bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurophysiological Differences in Emotional Processing by Cochlear Implant Users, Extending Beyond the Realm of Speech
Authors: Deroche Mickael L. D. , Felezeu Mihaela , Paquette Sébastien , Zeitouni Anthony , Lehmann Alexandre 
Published: February 2019

Objective:
Cochlear implants (CIs) restore a sense of hearing in deaf individuals. However, they do not transmit the acoustic signal with sufficient fidelity, leading to difficulties in recognizing emotions in voice and in music. The study aimed to explore the neurophysiological bases of these limitations.

Design:
Twenty-two adults (18 to 70 years old) with CIs and 22 age-matched controls with normal hearing participated. Event-related potentials (ERPs) were recorded in response to emotional bursts (happy, sad, or neutral) produced in each modality (voice or music) that were for the most part correctly identified behaviorally.

Results:
Compared to controls, the N1 and P2 components were attenuated and prolonged in CI users. To a smaller degree, N1 and P2 were also attenuated and prolonged in music compared to voice, in both populations. The N1–P2 complex was emotion-dependent (e.g., reduced and prolonged response to sadness), but this was also true in both populations. In contrast, the later portion of the response, between 600 and 850 ms, differentiated happy and sad from neutral stimuli in normal hearing but not in CI listeners.

Conclusions:
The early portion of the ERP waveform reflected primarily the general reduction in sensory encoding by CI users (largely due to CI processing itself), whereas altered emotional processing (by CI users) could be found in the later portion of the ERP and extended beyond the realm of speech.
Mood disorders are associated with inferior outcomes of anatomic total shoulder arthroplasty
Authors: Eads Ryan B. , Brolin Tyler J. , Smith Richard A. , Azar Frederick M. , Throckmorton Thomas W. 
Published: February 2019

Background:
Mood disorders (MD) have been associated with inferior outcomes after orthopaedic procedures, but little is known about their effect on total shoulder arthroplasty (TSA).

Methods:
In patients with primary TSA and a minimum of 2 yr clinical and radiographic follow-up, documentation of depression, anxiety, and/or use of a prescription mood-stabilizing drug indicated MD. Prolonged narcotic use was patient-reported consumption at most recent follow-up or filled narcotic prescription within 3 mo in a statewide database.

Results:
Chronic pain syndromes were more frequent in 24 patients with MD (76%) than in 63 without (1.6%), and narcotic use was higher (54% vs. 13%, respectively). There were no significant differences in range of motion, strength, complications, reoperations, or radiographic complications and none in the amount of improvement for any of the functional parameters.

Conclusions:
Patients with MD were four times more likely to require narcotics for pain control, although function improved by an amount similar to the control group.

Level of evidence:
Level III, retrospective comparison study.
Effect of dose of the corticosteroid injected locally on inflammatory diseases
Authors: Ahmadzadeh Heshmati Afshin , Ilka Shahab 
Published: February 2019

Background:
Local injection of corticosteroid medication is one of the most common therapeutic treatments in inflammatory diseases, yet there are still many controversies surrounding its use.

Methods:
One hundred and seventy patients with de Quervain disease, lateral epicondylitis, or plantar fasciitis were entered into the study and divided into two groups (groups 1 and 2) according to doses of the steroids (20 mg and 40 mg methylprednisolone acetate, respectively). Patients were evaluated before injection and at 3 wk and 6 wk after injection using a visual analogue scale, quick Disabilities of the Arm, Shoulder and Hand score, the American Orthopedic Foot and Ankle Society Score, and grip strength. Complications were recorded at each visit.

Results:
All outcome parameters significantly improved 3 wk after injection in all patients. Improvement between weeks 3 and 6 was not significant. There was no significant difference between patients in group 1 and 2 except patients in group 1 with plantar fasciitis had better outcome than those in group 2 at 6 wk. The only encountered complication was change in color of the skin in three patients.

