bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing and Psychometrically Testing the Functions of Diabetes Peer Support Group Scale
Authors: Chiou Chii-Jun , Huang Hsiao-Ling , Lin Ying-Chun , Wang Ruey-Hsia 
Published: November 2016

ABSTRACT

Background:
Peer support groups for people with diabetes are increasingly considered a part of the healthcare system. Understanding the functions of peer support groups assist healthcare professionals to provide critical assistance.

Purpose:
The purpose of this study was to develop and assess the psychometric properties of the Functions of Diabetes Peer Support Group (F-DPSG) scale.

Methods:
This study used a cross-sectional design. A 16-item F-DPSG scale was developed and administered to 589 patients with Type 2 diabetes who were selected from 34 diabetes peer support groups in Taiwan. Construct validity was evaluated using exploratory and confirmatory factor analyses and by examining the correlation with the score of the Chinese Diabetes Management Self-Efficacy Scale. Reliability was tested using internal consistency and test–retest reliability.

Results:
The 16-item F-DPSG scale, including four subscales, was supported by a second-order confirmatory factor analysis, with the following fit indices: χ2/df ratio = 2.60, comparative fit index = .94, normed fit index = .91, and root mean square error of approximation = .07. The four subscales were “enhancing self-care practice,” “obtaining knowledge and skills,” “psychological support,” and “collective identification.” The score of the F-DPSG scale correlated significantly with the score of the Chinese Diabetes Management Self-Efficacy Scale (r = .45, p < .001). The Cronbach’s α and test–retest reliability of the F-DPSG global scale and subscales were all above .70.

Conclusions/Implications for Practice:
The F-DPSG scale showed satisfactory reliability and validity. Healthcare providers may use the F-DPSG scale to assess the functions of peer support groups for people with diabetes and to provide necessary assistance.
A Comparison of the Strength of Association of Reid Colposcopic Index and Swede Score With Cervical Histology
Authors: Ranga Renu , Rai Shweta , Kumari Aruna , Mathur Sandeep , Kriplani Alka , Mahey Reeta , Agarwal Nutan , Kachhawa Garima , Vanamail Perumal , Bhatla Neerja 
Published: November 2016

Objective
Colposcopic scoring systems provide an objective diagnosis and select patients who require treatment. A new scoring system, Swede score, has added lesion size as a parameter. This study aimed to compare the strength of association of Reid colposcopic index versus Swede score and assess their utility in low-resource settings.

Methods
In this prospective study, 150 women aged 30 to 59 years with abnormal screening result were enrolled. All women underwent colposcopy; the findings were scored by both Reid colposcopic index and Swede score, biopsy taken from all abnormal areas. Performances of both the scores were calculated.

Results
A total of 33 (22%) CIN 2+ lesions were detected. Reid colposcopic index at a cutoff of 5 had sensitivity, specificity, positive predictive value, and negative predictive value for detecting CIN2+ lesions of 96.97%, 95.35%, 88.89%, and 98.8%, respectively. Using Swede score at a cutoff of 8, sensitivity, specificity, positive predictive value, and negative predictive value were 42.42%, 100%, 100%, and 81.9%, and with a cutoff of 5, these were 100%, 88.37%, 76.74%, and 100%, respectively. The correlation coefficient (R
2) was 0.919. By Spearman rank correlation coefficient, the strength of correlation between Swede score and RCI was 0.937 (p < .001).

Conclusions
Swede score can be used flexibly depending on the setting. The lower threshold (5) with high sensitivity can be used for screening, whereas the higher threshold (8) with high specificity can be used for screen-and-treat selection to decrease the overtreatment rate. Thus, it is a more attractive option for cancer prevention programs in low-resource settings.
Caudal septum surgery techniques reviewed
Authors: Cobo Roxana , Caldas Angie 
Published: November 2016

