bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complications and Costs of Peripherally Inserted Central Venous Catheters Compared With Implantable Port Catheters for Cancer Patients
Authors: Pu Ya-Lou , Li Zhuang-Shuang , Zhi Xiao-Xu , Shi Yi-An , Meng Ai-Feng , Cheng Fang , Ali Ali , Li Cheng , Fang Hong , Wang Cheng 
Published: August 2019

Background
Peripherally inserted central catheters (PICCs) and implantable port catheters (IPCs) are 2 most common central venous access for cancer patients receiving chemotherapy. However, no specific evidence exists to guide practitioners on safety and less cost.

Objective
To compare the differences of complications and costs of PICC and IPC in the treatment of cancer patients with chemotherapy and to provide a basis for better clinical decision making.

Methods
All the cohort studies were searched in the Cochrane Library, JBI, PubMed, Elsevier, Web of Science, CINAHL, CBM, and CNKI from inception to July 2018. Two reviewers screened and selected trials, evaluated quality, and extracted data. Meta-analysis and description of the outcomes were performed by using the RevMan 5.3 software.

Results
A total of 761 articles were retrieved, with 15 articles meeting eligibility criteria. Outcome analysis showed no difference in 1-puncture success rate. Peripherally inserted central catheter use was associated with higher complication rates than IPC, including occlusion, infection, malposition, catheter-related thrombosis, extravasation, phlebitis, and accidental removal rate. The life span of IPC was longer than that of PICC, and the costs of IPC were lower.

Conclusions
Implantable port catheter has advantages over PICC in reducing cancer patients’ complications and less cost in terms of long-term cancer chemotherapy.

Implications for Practice
In terms of safety, the results provide evidence for practitioners to choose which type of central venous catheters is better for cancer chemotherapy patients. In terms of costs, practitioners need to make decisions about which type of central venous catheters has less cost.
How Important Are Parental Age and Educational Level in Nonurgent Admissions to the Pediatric Emergency Department?
Authors: Kurt Funda , Beğde Firat , Oğuz Sinan , Tekin Deniz , Suskan Emine 
Published: August 2019

Objective
The aims of the present study were to investigate the reasons parents prefer the pediatric emergency department for nonurgent admissions and to evaluate the effect of parental age and educational level on nonurgent admissions and the relationship between the reasons for nonurgent admissions and child age.

Methods
We conducted a cross-sectional survey at an emergency department of a tertiary care pediatric referral center. A questionnaire that was prepared to understand the reasons underlying nonurgent admissions was administered to the parents of 1033 children who were classified as nonurgent cases using the Pediatric Canadian Triage and Acuity Scale (4–5).

Results
The most common reasons for nonurgent admissions were the concern for progression in child's complaints, the complaints with an onset outside working hours, and the parental perception that more cautious and better care is provided in the emergency department. The most urgent complaints from the parental perspective included fever (23.1%), vomiting (11.0%), and diarrhea (10.5%), respectively. The mean age of the mothers was 31.1 ± 5.9 years (17–51 years), and the mean age of the fathers was 34.94 ± 6.1 years (20–60 years). Parents younger than 30 years were more likely to prefer the emergency department due to convenience and economic reasons. Nonurgent admissions due to confidence in the emergency department were more frequent among parents who were primary school graduate.

Conclusions
It is critically important to examine why parents prefer the emergency department for nonurgent conditions of their children and to develop solution offers in this regard. The improvements to be made in the emergency department would both prioritize patients requiring urgent care and increase the productivity of emergency department staff.
Relationship Between Obesity and Balance in the Community-Dwelling Elderly Population
Authors: Lee Jae Joon , Hong Dong Whan , Lee Seung Ah , Soh Yunsoo , Yang Miryeong , Choi Kwang Min , Won Chang Won , Chon Jinmann 
Published: August 2019

Introduction
Although there are similar characteristics between obese individuals and fall-susceptible population, little is known about relationships between body weight and risk factors for fall, particularly in the elderly population. The aim of this study was to determine whether body mass index–based obesity is associated with decreased balance and whether instability has relationships with the main risk factors for falls.

Methods
A total of 317 participants were categorized based on their body mass index. Clinical balance assessments were performed using the Berg Balance Scale, Timed Up and Go test, and Short Physical Performance Battery. The knee extensor strength of each individual was measured using a dynamometer. Total sway distance was calculated on InBody posturography in four conditions.

