bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac Autonomic Effects of Secondhand Exposure to Nicotine from Electronic Cigarettes
Authors: Lee Mi-Sun , Rees Vaughan W. , Koutrakis Petros , Wolfson Jack M. , Son Youn-Suk , Lawrence Joy , Christiani David C. 
Published: December 2018

Background:
The rapid increase in prevalence of e-cigarette (EC) use may lead to widespread exposure to secondhand emissions among nonsmokers, but evidence on the potential cardiovascular health risks is limited. We aimed to investigate the effect of short-term secondhand exposure to nicotine from e-cigarette (EC) emissions on cardiac autonomic function using heart rate variability (HRV).

Methods:
A randomized, repeated measures crossover study of healthy nonsmoking volunteers was conducted. Standard deviation of NN intervals (SDNN), average of the standard deviation of NN intervals (ASDNN), root mean square of successive differences (rMSSD), and heart rate–corrected QT interval (QTc) were calculated during 1 hour of EC exposure session.

Results:
Nicotine from EC emissions was associated with a 7.8% decrease in SDNN (95% CI [confidence interval]: −11.2%, −4.3%), 7.7% decrease in ASDNN (95% CI: −11.0%, −4.2%), and 3.8 milliseconds decrease in QTc (95% CI: −5.8, −1.9). Compared with a short exposure time period (<15 minutes), greater nicotine associated with reductions in ASDNN (P
for interaction = 0.076) with longer exposure time periods. For QTc, greater nicotine associated with reductions were found during 15- to 30-minute exposure time period (P
for interaction = 0.04).

Conclusion:
We present the first evidence of cardiac autonomic effects of short-term secondhand exposure to nicotine from EC emissions among healthy nonsmokers. Further comprehensive research on EC exposure extending to more subjects and flavor compounds is warranted.
Plastic Surgery Faces the Web: Analysis of the Popular Social Media for Plastic Surgeons
Authors: Ben Naftali Yeela , Duek Ori Samuel , Rafaeli Sheizaf , Ullmann Yehuda 
Published: December 2018

Background:
The use of social media is growing tremendously along with its impact on the practice of plastic surgery, for better or for worse. Patients are increasingly using social media to obtain information about either the procedure or the surgeon.

Objectives:
The aims of this study were to examine social media posting regarding plastic surgery and to analyze successful online communication methods of the plastic surgeons with the public.

Methods:
A prospective analysis of 3 popular, global social media networks was performed, using the English language key phrases “plastic surgery” and “#plastic_surgery.” Three hundred posts related to plastic surgery published on Instagram, YouTube, and Facebook in November 2017 were assessed by the following parameters: author identity, subject (self-promotion, educational, commercial, and personal posts), “social media currency” (likes, shares, comments, and views), and if special effects (videos, photos, etc.) or viral subjects such as reality stars or shaming were utilized.

Results:
Sixty-three percentage of the posts on Instagram originated with plastic surgeons, compared with 18% on Facebook and only 13% on YouTube (P < 0.01); together, the plastic surgeons’ posts comprise 31% of the total posts, whereas 49% of posts published by commercial companies (P < 0.01). Most of the posts on Instagram were self-promotional (83%), in comparison to Facebook (29%) or YouTube (6%); P < 0.01. YouTube posts are more personal in nature compared with Instagram and Facebook [39%, 7%, 9%, respectively (P < 0.01)]. Educational content in the posts accounts for only 16% of them, P < 0.01. Shaming is seen in 21% of the posts, especially in Facebook (39%), and mainly related to famous public figures (25%); P < 0.05. Celebrity endorsed posts received more attention in every aspect of social media currency (likes, comments, shares, and views). The use of images of women attracts attention and is widely used in social media posts of plastic surgery (68%). Posts that chose to include videos (22%) are generously rewarded. Online shaming also attracts attention, mostly found in Facebook (39%), and mainly of a public figure (25%). The 10 most powerful attention drawing motives were jokes, attractive female plastic surgeons, celebrities, personal stories, provocative surgeries, videos or photos of surgeries, sex, shaming, and patient education.

