bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chitin nanocrystal-assisted 3D bioprinting of gelatin methacrylate scaffolds
Authors: Ling Zhengyun , Zhao Jian , Song Shiyu , Xiao Shuwei , Wang Pengchao , An Ziyan , Fu Zhouyang , Shao Jinpeng , Zhang Zhuang , Fu Weijun , Song Shenghan 
Published: June 2023

Abstract
In recent years, there has been an increasing focus on the application of hydrogels in tissue engineering. The integration of 3D bioprinting technology has expanded the potential applications of hydrogels. However, few commercially available hydrogels used for 3D biological printing exhibit both excellent biocompatibility and mechanical properties. Gelatin methacrylate (GelMA) has good biocompatibility and is widely used in 3D bioprinting. However, its low mechanical properties limit its use as a standalone bioink for 3D bioprinting. In this work, we designed a biomaterial ink composed of GelMA and chitin nanocrystal (ChiNC). We explored fundamental printing properties of composite bioinks, including rheological properties, porosity, equilibrium swelling rate, mechanical properties, biocompatibility, effects on the secretion of angiogenic factors and fidelity of 3D bioprinting. The results showed that adding 1% (w/v) ChiNC to 10% (w/v) GelMA improved the mechanical properties and printability of the GelMA hydrogels, promoted cell adhesion, proliferation and vascularization and enabled the printing of complex 3D scaffolds. This strategy of incorporating ChiNC to enhance the performance of GelMA biomaterials could potentially be applied to other biomaterials, thereby expanding the range of materials available for use. Furthermore, in combination with 3D bioprinting technology, this approach could be leveraged to bioprint scaffolds with complex structures, further broadening the potential applications in tissue engineering.
New insights into the diagnosis and management of Stevens–Johnson syndrome and toxic epidermal necrolysis
Authors: Saito Yuki , Abe Riichiro 
Published: June 2023

Purpose of review:
Recent studies have been clarifying the pathogenesis and early diagnostic markers of Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Additionally, the efficacy of tumor necrosis factor alpha inhibitors is attracting attention. This review provides) recent evidence for the diagnosis and management of SJS/TEN.

Recent findings:
Risk factors for the development of SJS/TEN have been identified, particularly the association between HLA and the onset of SJS/TEN with specific drugs, which has been intensively studied. Research on the pathogenesis of keratinocyte cell death in SJS/TEN has also progressed, revealing the involvement of necroptosis, an inflammatory cell death, in addition to apoptosis. Diagnostic biomarkers associated with these studies have also been identified.

Summary:
The pathogenesis of SJS/TEN remains unclear and effective therapeutic agents have not yet been established. As the involvement of innate immunity, such as monocytes and neutrophils, in addition to T cells, has become clear, a more complex pathogenesis is predicted. Further elucidation of the pathogenesis of SJS/TEN is expected to lead to the development of new diagnostic and therapeutic agents.
Is Lidocaine Patch Beneficial for Postoperative Pain?
Authors: Wu Xiaoxian , Wei Xiaoxia , Jiang Li , Cai Jiaqin , Ju Mingyu , Zheng Xiaochun 
Published: June 2023

Objectives:
The aim of this meta-analysis was to evaluate whether a lidocaine patch is beneficial for postoperative pain as an option for multimodal analgesia.

Methods:
Information was obtained from PubMed, Embase, and the Cochrane Central Register of Controlled Trials for clinical randomized controlled trials of lidocaine patches for postoperative pain (as of March 2022). Two researchers independently completed study screening, risk bias assessment, and data extraction. Review Manager (version 5.4, Cochrane Collaboration) was used to conduct the meta-analysis. The evaluation metrics were postoperative pain scores, opioid consumption, and patient satisfaction.

