bluuebunny/crossref_metadata_2025_split huggingface dataset:
Echo-guided Lower-back Sculpture and Volumization as a Complement to High-definition Liposuction (XPINE-FAT)
Authors: Manzaneda Cipriani Raul Martin , Viaro Mauricio , Adrianzen Gerardo A. 
Published: July 2022

Background:
Knowledge about lower-back aesthetics is very limited, especially regarding surgical techniques that improve its appearance. Thus, this study aimed to describe a high-definition liposuction technique with intramuscular grafting of erector spinae muscles (longissimus).

Methods:
A total of 15 female patients 25–48 years of age were recruited between November 2021 and January 2022, who underwent body contouring surgery and subsequently underwent a low-back lipodefinition and echo-guided intramuscular erector spinae (longissimus) fat graft to complement the procedure. As part of the study, measurements were performed before surgery and in the immediate postoperative period. The data were stored in a database and analyzed with the SPSS Version 25 statistical software.

Results:
The patients’ ages ranged from 25 to 48 years (mean: 37 years), with a body mass index of 18.6–29.3 (mean: 25.5). The surgical times ranged between 1 and 8 hours (mean: 3.73 hours); hospitalization times were 0.7–1 days (mean: 0.940 days). Lipograft was performed on the erector spinae muscles (longissimus), the right one with a range of 20–60 cm3 (mean: 43.33 cm3) and percentage increase of 65.3% (P < 0.0001). Regarding the left erector, similar volumes between 20 and 60 cm3 (mean: 44.67 cm3) were grafted with a percentage increase of 66.4% (P < 0.0001).

Conclusions:
XPINE-FAT is a safe technique that allows an increase in the immediate intramuscular thickness of the erector spinae muscles (longissimus). We observed no adverse events during the study.
Chimeric Anterolateral Thigh Flap for One-stage Reconstruction after Cervical Exenteration with Anterior Mediastinal Tracheostomy
Authors: Liu Pin-Han , Hung Chung-Jye , Tseng Yau-Lin , Lee Yao-Chou 
Published: July 2022

Summary:
Cervical exenteration with anterior mediastinal tracheostomy is rarely performed for extensive cervicothoracic malignancies. Although it provides effective palliation and occasional cure, reconstruction remains a formidable challenge owing to its complexity and high mortality. The resultant defects usually require an intestinal flap or tubed skin flap to restore the alimentary tract, soft-tissue interposition to separate the relocated trachea from the innominate artery, and another tubed or fenestrated skin flap to create a tension-free tracheocutaneous anastomosis and provide coverage for the exposed vessels, hopefully in one stage. We report a case involving a 60-year-old woman with recurrent medullary thyroid cancer who developed dyspnea and dysphagia. Salvage cervical exenteration and anterior mediastinal tracheostomy were complicated by tissue fibrosis caused by previous surgical and radiation therapies, resulting in complex defects with segmental loss of the esophagus, a short stump of trachea incapable of tracheocutaneous anastomosis, and great-vessel exposure. We used a chimeric anterolateral thigh flap consisting of a tubed skin flap for pharyngoesophageal reconstruction, a fenestrated skin flap for tracheostomy and neck coverage, and a vastus lateralis muscle bulk to separate the innominate artery from the relocated trachea. To our knowledge, this is the first report describing the reconstruction of such a complex defect with a single skin flap in a single stage.
CULTURE POSITIVITY RATES OF DEEP VITREOUS BIOPSY UNDER AIR VIS-À-VIS CONVENTIONAL ANTERIOR VITREOUS BIOPSY IN ENDOGENOUS ENDOPHTHALMITIS
Authors: Dave Vivek Pravin , Vithalani Nidhi , Sheba Esther , Joseph Joveeta , Pathengay Avinash 
Published: July 2022

Purpose:
To describe the comparison of the culture positivity rates of deep vitreous biopsy under air and conventional anterior vitreous biopsy in endogenous endophthalmitis.

