bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occipital to Angular Artery Bypass for Post-irradiation Ischemia: 3-Dimensional Operative Video
Authors: Zenonos Georgios A , Morcos Jacques J 
Published: June 2019

Abstract
The authors present a 3D surgical video of a direct occipital to angular artery bypass for cerebral revascularization in the setting of Post-irradiation middle cerebral artery stenosis and symptomatic hypoperfusion. The case refers to a 50-yr-old woman with a history of an unresectable residual skull base meningioma, previously approached through a left frontotemporal craniotomy, and treated with radiation 5 yr prior to presentation. She now presented with right-sided limb shaking transient ischemic attacks and aphasia, along with evidence of left middle cerebral artery territory ischemia. Her symptoms were progressive, despite extensive external carotid collateral blood supply through the prior craniotomy.
The video analyzes the surgical steps of the procedure, emphasizing multiple surgical pearls. After positioning, an incision is designed to expose the full course of the occipital artery. After dissection of the donor vessel, a craniotomy is performed to expose the distal sylvian fissure. The donor and recipient vessels are prepared, and the anastomosis is performed with interrupted sutures given the sub-millimeter diameter of the recipient vessel (suture used: 10-0 Ethilon BV75-3 Taper, Ethicon, Johnson & Johnson). Every step of the closure is modified to avoid any constriction of the donor vessel. The patient tolerated the procedure well, and multiple modalities, both intra- and post operatively confirmed patency of, and robust flow within the bypass.
No identifying patient information is included. However, the patient's consent was obtained for this publication.
Transdiscal C7 Pedicle Subtraction Osteotomy With a Strut Graft and the Correction of Sagittal and Coronal Imbalance of the Cervical Spine
Authors: Park Jong-Hyeok , Lee Jong Beom , Kim Il Sup , Hong Jae Taek 
Published: June 2019

Abstract

BACKGROUND
Cervical spine deformity negatively affects patients’ quality of life. Pedicle subtraction osteotomy (PSO) has reported to correct cervical deformity but it is challenging and carries a significant risk of morbidity.

OBJECTIVE
To report transdiscal C7 PSO with a strut graft for the correction of sagittal and coronal imbalance in patients with fixed cervical deformity.

METHODS
After standard exposure, the spine was instrumented from C2 to T3. T1 subtotal laminectomy, and C6 to C7 total laminectomies were necessary for C7 PSO. Osteotomy was initiated with removal of C6–7 and C7–T1 facet joints to isolate C7 pedicles and identify bilateral C7/C8 roots. Bilateral C7 pediculectomies and transdiscal PSO were performed. A rectangular strut allograft was then inserted into the PSO site. The location of the strut graft was used as a fulcrum of sagittal and coronal correction. The head fixator was released and the head was extended under intraoperative neuromonitoring, and then detailed sagittal and coronal balances were controlled by compressing or distracting between the pedicle screws above and below the osteotomy.

RESULTS
This technique was applied in 2 patients with fixed subaxial cervical deformities. Transdiscal PSO could add more amount of correction and provide the additional fusion surface. The strut graft prevented sagittal translation, foraminal narrowing, and excessive focal cord kinking during PSO. Both patients showed radiologic and clinical improvements after surgery, and no neurovascular complication occurred after the surgery.

CONCLUSION
Transdiscal C7 PSO with a strut graft placement provided a safe way of correcting sagittal and coronal imbalance simultaneously and reduced neurological complication by preventing sagittal translation, foraminal narrowing and spinal cord kinking.
Injectable Amniotic Membrane/Umbilical Cord Particulate for Knee Osteoarthritis: A Prospective, Single-Center Pilot Study
Authors: Castellanos Ramon , Tighe Sean 
Published: June 2019

Abstract

Objective
To evaluate the short-term safety and effectiveness of amniotic membrane/umbilical cord particulate (AMUC) in managing pain in patients with various severities of knee osteoarthritis (OA).

Design
Single-center, prospective, investigator-initiated pilot study.

Setting
Private practice.

Subjects
A total of 20 knee OA patients aged ≥18 years were enrolled with pain >40 mm, as determined by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)–A.

