Defining a danger zone for iatrogenic long thoracic nerve injury in gender-affirming mastectomy.

The long thoracic nerve's (LTN) superficial location on the chest wall renders it vulnerable to iatrogenic injury. Plastic surgeons' gender-affirming mastectomy volumes are rapidly increasing. This operation involves lateral chest contouring placing the distal LTN at risk of injury along the chest wall.

Caseworker Visitation After Reunification and Children's Reentry Into Foster Care: A Survival Analysis.

To prevent children from reentering the welfare system, it is crucial to understand the role of caseworker visits after reunification on reentry and identify the factors related to reentry. Utilizing the administrative data of one Mid-Atlantic state, children who reunified with their families between July 2016 and June 2020 were selected as the study sample ( = 3,510). Reentry rates were higher for children who did not have caseworker visits after reunification than for those who did.

Factors Associated With Permanency for Children in Out-Of-Home Placement: A Survival Analysis.

Achieving permanency is a main goal of the child welfare system. To promote timely achievement of permanency, it is important to understand the determinants associated with permanency outcomes. This study aims to examine the length of time children spend in foster care and identify factors associated with achievement of permanency using administrative data from one state spanning a six-year timeframe and including a final sample of 1,874 children.

Who tells the story of burns in low-and-middle income countries? - A bibliometric study.

Low- and middle-income countries (LMICs) remain drastically underrepresented in health research, with African countries producing less than 1% of the global output. This work investigates authorship patterns of publications on burns in LMICs. Original research studies addressing burn injuries in LMICs and published between 1st January 2015 and 31st December 2020 were included in the review.

Female Leadership in Academic Plastic Surgery: A Comprehensive Analysis.

Background: Gender equity remains to be realized in academic plastic and reconstructive surgery. The purpose of this study was to measure the proportion of women in leadership roles in academic plastic and reconstructive surgery to verify where gender gaps may persist.

Methods: Six markers of leadership were analyzed: academic faculty rank, manuscript authorship, program directorship, journal editor-in-chief positions, society board of directors membership, and professional society membership.

Assessment of surgical capacity in Chiapas, Mexico: a cross-sectional study of the public and private sector.

Introduction: Surgical, anaesthesia and obstetric (SAO) care are essential, life-saving components of universal healthcare. In Chiapas, Mexico's southernmost state, the capacity of SAO care is unknown. This study aims to assess the surgical capacity in Chiapas, Mexico, as it relates to access, infrastructure, service delivery, surgical volume, quality, workforce and financial risk protection.

The Plastic Surgery Workforce and Its Role in Low-income Countries.

Background: Plastic surgery varies in scope, especially in different settings. This study aimed to quantify the plastic surgery workforce in low-income countries (LICs), understand commonly treated conditions by plastic surgeons working in these settings, and assess the impact on reducing global disease burden.

Methods: We queried national and international surgery societies, plastic surgery societies, and non-governmental organizations to identify surgeons living and working in LICs who provide plastic surgical care using a cross-sectional survey.

Sports-Related Craniofacial Injuries Among Pediatric and Adolescent Females: A National Electronic Injury Surveillance System Database Study.

Background: Number of female athletes continues to exponentially increase in all sports; however, available literature detailing craniofacial injuries remains scarce. Compared to male athletes, female athletes may experience different types of injuries. These may be related to sex differences such as craniofacial pain and dimensions.

Access to Essential Surgical Care in Chiapas, Mexico: A System-Wide Geospatial Analysis.

Background: Long travel times to reach essential surgical care in Chiapas, Mexico's poorest state, can delay lifesaving procedures and contribute to adverse outcomes. Geographical access to surgical facilities is 1 of the 6 indicators of the Lancet Commission on Global Surgery and has been measured extensively worldwide. Our objective is to determine the population with 2-h geographical access to facilities capable of performing the Bellwether procedures (laparotomy, cesarean delivery, and open fracture repair).

