bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARISON BETWEEN SEVERAL OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY DEVICES AND INDOCYANINE GREEN ANGIOGRAPHY OF CHOROIDAL NEOVASCULARIZATION
Authors: Corvi Federico , Cozzi Mariano , Barbolini Erika , Nizza Dario , Belotti Maria , Staurenghi Giovanni , Giani Andrea 
Published: February 2019

Purpose:
To compare indocyanine green angiography and four different optical coherence tomography angiography (OCTA) devices and to test their reproducibility in the evaluation of choroidal neovascularization (CNV).

Methods:
This study was an observational case series of Type 1 and Type 2 CNV presenting at the Eye Clinic, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, University of Milan, imaged with indocyanine green angiography and four different OCTA devices: prototype PlexElite (Carl Zeiss Meditec), prototype Spectralis OCTA (Spectralis; Heidelberg Engineering, Heidelberg, Germany), Optovue RTVue XR Avanti (Optovue, Inc, Fremont, CA), and AngioPlex (Cirrus 5000 HD-OCT; Carl Zeiss Meditec, Inc, Dublin, CA). Optical coherence tomography angiography examinations were performed using a 3 × 3-mm or 6 × 6-mm volume scan pattern to capture the full lesion. The mean area of CNV, vessel density, and fractal dimension were compared between the devices.

Results:
Seventeen eyes of 17 patients with CNV were enrolled. The CNV area was significantly larger in indocyanine green angiography than in the OCTA devices. Moreover, the four different instruments produced measurements with different mean values of CNV area, vessel density, and fractal dimension. The Bland–Altman analysis revealed that the limits of agreement for the comparisons were not acceptable.

Conclusion:
The choroidal neovascularization area is larger when imaged with standard indocyanine green angiography than with different OCTA devices with different algorithms, wavelengths, and scan patterns. The differences between several OCTA devices in the evaluation of quantitative parameters of CNV, such as CNV area, vessel density, and fractal dimension, suggest the necessity to standardize OCTA measurements for research and clinical practice.
Is Student Stress Related to Personality or Learning Environment in a Physician Assistant Program?
Authors: Wardley C. Sonia , Applegate E. Brooks , Almaleki A. Deyab , Van Rhee James A. 
Published: February 2019

Purpose
The purpose of this research was to study the impact of students' personalities and 2 different learning environments—lecture-based learning (LBL) and problem-based learning (PBL)—on the stress perceived by 5 cohorts of physician assistant (PA) students.

Methods
Students rated their stress related to family obligations, financial concerns, schoolwork, relocation, and overall stress on 6 occasions over the course of the 2-year program. Personalities of students were assessed using the California Psychological Inventory 7 months into the program. Students' expectations and observations of their learning environments were measured using the PA School Learning Environment Survey at the beginning and end of the didactic year.

Results
Personalities of LBL and PBL students were very similar, but LBL students who scored higher on the Independence concept were less stressed about their schoolwork. The LBL students, in general, were more discontented with their learning environment, but this finding was not related to higher schoolwork-related stress. In contrast, PBL students' personalities were not related to stress, and PBL students also rated some dimensions of their learning environment higher than they had expected. However, those PBL students who rated the PBL environment less favorably also reported higher schoolwork-related stress.

Conclusions
High stress perceived by LBL students was related to some personality concepts but not to the students' learning environment, despite their overall disappointment with that environment. The PBL students were more stressed by schoolwork, although their stress was not related to personality. Problem-based learning students, except for those most highly stressed, tended to rate their learning environment more favorably.
Sitting Up Vertigo. Proposed Variant of Posterior Canal Benign Paroxysmal Positional Vertigo
Authors: Scocco Darío H. , García Iván E. , Barreiro María A. 
Published: February 2019

Objective:
To describe a variant of posterior canal benign paroxysmal positional vertigo (BPPV).

Study Design:
Retrospective case review.

Setting:
Tertiary referral center.

Patients:
Fifteen patients with symptoms of BPPV and oculomotor evidence of activation of posterior semicircular canal (P-SCC) cupula that arises when sitting up from Dix-Hallpike maneuver (DH).

Intervention:
All patients were examined with videonystagmography and underwent brain magnetic resonance imaging (MRI).

