bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metformin use and prostate cancer risk
Authors: Feng Zhaohan , Zhou Xiaofeng , Liu Naibo , Wang Jianfeng , Chen Xing , Xu Xin 
Published: March 2019

Abstract

Background:
The relationship between metformin use and the risk of prostate cancer is still inconclusive. Therefore, we performed a systematic review and meta-analysis of all eligible cohort studies to evaluate a potential association of metformin use with prostate cancer risk.

Methods:
A comprehensive literature search was performed in PubMed and Web of Science databases through July 2018. A DerSimonian and Laird random-effects model was applied to calculate the pooled relative risk (RR) and its 95% confidence interval (CI).

Results:
Eighteen cohort or nested case-control studies were included in this study with a total of 52,328 cases. In a random-effect pooled analysis, metformin use was not significantly associated with the risk of prostate cancer (RR 0.97, 95% CI 0.80–1.16, P = .711). Statistically significant heterogeneity was identified among included studies (P < .001, I

2
= 98.1%). Sensitivity analysis indicated that no single study dominated the pooled RR.

Conclusion:
The present large meta-analysis of cohort studies did not find an association between metformin use and prostate cancer risk.
Relationship between knee extension strength and gait styles in patients with dementia
Authors: Nakayama Naoyuki , Suzuki Makoto , Hamaguchi Toyohiro 
Published: March 2019

Abstract
This study aimed to investigate the relationship between knee extension strength and gait performance with walking aids and the threshold level of strength to predict gait performance with walking aids in patients with dementia using ordinal logistic modeling.
This cross-sectional, observational correlation study was conducted in 56 hospital inpatients with dementia. Knee extensor strength was measured using a hand-held dynamometer. Gait performance was assessed by determining the walking aid that enables the subject to walk 10 m independently as well as without a walking aid.
Ordinal logistic modeling showed that the strength of the knee extensor muscles was a significant gait predictor with walking aids (P = .028). Knee extension strength of 0.17, 0.43, and 0.57 N m/kg could reach 80% independence probability for gait with walker, with cane, and without walking aid, respectively.
Knee extension strength was significantly related to gait performance with walking aid in people with dementia. Moreover, there are threshold levels of strength that could predict gait with particular walking aid in people with dementia. With regard to resistance training and prescription of walking aids, the probability of independence evaluated from ordinal logistic modeling contributes to efficient rehabilitation intervention.
Clinical characteristics of dysphagic stroke patients with salivary aspiration
Authors: Yu Kwang Jae , Park Donghwi 
Published: March 2019

Abstract
The aim of this study was to evaluate the correlation between radionuclide salivagram findings and clinical characteristics in stroke patient with swallowing difficulty.
In this study, dysphagic stroke patients who had undergone both a radionuclide salivagram and videofluoroscopic swallowing study (VFSS) were included retrospectively. To evaluate the correlations between clinical parameters and salivary aspiration, clinical parameters, such as stroke lesion, the degree of paralysis, sex, age, onset duration of stroke, the score of the Mini-Mental State Examination (MMSE), the score of the Global Deterioration Scale (GDS), the total score of the Modified Barthel Index (MBI), and each sub-score of the MBI were collected and analyzed.
In the results of this study, the MMSE score was the only significant parameter for predicting positive findings in a salivagram in a multivariate logistic regression analysis in patients with supratentorial stroke. In patients with infratentorial stroke, however, the transfer sub-score of MBI was the only significant parameter for predicting positive findings in a salivagram in a multivariate logistic regression analysis.
In conclusion, care should be taken to prevent salivary aspiration when the MMSE score is less than eight in patients with supratentorial stroke, and the transfer sub-score of MBI score is less than three in patients with infratentorial stroke.
CRISPR: a promising tool for lipid physiology and therapeutics
Authors: Furgurson Mia , Lagor William R. 
Published: March 2019

Purpose of review
The purpose is to review recent progress in applying the CRISPR/Cas9 system to lipid metabolism and therapeutics.

Recent findings
The CRISPR/Cas9 system has been used to generate knockout animals for lipid genes in multiple species. Somatic genome editing with CRISPR/Cas9 can efficiently disrupt genes in adult animals, including a new strategy for generating atherosclerosis. Refinements to the CRISPR/Cas9 system including epigenetic modulators and base editors offer new avenues to manipulate gene expression. The recent report of germline genome editing in humans highlights the promise as well as perils of this technology.

