bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Preliminary Testing of a Screening Measure of Acceptance and Willingness in Relation to Pain, Fatigue, and Sadness in Chronic Pain
Authors: Vowles Kevin E. , Johnson Linea E. , Gertz Kevin J. , Jensen Mark P. 
Published: March 2016

Background:
The manner in which one responds to the experience of chronic pain is a primary determinant of pain-related distress and disruptions in functioning. In particular, responses to pain that reflect substantial unwillingness, or a lack of acceptance, in relation to pain are reliably associated with greater difficulties in comparison with responses that reflect willingness and acceptance. To date, several multi-item self-report assessments have been developed to evaluate pain-related willingness and acceptance. The purpose of the present research was to develop and evaluate a single item measure, the Acceptance and Willingness screener (AWS).

Methods:
Participants included 172 individuals with chronic pain. The AWS consisted of 4 statements, reflecting various degrees of acceptance and willingness to experience pain, and participants were asked to endorse the statement that was most reflective of their views.

Results:
Overall, responses were fairly evenly distributed across the statements (range, 20% to 29%). Correlation and regression results indicated significant associations between AWS responses and measures of pain intensity, depression, pain interference, and engagement in activity. Furthermore, when individuals were grouped according to the statement endorsed, significant between-group differences were indicated across these same measures. Differences were particularly pronounced for groups endorsing the lowest levels of acceptance and willingness and those endorsing the highest.

Conclusions:
These results correspond with previous work and provide initial support for the validity of a single item screening measure of acceptance and willingness in chronic pain.
Inflammatory/hemostatic biomarkers and coronary artery calcification in midlife women of African-American and White race/ethnicity: the Study of Women's Health Across the Nation (SWAN) heart study
Authors: Wang Norman C. , Matthews Karen A. , Barinas-Mitchell Emma J.M. , Chang Chung-Chou H. , El Khoudary Samar R. 
Published: March 2016

Abstract

Objective:
Inflammatory/hemostatic biomarkers are associated with coronary heart disease events, but relationships in asymptomatic midlife women are uncertain. We evaluated separately whether high-sensitivity C-reactive protein (hsCRP), fibrinogen, plasminogen-activator inhibitor 1, tissue plasminogen activator antigen, and circulating factor VII (factor VIIc) were associated with coronary artery calcification (CAC) in healthy midlife women.

Methods:
A cross-sectional study was performed of participants from the Study of Women's Health Across the Nation. Logistic and Tobit regression was used to assess associations between log-transformed biomarkers, and CAC presence (CAC > 0) and extent. Effect modification by race/ethnicity was evaluated.

Results:
The study included 372 women (mean age 51.3 y; 35.2% African-American). All biomarkers were positively associated with CAC presence and extent (P < 0.001 for all), adjusting for Framingham risk score, site, race/ethnicity, menopause status, income, and education. Additional adjustment for body mass index explained all associations except for factor VIIc, which remained associated with CAC extent only (P = 0.02). Final adjustment for insulin resistance, family history of cardiovascular disease, and cardiovascular medication use produced similar results. Associations between hsCRP, and CAC presence and extent were modified by race/ethnicity (P < 0.05). Log(hsCRP) was positively associated with CAC presence (odds ratio 3.25; 95% CI, 1.53-6.90; P = 0.002; per 1 log unit increase) and CAC extent (β = 19.66; SE = 7.67; P = 0.01; per 1 log unit increase) in African-Americans only.

Conclusions:
Inflammatory/hemostatic biomarkers were associated with CAC through obesity, except for factor VIIc. Among African-American women only, hsCRP was independently associated with CAC, suggesting that hsCRP may have a role in coronary heart disease prevention in African-American midlife women.
Neuroimaging in Blast-Related Mild Traumatic Brain Injury
Authors: Mu Weiya , Catenaccio Eva , Lipton Michael L. 
Published: March 2016

Objective:
To summarize imaging findings in blast-related mild traumatic brain injury.

