bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Real-Time Adherence Feedback to Enhance Communication About Adherence to Antiretroviral Therapy: Patient and Clinician Perspectives
Authors: Hill Lauren M. , Golin Carol E. , Pack Allison , Carda-Auten Jessica , Wallace Deshira D. , Cherkur Sruthi , Farel Claire E. , Rosen Elias P. , Gandhi Monica , Asher Prince Heather M. , Kashuba Angela D. M. 
Published: April 2019

Abstract
New technologies for real-time adherence monitoring hold the potential to enhance antiretroviral therapy adherence interventions by providing objective information about daily medication-taking behavior. To realize this potential, we need to understand how to integrate real-time adherence feedback into existing best practices to promote antiretroviral therapy adherence at the point of care. Using in-depth interviews with 30 HIV-infected patients and 29 HIV care clinicians, our primary aims were to understand patients' and clinicians' perceptions of anticipated benefits and preferred uses of objective feedback to enhance conversations about adherence and to identify concerns about the impact of objective monitoring on patient–clinician relationships and communication. Both patients and clinicians suggested that identifying patterns of nonadherence with real-time feedback could (a) facilitate collaborative adherence problem-solving, (b) motivate patient adherence, and (c) reinforce the importance of optimal adherence. Some clinicians worried that delivery of real-time feedback could imply mistrust of patient-reported adherence and suggested careful framing of monitoring results. A few patients and clinicians were concerned that negative reactions to monitoring could discourage retention in care and reduce adherence motivation. These results indicate the potential of real-time feedback to enhance existing evidence-based adherence interventions targeting the key adherence precursors of adherence information, motivation, and behavioral skills. Guidance for the delivery of real-time adherence feedback should focus on both optimizing adherence and mitigating negative perceptions of adherence monitoring.
The Dutch Breast Implant Registry: Registration of Breast Implant–Associated Anaplastic Large Cell Lymphoma—A Proof of Concept
Authors: Becherer Babette E. , de Boer Mintsje , Spronk Pauline E. R. , Bruggink Annette H. , de Boer Jan Paul , van Leeuwen Flora E. , Mureau Marc A. M. , van der Hulst René R. J. W. , de Jong Daphne , Rakhorst Hinne A. 
Published: April 2019

Background:
The Dutch Breast Implant Registry (DBIR) was established in April of 2015 and currently contains information on 38,000 implants in 18,000 women. As a clinical registry, it evaluates the quality of breast implant surgery, including adverse events such as breast implant–associated (BIA) anaplastic large cell lymphoma (ALCL). To examine the efficacy of the DBIR, the capture rate of BIA-ALCL was compared to the registration of BIA-ALCL in the Dutch Nationwide Network and Registry of Histo- and Cytopathology (PALGA) as a gold standard, in combination with matching these databases to obtain complementary information.

Methods:
All BIA-ALCL patients diagnosed and registered in The Netherlands in 2016 and 2017 were identified separately in the PALGA and DBIR databases. In addition, both databases were matched using indirect key identifiers. Pathologic information from the PALGA and clinical and device characteristics from the DBIR were obtained for all patients.

Results:
Matching of both databases gave a capture rate of BIA-ALCL in the DBIR of 100 percent (n = 6) in 2016 and 70 percent (n = 7) in 2017. In total, 17 patients were identified in the PALGA, of which 14 patients were also identified in the DBIR; three patients were not registered; and 10 patients were registered false-positive. Of all confirmed patients, symptoms, staging results, treatment, and implant information were registered.

