bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Novel Extended Deep Plane Facelift Technique for Jawline Rejuvenation and Volumization
Authors: Jacono Andrew A , Bryant Lucas M , Ahmedli Nigar N 
Published: November 2018

Abstract

Background
Jawline aging is a complex process. We believe loss of posterior jawline definition and volume depletion is an underappreciated factor in the aging face.

Objectives
The aim of this study was to describe a novel composite, rotational flap modification of an extended deep-plane rhytidectomy. We evaluated long-term efficacy on improving jawline contour and volumization of the posterior mandibular region overlying the gonial angle.

Methods
We performed a prospective study on patients who underwent our modification of extended deep-plane rhytidectomy. We define and introduce the mandibular defining line, a new anatomic metric in evaluating the mandibular contour. We define the area of the posterior lower face overlying the gonion and mandibular angle as the gonial area. Using 3-dimensional photography, we quantify contour changes along the mandibular border and volume change along the gonial area.

Results
Eighty-nine patients (178 hemifaces) were analyzed. The mean gonial area volume gained was 3.5 cc. Average follow-up was 19 months. There was a statistically significant change in the mean mandibular defining line from 7.1 cm preoperatively to 9.8 cm postoperatively. This represents a lengthening of the visual perspective of the mandibular contour of 2.7 cm.

Conclusions
Composite, rotational flap modification of extended deep-plane rhytidectomy provides significant long-term augmentation of volume to the posterior mandibular region and lengthens the visual perspective of the inferior mandibular contour, creating a more youthful jawline. In selected cases, this may obviate the need for other volumization procedures used to improve jawline contour, such as autologous fat grafting.

Level of Evidence: 4
Ledipasvir/Sofosbuvir for 8 Weeks to Treat Acute Hepatitis C Virus Infections in Men With Human Immunodeficiency Virus Infections: Sofosbuvir-Containing Regimens Without Interferon for Treatment of Acute HCV in HIV-1 Infected Individuals
Authors: Naggie Susanna , Fierer Daniel S , Hughes Michael D , Kim Arthur Y , Luetkemeyer Annie , Vu Vincent , Roa Jhoanna , Rwema Steve , Brainard Diana M , McHutchison John G , Peters Marion G , Kiser Jennifer J , Marks Kristen M , Chung Raymond T ,   Acquired Immunodeficiency Syndrome Clinical Trials Group (ACTG) A5327 Study Team, Alston-Smith Beverly , Weichmann Laura , Sise Thucuma , Cosimano Emily , Jennings Cheryl , Moyo Sikhulile , Dadson Oswald , Luetkemeyer Annie , Dwyer Jay , Hughes Valery , Grenade Joanne , Stroberg Todd , Ilmet Tiina , Henn Sarah , Kiger Kristi , Flynn Teri , Sbrolla Amy , Nuffer Kathleen , Wyles David , McGregor Donna , Hawkins Claudia , Williams Brett , Green Tondria , Tebas Pablo , Kim Deborah , Bedimo Roger , Wise Holly , Arduino Roberto C , Villamil Aristoteles 
Published: November 2018

AbstractBackgroundCurrent guidelines for the management of hepatitis C virus (HCV) infections provide varying recommendations for the optimal treatment of acute HCV infections. There are limited data from small cohort studies to provide guidance on the best approach to treatment of this important patient population.MethodsSofosbuvir-Containing Regimens Without Interferon for Treatment of Acute HCV in HIV-1 Infected Individuals is an open-label, 2-cohort, Phase 1 clinical trial in which the second cohort assessed the safety and efficacy of 8 weeks of ledipasvir/sofosbuvir for the treatment of acute HCV infections in participants with chronic human immunodeficiency virus (HIV)-1 infections. This final analysis of the second cohort had a planned accrual of 27 participants, based on non-inferiority criteria, compared to the study-defined, historical, sustained virologic response (SVR) of 60% with pegylated-interferon/ribavirin.ResultsWe enrolled 27 men (9 Hispanic; 11 White, non-Hispanic; 5 Black, non-Hispanic; 2 Asian or Pacific Islander; median age 46 years). Most (96%) had HCV genotype-1 infection and 59% had the favorable interleukin 28B CC genotype. The median baseline HCV RNA load was 6.17 log10 IU/mL (interquartile range 4.51 – 6.55). All participants (100%) achieved the primary outcome of a sustained virologic response 12 weeks after the date of the last dose of study treatment (90% confidence interval 90–100%), achieving non-inferiority versus the 60% historic benchmark. No treatment discontinuations occurred.ConclusionsThis multicenter clinical trial, investigating 8 weeks of ledipasvir/sofosbuvir for acute HCV infections in men with HIV infections, reports a 100% SVR. This study provides the rationale for larger studies of shortened courses of direct-acting antiviral therapies in persons with HIV infections, including those with high baseline HCV RNA loads.Clinical Trials RegistrationNCT02128217.
A Critical Assessment of the Asia Rebalance
Authors: Katagiri Nori 
Published: November 2018

