bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conformity of the Actual to the Planned Result in Orthognathic Surgery
Authors: Wilson Alex , Gabrick Kyle , Wu Robin , Madari Sarika , Sawh-Martinez Rajendra , Steinbacher Derek 
Published: July 2019

Background:
Virtual surgical planning has facilitated preoperative planning, splint accuracy, and intraoperative efficiency in orthognathic surgery. The translation of the virtual surgical plan to the actual result has not been adequately examined. The authors examined the conformity of the virtual surgical plan to the postoperative result. They hypothesize that the greatest conformity exists in the anteroposterior dimensions.

Methods:
The authors examined patients who underwent Le Fort I maxillary advancement, bilateral sagittal split osteotomy, and genioplasty. The preoperative virtual surgical planning file and postoperative cone beam computed tomographic scan were registered in Mimics using unchanged landmarks. The conformity to the virtual surgical plan was quantified using linear and angular measurements between bone surface landmarks. Results were compared using t tests, with p < 0.05 considered statistically significant

Results:
One hundred patients who underwent Le Fort I maxillary advancement, bilateral sagittal split osteotomy, and genioplasty were included. Three-dimensional analysis showed significant differences between the plan and outcome for the following landmarks: A point (y, p = 0.04; z, p = 0.04), B point (y, p = 0.02; z, p = 0.02), pogonion (y, p = 0.04), menton (x, p = 0.02; y, p = 0.01; z, p = 0.03), and anterior nasal spine (x, p = 0.04; y, p = 0.04; z, p = 0.01). Angular measurements sella-nasion-A point, sella-nasion-B point, and A point-nasion-B point were not statistically different.

Conclusions:
There is a high degree of conformity comparing the orthognathic virtual surgical plan to the actual postoperative result. However, some incongruency is seen vertically (maxilla) and sagittally (mandible, chin). Departures of the actual position compared with the plan could be the result of condylar position changes, osteotomy locations, aesthetic intraoperative decisions, and/or play in the system.
Outcomes Utilizing Inspira Implants in Primary Aesthetic and Reconstructive Surgery
Authors: Warren Peled Anne , Disa Joseph J. 
Published: July 2019

Summary:
The evolution of silicone implants has included advances in both gel and shell technology to improve the clinical outcomes of the implants. The newest generation of implants includes implants with thick, strong shells and highly cohesive gel fill. These advancements allow for better maintenance of implant form and shape over time and improved implant safety. The Natrelle Inspira product line offers 3 different levels of gel cohesivity in a range of profiles to provide a wide variety of options for use in both breast augmentation and postmastectomy breast reconstruction. This article will review the use of Inspira implants in primary aesthetic and reconstructive breast surgery.
Implementing a Mandated Program Across a Regional Health Care System: A Rapid Qualitative Assessment to Evaluate Early Implementation Strategies
Authors: Sperber Nina R. , Bruening Rebecca A. , Choate Ashley , Mahanna Elizabeth , Wang Virginia , Powell Byron J. , Damush Teresa , Jackson George L. , Van Houtven Courtney H. , Allen Kelli D. , Hastings Susan N. 
Published: July 2019

Background:
Rapid qualitative assessment was used to describe early strategies to implement an evidence-based walking program for hospitalized older adults, assiSTed eaRly mobIlity for hospitalizeD older vEterans (STRIDE), mandated by a regional Department of Veterans Affairs health care system office (Veterans Integrated Service Network [VISN]).

Methods:
Data were collected from 6 hospital sites via semistructured interviews with key informants, observations of telephone-based technical assistance, and review of VISN-requested program documents (eg, initial implementation plans). An overarching framework of actionable feedback for VISN leadership and specification of locally initiated implementation strategies, using the Expert Recommendations for Implementing Change (ERIC) compilation, was used. Actionable feedback was shared with VISN leadership 1 month after the initiative.

