bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Early Follow-Up Intervention on Parent-Reported Postconcussion Pediatric Symptoms: A Feasibility Study
Authors: Mortenson Patricia , Singhal Ashutosh , Hengel Alexander R. , Purtzki Jacqueline 
Published: March 2016

Objectives:
To investigate the effectiveness and feasibility of early intervention telephone counseling with parents in limiting postconcussion symptoms and impacts on children and youth.

Setting:
Recruitment occurred postdischarge from one pediatric emergency department.

Participants:
Sixty-six parents of children aged 5 to 16 years with a diagnosis of a concussion injury.

Design:
A pilot, randomized controlled study compared the efficacy of telephone counseling (reviewing symptom management and return to activity with parents at 1 week and 1 month postinjury) with usual care (no formalized follow-up).

Main Measures:
The Post-Concussion Symptom Inventory and the Family Burden of Injury Interview administered with parents by a blinded therapist at 3 months postinjury.

Results:
No significant difference between the groups at 3 months postinjury in postconcussion symptoms (P = .67) and family stress (P = .647).

Conclusion:
The findings suggest that the early counseling intervention strategy trialed herein may not be effective for children and youth who experience significant postconcussion symptoms. Further research is needed to determine whether more intensive and integrated care would better serve children.
Prognostic Markers for Poor Recovery After Mild Traumatic Brain Injury in Older Adults: A Pilot Cohort Study
Authors: Kristman Vicki L. , Brison Robert J. , Bédard Michel , Reguly Paula , Chisholm Shelley 
Published: March 2016

Objective:
To identify prognostic markers associated with poor recovery from mild traumatic brain injury (MTBI) in older adults.

Setting:
Three Ontario emergency departments.

Participants:
Forty-nine participants aged 65 years and older that visited an emergency department for MTBI.

Design:
Pilot prospective cohort study.

Main Measures:
Recovery from MTBI determined using the Rivermead Postconcussion symptom Questionnaire, the Glasgow Outcomes Scale—Extended, physical and mental health functioning (SF-12), and a single question on self-rated recovery assessed by telephone shortly after emergency department visit (baseline) and again 6 months later. Predictors were measured at baseline.

Results:
Markers potentially associated with poor recovery included reporting worse health 1 year before the injury, poor expectations for recovery, depression, and fatigue.

Conclusion:
Recovery after MTBI in older adults may be associated more with psychosocial than with biomedical or injury-related factors.
Does Co-Occurring Traumatic Brain Injury Affect VHA Outpatient Health Service Utilization and Associated Costs Among Veterans With Posttraumatic Stress Disorder? An Examination Based on VHA Administrative Data
Authors: Kehle-Forbes Shannon M. , Campbell Emily Hagel , Taylor Brent C. , Scholten Joel , Sayer Nina 
Published: March 2016

Objective:
To examine whether a traumatic brain injury (TBI) diagnosis was associated with increased outpatient service utilization and associated costs among Iraq and Afghanistan (Operation Enduring Freedom [OEF]/Operation Iraqi Freedom [OIF]/Operation New Dawn [OND]) War veterans with posttraumatic stress disorder (PTSD) who used Veterans Health Affairs (VHA) care in a 1-year period.

Setting:
N/A.

Participants:
OEF/OIF/OND veterans with a diagnosis of PTSD and/or TBI who utilized VHA services during fiscal year 2012 (N = 164 644).

Design:
Observational study using VHA administrative data.

Main Measures:
Outpatient VHA utilization (total and by category of care) and associated costs (total and by VA Health Economic Resource Center cost category).

Results:
Veterans in the comorbid PTSD/TBI group had significantly more total outpatient appointment than veterans with PTSD but no TBI. This pattern held for all categories of care except orthopedics. The comorbid TBI/PTSD group ($5769) incurred greater median outpatient healthcare costs than the PTSD ($3168) or TBI-alone ($2815) group.

