bluuebunny/crossref_metadata_2025_split huggingface dataset:
Whitnall’s barrier: a technique for the management of lacrimal gland prolapse
Authors: Mathewson Priscilla A , Athwal Sarju , Hyer Jonathan N , Ezra Daniel G 
Published: April 2023

Background:
Whitnall’s barrier procedure, a modified Beer and Kompatscher surgical technique to reposition the lacrimal gland is presented alongside a case series of patients demonstrating excellent aesthetic and functional outcomes.

Methods:
The Whitnall’s barrier procedure is illustrated procedurally and accompanied by a case series of 20 consecutive patients attending our institution between December 2016 and February 2020. All patients were cared for by a single surgical team. Lid contour and function were assessed post-operatively, as was patient satisfaction.

Results:
Thirty-seven eyes of 20 patients were included. All patients were female with an average age of 50 years. Fourteen patients underwent surgery for cosmesis; four had inactive thyroid eye disease and two had lacrimal gland enlargement secondary to dacryoadenitis. The degree of lacrimal gland prolapse was described as “mild” in two eyes and “moderate” in 35.
All cases had one or more additional surgical procedures. Mean follow up duration was 11 months with complete resolution of lacrimal gland prolapse in 34 eyes. The patient who did not have complete resolution had dacryoadenitis and required ongoing immunosuppressive therapy. Two patients were discharged on topical lubricants, one with thyroid eye disease, and one cosmetic patient who underwent upper and lower lid blepharoplasties at the same time. There were no intra-operative complications and no incidences of infection, dehiscence or damage to the lacrimal gland ductules.

Conclusions:
The Whitnall’s barrier technique is a safe and effective surgical procedure to restore the anatomical location of the lacrimal gland with excellent aesthetic and functional outcomes.
New and Recurrent Ulcerations After Free Tissue Transfer with Partial Bony Resection in Chronic Foot Wounds within a Comorbid Population: A Retrospective Cohort
Authors: Bhardwaj Priya , Zolper Elizabeth G. , Abadeer Andrew I. , Kim Kevin G. , Attinger Christopher E. , Atves Jayson N. , Fan Kenneth L. , Evans Karen K. 
Published: April 2023

BACKGROUND:
Chronic foot wounds often require bony resection, however altering the tripod of the foot carries a risk of new ulcer development nearing 70%. Resulting defects often require free tissue transfer (FTT) reconstruction; outcomes data for various bony resection and FTT options may guide clinical decision-making regarding bone and soft tissue management. We hypothesize that alteration of the bony tripod will increase risk of new lesion development following FTT reconstruction.

METHODS:
A single-center retrospective cohort analysis of FTT patients from 2011-2019 with bony resection and soft tissue defects of the foot was performed. Data collected included demographics, comorbidities, wound locations, and FTT characteristics. Primary outcomes were recurrent lesion(RL) and new lesion(NL) development. Multivariate logistic regression and cox hazards regression were used to produce adjusted odds ratios(OR) and hazard ratios(HR).

RESULTS:
Sixty-four patients(mean age 55.9 years) that underwent bony resection and FTT were included. Mean Charlson Comorbidity Index(CCI) was 4.1(standard deviation 2.0) and median follow up was 14.6 months(range 7.5-34.6). Wounds developed post-FTT in 42(67.1%)(RL 39.1%, NL 40.6%). Median time to NL development was 3.7 months(range 0.47-9.1). First metatarsal defect(OR 4.8, 95% CI 1.5-15.7) and flap with cutaneous component(OR 0.24, 95% CI 0.07-0.8) increased and decreased odds of NL development, respectively.

CONCLUSION:
First metatarsal defects significantly increase NL risk following FTT. The majority of ulcerations heal with minor procedures but require long-term follow up. While soft tissue reconstruction with FTT achieves success in the short-term, NL and RL occur at high rates in the months to years following initial healing.
Morphological Changes in Postaxial Polydactyly of the Foot: A Standardized Quantitative Analysis Using the Watanabe–Fujita Classification
Authors: Makino Aiko , Saito Susumu 
Published: April 2023

Background:
Postaxial polydactyly of the foot is one of the most common congenital abnormalities. A wide forefoot, short toe, and lateral joint deviation are associated with aesthetic and functional outcomes. This study used the Watanabe–Fujita classification to characterize the pre- and postoperative skeletal morphology of postaxial polydactyly of the foot.

