Reconstruction of Orbital Wall Fractures with a Combination of Resorbable Plates and Antibiotic-Impregnated Collagen Sheets.

(1) Background: Orbital wall fractures are common in maxillofacial trauma, and artificial implants are often used for reconstruction. However, there has always been concern about infection because implants are directly exposed to the airway. This study was conducted to determine the effectiveness of a combination of resorbable plates and antibiotic-impregnated collagen sheets in reconstructions of orbital fractures and to determine whether it had an effect in reducing postoperative antibiotic use. (2) Methods: The retrospective study was conducted on 195 patients who underwent orbital wall reconstruction from March 2019 to August 2022. The 176 patients in the control group underwent reconstruction using only resorbable plates and were administered postoperative antibiotics for 5 to 7 days. On the other hand, the 19 patients in the experimental group underwent reconstruction using a combination of resorbable plates and antibiotic-impregnated collagen sheets and only received antibiotics once before surgery. The occurrence of ocular complications, the length of hospitalization, the infection incidence rate, and the adverse effects of antibiotics were investigated. (3) Results: significant ocular complications were observed in the experimental group during a follow-up period of more than 1 year. Regarding postoperative infections, there were two cases of infection in the control group (infection rate: 1.14%), while no infection was found in the experimental group. The hospitalization period of the experimental group was significantly shorter than that of the control group (p < 0.01), and the incidence of total adverse effects of antibiotics, especially nausea, was lower in the experimental group (p = 0.02). (4) Conclusions: The combined use of resorbable plates and antibiotic-impregnated collagen sheets allows effective orbital wall reconstruction without infection, with a shorter hospital stay, and with fewer antibiotic adverse effects.

Volume changes in the reconstructed breast over two years after free abdominal tissue transfer: Comparison of unipedicled versus bipedicled flaps.

BACKGROUND: Volume changes in reconstructed flaps, particularly regarding symmetry, are an important consideration to improve long-term esthetic results in patients who undergo breast reconstruction. Asian patients with thin abdominal tissues tend to require bipedicled flaps, which provide a greater volume of abdominal tissue. We investigated volume changes in free abdominal flaps and the factors that may affect flap volume, particularly the number of pedicles. METHODS: The study included all consecutive patients who underwent immediate unilateral breast reconstruction using free abdominal flaps between January 2016 and December 2018. The initial flap volume was calculated intraoperatively, and the postoperative flap volume was calculated using computed tomography or magnetic resonance imaging based on the Cavalieri principle. RESULTS: The study included 131 of 249 patients. Compared with the initial inset volume, the mean flap volumes at 1 and 2 years postoperatively decreased to 80.11% and 73.80%, respectively. The multivariable analysis of factors that affect flap volume showed a significant association with the flap inset ratio, radiation (P = .019,.040, respectively). Stratification based on the number of pedicles showed that the flap inset ratio was significantly negatively correlated with the postoperative flap volume change in unipedicled (P < .05) but not in bipedicled flaps. CONCLUSIONS: The flap volume decreased over time, and its change had a negative correlation with the flap inset ratio in the unipedicled group. Therefore, prediction of postoperative volume changes in various clinical situations is important before breast reconstruction.

Photosensitive ion channels in layered MXene membranes modified with plasmonic gold nanostars and cellulose nanofibers.

Ion channels transduce external stimuli into ion-transport-mediated signaling, which has received considerable attention in diverse fields such as sensors, energy harvesting devices, and desalination membrane. In this work, we present a photosensitive ion channel based on plasmonic gold nanostars (AuNSs) and cellulose nanofibers (CNFs) embedded in layered MXene nanosheets. The MXene/AuNS/CNF (MAC) membrane provides subnanometer-sized ionic pathways for light-sensitive cationic flow. When the MAC nanochannel is exposed to NIR light, a photothermal gradient is formed, which induces directional photothermo-osmotic flow of nanoconfined electrolyte against the thermal gradient and produces a net ionic current. MAC membrane exhibits enhanced photothermal current compared with pristine MXene, which is attributed to the combined photothermal effects of plasmonic AuNSs and MXene and the widened interspacing of the MAC composite via the hydrophilic nanofibrils. The MAC composite membranes are envisioned to be applied in flexible ionic channels with ionogels and light-controlled ionic circuits.

Undifferentiated Pleomorphic Sarcoma of a Chronic Burn Scar of the Knee With Lymph Node Metastasis.

