bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Lexicon of Concepts of Humanistic Medicine: Exploring Different Meanings of Caring and Compassion at One Organization
Authors: Stergiopoulos Erene , Ellaway Rachel H. , Nahiddi Nima , Martimianakis Maria A. 
Published: April 2019

Purpose
There has been scant scholarly attention paid to characterizing how the numerous definitions of terms associated with compassion and humanism have been mobilized or what the organizational implications of pursuing different constructs might be. This study explored the uses and implications of the terminology associated with humanistic medicine in the work of the Associated Medical Services (AMS) Phoenix Project.

Method
This study involved two phases (2014–2015). First, two pilot group workshops with AMS Phoenix Project participants and stakeholders were conducted to explore ways of parsing and interpreting core concepts used in the project. The authors then assembled an archive of texts associated with the project, comprising the project website and blog posts, conference proceedings, and fellowship and grant applications. Informed by critical discourse analysis, the authors identified, described, and analyzed core terms related to the project’s mission and explored the type of health care practices and reforms implied by their use.

Results
Two recurring core terms, care/caring and compassion, and eight clusters of terms related to these core terms were identified in the archive. Caring and compassion as terms were articulated in various psychological, sociological, and political configurations. This polysemy reflected a diverse array of health care reform agendas.

Conclusions
Understanding how different interpretations of caring and compassion cluster around core topics and concerns of humanistic medicine offers scholars an entry point for comparing and appraising the quality and direction of reform agendas, including multilevel strategies that involve systems-level changes.
Rates of and Factors Associated With Patient-reported Illicit Drug Use Screening by Health Care Professionals in the United States From 2013 to 2015
Authors: Scialli Anna C. , Terplan Mishka 
Published: April 2019

Objectives:
To examine rates of and factors associated with patient-reported illicit drug use screening by health care professionals.

Methods:
The National Survey on Drug Use and Health (NSDUH), limited to individuals who reported prior year healthcare service utilization, was used to capture the odds of patient-reported illicit drug use screening for survey years 2013 to 2015. Screened patients were contrasted with those not screened by demographic and behavioral characteristics. Adjusted models were produced by year and adjusted odds ratios were compared for changes across years. A separate adjusted model including year as a fixed effect was produced to estimate changes in overall adjusted screening odds.

Results:
The percentage of individuals reporting screening by a health care provider increased from 48.5% in 2013 to 50.9% (2014), and 54.3% (2015) (P < 0.0001). The adjusted model, including year as a fixed effect, indicated that the odds of screening significantly increased from 2013 to 2015. In multivariable regression, individuals reporting screening were more likely to be female, of higher income and educational strata, and received drug or alcohol treatment in the past year and were less likely to be non-Hispanic Asian.

Conclusions:
Only roughly half of individuals seen by a healthcare provider report illicit drug use screening. Racial disparities in screening persist although they are overall decreasing. Coupling screening with treatment initiation, rather than brief intervention, may increase screening rates.
Paraoxonase 1 Was Negatively Associated With Intervertebral Disc Degeneration
Authors: Chen Fan , Liu Hui , Li Zemin , Pei Yuxin , Wang Hua , Zhang Jian , Wang Jianru , Zheng Zhaomin 
Published: April 2019

Study Design.
An in vivo and in vitro study of the correlation between Paraoxonase 1 (PON1) and intervertebral disc degeneration (IVDD).

Objective.
The aim of this study is to clarify the expression and role of PON1 on the process of IVDD.

Summary of Background Data.
IVDD is responsible for most of the spinal degenerative diseases. Inflammation and oxidative stress can deteriorate the living environment of nucleus pulposus (NP) cells, leading to IVDD. PON1 is an enzyme reported to have anti-inflammatory and anti-oxidative effects. There is no study about the correlation of PON1 expression with IVDD.

Methods.
Immunohistochemical (IHC), hematoxylin and eosin (H&E) staining, and Western blot examined the expression of PON1 in 88 human disc samples (male: female 43: 45) and rat models (n = 5 each group). The level of PON1 is measured in the tumor necrosis factor (TNF)-α and oxidative stress (H2O2)-induced degenerative NP cell models using Western blot and reverse transcription-polymerase chain reaction (RT-qPCR). The TNF-α, interleukin (IL)-1β, Mito superoxide (SOX), aggrecan, and collagen II are detected in nucleus pulposus (NP) cells transfected with si-RNA of PON1 using Enzyme-Linked Immunosorbent Assay (ELISA), mitoSOX staining Western blot, and RT-qPCR.

