bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Telemedicine During Interhospital Transport of Children With Operative Intracranial Hemorrhage*
Authors: Jackson Eric M. , Costabile Philomena M. , Tekes Aylin , Steffen Katherine M. , Ahn Edward S. , Scafidi Susanna , Noje Corina 
Published: August 2018

Objectives:
To analyze the impact of an intervention of using telemedicine during interhospital transport on time to surgery in children with operative intracranial hemorrhage.

Design:
We performed a retrospective chart review of children with intracranial hemorrhage transferred for emergent neurosurgical intervention between January 1, 2011 and December 31, 2016. We identified those patients whose neuroimaging was transmitted via telemedicine to the neurosurgical team prior to arrival at our center and then compared the telemedicine and nontelemedicine groups. Mann-Whitney U and Fisher exact tests were used to compare interval variables and categorical data.

Setting:
Single-center study performed at Johns Hopkins Hospital.

Patients:
Patients less than or equal to 18 years old transferred for operative intracranial hemorrhage.

Interventions:
Pediatric transport implemented routine telemedicine use via departmental smart phones to facilitate transfer of information and imaging and reduce time to definitive care by having surgical services available when needed.

Measurements and Main Results:
Fifteen children (eight in telemedicine group; seven in nontelemedicine group) met inclusion criteria. Most had extraaxial hemorrhage (87.5% telemedicine group; 85.7% nontelemedicine group; p = 1.0), were intubated pre transport (62.5% telemedicine group; 71.4% nontelemedicine group; p = 1.0), and arrived at our center’s trauma bay during night shift or weekend (87.5% telemedicine group; 57.1% nontelemedicine group; p = 0.28). Median trauma bay Glasgow Coma Scale scores did not differ (eight in telemedicine group; seven in nontelemedicine group; p = 0.24). Although nonsignificant, when compared with the nontelemedicine group, the telemedicine group had decreased rates of repeat preoperative neuroimaging (37.5% vs 57%; p = 0.62), shorter median times from trauma bay arrival to surgery (33 min vs 47 min; p = 0.22) and from diagnosis to surgery (146.5 min vs 157 min; p = 0.45), shorter intensive care stay (2.5 vs 5 d) and hospitalization (4 vs 5 d), and higher home discharge rates (87.5% vs 57.1%; p = 0.28).

Conclusions:
Telemedicine use during interhospital transport appears to expedite definitive care for children with intracranial hemorrhage requiring emergent neurosurgical intervention, which could contribute to improved patient outcomes.
Hypothesis Testing in Superiority, Noninferiority, and Equivalence Clinical Trials
Authors: Kumbhare Dinesh , Alavinia Mohammad , Furlan Julio 
Published: August 2018

Abstract
In medical research, it is important to be able to examine whether there is a significant difference between two samples. With this, establishing an appropriate hypothesis is a critical, basic step for correct interpretation of results in inferential statistical data analysis. It is important to note that the aim of hypothesis testing is not to “accept” or “reject” the null hypothesis but to gauge the likelihood that the observed difference is genuine if the null hypothesis is true.
Traditionally, the null hypothesis assumes that there is no statistically significant difference between the two groups. It has become more difficult to develop new treatments that are better than the standard of care. This review article summarizes and explains the methodology of the different types of clinical trials regarding the relevant basic statistical concepts and hypothesis testing.
Cryotherapy Reduces Muscle Spasticity But Does Not Affect Proprioception in Ischemic Stroke
Authors: Garcia Luccas Cavalcanti , Alcântara Carolina Carmona , Santos Gabriela Lopes , Monção João Victor Almeida , Russo Thiago Luiz 
Published: August 2018

Objective
The aim of the study was to evaluate the immediate effects of cryotherapy (using an ice pack) on ankle joint position sense and the degree of spasticity after chronic hemiparetic stroke.

Design
We used a sham-controlled crossover design. Sixteen chronic hemiparetic patients were randomly assigned to two groups: (1) those who received cryotherapy followed by a control intervention 15 days later (cryotherapy group) and (2) those who received the control intervention followed by cryotherapy 15 days later (control intervention group). Ankle joint position sense was measured on the paretic side using a Biodex Multi-joint System 3 dynamometer before and after 20 mins of either application on the calf muscles. Lower absolute error scores were calculated for data analyses and were used to determine joint position sense. The degree of spasticity of the plantar flexor muscles was scored according to the Modified Ashworth Scale.