Conclusions:
A 20-mg injection of methylprednisolone acetate locally was sufficient for improvement of symptoms in patients with de Quervain disease, lateral epicondylitis, and plantar fasciitis. More doses of the steroid had no more beneficial effect.
Use of 5-Aminolevulinic Acid and Daylight Photodynamic Therapy for the Treatment of Actinic Keratoses
Authors: Shive Melissa L. , Coakley Brandon J. , Bierman Dina F. , Serowka Lane Kathryn L. , Wiegell Stine R. , Haedersdal Merete , Zachary Christopher B. 
Published: February 2019

BACKGROUND
Photodynamic therapy (PDT) is an effective modality for the treatment of actinic keratoses (AKs). The use of methyl aminolevulinate with daylight PDT (D-PDT) has quickly gained popularity internationally because of its tolerability and high levels of safety and efficacy. However, there is a paucity of studies on the use of D-PDT with 5-aminolevulinic acid (ALA).

OBJECTIVE
To study the safety and efficacy of D-PDT in treating AKs on the face and scalp using ALA.

MATERIALS AND METHODS
Thirty patients were recruited for this prospective, uncontrolled study. Patients were treated with topical ALA on either the scalp or face, incubated for 30 minutes, and then sat at home in a shady area for 2 hours. Weather conditions, lux measurements, and AK counts at 3 and 6 months were measured.

RESULTS
Daylight PDT led to a median of 75% reduction in AK count at 6 months, with no significant adverse effects. Ninety-six percentage of patients were either moderately or very satisfied with the treatment, and the median peak pain score during treatment was 1. There was no correlation between weather or average lux received during treatment and 6-month outcomes.

CONCLUSION
Daylight PDT with ALA is a safe and effective treatment modality for AKs on the head.
What Is the Most Beautiful Facial Proportion in the 21st Century? Comparative Study among Miss Universe, Miss Universe Thailand, Neoclassical Canons, and Facial Golden Ratios
Authors: Burusapat Chairat , Lekdaeng Pattariya 
Published: February 2019

Background:
An ideal facial proportion has been attempted since the ancient times. However, modern facial proportions of the most beautiful women in the 21st century are unavailable and have never been determined.

Methods:
A retrospective review of the photographs of Miss Universe Thailand and Miss Universe from 2001 to 2015 was conducted. All photographs were searched from Internet websites. Twenty-six dominant points were identified. Comparisons of the facial proportion among Miss Universe Thailand, Miss Universe, neoclassical canons, and facial golden ratios were performed.

Results:
Sixteen Miss Universe Thailand and 16 Miss Universe were included. Nine points of facial proportions were found to be statistically significant between Miss Universe Thailand and neoclassical canons. Miss Universe Thailand showed wider nasofrontal angle, thinner lower-upper lip height ratio, and less chin projection. Ten points of facial proportions were found to be statistically significant between Miss Universe and neoclassical canons. Miss Universe showed wider nasofrontal and nasofacial angle, more nasal tip projection, and thinner lower-upper lip height ratio. Seven points of facial analysis were found to be statistically significant between Miss Universe Thailand and Miss Universe groups. Of the 16 facial golden ratios, 12 demonstrated statistical significance in both the Miss Universe Thailand and Miss Universe groups.

Conclusions:
Modern facial proportions of beauty are different from the past. Photogrammetic analysis demonstrated longer forehead, thinner lower-upper lip height proportion, wider interala-medial canthus width proportion, and wider nasofrontal angle compared with previous references. Furthermore, facial golden ratios were statistically significantly invalid in modern facial proportions of beauty.
Premature Expression of Pseudoexfoliation Syndrome With Presenile Cataract in a 28-Year-Old Lady
Authors: Kumar Praveen S. , Rao Aparna , Senthil Sirisha 
Published: February 2019

Purpose:
We report a case of premature expression of pseudoexfoliation syndrome with presenile cataract in a 28-year-old lady with primary developmental glaucoma who had undergone glaucoma filtration surgery 26 years ago.

