A new minimally invasive, nonexcisional, surgical browlift technique with minimal scarring: a protocol for a prospective observational study.

Background: The aim of this study is to prospectively evaluate the new minimal invasive (MINE) browlift technique with possibly superior results and minimal visible scarring. Study design: A prospective observational study will be performed on all available data from patients who will undergo a browlift procedure in the HMC from 1 June 2021 till 31 May 2024. Our goal is to include at least 50 patients. Inclusion criteria are: patients with medical (i.e. brow ptosis and facial paralysis) or cosmetic indication, patients with sufficient understanding of the Dutch or English language and willingness to participate in extra study specific follow-up moments and filling in of questionnaires. Exclusion criteria are: less than 18 years of age and patients with previous brow or eyelid surgery. Patients will be photographed preoperatively and postoperatively using the VECTRA camera. Outcome measurements: Scarring after procedure; functionality of eyebrow movement; amount of correction in brow ptosis, measured in VECTRA; longevity of procedure in months; aesthetic result as assessed by questionnaires and adverse effects of procedure will be measured. Ethics and dissemination: The database management software 'Castor' will be used to store and collect the data from the questionnaire. The Medical Research Ethics Committee found this study not eligible to be submitted to the Dutch Medical Research Involving Human Subjects Acts (WMO). Written consent will be obtained from all patients.

Does Scarpa's Fascia Preservation in Abdominoplasty Reduce Seroma? A Systematic Review.

Abdominoplasty is a widely utilized cosmetic surgery procedure. Despite its popularity, seroma formation remains a prevalent complication. Seroma can lead to extended recovery time, increased medical appointments, and the potential for infection or the need for additional surgical revision. Preserving Scarpa's fascia may mitigate the risk of seroma in patients following abdominoplasty. The goal of this systematic review was to determine the impact of preserving Scarpa's fascia on the occurrence of seroma and total drain output following an abdominoplasty procedure. This review searched academic literature in MEDLINE (via PubMed), EMBASE (OvidSP), and the Cochrane Central Register of Controlled Trials (CENTRAL) for clinical and observational studies published in peer-reviewed journals, from March 2022 to November 2022, that evaluated the impact of preserving Scarpa's fascia on postoperative seroma and total drain output during abdominoplasty. The primary outcomes of interest were seroma and total drain output, with secondary outcomes of interest including hematoma, time to drain removal, length of hospital stay, wound dehiscence, and infection rate. The systematic review of 8 studies, involving 846 patients, found that the preservation of Scarpa's fascia during an abdominoplasty procedure was associated with decreased seroma occurrence, reduced drain output, faster drain removal, and fewer infections. However, it did not affect the incidence of hematoma, hospital stay duration, or wound dehiscence. The preservation of Scarpa's fascia during an abdominoplasty procedure should be considered as a routine practice, because it has been shown to result in reduced seroma incidence rates and faster drain removal.

Line managers' hiring intentions regarding people with mental health problems: a cross-sectional study on workplace stigma.

OBJECTIVES: Stigma may negatively affect line managers' intention to hire people with mental health problems (MHP). This study aims to evaluate line managers' knowledge and attitudes concerning job applicants with MHP, and to assess which factors are associated with the intention (not) to hire an applicant with MHP. METHODS: A sample of Dutch line managers (N=670) filled out a questionnaire on their knowledge, attitudes and experiences concerning applicants/employees with MHP. Descriptive analyses and multiple regression analyses were used. RESULTS: The majority (64%) was reluctant to hire a job applicant with MHP, despite the fact that only 7% had negative and 52% had positive personal experiences with such employees. Thirty per cent were reluctant to hire an applicant if they knew the applicant had past MHP. Associated with higher reluctance to hire an applicant with MHP were the concerns that it will lead to long-term sickness absence (ß (95% CI)=0.39 (0.23 to 0.55)), that the employee cannot handle the work (ß (95% CI)=0.16 (0.00 to 0.33)) that one cannot count on the employee (ß (95% CI)=0.41 (0.23 to 0.58)) and higher manager education level (ß (95% CI)=0.25 (0.05 to 0.44)). Conversely, associated with positive hiring intentions was being in favour of diversity and/or inclusive enterprise (ß(95% CI)=-0.64 (-0.87 to -0.41)). CONCLUSIONS: As the majority of managers were reluctant to hire applicants with MHP, and even 30% were reluctant to hire applicants who had past MHP, these findings have major implications for social inclusion in the Netherlands, where about 75% of employees would disclose MHP at work.

The Physician's Tears: Experiences and Attitudes of Crying Among Physicians and Medical Interns.