Methods:
This retrospective study included 42 patients (51 feet) with postaxial polydactyly treated at the age of 1 year, and radiographs taken at ages 0 and 3–4 years were used for morphological analysis. The length of the reconstructed toe, the distance between the fourth and fifth metatarsals, and joint deviation angles were measured. The length parameters were standardized using the length of the third metatarsal. Morphological characteristics were compared based on the Watanabe–Fujita classification both at ages 0 and 3–4 years. Long-term outcomes were also evaluated in patients followed up for longer than 6 years.

Results:
The fifth-ray proximal phalangeal subtype had the shortest toe length both at ages 0 and 3–4 years. Proximal phalangeal joint lateral deviation improved postoperatively in 78% of patients with the fifth-ray middle phalangeal subtype, regardless of reconstruction type. There was no significant change in proximal phalangeal joint deviation between ages 3–4 and ≥7 years. A residual metatarsal was associated with lateral metatarsophalangeal joint deviation and a wide intermetatarsal distance, and required revision surgery.

Conclusion:
Morphological changes of postaxial polydactyly of the foot were successfully characterized using the Watanabe–Fujita classification. This classification could be useful for planning surgical strategies and anticipating morphological outcomes.

Level of Evidence:
Level III
In the Age of Social Media, How does the Public Choose a Plastic Surgeon? A Crowdsourcing Analysis of Major Deciding Factors
Authors: Elmer Nicholas A. , Veeramani Anamika , Hassell Natalie , Comer Carly , Manstein Samuel , Shiah Eric , Bustos Valeria , Lin Samuel J 
Published: April 2023

Background:
There are many factors patients consider when selecting a plastic surgeon. Previous studies have demonstrated the importance of board certification and reputation in making this decision. Despite this, there is a paucity of knowledge on the role that cost of procedure, social media, and surgeon training factor into the decision-making process.

Methods:
Our study used a population-based survey administered via Amazon Mechanical Turk. Adults 18 years and older and residing in the United States were asked to rank the importance of thirty-six factors from 0 (least important) to 10 (most important) when selecting a plastic surgeon.

Results:
369 responses were analyzed. The mean age of respondents was 36.9 (SD 10.9) and 174 participants (47.2%) were female. Of those surveyed, 216 (55.0%) had previously undergone plastic surgery and all respondents were considering plastic surgery either at the time of survey or in the future. The most common first step respondents would utilize in identifying a plastic surgeon was a web-based search (32.2%). The top three most important factors in selecting a plastic surgeon were surgeon’s experience with the desired procedure (7.48), surgeon’s board certification (7.38), and surgeon’s years in practice (7.36). The three least important factors were the surgeon’s race (5.43), number of social media posts (5.62), and television appearances (5.64).

Conclusion:
Our survey provides insight into the role that different elements play in the decision of selecting a plastic surgeon in the US. Understanding how patients select a plastic surgeon can help surgeons optimize these elements in their practices.
Towards a consensus approach for assessing capsular contracture severity and progression: A systematic review
Authors: Mohan A. S. , Sullivan Janessa , Tenenbaum M.M. , Broderick K.B. , Myckatyn T. M. 
Published: April 2023

Background:
Breast implants are the most commonly used medical devices in plastic surgery and capsular contracture is one of the most common complications. Yet, our assessment of capsular contracture is largely based on Baker grade which is problematically subjective and affords only 4 possible values.

Methods:
We performed a systematic review concluding in September 2021 in compliance with preferred reporting items for systematic reviews (PRISMA) guidelines. It identified 19 articles that propose approaches to measuring capsular contracture.

Results:
In addition to Baker’s grade, we identified several modalities reported to measure capsular contracture. These included magnetic resonance imaging, ultrasonography, sonoelastgraphy, mammacompliance measuring devices, applanation tonometry, histologic evaluation, and serology. Capsule thickness and other measures of capsular contracture inconsistently correlated with Baker grade while the presence of synovial metaplasia was consistently associated with Baker grade 1 and 2, but not 3 and 4 capsules.

