bluuebunny/crossref_metadata_2025_split huggingface dataset:
Natural Breast Symmetry in Preoperative Breast Cancer Patients
Authors: Cheong Audrey L. , Liu Jun , Reece Gregory P. , Nicklaus Krista M. , Catherine Bordes Mary , Hanson Summer E. , Markey Mia K. , Merchant Fatima A. 
Published: July 2019

Background:
Plastic surgeons aim to achieve breast symmetry during cosmetic and reconstructive breast surgery. They rely on measures of breast size, position, and projection to determine and achieve breast symmetry, but normative data on symmetry in preoperative breast reconstruction patients are scarce.

Methods:
A statistical evaluation was performed to examine the relationship of breast symmetry to demographic and clinical factors such as age, body mass index (BMI), race, and cancer status in a sample population of 87 patients who were scheduled to undergo mastectomy and breast reconstruction. The sternal notch to nipple (SN-N) distance and breast volume were measured on three-dimensional images, and distance and volume ratios across the left and right breasts were compared to determine symmetry. Ptosis grades were recorded and grade agreement (match) across the left and right breasts was assessed to determine shape symmetry.

Results:
A substantial portion of women (41.4%) showed SN-N distance differences >5 mm and 50.6% exhibited a volume difference >50 mL between their right and left breasts. Multiple linear regression modeling did not show any association between age, BMI, and cancer status and the SN-N and volume ratios. Race showed an association with volume symmetry but not with SN-N symmetry. A higher BMI increased the likelihood of ptosis disagreement. Additionally, tumor size did not impact overall breast symmetry.

Conclusion:
This study provides normative data on the extent of breast asymmetry in preoperative patients that can guide physicians in setting realistic goals for reconstruction procedures and manage patients’ expectations related to outcomes.
Establishment of a Standardized Technique for Concha-type Microtia―How to Incorporate the Cartilage Frame into the Remnant Ear
Authors: Yotsuyanagi Takatoshi , Yamashita Ken , Yamauchi Makoto , Nakagawa Tsugufumi , Sugai Asuka , Kato Shinji , Gonda Ayako , Suzuki Akiyo , Onuma Masahiro 
Published: July 2019

Background:
We have already reported surgical procedures for lobule-type microtia that provide an excellent contour and shape of the ear with minimum sacrifice of the donor. We have succeeded in establishing a standard surgical technique for almost all types of concha-type microtia that effectively uses the remnant ear and can use a unified costal cartilage frame.

Methods and Results:
The concept of our technique is that remnant cartilage should be used maximally but that the deformed area should be completely replaced by the costal cartilage frame. The differences between the cartilage frame for lobule-type microtia and that for concha-type microtia are that the lower half beneath the antihelical area and the concha cymba in the base frame are omitted in concha-type microtia. The area from the tragus to the incisura of the tragus in the antihelical-tragal frame is also omitted. The area of the helical crus in the helical frame and the lower half in the antihelix are not immobilized in the base frame and are free edges. On the other hand, the remnant cartilage outside the concha is removed, but the antitragus is preserved. When the cartilage frame and the remnant are incorporated, all of the components of the ear can be provided.

Conclusion:
The ears created by our technique have a natural appearance and clear contour.
Do different uses of performance measurement systems in hospitals yield different outcomes?
Authors: van Elten Hilco J. , van der Kolk Berend , Sülz Sandra 
Published: July 2019

Background
Inspired by the new public management movement, many public sector organizations have implemented business-like performance measurement systems (PMSs) in an effort to improve organizational efficiency and effectiveness. However, a large stream of the accounting literature has remained critical of the use of performance measures in the public sector because of the inherent difficulty in measuring output and the potential adverse effects of performance measurement. Although we acknowledge that PMSs may indeed sometimes yield adverse effects, we highlight in this study that the effects of PMSs depend on the way in which they are used.

Purpose
The aim of this study was to investigate various uses of PMSs among hospital managers and their effects on hospital outcomes, including process quality, degree of patient-oriented care, operational performance, and work culture.

Methodology
We use a survey sent to 432 Dutch hospital managers (19.2% response rate, 83 usable responses). For our main variables, we rely on previously validated constructs where possible, and we conduct ordinary least squares regressions to explore the relation between PMS use and hospital outcomes.

