bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychological profiles of excluded living liver donor candidates
Authors: Weng Li-Chueh , Huang Hsiu-Li , Lee Wei-Chen , Tsai Yu-Hsia , Lin Ching-Rong , Wang Woan-Shyuan , Wang Yi-Wen , Yang Tsui-Yun , Tseng Li-Chuan 
Published: December 2018

Abstract
Living donor liver transplantation has advantages over deceased organ liver transplantation. However, the living liver donor candidates must be carefully assessed before surgery. Candidates may be excluded for various reasons. The purpose of this study was to evaluate the psychological profiles of excluded living liver donor candidates according to the reason for exclusion.
A descriptive and cross-sectional study was conducted. Donor candidates were invited to participate if they were at least 20 years of age, related biologically or by marriage to the recipient (within 5 degrees), and had undergone living donor evaluation. Among the 338 participants recruited from August 2013 to December 2015, 116 were excluded for the following reasons: a medical condition (n = 35), failure to be chosen (n = 63), or withdrawal from the selection process (n = 18). The psychological profiles of these 3 exclusion groups were evaluated.
There were no significant group differences in age, sex, education level, religion, marital status, and consanguinity (P > .05). The withdrawal group had fewer recipients with an hepatitis B virus infection than did the other groups (χ
2 = 9.28, P = .01). Additionally, compared with the unchosen group, the withdrawal group had lower intimacy with the recipient (F = 5.32, P = .006) and higher ambivalence (F = 5.53, P = .005). In terms of family relationship parameters, the withdrawal group had lower family cohesion than the medical condition and unchosen groups (F = 4.44, P = .01), lower family expressiveness than the medical condition group (F = 3.76, P = .03), and higher family conflict than the medical condition and unchosen groups (F = 7.05, P = .001). The withdrawal group also had lower emotional social support than the medical condition group (F = 3.55, P = .03). There were no significant group difference in motivation, expectations, donation-related concerns, informational social support, value social support, instrumental social support, and health-related quality of life.
The living donor candidates who withdrew from the selection process had obvious ambivalence, poorer family relationships, and insufficient emotional social support. The transplantation team should respect the autonomy of the candidate's decision and mitigate the impact of the donation decision on living liver donor candidates.
The effect of marital status on glioma patient survival: analysis of 617 cases
Authors: Long Shengrong , Li Mingdong , Ou Shaowu , Li Guangyu 
Published: December 2018

Abstract
To study the effect of marital status on survival outcome in people diagnosed with glioma, not otherwise specified using the Surveillance, Epidemiology, and End Results (SEER) database.
We chose patients diagnosed with glioma between 2000 and 2014 from the SEER database and recorded their disease-related data. We then analyzed overall 5-year cause-specific survival with respect to different marital statuses. There were 617 patients (262 women and 355 men). Of these, 54.0% (n = 333), 24.6% (n = 152), 8.6% (n = 53), and 12.8% (n = 79) were married, single, divorced (or separated), and widowed, respectively. The 5-year cause-specific survival was 39.30%, 64.50%, 60.40%, and 10.10% in the married, single, divorce (or separated), and widowed groups, respectively. The widowed group had substantially higher risk of glioma-related death than did the married group (hazard ratio 1.77, 95% confidence interval 1.337–2.344, P < .001). Being widowed provided higher risk of glioma mortality compared than did marital statuses. Widowed people should be given more support and psychological intervention by society.
Maternal dietary patterns, supplements intake and autism spectrum disorders
Authors: Li Ya-Min , Shen Yi-Dong , Li Yong-Jiang , Xun Guang-Lei , Liu Huaqing , Wu Ren-Rong , Xia Kun , Zhao Jing-Ping , Ou Jian-Jun 
Published: December 2018

