bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fertility & Childbearing Outcomes of Practicing Female Plastic Surgeons
Authors: Hemal Kshipra , Chen Wendy , Bourne Debra A. 
Published: February 2023

Background:
Women now represent approximately a third of plastic surgery residents. 1,2 The impact of a career in plastic surgery on family planning is unknown. The aim of this study is to report the current status of fertility and childbearing outcomes of practicing female plastic surgeons.

Methods:
Following IRB approval, an anonymous online survey was distributed to all female active and candidate members of the American Society of Plastic Surgeons. Data collected included demographics, number and outcomes of pregnancies, obstetrical complications, infertility, maternity leave, and breastfeeding.

Results:
Response rate was 20%. Female plastic surgeons were less likely to have children and gave birth to their first child at an older age compared to the U.S. population. Plastic surgeons had 7 times higher odds of having difficulty conceiving or carrying a pregnancy than American women. The rate of miscarriage was twice that of the U.S. population. Furthermore, the rate of obstetrical complications and congenital malformations was higher than the U.S. population (47% vs 20%, and 8% vs 4%, respectively).
Women took a mean of 6.6 weeks for maternity leave. Forty-three percent were dissatisfied with leave and longer leave correlated with higher satisfaction. The mean length of breastfeeding was 7.6 months. Women who breastfed for a longer duration were more likely to feel satisfied with the amount of time they breastfed.

Conclusions:
Plastic Surgeons are at high risk for infertility, miscarriage, congenital malformations, and obstetrical complications. The data in this article provide a groundwork for identifying areas of concern and potential solutions.
Facial nerve high-resolution visualization and topographic microanatomy analysis from the distal intratemporal to extracranial pes segment – reconstructive implications
Authors: Mohanty Ahneesh J. , Cleveland Patrick , Shang Zhiguo , Glick Samuel , Sanchez Cristina , Jamieson Andrew R. , Rozen Shai M. 
Published: February 2023

Background:
Current knowledge of facial nerve topography between the stylomastoid foramen to the pes anserinus is very limited. Elucidating this segment's intraneural microanatomy may be advantageous in certain clinical settings: the planning of nerve grafts for gaps extending from the proximal facial nerve trunk to distal branches or in determining coaptation sites for hypoglossal jump grafts to provide selective upper and lower facial tone. This study is the first to provide high definition intraneural topography of the aforementioned segment to optimize reconstructive outcomes.

Methods:
16 facial nerves extending from the 2 nd genu to the pes anserinus were harvested from 8 cadavers en bloc to preserve orientation. Specimens were imaged by microCT using a serial 6-micron protocol and digitally reconstructed three- dimensionally to be analyzed using bioinformatic tools.

Results:
No clinically significant fascicular separation was noted between 14.4 mm proximal to the stylomastoid foramen until 4.4 mm distal to the foramen. Fascicles remained separate throughout the remainder of the specimen and found to undergo a mean rotation of 45.5 degrees (p=0.0002) between 8.9-13.7 mm distal to the stylomastoid foramen. This reliable clockwise rotation in left nerves and counterclockwise rotation in right nerves resulted in superficially-oriented fascicles entering the upper division of the pes anserinus, while deep-oriented fascicles entered the lower division.

Conclusion:
Intraneural facial nerve topography and rotation are consistent from 4 to 14 mm distal to the stylomastoid foramen, enabling surgeons to accurately place grafts targeted to either upper or lower face, thus optimizing functional accuracy and minimizing synkinesis.
Subfascial Axillary Hybrid Breast Augmentation: Technical Highlights and Step-by-Step Video Guide
Authors: Munhoz Alexandre Mendonça , Neto Ary de Azevedo Marques , Maximiliano João 
Published: February 2023

Summary:
Advances in breast augmentation techniques have led to safety improvements and better aesthetic results. The concurrent combination of the axillary approach with a subfascial pocket has been suggested for augmentation procedures, since it avoids breast scarring and the limitations of submuscular positioning represented by breast animation when the pectoral muscle is contracted. With the improvement of autogenous fat grafting techniques, new implant coverage options and more natural results have been proposed with more superficial implant pockets; simultaneous autogenous fat grafting with silicone implants (defined as hybrid breast augmentation) has recently been evaluated as a promising technique. Combining these two procedures allows core volume projection and natural cleavage, while camouflaging implant edges. Fat grafting is also useful in reducing intermammary distance and achieving a smaller and smoother transition between the breasts. This article and the accompanying videos provide a detailed, step-by-step guide to hybrid breast augmentation using a subfascial axillary approach, with a predictable and optimized surgical outcome.
Stem-cell enriched hybrid breast reconstruction reduces risk for capsular contracture in a hybrid breast reconstruction animal model
Authors: Diehm Yannick F. , Thomé Julia , Will Patrick , Kotsougiani-Fischer Dimitra , Haug Valentin F. , Siegwart Laura C. , Kneser Ulrich , Fischer Sebastian 
Published: February 2023

