bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel biomarkers of acute kidney injury in children: an update on recent findings
Authors: Sandokji Ibrahim , Greenberg Jason H. 
Published: April 2020

Purpose of review
The clinical diagnosis of acute kidney injury (AKI) relies largely on changes in serum creatinine; a delayed biomarker. Research in children has been focused on developing novel AKI biomarkers, which can improve the prediction, early detection and diagnosis of kidney injury, as well as our understanding of AKI pathophysiology. In this review, we describe recently published studies on urine or blood biomarkers of AKI. The mechanistic relevance of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1, interleukin (IL)-18, liver-type fatty acid binding protein, tissue inhibitor of metalloproteinase (TIMP)-2/insulin-like growth factor-binding protein (IGFBP)-7, uromodulin, as well as other inflammatory biomarkers are discussed in the context of AKI pathophysiology, as well as their performance predicting or diagnosing AKI.

Recent findings
Biomarkers of tubular injury, cell cycle arrest and inflammation are presented in this review. NGAL continues to be the most frequently studied biomarker and continues to have good performance in a variety of clinical settings, most notably after cardiopulmonary bypass. We also found promising results with less studied biomarkers for the prediction of AKI in children, including TIMP2, IGFBP7, uromodulin, tumor necrosis factor-α and IL-8.

Summary
Identifying new AKI biomarkers is a priority in pediatric nephrology research because of the morbidity associated with AKI, as well as the lack of therapies for AKI. Recent research suggests that novel AKI biomarkers have the potential to predict the development of AKI and diagnose AKI earlier than changes in serum creatinine. The diverse causes of AKI, the different settings where patients develop AKI and the changing biomarker reference ranges throughout childhood remain challenges in biomarker development.
The economics of a pediatric surgical ICU
Authors: Slater Bethany J. , Vogel Adam M. 
Published: April 2020

Purpose of review
The purpose of this review is to describe quality and financial economic principles that form the foundation for complex care delivery systems for the critically ill pediatric surgical population.

Recent findings
Advances in neonatology along with innovation in surgical techniques in children led to the need to care for more complex postoperative surgical patients. Several studies have demonstrated improved outcomes in specialized pediatric centers. Furthermore, there is some evidence to suggest that there is overall financial benefit with decreased costs and more efficient resource use to pediatric subspecialty critical care.

Summary
As more becomes known regarding the impact of specialized ICU environments, pediatric surgical critical care, and pediatric surgical ICUs have the potential to improve the value of care delivered to these complex patients. Well-designed, prospective, observational studies are needed to assist in defining appropriate outcome and quality measures to inform the development of these specialized units. Currently, there are a variety of models used in children's hospitals to care for critically ill surgical patients. This represents a tremendous opportunity for a collaborative, multidisciplinary effort amongst pediatric medical and surgical intensivists.
Renal replacement therapies for infants and children in the ICU
Authors: Sanderson Keia R. , Harshman Lyndsay A. 
Published: April 2020

Purpose of review
Pediatric acute kidney injury (AKI) in critically ill patients is associated with increased morbidity and mortality. Emerging data support that the incidence of pediatric AKI in the ICU is rising. For children with severe AKI, renal replacement therapy (RRT) can provide a lifesaving supportive therapy. The optimal timing to deliver and modality by which to deliver RRT remain a point of discussion within pediatric (and adult) literature. This review discusses the use of RRT for pediatric patients in the ICU. We discuss the most recent evidence-based methods for RRT with a focus on continuous RRT.

Recent findings
The feasibility of dialyzing the smallest infants and more medically complex children in the ICU is dependent on the advancements in dialysis access and circuit technology. At present, data indicate that upward of 27% of children in the ICU develop AKI and 6% require RRT. Newer dialysis modalities including prolonged intermittent hemodialysis and continuous flow peritoneal dialysis as well as newer dialysis technologies such as the smaller volume circuits (e.g., Cardio-Renal Pediatric Dialysis Emergency Machine, Newcastle Infant Dialysis and Ultrafiltration System) have made the provision of dialysis safer and more effective for pediatric patients of a variety of sizes.