Results
Sixteen patients completed the crossover experiment; however, data analysis was successfully conducted in 15 participants. Cryotherapy reduced the degree of spasticity of the plantar flexor muscles without altering ankle joint position sense.

Conclusions
Cryotherapy (using an ice pack) may reduce plantar flexor spasticity without influencing proprioception.
Abdominal Wall Reconstruction Risk Stratification Tools: A Systematic Review of the Literature
Authors: Bernardi Karla , Adrales Gina L. , Hope William W. , Keith Jerrod , Kuhlens Heidi , Martindale Robert G. , Melin Alyson A. , Orenstein Sean B. , Roth John Scott , Shah Shinil K. , Tsuda Shawn , Liang Mike K. ,   Ventral Hernia Outcomes Collaborative Writing Group
Published: August 2018

Background:
Ventral hernias are a common pathology encountered by surgeons. Multiple risk stratification tools have been developed in attempts to predict a patient’s postoperative risk for complication. The aim of this systematic review was to identify published stratification tools, to assess their generalizability, and develop an ensemble risk score model.

Methods:
A systematic review of the literature was performed using PubMed and following the PRISMA guidelines. Two independent reviewers identified articles describing hernia stratification tools or validating an established tool. Inclusion criteria included articles that studied ventral hernia risk score models developed through expert consensus or from data of at least 500 subjects, performed a multivariable analysis of at least 500 patients, or assessed a previously reported model. Studies were grouped by primary outcome, and the odds ratios for correlated variables were compiled. Outcomes described in 4 or more articles were then stacked to generate a cumulative risk score model for patients undergoing abdominal wall repair.

Results:
A total of 20 articles were found to meet our inclusion criteria and used to develop our ensemble model. Surgical-site infection, surgical-site occurrence, and hernia recurrence were the 3 primary outcomes used to calculate our stacked cumulative risk stratification score.

Conclusions:
There are multiple risk score tools published; however, all have their strengths and limitations. For this reason, we created a composite score model with data from major articles to predict a patient’s risk for postoperative complications. This model aims to ease the shared-decision making process for patients, surgeons, and institutions.
Evidence-Based Strategies for the Prehabilitation of the Abdominal Wall Reconstruction Patient
Authors: Joslyn Nichole A. , Esmonde Nick O. , Martindale Robert G. , Hansen Juliana , Khansa Ibrahim , Janis Jeffrey E. 
Published: August 2018

Summary:
It is inherently challenging to achieve successful surgical outcomes for ventral hernia repairs. For complex ventral hernias, attempts to reconstruct the abdomen in patients who are overweight, deconditioned, malnourished, chronically infected or inflamed, have previous hernia recurrence, or otherwise carry a number of serious comorbidities affecting their surgical fitness are a major undertaking requiring careful preparation and planning. As the rate of abdominal wall reconstructions rises, so does the complexity of these procedures. One could argue that the prehabilitation of these patients is equally, if not more, important than the surgical technique itself. To achieve desirable outcomes and avoid surgical-site occurrences (SSOs), the surgeon must familiarize him/herself with ways to optimize a patient preoperatively. Understanding and identifying the aforementioned modifiable risk factors for SSOs is crucial. It is also important to recognize the impact that acute changes in the microbiome perioperatively can have on the postoperative success. Familiarizing oneself with the available literature for these patients is imperative. This review presents discussion and guidance for understanding the challenges and best practices for providing hernia surgery and abdominal wall reconstruction and achieving durable outcomes, with minimal SSOs.
Obesity and Abdominal Wall Reconstruction: Outcomes, Implications, and Optimization
Authors: Pearson David G. , Carbonell Alfredo M. 
Published: August 2018