Purpose of reviewThe caudal septum has important functional and aesthetic implications. Deviations in this area can result in important nasal obstruction due not only to blockage of the nasal passage but also to compromise of the internal nasal valve. Cosmetically, alterations in the caudal septum can result in a twisted nasal tip, loss of projection, rotation, and imbalance in the ala-columellar relationship. Contemporary surgical options will be discussed showing how to preserve, reshape, and reinforce the caudal septum to obtain a final looking nose that is not only functional but also aesthetically pleasing.Recent findingsRecent publications have shown that cartilage preservation and remodeling techniques can be efficient in the treatment of the caudal septum. Adequate preoperative diagnosis must be made to be able to create a step-wise approach evolving from simple suturing techniques to more complex ones that require the use of grafts to reposition and keep the caudal septum in the midline with an adequate functional and cosmetic outcome.SummaryAdequate management of the caudal portion of the nasal septum is a challenge because of its importance in nasal function and cosmetic final results. There are many surgical options that can be used to correct and align this structure and there is no one single surgical technique that can be used in all cases. A step-wise approach is presented covering the different techniques used today evolving from simple to more complicated ones. The final surgical objective should be cosmetically pleasing noses that function appropriately.
Detection of Sepsis in Preterm Infants by Fecal Volatile Organic Compounds Analysis
Authors: Berkhout Daniel J.C. , Niemarkt Hendrik J. , Buijck Martin , van Weissenbruch Mirjam M. , Brinkman Paul , Benninga Marc A. , van Kaam Anton H. , Kramer Boris W. , Andriessen Peter , de Boer Nanne K.H. , de Meij Tim G.J. 
Published: November 2016

ABSTRACTObjectives:Several studies associated altered gut microbiota composition in preterm infants with late‐onset sepsis (LOS), up to days before clinical onset of sepsis. Microbiota analysis as early diagnostic biomarker is, however, in clinical practice currently not feasible because of logistic aspects and high costs. Therefore, we hypothesized that analysis of fecal volatile organic compounds (VOCs) may serve as noninvasive biomarker to predict LOS at a preclinical stage, because VOC reflect the composition and activity of intestinal microbial communities.Methods:In a prospective multicenter study, fecal samples were collected daily from infants with a gestational age of <30 weeks. VOC signatures of fecal samples from infants with LOS, collected up to 5 days before diagnosis, were analyzed by means of an electronic nose technology (Cyranose 320) and compared to matched controls.Results:Fecal VOC profiles of infants with LOS (n = 36) could be discriminated from controls (n = 40) at 3 days (area under the curve [±95% confidence interval], P value, sensitivity, specificity; 70.2 [52.2–88.3], 0.033, 57.1%, 61.5%), 2 days (77.7 [62.7–92.7], 0.050, 75.0%, 70.8%), and 1 day (70.4 [49.6–91.3], 0.037, 64.3%, 64.3%) before the onset of LOS.Conclusions:Fecal VOC profiles of preterm infants with LOS could be discriminated from matched controls, up to 3 days before clinical onset of the disease, underlining the hypothesis that intestinal microbiota may play an etiological role in LOS. Notably, VOC profiling is clinically feasible and the potential of this technique in the early detection of LOS needs to be confirmed in future studies.
New initiatives to develop self-testing for HIV
Authors: Witzel T. Charles , Rodger Alison J. 
Published: November 2016

Purpose of review
The purpose of this review is to describe the most recent literature on outcomes and issues associated with HIV self-testing (HIVST).

Recent findings
HIVST is acceptable to a range of populations in a variety of contexts, particularly if users’ values and preferences are taken into account in intervention development. Approaches being explored in ongoing and planned studies are the efficacy of HIVST to increase diagnosis of long-standing prevalent infections and to reduce the interval between HIV transmission and diagnosis, particularly in high-incidence groups. Though there is little evidence of harms related to HIVST, this remains a potential issue. Concerns remain about the reliability of currently available HIVST kits, which have lower sensitivity than testing options available in clinical settings, particularly in early HIV infection. Evidence on linkage to care for confirmatory testing after a reactive HIVST result and the cost-effectiveness of HIVST to increase rates of HIV diagnosis is currently limited.