Conclusions:
Currently, the DBIR contains 2 full registration years and captures most of the BIA-ALCL patients despite overestimation. Therefore, pathology confirmation remains essential. By matching these databases, complementary clinical and implant information could be retrieved, establishing the DBIR as an essential postmarketing surveillance system for health risk assessments.
Breast Cancer Knowledge and Decisions Made for Contralateral Prophylactic Mastectomy: A Survey of Surgeons and Women in the General Population
Authors: Hooper Rachel C. , Hsu Jessica , Duncan Anthony , Bensenhaver Jessica M. , Newman Lisa A. , Kidwell Kelly M. , Chung Kevin C. , Momoh Adeyiza O. 
Published: April 2019

Background:
Decisions made to undergo contralateral prophylactic mastectomy, in women at low risk for bilateral disease, are often attributed to a lack of knowledge. This study examines the role knowledge plays in determining surgical treatment for unilateral breast cancer made by laywomen and surgeons for themselves or loved ones.

Methods:
The study cohort had three groups: (1) laywomen in the general population, (2) breast surgeons, and (3) plastic surgeons. Laywomen were recruited using Amazon Mechanical Turk Crowd Sourcing. Breast and plastic surgeons from nine states were sent electronic surveys. Demographic and contralateral prophylactic mastectomy–specific data on decisions and knowledge were collected and analyzed.

Results:
Surveys from 1333 laywomen, 198 plastic surgeons, and 142 breast surgeons were analyzed. A significantly greater proportion of laywomen in the general population favored contralateral prophylactic mastectomy (67 percent) relative to plastic (50 percent) and breast surgeons (26 percent) (p < 0.0001). Breast surgeons who chose contralateral prophylactic mastectomy were younger (p = 0.044) and female (0.012). On assessment of knowledge, 78 percent of laywomen had a low level of breast cancer knowledge. Laywomen with higher levels of breast cancer knowledge had lower odds of choosing contralateral prophylactic mastectomy (OR, 0.37; 95 percent CI, 0.28 to 0.49).

Conclusions:
Fewer women are likely to make decisions in favor of contralateral prophylactic mastectomy with better breast cancer–specific education. A knowledge gap likely explains the lower rates with which surgeons choose contralateral prophylactic mastectomy for themselves or loved ones; however, some surgeons who were predominantly young and female favor contralateral prophylactic mastectomy. Improving patient education on surgical options for breast cancer treatment is critical, with well-informed decisions as the goal.
A New Technique for Robust Stabilization in the Keystone Area during Extracorporeal Septorhinoplasty
Authors: Kamburoğlu Haldun O. , Bitik Ozan 
Published: April 2019

Summary:
Although extracorporeal septorhinoplasty is the most powerful technique for correcting deviated and leaning noses, many investigators have abandoned it because of keystone problems. The authors defined a new neoseptum fixation technique and used it in 10 patients in 2016. Preoperative and postoperative Nasal Obstruction Symptom Evaluation scale and peak nasal inspiratory flow measurement, and septal indexes of the patients were compared. There was statistically significant improvement in the respiratory condition of all patients. No recurrence or dorsal irregularity has been observed. This new, easily applicable, and robust fixation method of extracorporeal septorhinoplasty may be a definitive solution to prevent keystone irregularities.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Complete Reoperation in Orthognathic Surgery
Authors: Wu Robin T. , Wilson Alexander T. , Gary Cyril S. , Steinbacher Derek M. 
Published: April 2019

Background:
Complete reoperation is defined as undergoing reoperative/repeated jaw osteotomies, in a patient who previously underwent orthognathic surgery. The purpose of this study is to (1) describe jaw positions at three time-points (before primary and before and after reoperative surgery), (2) investigate factors necessitating reoperation, and (3) outline the technical challenges.

Methods:
Repeated orthognathic surgery cases >1-year out were included. Demographic, radiologic, and perioperative data were compiled. Repeated osteotomies (Le-Fort and/or bilateral split sagittal osteotomy, with or without genioplasty), were compared to their respective primary procedures. Statistical analysis was performed using t tests and z-scores.