Summary:
It has never been more important for surgeons to effectively and efficiently perform ventral hernia repairs, which optimize outcomes and the value of care. Surgical patients in the United States are becoming increasingly complex. The comorbid diseases each unique patient brings to the operation further complicate the effort to optimize surgical outcomes. Obesity poses specific challenges to surgeons who deal with abdominal wall reconstruction. Herein, we discuss the impact of obesity and its associated comorbidities on the outcome of abdominal wall reconstruction and offer suggestions on how to optimize patients for best results.
A Current Review of Synthetic Meshes in Abdominal Wall Reconstruction
Authors: Cobb William S. 
Published: August 2018

Summary:
The use of mesh materials for reinforcement of the abdominal wall has revolutionized the approaches to hernia repair. Whether it’s a permanent, synthetic mesh, a biologically derived collagen graft, or a synthetic, bioresorbable construct, data demonstrate improved outcomes with respect to recurrence with their use. Numerous advances and development of component separation techniques of the abdominal wall musculature have provided surgeons the ability to close large fascial defects and reestablish the linea alba for midline hernias. Augmentation of the these repairs with a mesh helps to offset the tension on the fascial closure and provide biomechanical strength to the native tissue. However, the use of mesh materials as either permanent or temporary scaffolds is not without potential complications. Abdominal wall surgeons must have knowledge of the mesh composition and structure in an effort to mitigate these concerns. This chapter will review the polymers and characteristics of the currently available synthetic meshes for abdominal wall reconstruction in an effort to provide guidance to surgeons.
A Current Review of Hybrid Meshes in Abdominal Wall Reconstruction
Authors: Reid Chris M. , Jacobsen Garth R. 
Published: August 2018

Summary:
Complex abdominal wall defects remain a common problem, though there has been significant advancement in technique and biomaterials over the last decade. The newly developed hybrid meshes are targeted to address several shortcomings of other meshes. Specifically, the marriage of biosynthetic or biologic materials with permanent prosthetic material is designed so that each will counteract the other’s negative attributes. There are reports of permanent meshes having been associated with chronic pain, stiffness, and inflammation. However, their utility in maintaining biomechanical strength, thus limiting recurrence, makes them of value. In hybrid meshes, biosynthetic or biologic materials are coupled with permanent prosthetics, potentially protecting them from exhibiting deleterious effects by promoting and hastening tissue ingrowth. The various hybrid meshes currently available and investigational data are reviewed.
Theoretic and Evidence-Based Laparotomy Closure with Sutures and Meshes
Authors: Mioton Lauren M. , Dumanian Gregory A. 
Published: August 2018

Summary:
The ultimate tensile strength of newly apposed tissue is the sum of the strength of the physical construct holding the tissues and the strength of biologic healing. For successful incisional hernia repair, the total strength of the repair must remain greater than the forces applied. While much work has been done to understand the science of wound healing—the ability of an open defect to contract and close—far less has been done to understand the healing of 2 newly approximated previously nonwounded surfaces held together with sutures or other implants. In this article, the elements of ultimate tensile strength on laparotomy closure as well as their progression over time will be related to clinical studies of abdominal wall closure.
Reconstruction of the Abdominal Wall after Oncologic Resection: Defect Classification and Management Strategies
Authors: Mericli Alexander F. , Baumann Donald P. , Butler Charles E. 
Published: August 2018

Summary:
Compared with conventional ventral hernia repair, there are several additional considerations germane to the oncologic abdominal wall reconstruction, including the management of radiation soft-tissue injury, the management of bacterial contamination, and the location and extent of the defect. Herein, we review some of the unique challenges associated with oncologic abdominal wall reconstruction and introduce a new classification schema to assist the reconstructive surgeon in performing these complex cases.
Building a Multidisciplinary Hospital-Based Abdominal Wall Reconstruction Program: Nuts and Bolts
Authors: Schlosser Kathryn A. , Arnold Michael R. , Kao Angela M. , Augenstein Vedra A. , Heniford B. Todd 
Published: August 2018

Background:
A nationwide trend toward “centers of excellence” for medical and surgical care has led to development and scrutiny of high-volume surgical specialty centers. The prevalence of hernias and the complexity of successful repair have led to the establishment of specialty practices. Herein we review and discuss the components of the successful establishment of a tertiary hernia referral center.