Abstract
While the Obama administration’s Asia rebalance strategy received some praise from scholars and practitioners, it generated three problems that caused the USA to overlook many opportunities and neglect vital concerns. First, the strategy left Asia less stable by undermining US relations with China and smaller states in Southeast Asia. Secondly, it weakened America’s influence outside Asia by committing fewer resources. Finally, the rebalance was executed out of a relatively small cadre of government officials, allowing primarily civilian agencies to dictate Asia policy and excluding key branches of government. Furthermore, although the strategy competed with the strategies of restraint and offshore balancing, it never had the solid support of any international relations theories, leaving few scholars to directly associate it with a theory. Ultimately, the rebalance’s multiple logics prevented it from achieving intellectual hegemony in the American foreign policy discourse, and its substantive flaws and theoretical inconsistencies made difficult its acceptance as an enduring strategy in the Asia-Pacific region.
Mode classification in fast-rotating stars using a convolutional neural network: model-based regular patterns in δ Scuti stars
Authors: Mirouh Giovanni M , Angelou George C , Reese Daniel R , Costa Guglielmo 
Published: November 2018

ABSTRACT
Oscillation modes in fast-rotating stars can be split into several subclasses, each with their own properties. To date, seismology of these stars cannot rely on regular pattern analysis and scaling relations. However, recently there has been the promising discovery of large separations observed in spectra of fast-rotating δ Scuti stars; they were attributed to the island-mode subclass, and linked to the stellar mean density through a scaling law. In this work, we investigate the relevance of this scaling relation by computing models of fast-rotating stars and their oscillation spectra. In order to sort the thousands of oscillation modes thus obtained, we train a convolutional neural network isolating the island modes with 96 per cent accuracy. Arguing that the observed large separation is systematically smaller than the asymptotic one, we retrieve the observational $\Delta \nu \text{--} \overline{\rho }$ scaling law. This relation will be used to drive forward modelling efforts, and is a first step towards mode identification and inversions for fast-rotating stars.
What Isn’t a Case-Control Study?
Authors: Kicielinski Kimberly P , Dupépé Esther B , Gordon Amber S , Mayo Nancy E , Walters Beverly C 
Published: November 2018

Abstract

BACKGROUND
Confusion exists among neurosurgeons when choosing and implementing an appropriate study design and statistical methods when conducting research. We noticed particular difficulty with mislabeled and inappropriate case-control studies in the neurosurgical literature.

OBJECTIVE
To quantify and to rigorously review this issue for appropriateness in publication and to establish quality of the manuscripts using a rigorous technique.

METHODS
Following a literature search, pairs drawn from 5 independent reviewers evaluated a complete sample of 125 manuscripts claiming to be case-control studies with respect to basic case-control criteria. Seventy-five papers were then subjected to a more rigorous appraisal for quality using the SIGN Methodology Checklist for case-control studies.

RESULTS
Fifty publications were rejected based on basic criteria used to identify case-control design. Of the 75 subjected to quality analysis, 46 were felt to be acceptable for publication. Only 11 papers (9%) achieved the designation of high quality. Of the original 125 papers evaluated, 79 (63%) were inappropriately labeled case-control studies.

