bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delayed Breast Reconstruction on Patients With Upper Extremity Lymphedema
Authors: Siotos Charalampos , Hassanein Aladdin H. , Bello Ricardo J. , Sebai Mohamad E. , Seal Stella M. , Manahan Michele A. , Cooney Damon S. , Cooney Carisa M. , Rosson Gedge D. 
Published: June 2018

Background
Breast cancer–related lymphedema (BCRL) is a debilitating condition with morbidity, hindered quality of life, and increased health-related costs. Experimental studies support the use of musculocutaneous flaps for managing animal models with lymphedema. Although vascularized lymph node transfer (VLNT) and lymphovenous anastomosis are used to surgically treat patients with lymphedema, it is not known whether musculocutaneous or adipocutaneous flaps (eg, delayed autologous breast reconstruction) are effective for treating refractory upper extremity BCRL. We conducted a systematic review and pooled analysis to assess the impact of delayed breast reconstruction on developed BCRL.

Methods
Following PRISMA guidelines, we systematically searched PubMed, Scopus, EMBASE, and Google Scholar databases for relevant studies published through November 11, 2016. We screened 934 unique articles. Of these, we conducted full-text and reference screening on 37 articles. We then performed a pooled and sensitivity analysis using random effects.

Results
Eight studies met our inclusion criteria. One study was a case report; 7 studies were case series with sample sizes ranging from 3 to 38 patients. According to our pooled analysis 58% of patients reported improvement after breast reconstruction with or without VLNT. Sensitivity analysis revealed that 84% (95% confidence interval, 0.74–0.95) of patients who underwent breast reconstruction and VLNT reported improvement, whereas only 22% (95% confidence interval, 0.12–0.32) of those who had breast reconstruction alone reported improvement.

Conclusions
Our review summarizes the current evidence regarding the effect of delayed breast reconstruction on established lymphedema. The VLNT component of the autologous breast reconstruction procedures may be the largest contributing factor leading to lymphedema improvement.
Osteotomy in Genioplasty by Piezosurgery
Authors: Bertossi Dario , Albanese Massimo , Nocini Riccardo , Mortellaro Carmen , Kumar Narendra , Nocini Pier Francesco 
Published: June 2018

Background:
The chin is the most prominent and median sector of the lower third of the face giving harmony to nose and lips. The authors present the application of piezoelectric scalpel for the correction of different chin deformities. The distinctive characteristics of this device allow us to avoid or reduce the immediate genioplasty complications.

Methods:
Fifty-five patients with defective chin have been treated from January 2006 to April 2008. Intraoral chinplasty was performed during the correction of dentofacial dysmorphisms or associated with nasal surgery. The authors used a piezoelectric cutting device to perform different osteotomies and if necessary, interpositional graft was used to stabilize bony segments.

Results:
Piezosurgery has been associated with a fewer number of postoperative complications, especially as regard intraoperative bleeding, nerve injuries (immediate and late), hematomas and seromas, and asymmetry (immediate and early). The mean time for completing the complete procedure of genioplasty with piezosurgery was almost the same compared with the saw and drill.

Conclusions:
Chinplasty represents one of the most common ancillary procedures and may be associated with corrective surgery of dentofacial dysmorphisms. Mental nerve injuries, asymmetries, intraoperative bleeding are the main immediate complications of genioplasty. Distinctive characteristics of ultrasonic piezoelectric osteotomy are selective cut of mineralized structure with less risk of vascular and nervous damage (microvibrations), intraoperative precision (thin cutting scalpel and no macrovibrations), blood free site (cavitation effect). In our experience, piezoelectric scalpel, compared with saw and drill, enables us to reduce or avoid immediate complications of chin surgery, helping the surgeon to reach patients’ satisfaction.