Summary
Renal replacement in the ICU requires a multidisciplinary team approach that is facilitated by a pediatric nephrologist in conjunction with intensivists and skilled nursing staff. Although mortality rates for children on dialysis remain high, outcomes are improving with the support of the multidisciplinary team and dialysis technology advancements.
Extracorporeal membrane oxygenation in the pediatric population – who should go on, and who should not
Authors: Etchill Eric W. , Dante Siddhartha A. , Garcia Alejandro V. 
Published: April 2020

Purpose of review
The role of extracorporeal membrane oxygenation (ECMO), a method of providing cardiorespiratory support in instances of cardiac or respiratory failure, in neonates and children continues to expand and evolve. This review details the current landscape of ECMO as it applies to neonates and children.

Recent findings
Specifically, this review provides the most recent evidence for which patients should be considered for the various forms of ECMO including venovenous ECMO, venoarterial-ECMO, and extracorporeal cardiopulmonary resuscitation. Specific topics to be discussed include indications and contraindications for the different types of ECMO in neonates and children, anticoagulation strategies and ways to monitor end-organ function, outcomes specific to the different types and populations with a focus on meaningful survival to discharge and neurologic outcomes, and consideration of special populations such as low birth weight infants, traumatically injured patients, and children who received recent bone marrow transplants. This review also discusses still unanswered questions surrounding the most appropriate use of ECMO as its role and applications continue to evolve.

Summary
With rapidly increasing utilization of ECMO, neonatologists and pediatricians should be aware of the most recent evidence guiding its indications, applications, and limitations.
An update on frailty in lung transplantation
Authors: Varughese Rhea , Rozenberg Dmitry , Singer Lianne G. 
Published: April 2020

Purpose of review
Frailty is prevalent in lung transplant candidates, and recent studies have demonstrated associations with increased mortality before and after transplantation. This review highlights important findings on the trajectory of frailty throughout the lung transplant process and provides valuable insight into frailty and some of its modifiable elements.

Recent findings
There have been several frailty indices used in lung transplantation, specifically the Frailty Phenotype, Short Physical Performance Battery (SPPB), and Cumulative Deficits. The two most commonly used measures – Frailty Phenotype and SPPB – reflect physical frailty and have been associated with increased morbidity and mortality pre and post-transplantation. However, there is emerging evidence that physical elements of frailty are reversible with rehabilitation before and after transplantation with improvement in frailty by 6 months after transplantation. The associations of frailty with physical activity levels, exercise capacity, and inflammation are discussed.

Summary
Frailty is prevalent before transplant, but physical frailty is modifiable with rehabilitation and transplantation. Thus, physical frailty should not be an absolute contraindication to lung transplantation, but efforts should focus on elements of frailty that are potentially modifiable.
Forgiveness and Health Outcomes in Cancer Survivorship
Authors: Kim Jeongsuk , Hulett Jennifer , Heiney Sue P. 
Published: April 2020

BackgroundReligious and spiritual beliefs including forgiveness are an important aspect of cancer survivorship; however, the relationship between forgiveness and health is not well understood.ObjectiveThe aim of this study was to conduct a scoping review that examines and maps the current research regarding relationships between forgiveness and health outcomes in individuals with cancer.MethodsWe searched 5 electronic databases using key search terms related to forgiveness and cancer. Using a scoping review framework, we synthesized the existing literature regarding forgiveness and health among individuals with cancer and examined forgiveness as a process for coping with cancer.ResultsWe located 277 articles for review; 24 met inclusion criteria. Forgiveness in interpersonal relationships emerged more often as forgiveness coping than other types of forgiveness. Most studies reported a positive association between forgiveness and mental health. Fewer studies were available regarding relationships between forgiveness and physical health, and findings were mixed.ConclusionsForgiveness in interpersonal relationships is a spiritual concern for individuals with cancer. Addressing forgiveness needs may promote mental health in cancer survivors. More empirical evidence is needed to understand the role of forgiveness in physical health in individuals with cancer.Implications for PracticeAcknowledging forgiveness beliefs is a psychosocial-spiritual intervention that nurses can provide to support mental health in individuals with cancer. The potential role of forgiveness in physical health for individuals with cancer requires further study.
Body Image, Sexuality, and Sexual Functioning in Women With Gynecologic Cancer
Authors: Wilson Christina M. , McGuire Deborah B. , Rodgers Beth L. , Elswick R. K. , Temkin Sarah M. 
Published: April 2020