Methods:
Literature on establishment and impact of hernia specialty centers was reviewed, including the authors’ own practice. Factors and outcomes concerning the coordination, development, funding, and staffing of a hernia center were discussed and tabulated.

Results:
After establishment of a tertiary hernia center or center of excellence, institutions have reported an increase in surgical case volume, hernia complexity, patient comorbidity, and the area from which patients will travel. Driving factors for this practice development are varied and include team development, improvement in patient preoperative factors, and surgical outcomes assessment, among others.

Conclusions:
Establishment of a successful tertiary hernia referral center often includes institution participation, surgical expertise, interdisciplinary collaboration, and ongoing evaluation of outcomes. Success may be marked by increased case volume and tertiary referrals, but it is most evidenced by improved patient outcomes.
Patient Safety Culture, Health Information Technology Implementation, and Medical Office Problems That Could Lead to Diagnostic Error
Authors: Campione Joanne R. , Mardon Russell E. , McDonald Kathryn M. 
Published: August 2018

Background
Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment or by leading to unnecessary or harmful treatment.

Objectives
The aim of the study was to investigate the relationship between patient safety culture, health information technology (IT) implementation, and the frequency of problems that could lead to diagnostic errors in the medical office setting, such as unavailable test results, unavailable medical records, or unpursued abnormal results.

Methods
We used survey data from 925 medical offices nationwide that voluntarily submitted results to the 2012 Agency for Healthcare Research and Quality Medical Office Surveys on Patient Safety Culture database. At the office level, we ran a multivariate regression model to estimate the effect of culture on problem frequency while controlling for office-reported implementation levels of health IT, office characteristics such as the number of locations, and survey characteristics such as the percent of respondents that were physicians.

Results
The most frequent problem was “results from a lab or imaging test were not available when needed”; across 925 offices, the average was 15% reporting that it happened daily or weekly. Higher overall culture scores were significantly associated with fewer occurrences of each problem assessed. Compared with offices with completed health IT implementation, offices in the process of health IT implementation had higher frequency of problems.

Conclusions
This study offers insight into how patient safety culture and health IT implementation in medical offices can influence the frequency of breakdowns in processes of care, thereby identifying potential vulnerabilities that can increase diagnostic errors.
Colorectal Cancer Among Gout Patients Undergoing Colonoscopy
Authors: Slobodnick Anastasia , Krasnokutsky Svetlana , Lehmann Robert A. , Keenan Robert T. , Quach Jonathan , Francois Fritz , Pillinger Michael H. 
Published: August 2018

Background/Objective
The connection between gout and various cancers remains unclear. We assessed the relationship between gout and colorectal cancer in a population of veterans.

Methods
We reviewed the Computerized Patient Record System of the VA New York Harbor Health Care System to assess the 10-year occurrence of colorectal cancer in patients with gout undergoing colonoscopy, versus patients with osteoarthritis but no gout.

Results
Gout and osteoarthritis subjects were similar in age, ethnicity, body mass index, and smoking history. Among 581 gout and 598 osteoarthritis subjects with documented colonoscopies, the 10-year prevalence of colorectal cancer was significantly lower in gout (0.8%) versus osteoarthritis (3.7%) (p = 0.0008) patients. Differences in colorectal cancer rates remained significant after stratifying for nonsteroidal anti-inflammatory drug use. Among gout subjects, use of colchicine and/or allopurinol, as well as the presence/absence of concomitant osteoarthritis, did not influence colorectal cancer occurrence. On subanalysis, differences in colorectal cancer occurrence between gout and osteoarthritis subjects persisted among those who underwent diagnostic (0.5% in gout vs 4.6% in osteoarthritis subjects, p < 0.001) but not screening (0.9% in gout subjects vs 1% in osteoarthritis subjects, p = 1.0) colonoscopy. There was no significant difference in nonmalignant colorectal polyp occurrence between gout and osteoarthritis subjects.