Conclusions:
There remains no particular method to reliably and specifically measure the contracture of capsules that form around breast implants. As such, we would recommend that for research investigators use more than one modality to measure capsular contracture. Other variables that can impact breast implant stiffness and associated discomfort beyond capsular contracture need to be considered when evaluating patient outcomes. Given the value placed on capsular contracture outcomes in assessing breast implant safety, and the prevalence of breast implants overall, the need for a more reliable approach to measuring this outcome persists.
False-Positive Uptake in Splenic Hemangioma on 68Ga-DOTATATE PET/CT
Authors: Zhu Brian , Yoon Emily , Mahajan Sonia , Kranz Anca-Oana 
Published: April 2023

Abstract
Somatostatin receptor imaging using 68Ga-DOTATATE PET is widely popular for evaluation of neuroendocrine tumors. 68Ga-DOTATATE PET/CT shows highest physiologic uptake in spleen followed by other organs such as kidneys, adrenal glands, and liver. Hemangiomas, although rare, are the most common primary benign neoplasm of the spleen, composed of endothelial-lined vascular channels. We present a case of 77-year-old man who underwent 68Ga-DOTATATE PET/CT scan for evaluation of pancreatic neuroendocrine tumor and incidentally demonstrated intense radiotracer uptake in splenic hemangiomata.
68Ga-FAPI-04 PET/MR Versus 18F-FDG PET/CT in the Detection of Ovarian Cancer
Authors: Sun Gaofeng , Zou Ruoyao , Yao Liangqing , Zuo Changjing 
Published: April 2023

Abstract
A 75-year-old woman presented with right lower abdominal pain. Pelvic ultrasound showed a cystic solid mass in the right adnexa. Painless enlarged lymph nodes on the left supraclavicular side with biopsy were suggestive of metastatic cancer. 18F-FDG PET/CT performed to evaluate the primary tumor showed intense uptake in both regions of the right adnexa and the gastric sinus, but 68Ga-FAPI PET/MRI showed uptake only in the right adnexal region. A subsequent gastroscopic biopsy confirmed atrophic inflammation. Finally, surgery histopathology revealed ovarian cancer. This case demonstrated that 68Ga-FAPI PET/MRI may help exclude suspected primary gastric carcinoma with false-positive 18F-FDG uptake.
Pancreatic Perivascular Epithelioid Cell Tumor Revealed by 68Ga-DOTATATE PET/CT
Authors: Sun Rui , Zeng Guangping , Chen XiaoLiang 
Published: April 2023

Abstract
We report 68Ga-DOTATATE PET/CT findings of pancreatic perivascular epithelioid cell tumor in a 55-year-old woman. 68Ga-DOTATATE PET/CT showed increased radioactivity in the region of pancreatic body, which suggested malignant tumor. However, postoperative pathological findings demonstrated the presence of perivascular epithelioid cell tumor. This case emphasizes the need to increase awareness of this tumor in the differential diagnosis of pancreatic nodules with moderate DOTATATE activity.
Identification of Factors that May Predict Career Trajectory Among Neuro-Ophthalmology Fellows
Authors: Patel Aakash N. , Tian Jing , Henderson Amanda D. 
Published: April 2023

Background:
There is modest literature regarding fellowship applicant factors that may predict future career achievement. We aim to characterize neuro-ophthalmology fellows and identify and analyze characteristics that may predict future career trajectory.

Methods:
Data, including demographic information, academic background, scholarly activities, and practice information, were collected using publicly available sources, on individuals who completed neuro-ophthalmology fellowships from 2015 to 2021. Summary statistics describing the cohort were calculated. Prefellowship characteristics were compared with postfellowship characteristics to evaluate which prefellowship characteristics may predict postfellowship academic productivity and career achievement.