Results:
ERIC implementation strategies identified were as follows: (1) promoting adaptability—4 sites had physical therapists/kinesiotherapists instead of assistants walk patients; (2) promoting network weaving—strengthening nursing and PT/KT partnership with regular communication opportunities or a point person was important for implementation; (3) distributing educational materials—2 sites distributed information about STRIDE via e-mail and in person; and (4) organizing clinician implementation team meetings—3 sites used interdisciplinary team meetings to communicate with the clinical staff about STRIDE.

Conclusion:
This qualitative study sheds light on early experiences with implementing STRIDE; the results have been instructive for ongoing implementation and future dissemination of STRIDE, and the approach can be applied across contexts to inform implementation of other programs.
Spectral Computed Tomographic Parameters Predict the Therapeutic Efficacy and Overall Survival of the Angiogenesis Inhibitor AL3818 in Hepatic Lesions: Preliminary Animal Study
Authors: Zhou Yue , Gong Yi , Wang Mingyue , Xu Han , Hou Ping , Dong Junqiang , Wang Feng , Gao Jian-bo 
Published: July 2019

Objective
This study aimed to investigate the predictive and prognostic values of repeated spectral computed tomographic (CT) parameter changes for the prediction of treatment responses to the angiogenesis inhibitor AL3818 in hepatic tumors.

Methods
A total of 30 rabbits with VX2 hepatic tumors that underwent spectral contrast-enhanced abdominal CT before and during treatment were included in the study. The percent change (Δ, %) of the normalized iodine concentration (nIC) during the arterial phase (AP) and venous phase (VP) was used to predict the tumor response and to calculate the overall survival (OS). The threshold of the nIC for tumor response prediction and prognostic significance was determined by a receiver operating characteristic curve and Kaplan-Meier analysis.

Results
After treatment, there were 43% (13/30) responders and 57% (17/30) nonresponders. When ΔnICAP ≥ −13.10% was used as the threshold, the sensitivity and specificity for the prediction of tumor response were 82.41% and 92.31%, respectively. ΔnICVP resulted in 88.20% sensitivity and 76.92% specificity for cutoff values ≥10.78%. Kaplan-Meier analyses showed that high ΔnICAP and ΔnICVP were associated with improved OS.

Conclusions
The current study shows the capability of the changes (Δ) in repeated spectral CT parameters to predict the tumor response during antiangiogenesis therapy in small hepatic tumors. ΔnICAP and ΔnICVP were predictors for treatment response and were associated with OS.
Novel Characteristic Skull Magnetic Resonance Imaging Features Associated With Meningioma
Authors: Matsushima Satoshi , Shimizu Tetsuya , Fukasawa Nei , Ojiri Hiroya 
Published: July 2019

Objective
Meningioma-related skull magnetic resonance imaging findings other than hyperostosis are not widely recognized. We evaluated the novel findings of the skull adjacent to meningiomas.

Methods
Records from patients with meningiomas located adjacent to the skull on magnetic resonance imaging (n = 32) were included. Three skull findings (intramedullary prominent vessel, intramedullary enhancement, intramedullary T2-hyperintensity) and the widely known hyperostosis were retrospectively visually assessed. The frequency of these 3 findings and the relevance to each other, and their relationships with hyperostosis, size, length adjacent to the skull, and relative signal intensity of the meningioma were examined.

Results
The incidence of the three findings was 46.88%, 53.13%, and 62.5%, respectively, and that of hyperostosis was 46.88%. Each association involving the findings was strong, and they were significantly related to the size and length.