Background:
Hybrid breast reconstruction (HBR) combines silicone implants with fat grafting to improve implant coverage, treating local tissue deficiencies and leading to a more natural breast appearance. Recent data also indicated less capsular contracture after HBR. We developed a novel technique and animal model of cell-assisted HBR (CA-HBR) to illuminate its effects on capsular contracture.

Methods:
Animals received silicone implants in a dorsal sub-muscular pocket. While animals of group HBR received fat grafting around the implant without stem cell enrichment, rats of the CA-HBR1 and the CA-HBR2 group received stem-cell enriched fat grafting with 2x10 6 and 4x10 6 adipose derived stem cells immediately after implant insertion. On day 60, animals underwent sonography and elastography imaging, were euthanized and outcome analysis was performed by means of histology, immunohistochemistry, chemical collagen quantification and gene expression analysis.

Results:
With this novel technique, long-term survival of ADSCs within the implant pocket was demonstrated after 60 days post implant insertion. CA-HBR led to significantly reduced thickness and collagen density of capsular contractures. Additionally, CA-HBR resulted in reduced fibrotic responses with less occurrence of collagen I and TGFβ in capsule tissue. Moreover, the addition of stem cells suppressed fibrotic and inflammatory responses on a genetic level with significant under-expression of collagen I and TGFβ1.

Conclusion:
With this new technique and animal model, we observed a preventive effect on capsular contracture substantiating the basis of clinical outcomes of HBR. We propose that the addition of stem cells to HBR might booster its beneficial results.
Modifying effect of outdoor recreational activity on the association between anger expression and cardiovascular disease risk: the Circulatory Risk in Communities Study
Authors: Tezuka Kazuhide , Kubota Yasuhiko , Ohira Tetsuya , Muraki Isao , Hayama-Terada Mina , Shimizu Yuji , Imano Hironori , Shirai Kokoro , Okada Takeo , Kiyama Masahiko , Iso Hiroyasu 
Published: February 2023

ABSTRACT

Objective
Outdoor recreational activity (ORA) has been suggested as a practical strategy for anger management to moderate the risk of cardiovascular disease (CVD). However, there is a lack of evidence pertaining to this topic. Our aim was to examine whether ORA modified the association between anger expression and the risk of CVD.

Methods
A community-based cohort study was conducted among 1877 Japanese individuals aged 40—79 years at baseline in 1997. The anger expression was measured using the Spielberger Anger Expression Scale. Stratified into low and high ORA (0 and ≥ 1 of the four behaviors), a Cox proportional hazards model was used to assess the anger expression-related risk of incident CVD (ischemic heart disease and stroke).

Results
We identified 76 incident CVDs during a median follow-up of 18.8 years. Among participants with low ORA, anger expression was associated with an increased risk of CVD, whereas no association was identified among those with high ORA. The standardized hazard ratios were 1.53 (95% CI, 1.23-1.91) and 0.77 (0.51-1.15) among those with low and high ORA, respectively: p for interaction = .004. Similar associations were observed regarding the risk of total and ischemic stroke, and ischemic CVD.

Conclusions
We found an elevated risk of CVD associated with anger expression among participants with low ORA but not among those with high ORA, suggesting that ORA use may mitigate the association between anger expression and CVD risk.
Evaluation of Policies Limiting Opioid Exposure on Opioid Prescribing and Patient Pain in Opioid-Naive Patients Undergoing Elective Surgery in a Large American Health System
Authors: Rennert Lior , Howard Kerry A. , Walker Kevin B. , Furmanek Douglas L. , Blackhurst Dawn W. , Cancellaro Vito A. , Litwin Alain H. 
Published: February 2023

Objectives
Overprescribing to opioid-naive surgical patients substantially contributes to opioid use disorders, which have become increasingly prevalent. Opioid stewardship programs (OSPs) within healthcare settings provide an avenue for introducing interventions to regulate prescribing. This study examined the association of OSP policies limiting exposure on changes in surgery-related opioid prescriptions and patient pain.

