bluuebunny/crossref_metadata_2025_split huggingface dataset:
Liposuction Assisted Abdominoplasty: An Enhanced Abdominoplasty Technique
Authors: Brauman Daniel , van der Hulst Rene R. W. J. , van der Lei Berend 
Published: October 2018

Background:
Combining liposuction with abdominoplasties was considered risky during the 1980s and 1990s due to reports of increased complications rates and the belief that liposuction posed a danger to flap circulation. However, the corresponding author’s intraoperative observations at that time, that liposuction preserved all but the smallest blood vessels, negated the prevailing opinions that liposuction increased the risk to flap circulation, and in October 1996, liposuction assisted abdominoplasty (LAA) was first performed. Thereafter, LAA was honed to become a lipoabdominoplasty technique—not merely a combination of liposuction and abdominoplasty, a technique that utilizes liposuction as a dissection tool—hydro- and lipo-dissection, to dissect free and separate the abdominal flap from the deep fascia. Enhanced flap excursion could be demonstrated intraoperatively by selectively transecting the skin retaining ligaments and limiting liposuction to the flap’s undersurface, created a vascular lining layer rich in anastomosing blood vessels that provided a rich blood supply to the flap, enabling increased flap excursion.

Methods:
Five ninety-three consecutive ambulatory LAAs with circumferential torso liposuction and other area liposuction are presented and the surgical technique is illustrated and discussed.

Results:
There were no serious adverse events, anesthesia complications, hospital transfers, no venous thromboembolism or postoperative respiratory complications in the 593 cases. Patient satisfaction was high, and the results compared favorably with abdominoplasty results published in the scientific literature.

Conclusions:
LAA is a safe and effective abdominoplasty technique. Extensive clinical experience with LAA suggests longer flap excursion and improved perfusion. It routinely incorporates circumferential torso and other areas liposuction and has commonly included buttock fat grafting.
No Difference in Return to Sport and Other Outcomes Between Operative and Nonoperative Treatment of Medial Epicondyle Fractures in Pediatric Upper-Extremity Athletes
Authors: Axibal Derek Paul , Carry Patrick , Skelton Anne , Mayer Stephanie Watson 
Published: October 2018

Objective:
Compare outcomes of operative and nonoperatively managed medial epicondyle fractures in upper-extremity athletes.

Design:
Retrospective chart review and phone survey.

Setting:
Level 1, tertiary-referral pediatric hospital.

Patients:
Propensity scores (probability of operative treatment) were estimated from a logistic regression model that included sex, age, displacement, limb dominance, and injury severity (presence of an additional fracture, nerve injury, or elbow dislocation). These were used to match subjects in the operative group to the nonoperative group.

Main Outcome Measures:
Return to sport, duration of time required to return to sport, pain, range of motion (ROM), need for physical therapy, and complications were recorded for both groups.

Results:
Twenty-eight nonoperative subjects were matched to 14 operative subjects. There was no significant difference in the proportion of subjects who returned to the same sport (92.9% in each group), performance at preinjury level of competition, or median time to return to play (P = 0.7106). There was no significant difference in functional limitations in social-/work-related activities (P > 0.9999), pain in the past 30 days (P = 0.0640), need for physical therapy (P = 0.5680), ROM limitations (P = 0.0988), difficulty in sleeping (P = 0.4773), or complications (P = 0.4081).

Conclusions:
Our study found no statistical difference in outcomes or complications between operative and nonoperatively treated moderately displaced medial epicondyle fractures in adolescent upper-extremity athletes. Our data show that similar outcomes may be achieved with both treatment groups for medial epicondyle fractures in upper-extremity athletes.
Peripheral Vestibular Disorders: An Epidemiologic Survey in 70 Million Individuals
Authors: Hülse Roland , Biesdorf Andreas , Hörmann Karl , Stuck Boris , Erhart Michael , Hülse Manfred , Wenzel Angela 
Published: October 2018

Background:
Dizziness is a common complaint in medicine. Nevertheless, there is a lack of valid data concerning the age and gender distribution of dizziness disorders within a larger population. Therefore, the aim of the present study is to undertake a representative epidemiological survey that examines all age groups of an entire population and describes the age and gender distribution of the most common peripheral vestibular disorders.