Results
The results of three clinical balance assessment tools showed significant correlation with body mass index. The obese group showed decreased isokinetic knee extensor muscle strength and had a higher total sway distance than the normal weight group.

Conclusions
The elderly population with obesity exhibits poor balance performing ability, and it is associated with the decreased strength of the lower limbs and impaired postural stability. The logistic regression analysis of our study showed that body mass index–based obesity can be regarded as a fall risk.
Effects of Adding a Neurodynamic Mobilization to Motor Control Training in Patients With Lumbar Radiculopathy Due to Disc Herniation
Authors: Plaza-Manzano Gustavo , Cancela-Cilleruelo Ignacio , Fernández-de-las-Peñas César , Cleland Joshua A. , Arias-Buría José L. , Thoomes-de-Graaf Marloes , Ortega-Santiago Ricardo 
Published: August 2019

Objective
The aim of the study was to investigate the effects of the inclusion of neural mobilization into a motor control exercise program on pain, related disability, neuropathic symptoms, straight leg raise, and pressure pain threshold in lumbar radiculopathy.

Design
This is a randomized clinical trial.

Methods
Individuals with low back pain, with confirmed disc herniation, and lumbar radiculopathy were randomly assigned to receive eight sessions of either neurodynamic mobilization plus motor control exercises (n = 16) or motor control exercises alone (n = 16). Outcomes included pain, disability, neuropathic symptoms, straight leg raise, and pressure pain threshold at baseline, after four visits, after eight visits, and after 2 mos.

Results
There were no between-groups differences for pain, related disability, or pressure pain threshold at any follow-up period because both groups get similar and large improvements. Patients assigned to the neurodynamic program group experienced better improvements in neuropathic symptoms and the straight leg raise compared with the motor control exercise group (P < 0.01).

Conclusions
The addition of neurodynamic mobilization to a motor control exercise program leads to reductions in neuropathic symptoms and mechanical sensitivity (straight leg raise) but did not result in greater changes of pain, related disability, or pressure pain threshold over motor control exercises program alone in subjects with lumbar radiculopathy. Future trials are needed to further confirm these findings because between-groups differences did not reach clinically relevance.
Upper Extremity Axon Counts and Clinical Implications for Motor Nerve Transfer
Authors: Cheah Andre , Lee Ellen Y. , Lim Aymeric Y. T. 
Published: August 2019

Background:
Nerve transfers are planned based on the following parameters: location, number of branches, and axon count matching of the donor and recipient nerves. The authors have previously defined the former two in upper limb muscles. In the literature, axon counts are obtained from various sources, using different methods of histomorphometry. This study describes the axon counts of the same primary motor nerve branches from the authors’ previous study using a uniform method of manual histomorphometry and completes the authors’ blueprint of upper limb neuromuscular anatomy for reconstructive surgery.

Methods:
The distal ends of the primary nerve branches of 23 upper limb muscles were harvested from 10 fresh frozen cadaveric upper limbs. Manual quantitative histomorphometry was performed by two independent investigators, and the average was reported.

Results:
The primary nerve branches of the arm muscles had higher average axon counts (range, 882 to 1835) compared with those of the forearm muscles (range, 267 to 883). In the forearm, wrist flexor (range, 659 to 746) and extensor (range, 543 to 745) nerve branches had axons counts that were similar to those of potential donors (e.g., supinator, n = 602; pronator teres, n = 625; flexor digitorum superficialis, n = 883; and flexor digitorum profundus, n = 832).

Conclusions:
Apart from describing the axon counts of the upper limb, the authors have found that the forearm axon counts are very comparable. This insight, when combined with information on the location and number of primary nerve branches, will empower surgeons to tailor bespoke nerve transfers for every clinical situation.
Composite Buttock Augmentation: The Next Frontier in Gluteal Aesthetic Surgery
Authors: Aslani Alex , Del Vecchio Daniel A. 
Published: August 2019

Background:
Despite rapid growth, gluteal fat transplantation has a dismal safety record and often results in inadequate domal projection. Implants alone for gluteal augmentation have also been reported to be less than ideal, with significant complication rates. The idea of combining both implants and fat, as has been described in the breast, was therefore applied to surgery of the buttocks.