Conclusions
Intramedullary prominent vessel, intramedullary enhancement, and intramedullary T2-hyperintensity may be novel characteristic skull findings associated with meningioma.
Von Meyenburg Complex: Current Concepts and Imaging Misconceptions
Authors: Guo Yang , Jain Dhanpat , Weinreb Jeffrey 
Published: July 2019

Abstract
Von Meyenburg complexes, also known as biliary hamartomas, are ductal plate malformations that are usually diagnosed on imaging studies when there are multiple as small hepatic cysts. However, because of variations in histology, they actually have a wide spectrum of imaging appearances ranging from solid, to mixed solid and cystic, to cystic lesions. The objective of the review is to provide up-to-date information about the embryopathogenesis of von Meyenburg complexes, their imaging appearances, diagnostic pitfalls, and clinical significance.
Differentiation of Hepatic Sclerosed Hemangiomas From Cavernous Hemangiomas Based on Gadoxetic Acid–Enhanced Magnetic Resonance Imaging Features
Authors: Hwang Jeong Ah , Kang Tae Wook , Cha Dong Ik , Kim Seong Hyun , Ha Sang Yun , Kim Seon Woo 
Published: July 2019

Objective
The objective of this study was to evaluate the imaging features of a hepatic sclerosed hemangioma by comparing them with those of a cavernous hemangioma using magnetic resonance imaging with gadoxetic acid enhancement.

Methods
Nine patients with hepatic sclerosed hemangiomas and 36 patients with cavernous hemangiomas (control group) who underwent gadoxetic acid–enhanced magnetic resonance imaging were included. Qualitative values (imaging findings and enhancement pattern [typical vs atypical enhancement]) and quantitative values (apparent diffusion coefficient) were evaluated.

Results
Patients with sclerosed hemangiomas showed significantly more irregular tumor margin on hepatobiliary phase images, peritumoral arterial enhancement, and a lower proportion of hyperintensity on heavily T2-weighted images compared with controls (all P values <0.05). In addition, the sclerosed hemangioma group had significantly more frequent atypical enhancement patterns than did the control group (88.9% vs 33.3%; P = 0.006). However, the mean apparent diffusion coefficient value of hemangiomas was not significantly different between the 2 groups (P = 0.639).

Conclusions
Gadoxetic acid–enhanced magnetic resonance images can help in differentiating between hepatic sclerosed hemangiomas and cavernous hemangiomas.
Tumor Contrast Enhancement and Whole-Body Elimination of the Manganese-Based Magnetic Resonance Imaging Contrast Agent Mn-PyC3A
Authors: Erstad Derek J. , Ramsay Ian A. , Jordan Veronica Clavijo , Sojoodi Mozhdeh , Fuchs Bryan C. , Tanabe Kenneth K. , Caravan Peter , Gale Eric M. 
Published: July 2019

Objectives
The goals of this study were to compare the efficacy of the new manganese-based magnetic resonance imaging (MRI) contrast agent Mn-PyC3A to the commercial gadolinium-based agents Gd-DOTA and to Gd-EOB-DTPA to detect tumors in murine models of breast cancer and metastatic liver disease, respectively, and to quantify the fractional excretion and elimination of Mn-PyC3A in rats.

Methods
T1-weighted contrast-enhanced MRI with 0.1 mmol/kg Mn-PyC3A was compared with 0.1 mmol/kg Gd-DOTA in a breast cancer mouse model (n = 8) and to 0.025 mmol/kg Gd-EOB-DTPA in a liver metastasis mouse model (n = 6). The fractional excretion, 1-day biodistribution, and 7-day biodistribution in rats after injection of 2.0 mmol/kg [52Mn]Mn-PyC3A or Gd-DOTA were quantified by 52Mn gamma counting or Gd elemental analysis. Imaging data were compared with a paired t test; biodistribution data were compared with an unpaired t test.

Results
The postinjection-preinjection increases in tumor-to-muscle contrast-to-noise ratio (ΔCNR) 3 minutes after injection of Mn-PyC3A and Gd-DOTA (mean ± standard deviation) were 17 ± 3.8 and 20 ± 4.4, respectively (P = 0.34). Liver-to-tumor ΔCNR values at 8 minutes postinjection of Mn-PyC3A and Gd-EOB-DTPA were 28 ± 9.0 and 48 ± 23, respectively (P = 0.11). Mn-PyC3A is eliminated with 85% into the urine and 15% into the feces after administration to rats. The percentage of the injected doses (%ID) of Mn and Gd recovered in tissues after 1 day were 0.32 ± 0.12 and 0.57 ± 0.12, respectively (P = 0.0030), and after 7 days were 0.058 ± 0.051 and 0.19 ± 0.052, respectively (P < 0.0001).