BackgroundCervical and uterine cancers are common in women. Diagnosis and treatment of these cancers can lead to significant issues with body image, sexuality, and sexual functioning. A comprehensive review can improve understanding of these 3 concepts, in turn enhancing identification and management.ObjectivesTo (1) present the qualitative, descriptive, and correlational research literature surrounding body image, sexuality, and sexual functioning in women with uterine and cervical cancer; (2) identify gaps in the literature; and (3) explore the implications of the findings for future research.MethodsA comprehensive search of the literature was undertaken by searching PubMed, CINAHL, and PsycINFO using predetermined subject headings, keywords, and exploded topics. After a comprehensive evaluation using specific criteria, 121 articles were reviewed.ResultsQualitative studies provided information about women’s issues with body image, sexuality, and sexual functioning, whereas quantitative studies focused primarily on sexual functioning. The literature lacks correlational studies examining body image and sexuality. Significant issues regarding communication and quality of life were noted, and few studies were based on clear conceptual models.ConclusionThe state of the science gleaned from this review reveals that while much is known about sexual functioning, little is known about body image and sexuality.Implications for PracticeFurther work is warranted to develop conceptual models and research on body image, sexuality, and sexual functioning as a foundation for interventions to improve quality of life.
3 Dimensions of Treatment Decision Making in Adolescents and Young Adults With Cancer
Authors: Pyke-Grimm Kimberly A. , Franck Linda S. , Halpern-Felsher Bonnie , Goldsby Robert E. , Rehm Roberta S. 
Published: April 2020

Background
Adolescents and young adults (AYAs) experience treatment nonadherence rates as high as 60%, which can increase the risk of cancer relapse. Involvement of AYAs in treatment decisions might support adherence to medical treatment.

Objective
The aim of this study was to explore the involvement of AYAs, aged 15 to 20 years, in cancer treatment decision making (TDM).

Methods
Using interpretive focused ethnography, we conducted interviews with 16 AYAs (total of 31 interviews) receiving cancer treatment within 1 year of diagnosis. Participants reflected on a major recent TDM experience (eg, clinical trial, surgery) and other treatment decisions.

Results
Participants distinguished important major cancer treatment decisions from minor supportive care decisions. We identified 3 common dimensions related to AYAs’ involvement in cancer TDM: (1) becoming experienced with cancer, (2) import of the decision, and (3) decision-making roles. The preferences of AYAs for participation in TDM varied over time and by type of decision. We have proposed a 3-dimensional model to illustrate how these dimensions might interact to portray TDM during the first year of cancer treatment for AYAs.

Conclusions
As AYAs accumulate experience in making decisions, their TDM preferences might evolve at different rates depending on whether the decisions are perceived to be minor or major. Parents played a particularly important supportive role in TDM for AYA participants.

Implications for Practice
Clinicians should consider the AYAs’ preferences and the role they want to assume in making different decisions in order to support and encourage involvement in their TDM and care.
Prevalence and Risk Factors of Falls in Adults 1 Year After Total Hip Arthroplasty for Osteoarthritis
Authors: Hunter Susan W. , Bobos Pavlos , Somerville Lyndsay , Howard James , Vasarhelyi Edward M. , Lanting Brent 
Published: April 2020

