bluuebunny/crossref_metadata_2025_split huggingface dataset:
3D printing of cell-delivery scaffolds for tissue regeneration
Authors: Xue Jianmin , Qin Chen , Wu Chengtie 
Published: April 2023

Abstract
Tissue engineering strategy that combine biomaterials with living cells has shown special advantages in tissue regeneration and promoted the development of regenerative medicine. In particular, the rising of 3D printing technology further enriched the structural design and composition of tissue engineering scaffolds, which also provided convenience for cell loading and cell delivery of living cells. In this review, two types of cell-delivery scaffolds for tissue regeneration, including 3D printed scaffolds with subsequent cell-seeding and 3D cells bioprinted scaffolds, are mainly reviewed. We devote a major part to present and discuss the recent advances of two 3D printed cell-delivery scaffolds in regeneration of various tissues, involving bone, cartilage, skin tissues etc. Although two types of 3D printed cell-delivery scaffolds have some shortcomings, they do have generally facilitated the exploration of tissue engineering scaffolds in multiple tissue regeneration. It is expected that 3D printed cell-delivery scaffolds will be further explored in function mechanism of seeding cells in vivo, precise mimicking of complex tissues and even organ reconstruction under the cooperation of multiple fields in future.
PAs as principal investigators of FDA-regulated clinical trials
Authors: Nalepinski Colleen Elizabeth Gosa 
Published: April 2023

ABSTRACT
A misconception exists that only physicians can be principal investigators for FDA-regulated human clinical trials such as interventional studies. This article reviews existing guidelines and dispels the notion that physician associates/assistants (PAs) cannot be principal investigators for clinical trials. Additionally, this article describes an implementation plan to correct the misconception and establish a reference for future PAs seeking the role of principal investigator in clinical trials.
Hemostatic In Vitro Properties of Novel Plasma Supernatants Produced from Late-storage Low-titer Type O Whole Blood
Authors: Mihalko Emily P. , Srinivasan Amudan J. , Rahn Katelin C. , Seheult Jansen N. , Spinella Philip C. , Cap Andrew P. , Triulzi Darrell J. , Yazer Mark H. , Neal Matthew D. , Shea Susan M. 
Published: April 2023

Background
The use of low-titer group O whole blood is increasing. To reduce wastage, unused units can be converted to packed red blood cells. Supernatant is currently discarded post-conversion; however, it could be a valuable transfusable product. The aim of this study was to evaluate supernatant prepared from late-storage low-titer group O whole blood being converted to red blood cells, hypothesizing it will have higher hemostatic activity compared to fresh never-frozen liquid plasma.

Methods
Low-titer group O whole blood supernatant (n = 12) prepared on storage day 15 was tested on days 15, 21, and 26 and liquid plasma (n = 12) on 3, 15, 21, and 26. Same-day assays included cell counts, rotational thromboelastometry, and thrombin generation. Centrifuged plasma from units was banked for microparticle characterization, conventional coagulation, clot structure, hemoglobin, and additional thrombin generation assays.

Results
Low-titer group O whole blood supernatant contained more residual platelets and microparticles compared to liquid plasma. At day 15, low-titer group O whole blood supernatant elicited a faster intrinsic clotting time compared to liquid plasma (257 ± 41 vs. 299 ± 36 s, P = 0.044), and increased clot firmness (49 ± 9 vs. 28 ± 5 mm, P < 0.0001). Low-titer group O whole blood supernatant showed more significant thrombin generation compared to liquid plasma (day 15 endogenous thrombin potential 1,071 ± 315 vs. 285 ± 221 nM·min, P < 0.0001). Flow cytometry demonstrated low-titer group O whole blood supernatant contained significantly more phosphatidylserine and CD41+ microparticles. However, thrombin generation in isolated plasma suggested residual platelets in low-titer group O whole blood supernatant were a greater contributor than microparticles. Additionally, low-titer group O whole blood supernatant and liquid plasma showed no difference in clot structure, despite higher CD61+ microparticle presence.