Level of Evidence:
IV.
Jugular Bulb Anatomy for Lateral Skull Base Approaches
Authors: Cömert Ela , Kiliç Caner , Cömert Ayhan 
Published: June 2018

Background:This study was designed to define the detailed anatomical relations of the jugular bulb with the facial nerve, sigmoid sinus, otic capsule, and internal acoustic canal allowing the safe management of the jugular bulb.Methods:Thirty-five formalin-perfused cadaveric temporal bones that had well mastoid and petrous pneumatization without any neurovascular variations on computed tomography scan were selected for the study. The bones were dissected via translabyrinthine approach.Results:The dome of the jugular bulb was located under the facial nerve in 21 of the cases (60%), in the mastoid cavity in 8 of the cases (22.9%), and in the tympanic cavity in 6 of the cases (17.1%). Significant difference was observed only between the temporal bones in which the dome of the jugular bulb was located in the mastoid cavity and under the facial nerve with regard to the mastoid cortex-lateral semicircular canal measurement (P = 0.04).Conclusion:Because of the high variability of the position of the dome of the jugular bulb, the precise knowledge of the relations of the jugular bulb and the preoperative radiologic verification of possible variations are essential to avoid the problems associated with its position and to decide the approach individually.
Bilateral Harvesting of a Fibula Free Flap: Assessment of Morbidity
Authors: Ferrari Silvano , Perlangeli Giuseppe , Mammi Patrizia , Varazzani Andrea , Bianchi Bernardo , Fusetti Stefano , Brevi Bruno Carlo , Ferri Andrea 
Published: June 2018

Purpose:
To investigate morbidity related to harversting of bilateral fibula free flap for head and neck reconstruction using subjective and functional tests.

Methods:
Patients were retrospectively evaluated using point evaluation system (PES) and balance evaluation systems test (BESTest) questionnaires to assess morbidity related to surgery.

Results:
Five patients were enrolled in the study. Mean PES scores was 22.2 over 24. Mean overall function assessed with BESTest was 77.6%, and the results were poorest for section I. Sections V and VI had scores of 88% and 83%, respectively, indicating that the sensory balance and gait stability of the patients were compromised only minimally.

Conclusion:
Bilateral harvesting of the fibula free flap is not associated with an increase in long-term morbidity and does not lead to significant functional impairments. Therefore, this procedure should be considered safe, and can be performed without concern regarding morbidity, when bone reconstruction with a fibula free flap is indicated.
Introducing the Rectus Fascia Scalp Augmentation Technique: A New Method for Improving Scalp Durability in Cranioplasty Reconstruction
Authors: Wolff Amir , Santiago Gabriel , Weingart Jon , Huang Judy , Gordon Chad R. 
Published: June 2018

Objective:
Patients with cranioplasty in need of skull reconstruction are at increased risk of complications when presenting with abnormally thin scalps. As such, the authors sought to develop and investigate a new technique for scalp augmentation using autologous rectus fascia grafts (ARFGs) for prevention of implant extrusion and long-term scalp durability.

Methods:
A retrospective review of our database, consisting of 450 consecutive cranial reconstructions from 2012 to 2017, was performed under institutional review board approval. Selection criteria included all adult patients requiring implant-based cranioplasty reconstruction and concomitant scalp augmentation using ARFGs. All long-term outcomes were reviewed for scalp-related complications and are presented here.

Results:
In total, 12 consecutive patients receiving ARFGs were identified. Average follow-up was 10 months (range = 2–17 months). Average graft size and dimension was 82 cm2 (range = 12–360 cm2). All patients (n = 12) underwent concomitant cranioplasty reconstruction and had a history of at least 5 or greater previous neurocranial operations. Six patients had radiation therapy prior to cranioplasty. Two major complications (2/12, 17%) were identified related to deep, recurrent intracranial infections. More importantly, none of the patients (n = 12) in this study cohort developed scalp breakdown and/or implant extrusion in the areas of rectus fascia scalp augmentation.

Conclusion:
The use of ARFGs for underlay scalp augmentation appears to be both safe and reliable based on our preliminary experience. This new approach is extremely valuable when performing large-size cranioplasty reconstruction in patients with abnormally thin scalps, an extensive neurosurgical history, and/or suboptimal tissue quality. Furthermore, this method has been successful in avoiding free tissue transfer and/or staged tissue expansion as first-line surgery in our complicated cranioplasty population.
Sphenoid Sinus Mucocele Caused by Complications After Transsphenoidal Pituitary Surgery
Authors: Lee Dong Hoon , Jang Woo Youl , Yoon Tae Mi , Lee Joon Kyoo , Jung Shin , Lim Sang Chul 
Published: June 2018

Objective:
The purpose of this study was to review the clinical characteristics, treatment methods, and surgical outcomes of sphenoid sinus mucocele after transsphenoidal pituitary surgery.

