bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multidisciplinary Care for Adults With Chronic Pancreatitis
Authors: Petrik Megan L. , Freeman Martin L. , Trikudanathan Guru 
Published: February 2022

Abstract
Chronic pancreatitis (CP) is associated with a high disease burden, extensive negative impact on quality of life, increased rates of depression and anxiety, and significant health care utilization and expenditures. Pain is a hallmark feature of CP, present in up to 90% of patients with this condition, and can lead to high rates of disability, hospitalization, and opioid medication use. Current perspectives on the management of CP have evolved to advocate a multidisciplinary approach which offers new pathways for helping patients manage symptoms. Psychologists play an important role in a multidisciplinary team effort by applying scientifically based psychological principles and techniques to improve pain and adaptation to chronic illness. This review will detail the fundamentals of delivering psychological interventions for adults with CP managed in an outpatient setting. Recommendations for integrating psychological care in multidisciplinary management of CP will be offered. Future directions for psychological care in CP multidisciplinary teams are also discussed.
Identification of Malnutrition Risk Using Malnutrition Screening Tool in an Ambulatory Pancreas Clinic
Authors: Madril Peter , Golian Paige , Nahikian-Nelms Marcia , Hinton Alice , Hart Philip A. , Roberts Kristen M. 
Published: February 2022

Objectives
The aim of this project was to assess malnutrition risk in a well-defined cohort of pancreatic diseases.

Methods
We performed a retrospective, cross-sectional study of 401 subjects with available malnutrition screening tool scores who received care at a single outpatient pancreas clinic during a 6-month study period. Univariate analyses were performed to compare demographic, anthropometric, symptoms/diseases, and risk for malnutrition characteristics across 3 strata of diseases: acute pancreatitis (n = 141), chronic pancreatitis (n = 193), and other pancreatic diagnoses (n = 67).

Results
A total of 18% of subjects were identified as at risk for malnutrition, including 25% who reported involuntary weight loss and/or decreased appetite. Subjects categorized as at risk for malnutrition were more likely to have gastrointestinal symptoms. Although the nutrition consultation rates were higher in subjects at risk for malnutrition (P = 0.03), 66% did not receive a clearly indicated dietary evaluation or management recommendations. One fifth of all patients in an ambulatory pancreas clinic are identified as at risk for malnutrition using a simple, validated tool.

Conclusions
The majority of patients at increased risk for nutritional complications did not receive nutritional recommendations.
Toll-Like Receptor 3 Is Critical to the Pancreatic Islet Milieu That Is Required for Coxsackievirus B4–Induced Type 1 Diabetes in Female Nonobese Diabetic Mice
Authors: Benner Sarah E. , Walter Debra L. , Thuma Jean R. , Courreges Maria , James Calvin B. L. , Schwartz Frank L. , McCall Kelly D. 
Published: February 2022

Objective
Genetic and environmental influences play a role as triggers of type 1 diabetes mellitus (T1DM). Female nonobese diabetic (NOD) mice are useful for studying T1DM as they spontaneously develop T1DM, which can be accelerated by some viruses. Toll-like receptor 3 (TLR3) is believed to play a critical role in viral-induced T1DM and β-cell destruction, because female Tlr3 knockout (Tlr3
−/−) NOD mice are protected from Coxsackievirus B4 (CVB4)-induced acceleration of T1DM. However, the exact role(s) TLR3 plays in the pathogenesis of CVB4-induced T1DM remain unknown.

Methods
This longitudinal study used immunostaining, laser capture microdissection, and reverse transcription real-time polymerase chain reaction of islets from female uninfected and CVB4-infected Tlr3
+/+ and Tlr3
−/− NOD mice.

Results
Islets isolated from female Tlr3+/+
NOD mice 4 to 8 weeks of age had higher amounts of insulitis, Cxcl10, Il1b, Tnfa, and Tgfb1 expression compared with Tlr3−/−
NOD mice. After CVB4 infection, Tlr3+/+
NOD mice had higher amounts of insulitis and T-cell infiltration at 3 days after infection compared with Tlr3−/−
CVB4-infected NOD mice.

