bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and Efficacy of Outpatient Drainless Abdominoplasty: A Single-Surgeon Experience of 454 Consecutive Patients
Authors: Paranzino Alisha B , Sims Jason , Kirn David S 
Published: June 2023

Abstract

Background
The incidence of seroma after abdominoplasty is accepted as approximately 10% (with a range) in the literature. Progressive tension sutures (PTS) have arisen as a means of reducing seroma, however there are conflicting data regarding their efficacy.

Objectives
The primary aim of this study was to describe the incidence of postabdominoplasty seroma in the setting of drainless abdominoplasty with PTS.

Methods
A retrospective chart review was performed of all abdominoplasties (n = 454) during a 20-year period. At approximately the halfway point of this time frame, the abdominoplasty technique was changed from the use of 2 drains to the use of PTS without drains. Additionally, pulsed electromagnetic field therapy (PEMF) and liposomal bupivacaine (Exparel, Pacira Pharmaceuticals, Inc., Parsippany, NJ) were added as pain control adjuncts.

Results
There were 194 patients in the drain group and 260 patients in the PTS/no drains group. The group without drains contained a significantly higher proportion of massive weight loss patients (4.1% vs 9.2%, P = .041). The majority of the group without drains underwent outpatient surgery (89.7% vs 98.8%, P &lt; .001). The overall complication rate was significantly lower in the no drains group (31.4% vs 13.8%, P &lt; .001). The incidence of seroma was dramatically reduced in the group without drains (24.7% vs 0.0%, P &lt; .001).

Conclusions
PTS are highly effective in preventing seroma and can be safely employed as an alternative to drains in abdominoplasty. PEMF may play a role in seroma prevention and is also helpful for pain control. With these techniques to mitigate complications and minimize postoperative pain, abdominoplasty can be performed safely and effectively in a purely outpatient setting.

Level of Evidence: 3
Impact of Obesity on Outcomes of Prepectoral vs Subpectoral Implant-Based Breast Reconstruction
Authors: Asaad Malke , Hassan Abbas M , Morris Natalie , Kumar Saloni , Liu Jun , Butler Charles E , Selber Jesse C 
Published: June 2023

Abstract

Background
The impact of obesity on outcomes of prepectoral vs subpectoral implant–based reconstruction (IBR) is not well-established.

Objectives
The goal of this study was to assess the surgical and patient-reported outcomes of prepectoral vs subpectoral IBR. The authors hypothesized that obese patients would have similar outcomes regardless of device plane.

Methods
We conducted a retrospective review of obese patients who underwent 2-stage IBR from January 2017 to December 2019. The primary endpoint was the occurrence of any breast-related complication; the secondary endpoint was device explantation.

Results
The authors identified a total of 284 reconstructions (184 prepectoral, 100 subpectoral) in 209 patients. Subpectoral reconstruction demonstrated higher rates of overall complications (50% vs 37%, P = .047) and device explantation (25% vs 12.5%, P = .008) than prepectoral reconstruction. In multivariable regression, subpectoral reconstruction was associated with higher risk of infection (hazard ratio [HR], 1.65; P = .022) and device explantation (HR, 1.97; P = .034). Subgroup analyses demonstrated significantly higher rates of complications and explantation in the subpectoral group in those with a body mass index (BMI) ≥ 35 and BMI ≥40. The authors found no significant differences in mean scores for satisfaction with the breast (41.57 ± 13.19 vs 45.50 ± 11.91, P = .469), psychosocial well-being (39.43 ± 11.23 vs 39.30 ± 12.49, P = .915), and sexual well-being (17.17 ± 7.83 vs 17.0 ± 9.03, P = .931) between subpectoral and prepectoral reconstruction.

Conclusions
Prepectoral reconstruction was associated with significantly decreased overall complications, infections, and device explantation in obese patients compared with subpectoral reconstruction. Prepectoral reconstruction provides superior outcomes to subpectoral reconstruction with comparable patient-reported outcomes.