Abstract
The aim of this study was first to investigate associations between maternal dietary patterns and autism spectrum disorders (ASDs) and second to investigate association between maternal supplement intake and ASD.
We used a case-control study design to enroll typically developing (TD) children and children with ASD, and data were derived from the Autism Clinical and Environmental Database (ACED).
Three seventy four children with AUTISM and 354 age matched TD children were included. The multivariate logistic regression model revealed that maternal unbalanced dietary patterns before conception had a significant increased risk of ASD in offspring (mostly meat: adjusted OR, 4.010 [95% CI, 1.080, 14.887]; mostly vegetable: adjusted OR, 2.234 [95% CI, 1.009, 4.946]); maternal supplementation of calcium during pregnancy preparation was associated with decreased ASD risk (adjusted OR, 0.480 [95% CI, 0.276, 0.836]).
This study provided preliminary evidence that maternal unbalanced dietary patterns may be a risk factor for ASD and supplementation of calcium during pregnancy preparation may be inversely associated with ASD in offspring.
Different clinical predictors of aspiration pneumonia in dysphagic stroke patients related to stroke lesion
Authors: Yu Kwang Jae , Moon Hyunseok , Park Donghwi 
Published: December 2018

Abstract
Although stroke is one of the most common causes of dysphagia, no studies have investigated the radionuclide salivagram as a predictor of aspiration pneumonia in patients with stroke. In addition, few researches on the risk factors of aspiration pneumonia in patients with subacute and chronic stroke undergoing rehabilitation in the rehabilitation unit have been rarely conducted. In this study, therefore, we investigated whether a radionuclide salivagram could predict aspiration pneumonia, and tried to find other clinical factors that may be helpful in predicting aspiration pneumonia in stroke patients undergoing rehabilitation in the rehabilitation department.
From March 2013 and January 2018, a retrospective review of the medical records of 1182 subacute and chronic stroke patients who were admitted to rehabilitation department (South Korea) was carried out. We included 117 stroke patients with swallowing difficulties who were admitted to our rehabilitation department and satisfied our criteria retrospectively. Stroke lesion, the degree of paralysis, sex, age, onset duration, feeding methods, the Mini-Mental State Examination (MMSE), the Global Deterioration Scale (GDS), the presence of aspiration in VFSS or salivagram, the penetration-aspiration scale (PAS), and the total score of the Modified Barthel Index (MBI) were investigated by reviewing medical records.
To evaluate the predictor of aspiration pneumonia for patients with stroke, multivariate logistic regression analysis with forward stepwise was performed. In the results of this study, only MMSE was significant as a clinical predictor, but not aspiration in VFSS or salivagram in multivariate analysis of supratentorial stroke patients (OR, 0.895) (95% CI, 0.830–964). In multivariate analysis of infratentorial stroke patients, combined results of salivagram and VFSS (aspiration in a salivagram or VFSS) (OR, 0.956) (95% CI, 0.919–995), and total MBI scores were significant as clinical predictors (OR, 24.882) (95% CI, 1.298–477.143).
In conclusion, MMSE can be a clinical predictor of the occurrence of aspiration pneumonia in patients with supratentorial stroke. In contrast, total MBI score and combined results of a salivagram and VFSS can be clinical predictors of the occurrence of aspiration pneumonia in patients with infratentorial stroke.
Use of Asynchronous Audio Feedback in Discussion Boards With Online RN-BSN Students
Authors: London Julie 
Published: December 2018

Background
Learning management systems are offering more complex technological tools to educators than ever before. One of these tools gaining interest is embedding audio files in discussion boards so the student can hear verbal feedback from the instructor. This study explored the effect of embedding audio feedback in discussion boards with RN-BSN students.

Purpose
The purpose of this research was to examine the instructional methodology of text-only versus audio-only feedback in discussion boards and the subsequent impact on teaching presence and sense of community in the course room.

Methods
A quasi-experimental posttest design with a comparison group was used to examine the impact of using audio-only compared with text-only feedback in discussion boards.

Results
Multiple regression statistics consistently indicated that text-only feedback was preferred by online RN-BSN students in discussion boards over audio-only feedback.

Conclusion
Use of text-only feedback in online course discussion boards increases the perception of teaching presence and sense of community.
Total Muscle Coverage versus AlloDerm Human Dermal Matrix for Implant-Based Breast Reconstruction
Authors: Ivey J. Simon , Abdollahi Hamid , Herrera Fernando A. , Chang Eric I. 
Published: December 2018

Background:
Prosthetic breast reconstruction is the most common method for treatment of patients undergoing mastectomy. Acellular dermal matrix has become more popular in implant-based breast reconstruction.