Assessment of diagnostics capacity in hospitals providing surgical care in two Latin American states.

Background: Diagnostic services are an essential component of high-quality surgical, anesthesia and obstetric (SAO) care. Efforts to scale up SAO care in Latin America have often overlooked diagnostics capacity. This study aims to analyze the capacity of diagnostic services, including radiology, pathology, and laboratory medicine, in hospitals providing SAO care in the states of Chiapas, Mexico and Amazonas, Brazil.

Projected impact of COVID-19 mitigation strategies on hospital services in the Mexico City Metropolitan Area.

Evidence-based models may assist Mexican government officials and health authorities in determining the safest plans to respond to the coronavirus disease 2019 (COVID-19) pandemic in the most-affected region of the country, the Mexico City Metropolitan Area. This study aims to present the potential impacts of COVID-19 in this region and to model possible benefits of mitigation efforts. The COVID-19 Hospital Impact Model for Epidemics was used to estimate the probable evolution of COVID-19 in three scenarios: (i) no social distancing, (ii) social distancing in place at 50% effectiveness, and (iii) social distancing in place at 60% effectiveness.

Socioeconomic Characteristics of Patients Undergoing Ambulatory Parathyroidectomy and a Comparison of Institutional Charges.

Background: Parathyroidectomy is frequently performed as ambulatory surgery. This study seeks to characterize the socioeconomic factors that may impact the patient selection for outpatient parathyroidectomy.

Methods: The 2016 Florida State Inpatient Database (SID) and the 2016 Florida State Ambulatory Surgery Database (SASD) were queried for all patients undergoing parathyroidectomy using the International Classification of Diseases 10 (ICD-10) procedure codes.

Metabolic syndrome exacerbates amyloid pathology in a comorbid Alzheimer's mouse model.

Alzheimer's disease (AD) often coexists with other aging-associated diseases including obesity, diabetes, hypertension, and cardiovascular diseases. The early stage of these comorbidities is known as metabolic syndrome (MetS) which is highly prevalent in mid-life. An important cause of MetS is the deficiency of SIRT3, a mitochondrial deacetylase which enhances the functions of critical mitochondrial proteins, including metabolic enzymes, by deacetylation.

Repair of Acute Type-A Aortic Dissection in the Present Era: Outcomes and Controversies.

Acute Type-A aortic dissection (AAAD) remains a surgical emergency with a relatively high operative mortality despite advances in medical and surgical management over the past three decades. In spite of the severity of disease, there is a paucity of studies reviewing key controversies surrounding AAAD repair and management. A systematic literature search was performed using Cochrane review and PubMed bibliography review.

Readmission and reinjury patterns in pediatric assault victims.

Introduction: Repeated pediatric assault should be a never event. The purpose of this study was to evaluate the readmission and reinjury patterns in pediatric victims of assault including readmissions to different hospitals across the US.

Methods: The 2010-2014 Nationwide Readmissions Database was queried for all nonelective admissions for patients under the age of 18 years.

The Configuration of the Perivascular System Transporting Macromolecules in the CNS.

Large blood vessels entering the CNS are surrounded by perivascular spaces that communicate with the cerebrospinal fluid and, at their termini, with the interstitial space. Solutes and particles can translocate along these perivascular conduits, reportedly in both directions. Recently, this prompted a renewed interest in the intrathecal therapy delivery route for CNS-targeted therapeutics.

Nine-valent HPV vaccine efficacy against related diseases and definitive therapy: comparison with historic placebo population.

Objective: Nine-valent human papillomavirus (9vHPV) vaccine efficacy against disease and cervical surgeries related to all nine vaccine components was assessed compared with a historic placebo population. This was not assessed in the 9vHPV vaccine efficacy trial since the trial was quadrivalent HPV (qHPV) vaccine-controlled, efficacy was measured for the five HPV types covered only by 9vHPV vaccine (HPV31/33/45/52/58), but not the four types covered by both vaccines (HPV6/11/16/18).

