bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polidocanol: A Review of Off-Label Dermatologic Uses
Authors: Nguyen Quoc-Bao D. , Stender Carly , Bur Delfina , Silapunt Sirunya 
Published: June 2022

BACKGROUND
Polidocanol is an FDA-approved treatment of incompetent great saphenous veins, accessory saphenous veins, and visible varicosities of the great saphenous vein system, but numerous other off-label dermatological applications have been reported.

OBJECTIVE
To describe the various off-label dermatological clinical uses of polidocanol, as well as efficacy and adverse effects.

METHODS
The review of studies searchable on PubMed from 2004 to 2021 describing clinical uses of polidocanol to determine efficacy and adverse effects associated with various dermatologic applications.

RESULTS
Polidocanol has shown efficacy in the treatment of mucocele of minor salivary gland, hemangioma, upper extremity veins, reticular veins of the chest, facial veins, pyogenic granuloma, lymphangioma circumscriptum, digital mucous cyst, mixed skin ulcers, cutaneous focal mucinosis, seromas, glomuvenous malformations, acne cysts, lymphocele, and dissecting cellulitis. Commonly reported side effects include pain, erythema, swelling, ecchymosis, and ulceration. Most sources were case reports and small prospective studies, as such the strength of data supporting many uses is limited by small sample sizes and lack of controls.

CONCLUSION
Although polidocanol is currently only FDA approved for incompetent great saphenous veins, accessory saphenous veins, and visible varicosities of the great saphenous vein system, the use of polidocanol has been selected for a variety of off-label clinical applications.
National Trends in Venous Thromboembolism in the Adult Craniofacial Trauma Population
Authors: Lewin Grant M. , Gelfond Allison L. , Crumm Erin G. , Patel Parit A. 
Published: June 2022

Background:
Venous thromboembolism (VTE), specifically deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major complication in plastic surgery; however, there is a paucity of evidence about the incidence of VTE in the craniofacial subpopulation. We investigated the incidence and risk factors for VTE in the adult craniofacial trauma population.

Methods:
This retrospective review identified patients from the 2016 and 2017 Healthcare Cost and Utilization Project's National Inpatient Sample with a diagnosis for an initial encounter of a facial fracture. International Classification of Disease codes identified patients with DVT or PE. Groups were identified: adult craniofacial patients with and without a VTE diagnosis. The groups were analyzed to determine risk factors for developing a VTE during inpatient admissions.

Results:
A total of 203,240 patients were identified based on a diagnosis for an initial encounter of a facial fracture. Among those, 3350 (1.65%) were diagnosed with a DVT and 1455 (0.72%) with a PE. Risk factors for VTE were male sex (P = 0.011), longer hospital stay (P = 0.000), and higher Elixhauser comorbidity index (P = 0.000). Additionally, PE was an independent predictor of mortality [odds ratio (OR), 2.129] but DVT was not (OR, 1.148). Cranial and frontal fractures were independently associated with an increase in DVT (OR, 2.481) and PE (OR, 1.489).

Conclusions:
This study demonstrates that craniofacial trauma patients are at risk for VTE and should be risk-stratified for chemoprophylaxis therapy. Further studies in thromboembolism prophylaxis for facial fractures are warranted as the data are limited.
Implementation of SEEK in a Children’s Advocacy Center: A Process Improvement Initiative
Authors: Letson Megan M. , Brink Farah W. , Daniels Alicia , Thompson Sandra , Wolf Kathryn G. , Michaels Nichole L. 
Published: June 2022

Introduction:
Risk factors for child maltreatment are well-described, but clinicians may overlook these risk factors. The Safe Environment for Every Kid (SEEK) model is an evidence-based approach to identifying psychosocial risk factors for child maltreatment. This article describes a quality improvement initiative to implement the SEEK model in a unique pediatric setting, a Children’s Advocacy Center.

Methods:
The objectives were to (1) describe the identification of psychosocial risk factors for child maltreatment by implementing the SEEK screening tool with each new family, (2) achieve and sustain a SEEK completion rate of greater than 85%, and (3) achieve and sustain a SEEK follow-up compliance rate of greater than 75%. Structured quality improvement methods, including several plan-do-study-act cycles, were used to implement interventions.