Summary
CRISPR/Cas9 is a transformative technology that will help advance on our understanding of lipid metabolism and physiology. Somatic genome editing is a particularly promising approach for editing genes in tissues of live organisms, and represents a new means of addressing unmet therapeutic challenges in humans. Educational outreach, public debate, and consideration of ethics and safety must guide the use of genome editing in humans.
New insights into angiopoietin-like proteins in lipid metabolism and cardiovascular disease risk
Authors: Kersten Sander 
Published: March 2019

Purpose of review
The angiopoietin-like proteins (ANGPTLs), consisting of ANGPTL3, ANGPTL4, and ANGPTL8, have gained significant interest for their role as inhibitors of lipoprotein lipase (LPL) and for their potential as therapeutic targets for correcting dyslipidemia. This review provides an overview of the most relevant new insights on the connection between ANGPTLs, plasma lipids, and coronary artery disease.

Recent findings
Carriers of loss-of-function variants in ANGPTL3 have a reduced risk of coronary artery disease and reduced plasma levels of triglycerides and LDL-C, while carriers of loss-of-function variants in ANGPTL4 have a reduced risk of coronary artery disease and reduced plasma levels of triglycerides and increased HDL-C. There is evidence that carrier status of ANGPTL4 loss-of-function variants may also influence risk of type 2 diabetes. ANGPTL3 is produced in liver and is released as a complex with ANGPTL8 to suppress LPL activity in fat and muscle tissue. ANGPTL4 is produced by numerous tissues and likely mainly functions as a locally released LPL inhibitor. Both proteins inactivate LPL by catalyzing the unfolding of the hydrolase domain in LPL and by promoting the cleavage of LPL. Antisense oligonucleotide and monoclonal antibody-based inactivation of ANGPTL3 reduce plasma triglyceride and LDL-C levels in human volunteers and suppress atherosclerosis in mouse models.

Summary
ANGPTL3/ANGPTL8 and ANGPTL4 together assure the appropriate distribution of plasma triglycerides across tissues during different physiological conditions. Large-scale genetic studies provide strong rationale for continued research efforts to pharmacologically inactivate ANGPTL3 and possibly ANGPTL4 to reduce plasma lipids and coronary artery disease risk.
Identifying Drug Repurposing Opportunities in Oncology
Authors: Orecchioni Stefania , Roma Stefania , Raimondi Sara , Gandini Sara , Bertolini Francesco 
Published: March 2019

Abstract
The never-ending explosion in the cost of new oncology drugs is reducing in many countries the access to the most recent, effective anticancer therapies and represents a significant obstacle to the design and realization of combinatorial trials. Already approved, anticancer and nonanticancer drugs can be considered for in silico, preclinical, and clinical repurposing approaches and offer the significant advantages of a potentially cheaper, faster, and safer validation. This review discusses recent advances and challenges in the field.
Abdominal Contouring and Male Gender
Authors: Donato Daniel P. , Simpson Andrew M. , Garlick Jared W. , Kwok Alvin C. , Crombie Courtney , Agarwal Jayant P. 
Published: March 2019

Background
Males represent a significant portion of patients undergoing abdominal contouring. Despite this, there are few studies examining the implication of gender on complications.

Objective
The aim of this study was to examine the association between gender and early postoperative outcomes in patients undergoing abdominal contouring procedures.

Methods
The American College of Surgeons National Surgical Quality Improvement Program database (2006–2016) was queried to identify subjects undergoing panniculectomy or abdominoplasty. Minor and major complications were identified. Operative time and length of hospital stay were evaluated. A logistic regression model was used to examine associations between patient gender and adverse outcomes.

Results
Ten thousand four hundred seventy-three patients were identified. Of these, 4369 underwent abdominoplasties, and 6104 underwent panniculectomies. Males represented a higher percentage of the panniculectomy cohort (15.3% vs 9.2%). Males were older and generally had more comorbidities including diabetes, hypertension, chronic obstructive pulmonary disease, and elevated body mass index. Males also had a higher American Society of Anesthesiologists classification (P < 0.001). In the abdominoplasty cohort, male gender is an independent risk factor for any complication (odds ratio [OR], 1.3; confidence interval [CI], 1.16–1.45; P < 0.001) and major complications (OR, 1.52; CI, 1.01–2.29; P = 0.043). In the panniculectomy cohort, male gender is also an independent risk factor for any complication (OR, 1.47; CI, 1.24–1.75; P < 0.001) and major complications (OR, 1.43; CI, 1.12–1.83; P < 0.001). Males also had a significantly longer operative times in this cohort (171.3 vs 157.5 minutes; P < 0.001).

