bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Fourteen-year Review of Practice Patterns and Evidence-based Medicine in Operative Metacarpal Fracture Repair
Authors: Sasson Daniel C. , Shah Nikhil D. , Yuksel Selcen S. , Kearney Aaron M. , Brandt Keith , Gosain Arun K. 
Published: January 2022

Background:
The American Board of Plastic Surgery has been collecting practice data on metacarpal fracture operative repair since 2006 as part of its Continuous Certification process. These data allow plastic surgeons to compare their surgical experience to national trends. Additionally, these data present the opportunity to analyze those trends in relation to evidence-based medicine.

Methods:
Data on metacarpal fracture operative repair from May 2006 to December 2014 were reviewed and compared with those from January 2015 to March 2020. National practice trends observed in these data were evaluated and reviewed alongside published literature and evidence-based medicine.

Results:
In total, 1160 metacarpal fracture repair cases were included. Outpatient (as opposed to inpatient) operative repairs have been trending upward, from 50% to 61% (P < 0.001). Most repairs were performed under general anesthesia (68%), and there was a decrease in the use of regional anesthesia between our two cohorts (14%–9%; P = 0.01). An open reduction with internal fixation was the most popular technique (51%), and a decrease in the use of closed reduction with splinting was observed (16%–10%; P = 0.001). Stiffness was the most commonly reported adverse event. Topics addressed in evidence-based medicine articles but not tracer data included interosseous wiring, which has shown success in spiral shaft fracture treatment with minimal complications, and nonoperative management.

Conclusion:
As evidence-based recommendations continue to change with additional research inquiry, tracer data can provide an excellent overview of the current practice of metacarpal fracture repair and how effectively physicians adapt to remain aligned with best practices.
The Plastic Surgery Common Application: Improving Efficiency and Reducing Inequity in the Application Process
Authors: Jackson Kianna R. , Makhoul Alan T. , Janis Jeffrey E. , Drolet Brian C. 
Published: January 2022

Summary:
The residency application process is expensive, costing an average of $2149 in application fees per applicant during the 2020–2021 cycle. Additionally, the number of applications per applicant continues to rise annually across all specialties. This considerable cost creates a financial barrier for students, particularly those from first-generation and underrepresented backgrounds. Moreover, the Electronic Residency Application Service (ERAS) application generates a lengthy, diluted output that hinders a holistic review. We developed the Plastic Surgery Common Application (PSCA), a focused, specialty-specific application external to ERAS with the goal of lessening the financial barrier for students and improving reviewer satisfaction. The PSCA was revised over a 5-month period after prepiloting with stakeholders. All integrated plastic surgery programs were invited to participate. Of the 86 plastic surgery programs, 20 agreed to participate in the pilot, accepting both ERAS and PSCA for direct comparison. A total of 181 completed applications were received through the PSCA. In a postparticipation survey, most applicants and reviewers felt that the PSCA offered a reasonable alternative to ERAS, despite minor technical difficulties. The PSCA pilot demonstrates that there is a reasonable alternative to applying to residency through ERAS and offers a template for developing a system that is not cost-prohibitive to applicants. The PSCA also demonstrates the benefit of a specialty-specific, customizable application for reviewer efficiency and satisfaction.
Early Clinical Outcomes of Polydioxanone Mesh for Prepectoral Prosthetic Breast Reconstruction
Authors: Qiu Cecil S. , Seth Akhil K. 
Published: January 2022

Background:
Many biologic matrices and synthetic meshes are available as adjuncts for prosthetic and autologous breast reconstructions to help control implant position and to reinforce abdominal flap donor sites. Absorbable synthetic meshes may have advantages over biologic matrices and permanent meshes, such as lower cost and better long-term biocompatibility. We present a prospective case series of patients undergoing two-stage, prepectoral breast reconstruction with polydioxanone (PDO) mesh.

Methods:
This prospective, consecutive single-surgeon series of patients who received PDO mesh during two-stage, prepectoral breast reconstruction involved incorporation of the PDO mesh at stage 1 as an anterior tarp over the tissue expander. A detailed description of surgical technique is provided herein. Surgical complications monitored included surgical site infection, wound dehiscence, mastectomy skin flap necrosis, hematoma or seroma requiring operative intervention, and reconstructive failure.