Results:
The percentage of caregivers who completed the SEEK questionnaire increased from a baseline of 76% to 86%, which was sustained for more than 2 years, resulting in a better understanding and support of families’ needs. Caregivers completed 3,606 SEEK Parent Questionnaire-R. Mental health concerns and food insecurity were among the most commonly endorsed items. Follow-up compliance increased from 47% to 90%, a level that has been maintained.

Conclusions:
While Children’s Advocacy Centers evaluate children with suspected abuse, identifying current stressors in the home and linking families with resources to address their immediate psychosocial concerns can improve short- and long-term outcomes. This initiative demonstrates the feasibility of incorporating consistent screening for psychosocial risk factors for child maltreatment in this busy environment.
Sustaining Improvements in CLABSI Reduction in a Pediatric Cardiac Intensive Care Unit
Authors: Gauntt Jennifer , Brandt Sarah , Dolan Kevin , Manley Jaime , Tyner Roxann , Beauseau Wendi , Simsic Janet M. 
Published: June 2022

Introduction:
Central line-associated bloodstream infections (CLABSIs) are preventable events that increase morbidity and mortality. The objective of this quality project was to reduce the incidence of CLABSIs in a pediatric cardiothoracic intensive care unit.

Methods:
Institutional review of an unacceptably high rate of CLABSIs led to the implementation of 4 new interventions. These interventions included: the use of sequential cleaning between line accesses, Kamishibai card audits, central line utilization and entry audits, and proctored simulation of line access.

Results:
There was a reduction in CLABSI rate from 1.52 per 1,000 central line days in 2018 to 0.37 per 1,000 central line days in 2020 and 0.32 in 2021. Additionally, central line days per 100 patient days decreased from 77 to 70 days over the study period. The cardiothoracic intensive care unit went 389 days without a CLABSI from October 2020 to November 2021.

Conclusions:
Implementation of multiple interventions led to a successful reduction in the incidence of CLABSIs in our unit, with a sustained reduction over 1 year.
Comparison of Liposomal Bupivacaine to a Local Analgesic Cocktail for Transversus Abdominis Plane Blocks in Abdominally Based Microvascular Breast Reconstruction
Authors: Lombana Nicholas F. , Falola Reuben A. , Zolfaghari Kiumars , Roth Clark , Abraham Jasson T. , Saint-Cyr Michel H. 
Published: June 2022

Background:
Transversus abdominis plane blocks can improve pain control and decrease opioid use within an enhanced recovery after surgery (ERAS) protocol in patients undergoing abdominally based autologous breast reconstruction. The authors have transitioned to using a local analgesic cocktail for transversus abdominis plane blocks. The purpose of this study was to compare postoperative opioid use in patients who received the blocks.

Methods:
Patients who underwent abdominally based autologous breast reconstruction between November of 2015 and December of 2019 were retrospectively reviewed. The study group received bupivacaine, ketorolac, dexmedetomidine, and dexamethasone; the control group received liposomal bupivacaine with or without bupivacaine, ketorolac, or dexmedetomidine, as a transversus abdominis plane block. The primary outcome of interest was postoperative opioid use and pain scores.

Results:
One hundred four women met inclusion criteria: 36 in group A (before ERAS, before transversus abdominis plane block), 38 in group B (ERAS, transversus abdominis plane block with liposomal bupivacaine), and 30 in group C (ERAS, transversus abdominis plane block with local anesthetic cocktail). Total daily oral morphine equivalent consumption (group A, 633; group B, 240; group C, 135; p < 0.0001) and average daily oral morphine equivalent consumption (group A, 137; group B, 56; group C, 29; p < 0.0001) were significantly less for group C in the inpatient phase. Patients in group C were prescribed significantly fewer outpatient oral morphine equivalents (group A, 79; group B, 74; group C, 52; p = 0.01).