Design:
Our structured review of the literature yielded 5 structural magnetic resonance imaging (sMRI), 18 diffusion tensor imaging, 9 functional magnetic resonance imaging (fMRI), 3 positron emission tomography, 4 magnetoencephalography, 2 electroencephalography, and 1 single-positron emission computerized tomography studies.

Results:
Four of the 5 sMRI studies reported decreased cortical thickness and decreased thalamus and amygdala volume. Diffusion tensor imaging studies showed abnormal diffusion within white matter tracts commonly associated with traumatic brain injury, including the corpus callosum (8 of the 18) and superior longitudinal fasciculus (8 of the 18). Resting-state fMRI studies reported a variety of functional network differences. Other functional imaging studies showed diffuse changes in activity, especially in the frontal, parietal, temporal, and cingulate regions.

Conclusion:
Vast variation in the sample, design, and measurement features across studies precludes salient conclusions regarding the effectiveness of neuroimaging to assess outcomes and elucidate pathomechanisms. The inherent spatial heterogeneity of mild traumatic brain injury pathology presents a major challenge to meaningful convergence across and generalizable inferences. Approaches to standardize methodology and facilitate access to data and integration across studies hold promise for enhancing our understanding of this complex brain disorder, but can only bear fruit if they are actually consistently implemented.
Characteristics and Concerns of Caregivers of Adults With Traumatic Brain Injury
Authors: Powell Janet M. , Wise Elizabeth K. , Brockway Jo Ann , Fraser Robert , Temkin Nancy , Bell Kathleen R. 
Published: March 2016

Objective:
To describe the characteristics of caregivers of adults with traumatic brain injury (TBI) and their concerns in the first months after community discharge of the TBI survivor.

Design:
Secondary analysis of data collected during a parallel-group randomized controlled trial.

Setting:
Community.

Participants:
A total of 153 consecutively enrolled caregivers of adults with moderate to severe TBI discharged to the community following acute and/or rehabilitation care at a Level I trauma center with 71 caregivers in the treatment group identifying concerns as part of the intervention procedures.

Main Measures:
Caregiver demographics, caregiver-survivor relationship characteristics, caregiver activity changes, and concerns targeted by caregivers for education and problem-solving via biweekly phone calls.

Results:
Thirty-nine percent of caregivers were spouses and 35% parents. Sixty-five percent lived in the same house as the survivor preinjury with 86% in touch daily to several times per week. Concerns targeted by more than one-third of caregivers related to managing their emotional adjustment, strategies for getting things done, managing survivor emotions and behaviors, and engaging in healthful habits.

Conclusions:
Caregivers of TBI survivors targeted personal concerns relating to their own emotional adjustment and participation as well as concerns relating to symptoms and recovery of the TBI survivor to address through education and problem-solving.
Compensatory Cognitive Training for Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans With Mild Traumatic Brain Injury
Authors: Storzbach Daniel , Twamley Elizabeth W. , Roost Mai S. , Golshan Shahrokh , Williams Rhonda M. , O'Neil Maya , Jak Amy J. , Turner Aaron P. , Kowalski Halina M. , Pagulayan Kathleen F. , Huckans Marilyn 
Published: March 2016

Objective:
The purpose of the study was to evaluate the efficacy of group-based compensatory cognitive training (CCT) for Operation Enduring Freedom (OEF)/Operation Iraqi Freedom(OIF)/Operation New Dawn (OND) Veterans with a history of mild traumatic brain injury.

Method:
One hundred nineteen OEF/OIF/OND Veterans with history of mild traumatic brain injury participated at 3 sites, and 50 of the Veterans were randomized to CCT group, while 69 Veterans were randomized to the usual care control group. The CCT group participated in 10 weeks of CCT. Both CCT and usual care groups were assessed at baseline, 5 weeks (midway through CCT), 10 weeks (immediately following CCT), and 15 weeks (5-week follow-up) on measures of subjective cognitive complaints, use of cognitive strategies, psychological functioning, and objective cognitive performance.