CONCLUSION
Mislabeling and use of inappropriate study design are common in the neurosurgical literature. Manuscripts should be evaluated rigorously by reviewers and readers, and neurosurgical training programs should include instruction on choice of appropriate study design and critical appraisal of the literature.
Inhibition of Manual Movements at Speech Arrest Sites in the Posterior Inferior Frontal Lobe
Authors: Breshears Jonathan D , Southwell Derek G , Chang Edward F 
Published: November 2018

Abstract

BACKGROUND
Intraoperative stimulation of the posterior inferior frontal lobe (IFL) induces speech arrest, which is often interpreted as demonstration of essential language function. However, prior reports have described “negative motor areas” in the IFL, sites where stimulation halts ongoing limb motor activity.

OBJECTIVE
To investigate the spatial and functional relationship between IFL speech arrest areas and negative motor areas (NMAs).

METHODS
In this retrospective cohort study, intraoperative stimulation mapping was performed to localize speech and motor function, as well as arrest of hand movement, hand posture, and guitar playing in a set of patients undergoing awake craniotomy for dominant hemisphere pathologies. The incidence and localization of speech arrest and motor inhibition was analyzed.

RESULTS
Eleven patients underwent intraoperative localization of speech arrest sites and inhibitory motor areas. A total of 17 speech arrest sites were identified in the dominant frontal lobe, and, of these, 5 sites (29.4%) were also identified as NMAs. Speech arrest and arrest of guitar playing was also evoked by a single IFL site in 1 subject.

CONCLUSION
Inferior frontal gyrus speech arrest sites do not function solely in speech production. These findings provide further evidence for the complexity of language organization, and suggest the need for refined mapping strategies that discern between language-specific sites and inhibitory motor areas.
Surgical Stabilization Improves 30-day Mortality in Patients With Traumatic Flail Chest: A Comparative Case Series at a Major Trauma Center
Authors: Walters Samuel T. , Craxford Simon , Russell Rebecca , Khan Tanvir , Nightingale Jessica , Moran Chris G. , Taylor Andrew M. , Forward Daren P. , Ollivere Benjamin J. 
Published: November 2018

Objectives:
To evaluate the outcomes including early mortality after surgical rib fixation using a locking plate system as part of a newly introduced chest trauma pathway.

Design:
Prospective cohort study with retrospective case-controlled matching with a minimum of 1-year follow-up.

Setting:
Regional Level 1 trauma center.

Patients/Participants:
Consecutive patients undergoing surgical rib fixation were prospectively recruited over a 3-year period (56 patients) and matched to similar patients managed nonoperatively (89 patients) using our local trauma registry. Matching was based on injury severity scores and patient demographics.

Intervention:
Surgical rib fixation with locking plates.

Main Outcome Measurements:
The primary outcome measure was 30-day mortality with secondary outcomes of hospital length of stay, intensive care unit length of stay, and patient-reported outcome measures including quality of life (EuroQol—EQ-5D-5L). Official causes of death were obtained from the coroner including postmortem results.

Results:
There was a significant reduction in 30-day mortality in the fixed patients with 1.8% (1/56) compared to 12.4% (11/89) of the nonfixed patients (P = 0.03). This difference remained significant after further exclusion of other nonsurvivable injuries (P = 0.046). Although hospital length of stay was significantly longer in the fixed group, there was no difference on multivariable analysis. Other secondary outcomes were comparable between the groups with no significant differences in any patient-reported measures.

Conclusions:
Mortality was significantly lower in patients who underwent rib stabilization. Quality of life and other patient-reported measures were similar, demonstrating no evidence of detrimental longer-term effects of rib stabilization.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Biomarkers for immune checkpoint inhibitors in advanced nonsmall cell lung cancer
Authors: Pirker Robert 
Published: November 2018

Purpose of review
Immune checkpoint inhibitors have been established as a new class of anticancer drugs for patients with advanced nonsmall cell lung cancer. Predictive biomarkers might help to select those patients who will derive the greatest benefit from these expensive drugs. This review summarizes the current status of predictive biomarkers for immune checkpoint inhibitors in advanced nonsmall cell lung cancer.

Recent finding
Programmed death ligand 1 (PD-L1) staining on tumor cells and immune cells has been studied as a predictive biomarker for immune checkpoint inhibitors. Higher PD-L1 levels appeared to be associated with greater benefit from these drugs in many studies, although such an association was absent in some studies. Tumor mutational load was associated with benefit from the combination of nivolumab plus ipilimumab. Immune checkpoint inhibitors combined with first-line chemotherapy improved survival compared to chemotherapy alone. These improvements were clinically relevant also in patients with PD-L1 expression in less than 1% of tumor cells.