Results
We find that the way in which PMSs are used is associated with hospital outcomes. An exploratory use of PMS has a positive association with patient-oriented care and collective work culture. Furthermore, the operational use of PMSs is positively related to operational performance but negatively related to patient-oriented care. There is no single best PMS use that positively affects all performance dimensions.

Practice Implications
The way in which managers use PMSs is related to hospital outcomes. Therefore, hospital managers should critically reflect on how they use PMSs and whether their type of use is in line with the desired hospital outcomes.
High Frequency Electrotherapy for the Treatment of Meibomian Gland Dysfunction
Authors: Ferrari Giulio , Colucci Annalisa , Barbariga Marco , Ruggeri Alfredo , Rama Paolo 
Published: July 2019

Purpose:
To test the safety and efficacy of high frequency electrotherapy (ET) on the clinical signs and symptoms of patients affected by dry eye and meibomian gland dysfunction (MGD).

Methods:
Twenty-five patients affected by MGD were enrolled. Quantum Molecular Resonance ET was administered by means of the Rexon-Eye device 4 times, once per week for 4 weeks. Patients were reexamined 1 month after the last treatment. The primary endpoint was reduction in corneal fluorescein staining. Additional endpoints were tear break-up time, Ocular Surface Disease Index score, meibomian gland secretion score, and the number of expressible meibomian glands. Safety endpoints were Logarithm of the Minimum Angle of Resolution (LogMar) best spectacle-corrected visual acuity and intraocular pressure.

Results:
Corneal fluorescein staining improved by 62.5% (P < 0.0001), tear breakup time increased by 30.9% (P < 0.0001), and the Ocular Surface Disease Index score improved by 37% (P < 0.001). The meibum quality and the number of expressible meibomian glands also increased (35.7% and 12%, P < 0.001 and P < 0.0001, respectively). Schirmer test scores increased after treatment by 16.5% (P = 0.01). No adverse events were observed.

Conclusions:
Quantum Molecular Resonance ET appears to be safe and significantly reduces symptoms and signs associated with MGD. It may have a relevant role in the treatment of evaporative dry eye disease.
Clinical Outcome of Autologous Cultivated Oral Mucosal Epithelial Transplantation in Ocular Surface Reconstruction
Authors: Gopakumar Vidya , Agarwal Shweta , Srinivasan Bhaskar , Krishnakumar Subramanian , Krishnan Uma Maheswari , Iyer Geetha 
Published: July 2019

Purpose:
To evaluate the outcomes of autologous cultivated oral mucosal epithelial transplantation (COMET) in ocular surface reconstructive procedures.

Methods:
Twenty-five eyes of 24 patients who underwent COMET for ocular surface reconstruction were studied retrospectively from April 2011 to March 2014. Oral mucosal biopsy of 2 mm2 was harvested from all patients and cultured on amniotic membrane for 14 days. COMET was performed as a means to achieve corneal epithelization (group 1) and for fornix reconstruction (group 2). The extent of epithelization achieved (group 1) and the depth of the fornix reconstructed (group 2) were the primary outcome measures.

Results:
Six eyes of 5 patients [2 chemical injury (CI), 3 Stevens–Johnson Syndrome (SJS)] underwent COMET for nonhealing of an epithelial defect within a month after insult or had a nonhealing defect since insult despite maximal medical/surgical therapy. Group 2 included 19 eyes of 19 patients (10 CI, 8 SJS, 1 ocular cicatricial pemphigoid) which underwent COMET for fornix reconstruction. Postsurgery, the cornea was fully epithelized in 66.67% of the eyes (n = 4) and partially epithelized in 33.33% of the eyes (n = 2). The overall improvement in surface epithelization was statistically significant (P = 0.046). Reconstruction of an anatomically deep fornix was achieved in 57% of the eyes (4 CI, 6 SJS and 1 ocular cicatricial pemphigoid). The fornix was partially formed in 26% of the eyes (4 CI and 1 SJS). The overall improvement in fornix reconstruction was considered statistically significant (P = 0.024). The follow-up ranged from 1 to 5 to 27 months with a mean follow-up of 18 months SD ±8.9.

