bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insulin Pump Therapy
Authors: Nimri Revital , Nir Judith , Phillip Moshe 
Published: December 2019

Background:
Advances in pump technology have increased the popularity of this treatment modality among patients with type 1 diabetes and recently also among patients with type 2 diabetes.

Areas of Uncertainty:
Four decades after the incorporation of the insulin pump in clinical use, questions regarding its efficacy, occurrence rate of short-term complications as hypoglycemia and diabetes ketoacidosis, timing of pump initiation, and selected populations for use remain unanswered.

Data Sources:
A review of the literature was performed using the PubMed database to identify all articles published up till December 2018, with the search terms including insulin pump therapy/continuous subcutaneous insulin delivery. The Cochrane database was searched for meta-analysis evaluating controlled randomized trials. Consensuses guidelines published by the International Society for Pediatric and Adolescent Diabetes, American Diabetes Association, and Advanced Technologies and Treatments for Diabetes year books were additionally reviewed for relevant cited articles.

Therapeutic Advances:
Insulin pump therapy offers flexible management of diabetes. It enables adjustment of basal insulin to daily requirements and circadian needs, offers more precise treatment for meals and physical activity, and, when integrated with continuous glucose monitoring, allows glucose responsive insulin delivery. The ability to download and transmit data for analysis allow for treatment optimization. Newer pumps are simple to operate and increase user experience. Studies support the efficacy of pump therapy in improving glycemic control and reducing the occurrence of hypoglycemia without increasing episodes of diabetes ketoacidosis. They also improve quality of life. Recent evidence suggests a role for pump therapy in reducing microvascular and macrovascular diabetes-related complications.

Conclusions:
Insulin pump therapy appears to be effective and safe in people with T1D regardless of age. Future advancements will include incorporation of closed loop and various decision support systems to aid and improve metabolic control and quality of life.
The Lived Experience of Work-Related Issues Among Oncology Nurses
Authors: Diaw Marielle , Sibeoni Jordan , Manolios Emilie , Gouacide Jean-Marc , Brami Cloé , Verneuil Laurence , Revah-Levy Anne 
Published: December 2019

Background
Many qualitative studies have focused on the experience of nurses specialized in oncology and the ways they describe and understand that experience.

Objective
We aimed to perform a metasynthesis, a systematic review, and an analysis of qualitative studies focused on the experiences and perspectives of oncology nurses about work-related issues.

Methods
We searched international publications to identify relevant qualitative research exploring oncology nurses’ experiences. Thematic analysis was used to identify key themes and synthesize them.

Results
We identified 63 articles from 61 studies (>1000 nurses) from 23 countries. Two main themes emerged: (1) the relational dimension of work-related issues, on the one hand with other professionals and on the other hand with patients and families; and (2) the strategies for coping with the work-related difficulties, including partnership, communication and support, and training.

Conclusions
Our results revealed the central place of loneliness. The nurses simultaneously described feeling lonely due to their individual stance and being alone due to the absence of institutional support, with a confusion between these 2 forms of loneliness. This finding echoes specific aspects of oncology.

Implications for Practice
Specific training and support group appear to be relevant ways to help oncology nurse to cope better with this loneliness and to bear the stress of this difficult field.
Differentiating Parkinson Disease Subtypes Using Clinical Balance Measures
Authors: Prime Morgane , McKay J. Lucas , Bay Allison A. , Hart Ariel R. , Kim Chaejin , Abraham Amit , Hackney Madeleine E. 
Published: December 2019

Background and Purpose:
People with Parkinson disease (PD) present phenotypes that are characterized as tremor-dominant (TD) or postural instability/gait difficulty (PIGD) subtypes. Differentiation of subtypes allows clinicians to predict disease course and adjust treatment. We examined whether brief mobility and balance measures can discriminate PIGD from TD phenotypes.

Methods:
We performed a cross-sectional study with individuals with PD (n = 104). Blinded raters assessed participants with the Unified Parkinson's Disease Rating Scale (UPDRS) or Movement Disorders Society revision (MDS-UPDRS), and balance assessments: 360° turn test, one-leg stance, a reactive postural control test, and tandem walk. Participants were classified as PIGD or TD based on the UPDRS or MDS-UPDRS assessment results. Differences in balance variables between subtypes were assessed with univariate analyses. Receiver operating characteristic (ROC) curve analyses were performed to investigate the ability of balance variables to differentiate PD subtypes.

