bluuebunny/crossref_metadata_2025_split huggingface dataset:
Syringe Suction Yields Greater Adipocyte Viability for Fat Grafting
Authors: Kuykendall Lauren , Threet Abby , Le Nicole K. , Moffitt Joseph , McLaughlin Mariel , Serraneau Karisa 
Published: February 2023

Abstract
Autologous fat grafting is a technique that can be used for cosmetic and reconstructive indications such as oncologic defects, aging, trauma, and congenital malformations. However, there is no standardized technique, and one of the main challenges is the unpredictable rate of fat resorption. When using fat grafting, it is crucial to understand the different factors that contribute to adipocyte viability. A literature search, using PubMed, was conducted in 2022 with variations of the terms “autologous fat grafting,” “fat harvesting,” “fat processing,” and “fat injection.” Articles in the English language that presented original data about different factors that may affect adipocyte viability for fat grafting were included in this review. Syringe suction harvests (lower pressures), compared with other methods with higher pressures, were found to have increased adipocyte counts and viability, but this did not translate clinically during in vivo studies. The studies have shown that, despite our efforts in optimizing fat harvest, processing, and injection, no statistical or clinical differences have been found. Additional studies are still needed to determine a universal protocol for optimal fat graft survival.
The Efficacy of Subdermal Pocket Procedure in Fingertip Replantation With Composite Graft
Authors: Yeh Jui-Po , Lin Tsan-Shiun 
Published: February 2023

BackgroundMicrosurgical replantation of fingertip amputation is sometimes difficult because of a lack of available vessels. Composite grafting is an alternative method for nonvascularized replantation, but it has a limited success rate. The subdermal pocket (SDP) procedure is proposed to increase the survival of composite graft.Aim and ObjectivesWe aimed to compare the success rate of the composite graft used in fingertip replantation with or without application of the SDP procedure.Patients and MethodsFrom 2000 to 2020, 29 fingertip amputations (28 complete amputations, 1 near-complete amputation) from 28 patients were included. Five of the fingertip amputations were classified as Ishikawa zone Ib and 24 as Ishikawa zone II. Seventeen fingers underwent replantation with composite graft plus SDP procedure, whereas the remaining 12 fingers received replantation with composite graft only.ResultsThe overall success rate was 70.59% (12 of 17) in the SDP group and 41.67% (5 of 12) in the composite graft-only group (P= 0.119; odds ratio, 3.36). In the subgroup of Ishikawa zone II fingertip amputations, the success rate was 66.67% (10 of 15) in the SDP group and 22.22% (2 of 9) in the composite graft-only group (P= 0.035; odds ratio, 7.0).ConclusionsThe SDP procedure could increase the success rate of fingertip replantation with composite graft, especially for Ishikawa zone II amputations.
Application of Autogenous Dermis Combined With Local Flap Transplantation in Repair of Titanium Mesh Exposure After Cranioplasty
Authors: Wei Zhiyi , Yang Xiaolan , Lin Tianlai , Zhu Jingfa , Fang Xiangjian , Zhu Yixin , Cheng Juntao 
Published: February 2023

Objectives:
To investigate the clinical outcome of autogenous dermis combined with local flap transplantation in the treatment of titanium mesh exposure after cranioplasty.

Methods:
We studied a total of 8 patients with titanium mesh exposure after cranioplasty. After debridement of the head wound, the autogenous dermal tissue from the lateral thigh was transplanted to the surface of titanium mesh, and the local skin flap was then applied after suturing and fixation to repair the wound on the surface of the dermis. To repair the lateral thigh dermal tissue area, a local skin flap was obtained, and a blade thick skin graft was used.

Results:
Both dermal tissue and local skin flap survived. In the meanwhile, the donor skin area of the lateral thigh healed well, with only slight scar hyperplasia, and the titanium mesh was preserved. There was no recurrence after 6 months of follow-up.