Results:
Sixteen randomized controlled trials were included, and data from 918 patients were available. Pain scores differed between the 2 groups at 12, 24, and 48 hours postoperatively, and the pain scores of the lidocaine patch group were significantly lower (mean difference [MD]=−1.32 [95% CI, −1.96 to −0.68], P<0.0001; I
2=92%) at 12 hours after the operation; (MD=−1.23 [95% CI, −1.72 to −0.75], P<0.00001; I
2=92%) at 24 hours after the operation; and (MD=−0.25 [95% CI,−0.29 to −0.21], P<0.00001; I
2=98%) at 48 hours after the operation. In addition, the lidocaine patch group had decreased opioid requirements (MD=−3.57 [95% CI, −5.06 to −2.09], P<0.00001; I
2=96%). The lidocaine patch group seemed to be more satisfied, but there was no statistically significant difference (risk ratio, 1.50 [95% CI, 0.74 to 3.05], P=0.26) between the groups.

Discussion:
Lidocaine patches are beneficial for postoperative pain and can be used in multimodal analgesia to reduce opioid use, but there is no significant increase in patient satisfaction with pain control. More data are needed to support this conclusion due to the large heterogeneity in the present study.
A novel technique for unilateral dissection of the penile neurovascular bundle to prevent loss of penile sensation during treatment of Peyronie’s disease—Initial results of a pilot study
Authors: Pinkhasov Alexandr M. , Beamer Matthew , Shulman Daniel , Yakubov Rachel , Pinkhasov Esther , Kravchick Sergey 
Published: June 2023

Abstract

Background
Plaque incision/excision and grafting are surgical techniques used to treat patients with Peyronie's disease who are refractory to less invasive interventions, have severe penile curvature, or have an hourglass deformity. However, the procedure carries the risk of penile sensory loss because of the need for dissection of the neurovascular bundle (NVB). The aim of this study was to assess the feasibility of a novel technique for unilateral NVB dissection and its ability to preserve penile sensitivity while maintaining adequate correction of the penile curvature.

Materials and methods
Charts of patients who underwent unilateral NVB dissection during Peyronie's plaque incision/excision and grafting were retrospectively reviewed. All patients received preprocedural intracavernosal injections of TriMix, and the curvature was measured to be >70 degrees. In 3 cases, an incision and minimal excision of the plaque were performed at the point of maximum curvature on the concave side of the curvature. In 3 cases, Tutoplast allografts (Coloplast US, Minneapolis, MN) were used, whereas autografts were used in 2 other cases. All patients were examined at 1, 3, and 6 months after the procedure when curvature and penile sensation were assessed.

Results
Five patients underwent this procedure. The mean age of patients was 55 years (45–70 years). All plaques were dorsally located. The mean preoperative curvature was 78 degrees (75–90 degrees). At the 6-month follow-up, all patients had <15 degrees residual curvature and were satisfied with their cosmetic results. Only 1 patient continued with phosphodiesterase-5 inhibitors to improve potency at the 6-month follow-up. All patients reported normal penile glans sensation. Four patients experienced decreased sensation at the site of NVB dissection, but this was only detected when compared with the contralateral side. Only 2 patients reported a difference after 6 months, and only a minor area of involvement was noted.

Conclusions
Unilateral NVB dissection is a feasible technique that does not compromise surgical success in curvature correction and helps avoid sensory injury to the penile glans.
Expansion of Urology Residency Training Programs Has Not Had a Negative Impact on Trainee Case Log Experience
Authors: Corey Zachary , Lehman Erik , Raman Jay D. 
Published: June 2023

Background:
The expansion of urology residency programs is necessary to offset the projected workforce shortage. However, this expansion must occur without compromising the current trainee environment. To date, there is limited information on how the growth of urology residency programs has affected resident operative experience.

Objective:
We examined the Accreditation Council for Graduate Medical Education (ACGME) Case Log Graduate Statistics National Report for Urology from 2016 to 2021 to determine changes in the number and types of cases that graduating residents performed.

Methods:
The Urology ACGME Case Log Graduate Statistics National Report for the academic years 2015 to 2016 to 2020 to 2021 were analyzed. Data were grouped into 6 major categories: general, endourology, reconstructive, oncology, pediatrics, and laparoscopic/robotic.

Results:
There was an increase in the average total cases logged by graduating urology residents from 1449.3 to 1569.4 cases per resident (P < .0001). The average number of general urology procedures increased (P = .0071). There was also an increase in the average number of reconstructive (P = .0470), oncology (P = .0215), and laparoscopic/robotic (P ≤ .0001) cases performed by graduating urology residents. There was no difference in the average number of endourology cases completed by graduating residents (P = .0918). There was a significant decrease in the average number of pediatric cases performed by graduating residents (P = .0002).