Methods:
One hundred forty-seven consecutive cases of buttock augmentation were reviewed. Average follow-up was 18 months. The technique of composite buttock augmentation used progressive instrument dissection to precisely define the correct intramuscular plane of the implant pocket with a minimum amount of pocket access dissection.

Results:
Operating times averaged 1 hour 55 minutes. The average volume of fat inserted was 380 cc. The average implant volume was 300 cc. Complications included implant displacements and implant pocket infections requiring surgical intervention. There were no cases of pulmonary thromboembolism, fat embolism, or death.

Conclusions:
Taking a lesson from composite breast augmentation, composite buttock augmentation is a new method for gluteal reshaping that seeks to use the best of both worlds: the reliable core projection of an implant combined with the natural appearance and feel of fat. Progressive instrument dissection seeks to minimize unnecessary dissection and to accurately and safely define the intramuscular pocket. The intramuscular placement of implants instead of fat should eliminate the risk of fatal fat pulmonary embolism in these patients.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Clockwise Rotation of the Occlusal Plane for Aesthetic Purposes by Double Jaw Surgery without Orthodontic Treatment
Authors: Lee Tae Sung , Park Sanghoon 
Published: August 2019

Summary:
The occlusal plane angle is an important factor in lateral facial aesthetics. Low occlusal plane facial profiles appear planar and long-faced, whereas high occlusal plane facial profiles are considered more attractive, especially in Asian regions. Clockwise rotation of the occlusal plane for truly aesthetic purposes can be accomplished with double jaw surgery, without need for orthodontic treatments. Patients with normal occlusion who desired to improve their lateral facial aesthetics were included in this study. A conventional Le Fort I osteotomy was followed by a sagittal split ramus osteotomy under general anesthesia. The movement of the maxillomandibular complex was determined in accord with a preoperative analysis. From 2015 to 2017, 43 patients with normal occlusion underwent double jaw surgery without orthodontic treatment. Whereas all patients were subjectively satisfied with the surgery, two underwent orthodontic treatment to correct mild occlusal discrepancies noticed after surgery. There were no delayed occlusal problems or relapses reported during the study. For patients who desired to improve their lateral facial aesthetics but had normal occlusion, orthognathic surgery without orthodontic treatment can be effective. Clockwise rotation of the occlusal plane by double jaw surgery without orthodontic treatment resulted in satisfactory aesthetic outcomes with stable and reliable long-term results.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Non-Midline Frontal Encephalocele Presenting as Disappearing Dermoid
Authors: Khavanin Nima , Steinberg Jordan P. 
Published: August 2019

Abstract
Congenital masses in the lateral brow are most commonly dermoid cysts and can often be excised surgically without additional investigation. These dermoids may rarely develop intracranial extension due to underlying bony erosions and become less prominent over time – a “disappearing dermoid.” However, the authors present an unusual alternative case in which an off-midline frontal encephalocele initially presented as a firm irreducible mass but exhibited changing characteristics over time.
Pituitary Stalk Interruption Syndrome
Authors: Xu Chuanna , Wang Tiejun , Feng Yan 
Published: August 2019

Abstract
Pituitary stalk interruption syndrome is a congenital disease with isolated growth hormone deficiency or multiple anterior pituitary hormone deficiencies. Here, the authors report a 22-year-old female presenting with growth retardation for 13 years. Growth hormone replacement therapy was performed when the patient was young, so her height improved. Besides, she had no secondary sexual characteristics development.
Oculo-Auriculo-Fronto-Nasal Syndrome With Duane Retraction Syndrome and Dysplastic Bony Structure in the Midline of Nose
Authors: Ito Riri , Osawa Masayuki , Yamamoto Yuhei , Murao Naoki , Hayashi Toshihiko , Maeda Taku , Ishikawa Kosuke , Oyama Akihiko , Funayama Emi 
Published: August 2019

