bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Intervention is Associated With Improvements in the ASIA Impairment Scale in Gunshot-induced Spinal Injuries of the Thoracic and Lumbar Spine
Authors: Goh Brian C. , Striano Brendan M. , Crawford Alexander M. , Tobert Daniel G. , Fogel Harold A. , Cha Thomas D. , Schwab Joseph H. , Bono Christopher M. , Hershman Stuart H. 
Published: March 2022

Study Design:
Retrospective cohort study of patients from the National Spinal Cord Injury Statistical Center (NSCISC).

Objective:
The aim was to compare the outcomes of patients with gunshot-induced spinal injuries (GSIs) treated operatively and nonoperatively.

Summary of Background Data:
The treatment of neurological deficits associated with gunshot wounds to the spine has been controversial. Treatment has varied widely, ranging from nonoperative to aggressive surgery.

Methods:
Patient demographics, clinical information, and outcomes were extracted. Surgical intervention was defined as a “laminectomy, neural canal restoration, open reduction, spinal fusion, or internal fixation of the spine.” The primary outcome was the American Spinal Injury Association (ASIA) Impairment Scale. Statistical comparisons of baseline demographics and neurological outcomes between operative and nonoperative cohorts were performed.

Results:
In total, 961 patients with GSI and at least 1-year follow-up were identified from 1975 to 2015. The majority of patients were Black/African American (55.6%), male (89.7%), and 15–29 years old (73.8%). Of those treated surgically (19.7% of all patients), 34.2% had improvement in their ASIA Impairment Scale score at 1 year, compared with 20.6% treated nonoperatively. Overall, surgery was associated with a 2.0 [95% confidence interval (CI): 1.4–2.8] times greater likelihood of ASIA Impairment Scale improvement at 1 year. Specifically, benefit was seen in thoracic (odds ratio: 2.5; 95% CI: 1.4–4.6) and lumbar injuries (odds ratio: 1.7; 95% CI: 1.1–3.1), but not cervical injuries.

Conclusions:
While surgical indications are always determined on an individualized basis, in our review of GSIs, surgical intervention was associated with a greater likelihood of neurological recovery. Specifically, patients with thoracic and lumbar GSIs had a 2.5 and 1.7-times greater likelihood of improvement in their ASIA Impairment Scale score 1 year after injury, respectively, if they underwent surgical intervention.
Mapping Injury Prevention With Microsoft Excel
Authors: Sharrah Mark L. , Bechtel Kaitlin E. 
Published: March 2022

BACKGROUND:
Level I trauma centers must conduct injury prevention activities within their communities, despite limited resources available to them. To direct resources where they are most needed, injury prevention personnel at our trauma center use a novel method employing standard computer software. Although this method can be applied toward any injury population and prevention program, the example of targeting elderly falls prevention with A Matter of Balance classes is provided.

OBJECTIVE:
To share an innovative, yet efficient, technique to direct injury prevention efforts using Microsoft Excel map charts.

METHODS:
Using fictitious trauma registry data, an elderly falls rate is computed for each zip code. The top falls areas are then compared visually with areas where A Matter of Balance classes were conducted using Microsoft Excel map charts.

RESULTS:
Disparate areas of outreach, as well as areas where resources are inefficiently utilized, present in a manner that is easily recognized and communicated.

CONCLUSION:
Microsoft Excel map charts provide an effective and efficient means of displaying areas of greatest need, assessing disparities between those needs and outreach efforts that were conducted, and communicating with leadership.
Multiregion Trauma Center Follow-Up Protocol for Transferred Trauma Patients
Authors: Moran Mary E. , Moore Deanah , Krizo Jessica , Keefe Judy , Houck Olivia C , Rossler Danielle N. , George Richard L. 
Published: March 2022

BACKGROUND:
Trauma centers routinely utilize the Injury Severity Score for performance improvement. Yet, transferring facilities do not always have access to patients' final Injury Severity Score.

OBJECTIVE:
The purpose of this project was to develop and implement a multiregion Injury Severity Score follow-up feedback protocol for transferring facilities to receive standardized information on patient treatment and the ability to calculate an accurate follow-up Injury Severity Score of transferred patients.