Methods
Patients received an ultrasound-guided, intra-articular injection of 50 mg of AMUC particulate reconstituted in 2 mL of preservative-free saline. All patients were then monitored at six weeks, 12 weeks, and 24 weeks postinjection. Patients who did not show >30% reduction in pain received a second injection of AMUC at six weeks. WOMAC, Patient Global Assessment, medication usage, and magnetic resonance imaging (MRI) were assessed.

Results
Knee OA pain significantly decreased from 74.3 ± 17.2 at baseline to 45.0 ± 25.4 at six weeks (P < 0.01), 35.4 ± 26.6 at 12 weeks (P < 0.001), and 37.4 ± 26.7 at 24 weeks (P < 0.001). This pain reduction was associated with a significant improvement in physical function (WOMAC-C) at all time points (P < 0.05) and stiffness (WOMAC-B) at 12 weeks (P = 0.01). Eleven patients received a second injection, which was significantly correlated with body mass index >30 kg/m2 (P = 0.025). MRI evaluation of the overall population revealed an improvement in the severity of bone marrow lesions in seven patients. No adverse events were observed.

Conclusions
AMUC particulate injection relieved pain and improved physical function in patients with symptomatic knee OA.
Malignant Hyperthermia During Translabyrinthine Acoustic Neuroma Surgery After Previous Uneventful Surgery
Authors: Erbele Isaac , Chapman Eric , Wilson Meghan N. , Arriaga Moises A. 
Published: June 2019

Objective:
Review current literature and guidelines for malignant hyperthermia in the context of neurotologic surgery.

Patient:
A case of malignant hyperthermia during vestibular schwannoma surgery, in a patient previously exposed to anesthesia.

Interventions:
Excision of vestibular schwannoma, acute management of malignant hyperthermia.

Main Outcome Measures:
Knowledge of the basic pathophysiology, clinical manifestations, and treatment protocols for malignant hyperthermia.

Results:
Rapid termination of the procedure and appropriate modifications in surgical technique permitted expeditious treatment of malignant hyperthermia and prevented its lethality.

Conclusions:
Malignant hyperthermia is a rare and lethal condition that may arise in neurotologic surgery, even in patients who have previously received general anesthesia. The neurotologic surgeon has a role in early recognition and expeditious termination of surgery to help reduce its mortality.
Benefit of Gemcitabine/Nab-Paclitaxel Rescue of Patients With Borderline Resectable or Locally Advanced Pancreatic Adenocarcinoma After Early Failure of FOLFIRINOX
Authors: Vreeland Timothy J. , McAllister Florencia , Javadi Sanaz , Prakash Laura R. , Fogelman David R. , Ho Linus , Varadhachary Gauri , Aloia Thomas A. , Vauthey Jean-Nicolas , Lee Jeffrey E. , Kim Michael P. , Katz Matthew H. G. , Tzeng Ching-Wei D. 
Published: June 2019

Objectives
Neoadjuvant therapy (NT) is used for advanced pancreatic ductal adenocarcinoma (PDAC). No clear guidelines exist for switching therapies when patients do not respond to initial NT. We sought to characterize patients who underwent early switch from FOLFIRINOX to gemcitabine/nab-paclitaxel (GA) as NT for PDAC.

Methods
We identified patients at a single institution switched from FOLFIRINOX to GA within the first 4 months of NT for PDAC during 2012–2017. We compared clinicopathologic data and oncologic outcomes.

Results
Of 25 patients who met the criteria, 21 showed a serologic or radiographic response to GA; 11 (52%) reached resection. Responders had decreased carbohydrate antigen (CA) 19-9 levels from pretreatment to post-GA (P = 0.036). Resected responders had significantly decreased CA 19-9 comparing preswitch to post-GA (P = 0.048). The only predictor of GA response was prechemotherapy CA 19-9 of less than1000 U/mL (P = 0.021). Predictors of reaching resection were head/uncinate tumor (P = 0.010) and presenting stage lower than locally advanced (P = 0.041).

