bluuebunny/crossref_metadata_2025_split huggingface dataset:
Myopic outcome after intraocular lens implantation in a patient who previously had small-incision lenticule extraction
Authors: Li Xinxin , Li Shaowei , Li Luyao , Liu Chang , Li Qiumei 
Published: February 2022

Introduction:
This is a report of cataract surgery in a post–small-incision lenticule extraction (SMILE) patient with low myopia.

Patient and clinical findings:
A 49-year-old man underwent bilateral SMILE 18 months previously, and the visual acuity of both eyes recovered to 20/20. The patient noticed a gradual reduction in visual acuity in his left eye and blurring for 3 months. The corrected distance visual acuity (CDVA) was 20/67 in his left eye.

Diagnosis, intervention, and outcomes:
The slitlamp examination revealed an anterior subcapsular cataract. The intraocular lens (IOL) power was calculated by using a multiformula averaging method. A standard femtosecond laser–assisted phacoemulsification cataract surgery was performed and a trifocal IOL implanted. 2 months after IOL implantation, the uncorrected distance visual acuity of the left eye was 20/33, the autorefraction values were −1.37 −0.25 × 146, and the CDVA was 20/20.

Conclusions:
This case report showed that current postrefractive IOL power calculation formulas or methods may lead to myopic outcomes in patients who previously received SMILE. A standard IOL calculation may be more suitable for such patients. Additional case studies are needed to accurately calculate IOL power after SMILE similar to laser in situ keratomileusis.
Seasonality of Pediatric Mental Health Emergency Department Visits, School, and COVID-19
Authors: Copeland John Nathan , Babyak Michael , Inscoe Adrienne Banny , Maslow Gary R. 
Published: February 2022

Objectives
The aim of this study was to explore how the academic calendar, and by extension school-year stressors, contributes to the seasonality of pediatric mental health emergency department (ED) visits.

Methods
The authors reviewed all pediatric mental health ED visits at a large urban medical center from 2014 to 2019. Patients who were younger than 18 years at time of presentation, were Durham residents, and had a primary payer of Medicaid were included in the sample population, and the dates of ED visits of the sample population were compared against dates of academic semesters and summer/winter breaks of a relevant school calendar. Of patients with multiple ED visits, only the first ED presentation was included, and descriptive statistics and a rate ratio were used to describe the study group and identify the rate of ED visits during semesters compared with breaks.

Results
Among the sample population from 2014 to 2019, there were 1004 first pediatric mental health ED visits. Of these ED visits, the average number of visits per week during summer/winter breaks was 2.2, and the average number of visits per week during academic semester dates was 3.4. The rate of ED visits was significantly greater during academic semesters compared with breaks (Rate Ratio, 1.6; 95% confidence interval, 1.4–2.0; P < 0.001).

Conclusions
Children may be at greater risk of behavioral health crises or having increased mental needs when school is in session. As many children's mental health has worsened during the COVID-19 (coronavirus disease 2019) pandemic, these findings highlight the need for increased mental health services in the school setting as children return to in-person learning. In addition, it may benefit health systems to plan behavioral health staffing around academic calendars.
Methodologic and Reporting Quality of Economic Evaluations in Hand and Wrist Surgery: A Systematic Review
Authors: Uhlman Kathryn , Miroshnychenko Anna , Duku Eric , Xie Feng , Thoma Achilles 
Published: February 2022

Background:
Economic evaluations can inform decision-making; however, previous publications have identified poor quality of economic evaluations in surgical specialties.

Methods:
Study periods were from January 1, 2006, to April 20, 2020 (methodologic quality) and January 1, 2014, to April 20, 2020 (reporting quality). Primary outcomes were methodologic quality [Guidelines for Authors and Peer Reviewers of Economic Submissions to The BMJ (Drummond’s checklist), 33 points; Quality of Health Economic Studies (QHES), 100 points; Consensus on Health Economic Criteria (CHEC), 19 points] and reporting quality (Consolidated Health Economic Evaluation Standards (CHEERS) statement, 24 points).

