bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postmenopausal hormone treatment alters neural pathways but does not improve verbal cognitive function
Authors: Berent-Spillson Alison , Kelley Angela S. , Persad Carol C. , Love Tiffany , Frey Kirk A. , Reame Nancy E. , Koeppe Robert , Zubieta Jon-Kar , Smith Yolanda R. 
Published: July 2018

Abstract

Objective:
Cognitive outcomes in trials of postmenopausal hormone treatment have been inconsistent. Differing outcomes may be attributed to hormone formulation, treatment duration and timing, and differential cognitive domain effects. We previously demonstrated treatment benefits on visual cognitive function. In the present study, we describe the effects of hormone treatment on verbal outcomes in the same women, seeking to understand the effects of prior versus current hormone treatment on verbal function.

Methods:
This is a cross-sectional evaluation of 57 women (38 hormone users [25 prior long-term users and 13 current users] and 19 never-users). Hormone users took identical formulations of estrogen or estrogen + progestin (0.625 mg/d conjugated equine estrogens with or without medroxyprogesterone acetate) for at least 10 years, beginning within 2 years of menopause. Women were evaluated with tests of verbal function and functional magnetic resonance imaging (fMRI) of a verbal discrimination task.

Results:
All women scored similarly on assessments of verbal function (Hopkins Verbal Learning Test and a verbal discrimination task performed during the fMRI scanning session); however, women ever treated with hormones had more left inferior frontal (T = 3.72; P < 0.001) and right prefrontal cortex (T = 3.53; P < 0.001) activation during the verbal task. Hormone-treated women performed slightly worse on the verbal discrimination task (mean accuracy 81.72 ± 11.57 ever-treated, 85.30 ± 5.87 never-treated, P = 0.14), took longer to respond (mean reaction time 1.10 ± 0.17 s ever-treated, 1.02 ± 0.11 never-treated, P = 0.03), and remembered fewer previously viewed words (mean accuracy 62.21 ± 8.73 ever-treated, 65.45 ± 7.49 never-treated, P = 0.18). Increased posterior cingulate activity was associated with longer response times (R = 0.323, P = 0.015) and worse delayed verbal recall (R = −0.328, P = 0.048), suggesting that increased activation was associated with less efficient cognitive processing. We did not detect between group differences in activation in the left prefrontal cortex, superior frontal cortex, thalamus, or occipital/parietal junction.

Conclusions:
Although current and past hormone treatment was associated with differences in neural pathways used during verbal discrimination, verbal function was not higher than never-users.
The Effects of Presurgical Nasoalveolar Molding on the Midface Symmetry of Children with Unilateral Cleft Lip and Palate: A Long-term Follow-up Study
Authors: AlHayyan Wasmiya A. , Pani Sharat Chandra , AlJohar Aziza J. , AlQatami Fawzi M. 
Published: July 2018

Background:
Midface symmetry is an important indicator of success of complete unilateral cleft lip and palate (CUCLP) treatment. There is little literature on the long-term effects of presurgical nasoalveolar molding (PNAM) on midface symmetry in children treated for CUCLP. This study aimed to compare children with CUCLP who underwent PNAM before surgical interventions, children who did not receive PNAM, and age- and sex-matched controls in terms of midface symmetry.

Methods:
We evaluated 39 frontal facial photographs of 13 patients with CUCLP who underwent PNAM as part of the treatment (group 1: PNAM), 13 patient with CUCLP who did not undergo PNAM (group 2: no nasoalveolar molding), and 13 age- and sex-matched controls. The children were evaluated in their fifth year of life. Three midline and 3 bilateral orthopometric midface landmarks were programmed using a custom software (OnyxCeph3, Image Instruments GmbH, Germany), and corresponding linear measurements from the midline were obtained and compared between the groups using 1-way analysis of variance and Scheffe’s post hoc test.

Results:
Significant differences were observed between the control and CUCLP groups for the measurements of the proanasale, subnasale, and zygion. However, there were no significant differences between the PNAM and no nasoalveolar molding groups for the 6 midface landmarks.