Results:
All patients showed up-beating nystagmus with ipsilateral torsional component when coming up from right or left side DH. Most patients described vertiginous symptoms when sitting up from bed and many described severe non-positional disequilibrium. Eight patients had been treated with Epley canalith repositioning maneuver (CRM) at our clinic for posterior canal BPPV. Four of them were re-tested within an hour for CRM effectiveness and the rest, a week later. Three patients had been diagnosed with BPPV and were being treated with CRM in other institutions. Four patients showed these findings but they had not previously undergone CRM. All patients were treated with CRM without success, but they resolved their positional vertigo by means of Brandt Daroff exercises. No patient showed evidence of central vestibular disorder.

Conclusion:
We propose a P-SCC canalolithiasis limited to the periampullar portion by means of an anatomical restriction of distal movement of the otoconial debris. This syndrome seems to be more frequent early after CRM of classical P-SCC canalolithiasis. Close attention to ocular movement on sitting up after DH on patients is warranted.
Disease knowledge and self-management behavior of COPD patients in China
Authors: Yang Hua , Wang Huijun , Du Liying , Wang Ying , Wang Xiujin , Zhang Ruimin 
Published: February 2019

Abstract
This study aims to investigate the disease knowledge and self-management behavior of patients with chronic obstructive pulmonary disease (COPD) in the respiratory ward of a tertiary hospital in China, and analyze the relationship between these.
A total of 360 COPD patients were surveyed using the internationally validated COPD Questionnaire (COPD-Q), the COPD Patients’ Self-Management Behavior Scale and a general sociodemographic questionnaire, and 346 valid responses were obtained.
The results revealed that the surveyed COPD patients scored an average of 4.90 ± 2.50 points (maximal of 13 points) on the COPD-Q and 117.23 ± 20.56 points on the COPD Self-Management Behavior Scale, in which 86.1% of COPD patients were classified as having low to medium levels of self-management behavior. Pearson correlation analysis revealed that the total points on the COPD Self-Management Behavior Scale, symptom management, daily life management, emotional management and information management were all positively correlated to the disease knowledge of COPD (P < .01). In addition to COPD knowledge, the multiple regression analysis revealed that age, marital status and place of residence could also affect self-management behavior.
The level of disease knowledge and self-management behaviors of patients with COPD is rather low in China. COPD knowledge level was found to correlate with the level of self-management behavior. Health education that enhances the disease knowledge of COPD patients might thereby be necessary to help improve self-management behavior.
Diagnostic accuracy of γ-glutamyl transpeptidase-to-platelet ratio for predicting hepatitis B-related fibrosis: a meta-analysis
Authors: Lian Ming-Jian , Zhang Jia-Qin , Chen Shi-Dong , Zhang Dong-Dong , Yang Yuan-Yuan , Hong Guo-Lin 
Published: February 2019

Background and aim
Emerging published data on the accuracy of γ-glutamyl transpeptidase-to-platelet ratio (GPR) for diagnosing hepatitis B virus (HBV)-related fibrosis are inconsistent. The aim of this study was to systematically review the performance of GPR for diagnosing HBV-related significant fibrosis, severe fibrosis, and cirrhosis.

Patients and methods
A comprehensive literature search of PubMed, Web of Science, and EMBASE was conducted before July 2018. Study selection was performed according to inclusion and exclusion criteria. The relevant parameters of eligible studies were abstracted. The methodological quality was assessed according to the Quality Assessment of Diagnostic Accuracy Studies. Areas under summary receiver operating characteristic curves, sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratios were used to examine the GPR accuracy for the diagnosis of significant fibrosis, severe fibrosis, and cirrhosis.

Results
A total of 10 studies including 5882 patients with HBV infection underwent liver biopsy were incorporated. The prevalence of significant fibrosis, severe fibrosis, and cirrhosis were 58% (range: 22–72%), 36% (range: 10–55%), and 19% (range: 2–33%), respectively. Areas under summary receiver operating characteristic curves of GPR for predicting significant fibrosis, severe fibrosis, and cirrhosis were 0.733, 0.777, and 0.796, respectively. Subgroup analysis was performed according to geographical region and histological scoring system with similar results.

