bluuebunny/crossref_metadata_2025_split huggingface dataset:
Old Friend or New Ally: A Comparison of Follicular Unit Transplantation and Follicular Unit Excision Methods in Hair Transplantation
Authors: Gupta Aditya K. , Love Robin P. , Harris James A. 
Published: March 2020

BACKGROUNDFollicular unit excision (FUE) and follicular unit transplantation using strip surgery (FUT) are the dominant graft harvest methods in hair transplantation. The increase in the demand for FUE has reignited the debate of the relative superiority of the 2 methods.OBJECTIVETo present a critical comparison of FUE and FUT graft harvesting techniques.MATERIALS AND METHODSSearch of PubMed, trade publications, and printed references.RESULTSFollicular unit excision and FUT methods provide high-quality grafts, but differ in their scarring patterns of the donor region. Follicular unit transplantation results in a linear scar, whereas FUE produces punctate scars that are typically easily concealed. Distinct subgroups of hair transplant patients are eligible for FUE, FUT, or both procedures.CONLCUSIONBoth FUE and FUT are equally effective in generating high-quality grafts. This detailed evaluation of the FUT and FUE procedures will assist hair restoration surgeons make informed decisions about the best approach for their patients.
The impact of peri-operative intravenous lidocaine on postoperative outcome after elective colorectal surgery
Authors: Rollins Katie E. , Javanmard-Emamghissi Hannah , Scott Michael J. , Lobo Dileep N. 
Published: March 2020

BACKGROUND
There has recently been increasing interest in the use of peri-operative intravenous lidocaine (IVL) due to its analgesic, anti-inflammatory and opioid-sparing effects. However, these potential benefits are not well established in elective colorectal surgery.

OBJECTIVES
To examine the effect of peri-operative IVL infusion on postoperative outcome in patients undergoing elective colorectal surgery.

DESIGN
A meta-analysis of randomised controlled trials (RCTs) comparing peri-operative IVL with placebo infusion in elective colorectal surgery. The primary outcome measure was postoperative pain scores up to 48 h. The secondary outcome measures included time to return of gastrointestinal function, postoperative morphine requirement, anastomotic leak, local anaesthetic toxicity and hospital length of stay.

DATA SOURCES
PubMed, Scopus and the Cochrane Library databases were searched on 5 November 2018.

ELIGIBILITY CRITERIA
Studies were included if they were RCTs evaluating the role of peri-operative IVL vs. placebo in adult patients undergoing elective colorectal surgery. Exclusion criteria were paediatric patients, noncolorectal or emergency procedures, non-RCT methodology or lack of relevant outcome measures.

RESULTS
A total of 10 studies were included (n = 508 patients; 265 who had undergone IVL infusion, 243 who had undergone placebo infusion). IVL infusion was associated with a significant reduction in time to defecation (mean difference −12.06 h, 95% CI −17.83 to −6.29, I
2 = 93%, P = 0.0001), hospital length of stay (mean difference −0.76 days, 95% CI −1.32 to −0.19, I
2 = 45%, P = 0.009) and postoperative pain scores at early time points, although this difference does not meet the threshold for a clinically relevant difference. There was no difference in time to pass flatus (mean difference −5.33 h, 95% CI −11.53 to 0.88, I
2 = 90%, P = 0.09), nor in rates of surgical site infection or anastomotic leakage.

CONCLUSION
This meta-analysis provides some support for the administration of peri-operative IVL infusion in elective colorectal surgery. However, further evidence is necessary to fully elucidate its potential benefits in light of the high levels of study heterogeneity and mixed quality of methodology.
Nitrate Esters Alleviated Coronary Atherosclerosis Through Inhibition of NF-κB–Regulated Macrophage Polarization Shift in Epicardial Adipose Tissue
Authors: Wei Chun-Yan , Wang Yong-Mei , Han Lu , Chen Fang-Fang , Li Yi-Hui , Tang Meng-Xiong , Zhang Wei , Wang Zhi-Hao , Zhong Ming 
Published: March 2020