Patients and Methods:
A total of 404 patients who underwent transsphenoidal pituitary surgery between January 2010 and December 2016 were identified. Among them, 5 patients with sphenoid sinus mucocele were included in this study. In our hospital, a single-nostril endonasal endoscopic wide sphenoidotomy is routinely used for pituitary tumor surgery.

Results:
The occurrence rate of sphenoid sinus mucocele was 1.2% (5/404). Of the 5 patients, 2 were males and 3 were females. Four lesions (80.0%) were located in the right sphenoid sinus and 1 lesion (20.0%) was located in the left sphenoid sinus. Endoscopic marsupialization for sphenoid sinus mucocele was performed under local anesthesia in all patients. There were no major complications resulting from the surgical intervention, and there was no recurrence at the time of the last follow-up.

Conclusion:
Sphenoid sinus mucocele after endonasal transsphenoidal pituitary surgery is an extremely rare complication. Nasal endoscopy and MRI are useful for diagnosing this lesion. Endoscopic marsupialization is a safe and effective procedure for sphenoid sinus mucocele after endonasal transsphenoidal pituitary surgery.
Correcting the Cleft Lip Nose Deformity: The Graft Number 1 for the Columella
Authors: Monasterio Luis , Villalobos Bruno , Monasterio Luis F. 
Published: June 2018

Background:
The nose deformity associated with cleft lip is difficult to solve in the primary and secondary surgery. In an adult patient, many techniques are used including mobilization, suspension, fixation and trimming the alar cartilages, septoplasty, nasal bones osteotomies, and dorsal bone and cartilage resection. Different types of cartilage grafts are commonly used.

Methods:
A septal cartilage graft was used in 75 adult patients with mild to severe cleft lip deformities. Based on the golden ratio proportions of the columella that can be observed in the lateral view, a septal cartilage graft with a number 1 shape was created and inserted between the medial cruras in 75 patients, with unilateral or bilateral cleft lip, between 2007 and 2014. Complementary surgery was done in the nose of all the patients. A retrospective, observational, and descriptive study was made with presurgical and postsurgical photographs, throughout a 6-month follow-up period.

Results:
Excellent cosmetic and functional results were seen, especially in the lateral view. There was 1 septal perforation reported. The patients were satisfied with the aesthetic results.

Conclusion:
The graft number 1 works in the reality; it has proven to be a stable support to the affected cartilage, projects a nice nasal tip, and is a lasting solution for adults.
Relationships Between Cognitive Complaints and Quality of Life in Older Adults With Mild Cognitive Impairment, Mild Alzheimer Disease Dementia, and Normal Cognition
Authors: Stites Shana D. , Harkins Kristin , Rubright Jonathan D. , Karlawish Jason 
Published: June 2018

Purpose:
To examine in persons with varying degrees of cognitive impairment the relationship between self-reports of cognitive complaints and quality of life (QOL).

Methods:
Older adults (n=259) with normal cognition, mild cognitive impairment (MCI), and mild stage Alzheimer disease (AD) dementia completed tests of cognition and self-report questionnaires about QOL and 3 kinds of cognitive complaints: cognitive difficulties, distress from cognitive difficulties, and believing you had more memory problems than most people. Bivariate, multivariable, and multivariate regression analyses assessed relationships between domains of QOL and each cognitive complaint.

Results:
Bivariate and multivariable analyses controlling for severity of cognitive and functional impairment found that cognitive complaints were related to relatively lower quality of daily life (QOL-AD, Dementia Quality of Life Scale), greater depression (GDS), more anxiety (BAI), higher perceived stress (PSS), and lower general mental well-being (SF-12 MCS).

Discussion:
Cognitive complaints have robust associations with QOL. These findings have implications for AD prevention trials and management of clinical populations.
Alzheimer Disease Clinical Trial Recruitment
Authors: Barber Justin M. , Bardach Shoshana H. , Jicha Gregory A. 
Published: June 2018

Background:
Slow participant recruitment impedes Alzheimer disease research progress. Although research suggests that direct involvement with potential participants supports enrollment, strategies for how best to engage potential participants are still unclear.

Purpose:
This study explores whether community health fair (HF) attendees who engage in a brief cognitive screen (BCS) are more likely to enroll in research than attendees who do not complete a BCS.