Conclusions:
Transversus abdominis plane blocks are a significant component of an ERAS protocol for abdominally based breast reconstruction. Liposomal bupivacaine is a popular option for transversus abdominis plane blocks. The authors’ results demonstrate that a local anesthetic cocktail, composed of economical and readily available medications, can provide excellent patient pain control and decrease postoperative opioid use.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Current Practices in the Pathologic Assessment of Breast Tissue in Transmasculine Chest Surgery
Authors: Goodwin Isak A. , Luo Jessica , Magno-Pardon David A. , Veith Jacob , Willcockson James , Carter Gentry , Matsen Cindy , Kwok Alvin C. , Agarwal Cori A. 
Published: June 2022

Background:
No guidelines exist regarding management of breast tissue for transmasculine and gender-nonconforming individuals. This study aims to investigate the experiences and practices regarding perioperative breast cancer risk management among the American Society of Plastic Surgeons members performing chest masculinization surgery.

Methods:
An anonymous, online, 19-question survey was sent to 2517 U.S.-based American Society of Plastic Surgeons members in October of 2019.

Results:
A total of 69 responses were analyzed. High-volume surgeons were more likely from academic centers (OR, 4.88; 95 percent CI, 1.67 to 15.22; p = 0.005). Age older than 40 years [n = 59 (85.5 percent)] and family history of breast cancer in first-degree relatives [n = 47 (68.1 percent)] or family with a diagnosis before age 40 [n = 49 (71.0 percent)] were the most common indications for preoperative imaging. Nineteen of the respondents (27.5 percent) routinely excise all macroscopic breast tissue, with 21 (30.4 percent) routinely leaving breast tissue. Fifty-one respondents (73.9 percent) routinely send specimens for pathologic analysis. There was no significant correlation between surgical volume or type of practice and odds of sending specimens for pathologic analysis. High patient costs and patient reluctance [n = 27 (39.1 percent) and n = 24 (35.3 percent), respectively] were the most often cited barriers for sending specimens for pathologic analysis. Six respondents (8.7 percent) have found malignant or premalignant lesions in masculinizing breast specimens.

Conclusions:
Large variation was found among surgeons’ perioperative management of chest masculinizing surgery patients regarding preoperative cancer screening, pathologic assessment of resected tissue, and postoperative cancer surveillance. Standardization of care and further studies are needed to document risk, incidence, and prevalence of breast cancer in the transmasculine population before and after surgery.
Best Practices for BREAST-Q Research: A Systematic Review of Study Methodology
Authors: Gallo Lucas , Chu Jacqueline J. , Shamsunder Meghana G. , Hatchell Alexandra , Patel Aadit R. , Godwin Kendra , Hernandez Marisol , Pusic Andrea L. , Nelson Jonas A. , Voineskos Sophocles H. 
Published: June 2022

Background:
Data heterogeneity and methodologic errors hinder the ability to draw clinically meaningful conclusions from studies using the BREAST-Q Reconstruction Module patient-reported outcome measure. In this systematic review, the authors evaluate the quality of BREAST-Q Reconstruction Module administration in relation to the BREAST-Q version 2.0 user’s guide and the reporting of key methodology characteristics. The authors also describe a framework for improving the quality of BREAST-Q data analysis and reporting.

Methods:
The authors conducted a systematic search of PubMed, Embase, Cochrane CENTRAL, and Ovid HAPI databases to identify articles on the BREAST-Q Reconstruction Module to assess postmastectomy breast reconstruction outcomes. The authors registered the protocol before study implementation on Open Science Framework (https://osf.io/c5236) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data on mode of BREAST-Q administration, time horizon justification, and sample size calculation were collected.

Results:
The authors included 185 studies in the analysis. Errors in BREAST-Q administration were identified in 36 studies (19.5 percent). Appropriate administration of the BREAST-Q could not be determined in 63 studies (34.1 percent) because of insufficient reporting. Time horizon for the primary outcome was reported in 71 studies (38.4 percent), with only 17 (9.2 percent) reporting a sample size calculation.