Conclusions:
PNAM does not seem to significantly impact the long-term midface symmetry in children with CUCLP.
Rare Hypothenar Myxoma Causing Ulnar Neuropathy: Histopathology and Treatment Pearls
Authors: Firouzbakht Peter K. , Israel Jacqueline S. , Christie Brian M. , Rao Venkat K. 
Published: July 2018

Summary:
A myxoma is a neoplasm comprised of mesenchymal connective tissue. Myxomas of the upper extremity, and particularly of the hand, are rare. We present a case of a hypothenar myxoma causing ulnar neuropathy in a patient with a history of acute inflammatory demyelinating process. Treatment and management of myxoma may vary depending on whether the process is malignant or benign; thus, histologic diagnosis is critical to determining treatment. The purpose of this article is to review the pathophysiology and clinical features of myxomas, and to provide recommendations for evaluating and treating individuals with extremity masses of unclear clinical diagnosis.
Do post-traumatic pain and post-traumatic stress symptomatology mutually maintain each other? A systematic review of cross-lagged studies
Authors: Ravn Sophie Lykkegaard , Hartvigsen Jan , Hansen Maj , Sterling Michele , Andersen Tonny Elmose 
Published: July 2018

AbstractAfter traumatic exposure, individuals are at risk of developing symptoms of both pain and post-traumatic stress disorder (PTSD). Theory and research suggest a complex and potentially mutually maintaining relationship between these symptomatologies. However, findings are inconsistent and the applied methods are not always well suited for testing mutual maintenance. Cross-lagged designs can provide valuable insights into such temporal associations, but there is a need for a systematic review to assist clinicians and researchers in understanding the nature of the relationship. Thus, the aim of this systematic review was to identify, critically appraise, and synthesize results from cross-lagged studies on pain and PTSD symptomatology to assess the evidence for longitudinal reciprocity and potential mediators. Systematic searches resulted in 7 eligible studies that were deemed of acceptable quality with moderate risk of bias using the cohort study checklist from Scottish Intercollegiate Guidelines Network. Furthermore, synthesis of significant pathways in the cross-lagged models showed inconsistent evidence of both bidirectional and unidirectional interaction patterns between pain and PTSD symptomatology across time, hence not uniformly supporting the theoretical framework of mutual maintenance. In addition, the synthesis suggested that hyperarousal and intrusion symptoms may be of particular importance in these cross-lagged relationships, while there was inconclusive evidence of catastrophizing as a mediator. In conclusion, the findings suggest an entangled, but not necessarily mutually maintaining relationship between pain and PTSD symptomatology. However, major variations in findings and methodologies complicated synthesis, prompting careful interpretation and heightening the likelihood that future high-quality studies will change these conclusions.
Contemporary Role and Responsibilities of the Director of Clinical Education: A National Qualitative Study
Authors: McCallum Christine , Engelhard Chalee , Applebaum Donna , Teglia Valerie 
Published: July 2018

Introduction.
Clinical education is of broad and current interest topic in physical therapist (PT) education today. The director of clinical education (DCE) is the core faculty member responsible for the components of the clinical education (CE) curriculum. Previous work has questioned whether the position would be a “dinosaur or a rising phoenix”. The objectives of this study was to comprehensively examine the full scope of the role and responsibilities of the DCE.

Methods.
A non-experimental, qualitative descriptive study design was used. A constructivist theoretical framework guided the work. Eleven teams of DCEs and program directors (PD) participated in semi-structured interviews. Onsite interviews were conducted by trained interviewers and transcribed verbatim for analysis. A process of thematic analysis was used to develop results.

Results.
Five themes and 19 subthemes were developed. The DCE was shown to be a value-added position in professional physical therapist programs, whose role and responsibilities are responsive to both internal and external factors to the academy. There is an evolutionary process to the development of a DCE within the academy. A common vision was shared by DCEs and PDs about the future direction of the DCE in today's clinical education marketplace.

Discussion.
The DCE is a central player in moving academic physical therapist education forward. The patterns of current DCE practice may shed light on plausible reasons for challenges association with the CE atmosphere. Study limitations could include interview bias and bias in analysis.