Methods:
The authors conducted a retrospective review of all patients undergoing prosthetic breast reconstruction between August of 2002 and December of 2013. Patients were analyzed in terms of demographics, fill volumes, number of expansions, costs, and complications.

Results:
A total of 284 patients underwent mastectomy surgery with 481 implant-based breast reconstructions. Four hundred eight tissue expanders had total muscle coverage, whereas 73 had AlloDerm. The rate of overall complications and major complications was significantly higher in the AlloDerm group: 20.5 percent versus 8.8 percent (p = 0.005), and 13.7 percent versus 5.1 percent (p = 0.0001), respectively. The mean initial fill volume was significantly lower in the total muscle coverage group compared to the acellular dermal matrix group (54 ± 47 versus 167 ± 139; p = 0.00003), resulting in a higher number of expansions (8.1 versus 5.8; p = 0.000051) and longer time to full expansion (60.2 days versus 43.3 days; p = 0.0002). This did not translate into a faster time to expander exchange (162.4 days versus 162.3 days; p = 0.13). Use of AlloDerm added a mean cost of $2217 for each breast.

Conclusions:
Implant-based breast reconstruction has evolved with the advent of acellular dermal matrices. Although the use of acellular dermal matrix allows increased initial fill volumes and fewer total expansions, there is an increased risk of complications and increased costs, especially in patients undergoing bilateral reconstruction. Total muscle coverage remains an excellent option for providing quality breast reconstruction without increased complications.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
A New Method for Partial Breast Reconstruction: 3-Year New Zealand Experience
Authors: Harman John , Govender Stan , Simpson John , Benjamin Benji 
Published: December 2018

Summary:
In New Zealand, oncoplastic surgery is common, but partial breast reconstruction presents challenges for radiation therapy targeting. Tissue rearrangement creates ambiguity when targeting the tumor bed, with resultant overestimation of treatment volumes. Thus, adoption of advanced methods of radiation therapy have been hindered. This pilot study describes use of a novel three-dimensional implant that provides a scaffolding for tissue ingrowth during partial breast reconstruction and delineates the tumor bed more precisely to assist radiation planning and mammographic surveillance. After informed consent, 15 women were implanted with the three-dimensional bioabsorbable implant. The device was sutured to the tumor bed during lumpectomy, and tissue flaps were mobilized and attached to the implant. Visualization of the marker and radiation treatment volumes were recorded and compared. The implant provided volume replacement and helped to maintain breast contour. Cosmetic outcomes were excellent; no device- or radiation-related complications occurred. One patient had a postoperative hematoma that resolved after percutaneous drainage; there were no postoperative infections. Three-year follow-up shows no tumor recurrences and no untoward effects. When compared to conventional radiation targeting, use of the implant showed that a greater than 50 percent reduction in treatment volume was possible in some cases. Three-year mammograms show no significant artifact, normal tissue ingrowth, and minimal fibrosis. This study describes a method of oncoplastic breast reconstruction using an implantable device that marks the site of tumor excision and provides for volume replacement with tissue ingrowth. Patients tolerated it well, and radiation therapy planning, positioning, and treatment were facilitated.
Detailed Vascular Anatomy and Flap Harvest Technique of the Serratus Anterior/Rib Composite Flap
Authors: Matsumoto Hiroshi , Shinaoka Akira , Ohtsuka Aiji , Kimata Yoshihiro 
Published: December 2018

Background:
The hemodynamics of blood flowing from the anterior serratus to the ribs has yet to be analyzed in detail in serratus anterior/rib composite flaps. The authors focused on new blood circulation, whereby the slip arteries branched from the serratus anterior branch, off the thoracodorsal artery and the intercostal arteries, directly through the interconnecting vessels (axial route). The authors analyzed in detail the hemodynamics of serratus anterior/rib composite flaps and developed a new method for flap elevation.

Methods:
The axial route was identified and analyzed by performing macroscopic autopsies of formalin perfusion-fixed cadavers involving three-dimensional computed tomographic angiography and vascular corrosion casting. Flap elevation was performed with new blood circulation, which included the axial route, and blood flow was evaluated using indocyanine green fluorescence angiography.