Conclusions:
Co-occurring TBI increases the already high level of healthcare utilization by veterans with PTSD, suggesting that OEF/OIF/OND veterans with comorbid PTSD/TBI have complex and wide-ranging healthcare needs.
The Diagnostic Role of SPINK1 in Differentiating Hepatocellular Carcinoma From Nonmalignant Lesions
Authors: Holah Nanis S. , El-Azab Dina S. , Aiad Hayam A.E.-S. , Sweed Dina M.M. 
Published: March 2016

Background and Aim:
Distinction of small-sized hepatocellular carcinoma (HCC) from dysplastic nodules may be difficult. In addition, distinction of well-differentiated HCC (WD-HCC) from high-grade dysplastic nodule (HGDN) is also difficult in small needle biopsy. We aimed to study serine peptidase inhibitor, Kazal type 1 (SPINK1) immunohistochemical expression in HCC to differentiate it from nonmalignant lesions.

Methods:
This study included 179 specimens from the archival material of Pathology Department, National Liver Institute, Menoufia University, between 2007 and 2014, divided as 93 HCC and 86 nonmalignant lesions. All cases were stained for SPINK1 antibody.

Results:
SPINK1 was expressed in 76.3% of HCC cases with a diagnostic accuracy of 79.3%.
There was a significant difference between focal nodular hyperplasia and WD-HCC cases regarding mean value of SPINK1 expression (P=0.015). In addition, there was low SPINK1 score in cirrhosis cases compared with WD-HCC. Moreover, there was a high significant difference between WD-HCC and HGDN regarding SPINK1 expression (P=0.001), with 83.3% sensitivity and 84.6% specificity.

Conclusions:
SPINK1 can be used to differentiate between a WD-HCC and a HGDN with high diagnostic validity.
Determining the Safety and Efficacy of Gluteal Augmentation: A Systematic Review of Outcomes and Complications
Authors: Sinno Sammy , Chang Jessica B. , Brownstone Nicholas D. , Saadeh Pierre B. , Wall Simeon 
Published: March 2016

Background:
Augmentation gluteoplasty has been performed more frequently in the past decade, with over 21,000 procedures performed in the past year alone. The most popular methods for buttock augmentation involve silicone prostheses and autologous fat grafting. A comparison of complications of these two techniques does not exist in our literature.

Methods:
The PubMed, MEDLINE, and Cochrane databases were searched through April of 2015 for studies that achieved buttock augmentation through the use of silicone implant placement or autologous lipoinjection. Complication outcomes of interest included wound dehiscence, infection, seroma, hematoma, asymmetry, and capsular contracture.

Results:
Forty-four articles met inclusion criteria. The most commonly reported complications in 2375 patients receiving silicone implants were wound dehiscence (9.6 percent), seroma (4.6 percent), infection (1.9 percent), and transient sciatic paresthesias (1.0 percent), with an overall complication rate of 21.6 percent (n = 512). The most commonly reported complications in 3567 patients receiving autologous fat injection were seroma (3.5 percent), undercorrection (2.2 percent), infection (2.0 percent), and pain or sciatalgia (1.7 percent), with an overall complication rate of 9.9 percent (n = 353). Patient satisfaction after surgery was assessed differently among studies and could not be compared quantitatively.

Conclusions:
Although gluteal augmentation was once reported to have complication rates as high as 38.1 percent, a systematic review of the two most popular techniques demonstrated substantially lower overall complication rates. The overall complication rate with autologous fat grafting (9.9 percent) is lower than that with silicone buttock implants (21.6 percent). A standardized method of measuring patient satisfaction is necessary to fully understand outcomes of these increasingly popular procedures.
Emergence of Secondary Trigger Sites after Primary Migraine Surgery
Authors: Punjabi Ayesha , Brown Matthew , Guyuron Bahman 
Published: March 2016

Background:
Surgical decompression of a migraine headache may unmask headaches originating from secondary sites. A retrospective chart review investigated the incidence and characteristics of secondary trigger sites to identify clinical patterns that could aid in predicting and perhaps reducing postoperative migraines.

Methods:
One hundred eighty-five charts for migraine patients who underwent surgery at the senior author’s (B.G.) practice were reviewed. Sites from which migraine headaches initiated or occurred independently were considered primary. The sites that were not active at the time of preoperative evaluation but became active after surgery were considered secondary. Bivariate analysis was performed to characterize postoperative migraines.