Methods
We evaluated policies implemented by an OSP in a large American healthcare system between 2016 and 2018: nonopioid medication during surgery, decrease of available opioid dosage vials in operating rooms, standardization of opioid in-patient practices through electronic health record alerts, and limit to postsurgery opioid supply. Generalized linear mixed effects models examined the association of interventions with outcome changes in 9262 opioid-naive patients undergoing elective surgery. Outcomes were discharge pain, morphine milligram equivalent in the first prescription postsurgery, and opioid prescription refills.

Results
Decreases in all prescription outcomes and discharge pain were observed following onset of OSP interventions (P’s < 0.001). Among individual policies, standardization of in-patient prescribing practices was associated with the strongest decrease in prescribed morphine milligram equivalent. Importantly, there was no evidence of an increase in discharge pain related to any intervention.

Conclusions
This study promotes the potential of OSP formation and policies to reduce opioid prescribing without compromising patient pain. The most effective policy, standardization of in-patient prescribing practices through alerts, suggests that reminding prescribers to re-evaluate the patient’s need is effective in changing behavior. The findings offer considerations for OSP formation and policy implementation across health systems to improve quality and safety in opioid prescribing.
Uptake of medical male circumcision with household-based testing, and the association of traditional male circumcision and HIV infection
Authors: Zewdie Kidist , Pickles Michael , Floyd Sian , Fidler Sarah , Ayles Helen , Bock Peter , Hoddinott Graeme , Mandla Nomtha , Shanaube Kwame , Simwinga Musonda , Fraser Christophe , Seeley Janet , Piwowar-Manning Estelle , Hayes Richard , Donnell Deborah 
Published: February 2023

Objectives:
Voluntary medical male circumcision (VMMC) is an important component of combination HIV prevention. Inclusion of traditionally circumcised HIV negative men in VMMC uptake campaigns may be important if traditional male circumcision is less protective against HIV acquisition than VMMC.

Methods:
We used data from the HIV Prevention Trials Network (HPTN) 071 (PopART) study. This cluster-randomized trial assessed the impact of a combination prevention package on population-level HIV incidence in 21 study communities in Zambia and South Africa. We evaluated uptake of VMMC, using a two-stage analysis approach and used discrete-time survival analysis to evaluate the association between the types of male circumcision and HIV incidence.

Results:
A total of 10 803 HIV-negative men with self-reported circumcision status were included in this study. At baseline, 56% reported being uncircumcised, 26% traditionally circumcised and 18% were medically circumcised. During the PopART intervention, 11% of uncircumcised men reported uptake of medical male circumcision. We found no significant difference in the uptake of VMMC in communities receiving the PopART intervention package and standard of care {adj. rate ratio=1·10 [95% confidence interval (CI) 0.82, 1.50, P = 0.48]}. The rate of HIV acquisition for medically circumcised men was 70% lower than for those who were uncircumcised adjusted hazard ratio (adjHR) = 0.30 (95% CI 0.16–0.55; P < 0.0001). There was no difference in rate of HIV acquisition for traditionally circumcised men compared to those uncircumcised adjHR = 0.84 (95% CI 0.54, 1.31; P = 0.45).

Conclusions:
Household-based delivery of HIV testing followed by referral for medical male circumcision did not result in substantial VMMC uptake. Traditional circumcision is not associated with lower risk of HIV acquisition.
Creatinine and cystatin C-based estimated glomerular filtration rate estimates of kidney function in Black people with HIV on antiretroviral therapy
Authors: Mazaheri Tina , Buchanan Devon , Hung Rachel , Campbell Lucy , Hamzah Lisa , Bramham Kate , Vincent Royce P. , Post Frank A. 
Published: February 2023

Background:
To reduce health inequalities, the creatinine-based chronic kidney disease epidemiology collaboration 2021 formula for estimated glomerular filtration rate (eGFR) is replacing the 2009 formula, which required adjustment specifically for Black individuals. We compared the 2021 and 2009 creatinine-based formulae with cystatin C-based eGFR in Black people on antiretroviral therapy (ART) with HIV RNA <200 c/ml.

Methods:
Cross-sectional analysis of paired serum creatinine and cystatin C measurements. Bias, imprecision, accuracy, and performance for identifying individuals with eGFR cystatin C <60 (units: ml/min per 1.73 m2) were determined. The effects of ART with no, mild-moderate, or marked effect on tubular creatinine secretion on the performance of the 2021 formula was assessed.