Methods:
A population-based epidemiological survey based on confirmed ICD-10 codes, of an entire national population was performed. The population-based data of 70,315,919 patients were leveraged, as provided by 123 statutory health insurance companies in Germany. Patients of all age groups were analyzed. Outcome measures were age and gender distribution and the prevalence of unspecific vertigo, Meniere's disease, benign paroxysmal positional vertigo, vestibular neuritis, and other peripheral vestibular disorders.

Results:
The prevalence among the recorded diagnoses was 6.5% (6,461/100,000 individuals), with women (N = 2,973,323; 65.4%) being significantly more frequently affected by vertigo than men (N = 1,570,240; 34.6%; p < 0.001). Vertigo is rare in childhood (i.e., up to 10–14 yr of age). Subsequently, the prevalence of the analyzed diseases increases with age, up to a peak between 74 and 94 years.

Conclusions:
The results demonstrate that peripheral vestibular disorders are common in a developed country, across all age groups and a specific distribution of these disorders can be identified for every age group and gender. The impact of these disorders on the German healthcare system is currently underestimated.
Cochlear Implantation in Chronic Otitis Media: Investigation of Long-term Speech Comprehension and Rate of Complications
Authors: Rak Kristen , Völker Johannes , Schendzielorz Philipp , Kaulitz Stefan , Steinbach Julia , Shehata-Dieler Wafaa , Schraven Sebastian P. , Mlynski Robert , Radeloff Andreas , Hagen Rudolf 
Published: October 2018

Objective:
To analyze the long-term speech comprehension and rate of complications of cochlear implantation in chronic otitis media.

Study Design:
Retrospective data analysis.

Setting:
Tertiary referral center with a large cochlear implant program.
Main Outcome Measure: Speech perception scores in quiet and background noise and rate of complications.

Patients:
Forty ears from a total of 38 patients with a mean age of 63.28 ± 2.16 years at the time of implantation were included.

Results:
Patients with a history of multiple ear surgeries, with no alternative option for hearing restoration than a cochlear implant, were implanted with satisfactory results in regard to speech comprehension. Preoperative bone conduction PTA4 correlated to postoperative speech comprehension scores in background noise. The rate of complications was low, but higher than in cases of cochlear implantation in normal middle ears.

Conclusion:
Cochlear implantation in chronic otitis media can be a satisfactory and safe procedure, if the surgery technique and aftercare is appropriate to the altered anatomy.
Parental Factors in Pediatric Functional Abdominal Pain Disorders
Authors: Zeevenhooven Judith , Rutten Juliette M.T.M. , van Dijk Marieke , Peeters Babette , Benninga Marc A. 
Published: October 2018

ABSTRACTObjectives:Parental factors are suggested to play a role in pediatric irritable bowel syndrome (IBS) and functional abdominal pain—not otherwise specified (FAP‐NOS) and may influence treatment. Since studies on parental factors mainly focus on mothers, this study aims to compare physical health, psychological distress, personality dimensions, and parenting behavior of both parents of children with IBS or FAP‐NOS to parents of controls.Methods:Parents of 91 children with IBS or FAP‐NOS were included in this explorative cross‐sectional cohort study. Parents of 74 age‐matched healthy children were used as controls. Questionnaires were used to measure demographics, physical health, psychological distress and symptoms, personality dimensions, and child‐rearing practices.Results:A total of 59 mothers and 52 fathers of 61 children with IBS/FAP‐NOS (response rate 61.0%) and 56 mothers and 49 fathers of 59 controls completed the study (response rate 70.9%). Mothers of children with IBS/FAP‐NOS reported more physical problems. Psychological distress and symptoms, personality dimensions, and child‐rearing practices did not differ between mothers of both groups. Fathers of children with IBS/FAP‐NOS had significantly lower scores on the child‐rearing practice subscale of ignoring of unwanted behavior. In the IBS/FAP‐NOS group, fathers were more depressed and less agreeable than mothers. No differences on all assessed outcomes were found between parents of children with IBS and children with FAP‐NOS.Conclusions:Mothers of children with IBS/FAP‐NOS and healthy peers differ with respect to physical health. Fathers in both groups differ with respect to child‐rearing style. Clinicians should be aware of these differences when treating children with these disorders.
Stepping Activity in Children With Congenital Myotonic Dystrophy
Authors: Hayes Heather A. , Dibella Deanna , Crockett Rebecca , Dixon Melissa , Butterfield Russel J. , Johnson Nicholas E. 
Published: October 2018

Purpose:
The purpose of this study was to investigate the physical activity levels in children with congenital myotonic dystrophy (CDM), and to examine whether patient clinical and functional characteristics correlated to physical activity.