Materials:
A retrospective, consecutive, comparative series including cases of endogenous endophthalmitis from January 2014 to January 2021. They were divided into those where conventional anterior vitreous biopsy was taken and those where a deep biopsy was taken under air (DBA group). The culture positivity rate among the two groups was compared, and factors affecting the same were analyzed by a regression analysis.

Results:
There were 140 eyes in the conventional anterior vitreous biopsy group and 44 eyes in the DBA group. Sex, age, duration of symptoms, underlying systemic illness, presenting vision in logMAR, and total number of vitreous interventions were comparable between the two groups. Visual outcome was better in patients undergoing DBA as compared with those who underwent conventional anterior vitreous biopsy , (1.28 ± 1.01 logMAR, 20/380 vs. 1.88 ± 1.33 logMAR, 20/1,500, P = 0.03). No case in the DBA group developed retinal detachment or any complication attributable to the technique. In the conventional anterior vitreous biopsy group, the culture positivity was seen in 43/140 samples (30.71%), and in the DBA group, it was noted in 29/44 samples (65.9%). Taking a DBA was the only factor that was significant both in bivariate (odds ratio 4.36, 95% confidence interval 2.12–8.95, P < 0.0001) and multivariate analysis (odds ratio 4.02, 95% confidence interval 3.1–7.43, P < 0.0001).

Conclusion:
Vitreous sampling can be performed from the deep vitreous cavity in endogenous endophthalmitis safely and effectively under air infusion, improving the culture positivity rates.
INFUSION-ASSISTED EVACUATION OF SUBMACULAR HEMORRHAGE
Authors: Park Jong G. , Wolfe Jeremy D. 
Published: July 2022

Purpose:
To report a novel surgical technique for evacuating submacular hemorrhage using the infusion stream of a 25-gauge vitrectomy system.

Methods:
Surgical case and video.

Results:
A 54-year-old man was taken to the operating room for a total hyphema, nonclearing vitreous hemorrhage, and elevated intraocular pressure after multiple tractional retinal detachment repairs by an outside surgeon. Intraoperatively, the hyphema and vitreous hemorrhage were cleared, and the source of bleeding was discovered to be an avulsed vessel through a pre-existing retinal break just superior to the optic nerve. A large submacular hemorrhage was also present that was unable to be drained through the break by aspiration alone. With the vitreous cavity under fluid, the infusion cannula was manipulated to guide the infusion stream onto the macula. The stream was directed in a distal to proximal manner toward the retinal break, and the submacular blood was successfully expressed out through the break. Postoperatively, the retina remained attached with almost complete resolution of the submacular hemorrhage.

Conclusion:
Using the mechanical pressure of the infusion stream can be an effective method for evacuating large subretinal hemorrhages.
PARACENTRAL ACUTE MIDDLE MACULOPATHY AFTER COVID-19: MULTIMODAL EVALUATION
Authors: Castro Catarina S. , Ferreira André S. , Silva Nisa P. , Lume Miguel R. , Furtado Maria J. 
Published: July 2022

Purpose:
To report the case and multimodal imaging findings of a healthy young woman who developed paracentral acute middle maculopathy 9 weeks after COVID-19.

Methods:
Case report. Ultra-widefield fundus photography, macular spectral domain optical coherence tomography, fluorescein angiography, and optical coherence tomography angiography were performed.

Results:
A 36-year-old woman went to the emergency department with sudden, painless, left eye vision loss. The only relevant medical history was COVID-19 9 weeks before. The best-corrected visual acuity was 20/200, a left eye relative afferent pupillary defect was present, and superficial hemorrhages throughout the macular area and peripheral retina were found. Nearly 4 hours after admission, the left eye best-corrected visual acuity recovered to 20/20 without relative afferent pupillary defect. Five days after presentation in the emergency department, the patient returned with recurrent left eye vision loss, with spontaneous recovery within 12 hours. Macular spectral domain optical coherence tomography revealed hyperreflectivity of the inner plexiform and inner nuclear layers, and the diagnosis of paracentral acute middle maculopathy was established. The patient started oral acetylsalicylic acid and oral prednisolone. The patient did not report any new episodes of vision loss, and there was a progressive resolution of abnormal fundus findings.