Conclusions:
COMET, by providing an alternate source of epithelium, aids in faster epithelization and thus can be considered as an option in management of severe grade CI or SJS in the acute stage as well as in fornix reconstructive procedures in chronic stage of ocular surface disorders.
Essential key messages about diagnosis, imaging, and self-care for people with low back pain: a modified Delphi study of consumer and expert opinions
Authors: French Simon D. , Nielsen Mandy , Hall Leanne , Nicolson Philippa J.A. , van Tulder Maurits , Bennell Kim L. , Hinman Rana S. , Maher Chris G. , Jull Gwendolen , Hodges Paul W. 
Published: July 2019

Abstract
People with back pain regularly search for information online; however, the quality of this online information is often poor. We established a list of the most important messages about diagnosis, imaging, and self-care for people with low back pain, based on consensus opinion and prioritised in order of importance. A list of key messages was derived from clinical practice guidelines for back pain. During 2 survey rounds, a Delphi panel of consumers with back pain and experts rated the importance of each item and suggested additional statements. Messages were retained that were rated as important by more than 70% of the panel. Retained messages were reviewed by consumer focus groups. A priority pairwise ranking activity determined the rank order of the important messages. A final online survey determined the robustness and currency of the final list of statements. The Delphi process and consumer focus groups resulted in 30 unique messages. Experts considered that the most important messages for patients are (1) remain active and (2) reassurance that back pain is a normal experience and not necessarily related to serious harm. This differed from the preferences of people with back pain who prioritised messages related to (1) identification of more serious pathology and (2) principles of management. This list of important key messages about diagnosis, imaging, and general self-care for people with back pain can be used to inform the development of education resources, including new web sites, as well as to direct clinicians in the information they provide to patients.
Cell-specific role of histone deacetylase 6 in chemotherapy-induced mechanical allodynia and loss of intraepidermal nerve fibers
Authors: Ma Jiacheng , Trinh Ronnie T. , Mahant Iteeben D. , Peng Bo , Matthias Patrick , Heijnen Cobi J. , Kavelaars Annemieke 
Published: July 2019

Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a serious adverse side effect of cancer treatment with no Food and Drug Administration-approved medication for its prevention or management. Using RNA sequencing analysis of dorsal root ganglia (DRG), we identify critical contributions of histone deacetylase 6 (HDAC6) and mitochondrial damage to the establishment of CIPN in a mouse model of cisplatin-induced neuropathy. We show that pharmacological inhibition of HDAC6 using ACY-1215 or global deletion of HDAC6 is sufficient to prevent cisplatin-induced mechanical allodynia, loss of intraepidermal nerve fibers (IENFs), and mitochondrial bioenergetic deficits in DRG neurons and peripheral nerves in male and female mice. The bioenergetic deficits in the neuronal cell bodies in the DRG are characterized by reduced oxidative phosphorylation, whereas the mitochondrial deficits in the nerves are due to a reduction in axonal mitochondrial content. Notably, deleting HDAC6 in sensory neurons protects against the cisplatin-induced loss of IENFs and the reduction in mitochondrial bioenergetics and content in the peripheral nerve. By contrast, deletion of HDAC6 in sensory neurons only partially and transiently prevents cisplatin-induced mechanical allodynia and does not protect against impairment of mitochondrial function in DRG neurons. We further reveal a critical role of T cells in the protective effects of HDAC6 inhibition on these signs of CIPN. In summary, we show that cisplatin-induced mechanical allodynia is associated with mitochondrial damage in DRG neurons, whereas the loss of IENFs is related to bioenergetic deficits in peripheral nerves. Moreover, our findings identify cell-specific contributions of HDAC6 to mechanical allodynia and loss of IENFs that characterize cisplatin-induced peripheral neuropathy.
A Multicenter Study on the Early Assessment of Functional Capacity of Patients With Brain Tumor After Surgery
Authors: Ślusarz Robert , Biercewicz Monika , Rosińczuk Joanna , Lorencowicz Regina 
Published: July 2019