Methods:
Twenty-five children with CDM were assessed on functional measures, clinical measures, and physical activity levels.

Results:
Results support that children with CDM spend the majority of their time inactive. There was a negative correlation between inactivity and cytosine-thymine-guanine repeats, suggesting increased inactivity with increased CDM severity. Age, body mass index, and lean muscle mass may be factors influencing activity levels.

Conclusions:
Children in this study received one-third the recommended steps per day. The number of steps per day is not correlated with clinical measures.
Physical Therapy Management of Congenital Muscular Torticollis: A 2018 Evidence-Based Clinical Practice Guideline From the APTA Academy of Pediatric Physical Therapy
Authors: Kaplan Sandra L. , Coulter Colleen , Sargent Barbara 
Published: October 2018

Background:
Congenital muscular torticollis (CMT) is a postural deformity evident shortly after birth, typically characterized by lateral flexion/side bending of the head to one side and cervical rotation/head turning to the opposite side due to unilateral shortening of the sternocleidomastoid muscle; it may be accompanied by other neurological or musculoskeletal conditions. Infants with CMT should be referred to physical therapists to treat these postural asymmetries as soon as they are identified.

Purpose:
This update of the 2013 CMT clinical practice guideline (CPG) informs clinicians and families as to whom to monitor, treat, and/or refer and when and what to treat. It links 17 action statements with explicit levels of critically appraised evidence and expert opinion with recommendations on implementation of the CMT CPG into practice.

Results/Conclusions:
The CPG addresses the following: education for prevention; referral; screening; examination and evaluation; prognosis; first-choice and supplemental interventions; consultation; discontinuation from direct intervention; reassessment and discharge; implementation and compliance audits; and research recommendations. Flow sheets for referral paths and classification of CMT severity have been updated.
Association of Fibroblast Growth Factor-23 (FGF-23) With Incident Frailty in HIV-Infected and HIV-Uninfected Individuals
Authors: Wang Ruibin , Shlipak Michael G. , Ix Joachim H. , Brown Todd T. , Jacobson Lisa P. , Palella Frank J. , Lake Jordan E. , Koletar Susan L. , Semba Richard D. , Estrella Michelle M. 
Published: October 2018

Background:
In the Multicenter AIDS Cohort Study, we examined whether fibroblast growth factor-23 (FGF-23), a bone-derived phosphaturic hormone involved in bone metabolism, is associated with incident frailty. Furthermore, we examined whether this association differs by HIV serostatus and race.

Methods:
Of 715 men assessed for frailty and selected for FGF-23 measurements using stored blood samples (2007–2011), 512 men were nonfrail at/before the baseline visit. Frailty was defined by the presence of ≥3 of the following on 2 consecutive 6-month visits within 1 year: unintentional weight loss ≥10 pounds, weakness, slowness, low energy, and low physical activity. We determined the association of FGF-23 levels with incident frailty using proportional hazards models adjusting for sociodemographics, comorbidities, and kidney function.

Results:
Sixty-five percent were HIV-infected; 29% were black. Median baseline FGF-23 levels were lower in HIV-infected vs. HIV-uninfected men (33.7 vs. 39.9 rU/mL, P = 0.006) but similar by race. During a median follow-up of 6.6 years, 32 men developed frailty; they had higher baseline FGF-23 levels vs. men who remained nonfrail (45 vs. 36 rU/mL, P = 0.02). FGF-23 (per doubling) was associated with a 1.63-fold risk of frailty [95% confidence interval (CI): 1.19 to 2.23]; results did not differ by HIV serostatus. Conversely, FGF-23 was associated with a 2.72-fold risk of frailty among blacks (95% CI: 1.51 to 4.91) but had minimal association among nonblacks (hazard ratio = 1.26, 95% CI: 0.77 to 2.05; p-interaction = 0.024).

Conclusions:
Among men with or at-risk of HIV infection, higher FGF-23 was associated with greater risk of frailty, particularly in blacks. The mechanisms by which FGF-23 may contribute to frailty warrant further study.
Impact of an HIV Care Coordination Program on Durable Viral Suppression
Authors: Robertson McKaylee M. , Penrose Kate , Irvine Mary K. , Robbins Rebekkah S. , Kulkarni Sarah , Braunstein Sarah L. , Waldron Levi , Harriman Graham , Nash Denis 
Published: October 2018

Background:
To assess long-term effectiveness of an intensive and comprehensive Ryan White Part A-funded HIV Care Coordination Program recruiting people living with HIV with a history of suboptimal HIV care outcomes.