Malignant transformation of chronic burn scars are usually toward cutaneous lineages, including squamous cell carcinoma, basal cell carcinoma, and malignant melanoma. Sarcomas are less common. Undifferentiated pleomorphic sarcoma(UPS) is a subtype of soft tissue sarcoma with storiform-pleomorphic cells of uncertain origin, and has sparingly been reported to arise from burn scars. The majority are localized lesions probably due to the spatial distance of mesenchymal cells from the epithelium. The authors describe a rare case of UPS of the chronic burn scar of his knee with ipsilateral femoral and external iliac lymph node metastasis.

The Oblique Extended Reverse First Dorsal Metacarpal Artery Perforator Flap for Coverage of the Radial-Volar Defect of the Proximal Interphalangeal Joint in the Index Finger: A Case Report.

The dorsal metacarpal artery perforator flap is a flap that rises from the hand dorsum. Owing to its reliability and versatility, this flap is used as a workhorse for finger defect. However, to cover the radial-volar defect of the proximal interphalangeal joint (PIPJ) of the index finger, a longer flap is required than before. Here, we introduce the oblique extended reverse first dorsal metacarpal artery (FDMA) perforator flap to cover the radial-volar aspect defect of the index finger. A 45-year-old man got injured to the radial-volar defect of PIPJ of the left index finger caused by thermal press machine. The wound was 2 × 1 cm in size, and the joint and bone were exposed. We used FDMA perforator from anastomosis with palmar metacarpal artery at metacarpal neck. Since the defect was extended to the volar side, the flap was elevated by oblique extension to the fourth metacarpal base level. The fascia was included to the flap, and the flap was rotated counterclockwise. Finally, PIPJ was fully covered by the flap. Donor site was primarily closed. After 12 months of operation, the flap was stable without complication and limitation of range of motion. The oblique extended reverse FDMA perforator flap is a reliable method for covering the radial-volar defect of the PIPJ of the index finger. This flap, which also has an aesthetic advantage, will be a good choice for hand surgeons who want to cover the PIPJ defect of the index finger using a nonmicrosurgical option.

Adaptive IR- and Water-Gating Textiles Based on Shape Memory Fibers.

Thermoregulation is an essential function of the human body for adapting to the surrounding temperature. Stimuli-responsive smart textiles can provide effective protection of the human skin temperature from a continuously changing environment. Herein, we develop a smart textile based on shape memory polymer (SMP) fibers for adaptive regulation of IR and water transmission on human skin. An SMP textile is fabricated with hierarchical micro/nanoporous structures to enhance thermal insulation performance, and silver nanowires are coated on one side to provide asymmetric IR reflectivity and hydrophilicity. The porous SMP textile shows great tunability of thermal insulation and asymmetric wettability by deformation and recovery of the shape and structure in response to stimuli. The degree of thermal insulation is controlled by 65.7% of the original value, and the surface temperature of the SMP textile on a hot plate is successfully controlled in the IR images due to adaptive IR reflectivity. Additionally, the directional transportation of water droplets can be switched on/off according to the shape of the SMP textiles, which can be employed for sweat removal from the human skin. This IR- and water-gating smart textile can provide a feasible strategy for protecting the human skin from external environmental changes.

Video Game Addictive Symptom Level, Use Intensity, and Hedonic Experience: Cross-sectional Questionnaire Study.

BACKGROUND: The effects of behavioral addiction to video games has received increasing attention in the literature, given increased use intensity among subgroups of video game players. OBJECTIVE: This study seeks to empirically determine the relationship between intensity of video gaming and hedonic experience of the player. METHODS: We conducted a survey of 835 individuals who regularly play video games to determine the relationship between intensity of use and hedonic experience. We divided the sample into quartiles by self-reported video game addictive symptom level (from the Internet Gaming Disorder Scale) and conducted polynomial regressions separately for each quartile. RESULTS: We found that the higher video game addictive symptom level groups experienced a U-shaped (curvilinear) relationship between hedonic experience and intensity of play, whereas groups with lower video game addictive symptom levels exhibited no such relationship. The coefficients for the highest addictive symptom level group (quartile 4) for marginal effects for hours played per week and hours played per week squared were significantly negative (P=.005) and significantly positive (P=.004), respectively. CONCLUSIONS: Our results are consistent with sensitization and tolerance theories, which suggest that high-symptom groups experience frustration and disappointment until they achieve excessive dopamine release, at which point their hedonic experience is expected to improve with additional play. Conversely, low-symptom groups experience no such fall-and-rise pattern. This result is consistent with the outcome that members of the latter group play the game for the direct experience, such that their hedonic experience is more directly related to events occurring in the game than to the increasingly elusive pursuit of excessive dopamine release. We also find that high-symptom groups spend substantially more time and money to support video game use and are much more likely to engage in video game use at the expense of other important activities, such as working, sleeping, and eating.