Results:
The interconnecting vessels penetrated the intercostal muscles at a mean distance of 4.5 cm from the anterior margin of the attachment sites of the serratus anterior muscle to the ribs and at a mean distance of 7.4 cm from the costochondral junction. The interconnecting vessels had a mean diameter of 0.5 mm. Vascular corrosion casting helped identify multiple capillaries that were distributed from the intercostal arteries to the periosteum of the ribs. In addition, intraoperative indocyanine green fluorescence angiography confirmed blood flow from the slip arteries to the intercostal arteries.

Conclusion:
Good blood flow in harvested graft tissue can be achieved by including the axial route with the periosteal blood circulation at the rib attachment sites of the serratus anterior in a serratus anterior/rib composite flap.
Baseline Lymphatic Dysfunction Amplifies the Negative Effects of Lymphatic Injury
Authors: Hespe Geoffrey E. , Ly Catherine L. , Kataru Raghu P. , Mehrara Babak J. 
Published: December 2018

Background:
Genetic mutations and obesity increase the risk of secondary lymphedema, suggesting that impaired lymphatic function before surgical injury may contribute to disease pathophysiology. Previous studies show that obesity not only decreases lymphatic function, but also markedly increases pathologic changes, such as swelling, fibroadipose deposition, and inflammation. However, although these reports provide circumstantial evidence supporting the hypothesis that baseline lymphatic defects amplify the effect of lymphatic injury, the mechanisms regulating this association remain unknown.

Methods:
Baseline lymphatic morphology, leakiness, pumping, immune cell trafficking, and local inflammation and fibroadipose deposition were assessed in wild-type and Prox1-haploinsufficient (Prox1+/-) mice, which have previously been shown to have abnormal vasculature without overt evidence of lymphedema. In subsequent experiments, wild-type and Prox1+/- mice underwent popliteal lymph node dissection to evaluate the effect of lymphatic injury. Repeated testing of all variables was conducted 4 weeks postoperatively.

Results:
At baseline, Prox1+/- mice had dilated, leaky lymphatic vessels corresponding to low-grade inflammation and decreased pumping and transport function, compared with wild-type mice. Popliteal lymph node dissection resulted in evidence of lymphedema in both Prox1+/- and wild-type mice, but popliteal lymph node dissection–treated Prox1+/- mice had increased inflammation and decreased lymphatic pumping.

Conclusions:
Subclinical lymphatic dysfunction exacerbates the pathologic changes of lymphatic injury, an effect that is multifactorial and related to increased lymphatic leakiness, perilymphatic accumulation of inflammatory cells, and impaired pumping and transport capacity. These findings suggest that preoperative testing of lymphatic function may enable clinicians to more accurately risk-stratify patients and design targeted preventative strategies.
An Analysis of Differences in the Number of Children for Female and Male Plastic Surgeons
Authors: Furnas Heather J. , Li Alexander Y. , Garza Rebecca M. , Johnson Debra J. , Bajaj Anureet K. , Kalliainen Loree K. , Weston Jane S. , Song David H. , Chung Kevin C. , Rohrich Rod J. 
Published: December 2018

Background:
Historically, the structure of surgical programs discourages women interested in both surgery and motherhood from pursuing a surgical career, and women plastic surgeons have been more likely than men to have no children or to have fewer, later in life. Female plastic surgery trainees now constitute over one-third of residents, and pregnancy rates can be expected to rise, but with women now a majority in medical schools, the specialty’s maternity policies may be deterring interested women from entering the specialty. A survey study was conducted to measure reproductive outcomes and to identify current disparities between women and men plastic surgeons.

Methods:
An anonymous electronic survey was distributed to American Society of Plastic Surgeons members and candidates, allowing comparisons of men’s and women’s responses. Differences were tested by the Fisher’s exact and chi-square tests.

Results:
Compared with male respondents, women were more likely than men to have no biological children (45.1 percent versus 23.1 percent). They were nearly twice as likely to delay having children because of the demands of training (72.6 percent versus 39.2 percent) and to experience infertility (26.3 percent versus 12.5 percent). Among the childless plastic surgeons, women were 11 times more likely to say they did not want children compared with men (20.1 percent versus 1.8 percent).

