bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pain Assessment for Nursing Home Residents
Authors: Dirk Kennedy , Rachor Geoffrey S. , Knopp-Sihota Jennifer A. 
Published: February 2019

Background
The burden of pain in nursing homes is substantial; however, pain assessment for both acute and chronic conditions remains inadequate, resulting in inappropriate or inadequate treatment. Complexities in assessing resident pain have been attributed to factors (barriers and facilitators) arising at the resident, healthcare provider, and healthcare system levels.

Objectives
In this systematic review protocol, we identify our research approach that will be used to critically appraise and synthesize data in order to assess barriers and facilitators to pain assessment in nursing home residents aged ≥65 years.

Methods
This is a Cochrane style systematic review protocol adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Protocols reporting standards. This review will include primary (original) qualitative literature concerning either barriers or facilitators to pain assessment in older adult nursing home residents. A thematic analysis approach will be employed in collating and summarizing included data and will be categorized into resident, healthcare provider, and system-level factors. Database searches will include Abstracts in Social Gerontology, CINAHL, Cochrane Central Register of Controlled Trials, Embase, MEDLINE, and Web of Science.

Discussion
The identification of barriers and facilitators to pain assessment in older adult nursing home residents may assist healthcare providers across all platforms and levels of education to improve pain assessment among nursing home residents. Improving the assessment of pain has the potential to improve quality of care and ultimately quality of life for older adult nursing home residents.
Maternal Adverse Childhood Experiences, Family Strengths, and Chronic Stress in Children
Authors: Condon Eileen M. , Holland Margaret L. , Slade Arietta , Redeker Nancy S. , Mayes Linda C. , Sadler Lois S. 
Published: February 2019

Background
Researchers have demonstrated that maternal adverse childhood experiences (ACEs), such as abuse and neglect, are associated with prenatal risk factors and poor infant development. However, associations with child physiologic and health outcomes, including biomarkers of chronic or “toxic” stress, have not yet been explored.

Objectives
The purpose of this study was to examine the associations among past maternal experiences, current maternal posttraumatic stress disorder (PTSD) symptoms, and children's indicators of exposure to chronic stress in a multiethnic sample of mothers and children at early school age (4 to 9 years).

Methods
This cross-sectional study included maternal–child dyads (N = 54) recruited from urban community health centers in New Haven, Connecticut. Mothers reported history of ACEs, family strengths, and current PTSD symptoms. Child measures included biomarkers and health and developmental outcomes associated with chronic stress. Correlational and regression analyses were conducted.

Results
Childhood trauma in mothers was associated with higher systolic blood pressure percentile (ρ = .29, p = .03) and behavioral problems (ρ = .47, p = .001) in children, while maternal history of family strengths was associated with lower salivary interleukin (IL)-1β (ρ = −.27, p = .055), salivary IL-6 (ρ = −.27, p = .054), and body mass index z-scores (ρ = −.29, p = .03) in children. Maternal PTSD symptoms were associated with more child behavioral problems (ρ = .57, p < .001) and higher odds of asthma history (ρ = .30, p = .03).

Discussion
Results indicate that past maternal experiences may have important influences on a child's health and affect his or her risk for experiencing toxic stress.
Rebury the “Atavistic Skull” Studied by Lombroso?
Authors: Ciliberti Rosagemma , Armocida Giuseppe , Licata Marta 
Published: February 2019

Abstract
On May 16, 2017, the judgment of the Italian court ended the legal battle concerning the repatriation request of the famous skull, belonging to the “brigand” Giuseppe Villella. During the autopsy examination on the corpse of Villella, Lombroso observed a median occipital dimple on the skull, a feature visible in other mammals, including primates, but absent in humans. This feature could demonstrate an anomalous dimension of the median lobe of Villella's cerebellum. From this anatomical finding, Lombroso consolidated the atavism theory, which established a close connection between morphological features and behavior.
The Lombroso Museum and the University of Turin reiterated the legitimacy of the possession of the skull as cultural property in accordance with the Code of Cultural Heritage and as a find of forensic psychopathology. Finally, the court rejected the request from Villella's hometown, highlighting that the scientific theory is unquestionably invalid, but his existence cannot be denied.
The “special” nature of human remains emerges from the special way in which the Code of Ethics of the International Council of Museums treats them, which also implies respect to the other material of the museum collections.
Structural Gender Dimorphism and the Biomechanics of the Gluteal Subcutaneous Tissue: Implications for the Pathophysiology of Cellulite
Authors: Rudolph Christina , Hladik Casey , Hamade Hassan , Frank Konstantin , Kaminer Michael S. , Hexsel Doris , Gotkin Robert H. , Sadick Neil S. , Green Jeremy B. , Cotofana Sebastian 
Published: February 2019

Background:
This study was performed to investigate gender differences in gluteal subcutaneous architecture and biomechanics to better understand the pathophysiology underlying the mattress-like appearance of cellulite.