METHODS:
This project included 25 Adult and Pediatric Level I, II, and III trauma centers within three regional trauma systems in a Midwestern state. This project included trauma centers that used one of the two different trauma registry software systems as a solution to develop and implement a protocol for follow-up feedback for transferred trauma patients. A template was created to capture data posttransfer to calculate a final Injury Severity Score.

RESULTS:
The feedback protocol was well received by participating regions. Implementation revealed the impact of variable trauma registry software on the ability to create multi-institution feedback programs.

CONCLUSION:
Trauma systems can implement similar strategies to ensure transferring trauma centers routinely receive standardized, timely patient feedback.
Cannabidiol for the Management of Endometriosis and Chronic Pelvic Pain
Authors: Mistry Megha , Simpson Paul , Morris Edward , Fritz Ann-Katrin , Karavadra Babu , Lennox Carole , Prosser-Snelling Ed 
Published: March 2022

(Abstracted from J Minim Invasive Gynecol 2022;29:169–176)
Current treatments for women with endometriosis are largely ineffective for management of pain and other symptoms. In addition, they often affect fertility and can have undesirable adverse effects that impede the long-term management of the condition.
Anterior Neck Resurfacing Using Multiple Free Flaps in Patients With Burn Sequelae of the Anterior Neck and Chest
Authors: Angrigiani Claudio , Neligan Peter C. , Artero Guillermo , Thrikutam Nikhitha P. 
Published: March 2022

Background
It has been established that patients with burn sequelae of the anterior neck and chest have a significant degree of flap descent and deficit in neck extension when resurfaced with a single free flap. A protocol was developed to avoid flap descent in these patients by resurfacing the neck with multiple free flaps. The purpose of this article is to present our protocol for treatment and long-term results of this technique.

Methods
Twenty-five 25 patients with burn sequelae of the anterior neck and anterior thorax were retrospectively identified. Ten patients were treated with a single free flap (group 1), and 15 patients were treated with multiple free flaps (group 2). Patients were followed up for an average of 7 years after their definitive reconstructive procedure at which time measurements including flap descent from sternal notch, deficit of neck extension, and subjective reports of discomfort were obtained.

Results
Patients in group 1 demonstrated 8 cm (interquartile range [IQR], 1.75 cm) of flap descent, whereas patients in group 2 demonstrated 0.5 cm (IQR, 0 cm) of flap descent. Patients in group 1 demonstrated 12.5 degrees (IQR, 10 degrees) of deficit in neck extension, whereas patients in group 2 demonstrated 0 degrees (IQR, 0 degrees) of deficit in neck extension. Analysis demonstrated significantly greater descent and deficit in neck extension in group 1 compared with group 2.

Conclusions
Patients with burn sequelae of the neck and anterior chest experience less flap descent and deficits in neck extension when resurfaced with multiple free flaps.
Innervated Reconstruction of Fingertip Degloving Injury Using a Dorsal Digital Perforator Flap Combined With a Cross-Finger Flap
Authors: Wang Tongfu , Wang Li , Wang Hui , Zhang Wenlong , Yu Zhiliang , Zhang Jingyu 
Published: March 2022

Background
The reconstruction of a fingertip degloving injury presents a functional and aesthetic challenge. We used a dorsal digital perforator flap combined with a cross-finger flap to reconstruct this type of injury. The purposes of this retrospective study were to evaluate the efficacy of the combined flaps and to present our clinical experience.

Methods
From November 2016 to October 2019, 16 patients (13 men and 3 women) with fingertip degloving injuries were treated with a dorsal digital perforator flap combined with a cross-finger flap for innervated reconstruction. We used an innervated dorsal digital perforator flap for the reconstruction of the dorsal defect of the degloved fingertip and an innervated cross-finger flap for the volar defect. The average size of the defect was 4.2 × 1.9 cm. The average sizes of the flaps were 2.3 × 2.1 cm (the dorsal digital perforator flap) and 2.5 × 2.1 cm (the cross-finger flap).