Results:
Forty-seven hand economic evaluations were included. Partial economic analyses (i.e., cost analysis) were the most common (n = 34; 72 percent). Average scores of full economic evaluations (i.e., cost-utility analysis and cost-effectiveness analysis) were: Drummond’s checklist, 27.08 of 33 (82.05 percent); QHES, 79.76 of 100 (79.76 percent); CHEC, 15.54 of 19 (81.78 percent); and CHEERS, 20.25 of 24 (84.38 percent). Cost utility analyses had the highest methodologic and reporting quality scores: Drummond’s checklist, 28.89 of 35 (82.54 percent); QHES, 86.56 of 100 (86.56 percent); CHEC, 16.78 of 19 (88.30 percent); and CHEERS, 20.8 of 24 (86.67 percent). The association (multiple R) between CHEC and CHEERS was strongest: CHEC, 0.953; Drummond’s checklist, 0.907; and QHES, 0.909.

Conclusions:
Partial economic evaluations in hand surgery are prevalent but not very useful. The Consensus on Health Economic Criteria and Consolidated Health Economic Evaluation Standards should be used in tandem when undertaking and evaluating economic evaluation in hand surgery.
Transfer of a C7 Fascicle for the Pectoralis Major to the Suprascapular Nerve: A 3-Year Follow-Up Patient Series
Authors: Cambon-Binder Adeline , Belkheyar Zoubir 
Published: February 2022

Background:
In patients with C5-C6 brachial plexus injury, spinal accessory nerve transfer to the suprascapular nerve is usually performed for the restoration of shoulder abduction. In order to minimize donor deficits, we transferred one fascicle of the ipsilateral C7 root, dedicated to the pectoralis major muscle, to the suprascapular nerve.

Methods:
Ten patients with a mean age of 33 years (range, 19 to 51 years) were operated on at a mean delay of 4 months after their trauma (range, 2 to 7 months). Patients had C5-C6 brachial plexus palsy with avulsed roots on spinal magnetic resonance imaging scan. In addition to the partial C7 transfer, patients sustained nerve transfers to the posterior branch of the axillary nerve and to the motor branches of the musculocutaneous nerve for the biceps and brachialis muscles.

Results:
At a mean follow-up of 36 months (range, 29 to 42 months), mean shoulder abduction and external rotation ranges of motion were, respectively, 99 degrees (range, 60 to 120 degrees; p = 0.001) and 58 degrees (range, 0 to 80 degrees; p = 0.001). In nine patients, shoulder abduction strength was graded M4, according the British Medical Research Council grading scale, against 1.6 kg (range, 1 to 2 kg), and was graded M3 in one patient. External rotation strength was graded M4 in nine patients and M3 in one patient. Residual strength of the pectoralis major muscle was graded M4+ in every patient.

Conclusions:
C7 partial transfer to the suprascapular nerve showed satisfactory results at long-term follow-up for active shoulder abduction and external rotation recovery in C5-C6 brachial plexus palsies. This technique replaced spinal accessory nerve transfer in the authors’ practice.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
The Best of Chest Wall Reconstruction: Principles and Clinical Application for Complex Oncologic and Sternal Defects
Authors: Isaac Kathryn V. , Elzinga Kate , Buchel Edward W. 
Published: February 2022

Learning Objectives:
After studying this article, the participant should be able to: 1. Appraise and evaluate risk factors for respiratory compromise following oncologic resection. 2. Outline and apply an algorithmic approach to reconstruction of the chest wall based on defect composition, size, and characteristics of surrounding tissue. 3. Recognize and evaluate indications for and types of skeletal stabilization of the chest wall. 4. Critically consider, compare, and select pedicled and free flaps for chest wall reconstruction that do not impair residual respiratory function or skeletal stability.

Summary:
Chest wall reconstruction restores respiratory function, provides protection for underlying viscera, and supports the shoulder girdle. Common indications for chest wall reconstruction include neoplasms, trauma, infectious processes, and congenital defects. Loss of chest wall integrity can result in respiratory and cardiac compromise and upper extremity instability. Advances in reconstructive techniques have expanded the resectability of large complex oncologic tumors by safely and reliably restoring chest wall integrity in an immediate fashion with minimal or no secondary deficits. The purpose of this article is to provide the reader with current evidenced-based knowledge to optimize care of patients requiring chest wall reconstruction. This article discusses the evaluation and management of oncologic chest wall defects, reviews controversial considerations in chest wall reconstruction, and provides an algorithm for the reconstruction of complex chest wall defects. Respiratory preservation, semirigid stabilization, and longevity are key when reconstructing chest wall defects.
Who’s Auditioning Who? Applicant-Reported Elements of the Best and Worst Plastic Surgery Subinternships
Authors: Wickenheisser Victoria A. , Langdell Hannah C. , Brown David A. , Phillips Brett T. 
Published: February 2022