Results.
The expression of PON1 is significantly suppressed in human and rat degenerative intervertebral discs. The level of PON1 is significantly decreased in TNF-α and oxidative stress (H2O2)-induced degenerative NP cell models. ELISA results show that the level of TNF-α and IL-1β obviously increased; Mito SOX staining indicates that the Mito SOX fluorescence significantly increased, and the expression of aggrecan and collagen reduced in NP cells transfected with si-RNA of PON1.

Conclusion.
Our study indicates that low PON1 expression is predictive of severe IVDD; PON1 plays an important role of keeping the homeostatic balance of intervertebral discs, and therapeutic approach regarding PON1 may be helpful to alleviate IVDD in the future.

Level of Evidence: N/A
Geography of Lumbar Paravertebral Muscle Fatty Infiltration
Authors: Crawford Rebecca J. , Volken Thomas , Ni Mhuiris Áine , Bow Cora C. , Elliott James M. , Hoggarth Mark A , Samartzis Dino 
Published: April 2019

Study Design.
Cross-sectional.

Objective.
We quantified fatty infiltration (FI) geography of the lumbar spine to identify whether demographics, temporal low back pain (LBP), and disability influence FI patterns.

Summary of Background Data.
Lumbar paravertebral muscle FI has been associated with age, sex, LBP, and disability; yet, FI accumulation patterns are inadequately described to optimize interventions.

Methods.
This cross-sectional study employed lumbar axial T1-weighted magnetic resonance imaging in 107 Southern-Chinese adults (54 females, 53 males). Single-slices at the vertebral inferior end-plate per lumbar level were measured for quartiled-FI, and analyzed against demographics, LBP, and disability (Oswestry Disability Index).

Results.
Mean FI% was higher in females, on the right, increased per level caudally, and from medial to lateral in men (P < 0.05). FI linearly increased with age for both sexes (P < 0.01) and was notably higher at L 4&5 than L1, 2&3 for cases aged 40 to 65 years. BMI and FI were unrelated in females and inversely in males (P < 0.001). Females with LBPweek and males with LBPyear had 1.7% (each) less average FI (P < 0.05) than those without pain at that time-point. Men locating their LBP in the back had less FI than those without pain (P < 0.001). Disability was unrelated to FI for both sexes (P > 0.05).

Conclusion.
Lumbar paravertebral muscle FI predominates in the lower lumbar spine, notably for those aged 40 to 65, and depends more on sagittal than transverse distribution. Higher FI in females and differences of mean FI between sexes for BMI, LBP, and disabling Oswestry Disability Index suggest sex-differential accumulation patterns. Our study contradicts pain models rationalizing lumbar muscle FI and may reflect a normative sex-dependent feature of the natural history of lumbar paravertebral muscles.

Level of Evidence: 2
Acrochordon With Histological Features of Lichen Sclerosus
Authors: Arnold Kathryn A. , Sundharkrishnan Lohini , Bolotin Diana , Shea Christopher R. 
Published: April 2019

Abstract:
Lichen sclerosus (LS) is a chronic inflammatory dermatosis that classically presents as sclerotic, atrophic plaques in the genital region. We present a case of acrochordon with histological features of LS, clinically mimicking intradermal nevus, in a 53-year-old man with no prior history of LS. Our case highlights an unusual morphologic variant of acrochordon and illustrates the role of chronic pressure and occlusion in the development of secondary features of LS.
Endometriosis of the Eyelid, an Extraordinary Extra-abdominal Location Highlighting the Spectrum of Disease
Authors: Sharghi Kevin G. , Ramey Nicholas A. , Rush Patrick S. , Grider Douglas J. 
Published: April 2019