Results:
Fifteen patients were included (28.1 years; 71 percent female). Reoperative/repeated surgery was most often needed to address iatrogenic bony malposition and asymmetry. Relapse was a less common indication. Time between reoperative and primary surgery was 14 months. Sagittal discrepancies (p = 0.029) were the most frequent reason for primary orthognathic surgery (e.g., mandibular hypoplasia (p = 0.023). Reoperative/repeated orthognathic was performed for asymmetry (p = 0.014). Repeated procedures used more 3-dimensional planning (p < 0.001), required all three osteotomies (p = 0.034), had longer operative times (p = 0.078), and all required hardware removal (p < 0.001). Anatomical outcomes were good with 100% patient satisfaction at long-term follow-up.

Conclusions:
Reoperative/repeated orthognathic surgery is challenging and underreported in the literature. Whereas primary orthognathic typically addressed sagittal discrepancies, reoperative/repeated osteotomies were needed to correct iatrogenic bone malposition and asymmetries. Challenges include: re-planning, scar burden, need to remove integrated hardware, and repeated osteotomy/fixation. Despite these difficulties, outcomes and patient acceptance were good.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Cryopreservation and Transplantation of Vascularized Composite Transplants: Unique Challenges and Opportunities
Authors: Shani Nir , Friedman Or , Arav Amir , Natan Yehudit , Gur Eyal 
Published: April 2019

Summary:
Vascularized composite allotransplantation is the ultimate reconstructive tool when no other means of reconstruction are available. Despite its immense potential, the applicability of vascularized composite allotransplantation is hampered by high rejection rates and the requirement for high doses of immunosuppressive drugs that are associated with severe adverse effects and death. Because this is a non–life-saving procedure, widespread use of vascularized composite allotransplantation demands methods that will allow the reduction or elimination of immunosuppressive therapy. Efficient methods for the cryopreservation of biological cells and tissues have been sought for decades. The primary challenge in the preservation of viable tissue in a frozen state is the formation of intracellular and extracellular ice crystals during both freezing and thawing, which cause irreversible damage to the tissue. Recent proof-of-concept transplantations of a complete cryopreserved and thawed hindlimb in a rat model have demonstrated the potential of such methods. In the current review, the authors discuss how limb cryopreservation can attenuate or eliminate allograft rejection by either enabling better human leukocyte antigen matching or by adaptation of clinical tolerance protocols such as mixed chimerism induction. Also, the authors discuss the possible advantages of cryopreservation in autologous tissue salvage and cryopreservation following trauma. Clinical-grade cryopreservation may revolutionize the field of reconstruction, organ banking, and complex traumatic limb injury management.
Fat Grafting in Managing Craniofacial Deformities
Authors: Denadai Rafael , Raposo-Amaral Cesar Augusto , Raposo-Amaral Cassio Eduardo 
Published: April 2019

Background:
The successful correction of craniofacial contour deformities remains a major challenge in plastic surgery. This article reviews important concepts and strategies for craniofacial fat grafting and presents a SOBRAPAR Hospital algorithm focused on achieving craniofacial contour symmetry as early as possible without compromising function.

Methods:
Principle-based methods (i.e., anatomical facial fat compartments, fluid accommodation model, multistage site-specific craniofacial fat grafting, and structural fat-grafting technique) were itemized into an algorithm to aid in planning and selecting the best surgical approach (i.e., bone and/or soft tissue procedures) in order to obtain craniofacial contour symmetry.

Results:
The treatment plan and choice of surgical technique implemented to address bone and/or or soft tissue deformities were determined by specific diagnosis, patient age at presentation, and functional status. Bony reconstruction in skeletally immature patients is reserved solely for those patients with functional issues.