Conclusions
Male gender is independently associated with minor and major complications in these patient populations. With this knowledge, plastic surgeons may be better able to identify higher-risk individuals and educate patients on their risk profile.
Nipple Areola Complex Reconstruction With the “Half-Dome” Technique Following Implant-Based Breast Reconstruction
Authors: Chen Wendy , Fishman Jordan E. , de la Cruz Carolyn 
Published: March 2019

Background
No single technique for nipple areola reconstruction best fits every patient and clinical scenario. Many techniques fail to provide long-term projection. One especially challenging cohort are those patients who have undergone bilateral implant-based reconstruction. We developed a modification of the C-V flap reconstruction that increases projection in the bilateral, implant-based reconstruction patient.

Methods
All patients who underwent nipple areola reconstruction following implant-based breast reconstruction and who had at least a 12-month follow-up visit were identified. Nipple projection was measured and compared between the 2 groups.

Results
Forty patients were identified. Twelve patients, 23 nipples, underwent the standard C-V flap reconstruction. Twenty-eight patients, 59 nipples, underwent the half-dome modification. Average nipple projection following the half-dome technique is more than twice that of the C-V flap.

Conclusions
The half-dome technique provides a useful alternative modification of the C-V flap in patients with implant-based reconstruction.
Effect on Facial Growth of the Management of Cleft Lip and Palate
Authors: Farber Scott J. , Maliha Samantha G. , Gonchar Marina N. , Kantar Rami S. , Shetye Pradip R. , Flores Roberto L. 
Published: March 2019

Abstract
Treatment of cleft lip and palate ordinarily requires multiple interventions spanning the time of birth to adulthood. Restriction of facial growth, a common occurrence in affected children, is due to multiple factors. There are multiple surgical and therapeutic options, which may have influence on facial growth in these patients. As restriction to facial development can have significant implications to form, function, and psychological well-being, practitioners should have an appreciation for the effects of the different cleft therapies to facial growth. We have outlined and thoroughly reviewed in chronological order all of the interventions from birth to adulthood necessary in the comprehensive care of the patient with cleft lip and palate, along with the effects they may or may not have on facial growth.
Early Experience With Body Contouring Procedures in Patients With End-Stage Renal Disease Awaiting Renal Transplant
Authors: Xue Yunfeng , Song Ping , Wong Michael S. 
Published: March 2019

Introduction
Patients with (end-stage renal disease) ESRD often have many medical comorbidities, posing a higher risk for any surgical procedure. Obese patients are asked to lose weight to become more acceptable renal transplant candidates. Unfortunately, this often results in a panniculus and excess ptotic skin with accompanying functional and aesthetic concerns. We report our early experience in body contouring procedures in patients with ESRD who underwent massive weight loss.

Methods
Three patients with ESRD on the renal transplant waitlist at UC Davis Medical Center opted for elective body contouring procedures before their transplant surgery. All 3 patients were determined by the transplant team to have a high-risk panniculus and were referred to plastic surgery for panniculectomy before renal transplant. Two of the patients had concurrent lower body lift with panniculectomy, and the third patient underwent modified upper body lift with gynecomastia surgery 7 months after the initial panniculectomy.

Results
The mean age of the group was 49 (range = 40–62) years, including 1 male and 2 female patients. The average body mass index of the group was 25.6 (range = 22.8–31.8), and all 3 patients had massive weight loss, with a mean BMI drop of 28.1 (range = 24.2–34.9). Postoperatively, only 1 patient experienced minor wound healing delay, which resolved 3 months after surgery with debridement in clinic and local wound care.