Methods:
We merged programmatic data on CCP clients with surveillance data on all adults diagnosed with HIV. Using propensity score matching, we identified a contemporaneous, non–CCP-exposed comparison group. Durable viral suppression (DVS) was defined as regular viral load (VL) monitoring and all VLs ≤200 copies per milliliter in months 13–36 of follow-up.

Results:
Ninety percent of the combined cohort (N = 12,414) had ≥1 VL ≤200 during the follow-up period (December 1, 2009–March 31, 2016), and nearly all had routine VL monitoring, but only 36.8% had DVS. Although DVS did not differ overall (relative risk: 0.99, 95% confidence interval: 0.95 to 1.03), CCP clients without any VL suppression (VLS) in the 12-month pre-enrollment showed higher DVS versus “usual care” recipients (21.3% versus 18.4%; relative risk: 1.16, 95% confidence interval: 1.04 to 1.29).

Conclusions:
Enrollment in an intensive intervention modestly improved DVS among those unsuppressed before CCP enrollment. This program shows promise for meeting treatment-as-prevention goals and advancing progress along the HIV care continuum, if people without evidence of VLS are prioritized for CCP enrollment over those with recent evidence of VLS. Low overall DVS (<40%) levels underscore a need for focused adherence maintenance interventions, in a context of high treatment access.
Establishing the first Hartford consensus-compliant medical school in the United States
Authors: Fridling Jeremy , Van Cott Christine , Violano Pina , Jacobs Lenworth 
Published: October 2018

BACKGROUND
Following the Hartford Consensus meetings, the Stop the Bleed Campaign was created to reduce the prevalence of death from exsanguination in the case of traumatic hemorrhage. The campaign revolves around providing hemorrhage control training to members of the public and increasing public access to hemorrhage control equipment. To our knowledge, no medical school has established a self-sustaining Stop the Bleed program to train their students and faculty as well as made hemorrhage control equipment available for use in an emergency.

METHODS
Bleeding control classes were offered at the Frank H. Netter MD School of Medicine beginning in January 2018. A proposal was made to the medical school's Council on Curriculum Oversight in May 2018 to incorporate the training as part of the required curriculum for first-year students. A second proposal was made to Quinnipiac University’s Emergency Management Team in June 2018 to purchase hemorrhage control equipment.

RESULTS
Twelve bleeding control courses were held between January and August 2018. Two hundred ten medical students, 19 faculty members, and 36 public safety officers completed initial training. Thirty-four medical students, two faculty members, and two public safety officers became certified instructors. Training was incorporated into the first-year curriculum to be taught by certified second-year students under the direction of the school’s Department of Surgery. The school purchased approved training equipment. A student-coordinator position was created in the Surgery Interest Group. Hemorrhage control equipment was purchased for each public safety officer, patrol vehicles, and for the Central Dispatch headquarters. Public-access equipment has been purchased for each Automated External Defibrillator cabinet at the medical school.

CONCLUSION
The School of Medicine community has been empowered with the ability to save lives. Students and faculty have been trained in life-saving skills, a self-sustaining training process has been created, and equipment has been purchased for hemorrhage control efforts.
Emergence of robust nucleosome patterns from an interplay of positioning mechanisms
Authors: Nuebler Johannes , Wolff Michael , Obermayer Benedikt , Möbius Wolfram , Gerland Ulrich 
Published: October 2018

AbstractProper positioning of nucleosomes in eukaryotic cells is determined by a complex interplay of factors, including nucleosome-nucleosome interactions, DNA sequence, and active chromatin remodeling. Yet, characteristic features of nucleosome positioning, such as gene-averaged nucleosome patterns, are surprisingly robust across perturbations, conditions, and species. Here, we explore how this robustness arises despite the underlying complexity. We leverage mathematical models to show that a large class of positioning mechanisms merely affects the quantitative characteristics of qualitatively robust positioning patterns. We demonstrate how statistical positioning emerges as an effective description from the complex interplay of different positioning mechanisms, which ultimately only renormalize the model parameter quantifying the effective softness of nucleosomes. This renormalization can be species-specific, rationalizing a puzzling discrepancy between the effective nucleosome softness of S. pombe and S. cerevisiae. More generally, we establish a quantitative framework for dissecting the interplay of different nucleosome positioning determinants.
Aberrant PARP1 Activity Couples DNA Breaks to Deregulated Presynaptic Calcium Signalling and Lethal Seizures
Authors: Komulainen Emilia , Badman Jack , Rey Stephanie , Rulten Stuart , Ju Limei , Fennell Kate , McKinnon Peter J. , Staras Kevin , Caldecott Keith W 
Published: October 2018