Conclusion:
SARS-CoV-2 infection increases the risk of vascular thrombotic events with possible involvement of the retinal circulation, and paracentral acute middle maculopathy may present as a possible complication. Ophthalmologists should be able to recognize it promptly through multimodal imaging findings.
BILATERAL PERIPAPILLARY CHOROIDAL NEOVASCULARIZATION IN AN OTHERWISE HEALTHY TEENAGER TREATED WITH ANTIVASCULAR ENDOTHELIAL GROWTH FACTOR INJECTIONS
Authors: Hassoun Mohamad R. , Couvillion Austin , Pieramici Dante J. 
Published: July 2022

Purpose:
This case report describes the presentation, diagnostic reasoning, and successful management of a 14-year-old teenage boy found to have bilateral peripapillary choroidal neovascularization.

Methods:
This is a case of a teenage boy with an unremarkable ocular and systemic history presenting with decreased visual acuity, macular edema, and bilateral peripapillary choroidal neovascularization.

Results:
After intravitreal antivascular endothelial growth factor injections, the patient's visual acuity improved. Imaging further revealed that the initially present macular edema, subretinal fluid, and peripapillary choroidal neovascularizations markedly improved after treatment.

Conclusion:
Peripapillary choroidal neovascularizations are often not trivial to diagnose. As this report illustrates, work-up with different modalities is extremely valuable, and antivascular endothelial growth factor injections may help decrease exudation and improve visual outcomes.
The Vision Correction Questionnaire: an electronic patient-reported outcome measure for refractive surgery
Authors: Frings Andreas , Ziaei Mohammed , Lundström Mats , Allan Bruce D. 
Published: July 2022

Purpose:
To develop a psychometrically robust electronic patient reported outcome measure (ePROM) for refractive surgery.

Setting:
Moorfields Eye Hospital, London, United Kingdom.

Design:
Questionnaire development study.

Methods:
Items were derived in 6 domains (spectacle dependence, visual quality, eye comfort, functional freedom, emotional wellbeing, and satisfaction with treatment) from existing Rasch adjusted instruments, patient and surgeon feedback, and refinement in semistructured interviews before administration to a field test cohort (n = 360) of patients undergoing routine refractive surgery. Spectacle dependence and satisfaction with treatment items were used to provide descriptive statistical information only. Contemporary criteria for item reduction and Rasch modeling were applied to the remaining domains. The finalized questionnaire was then administered to a second patient cohort (n = 120) before and after surgery to assess sensitivity to change.

Results:
A 5-item scale derived for emotional wellbeing was unidimensional and a good fit to the Rasch model with ordered category response profiles, adequate precision (person separation 2.22 logits, reliability coefficient 0.83), and no misfitting items. Mean logit scores were 0.91 higher after treatment (effect size 1.26) suggesting a positive impact on emotional wellbeing. Functional scales could not be derived for visual quality, eye comfort, or functional freedom. Single-item ratings for visual quality and eye comfort were retained in our final 11-item questionnaire.

Conclusions:
This short ePROM should integrate well with routine clinical care and clinical trials in refractive surgery. The Rasch adjusted emotional wellbeing scale may help quantify the way patients feel about refractive surgery, with the remaining items providing useful descriptive information.
Does Learner Self-Efficacy Influence Accurate Identification of Heart Sound Descriptions?
Authors: Garvick Sarah , Gillette Chris , Geigler Bryan , Gao Hong , Crandall Sonia 
Published: July 2022

Introduction
Although physician assistant (PA) training includes cardiac instruction, there is a lack of theory-based research investigating skill and behavioral development in PA students. The objective of this study was to examine the relationship between self-efficacy and ability to correctly identify heart sounds.

Methods
A cross-sectional study was conducted among 2 cohorts of PA students at one institution. Students answered self-efficacy items using 5-point Likert-type answers and identified specific heart sounds from text descriptions. Data from 154 students were analyzed using Cronbach’s alpha and bivariate statistical tests.

Results
Second-year students identified more heart sounds correctly than first-year students (8 v. 7, Z = −2.64, p = 0.01). Students with more confidence were more likely to correctly identify specific heart sounds.