Conclusion:
By adopting principle-based methods and fat compartment theory, we are able to achieve craniofacial contour symmetry and aesthetically pleasing outcomes without compromising function.
Long-Term Outcomes of Brachial Plexus Reconstruction with Sural Nerve Autograft for Brachial Plexus Birth Injury
Authors: Manske M. Claire , Bauer Andrea S. , Hentz Vincent R. , James Michelle A. 
Published: April 2019

Background:
Infants with brachial plexus birth injury who do not recover motor function spontaneously in a timely manner are candidates for brachial plexus reconstruction with nerve autograft. Outcomes of this intervention are incompletely understood. The authors present the long-term outcomes of brachial plexus reconstruction with sural nerve autograft in infants with brachial plexus birth injury.

Methods:
The authors retrospectively reviewed all infants with brachial plexus birth injury who underwent brachial plexus reconstruction with sural nerve autograft between 1992 and 2014 with a minimum 2-year follow-up. The authors used Active Movement Scale scores to determine the presence and timing of shoulder, elbow, and wrist recovery. They assessed recovery of hand function in infants with global brachial plexus birth injury with the Raimondi scale. The number and type of secondary reconstructive procedures were identified.

Results:
Forty-three infants who underwent brachial plexus reconstruction at age 7 ± 2 months old were followed for 7 ± 5 years. Most infants recovered antigravity elbow flexion (91 percent) and shoulder abduction (67 percent), but fewer recovered antigravity shoulder external rotation (19 percent) and wrist extension (37 percent). Mean postoperative times until observed antigravity motor strength (Active Movement Scale score >5) at the shoulder, elbow, and wrist were all greater than 12 months; evidence of initial motor recovery (Active Movement Scale score >2) was observed earlier. The mean Raimondi score in infants with global brachial plexus birth injury was 2.2 (range, 0 to 5) at final follow-up. Thirty-three children underwent 2 ± 1.2 secondary reconstructive procedures.

Conclusions:
Brachial plexus reconstruction with sural nerve autograft reliably results in recovery of shoulder abduction and elbow flexion, but recovery of shoulder external rotation and wrist extension is less predictable, and recovery often takes more than 1 year. Secondary procedures are often performed to optimize function.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Unconventional Perfusion Flaps in the Experimental Setting: A Systematic Review and Meta-Analysis
Authors: Casal Diogo , Tanganho David , Cunha Teresa , Mota-Silva Eduarda , Iria Inês , Pais Diogo , Videira Paula , Videira-Castro José , Goyri-O’Neill João 
Published: April 2019

Background:
Unconventional perfusion flaps offer multiple potential advantages compared with traditional flaps. Although there are numerous experimental articles on unconventional perfusion flaps, the multiple animal species involved, the myriad vascular constructions used, and the frequently conflicting data reported make synthesis of this information challenging. The main aim of this study was to perform a systematic review and meta-analysis of the literature on the experimental use of unconventional perfusion flaps, to identify the best experimental models proposed and to estimate their global survival rate.

Methods:
The authors performed a systematic review and meta-analysis of all articles written in English, French, Italian, Spanish, and Portuguese on the experimental use of unconventional perfusion flaps and indexed to PubMed from 1981 until February 1, 2017.

Results:
A total of 68 studies were found, corresponding to 86 optimized experimental models and 1073 unconventional perfusion flaps. The overall unconventional perfusion flap survival rate was 90.8 percent (95 percent CI, 86.9 to 93.6 percent; p < 0.001). The estimated proportion of experimental unconventional perfusion flaps presenting complete survival or nearly complete survival was 74.4 percent (95 percent CI, 62.1 to 83.7 percent; p < 0.001). The most commonly reported animal species in the literature were the rabbit (57.1 percent), the rat (26.4 percent), and the dog (14.3 percent). No significant differences were found in survival rates among these species, or among the diverse vascular patterns used.