We examined several aspects of the crying experiences of physicians and medical interns, including the most common reasons to cry in the workplace, and their perceptions of and attitudes towards crying in the workplace and in the presence of a patient. A sample of Dutch physicians and medical interns (Nphysicians = 1068 and Nmedical interns = 302 and for the full version Nphysicians = 776 and Nmedical interns = 181) completed an especially designed anonymous online questionnaire about experiences with crying in the workplace, and perceptions of and attitudes towards crying in the workplace and in the presence of patients. Crying is a rather frequent behavior among physicians, in particular when they have to deal with the severe suffering of patients and their relatives. We found a considerable variety in the attitudes and perception of crying in the work setting, although there was also much agreement that crying in the presence of a patient is only appropriate if it is over the condition of the patient. Physicians reported a slightly more positive attitude and a stronger need for more attention to this topic in training and education than medical interns. Crying in the medical setting is a common, though understudied phenomenon. There is a strong need for further research on this topic in order to understand it better and how and when it might interfere with or facilitate with the therapeutic process. We strongly feel that currently the time is ripe for this topic because in particular the physicians expressed a greater need for more attention to this topic in training and the medical interns showed signs of, perhaps unhealthy, suppression of their emotions.

Inflammatory cytokines and mononuclear cells in sudden sensorineural hearing loss.

OBJECTIVE: This study evaluated tumour necrosis factor-α, interleukins 10 and 12, and interferon-γ levels, peripheral blood mononuclear cells, and clusters of differentiation 17c and 86 expression in unilateral sudden sensorineural hearing loss. METHODS: Twenty-four patients with unilateral sudden sensorineural hearing loss, and 24 individuals with normal hearing and no history of sudden sensorineural hearing loss (who were attending the clinic for other problems), were enrolled. Peripheral blood mononuclear cells, and clusters of differentiation 11c and 86 were isolated and analysed. Plasma and supernatant levels of tumour necrosis factor-α, interferon-γ, and interleukins 10 and 12 were measured. RESULTS: There were no significant differences with respect to age and gender. Monocyte population, mean tumour necrosis factor-α level and cluster of differentiation 86 expression were significantly increased in the study group compared to the control group. However, interferon-γ and interleukin 12 levels were significantly decreased. The difference in mean interleukin 10 level was not significant. CONCLUSION: Increases in tumour necrosis factor-α level and monocyte population might play critical roles in sudden sensorineural hearing loss. This warrants detailed investigation and further studies on the role of dendritic cells in sudden sensorineural hearing loss.

One rule for the goose, one for the gander? Wrongfulness and harmfulness in determining reactions to offenders and victims of crime.

People's reactions to offenders and victims of crime follow different rationales. Whereas the punishment of the offender is primarily determined by the severity of the crime (which includes its foreseeable harmful consequences), the actual harm that is experienced by the victim drives the need for his or her support and assistance. With the introduction of the Victim Impact Statement (VIS), in which victims are allowed to express the (harmful) consequences of the crime on their lives, the question is raised whether allowing such victim input during criminal proceedings would influence the offender's sentence. The main goal of the current research is to disentangle how a crime's wrongfulness and harmfulness influence people's reactions to offenders and victims. We show that, whereas people's perceptions of the offender (and the outcome of the trial) are influenced by the severity of the crime, people's judgements related to the victim are more likely to be influenced by an interaction between the severity of the crime and the experienced harm of the crime. That is, in this study no support was found for the argument that the delivery of a VIS would lead to a violation of the proportionality principle.

When love hurts: assessing the intersectionality of ethnicity, socio-economic status, parental connectedness, child abuse, and gender attitudes in juvenile violent delinquency.

Researchers have not yet reached agreement about the validity of several competing explanations that seek to explain ethnic differences in juvenile violent offending. Ethnicity cannot solely explain why boys with an ethnic minority background commit more (violent) crimes. By assessing the intersectionality of structural, cultural and individual considerations, both the independent effects as well as the interplay between different factors can be examined. This study shows that aforementioned factors cumulatively play a role in severe violent offending, with parental connectedness and child abuse having the strongest associations. However, since most variables interact and ethnicity is associated with those specific factors, a conclusion to be drawn is that ethnicity may be relevant as an additional variable predicting severe violent offending although indirectly.

Comparison of premolar cuspal deflection in bulk or in incremental composite restoration methods.