Results:
Seven patients with fourteen breast reconstructions were included in the study. All patients had unilateral cancer and underwent bilateral mastectomies with immediate reconstruction. The average age of patient was 50.0 (SD 7.4) and BMI was 29.3 (SD 2.7). Patients were followed for a median of 274 days, during which only one late infection (7.1%) occurred requiring expander removal.

Conclusions:
PDO mesh has an acceptable short-term complication rate in two-stage prepectoral prosthetic breast reconstruction. Future investigations should elucidate its comparative efficacy and safety against alternative products with respect to long-term outcomes.
Corneal Pigment Opacity From Face-Down Positioning After Pars Plana Vitrectomy, Treated With Descemet Stripping Only Technique
Authors: Yung Madeline , Lee Edward H. , Chow Jason , Kim Esther , Park Susanna , Tu Lien , Mannis Mark J. 
Published: January 2022

Purpose:
The purpose of this study was to report a case of corneal opacity resulting from pigment deposition after face-down positioning, which was treated with Descemet stripping only (DSO) to enable concurrent pars plana vitrectomy (PPV) for retinal detachment repair.

Methods:
A 79-year-old man with a history of Fuchs endothelial dystrophy and retinal detachment presented for the repair of recurrent retinal detachment and evaluation of a central corneal opacity.

Results:
The patient was found to have significant corneal endothelial pigment deposition obscuring the view to the fundus. A repeat macula-involving retinal detachment was visualized on limited fundoscopic examination and confirmed using ultrasonography. The patient subsequently underwent combination scleral buckle, DSO, and PPV. DSO achieved corneal clarity for the entire duration of the PPV and allowed for the necessary postoperative face-down positioning. Immunohistochemistry of the corneal specimen revealed deposition of retinal pigment epithelium as the origin of the pigment opacity. The corneal edema cleared at postoperative month 4, and the retina remained attached, resulting in an improvement of visual acuity from counting fingers preoperatively to 20/70.

Discussion:
This is, to the best of our knowledge, the first case describing the formation of a corneal endothelial opacity because of retinal pigment epithelium deposition associated with face-down positioning after PPV for retinal detachment. DSO is a minimally invasive, viable alternative to endothelial keratoplasty or temporary keratoprosthesis placement for the clearance of focal corneal endothelial opacities for PPV.
Use of a Single Radial Incision to Improve Curvature Matching and Graft Adhesion in Descemet Membrane Endothelial Keratoplasty in a Patient With Keratoconus
Authors: García-Onrubia Luis , Stanojcic Nick , Bhogal Maninder 
Published: January 2022

Purpose:
The purpose of this study was to report a novel surgical technique for altering donor Descemet membrane endothelial keratoplasty (DMEK) curvature to match host posterior stroma in a patient with advanced keratoconus (KC) and endothelial decompensation.

Methods:
We report a 56-year-old man with Fuch endothelial dystrophy and KC, who underwent DMEK due to endothelial decompensation. A triangular area of graft detachment centered on the apex of cones persisted after repeat gas tamponade. A radial incision from the graft edge to the apex was used to allow overlapping of the graft, thereby increasing the grafts curvature.

Results:
The use of a radial incision in the Descemet membrane (DM) graft was made to allow the graft overlap and adapt to the new shape. By matching the donor curvature to that of the hosts posterior curvature, full adhesion of the graft was achieved with the use of a short-acting air bubble by 1 week after the procedure.

Conclusions:
The mismatch in the curvature of the DM graft and the host posterior corneal surface, in cases with KC or very steep corneas, should be taken into consideration because it can lead to redundancy folds. These can result in atypical, conical detachments, distinct from the typical peripheral detachments seem commonly in DMEK. A single radial incision in the DM graft combined with air tamponade is a feasible treatment option in cases where DMEK fails to attach because of apparent curvature mismatch between the donor and host.
Meningococcal Vaccination and Risk of Serious Adverse Events
Authors: Fontalvo-Mendoza María Fernanda , Pérez-Romero Diana Marcela , Quintana-Pájaro Loraine , Ramos-Villegas Yan Carlos , Ballestas Ezequiel García , Florez-Perdomo William A. , Ghosh Amrita , Pal Ranabir , Moscote-Salazar Luis Rafael , Agrawal Amit 
Published: January 2022

Background
Adverse events after immunization are an integral part of meningococcal polysaccharide vaccine that need to be minimized by a holistic approach from production to administration. This study aimed to characterize serious adverse events in meningococcal vaccine recipients.