AbstractDefects in DNA single-strand break repair result in cerebellar ataxia which inXrcc1Nes-Cremice is promoted by hyperactivity of the DNA strand break sensor protein, Parp1. Here, we show that Parp1 hyperactivity extends beyond the cerebellum in Xrcc1-defective brain, resulting in lethal seizures and shortened lifespan. We demonstrate that aberrant Parp1 activation triggers seizure-like activity in Xrcc1-defective hippocampusex vivoand aberrant presynaptic calcium signalling in isolated hippocampal neuronsin vitro.Moreover, we show that these defects are prevented by Parp1 inhibition and/or deletion. Collectively, these data identify aberrant Parp1 activity at unrepaired DNA breaks as a cell-autonomous source of deregulated presynaptic calcium signalling, and highlight PARP inhibition as a possible therapeutic approach inXRCC1-mutated neurodegenerative disease.SummaryPARP1 activity and presynaptic Ca2+signalling
Reversal of microRNA-blocked tumor suppressors by biphenyldicarboxylate impedes endotoxin-induced hepatic hyperplasia
Authors: Tan Li-Li , Chen Dong-Mei , Song Jian-Ping , Xu Qin , Li Chang-Qing , Zeng Qing-Ping 
Published: October 2018

AbstractHepatocellular carcinoma (HCC) is one of the most common malignant tumor and the leading cause of cancer-related death worldwide. Biphenyldicarboxylate (BPDC), an intermediate of schisandrin C fromSchisandra chinensis, has been used as a hepatoprotective agent that compromises hepatic injuries in China for decades. Whether BPDC is also implicated in the prevention of HCC remains understood. Here, we report that the bacterial endotoxin lipopolysaccharide (LPS) promotes hepatic inflammation and hyperplasia, during which the common tumor markers, alpha fetoprotein (AFP) and carcinoembryonic antigen (CEA), were unregulated, whereas the tumor suppressors, PTEN, FOXO1 and MEN1, were downregulated through increasing the microRNAs, miR-21, miR-122 and miR-24. In contrast, BPDC dampened hepatic inflammation and hyperplasia accompanied by the upregulation of PTEN, FOXO1 and MEN1 through decreasing miR-21, miR-122 and miR-24. However, BPDC failed to downregulate the tumor marker AEG-1 via increasing miR-195. Taken together, BPDC exerts anti-tumor effects by upregulating tumor suppressors upon decreases of miRNAs rather than downregulating tumor markers by increases of miRNAs.
Intention to learn differentially affects subprocesses of procedural learning and consolidation: Evidence from a probabilistic sequence learning task
Authors: Horváth Kata , Török Csenge , Pesthy Orsolya , Nemeth Dezso , Janacsek Karolina 
Published: October 2018

AbstractProcedural memory facilitates the efficient processing of complex environmental stimuli and contributes to the acquisition of automatic behaviours and habits. Learning can occur intentionally or incidentally, yet, how the mode of learning affects procedural memory is still poorly understood. Importantly, procedural memory is a complex cognitive function composed of different subprocesses, including the acquisition and consolidation of statistical, frequency-based and sequential, order-based knowledge. Therefore, we tested how statistical and sequence knowledge develops during incidental versus intentional procedural memory formation and during consolidation. Seventy-four young adults performed either the uncued, incidental (N = 37) or the cued, intentional (N = 37) version of a probabilistic sequence learning task. Performance was retested after a 12-hour offline period, enabling us to test the effect of sleep on consolidation; therefore, half of the participants slept during the delay, while the other half had normal daily activity (PM-AM versus AM-PM design). The mode of learning (incidental versus intentional) had no effect on the acquisition of statistical knowledge, while intention to learn increased sequence learning performance. Consolidation was not affected by intention to learn: Both statistical and sequence knowledge was retained over the 12-hour delay, irrespective of the mode of learning and whether the delay included sleep or wake activity. These results suggest a time-dependent instead of sleep-dependent consolidation of both statistical and sequence knowledge. Our findings could contribute to a better understanding of how the mode of learning (intentional or incidental) affects procedural memory formation and consolidation.