Conclusion
GPR has moderate diagnostic accuracy for predicting HBV-related significant fibrosis, severe fibrosis, and cirrhosis, and further studies with large sample size, rigorous design, multicenter study population are urgently needed.
ACO Affiliated Hospitals Increase Implementation of Care Coordination Strategies
Authors: Anderson Andrew C. , Chen Jie 
Published: February 2019

Background:
Hospitals affiliated with Accountable Care Organizations (ACOs) may have a greater capacity to collaborate with providers across the care continuum to coordinate care, due to formal risk sharing and payment arrangements. However, little is known about the extent to which ACO affiliated hospitals implement care coordination strategies.

Objectives:
To compare the implementation of care coordination strategies between ACO affiliated hospitals (n=269) and unaffiliated hospitals (n=502) and examine whether the implementation of care coordination strategies varies by hospital payment model types.

Measures:
We constructed a care coordination index (CCI) comprised of 12 indicators that describe evidence-based care coordination strategies. Each indicator was scored on a 5-point Likert scale from 1=“not used at all” to 5=“used widely” by qualified representatives from each hospital. The CCI aggregates scores from each of the 12 individual indicators to a single summary score for each hospital, with a score of 12 corresponding to the lowest and 60 the highest use of care coordination strategies.

Research Design:
We used state-fixed effects multivariable linear regression models to estimate the relationship between ACO affiliation, payment model type, and the use care coordination strategies.

Results:
We found ACO affiliated hospitals reported greater use of care coordination strategies compared to unaffiliated hospitals. Fee-for-service shared savings and partial or global capitation payment models were associated with a greater use of care coordination strategies among ACO affiliated hospitals.

Conclusion:
Our findings suggest ACO affiliation and multiple payment model types are associated with the increased use of care coordination strategies.
Implications of Ankyloglossia on Breastfeeding
Authors: Hill Rebecca 
Published: February 2019

Abstract

Objective:
The purpose of this integrative review was to synthesize the literature on the relationship between infant breastfeeding and ankyloglossia.

Data Sources:
The search terms tongue-tie or ankyloglossia and breastfeeding were used via CINAHL, Ovid MEDLINE, Health Reference Academic, and PsycINFO. Primary research articles and clinical reviews were considered in the search parameters.

Study Selection:
Searches yielded 201 articles written in English and published between 1999 and 2018. After screening, 50 full-text articles were assessed for eligibility, 43 of which were omitted for irrelevance. Three qualitative and four quantitative studies remained for inclusion in the review.

Data Extraction:
Studies were reviewed for information on the relationship between ankyloglossia and breastfeeding. Studies examining results of ankyloglossia treatment were omitted. Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used.

Data Synthesis:
Analysis revealed a varied degree of difficulties with breastfeeding when the infant has ankyloglossia. Prevalence is uncertain due to lack of universal screening guidelines, and infrequent use of screening tools. No studies were found that examined psychological ramifications of feeding difficulties with ankyloglossia. There are no validated screening tools for ankyloglossia.

Conclusion:
More research is necessary on effects of breastfeeding difficulties of infants with ankyloglossia on the mother–infant relationship. A reliable screening tool needs to be developed and validated. Education for nurses to assess infants with ankyloglossia in a systematic fashion should be explored. Investigation of psychological sequelae, including maternal stress, postpartum depression, and mother–infant bonding is an important next step in the research of infants with ankyloglossia.
Intrusive Rumination, Deliberate Rumination, and Posttraumatic Growth Among Adolescents After a Tornado
Authors: Xu Wei , Jiang Huili , Zhou Yuyang , Zhou Linli , Fu Hong 
Published: February 2019