Abstract
Oculo-auriculo-fronto-nasal syndrome (OAFNS) is a rare anomaly characterized by features overlapping those of frontonasal dysplasia (FND) and the oculo-auriculo-vertebral spectrum (OAVS).
1
The FND features malformation of frontonasal process-derived structures, characterized by anomalies in the central portion of the face. The OAVS is characterized by developmental anomalies of the first and second pharyngeal arches. The OAFNS is a condition with clinical features of both FND and OAVS.
Here, the authors present the case of a male with OAFNS who not only exhibited typical OAFNS symptoms but also a dysplastic bony structure that bridged the anterior nasal spine and inferior nasal bones, and unilateral type 3 Duane retraction syndrome (absence of right-eye abduction). Abnormal nasal bones are characteristic of OAFNS; such abnormalities are absent from FND and OAVS. The authors reduced the dysplastic nasal bony structure via open external rhinoplasty, followed by lateral nasal osteotomy when he was 16 years of age. The nasal dorsum appeared natural after surgery and he was satisfied with the result.
Elderly adults with isolated hip fractures- orthogeriatric care versus standard care: A practice management guideline from the Eastern Association for the Surgery of Trauma
Authors: Mukherjee Kaushik , Brooks Steven E. , Barraco Robert D. , Como John J. , Hwang Franchesca , Robinson Bryce R. H. , Crandall Marie L. 
Published: August 2019

BACKGROUND
Elderly patients commonly suffer isolated hip fractures, causing significant morbidity and mortality. The use of orthogeriatrics (OG) management services, in which geriatric specialists primarily manage or co-manage patients after admission, may improve outcomes. We sought to provide recommendations regarding the role of OG services.

METHODS
Using GRADE methodology with meta-analyses, the Practice Management Guidelines Committee of the Eastern Association for the Surgery of Trauma conducted a systematic review of the literature from January 1, 1900, to August 31, 2017. A single Population, Intervention, Comparator and Outcome (PICO) question was generated with multiple outcomes: Should geriatric trauma patients 65 years or older with isolated hip fracture receive routine OG management, compared with no-routine OG management, to decrease mortality, improve discharge disposition, improve functional outcomes, decrease in-hospital medical complications, and decrease hospital length of stay?

RESULTS
Forty-five articles were evaluated. Six randomized controlled trials and seven retrospective case-control studies met the criteria for quantitative analysis. For critical outcomes, retrospective case-control studies demonstrated a 30-day mortality benefit with OG (OR, 0.78 [0.67, 0.90]), but this was not demonstrated prospectively or at 1 year. Functional outcomes were superior with OG, specifically improved score on the Short Physical Performance Battery at 4 months (mean difference [MD], 0.78 [0.28, 1.29]), and improved score on the Mini Mental Status Examination with OG at 12 months (MD, 1.57 [0.40, 2.73]). Execution of activities of daily living was improved with OG as measured by two separate tests at 4 and 12 months. There was no difference in discharge disposition. Among important outcomes, the OG group had fewer hospital-acquired pressure ulcers (OR, 0.30 [0.15, 0.60]). There was no difference in other complications or length of stay. Overall quality of evidence was low.

CONCLUSION
In geriatric patients with isolated hip fracture, we conditionally recommend an OG care model to improve patient outcomes.

LEVEL OF EVIDENCE
Systematic review/meta-analysis, level III.
Safety profile and impact of low-titer group O whole blood for emergency use in trauma
Authors: Williams James , Merutka Nicholas , Meyer David , Bai Yu , Prater Samuel , Cabrera Rodolfo , Holcomb John B. , Wade Charles E. , Love Joseph D. , Cotton Bryan A. 
Published: August 2019

PURPOSE
Following US military implementation of a cold-stored whole blood program, several US trauma centers have begun incorporating uncrossmatched, group O cold-stored whole blood into civilian trauma resuscitation. We set out to evaluate the safety profile, transfusion reactions events, and impact of low-titer group O whole blood (LTO-WB) at our center.

METHODS
In November 2017, we added LTO-WB to each of our helicopters and to our emergency department (ED) refrigerator, alongside that of existing red blood cells and plasma. We collected information on all patients with trauma receiving prehospital or ED transfusion of uncrossed, emergency release blood products between November 2017 and June 2018. Patients were divided into those receiving any LTO-WB and those receiving only red blood cell and or plasma (COMP). Serial hemolysis panels were obtained at 3 hours, 24 hours, and 48 hours. All data were run using STATA 12.1. Statistical significance was set at p < 0.05.

