bluuebunny/crossref_metadata_2025_split huggingface dataset:
Empiric Switching of Gadolinium-Based Contrast Agents in Patients With History of Previous Immediate Hypersensitivity Reaction to GBCA
Authors: Walker Daniel , McGrath Trevor A. , Glikstein Rafael , Chakraborty Santanu , Blanchette Charles , Schieda Nicola 
Published: December 2020

Background
Breakthrough hypersensitivity reactions (HRs) to gadolinium-based contrast agent (GBCA) occur in 40% of patients despite corticosteroid premedication. Other strategies to reduce HRs are not well studied.

Objective
The aim of this study was to prospectively evaluate HR rate to GBCA among patients with history of HR to GBCA, empirically given an alternative GBCA prior to repeat administration.

Materials and Methods
From September 2019 to September 2020, patients with prior HR to GBCA received 13-hour oral corticosteroid and diphenhydramine premedication prescription with switching of GBCA to gadoterate (previously unavailable at our institution before September 2019). Power analysis (α error, 0.05; β error, 0.80) determined 21 patients were required. Patients were evaluated under a quality assurance waiver from the institutional review board. A radiologist documented the nature of initial HR and inciting GBCA, premedication received, incidence, and severity of breakthrough HR.

Results
After exclusions, we evaluated 26 patients with mild (92.3% [24/26]) or moderate (7.7% [2/26]) HR to gadobutrol (53.8% [14/26]), gadoxetate (3.8% [1/26]), and gadopentetate (3.8% [1/26]). In 38.5% (10/26), inciting GBCA was unknown but was likely gadobutrol or gadopentetate based on availability. There were 22 females. The mean patient age was 52.1 ± 15.8 years.
From 27 gadoterate administrations, 59.3% (16/27) patients received corticosteroid and diphenhydramine premedication, 11.1% (3/27) received only diphenhydramine, and 29.6% (8/27) with no premedication.
Hypersensitivity reaction rate after empiric switching to gadoterate was 3.7% (1 mild reaction; 95% confidence interval [CI], 0.09%–18.9%) overall with no difference in patients with (6.3% [1/16]; 95% CI, 0.15%–28.7%) or without (0%; [0/11] upper bound 95% CI, 25.0%) corticosteroid premedication.

Conclusions
In this prospective single-arm study, empirically switching GBCA to gadoterate in patients with prior HR to GBCA substantially reduced the expected rate of subsequent HRs in patients with and without the use of corticosteroid premedication.

Implications for Patient Care
Empirically switching GBCAs, with or without the use of corticosteroid premedication, can substantially reduce the rate of hypersensitivity breakthrough reactions.
Postoperative Health-related Quality of Life in Reduction Mammaplasty
Authors: Lin Yan , Yang Yan , Zhang Xiaoyu , Li Wandi , Li Haoran , Mu Dali 
Published: December 2020

Background
Breast hypertrophy is a chronic health problem. Until now, reduction mammaplasty is still a critical treatment for this disease. Given the publications, which reviewed the relationship between operation and quality of life, based on nonrandomized controlled studies and how low their quality are. Thus, we aimed to assess the effectiveness of reduction mammaplasty in improving health-related quality of life based on high-quality randomized-controlled trials.

Method
A systematic search of the following databases: PubMed (MEDLINE), the Cochrane Library, the Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, ClinicalTrials.gov, BIOSIS previews, and GreyNet. All the English publications have been searched without any restrictions of time, countries, or article type. Studies examining the effects of breast reduction versus control group on postoperative quality of life were included. Data on studies, patient characteristics, outcome measures were extracted. Statistical analysis was performed using Review Manager 5.3.

Results
In all, 7 randomized-controlled trials involving 285 participants were included, in which 4 studies were pooled in the meta-analysis. Because of the effect of reduction mammaplasty, statistically significant improvements were found on pain (standardised mean difference [SMD], −1.29; 95% confidence interval [CI], −1.63 to −0.96; P < 0.00001), physical function (SMD, 0.97; 95% CI, 0.69–1.25; P < 0.00001) and psychological function (SMD, −0.79; 95% CI, −1.07 to −0.52; P < 0.00001).