Conclusion:
Social media have become an important tool for self-promotion and a means to providing better customer service. This trend applies to the plastic surgeon as well. The study’s main insights were to use Instagram, personal stories, educational post, videos and other unique inputs, and involve celebrities in the posts. In general, it would be wise to invest and understand these communication platforms, as they have become the path to dominate the field.
The Suture Tab Technique: Securing Implant Position in Prepectoral Breast Reconstruction
Authors: Janhofer David E. , Economides James M. , Song David H. 
Published: December 2018

Summary:
Human acellular dermal matrix (ADM) can augment prepectoral prosthetic-based direct-to-implant breast reconstruction by providing an additional soft-tissue layer between breast implant and skin, as well as to reinforce the inframammary fold and breast pocket. Utilizing ADM in this way has helped reduce rates of implant rippling, capsular contracture, and implant extrusion. Difficulty in securing ADM-wrapped implants has caused many surgeons to improvise techniques for secure implantation. Here, we describe a simple technique for creating suture tabs within the ADM for efficient fixation of the ADM-implant construct to the chest wall.
Preoperative Computed Tomography Angiography in Autologous Breast Reconstruction—Incidence and Impact of Incidentalomas
Authors: Tevlin Ruth , Borrelli Mimi R. , Nguyen Dung , Momeni Arash 
Published: December 2018

Background:
Incidentalomas are lesions found coincidentally during examination, imaging, or surgical procedures. Preoperative computed tomography angiography (CTA) before abdominal flap harvest for breast reconstruction can lead to identification of incidentalomas leading to the need for further investigations. The aim of this study was to examine the prevalence of incidental findings on preoperative CTA and to determine their impact on management.

Methods:
A retrospective chart review was performed at a single tertiary institution. CTA reports were analyzed for the presence of incidental findings and details of follow-up were studied. Logistic regression was used to identify factors associated with incidental findings.

Results:
One hundred eighteen patients with a mean age of 49 years were included in the study. The majority of patients underwent bilateral reconstruction (65%, n = 77) in the immediate setting (70%, n = 83). Fifty-six percentage had an incidental finding on CTA, with hepatic (20%), renal (14%), and osseous (11%) abnormalities being most common. Additional imaging including ultrasound, CT, and magnetic resonance imaging were recommended in 19 cases (16%). Additional consultations were sought for 3 patients before reconstruction (with suspicion of bone metastases, an intraabdominal mass, and suspicion of colonic malignancy, respectively). No significant surgical delay secondary to CT findings was noted.

Conclusions:
Incidentalomas following preoperative CTA of the abdomen/pelvis are common (56%). However, unlike previous reports, we did not observe a change in reconstructive plan following incidentaloma discovery. We recommend that all patients are counseled pre-CTA regarding the possibilities of incidentaloma detection and need for additional imaging.
Comparison of Tri-folded and Scroll-based Graft Viability in Preloaded Descemet Membrane Endothelial Keratoplasty
Authors: Barnes Kali , Chiang Eric , Chen Conan , Lohmeier John , Christy Jason , Chaurasia Akash , Rosen Allison , Vora Parth , Cai Stephanie , Subramanya Anshul , Durr Nicholas , Allen Robert , Eghrari Allen Omid 
Published: December 2018

Purpose:
To compare corneal endothelial damage associated with 2 techniques for preloaded Descemet membrane endothelial keratoplasty (DMEK): a tri-folded graft stored in a plastic cartridge designed for DMEK and a scrolled graft stored in a modified Jones Tube, at the time of preparation and after shipping.

Methods:
DMEK grafts were prepared at the Rocky Mountain Lions Eye Bank. The grafts were either tri-folded and loaded in a plastic cartridge or scrolled and loaded into a modified Jones Tube. In each group, the grafts were then either immediately removed from the cartridges or shipped for 48 hours. The grafts were then stained with Calcein AM and imaged using a fluorescent microscope. Endothelial cell loss (ECL) was determined using trainable segmentation in Fiji by 2 graders. At each time point, rates of ECL loss were compared across the 2 groups. To explore the role of donor characteristics, a multivariable regression model was produced to account for method (tri-folding vs. scroll), donor age, donor gender, death-to-preservation time, death-to-preparation time, and shipping.