Methods/Results:
We report a case of a 28-year-old Indian lady with progressive diminution of vision associated with photophobia in the left eye for 5 years and loss of vision in the right eye since childhood. She underwent glaucoma filtration surgery in the left eye at the age of 2 and was on 2 topical glaucoma medications when she presented to us. Refractive error was −17.00 D with −3.50 D @ 90-degree cylinder in the left eye. The right eye was phthisical. Left eye showed superior diffuse bleb, enlarged but clear cornea with superior Haab’s striae, deep and quiet anterior chamber and patent surgical iridectomy at 1 o’clock position. There was diffuse iris atrophy with pseudoexfoliation at the pupillary ruff and over the anterior lens capsule. Lens showed grade 2 nuclear cataract. Intraocular pressure in the left eye was 23 mm Hg. Fundus examination showed 0.9 cupping with an inferior notch and diffuse pallor of the optic disc. Axial length of left eye was 31.44 mm. On the basis of these findings, she was diagnosed with primary developmental glaucoma and high myopia, status after glaucoma filtration surgery with presenile cataract and pseudoexfoliation in the left eye. The topical antiglaucoma medications were augmented. After 1 month, intraocular pressure in the left eye was reduced to 14 mm Hg. She was advised to continue topical glaucoma medications and regular follow-up.

Conclusions:
The present case is the first to describe the unusual presentation of pseudoexfoliation in a young individual along with presenile cataract. Simultaneous occurrence of pseudoexfoliation with cataract could be due to previous intraocular surgery, iris trauma, possible low-grade inflammation, and high myopia in a predisposed eye. The clinician should be aware that although a rare condition, pseudoexfoliation can occur in the young and may be associated with presenile cataract.
Fatality While Bear Hunting
Authors: Spagnolia Alessandra , Kemp Walter L. 
Published: February 2019

Abstract
When a hunter intentionally fires a weapon and the projectile strikes another human, the manner of death is most often certified as a homicide. The intent of the individual firing the weapon is unknown and the possibility that a hunting “accident” represents a concealed intentional homicide must always be considered. However, in some circumstances such as a documented ricochet, the manner of death may be certified as accident.
The death of a hunter who was being mauled by a grizzly bear and subsequently died will be presented. While the man had injuries from the mauling, these injuries were, with treatment, survivable; however, he also had a gunshot wound of the left shoulder into the trunk. His partner had shot the bear, but unfortunately, 1 projectile perforated the bear and struck the decedent.
According to the National Association of Medical Examiners' Guide for Manner of Death Classification, if a hunter intentionally fires a weapon and kills a human the manner of death may be classified as homicide; however, if a weapon is discharged and the projectile strikes an object, ricochets, and kills a human, the manner of death may be classified as accident. In the death reported, the scenario does not exactly fit either of the above 2 situations. In this current case, given that (1) the decedent's friend fired a projectile with an intent to hit the bear that was mauling his partner and (2) that the projectile perforating the bear and entering his partner was unintended, the manner of death was certified as accident.
System Support Mapping: A Novel Systems Thinking Tool Applied to Assess the Needs of Maternal and Child Health Title V Professionals and Their Partners
Authors: Calancie Larissa , Margolis Lewis , Chall Steven A. , Mullenix Amy , Chaudhry Atyya , Hassmiller Lich Kristen 
Published: February 2019

Context:
The Maternal and Child Health (MCH) workforce aims to improve health outcomes for women, children, and families. The work requires coordination and partnerships that span disciplines and service systems. As such, workforce needs assessment requires an approach that is broad, flexible, and “systems-aware.”

Objective:
To illustrate the use of System Support Mapping, a novel systems thinking tool that was used to guide participants through a structured assessment of their discrete responsibilities, key needs, and specific resources required for each.

Participants:
Thirty-four Title V MCH professionals and partners from 15 states or jurisdictions.

Main Outcome Measure(s):
Description and frequency of Title V MCH professionals' coded roles, responsibilities, needs, resources, and wishes. An aggregated map illustrating interconnections between identified codes is presented.

Results:
State- and local-level MCH professionals reported a range of roles, responsibilities, needs, resources, and wishes. The most and least frequently reported roles, responsibilities, needs, resources, and wishes by state- and local-level MCH professionals are listed, as well as the most frequent connections between those responses. The most frequent responsibility reported in local maps was “link to or provide care or resources” (82%), whereas the most frequent responsibility reported in state maps was “system management” (65%). System management was indirectly connected to 3 wishes: “access to data or information,” “funding or resources,” and “collaboration, coordination, or support from community or other external organizations.”