Methods
A search was carried out following a strategy Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using PubMed, EMBASE, EBSCO, and SCOPUS databases till May 2020. A series of cases, observational prospective and retrospective cohort, case and control, randomized control trials, and patients of any age vaccinated against meningococcus were included.

Results
A total of 8 selected studies included 7,213,663 children and adults, immunized with meningococcal vaccines. Adverse events in the neurological system are shown (4 studies); the most important are seizures, respiratory system (dyspnea and bronchospasm) and dermatological reactions (angioedema), anaphylaxis, and infectious processes.

Conclusions
Vaccination is adequate protection against meningococcal infections, with reported minimal adverse effects after immunization that do not constitute absolute contraindications to vaccination except allergic or anaphylactic reaction that needs further evaluation.
Anti–SARS-CoV-2 Monoclonal Antibodies for Early COVID-19
Authors: Belden Katherine A. , Hess Bryan , Brugger Caroline , Carr Rachel , Braun Todd , DeRose Joseph , Zurlo John 
Published: January 2022

Background
Anti–SARS-CoV-2 monoclonal antibodies have been shown to reduce severe COVID-19 in high-risk ambulatory patients.

Methods
This operations study at 3 affiliated centers conducted from November 23, 2020, to April 30, 2021, identified and treated patients meeting criteria for anti–SARS-CoV-2 monoclonal antibody therapy. The primary study outcome was treatment of qualifying patients. Secondary outcomes included infusion complications, hospitalization/death, and symptom resolution.

Results
Three hundred sixty-seven patients were treated during the study period. The mean patient age was 63 years (SD, 13.47 years). A total of 201 patients (55%) were male, 276 patients (75%) were White, 54 patients (15%) were African American, 10 patients (2.7%) were Asian, and 9 patients (2.4%) identified as Latino or Hispanic. Patients had a first positive direct SARS-CoV-2 test within 10 days of infusion and met high-risk criteria with 232 patients (63%) having more than 1 risk factor. Thirty-two patients (9%) had received at least 1 dose of SARS-CoV-2 vaccination. Four patients experienced an infusion reaction. Of 236 patients reporting time to symptom resolution, 172 patients (73%) were symptom free within 5 days of infusion. Twenty patients (5%) treated were hospitalized for COVID-19 within 30 days of infusion including 1 patient death from COVID-19.

Conclusions
Our study demonstrates that treatment with anti–SARS-CoV-2 neutralizing monoclonal antibodies is feasible in a high-resource health care setting. Infusion was well tolerated by the majority of patients, and there were no known infusion center SARS-CoV-2 exposures.
Bilateral corneal opacities and surface irregularity: role of contact lenses in a case of paraproteinemic keratopathy and multiple myeloma
Authors: Nguyen Lily T. , Smith Ronald J. , Yu Xiao X. , Ilsen Pauline F. 
Published: January 2022

Introduction:
This report features an interdisciplinary approach to diagnose and manage a case of paraproteinemic keratopathy and multiple myeloma. In addition, it suggests that rigid gas-permeable contact lenses (RGP CLs) may be a viable alternative to corneal surgery to reduce visual symptoms.

Patient and clinical findings:
A 57-year-old man symptomatic for progressive blur and glare over 2 years presented with an outside diagnosis of corneal dystrophy. An examination revealed bilateral diffuse subepithelial corneal crystals in conjunction with peripheral annular deposits with demarcated ridges. Corneal topography revealed central irregular astigmatism induced by these peripheral corneal opacities.

Diagnosis, intervention, and outcomes:
A hematological workup confirmed IgG Kappa monoclonal gammopathy and multiple myeloma. Visual rehabilitation for paraproteinemic keratopathy was achieved with RGP CLs, which are expected to maintain stable visual acuity while the patient undergoes systemic chemotherapy.