Conclusions:
The application of autogenous dermis combined with local skin flap to repair titanium mesh exposure can effectively avoid skin flap necrosis, potential re-exposure of titanium mesh, sub-flap effusion, infection, and other problems. This method has an ideal effect, has easy access to materials, and reduces patients’ economic burden. It is worth popularizing.
Comparison of Piezosurgery and Conventional Osteotomy for Orbital Hypertelorism Surgical Correction
Authors: Liu Xiangqi , Zhang Ziwei , Kim Byeong Seop , Lin Li , Han Wenqin , Chai Gang , Xu Haisong , Yang Xianxian 
Published: February 2023

The purpose of this study was to compare the safety and effect of piezosurgery with conventional osteotomy in a box-shifting procedure for orbital hypertelorism (ORH) correction surgery. This study retrospectively analyzed the clinical record of 10 ORH patients aged from 5 to 12 years, and they were second-degree ORH with an interorbital distance (IOD) of 35 to 37.8 mm. Three of them received the osteotomy with piezosurgery (the piezosurgery group), whereas the other 7 patients received osteotomy with the conventional osteotomy method (the control group). They were compared with age and preoperative IOD. All the patients’ IOD was effectively improved to normal range after the surgery. The results showed that the application of piezosurgery did not prolong the surgery time (piezosurgery group: 8.3±0.5 hours; control group: 8.7±1.4 hours, P=0.68). Furthermore, the patients in the piezosurgery group had less drainage volume (piezosurgery group: 79.1±12 mL; the control group: 170±41.3 mL, P=0.0065) and shorter postoperative hospital stay (piezosurgery group: 8.3±2.0 d; control group: 12.43±2.29 d, P=0.029). There were 2 patients who had wound infections, 1 in the piezosurgery group and 1 in the control group, respectively. However, 1 patient in the control group suffered from cerebrospinal fluid leakage. On the basis of the results, the application of piezosurgery benefited the patients on a better and smoother recovery course with less drainage and shorter hospital stays. The advantages of piezosurgery are the fine and precise osteotomy and the protection for soft tissue, which make it a comparatively safe and effective tool for craniofacial surgery, especially for young patients.
Sunken Upper Eyelid Deformity Correction by Orbital Fat Pad Repositioning and Orbicularis Oculi Muscle Folding in Blepharoplasty
Authors: Li XiuQi , Xia Lin , Ma Ling 
Published: February 2023

Background:
Sunken upper eyelid deformity results in an aged and unnatural appearance and is common among Asians along with the single eyelid. The upper eyelid volume restoration is as important as the creation of a supratarsal fold for patients with sunken eyelids. In the present study, the combination of orbital fat pad repositioning and orbicularis oculi muscle flap folding was established to correct the upper eyelid depression during blepharoplasty.

Methods:
A retrospective study was conducted on patients who underwent the orbital fat pad repositioning and orbicularis oculi muscle flap folding to correct the upper eyelid depression between July 2020 and October 2021. The preoperative and postoperative sunken depths were calculated and compared, and overall patient satisfaction was performed to evaluate the operation efficiency.

Results:
There were 40 patients, including 39 females and 1 male, who underwent surgery with an average age of 25.4 years. During the mean follow-up period of 12.7 months, the sunken depth improved from 3.2 mm preoperatively to 1.5 mm postoperatively with a statistical significance. Satisfactory results were achieved without major complication.

Conclusions:
For patients with mild to moderate sunken upper eyelids, the combination of orbital fat pad repositioning and orbicularis oculi muscle folding has been proved efficient and consistent to restore the upper eyelid volume and helpful to build esthetic double eyelids.
Patient-Specific Implants and Fat Grafting for Contour Deformities Post Craniosynostosis Reconstruction: A Therapeutic Approach
Authors: Chocron Yehuda , Alabdulkarim Abdulaziz , Gilardino Mirko S. 
Published: February 2023

Background:
Contour deformities after fronto-orbital advancement for craniosynostosis reconstruction are commonly encountered. There is a paucity of literature describing secondary procedures to correct such deformities with reported outcomes. An approach to defect analysis and procedure selection is lacking. The authors present our experience utilizing fat grafting (FG) and patient-specific implant (PSI) reconstruction as management strategies for this population.

Methods:
A retrospective analysis of consecutive patients who underwent secondary onlay PSI or FG for contour deformities after primary craniosynostosis reconstruction was carried out. Patient demographics, defect analysis, surgical approach, postoperative complications, and esthetic outcomes were recorded. Data were pooled across the entire cohort and presented in a descriptive manner.