ABSTRACT

BACKGROUND: Brain tumors pose a great therapeutic problem as they cause the impairment of basic vital functions and disability of various levels. The goal of this research was to describe and compare the functional capacity of patients in an early period after surgical treatment of brain tumor. METHODS: This multicenter study includes 165 patients who underwent surgical treatment of brain tumor, hospitalized on neurosurgical wards in Poland. The research was based on the assessment of patients’ functional capacity measured with the Functional Capacity Scale (FCS). The patients were examined twice: first, on the day of admission and, second, on the day of discharge. Patient FCS scores were compared with the scores obtained using the Karnofsky Performance Scale and Glasgow Outcome Scale. RESULTS: The mean FCS score was 43.72 points on the day of admission and 43.07 points on the day of discharge from hospital (P > .05). The FCS was correlated with age (r = 0.373, P < .001) and consciousness level (r = −0.418, P < .001). A high correlation (P < .001) was found between the scales used for the assessment of functional capacity (r = 0.68–0.84). CONCLUSIONS: Most patients showed independence in terms of functional capacity on the day of discharge. Significant factors influencing patient functional capacity are age and level of consciousness. The use of the FCS allows for an accurate assessment of the functional condition of a patient and correlates with the Karnofsky Performance Scale and Glasgow Outcome Scale.
Speech Perception Outcomes in Transcutaneous Versus Percutaneous Bone Conduction Stimulation in Individuals With Single-sided Deafness
Authors: Snapp Hillary A. , Morgenstein Kari E. , Kuzbyt Brianna 
Published: July 2019

Objective(s):To investigate the differences in percutaneous versus passive transcutaneous bone-conduction stimulation in individuals with single-sided deafness.Study Design:Prospective, single-subject.Setting:Tertiary academic referral center.Patients:Adult bone-anchored implant listeners with single-sided deafness using a percutaneous implant system.Interventions:Experienced percutaneous bone anchored implant recipients were tested in the percutaneous and transcutaneous conditions using a BAHA 5 (Cochlear Corp., Cochlear Bone-Anchored Solutions, Mölnlycke, Sweden) sound processor on the patient's own abutment and on a softband.Main Outcome Measures:Phoneme recognition was assessed using Consonant-Nucleus-Consonant (CNC) words for soft (47 dB SPL) and average (62 dB SPL) speech inputs. Speech perception in noise performance was also assessed for soft (47 dB SPL) and average (62 dB SPL) speech inputs using sentences presented in multi-talker babble. Aided free-field thresholds were obtained in both conditions using warble tone stimuli.Results:Compared with percutaneous bone-conduction stimulation, transcutaneous stimulation demonstrated reduced effective gain for high frequency stimulation. Transcutaneous stimulation required higher signal to noise ratios to achieve comparable performance to the percutaneous condition. Phoneme recognition was poorer in transcutaneous versus percutaneous stimulation with the most significant impact observed for soft speech inputs.Conclusion:A significant performance gap in speech recognition is observed between percutaneous and transcutaneous bone-conduction stimulation in individuals with single-sided deafness at the same signal to noise ratios. Compared with percutaneous bone-conduction stimulation, transcutaneous stimulation demonstrated reduced effective gain, decreased phoneme recognition, word recognition, and performance in noise, with the most significant impact observed for soft speech inputs.
Historic review of long-term outcomes research
Authors: Rylander Christian 
Published: July 2019

Purpose of review
This review summarizes the results from long-term intensive care outcome research over the past 50 years. Key findings from early studies are reflected in citations of contemporary research.

Recent findings
The postintensive care syndrome (PICS) is a multifaceted entity of residual disability and complications burdening survivors of critical illness. Some interventions applied early in the history of outcomes research have now been confirmed as effective in counteracting specific PICS components.

Summary
Interest in patient-centred outcomes has been present since the beginning of modern intensive care. Findings from early long-term studies remain valid even in the face of contemporary large registries that facilitate follow-up of larger cohorts. A further understanding of the mechanisms leading to experienced physical and psychological impairment of PICS will be essential to the design of future intervention trials.
Vascular malformations syndromes: an update
Authors: Martinez-Lopez Antonio , Salvador-Rodriguez Luis , Montero-Vilchez Trinidad , Molina-Leyva Alejandro , Tercedor-Sanchez Jesus , Arias-Santiago Salvador 
Published: July 2019

Purpose of review
To provide an update of vascular malformation syndromes by reviewing the most recent articles on the topic and following the new International Society for the Study of Vascular Anomalies (ISSVA) 2018 classification.