Subjects:
A total of 483 HF attendees.

Methods:
Attendees were tracked for a 1-year period to ascertain research involvement.

Results:
In total, 364 attendees expressed interest in research and 126 completed a BCS. Over the follow-up period, 21 individuals prescreened as eligible and 19 enrolled in an investigational study. Among all HF attendees, BCS completers had a 2.5-fold increase in subsequently prescreening as eligible as compared with non-BCS completers. However, when limited only to participants who stated an interest in research, this difference was no longer significant.

Conclusions:
Completing a BCS at a community event may be an indicator of future research engagement, but for those already interested in participation, the BCS may be a poor indicator of future involvement. The BCS may also reduce anxiety and stigma around memory evaluation, which may translate into research engagement in the future.
MRI in multiple sclerosis: what is changing?
Authors: Filippi Massimo , Preziosa Paolo , Rocca Maria A. 
Published: June 2018

Purpose of review
To summarize recent findings from the application of MRI in the diagnostic work-up of patients with suspected multiple sclerosis (MS), and to review the insights into disease pathophysiology and the utility of MRI for monitoring treatment response.

Recent findings
New evidence from the application of MRI in patients with clinically isolated syndromes has guided the 2017 revision of the McDonald criteria for MS diagnosis, which has simplified their clinical use while preserving accuracy. Other MRI measures (e.g., cortical lesions and central vein signs) may improve diagnostic specificity, but their assessment still needs to be standardized, and their reliability confirmed. Novel MRI techniques are providing fundamental insights into the pathological substrates of the disease and are helping to give a better understanding of its clinical manifestations. Combined clinical-MRI measures of disease activity and progression, together with the use of clinically relevant MRI measures (e.g., brain atrophy) might improve treatment monitoring, but these are still not ready for the clinical setting.

Summary
Advances in MRI technology are improving the diagnostic work-up and monitoring of MS, even in the earliest phases of the disease, and are providing MRI measures that are more specific and sensitive to disease pathological substrates.
Update on amino acid PET of brain tumours
Authors: Langen Karl-Josef , Galldiks Norbert 
Published: June 2018

Purpose of review
The aim of this study was to give an update on the emerging role of PET using radiolabelled amino acids in the diagnostic workup and management of patients with cerebral gliomas and brain metastases.

Recent findings
Numerous studies have demonstrated the potential of PET using radiolabelled amino acids for differential diagnosis of brain tumours, delineation of tumour extent for treatment planning and biopsy guidance, differentiation between tumour progression and recurrence versus treatment-related changes, and for monitoring of therapy. The Response Assessment in Neuro-Oncology (RANO) working group – an international effort to develop new standardized response criteria for clinical trials in brain tumours – has recently recommended the use of amino acid PET imaging for brain tumour management in addition to MRI at every stage of disease. With the introduction of F-18 labelled amino acids, a broader clinical application has become possible, but is still hampered by the lack of regulatory approval and of reimbursement in many countries.

Summary
PET using radiolabelled amino acids is a rapidly evolving method that can significantly enhance the diagnostic value of MRI in brain tumours. Current developments suggest that this imaging technique will become an indispensable tool in neuro-oncological centres in the near future.
Evolutionary trade-offs between unicellularity and multicellularity in budding yeast
Authors: Kuzdzal-Fick Jennie J. , Chen Lin , Balázsi Gábor 
Published: June 2018

ABSTRACTMulticellular organisms appeared on Earth through several independent major evolutionary transitions. Are such transitions reversible? Addressing this fundamental question entails understanding the benefits and costs of multicellularity versus unicellularity. For example, some wild yeast strains form multicellular clumps, which might be beneficial in stressful conditions, but this has been untested. Here we show that unicellular yeast evolves from clump-forming ancestors by propagating samples from suspension after larger clumps have settled. Unicellular yeast strains differed from their clumping ancestors mainly by mutations in theAMN1(Antagonist of Mitotic exit Network) gene. Ancestral yeast clumps were more resistant to freeze/thaw, hydrogen peroxide, and ethanol stressors than their unicellular counterparts, while unicellularity was advantageous without stress. These findings inform mathematical models, jointly suggesting a trade-off between the benefits and downsides of multicellularity, causing bet-hedging by regulated phenotype switching as a survival strategy in unexpected stress.
Bats adjust temporal features of echolocation calls but not those of communication calls in response to traffic noise
Authors: Song Shengjing , Lin Aiqing , Jiang Tinglei , Zhao Xin , Metzner Walter , Feng Jiang 
Published: June 2018