Level of Evidence: 4
Existential Ethics: Thinking Hard About Lawyer Responsibility for Clients’ Environmental Harms
Authors: Vaughan Steven 
Published: June 2023

Abstract
This paper challenges the conventional understanding among many legal ethicists that environmental harm can be a necessary, if regrettable, collateral effect of lawyerly work. It argues that lawyers sometimes do things that cost society too much and that legal ethics (being the rules of ethical conduct set out by regulators of lawyers and broader theories of ‘good’ lawyering) has the potential to act as a mediator on lawyers’ environmental harm-causing action. The paper begins by examining lawyers’ formal rules of professional conduct in England & Wales, showing how those rules require lawyers to provide active counselling to clients but do not fully address clients’ legally permissible choices that may result in environmental harm. The paper then turns to theories of legal ethics that go beyond these baseline rules. Here, I argue that the dominant ‘Standard Conception’ of lawyers as neutral technicians is not only implausible in the context of environmental law but also fundamentally incomplete. The paper also considers the ethical implications of a lawyer’s initial decision to represent a client. The commonly held belief that ‘Everyone deserves legal advice’ often masks a simple ethical choice, where lawyers prioritise commercial concerns over environmental considerations, unburdened by more complex ethical constraints. However, this rationalisation rests on unsound premises and frequently clashes with lawyers’ personal moral boundaries; a problem I label ‘Meatloaf Lawyering’. Ultimately, I argue that lawyers have significant ethical agency and that their professional obligations do not impede (and sometimes require) an active, ethically responsible stance towards environmental harms.
Dis-Oriented Desires and Angela Carter’s Intersectionality: Nationalism, Masochism, and the Search for “the Other’s Otherness”
Authors: Uematsu Nozomi , Barai Aneesh 
Published: June 2023

Abstract
This article examines Carter’s portrayal of the intersections of race, gender, and nationalism through imagery drawn from the nationalist tales Momotaro (Peach Boy) and through figuration of the lion and the unicorn in her writing during and after staying in Japan. Analyzing Miss Z and Fireworks, we argue that Carter’s depictions of fantastical creatures reveal a proto-intersectional awareness of complex power interconnections between race and gender, specifically in relation to ideas of whiteness and masochism. Like her contemporary Taeko Kono, Carter critiques men’s masochism and theorizes a type of feminine masochism. Carter grows in awareness of both racial politics (whiteness) and masochism in Japanese culture and attempts to grasp the “essence of the other’s otherness” therein. In doing so, she conceptualizes intersectional power relations of gender and race.
Comparison between ticagrelor and clopidogrel in myocardial infarction patients with high bleeding risk
Authors: Tjerkaski Jonathan , Jernberg Tomas , Alfredsson Joakim , Erlinge David , James Stefan , Lindahl Bertil , Mohammad Moman Aladdin , Omerovic Elmir , Venetsanos Dimitrios , Szummer Karolina 
Published: June 2023

ABSTRACT

Aims
Ticagrelor is associated with a lower risk of ischemic events than clopidogrel. However, it is uncertain whether the benefits of more intensive anti-ischemic therapy outweigh the risks of major bleeding in patients who have a high bleeding risk (HBR). Therefore, this study compared ticagrelor and clopidogrel in myocardial infarction (MI) patients with HBR.

Methods and results
This study included all patients enrolled in the SWEDEHEART registry who were discharged with dual antiplatelet therapy using ticagrelor or clopidogrel following MI between 2010 and 2017. High bleeding risk was defined as a PRECISE-DAPT score ≥25. Information on ischemic events, major bleeding, and mortality was obtained from national registries, with 365 days of follow-up. Additional outcomes include major adverse cardiovascular events (MACE), a composite of MI, stroke and all-cause mortality, and net adverse clinical events (NACE), a composite of MACE and bleeding. This study included 25 042 HBR patients, of whom 11 848 were treated with ticagrelor. Ticagrelor was associated with a lower risk of MI, stroke, and MACE, but a higher risk of bleeding compared to clopidogrel. There were no significant differences in mortality and NACE. Additionally, when examining the relationship between antiplatelet therapy and bleeding risk in 69 040 MI patients, we found no statistically significant interactions between the PRECISE-DAPT score and treatment effect.

Conclusions
We observed no difference in NACE when comparing ticagrelor and clopidogrel in HBR patients. Moreover, we found no statistically significant interactions between bleeding risk and the comparative effectiveness of clopidogrel and ticagrelor in a larger population of MI patients.
Short-duration head-up tilt test potentiated with sublingual nitroglycerin in suspected vasovagal syncope: the fast Italian protocol
Authors: Russo Vincenzo , Parente Erika , Tomaino Marco , Comune Angelo , Sabatini Antonella , Laezza Nunzia , Carretta Domenico , Nigro Gerardo , Rago Anna , Golino Paolo , Brignole Michele 
Published: June 2023

Abstract

Background
The traditional nitroglycerin (NTG) head-up tilt test (HUTT) is time-consuming and the test duration is a barrier to widespread utilization in clinical practice. It was hypothesized that a short-duration protocol is not inferior to the traditional protocol regarding the positivity rate and has a similar distribution of hemodynamic response.