Conclusions:
System Support Mapping can be used to support needs assessment with MCH professionals. System Support Maps show not only the most and least frequently reported roles, responsibilities, needs, resources, and wishes of participants but also how those responses are connected and potentially interdependent. System Support Maps may be useful for MCH leaders determining how best to organize their teams to take on complex public health challenges and prioritize improvements that will better support their work.
Systemic Administration of Adipose-Derived Stromal Cells Concurrent with Fat Grafting
Authors: Hong Ki Yong , Kim Il-Kug , Park Seong Oh , Jin Ung Sik , Chang Hak 
Published: February 2019

Background:
Cell-assisted lipotransfer, a technique involving free fat grafting mixed with adipose-derived stromal cells, has gained popularity for enhancing fat graft retention. In terms of stem cell delivery, intravenous injection can be a novel alternative with clinical value. However, the effects of intravenously injected adipose-derived stromal cells concurrent with fat grafting have not been described. The authors investigated the histologic and microenvironmental changes in grafted fat when adipose-derived stromal cells were injected intravenously concurrent with grafting.

Methods:
Using a modified animal model of cell-assisted lipotransfer, adipose tissue from green fluorescent protein–expressing C57BL/6J (B6) mice was grafted into recipient wild-type B6 mice, followed by intravenous injection of adipose-derived stromal cells from DsRed-expressing B6 mice. The distribution of adipose-derived stromal cells was evaluated using bioluminescent imaging, and graft volume was measured using micro–computed tomographic scans. Donor fat and adipose-derived stromal cells were traced using immunofluorescent staining.

Results:
The authors identified the recruitment of adipose-derived stromal cells inside the graft after intravenous injection of adipose-derived stromal cells concurrent with grafting despite the arrest of cells in the lungs. Intravenous injection of adipose-derived stromal cells resulted in significantly higher adipogenesis gene expression, retention of graft volume, and vascular density of the graft. A tracing study performed until postoperative week 8 revealed that intravenously injected adipose-derived stromal cells mainly induced angiogenesis and adipogenesis by paracrine action rather than direct differentiation.

Conclusions:
Consistent with results of cell-assisted lipotransfer, adipose-derived stromal cell supplementation by systemic administration led to improved retention of the fat graft. The findings broaden the surgical options for fat grafting and enhance the clinical value of cell-assisted lipotransfer.
Venous Thromboembolism after Abdominal Wall Reconstruction: A Prospective Analysis and Review of the Literature
Authors: Kraft Casey T. , Janis Jeffrey E. 
Published: February 2019

Background:
Ventral hernias are a common problem after exploratory laparotomy, and plastic surgeons often become involved for hernia repair in complex situations. Plastic surgeons can achieve fascial closure through primary repair, an external oblique aponeurosis release, or a transversus abdominis release. Currently, there is scant literature evaluating venous thromboembolism rates after these procedures. The authors sought to evaluate their own experience with complex abdominal wall reconstruction and venous thromboembolism events.

Methods:
The authors retrospectively reviewed their prospectively collected database of all patients who have undergone complex abdominal wall reconstruction performed by a single surgeon at their institution from September of 2013 to February of 2018. Demographic data, anticoagulant use, Caprini score, operative time, and postoperative venous thromboembolism events were recorded. A literature search was also performed, identifying all published articles evaluating venous thromboembolism events after abdominal wall reconstruction.

Results:
The authors identified 175 patients for analysis. Four patients were found to have postoperative venous thromboembolism events, for a total venous thromboembolism rate of 2.3 percent. The average Caprini score for these patients was 8.5, compared to 5.26 for those without a venous thromboembolism event, and no deaths were reported from these complications. On literature review, three articles were identified in the literature discussing venous thromboembolism after abdominal wall reconstruction, all based on the American College of Surgeons National Surgical Quality Improvement Program database.