Methods:
Ten male and 10 female body donors [mean age, 76 ± 16.47 years (range, 36 to 92 years); mean body mass index, 25.27 ± 6.24 kg/m2 (range, 16.69 to 40.76 kg/m2)] were used to generate full-thickness longitudinal and transverse gluteal slices. In the superficial and deep fatty layers, fat lobule number, height, and width were investigated. The force needed to cause septal breakage between the dermis and superficial fascia was measured using biomechanical testing.

Results:
Increased age was significantly related to decreased dermal thickness, independent of sex (OR, 0.997, 95 percent CI, 0.996 to 0.998; p < 0.0001). The mean number of subdermal fat lobules was significantly higher in male body donors (10.05 ± 2.3) than in female body donors (7.51 ± 2.7; p = 0.003), indicating more septal connections between the superficial fascia and dermis in men. Female sex and increased body mass index were associated with increased height of superficial fat lobules. The force needed to cause septal breakage in male body donors (38.46 ± 26.3 N) was significantly greater than in female body donors (23.26 ± 10.2 N; p = 0.021).

Conclusions:
The interplay of dermal support, septal morphology, and underlying fat architecture contributes to the biomechanical properties of the subdermal junction. This is influenced by sex, age, and body mass index. Cellulite can be understood as an imbalance between containment and extrusion forces at the subdermal junction; aged women with high body mass index have the greatest risk of developing (or worsening of) cellulite.
Fenestration Improves Acellular Dermal Matrix Biointegration: An Investigation of Revascularization with Photoacoustic Microscopy
Authors: Cottler Patrick S. , Olenczak J. Bryce , Ning Bo , Seaman Scott A. , Thuman Jenna M. , Sun Naidi , Piñeros-Fernandez Angela , Hu Song , DeGeorge Brent R. , Campbell Chris A. 
Published: February 2019

Background:
Acellular dermal matrices have revolutionized alloplastic breast reconstruction. Furthering our knowledge of their biointegration will allow for improved design of these biomaterials. The ideal acellular dermal matrix for breast reconstruction would provide durable soft-tissue augmentation while undergoing rapid biointegration to promote physiologic elasticity and reduced infectious complications. The inclusion of fenestrations in their design is thought to promote the process of biointegration; however, the mechanisms underlying this theory have not been evaluated.

Methods:
Biointegration of standard and fenestrated acellular dermal matrices was assessed with serial photoacoustic microscopic imaging, in a murine dorsal skinfold window chamber model specifically designed to recapitulate the microenvironment of acellular dermal matrix–assisted alloplastic breast reconstruction. Photoacoustic microscopy allows for a serial, real-time, noninvasive assessment of hemoglobin content and oxygen saturation in living tissues, generating high-resolution, three-dimensional maps of the nascent microvasculature within acellular dermal matrices. Confirmatory histologic and immunohistochemical assessments were performed at the terminal time point.

Results:
Fenestrated acellular dermal matrices demonstrated increased fibroblast and macrophage lineage host cell infiltration, greater mean percentage surface area vascular penetration (21 percent versus 11 percent; p = 0.08), and greater mean oxygen saturation (13.5 percent versus 6.9 percent; p < 0.05) than nonfenestrated matrices by 2 weeks after implantation. By 21 days, host cells had progressed nearly 1 mm within the acellular dermal matrix fenestrations, resulting in significantly more vascularity across the top of the fenestrated matrix (3.8 vessels per high-power field versus 0.07 vessels per high-power field; p < 0.05).

Conclusions:
Inclusion of fenestrations in acellular dermal matrices improves the recellularization and revascularization that are crucial to biointegration of these materials. Future studies will investigate the optimal distance between fenestrations.
External and Internal Diameters of the Facial Artery Relevant to Intravascular Filler Injection
Authors: Lee Shin-Hyo , Ha Tae-Jun , Koh Ki-Seok , Song Wu-Chul 
Published: February 2019

Background:
Vision loss and skin necrosis caused by an accidental intraarterial embolism or vascular compression are rare but devastating complications when injecting filler materials into the face.

Methods:
The external and internal diameters and wall thicknesses of the facial artery and its branches were measured from 41 formalin-embalmed cadavers after removing connective tissues attached to the arterial wall.