Conclusion:
The expansion of urology programs and trainee positions has not negatively affected the average operative case log experience of residents between the 2015 to 2016 and 2020 to 2021 academic years.
Can Propranolol Affect Platelet Indices in Infantile Hemangioma?
Authors: Eroglu Nilgun , Sen Hilal Susam , Kar Yeter Duzenli , Pektas Ayhan , Eker Ibrahim 
Published: June 2023

Introduction:
Propranolol, a nonselective beta-blocker used in the medical treatment of infantile Hemangioma (IH), has been shown to decrease the levels of vascular endothelial growth factor and reduce angiogenesis with its antiproliferative and antiangiogenetic effects.

Materials and Methods:
It has been reported that the storage, transport, and secretion of vascular endothelial growth factor (VEGF) are associated with platelet volume indices (PVI). We aimed to investigate the effect of propranolol on PVI in IH patients. Propranolol treatment was started on 22 IH patients. Platelets, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit values in the follow-ups at months 0, 1, and 2 were compared between 22 patients who received treatment and 25 patients who did not.

Results:
While a statistically significant difference between months 0, 1, and 2 in PDW and MPV values was detected in the treated group, it was not detected in the untreated group. Taking into consideration that VEGF levels were higher at the beginning of the treatment in the pathophysiology of the disease, it was thought that the decrease in VEGF levels by propranolol may have led to a decrease in MPV and PDW levels in the treatment group.

Conclusion:
Consequently, in IH cases, propranolol response follow-up can be evaluated with PVIs, especially MPV and PDW, and it may facilitate clinicians’ monitoring of the disease after propranolol administration.
Effect of Low-dose Atropine on Binocular Vision and Accommodation in Children Aged 6 to 17 Years
Authors: Breliant Rachel Emily , Pang Yi , Bandstra Alaina , Kattouf Valerie 
Published: June 2023

SIGNIFICANCE
Low-dose atropine is one of the leading treatments of myopia progression in children. However, the effect of low-dose atropine on binocular vision measurements has not been thoroughly studied.

PURPOSE
This study aimed to determine the effect of 0.01, 0.03, and 0.05% atropine on visual acuity, pupil size, binocular vision, and accommodation in children aged 6 to 17 years.

METHODS
Forty-six children (28 girls and 18 boys) were randomized into four groups: placebo (n = 10) and 0.01% (n = 13), 0.03% (n = 11), and 0.05% (n = 12) atropine. One drop of atropine or placebo was administered into each eye once. The following measurements were collected before applying the eye drops and 30 minutes, 60 minutes, and 24 hours after application of eye drops: habitual visual acuity at distance and near, pupil size, dissociated phoria at distance and near, negative and positive fusional vergence, near point convergence, near point convergence stamina and fragility, accommodative lag, and amplitude of accommodation. Repeated-measures analysis of variance was used, and P < .05 was considered statistically significant.

RESULTS
Differences in pupil diameters under photopic and scotopic conditions were statistically significant when comparing all three atropine groups with placebo over time (P < .001). Pupil size in both the 0.03 and 0.05% atropine groups was enlarged from baseline at the 30-minute, 60-minute, and 24-hour time points (P < .05) in both photopic and scotopic conditions. Pupil size in the 0.01% atropine group had minimal change, and only the scotopic 60-minute time point was statistically significant (P = .02). All three concentrations of atropine eye drops have no significant effect on accommodation, binocular vision measurements, or visual acuity compared with the control group.

CONCLUSIONS
Pupil size was significantly enlarged by 0.03 and 0.05% atropine in both photopic and scotopic conditions. Low-dose atropine eye drops have no significant effect on accommodation, binocular vision measurements, or visual acuity compared with control.
Case Report: Conjunctival Chemosis as a Presenting Sign of Plasmablastic Lymphoma in a HIV Negative Patient
Authors: Mani Shital 
Published: June 2023

ABSTRACT

Significance
Plasmablastic lymphoma (PBL) involving the ocular adnexa, although reported in the literature, is a rare clinical entity, especially when found in an immunocompetent patient. Understanding the clinical presentation can aid eye care practitioners in seeking timely diagnosis to avoid further delays in the treatment of this disease.