Abstract:
Cutaneous endometriosis is an uncommon dermatologic disorder predominantly seen in young women. Most commonly, it presents within a region of a previous surgical scar, often in relation to a gynecologic procedure on the abdomen or in close proximity to the umbilicus. The typical clinical presentation is that of papules or nodules with monthly cyclical pain and size variation. Histologically, the lesions are composed of endometrial stroma and glands. The pathophysiology is not well understood but is believed to be due to metastasis or seeding of endometrial cells. When this uncommon disorder occurs outside of the most typical clinical setting, it may cause some diagnostic difficulty. In this report, we present the first known case of cutaneous endometriosis on the eyelid.
Hypopigmented Macules as Manifestation of Lichen Planus and Lichen Planopilaris
Authors: Arnold David , Hoffman Melissa B. , Onajin Oluwakemi , Sangüeza Omar P. , McMichael Amy 
Published: April 2019

Abstract:
Lichen planus (LP) is an idiopathic inflammatory disease of the skin, hair, nails, and mucous membranes. Classic cutaneous LP is characterized by violaceous flat-topped papules that typically favor the extremities. LP on the scalp, otherwise known as lichen planopilaris, classically presents with scarring alopecia, perifollicular erythema and follicular prominence. Although LP pigmentosus presents primarily as hyperpigmentation, there is only one previous report of hypopigmented LP. In this report, the authors report 2 cases of LP that presented primarily as hypopigmented macules in 2 African American men. The first patient presented with hypopigmented macules on face and scalp as well as trunk and extremities. The second patient presented with hypopigmented macules on scalp with associated alopecia. Histopathological examination from both patients showed features of LP. The authors propose a new variant of LP that presents acutely as hypopigmented lesions.
Syringotropic Mycosis Fungoides: A Variant of Folliculotropic Mycosis Fungoides or a Distinct Entity?
Authors: Echols Kathryn F. , Bressler Lindsey , Armeson Kent , Maize John C. 
Published: April 2019

Abstract:
Syringotropic mycosis fungoides (MF) is classified under folliculotropic MF. Although there is significant overlap between the 2, this study demonstrates that folliculotropism is frequently present in syringotropic MF, and when not present, the specimen did not include a follicle to examine. In addition, few of the pathology reports mentioned folliculotropism or syringotropism, although this is an important prognostic feature.
Corynebacterium kroppenstedtii: a challenging culprit in breast abscesses and granulomatous mastitis
Authors: Saraiya Nidhi , Corpuz Marilou 
Published: April 2019

Purpose of review

Corynebacterium kroppenstedtii is a difficult pathogen associated with granulomatous mastitis and recurrent breast abscesses. Despite over a dozen studies, there is no guidance on surgical interventions, steroid use, or dosing or duration of antibiotic treatment.

Recent findings
Initially seen in predominantly Maori and Pacific Islander multiparous, postlactating women, C. kroppenstedtii breast infection has since been reported throughout the world, including in nulliparous women. Additionally, emerging data suggest that hyperprolactinemia is a modifiable risk factor for these infections. This article reviews a patient case and data from 87 other cases to compile current best practices for diagnosis, treatment, and monitoring, and provides areas for future study.

Summary
In cases of granulomatous mastitis and breast abscess, especially if recurrent, infection with C. kroppenstedtii should be considered. Microbiologists should be alerted to the specialized growth conditions and tools needed for appropriate culturing, identification, and antibiotic susceptibility testing. Clinicians should utilize a multimodal approach with surgical and antibiotic treatment to maximize clinical cure and reduce recurrence.
A Synthetic Biodegradable Temporising Matrix in Degloving Lower Extremity Trauma Reconstruction: A Case Report
Authors: Damkat-Thomas Lindsay , Greenwood John E. , Wagstaff Marcus J. D. 
Published: April 2019

Summary:
Presented is the case of an obese, 72 year-old diabetic man with a dorsal foot de-gloving injury. Whilst the tendons of extensor hallucis longus, extensor digitorum longus to all digits, and extensor digitorum brevis to hallux and second toe were intact after surgical debridement, none had any covering paratenon. The joint between the medial cuneiform and first metatarsal was open. Reconstructive options were limited by his age and co-morbidities. A novel, completely synthetic dermal matrix (NovoSorb BTM) was applied, after which the patient was discharged home to attend for dressings and review of integration progress as an outpatient. He was allowed to mobilise without limitation. Because of the poor quality of the wound bed (and patient), the material integrated slowly over 9 weeks. Delamination of the matrix, and definitive closure by application of sheet split skin autograft, produced a robust, soft, mobile and excellent aesthetic result, over which he could wear footwear immediately. Clinically, the paratenon-denuded tendons glided under the neo-dermis without tethering to the overlying integrated matrix, allowing a full range of digital movement. This was confirmed on ultrasound examination, which also demonstrated no inflammation or oedema. Already proven in extensive burns, necrotising fasciitis and complex surgical wounds, BTM represents a useful addition to the reconstructive surgeon’s toolbox.
Columella Elongation Surgery Outcome in Complete Bilateral Cleft Lip and Palate
Authors: Broll Daiana , de Souza Telma V. , Nobrega Eudes , Luz Cristiane L. , Repeke Carlos E. , da Silva Luiz C. , Garib Daniela G. , Ozawa Terumi O. 
Published: April 2019