Conclusions:
Poor institutional maternity support results in a persistent, wide gap in reproductive outcomes between female and male plastic surgeons. Establishing a universal, comprehensive parental support policy is essential to closing that gap.
Pediatric Nasoorbitoethmoid Fractures: Cause, Classification, and Management
Authors: Lopez Joseph , Luck J. D. , Faateh Muhammad , Macmillan Alexandra , Yang Robin , Siegel Gabriel , Susarla Srinivas M. , Wang Howard , Nam Arthur J. , Milton Jacqueline , Grant Michael P. , Redett Richard , Tufaro Anthony P. , Kumar Anand R. , Manson Paul N. , Dorafshar Amir H. 
Published: December 2018

Background:
Currently, there is a paucity of information on the presentation and proper management of pediatric nasoorbitoethmoid fractures. The purpose of this study was to examine the incidence, cause, associated injuries, and management of these fractures. Furthermore, the authors sought to assess outcomes after transnasal wiring or suture canthopexy for type III nasoorbitoethmoid fractures.

Methods:
A retrospective cohort review was performed of all patients with nasoorbitoethmoid fractures who presented to a Level I trauma center from 1990 to 2010. Charts and computed tomographic imaging were reviewed, and nasoorbitoethmoid fractures were labeled based on the Markowitz-Manson classification system. Patient fracture patterns, demographics, characteristics, and outcomes were recorded. Univariate and multivariate methods were used to compare groups.

Results:
A total of 63 pediatric patients were identified in the study period. The sample’s mean age was 8.78 ± 4.08 years, and 28.6 percent were girls. The sample included 18 type I injuries, 28 type II injuries, and 17 type III injuries. No significant demographic differences were found between patients with type I, II, and III fractures (p > 0.05). Operative intervention was pursued in 16.7, 46.4, and 82.4 percent of type I, II, and III nasoorbitoethmoid fractures, respectively. In patients with type III nasoorbitoethmoid fractures, no patients with transnasal wiring developed telecanthus.

Conclusions:
Pediatric nasoorbitoethmoid fractures are uncommon injuries. Type I fracture can often be treated with close observation. However, type II and III injury patterns should be evaluated for operative intervention. Transnasal wiring is an effective method to prevent traumatic telecanthus deformity in type III fracture patterns.
Botulinum Toxin versus Placebo: A Meta-Analysis of Prophylactic Treatment for Migraine
Authors: Bruloy Eva , Sinna Raphael , Grolleau, M.D. Jean-Louis , Bout-Roumazeilles Apolline , Berard Emilie , Chaput Benoit 
Published: December 2018

Background:
The purpose of this study was to assess the efficacy of botulinum toxin in reducing the frequency of migraine headaches.

Methods:
The MEDLINE, Embase, and Cochrane Library databases were searched to identify randomized, double-blind, placebo-controlled trials that compared patients receiving botulinum toxin versus placebo injections in the head and neck muscles, for the preventive treatment of migraine. The primary outcome was change in the number of headache episodes per month from baseline to 3 months.

Results:
There were 17 studies including a total of 3646 patients. Overall analysis reported a tendency in favor of botulinum toxin over placebo at 3 months, with a mean difference in the change of migraine frequency of −0.23 (95 percent CI, −0.47 to 0.02; p = 0.08). The reduction in frequency of chronic migraines was significant, with a mean differential change of −1.56 (95 percent CI, −3.05 to −0.07; p = 0.04). Analysis of chronic migraine frequency was also significant after 2 months. The findings also highlighted an improvement of the patient’s quality of life at 3 months in the botulinum toxin group (p < 0.00001). Further adverse events were traced in the botulinum toxin type A group with a statistically significant risk ratio of 1.32 (p = 0.002).

Conclusions:
This meta-analysis reveals that botulinum toxin type A injections are superior to placebo for chronic migraines after 3 months of therapy. For the first time, a real benefit in patient quality of life is demonstrated with only few and mild adverse events.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.