Results:
Fourteen patients (36% syndromic and 64% isolated) were identified that either underwent PSI (n = 7) with a mean follow-up of 56.3 weeks, FG (n = 5) with a mean follow-up of 36 weeks or a combination of both (n = 2) for deformities postcraniosynostis surgery. Supraorbital retrusion and bitemporal hollowing were the most common deformities. There were no intraoperative or postoperative complications. All patients achieved Whitaker class I esthetic outcomes and there were no additional revisions during the defined study period. The presence of a significant structural component or large (>5 mm) depression typically necessitated a PSI.

Conclusions:
Contour deformities after fronto-orbital advancement reconstruction can be successfully managed using FG and PSI either as a combination procedure or in isolation. The authors have proposed anatomical criteria based on our experience to help guide procedure selection. Future prospective studies would be beneficial in providing more objective assessment criteria.
THE ROLES OF EXTRACELLULAR VESICLES IN SEPSIS AND SYSTEMIC INFLAMMATORY RESPONSE SYNDROME
Authors: Weber Birte , Henrich Dirk , Hildebrand Frank , Marzi Ingo , Leppik Liudmila 
Published: February 2023

ABSTRACT
Sepsis is a life-threatening organ dysfunction, caused by dysregulation of the host response to infection. To understand the underlying mechanisms of sepsis, the vast spectrum of extracellular vesicles (EVs) is gaining importance in this research field. A connection between EVs and sepsis was shown in 1998 in an endotoxemia pig model. Since then, the number of studies describing EVs as markers and mediators of sepsis increased steadily. Extracellular vesicles in sepsis could be friends and foes at the same time depending on their origin and cargo. On the one hand, transfer of EVs or outer membrane vesicles can induce sepsis or systemic inflammatory response syndrome with comparable efficiency as well-established methods, such as cecal ligation puncture or lipopolysaccharide injection. On the other hand, EVs could provide certain therapeutic effects, mediated via reduction of reactive oxygen species, inflammatory cytokines and chemokines, influence on macrophage polarization and apoptosis, as well as increase of anti-inflammatory cytokines. Moreover, EVs could be helpful in the diagnosis of sepsis. Extracellular vesicles of different cellular origin, such as leucocytes, macrophages, platelets, and granulocytes, have been suggested as potential sepsis biomarkers. They ensure the diagnosis of sepsis earlier than classical clinical inflammation markers, such as C-reactive protein, leucocytes, or IL-6. This review summarizes the three roles of EVs in sepsis—mediator/inducer, biomarker, and therapeutic tool.
CLINICAL, MOLECULAR, AND EXOSOMAL MECHANISMS OF CARDIAC AND BRAIN DYSFUNCTION IN SEPSIS
Authors: Morris Daniel C. , Zhang Zheng Gang , Jaehne Anja K. , Zhang Jing , Rivers Emanuel P. 
Published: February 2023

ABSTRACT
Sepsis is a complex disease resulting from a dysregulated inflammatory response to an infection. Initiation of sepsis occurs from a localized infection that disseminates to the bloodstream placing all organ systems at risk. Septic shock is classically observed to manifest itself as systemic hypotension with hyporesponsiveness to vasopressor agents. Myocardial dysfunction occurs resulting in an inability to perfuse major organ systems throughout the body. Most importantly, the brain is hypoperfused creating an ischemic and inflammatory state resulting in the clinical observation of acute mental status changes and cognitive dysfunction commonly known as sepsis-associated encephalopathy. This short review describes the inflammatory molecular mechanisms of myocardial dysfunction, discusses the evidence of the dual roles of the microglia resulting in blood-brain barrier disruption, and suggests that septic-derived exosomes, endosome-derived lipid bilayer spheroids released from living cells, influence cardiac and neurological cellular function.
The Impact of the Patient Role on Medical Student Learning During Peer Simulation
Authors: Rudinsky Sherri L. , Weissbrod Elizabeth , Cole Rebekah 
Published: February 2023

Introduction
Simulation-based learning is an effective approach to teaching and assessing medical students. However, there is a lack of research regarding how playing the patient role during peer simulation impacts medical student learning. This study, therefore, examines the experiences of first-year medical students in the patient role during a high-fidelity, multiday peer simulation.