Conclusion.
The contemporary role and responsibilities of the DCE were identified, with recommendations for additional studies to enhance the understanding of the DCE in today's academic and clinical environment.
International Society for the Study of Vulvovaginal Disease Recommendations Regarding Female Cosmetic Genital Surgery
Authors: Vieira-Baptista Pedro , Almeida Gutemberg , Bogliatto Fabrizio , Bohl Tanja Gizela , Burger Matthé , Cohen-Sacher Bina , Gibbon Karen , Goldstein Andrew , Heller Debra , Likes Wendy , Longo da Silva Celene , Marchitelli Claudia , Moyal-Barracco Micheline , Posey Kathleen , Sluga Maria Celeste , Stockdale Colleen Kennedy , Marquini Gisele Vissoci , Zalewski Kamil 
Published: July 2018

Abstract
Female genital cosmetic surgeries (FGCSs) and procedures are increasingly being advertised as common, simple, and complication-free, capable of not only improving aesthetic appearance but also increasing self-esteem and sexual pleasure.
Guidelines for physicians and clear, scientifically correct information for patients must be made available, to minimize the number of ineffective or deleterious procedures.
The International Society for the Study of Vulvovaginal Disease positions/recommendations regarding FGCS are as follows:
1. There is a wide variation regarding genital normalcy; providers must be able to explain this to women.
2. There are no data supporting FGCS including, G-spot augmentation, hymenoplasty, vulvar and perianal bleaching/whitening, vaginal tightening procedures, and other procedures aimed at increasing sexual function.
3. Women should not be offered FGCS before the age of 18 years.
4. Women undergoing FGCS should be evaluated by a provider with expertise in vulvovaginal diseases, including attention to their psychological, social, and sexual context. Evaluation by an experienced mental health provider should be considered when the motivation for seeking surgery and/or expectations are not clear or realistic.
5. Female genital cosmetic surgery is not exempt from complications.
6. Informed consent must always be obtained.
7. Surgeons performing FGCS should refrain from solicitous advertising or promoting procedures without scientific basis, including on Web sites.
8. Surgeons should not perform surgery that they do not agree with and explain their rationale/position when pressured by patients.
9. The genital surgeon must be adequately trained in performing FGCS including knowledge of the anatomy, physiology and pathophysiology of the vulva, vagina and adjacent organs.
Relevance of human fat distribution on lipid and lipoprotein metabolism and cardiovascular disease risk
Authors: Piché Marie-Eve , Vasan Senthil K. , Hodson Leanne , Karpe Fredrik 
Published: July 2018

Purpose of review
Upper body abdominal and lower body gluteofemoral fat depot masses display opposing associations with plasma lipid and lipoprotein and cardiovascular disease (CVD) risk profiles. We review developments on adipose tissue fatty acid metabolism in the context of body fat distribution and how that might be related to adverse lipid and lipoprotein profiles and CVD risk.

Recent findings
Recent data have confirmed the paradoxical relationship of upper abdominal and lower body gluteofemoral adiposity and CVD risk. Mechanistically, this is likely to reflect the different ways fat depots handle lipid storage and release, which impacts directly and indirectly on lipid and lipoprotein metabolism. The upper body enhances immediate fat storage pathway with rapid uptake of dietary-derived fatty acids, whereas the lower body fat depot has a reduced lipid turnover accommodating a slower fat redistribution. Body fat distribution and the fat depots’ ability to undergo appropriate expansion when fat storage is required, rather than overall body fatness, appear as the important determinant of metabolic health.

Summary
A focus on fat distribution in overweight people, preferably using precise imaging methods, rather than quantifying total body fatness, is likely to provide the medical community with better tools to stratify and treat patients with obesity-related complications.
Efficacy of Compression Gloves in the Rehabilitation of Distal Radius Fractures
Authors: Miller-Shahabar Inbar , Schreuer Naomi , Katsevman Haim , Bernfeld Benjamin , Cons Anat , Raisman Yael , Milman Uzi 
Published: July 2018

Objective
The aim of this study was to examine the outcomes of wearing made-to-measure compression gloves after distal radius fracture.

Design
In a randomized controlled trial, adults who were about 6 wks post distal radius fracture were recruited and divided into a comparison control group (n = 15), who received standard rehabilitation twice a week for half an hour, and an intervention group (n = 17), who additionally used compression gloves. All treatments were conducted at a single rehabilitation clinic. Outcomes assessed were wrist and finger range of motion, grip strength, swelling, pain, and activities of daily living (using the Patient Rating Wrist Evaluation). The intervention group underwent additional objective dynamic assessments of range of motion with and without the gloves.

Results
The intervention group demonstrated reduced swelling, pain, and analgesic use; increased wrist range of motion; better scores for specific hand functions; and greater participation in activities of daily living compared with the comparison group.