Results:
The diameter and thickness of the facial artery exhibited significant interregional differences. The external and internal diameters of the facial artery were 1.9 ± 0.4 and 1.2 ± 0.3 mm (mean ± SD), respectively, at the inferior border of the mandible; 1.7 ± 0.3 and 1.2 ± 0.3 mm in the vicinity of the inferior labial artery; 1.5 ± 0.3 and 1.0 ± 0.3 mm at the mouth corner; 1.4 ± 0.3 and 0.9 ± 0.2 mm in the vicinity of the superior labial artery; and 1.1 ± 0.2 and 0.7 ± 0.2 mm in the vicinity of the lateral nasal artery. The external and internal diameters at the proximal parts of the inferior labial artery, superior labial artery, and lateral nasal artery were 1.0 ± 0.3 and 0.6 ± 0.2 mm, 0.9 ± 0.3 and 0.6 ± 0.2 mm, and 0.8 ± 0.2 and 0.5 ± 0.2 mm, respectively.

Conclusion:
Morphometric examinations of the facial artery under stereomicroscope observation as performed in the present study are expected to be more accurate than direct measurements obtained during cadaveric dissection or conventional histologic evaluations.
Fat Grafting into Younger Recipients Improves Volume Retention in an Animal Model
Authors: Chung Natalie N. , Ransom Ryan C. , Blackshear Charles P. , Irizarry Dre M. , Yen Derek , Momeni Arash , Lee Gordon K. , Nguyen Dung H. , Longaker Michael T. , Wan Derrick C. 
Published: February 2019

Background:
Soft-tissue deficits associated with various craniofacial anomalies can be addressed by fat grafting, although outcomes remain unpredictable. Furthermore, consensus does not exist for timing of these procedures. Whereas some advocate approaching soft-tissue reconstruction after the underlying skeletal foundation has been corrected, other studies have suggested that earlier grafting may exploit a younger recipient niche that is more conducive to fat graft survival. As there is a dearth of research investigating effects of recipient age on fat graft volume retention, this study compared the effectiveness of fat grafting in younger versus older animals through a longitudinal, in vivo analysis.

Methods:
Human lipoaspirate from three healthy female donors was grafted subcutaneously over the calvaria of immunocompromised mice. Volume retention over 8 weeks was evaluated using micro–computed tomography at three experimental ages: 3 weeks, 6 months, and 1 year. Histologic examination was performed on explanted grafts to evaluate graft health and vascularity. Recipient-site vascularity was also evaluated by confocal microscopy.

Results:
The greatest retention of fat graft volume was noted in the youngest group compared with both older groups (p < 0.05) at 6 and 8 weeks after grafting. Histologic and immunohistochemical analyses revealed that improved retention in younger groups was associated with greater fat graft integrity and more robust vascularization.

Conclusion:
The authors’ study provides evidence that grafting fat into a younger recipient site correlates with improved volume retention over time, suggesting that beginning soft-tissue reconstruction with fat grafting in patients at an earlier age may be preferable to late correction.
Application of Hydroxycholesterols for Alveolar Cleft Osteoplasty in a Rodent Model
Authors: Bakshi Reena , Hokugo Akishige , Zhou Situo , Zhang Zheyu , Wang Lixin , Rezzadeh Kameron , Segovia Luis Andres , Jarrahy Reza 
Published: February 2019

Background:
Bone morphogenetic proteins (BMPs) have played a central role in the regenerative therapies for bone reconstruction, including alveolar cleft and craniofacial surgery. However, the high cost and significant adverse effect of BMPs limit their broad application. Hydroxycholesterols, naturally occurring products of cholesterol oxidation, are a promising alternative to BMPs. The authors studied the osteogenic capability of hydroxycholesterols on human mesenchymal stem cells and the impact of hydroxycholesterols on a rodent alveolar cleft model.

Methods:
Human mesenchymal stem cells were treated with control medium or osteogenic medium with or without hydroxycholesterols. Evaluation of cellular osteogenic activity was performed. A critical-size alveolar cleft was created and one of the following treatment options was assigned randomly to each defect: collagen sponge incorporated with hydroxycholesterols, BMP-2, or no treatment. Bone regeneration was assessed by means of radiologic and histologic analyses and local inflammation in the cleft evaluated. Moreover, the role of the hedgehog signaling pathway in hydroxycholesterol-mediated osteogenesis was examined.