Conclusion:
These data do not differ significantly from those reported regarding the use of unconventional perfusion flaps in human medicine, suggesting that rabbit, rat, and canine experimental unconventional perfusion flap models may adequately mimic the clinical application of unconventional perfusion flaps.
Streamlining the Assessment of Patient-Reported Outcomes in Weight Loss and Body Contouring Patients: Applying Computerized Adaptive Testing to the BODY-Q
Authors: Geerards Daan , Klassen Anne F. , Hoogbergen Maarten M. , van der Hulst René R.W.J. , van den Berg Lisa , Pusic Andrea L. , Gibbons Chris J. 
Published: April 2019

Background:
The BODY-Q is a widely used patient-reported outcome measure of surgical outcomes in weight loss and body contouring patients. Reducing the length of the BODY-Q assessment could overcome implementation barriers in busy clinics. A shorter BODY-Q could be achieved by using computerized adaptive testing, a method to shorten and tailor assessments while maintaining reliability and accuracy. In this study, the authors apply computerized adaptive testing to the BODY-Q and assess computerized adaptive testing performance in terms of item reduction and accuracy.

Methods:
Parameters describing the psychometric properties of 138 BODY-Q items (i.e., questions) were derived from the original validation sample (n = 734). The 138 items are arranged into 18 scales reflecting Appearance, Quality of Life, and Experience of Care domains. The authors simulated 1000 administrations of the computerized adaptive testing until a stopping rule, reflecting assessment accuracy of standard error less than 0.55, was met. The authors describe the reduction of assessment length in terms of the mean and range of items administered. The authors assessed accuracy by determining correlation between full test and computerized adaptive testing scores.

Results:
The authors ran 54 simulations. Mean item reduction was 36.9 percent (51 items; range, 48 to 138 items). Highest item reduction was achieved for the Experience of Care domain (56.2 percent, 22.5 items). Correlation between full test scores and the BODY-Q computerized adaptive test scores averaged 0.99.

Conclusions:
Substantial item reduction is possible by using BODY-Q computerized adaptive testing. Reduced assessment length using BODY-Q computerized adaptive testing could reduce patient burden while preserving the accuracy of clinical patient-reported outcomes for patients undergoing weight loss and body contouring operations.
Five-Year Experience with Fifth-to-Seventh Nerve Transfer for Smile
Authors: Banks Caroline A. , Jowett Nate , Iacolucci Carlo , Heiser Alyssa , Hadlock Tessa A. 
Published: April 2019

Background:
Masseteric- or deep temporal–to-facial nerve transfer (five-to-seven nerve transfer) is increasingly used in facial reanimation; however, the indications and clinical variables affecting outcomes for five-to-seven nerve transfer have not been defined. The authors describe their early experience with five-to-seven nerve transfer, reporting function and patient-reported outcomes, to identify potential parameters that are predictive of outcome.

Methods:
The authors conducted a retrospective chart review of all patients who underwent five-to-seven nerve transfer for smile reanimation from 2012 to 2017. Age, sex, cause of facial paralysis, onset and duration of paralysis, history of adjuvant chemotherapy and/or radiation therapy, donor nerve used, adjunctive procedures, and final excursion were recorded. Standard photographs and videos, and data regarding clinical facial nerve function and patient-reported quality of life, were obtained preoperatively and postoperatively.

Results:
Sixty patients were identified. Forty-seven had flaccid facial paralysis and 13 had postparalysis facial palsy. Among flaccid facial paralysis patients, masseteric nerve transfer was successful in 30 patients (88 percent) and deep temporal nerve transfer was successful in three cases (60 percent). Among postparalysis facial palsy patients, five-to-seven nerve transfer was successful in two patients (20 percent). Average quality-of-life scores improved significantly from preoperatively (46) to postoperatively (59) among flaccid facial paralysis patients with successful five-to-seven nerve transfer.

Conclusions:
Five-to-seven nerve transfer is a viable option in facial reanimation. Shorter denervation times and preoperative flaccidity are favorable predictors of outcome. Five-to-seven nerve transfer as an adjunct to primary repair appears highly effective for enhancing smile function. Five-to-seven nerve transfer results are not reliable in patients with postparalysis facial palsy.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.