Results:
Data were collected on 174 individuals (41.6% men, 58.4% women). Sixty-five percent were residency-trained in ophthalmology, 31% neurology, 1.7% both, and 1.7% pediatric neurology. Fifty-eight percent completed residency in the US, 8% in Canada, 32% internationally, and 2% in multiple locations. Among those practicing in the US/Canada, 63.8% practice at academic centers, 35.3% private practice, and 0.9% at both. Thirty-one percent completed additional subspecialty training and 17.8% additional graduate degrees. Completion of additional fellowship training or graduate degrees, and publication of more papers before fellowship, correlated with later academic productivity. There were no significant correlations between completion of an additional fellowship or graduate degree with current practice environment or attainment of leadership roles. There were no significant correlations between total publishing productivity prefellowship and practice environment or leadership roles postfellowship.

Conclusions:
Additional graduate degrees/subspecialty training, and prefellowship academic productivity, correlated with later academic productivity among neuro-ophthalmologists, suggesting that these metrics may be helpful in predicting future academic performance among fellowship applicants.
Self-consistent Sierpinski iteration of toughening mechanism in elastomer undergoing scaled segment-chain-network
Authors: Xing Ziyu , Lu Haibao , Fu Yong-Qing 
Published: April 2023

Understanding working principles and toughening mechanisms of soft elastomers has been a huge challenge due to their significant scaling effects from molecules to bulk polymer. In this study, by combining Sierpinski fractal and scaling theory, an extended Kelvin model is developed to investigate the mechanical behaviour of the soft elastomer undergoing scaled segment-chain-network. According to the scaling theory, a radial distribution function was initially introduced to explain the diffusion and relaxation behaviours of molecular segments with the Sierpinski fractal features. The self-consistent iteration of the Sierpinski fractal is then used to describe the scaling effects of segments and networks. Rubber elasticity of the polymer network is further formulated based on the self-consistent iteration equation and scaling theory. A constitutive stress–strain relationship is also derived to explore the toughness mechanism and working principle in the polymer elastomer. Finally, the effectiveness of the proposed model is verified using finite-element analysis and experimental results reported in the literature, to explore a scaling insight into toughening mechanisms of elastomers governed by the self-consistent Sierpinski iteration.
Genomics of severe and treatment-resistant obsessive-compulsive disorder treated with deep brain stimulation: a preliminary investigation
Authors: Chen Long Long , Naesström Matilda , Halvorsen Matthew , Fytagoridis Anders , Mataix-Cols David , Rück Christian , Crowley James J. , Pascal Diana 
Published: April 2023

ABSTRACTIndividuals with severe and treatment-resistant obsessive-compulsive disorder (trOCD) represent a small but severely disabled group of patients. Since trOCD cases eligible for deep brain stimulation (DBS) probably comprise the most severe end of the OCD spectrum, we hypothesize that they may be more likely to have a strong genetic contribution to their disorder. Therefore, while the worldwide population of DBS-treated cases may be small (∼300), screening these individuals with modern genomic methods may accelerate gene discovery in OCD. As such, we have begun to collect DNA from trOCD cases who qualify for DBS, and here we report results from whole exome sequencing and microarray genotyping of our first five cases. All participants had previously received DBS in the bed nucleus of stria terminalis (BNST), with two patients responding to the surgery and one showing a partial response. Our analyses focused on gene-disruptive rare variants (GDRVs; rare, predicted-deleterious single-nucleotide variants or copy number variants overlapping protein-coding genes). Three of the five cases carried a GDRV, including a missense variant in the ion transporter domain ofKCNB1, a deletion at 15q11.2, and a duplication at 15q26.1. TheKCNB1variant (hg19 chr20-47991077-C-T, NM_004975.3:c.1020G>A, p.Met340Ile) causes substitution of methionine for isoleucine in the trans-membrane region of neuronal potassium voltage-gated ion channel KV2.1. ThisKCNB1substitution (Met340Ile) is located in a highly constrained region of the protein where other rare missense variants have previously been associated with neurodevelopmental disorders. The patient carrying the Met340Ile variant responded to DBS, which suggests that genetic factors could potentially be predictors of treatment response in DBS for OCD. In sum, we have established a protocol for recruiting and genomically characterizing trOCD cases. Preliminary results suggest that this will be an informative strategy for finding risk genes in OCD.
Utility of Technology in the Treatment of Type 1 Diabetes: Current State of the Art and Precision Evidence
Authors: Jacobsen Laura M. , Sherr Jennifer L. , Considine Elizabeth , Chen Angela , Peeling Sarah , Hulsmans Margo , Charleer Sara , Urazbayeva Marzhan , Tosur Mustafa , Alamarie Selma , Redondo Maria J. , Hood Korey K. , Gottlieb Peter A. , Gillard Pieter , Wong Jessie J. , Hirsch Irl B. , Pratley Richard E. , Laffel Lori , Mathieu Chantal 
Published: April 2023