Results:
All cellular osteogenic activities were significantly increased on human mesenchymal stem cells treated with hydroxycholesterols relative to others. The alveolar cleft treated with collagen sponge with hydroxycholesterols and BMP-2 demonstrated robust bone regeneration. The hydroxycholesterol group revealed histologically complete bridging of the alveolar defect with architecturally mature new bone. The inflammatory responses were less in the hydroxycholesterol group compared with the BMP-2 group. Induction of hydroxycholesterol-mediated in vitro osteogenesis and in vivo bone regeneration were attenuated by hedgehog signaling inhibitor, implicating involvement of the hedgehog signaling pathway.

Conclusion:
Hydroxycholesterols may represent a viable alternative to BMP-2 in bone tissue engineering for alveolar cleft.
How Can Programs Better Support Female Sex Workers to Avoid HIV Infection in Zimbabwe? A Prevention Cascade Analysis
Authors: Fearon Elizabeth , Phillips Andrew , Mtetwa Sibongile , Chabata Sungai T. , Mushati Phillis , Cambiano Valentina , Busza Joanna , Napierala Sue , Hensen Bernadette , Baral Stefan , Weir Sharon S. , Rice Brian , Cowan Frances M. , Hargreaves James R. 
Published: February 2019

Background:
“HIV prevention cascades” have been proposed to support programs by identifying gaps in demand for, access to, and capability to adhere to HIV prevention tools, but there are few empirical examples to guide development. We apply a prevention cascade framework to examine prevention coverage and factors associated with condoms and/or PrEP adherence among female sex workers.

Setting:
Seven sites across Zimbabwe.

Methods:
Seven respondent-driven sampling surveys from the intervention sites of a pragmatic cluster-randomized trial in Zimbabwe in 2016 were analyzed, and 611/1439 women testing HIV-negative included. We operationalized key components of an HIV prevention cascade including demand, supply, and capability to adhere to 2 tools for HIV prevention: condoms and pre-exposure prophylaxis (PrEP). We used adjusted logistic regression to identify determinants of adherence to condoms and PrEP in turn, examining the effect of adherence to one tool on adherence to the other.

Results:
There were 343/611, 54.7%, women reporting adherence to condoms and/or PrEP, leaving almost half uncovered. Although women were aware that condoms prevented HIV and reported good access to them, only 45·5% reported full adherence to condom use. For PrEP, a new technology, there were gaps along all 3 domains of demand, supply, and adherence. Alcohol use decreased adherence to PrEP and condoms. Younger and newer entrants to sex work were less likely to take PrEP every day.

Conclusions:
HIV prevention programming among female sex workers in Zimbabwe could consider increasing awareness of PrEP alongside supply, alcohol use interventions, and approaches to engaging younger women.
Insomnia as an Independent Predictor of Incident Cardiovascular Disease in HIV: Data From the Veterans Aging Cohort Study
Authors: Polanka Brittanny M. , Kundu Suman , So-Armah Kaku A. , Freiberg Matthew S. , Gupta Samir K. , Bedimo Roger J. , Budoff Matthew J. , Butt Adeel A. , Chang Chung-Chou H. , Gottlieb Stephen S. , Marconi Vincent C. , Womack Julie A. , Stewart Jesse C. 
Published: February 2019

Background:Insomnia is associated with increased cardiovascular disease (CVD) risk in the general population and is highly prevalent in people with HIV. The CVD risk conferred by insomnia in the HIV population is unknown.Methods:Using the Veterans Aging Cohort Study Survey Cohort, insomnia symptoms were measured and dummy coded with the item, “Difficulty falling or staying asleep?” (5-point scale from no difficulty to bothers a lot). Incident CVD eventICD-9codes (acute myocardial infarction, stroke, or coronary artery revascularization) were identified with the Department of Veterans Affairs (VA) and Medicare administrative data and VA fee-for-service data. Those with baseline CVD were excluded.Results:HIV-infected (N = 3108) veterans had a median follow-up time of 10.8 years, during which 267 CVD events occurred. Compared to HIV-infected veterans with no difficulty falling or staying asleep, HIV-infected veterans bothered a lot by insomnia symptoms had an increased risk of incident CVD after adjusting for demographics [hazard ratio (HR) = 1.64, 95% confidence interval (CI): 1.16 to 2.31,P= 0.005], CVD risk factors (HR = 1.62, 95% CI: 1.14 to 2.30,P= 0.007), additional potential confounders (hepatitis C infection, renal disease, anemia, alcohol use, and cocaine use; HR = 1.70, 95% CI: 1.19 to 2.43,P= 0.003), and HIV-specific factors (HIV-1 RNA, CD4+T-cell count, and antiretroviral therapy; HR = 1.66, 95% CI: 1.16 to 2.37,P= 0.005). Additional adjustment for nonbenzodiazepine sleep medication (HR = 1.62, 95% CI: 1.13 to 2.32,P= 0.009) did not attenuate the association; however, it fell short of significance atP< 0.01 after adjustment for depressive symptoms (HR = 1.51, 95% CI: 0.98 to 2.32,P= 0.060) or antidepressant medication (HR = 1.51, 95% CI: 1.04 to 2.19,P= 0.031).Conclusions:Highly bothersome insomnia symptoms were significantly associated with incident CVD in HIV-infected veterans, suggesting that insomnia may be a novel, modifiable risk factor for CVD in HIV.
Elevated Microparticle Tissue Factor Activity Is Associated With Carotid Artery Plaque in HIV-Infected Women
Authors: Lin Juan , Xue Xiaonan , Anastos Kathryn , Cohen Mardge H. , Gange Stephen J. , Lazar Jason M. , Liu Chenglong , Mack Wendy J. , Tien Phyllis C. , Tilley Cathy , Hodis Howard N. , Landay Alan L. , Tracy Russell P. , Kaplan Robert C. , Hanna David B. 
Published: February 2019