Background:
The evaluation of surgical outcomes is needed to achieve excellence in nasal reconstruction of patients with complete bilateral cleft lip and palate (BCLP). The study objective is to evaluate the quality of nasal aesthetics after the columella elongation surgery.

Methods:
The sample of this study consisted of 70 patients with complete BCLP, operated on columella elongation surgery and analyzed at 6 to 12 years. The system for evaluation of nasal appearance after the columella elongation surgery was performed by objective and subjective analyses.

Anthropometric Measurements:
Four anthropometric nose measurements were performed directly on the faces, and the same was performed in control group (60 children without oral clefts), paired by age and sex with the experimental group. The measurements were repeated 3 times (triplicate).

Subjective Analysis:
Scores to evaluate nasal width, nasal tip projection, and length of the columella were applied before and after the columella elongation surgery by 5 raters from the rehabilitation team. Interrater and intrarater agreement was calculated by means of the kappa test.

Results:
Nasal width in BCLP group was higher when compared to the control group (P < 0.05). Nasal tip projection (subnasal–pronasal) and columella length (subnasal–columella) were decreased in BCLP group compared to that of the controls (P < 0.05). Columella width was similar in both study groups (P > 0.05). All scores of nasal aesthetics significantly improved after the columella elongation surgery.

Conclusions:
Nose of the patients with BCLP is wider, is less projected, and has the shorter columella compared to that of the noncleft subjects. After secondary columella elongation surgery in BCLP, nasal width, nasal projection, and columella length significantly improved.
Sigma-lead Male-to-Female Gender Affirmation Surgery: Blending Cosmesis with Functionality
Authors: Kaushik Narendra , Jindal Omi , Bhardwaj Devendra K. 
Published: April 2019

Background:
Current male-to-female (MtF) sex-reassignment-surgery techniques have not been fully successful to achieve the ideal objectives. The ordeal of multiple procedures, associated complications, and suboptimal results leads to high rate of dissatisfaction. We have tried to overcome functional inadequacy and address the esthetic issues for outer genitalia and vagina with our innovative “true shape sigma-lead SRS: Kaushik’s technique,” which has now become the technique of choice for MtF genital SRS for our patients.

Methods:
Between April 2007 and April 2017, authors performed 386 sigma-lead SRS in MtF transsexuals. Results were analyzed based on complications, resurgeries, and esthetic/functional outcomes. Corrective SRS using rectosigmoid constituted 145 cases and is not a part of this study.

Results:
Maximum follow-up was 7 years (average 34 months). Seventy-eight (20.2%) patients had complications, majority being minor (97.4%). Forty-four (11.4%) required resurgeries, 10 (2.6%) were corrective for introital stricture and mucosal prolapse, whereas 34 (8.8%) opted for optional minor esthetic enhancement. The overall satisfaction rate for cosmetic and functional outcomes was 4.7 out of 5. In addition to review of the literature, innovations in the technique have been explained.

Conclusions:
Kaushik’s sigma-lead MtF SRS technique is a step short to become the gold standard of genital SRS because it has proven to be safe and reliable. It allows faster healing, minimal dilation, and nearly natural cosmetic results in the form of clitoris/clitoral hood, labia minora, labia majora along with self-lubricating, fully deep, and sensate neovagina with orgasmic capabilities. This is perhaps the largest reported series of rectosigmoid use in transsexuals carried out for primary vaginoplasty.
Quantification of Head Shape and Cranioplasty Outcomes: Six-compartment Volume Method Applied to Sagittal Synostosis
Authors: Liaw William X.Z. , Parr William C.H. , Peltz Tim S. , Varey Alex , Hunt Jeremy , Gianoutsos Mark , Marucci Damian D. , Walsh William 
Published: April 2019

Background:
Premature fusion of the sagittal (midline) suture between 2 parietal bones is the most common form of craniosynostosis. Surgical correction is mandated to improve head shape and to decrease the risk of raised intracranial pressure. This study evaluated the utility of 3-dimensional (3D) imaging to quantify the volumetric changes of surgical correction. Currently there is no standardized method used to quantify the outcomes of surgery for craniosynostosis, with the cranial index (width: length ratio) being commonly used.