Results
All flaps and skin grafts survived completely without ischemia or venous congestion. All wounds and their donor sites healed primarily without exudation and infection. Patients were followed up for a mean time of 11.3 ± 1.9 months (range, 9–15 months). At the final follow-up, no significant difference was seen in the averaged total active motion between the injured fingers and the contralateral fingers. No significant difference was found in the averaged total active motion between the donor fingers and the contralateral fingers. All flaps obtained excellent or good sensory performance. All flaps had mild cold intolerance. Thirteen patients had no pain, 2 reported mild pain, and 1 experienced moderate pain. Ten patients were very satisfied with the appearance of the reconstructed finger.

Conclusions
The dorsal digital perforator flap combined with a cross-finger flap is an effective and reliable method for the reconstruction of fingertip degloving injuries.
Impact of Socioeconomic Status on Breast Reconstruction Outcomes
Authors: Martin Morgan S. , Kebede Sara , Saad Omar A. , Baker Nusaiba F. , Losken Albert 
Published: March 2022

Background
Minority patients and those from low socioeconomic backgrounds are faced with barriers to care regarding breast reconstruction. With this study, we seek to elucidate variances in demographics to determine predictors of complications in implant-based breast reconstruction.

Methods
Patients who underwent breast reconstruction with either direct to implant or immediate expander reconstruction by 1 surgeon were identified using the preoperative Breast-Q.
Current income statistics available from the US Census Bureau by self-reported zip code were used to determine the median household income (MHI) to stratify differing socioeconomic backgrounds. Demographics were compared with body mass index, comorbidities, overall rate of postoperative complications, rate of implant infection, and type of reconstruction.

Results
Two hundred ninety-five patients met inclusion criteria. Overall rate of complications and rate of breast implant infection was higher for MHI of less than $50,000 compared with greater than $50,000 (P = 0.043 overall complications 40.20% vs 28.8%) (P = 0.04 implant infection 14.4% vs 7.1%). African American patients had higher body mass index (P = <0.001), rates of HTN (P = <0.001), and diabetes (P = 0.001), and were more likely to have a lower income (P = <0.001). There was, however, no difference in overall complications (P = 0.26), implant infection rate (P = 0.994), or capsular contracture (0.367) based on race. There was no difference in rate of comorbidities between low and high socioeconomic areas.

Conclusion
This cohort demonstrates a higher rate of overall complications and infection in patients with a lower MHI and no difference based on race despite having higher risk factors for complications.
Socioeconomic status is a multifaceted barrier to care that must be addressed in the perioperative period to decrease breast implant associated complications.
Reconstructive Trends After Tissue-Expander Loss in Breast Reconstruction
Authors: Ghosh Kanad , Marquez Jocellie , Niu Ellen , Rogoff Hunter , Monroig Kaitlin , Marmor William , Kianian Sara , Bui Duc T. , Huston Tara L. 
Published: March 2022

Purpose
Tissue-expander breast reconstruction (TEBR) is a common method of reconstruction after mastectomy but may result in complications that may necessitate removal. Although complications in TEBR have been well studied, there is a paucity of data regarding outcomes after tissue-expander loss. In this study, we examine the eventual reconstructive pathways and associated factors of patients who required tissue-expander removal after infection.

Methods
This retrospective study examines patients undergoing breast reconstruction at a single institution. Patients included underwent mastectomy, immediate TEBR, and subsequent tissue-expander loss. Patients who underwent autologous reconstruction after mastectomy or had successful TEBR were excluded. Patients were followed for an average of 7 years, with a minimum of 2 years and a maximum of 13 years.