RESULTS
One hundred ninety-eight patients received LTO-WB and 152 patients received COMP. There were no differences in age, sex, or mechanism. The LTO-WB patients had higher chest Abbreviated Injury Scale scores (median, 3 vs. 2; p = 0.027), as well as worse arrival base excess (median, −7 vs. −5; p = 0.014) and lactate (5.1 vs. 3.5; p < 0.001). The LTO-WB patients received less post-ED blood products than the COMP patients (median, 0 vs. 3; p = 0.001). There was no difference in survival (LTO-WB, 73%; COMP, 74%; p = 0.805). There were only two suspected transfusion reactions, both in the COMP group (p = 0.061). There was no difference in hemolysis panel values. Controlling for age, severity of injury, and prehospital physiology, LTO-WB was associated with a 53% reduction in post-ED blood product transfusion (odds ratio, 0.47; 0.23–0.94 95% CI; p = 0.033) and two-fold increase in likelihood of survival (odds ratio, 2.19; 1.01–4.76 95% CI; p = 0.047).

CONCLUSION
Low-titer group O whole blood has similar evidence of laboratory hemolysis, similar transfusion reaction rates, and is associated with a reduction in post-ED transfusions and increase likelihood of survival.

LEVEL OF EVIDENCE
Therapeutic, Level II.
Depressive Symptom Dimensions in Treatment-Resistant Major Depression and Their Modulation With Electroconvulsive Therapy
Authors: Wade Benjamin S.C. , Hellemann Gerhard , Espinoza Randall T. , Woods Roger P. , Joshi Shantanu H. , Redlich Ronny , Jørgensen Anders , Abbott Christopher C. , Oedegaard Ketil J. , McClintock Shawn M. , Oltedal Leif , Narr Katherine L. 
Published: August 2019

ObjectiveSymptom heterogeneity in major depressive disorder obscures diagnostic and treatment-responsive biomarker identification. Whether symptom constellations are differentially changed by electroconvulsive therapy (ECT) remains unknown. We investigate the clustering of depressive symptoms over the ECT index and whether ECT differentially influences symptom clusters.MethodsThe 17-item Hamilton Depression Rating Scale (HDRS-17) was collected from 111 patients with current depressive episode before and after ECT from 4 independent participating sites of the Global ECT-MRI Research Collaboration. Exploratory factor analysis of HDRS-17 items pre- and post-ECT treatment identified depressive symptom dimensions before and after ECT. A 2-way analysis of covariance was used to determine whether baseline symptom clusters were differentially changed by ECT between treatment remitters (defined as patients with posttreatment HDRS-17 total score ≤8) and nonremitters while controlling for pulse width, titration method, concurrent antidepressant treatment, use of benzodiazepine, and demographic variables.ResultsA 3-factor solution grouped pretreatment HDRS-17 items into core mood/anhedonia, somatic, and insomnia dimensions. A 2-factor solution best described the symptoms at posttreatment despite poorer separation of items. Among remitters, core mood/anhedonia symptoms were significantly more reduced than somatic and insomnia dimensions. No differences in symptom dimension trajectories were observed among nonremitting patients.ConclusionsElectroconvulsive therapy targets the underlying source of depressive symptomatology and may confer differential degrees of improvement in certain core depressive symptoms. Our findings of differential trajectories of symptom clusters over the ECT index might help related predictive biomarker studies to refine their approaches by identifying predictors of change along each latent symptom dimension.
The Neural Basis of Predictive Pursuit
Authors: Yoo Seng Bum Michael , Tu Jiaxin Cindy , Piantadosi Steven T. , Hayden Benjamin Yost 
Published: August 2019

ABSTRACTIt remains unclear how and to what extent non-human animals make demanding on-the-fly predictions during pursuit. We studied this problem in a novel laboratory pursuit task that incentivizes prediction of future prey positions. We trained three macaques to perform joystick-controlled pursuit of prey that followed intelligent escape algorithms. Subjects reliably aimed towards the prey’s likely future positions, indicating that they generate internal predictions and use those predictions to guide behavior. We then developed a generative model that explains real-time pursuit trajectories and showed that our subjects use prey position, velocity, and acceleration to make predictions. We identified neurons in the dorsal anterior cingulate cortex (dACC) whose responses track these three variables. These neurons multiplexed prediction-related variables with a distinct and explicit representation of the prey’s future position. Our results provide a clear demonstration that the brain can explicitly represent future predictions and highlight the critical role of anterior cingulate cortex for future-oriented cognition.One-sentence summaryIn a dynamic pursuit environment, monkeys actively predict future prey positions and dACC neurons encode these future positions.