Abstract
Total hip arthroplasty is very successful in alleviating the pain from osteoarthritis. However, deficits in lower limb strength, gait, and balance after surgery has identified this group at risk of falls. Considering the high number of people annually receiving a total hip arthroplasty, further elaboration of factors associated with falls is needed to refine fall prevention guidelines. The objective was to examine the prevalence and circumstances of falling and the risk factors associated with falling in older adults in the first year after total hip arthroplasty surgery. This was a cross-sectional study involving 108 individuals (age of 72.4 ± 6.5 yrs, 60% females) who had unilateral total hip arthroplasty. The primary outcome was falls and their circumstances during the 12 mos after the total hip arthroplasty. Twenty-five people (23.1%) had at least one fall and most falls (56%) occurred 6–12 mos after surgery. Falls resulted in minor injuries for 44% and 12% reported major injuries. The strongest independent predictor for falls was a history of a previous joint replacement with odds ratio of 7.38 (95% CI = 2.41–22.62, P < 0.001). Overall, the information highlights that falls are common after total hip arthroplasty, yet considering the older age of people having this surgery screening for falls risk should follow established guidelines.
Outcome of Quality of Life for Women Undergoing Autologous versus Alloplastic Breast Reconstruction following Mastectomy: A Systematic Review and Meta-Analysis
Authors: Eltahir Yassir , Krabbe-Timmerman Irene S. , Sadok Nadia , Werker Paul M. N. , de Bock Geertruida H. 
Published: April 2020

Background:
This review aimed to meta-analyze the quality of life of alloplastic versus autologous breast reconstruction, when measured with the BREAST-Q.

Methods:
An electronic PubMed and EMBASE search was designed to find articles that compared alloplastic versus autologous breast reconstruction using the BREAST-Q. Studies that failed to present BREAST-Q scores and studies that did not compare alloplastic versus autologous breast reconstruction were excluded. Two authors independently extracted data from the included studies. A standardized data collection form was used. Quality was assessed using the Newcastle-Ottawa Scale. The mean difference and 95 percent confidence intervals between breast reconstruction means were estimated for each BREAST-Q subscale. Forest plots and the I
2 statistic were used to assess heterogeneity and funnel plot publication bias. The Z test was used to assess overall effects.

Results:
Two hundred eighty abstracts were found; 10 articles were included. Autologous breast reconstruction scored significantly higher in the five subscales than alloplastic breast reconstruction. The Satisfaction with Breasts subscale indicated the greatest difference, with a mean difference of 6.41 (95 percent CI, 3.58 to 9.24; I

2
= 70 percent). The Satisfaction with Results subscale displayed a mean difference of 5.52. The Sexual Well-Being subscale displayed a mean difference of 3.85. The Psychosocial Well-Being subscale displayed a mean difference of 2.64. The overall difference in physical well-being was significant, with high heterogeneity (mean difference, 3.33; 95 percent CI, 0.18 to 6.48; I

2
= 85).

Conclusion:
Autologous breast reconstruction had superior outcomes compared with alloplastic breast reconstruction as measured by the BREAST-Q.
Immediate Contralateral Mastopexy/Breast Reduction for Symmetry Can Be Performed Safely in Oncoplastic Breast-Conserving Surgery
Authors: Deigni Olivier A. , Baumann Donald P. , Adamson Karri A. , Garvey Patrick B. , Selber Jesse C. , Caudle Abigail S. , Smith Benjamin D. , Hanson Summer E. , Robb Geoffrey L. , Schaverien Mark V. 
Published: April 2020

Background:
Oncoplastic breast-conserving surgery expands the indications for breast conservation. When performed using modified mastopexy/breast reduction techniques, the optimal timing of the contralateral symmetrizing mastopexy/breast reduction remains unclear. This study examined the effect of the timing of symmetrizing mastopexy/breast reduction on oncoplastic breast-conserving surgery outcomes.

Methods:
A retrospective study was conducted of all patients who underwent oncoplastic breast-conserving surgery using mastopexy/breast reduction techniques at a single center from 2010 to 2016. Patients who received synchronous (immediate) contralateral breast symmetrizing mastopexy were compared with those who underwent a delayed symmetrizing mastopexy procedure. Demographic, treatment, and outcome data were collected. Descriptive statistics were used and multivariate analysis was performed to evaluate the various relationships.