Conclusion
This randomized controlled trial shows that using compression gloves during the rehabilitation phase after distal radius fracture improves daily functioning and reduces adverse symptoms. These improvements, which are important in their own right, are also expected to aid in preventing the development of chronic conditions and disability.

Evidence Level II
Un-blinded prospective comparative study.
Mechanical In-exsufflation-Expiratory Flows as Indication for Tracheostomy Tube Decannulation
Authors: Bach John R. , Giménez Gloria C. , Chiou Michael 
Published: July 2018

Abstract
Mechanical insufflation exsufflation-expiratory flows (MIE-EFs) correlate with upper airway patency. Patients dependent on continuous noninvasive ventilatory support with severe spinal muscular atrophy type 1, now over 20 yrs old, have used MIE sufficiently effectively along with continuous noninvasive ventilatory support to avoid tracheotomy indefinitely. Although MIE-EFs can apparently decrease in amyotrophic lateral sclerosis to necessitate tracheotomy, they can increase over time and remain effective in all spinal muscular atrophy types. Two cases demonstrate an association between increasing MIE-EF and, ultimately, successful decannulation of a patient with spinal muscular atrophy type 2 who was continuous tracheostomy mechanical ventilation dependent and a patient with obesity hypoventilation syndrome. Only when MIE-EF increased to exceed 200 l/min did the decannulations succeed. Definitive noninvasive management (continuous noninvasive ventilatory support) of these patients may be possible only when MIE is effective, and the greater the MIE-EF, the greater its effectiveness. Thus, increasing MIE-EF can signal resolution of upper airway obstruction sufficiently to permit decannulation whether a patient is ventilator dependent or not.
Family Testing: An Index Case Finding Strategy to Close the Gaps in Pediatric HIV Diagnosis
Authors: Simon Katherine R. , Flick Robert J. , Kim Maria H. , Sabelli Rachael A. , Tembo Tapiwa , Phelps Benjamin Ryan , Rosenberg Nora E. , Ahmed Saeed 
Published: July 2018

Abstract:
Despite significant advances in pediatric HIV treatment, too many children remain undiagnosed and thus without access to lifesaving antiretroviral therapy. It is critical to identify these children and initiate antiretroviral therapy as early as possible. Although the children of HIV-infected adults are at higher risk of infection, few access HIV testing services because of missed opportunities in existing case finding programs. Family testing is an index case finding strategy through which HIV-infected patients are systematically screened to identify family members with unknown HIV status. By specifically targeting a high-risk population, family testing is a pragmatic, high-yield, and efficient approach to identify previously undiagnosed HIV-infected children and link them to care before they become symptomatic. Despite this, incorporation of family testing into national guidelines and implementation of this case finding approach is variable. In this article, we review the evidence base for family testing, describe its challenges, and provide guidance and sample tools for program managers aiming to integrate family testing into existing health systems.
The Case For Family-Centered Differentiated Service Delivery for HIV
Authors: Grimsrud Anna , Bygrave Helen , Wilkinson Lynne 
Published: July 2018

Abstract:
Differentiated care, or differentiated service delivery (DSD), is increasingly being promoted as one of the possible ways to address and improve access, quality, and efficiency of HIV prevention, care, and treatment. Family-centered care has long been promoted within the provision of HIV services, but the full benefits have not necessarily been realized. In this article, we bring together these two approaches and make the case for how family-centered DSD can offer benefits to both people affected by HIV and the health system. Family-centered DSD approaches are presented for HIV testing and antiretroviral therapy (ART) delivery, referencing policies, best practice examples, and evidence from the field. With differentiated family-centered ART delivery, the potential efficiencies gained by extending ART refills can both benefit clients by reducing the frequency and intensity of contact with the health service and lead to health system gains by not requiring multiple providers to care for one family. A family-centered DSD approach should also be leveraged along the HIV care cascade in the provision of prevention technologies and mobilizing family members to receive regular HIV testing. Furthermore, a family-centered lens should be applied wherever DSD is implemented to ensure that, for example, adolescents who are pregnant receive an adapted package of quality care.
How Does Smoking Cessation Affect Disease Activity, Function Loss, and Quality of Life in Smokers With Ankylosing Spondylitis?
Authors: Dülger Seyhan , Aykurt Karlibel İlknur , Kasapoğlu Aksoy Meliha , Altan Lale , Şengören Dikiş Özlem , Yildiz Tekin 
Published: July 2018

Background
Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that can progressively restrict spinal mobility.