Methods
Using a phenomenological approach to qualitative data analysis, we analyzed 175 student reflection papers assigned to the students at the conclusion of the peer simulation. Our research team individually coded each paper and then came to a consensus on themes and patterns within the data.

Results
We discovered the following 4 themes within the data: (1) communication, (2) empathy, (3) stress, and (4) professional identity. Through observation and peer simulation students learned the importance of team, patient, and nonverbal communication, especially during transitions of care. Next, the students recognized the importance of quality patient care and prioritizing the humanity of their future patients. The students also connected stress and mistakes, teaching them the importance of stress management. Finally, inspired by their peers and looking to their future selves, the students expressed a commitment to continued professional development.

Conclusions
The patient role during peer simulation is an impactful learning experience for first-year medical students. Our study holds important implications for ways in which medical educators can maximize the benefits of simulation-based education for junior medical student learning.
Prevalence and Risk Factors for Urinary Incontinence in Nulliparous Women: A Contemporary, Population-Based Cohort Study
Authors: Kupfer Nathalie , Clancy Aisling , Maguire Finlay , Stairs Jocelyn 
Published: February 2023

Importance and Objectives
Epidemiologic studies of incontinence largely focus on parous women, and there are limited data regarding nulliparous women. Our objectives were to evaluate risk factors for urinary incontinence among a nationally representative, contemporary sample of nulliparous women of all ages in the United States and to describe the prevalence and subtypes of urinary incontinence and nocturia in this population.

Study Design
This cross-sectional, population-based study used the National Health and Nutrition Examination Survey cycles 2011–2018 to assemble a sample of nulliparous women 20–80 years old. Crude and adjusted odds ratios were estimated using multivariable logistic regression for the exposures of interest: body mass index (BMI), age, physical activity, prior hysterectomy, and current smoking. Prevalence of urinary incontinence and nocturia were estimated.

Results
Among 1,603 nulliparous women, prevalence of any urinary incontinence was 29.38%. Prevalence of stress, urgency, and mixed urinary incontinence and nocturia, respectively, were 27.68%, 19.64%, 10.57%, and 58.95%. Women with a BMI ≥25 (calculated as weight in kilograms divided by height in meters squared; adjusted odds ratio [aOR], 1.57; 95% confidence interval [CI], 1.11–2.23), at least 45 years (aOR, 3.75; 95% CI, 2.31–5.83), and current smoking (aOR, 1.63; 95% CI, 1.07–2.49) had increased the odds of incontinence compared with women without these risk factors. When stress urinary incontinence (SUI) was considered alone, only women with a BMI ≥25 (aOR, 1.66; 95% CI, 1.20–2.31) and age at least 45 years (aOR, 3.17; 95% CI, 2.01–5.00) had increased odds of SUI compared with women without these risk factors.

Conclusions
Urinary incontinence and nocturia are prevalent in nulliparous women, and age, elevated BMI, and current smoking may represent risk factors for incontinence in this population.
Aripiprazole Used to Treat Capgras Syndrome in an Adolescent Diagnosed With Autism
Authors: Baykal Saliha , Mutlu Caner 
Published: February 2023

Objectives
This report discusses the emergence, clinical appearance, and treatment of the rare entity Capgras syndrome (CS) in an adolescent diagnosed with autism.

Methods
After a brief introduction to the CS, we conduct a detailed description of the case and review, after a search on the PubMed database, the known pathophysiology, psychiatric disorders associated with the onset of this syndrome, and the management of CS.

Results
Capgras syndrome generally emerges during the course of delusional disorder, schizophrenia, or mood disorders, and for reasons such as neurological, infectious, or endocrinological diseases, drug intoxications, or deprivation. We encountered no previous reports of CS developing during the course of autism. There are no prospective studies concerning the treatment of the syndrome. However, antipsychotic drug use is primarily recommended in treatment. Antipsychotic drug therapy was therefore planned for the treatment of delusion, a psychotic symptom, in this case. The atypical antipsychotic aripiprazole was used based on the presence of accompanying diagnosis of autism, and the patient's body mass index and age. A relatively high dose of aripiprazole was required for the first psychotic attack in our patient. However, a good level of response was achieved within the expected time frame. In addition, no marked adverse effects were observed.