OBJECTIVES: This study examined the cuspal deflection of maxillary premolars when either a bulk filling or incremental filling technique was employed using a range of composites with different elastic moduli. METHODS: Four brands of composite materials, Heliomolar (HM, Ivoclar Vivadent, Schaan, Liechtenstein), Heliomolar HB (HH, Ivoclar Vivadent, Schaan, Liechtenstein), Filtec Supreme XT (FS, 3M Dental Product, St Paul, MN, USA), and Renew (RN, Bisco Inc, Schaumburg, IL, USA), as well as three filling techniques, bulk filling, two-layer incremental filling, and three-layer incremental filling methods, were used. One hundred twenty caries-free human premolars were collected and divided into four groups according to the filling material used. Each of these four groups was then subdivided into three groups according to filling method. In group 1, a bulk filling of 0.15 g of each resin was inserted and light-cured with LED light from the occlusal, mesial, and distal surfaces for 60 seconds each. Group 2 was given two horizontal increments, 0.08 g and 0.07 g, with each increment light-cured from the occlusal, mesial, and distal surfaces for 30 seconds each. In group 3, three horizontal increments of 0.05 g were used, each of which was light-cured from the occlusal, mesial, and distal surfaces for 20 seconds each. The cuspal deflection was measured using a customized cuspal deflection measuring machine for 10 minutes after initiating light polymerization. The elastic modulus of each composite resin material was measured using a three-point bending test. Two-way analysis of variance (ANOVA) with a Dunnet test was used to examine the effect of the two variables (curing methods, materials) on the amount of cuspal deflection at the 95% confidence level. In each material, groups 1, 2 and 3 were compared using one-way ANOVA and a Dunnet test at the 95% confidence level. The elastic moduli of HM, HH, FS, and RN were compared using one-way ANOVA and a Tukey test at the 95% confidence level. The relationship between the amount of cuspal deflection in each group and the elastic modulus of the composite was analyzed using a Pearson correlation test. RESULTS: The amount of cuspal deflection in HH was larger than in the other materials (HM, FS, and RN; p<0.05). There was no significant difference between HM, FS, and RN. The amount of cuspal deflection was greatest in group 1, followed in order by groups 2 and 3 (p<0.05). The amount of cuspal deflection was in the following order: group 1≥2≥3 in HM, and 1>2, 3 in HH, FS, and RN. The elastic modulus was HH>RN>FS>HM (p<0.05). There was a positive correlation between the cuspal deflection and the elastic modulus of the composite. CONCLUSIONS: The incremental filling techniques reduced the amount of cuspal deflection in all composite groups with different elastic moduli. The amount of cuspal deflection showed a positive correlation with the elastic modulus of the composite.

Distortion free pulse delay system using a pair of tunable white light cavities.

Recently, a tunable bandwidth white light cavity (WLC) was demonstrated by using an anomalously dispersive intra-cavity medium to adjust a cavity linewidth without reducing the cavity buildup factor [G.S. Pati et al., Phys. Rev. Lett. 99, 133601 (2007)]. In this paper, we show theoretically how such a WLC can be used to realize a distortion-free delay system for a data pulse. The system consists of two WLCs placed in series. Once the pulse has passed through them, the fast-light media in both WLCs are deactivated, so that each of these now acts as a very high reflectivity mirror. The data pulse bounces around between these mirrors, undergoing negligible attenuation per pass. The trapped pulse can be released by activating the fast-light medium in either WLC. Numerical simulations show that such a system can far exceed the delay-bandwidth constraint encountered in a typical data buffer employing slow light. We also show that the pulse remains virtually undistorted during the process.

Oral arginine supplementation and the effect on skin graft donor sites: a randomized clinical pilot study.

Although arginine has been shown to improve healing in rodents and in small induced wounds in healthy volunteers, little is known about the effects of arginine supplementation on healing of clinically relevant surgical wounds. We studied 18 patients in a double-blind randomized pilot study (12 men, 6 women), who underwent skin transplantation as part of reconstructive surgery. Patients were randomly assigned to receive arginine (n = 8) or placebo (n = 10) supplementation as an enteral dose of 36.2 g of l-arginine-HCl or an isocaloric amount of placebo (51.2 g alanine), respectively. Wound healing was evaluated at the donor sites of skin grafts by measuring angiogenesis, reepithelialization, and neutrophil count. Arginine metabolism was studied by measuring plasma and wound fluid amino acid concentrations. Our results show that none of these parameters were significantly different between the oral arginine supplementation group and the placebo group. In conclusion, enteral arginine supplementation does not improve wound healing of skin donor sites.

Pseudotumour in the bladder as a complication of total hip replacement: ultrasonography, CT and MR findings.