Methods and results
Patients undergoing HUTT were randomized 1:1 to a 10 min passive phase plus a 10 min 0.3 mg NTG if the passive phase was negative (Fast) or to a 20 min passive phase plus a 15 min 0.3 mg NTG if the passive phase was negative (Traditional). A sample size of 277 patients for each group achieved 80% power to detect an expected difference of 0% with a non-inferiority margin of -10% using a one-sided t-test and assuming a significant level alpha of 0.025. A total of 554 consecutive patients (mean age 46.6 ± 19.3 years, 47.6% males) undergoing HUTT for suspected vasovagal syncope were randomly assigned to the Fast (n = 277) or Traditional (n = 277) protocol. A positive response was defined as the induction of syncope in presence of hypotension/bradycardia, and was observed in 167 (60.3%) patients with Fast and in 162 (58.5%) patients with the Traditional protocol. There was a trend of lesser vasodepressor response (14.8% Fast vs. 20.6% Traditional) which was significant during the passive phase (P = 0.01).

Conclusion
The diagnostic value of the Fast HUTT protocol is similar to that of the Traditional protocol and therefore the Fast protocol can be used instead of the Traditional protocol.
COVID-19 vaccination-related myocarditis: a Korean nationwide study
Authors: Cho Jae Yeong , Kim Kye Hun , Lee Nuri , Cho Soo Hyeon , Kim Seung Yun , Kim Eun Kyoung , Park Jae-Hyeong , Choi Eui-Young , Choi Jin-Oh , Park Hyukjin , Kim Hyung Yoon , Yoon Hyun Ju , Ahn Youngkeun , Jeong Myung Ho , Cho Jeong Gwan 
Published: June 2023

Abstract

Aims
A comprehensive nationwide study on the incidence and outcomes of COVID-19 vaccination-related myocarditis (VRM) is in need.

Methods and results
Among 44 276 704 individuals with at least 1 dose of COVID-19 vaccination, the incidence and clinical courses of VRM cases confirmed by the Expert Adjudication Committee of the Korea Disease Control and Prevention Agency were analyzed. COVID-19 VRM was confirmed in 480 cases (1.08 cases per 100 000 persons). Vaccination-related myocarditis incidence was significantly higher in men than in women (1.35 vs. 0.82 per 100 000 persons, P &lt; 0.001) and in mRNA vaccines than in other vaccines (1.46 vs. 0.14 per 100 000 persons, P &lt; 0.001). Vaccination-related myocarditis incidence was highest in males between the ages of 12 and 17 years (5.29 cases per 100 000 persons) and lowest in females over 70 years (0.16 cases per 100 000 persons). Severe VRM was identified in 95 cases (19.8% of total VRM, 0.22 per 100 000 vaccinated persons), 85 intensive care unit admission (17.7%), 36 fulminant myocarditis (7.5%), 21 extracorporeal membrane oxygenation therapy (4.4%), 21 deaths (4.4%), and 1 heart transplantation (0.2%). Eight out of 21 deaths were sudden cardiac death (SCD) attributable to VRM proved by an autopsy, and all cases of SCD attributable to VRM were aged under 45 years and received mRNA vaccines.

Conclusion
Although COVID-19 VRM was rare and showed relatively favorable clinical courses, severe VRM was found in 19.8% of all VRM cases. Moreover, SCD should be closely monitored as a potentially fatal complication of COVID-19 vaccination.
Body Cell Mass to Fat-Free Mass Ratio and Extra- to Intracellular Water Ratio Are Related to Maximal Oxygen Uptake
Authors: Yamada Yosuke , Yoshida Tsukasa , Murakami Haruka , Gando Yuko , Kawakami Ryoko , Ohno Harumi , Tanisawa Kumpei , Konishi Kana , Tripette Julien , Kondo Emi , Nakagata Takashi , Nanri Hinako , Miyachi Motohiko 
Published: June 2023