Conclusions
When patients do not respond to neoadjuvant FOLFIRINOX, early switch to GA should be considered. Future efforts should be directed toward identifying markers that will allow correct choice of initial therapy rather than attempting to rescue patients who respond poorly to first-line therapy.
Symptom Experience of Older Adults With Type 2 Diabetes and Diabetes-Related Distress
Authors: Hernandez Lenore , Leutwyler Heather , Cataldo Janine , Kanaya Alka , Swislocki Arthur , Chesla Catherine 
Published: June 2019

Background
An older, more diverse population and longer life spans are major contributors to the anticipated tripling of Type 2 diabetes prevalence by 2050. Diabetes-related distress affects up to 40% of people diagnosed with Type 2 diabetes and may be a greater risk for older adults due to greater prevalence of comorbidities.

Objective
The objective of this phenomenological study was to describe how diabetes-related distress in older adults (≥65 years) with Type 2 diabetes might be uniquely experienced.

Methods
Participants were recruited using convenience sampling and snowball sampling. Interpretive phenomenology guided the research design and analysis. With interpretive interviews, we investigated the everyday health, symptoms, and life experiences of living with Type 2 diabetes and elevated diabetes distress.

Results
Among the older adults in this study, the most prevalent symptoms were fatigue, hypoglycemia, diarrhea, pain, loss of balance, and falling. These diabetes-related symptoms led to substantial loss of independence, decreased quality of life, and constrained social lives due to restricted activities.

Discussion
Diabetes-related distress presents with some unique symptoms and responses in older adults. Improving knowledge regarding the symptom experience of older adults with diabetes-related distress may allow healthcare providers to tailor treatment and thus improve outcomes for older adults struggling with diabetes.
Early Intervention Therapy Services for Infants With or at Risk for Cerebral Palsy
Authors: Gmmash Afnan S. , Effgen Susan K. 
Published: June 2019

Objective:
The purpose of this study was to explore the practices physical therapists and occupational therapists use in early intervention (EI) for infants with or at risk for cerebral palsy (CP).

Methods:
A survey was disseminated nationally to EI providers using an online anonymous link.

Results:
Two hundred sixty-nine therapists completed at least 50% of the survey. Four percent of therapists use the General Movement Assessment to predict CP, 57% reported infants at risk for CP receive therapy once a week, 89% identified parents' goals as the most important factor in customizing the EI program, and 75% provide parents with home programs. However, 73% never or rarely use outcome measures to prioritize parents' goals; 31% provide parents with individualized home program and more than 60% never assess environmental enrichment.

Conclusion:
Therapists do not incorporate sufficient strategies for goal-oriented interventions, comprehensive parent education, and optimum environmental enrichment.
Toxic Shock Syndrome Caused by Staphylococcal Infection After Breast Implant Surgery
Authors: Hisanaga Kana , Kadota Hideki , Fukushima Seita , Inatomi Yusuke , Shimamoto Ryo , Kamizono Kenichi , Hanada Masuo , Yoshida Sei 
Published: June 2019

Abstract
Toxic shock syndrome is a rare but life-threatening complication after breast implant surgery. We describe a 77-year-old woman who developed toxic shock syndrome caused by methicillin-resistant Staphylococcus aureus after breast implant reconstruction. Despite a high fever and markedly increased white blood cell count, suggesting severe infection, she initially had no symptoms of local findings, such as wound swelling and redness of the breast. Soon after diagnosis of toxic shock syndrome and removal of her breast implant, she was recovered from the shock state. To date, 16 cases of toxic shock syndrome have been reported, including this case, and they were related to breast implants or tissue expander surgery. The common and noteworthy characteristic of these cases was the lack of local findings, such as swelling or redness, which suggests infection. Therefore, early diagnosis is generally difficult, and the initiation of proper treatment can be delayed without knowledge of this characteristic. Toxic shock syndrome requires early diagnosis and treatment. If the patient has a deteriorated vital sign after breast implant surgery or tissue expander breast reconstruction, toxic shock syndrome should be suspected, even if there are no local signs of infection, and removal of the artifact should be considered as soon as possible.
Chaperone Use in Plastic and Reconstructive Surgery Outpatient Clinics
Authors: Vakayil Victor , Kim Nicholas , Barta Jo , Choudry Umar 
Published: June 2019

Introduction
Patient perspectives on chaperone use during examinations, especially in surgical subspecialties, are understudied. We aimed to identify specific patient cohorts that desire the presence of chaperones and compare patient and surgeon perspectives, all in an effort to improve quality of care.