Conclusions
Subjects with gout had decreased colonoscopy-documented occurrence of colorectal cancer compared with osteoarthritis subjects, suggesting a possible protective effect.
Association of Serum Lipid Profile With Coronary Computed Tomographic Angiography–derived Morphologic and Functional Quantitative Plaque Markers
Authors: Baumann Stefan , Kryeziu Philipp , Tesche Christian , Shuler Darby C. , Becher Tobias , Rutsch Marlon , Behnes Michael , Stach Ksenija , Jacobs Brian E. , Renker Matthias , Henzler Thomas , Haubenreisser Holger , Schoenberg Stefan O. , Weiss Christel , Borggrefe Martin , Schwemmer Chris , Schoepf U. Joseph , Akin Ibrahim , Lossnitzer Dirk 
Published: August 2018

Purpose:
Recent advances in image quality of coronary computed tomographic angiography (cCTA) have enabled improved characterization of coronary plaques. Thus, we investigated the association between quantitative morphological plaque markers obtained by cCTA and serum lipid levels in patients with suspected or known coronary artery disease.

Materials and Methods:
We retrospectively analyzed data of 119 statin-naive patients (55±14 y, 66% men) who underwent clinically indicated cCTA between January 2013 and February 2017. Patients were subdivided into a plaque and a no-plaque group. Quantitative and morphologic plaque markers, such as segment involvement score, segment stenosis score, remodeling index, napkin-ring sign, total plaque volume, calcified plaque volume, and noncalcified plaque volume (NCPV) and plaque composition, were analyzed using a semiautomated plaque software prototype. Total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein, low-density lipoprotein/high-density lipoprotein ratio, and triglycerides were determine in both groups.

Results:
Higher age (61±11 y vs. 52±14 y, P<0.0001) and a higher likelihood of male gender (77% vs. 56%, P<0.0001) were observed in the plaque group. Differences in lipid levels were neither observed for differentiation between plaque presence or absence, nor after subcategorization for plaque composition. LDL serum levels >160 mg/dL correlated with higher NCPV compared with patients with LDL between 100 and 160 mg/dL (112 vs. 27 mm3, P=0.037). Other markers were comparable between the different groups.

Conclusion:
Statin-naive patients with known or suspected coronary artery disease did not show differences in lipid levels related to plaque composition by cCTA. Patients with plaques tended to be men and were significantly older. High LDL levels correlated with high NCPV.
Augmenter of Liver Regeneration Protects Against Acetaminophen-Induced Acute Liver Injury in Mice by Promoting Autophagy
Authors: Hu Ting , Sun Hang , Deng Wan-Yan , Huang Wen-Qi , Liu Qi 
Published: August 2018

ABSTRACT
Most cases of acute liver failure are caused by acetaminophen (APAP) overdose. Oxidative stress is a key factor in APAP toxicity. Although augmenter of liver regeneration (ALR) has both antioxidative and antiapoptotic effects, its therapeutic potential in APAP hepatotoxicity remains unknown. The current study assessed the protective effects and associated mechanisms of ALR against APAP-induced acute liver injury in female BALB/c mice. We found that serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, intrahepatic hemorrhage and necrosis were increased at 3, 6, 12, 24, 48, and 72 h after 600 mg/kg APAP i.p. injection. During the early stages (before 12 h) of acute liver injury, ALR levels increased significantly, followed by a decrease to control level at 24 h after APAP administration. ALR treatment increased autophagosomes, promoted the conversion of LC3 I to LC3 II, and the degradation of p62. ALR attenuated APAP-stimulated increases in ALT, AST, myeloperoxidase (MPO), malondialdehyde (MDA), and reactive oxidative species (ROS) levels; intrahepatic hemorrhage; and necrosis as well as superoxide dismutase (SOD) and Glutathione (GSH) depletion. We found that APAP caused release of the mitochondrial intermembrane proteins apoptosis-inducing factor (AIF) and cytochrome c and that ALR inhibited this change. Meanwhile, ALR decreased expression of cleaved-caspase 3 and apoptotic cells. Subsequently, we investigated the significance of autophagy in APAP-induced acute liver injury by treatment with 3-methyladenine (3-MA), which were classical pharmaceuticals for suppressing autophagy. ALR directly induced autophagy flux; and the inhibition of autophagy reversed the beneficial effects of ALR on hepatotoxicity. Our findings suggest that ALR protects against APAP hepatotoxicity by activating the autophagy pathway.