Abstract:
Nitrate esters have been used in clinical practice for more than one century for the treatment of angina. Their clinical effectiveness is due to vasodilator activity in arteries through a method of delivering nitric oxide or a nitric oxide–like compound. Recently, an increasing numbers of functions of this molecule in biology and pathophysiology have been discovered. Macrophage polarization shift in epicardial adipose tissue (EAT) has been demonstrated to be correlated with the severity of coronary artery disease (CAD). In this study, we aimed to investigate whether nitrate esters could improve coronary atherosclerosis through inhibition of macrophage polarization shift in EAT. A case–control study enrolled 48 subjects in 2 groups: CAD patients with or without nitrate esters treatment. Infiltration of M1/M2 macrophages and the expressions of pro-inflammatory and anti-inflammatory cytokines in EAT and subcutaneous white adipose tissue were investigated by immunohistochemical stain among subjects undergoing coronary artery bypass graft surgery. The expression levels of metabolic genes were investigated by real-time reverse transcription-polymerase chain reaction (RT-PCR). We found that nitrate ester treatment significantly inhibited NF-кB activity and decreased macrophage infiltration and M1/M2 macrophage ratio in EAT in patients with CAD. The expressions of pro-inflammatory cytokines were significantly decreased, along with significantly elevated expressions of anti-inflammatory cytokines in CAD patients with nitrate ester treatment, corresponding EAT dysfunction was ameliorated and the severity of patients with CAD (Gensini score) was significantly decreased. The protective effects on macrophage polarization and EAT function through NF-кB activity inhibition suggested a potential mechanism of nitrate esters in alleviating the severity of CAD.
Consecutive hyperopia after myopic laser in situ keratomileusis: March consultation #1
Authors: Nuijts Rudy M.M.A. , Kartal Serdar 
Published: March 2020

A 31-year-old woman was seen at our clinic with dissatisfying hyperopic error after a myopic laser treatment of her left eye in April 2018. The surgery took place 1 year previously. There were no abnormalities in her medical history.
The preoperative corrected distance visual acuity (CDVA) in the left eye was 20/16 with −7.50 −0.50 × 75. The refraction in the right eye was −3.50 −1.25 × 90. The cycloplegic correction of the left eye preoperatively was −6.50 −0.50 × 68. A femtosecond-assisted laser in situ keratomileusis procedure was performed with an optical zone of 6.3 mm, an ablation zone of 7.97 mm, and a maximum ablation depth of 121 μm. The laser was set at a correction of −7.50 −0.5 × 75. The temperature and humidity during the laser treatment were 20 degrees and 47%, respectively. Figure 1 shows the excimer laser treatment data (AMARIS 750, SCHWIND eye-tech-solutions).
At 1 week postoperatively the uncorrected distance visual acuity (UDVA) was 20/25, and at 1 month postoperatively the CDVA was 20/16 with +2.50. Slitlamp examination showed a clear cornea. No corneal topography was made at that timepoint. At referral 7 months later, the patient's UDVA was 20/100 and CDVA was 20/16 with +2.50 −1.25 × 140 in the left eye. The patient reports decreased vision since the treatment in 2018 and wants to see better without spectacles.
Figure 2 shows the postoperative Scheimpflug topography of the left eye, flat keratometry (K1) 36.1 @ 178.4 and steep keratometry (K2) 36.6 @ 88.4. What do you believe could be the cause of this overcorrection? What is your advice in terms of correction of the refractive error for this patient?
Child and Family Perspectives on Adjustment to and Coping With Pediatric Inflammatory Bowel Disease
Authors: Easterlin Molly C. , Berdahl Carl T. , Rabizadeh Shervin , Spiegel Brennan , Agoratus Lauren , Hoover Clarissa , Dudovitz Rebecca 
Published: March 2020