Results:
No differences between subtypes were observed for tandem walk or reactive postural control. Participants with PIGD performed worse on number of steps and time to complete the 360° turn test and on one-leg stance time. ROC curves showed only the 360° turn test discriminated PIGD from TD with high specificity (0.84). Post hoc analyses revealed that the 360° turn test is the most discriminatory for classifying PD subtypes in early stages of the disease. ROC analyses based on combined models including both the 360° test and tandem walk test performance increased the specificity to 0.97.

Discussion and Conclusions:
The 360° turn test requires minimal time to administer and may be useful in mild-moderate PD for distinguishing PIGD from TD subtypes.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A295).
Week 96 results of a phase 3 trial of darunavir/cobicistat/emtricitabine/tenofovir alafenamide in treatment-naive HIV-1 patients
Authors: Orkin Chloe , Eron Joseph J. , Rockstroh Jürgen , Podzamczer Daniel , Esser Stefan , Vandekerckhove Linos , Van Landuyt Erika , Lathouwers Erkki , Hufkens Veerle , Jezorwski John , Opsomer Magda 
Published: December 2019

Background:
Darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) 800/150/200/10 mg was investigated through 96 weeks in AMBER (NCT02431247).

Methods:
Treatment-naive, HIV-1-positive adults [screening plasma viral load ≥1000 copies/ml; CD4+ cell count >50 cells/μl) were randomized (1 : 1) to D/C/F/TAF (N = 362) or D/C plus emtricitabine/tenofovir-disoproxil-fumarate (F/TDF) (N = 363) over at least 48 weeks. After week 48, patients could continue on or switch to D/C/F/TAF in an open-label extension phase until week 96.

Results:
At week 96, D/C/F/TAF exposure was 626 patient-years (D/C/F/TAF arm) and 109 patient-years (control arm post switch), week 96 virologic suppression (viral load <50 copies/ml; FDA-Snapshot, from baseline) was 85.1% (308/362) (D/C/F/TAF) and 83.7% (304/363) (control). Week 96 virologic failure (viral load ≥50 copies/ml; FDA-Snapshot) was 5.5% (20/362) and 4.4% (16/363), respectively. No darunavir, primary protease inhibitor or tenofovir resistance-associated mutations (RAMs) were observed post baseline. In one patient in each arm, an M184I and/or V RAM was detected. Few adverse event-related discontinuations (3% D/C/F/TAF; <1% control post switch) and no deaths occurred on D/C/F/TAF. Improved renal and bone parameters were maintained in the D/C/F/TAF arm and observed in the control arm post switch. Increases in total-cholesterol/high-density-lipoprotein--cholesterol rtio at week 96 were +0.25 versus baseline (D/C/F/TAF) and +0.24 versus switch (control).

Conclusion:
At week 96, D/C/F/TAF resulted in high virologic response and low virologic failure rates, with no resistance development to darunavir or TAF/TDF. Bone, renal and lipid safety were consistent with known D/C/F/TAF component profiles. Control arm safety post switch was consistent with the D/C/F/TAF arm. AMBER week 96 results confirm the efficacy, high barrier to resistance and bone/renal safety benefits of D/C/F/TAF for treatment-naive patients.
An Extraordinary Case of Brown Fat Distribution
Authors: Reichel Cedric , Deroose Christophe , Van Laere Koen , Goffin Karolien 
Published: December 2019

Abstract
We report the case of a 27-year-old woman who underwent an 18F-FDG PET/CT, after administration of 20 mg propranolol, 20 minutes preinjection, to investigate B-symptoms as well as right-sided shoulder pain. Unilateral hypermetabolism was seen in the left cervical, thoracic, and paravertebral brown fat, without any uptake on the contralateral side. The patient was born with neuroblastoma in the right thoracic area. She underwent surgery a few days after birth. As brown fat activation is under sympathetic control, we hypothesize that a surgical lesion to the right orthosympathetic trunk resulted in sympathetic denervation, responsible for this distribution.
Esophageal Adenocarcinoma With Subscalp Metastasis as the First Manifestation Detected by 18F-FDG PET/CT
Authors: Xu Tingting , Zhang Xinyi , Fu Wenhui , Zeng Chengrun , Chen Yue 
Published: December 2019