Background:
Many integrated plastic surgery applicants choose to complete one or more visiting subinternships or “away rotations” at programs outside of their home institution. As these rotations are so critical on both sides of the application process, the authors sought to identify the factors that influence subinternship experiences for plastic surgery applicants.

Methods:
A survey was used to collect information about demographics, the subinternship experience, and interview preferences. The survey was distributed to current plastic surgery interns and applicants who applied to Duke Plastic Surgery in the 2019/2020 application cycle.

Results:
One hundred forty-two responses were received (response rate, 35.2 percent). The mean number of subinternships completed was 4.47. The defining feature of respondents’ best subinternship most often included engagement from faculty and residents, autonomy, and integration with the team. The worst feature of respondents’ worst subinternship experience most often included a sense of disinterested or “malignant” residents and faculty, lacking operative/educational opportunities, and disorganization of the rotation. The majority of applicants (60.3 percent) would prefer to return for a standard interview day over interviewing while on rotation.

Conclusions:
The subinternship experience remains a critical part of the applicant experience when applying to integrated plastic surgery residency programs. The experience on these rotations leaves a lasting impression that is highly variable and influences future recommendations to peers. Rotating students value inclusivity and case volume, and they take note of negative interactions they witness among residents and faculty. These results can help as programs design their subinternship experience for visiting students in the future.
Uneven Progress in Gender Equality at Plastic Surgery Conferences: Lessons from a Decade of Meetings
Authors: Bregman Dana E. , Ha Grace , Tanna Neil 
Published: February 2022

Background:
The demographics of plastic surgeons and plastic surgery trainees are changing, reflecting an increase in the diversity of medical school graduates. The authors investigated the gender diversity of speakers at several plastic surgery conferences and evaluated temporal trends over a 10-year period.

Methods:
The following societies’ conferences and years were included based on the conference agendas available for review: American Society for Aesthetic Plastic Surgery, Plastic Surgery Research Council, American Association of Plastic Surgeons, Northeastern Society of Plastic Surgeons, and American Society for Reconstructive Microsurgery. Differences in the average amount of time spoken were analyzed using an independent one-tailed t test.

Results:
The number of female speakers and the time allotted to speak increased for all conferences. There was not a consistent difference in the amount of time individual men and women were allotted to speak. Across the five conferences, there was no consistent relationship found between years since board certification and female participation in conference. Gender diversity among speakers at plastic surgery conferences has not kept pace with the increase in female plastic surgery trainees because those who are selected to speak are overwhelmingly men. The hypothesis that a paucity of female speakers reflects the relatively shorter duration of career experience of female plastic surgeons was not supported by these findings.

Conclusion:
It is imperative that conferences increase the participation of women and strive toward more accurately reflecting the burgeoning role that female surgeons have in the field at present and will have in the future.
Amino Acid Uptake, Glucose Metabolism, and Neuroinflammation in John Cunningham Virus Associated Progressive Multifocal Leukoencephalopathy
Authors: Unterrainer Marcus , Mahler Christoph , Schumacher Adrian-Minh , Ruf Viktoria , Blum Bernhard , Quach Stefanie , Brendel Matthias , Rupprecht Rainer , Bartenstein Peter , Kerschensteiner Martin , Kümpfel Tania , Albert Nathalie L. 
Published: February 2022

Abstract
A 69-year-old woman presented with progressive dysarthria and cognitive deficits. On MRI, a T2-hyperintense, non–contrast-enhancing lesion was found in the left precentral area. 18F-FET and 18F-FDG PET scans revealed faint amino acid uptake and glucose hypometabolism of the lesion. To assess a neuroinflammatory component, TSPO PET with 18F-GE-180 was performed, where tracer uptake markedly exceeded the T2-hyperintense areas. Histology derived from a stereotactic biopsy findings confirmed John Cunningham virus–associated progressive multifocal leukoencephalopathy. This case underlines that TSPO PET comprises distinct imaging advantages over other established radioligands such as 18F-FET and 18F-FDG in progressive multifocal leukoencephalopathy.
68Ga-DOTANOC PET/CT in Multiple Endocrine Neoplasia 1 With Associated Adrenocortical Carcinoma
Authors: Basheer Shyma , Ratheesan Ramkesh , Sarma Manjit , Palaniswamy Shanmuga Sundaram , Mathews Anitha 
Published: February 2022