Results:
Veterans who participated in CCT reported significantly fewer cognitive and memory difficulties and greater use of cognitive strategies. They also demonstrated significant improvements on neurocognitive tests of attention, learning, and executive functioning, which were 3 of the cognitive domains targeted in CCT.

Conclusions:
Findings indicate that training in compensatory cognitive strategies facilitates behavioral change (ie, use of cognitive strategies) as well as both subjective and objective improvements in targeted cognitive domains.
Surgical Management of Obstructive Sleep Apnea
Authors: Tanna Neil , Smith Benjamin D. , Zapanta Philip E. , Karanetz Irena , Andrews Brian T. , Urata Mark M. , Bradley James P. 
Published: March 2016

Summary:Surgical management of snoring and obstructive sleep apnea is indicated when a surgically correctable abnormality is believed to be the source of the problem. Many patients opt for surgical treatment after noninvasive forms of treatment have been proven ineffective or difficult to tolerate. With increasing frequency, functional rhinoplasty, septoplasty, turbinoplasty, palatal surgery, and orthognathic surgery are being used in the management of snoring and obstructive sleep apnea. Plastic surgeons’ experience with aesthetic nasal surgery, nasal reconstruction, palatal surgery, and craniofacial surgery puts them at the forefront of performing surgery for snoring and sleep apnea. The role of functional septorhinoplasty, turbinoplasty, palatal surgery, genioglossal advancement, and orthognathic surgery is indispensable in the surgical management of obstructive sleep apnea. Multidisciplinary management of these patients is critical, and plastic surgeons are encouraged to work collaboratively with sleep medicine clinicians and centers.
Body Image Disorders and Surgical Timing in Patients Affected by Poland Syndrome: Data Analysis of 58 Case Studies
Authors: Baldelli Ilaria , Santi Pierluigi , Dova Laura , Cardoni Gaia , Ciliberti Rosagemma , Franchelli Simonetta , Merlo Domenico F. , Romanini Maria V. 
Published: March 2016

Background:
Poland syndrome is a congenital anomaly of pectoralis muscles, breast, chest, and upper arm. Several studies have reported that patients affected by chest wall deformities often experience body image disorders and decreased quality of life. Cosmetic corrective surgery is generally postponed until physical development is achieved, and latissimus dorsi flap surgery is usually suggested. This study aims to propose a new surgical timing for these patients.

Methods:
Patients affected by Poland syndrome (n = 58) and control patients (n = 50) were included in the study, and their body-related psychopathology was evaluated through the Body Uneasiness Test, a valuable multidimensional tool for the clinical assessment of body uneasiness. The Global Severity Index and several subscales were considered. Age and surgical status were taken into account.

Results:
Significant differences were detected between Poland syndrome patients and controls with respect to all Body Uneasiness Test subscales. Among subjects aged younger than 20 years, the group of patients not operated on was the most affected, whereas the group of peers after surgery showed scores similar to those detected in the control group.

Conclusions:
Surgical planning for patients with Poland syndrome should start in the period of growth to allow proper body image stabilization. Current surgical options allow for reduction of the use of invasive interventions such as the latissimus dorsi flap, in favor of less invasive surgical techniques such as expanders, implants, and autologous fat grafting. This new surgical timing will help to ameliorate problems with physical and mental development.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Carbon Ion Implantation: A Good Method to Enhance the Biocompatibility of Silicone Rubber
Authors: Zhou Xin , Chen Xing , Mao Tong-cun , Li Xiang , Shi Xiao-hua , Fan Dong-li , Zhang Yi-ming 
Published: March 2016

Background:
Silicone rubber and silicone rubber–based materials have been used as medical tissue implants in the field of plastic surgery for many years, but there are still some reports of adverse reactions to long-term implants. Earlier studies have shown that ion implantation could enhance the biocompatibility of biomaterials. However, whether ion implantation has a good effect on silicone rubber is unknown.

