bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Randomized, Controlled Pilot Trial Comparing Platelet-Rich Plasma to Topical Minoxidil Foam for Treatment of Androgenic Alopecia in Women
Authors: Bruce Alison J. , Pincelli Thais P. , Heckman Michael G. , Desmond Cheryl M. , Arthurs Jennifer R. , Diehl Nancy N. , Douglass Erika J. , Bruce Charles J. , Shapiro Shane A. 
Published: October 2019

BACKGROUNDAndrogenic alopecia (AGA) is a common hair loss disorder. Studies have demonstrated successful treatment with platelet-rich plasma (PRP) in men, but studies in women are few.OBJECTIVETo evaluate PRP in the treatment of AGA in women, compared with topical minoxidil.MATERIALS AND METHODSTwenty women with AGA received topical minoxidil for 12 weeks and injectable PRP for 12 weeks in a randomized crossover design with an 8-week washout between treatments. Standardized TrichoScan analysis and quality-of-life questionnaires were assessed at baseline and 12-week follow-up for each treatment.RESULTSAfter PRP, significant increases from baseline to Week 12 in TrichoScan analysis hair count (p= .002) and vellus hair density (p= .009) occurred. However, minoxidil resulted in significant increases in hair count (p< .001), vellus hair density (p= .03), terminal hair density (p= .004), and cumulative thickness (p= .004). Several quality of life responses improved from baseline to Week 12 after PRP treatment, whereas no improvements were noted after minoxidil.CONCLUSIONPlatelet-rich plasma is an effective treatment for hair regrowth in female AGA, although not as effective as minoxidil. However, the improved quality of life responses after PRP, but not minoxidil, suggest a potential overall greater degree of satisfaction with PRP.LEVELS OF EVIDENCEI.CLINICAL TRIAL REGISTRATIONNCT03488108.
Patterns and Variability of Endocrine-disrupting Chemicals During Pregnancy
Authors: Buck Louis Germaine M. , Yeung Edwina , Kannan Kurunthachalam , Maisog Joseph , Zhang Cuilin , Grantz Katherine L. , Sundaram Rajeshwari 
Published: October 2019

Background:
The exposome is a novel research paradigm offering promise for understanding the complexity of human exposures, including endocrine-disrupting chemicals (EDCs) and pregnancy outcomes. The physiologically active state of pregnancy requires understanding temporal changes in EDCs to better inform the application of the exposome research paradigm and serve as the impetus for study.

Methods:
We randomly selected 50 healthy pregnant women with uncomplicated pregnancies from a pregnancy cohort who had available serum/urine samples in each trimester for measuring 144 persistent and 48 nonpersistent EDCs. We used unsupervised machine-learning techniques capable of handling hierarchical clustering of exposures to identify EDC patterns across pregnancy, and linear mixed-effects modeling with false-discovery rate correction to identify those that change over pregnancy trimesters. We estimated the percent variation in chemical concentrations accounted for by time (pregnancy trimester) using Akaike Information Criterion–based R
2 methods.

Results:
Four chemical clusters comprising 80 compounds, of which six consistently increased, 63 consistently decreased, and 11 reflected inconsistent patterns over pregnancy. Overall, concentrations tended to decrease over pregnancy for persistent EDCs; a reverse pattern was seen for many nonpersistent chemicals. Explained variance was highest for five persistent chemicals: polybrominated diphenyl ethers #191 (51%) and #126 (47%), hexachlorobenzene (46%), p,p’-dichloro-diphenyl-dichloroethylene (46%), and o,p’-dichloro-diphenyl-dichloroethane (36%).

Conclusions:
Concentrations of many EDCs are not stable across pregnancy and reflect varying patterns depending on their persistency underscoring the importance of timed biospecimen collection. Analytic techniques are available for assessing temporal patterns of EDCs during pregnancy apart from physiologic changes.
Acellular Dermal Matrix Performance Compared with Latissimus Dorsi Myocutaneous Flap in Expander-Based Breast Reconstruction
Authors: Patrinely James Randall , Farinas Angel , Al-Majed Bader , Forte Antonio Jorge , TerKonda Sarvam , Perdikis Galen 
Published: October 2019

Background:
Latissimus dorsi myocutaneous flap (LDMF) with tissue expander provides excellent results in breast reconstruction. Acellular dermal matrix (ADM) has been used in expander-based reconstruction (EBR) with good results. This study assesses how ADM compares to LDMF in EBR.