Discussion
Results are consistent with social cognitive theory showing that self-efficacy may be related to outcome performance in PA students. Educational processes that cultivate self-efficacy may increase proficiency in cardiac auscultation.
A Tale of Two Curriculums: The Implications of Curriculum Design on Student Burnout
Authors: Sivahop Jacqueline , Broadfoot Kirsten , Bowser Jonathan 
Published: July 2022

Introduction
The purpose of this study was to determine whether a difference exists in the 3 subconstructs of burnout between 2 cohorts of physician assistant (PA) students in different curricula, and the impact of 4 modifiable curricular factors on student experiences of burnout.

Methods
Using a mixed-methods study design, 86 students completed the Maslach Burnout Inventory–General Survey for Students (MBI-GSS) 8 months postmatriculation. Focus group interviews expanded on the quantitative results and effects of the 4 modifiable factors.

Results
No significant statistical difference was found in the emotional exhaustion (p = 0.35), cynicism (p = 0.29), or professional efficacy (p = 0.23) scores between the 2 cohorts of PA students. Students did not describe the exact dimensions of burnout; however, qualitative data provided 5 emergent codes based on their experiences.

Discussion
Despite curricular modifications to address student burnout in the Colorado Curriculum, a statistical difference in burnout scores was not found between the 2 student cohorts. Qualitative findings suggest that PA education programs should examine external factors and student-lived experiences that contribute to burnout in addition to curricular components.
Needs of Parents of Children With Spina Bifida
Authors: Joseph Rachel 
Published: July 2022

Abstract
Spina bifida (SB) is a birth defect involving the neural tube of the spine. The severity of the condition depends on the extent of the defect. The most severe cases of SB are debilitating and can significantly affect the quality of life of babies born with the defect.
Complications of SB can include mobility issues, orthopedic abnormalities, elimination impairments, infections, cognitive delays, and frequent hospitalizations, and these can span the lifetime of the child. The complications and needs associated with SB become very specific as the child reaches adulthood. According to the Centers for Disease Control and Prevention, approximately one in every 2,758 babies born annually in the United States are diagnosed with SB. Learning that a child will be born with a birth defect can be devastating for parents. Several decisions need to be made at birth and as the child grows. Many parents facing such news are overwhelmed and experience a range of emotions. The needs of parents caring for children with SB will vary based on their understanding of the disease process, ability to access resources, availability of a support system, and the capacity to cope with the challenges that arise when caring for a child born with this condition. Nurses must be diligent in exploring the needs of this parent population. This article is intended to raise awareness among nurses regarding parental needs so that they can support and assist parents in developing more effective ways to navigate through their journey.
Drug-induced comorbidities in patients with sarcoidosis
Authors: Drent Marjolein , Jessurun Naomi T. , Wijnen Petal A. , Bekers Otto , Bast Aalt 
Published: July 2022

Purpose of review
Sarcoidosis is a chronic multisystemic inflammatory disease of unknown aetiology with a wide range of highly variable clinical manifestations and unpredictable disease course. Sarcoidosis patients may present with specific organ-related symptoms involving functional impairments, and less specific symptoms. The decision whether and when to treat a sarcoidosis patient with pharmacotherapy depends on two major factors: risk of organ failure and/or death and impairment of quality of life. This decision is complex and not standardized.

Recent findings
Glucocorticoids (GCs) are recommended as initial treatment, when needed. Subsequent GC-sparing alternatives frequently follow. Comorbidities or adverse drug reactions (ADRs) from drugs used in sarcoidosis treatment are sometimes very hard to differentiate from symptoms associated with the disease itself, which may cause diagnostic dilemmas. An ideal approach to minimalize ADRs would involve genetic screening prior to prescribing certain ‘high-risk drugs’ and therapeutic drug monitoring during treatment. Pharmacogenomic testing aims to guide appropriate selection of medicines, with the potential of reducing unnecessary polypharmacy while improving clinical outcomes.