Methods:
Three types of carbon ion silicone rubber were obtained by implanting three doses of carbon ions. Then, the antibacterial adhesion properties and the in vivo host responses were evaluated. The antibacterial adhesion properties were examined by plate colony counting, fluorescence staining, and scanning electron microscopic observation. The host responses were evaluated by surveying inflammation and fiber capsule formation that developed after subcutaneous implantation in Sprague-Dawley rats for 7, 30, 90, and 180 days. In addition, the possible mechanism by which ion implantation enhanced the biocompatibility of the biomaterial was investigated and discussed.

Results:
Carbon ion silicone rubber exhibits less bacterial adhesion, less collagen deposition, and thinner and weaker tissue capsules. Immunohistochemical staining results for CD4, tumor necrosis factor-α, α-smooth muscle actin, and elastin showed the possible mechanism enhancing the biocompatibility of silicone rubber. These data indicate that carbon ion silicone rubber exhibits good antibacterial adhesion properties and triggers thinner and weaker tissue capsules. In addition, high surface roughness and high zeta potential may be the main factors that induce the unique biocompatibility of carbon ion silicone rubber.

Conclusion:
Ion implantation should be considered for further investigation and application, and carbon ion silicone rubber could be a better biomaterial to decrease silicone rubber–initiated complications.
Evaluation of Cutaneous Spatial Resolution and Pressure Threshold Secondary to Digital Nerve Repair
Authors: Klein Holger J. , Fakin Richard M. , Ducommun Pascal , Giesen Thomas , Giovanoli Pietro , Calcagni Maurizio 
Published: March 2016

Background:
As the sophistication of functional reconstruction procedures continues to increase, so does the need for valid, precise, and reliable instruments to assess their clinical results. The authors compare two tests for spatial resolution and two for cutaneous pressure threshold in an adult patient cohort having undergone microsurgical digital nerve repair after traumatic transection.

Methods:
Patients who underwent epineural coaptation after digital nerve transection at the authors’ institution between June of 2006 and December of 2011 were asked to participate in a follow-up examination assessing spatial resolution (two-point discrimination and grating orientation test) and cutaneous pressure threshold (Semmes-Weinstein monofilament test and pressure-specifying sensory device). Interinstrument correlations were conducted and critically elucidated.

Results:
Eighty-one patients (26 female and 55 male patients; median age, 42 years; interquartile range, 23 years) were examined with a mean follow-up period of 3.5 ± 1.4 years. Although all tests could differentiate between the healthy and operated fingers, poor to moderate correlations were found between two-point discrimination and grating orientation test (ρoperated = 0.483, p < 0.0001; ρhealthy = 0.350, p < 0.0001), and between Semmes-Weinstein monofilament test and Pressure-Specified Sensory Device testing (ρoperated = 0.287, p = 0.01; ρhealthy = 0.382, p < 0.001), indicating that they measure different properties. Altogether, the grating orientation test proved superior to two-point discrimination, whereas Pressure-Specified Sensory Device testing was superior to Semmes-Weinstein monofilament testing.

Conclusions:
Thoughtful use of test instruments is advisable when assessing sensibility of the hand. This study suggests including Pressure-Specified Sensory Device testing to assess cutaneous pressure threshold and the grating orientation test to assess spatial resolution in clinical, routine test batteries.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Diagnostic, III.
A Comparison of Robotically Assisted Microsurgery versus Manual Microsurgery in Challenging Situations
Authors: Willems Joost I. P. , Shin Alexandra M. , Shin Delaney M. , Bishop Allen T. , Shin Alexander Y. 
Published: March 2016

Background:
Microsurgery can be challenging secondary to orientation of the vessels, accessibility, or depth of the wound. Robotically assisted microsurgery reduces tremors and improves visualization and may improve the quality of anastomosis compared with traditional microsurgery. The purpose of this study was to compare robotically assisted microsurgery to traditional microsurgery in technically challenging situations with respect to time of anastomosis, quality of anastomosis, and Objective Structured Assessment of Technical Skills.