Results:
Of 185 patients, 33 (17.8 percent) developed secondary migraine headache trigger sites. Of patients with primary site I (frontal) symptoms, 20.83 percent had site III (septonasal) symptoms unmasked after surgery (versus 7 percent for patients with other primary sites; p = 0.04). Of the patients with site II (temporal) migraines, 17.14 percent had secondary frontal symptoms (versus 5.68 percent; p = 0.04). Primary site II symptoms predicted postoperative site IV (occipital) symptoms (11.43 versus 1.1 percent; p = 0.008), and primary occipital symptoms predicted postoperative temporal symptoms (11.1 versus 2.33 percent; p = 0.04).

Conclusions:
The authors observed that 17.8 percent of patients develop postoperative migraine headache triggers that are not reported during the initial assessment. Knowledge of secondary migraine emergence patterns, and the presence of some preoperative symptoms, can aid in predicting the migraines that will arise from a new site postoperatively.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
In Vitro Validation of a Closed Device Enabling the Purification of the Fluid Portion of Liposuction Aspirates
Authors: Cicione Claudia , Di Taranto Giuseppe , Barba Marta , Isgrò Maria A. , D’Alessio Alessio , Cervelli Daniele , Sciarretta Fabio V. , Pelo Sandro , Michetti Fabrizio , Lattanzi Wanda 
Published: March 2016

Background:
Adipose tissue harvested through lipoaspiration is widely exploited in plastic and cosmetic surgery, because of its remarkable trophic properties, especially relying on the presence of adipose-derived stem cells. The common procedures for adipose-derived stem cell isolation are mainly based on tissue fractionation and enzymatic digestion, requiring multiple hours of uninterrupted work, unsuitable for direct surgical applications. Recent studies demonstrated the feasibility of isolating adipose stromal cells without the need for enzymatic digestion. These studies reported the processing of the fluid portion of liposuctioned adipose tissue (lipoaspirate fluid), which contains a significant amount of progenitor cells endowed with plastic and trophic features. In this article, the authors introduce a brand new closed device—the MyStem EVO kit—which allows nonenzymatic tissue separation and rapid isolation of lipoaspirate fluid from human liposuctioned adipose tissue.

Methods:
Adipose tissue was liposuctioned from 14 donors, split into aliquots, and alternatively processed using either centrifugation or the MyStem EVO kit, to separate fatty and lipoaspirate fluid portions. The samples were analyzed comparatively by flow cytometry, histology, and differentiation assays. Osteoinductive and angioinductive features were analyzed through in vitro co-culture assays.

Results:
The alternative procedures enabled comparable yields; the kit rapidly isolated lipoaspirate fluid comprising a homogenous cell population with adipose stem cell immunophenotype, bilineage potential, and efficient osteoinductive and angioinductive features.

Conclusion:
MyStem EVO allows the rapid isolation of lipoaspirate fluid with trophic properties within a closed system, and is potentially useful for regenerative medicine applications.
The Economic Impact of Closed-Incision Negative-Pressure Therapy in High-Risk Abdominal Incisions: A Cost-Utility Analysis
Authors: Chopra Karan , Gowda Arvind U. , Morrow Chris , Holton Luther , Singh Devinder P. 
Published: March 2016

Background:
Complex abdominal wall reconstruction is beset by postoperative complications. A recent meta-analysis comparing the use of closed-incision negative-pressure therapy to standard dressings found a statistically significant reduction in surgical-site infection. The use of closed-incision negative-pressure therapy is gaining acceptance in this population; however, the economic impact of this innovative dressing remains unknown. In this study, a cost-utility analysis was performed assessing closed-incision negative-pressure therapy and standard dressings following closure of abdominal incisions in high-risk patients.

Methods:
Cost-utility methodology involved reviewing literature related to closed-incision negative-pressure therapy in abdominal wall surgery, obtaining utility estimates to calculate quality-adjusted life-year scores for successful surgery and surgery complicated by surgical-site infection, summing costs using Medicare Current Procedural Terminology codes, and creating a decision tree illuminating the most cost-effective dressing strategy. One-way sensitivity analysis was performed to assess the robustness of the results.