Methods:
The cohorts comprised 124 patients (218 breasts) who had EBR using ADM between 2006 and 2012, and 242 patients (266 breasts) who had EBR using LDMF between 1994 and 2012. Postoperative complications, reoperations, Breast-Q scores, and objectively assessed aesthetic outcomes were compared.

Results:
Median age was 55 years for both ADM (range 23–84) and LDMF (range 26–88) groups. No statistically significant differences were noted between the groups in the rates of major postoperative complications (P > 0.3). Forty-nine of the 218 (22.5%) in the ADM group and 67 of 266 (25.2%) in the LDMF group had a total of 63 and 84 reoperations, respectively (P = 0.52), with no significant differences in the reoperations rate (P > 0.3). No significant differences were observed in the Breast-Q scores. Some categorical differences were noted in the aesthetic outcomes; however, the difference between the overall outcomes was not significant (P = 0.54).

Conclusion:
Our study revealed no statistically significant differences in the complications or reoperation rates, patient satisfaction, or overall aesthetic outcomes when comparing the use of ADM to LDMF in EBR. In conclusion, this study supports the hypothesis that ADM performs as well as LDMF in EBR.
Eyebrow Height Changes with Aging: A Systematic Review and Meta-analysis
Authors: Asaad Malke , Kelarji Ahmad Beshr , Jawhar Cham Shaban , Banuelos Joseph , Taslakian Editt , Wahood Waseem , Vyas Krishna S. , Sharaf Basel 
Published: October 2019

Background:
The eyebrows play an important role in emotional facial expressions, nonverbal communication, and facial esthetics. A comprehensive understanding of the mechanisms underlying eyebrow aging is vital in allowing plastic surgeons to appropriately address these age-related changes and to recreate an aesthetically desirable outcome for patients seeking brow rejuvenation. The aim of this study is to summarize the current literature on eyebrow height changes with aging.

Methods:
A comprehensive search was conducted across several databases to identify all published studies that reported changes of eyebrow position or height with aging, from 1946 to January 2019. Studies that reported eyebrow position at the level of medial canthus, mid-pupil, and lateral canthus were included in a meta-analysis.

Results:
A total of 346 articles were initially identified, of which 19 met our inclusion criteria. Of 3,634 patients who were identified, 2,237 (64%) were females and 1,274 (36%) were males. Eyebrow height showed significant increase with aging at the level of medial canthus (mean difference 1.4 mm; 95% CI: 0.22–2.59; P = 0.02), and the level of mid-pupil (mean difference 1.17 mm; 95% CI: 0.54–1.8; P = 0.0002). However, no significant difference was found at the level of lateral canthus (mean difference 0.19 mm; 95% CI: −0.87 to 1.25; P = 0.72).

Conclusions:
Based on the reviewed literature to date, the medial eyebrow height increases with age, whereas it remains stable at the level of the lateral canthus. These results should be considered when considering eyebrow rejuvenation.
Nasal Skin Thickness Measurements Using Computed Tomography in an Adult Saudi Population
Authors: Jomah Jamal , Elsafi Rawan Adel , Ali Khaled Salah Abdel Elaleem , Abdullah Reem , Gelidan Adnan Ghazi 
Published: October 2019

Background:
Rhinoplasty is one of the most challenging operations in plastic surgery, and nasal skin thickness is a significant factor in determining rhinoplasty success. Only a few studies have measured nasal skin thickness before rhinoplasty. The present study was designed to measure nasal skin thickness to shed light on its importance to successful rhinoplasty.

Methods:
Altogether, 60 patients underwent measurements of nasal skin thickness at 4 aesthetic points: nasion, rhinion, nasal tip, columella. The thickness was measured using computed tomography (CT), an objective, reliable tool for this purpose. Universally adopted Hounsfield unit measurement using in house software (Consultant Radiology Center, Riyadh, Saudi Arabia) was performed using CT scan.

Results:
The study group included 32 women and 28 men. Age range was 18–68 years, but most of the patients (53.3%) were within the 20–30-year age range. CT results showed that the mean nasal skin thickness was 3.96 ± 1.08 mm at the nasion, 1.86 ± 0.62 mm at the rhinion, 3.32 ± 0.78 mm at the nasal tip, and 3.32 ± 0.73 mm at the columella. When the nasal skin thicknesses were compared between men and women, a significant difference was observed only at the columella (P = 0.016).