ABSTRACTObjectives:Children with inflammatory bowel disease (IBD) are at increased risk for poor mental health. The etiology of this risk is not clear, though may be related to the disease, its treatment, and/or the experience of these. We sought to describe the challenges that children with IBD and their families face in living with a chronic condition and undergoing repeated intravenous infusions; and identify coping mechanisms to understand how medical systems may support resilience.Methods:Semistructured qualitative interviews with 18 patient‐guardian dyads at a tertiary outpatient infusion center, explored feelings related to IBD, the infusion process, and coping. Interviews were recorded, transcribed, and analyzed in ATLAS.ti. Two coders identified themes; developed a codebook and coded transcripts using the constant comparative method; and described themes/patterns.Results:Participants identified challenges related to IBD (unpredictable nature, disrupted normalcy, treatment decisions, managing relationships, life transitions) and a subset of challenges related to the infusion procedure (anxiety of unknown, managing pain/anxiety during IV placement, logistics). Participants coped through social support, cognitive strategies (positive attitude) and/or behavioral strategies for managing emotions (preparation for intravenous [IV] placement), and confidence in the medical care. By employing these coping strategies, participants came to accept IBD, adapt to the “new norm,” and learned life lessons and resilience.Conclusions:To support coping, clinical teams might provide anticipatory guidance to decrease anxiety of the unknown and identify cognitive‐behavioral strategies for managing emotions. Delivery systems that build relationships, maintain normalcy, and consider needs of the family may further facilitate coping.
Providing Early Attending Physician Expertise via Telemedicine to Improve Rapid Response Team Evaluations*
Authors: Fiero Marie L. , Rosenblatt Samuel , Zhang Bingqing , Snyder Megan , Priestley Margaret A. , Chuo John , Fuller Kate , Mensinger Janell , Bonafide Christopher P. , Sutton Robert M. 
Published: March 2020

Objectives:
To evaluate the effect of providing early attending physician involvement via telemedicine to improve the decision process of rapid response teams.

Design:
Quasi-experimental; three pairs of control/intervention months: June/July; August/October; November/December.

Setting:
Single-center, urban, quaternary academic children’s hospital with three-member rapid response team: critical care fellow or nurse practitioner, nurse, respiratory therapist. Baseline practice: rapid response team leader reviewed each evaluation with an ICU attending physician within 2 hours after return to ICU.

Subjects:
1) Patients evaluated by rapid response team, 2) rapid response team members.

Interventions:
Implementation of a smartphone-based telemedicine platform to facilitate early co-assessment and disposition planning between the rapid response team at the patient’s bedside and the attending in the ICU.

Measurements and Main Results:
As a marker of efficiency, the primary provider outcome was time the rapid response team spent per patient encounter outside the ICU prior to disposition determination. The primary patient outcome was percentage of patients requiring intubation or vasopressors within 60 minutes of ICU transfer. There were three pairs of intervention/removal months. In the first 2 pairs, the intervention was associated with the rapid response team spending less time on rapid response team calls (June/July: point estimate –5.24 min per call; p < 0.01; August/October: point estimate –3.34 min per call; p < 0.01). During the first of the three pairs, patients were significantly less likely to require intubation or vasopressors within 60 minutes of ICU transfer (adjusted odds ratio, 0.66; 95 CI, 0.51–0.84; p < 0.01).

Conclusions:
Early in the study, more rapid ICU attending involvement via telemedicine was associated with rapid response team providers spending less time outside the ICU, and among patients transferred to the ICU, a significant decrease in likelihood of patients requiring vasopressors or intubation within the first 60 minutes of transfer. These findings provide evidence that early ICU attending involvement via telemedicine can improve efficiency of rapid response team evaluations.
Superonasal Transconjunctival Optic Nerve Sheath Decompression: A Simplified Technique for Safe and Efficient Decompression
Authors: Melson Andrew T. , Warmath Jacob D. , Moreau Annie , Farris Bradley K. 
Published: March 2020

Background:
Severe, permanent vision loss is a feared sequela of untreated or refractory idiopathic intracranial hypertension (IIH). For patients with progressive vision loss despite maximally tolerated medical treatment, optic nerve sheath decompression (ONSD) remains a viable and effective option to protect vision. Our objective is to introduce a modified transconjunctival technique for ONSD and determine its safety, efficacy, and efficiency in patients with IIH.