Results:
A total of 40 grafts were prepared, processed, imaged, and analyzed. No significant difference in cell loss was seen between groups at either time point alone. In the multivariate model, no significant increase in cell loss was associated with either tri-folding (3.7% less ECL; P = 0.051) or shipping (4.3% less ECL; P = 0.049).

Conclusions:
All techniques used resulted in clinically acceptable levels of ECL. Tri-folded tissue in a plastic cartridge did not result in ECL inferior to a scroll when prepared either immediately or preloaded for 48 hours.
Overestimation of an Outbreak of Enterobacter cloacae in a Neonatal Intensive Care Unit in Germany, 2015
Authors: Steffen Gyde , Pietsch Michael , Kaase Martin , Gatermann Sören , Werner Guido , Fuchs Stephan , Pfeifer Yvonne , Schmitt Wolfgang , Adam Henning , Eckmanns Tim , Haller Sebastian 
Published: December 2018

Background:In August 2015, 17 neonates withEnterobacter cloacae (E. cloacae) colonization were identified in a neonatal intensive care unit (NICU) in Germany. Two developed severe brain abscesses. Despite temporary NICU closure in September, another infant withE. cloacaecolonization was detected in October 2015.Methods:We defined potential cases as inpatients treated in the NICU or any pediatric/maternity ward in 2015 withE. cloacaein any specimen before molecular typing. Cases were at first confirmed by arbitrarily-primed-polymerase-chain-reaction and later by XbaI-macrorestriction/pulsed-field gel electrophoresis and next-generation-sequencing. Enhanced barrier precautions and cohorting were implemented for all potential cases and microbiologic screening was extended from NICU to all pediatric/maternity wards.Results:Of 41 potential cases (occurring between 08/04/2015 and 15/11/2015 in 4 wards), the isolates of 23 shared identical arbitrarily-primed-polymerase-chain-reaction patterns; 3 without plausible epidemiologic link. Pulsed-field gel electrophoresis analyses verified only 10 cases (all in the NICU); next-generation-sequencing analysis confirmed these results. In addition 6 cases without isolates available for genotyping were closely linked in place and time.Conclusions:Forty-one suspected patients were cohorted and the NICU was temporarily closed. Further analyses revealed that only 16 cases belonged to the outbreak. Only close interdisciplinary collaboration and highly discriminatory genotyping methods allowed to clearly differentiate between cases and noncases in thisE. cloacaeoutbreak.
Bony Orbital Volume Expansion in Thyroid Eye Disease
Authors: Ugradar Shoaib , Goldberg Robert A. , Rootman Daniel B. 
Published: December 2018

Purpose:
To quantify changes to the bony orbital volume (BOV) in patients with thyroid eye disease (TED) relative to normal controls.

Methods:
In this case–control study, all patients affected with TED seen over a 2-year period were screened for study entry. Eligible participants were adults with clinical evidence of TED and CT scans of their orbits obtained during the course of their routine care. Exclusion criteria included the history of decompression surgery and/or medical or other ophthalmic conditions that could alter the orbital anatomy. The primary outcome was the measurement of the BOV. Secondary outcome measures included the relationships between BOV and muscle volume, fat volume, Hertel measurements, duration of the disease, and the occurrence of dysthyroid optic neuropathy in patients with TED. Three-dimensional reconstructions of the orbits were created to measure BOV, muscle volume, and fat volume.

Results:
A total of 100 participants were included in the study, contributing 200 orbits. This sample was comprised of 50 patients with TED (37 female, 13 male) and 50 controls (37 female and 13 male). There were no differences between the control and patient groups in age or sex. Of the patients with TED, 14 were diagnosed with dysthyroid optic neuropathy (15 orbits, 1 case was bilateral). The mean (standard deviation [SD]) clinical activity score for males was 4.1 (2.29) and 4.35 (2.63) for females. The mean (SD) BOV for males in the TED group was 28.62 ml (3.47), while that of the control group was 24.59 ml (2.19). This difference was significant (p < 0.01). The mean (SD) BOV for females with TED was 24.33 ml (2.39), while that of the female control group was 20.97 ml (1.84). This was again significant (p < 0.01). There was a significant relationship between the BOV and fat volume (p <0.05). There were no significant relationships between BOV and: muscle volume, duration of disease (p = 0.705), Hertel measurements (p = 0.212), age (p = 0.9), and dysthyroid optic neuropathy (p = 0.12).