Abstract
Posttraumatic growth (PTG) may exist in trauma survivors, especially adolescents, whereas rumination is a typical cognitive characteristic among traumatized individuals. However, there were mixed relationships between rumination (intrusive rumination, deliberate rumination) and PTG. The study aimed to increase understanding of the relationships between them by investigating the role of social support among adolescents after the Yancheng tornado. Four hundred forty-three middle school students in the core area of the tornado were administered a revised social support scale based on Furman and Buhrmester's Network of Relationships Inventory, Event-Related Rumination Inventory, and Posttraumatic Growth Inventory. Results showed a nonsignificant relationship between intrusive rumination and PTG, whereas a positive relationship was found between deliberate rumination and PTG. Moreover, social support did not moderate the relationship between intrusive rumination and PTG, but it significantly mediated the relationship between deliberate rumination and PTG. Clinical implications on trauma intervention and limitations as well as future research directions were discussed.
Single Port Endoscope-Assisted Excision of Forehead Lesions: An Innovative Way of Improving the Optical Cavity
Authors: Narayanan Vairavan , Jayapalan Ronie Romelean , Singh Sidhu Amritpal , Koh Kiok Miang Roy 
Published: February 2019

Abstract
Exophytic lesions involving the face present with an undesirable esthetic deformity and usually necessitate surgical excision. Conventional open excision techniques may lead to scar formation or pigmentation issues postoperatively. Minimally invasive endoscope-assisted surgery will be able to overcome these problems. However, this technique is not widely used because of the limited optical cavity working space, which hinders good visualization. We describe a technique to improve the optical cavity workspace to enable adequate endoscope-assisted surgical excision of forehead lesions in 2 cases. Foley's catheter and ribbon gauze were used in both cases to gain optical cavity workspace. The surgical technique is described in detail. One case had a frontal osteoma, whereas other was a nodular fasciitis of the forehead, confirmed by histology. Postoperative follow-up showed good outcomes at 1 year with no recurrences. Both patients were satisfied with the surgical and cosmetic outcomes. Endoscopic excision of a forehead lesion using the described technique is both safe and reliable. It is an excellent method for excising benign growths over the forehead while being cosmetically acceptable.
Angiolymphoid Hyperplasia With Eosinophilia: New Concept to Lower Recurrence
Authors: Labib Amir , Estawrow Mina 
Published: February 2019

Abstract
Angiolymphoid Hyperplasia with Eosinophilia (AHLE) is a rare benign vascular disorder of unknown etiology. While World Health Organization recognizes it as a benign neoplasm, its progressive nature and high recurrence rate are consistent with being a locally malignant tumor. It may present as solitary or multiple nodules with more predilection to head and neck region, especially auricular area. Despite variety of available treatment options, high recurrence rate remains a compelling issue. The spectrum of these treatment modalities includes topical or systemic steroids use, intralesional injection of certain materials such as Bleomycin, Vinblastine or interferon, or even surgical excision.
In our study, the authors present a case of middle-aged female with recurrent AHLE in left concha and preauricular region. Excision of the lesion with 4 mm of the normal surrounding skin, preserving auricular cartilage, was done while the resultant defect was covered by grafted Temporoparietal Fascia Flap. Our 1-year follow-up period showed aesthetically accepted outcome with no recurrence.
The authors hypothesize that treating AHLE as a locally malignant tumor by excising the lesion with 4 mm safety margin decreases recurrence rates. Moreover, reconstruction by grafted temporoparietal fascia flap achieves a reasonable aesthetic outcome with minimal donor site morbidity.
National 30-Day Outcomes for Posterior Cranial Vault Distraction
Authors: Chouairi Fouad , Torabi Sina J. , Alperovich Michael 
Published: February 2019

Background:
Posterior vault distraction (PVD) can rapidly expand calvarial volume in infancy. Limited data exist regarding its perioperative and postoperative safety profile. This study sought to investigate the patient profile, outcomes, and safety of PVD using a national pediatric database.

Methods:
Posterior vault distraction patients between 2012 and 2016 were isolated from the National Surgical Quality Improvement Program Pediatric database. Patient background, perioperative outcomes, and risk factors were analyzed using chi-squared, t test analysis, and multivariate regression.

Results:
Ninety-four patients who underwent PVD were isolated with 67 ultimately meeting inclusion criteria for the study. The majority of patients undergoing PVD had limited other documented comorbidities. No patients required reoperation or 30-day readmission. There were no incidences of stroke, surgical site infection, or death. Subdividing outcomes by specialty, plastic surgeons performed PVD on significantly older patients than neurosurgeons (188 days vs 138 days, P = 0.008). Increasing age was associated with increasing operative time (P < 0.001). Furthermore, increasing age is associated with greater absolute transfusion requirements (P = 0.018) and higher, but not significant, risk of requiring any volume of blood transfusion (P = 0.105).