Summary
PD-L1 expression on tumor and immune cells and tumor mutational load allow better selection of patients for treatment with immune checkpoint inhibitors as single agents. The role of PD-L1 for the selection of patients for chemoimmuntherapy remains to be seen.
Cardiovascular Diseases and Long-term Self-reported Exposure to Pollution
Authors: Salameh Pascale , Zeidan Rouba Karen , Hallit Souheil , Farah Rita , Chahine Mirna , Asmar Roland , Hosseini Hassan 
Published: November 2018

Background:
Cardiovascular diseases (CVDs) are linked to high mortality and morbidity, particularly in developing countries. Some studies have linked indoor and outdoor pollution to CVD, but results are inconsistent. Our objective was to assess this association in Lebanon, a Middle Eastern country.

Methods:
A national cross-sectional study was conducted across Lebanon. CVD prevalence, which included prevalent ischemic heart and cerebrovascular diseases, was assessed. Moreover, in addition to self-reported items of pollution exposure, we assessed potential predictors of CVD, including sociodemographic characteristics, self-reported health information, and biological measurements.

Results:
We assessed the dose-effect relationship of pollution items in relation with CVD. Self-reported indoor and outdoor pollution exposures were associated with CVD, with or without taking biological values into account. Moreover, we found a dose-effect relationship of exposure with risk of disease (44% increase in risk of CVD for every additional pollution exposure item), after adjustment for sociodemographic and biological characteristics.

Conclusion:
Although additional studies would be necessary to confirm these findings, interventions should start to sensitize the population about the effect of pollution on chronic diseases and the work of reducing pollution and improving air quality should be implemented to decrease the disease burden on the population and health system.
Minimizing Endothelial Cell Loss Caused by Orientation Stamps on Preloaded Descemet Membrane Endothelial Keratoplasty Grafts
Authors: Newman Lara R. , Tran Khoa D. , Odell Kelly , Dye Philip K. , Galloway Joshua , Sales Christopher S. , Straiko Michael D. , Terry Mark A. 
Published: November 2018

Purpose:
To quantify endothelial cell loss (ECL) caused by orientation stamps on prestripped and preloaded Descemet membrane endothelial keratoplasty (DMEK) grafts, and to examine a method for reducing ECL using a smaller stamp.

Methods:
Ten prestripped and 10 preloaded DMEK grafts were prepared with S-stamps. Ten additional preloaded DMEK grafts were prepared with both an S-stamp and a smaller F-stamp in different paracentral areas of the graft. The footprint of each stamp was measured using ink on cardstock. DMEK grafts were stored in viewing chambers filled with 20 mL of Optisol-GS for 3 days at 4°C. ECL was quantified using Calcein-AM staining and FIJI Weka Segmentation.

Results:
S-stamps on prestripped DMEK grafts contributed an average ECL of 1.1% ± 0.5% (range: 0.6%–2.2%) toward total graft damage, whereas S-stamps on preloaded DMEK grafts contributed approximately twice that amount (average ECL: 2.0% ± 0.7%, range: 1.3%–3.1%, P = 0.004). Overall ECL for prestripped grafts (average: 7.1% ± 3.3%, range: 3.3%–13.7%) and preloaded grafts (average: 11.3% ± 4.2%, range: 6.9%–19.4%) was similar to previous reports. The footprint of the S-stamp was approximately 45% larger than that of the F-stamp. In 10 preloaded grafts marked with both stamps, the S-stamp caused an average ECL of 1.9% ± 0.6% (range: 1.2%–3.2%), whereas the smaller F-stamp caused an average ECL of 1.0% ± 0.2% (range: 0.8%–1.4%, P = 0.0002).