Summary statementThis study reveals the impact of anthropogenic noise on spectrally distinct vocalizations and the limitations of the acoustic masking hypothesis to explain the vocal response of bats to chronic noise.AbstractThe acoustic masking hypothesis states that auditory masking may occur if the target sound and interfering sounds overlap spectrally, and it suggests that animals exposed to noise will modify their acoustic signals to increase signal detectability. However, it is unclear if animals will put more effort into changing their signals that spectrally overlap more with the interfering sounds than when the signals overlap less. We examined the dynamic changes in the temporal features of echolocation and communication vocalizations of the Asian particolored bat (Vespertilio sinensis) when exposed to traffic noise. We hypothesized that traffic noise has a greater impact on communication vocalizations than on echolocation vocalizations and predicted that communication vocalization change would be greater than echolocation. The bats started to adjust echolocation vocalizations on the fourth day of noise exposure, including an increased number of call sequences, decreased number of calls, and vocal rate within a call sequence. However, there was little change in the duration of the call sequence. In contrast, these communication vocalization features were not significantly adjusted under noise conditions. These findings suggest that the degree of spectral overlap between noise and animal acoustic signals does not predict the level of temporal vocal response to the noise.
Auditory attention reduced ear-canal noise in humans, but not through medial olivocochlear efferent inhibition: Implications for measuring otoacoustic emissions during behavioral task performance
Authors: Francis Nikolas A. , Zhao Wei , Guinan John J. 
Published: June 2018

AbstractOtoacoustic emissions (OAEs) are often measured to non-invasively determine activation of medial olivocochlear (MOC) efferents in humans. Usually these experiments assume that ear-canal noise remains constant. However, changes in ear-canal noise have been reported in some behavioral experiments. We studied the variability of ear-canal noise in eight subjects who performed a two-interval-forced-choice (2IFC) sound-level-discrimination task on monaural tone pips in masking noise. Ear-canal noise was recorded directly from the unstimulated ear opposite the task ear. Recordings were also done with similar sounds presented, but no task done. In task trials, ear-canal noise was reduced at the time the subject did the discrimination, relative to the noise level earlier in the trial. In two subjects, there was a decrease in ear-canal noise, primarily at 1-2 kHz, with a time course similar to that expected from inhibition by MOC activity elicited by the task-ear masker noise. These were the only subjects with spontaneous OAEs (SOAEs). We hypothesize that the SOAEs were inhibited by MOC activity elicited by the task-ear masker. Based on the standard rationale in OAE experiments that large bursts of noise are artifacts due to subject movement, noise bursts above a sound-level criterion were removed. As the criterion was lowered and more high-and moderate-level noise bursts were removed, the reduction in noise level from the beginning of the trial to the time of the 2IFC discrimination became less. This pattern is opposite that expected from MOC inhibition (which is greater on lower-level sounds), but can be explained by the hypothesis that subjects move less and create fewer bursts of noise when they concentrate on doing the task. In contrast, for the six subjects with no SOAEs, in no-task trials the noise level was little changed throughout the trial. Our results show that measurements of MOC effects on OAEs must measure and account for changes in ear-canal noise, especially in behavioral experiments. The results also provide a novel way of showing the time course of the buildup of attention in ear-canal noise during a 2IFC task.
Bulk Tissue Cell Type Deconvolution with Multi-Subject Single-Cell Expression Reference
Authors: Wang Xuran , Park Jihwan , Susztak Katalin , Zhang Nancy R. , Li Mingyao 
Published: June 2018

AbstractWe present MuSiC, a method that utilizes cell-type specific gene expression from single-cell RNA sequencing (RNA-seq) data to characterize cell type compositions from bulk RNA-seq data in complex tissues. When applied to pancreatic islet and whole kidney expression data in human, mouse, and rats, MuSiC outperformed existing methods, especially for tissues with closely related cell types. MuSiC enables characterization of cellular heterogeneity of complex tissues for identification of disease mechanisms.