Conclusions:
The authors identified important yet actionable shortcomings in the BREAST-Q literature. Researchers are encouraged to review the BREAST-Q user’s guide in the study design phase to mitigate errors in patient-reported outcome measure administration and reporting for future trials using the BREAST-Q Reconstruction Module. Adhering to these guidelines will allow for greater clinical utility and generalizability of BREAST-Q research.
Asymptomatic Fellow Eye Involvement in Nonarteritic Anterior Ischemic Optic Neuropathy
Authors: Brossard Barbosa Natalie , Donaldson Laura , Margolin Edward 
Published: June 2022

Background:
Sequential nonarteritic anterior ischemic optic neuropathy (NAION) has been reported to occur in approximately 15% of patients within 5 years of the first episode. However, the incidence of presumed previous asymptomatic episode of NAION in fellow eye of patients presenting with acute NAION has not been previously reported. We reviewed charts of patients with acute NAION seen over a 5-year period to determine the frequency of visual field (VF) defect in the fellow eye secondary to presumed previous asymptomatic episode of NAION.

Methods:
Retrospective chart review of all patients presenting to single, tertiary university-affiliated neuro-ophthalmology practice from January 2016 to September 2021 with diagnosis of acute NAION. Patients were determined to have had a presumed previous episode of asymptomatic NAION in the fellow eye if VF defect and corresponding optic nerve head pallor as well as thinning on peripapillary ocular coherence tomography (OCT) and ganglion cell analysis of macular complex were present and alternate causes of VF were excluded.

Results:
One hundred ninety-two patients with the diagnosis of acute NAION were identified. One hundred thirty-nine had reliable VFs and were included in this study. VF defects in the fellow eye were present in 63 patients (45.4%). Of these, 54 (39%) were determined to represent previous NAION. In 14 of 139 patients (10%), a presumed episode of previous NAION in the fellow eye was asymptomatic. The most prevalent defect in asymptomatic eye was inferior altitudinal defect sparing fixation (7 of 14, 50%). The presence of obstructive sleep apnea, hypertension, diabetes, age, or sex was not predictive of previous episode of asymptomatic NAION.

Conclusion:
Unrecognized presumed previous episode of NAION occurred in a significant proportion of patients with acute NAION (14 of 139, 10.1%). In 100% of cases, the VF defect in the asymptomatic fellow eye was in a hemifield where there was a new loss in the symptomatic eye.
The Role of Tocilizumab in Glucocorticoid Resistant Giant Cell Arteritis: A Case Series and Literature Review
Authors: Stretton Brandon , Tan Yiran , Hassall Mark , Simon Sumu 
Published: June 2022

Background:
Glucocorticoid-resistant giant cell arteritis (GCA) describes a subgroup of patients whose visual acuity further declines despite immediate administration of high-dose intravenous glucocorticoids. Tocilizumab, a recombinant humanized anti-interleukin-6 receptor monoclonal antibody may be used as “rescue” therapy in these cases but requires more research.

Methods:
We present a literature review on tocilizumab as rescue therapy and a retrospective case series of 5 consecutive glucocorticoid (GC) resistant, temporal artery biopsy (TAB) negative patients.

Results:
The use of tocilizumab as rescue therapy for GC-resistant GCA is limited to 3 case reports. Two cases saw visual acuity improvement in the newly affected contralateral eye after 8 mg/kg of intravenous tocilizumab (from 6/60 to 6/15 in one case and hand motion to 6/6 in another). The third described stabilization and prevention of further best-corrected visual acuity (BCVA) decline. All 5 of our patients presented with acute monocular vision loss. BCVA ranged from 6/12 to light perception (LP). All patients were promptly commenced on 1 g intravenous methylprednisolone daily. Weekly 162 mg of subcutaneous tocilizumab was commenced once contralateral eye involvement was noted. Tocilizumab resulted in bilateral BCVA gains in 2 cases, recovery of the contralateral eye in one, and no effect in the remaining 2 cases. BCVA recovery was no light perception to 6/6 after 6 weeks of tocilizumab. Tocilizumab had no effect in cases with severe vision loss and high C-reactive protein on presentation.