Conclusions:
Loss of endothelial cells associated with graft-stamping was greater in preloaded tissue than in prestripped tissue and was less with a smaller F-stamp than with a larger S-stamp. Using a smaller stamp could help minimize ECL in prestripped and preloaded DMEK grafts.
Concomitant Left Atrial Reduction in Rheumatic Mitral Valve Disease with Giant Left Atrium
Authors: Adalti Sudhir , Patel Kartik G. , Doshi Chirag P. , Ananthnarayanan Chandrashekhar , Mehta Chintan N. , Wadhawa Vivek A. , Gupta Vijay , Patel Sanjay K. 
Published: November 2018

Objective The giant left atrium is a frequent finding with rheumatic heart disease. The enlarged left atrium was found to be a risk factor for early mortality and postoperative higher thromboembolic events, but its management remains controversial. Most of the surgeons just do the mitral valve procedure without any intervention for enlarged left atrium. We present our center's experience of patients with giant left atrium who underwent a newer technique of left atrium reduction concomitant with mitral valve procedure. Methods Between January 2012 and February 2015, 25 patients, who underwent surgery for concomitant left atrium reduction with mitral valve disease, were included in the study after institute's ethics committee clearance. Patients having combined aortic and mitral valve disease were excluded. Preoperative, intraoperative, and postoperative data were collected. All the patients were also followed up clinically and echocardiographically in postoperative period. Results There were 15 (60%) females. The mean ± SD age of the patients was 36.92 ± 5.4 years. Preoperatively, all patients were in long-standing persistent atrial fibrillation. The mean ± SD bypass and aortic cross-clamp time were 74.56 ± 3.85 and 51.72 ± 4.32 minutes, respectively. There was a significant reduction of left atrium diameter and volume from 94.48 ± 11.0 mm to 40.08 ± 1.35 mm and 348.3 ± 121.1 to 26.57 ± 2.9 mL/m2, respectively. There was no early or late mortality. At a mean ± SD follow-up of 42.28 ± 12.1 months, all patients were in New York Heart Association I or II class and 24 (96%) patients were in normal sinus rhythm. Conclusions Concurrent left atrium reduction with mitral valve procedure is a feasible and effective technique for event-free survival of the patients having giant left atrium with mitral disease.
Determinants of Influenza and Pertussis Vaccination Uptake in Pregnancy
Authors: Wilcox Christopher R. , Calvert Anna , Metz Jane , Kilich Eliz , MacLeod Rachael , Beadon Kirsten , Heath Paul T. , Khalil Asma , Finn Adam , Snape Matthew D. , Vandrevala Tushna , Nadarzynski Tom , Coleman Matthew A. , Jones Christine E. 
Published: November 2018

Introduction:
Uptake rates of antenatal vaccination remain suboptimal. Our aims were to determine (1) the acceptability of routine vaccination among pregnant women, (2) the confidence of maternity healthcare professionals (HCPs) discussing vaccination and (3) HCP opinion regarding the optimum healthcare site for vaccine administration.

Methods:
Separate questionnaires for pregnant women and HCPs were distributed within 4 national health service (NHS) trusts in South England (July 2017 to January 2018).

Results:
Responses from 314 pregnant women and 204 HCPs (18% obstetricians, 75% midwives, 7% unidentified) were analyzed. Previous/intended uptake of influenza and pertussis vaccination was 78% and 92%, respectively. The commonest reason for declining vaccination was feared side effects for their child. White British women (79%) were significantly more accepting of influenza [85% vs. 61%; odds ratio (OR) 3.25; 95% confidence interval [CI], 1.67–6.32] and pertussis vaccination (96% vs. 83%; OR 4.83; 95% CI: 1.77–13.19) compared with nonwhite British women. Among HCPs, 25% were slightly or not at all confident discussing vaccination. Obstetricians felt significantly more confident discussing pertussis vaccination than midwives (68% vs. 55% were very/moderately confident; OR 2.05; 95% CI: 1.02–4.12). Among HCPs, 53%, 25% and 16% thought vaccines should be administered in primary care (general practice), community midwifery and in hospital, respectively.

Conclusion:
Misconceptions exist regarding safety/efficacy of antenatal vaccination, and framing information towards the child’s safety may increase uptake. Education of HCPs is essential, and vaccine promotion should be incorporated into routine antenatal care, with an emphasis on women from ethnic minorities. Administration of vaccines in primary care presents logistical barriers; however, support for alternative sites appears low among HCPs.