Conclusions
Our findings based on the randomized-controlled trials suggest that the quality of life of women undergoing breast reduction surgery is significantly improved. Reduction mammaplasty is an effective treatment for symptomatic breast hypertrophy.
Personal Approach to Optimizing Inframammary Fold Incision for Asian Augmentation Mammoplasty
Authors: Lai Ya-Wei , Huang Shu-Hung , Lee Youngdae , Chen Fang-Ming , Lai Chung-Sheng 
Published: December 2020

Background
The rates of aesthetic breast augmentation have risen substantially in Asia. Outcomes of various breast augmentation approaches in Asia have not been comprehensively studied. In the past, the inframammary approach to breast augmentation was not popular because of conspicuous scarring. In this article, the authors review academic articles related to the use of an inframammary incision for breast augmentation in Asian women and present our recommendations for the available techniques.

Methods
A literature search was performed for articles published after 2015 on Asian women with augmentation mammoplasty describing techniques, incision sites, outcomes, and complications. The search was performed using the MEDLINE, Embase, and Cochrane databases. We also included our own technique to demonstrate the outcome of augmentation mammoplasty through inframammary incision.

Results
Eight articles satisfied our inclusion criteria. Evidence indicates that with proper preoperative design and surgical techniques, scarring resulting from the inframammary approach is not inferior to that resulting from the transaxillary approach in Asian patients. Long-term satisfaction with the inframammary approach to breast augmentation is high in Asian patients.
Eight articles reported the outcomes of 1168 women receiving breast augmentation. Inframammary incisions were used in 45.29% of patients (529 patients). After the 2015 publication of Zelken's review paper on Asian breast augmentation, the rate of inframammary incisions increased from 3.1% to 45.29%.

Conclusions
With precise design of the new inframammary fold, accurate wound suture fixation, and postoperative scar care, the inframammary approach to breast augmentation offers optimal operative visualization, reduced pain, fewer complications, and desirable esthetic outcomes even in Asian patients. This study demonstrates that the percentage of inframammary fold approach of Asian esthetic mammoplasty grows rapidly after 2015.
Achieving an Optimal Outcome in Immediate Breast Reconstruction
Authors: Song Ping , Pu Lee L. Q. 
Published: December 2020

Abstract
Performing immediate breast reconstruction requires careful consideration of preoperative, intraoperative, and postoperative factors. One of the fundamental necessities is a well-coordinated multidisciplinary team to achieve successful reconstruction. Clear and effective communication between the oncological surgeon and plastic surgeon is imperative. The treatment plan must take into account any potential neoadjuvant and adjuvant therapies. Surgical planning and incisional approach must be carefully considered to optimize a safe oncologic surgery and ensure a viable reconstructive outcome. Furthermore, there are fundamentals to immediate breast reconstruction that must be met to obtain an aesthetically pleasing and structurally durable breast reconstruction. The goal of this article was to highlight important considerations in surgical planning and execution of immediate breast reconstruction so that an optimal outcome can be accomplished after either autologous or implant-based breast reconstruction.
Contemporary Breast Augmentation Practice in the United States
Authors: Xue Yunfeng , Pu Lee L.Q. 
Published: December 2020

Abstract
Breast augmentation is one of the most commonly performed cosmetic surgical procedures in the United States. Modern breast augmentation has evolved with the development of various implant options, as well as surgical techniques. To achieve ideal result, it is important for the surgeon to develop a systematic approach to evaluate each patient. The 5 key steps in determining the best surgical plan include: (1) assess the need for concurrent mastopexy, (2) implant selection, (3) pocket plane, (4) inframammary fold position, (5) choice of incision. The purpose of this review is to discuss the principles behind each of these key concepts and how to utilize them in achieving the optimal outcome in breast augmentation.
The Superficial Inferior Epigastric Artery Based Abdominal Flap for Reconstruction of Extensive Defects of the Hand and Forearm
Authors: Chaware Suresh Mahadev , Dhopte Amol Anand 
Published: December 2020

Introduction
The reconstruction of the hand and forearm targets the restoration of their function and aesthetic appearance. Inferiorly based abdominal flaps are reliable and versatile flaps that can cover large defects of the forearm and hand. Here we present a modified abdominal flap design based exclusively on the superficial inferior epigastric artery (SIEA) to reconstruct the hand and forearm's extensive defects. The donor site is closed primarily.