Abstract
Multiple endocrine neoplasia 1 (MEN1) syndrome is an autosomal dominant syndrome comprising a triad of pancreatic, pituitary, and parathyroid tumors. Adrenal cortical carcinoma occurs rarely in MEN1 syndrome. Here, we have presented a case of a 62-year-old woman with adrenal mass and elevated serum parathormone levels, who underwent 68Ga-DOTANOC PET/CT. 68Ga-DOTANOC PET/CT showed intense tracer concentration in the left adrenal mass and lesions in the liver, pancreas, and peritoneum. Biopsy of the peritoneal deposit revealed metastatic adrenocortical carcinoma, and further genetic testing showed MEN1 mutation.
The Clinical Significance of Small Vessel Vasculitis on Temporal Artery Biopsies
Authors: Quigley Julian , Sammel Anthony Michael , Laurent Rodger , Brewer Janice , Hsiao Edward , Schembri Geoffrey , Fraser Clare L. 
Published: February 2022

Background:
Giant cell arteritis (GCA) is the most common type of systemic vasculitis in the elderly. Untreated, it can lead to irreversible blindness. Its diagnosis relies on a temporal artery biopsy (TAB). However, a proportion of patients have small vessel vasculitis (SVV) on biopsy; the prognosis of which remains unclear. The aim of this study is to compare the clinical presentation and long-term outcomes of those with SVV with negative and positive biopsies to determine whether long-term corticosteroid therapy can be avoided in these patients.

Methods:
Post hoc analysis of patients with suspected GCA who underwent TAB and fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) scan as part of a prospective GCA and PET cohort. Patients were divided in to 3 groups based on TAB result: positive (inflammation in the main artery wall), negative (no inflammation), and SVV (isolated vasa vasorum or periadventitial SVV). Clinical, serological, and PET/CT data of patients with SVV were compared with those with positive and those with negative biopsies.

Results:
For the 58 eligible patients recruited between May 2016 and December 2017, 11 had SVV, 12 had positive, and 35 had negative biopsies. Patients with SVV had similar clinical, serological, and PET/CT findings to those with negative biopsies. Compared with those with positive biopsies, patients with SVV had lower erythrocyte sedimentation rate (25 vs 78 mm/hour; P = 0.02), platelet count (296 vs 385 ×109/L; P = 0.03), and a lower median total vascular score on PET/CT scan (1.0 vs 13.5; P = 0.01). Median prednisone dose was lower (4.8 vs 11.7 mg; P = 0.015) and fewer were on steroid-sparing agents (20% vs 67%; P = 0.043) at 6 months. The percentage of patients with a clinical diagnosis of GCA was similar between those with SVV (3/11, 27.3%) and those with negative biopsies (5/35, 14.3%; P = 0.374).

Conclusions:
Patients with SVV on TAB had similar clinical features, PET/CT findings, and 6-month outcomes to those with negative biopsies. Small vessel vasculitis can be treated as equivalent to a negative biopsy when being considered for diagnosis and treatment of GCA.
An inactivated SARS-CoV-2 vaccine is safe and induces humoral and cellular immunity against virus variants in healthy children and adolescents in Chile
Authors: Soto Jorge A , Melo-González Felipe , Gutierrez-Vera Cristián , Schultz Bárbara M , Berríos-Rojas Roslye V , Rivera-Pérez Daniela , Piña-Iturbe Alejandro , Hoppe-Elsholz Guillermo , Duarte Luisa F , Vázquez Yaneisi , Moreno-Tapia Daniela , Ríos Mariana , Palacios Pablo A , Garcia-Betancourt Richard , Santibañez Álvaro , Mendez Constanza , Diethelm-Varela Benjamín , Astudillo Patricio , Calvo Mario , Cárdenas Antonio , González Marcela , Goldsack Macarena , Gutiérrez Valentina , Potin Marcela , Schilling Andrea , Tapia Lorena I , Twele Loreto , Villena Rodolfo , Grifoni Alba , Sette Alessandro , Weiskopf Daniela , Fasce Rodrigo A , Fernández Jorge , Mora Judith , Ramírez Eugenio , Gaete-Argel Aracelly , Acevedo Mónica , Valiente-Echeverría Fernando , Soto-Rifo Ricardo , Retamal-Díaz Angello , Muñoz-Jofré Nathalia ,   PedCoronaVac03CL Study Group, Meng Xing , Xin Qianqian , Alarcón-Bustamante Eduardo , González-Aramundiz José V , Corre Nicole Le , Álvarez María Javiera , González Pablo A , Abarca Katia , Perret Cecilia , Carreño Leandro J , Kalergis Alexis M , Bueno Susan M 
Published: February 2022