Conclusions:
This report emphasizes the value of thoroughly investigating dystrophy-like corneal deposits of unknown etiology as monoclonal gammopathy can have adverse or even fatal systemic implications. To the authors’ knowledge, this is the first study to directly suggest RGP CL as an adaptable and economical means to improve acuity in certain cases of paraproteinemic keratopathy without resorting to surgical intervention.
Building an Advising Model for Physician Assistant Education
Authors: Fleming Shani , Gordes Karen L. , Kulo Violet , Cawley James F. 
Published: January 2022

Abstract:
Physician assistant education is balancing an explosion of new programs, an increase in novice faculty, and expectations from accreditation standards to track student progress longitudinally. The traditional “one-size fits all” model of advising will not meet the demands of this changing educational environment. This article introduces a longitudinal advising model that integrates various strategies from existing models such as proactive, appreciative advising, and the GROW (Goal, Reality, Options, Will) coaching model with a focus on the goal of achieving the new Physician Assistant Education Association (PAEA) Competencies for the New Graduate.
The COVID-19 Pandemic Significantly Impacts Pregnancy Planning and Mental Health of Women With Inflammatory Bowel Disease
Authors: Tandon Parul , O’Connor Katie , Nguyen Geoffrey , Maxwell Cynthia , Huang Vivian 
Published: January 2022

Background and Goals:
The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted daily life, particularly in those with inflammatory bowel disease (IBD). We aimed to determine the impact of the pandemic on the pregnancy planning and mental health of women with IBD.

Methods:
Women with IBD (age 18 to 45 y) were asked to complete anonymous surveys on the impact of the COVID-19 pandemic on pregnancy planning and mental health symptoms such as stress (Perceived Stress Scale), depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder-7). Univariate and multivariable analyses were conducted to identify risk factors associated with stress, depression, and anxiety during the pandemic.

Results:
Seventy-three women with IBD were included (mean age: 32.1). Of 39 patients who were preconception, 20 (51.3%) reported a significant impact of the pandemic on pregnancy planning, with common reasons for not planning conception being fear of transmission of the virus to the fetus, lack of social supports, and no desire to be in hospital during pregnancy. Over half of all women reported an increase in stress and depression symptoms during the pandemic, with over half also reporting symptoms of anxiety. On multivariable linear regression analyses, increased anxiety levels were a significant predictor of increased stress and depression symptoms during the pandemic. Urban residence and younger age were significant predictors of increased anxiety symptoms during the pandemic.

Conclusion:
A significant proportion of women with IBD experienced an impact of the COVID-19 pandemic on pregnancy planning and mental health illnesses such as stress, depression, and anxiety.
Crossed cerebellar diaschisis in Alzheimer’s disease
Authors: Tripathi Shailendra Mohan , Murray Alison D. , Wischik Claude M. , Schelter Bjoern 
Published: January 2022

Background
Crossed cerebellar diaschisis (CCD) is characterized by hypometabolism and hypoperfusion on molecular imaging in the cerebellum due to a supratentorial lesion on the contralateral side. CCD is a well-established phenomenon in acute or subacute conditions such as infarction but it has been less well described in chronic conditions such as neurodegenerative dementias. Here, we investigate CCD in a large sample of 830 people meeting research criteria for Alzheimer’s disease (AD) using [18F]fluorodeoxyglucose-positron emission tomography (FDG-PET).

Materials and methods
This study is based on FDG-PET data collected at baseline as part of two large-scale Phase III clinical trials of a novel tau aggregation inhibitor medication, methylthioninium in mild to moderate AD participants. Quantification of FDG-PET hypometabolism was carried out using standardized uptake value ratio (SUVR), with the pons as the comparison region. SUVR was compared in different regions of interest between the right and left hemispheres of the brain and cerebellum in people with mild AD (Mini-Mental State Examination score ≥ 20).

Results
Comparison of SUVR in different brain regions demonstrated significant differences in the temporal, occipital and cerebellar cortices. Right and left asymmetry was noted with lower SUVR in the left temporal and occipital regions, whereas SUVR was lower in the right side of the cerebellum.

Conclusion
Here, we found robust evidence of CCD in a large sample of people with AD, a chronic neurodegenerative condition. The presence of this phenomenon in AD opens up a new avenue of research in AD pathogenesis and has the potential to change future diagnostic and therapeutic strategies.
Comparison of reprojected bone SPECT/CT and planar bone scintigraphy for the detection of bone metastases in breast and prostate cancer
Authors: Arvola Samuli , Seppänen Marko , Malaspina Simona , Mätzke Sorjo , Raiko Juho , Timonen Kirsi L. , Ettala Otto , Jambor Ivan , Anttinen Mikael , Kuisma Anna , Löyttyniemi Eliisa , Boström Peter J. , Sohlberg Antti , Noponen Tommi 
Published: January 2022

Objective
The aim of this study was to compare reprojected bone SPECT/CT (RBS) against planar bone scintigraphy (BS) in the detection of bone metastases in breast and prostate cancer patients.