Abstract
Subscalp metastases occur infrequently in malignant tumors but may appear as an initial clinical presentation. This report presents the case of a 53-year-old man who recently found a painless nodule under the right side of his scalp. 18F-FDG PET/CT, endoscopy, and tissue biopsy diagnosed the nodule as a metastasis of esophageal adenocarcinoma.
18F-FDG PET/CT-Guided Diagnosis and Evaluation of Treatment Response to Cyclosporine A in Maldistributed Subcutaneous Panniculitis-like T-Cell Lymphoma Without Typical Skin Rash
Authors: Abe Yoshiaki , Narita Kentaro , Kobayashi Hiroki , Kitadate Akihiro , Takeuchi Masami , Matsue Kosei 
Published: December 2019

Abstract
A 30-year-old woman presented with persistent fever and elevated lactate dehydrogenase levels without skin rash. 18F-FDG PET/CT revealed FDG uptake in subcutaneous tissues in the forearm, buttocks, and lower limbs, whereas the trunk was unaffected. She was diagnosed with subcutaneous panniculitis-like T-cell lymphoma based on a PET/CT-guided subcutaneous tissue biopsy from the thigh. Although conventional cytotoxic agent–based chemotherapies failed to achieve disease remission, subsequent cyclosporine A treatment promptly resolved the fever and laboratory abnormalities. Remarkably, abnormal FDG uptake disappeared entirely on follow-up PET/CT, demonstrating its utility in the evaluations of responses to emerging cyclosporine A–based treatments in subcutaneous panniculitis-like T-cell lymphoma.
False-Positive 18F-FDG and 18F-Fluorothymidine Uptake in a Patient With Round Atelectasis
Authors: Norikane Takashi , Yamamoto Yuka , Mitamura Katsuya , Tani Ryosuke , Nishiyama Yoshihiro 
Published: December 2019

Abstract
A 64-year-old man with no significant medical history demonstrated a right lower lobe opacity on routine chest radiography. Transaxial CT showed a round, well-circumscribed, pleural mass with comet-tail sign in the right lower lobe and pleural thickening with pleural effusion. 18F-FDG PET/CT showed hypermetabolic activity in the mass (SUVmax 9.61). 18F-fluorothymidine PET/CT also showed mild increased uptake in the mass (SUVmax 3.26). Lung biopsy and follow-up CT scan revealed round atelectasis.
Near Complete Recovery of Visual Acuity After Calcium Hydroxylapatite Injection–Related Vision Loss
Authors: Liu Ying-Chun , Tsai Ming-Feng , Chen Yu-Fan 
Published: December 2019

Abstract
Injection of fillers has gained popularity over the past decades in aesthetic treatments. Calcium hydroxylapatite (CaHA; Radiesse) was introduced in the year 2003 and received approval from the Food and Drug Administration in 2006 for the treatment of moderate-to-severe wrinkles. The properties of CaHA include biostimulation, neocollagenesis, and stability over a long period. However, similar to other fillers, CaHA is associated with the risk of complications such as ecchymosis, inflammation, local infection, skin necrosis, and vascular occlusion. Iatrogenic vision loss remains the most devastating complication related to vascular occlusion. Development of vision impairment is associated with a relatively high risk of permanent damage to vision acuity and poor prognosis. The current report presents a case of a patient who suffered from skin necrosis, vision impairment, and ophthalmoplegia after the injection of CaHA into the nasal dorsum. Significant improvement in visual acuity was observed during hospitalization after the treatment. The patient recovered to near-normal visual acuity and completely recovered from ophthalmoplegia. We aimed to discuss the current treatment employed and review the literature on CaHA-related vision loss.
Attitudes of Hand Surgeons and Hand Reconstruction Patients Toward Hand Allotransplantation in Taiwan
Authors: Wei Hao-I , Do Nicholas T. , Din Rong-Yao , Lin Chih-Hung , Lin Cheng-Hung 
Published: December 2019

Background
Recent advances in immunosuppressive protocols have increasingly made hand allotransplantation a realistic reconstructive option with more than 100 cases performed worldwide. While attitudes toward allotransplantation have been assessed for North American surgeons and patients alike, similar assessments have previously remained unconducted in Asia in general and Taiwan in specific. This study examines the perceptions of both Taiwanese hand surgeons and hand reconstruction patients.

Methods
An email-based survey was sent to all active members of the Taiwanese Society for Surgery of the Hand. Surgeon training backgrounds and practice profiles were gathered as well as current beliefs on indications, risks, ethicality, priority of psychosocial issues, and obstacles to implementation. Patients receiving rehabilitation at Chang Gung Memorial Hospital Linkou after severe upper extremity injuries were invited to complete a patient survey. Demographics, injury characteristics, understanding of allotransplantation and immunosuppression, willingness to donate, and willingness to receive transplantation were assessed.