Methods:
We performed analyses for a retrospective case series of consecutive patients with IIH by modified dandy criteria who underwent isolated superonasal transconjunctival optic nerve sheath decompression (stOND) at single eye institute in a large academic center from January 2013 to February 2017. Sixty-six patients were identified who met these criteria with at least 6 weeks of follow-up data. Primary outcome measures were visual field mean deviation, grading of papilledema by the modified Frisen scale, and best-corrected visual acuity. Secondary outcome measures were presence of postoperative diplopia and operative time.

Results:
One hundred thirty-two eyes of 66 patients were identified; 58 were female (88%), and 8 were male (12%). The mean age was 30 years (range 13–55) with an average lumbar puncture opening pressure of 38 cm H2O. Participants mean body mass index was 36 (range 20–59) with Grade 3 papilledema on average by the modified Frisen scale. No patients experienced operative complications, postoperative diplopia, or worse visual acuity at 1 week after surgery. Average operative time was 50 minutes (range: 25–89). The median decrease in papilledema grading was 3 grades on the Frisen scale (95% confidence interval [CI], 2–3, P < 0.0001). Snellen visual acuity changes did not meet statistical significance. The average Humphrey Visual Field mean deviation change was +1.91 (95% CI, 0.58–3.24, P = 0.0052). Despite successful bilateral decompressions, 4 patients (6.1%) progressed in their visual loss.

Conclusions:
The superonasal transconjunctival approach to ONSD is a safe, efficient and effective surgical treatment for patients with deteriorating visual function due to IIH. Although additional study is required to further clarify the best timing and indications for ONSD among other treatment options for refractory IIH, providers should be aware of the reduced complication rates and efficacy of the stOND technique.
Enhancing Stroke Recovery Across the Life Span With Noninvasive Neurostimulation
Authors: Dukelow Sean , Kirton Adam 
Published: March 2020

Summary:
Stroke is the leading cause of neurologic disability not only in adults but perinatal and childhood stroke affect millions of children as well worldwide with deficits that last a lifetime. The rapidly increasing evidence base for how noninvasive neuromodulation may enhance stroke recovery in adults may be applicable to the youngest stroke survivors. In return, how the plasticity of the developing brain contributes to stroke recovery and its modulation may provide equally valuable insight toward mechanisms and opportunities for enhancing recovery in all stroke patients. Despite this synergistic relationship, examinations of stroke recovery and neuromodulation across the life span have rarely been considered. Here, we attempt to amalgamate the worlds of adult, childhood, and perinatal stroke to explore the differences and commonalities between the models and approaches that are driving advances in noninvasive neuromodulation toward better outcomes for stroke patients of all ages.
Safety and Tolerability of Repetitive Transcranial Magnetic Stimulation During Pregnancy: A Case Report and Literature Review
Authors: Damar Ugur , Lee Kaye Harper , Smith Nicole A. , Pennell Page B. , Rotenberg Alexander 
Published: March 2020

Summary:
Patients with neuropsychiatric disease may benefit from repetitive transcranial magnetic stimulation as a nonpharmacologic alternative to relieve symptoms of major depression, obsessive compulsive disorder, and perhaps other syndromes such as epilepsy. We present a case of repetitive transcranial magnetic stimulation treatment as an adjunct therapy for a patient experiencing refractory epileptic seizures during the third trimester of pregnancy. Notably, the patient tolerated repetitive transcranial magnetic stimulation well, without adverse events, and delivered a healthy child. We also summarize the current literature pertaining to therapeutic repetitive transcranial magnetic stimulation use during pregnancy.
Neurophysiological Intraoperative Monitoring in the Elderly
Authors: De la Maza Krzeptowsky Lilia C. , San-Juan Daniel , Ximénez Camilli Cecilia , Alvarez Perera Luis Á. , Valdez Ruvalcaba Hector , Morales Báez Jorge A. , Anschel David J. 
Published: March 2020

Introduction:
Intraoperative neurophysiological monitoring (IONM) is widely used to prevent nervous system injury during surgeries in elderly patients. However, there are no studies that describe the characteristics and changes in neurophysiological tests during the IONM of patients aged 60 years and older. The study aims to describe and compare IONM changes during surgeries in adult patients aged 18 to 59 years with those aged 60 years and older.