Methods
Twenty-six breast and 105 prostate cancer patients with high risk for bone metastases underwent 99mTc-HMDP BS and whole-body SPECT/CT, 1.5-T whole-body diffusion-weighted MRI and 18F-NaF or 18F-PSMA-1007 PET/CT within two prospective clinical trials (NCT01339780 and NCT03537391). Consensus reading of all imaging modalities and follow-up data were used to define the reference standard diagnosis. The SPECT/CT data were reprojected into anterior and posterior views to produce RBS images. Both BS and RBS images were independently double read by two pairs of experienced nuclear medicine physicians. The findings were validated against the reference standard diagnosis and compared between BS and RBS on the patient, region and lesion levels.

Results
All metastatic patients detected by BS were also detected by RBS. In addition, three metastatic patients were missed by BS but detected by RBS. The average patient-level sensitivity of two readers for metastases was 75% for BS and 87% for RBS, and the corresponding specificity was 79% for BS and 39% for RBS. The average region-level sensitivity of two readers was 64% for BS and 69% for RBS, and the corresponding specificity was 96% for BS and 87% for RBS.

Conclusion
Whole-body bone SPECT/CT can be reprojected into more familiar anterior and posterior planar images with excellent sensitivity for bone metastases, making additional acquisition of planar BS unnecessary.
Test–retest repeatability and interobserver variation of healthy tissue metabolism using 18F-FDG PET/CT of the thorax among lung cancer patients
Authors: Malaih Afnan A. , Dunn Joel T. , Nygård Lotte , Kovacs David G. , Andersen Flemming L. , Barrington Sally F. , Fischer Barbara M. 
Published: January 2022

Objectives
The aim of this study was to assess the test–retest repeatability and interobserver variation in healthy tissue (HT) metabolism using 2-deoxy-2-[18F]fluoro-d-glucose (18F-FDG) PET/computed tomography (PET/CT) of the thorax in lung cancer patients.

Methods
A retrospective analysis was conducted in 22 patients with non-small cell lung cancer who had two PET/CT scans of the thorax performed 3 days apart with no interval treatment. The maximum, mean and peak standardized uptake values (SUVs) in different HTs were measured by a single observer for the test–retest analysis and two observers for interobserver variation. Bland–Altman plots were used to assess the repeatability and interobserver variation. Intrasubject variability was evaluated using within-subject coefficients of variation (wCV).

Results
The wCV of test–retest SUVmean measurements in mediastinal blood pool, bone marrow, skeletal muscles and lungs was less than 20%. The left ventricle (LV) showed higher wCV (>60%) in all SUV parameters with wide limits of repeatability. High interobserver agreement was found with wCV of less than 10% in SUVmean of all HT, but up to 22% was noted in the LV.

Conclusion
HT metabolism is stable in a test–retest scenario and has high interobserver agreement. SUVmean was the most stable metric in organs with low FDG uptake and SUVpeak in HTs with moderate uptake. Test–retest measurements in LV were highly variable irrespective of the SUV parameters used for measurements.
Polyarteritis nodosa
Authors: Bilginer Yelda , Ozen Seza 
Published: January 2022

Purpose of review
The aim is to review recent reports on childhood polyarteritis nodosa, including recent reports on treatment and outcome. Recently deficiency of adenosine deaminase-2 (ADA2), which may present as a polyarteritis nodosa-mimic, is becoming an important part of our practice. We also aim to highlight differences of childhood polyarteritis nodosa with deficiency of ADA2 as well as adult-onset disease.

Recent findings
The few recent childhood series confirm the systemic nature of this vasculitis with predominantly medium-vessel involvement. American College of Rheumatology Vasculitis foundation has suggested recommendations for the management of this vasculitis. Unfortunately, we lack large patient numbers to provide us high evidence for the treatment of these patients. However, for induction mycophenolate mofetil or shorter courses of cyclophosphamide can be considered.
Deficiency of ADA2 is now in the differential diagnosis of polyarteritis nodosa patients presenting with a family history and/or stroke with hematological and/or immunological abnormalities.

Summary
We need collaborative work to define management and treatment strategies for childhood polyarteritis nodosa. Distinguishing deficiency of ADA2 is important because the treatment is different.