Results:
We included 362 individuals (mean age 51 years, 56% female, mean eGFR-cystatin C 88.3). Overall, the 2021 (vs. the 2009 race-adjusted) formula was less biased and had improved imprecision and accuracy compared with eGFR-cystatin C but underestimated eGFR-cystatin C in those with eGFR ≥90 and overestimated eGFR-cystatin C in those with eGFR <60. The 2021 (vs. the 2009) formula had high specificity (95% vs. 97%) and negative predictive value (97% vs. 96%), but low sensitivity (56% vs. 52%) and positive predictive value (44% vs. 54%) for identifying individuals with eGFR-cystatin C <60 (P > 0.25). Performance at the eGFR <60 cut-off was minimally affected by ART exposure group.

Conclusion:
The CKD-EPI 2021 creatinine-based formula was better aligned with eGFR-cystatin C than the 2009 formula. eGFR-cystatin C may provide clinically useful information in Black people with eGFR <60 irrespective of ART regimen.
Assessing renal impairment in treatment-naïve adolescents living with HIV commencing antiretroviral therapy in Zimbabwe
Authors: Byers Bradley W. , Drak Douglas , Shamu Tinei , Chimbetete Cleophas , Dahwa Rumbidzai , Gracey David M. 
Published: February 2023

Objective:
People with HIV (PWH) are increasingly experiencing non-communicable complications, including renal impairment, which are associated with worse clinical outcomes. Limited information exists surrounding renal impairment in paediatric PWH, of which the majority live in sub-Saharan Africa, and further information is required to guide clinical practice. This study describes the prevalence of new or worsening renal impairment in adolescents commencing antiretroviral therapy (ART) in Zimbabwe and associated risk factors.

Design:
Retrospective cohort study.

Methods:
Data were collected between January 2010 to January 2019 from the medical records of adolescents aged 12–17 years initiating ART at an outpatient HIV clinic in Zimbabwe. Renal function (estimated glomerular filtration rate, eGFR) was calculated using the Full Age Spectrum formula. Proteinuria was defined as a single urine dipstick score of ≥1+. Potential predictors of renal impairment at follow-up were assessed by logistical regression.

Results:
Two hundred and sixty-six adolescents were included in analysis. Baseline renal impairment (eGFR < 90 ml/min/1.73 m2) and proteinuria were present in 13% and 7% of the cohort, respectively. After a median of 4.1 years (interquartile range: 1.9–6.9) following ART commencement, mean eGFR increased by 10 ml/min/1.73 m2 (P < 0.01), and the prevalence of renal impairment decreased to 8% (P < 0.01). Baseline renal impairment predicted renal impairment at follow-up (odds ratio [OR] 8.98; 95% confidence interval [CI] 2.81–28.68; P < 0.01). Proteinuria trended towards association with renal impairment at follow-up (OR 4.39; 95% CI 0.95–20.31; P = 0.06).

Conclusions:
Renal impairment is common in adolescent ART-naïve PWH, and baseline renal impairment is associated with longstanding renal impairment, whereas baseline proteinuria trended towards an association with longstanding renal impairment.
Identifying miRNA biomarkers of polycystic ovary syndrome through text mining
Authors: Wang Yan , Yuan Xiao-Jing , Zhao Bin 
Published: February 2023

Objective:
Polycystic ovary syndrome (PCOS) is an endocrine disorder with diverse clinical manifestations that often occurs in women of childbearing age. However, its molecular pathogenesis remains unclear, and this study aimed to identify miRNA targets in PCOS through text mining and database analysis.

Methods:
First, three different sets of text mining genes (TMGs) associated with “polycystic ovary syndrome”, “obesity/adiposis”, and “anovulation” keywords were retrieved from the GenCLiP3 database, and overlapping genes were selected. Second, Gene ontology annotation and biological pathway enrichment analyses of these overlapping TMGs were performed, followed by protein–protein interaction (PPI) network analysis. Third, genes in the gene module clustered in the PPI were selected to predict potential miRNAs for PCOS via miRNA-mRNA analysis.

Results:
A total of 4291 TMGs related to three different keywords were obtained through text mining; 72 intersect TMGs were retained among the three gene sets, and 62 TMGs participated in the establishment of the PPI network, of which 18 were aggregated in the gene module. Finally, 11 miRNAs that simultaneously bound to two TMGs (IGF1, ESR1, MAPK1, NAMPT, PIK3CA, and SERPINE1) could be prioritized as targets to study PCOS.