Conclusions:
This study found that the BOV is significantly greater in patients with TED, suggesting that TED is associated with widespread bony remodeling of the orbit.
The Suitability of Grounded Theory Research for Correctional Nursing
Authors: Dhaliwal Kirnvir , King-Shier Kathryn , Hirst Sandra P. 
Published: December 2018

ABSTRACT
The tension between custody and caring is particular to correctional nursing practice, including issues such as the correctional priorities of safety and security that often dominate nursing practice. The evidence that should underlie correctional nursing practice is regrettably sparse. There are two reasons a grounded theory (GT) approach is paramount for building foundational knowledge to advance correctional nursing practice. First, the development of theories regarding correctional nursing practice will provide an in-depth understanding of this subspecialty of nursing and lead to further research endeavors. Second, correctional nursing practice is a process carried out in correctional institutions. The GT approach is “process oriented” and thus is appropriate for exploring the implementation of correctional nursing practice. Two GT approaches have evolved since first described by Glaser and Strauss. We contend that the approach offered by Strauss and Corbin may be more beneficial for studying how correctional nurses implement their practice.
The Economic Value of Mobility with a Prosthesis
Authors: Boone David Alan 
Published: December 2018

ABSTRACT
The primary purpose for creation of a leg prosthesis is to enable mobility, including standing, transferring, and walking. It is proposed that to adequately assess the health economic ramifications of alternatives in prosthetic care for persons who have had an amputation, one should consider the value of mobility. This article explores some key constructs in elucidation of the value of mobility with a prosthesis: 1) mobility is not binary; it has quality aspects that impact its value; 2) overall direct health care costs have been shown to be reduced beyond the cost of associated prosthetic technologies when this technology improves safety and reduces injury; 3) amputation creates chronic disability that is better reflected by the burden of disease than by mortality alone in health economic analyses; and 4) significant indirect value is provided by a prosthesis that enables physical activity and the resulting health benefits. Human needs and health economic goals can be aligned. Invention of new technology that maximizes physical restoration and human potential should be evaluated not only on its cost, but also on the substantial value provided.
Health Technology Assessment as Theoretical Framework to Assess Lower-Limb Prosthetics—Issues and Opportunities from an International Perspective
Authors: Cutti Andrea G. , Lettieri Emanuele , Verni Gennaro 
Published: December 2018

ABSTRACT
Lower-limb prosthetics is rapidly advancing through innovative technologies. Simultaneously, patients in need of prosthetic rehabilitation treatments are expected to double by 2050. Unfortunately, available economic resources are not growing at a comparable pace. The result is the widening gap between what is technologically possible and what is economically sustainable. In this context, health technology assessment (HTA) stands out as a multidisciplinary process, grounded on scientific evidence, that can support decision makers on how best to allocate limited funds to health interventions and technologies. The aim of this contribution is to introduce the HTA concepts and methods of possible interest for the field of orthotics and prosthetics (O&P) in general and lower-limb prosthetics, in particular, from an international perspective. This will be accomplished by answering six questions:
1. What is HTA and how does it differ from evidence-based practice (EBP)?
2. Why should we care about HTA in O&P?
3. Do policy makers care about HTA reports?
4. Are there structured tools to run HTA appraisals that are suitable for the O&P field?
5. Are there challenges to consider when running an HTA on medical devices, including lower-limb prosthetics?
6. Are there strategies to adopt to improve evidence collection and HTA on lower-limb prosthetics?
Collectively, the answers culminate in the position that HTA is highly desirable, but poses challenges to O&P, because medical devices have unique features (e.g., incremental innovation and operator dependence), and because the level of evidence is generally low. To address these challenges, we proposed seven driving concepts that can improve evidence collection and the HTA of lower-limb prosthetics. Among them, managed entry agreements, registry big data, and Internet-of-things strategies can support value-for-money approaches and can mark a true change in lower-limb prosthetic accessibility.
Economic Benefits of Microprocessor Controlled Prosthetic Knees: A Modeling Study
Authors: Chen Christine , Hanson Mark , Chaturvedi Ritika , Mattke Soeren , Hillestad Richard , Liu Harry H. 
Published: December 2018

ABSTRACT

Background
Advanced prosthetic knees allow for more dynamic movements and improved quality of life, but payers have recently started questioning their value. To answer this question, the differential clinical outcomes and cost of microprocessor-controlled knees (MPK) compared to non-microprocessor controlled knees (NMPK) were assessed.