Recent findings
This review discusses the main features and diagnostic approaches of the vascular malformation syndromes, the new genetic findings and the new therapeutic strategies developed in recent months.

Summary
Some vascular malformations can be associated with other anomalies, such as tissue overgrowth. PIK3CA-related overgrowth spectrum (PROS) is a group of rare genetic disorders with asymmetric overgrowth caused by somatic mosaic mutations in PI3K-AKT-mTOR pathway that encompass a heterogeneous group of rare disorder that are associated with the appearance of overgrowth. CLOVES syndrome and Klippel–Trénaunay syndrome are PROS disease. Proteus syndrome is an overgrowth syndrome caused by a somatic activating mutation in AKT1. CLOVES, Klippel–Trénaunay and Proteus syndromes are associated with high risk of thrombosis and pulmonary embolism. Hereditary hemorrhagic telangiectasia is an autosomic dominant disorder characterized by the presence of arteriovenous malformations. New therapeutic strategies with bevacizumab and thalidomide have been employed with promising results.
Osteogenesis imperfecta: advancements in genetics and treatment
Authors: Rossi Vittoria , Lee Brendan , Marom Ronit 
Published: July 2019

Purpose of reviewThe purpose of this review is to outline the current understanding of the molecular mechanisms and natural history of osteogenesis imperfecta, and to describe the development of new treatments for this disorder.Recent findingsThe introduction of next-generation sequencing technology has led to better understanding of the genetic cause of osteogenesis imperfecta and enabled cost-effective and timely diagnosis via expanded gene panels and exome or genome sequencing. Clinically, despite genetic heterogeneity, different forms of osteogenesis imperfecta share similar features that include connective tissue and systemic manifestations in addition to bone fragility. Thus, the goals of treatment in osteogenesis imperfecta extend beyond decreasing the risk of fracture, to include the maximization of growth and mobility, and the management of extraskeletal complications. The standard of care in pediatric patients is bisphosphonates therapy. Ongoing preclinical studies in osteogenesis imperfecta mouse models and clinical studies in individuals with osteogenesis imperfecta have been instrumental in the development of new and targeted therapeutic approaches, such as sclerostin inhibition and transforming growth factor-β inhibition.SummaryOsteogenesis imperfecta is a skeletal dysplasia characterized by bone fragility and extraskeletal manifestations. Better understanding of the mechanisms of osteogenesis imperfecta will enable the development of much needed targeted therapies to improve the outcome in affected individuals.
Measuring Communication Similarity Between Hospice Nurses and Cancer Caregivers Using Latent Semantic Analysis
Authors: Kane Lauren , Clayton Margaret F. , Baucom Brian R. , Ellington Lee , Reblin Maija 
Published: July 2019

Background
Optimal end-of-life care requires effective communication between hospice nurses, caregivers, and patients, yet defining and evaluating effective communication are challenging. Latent semantic analysis (LSA) measures the degree of communication similarity (talking about the same topic) without relying on specific word choices or matching of communication behaviors (question-answer), thus more comprehensively evaluating communication interactions.

Objective
Guided by the Communication Accommodation Theory, we evaluated communication similarity, indicating theoretical convergence, between hospice nurses and caregivers of cancer patients, identifying nurse attributes and communication skills that were associated with greater communication similarity.

Methods
A descriptive secondary analysis of self-reported nurse data and 31 audio-recorded cancer patient home hospice nursing visits across 2 states and 7 hospices.

Results
The average LSA score was 0.83 (possible range, 0–1). A nurse preference for greater patient-oriented visits, use of more Nurse Partnering statements, and less Conversation Dominance (ratio of total nurse to total caregiver talk) were associated with higher LSA scores.

Conclusions
Effective communication is essential to optimal end-of-life care. Latent semantic analysis is a feasible and promising approach for assessing communication similarity during home hospice care.

Implications for Practice
Hospice nurses are at the forefront of family caregiver communication, playing a vital role in empowering caregivers to assume required patient care tasks. Communication strategies such as the use of partnering statements that increase LSA scores can be taught to hospice nurses and other members of the hospice interdisciplinary team as a way to enrich communication skills and improve communication confidence and can be translated into other oncology nursing contexts.