Results
A total of 674 TEBR patients were initially screened, of which 60 patients (8.9%) required tissue-expander removal because of infection or skin necrosis. Thirty-one of these patients (group 1) did not complete reconstruction after initial tissue-expander loss, whereas the remaining 29 patients (group 2) underwent either TEBR or autologous reconstruction after tissue-expander loss. Group 1 had a significantly higher mean body mass index than group 2 (32.61 ± 8.88 vs 28.69 ± 5.84; P = 0.049) and also lived further away from our institution than group 2 (P = 0.052), which trended toward significance. There were otherwise no significant differences in demographics between the 2 groups.
Among the 29 patients in group 2, 18 patients underwent a second TEBR (group 2a), and 11 patients underwent autologous reconstruction (group 2b). Patients in group 2b had a significantly greater mean number of complication related admissions (1.11 ± 0.323 vs 1.55 ± 0.688; P = 0.029) and also had higher occurrence of postmastectomy radiation therapy (16.7% vs 45.5%; P = 0.092), although this was not significant. There were otherwise no differences between the 2 groups.

Conclusion
Our data demonstrate the trends in breast reconstruction decision making after initial tissue-expander loss. This study elucidates the factors associated with patients who undergo different reconstructive options. Further work is needed to delineate the specific reasons between the decision to pursue different reconstructive pathways among a larger cohort of patients.
Long Term Incidence and Outcomes of Sinonasal and Otologic Disease in Patients With Pyriform Aperture Stenosis and Choanal Atresia
Authors: Godse Neal R. , Lu Nathan , Shaffer Amber D. , Stapleton Amanda L. 
Published: March 2022

Abstract:
Pyriform aperture stenosis (PAS) and choanal atresia (CA) are 2 anatomic causes of newborn nasal obstruction. The goal of management of PAS and CA is to establish a patent nasal airway, often requiring surgery. No previous study has sought to assess the long term sinonasal and otologic disease incidence and outcomes in the PAS and CA population after surgical intervention. The goal of this study was to investigate whether surgical intervention in PAS and CA is correlated with the long-term development of sinonasal disease or otologic disease (either recurrent acute otitis media or chronic otitis media with effusion). Patients with a diagnosis of PAS or CA who underwent surgical intervention were retrospectively identified. Pertinent demographic risk factors, medical and syndromic diagnoses, number of surgical interventions, types of surgical interventions, and presence of sinonasal and otologic diseases were assessed. Fifty-three patients were included in the study: 8 patients with PAS and 45 with CA. The average follow-up time was 2.9 years. No PAS patients developed otologic or sino-nasal disease. Four of 45 patients with CA developed recurrent acute sinusitis (3 non-syndromic and 1 syndromic) and 19 of 45 patients developed otologic disease (9 non-syndromic and 10 syndromic). Coloboma, Heart, Choanal Atresia, Growth Retardation, Genitourinary, Ear Syndrome and unilateral CA correlated significantly with the subsequent development of otologic disease; however, the number of surgeries did not. This study suggests that surgery for PAS and CA do not increase the risk of long-term development of sinonasal or otologic disease.
Accuracy and Security Analysis of a Cranio-Maxillofacial Plastic Surgery Robot Equipped With Piezosurgery in Genioplasty
Authors: Sun Tiecheng , Lei Bowen , Zhong Yehong , Chen Zhewei , Yang Bin 
Published: March 2022

Abstract:
This study aims to verify that the craniofacial plastic surgery robot with piezosurgery is more accurate and safer than traditional operations in genioplasty. This study chose data from the Digital Plastic Surgery of Plastic Surgery Hospital in the Chinese Academy of Medical Sciences and Peking Union Medical College. The CT data of the patient’s skull were reconstructed in the software, and the authors designed the measurement index. The surgical plan was designed as an ideal scheme (control group). Patients underwent traditional surgery according to the preoperative surgery plan (clinical group). Guided by surgical navigation, the osteotomy was operated on patients' same size plaster model using the surgery robot equipped with a piezosurgery (robot group). At last, the accuracy was calculated by CT data. There was no significant difference between the robotic group and control groups in the postoperative measurement index (P < 0.05). There was no significant difference between the robotic group and the control group (P > 0.05) in the line of osteotomy, but there was a significant difference between the clinical group and the control group in the line of the osteotomy.
Geographic Financial Analysis of Craniosynostosis Surgery in the United States
Authors: Kalmar Christopher L. , Zapatero Zachary D. , Kosyk Mychajlo S. , Bartlett Scott P. , Taylor Jesse A. 
Published: March 2022

Background:
The purpose of this study was to investigate the financial implications of demographic and socioeconomic factors upon the cost of surgical procedures for craniosynostosis.