Purpose
To report orbital plasmablastic lymphoma in a human immunodeficiency virus (HIV)-negative patient and discuss the presenting clinical signs, symptoms, and other diagnostic findings for the proper treatment and management of this condition.

Case Report
A 79-year-old white male presented to our clinic for a second opinion for evaluation of a swollen, mildly painful right eye for two months. The patient also complained of intermittent tenderness of the right frontal and paranasal sinuses. The initial diagnosis was preseptal cellulitis. Best-corrected visual acuity was 20/40 in the right eye and 20/30 in the left eye. A thorough comparison of the globe revealed subtle proptosis in the right eye. Slit lamp evaluation revealed severe conjunctival chemosis, which was greatest in the inferotemporal quadrant, and diffuse right inferior eyelid edema. Globe proptosis was quantified via Luedde Exophthalmometer (Gulden Ophthalmics). Exophthalmometry values were 22 mm in the right eye and 20 mm in the left eye, suggesting mild proptosis of the right eye. Magnetic resonance imaging (MRI) of the brain and orbits revealed an expansile lesion in the right maxillary, ethmoid, and paranasal sinuses. The mass also extended into the anterior cranial fossa and the right orbit. Needle biopsy and immunohistochemical analysis confirmed a diagnosis of plasmablastic lymphoma. The patient chose to discontinue chemotherapy owing to adverse systemic effects and succumbed to the disease 36 months after the initial diagnosis.

Conclusions
Unilateral conjunctival chemosis with no improvement or resolution warrants further investigation and workup. Eye care practitioners play a crucial role in the diagnosis and management of these patients in close collaboration with pathology, hematology, and oncology specialists.
Case Report: An Unusual Presentation of Leber’s Hereditary Optic Neuropathy
Authors: Labreche Tammy , Furtado Nadine M. 
Published: June 2023

ABSTRACT

Significance
Leber’s hereditary optic neuropathy (LHON) is often associated with onset in the young, adult male demographic. This case report serves as a reminder that it can affect both sexes with onset into middle-age.

Purpose
LHON is a maternally-inherited mitochondrial disorder that typically affects males during young adulthood. It presents with a rapid, yet painless loss of vision with the fellow eye often affected within a few months. The optic neuropathy causes a dense central scotoma with visual acuities reduced to less than 20/400.

Case Report
A 60-year-old Caucasian female presented with reports of decreased vision in both eyes for the previous two months. She had been followed for the previous five years for glaucoma suspect monitoring, with full fields and normal OCT scans. Entering visual acuity was finger counting at 1 meter OD and 20/100 OS. Pupil testing revealed a grade 1 relative afferent pupillary defect OD. Dilated fundus examination revealed stable moderate optic nerve cupping and intact neuroretinal rim tissue. Humphrey 24-2 Swedish Interactive Thresholding Algorithm (SITA) Standard visual field testing showed a significant superior altitudinal defect and inferior paracentral defect in the right eye, and a partial superior arcuate in the left eye. Magnetic resonance imaging (MRI) with contrast of the head and orbits was normal. A history of alcoholism was elicited and Leber’s hereditary optic neuropathy testing revealed positive 11778 mutation at homoplasmy.

Conclusions
Although still uncommon, presentation of LHON in a middle-aged female is possible, and should be considered a viable differential when individuals present with painless vision loss and central/centrocecal scotomas.
Intraoral Scanning Evaluation of Maxillary Arch Changes after Modified Sommerlad Palatoplasty for around Three Years
Authors: Li Yuanyuan , Tao Hongxu , Yao Meilin , Wu Min , Tsauo Chialing , Shi Bing , Liu Renkai , Li Chenghao 
Published: June 2023

Background:
The purpose of this study was to investigate dental arch changes after modified Sommerlad palatoplasty in patients with cleft palate by intraoral scanning technique in children with early deciduous dentition.