Methods:
Two investigators with no prior surgery or microsurgery experience performed 160 anastomoses on artificial microvessels after undergoing standardized traditional and robotically assisted microsurgery courses. Five different exposure groups were created with depths of 0, 10, and 20 cm and sidewall angles of 20 and 30 degrees. A comparison of 80 manual with 80 robotically assisted microsurgery anastomoses in different exposure groups was undertaken. The modified Objective Structured Assessment of Technical Skills scoring system, duration per anastomosis, and a subjective comfort scale were evaluated.

Results:
In the most difficult exposure, Objective Structured Assessment of Technical Skills scores were similar in both groups (p = 0.98), the duration was higher in the manual group (p = 0.004), and the subjective comfort rating was higher in the robotically assisted microsurgery group (p < 0.001). In the easiest (0-cm depth, flat) exposure, Objective Structured Assessment of Technical Skills scores were higher in the manual group (p = 0.018) and the duration was longer in the robotically assisted microsurgery group (p = 0.008).

Conclusions:
Manual surgery was superior to robotically assisted microsurgery in technically easy exposures. In difficult exposures (greater depth and lower sidewall angles), however, robotically assisted microsurgery had a shorter surgery time and a higher comfort rating, with Objective Structured Assessment of Technical Skills scores similar to those assessing traditional microsurgery.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
A Practical Approach to Rhinoplasty
Authors: Rohrich Rod J. , Ahmad Jamil 
Published: March 2016

Learning Objectives:
After studying this article, the participant should be able to: 1. Understand both preoperative aesthetic and functional assessment of the rhinoplasty patient. 2. Develop an operative plan to address aesthetic goals while preserving/improving nasal airway function.

Summary:
Rhinoplasty continues to be one of the most commonly performed aesthetic surgical procedures. Over the past 25 years, the open approach has increased in popularity and is the focus of this article. The principles for successful rhinoplasty include comprehensive clinical analysis and defining rhinoplasty goals, preoperative consultation and planning, precise operative execution, postoperative management, and critical analysis of one’s results. Systematic nasal analysis is critical to establish the goals of surgery. Techniques to address the nasal dorsum, nasal airway, tip complex, alar rims, and bony vault that provide consistent results are discussed.
Five Topics Health Care Simulation Can Address to Improve Patient Safety: Results From a Consensus Process
Authors: Sollid Stephen J.M. , Dieckman Peter , Aase Karina , Søreide Eldar , Ringsted Charlotte , Østergaard Doris 
Published: March 2016

Objectives
There is little knowledge about which elements of health care simulation are most effective in improving patient safety. When empirical evidence is lacking, a consensus statement can help define priorities in, for example, education and research. A consensus process was therefore initiated to define priorities in health care simulation that contribute the most to improve patient safety.

Methods
An international group of experts took part in a 4-stage consensus process based on a modified nominal group technique. Stages 1 to 3 were based on electronic communication; stage 4 was a 2-day consensus meeting at the Utstein Abbey in Norway. The goals of stage 4 were to agree on the top 5 topics in health care simulation that contribute the most to patient safety, identify the patient safety problems they relate to, and suggest solutions with implementation strategies for these problems.

Results
The expert group agreed on the following topics: technical skills, nontechnical skills, system probing, assessment, and effectiveness. For each topic, 5 patient safety problems were suggested that each topic might contribute to solve. Solutions to these problems and implementation strategies for these solutions were identified for technical skills, nontechnical skills, and system probing. In the case of assessment and effectiveness, the expert group found it difficult to suggest solutions and implementation strategies mainly because of lacking consensus on metrics and methodology.

Conclusions
The expert group recommends that the 5 topics identified in this consensus process should be the main focus when health care simulation is implemented in patient safety curricula.