Conclusions
In our early experience, we have seen that body contouring surgery in patients with ESRD awaiting renal transplant has an acceptable and manageable risk profile. By making minor modifications to preoperative, intraoperative, and postoperative routines, body contouring procedures can be safely performed in this patient population and can significantly decrease the functional and aesthetic problems caused by excess skin, resulting in improved body image and quality of life.
Tailored Microform Cleft Lip Repair: Personalizing Small Incisions, Orbicularis Reconstruction, and Rhinoplasty
Authors: He Lin , Yu Xueyuan , Liu Xiangyu , Chen Wendy , Shu Maoguo 
Published: March 2019

Background:
In the last decade, many surgeons have reported their perspectives on microform cleft lip repair, including techniques for incision placement and size, philtral reconstruction, and nasal base reconstruction. This interest demonstrates continued controversy in the repair of microform cleft lip.

Methods:
This is a retrospective cohort of patients from 2010 to 2016. The authors included patients with microform cleft lip repaired by our described technique who had both preoperative photographs, as well as photographs taken at >1-year follow-up. Patient outcomes were assessed through anthropometric measurements and also subjectively by 3 senior residents of plastic surgery.

Results:
The inclusion criteria yielded 36 microform cleft lip patients. Most patients were satisfied with their results. Regarding subjective assessment, the scar appearance and symmetry was fairly good. Objective measurements indicated excellent symmetry, with the cleft side achieving 92.58% of the height and measurements of the non-cleft side.

Conclusions:
Our method of combining labial muscle reconstruction through a personalized, small incision effectively corrects microform cleft lip deformity with minimal scar burden.
Direct Three-Dimensional Diagnosis of Ex Vivo Facial Fractures
Authors: Sirin Yigit , Yildirimturk Senem , Horasan Sinan , Guven Koray 
Published: March 2019

Abstract
The aim of the present study is to assess the reliability and accuracy of different 3-dimensional (3D) reconstruction algorithms in detecting undisplaced condylar, zygomatic arc, and orbital rim fractures based on cone-beam computed tomography data set. Twenty sheep heads were used in the present study. Sixty fractured and 60 nonfractured (control) zones were randomly allocated. Three groups consisting of nondisplaced fractures of condyle (CF, n = 20), orbital (OF, n = 20), and zygomatic arc (ZF, n = 20) were created by using a diamond cutting disc. Soft tissues were only dissected and no fractures were generated in the control group (n = 60). The 3D reconstructions were created by using multiplanar reconstruction (MPR), surface rendering (SR), volume rendering (VR), and maximum intensity projection (MIP) algorithms. Final 3D models were examined in Osirix software (Pixmeo SARL, Bernex, Switzerland) by 6 observers. Diagnostic accuracies of each algorithm were statistically compared by receiver operating characteristics (ROC) and area under the ROC curves (AUCs). For the detection of CF, AUC for VR algorithm was found to be statistically larger than that of MIP while AUCs for VR and MIP were larger than those of MPR and SR for OF detection. For the detection of ZF, AUCs for MPR and VR were significantly larger than those of MIP and SR (P < 0.05 for each). Within the limitations of this experimental study, it can be concluded that for maxillofacial surgeons, it is more likely to detect condylar, orbital, and zygomatic fractures by using VR algorithm in 3D reconstruction.
Simultaneous Forehead Lift and Blepharoplasty Techniques in Management of Orbito-Temporal Plexiform Neurofibroma
Authors: Choi Jangyoun , Choi Hyuk Joon , Kang Kyo Joon , Kwon Ho , Shin Jongweon 
Published: March 2019

Abstract
Plexiform neurofibromas are common complications in neurofibromatosis type 1 patients. Currently, surgery is the treatment of choice. However, complete surgical resection is difficult due to the infiltration to the surrounding tissue and the increased vascularity. Plexiform neurofibromas arising in the orbito-temporal area pose a greater challenge due to its critical function and cosmetic importance of the face. Such plexiform neurofibromas, separately designated as orbito-temporal plexiform neurofibromas, show complex symptoms such as severe ptosis, ectropion, lacrimal gland dysfunction, and even vision loss. We present a case of successful correction of upper eyelid entropion and severe eyebrow ptosis in a 48-year-old orbito-temporal plexiform neurofibromas patient with combined forehead lift and blepharoplasty techniques including double fold formation and mass excision.
A New Method for Determining the Level of the Carotid Artery Bifurcation
Authors: Denli Yalvac Emine Seyma , Balak Naci , Atalay Basak , Bademci Mehmet Senel , Kocaaslan Cemal , Oztekin Ahmet , Ankarali Handan , Aydin Ebuzer 
Published: March 2019