Methods:
This study included 60 patients with nonsyndromic unilateral complete cleft lip with palate or cleft palate only treated by modified Sommerlad palatoplasty without relaxed excision before 18 months of age and 95 healthy controls without cleft. Three-dimensional images of the maxillary dental arches of all participants at age 3 to 4 years were obtained by intraoral scanning technique. Seven parameters (anterior dental arch width, middle dental arch width, posterior dental arch width, anterior palatal arch width, posterior palatal arch width, anterior dental arch length, and entire dental arch length) were measured.

Results:
Compared with the male group, the posterior palatal arch width distance of controls in the female group decreased significantly (P = 0.039), and the middle dental arch width, posterior dental arch width, and posterior palatal arch width distance of female patients decreased (P = 0.013, P = 0.002, P = 0.005, respectively). The anterior dental arch length and entire dental arch length distance of children in the unilateral complete cleft lip with palate group was shorter than those of children with cleft palate only (P < 0.0001, P < 0.0001, respectively). The patient group showed decreased distance of anterior dental arch width, anterior palatal arch width, anterior dental arch length, and entire dental arch length, and increased distance of posterior dental arch width and posterior palatal arch width compared with the control group (P = 0.0002, P = 0.002, P < 0.0001, P < 0.0001, P = 0.007, P = 0.027, respectively).

Conclusion:
The results indicated that the modified palatoplasty group showed no growth inhibition in the middle or posterior dental arch width, or palatal arch width, but slight but significant inhibition in the length of the anterior and entire dental arch.

CLINICAL QUESTION/LEVEL OF EVIDNCE:
Therapeutic, IV.
Comparing Migraine Headache Index versus Monthly Migraine Days after Headache Surgery: A Systematic Review and Meta-Analysis
Authors: Ormseth Benjamin H. , ElHawary Hassan , Huayllani Maria T. , Weber Kevin D. , Blake Pamela , Janis Jeffrey E. 
Published: June 2023

Background:
Nerve deactivation surgery for the treatment of migraine has evolved rapidly over the past 2 decades. Studies typically report changes in migraine frequency (attacks/month), attack duration, attack intensity, and their composite score—the Migraine Headache Index—as primary outcomes. However, the neurology literature predominantly reports migraine prophylaxis outcomes as change in monthly migraine days (MMD). The goal of this study was to foster common communication between plastic surgeons and neurologists by assessing the effect of nerve deactivation surgery on MMD and motivating future studies to include MMD in their reported outcomes.

Methods:
An updated literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The National Library of Medicine (PubMed), Scopus, and Embase were systematically searched for relevant articles. Data were extracted and analyzed from studies that met the inclusion criteria.

Results:
A total of 19 studies were included. There was a significant overall reduction in MMDs [mean difference (MD), 14.11; 95% CI, 10.95 to 17.27; I2 = 92%], total migraine attacks per month (MD, 8.65; 95% CI, 7.84 to 9.46; I2 = 90%), Migraine Headache Index (MD, 76.59; 95% CI, 60.85 to 92.32; I2 = 98%), migraine attack intensity (MD, 3.84; 95% CI, 3.35 to 4.33; I2 = 98%), and migraine attack duration (MD, 11.80; 95% CI, 6.44 to 17.16; I2 = 99%) at follow-up (range, 6 to 38 months).

Conclusion:
This study demonstrates the efficacy of nerve deactivation surgery on the outcomes used in both the plastic and reconstructive surgery and neurology literature.
Reconstruction of a Large Lower Lip Defect Including Vermilion Using a V-Y Advanced Flap Combined with a Musculomucosal Stacked Flap
Authors: Wu Tong , Yang Tianye , Yin Qiang , Chen Kang , Rong Li 
Published: June 2023

Summary:
Reconstruction of large lower lip defects is challenging, especially when repairing the vermilion at the same time. The authors describe a novel method for reconstruction of a large lower-lip defect including the vermilion. The reconstruction includes two layers: the anterior layer, reconstructed from V-Y advanced musculocutaneous flap of the cheek; and the posterior layer, reconstructed from the musculomucosal flap from the remnant lower lip. Stacking of the bilateral musculomucosal flaps raises the height of the posterior layer and covers the top of the lower lip to form the new vermilion. This is a simple and reliable method with satisfactory cosmetic and functional results.