Conclusions
Aripiprazole seems to be an effective and well-tolerated antipsychotic drug in the treatment of CS accompanying autism.
Pre-diagnosis plasma cell-free DNA methylome profiling up to seven years prior to clinical detection reveals early signatures of breast cancer
Authors: Cheng Nicholas , Skead Kimberly , Singhawansa Althaf , Ouellette Tom W. , Elliott Mitchell , Cescon David W. , Bratman Scott V. , De Carvalho Daniel D. , Soave David , Awadalla Philip 
Published: February 2023

AbstractProfiling of cell-free DNA (cfDNA) has been well demonstrated to be a potential non-invasive screening tool for early cancer detection. However, limited studies have investigated the detectability of cfDNA methylation markers that are predictive of cancers in asymptomatic individuals. We performed cfDNA methylation profiling using cell-free DNA methylation immunoprecipitation sequencing (cfMeDIP-Seq) in blood collected from individuals up to seven years before a breast cancer diagnosis in addition to matched cancer-free controls. We identified differentially methylated cfDNA signatures that discriminated cancer-free controls from pre-diagnosis breast cancer cases in a discovery cohort that is used to build a classification model. We show that predictive models built from pre-diagnosis cfDNA hypermethylated regions can accurately predict early breast cancers in an independent test set (AUC=0.930) and are generalizable to late-stage breast cancers cases at the time of diagnosis (AUC=0.912). Characterizing the top hypermethylated cfDNA regions revealed significant enrichment for hypermethylation in external bulk breast cancer tissues compared to peripheral blood leukocytes and breast normal tissues. Our findings demonstrate that cfDNA methylation markers predictive of breast cancers can be detected in blood among asymptomatic individuals up to six years prior to clinical detection.
Higher alpha diversity and Lactobacillus blooms are associated with better engraftment after Fecal Microbiota Transplant in Inflammatory Bowel Disease
Authors: Zhang Yanjia Jason , Bousvaros Athos , Docktor Michael , Kaplan Abby , Rufo Paul A. , Leier McKenzie , Weatherly Madison , Zimmerman Lori , Tu Nguyen Le Thanh , Barton Brenda , Russell George , Alm Eric J. , Kahn Stacy A. 
Published: February 2023

AbstractBackgroundFecal Microbiota Transplant (FMT) has proven effective in treating recurrentClostridioides difficileinfection (rCDI) and has shown some success in treating inflammatory bowel diseases (IBD). There is emerging evidence that host engraftment of donor taxa is a tenet of successful FMT. However, there is little known regarding predictors of engraftment. We undertook a double-blind, randomized, placebo-controlled pilot study to characterize the response to FMT in children and young adults with mild to moderate active Crohn’s disease (CD) and ulcerative colitis (UC).ResultsSubjects with CD or UC were randomized to receive antibiotics and weekly FMT or placebo in addition to baseline medications. The treatment arm received seven days of antibiotics followed by FMT enema and then capsules weekly for seven weeks. We enrolled four subjects with CD and 11 with UC, ages 14-29 years. Due to weekly stool sampling, we were able to create a time series of alpha diversity, beta diversity and engraftment as they related to clinical response. Subjects exhibited a wide range of microbial diversity and donor engraftment as FMT progressed. Specifically, engraftment ranged from 26% to 90% at week 2 and 3% to 92% at two months. Consistent with the current literature, increases over time of both alpha diversity (p< 0.05) and donor engraftment (p< 0.05) correlated with improved clinical response. Additionally, our weekly time series enabled an investigation into the clinical and microbial correlates of engraftment at various time points. We discovered that the post-antibiotic but pre-FMT time point, often overlooked in FMT trials, was rich in microbial correlates of eventual engraftment. Greater residual alpha diversity after antibiotic treatment was positively correlated with engraftment and subsequent clinical response. Interestingly, a transient rise in the relative abundance of Lactobacillus was also positively correlated with engraftment, a finding that we recapitulated with our analysis of another FMT trial with publicly available weekly sequencing data.ConclusionsWe found that higher residual alpha diversity and Lactobacillus blooms after antibiotic treatment correlated with improved engraftment and clinical response to FMT. Future studies should closely examine the host microbial communities pre-FMT and the impact of antibiotic preconditioning on engraftment and response.