Summary
A multidisciplinary approach to the management of sarcoidosis may avoid unnecessary ADRs. It is important to consider the possibility of drug-induced damage in sarcoidosis, especially if the clinical situation deteriorates after the introduction of a particular drug.
Pleuroparenchymal fibroelastosis
Authors: Cottin Vincent , Si-Mohamed Salim , Diesler Rémi , Bonniaud Philippe , Valenzuela Claudia 
Published: July 2022

Purpose of review
Pleuroparenchymal fibroelastosis (PPFE) is a clinico-radiologic-pathologic interstitial lung disease (ILD) characterized by fibrosis that has upper lobe and subpleural predominance, involving both the visceral pleura and the subjacent subpleural lung parenchyma, and comprises dense fibroelastic changes with prominent elastosis of the alveolar walls together with fibrous thickening of the visceral pleura. The goal of this review is to summarize the state-of-the-art understanding in PPFE.

Recent findings
PPFE was described in an increasing number of conditions. The course of disease is heterogeneous. Idiopathic PPFE, cases associated with telomerase-related gene mutations, cases related to a history of chemotherapy, and cases combining PPFE with a pattern of usual interstitial pneumonia, may have a particularly poor prognosis. Well-conducted retrospective studies identified marked PPFE features in approximately 10% of patients with idiopathic pulmonary fibrosis, 11% of patients with systemic sclerosis-associated ILD, 6.5% of patients with rheumatoid arthritis-associated ILD, and 23% of patients with hypersensitivity pneumonitis. Drug therapy has not been evaluated prospectively. A small retrospective study suggests that nintedanib may slow disease progression. However, whether the efficacy of antifibrotics is comparable in PPFE and in other forms of progressive pulmonary fibrosis warrants further evaluation.

Summary
Accumulating data indicate that PPFE features are associated with poor prognosis in fibrosing ILDs. Further research on the management of PPFE is warranted.
Women and thyroid cancer incidence: overdiagnosis versus biological risk
Authors: Lam Diana , Davies Louise , Sawka Anna M. 
Published: July 2022

Purpose of the review
Our aim is to discuss the concepts of sex and gender in the context of thyroid cancer epidemiology.

Recent findings
It has been long-established in global epidemiologic data that thyroid cancer incidence rates are higher in women than men. However, what has been less well understood is whether this reflects sex disparities in cancer susceptibility, gender disparities in detection, or a combination. A recent meta-analysis of autopsy data from individuals who were not known to have thyroid cancer in their lifetime demonstrated no difference in the prevalence of thyroid cancer in women and men, suggesting that gender differences may be the reason for gender-based differences in thyroid cancer detection. This finding, and sex differences in auto immunity and other factors that may affect cancer susceptibility are explored.

Summary
Additional research to explore gender- and sex-specific data on thyroid cancer would inform our understanding of the differences and similarities between men and women in susceptibility and detection of thyroid cancer and help to optimize disease management for all genders and both sexes.
Normothermic machine perfusion of kidneys: current strategies and future perspectives
Authors: Messner Franka , Bogensperger Christina , Hunter James P. , Kaths Moritz J. , Moers Cyril , Weissenbacher Annemarie 
Published: July 2022

Purpose of review
This review aims to summarize the latest original preclinical and clinical articles in the setting of normothermic machine perfusion (NMP) of kidney grafts.

Recent findings
Kidney NMP can be safely translated into the clinical routine and there is increasing evidence that NMP may be beneficial in graft preservation especially in marginal kidney grafts. Due to the near-physiological state during NMP, this technology may be used as an ex-vivo organ assessment and treatment platform. There are reports on the application of mesenchymal stromal/stem cells, multipotent adult progenitor cells and microRNA during kidney NMP, with first data indicating that these therapies indeed lead to a decrease in inflammatory response and kidney injury. Together with the demonstrated possibility of prolonged ex-vivo perfusion without significant graft damage, NMP could not only be used as a tool to perform preimplant graft assessment. Some evidence exists that it truly has the potential to be a platform to treat and repair injured kidney grafts, thereby significantly reducing the number of declined organs.

Summary
Kidney NMP is feasible and can potentially increase the donor pool not only by preimplant graft assessment, but also by ex-vivo graft treatment.