Evaluation of quality and educational effect of microsurgery videos on YouTube: a randomized controlled trial.

Widespread use of smartphones and wireless internet have made YouTube an easily accessible educational modality. Many residents use YouTube to acquire knowledge regarding microsurgical techniques; however, its quality and effect has not been verified. We included 22 residents working in the Department of Plastic and Reconstructive Surgery at our institute. Using block randomization, seven were allocated to a textbook group (TG), eight to a free-searching group (FSG), and seven to a designated-video group (DVG). After reviewing textbooks, YouTube videos, or designated videos, respectively, each group performed microsurgical anastomosis using artificial vessels. The total procedure time, Objective Structured Assessment of Technical Skills (OSATS), operative errors, and degree of leakage were assessed by blinded evaluators. Self-confidence rates were also compared. The YouTube groups (FSG and DVG) performed better than the TG. Although procedure time was significantly longer in the DVG (p = .006), the performance of DVG was better than that of TG in all assessments (OSATS: p = .012; operative errors: p = .002; leakage: p = .010). FSG showed more operative errors (p = .004) and leakage (p = .007) compared to DVG, but had higher OSATS (p = .008) and fewer operative errors (p = .002) than TG. The post-intervention confidence rates were significantly higher in FSG and DVG compared to TG (p = .002 and p = .001, respectively). Although there are concerns regarding the reliability of YouTube videos, microsurgery videos on YouTube had positive effects on microsurgery practice. Therefore, YouTube may help to improve the microsurgical skills of residents. If a quality control system is introduced for YouTube videos, their educational effects may be enhanced.

Investigating 'Fear of Missing Out' (FOMO) as an extrinsic motive affecting sport event consumer's behavioral intention and FOMO-driven consumption's influence on intrinsic rewards, extrinsic rewards, and consumer satisfaction.

This study posits that Fear of Missing Out (FOMO) can function as an extrinsic motive stimulating sport event consumption by inducing consumers to overcome leisure constraints. Also, FOMO-driven consumption is proposed to affect consumption experience for being grounded on extrinsic than intrinsic rewards. In Study 1, the moderation of FOMO between intrapersonal and structural constraints and sport media viewing intention are tested. In Study 2, the relations among FOMO-driven consumption, intrinsic rewards (i.e., enjoyment), extrinsic rewards (i.e., social adherence), and consumer satisfaction are assessed. Study 1 results support the notion that FOMO can boost sport media viewing intention through two mechanisms: by directly stimulating intention and by lifting the negative effect of constraints on intention. In Study 2, FOMO-driven consumption shows a stronger link to extrinsic than intrinsic rewards, extrinsic reward is marginally but negatively associated with intrinsic reward, and intrinsic reward is a stronger predictor of satisfaction. Overall, FOMO is identified as a meaningful extrinsic motive for sport event consumption though its effects on consumer satisfaction are arguable. Implications for FOMO-driven marketing are discussed.

Central Nervous System Solitary Fibrous Tumor/Hemangiopericytoma Penetrating the Skull Bone: An Unusual Presentation.

BACKGROUND: Central nervous system (CNS) solitary fibrous tumor/hemangiopericytoma (SFT/HPC) is a soft tissue neoplasm that accounts for <1% of all intracranial tumors. Its growth will be mostly intracranial, usually along the sinuses. We have reported a rare case of direct extracranial extension of CNS SFT/HPC penetrating the frontal bone. CASE DESCRIPTION: A 64-year-old woman had visited our institution for treatment of a forehead mass. With the impression that it was a subcutaneous mass, we had planned a simple excision with the patient under local anesthesia. However, the intraoperative findings showed extension of the mass into the skull and attachment to the dura mater. Brain magnetic resonance imaging showed a 1.8-cm solid mass with an adjacent skull defect, and examination of the biopsy specimen confirmed the diagnosis as grade II CNS SFT/HPC. Definitive excision was performed by en bloc tumor resection with a 2-cm safety margin. Adjuvant radiotherapy was performed with 60 Gy in 30 fractions. The patient showed no signs of recurrence or metastasis during 2 years of follow-up. CONCLUSIONS: The present case has shown that CNS SFT/HPC can infiltrate the full thickness of the skull bone and grow extracranially, even if low grade. However, the unusual presentation of the present made early exploration and total resection possible.