We report a pseudotumour in the urinary bladder following total hip replacement with review of the literature. Pseudotumour in the urinary bladder as a late complication of total hip replacement is an extremely rare condition. In this case, cross-sectional imaging modalities including sonography, CT and MR showed a hypervascular polypoid mass in the urinary bladder and adjacent wall thickening with a band connecting between the mass and the acetabulum. Histopathological diagnosis confirmed acute and chronic inflammation with calcification.

Changes in intrapulpal temperature after Er:YAG laser irradiation.

OBJECTIVE: This study was performed to investigate the changes in temperature induced by an Er:YAG laser irradiation and to find the means to minimize potential thermal damage due to temperature rise after irradiation. BACKGROUND DATA: Intrapulpal temperature rise was found to last after irradiation at times, although the addition of appropriate water spray during tooth ablation by Er:YAG laser produced efficient ablation with little thermal damage. METHODS: To investigate intrapulpal temperature change, each extracted tooth specimen was embedded into a resin block and temperature-measuring probes were placed on the irradiated and the opposite pulpal walls. An Er:YAG laser irradiation was performed at 300 mJ/pulse and 20 Hz, with a water flow rate of 1.6 mL/min for 3 sec. Each lasing was followed by (1) no application of post-irradiation water spray, (2) post-irradiation water spray for 1 sec and (3) for 2 sec. RESULTS: No significant temperature change was found on the irradiated pulpal wall during Er:YAG laser, while there existed significant temperature rise on the irradiated pulpal wall after irradiation. However, the addition of water spray for 1 or 2 sec after irradiation significantly decreased intrapulpal temperature compared to no application of post-irradiation water spray. There were no significant differences between the 1- and 2-sec groups. CONCLUSION: It is suggested that the addition of water spray for 1 or more seconds after irradiation reduces post-irradiation temperature rise, possibly leading to thermal damage on the dental pulp tissue.

Irradiation time and ablation rate of enamel in contact and non-contact irradiation with Er:YAG laser.

OBJECTIVE: The relationship between changes in ablation rate of enamel with irradiation time was investigated to find the most effective irradiation time for tooth ablation by Er:YAG laser. BACKGROUND DATA: Previous studies have shown that the Er:YAG laser has the ability to ablate tooth material effectively, but that the efficiency and effectiveness of ablation are determined by various parameters such as energy, pulse frequency, the amount of water, and irradiation time. METHODS: Contact and non-contact irradiation of the Er:YAG laser were carried out respectively for 1, 3, 5, and 7 s on the enamel surface of each specimen using a combination of a 400 mJ/pulse at 20 Hz and water flow rate of 6.75 mL/min, and quantitative measurements using a mass balance were performed to compare the resulting ablation rates. RESULTS: The ablation weight, by taking the mean of both contact and non-contact irradiation, generally increased with irradiation exposure time, but no significant increases in ablation were seen in specimens that had been exposed for > 3 s in either the contact or non-contact irradiation group. Results in the non-contact irradiation group indicated superior ablation of enamel compared to that in the contact irradiation group. CONCLUSION: Irradiation exposure of < or = 3 s per application of laser beam is recommended to ablate enamel effectively in both non-contact and contact irradiation.

Urinary ascites and anuria caused by bilateral fungal balls in a premature infant.

A case is reported of anuria and urinary ascites secondary to bilateral ureteropelvic obstruction by fungal balls. Management consisted of bilateral nephrostomy drainage with local irrigation with amphotericin B, and systemic antifungal treatment without surgery. Aspiration by paracentesis was performed for the urinary ascites and continuous drainage through an 8 Fr pig tail catheter for the urinoma. The literature on renal fungus balls in neonates and infants is reviewed.

Circumcision practice patterns in South Korea: community based survey.

OBJECTIVES: To assess the prevalence of circumcision in South Korean young men dwelling in the community, investigate attitudes and perspectives about circumcision, and how they perceive physician involvement in the decision process. METHODS: Between May and November 2001, this cross sectional survey was performed. Of 27 202 men aged 20 years dwelling in the community of Choong-chung South Province, 2700 were randomly selected at a 10.0% sampling fraction after a sampling process by census district and a total of 1742 (64.5%) agreed to participate in the study. These subjects completed self administered questionnaires and we included 1674 men (a response rate 62.0%) in the study. RESULTS: The overall proportion of circumcised was 1306 (78.0%) and an additional 192 (11.5%) wished to be circumcised later. Circumcision was carried out mostly during their elementary and middle school years. Of men circumcised, the decision whether to circumcise was most often made by their parents. Of the subjects, 75.0% believed that circumcision is necessary, while 2.9% believed it to be unnecessary. Among those who believed circumcision to be necessary, the most common reason was to improve penile hygiene (89.1%). CONCLUSIONS: Our results indicate a positive attitude toward circumcision in South Korean men, linking it with hygienic practices. Circumcision in South Korea depends on the perpetuation of cultural beliefs that support it.