Conclusions
Mn-PyC3A provides comparable tumor contrast enhancement to Gd-DOTA in a mouse breast cancer model and is more completely eliminated than Gd-DOTA; partial hepatobiliary elimination of Mn-PyC3A enables conspicuous delayed phase visualization of liver metastases.
18F-DCFPyL Uptake in an Incidentally Detected Follicular Lymphoma by PET/CT Performed for Biochemically Recurrent Prostate Cancer
Authors: Meijer Dennie , Wondergem Maurits , Knol Remco J.J. , Broos Wouter A.M. , van der Zant Friso M. 
Published: July 2019

Abstract
A 75-year-old man, treated with curative intent for histopathologically proven prostate cancer (initial prostate-specific antigen, 27 ng/mL; Gleason 4 + 5 = 9) through external beam radiation therapy in 2010 in combination with 3 years of androgen deprivation therapy (leuprorelin), underwent 18F-DCFPyL PET/CT for biochemical recurrence with a prostate-specific antigen of 4.1 ng/mL in February 2019. Multiple pelvic and some para-aortic lymph nodes showed highly increased 18F-DCFPyL uptake, suspicious for metastases. Incidentally, a solid mesenteric mass and mesenteric lymph nodes with moderately increased 18F-DCFPyL uptake were found. Upon histopathological evaluation, this proved to be a low-grade follicular lymphoma.
Telemedicine Based Remote Home Monitoring After Liver Transplantation
Authors: Lee Tiffany C. , Kaiser Tiffany E. , Alloway Rita , Woodle Ervin Steve , Edwards Michael J. , Shah Shimul A. 
Published: July 2019

Objective:
This study assesses the impact of a telemedicine-based home management program (THMP) on patient adherence, hospital readmissions, and quality of life (QOL) after liver transplantation (LT).

Summary of Background Data:
Telemedicine interventions represent an opportunity to personalize care and can lead to improved adherence and patient satisfaction. However, there is limited data on impact of these interventions on outcomes after LT. Therefore, we conducted the first randomized controlled trial (RCT) of a THMP compared to standard of care (SOC) after LT.

Methods:
One hundred six consecutive LT recipients were randomized (1:1) to 1 of 2 posttransplant care strategies: SOC or THMP. The THMP included an electronic tablet and bluetooth devices to support daily text messages, education videos, and video FaceTime capability; data was cyber-delivered into our electronic medical record daily. Endpoints were THMP participation, 90-day hospital readmission rate, and QOL.

Results:
One hundred patients completed the study with 50 enrolled in each arm. Participation and adherence with telemedicine was 86% for basic health sessions (vital sign recording), but only 45% for using messaging or FaceTime. The THMP group had a lower 90-day readmission rate compared to SOC (28% vs 58%; P = 0.004). The THMP cohort also showed improved QOL in regards to physical function (P = 0.02) and general health (P = 0.05) at 90 days.

Conclusions:
To our knowledge, this is the first RCT demonstrating the impact of THMP after LT. The magnitude of effect on LT outcomes, hospital readmissions, and QOL suggests that the adoption of telemedicine has great potential for other major operations.
Hereditary Susceptibility for Triple Negative Breast Cancer Associated With Western Sub-Saharan African Ancestry
Authors: Newman Lisa A. , Jenkins Brittany , Chen Yalei , Oppong Joseph K. , Adjei Ernest , Jibril Aisha S. , Hoda Syed , Cheng Esther , Chitale Dhananjay , Bensenhaver Jessica M. , Awuah Baffour , Bekele Mahteme , Abebe Engida , Kyei Ishmael , Aitpillah Frances , Adinku Michael , Nathanson Saul David , Jackson LaToya , Jiagge Evelyn , Merajver Sofia , Petersen Lindsay F. , Proctor Erica , Gyan Kofi K. , Martini Rachel , Kittles Rick , Davis Melissa B. 
Published: July 2019

Objective:
To investigate subtype-specific risk of germline alleles associated with triple negative breast cancer (TNBC) in African ancestry populations.

