull base region, where surgical access is difficult due to its complex anatomy. To overcome this problem, the authors introduced the use of a harmonic scalpel in endoscopic skull base surgery for vascular tumors. Here, the authors report the outcomes of endoscopic harmonic scalpel-assisted surgery in 6 juvenile angiofibromas and 2 hemangiomas. All surgeries were performed using Ethicon Endo-Surgery HARMONIC ACE 5 mm Diameter Shears. The median intraoperative blood loss was 400 mL (range: 200–1500 mL). The median length of hospital stay was 7 days (range: 5–10 days). Recurrence was recorded in 1 patient with juvenile angiofibroma, which was successfully resolved with revision surgery. In this institutional experience, ultrasonic technology showed precise cutting with minimal bleeding, resulting in reduced surgical morbidity compared with conventional endoscopic instruments.