Results:
The aforementioned meta-analysis comparing closed-incision negative-pressure therapy to standard dressings included a subset of five studies assessing abdominal wall surgery in 829 patients (260 closed-incision negative-pressure therapy and 569 standard dressings). Decision tree analysis revealed an estimated savings of $1546.52 and a gain of 0.0024 quality-adjusted life-year with closed-incision negative-pressure therapy compared with standard dressings; therefore, closed-incision negative-pressure therapy is a dominant treatment strategy. One-way sensitivity analysis revealed that closed-incision negative-pressure therapy is a cost-effective option when the surgical-site infection rate is greater than 16.39 percent.

Conclusion:
The use of closed-incision negative-pressure therapy is cost-saving following closure of abdominal incisions in high-risk patients.
Opsoclonus-Myoclonus Syndrome in Primary Central Nervous System Lymphoma
Authors: Grubbs Joseph , Trobe Jonathan D. , Fisher-Hubbard Amanda 
Published: March 2016

Abstract:
Adult-onset opsoclonus-myoclonus syndrome (OMS) has been associated with multiple cancers, most commonly small-cell lung carcinoma and breast adenocarcinoma. A 53-year-old woman who presented with OMS was found to have primary central nervous system (CNS) diffuse large B-cell lymphoma. OMS has been described in only 5 cases with non-Hodgkin lymphoma (NHL), and this is only the third reported case of OMS in NHL limited to the CNS. Although the paraneoplastic antibody panel was negative, we presume that the OMS was a paraneoplastic manifestation. Antineoplastic and anti-immune therapy had no effect on the neurologic manifestations.
Strabismus Surgery in Patients With Ocular Neuromyotonia: Potential Unmasking of the Condition and Effective Management Tool
Authors: Kim J. Anna , Velez Federico G. , Pineles Stacy L. 
Published: March 2016

Background:
Ocular neuromyotonia (ONM) is a rare motility disorder in which paroxysms of tonic extraocular muscle contraction from abnormal ocular motor nerve firing result in episodic diplopia and strabismus. Medical therapy with membrane-stabilizing agents has varied success. A surgical approach to treatment has not yet been described. We report the outcomes of strabismus surgery in patients with ONM.

Methods:
We describe 3 patients with sixth nerve paresis and ONM of the affected lateral rectus muscle who underwent strabismus surgery. All patients had a history of radiation therapy for intracranial tumors. Ophthalmologic and orthoptic examinations were performed with appropriate medical and neuroradiologic evaluation. Preoperative and postoperative data are presented and analyzed.

Results:
Two patients were noted to have ONM after their first strabismus surgery for a sixth nerve palsy. Patients 1 and 2 had 3 surgeries, whereas Patient 3 had 1 operation. Extraocular muscles operated on included the medial rectus and lateral rectus. Preoperative primary gaze baseline esotropia ranged from 35 to 75 prism diopters (Δ). All patients achieved improvement in ocular alignment and motility. Postoperative primary gaze deviations ranged from orthotropia to 20Δ of esotropia. Abduction deficits were unchanged or improved. The follow-up period ranged from 15 months to 2 years.

Conclusions:
Patients with ONM of a paretic rectus muscle can achieve binocular fusion with strabismus surgery. ONM may manifest postoperatively in patients with a sixth nerve palsy and a contractured medial rectus who, preoperatively, were not noted to have ONM.
Application of integrated TOPSIS in ASC index: partners benchmarking perspective
Authors: Sahu Anoop Kumar , Sahu Nitin Kumar , Sahu Atul Kumar 
Published: March 2016