Background:
Breast cancer (BC) mortality is higher in African American (AA) compared to White American (WA) women; this disparity is partly explained by 2-fold higher TNBC incidence.

Methods:
We used a surgically maintained biospecimen cohort of 2884 BC cases. Subsets of the total (760 AA; 962 WA; 910 West African/Ghanaian; 252 East African/Ethiopian) were analyzed for genotypes of candidate alleles. A subset of 417 healthy controls were also genotyped, to measure associations with overall BC risk and TNBC.

Results:
TNBC frequency was highest in Ghanaian and AA cases (49% and 44% respectively; P < 0.0001) and lowest in Ethiopian and WA cases (17% and 24% respectively; P < 0.0001). TNBC cases had higher West African ancestry than non-TNBC (P < 0.0001). Frequency of the Duffy-null allele (rs2814778; an African ancestral variant adopted under selective pressure as protection against malaria) was associated with TNBC-specific risk (P < 0.0001), quantified West African Ancestry (P < 0.0001) and was more common in AA, Ghanaians, and TNBC cases. Additionally, rs4849887 was significantly associated with overall BC risk, and both rs2363956 and rs13000023 were associated with TNBC-specific risk, although none as strongly as the Duffy-null variant.

Conclusions:
West African ancestry is strongly correlated with TNBC status, as well as germline variants related to BC risk. The Duffy-null allele was associated with TNBC risk in our cohort.
Intraoperative Increase of Portal Venous Pressure is an Immediate Predictor of Posthepatectomy Liver Failure After Major Hepatectomy
Authors: Bogner Andreas , Reissfelder Christoph , Striebel Fabian , Mehrabi Arianeb , Ghamarnejad Omid , Rahbari Mohammad , Weitz Jürgen , Rahbari Nuh N. 
Published: July 2019

Objectives:
The aim of this study was to assess intraoperative changes of hepatic macrohemodynamics and their association with ascites and posthepatectomy liver failure (PHLF) after major hepatectomy.

Summary of Background Data:
Large-scale ascites and PHLF remain clinical challenges after major hepatectomy. No study has concomitantly evaluated arterial and venous liver macrohemodynamics in patients undergoing liver resection.

Methods:
Portal venous pressure (PVP), portal venous flow (PVF), and hepatic arterial flow (HAF) were measured intraoperatively pre- and postresection in 67 consecutive patients with major hepatectomy (ie, resection of ≥3 liver segments). A group of 30 patients with minor hepatectomy served as controls. Liver macrohemodynamics and their intraoperative changes (ie, Δ) were analyzed as predictive biomarkers of ascites and PHLF using Fisher exact, t test, or Wilcoxon rank sum test for univariate and logistic regression for multivariate analyses.

Results:
Major hepatectomy increased PVP by 26.9% (P = 0.001), markedly decreased HAF by 40.7% (P < 0.001), and slightly decreased PVF by 13.4% (P = 0.011). Minor resections had little effects on hepatic macrohemodynamics. There was no significant association of liver macrohemodynamics with ascites. While middle hepatic vein resection caused higher postresection PVP after right hepatectomy (P = 0.04), the Pringle maneuver was associated with a significant PVF (P = 0.03) and HAF reduction (P = 0.03). Uni- and multivariate analysis revealed an intraoperative PVP increase as an independent predictor of PHLF (P = 0.025).