Methods:
A retrospective cohort study was conducted of admissions for craniosynostosis surgery in the United States from 2015 through 2020 using the Pediatric Health Information System. Patient demographics, case volume, and surgical approach were analyzed in context of hospital charges.

Results:
During the study interval, 3869 patients were admitted for surgery for craniosynostosis. In multivariate regression accounting for demographic and socioeconomic factors, hospital admission charges were significantly higher in patients with longer hospital length of stay (P < 0.001), longer ICU length of stay (P < 0.001), living in an underserved area (P = 0.046), preoperative risk factors (P = 0.016), and those undergoing open procedures (P < 0.001); hospital admission charges were significantly lower in patients with White race (P = 0.020) and those treated at high-volume centers (P < 0.001). In multivariate regression, ICU length of stay was significantly higher in patients with preoperative risk factors (P < 0.001), undergoing open procedures (P < 0.001), government insurance (P = 0.018), and not treated at high-volume centers (P = 0.005). There were significant differences in admission charges (P < 0.001), charge-to-cost ratios (P < 0.001), and likelihood of being treated at high-volume craniofacial centers (P < 0.001) across geographic regions of the country.

Conclusions:
In the United States, there is significant sociodemographic variability in charges for craniosynostosis care, with increased hospital charges independently associated with non-White race, preoperative risk factors, and living in an underserved area.
Prevalence and Risk Factors for Chronic Maxillary Sinusitis After Surgery for Mid-Facial Fracture: A Cross-Sectional Study
Authors: Jiang Linli , Wu Mengsong , Li Hui , Liang Jiayu , Chen Jinlong , Liu Lei 
Published: March 2022

Abstract:
Posttraumatic chronic maxillary sinusitis deleteriously affects the life quality of patients with recurrent episodes and related discomfort. However, few studies have been performed to investigate the prevalence of chronic maxillary sinusitis after surgery of mid-facial fracture and related risk factors. The early prevention and cure of posttraumatic chronic maxillary sinusitis have received little attention. This study aimed to investigate the prevalence of chronic maxillary sinusitis after surgery for mid-facial fracture and to identify related risk factors. The authors retrospectively collected the medical history, radiographic examination, and clinical examination of patients with mid-facial fracture (experimental group) and patients with mandibular cyst (control group) in our department between January 2015 and December 2020. A total of 298 patients (416 maxillary sinuses) in the experimental group and 172 patients (344 maxillary sinuses) in the control group were included for analyses. The prevalence of chronic maxillary sinusitis in the experimental group and control group were, respectively, 9.14% and 2.04% (P < 0.05). History of sinusitis/rhinitis (odds ratio = 63.70, P = 0.000) was an independent risk factor for posttraumatic chronic maxillary sinusitis. In conclusion, these findings showed that the prevalence of chronic maxillary sinusitis after surgery for midfacial fracture was significantly higher than that in the control group and long-term follow-up may be beneficial for these patients. Moreover, patients with a history of sinusitis/rhinitis should be informed of the increased risk.
Technical Strategies for Custom–Made Surgical Guide in Removal of Impacted Supernumerary Mandibular Premolars
Authors: Zheng Xianghuai , Lin Xi , Zhang Zhaoqiang 
Published: March 2022

Abstract:
The aim of this study is to evaluate the technique of surgical guide in the extraction of impacted supernumerary mandibular premolars. This case series included 5 patients. Impacted supernumerary mandibular premolars were removed through a lateral window approach using the surgical guides. The mental nerve and adjacent teeth were properly protected by our custom made surgical guides. All cases successfully underwent the operation. An average of 5.01 ± 1.10 min was required to locate the supernumerary mandibular premolar. There were no complications involving injury to the mental nerve injury or adjacent teeth in any case. The application of custom–made surgical guides in the extraction of impacted supernumerary mandibular premolars showed an acceptable clinical outcome in this case series.