Abstract
Fat-free mass (FFM) is a heterogeneous compartment comprising body cell mass (BCM), intracellular water (ICW), extracellular solids, and extracellular water (ECW). The BCM/FFM and ECW/ICW ratios vary among individuals and decrease with age. This study aimed to determine whether BCM/FFM and ECW/ICW ratios are predictors of maximal oxygen uptake (V̇̇O2peak) independently of age, sex, and objectively measured physical activity (PA). A total of 115 Japanese males and females, aged 55.3 ± 8.0 years (mean ± standard deviation), were included in the study. Anthropometry, explosive leg muscle power, and V̇̇O2peak were measured, and BCM, FFM, ICW, and ECW were estimated. Step count and PA were objectively measured using a triaxial accelerometer. Blood flow volume was assessed using ultrasonography. BCM and ICW were negatively correlated with age, whereas FFM and ECW were not significantly correlated with age. FFM, ICW/ECW, BCM/FFM, step counts, moderate and vigorous PA, and leg muscle power were positively correlated with V̇̇O2peak, even after adjusting for age and sex (p &lt; .05). Multiple regression analysis indicated that either BCM/FFM or ECW/ICW, leg power, and objectively measured PA were associated with V̇̇O2peak independent of age, sex, and FFM. Blood flow volume was significantly correlated with ECW (p &lt; .05), but not with BCM. The BCM/FFM and ECW/ICW ratios were significant predictors of V̇̇O2peak, independent of age, sex, FFM, leg power, and objectively measured PA.
“They Did Not Know What They Were Doing”: Climate Change and Intergenerational Compassion
Authors: Roy Senjooti , Ayalon Liat 
Published: June 2023

Abstract

Background and Objectives
Compassion is described as an affective experience arising from witnessing the undeserved suffering of another that propels one to provide protection and cooperation. Climate change is often associated with “underserved suffering,” especially of younger and future generations. Consequently, contemporary climate discourse has expressed hostility toward older generations for inflicting such suffering. Studies on intergenerational relations within the context of climate change agree that intergenerational solidarity, rather than conflict, is necessary for effective climate action. Because compassion is instrumental to solidarity, in this study, we explore intergenerational climate-related expressions of compassion leading to intergenerational solidarity.

Research Design and Methods
We interviewed 16 climate activists from 8 countries (aged 16–76 years) to understand how they view climate responsibility. Thematic analysis was undertaken to create and explore themes related to intergenerational compassion and solidarity.

Results
Compassion flowed in both directions: from younger to older generations in the form of forgiveness, empathy, and understanding, and from older to younger generations through advocacy, lifestyle changes, and transmission of knowledge and skills. All participants emphasized solutions over accusations. Areas of focus varied between industrialized and developing countries. Cultural factors played an essential role in intergenerational perceptions.

Discussion and Implications
Climate change can be a polarizing issue with older adults fielding accusations and younger people facing criticism for demanding climate action. Examples of intergenerational compassion can counter ageism, reshape climate narratives, encourage intergenerational cooperation, harness the skills of different generations, and create a sustainable world for all ages.
A Phase I Study of Ex Vivo Expanded Allogeneic Bone Marrow–Derived Mesenchymal Stem Cells for the Treatment of Pediatric Perianal Fistulizing Crohn’s Disease
Authors: Lightner Amy L , Otero-Pineiro Ana , Reese Jane , Ream Justin , Nachand Douglas , Adams Ashley C , VanDenBossche Alexandra , Kurowski Jacob A 
Published: June 2023

Abstract

Background
Perianal fistulizing Crohn’s disease is notoriously difficult to treat. Recent studies of mesenchymal stem cells have demonstrated safety and efficacy of this novel treatment approach. However, no studies to date have included pediatric patients. We sought to determine safety and efficacy of mesenchymal stem cells for pediatric perianal fistulizing Crohn’s disease.

Methods
This was a phase I clinical trial to evaluate safety and feasibility of mesenchymal stem cells in pediatric perianal Crohn’s patients 13 to 17 years of age. At the time of an exam under anesthesia, following curettage of the fistula tract and closure of the internal opening with absorbable suture, 75 million mesenchymal stem cells were administered with a 22-gauge needle. This was repeated at 3 months if complete clinical and radiographic healing were not achieved. Adverse and serious adverse events at were measured at postprocedure day 1, week 2, week 6, month 3, month 6, and month 12. Clinical healing, radiographic healing per magnetic resonance imaging, and patient-reported outcomes were measured at the same time points.