Conclusion:
Intraoperative PVP kinetics serve as independent predictive biomarker of PHLF after major hepatectomy. These data highlight the importance to assess intraoperative dynamics rather than the pre- and postresection PVP values.
Effect of Remote Ischemic Preconditioning Conducted in Living Liver Donors on Postoperative Liver Function in Donors and Recipients Following Liver Transplantation
Authors: Jung Kyeo-Woon , Kang Jiwon , Kwon Hye-Mee , Moon Young-Jin , Jun In-Gu , Song Jun-Gol , Hwang Gyu-Sam 
Published: July 2019

Objective:
This study aimed to assess the effects of remote ischemic preconditioning (RIPC) on liver function in donors and recipients after living donor liver transplantation (LDLT).

Background:
Ischemia reperfusion injury (IRI) is known to be associated with graft dysfunction after liver transplantation. RIPC is used to lessen the harmful effects of IRI.

Methods:
A total of 148 donors were randomly assigned to RIPC (n = 75) and control (n = 73) groups. RIPC involves 3 cycles of 5-minute inflation of a blood pressure cuff to 200 mm Hg to the upper arm, followed by 5-minute reperfusion with cuff deflation. The primary aim was to assess postoperative liver function in donors and recipients and the incidence of early allograft dysfunction and graft failure in recipients.

Results:
RIPC was not associated with any differences in postoperative aspartate aminotransferase (AST) and alanine aminotransferase levels after living donor hepatectomy, and it did not decrease the incidence of delayed graft hepatic function (6.7% vs 0.0%, P = 0.074) in donors. AST level on postoperative day 1 [217.0 (158.0, 288.0) vs 259.5 (182.0, 340.0), P = 0.033] and maximal AST level within 7 postoperative days [244.0 (167.0, 334.0) vs 296.0 (206.0, 395.5), P = 0.029) were significantly lower in recipients who received a preconditioned graft. No differences were found in the incidence of early allograft dysfunction (4.1% vs 5.6%, P = 0.955) or graft failure (1.4% vs 5.6%, P = 0.346) among recipients.

Conclusions:
RIPC did not improve liver function in living donor hepatectomy. However, RIPC performed in liver donors may be beneficial for postoperative liver function in recipients after living donor liver transplantation.
Comparing Perioperative Mortality and Morbidity of Minimally Invasive Esophagectomy Versus Open Esophagectomy for Esophageal Cancer
Authors: Sakamoto Takashi , Fujiogi Michimasa , Matsui Hiroki , Fushimi Kiyohide , Yasunaga Hideo 
Published: July 2019

Objective:
We compared the surgical outcomes of minimally invasive esophagectomy (MIE) and open esophagectomy (OE) for esophageal cancer.

Summary Background Data:
MIE has become a widespread procedure. However, the definitive advantages of MIE over OE at a nationwide level have not been established.

Methods:
We analyzed patients who underwent esophagectomy for clinical stage 0 to III esophageal cancer from April 2014 to March 2017 using a Japanese inpatient database. We performed propensity score matching to compare in-hospital mortality and morbidities between MIE and OE, accounting for clustering of patients within hospitals.

Results:
Among 14,880 patients, propensity matching generated 4572 pairs. MIE was associated with lower incidences of in-hospital mortality (1.2% vs 1.7%, P = 0.048), surgical site infection (1.9% vs 2.6%, P = 0.04), anastomotic leakage (12.8% vs 16.8%, P < 0.001), blood transfusion (21.9% vs 33.8%, P < 0.001), reoperation (8.6% vs 9.9%, P = 0.03), tracheotomy (4.8% vs 6.3%, P = 0.002), and unplanned intubation (6.3% vs 8.4%, P < 0.001); a shorter postoperative length of stay (23 vs 26 days, P < 0.001); higher incidences of vocal cord dysfunction (9.2% vs 7.5%, P < 0.001) and prolonged intubation period after esophagectomy (23.2% vs 19.3%, P < 0.001); and a longer duration of anesthesia (408 vs 363 minutes, P < 0.001).

Conclusion:
MIE had favorable outcomes in terms of in-hospital mortality, morbidities, and the postoperative hospital stay.