Abstract
Exact localization of the bifurcation of the common carotid artery using skin surface landmarks is important for various diagnostic and therapeutic purposes, including emergency cases. Traditional methods have confirmed their accuracy in only a certain percentage of cases and there are inconsistencies among various publications. The cervical computed tomography-angiographic examinations for any diagnostic purpose between June 2017 and December, 2017 in the authors’ hospital were examined. Measurements were performed for (MT-CB) and (MT-SE) distances and the results were recorded [MT = The tip of the mastoid process; CB = common carotid artery bifurcation; SE = sternal extremity of the clavicle]. Cervical computed tomography angiography was found in the records of 91 patients in the 6-month period between June 2017 and December 2017. After exclusion criteria were applied, a total of 116 carotid bifurcation levels on the right and left sides were measured in 58 patients. The mean MT-CB distance was 6.29 ± 0.9 cm (range: 2.9–8.4 cm). The mean distance between MT and SE was 15.3 ± 1.7 cm (range: 9.9–19.0 cm). The (MT-CB): (MT-SE) ratios ranged from 29% to 51% with a mean of 41 ± 4.2% (95% CI: 39.88%–42.10%) and a median of 41.1% (P < 0.05) (Kolmogorov–Smirnov test). The distance ratio values did not change significantly according to age and gender (respectively P = 0.341, P = 0.093). These results show that the CB is usually located at two-fifths of the distance from the mastoid tip to the sternal extremity of the clavicle and closer to the mastoid tip.
The Implementation of a Multidisciplinary Approach for Potential Organ Donors in the Emergency Department
Authors: Witjes Marloes , Kotsopoulos Angela M.M. , Otterspoor Luuk , Herold Ingeborg H.F. , Simons Koen S. , Woittiez Karen , Eijkenboom Jos J.A. , van der Hoeven Johannes G. , Jansen Nichon E. , Farid Abdo Wilson 
Published: March 2019

Background.
The aim of this study was to evaluate the implementation process of a multidisciplinary approach for potential organ donors in the emergency department (ED) in order to incorporate organ donation into their end-of-life care plans.

Methods.
A new multidisciplinary approach was implemented in 6 hospitals in The Netherlands between January 2016 and January 2018. The approach was introduced during staff meetings in the ED, intensive care unit (ICU), and neurology department. When patients with a devastating brain injury had a futile prognosis in the ED, without contraindications for organ donation, an ICU admission was considered. Every ICU admission to incorporate organ donation into end-of-life care was systematically evaluated with the involved physicians using a standardized questionnaire.

Results.
In total, 55 potential organ donors were admitted to the ICU to incorporate organ donation into end-of-life care. Twenty-seven families consented to donation and 20 successful organ donations were performed. Twenty-nine percent of the total pool of organ donors in these hospitals were admitted to the ICU for organ donation.

Conclusions.
Patients with a devastating brain injury and futile medical prognosis in the ED are an important proportion of the total number of donors. The implementation of a multidisciplinary approach is feasible and could lead to better identification of potential donors in the ED.
Processing of Local and Global Auditory Deviants in Parkinson Disease: Electrophysiological Evidence for Enhanced Attention Capture
Authors: Heldmann Marcus , Teichmann Sebastian , Al-Khaled Mohamed , Brüggemann Norbert , Münte Thomas F. 
Published: March 2019

Objective:
To investigate automatic auditory-change detection in patients with Parkinson disease (pwPD).

Background:
Previous results regarding changes in preattentive processing in pwPD have been inconclusive.

Methods:
We employed a paradigm assessing the preattentive processing of sequences of auditory tones containing deviants at either the local or global level, or at both levels. Twenty pwPD and 20 age-matched healthy controls were exposed to the tone series while they performed a visual task and had their event-related potentials recorded by electroencephalogram.

Results:
Event-related potentials showed a mismatch negativity, which was largest for the double-deviant stimuli, of intermediate amplitude for the local deviant stimuli, and smallest for the global deviant stimuli. The mismatch negativity was of similar size in the patients and controls, with the exception of the double-deviant condition (larger in controls). By contrast, the subsequent positive component was more pronounced for the Parkinson disease group than controls, particularly for the double-deviant condition.

Conclusions:
The larger positivity suggests that pwPD are more prone to distraction than healthy controls, probably because dopaminergic medication shifts the stability-flexibility balance toward cognitive flexibility with increased distractibility.