Conclusions:
The nasal skin is thickest at the nasion, thinner at the rhinion, and again thicker at the nasal tip and columella. Our data could be useful for plastic surgeons who could take the patient’s own nasal area thickness into consideration when planning his or her rhinoplasty.
Epithelial Ingrowth Post Phacoemulsification in a Case of Recurrent Pterygium
Authors: Khurana Surbhi , Gupta Parul Chawla , R Balamurugan , Sharma Vijay Kumar , Ram Jagat 
Published: October 2019

Purpose:
To report an unusual case of epithelial ingrowth after phacoemulsification with posterior chamber intraocular lens implantation in a patient with recurrent pterygium, along with confocal microscopy findings of epithelial ingrowth.

Methods:
This is a case report and review of the literature.

Results:
A healthy 68-year-old woman presented with epithelial ingrowth with a best-corrected visual acuity of 6/60 in the left eye (−4.0 × 85 DC). She underwent pterygium surgery a decade ago, followed by recurrence 7 years later and an uneventful phacoemulsification surgery with posterior chamber intraocular lens implantation in the previous year. Confocal microscopy showed vacuolated cells in the area of epithelial ingrowth, which were similar to conjunctival cells of the pterygium. The postoperative period after cataract surgery was uneventful.

Conclusions:
This is the first case report to document epithelial ingrowth after phacoemulsification in a patient with recurrent pterygium and that demonstrates confocal microscopy findings showing conjunctival cells of pterygium as the origin of epithelial ingrowth. We recommend making clear corneal side-port incisions during phacoemulsification away from the site of pterygium in such cases and to check for postoperative wound leaks and tissue incarceration.
Keratoconus Could Be Associated With Psoriasis: Novel Findings From a Comparative Study
Authors: Akcam Hanife Tuba , Karagun Ebru , Iritas Ilter , Eyup Yavuz 
Published: October 2019

Purpose:
To explore the relationship between keratoconus (KC) and psoriasis.

Methods:
One hundred ten eyes of 55 patients with psoriasis (study group, SG) and 110 eyes of age–sex-matched 55 healthy volunteers (control group, CG) were included in the study. All cases underwent a detailed dermatological and ophthalmological examination including corneal topography. Moreover, Psoriasis Area and Severity Index (PASI) scoring of the patients was carried out in the SG. A thorough comparison of pachymetric, aberrometric, and topometric values between the groups was performed, and the results were interpreted. A χ2 test, Mann–Whitney U test, and Pearson correlation test were used for statistical assessment.

Results:
Although the average Kmax (44.6 in the SG; 44.5 in the CG; P = 0.613) and Belin/Ambrósio enhanced ectasia total deviation value (1.34 in SG; 1.20 in CG; P = 0.880) were similar between the groups, the mean index of vertical asymmetry value in the SG (0.14 mm) was significantly higher than that in the CG (0.11 mm) (P = 0.041). Moreover, 28 eyes from 16 patients with psoriasis were found to be associated with KC because 26 of those 28 eyes were KC suspects and 2 of them were definite KC. A positive correlation was found among topometric parameters, especially between duration of the disease and PASI score. A negative correlation was discovered between topometric parameters and the early beginning of psoriasis.

Conclusions:
Serious changes in topography maps may occur in psoriatic patients. The changes were found to be more evident in the presence of a higher PASI score and the early beginning and longer duration of the disease. The results hinted a potential relationship between psoriasis and KC.
Precision medicine in severe pediatric asthma: opportunities and challenges
Authors: Vijverberg Susanne J.H. , Brinkman Paul , Rutjes Niels W.P. , Maitland-van der Zee Anke H. 
Published: October 2019

Purpose of review
Severe pediatric asthma exerts a substantial burden on patients, their families and society. This review provides an update on the latest insights and needs regarding the implementation of precision medicine in severe pediatric asthma.