Results
Forty-four hand surgeons responded (24.3% response rate). The majority (61.4%) considered hand allotransplantation to be a high-risk operation, although 40% supported the development of hand allotransplantation under current techniques and immunosuppression. Bilateral hands loss was the most commonly accepted indication for transplant (90.9%), whereas dominant hand loss was less frequently accepted (43.2%). Treatment compliance and functional outcomes were the most frequent psychosocial issues of concern regarding patient counseling. Patient respondents were mostly in the fifth decade of life (29.5%) with at least a high school education (75.0%). Most were aware of the feasibility of hand transplantation (68.2%). Patients were more likely than surgeons to consider nondominant hand, multiple-digit, and thumb-only amputations as indications for transplantation. Functional outcomes and financial considerations were the most frequent patient concerns.

Conclusions
This study indicates there is support for hand allotransplantation as a solution for limb loss in both hand surgeons and hand patients in Taiwan. This study adds to the lack of knowledge regarding surgeon and patient attitudes toward allotransplantation in Asia, although further work is required to assess the willingness of broader Taiwanese medical to refer candidates and for the general population to donate.
Distant Intramuscular Metastases of Head and Neck Squamous Cell Carcinoma
Authors: Hsu I. , Yen Chao-Wu , Huang Kuo-Feng , Lin Yu-San 
Published: December 2019

ObjectivesMetastasis of head and neck squamous cell carcinoma (HNSCC) usually occurs regionally in the neck lymph nodes, but also more infrequently at distant organs (eg, the lungs, bone, and liver). Intramuscular metastasis (IMM) has rarely been described. Therefore, we aimed to identify this disease characteristic and to evaluate available medical management options.MethodsData of surgically treated HNSCC patients (n = 1150) at the Chi Mei Medical Center, Taiwan (2005–2015), were retrospectively reviewed. Literature searches were also conducted (1985–2015) to analyze the behavior of HNSCC with distant IMMs.ResultsWe identified 1 HNSCC patient with histopathologically proven IMMs. Ten similar cases were also identified in the available literature. Two-thirds of lesions arose in patients with laryngeal/hypopharyngeal malignancies, and two-thirds of lesions were located in the lower limbs. Lesions were subjectively painful and usually had rim enhancement with central hypoattenuation in contrast-enhanced computed tomography/magnetic resonance imaging. The mean duration between primary tumor diagnosis and secondary lesion detection was 13.7 months. No patient survived more than 2 years after establishing a diagnosis of HNSCC with IMMs.ConclusionsDistant IMMs are extremely rare in HNSCC patients and have a poor clinical outcome. Differentiating this disease from sarcoma via anatomic distribution or diagnostic imaging studies is not straightforward. Biopsies for histopathologic examination are mandatory. Treatment of HNSCC patients with IMMs is mainly palliative for life quality preservation and not lifetime prolongation. Radiotherapy is established as a first-line treatment for symptom control with surgical intervention usually preserved for refractory cases.
Use of Anterolateral Thigh Flap and Fibula Flap in Oncologic Maxillary Reconstruction
Authors: Chen Szu-Han , Kuo Yao-Lung , Chang Tzu-Yen , Lee Yao-Chou 
Published: December 2019

Background
Maxillary defects after oncologic resection can lead to not only cosmetic deformity but also functional problem. Reconstruction of maxillary defects remains the most challenging endeavor for plastic surgeons. An algorithm to guide plastic surgeons in selecting either the anterolateral thigh flap or the fibula flap for oncologic maxillary reconstruction has not been well established.

Methods
Patients who underwent oncologic maxillectomy and free flap reconstruction from August 2012 to April 2018 were enrolled for retrospective chart review. Their operative findings and postoperative outcomes were analyzed as a case series. The reconstructive plan was decided using the 4 essential components in sequence: the anterior maxillary arch, orbital floor, eyeball, and oro-sinonasal communication, which are the main considerations in the established classification systems. Accordingly, when the anterior maxillary arch was lost or when the orbital floor was lost with eyeball preservation, a fibula flap was used. Otherwise, an anterolateral thigh flap was used.