Methods
This is a retrospective study of the patients who underwent reconstruction of hand and forearm defects with SIEA flap from 2006 to 2018. The flap was designed on the ipsilateral hemiabdomen with a narrow pedicle based on the SIEA. We describe the anatomical basis and the outcomes of SIEA flap for reconstruction of the hand and forearm's extensive defects.

Results
Forty-eight soft tissue defects of the hand and forearm were reconstructed with the SIEA-based abdominal flap. Twenty-nine (60.41%) dorsal defects, 4 (8.33%) volar defects, 4 (8.33%) circumferential defects, 6 (12.5%) hand amputation stump, and 5 (10.41%) finger and thumb defects were covered using the SIEA flap. Forty-seven (97.91%) flaps had complete survival, whereas 1 (2.08%) flap had distal necrosis at the time of division. One (2.08%) flap had marginal necrosis, and 1 (2.08%) flap had distal necrosis after the division. The donor site was closed primarily in all patients. One (2.08%) patient had wound dehiscence at the abdominal donor site. All flaps gave excellent coverage with a satisfactory contour.

Conclusion
Abdominal flap based on SIEA is a safe, reliable, and versatile flap for the reconstruction of extensive soft-tissue defects of the hand and forearm. An ability to provide a large amount of skin and soft tissue and the abdominal donor site's primary closure make it a favorable option for upper limb reconstruction in regions with limited resources and technical expertise.
Palatal Re-Repair With Z-Plasty in Treatment of Velopharyngeal Insufficiency of Syndromic and Nonsyndromic Patients With Cleft Palate
Authors: Ahti Veera , Alaluusua Suvi , Vuola Pia , Rautio Jorma , Leikola Junnu , Saarikko Anne 
Published: December 2020

Background:
Velopharyngeal insufficiency (VPI) often results from palatal shortening or insufficient levator function after cleft palate repair.

Aims:
To assess the efficacy of palatal re-repair with Z-plasty in treatment of VPI for patients with isolated cleft palate (ICP).

Methods:
This retrospective analysis comprised 130 consecutive patients who had ICP with VPI that required Z-plasty as secondary surgery between 2008 and 2017. Pre- and post-operative evaluation of velopharyngeal function was done perceptually and instrumentally by Nasometer.

Results:
Median patient age at Z-plasty was 6.8 years (range 3.0–20.1). Of the 130 patients, preoperatively VPI was severe in 73 (56%), mild-to-moderate in 55 (42%), and borderline in 2 (2%). Postoperatively, 105 (81%) of patients achieved adequate (normal or borderline) velopharyngeal competence and 16 (12%) required second operation for residual VPI. The success rate was 84% in nonsyndromic patients, 79% in nonsyndromic Pierre Robin sequence patients, and 58% in syndromic patients. In syndromic children, the speech outcome was significantly worse than in nonsyndromic children (P = 0.014). Complications included wound healing problems in 3 patients (2%), mild infection in 1 patient (1%), postoperative bleeding in 1 (1%), and postoperative fistula in 2 (2%).

Conclusion:
Palatal re-repair with Z-plasty is a safe operation for VPI correction in patients with ICP with a success rate of 81%. In syndromic patients, the procedure did not seem to work as well as in nonsyndromic patients.
Examination of the Safe Zone in Mandibular Ramus Osteotomies
Authors: Sevmez Fatma , Orhan Mustafa , Bahşi Ilhan , Yalçin Eda Didem 
Published: December 2020