Conclusions:
We agree with existing hypothesis that tocilizumab likely prevents a “pending” central retinal artery occlusion by maintaining retinal vasculature perfusion. Our case series suggests that there is a role for tocilizumab as “rescue” therapy for GC-resistant GCA, where vision loss would otherwise be imminent.
Ultrarapid Targeted Nanopore Sequencing for Fusion Detection of Leukemias
Authors: Yeung Cecilia CS , Sala-Torra Olga , Reddy Shishir , Hung Ling-Hong , Radich Jerry , Yeung Ka Yee 
Published: June 2022

AbstractAcute leukemia (AL), a cancer of the blood, has continued high mortality rates despite a plethora of available treatments. Variable prognosis, treatment response and survival are largely based on distinct cytogenetic and molecular aberrations that characterize AL subtypes. Fast and cost-effective methods of detecting AL fusions and mutations are needed to improve clinical outcomes for patients. We report preliminary data on an ultrarapid and portable nanopore long-read sequencing assay with a same-day turnaround time of ~6-7 hours for identifying key leukemic fusions. Leukemias frequently present with recurrent fusions that impact risk stratification and therapy choice, our assay can help oncologists overcome time related challenges to get patients on treatments faster.
Lateralization of orthographic processing in fixed-gaze and natural reading conditions
Authors: Nárai Ádám , Nemecz Zsuzsanna , Vidnyánszky Zoltán , Weiss Béla 
Published: June 2022

AbstractLateralized processing of orthographic information is a hallmark of proficient reading. However, how this finding obtained for fixed-gaze processing of orthographic stimuli translates to ecologically valid reading conditions remained to be clarified. To address this shortcoming, here we assessed the lateralization of early orthographic processing in fixed-gaze and natural reading conditions using concomitant eye-tracking and EEG data recorded from young adults without reading difficulties. Sensor-space analyses confirmed the well-known left-lateralized negative-going deflection of fixed-gaze EEG activity throughout the period of early orthographic processing. At the same time, fixation-related EEG activity exhibited left-lateralized followed by right-lateralized processing of text stimuli during natural reading. A strong positive relationship was found between the early leftward lateralization in fixed-gaze and natural reading conditions. Using source-space analyses, early left-lateralized brain activity was obtained in lateraloccipital and posterior ventral occipito-temporal cortices reflecting letter-level processing in both conditions. In addition, in the same time interval, left-lateralized source activity was found also in premotor and parietal brain regions during natural reading. While brain activity remained left-lateralized in later stages representing word-level processing in posterior and middle ventral temporal regions in the fixed-gaze condition, fixation-related source activity became stronger in the right hemisphere in medial and more anterior ventral temporal brain regions indicating higher-level processing of orthographic information. Although our results show a strong positive relationship between the lateralization of letter-level processing in the two conditions and suggest lateralized brain activity as a general marker for processing of orthographic information, they also clearly indicate the need for reading research in ecologically valid conditions to identify the neural basis of visuospatial attentional, oculomotor and higher-level processes specific for natural reading.
Copresent microbiome and short-chain fatty acids profiles of plant biomass utilization in rumen simulation technique system
Authors: Shi Tao , Zhang Tingting , Wang Xihong , Wang Xiangnan , Shen Weijun , Guo Xi , Liu Yuqin , Li Zongjun , Jiang Yu 
Published: June 2022

AbstractRumen contents have considerable utility in converting plant biomass to short- chain fatty acids (SCFAs) when used as inoculum for in vitro fermentation. To better understand the microbial communities and their functions when in vitro ruminal fermentation, the microbiome and SCFAs production were investigated using rumen simulation technique (RUSITEC) system which was inoculated/co- inoculated with rumen contents from goat and cow. This study reconstructed 1677 microbial metagenome-assembled genomes (MAGs) from metagenomic sequencing. The copresent microbiome containing 298 MAGs were found in metagenomic data of these contents and previous ruminal representative samples. These copresent MAGs were overrepresented in decomposing various substrates, especially pectin and xylan. Additionally, the SCFAs productions in RUSITEC were linked with copresent MAGs. Copresent MAGs obtained from this study shows promise to point out the direction for further research on in vitro ruminal fermentation, and enables a better understanding of rumen microbiotal structures and functions under in vitro condition.Graphical Abstract