Conclusions
Plasma supernatant produced from late-storage low-titer group O whole blood shows comparable, if not enhanced, in vitro hemostatic efficacy to liquid plasma.

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A Novel Stepwise Technique for Safe and Effective Transoral Release of Irreducible Atlantoaxial Dislocation
Authors: Xu Jing , Mo Shaodong , Ma Xiangyang , Wang Jianhua , Zhang Kai , Wu Zenghui , Xia Hong , Yin Qingshui , Ai Fuzhi 
Published: April 2023

Study Design.
Retrospective cohort study.

Objective.
To verify the clinical efficacy of a novel transoral stepwise release technique (TSRT) for the treatment of irreducible atlantoaxial dislocations (IAAD).

Summary of Background Data.
Anterior release for IAAD remains challenging, with a 3.2 times higher complication rate than posterior release. However, there are some patients who cannot achieve successful reduction from a posterior approach and require the higher-risk anterior release. Our work presents a novel anterior release technique that aims to minimize iatrogenic injury and associated complications from an anterior release.

Materials and Methods.
IAAD cases who were treated with TSRT were retrospectively studied. Primary outcomes included fusion rate, complications, and neurological function over the course of a minimum 1-year follow-up. Radiographic differences between preoperative and postoperative imaging were also considered. A preoperative prediction model for the actual release grade was developed using multivariate logistic regression based on demographic factors and the craniovertebral abnormalities identified on preoperative images, evaluating the need for higher-grade TSRT release.

Results.
We included 201 IAAD cases, with 42% (84/201) demonstrating degeneration of the atlantoaxial joint or anterior–hook-like dens. The reduction was achieved in all cases, with 80% (160/201) of cases only requiring relatively low-grade or grade I types TSRT release. Degeneration of the atlantoaxial joint was significantly associated with the need for higher-grade TSRT release (odds ratio:16.68, CI: 2.91–94.54, P = 0.002). The overall complication rate was 4.5% (9/201). Over the course of follow-up, the fusion rate reached 98.5%, and the American Spinal Injury Association and Japanese Orthopedic Association scores were significantly improved to 97.28 and 16.25 (P < 0.01 and P < 0.01), respectively.

Conclusion.
This study demonstrated that our novel TSRT anterior release technique demonstrated complication rates similar to those published in the literature for posterior release. TSRT can be used as an alternative to posterior release techniques for refractory cases or when a posterior approach is not considered viable.
Development of a prediction model to identify undiagnosed chronic obstructive pulmonary disease patients in primary care settings in China
Authors: Zhang Buyu , Sun Dong , Niu Hongtao , Dong Fen , Lyu Jun , Guo Yu , Du Huaidong , Chen Yalin , Chen Junshi , Cao Weihua , Yang Ting , Yu Canqing , Chen Zhengming , Li Liming ,   on behalf of the China Kadoorie Biobank Collaborative Group
Published: April 2023

Abstract

Background:
At present, a large number of chronic obstructive pulmonary disease (COPD) patients are undiagnosed in China. Thus, this study aimed to develop a simple prediction model as a screening tool to identify patients at risk for COPD.

Methods:
The study was based on the data of 22,943 subjects aged 30 to 79 years and enrolled in the second resurvey of China Kadoorie Biobank during 2012 and 2013 in China. We stepwisely selected the predictors using logistic regression model. Then we tested the model validity through P-P graph, area under the receiver operating characteristic curve (AUROC), ten-fold cross validation and an external validation in a sample of 3492 individuals from the Enjoying Breathing Program in China.

Results:
The final prediction model involved 14 independent variables, including age, sex, location (urban/rural), region, educational background, smoking status, smoking amount (pack-years), years of exposure to air pollution by cooking fuel, family history of COPD, history of tuberculosis, body mass index, shortness of breath, sputum and wheeze. The model showed an area under curve (AUC) of 0.72 (95% confidence interval [CI]: 0.72–0.73) for detecting undiagnosed COPD patients, with the cutoff of predicted probability of COPD=0.22, presenting a sensitivity of 70.13% and a specificity of 62.25%. The AUROC value for screening undiagnosed patients with clinically significant COPD was 0.68 (95% CI: 0.66–0.69). Moreover, the ten-fold cross validation reported an AUC of 0.72 (95% CI: 0.71–0.73), and the external validation presented an AUC of 0.69 (95% CI: 0.68–0.71).