Objective
This study aimed to investigate how smoking cessation by AS patients affects disease activity and their psychological state, physical mobility, lung function, and quality of life.

Materials and Methods
This was a longitudinal, single-blind, controlled, and observational study on 92 AS patients. Pulmonary function test, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, chest expansion, Short-Form 36, and Ankylosing Spondylitis Quality of Life were evaluated. The patients were divided into smokers (group 1 = 54) and nonsmokers (group 2 = 38). The smokers were divided further into subgroups of those who quit smoking (group 1a = 17) and those who did not (group 1b = 37). Groups 1a and 1b patients were compared in terms of their baseline data and data 6 months after smoking cessation. In addition, group 1a patients' baseline data and data 6 months after smoking cessation were compared statistically.

Results
There was no statistically significant difference between groups 1a and 1b after 6 months in terms of the evaluated parameters, except for BASDAI. Bath Ankylosing Spondylitis Disease Activity Index was significantly lower in group 1a than group 1b (p = 0.02), indicating that. When the baseline data and data after 6 months of group 1a were compared, a significant improvement was found in BASDAI (p = 0.001), Bath Ankylosing Spondylitis Functional Index (p = 0.001), chest expansion (p = 0.001), ankylosing spondylitis quality of life (p = 0.003), and subparameters physical function (p = 0.015), physical role strength (p = 0.05), power/live/vitality (p = 0.025), social functioning (p = 0.039), pain (p = 0.036), and general health perception (p = 0.05) of Short-Form 36, as well as forced expiratory volume in the first second (p = 0.003) and forced vital capacity (p = 0.007).

Conclusions
We observed significant improvements in disease activity, physical mobility, and quality of life in AS patients who quit smoking.
Is Hepatectomy Justified for BRAF Mutant Colorectal Liver Metastases?
Authors: Gagnière Johan , Dupré Aurélien , Gholami Sepideh S. , Pezet Denis , Boerner Thomas , Gönen Mithat , Kingham Thomas P. , Allen Peter J. , Balachandran Vinod P. , De Matteo Ronald P. , Drebin Jeffrey A. , Yaeger Rona , Kemeny Nancy E. , Jarnagin William R. , D’Angelica Michael I. 
Published: July 2018

Objective:
To analyze clinical outcomes and prognostic variables of patients undergoing hepatic resection for BRAF mutant (BRAF-mut) colorectal liver metastases (CRLM).

Background:
Outcomes following hepatectomy for BRAF-mut CRLM have not been well studied.

Methods:
All patients who underwent hepatectomy for CRLM with complete resection and known BRAF status during 2001 to 2016 at 3 high-volume centers were analyzed.

Results:
Of 4124 patients who underwent hepatectomy for CRLM, 1497 had complete resection and known BRAF status. Thirty-five (2%) patients were BRAF-mut, with 71% of V600E mutation. Compared with BRAF wild-type (BRAF-wt), BRAF-mut patients were older, more commonly presented with higher ASA scores, synchronous, multiple and smaller CRLM, underwent more major hepatectomies, but had less extrahepatic disease. Median overall survival (OS) was 81 months for BRAF-wt and 40 months for BRAF-mut patients (P < 0.001). Median recurrence-free survival (RFS) was 22 and 10 months for BRAF-wt and BRAF-mut patients (P < 0.001). For BRAF-mut, factors associated with worse OS were node-positive primary tumor, carcinoembryonic antigen (CEA) >200 μg/L, and clinical risk score (CRS) ≥4. Factors associated with worse RFS were node-positive primary tumor, ≥4 CRLM, and positive hepatic margin. V600E mutations were not associated with worse OS or RFS. A case-control matching analysis on prognostic clinicopathologic factors confirmed shorter OS (P < 0.001) and RFS (P < 0.001) in BRAF-mut.

Conclusions:
Patients with resectable BRAF-mut CRLM are rare among patients selected for surgery and more commonly present with multiple synchronous tumors. BRAF mutation is associated with worse prognosis; however, long-term survival is possible and associated with node-negative primary tumors, CEA ≤ 200 μg/L and CRS < 4.