Methods
We conducted a literature review of the clinical and economic impacts of prosthetic knees, convened technical expert panel meetings, and implemented a simulation model over a 10-year time period for unilateral transfemoral Medicare amputees with a Medicare Functional Classification Level of 3 and 4 using estimates from the published literature and expert input. The results are summarized as an incremental cost effectiveness ratio (ICER) from a societal perspective, i.e., the incremental cost of MPK compared to NMPK for each quality-adjusted life-year gained. All costs were adjusted to 2016 U.S. dollars and discounted using a 3 percent rate to the present time.

Results
The results demonstrated that compared to NMPK over a 10-year time period: for every 100 persons, MPK results in 82 fewer major injurious falls, 62 fewer minor injurious falls, 16 fewer incidences of osteoarthritis, and 11 lives saved; on a per person per year basis, MPK reduces direct healthcare cost by $3,676 and indirect cost by $909, but increases device acquisition and repair cost by $6,287 and total cost by $1,702; on a per person basis, MPK is associated with an incremental total cost of $10,604 and increases the number of life years by 0.11 and quality adjusted life years by 0.91. MPK has an ICER ratio of $11,606 per quality adjusted life year, and the economic benefits of MPK are robust in various sensitivity analyses.

Conclusions
Advanced prosthetics for transfemoral amputees, specifically MPKs, are associated with improved clinical benefits compared to non-MPKs. The economic benefits of MPKs are similar to or even greater than those of other medical technologies currently reimbursed by U.S. payers.
Ruptured Extensor Pollicis Longus Tendon After a Nondisplaced Distal Radius Fracture in a Young Adult Soccer Player
Authors: Bogart Robert , Vidlock Kathryn 
Published: December 2018

Abstract:
Forearm fractures of the distal radius are one of the most common fractures seen in the upper extremity, and they represent approximately 1/6 of fractures treated in the emergency department. Forearm fractures are associated with a rare but known complication of a delayed ruptured extensor pollicis longus (EPL) tendon. This sequela is more commonly seen in adults after a nondisplaced distal radius fracture, with much variability in the incidence ranging from 0.07% to 5%. By contrast, this complication in the pediatric population is almost exclusively seen after a displaced or unstable fracture necessitating surgical correction with open reduction and internal fixation.
Self-expanding metal stent procedure for afferent loop syndrome with ascending cholangitis caused by remnant gastric cancer
Authors: Cha Ra Ri , Cho Su Beom , Kim Wan Soo , Kim Jin Joo , Lee Jae Min , Lee Sang Soo , Kim Hyun Jin , Cho Jin Kyu 
Published: December 2018

Abstract

Rationale:
Self-expanding metal stent placement is a useful procedure for intestinal obstruction. Afferent loop syndrome after gastrectomy is an uncommon complication of gastroenterostomy reconstruction. Ascending cholangitis caused by afferent loop syndrome is a potential, but rare, complication.

Patient concerns:
A 73-year-old man with abdominal pain and vomiting was admitted to the emergency room. His medical history was significant for subtotal gastrectomy with Billroth II anastomosis for benign gastric ulcer perforation 40 years prior. He had notable tenderness to palpation, particularly on the epigastric area, and a temperature of 39.0°C.

Diagnosis:
Abdominal computed tomography revealed afferent loop syndrome with ascending cholangitis caused by remnant gastric cancer.

Interventions:
Percutaneous catheter drainage for management of ascending cholangitis was performed on the day of admission. He was subsequently treated with self-expandable metal stent insertion into the stenotic lesion.

Outcomes:
After treatment with percutaneous transhepatic insertion of a self-expanding stent, the patient achieved complete resolution of symptoms. The patient died of disease progression 2 months later, without further recurrence of afferent loop syndrome.

Lessons:
Our case shows that insertion of a metal stent via percutaneous transhepatic biliary drainage (PTBD) can effectively treat ascending cholangitis and resolve afferent loop syndrome in inoperable patients.