Methods and Materials
We prospectively administered a 15-question survey to all patients visiting 2 plastic surgery outpatient clinics between January 2015 and April 2016. Data on demographics, types of procedures (cosmetic or reconstructive), area of examination (sensitive or nonsensitive), views on chaperone use, type of chaperone, and instances of inappropriate behavior by surgeons were collected. Univariate analysis was performed after stratifying patients on their individual desire to have a chaperone. Subsequently, multivariate regression models were constructed to identify individual patient cohorts independently more likely to require a chaperone.

Results
A total of 398 participants were surveyed. There were 58.3% female and 41.7% male respondents; of whom 41.8% were 55 years or older and 8.1% were younger than 24 years. Ninety percent of all patients were receiving care for a reconstructive procedure. Most (77%) were being examined over a nonsensitive area. Overall, 82.1% preferred not to have a chaperone present during examinations. Most (72.6%) felt the sex of the examining physician was inconsequential to their need for a chaperone. Most (54.8%) preferred either a family member or a friend to be the chaperone. Only 1.8% (n = 7) experienced inappropriate behavior, of whom 77% (n = 5) noted the absence of a chaperone while being examined. On multivariate analysis, younger patients and examination over a sensitive area were independently associated with a higher odd of requiring a chaperone (odds ratios, 3.4 [95% confidence interval, 1.3–8.9; P = 0.016] and 3.9 [95% confidence interval, 1.9–6.7; P < 0.001], respectively).

Conclusions
Most patients did not want a chaperone during examinations. Younger patients and those having a sensitive area examined were independently more likely to desire a chaperone. Patients preferred having their family member or friend as their chaperone. Given the major differences in perceptions, plastic surgeons should consider selectively using chaperones rather than the carte blanche use of chaperones with every patient.
Effects of Dressing Materials on Donor Site Morbidity
Authors: Macharia Mwea , Nangole Ferdinand Wanjala 
Published: June 2019

Abstract
Skin graft donor wounds should heal with rapid epithelialization resulting in good aesthetic and minimal donor site morbidity. Several dressing materials are now available for the dressing of the donor sites. Few studies have, however, been done to compare the efficacy of these dressing materials.
This study compared the effectiveness of paraffin gauze, hydrocolloid, antimicrobial biguanide foam, and silver hydrofiber dressings on donor site wounds at a tertiary hospital in Kenya.
Patients who underwent split-thickness skin graft were recruited and randomized into 4 arms. The donor site wound was dressed with either of the 4 dressing material mentioned earlier. The patient and observers were blinded. Outcome variables that were assessed were donor site pain on days 1, 3, and 10, and infection and percentage epithelialization on day 10.
Wounds dressed with hydrocolloids were the least painful on all the 3 postoperative days assessed. Those dressed with paraffin gauze were the most painful on day 1, whereas those with antimicrobial foam were the most painful on the 10th day. The mean (SD) percentage epithelialization of the wounds on the 10th day were as follows; hydrocolloids, 92.2% (20.9%); silver hydrofiber, 91.4% (18.8%); paraffin gauze, 73.4% (24.9%); and antimicrobial biguanide foam, 11.0% (10.3%). Paraffin gauze dressed wounds were the most infected at 22%.
In conclusion, all the 4 dressing materials had different scores among the factors assessed. Hydrocolloids dressings and silver hydrofiber dressing would, however, be the preferred dressing materials for the donor site based on these study findings as reflected by the high epithelialization low infection rates and less pain.
Real-time monitoring of mechanical cues in the regenerative niche reveal dynamic strain magnitudes that enhance bone repair
Authors: Klosterhoff Brett S. , Kaiser Jarred , Nelson Bradley D. , Karipott Salil S. , Ruehle Marissa A. , Hollister Scott J. , Weiss Jeffrey A. , Ong Keat Ghee , Willett Nick J. , Guldberg Robert E. 
Published: June 2019