Methods:
We performed a comparative retrospective study of patients aged 18 to 59 years versus those 60 aged years and older who underwent IONM during 2013 to 2018 in Mexico City. Sociodemographic characteristics were recorded and compared. Intraoperative neurophysiological monitoring techniques, their changes, and surgical procedures for both groups were analyzed and compared using descriptive statistics, Mann–Whitney U, Fisher, and χ2 tests. The sensitivity, specificity, and positive and negative predictive values were calculated.

Results:
In total, 195 patients were analyzed: 104 patients, 68.63 ± 6.54 years old (elderly group) and 91 patients, 42.3 ± 10.5 years old (younger group). No differences were found in the rates of signal change during IONM between the group of elderly patients and the younger group. The sensitivity, specificity, and positive and negative predictive values were 80%, 99%, 80%, and 99%, respectively.

Conclusions:
Elderly patients have a similar rate of changes in IONM signals compared with younger patients during heterogeneous surgeries guided by IONM.
Intrarater and Interrater Reliability of Heckmatt Scoring System in Amyotrophic Lateral Sclerosis
Authors: Kenis-Coskun Ozge , Gunes Taskin , Isak Baris , Yagci Ilker 
Published: March 2020

Purpose:
This study aims to determine the intrarater and interrater reliability of the Heckmatt score in the upper extremity muscles in patients with amyotrophic lateral sclerosis and to investigate its relationship with the clinical features and quantitative echo intensity measurements.

Methods:
The Heckmatt scores of multiple upper extremity muscles were calculated in 28 patients with amyotrophic lateral sclerosis and examined the relationships of these values with quantitative ultrasound (QUS) measurements and the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised.

Results:
The Heckmatt scores showed strong intrarater and interrater correlations with Cohen's Kappa scores ranging from 0.7 to 0.91. In all investigated muscles, the Heckmatt scores showed moderate correlations with quantitative echo intensity measurements and Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised dressing subscale.

Conclusions:
The Heckmatt score is a reliable method in evaluating muscles of the upper extremities in patients with amyotrophic lateral sclerosis. It moderately correlates with quantitative values and functional status.
Relationships between workload perception, burnout, and intent to leave among medical–surgical nurses
Authors: Phillips Carswella 
Published: March 2020

ABSTRACT

Aim:
These are turbulent times for hospitals, patients, and nurses. Nurse turnover is a global issue across all specialties but are exacerbated in medical–surgical areas where high nurse–patient ratios, use of point-of-care technologies, and stressful working conditions require sufficient numbers of highly trained nurses. These workload factors are further exaggerated by the current nursing shortage. The current nursing shortage crisis makes nursing job conditions more important than ever to examine. Despite heavy emphasis on promoting healthy work environments, job satisfaction, and retention of nurses working in intensive care and emergency room settings, limited research is available about the workload perception, burnout, and intent to leave among medical–surgical nurses. This study aimed to describe the relationships between workload perception, burnout, and intent to leave among medical–surgical nurses at two teaching hospitals in Southeastern United States.

Methods:
A survey design and convenience sampling method was used. A sample of 58 medical–surgical staff nurses participated in the study. A 42-item questionnaire composed of a demographic survey, Individual Workload Perception Scale, and Maslach Burnout Inventory Scale were used. Simple descriptive statistics, Pearson's product–moment correlations, and multiple regression analysis procedures were used to analyze the data.

Results:
More than half of the respondents reported high workloads and intentions to leave their current position. The overall burnout level for the sample was moderate to high. Moderate-to-strong intercorrelations were found between workload perception and intent to leave (r = 0.513, P < 0.0001), burnout and intent to leave (r = −0.435, P < 0.0006), and workload perception and burnout (r = −0.588, P < 0.0001). Workload perception and burnout among medical–surgical nurses both factored significantly on the intent to leave a current job (P < 0.05).

Conclusion:
The current study provides new insights about the relationships between workload perception, burnout, and intent to leave among medical–surgical nurses. The findings indicate the higher the nurses’ workload perception, the more likely they will leave their current job. Nurse managers should consider these findings when developing strategies to improve the work environment and nurse retention. Additional research is needed to gain more insight into the causality among workload perception, burnout, and intent to leave a current job among medical–surgical nurses.