Conclusions
Toll-like receptor 3 is necessary for establishment of a pancreatic islet inflammatory microenvironment by increasing insulitis and cytokine expression that facilitates CVB4-induced T1DM in female NOD mice.
Ptf1a Promoter-Driven Cre Expression During Spermatogenesis Causes Germline Recombination
Authors: Wang Jiale , Wang Oliver , Bi Yan , Wang Ying , Crawford Howard , Ji Baoan 
Published: February 2022

Objectives
Two independently developed Ptf1a-Cre mouse lines, Ptf1atm1(cre)Hnak and Ptf1atm1(Cre)Cvw, are widely used in pancreatic research. Recently, Ptf1atm1(cre)Hnak line was reported to transmit unwanted paternal recombination. We aimed to investigate whether this exists in the Ptf1atm1(Cre)Cvw line.

Methods
Ptf1atm1(Cre)Cvw mice were crossed with R26-LSL-LacZ reporter mice. DNA recombination and gene expression were examined by recombination-specific polymerase chain reaction, reverse transcription–polymerase chain reaction, and X-Gal staining.

Results
R26 locus recombination was detected in the pancreas as well as the testes and sperm of the double transgenic mice. Positive ptf1a mRNA expression from testes revealed that there was endogenous Ptf1a promoter activity in this extrapancreatic tissue. Of the 15 progenies that inherited LacZ from the male double transgenic mice, 4 (26.7%) were positive for complete whole-body recombination. The presence of recombination in R26 only mice suggested that the recombination occurred before meiosis.

Conclusions
Paternal germline recombination exists in the Ptf1atm1(Cre)Cvw mouse line. Ptf1a promoter-driven Cre expression during spermatogenesis before meiosis is the cause of germline recombination. Therefore, when male Ptf1a-Cre mice are used in compound mice breeding, it is necessary to genotype not only floxed alleles but also recombined alleles to examine unwanted recombinations.
Chronic Jetlag Alters the Landscape of the Pancreatic Lipidome
Authors: Schwartz Patrick B. , Barrett-Wilt Gregory A. , Ronnekleiv-Kelly Sean M. 
Published: February 2022

Objectives
The innate biologic clock plays a significant role in lipid metabolism, including the peripheral clock in the pancreas. However, an evaluation of the downstream lipids in the pancreatic lipidome is lacking. We sought to understand the diurnal variations of lipids within the pancreatic lipidome.

Methods
At 4 weeks of age, C57Bl/6J mice were subjected to either normal lighting conditions or a chronic jetlag (CJ) condition known to mimic chronic shiftwork in humans. At 9 months, mice were serially killed at 4-hour intervals for 24 hours. The pancreas was removed and subjected to untargeted liquid chromatography–mass spectrometry to examine the pancreatic lipidome.

Results
A total of 4.7% of the pancreatic lipidome was rhythmically expressed, which increased to 12.9% after CJ. After CJ, there was a 4.58-hour shift in the timing of peak 24-hour lipid expression. Chronic jetlag also led to the enrichment of diacylglycerols and triglycerides, while promoting a decrease in lysophosphatidylcholines and 44-carbon acyl chain lipids.

Conclusions
The pancreatic lipidome exhibits diurnal rhythmicity across a broad number of lipid classes. Chronic jetlag led to alterations in lipid composition that mirrored other metabolically active organs. Several of the reported changes may link altered sleep-wake cycles with known circadian disruption-induced pancreatic diseases.
Differentiation Between Solid Pseudopapillary Neoplasm of the Pancreas and Nonfunctional Pancreatic Neuroendocrine Neoplasm Using Endoscopic Ultrasound
Authors: Kataoka Kunio , Ishikawa Takuya , Ohno Eizaburo , Mizutani Yasuyuki , Iida Tadashi , Furukawa Kazuhiro , Nakamura Masanao , Honda Takashi , Ishigami Masatoshi , Kawashima Hiroki , Hirooka Yoshiki , Fujishiro Mitsuhiro 
Published: February 2022

Objectives
We investigated the utility of endoscopic ultrasound (EUS) for differentiating between solid pseudopapillary neoplasm of the pancreas (SPN) and pancreatic neuroendocrine neoplasm (PanNEN).