Methods:
A method for quantification of head shape using 3D imaging is described in which the cranium is divided up into 6 compartments and the volumes of 6 compartments are quantified and analyzed. The method is size invariant, meaning that it can be used to assess the long-term postoperative outcomes of patients through growth. The method is applied to a cohort of sagittal synostosis patients and a normal cohort, and is used to follow up a smaller group of synostotic patients 1, 2, and 3 years postoperatively.

Results:
Statistical analysis of the results shows that the 6-compartment volume quantification method is more accurate in separating normal from synostotic patient head shapes than the cranial index.

Conclusions:
Spring-mediated cranioplasty does not return head shape back to normal, but results in significant improvements in the first year following surgery compared with the preoperative sagittal synostosis head shape. 3D imaging can be a valuable tool in assessing the volumetric changes due to surgery and growth in craniosynstosis patients.
W-plasty in Scar Revision: Geometrical Considerations and Suggestions for Site-specific Design Modifications
Authors: Goutos Ioannis , Yousif Ali H. , Ogawa Rei 
Published: April 2019

Background:
A large proportion of scars in clinical practice represent good candidates for surgical revision by virtue of their unfavorable characteristics and relative orientation with respect to skin relaxed tension lines. W-plasty is a very popular excisional revision technique, which involves breaking up the scar margins into small triangular components, which are advanced and interdigitated without any rotation or transposition.

Methods:
We performed an extensive literature search using Pubmed MEDLINE, Web of Science, and Embase using the following keywords [W-plasty] AND [scar] AND [revision]. We retrieved 13 articles pertinent to the indications, geometrical design, and technical evolution of the W-plasty scar revision variants. We formulate indications for the use of isosceles/equilateral as opposed to scalene triangle W-plasty and integrate our experience with regards to the choice of geometrical design for different bodily regions.

Conclusions:
W-plasty represents a popular technique in reconstructive plastic surgery practice. We believe that the exact W-plasty design should be guided by the relaxed skin tension line definition and to this effect propose 2 main variants of geometrical design pertinent to the index anatomical site.
Evaluation of Corneal Morphology in Patients With Hemifacial Spasm
Authors: Ulusoy Döndü Melek , Ulusoy Ersin Kasim , Duru Zeynep , Çiçek Ayşe 
Published: April 2019

Purpose:
To determine whether the corneal topographic parameter values, individual corneal layer thicknesses, and its endothelial layer morphology are different in patients with hemifacial spasm (HFS) than in the control contralateral eye.

Methods:
This study was designed as a prospective study. Among patients who applied to our hospital within the past 3-year period, those with HFS in one eye (study eyes) and a completely normal contralateral eye (control eyes) were included in this study. In addition to a complete ophthalmologic examination, all patients were scanned by the Pentacam Scheimpflug camera, and a corneal endothelium cell count was taken using a Topcon Specular Microscope. Also, the thickness of the corneal sublayers was measured on the central cornea with anterior segment module of spectral domain optical coherence tomography. Data entered using SPSS software were then evaluated by paired t test; P<0.05 value was considered statistically significant.

Results:
Twenty-eight patients (16 women and 12 men) were evaluated. Steep K, Kmax, and astigmatism values were significantly higher in the study eyes of patients with HFS than in the control eyes (P<0.05, for all). In addition, the total corneal thickness and corneal stromal thickness measurements in the study eyes were statistically significantly thinner than the control eyes (P=0.04 and P<0.001, respectively). Specular microscopy parameters were not statistically significant between the study eyes and control eyes (P>0.05, for all).

Conclusion:
Corneal stromal thinning suggests that chronic exposure to hypoxia may induce this effect through extracellular matrix remodeling and losses in collagen framework content in patients with HFS.