Results:
There were 429 patients (713 breasts) included in the study; of these, 284 patients (568 breasts) underwent oncoplastic breast-conserving surgery involving mastopexy/breast reduction techniques and immediate symmetrizing mastopexy, and 145 patients underwent delayed contralateral symmetrizing mastopexy. The overall complication rate was similar between the immediate and delayed groups (25.4 percent versus 26.9 percent, respectively; p = 0.82), as was the major complication rate (10.6 percent versus 6.2 percent; p = 0.16). Complications resulted in a delay in adjuvant therapy in 18 patients (4.2 percent); in two patients (0.7 percent), this delay resulted from a complication in the contralateral symmetrizing mastopexy breast. Immediate contralateral symmetrizing mastopexy was not associated with increased risk of complications per breast (p = 0.82) or delay to adjuvant therapy (p = 0.6).

Conclusion:
Contralateral mastopexy/breast reduction for symmetry can be performed at the time of oncoplastic breast-conserving surgery in carefully selected patients without significantly increasing the risk of complications or delay to adjuvant radiation therapy.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Changing Role of Septal Extension versus Columellar Grafts in Modern Rhinoplasty
Authors: Rohrich Rod J. , Durand Paul D. , Dayan Erez 
Published: April 2020

Summary:
Effective control of nasal tip projection and rotation is a key component in modern rhinoplasty. Tip projection is a product of several anatomical factors: length and strength of lower lateral cartilages, the suspensory ligament, fibrous connections to the upper lateral cartilages, and the anterior septal angle. Several cartilage grafts have been described for effectively altering nasal tip projection and rotation. Columellar struts and septal extension grafts are both commonly used in modern rhinoplasty to affect projection and rotation of the nasal tip. Although columellar strut grafts have shown moderate efficacy in maintaining tip projection and unifying the tip complex, their effect on increasing tip projection has been shown to be very limited. In comparison, septal extension grafts have been shown to effectively control tip projection, rotation, and shape by securing the nasal tip to the septum. Varieties of septal extension grafts have been described to support the medial crura and control tip shape, all of which depend on the presence of a stable caudal septum. The type of graft used is dependent on the specific characteristics of the underlying tip structures. The authors’ aim is to provide an updated classification of cartilage grafts for altering nasal tip projection and rotation, and an algorithmic approach for their implementation. Although both columellar struts and septal extension grafts offer the modern rhinoplasty surgeon a way to alter tip projection and rotation, they do vary in efficacy. Understanding which graft to use and in what setting is key in successfully controlling projection, rotation, and shape of the nasal tip.
What Is Driving Paradigm Shifts in Plastic Surgery and Is Cosmetic Surgery Keeping Up?
Authors: Yao-Mei Tang Jasmine , Pawliuk Colleen , Bucevska Marija , Mulpuri Varshita , Arneja Jugpal S. 
Published: April 2020

Background:
Cosmetic surgery represents 20 to 30 percent of total plastic surgical volume. The authors hypothesize that with current capitalization and market share, cosmetic surgery should be proportionally represented in scientific innovation.

Methods:
All journals that may contain articles relevant to plastic surgery were selected from the 2016 edition of Journal Citation Reports. The authors identified, reviewed, and analyzed the 100 top-cited plastic surgery clinical articles using the Science Citation Index Expanded (1900 to 2017) as a proxy for innovation.

Results:
The top-100 articles were cited a median of 329.5 times (range, 240 to 1709 times). Sixteen journals were represented, led by Plastic and Reconstructive Surgery (45 percent) and Annals of Surgery (15 percent). Fifty-six percent were reconstructive, 13 percent were breast, 11 percent were pediatric/craniofacial, 11 percent were cosmetic, and 9 percent were hand/peripheral nerve articles. Only 11 percent of articles represented level of evidence I or II, with the majority (79 percent) of articles being level IV. Sixty-seven percent of publications originated from United States. The 11 cosmetic articles originated from different subspecialties: injectables, fillers, and fat grafting (n = 7); contouring (n = 2); facial cosmetic (n = 1); and general cosmetic (n = 1).

Conclusions:
Cosmetic innovation is not keeping up with reconstructive innovation; it is unknown why cosmetic surgery is lacking. The authors offer several speculations as to why there is a gap in cosmetic surgical research and, by proxy, innovation.