Bibliometric analysis of studies about acute myeloid leukemia conducted globally from 1999 to 2018.

A bibliometric study is performed to analyze publication patterns in a specific research area and to establish a landscape model that can be used to quantitatively weigh publications. This study aimed to investigate AML research networks and to conduct a trend-related keyword analysis. We analyzed 48,202 studies about AML published from 1999 to 2019 in the Web of Science Core Collection. The network analysis was conducted using the R&R studio software. The journal Blood had the highest number of published articles with an h-index of 410. The USA had the highest number of total publications (18,719, 38.3%) and research funded by the government, institutions, and pharmaceutical companies (5,436, 10.8%). The institute with the largest number of publications was the MD Anderson Cancer Center. Kantarjian H, Garcia-Manero G, and Ravandi F were the leading authors of publications about AML. Keyword analysis revealed that FLT 3, micro-RNA, and NK cell topics were the hotspots in the cell and gene area in all publications. The overall AML research landscape is popular in the field of translational research as it can identify molecular, cell, and gene studies conducted by different funding agencies, countries, institutions, and author networks. With active funding and support from the Chinese government, the productivity of scientific research is increasing not only in the AML field but also in the medical/health-related science field.

Schlieren imaging for the visualization of particles entrapped in bubble films.

Bubbles are one of the primary sources of transferring substances from water to air. When bubbles burst, small droplets containing microparticles and microorganisms previously suspended in water disperse. Hence, visualizing small objects in bubble films can provide a new methodology for investigating the material transfer from water to the environment and the dynamic behavior of objects in the films. We used Schlieren imaging of bubbles to visualize small objects such as bacteria and microplastics. Remarkably, black spots (Schlieren spots) appeared when light rays passed parallel to bubbles formed on the water containing microparticles and bacteria. The simulation method of Schlieren imaging of bubbles was developed to clarify the underlying mechanism and experimentally validated with different sizes and concentrations of microparticles. We found that a specific water meniscus is formed around a particle when the bubble film thickness is smaller than the particle diameter, and the meniscus plays an important role in enlarging the Schlieren spots. The Schlieren spots are forty times larger than the bubble film thickness in this work. To understand the magnification rule, we illuminated the correlation between bubble film thickness, particle diameter, and Schlieren spot diameter.

The 100 Most Influential Studies in Chimeric Antigen Receptor T-Cell: A Bibliometric Analysis.

Background: Bibliometric analyses are used to provide information on trends within a specific research field, along with indicators of the impact of a publication. With such an analysis, we map the scientific landscape of chimeric antigen receptor T-cell (CAR-T) research to see the emerging topics and infer directions the field might take. Methods: We extracted the 100 most-cited articles, published all periods (from 2008 to 2019) by the Web of Science Core Collection. Using their bibliographic details, including year of publication, country of author, research organization, author information, and keywords, we graph the networks created between the articles. Results: Of the 100 papers identified, the majority (93%) were written in the USA. Notable was that 34 papers were published from the University of Pennsylvania. Regarding authors, Carl H. June participated in 29 researches, followed by Bruce L. Levine who participated in 12. As for journals, Blood (n = 19) published the most papers, followed by Science Translational Medicine (n = 9) and Cancer Research (n = 9). Lastly, the most frequently used keywords were "adoptive immunotherapy" (n = 47), "lymphocytes" (n = 27), and "antitumor activity" (n = 22). Conclusion: By evaluating the top 100 most-cited papers in the CAR-T field, this study provides insight into the direction of the scientific growth and its trends, as well as information on the field's network structure.

Identification of Local Clusters of Mutation Hotspots in Cancer-Related Genes and Their Biological Relevance.