AbstractBackgroundMultiple vaccines against SARS-CoV-2 have been evaluated in clinical trials, but very few include the pediatric population. The inactivated vaccine CoronaVac® has shown to be safe and immunogenic in a phase 1/2 clinical trial in a pediatric cohort in China. This study is an interim safety and immunogenicity report of a phase 3 clinical trial for CoronaVac® in healthy children and adolescents in Chile.MethodsParticipants aged 3 to 17 years old received two doses of CoronaVac® in a four-week interval. Local and systemic adverse reactions were registered in 699 participants that received the first dose and 381 that received the second dose until December 31st, 2021. Whole blood samples were collected from 148 participants for humoral and cellular immunity analyses.ResultsThe primary adverse reaction reported after the first and second dose was pain at the injection site. The adverse reactions observed were primarily mild and local, and no severe adverse events were reported. Four weeks after the second dose, a significant increase in the levels of total and neutralizing antibodies was observed. Increased activation of specific CD4+ T cells was also observed four weeks after the second dose. Although antibodies induced by vaccination neutralize variants Delta and Omicron, titers were lower than the D614G variant. Importantly, comparable T cell responses were detected against these variants of concern.ConclusionsCoronaVac® is safe and immunogenic in subjects aged 3-17 years old and is thus likely to confer protection against infection caused by SARS-CoV-2 variants in this target population.
Childhood Trauma Exposure Increases Long COVID Risk
Authors: Van Den Hurk Alicia W. Villanueva , Ujvari Cady , Greenspan Noah , Malaspina Dolores , Jimenez Xavier F. , Walsh-Messinger Julie 
Published: February 2022

ABSTRACTBackgroundA proportion of those who contract COVID-19 will develop long COVID (i.e., symptoms that persist for three months or more). Childhood trauma contributes to a pro-inflammatory state in adulthood evidenced by high morbidity and early mortality, but it has not yet been investigated as a risk factor for long COVID.MethodsParticipants (N=338) completed online measures of premorbid health, COVID-19 positivity, symptoms, recovery, depression, anxiety, and post-traumatic stress disorder (PTSD). Questionnaires about childhood and recent traumatic experiences were completed by half of the sample (N=162).ResultsFifty-three percent of participants developed long COVID, of whom over 60% endorsed exercise intolerance and protracted myalgias, headaches, brain fog, and shortness of breath. Participants who experienced at least one childhood traumatic event were 3-fold more likely to develop the syndrome (OR=3.11, 95% CI, 1.49 to 6.48), while risk was nearly 6-fold increased for two or more events (OR=5.67, CI, 2.44 to 13.13). Regression models showed childhood trauma (OR=5.32, CI, 1.44 to 19.68), older age (OR=1.11, CI, 1.06 to 1.16), female sex (OR=4.02, CI, 1.34 to 12.12), along with chest pain (OR=8.77, CI, 2.80 to 27.43), brain fog (OR=3.33, CI, 1.16 to 9.57) and phantosmia (OR=5.90, CI, 1.40 to 24.86) during acute illness accurately classified long COVID status in 87% of participants.InterpretationsEarly adversity is a risk-factor for long COVID, likely due to altered immune response, central sensitization, and peripheral dysfunction. Childhood trauma, a crucial social determinant of health, should be routinely assessed in COVID-19 survivors and may aid in determining prognosis.