Methods
A retrospective analysis was performed on 29 and 77 consecutive patients with pathologically proven SPN and nonfunctional PanNEN. In patients who underwent contrast-enhanced harmonic EUS (CH-EUS), lesions were classified into 3 vascular patterns (hypoechoic/isoechoic/hyperechoic), and the presence of “the alveolus nest sign,” which we previously reported as a characteristic feature of SPN on CH-EUS, was also assessed.

Results
Conventional EUS findings showed that calcification echoes were significantly more frequent in SPN lesions than in PanNEN lesions (19/29 [66%] vs 21/77 [27%], P = 0.001) as was internal isoechogenicity or hyperechogenicity (10/29 [34%] vs 11/77 [14%], P = 0.029). Contrast-enhanced harmonic EUS findings showed that SPN lesions more frequently had the isoechoic or hypoechoic vascular pattern, and significantly more frequently had the alveolus nest sign (18/25 [72%] vs 4/60 [7%], P < 0.001). In a multivariate analysis, the presence of the alveolus nest sign contributed the most to the SPN diagnosis (odds ratio, 70; 95% confidence interval, 6.2–786).

Conclusions
Endoscopic ultrasound, particularly the presence of the alveolus nest sign on CH-EUS, is useful for differentiating SPN from PanNEN.
Provider Differences in Monitoring and Management of Exocrine Pancreatic Insufficiency in Chronic Pancreatitis
Authors: Srivoleti Padmavathi , Dolan Russell D. , Yang Allison L. , Jin David X. , Banks Peter A. , McNabb-Baltar Julia 
Published: February 2022

Objectives
Chronic pancreatitis (CP) is a common cause of exocrine pancreatic insufficiency (EPI). Regular monitoring and treatment are recommended to decrease morbidity. This study evaluates whether provider type impacts EPI monitoring and management in CP.

Methods
Fecal elastase 1 (FE-1) testing and pancreatic enzyme replacement therapy (PERT) utilization were retrospectively compared between primary care providers (PCPs), gastroenterologists and pancreas specialists using pairwise comparisons. Multivariate analysis was conducted to study the association between adequate PERT and age, sex, race, insurance status, provider type, and etiology.

Results
Among 256 patients, FE-1 was measured in 115 (44.9%) and of 143 (55.9%) patients who received PERT, 100 (69.9%) received adequate dosage. Fecal elastase 1 testing was performed in 7/57 (12.3%) by PCP, 11/38 (28.9%) by gastroenterologists, and 97/161 (60.2%) by pancreas specialists (P < 0.0001). Adequate PERT was prescribed in 7/24 (29.2%) patients by PCPs, 11/20 (55.0%) by gastroenterologists, and 82/99 (82.8%) by pancreas specialists (P < 0.0001). On multivariate analysis, pancreas specialists were significantly more likely to prescribe adequate PERT compared with PCP (odds ratio, 11.3; 95% confidence interval, 3.3–38.2; P < 0.001).

Conclusions
Many patients with CP receive inadequate surveillance and EPI treatment. Pancreas specialists are more likely to surveil and treat EPI adequately.
The Caring for Our Own Program
Authors: Larsson Laura , Johnson Catherine M. 
Published: February 2022

Background:
Research has identified workforce diversification as influential in improving health outcomes. The Caring for Our Own Program (CO-OP) set out to achieve classroom and workforce parity for rural Native American nurses and communities.

Purpose:
In this study, we report quantitative results of the first 20 years of the CO-OP and explore the extent to which the CO-OP model influenced degree completion for Native American students.

Approach:
The CO-OP employs a 4-pillar program model where sense of place, financial security, academic readiness, and social connection empower students as they progress. One hundred twenty-one Native American students have earned nursing degrees since inception. In addition, more than 10% of CO-OP undergraduates have returned to become nurse practitioners.