Conclusions:
Posterior vault distraction is a safe procedure to rapidly expand calvarial volume in the setting of craniosynostosis. Increasing patient age is the strongest predictor for prolonged operative time and higher blood transfusion volumes.
Effect of Fat Grafting on Postoperative Edema After Orthognathic Surgery
Authors: Cabrejo Raysa , Sawh-Martinez Rajendra , Steinbacher Derek M. 
Published: February 2019

Background:
Autologous fat grafting concurrent with orthognathic surgery is a powerful adjunctive aesthetic tool, and has been shown to have anti-inflammatory properties in prior studies. The purpose of this study is to evaluate the effect of fat grafting on postoperative edema following orthognathic surgery, and also consider the impact of age and BMI.

Methods:
A retrospective cohort study was performed. Three-dimensional photos (Canfield, Fairfield, NJ) from a series of postprocedure time-points were analyzed using Geomagic Studio 2013 (3D Systems, Morrisville, NC). An unstructured covariance linear mixed model was created to analyze the effect and extent of the effect of age, BMI, and fat using SPSS Statistics 24.0 (IBM, Armonk, NY).

Results:
One hundred thirty postoperative three-dimensional pictures were analyzed, from 31 patients. The linear mixed model demonstrates that the fat injected (P<0.001), age (P=0.001), and BMI (P<0.001) are significant factors in the postoperative volume. Age and BMI increase postoperative edema by 3.63 cm3 per year and 14.60 cm3 per kg/m2, respectively. Fat injected reduces postoperative edema by 8.72 cm3 per 1 cc injected.

Conclusion:
Increasing age and BMI lead to greater postoperative edema (3.88 cm3 per year and 14.60 cm3 per kg/m2, respectively). Fat grafting concurrent with orthognathic surgery reduces postoperative edema by 8.72 cm3 per 1 cc injected, and hastens return to steady state. This impact is more profound in patients with a greater age and BMI.
Three-Surface Reconstruction Using Single De-Epithelialized Radial Forearm Free Flap
Authors: Choi Jangyoun , Choi Hyuk Joon , Kang Kyo Joon , Jung Sung-No 
Published: February 2019

Abstract
Head and neck cancer often requires multiple defect reconstruction that are too far apart to handle with 1 flap. However, 1 flap with skin graft, or multiple flap reconstruction is always not possible due to recipient site factors and lack of sufficient donor site. In this report, we share our experience on reconstruction of multiple, and distant head and neck defects with 1 large radial forearm flap that was vertically inset to cover multiple defect on face, and then tunneled to reach down to the neck. Due to the longer dimension, this flap could be utilized not only to reconstruct the face and neck area, but also simultaneously reconstruct face and orbit, or face and scalp area. We think that this modification of the radial forearm flap could provide a useful surgical option for multiple and distant head and neck reconstructions.
Complications Associated With Anterior Iliac Bone Grafting for the Reconstruction of Dentoalveolar Defects
Authors: Tosun Emre , Akkocaoğlu Murat , Tüz Hakan H. , Avağ Canseda , Göktürk Tuğçe 
Published: February 2019

AbstractThe aim of this study is to evaluate donor- and recipient-site complications of iliac bone grafting for the reconstruction of atrophic jaws.Our study includes 86 consecutive patients with atrophic jaws who underwent iliac bone grafting surgery. At the donor site, hematoma, infection, paresthesia, chronic pain, prolonged gait disturbance, fracture of the ilium, and esthetic concerns; at the recipient site, hematoma, infection, prolonged pain, graft exposure, graft loss, and loss of the implants were evaluated.Grafting was successfully performed in all patients. The mean follow-up period was 35 months. Prolonged gait disturbance (20.9%) and paresthesia (9.3%) were the most frequently observed donor-site complications. At the recipient site, hematoma (8.1%), infection (12.8%), prolonged pain (11.6%), partial graft exposure (33.7%), total graft exposure (7%), partial graft loss (17.4%), and total graft loss (5.8%) were observed.Reconstruction of atrophic jaws can be achieved successfully with iliac bone grafting. However, there are possible donor- and recipient-site complications that have to be taken into consideration.