Conclusion(s):
The discovery of 11 miRNAs (miR-301a-3p, miR-301b-3p, miR-3666, miR-454-3p, miR-130a-3p, miR-130b-3p, miR-4295, miR-190a-3p, miR-5011-5p, miR-548c-3p, and miR-4799-5p) and 6 TMGs, which are associated with the HIF-1 signaling pathway (P = 4.799E-08), could be used as potential targets for PCOS.
Magnetic Resonance Elastography (MRE) of Bleomycin-Induced Pulmonary Fibrosis in an Animal Model
Authors: Fakhouri Faisal , Joseph Matthew , Ballinger Megan , Shukla Vasudha , Weimar David , Novak Caymen , Ghadiali Samir , Kolipaka Arunark 
Published: February 2023

Background
Idiopathic pulmonary fibrosis is responsible for 40,000 deaths annually in the United States. A hallmark of idiopathic pulmonary fibrosis is elevated collagen deposition, which alters lung stiffness. Clinically relevant ways to measure changes in lung stiffness during pulmonary fibrosis are not available, and new noninvasive imaging methods are needed to measure changes in lung mechanical properties.

Objectives
Magnetic resonance elastography (MRE) is an in vivo magnetic resonance imaging technique proven to detect changes in shear stiffness in different organs. This study used MRE, histology, and bronchoalveolar lavage (BAL) to study changes in the mechanical and structural properties of the lungs after bleomycin-induced pulmonary fibrosis in pigs.

Materials and Methods
Pulmonary fibrosis was induced in 9 Yorkshire pigs by intratracheal instillation of 2 doses of bleomycin into the right lung only. Magnetic resonance elastography scans were performed at baseline and week 4 and week 8 postsurgery in a 1.5 T magnetic resonance imaging scanner using a spin-echo echo planar imaging sequence to measure changes in lung shear stiffness. At the time of each scan, a BAL was performed. After the final scan, whole lung tissue was removed and analyzed for histological changes.

Results
Mean MRE-derived stiffness measurements at baseline, week 4, and week 8 for the control (left) lungs were 1.02 ± 0.27 kPa, 0.86 ± 0.29 kPa, and 0.68 ± 0.20 kPa, respectively. The ratio of the shear stiffness in the injured (right) lung to the uninjured control (left) lung at baseline, week 4, and week 8 was 0.98 ± 0.23, 1.52 ± 0.41, and 1.64 ± 0.40, respectively. High-dose animals showed increased protein in BAL fluid, elevated inflammation observed by the presence of patchy filtrates, and enhanced collagen and α-smooth muscle actin staining on histological sections. Low-dose animals and the control (left) lungs of high-dose animals did not show significant histopathological changes.

Conclusion
This study demonstrated that MRE can be used to detect changes in lung stiffness in pigs after bleomycin challenge.
Exploiting the Potential of Photon-Counting CT in Abdominal Imaging
Authors: Schwartz Fides Regina , Samei Ehsan , Marin Daniele 
Published: February 2023

Abstract
Photon-counting computed tomography (PCCT) imaging uses a new detector technology to provide added information beyond what can already be obtained with current CT and MR technologies. This review provides an overview of PCCT of the abdomen and focuses specifically on applications that benefit the most from this new imaging technique. We describe the requirements for a successful abdominal PCCT acquisition and the challenges for clinical translation. The review highlights work done within the last year with an emphasis on new protocols that have been tested in clinical practice. Applications of PCCT include imaging of cystic lesions, sources of bleeding, and cancers. Photon-counting CT is positioned to move beyond detection of disease to better quantitative staging of disease and measurement of treatment response.
Langerhans Cell Histiocytosis of Bilateral Parotid and Submandibular Glands
Authors: Prakash Sneha , Shamim Shamim Ahmed , Bakhshi Sameer , Pushpam Deepam , Sharma Aparna 
Published: February 2023

AbstractLangerhans cell histiocytosis is a disorder of the mononuclear phagocytic system. Virtually any organ can be involved, the bone, skin, lungs, and pituitary gland being the most common. We describe the case of a 30-year-old man who presented with painless neck swelling.18F-FDG PET/CT showed bilateral bulky parotid and submandibular glands with increased metabolic activity. Histopathology confirmed the diagnosis of Langerhans cell histiocytosis. To our knowledge, there has been no description of18F-FDG PET/CT findings in Langerhans cell histiocytosis of salivary glands in literature. We aim to aid in the diagnosis and management of this rare presentation.