Conclusions:
The CO-OP model replicated elsewhere may also succeed by adapting key concepts in that context to achieve health equity.
High-Risk Human Papillomavirus Messenger RNA Testing Using Urine, Cervicovaginal Self-Collected and Provider-Collected Cervical Samples Among Women in Mombasa, Kenya
Authors: Grabert Brigid K. , Islam Jessica Y. , Mutua Michael , Kabare Emmanuel , Manguro Griffins , Waweru Wairimu , Mandaliya Kishor , Shafi Juma , McClelland R. Scott , Smith Jennifer S. 
Published: February 2022

Abstract
We compared human papillomavirus messenger RNA testing using urine, self-, and provider-collected samples for the detection of high-grade cervical cytology and assessed acceptability of urine self-collection among females who engage in sex work in Kenya. Participants found urine sampling comfortable, but high-risk human papillomavirus messenger RNA detection in urine samples was less likely to detect high-grade lesions than self- and provider-collected cervical samples.
Polyembolokoilamania in Child Sexual Abuse
Authors: Donaruma-Kwoh Marcella M. , Weary Casey E. , Cruz Andrea T. 
Published: February 2022

Objective
To characterize the physical examination findings in children and adolescents who disclosed insertion of an object into their bodies as part of their sexual abuse history and to identify how this population compares to similar cases described in the published literature.

Methods
This is a 15-year retrospective review of children younger than 18 years seen at a large urban children's assessment center. In addition, we reviewed and summarized the last two decades of literature characterizing pediatric anogenital foreign bodies to better understand previously described findings in similar populations.

Results
Sixty-eight children whose abuse histories included anal or genital insertion of a foreign body still presented with normal examination findings in the vast majority (89.7%) of cases, despite the diversity of items described. The literature on anogenital foreign bodies was sparse, offered a variety of approaches to the overall evaluation of such cases, and demonstrated inconsistent consideration of child sexual abuse in response to the diagnosis.

Conclusions
This article further supports the literature reflecting the overall rarity of abnormal anogenital findings in the clinical assessment for sexual abuse.
Vascularized Bone Flap Options for Complex Thoracic Spinal Reconstruction
Authors: Asaad Malke , Houdek Matthew T. , Huang Tony C. T. , Rose Peter S. , Moran Steven L. 
Published: February 2022

Background:
Osseous reconstruction following total spondylectomy/vertebrectomy in the thoracic spine is indicated to restore spinal stability. To assist with bony reconstruction, vascularized bone flaps including free vascularized fibula flaps and pedicled rib flaps can be used. However, there are limited data comparing various techniques. The authors aimed to evaluate the outcomes of free vascularized fibula flaps and pedicled rib flaps used for thoracic spinal reconstruction.

Methods:
The authors reviewed 44 vascularized bone flaps [10 anterior pedicled rib flaps, 25 posterior pedicled rib flaps, and nine vascularized fibula flaps] for corpectomy defects spanning T1 to L1 between January of 1999 and June of 2018. Mean age and follow-up were 46 ±17 years and 74 ± 52 months, respectively.

Results:
The union rate was 93 percent, with a similar mean time to union among the three groups: free vascularized fibula flaps, 9 ± 4 months; anterior pedicled rib flaps, 9 ± 6 months; and posterior pedicled rib flaps, 9 ± 5 months (p = 0.95). Surgical-site complications were found in 27 vascularized bone flaps (61 percent), and reoperations and revisions were performed in 14 (32 percent) and 10 (23 percent) vascularized bone flaps, respectively. No differences were identified among anterior pedicled rib flaps, posterior pedicled rib flaps, and vascularized fibula flaps with regard to complication, reoperation, and revision rates.

Conclusions:
Free vascularized fibula flaps and pedicled rib flaps provide durable reconstruction for thoracic spinal defects. Union, time to union, revision, and reoperation rates were similar among anterior and posterior pedicled rib flaps and vascularized fibula flaps. Given the variability in indication and defect types among the flap cohorts, the authors’ results should be interpreted carefully as an insight into the outcomes of different vascularized bone flaps for the unique cases of thoracic spinal reconstruction rather than to compare the different flaps used.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
A Comprehensive Approach for Measuring Spatial Deviations of Computer-Assisted Mandibular Reconstruction
Authors: Yang Wei-fa , Yu Peirong , Zhu Wang-yong , Choi Wing Shan , Pu Jingya Jane , Su Yu-xiong 
Published: February 2022

Background:
Computer-assisted surgery has become the mainstream in mandibular reconstruction, but the lack of a standard measuring approach for spatial deviations of mandible hinders postoperative verification and the comparison of different subjects. This study aims to set up a comprehensive approach for measuring spatial deviations of computer-assisted mandibular reconstruction.