Psychological problems in young men with chronic prostatitis-like symptoms.

OBJECTIVE: To take a different perspective in assessing young men with chronic prostatitis-like symptoms, this study was designed since few prospective studies are available to survey a population of young men. MATERIAL AND METHODS: One hundred and fifty men aged 20 years dwelling in the community were randomly selected. Chronic prostatitis-like symptoms were measured by the National Institutes of Health-Chronic Prostatitis Symptom Index and the selfreported scores for pain and urinary symptoms were used to identify chronic prostatitis-like symptoms. The psychological methods used were the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Bem Sex Role Inventory. A total of 87 men (a response rate 58%) completed self-administered questionnaires. RESULTS: As the scores for pain and urinary symptoms increased, those for depression increased (p < 0.001 and p = 0.01, respectively). However, the mean scores for state and trait anxiety were not different according to the scores for pain and urinary symptoms. The mean masculinity scores were not different according to the scores for pain but those were significantly different according to the scores of urinary symptoms (p = 0.042). The mean femininity scores were not different according to the scores of pain and urinary symptoms. CONCLUSIONS: Our findings suggest that psychological factors, especially depression and weak masculine identity may be associated with an early stage of chronic prostatitis-like symptoms. Young men with chronic prostatitis-like symptoms also have psychological problems.

Factors influencing testicular volume in young men: results of a community-based survey.

OBJECTIVE: To investigate the factors influencing testicular volume in young men in the community. SUBJECTS AND METHODS: Between May and November 2001, 2700 men aged 20 years and dwelling in the community were randomly selected at a 10% sampling fraction after a sampling process by census district; 2080 men agreed to participate in the study. All volunteers underwent a standard evaluation, including a detailed medical history and physical examination. After excluding those with testicular diseases the study comprised 1792 men. RESULTS: There were significant but weak correlations between testicular volumes and height, body weight and body mass index. In a multivariate model, high environmental temperature was associated with a decreased likelihood (odds ratio, OR, 0.42; 95% confidence interval, CI, 0.29-0.60; P < 0.001) of a paired testicular volume being below the 25th percentile of all participants. The likelihood of a low paired testicular volume varied by area, with a 1.6-fold greater risk in men dwelling in large rural areas than in those in major towns. Increasing height was associated with a decreased likelihood (OR 0.60; 95% CI 0.38-0.96; P = 0.032) and low body weight with an increased likelihood of a low paired testicular volume (OR 2.54; 95% CI 1.57-4.12; P < 0.001). CONCLUSION: These results establish that demographic and environmental factors have an effect on testicular size and suggest that body size may be important in determining testicular size in late adolescents.

Influence of environmental factors on chronic prostatitis-like symptoms in young men: results of a community-based survey.

OBJECTIVES: To investigate the influence of environmental factors on chronic prostatitis-like symptoms among young men in a community. METHODS: Of 28,841 men aged 20 years dwelling in the community, a total of 16,321 men (response rate 56.6%) were included in this study. The National Institutes of Health Chronic Prostatitis Symptom Index was used to identify men with chronic prostatitis-like symptoms. The questionnaire also queried sociodemographic characteristics. The Korean Meteorological Administration provided information on the weather of the community. We determined the risk factors of chronic prostatitis-like symptoms among these environmental factors using univariate and multivariate analyses. RESULTS: Six percent of the men were identified as having significant prostatitis-like symptoms (perineal and/or ejaculatory pain and a total pain score of 4 or greater). The univariate logistic regression analysis indicated that education level, average duration of sunlight, and average temperature were risk factors for chronic prostatitis-like symptoms. As these variables increased, the scores of chronic prostatitis-like symptoms decreased. In the multivariate model used, the likelihood of chronic prostatitis-like symptoms varied by the final educational level, with middle school and high school graduates having 1.8 and 1.4-fold higher odds, respectively, than men attending college. In the same model, the average duration of sunlight was also an independent risk factor of chronic prostatitis-like symptoms (odds ratio 0.85; 95% confidence interval 0.77 to 0.95; P = 0.003), but the average temperature lost statistical significance. CONCLUSIONS: Our findings suggest that the community-based prevalence of chronic prostatitis-like symptoms may be high in young men. Higher education and a longer time in sunlight were associated with a decreased likelihood of chronic prostatitis-like symptoms.