Abstract
In the surgical procedures such as osteotomy to be applied to ramus of the mandible, care should be taken not to damage the inferior alveolar nerve (IAN). The safe zone, which is the area above and behind the mandibular foramen (MF), is the ramus of mandible area, where these surgeries can be performed without damaging the inferior alveolar neurovascular bundle. It was aimed to determine the safe zone in the ramus of mandible in the cone-beam computed tomography (CBCT) images of individuals. The CBCT images of 300 Turkish individuals between the ages of 18 to 65 were bilaterally and retrospectively evaluated. Three parameters on the sagittal and two parameters on the axial plane were measured. Additionally, two ratios were calculated which determined the superior and posterior part of the safe zone through the measured parameters. In this study, the safe zone was determined as the area where 55% of the upper part and 49% of the posterior part of the mandibular ramus. Determining the safe zone in surgical procedures to be applied to the ramus of mandible will help protect the neurovascular structures passing through the MF, reduce complications and increase the success rate of the surgical procedure. However, it is seen that there are few studies on this subject in the literature and there are some differences between these studies. The authors think that preoperative CBCT screening will be safer for each patient in the mandibular ramus osteotomies and more studies should be done on different populations to determine standard values.
Bone Marrow-Derived Mononuclear Cell Transplantation Can Reduce Systemic Inflammation and Endothelial Glycocalyx Damage in Sepsis
Authors: Matsubara Tsunehiro , Umemura Yutaka , Ogura Hiroshi , Matsuura Hiroshi , Ebihara Takeshi , Matsumoto Hisatake , Yamakawa Kazuma , Shimizu Kentarou , Okada Hideshi , Shimazu Takeshi 
Published: December 2020

ABSTRACT
Bone marrow-derived mononuclear cells (BMMNCs) secrete anti-inflammatory mediators that protect against acute inflammation. Current evidence suggests that BMMNC transplantation can reduce acute tissue injury caused by systemic inflammation and lung dysfunction. This study evaluated the role of BMMNCs in reducing systemic inflammatory responses to vascular endothelial injury in sepsis. Bone marrow cells were harvested from the tibias and femurs of 12-week-old male Wistar rats; BMMNCs were separated by density centrifugation. Additional rats underwent cecal ligation and puncture (CLP) or similar sham surgery. BMMNCs were injected intravenously 30 min after CLP. The Sham and CLP Control groups were administered PBS. The 7-day survival rate improved markedly in the CLP-BMMNC group compared with that in the Control group. BMMNCs markedly suppressed the serum levels of pro-inflammatory mediators such as tumor necrosis factor-alpha, interleukin-6, and histone H3 at 3, 6, and 12 h after CLP. In the CLP-BMMNC group, the serum levels of syndecan-1, the main component of the vascular endothelial glycocalyx layer, were notably lower than those in the Control group 6 h after CLP. Histological analysis revealed improvement of morphological damages in the CLP-BMMNC group. Ultrastructural analysis revealed that the glycocalyx structure was maintained and the continuity of the vascular endothelial glycocalyx layer was preserved in the BMMNC group, compared with the case for the Control group at 6 and 12 h. Therefore, BMMNC transplantation may provide reduced systemic inflammation and endothelial glycocalyx damage, dramatically improving the survival of rats. These findings provide insights into formulating potential therapeutic strategies against sepsis.
The Nomenclature of Electroconvulsive Therapy
Authors: Sidhom Emad , Omar Mostafa Hussein 
Published: December 2020

Abstract
Electroconvulsive therapy (ECT) is an established but stigmatized psychiatric treatment. The term ECT reflects the treatment's modality and action. Several authors proposed different names for ECT to deal with stigma; however, available literature that promoted different names did not address the risk/benefit ratio or offer evidence-based approach to the efficacy of this approach. We aim to examine proposed names for their specificity, accuracy, understandability, and popularity. In addition, we aim to find evidence-based methods to combat the ECT-related stigma. We reviewed the literature relating to the proposed names using snowballing technique for literature search. Known ECT alternative names were used for search, and whenever another name appears, it was added to our search list. We conducted Medline, PsycINFO, Google Scholar, and PubMed search to check for popularity and cross examine whether proposed terms refer back to ECT. We searched for ECT and stigma, to find evidence for methods to tackle ECT-related stigma. Once, the search stopped yielding newer ideas, we stopped the search at a point of saturation, where no more ideas where generated. Our name search yielded 14 terms. Nine names avoided “electricity” and “convulsion,” because of perceived associated stigma. Presence of different terminology can affect the clarity of patient-doctor communication, with no evidence of added benefit. Alternative names may affect doctor-doctor communication about this treatment. We concluded that it is safer to retain the term ECT for the sake of consistency and clarity of communication. Education and experience are evidence-based effective methods of tackling ECT-related stigma.
Survival Rate Following Involuntary Electroconvulsive Therapy: A Population-Based Study
Authors: Salagre Estela , Rohde Christopher , Ishtiak-Ahmed Kazi , Gasse Christiane , Østergaard Søren D. 
Published: December 2020

Objective
Involuntary electroconvulsive therapy (ECT) can be a lifesaving intervention for patients suffering from potentially lethal conditions who are unable to give informed consent. However, its use is not widespread, probably partly because of the scarce data on hard outcomes following involuntary ECT. In Denmark, involuntary ECT is only used when patients are at imminent/potential risk of dying if not receiving ECT. Here, we aimed to estimate the 1-year survival rate after the administration of involuntary ECT as a proxy for the effectiveness of this treatment.