Recent findings
Biologicals targeting underlying inflammatory pathways are increasingly available to treat children with severe asthma, holding the promise to enable precision medicine in this heterogeneous patient population with high unmet clinical needs. However, the current understanding of which child would benefit from which type or combination of biologicals is still limited, as most evidence comes from adult studies and might not be generalizable to the pediatric population. Studies in pediatric severe asthma are scarce due to the time-consuming effort to diagnose severe asthma and the challenge to recruit sufficient study participants. The application of innovative systems medicine approaches in international consortia might provide novel leads for – preferably noninvasive – new biomarkers to guide precision medicine in severe pediatric asthma.

Summary
Despite the increased availability of targeted treatments for severe pediatric asthma, clinical decision-making tools to guide these therapies are still lacking for the individual pediatric patient.
In patients with diabetic foot, improved left ventricular functions are detected by strain echocardiography after the diabetic foot treatment
Authors: Demirtas Derya , Kucukosmanoglu Mehmet 
Published: October 2019

Abstract
Diabetic foot is a macrovascular complication of diabetes mellitus (DM). In the literature, the relationship between diabetic foot and another macrovascular complication of DM is not clear. The aim of this study was to determine the current left ventricular (LV) systolic function in patients with diabetic foot and to investigate the effect of diabetic foot treatment on LV systolic functions.
In this study, 54 patients with diabetic foot and 22 patients without diabetic foot were included. Routine anamnesis, physical examination, echocardiography, and laboratory examinations were performed. In addition, LV global longitudinal strain (LV-GLS) was measured by strain echocardiography technique. LV ejection fraction (LV-EF) and LV-GLS measurements were repeated with echocardiography at the 3rd month of diabetic foot treatment.
The incidence of cardiovascular risk factors such as smoking, hypertension, and coronary artery disease was found to be higher in patients with diabetic foot. (P < .05 for each one). Similarly, in patients with diabetic foot, glucose, Hemoglobin A1c, neutrophil, sedimentation, urea, creatinine, potassium, uric acid, alanine aminotransferase, aspartate aminotransferase, C-reactive protein, and brain natriuretic protein were higher; high-density lipoprotein cholesterol level was found to be significantly lower. LV wall thicknesses and diameters were higher and LV-EF was lower in patients with diabetic foot (P < .05 each one). LV-GLS values were significantly lower in patients with diabetic foot (P < .05). Although no significant change was found in the LV-EF value at the 3rd-month follow-up echocardiography (48.6% ± 7.0% vs 48.5% ± 5.9% and P = .747), it was detected that LV-GLS values (17.3 ± 2.1 vs 18.4 ± 2.3) were significantly increased (P < .001).
LV systolic function was significantly affected in patients with diabetic foot. This may be related to the increased frequency of cardiovascular risk factors in these patients. However, the significant improvement in LV-GLS values after the diabetic foot treatment showed that diabetic foot itself was an important cause of LV systolic dysfunction.
Retropharyngeal hematoma following anterior cervical spine surgery
Authors: Ren Haiyong , Wang Jin , Yu Leijun 
Published: October 2019

Abstract

Rationale:
Retropharyngeal hematoma (RH) is an infrequent but potentially life-threatening complication of anterior cervical spine surgeries (ACSS). Challenging situations might be confronted and catastrophic events or even deaths still occurred occasionally during the treatment. Currently, no widely accepted protocol has been developed.

Patient concerns:
A 55 years old male underwent ACSS due to cervical myelopathy. Thirty-three hours after surgery the patient presented cervical swelling and obstructive dysphagia. Conservative treatment resulted in no recovery and cervical swelling progressed.

Diagnoses:
Emergent magnetic resonance imaging and plain radiograph established massive incisional and RHs. RH was shown to extend from the base of the skull to T1.

Interventions:
An emergent surgery was performed under local anesthesia and cervical hematoma was evacuated. Nonetheless, evacuation of the blood clots in the vision field resulted into incomplete recovery of throat blockage. A gloved finger was used to explore the retropharyngeal space and some hidden blood clots were found and evacuated, then the patient obtained complete relief of the symptoms.