AbstractThe greatest change in the treatment of people living with type 1 diabetes in the last decade has been the explosion of technology assisting in all aspects of diabetes therapy, from glucose monitoring to insulin delivery and decision making. Through screening of 835 peer-reviewed articles followed by systematic review of 70 of them (focusing on randomized trials and extension studies with ≥50 participants from the past 10 years), we conclude that novel technologies, ranging from continuous glucose monitoring systems, insulin pumps and decision support tools to the most advanced hybrid closed loop systems, improve important measures like HbA1c, time in range, and glycemic variability, while reducing hypoglycemia risk. Several studies included person-reported outcomes, allowing assessment of the burden or benefit of the technology in the lives of those with type 1 diabetes, demonstrating positive results or, at a minimum, no increase in self-care burden compared with standard care. Important limitations of the trials to date are their small size, the scarcity of pre-planned or powered analyses in sub-populations such as children, racial/ethnic minorities, people with advanced complications, and variations in baseline glycemic levels. In addition, confounders including education with device initiation, concomitant behavioral modifications, and frequent contact with the healthcare team are rarely described in enough detail to assess their impact. Our review highlights the potential of technology in the treatment of people living with type 1 diabetes and provides suggestions for optimization of outcomes and areas of further study for precision medicine-directed technology use in type 1 diabetes.Preface (Lay Abstract)We reviewed literature of the last decade to evaluate the impact of technology on the treatment of people living with type 1 diabetes. Screening of 835 articles and in-depth review of 70 showed that novel technologies, ranging from continuous glucose monitoring systems, insulin pumps and decision support tools to the most advanced hybrid closed loop systems, improve important measures like HbA1c and time in range, while reducing hypoglycemia risk. Of importance, several studies showed a positive impact on person-reported outcomes, like quality of life or, at a minimum, no increase in self-care burden compared with standard care.
Impacts of heat stress and its mitigation by capsaicin in health status and digestive enzymes in house sparrows (Passer domesticus)
Authors: Cacace Julia , Marinone Guido Fernández , Cid Fabricio Damián , Chediack Juan Gabriel 
Published: April 2023

ABSTRACTHeatwaves and warm spells at global level, product of climate change, causes alterations on homeostasis in animals (heat stress), so they must respond to these changes in order to survive. The response involves several physiological changes, such as releasing of glucocorticoids and catecholamines, to restore homeostasis. Due the lack of knowledge on this subject in wild birds, the objective of the present work was study the effect of heat stress on body condition and digestive system in house sparrows (Passer domesticus), as well as a possible role of capsaicin as a dietary additive in mitigating heat stress. In this work, we measure heterophils/lymphocytes ratio (as proxy of stress), body mass, hematocrit, uric acid and digestive enzymes (intestinal and pancreatic) under stress conditions at 32°±2 °C and under normal conditions at 22°±2 °C. In addition, we evaluate the effect of capsaicin in both situations (heat stress at 32°C and normal condition 22°C). We found an increase of H/L ratio and uric acid in plasma under heat stress, and decrease of H/L ratio with capsaicin on animals exposed to heat stress. Although a loss of intestinal mass was observed in animals exposed at 32°C, digestive enzyme activity does not change under heat stress or under capsaicin administration. Improving knowledge in this field is relevant at the level of animal nutrition and veterinary medicine, reducing the stress of wild birds in captivity and improving dietary mixes for future global warming scenarios.