Purpose– In the rapidly changing business environment, companies must align with suppliers to streamline operations, as well as working together to achieve a level of agility beyond individual companies (Linet al., 2006). Today’s more dynamic business environment increases the need for greater agility in supply chains, which increases both the importance and frequency of supplier/partner evaluation and benchmarking decision making. The purpose of this paper is to develop a multiple criterion appraisement index (model/module) for supplier/partner alternative firm benchmarking perspective under similar agile supply chain architecture.Design/methodology/approach– In this reporting, evaluation information against subjectivity (uncertain environment) indices has been transformed mathematical dimensionless numbers by fuzzy-based computation module. A new interval-valued fuzzy number set conjunction with modified “technique for order preference by similarity to ideal solution” methodology has been explored from benchmarking (ranking order of firm under similar criterion) point of view of supplier firms.Findings– In this context, a novel “fuzzy mathematical equation” has been developed in perceptive to compute the priority weights and appropriateness ratings of first-level measures which reduced the acquisition of supplementary priority weights and appropriateness ratings assessment in linguistic terms from group decision makers (DMs) for first-level indices. An empirical case study has been carried to ranking order the candidate partner/supplier alternative via collective index (CI) value. Lower value of “CI” reflected higher degree of performance extent. The authors found out the effectiveness and validity of proposed methodology for constructed appraisement module.Originality/value– This research work shall be valuable for that organization which volunteer to obtain the ranking order of partner/supplier alternative (benchmark) under similar agile supply chain architecture in accordance to group DMs’ comprehensive information for select best one supplier for own firm. In this reporting, a novel fuzzy mathematical equation has been developed in order to compute the important weights as well as priority rating of first-level indices/measure which reduced the supplementary important weights and priority rating assessment from group DMs in linguistic terms in order to obtain the measures rating and weights.
Assessing the CPRS Pathways to the Profession competency framework
Authors: Killingsworth Colleen , Flynn Terence 
Published: March 2016

Purpose– The purpose of this paper is to assess the leadership skills and competencies defined in the Pathways to the Profession and understand the value senior corporate communications managers place on those skills and competencies and how senior-level corporate communicators demonstration of those skills and competencies.Design/methodology/approach– Institutional review board approval was obtained for a qualitative research design based on focus groups conducted in four Canadian cities with 25 senior corporate communicators, human resources professionals, and general business managers.Findings– This research has validated the competencies and credentials for senior-level corporate communications and public relations executives as highlighted in the Pathways to the Profession framework. It has also provided the profession with an understanding of the value senior public relations and organizational managers place on professional association membership and professional and academic credentials. This research is an important contribution to the growing body of knowledge on competency frameworks as professional associations, such as the Canadian Public Relations Society, take leadership positions in providing educational institutions with sets of standards for public relations and corporate communications education in Canada.Practical implications– This research will help the public relations and corporate communications profession provide guidance to educational institutions programming for senior-level public relations and communications management education based on quantifiable data on the value executives place on a particular set of skills and competencies.Originality/value– This is the first study of its kind that examines the perceived competencies and skills of Canadian senior public relations/communications management leadership. Further this research sought to assess the value of academic and professional credentials necessary for participation in executive leadership roles.
Bridging organizational identity and reputation messages online: a conceptual model
Authors: Huang-Horowitz Nell C. , Freberg Karen 
Published: March 2016

Purpose– The purpose of this paper is to propose a conceptual model that can be used to bridge organizational identity and reputation messages. The proposed model may help organizations more-effectively build and maintain both their desired identity as well as reputation.Design/methodology/approach– The qualitative and exploratory procedure was used to develop a model for simultaneously managing and measuring both identity and reputation messages. The process of conceptualizing an exploratory, qualitative value model begins with identifying relevant concepts and measures. A qualitative review of reputation and identity scholarship was examined for recurring themes and concepts. These themes were then used to formulate the identity and reputation functions and value measures.Findings– The proposed conceptual model presents characteristics and attributes that scholars and practitioners may need to consider when managing an organization’s identity and reputation messages online. The paper also presents potential applications of the model.Practical implications– The proposed qualitative value model, if further tested and quantified, has three potential applications: integrating identity and reputation messages across multiple platforms; telling stories reflective of both identity and reputation messages; and determining the value of attribution across contingencies.Originality/value– Considering the interrelated nature of identity and reputation messages, it is necessary to formulate a model delineating how the two may be bridged with one another. By proposing the conceptual model for how organizations may be able to align their identity messages with reputation messages, this paper hopes to establish a more conscious connection between the identity and reputation scholarship.