Conclusion:
This prediction model can serve as a first-stage screening tool for undiagnosed COPD patients in primary care settings.
Global burden and trends of lung cancer incidence and mortality
Authors: Li Chao , Lei Shaoyuan , Ding Li , Xu Yan , Wu Xiaonan , Wang Hui , Zhang Zijin , Gao Ting , Zhang Yongqiang , Li Lin 
Published: April 2023

Abstract

Background:
Lung cancer has been the leading cause of cancer-related deaths worldwide for many years. This study aimed to investigate the global patterns and trends of lung cancer.

Methods:
Lung cancer incidence and mortality were derived from the GLOBOCAN 2020 database. Continuous data from Cancer Incidence in Five Continents Time Trends were used to analyze the temporal trends from 2000 to 2012 using Joinpoint regression, and average annual percent changes were calculated. The association between the Human Development Index and lung cancer incidence and mortality was assessed by linear regression.

Results:
An estimated 2.2 million new lung cancer cases and 1.8 million lung cancer-related deaths occurred in 2020. The age-standardized incidence rate (ASIR) ranged from 36.8 per 100,000 in Demark to 5.9 per 100,000 in Mexico. The age-standardized mortality rate (ASMR) varied from 32.8 per 100,000 in Poland to 4.9 per 100,000 in Mexico. Both ASIR and ASMR were approximately twice higher in men than in women. The ASIR of lung cancer showed a downward trend in the United States of America (USA) between 2000 and 2012, and was more prominent in men. The age-specific incidence rates of lung cancer for ages of 50 to 59 years showed an upward trend in China for both men and women.

Conclusions:
The burden of lung cancer is still unsatisfactory, especially in developing countries like China. Considering the effectiveness of tobacco control and screening in developed countries, such as the USA, there is a need to strengthen health education, accelerate the establishment of tobacco control policies and regulations, and improve early cancer screening awareness to reduce the future burden of lung cancer.
Does Sternal Displacement During Functional Activities Vary with Time and Adherence to Traditional Sternal Precautions? An Observational Study
Authors: Rodrigues Jeff , Beneck George J. 
Published: April 2023

Purpose:
The purpose of this study was to determine whether sternal displacement occurs, decreases over time, and varies with adherence to sternal precautions during functional activities after median sternotomy.

Methods:
Seventeen subjects had ultrasound images taken at two and then six to eight weeks after median sternotomy to measure the sternal gap and displacement during five activities commonly limited by sternal precautions. The subjects were divided into two groups based on self-reported compliance with sternal precautions.

Results:
At the upper sternal site, displacement occurred with all activities in both sessions and decreased over time. At the lower sternal site, displacement only occurred during dynamic activities and decreased over time. Subjects who fully complied with sternal precautions had less upper sternal displacement during stand-to-sit (P = .043; ES = −1.076) and trend toward reduced displacement during sit-to-stand and horizontal abduction with large effect sizes, −.893 and −.975, respectively.

Conclusion:
Sternal displacement may vary with the task performed and between sternal sites. Reduced sternal displacement identified over time indicates sternal healing. Pectoralis major tension seems to be a primary mechanism of sternal displacement during common functional activities. Our findings suggest that full compliance with sternal precautions may promote sternal healing.
The Resident Cosmetic Clinic: An Institutional Review and Outcomes Analysis of the Loma Linda University Experience
Authors: Desai Mansee , Chou Peichi Peggy , Luke Janiene 
Published: April 2023

BACKGROUND
As the number of dermatologists offering cosmetic procedures continues to increase, so does the need for hands-on exposure to cosmetic dermatology during residency. A resident cosmetic clinic (RCC) model presents as a mutually beneficial opportunity for trainees to obtain first-hand experience, while patients have access to more affordable pricing.