Results
Seven pediatric patients were enrolled and treated (6 male; median age of 16.7 years). There were no adverse or serious adverse events related to the investigational product or injection procedure. At 6 months, 83% had complete clinical and radiographic healing. The perianal Crohn’s Disease Activity Index, Wexner incontinence score, and Van Assche score had all decreased at 6 months.

Conclusions
Bone marrow–derived mesenchymal stem cells offer a safe, and likely effective, treatment approach for pediatric perianal fistulizing Crohn’s disease.
Association of Deforestation With Severe Fever With Thrombocytopenia Syndrome
Authors: Nam Hee-kyoung , Min Kyung-Duk , Jo Suyoung , Cho Sung-il 
Published: June 2023

Abstract

Background
Severe fever with thrombocytopenia syndrome (SFTS) virus was first isolated in China in 2009 and has since spread to several Asian countries. SFTS is closely related to environmental factors that accelerate vector growth. We evaluated the associations of SFTS and deforestation with environmental variables.

Methods
For this observational study, we generated multiple Poisson models using national SFTS outbreak data (2013–2018) and official environmental data for Korea. We included established risk factors as variables. Deforestation was used as the main variable. All variables were analyzed according to their spatial characteristics using the R-INLA package.

Results
SFTS cases increased over time and peaked in 2017, at 272, followed by a decrease in 2018. Disease mapping showed a high incidence of SFTS nationwide, with particular risks in Gangwon and Gyeonggi Provinces in the north, and Jeju in the south of South Korea. Deforestation was significantly associated with a higher risk of SFTS in the final model (relative risk, 1.751 [95% confidence interval, 1.125–2.743]).

Conclusions
SFTS outbreaks are associated with deforestation. Therefore, deforestation in Gyeonggi, Gangwon, and Jeju provinces of South Korea needs to be considered in vector-control strategies and active surveillance of SFTS occurrence.
Subgrouping in a ‘dialect continuum’: A Bayesian phylogenetic analysis of the Mixtecan language family
Authors: Auderset Sandra , Greenhill Simon J , DiCanio Christian T , Campbell Eric W 
Published: June 2023

AbstractSubgrouping language varieties within dialect continua poses challenges for the application of the comparative method of historical linguistics, and similar claims have been made for the use of Bayesian phylogenetic methods. In this article, we present the first Bayesian phylogenetic analysis of the Mixtecan language family of southern Mexico and show that the method produces valuable results and new insights with respect to subgrouping beyond what the comparative method and dialect geography have provided. Our findings reveal potential new subgroups that should be further investigated. We show that some unexpected groupings raise important questions for phylogenetics and historical linguistics about the effects of different methods of primary data gathering and organization that should be considered when interpreting subgrouping results.
Spatially resolved self-consistent spectral modelling of jellyfish galaxies from MUSE with FADO: trends with mass and stripping intensity
Authors: Azevedo Gabriel M , Chies-Santos Ana L , Riffel Rogério , Gomes Jean M , Lassen Augusto E , Benedetti João P V , S. de Souza Rafael , Xu Quanfeng 
Published: June 2023

ABSTRACT
We present a spatially resolved stellar population analysis of 61 jellyfish galaxies and 47 control galaxies observed with ESO/MUSE attempting to understand the general trends of the stellar populations as a function of the stripping intensity and mass. This is the public sample from the GASP programme, with 0.01 &lt; z &lt; 0.15 and 8.9 &lt; log (M⋆/M⊙) &lt; 12.0. We apply the spectral population synthesis code fado to fit self-consistently both the stellar and nebular contributions to the spectra of the sources. We present 2D morphological maps for mean stellar ages, metallicities, gas-phase oxygen abundances, and star formation rates for the galaxies with Integrated Nested Laplace Approximation (inla), which is efficient in reconstructing spatial data of extended sources. We find that ‘extreme stripping’ and ‘stripping’ galaxies are typically younger than the other types. Regarding stellar and nebular metallicities, the ‘stripping’ and ‘control passive’ galaxies are the most metal-poor. Based on the phase space for jellyfish cluster members we find trends in ages, metallicities, and abundances with different regions of the diagram. We also compute radial profiles for the same quantities. We find that both the stripping and the stellar masses seem to influence the profiles, and we see differences between various groups and distinct mass bins. The radial profiles for different mass bins present relations already shown in the literature for undisturbed galaxies, i.e. profiles of ages and metallicities tend to increase with mass. However, beyond ∼0.75 effective radius, the ages of the most massive galaxies become similar to or lower than the ages of the lower mass ones.