Background:Expression of tissue factor (TF) on the surface of activated monocytes may trigger thrombosis, leading to clotting risk, inflammation, and atherosclerosis. TF-positive microparticles (MP-TF) represent a functionally active form of TF that may be promulgated by long-term HIV infection. We hypothesized that greater MP-TF activity is associated with carotid artery plaque in HIV+ women.Setting:In a case–control study nested within the Women's Interagency HIV Study (WIHS), eligible HIV+ participants underwent B-mode carotid artery ultrasound at 2 study visits occurring 7 years apart. Cases were defined by the presence of at least 1 carotid artery plaque assessed at either visit. Cases were matched 1:2 to controls who were found not to have carotid artery plaques.Methods:Conditional logistic regression estimated the association of MP-TF activity with the presence of carotid artery plaque, adjusting for demographic and behavioral characteristics, HIV-related factors, cardiometabolic risk factors, and serum inflammation biomarkers (high-sensitivity C-reactive protein, IL-6, sCD14, sCD163, Gal-3, and Gal-3BP).Results:Elevated MP-TF activity (>0.537 pg/mL) was found to be significantly associated with greater odds of plaque (adjusted odds ratio 3.86, 95% confidence interval: 1.06 to 14.07,P= 0.04). The association was attenuated after further adjustment for IL-6 but was unaffected by adjustment for other biomarkers including those denoting monocyte activation.Conclusions:Our findings suggest a link among HIV infection, innate immune system perturbation, coagulation, and atherosclerosis.
18F-Choline PET/CT Imaging for Intracranial Hemangiopericytoma Recurrence
Authors: Jehanno Nina , Cassou-Mounat Thibaut , Mammar Hamid , Luporsi Marie , Huchet Virginie 
Published: February 2019

Abstract
We report the case of a 50-year-old man, with previous history of grade 3 intracranial hemangiopericytoma with initial complete surgical resection, addressed for local recurrence. Surgical revision performed 18 months after initial surgery allowed only partial resection, leaving residual disease along the optic nerve. Complementary radiotherapy with proton was decided. 18F-FDG PET/CT and 18F-choline PET/CT were both performed for treatment planning. 18F-FDG PET showed no uptake of the residual tumor, whereas 18F-choline depicted highly metabolic residual disease uptake with excellent delineation of local recurrence. 18F-choline PET/CT appears as a useful PET tracer for hemagiopericytoma imaging.
Metastatic Insulinoma Controlled by Targeted Radionuclide Therapy With 177Lu-DOTATATE in a Patient With Solitary Kidney and MEN-1 Syndrome
Authors: Novruzov Fuad , Mehmetbeyli Leyla , Aliyev Jamil A. , Abbasov Bahadur , Mehdi Elnur 
Published: February 2019

Abstract
A 54-year-old man with multiple endocrine neoplasia type 1 had previous history of parathyroid surgery and left thyroid lobectomy 5 years earlier, and was referred for recurrent hypoglycemic episodes. 68Ga-DOTATATE PET/CT had showed multiple lesions in the right lung, liver, and pancreas. Biopsy from pancreas revealed low-grade neuroendocrine neoplasia. After 2 fractions of 177Lu-DOTATATE therapy, the size of lesions and its activity reduced on the 68Ga-DOTATATE scan and the hypoglycemic episodes manifested every day have scaled down to 1 time over 1-year follow-up. Herein, we report a case of malignant insulinoma successfully treated with radiolabeled somatostatin receptor therapy using 177Lu-DOTATATE.