AbstractMechanical loads exerted on the skeleton during activities such as walking are important regulators of bone repair, but dynamic biomechanical signals are difficult to measure inside the body. The inability to measure the mechanical environment in injured tissues is a significant barrier to developing integrative regenerative and rehabilitative strategies that can accelerate recovery from fracture, segmental bone loss, and spinal fusion. Here we engineered an implantable strain sensor platform and measured strain across a bone defect in real-time throughout rehabilitation. We used the sensor to longitudinally quantify mechanical cues imparted by a load-sharing fixation plate that significantly enhanced bone regeneration in rats. We found that sensor readings correlated with the status of healing, suggesting a potential role for strain sensing as an X-ray-free healing assessment platform. This study demonstrates a promising approach to quantitatively develop and exploit mechanical rehabilitation strategies that enhance bone repair.
Can ethical leadership hinder sales performance? A limited resource perspective of job embeddedness
Authors: Lee Chih-Jen , Huang Stanley Y.B. 
Published: June 2019

Purpose
The purpose of this study is to borrow from a limited resource view of job embeddedness to argue that ethical leadership can hurt salespeople’s growth of sales performance by a latent growth model.

Design/methodology/approach
This work surveyed 825 salespeople in Greater China at three points over six months to test the latent growth model.

Findings
The findings reveal that as salespeople perceive more ethical leadership at the initial point, they may show more increases in job embeddedness behavior development that lead to decreases in social capital and human capital behavior development, which consequently decreases sales performance over time.

Originality/value
These findings unearth a novel idea that ethical leadership may erode growth of sales performance over time.
Knowledge sharing of inpatriates
Authors: Schuster Tassilo , Holtbrügge Dirk , Engelhard Franziska 
Published: June 2019

PurposeThe purpose of this study is to analyze the effects of inpatriates’ abilities, motivation and opportunities on knowledge sharing and the moderating role of boundary spanning in this context.Design/methodology/approachBy integrating the ability–motivation–opportunity framework with the concept of boundary spanning four hypotheses are developed, which are tested against the data of 187 inpatriates working in Germany.FindingsThe study reveals that inpatriates’ motivation and certain opportunities are positively related to knowledge sharing, whereas inpatriates’ abilities do not show a positive effect. Moreover, it is shown that inpatriate boundary spanning has a moderating effect on this relationship.Originality/valueBased on the results, the study enhances the current literature by introducing the concept of reputation asymmetry. Moreover, requirements of how inpatriates’ assignments should be designed and implications for further research are outlined.
Introduce a novel configurationof microchannel andhigh-conductivity insertsfor cooling of disc-shaped electronic components
Authors: Dadsetani Reza , Sheikhzadeh Ghanbar Ali , Hajmohammadi Mohammad Reza , Safaei Mohammad Reza 
Published: June 2019

Purpose
Electronic components’ efficiency is the cornerstone of technology progress. The cooling process used for electronic components plays a main role in their performance. Embedded high-conductivity material and provided microchannel heat sink are two common cooling methods. The former is expensive to implement while the latter needs micro-pump, which consumes energy to circulate the flow. The aim of this study is providing a new configuration and method for improving the performance of electronic components.

Design/methodology/approach
To manage these challenges and improve the cooling efficiency, a novel method named Hybrid is presented here. Each method's performance has been investigated, and the results are widely compared with others. Considering the micro-pump power, the supply of the microchannel flow and the thermal conductivity ratio (thermal conductivity ratio is defined as the ratio of thermal conductivity of high thermal conductivity material to the thermal conductivity of base solid), the maximum disk temperature of each method was evaluated and compared to others.

Findings
The results indicated that the Hybrid method can reduce the maximum disk temperature up to 90 per cent compared to the embedded high thermal conductivity at the same thermal conductivity ratio. Moreover, the Hybrid method further reduces the maximum disk temperature up to 75 per cent compared to the microchannel, at equivalent power consumption.

Originality/value
The information in this research is presented in such a way that designers can choose the desired composition, the limited amount of consumed energy and the high temperature of the component. According to the study of radial-hybrid configuration, the different ratio of microchannel and materials with a high thermal conductivity coefficient in the constant cooling volume was investigated. The goal of the investigation was to decrease the maximum temperature of a plate on constant energy consumption. This aim has been obtained in the radial-hybrid configuration.