Methods: Three international, randomized, double-blind studies were conducted using the same methodology.

Predicting outstanding results after reverse shoulder arthroplasty using percentage of maximal outcome improvement.

Background: The purpose of this study was to determine whether thresholds regarding the percentage of maximal improvement in the Simple Shoulder Test (SST) score and American Shoulder and Elbow Surgeons (ASES) score exist that predict excellent patient satisfaction after reverse shoulder arthroplasty (RSA).

Methods: Patients undergoing RSA with a single implant system were evaluated preoperatively and at a minimum 2-year follow-up. Receiver operating characteristic curve analysis determined thresholds to predict excellent patient satisfaction by evaluating the percentage of maximal improvement for SST and ASES scores.

Continuous Suture Technique for Aortic Valve Replacement: Technical Considerations and Controversies.

Continuous suture technique (CST) for aortic valve replacement (AVR) is a simple, secure, and fast surgical technique that has been shown to significantly decrease cross clamp time and cardiac bypass time, ultimately resulting in decreased myocardial ischemic injury, operation time, and hospital stay. However, previous studies have reported increased risk of periprosthetic regurgitation with CST for AVR. We describe our technique for AVR using CST in 100 patients with low complication rate and no perioperative paravalvular aortic insufficiency.

Outcomes of Arthroscopic Posterior Shoulder Stabilization in the Beach-Chair Versus Lateral Decubitus Position: A Systematic Review.

Background: Arthroscopic posterior shoulder stabilization can be performed with patients in the beach-chair (BC) and the lateral decubitus (LD) positions; however, the impact of patient positioning on clinical outcomes has not been evaluated.

Purpose: To compare clinical outcomes and recurrence rates after arthroscopic posterior shoulder stabilization performed in the BC and LD positions.

Study Design: Systematic review; Level of evidence, 4.

Preoperative Hypoglycemia and Hyperglycemia Are Related to Postoperative Infection Rates in Implant-Based Breast Reconstruction.

Objectives: Diabetic patients undergoing surgery are known to have a higher risk for infection. However, current literature does not adequately investigate the effects of preoperative hypoglycemia or hyperglycemia on postoperative infection risk.

Methods: A retrospective review of a national private payer database within the PearlDiver Supercomputer application (Warsaw, IN) for patients undergoing breast reconstruction with implant/expander (BR) was conducted.

Predicting outstanding results after anatomic total shoulder arthroplasty using percentage of maximal outcome improvement.

Background: The purpose of this study was to determine whether thresholds in the percentage of maximal improvement in the Simple Shoulder Test (SST) or American Shoulder and Elbow Surgeons (ASES) score exist for predicting "excellent" patient satisfaction after total shoulder arthroplasty (TSA).

Methods: A retrospective query identified patients who underwent TSA with a minimum of 2 years' follow-up. Preoperative and postoperative SST and ASES scores and postoperative patient satisfaction were recorded.

Efficacy, Immunogenicity, and Safety of a 9-Valent Human Papillomavirus Vaccine: Subgroup Analysis of Participants From Asian Countries.

Background: A 9-valent human papillomavirus-6/11/16/18/31/33/45/52/58 (9vHPV) vaccine extends coverage to 5 next most common oncogenic types (31/33/45/52/58) in cervical cancer versus quadrivalent HPV (qHPV) vaccine. We describe efficacy, immunogenicity, and safety in Asian participants (India, Hong Kong, South Korea, Japan, Taiwan, and Thailand) from 2 international studies: a randomized, double-blinded, qHPV vaccine-controlled efficacy study (young women aged 16-26 years; NCT00543543; Study 001); and an immunogenicity study (girls and boys aged 9-15 years; NCT00943722; Study 002).

Methods: Participants (N = 2519) were vaccinated at day 1 and months 2 and 6.