OBJECTIVES
(1) To assess volume and variety of cosmetic dermatological procedures during residency. (2) To compare Loma Linda University (LLU) Dermatology RCC data with national residency program data. (3) To provide guidance for other dermatology residency programs who wish to incorporate cosmetic training into their educational curriculum.

MATERIALS AND METHODS
In this cross-sectional, retrospective, chart review study, resident training in cosmetic procedures at the LLU RCC was quantified and compared with that of national program averages, minimums, and maximums as reported by the Accreditation Council for Graduate Medication Education.

RESULTS
LLU RCC residents performed more nonablative skin rejuvenation, intense pulsed light, and soft tissue augmentation procedures as the resident surgeon compared with other dermatology residents across the nation.

CONCLUSION
Institutional review highlights an unmet need for greater exposure to and training in a variety of dermatologic cosmetic procedures during residency. Practical considerations for achieving optimal learning experiences were provided through the implementation of a resident cosmetic clinic.
Factors Associated With Musculoskeletal Pain Among Hair Transplant Surgeons: Analyses of Survey Data and Review of the Literature
Authors: Gupta Aditya K. , Wang Tong , Polla Ravi Shruthi , Richards Dillon , Cooper Elizabeth A. , Jimenez Francisco 
Published: April 2023

BACKGROUND
The prevalence of work-related musculoskeletal disorders (WRMD) is increasing among all surgical specialties.

OBJECTIVE
Results of a cross-sectional survey of hair transplant surgeons were analyzed, with the aims to (1) determine the prevalence of WRMD, (2) assess risk factors associated with musculoskeletal (MSK) symptoms, and (3) identify mitigation measures.

MATERIALS AND METHODS
A survey pertaining to demographics, MSK-related symptoms and its impacts, and pain mitigation measures taken, if any, were distributed to 834 hair transplant surgeons. Risk factors associated with pain severity were assessed using linear regression.

RESULTS
Overall, 78.5% (73 of 93) respondents had experienced pain when performing surgery. Musculoskeletal symptoms were most severe in the neck, followed by upper/lower back, and extremities. Number of grafts performed per session of follicular unit extraction positively correlated with pain severity; female surgeons and surgeons aged >71 years were at higher risk. A majority expressed concern that WRMD may limit their career and agreed to a need for improved workplace education. Strength training and ergonomic improvements of surgical procedure were not commonly adopted.

CONCLUSION
In sum, WRMD can be debilitating in health care professionals. Workplace ergonomic adjustments and physical exercise programs may be warranted to better mitigate MSK symptoms.
SK Forceps: New Monopolar Electrosurgical Forceps Designed Specifically for Blepharoptosis Surgery
Authors: Kinoshita Shinsuke , Ukyo Hisaki , Masuda Naonori , Osawa Shunsuke 
Published: April 2023

Summary:
The electrode tips of conventional monopolar forceps are relatively blunt, complicating the delicate detachment manipulations required for blepharoptosis repair. This study describes the SK forceps, which is a new monopolar electrosurgical forceps we specifically designed for blepharoptosis surgery. The electrode tips in our design were engineered to be as fine as possible. The SK forceps can cut tissues with the electrode tips in contact in the closed position and coagulate bleeding while clasping the blood vessels. When inactivated, the SK forceps can perform similar manipulations to regular surgical forceps. Surgeons holding the nonactivated SK forceps in one hand and regular forceps in the other benefit from greatly improved maneuverability at every step of the procedure. Incision and dissection procedures performed with the SK forceps result in a surgical field with minimal bleeding because the forceps can simultaneously perform hemostasis and incision, which is a characteristic of a high-frequency electrosurgical unit. However, when unexpected bleeding is encountered in the operative field, the SK forceps can clamp the injured vessels and coagulate the bleeding more rapidly and confidently compared with the needle-type monopolar electrodes without switching instruments. Our design allows surgeons to perform successive procedural steps without switching instruments. This characteristic makes the SK forceps a beneficial instrument for blepharoptosis surgery.
3D Volume Assessment as an Objective Tool in Breast Asymmetry Management
Authors: Makram Mahmoud , Noaman Ayman , Abozeid Mohammed 
Published: April 2023

Background:
Throughout history, the female breast has been a universal symbol of femininity. The breast’s normal symmetrical appearance is an important aspect of the female form. Female breasts are not perfectly symmetrical by nature, and minor differences in shape or volume are common. However, it can be psychologically distressing for patients and affect their perception of their bodies. Aesthetic breast surgeons strive to minimize these differences in order to make them more acceptable to patients. This study aimed to provide an objective and practical strategy for effectively managing breast asymmetry.