Outcomes:
Normal respiration and swallowing functions were obtained after the surgery. Obviously, recovery of motor function was noted while no other complication was found at 3-month follow-up

Lessons:
Our case illustrated that dysphagia was an early symptom of RH. Posterior compression from RH could cause obstruction of the pharyngeal airway and lead to difficulty of intubation. Hematoma could spread through the retropharyngeal space, a hematoma exploration beyond the visual range might be necessary in some cases for fear of the hidden hematoma.
Standard median sternotomy, right minithoracotomy, totally thoracoscopic surgery, percutaneous closure, and transthoracic closure for atrial septal defects in children
Authors: Yi Kang , Guo Xujian , You Tao , Wang Yunfang , Ding Fan , Hou Xiaodong , Zhou Li 
Published: October 2019

Abstract

Background:
Atrial septal defect (ASD) is one of the most common congenital heart diseases, with an average of 1.64 per 1000 newborns with the ASD. Empirical studies suggest that surgery should be performed early in the presence of right atrium and or right ventricular enlargement, even for asymptomatic patients. Many surgical procedures can be used to treat ASD. But which method is the best choice remains unclear. This study aims to compare the efficacy and safety of standard median sternotomy, right minithoracotomy, totally thoracoscopic surgery, percutaneous closure, transcutaneous by echocardiography, and transcutaneous by radiotherapy for ASDs in children using Bayesian network meta-analysis (NMA).

Methods:
We will perform a comprehensive literature search using PubMed, EMBASE.com, the Cochrane Library, Web of Science, and Chinese Biomedical Literature Database to identify relevant studies from inception to April 2019. Randomized controlled trials, prospective or retrospective cohort studies that reported the efficacy and safety of surgical procedures for the treatment of atrial septal defects will be included. Risk of bias of the included randomized controlled trials and prospective or retrospective cohort studies will be evaluated according to the Cochrane Handbook 5.1.0 and the risk of bias in non-randomized studies of interventions, respectively. A Bayesian NMA will be performed using R 3.4.1.

Results:
The results of this NMA will be submitted to a peer-reviewed journal for publication.

Conclusion:
This NMA will summarize the direct and indirect evidence to assess the efficacy and safety of different surgical procedures for the treatment of ASDs.

Ethics and dissemination:
Ethics approval and patient consent are not required as this study is a network meta-analysis based on published trials.

PROSPERO registration number:
CRD42019130902.
Does cognitive-behavioral therapy reduce internet addiction? Protocol for a systematic review and meta-analysis
Authors: Zhang Junhua , Zhang Yu , Xu Fang 
Published: October 2019

Abstract

Background:
Cognitive-behavioral therapy has been considered as a means for internet addiction, but its long-term effect and the impact of internet addiction types and culture are still unclear.

Objective:
This study aims to assess the efficacy of cognitive-behavior therapy for internet addiction symptoms and associated other psychopathological symptoms.

Method and analysis:
We will search PubMed, Web of Knowledge, Ovid Medline, Chongqing Vip Database, Wanfang, and China National Knowledge Infrastructure database. Random-effects model in comprehensive meta-analysis software will be used to conduct main meta-analysis. Cochran Q and I
2 are be used to assess heterogeneity while funnel plots and the Egger test are used to assess publication bias. Risk of bias for each study included is assessed by using the Cochrane risk of bias tool. The primary outcome is internet addiction symptom while secondary outcomes are psychopathological symptoms, time spent online, and dropout.

Trials registration number:
PROSPERO CRD42019125667
Development and Psychometric Evaluation of the Patient Engagement in Health Care Questionnaire
Authors: Wu Qing , Ye Xuchun , Wu Yaping , Zhao Li 
Published: October 2019

Background:
Patient engagement in health care can contribute to improving care quality and safety. A valid measurement is essential for promoting it.

Purpose:
The purpose was to develop the Patient Engagement in Health Care Questionnaire and test its psychometric properties.

Methods:
An item pool was generated based on a literature review and qualitative research, and was reviewed by 2 expert panels. Two rounds of survey, with 364 and 433 patients, respectively, were conducted to evaluate psychometric properties of the questionnaire.

Results:
The questionnaire consists of 33 items. Exploratory factor analysis revealed a 6-factor model, explaining 67.16% of the variance, which included communication and information exchange, engaging in treatment and care, engaging in decision-making, giving feedback about care quality, monitoring care safety, and choosing health care providers. Confirmatory factor analysis indicated that the 6-factor model fit the data well. The scale-level content validity index, Cronbach α, and test-retest reliability were 0.935, 0.928, 0.882, respectively.

Conclusions:
The Patient Engagement in Health Care Questionnaire is a reliable and valid tool to assess patient engagement.