Results
Various maxillectomy defects were successfully reconstructed using an anterolateral thigh flap and a fibula flap. The defect types and corresponding reconstruction were fit into our proposed algorithm and classification. The corresponding outcomes were satisfactory.

Conclusion
The proposed algorithm by using the anterolateral thigh flap and the fibula flap for oncologic maxillary reconstruction is feasible, simple, and effective.
Myotomy In Situ for Essential Blepharospasm Refractory to Botulinum Toxin
Authors: Lai Hsin-Ti , Chen Austin D. , Lee Su-Shin , Lin Yi-Hui , Lai Chung-Sheng 
Published: December 2019

Background
Full myectomy is recommended for benign essential blepharospasm (BEB) refractory to botulinum toxin (BT) treatment, but long-term swelling, scar contracture, hollow appearance, and unnatural contour of the eyelids are common postoperative complications. We present myotomy in situ to minimize these adverse outcomes.

Methods
The redundant eyelid skin with its underlying muscle is resected first, and myotomy in situ is performed by completely cutting the residual orbicularis oculi muscles into multiple cubes and down to the subcutaneous layer, and then cutting the procerus and corrugator muscles down to the periosteum. Patient demographics, medical treatment history, BT injection history, blepharoptosis correction techniques, associated surgical procedures, and aesthetic outcomes were analyzed. Preoperative and postoperative BT injection dosage and frequency, as well as modified disability scores, were compared using paired Student t tests.

Results
Twenty-five patients underwent this technique. Their average ± SD age was 64.4 ± 8.9 years, with average postoperative follow-up occurring 17.0 ± 8.0 months. Associated diseases included blepharoptosis (88%) and apraxia of lid opening (44%). There were no postoperative hematoma, seroma, scar contracture, and depressed hollow eyelid contours. Preoperative to postoperative assessments revealed improvements in mean BT injection interval (10.4 ± 2.1 to 14.6 ± 2.9 weeks, P < 0.001), BT injection dosage (44.4 ± 13.3 to 28.1 ± 6.7 units, P < 0.001), and modified disability score (15.3 ± 3.0 to 2.8 ± 2.2, P < 0.001). All patients were highly satisfied with functional and aesthetic surgical outcomes (4.5 ± 0.6 on Likert scale).

Conclusions
Myotomy in situ is effective for patients with BEB who are refractory to BT treatment, with therapeutic benefits similar to that of full myectomy with the ability to maintain favorable cosmetic results. Relative high incidence of blepharoptosis and apraxia of lid opening in patients with refractory BEB was reported. Simultaneous correction of the ptosis can further optimize outcomes.
Knowledge about benefits and risks of undergoing cataract surgery among cataract patients in Southern China
Authors: Ye Guofang , Qu Bo , Shi Wen , Chen Xin , Ma Pengjuan , Zhong Yuxin , Chen Shida , Lamoureux Ecosse , Zheng Yingfeng 
Published: December 2019

AbstractObjectiveTo develop a theoretical framework for assessing knowledge about the possible outcomes of undergoing cataract surgery, and explore the association of knowledge level with psychological status and decision quality among patients with cataract in Southern China.MethodsThe details of the knowledge scale were based on the health education information booklet provided by National Eye Institute, NIH. We used a theory-based approach to assess gist knowledge, which comprises conceptual and numeric questions related to knowledge of the possible surgical outcomes. The scale was then used in a cross-sectional study to assess the association of knowledge score with psychological status and decision quality of cataract patients, including worry, anxiety, attitudes, intentions, decisional conflict, confidence in decision making, anticipated regret and temporal orientation.ResultsA total of 489 participants with age-related cataract were included in this study, and 10.2% (50/489) of them had adequate level of knowledge. The knowledge scale was significantly associated to the levels of worry (Odds Ratio (OR) = 0.36, 95%CI: 0.18, 0.70; P = 0.003), anxiety (beta coefficient = -5.36, 95%CI: -8.88,-1.84; P = 0.003), inaction regret (OR = 0.49, 95%CI : 0.28, 0.88; P = 0.016) and decision conflict (beta coefficient = -7.93, 95%CI: -12.81, -3.04; P = 0.002) in multivariate analyses adjusted for age, sex, education level and literacy level.ConclusionThe level of knowledge adequacy with cataract surgery outcomes is high in China and was associated with psychological status and decision quality. These findings suggest that strategies targeting knowledge of possible surgical outcomes may reduce psychological stress and improve decision quality among patients with age-related cataract.