Methods
We conducted a register-based cohort study involving (i) all patients receiving involuntary ECT in Denmark between 2008 and 2019, (ii) age- and sex-matched patients receiving voluntary ECT, and (iii) age- and sex-matched individuals from the general population. One-year survival rates were compared via mortality rate ratios.

Results
We identified 618 patients receiving involuntary ECT, 547 patients receiving voluntary ECT, and 3080 population-based controls. The survival rate in the year after involuntary ECT was 90%. For patients receiving involuntary ECT, the 1-year mortality rate ratios were 3.1 (95% confidence interval, 1.9–5.2) and 5.8 (95% confidence interval, 4.0–8.2) compared with those receiving voluntarily ECT and to the population-based controls, respectively. Risk factors for early death among patients receiving involuntary ECT were male sex, being 70 years or older and having organic mental disorder as the treatment indication.

Conclusions
Treatment with involuntary ECT is associated with a high survival rate, suggesting that the intervention is effective. However, patients receiving involuntary ECT constitute a high-risk population that should be monitored closely after this treatment.
Regionalization in elderly care: what makes up a healthcare region?
Authors: Schuurmans Jitse Jonne , van Pijkeren Nienke , Bal Roland , Wallenburg Iris 
Published: December 2020

PurposeThe purpose of this paper is to explore the formation and composition of “regions” as places of care, both empirically and conceptually.Design/methodology/approachThis paper draws on action-oriented research involving experiments aimed at designing, implementing and evaluating promising solutions to the entwined problems of a burgeoning elderly population and an increasing shortage of medical staff. It draws on ethnographic research conducted in 14 administrative areas in the Netherlands, a total of 273 in-depth interviews and over 1,000 h of observations.FindingsThis research challenges the understanding of a healthcare region as a clearly bounded topological area. It shows that organizations and professionals collaborate in a variety of different networks, some conterminous with the administrative region established by policymakers and others not. These networks are by nature unstable and dynamic. Attempts to form new regional collaborations with neighbouring organizations are complicated by existing healthcare governance and accountability structures that position organizations as competitors.Practical implicationsPolicymakers should take the pre-established partnerships of healthcare organizations into account before delineating the area in which regionalization is meant to take place. A better alignment of governance and accountability structures is also needed for regionalization to occur in healthcare.Originality/valueThis paper combines insights from valuation studies with sociogeographical literature and provides a framework for understanding the assembling and disassembling of “regions”.
The factors affecting student satisfaction with online education during the COVID-19 pandemic: an empirical study of an emerging Muslim country
Authors: Basuony Mohamed A.K. , EmadEldeen Rehab , Farghaly Marwa , El-Bassiouny Noha , Mohamed Ehab K.A. 
Published: December 2020

Purpose
This study aims to investigate factors affecting students’ satisfaction with online learning during the COVID-19 pandemic.

Design/methodology/approach
This study uses quantitative data. A survey of 280 respondents, representing undergraduate students in business schools in Cairo, Egypt is conducted. The survey includes both public and private universities. The participants are questioned about their opinions and attitudes toward satisfaction with online learning amidst the COVID-19 pandemic.

Findings
The findings of this study reveal that Egyptian university students prefer to use synchronous teaching methods using different platforms. Attending virtual sessions and real-time conference call classes are the most preferred mode of delivery as perceived by the respondents. Also, the results of this study found that the internet, platform, class time, loss of interest, motivation and self-motivation and use of online exams as an assessment can be considered as the factors that significantly affect students’ satisfaction with online learning in Egypt.

Originality/value
To the best of the knowledge, this study is among the first group of studies in Muslim emerging countries that explore the factors affecting students’ satisfaction with online learning during the COVID-19 pandemic.