Conclusions:
Patients undergoing complex abdominal wall reconstruction are at high risk for venous thromboembolism events. There is scant literature published on this topic, but surgeons should be aware of the risk for venous thromboembolism after complex abdominal wall reconstruction and work to minimize this risk as much as possible.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Lower Urinary Tract Symptoms in Women With Female Genital Mutilation
Authors: Geynisman-Tan Julia , Milewski Andrew , Dahl Carly , Collins Sarah , Mueller Margaret , Kenton Kimberly , Lewicky-Gaupp Christina 
Published: February 2019

Objective
This study aimed to describe symptom prevalence and quality of life impact from lower urinary tract symptoms (LUTS) in women living with female genital mutilation (FGM) in the United States.

Methods
A convenience sample of English-speaking women with FGM were invited to complete an anonymous survey including the Female Lower Urinary Tract Symptoms questionnaire to assess symptom prevalence and bother and the Pelvic Floor Impact Questionnaire-7 to assess quality of life impact from pelvic floor disorders. Data are reported as median (interquartile range). Correlations were calculated using Spearman ρ.

Results
Thirty women with an age of 29 (24–40) years were included. Sixty-seven percent self-identified as black/African and 77% were Muslim. Women reported being circumcised between ages 1 week and 16 years (median, 6 years). Forty percent reported type I circumcision, 23% reported type II, 23% reported type III, and 13% were unsure. Fifty percent were vaginally parous. Seventy-three percent of women reported the presence of LUTS. Twenty-seven percent voided at least 9 times per day, and 60% had nocturia at least 2 times. Bothersome voiding symptoms were commonly reported: urinary hesitancy (40%), strained urine flow (30%), and intermittent urine stream (47%). Fifty-three percent reported urgency urinary incontinence and 43% reported stress urinary incontinence. Symptom prevalence and bother were correlated for all 12 items (ρ = 0.51–0.90, P < 0.001). Median Pelvic Floor Impact Questionnaire-7 score was 102 (8–144), with 63% reporting urinary symptoms having “moderate” or “quite a bit of” impact on their activities, relationships, or feelings.

Conclusion
Lower urinary tract symptoms are common and bothersome in women with FGM. Providers caring for patients with FGM should inquire about LUTS.
A Prospective Randomized Trial Comparing Restorelle Y Mesh and Flat Mesh for Laparoscopic and Robotic-Assisted Laparoscopic Sacrocolpopexy
Authors: Ferrando Cecile A. , Paraiso Marie Fidela R. 
Published: February 2019

Objective
The primary objective of this study was to compare case and mesh placement times between Restorelle Y mesh and flat mesh. The secondary objective was to compare subjective and objective outcomes between the 2 mesh configurations.

Methods
This is a randomized trial of women undergoing laparoscopic (LSC) or robotic (RSC) sacrocolpopexy for posthysterectomy vaginal prolapse. Subjects were predetermined to undergo either an LSC or RSC and randomized to Y mesh or flat mesh. Case and mesh placement times were defined as incision time to time of closure and time from mesh introduced into the abdomen to placement of the last sacral stitch, respectively. All subjects underwent Pelvic Organ Prolapse Quantification System examination and completed the 20-item Pelvic Floor Disability Index preoperatively, at 6, 12, and 24 months.

Results
Sixty-two patients were enrolled, and 59 patients were implanted with mesh: 30 with Y mesh (17 LSC, 13 RSC) and 29 with flat mesh (18 LSC, 11 RSC). There were no differences in patient characteristics between mesh groups. Mean case and mesh placement times for all subjects were 204.4 ± 48 and 46.1 ± 13.5 minutes, respectively, with no differences between the groups. At 6 months, 20-item Pelvic Floor Disability Index scores improved significantly for all subjects with no differences by mesh type. Three subjects (5.5%) reported vaginal bulge symptoms, and no subjects were retreated for prolapse or were found to have recurrent prolapse on examination. There were also no mesh erosions.

Conclusions
Case and mesh placement times do not differ in patients undergoing LSC or RSC with either Restorelle Y mesh or flat mesh. At 6 months, subjective and objective successes were 94% and 100%, respectively.