Methods:
A systematic review was conducted to extract all measurements for computer-assisted mandibular reconstruction. Thereafter, eligible measurements were included in the authors’ comprehensive approach, which categorized the measurements according to different anatomical structures and landmarks.

Results:
A total of 80 studies were included in the authors’ systematic review, and 31 measurements were extracted. The authors established a comprehensive panel of anatomical landmarks to facilitate measurement, including parts, points, lines, planes, and angles. These measurements encompassed spatial deviations of the overall mandible, condyle, gonial angle, bone grafts, midline, surgical plate, osteotomy, and miscellaneous indicators. A calculation spreadsheet was developed to collect landmarks and compute deviations automatically with built-in formulas. Finally, a simplified panel of measurements was recommended for spatial deviations of mandibular reconstruction.

Conclusions:
A comprehensive approach for measuring spatial deviations of computer-assisted mandibular reconstruction was established. Future studies will confirm this approach as an effective and scientific system for postoperative verification of computer-assisted mandibular reconstruction.
Intraoperative Navigation in Plastic Surgery with Augmented Reality: A Preclinical Validation Study
Authors: Rudy Hayeem L. , Schreiber Jillian S. , Wake Nicole , Lesko Robert P. , Gordon Alexandra , Garfein Evan S. , Tepper Oren M. 
Published: February 2022

Background:
Augmented reality allows users to visualize and interact with digital images including three-dimensional holograms in the real world. This technology may have value intraoperatively by improving surgical decision-making and precision but relies on the ability to accurately align a hologram to a patient. This study aims to quantify the accuracy with which a hologram of soft tissue can be aligned to a patient and used to guide intervention.

Methods:
A mannequin’s face was marked in a standardized fashion with 14 incision patterns in red and nine reference points in blue. A three-dimensional photograph was then taken, converted into a hologram, and uploaded to HoloLens (Verto Studio LLC, San Diego, Calif.), a wearable augmented reality device. The red markings were then erased, leaving only the blue points. The hologram was then viewed through the HoloLens in augmented reality and aligned onto the mannequin. The user then traced the overlaid red markings present on the hologram. Three-dimensional photographs of the newly marked mannequin were then taken and compared with the baseline three-dimensional photographs of the mannequin for accuracy of the red markings. This process was repeated for 15 trials (n = 15).

Results:
The accuracy of the augmented reality-guided intervention, when considering all trials, was 1.35 ± 0.24 mm. Markings that were positioned laterally on the face were significantly more difficult to reproduce than those centered around the facial midline.

Conclusions:
Holographic markings can be accurately translated onto a mannequin with an average error of less than 1.4 mm. These data support the notion that augmented reality navigation may be practical and reliable for clinical integration in plastic surgery.
A Novel Algorithm for Defining the Mandibular Border
Authors: Rohrich Rod J. , Agrawal Nikhil A. , Avashia Yash , Savetsky Ira L. 
Published: February 2022

Summary:
Techniques for defining the mandibular angle are a particular focus for patients around the world. Developing the desirable sharp contours is a combination of reducing bulkiness around the mandible while augmenting the border. Invasive techniques (e.g., face lifts and chin augmentation) can help define the mandible; however, younger patients are demanding more affordable and less invasive procedures. The “Nefertiti lift,” masseter neurotoxin, buccal fat excision, mandibular border augmentation with filler, and liposuction of the neck can all be done in the office and will produce excellent results. If the loss of definition is due to superior soft tissue, the next step is to determine if this is based on anterior or posterior soft-tissue excess. Posteriorly, it is caused by masseter hypertrophy, and anteriorly, it may be because of an enlarged or full buccal fat pad in the lower cheek area. If the loss of definition is inferior, the next step is to again define if it is anterior or posterior. Anterior excess tissue can be corrected with liposuction of the neck along with energy-based skin tightening technology. Posteriorly, the inferior pull of the platysma can be blunted with neurotoxin. Finally, once the soft tissues are adequate, the mandibular border can be augmented with filler. In this article, the authors propose an algorithm for when to utilize each of these procedures while reviewing proper technique.