Mutation hotspots are either solitary amino acid residues or stretches of amino acids that show elevated mutation frequency in cancer-related genes, but their prevalence and biological relevance are not completely understood. Here, we developed a Smith-Waterman algorithm-based mutation hotspot discovery method, MutClustSW, to identify mutation hotspots of either single or clustered amino acid residues. We identified 181 missense mutation hotspots from COSMIC and TCGA mutation databases. In addition to 77 single amino acid residue hotspots (42.5 percent) including well-known mutation hotspots such as IDH1 (p.R132) and BRAF (p.V600), we identified 104 mutation hotspots (57.5 percent) as clusters or stretches of multiple amino acids, and the hotspots on MUC2, EPPK1, KMT2C, and TP53 were larger than 50 amino acids. Twelve of 27 nonsense mutation hotspots (44.4 percent) were observed in four cancer-related genes, TP53, ARID1A, CDKN2A, and PTEN, suggesting that truncating mutations on some tumor suppressor genes are not randomly distributed as previously assumed. We also show that hotspot mutations have higher mutation allele frequency than non-hotspots, and the hotspot information can be used to prioritize the cancer drivers. Together, the proposed algorithm and the mutation hotspot information can serve as valuable resources in the selection of functional driver mutations and associated genes.

Impact of Tumor Purity on Immune Gene Expression and Clustering Analyses across Multiple Cancer Types.

Surgical archives of tumor specimens are often impure. The presence of RNA transcripts from nontumor cells, such as immune and stromal cells, can impede analyses of cancer expression profiles. To systematically analyze the impact of tumor purity, the gene expression profiles and tumor purities were obtained for 7,794 tumor specimens across 21 tumor types (available in The Cancer Genome Atlas consortium). First, we observed that genes with roles in immunity and oxidative phosphorylation were significantly inversely correlated and correlated with the tumor purity, respectively. The expression of genes implicated in immunotherapy and specific immune cell genes, along with the abundance of immune cell infiltrates, was substantially inversely correlated with tumor purity. This relationship may explain the correlation between immune gene expression and mutation burden, highlighting the need to account for tumor purity in the evaluation of expression markers obtained from bulk tumor transcriptome data. Second, examination of cluster membership of gene pairs, with or without controlling for tumor purity, revealed that tumor purity may have a substantial impact on gene clustering across tumor types. Third, feature genes for molecular taxonomy were analyzed for correlation with tumor purity, and for some tumor types, feature genes representing the mesenchymal and classical subtypes were inversely correlated and correlated with tumor purity, respectively. Our findings indicate that tumor purity is an important confounder in evaluating the correlation between gene expression and clinicopathologic features such as mutation burden, as well as gene clustering and molecular taxonomy. Cancer Immunol Res; 6(1); 87-97. ©2017 AACR.

Prognostic implication of histological features associated with EHD2 expression in papillary thyroid carcinoma.

Papillary thyroid carcinoma (PTC) is a heterogeneous tumor with various histological and molecular subtypes. EHD2 is involved in endocytosis and endosomal recycling. This study aimed to investigate the prognostic significance of EHD2 expression in PTC and develop a new model for predicting persistent/recurrent disease after thyroidectomy. Pathologic slides of 512 consecutive patients with PTC ≥ 1 cm were retrospectively reviewed. BRAF mutation analysis and immunohistochemistry for EHD2 were performed. Clinical significance of EHD2 mRNA expression was analyzed in 388 PTC patients using The Cancer Genome Atlas dataset. The presence of dyscohesive cells and psammoma bodies were found have significant association with persistent/recurrent disease (p = 0.049 and p = 0.038, respectively). The best discrimination of disease-free survival was found by dividing patients into three prognostic groups based on the following two risk factors according to the size category: psammoma bodies ≥ 4 and dyscohesive cells (≥ 1% and ≥ 20% in PTCs of < 2.0 cm and ≥ 2.0 cm, respectively). In PTCs of ≥ 2.0 cm, patients with the two risk factors had a hazard ratio of 13.303 (p = 0.005) compared to those without risk factors. High expression level of EHD2 was associated with BRAF V600E (p < 0.001), presence of dyscohesive cells (p = 0.010), and absence of psammoma bodies (p = 0.001). Increased EHD2 mRNA expression level was associated with extrathyroidal extension (p < 0.001), pT3-4 (p < 0.001), lymph node metastasis (p < 0.001), higher risk of recurrence (p < 0.001), and BRAF V600E (p < 0.001). Our prognostic model is useful for predicting persistent/recurrent disease after surgery of PTC. EHD2 mRNA expression could be a novel prognostic marker for PTC patients.