Method:
This study was conducted between November 2017 and September 2021 on 20 female patients seeking breast asymmetry correction at Kasr El-Ainy Hospital. All patients had volumetric breast assessment using a three-dimensional (3D) imaging system (3D LifeViz, Quantificare system), and MRI breast volumetry was done preoperatively in all patients. The patients were managed with different single-stage surgical procedures depending on the objective assessment of the volume differences between their breasts.

Results:
Breast volume assessment using the 3D camera was done preoperatively and postoperatively. The preoperative mean volume difference was 159.45 cm3, and the postoperative mean difference was 16.75 cm3 with an overall reduction in mean volume difference of 89.5%. Comparing the 3D camera and MRI in assessing breast volume difference showed no statistical significance.

Conclusions:
The 3D technology is a useful objective tool to augment the surgeon’s experience. It helped achieve an 84.57% reduction in volume difference in managing breast asymmetry with a single-stage procedure.
miR-34a regulates macrophage-associated inflammation and angiogenesis in alcohol-induced liver injury
Authors: Wan Ying , Slevin Elise , Koyama Sachiko , Huang Chiung-Kuei , Shetty Ashok K , Li Xuedong , Harrison Kelly , Li Tian , Zhou Bingru , Lorenzo Sugeily Ramos , Zhang Yudian , Salinas Jennifer Mata , Xu Wenjuan , Klaunig James E. , Wu Chaodong , Tsukamoto Hidekazu , Meng Fanyin 
Published: April 2023

Background:
Alcohol-associated liver disease (ALD) is a syndrome of progressive inflammatory liver injury and vascular remodeling associated with long-term heavy intake of ethanol. Elevated miR-34a expression, macrophage activation, and liver angiogenesis in ALD and their correlation with the degree of inflammation and fibrosis have been reported. The current study aims to characterize the functional role of miR-34a-regulated macrophage- associated angiogenesis during ALD.

Methods & Results:
We identified that knockout of miR-34a in 5 weeks of ethanol-fed mice significantly decreased the total liver histopathology score and miR-34a expression, along with the inhibited liver inflammation and angiogenesis by reduced macrophage infiltration and CD31/VEGF-A expression. Treatment of murine macrophages (RAW 264.7) with lipopolysaccharide (20 ng/mL) for 24 h significantly increased miR-34a expression, along with the enhanced M1/M2 phenotype changes and reduced Sirt1 expression. Silencing of miR-34a significantly increased oxygen consumption rate (OCR) in ethanol treated macrophages, and decreased lipopolysaccharide-induced activation of M1 phenotypes in cultured macrophages by upregulation of Sirt1. Furthermore, the expressions of miR-34a and its target Sirt1, macrophage polarization, and angiogenic phenotypes were significantly altered in isolated macrophages from ethanol-fed mouse liver specimens compared to controls. TLR4/miR-34a knockout mice and miR-34a Morpho/AS treated mice displayed less sensitivity to alcohol-associated injury, along with the enhanced Sirt1 and M2 markers in isolated macrophages, as well as reduced angiogenesis and hepatic expressions of inflammation markers MPO, LY6G, CXCL1, and CXCL2.

Conclusion:
Our results show that miR-34a-mediated Sirt1 signaling in macrophages is essential for steatohepatitis and angiogenesis during alcohol-induced liver injury. These findings provide new insight into the function of microRNA-regulated liver inflammation and angiogenesis and the implications for reversing steatohepatitis with potential therapeutic benefits in human alcohol-associated liver diseases.