Summary
HIVST is a relatively new innovation that is acceptable to key populations and which could increase HIV testing rates and rates of HIV diagnosis, especially in at-risk groups. Concerns remain about test sensitivity (particularly in early infection), and linkages to care for confirmatory testing after a reactive HIVST.
A Comparison of Open, Laparoscopic, and Robotic Surgery in the Treatment of Right-sided Colon Cancer
Authors: Kang Jeonghyun , Park Yoon Ah , Baik Seung Hyuk , Sohn Seung-Kook , Lee Kang Young 
Published: November 2016

Introduction:Multidimensional comparison between open, laparoscopy, and robotic surgery in the management of right-sided colon cancer are lacking. The aim of this study was to compare the early perioperative results and oncologic outcomes among the 3 different methods.Patients and Methods:Between June 2007 and 2011, a total of 96 patients who underwent right hemicolectomy in a single institution were classified into the open surgery (OS; n=33), the laparoscopy surgery (LS; n=43), and the robot surgery (RS; n=20) groups. Perioperative and oncologic outcomes were compared among the 3 groups.Results:Patient demographics were comparable. Operation time was significantly longer in the RS and LS than the OS (P<0.001). There was 1 OS conversion in LS. There was no difference of total retrieved lymph node numbers among the 3 groups. Postoperative recovery was faster and hospital stay was shorter in RS than OS. However, there was no difference between LS and RS. After the median 40 months’ follow-up, 5-year disease-free survival was similar among the OS, LS, and RS (87.7%, 84%, and 89.5%, respectively). Total charge and total patient charge were significantly higher in RS than the others.Conclusions:Our comparative study demonstrates that the RS have better short-term outcomes in reducing hospital stay compared with the OS, but similar to the LS. Although the oncologic outcomes are similar, the benefit of RS in right hemicolectomy is unclear considering a high cost of RS.
Incidence of Port-Site Hernias: A Survey and Literature Review
Authors: Holihan Julie L. , Chen Jeffery S. , Greenberg James , Hehir Dermot , Johnston Sean M. , Marcus Daniel , Ryan Heidi , Tsuda Shawn , Liang Mike K. 
Published: November 2016

Background:
The impact of laparoscopy on the prevalence of incisional hernias remains unclear. The aim of this study is to determine (1) surgeon perceptions of port-site hernias (PSHs), (2) the true incidence of PSH.

Materials and Methods:
A survey on PSH was given to determine the surgeon-reported rate of PSH. A literature review was performed for studies with a primary outcome of PSH. Studies were evaluated using checklists, and scores were used to compare risk of bias. Risk of bias was graphed against PSH incidence.

Results:
From 38 surgeons surveyed, the surgeon perceived rate of PSH was a median (range) of 0.5% (0% to 5%) for ports ≤5 mm, 5% (0.1% to 20%) for ports extended, and 5% (0.1% to 40%) for ports ≥10 mm. Thirty studies showed a PSH rate from 0% to 39.3%. Higher quality studies reported higher rates of PSH.

Conclusions:
Surgeons underestimate the incidence of PSH, but high-quality literature suggests that it may be nearly 40%.
Comparison of Absorbable Versus Nonabsorbable Tackers in Terms of Long-term Outcomes, Chronic Pain, and Quality of Life After Laparoscopic Incisional Hernia Repair: A Randomized Study
Authors: Bansal Virinder K. , Asuri Krishna , Panaiyadiyan Sridhar , Kumar Subodh , Subramaniam Rajeshwari , Ramachandran Rashmi , Sagar Rajesh , Misra Mahesh C. 
Published: November 2016

Background:
Laparoscopic incisional and ventral hernia repair (LIVHR) has been associated with a high incidence acute and chronic pain due to use of nonabsorbable tackers. Several absorbable tackers have been introduced to overcome these complications. This randomized study was done to compare 2 techniques of mesh fixation, that is, nonabsorbable versus absorbable tackers for LIVHR.

Materials and Methods:
Ninety patients admitted for LIVHR repair (defect size <15 cm) were randomized into 2 groups: nonabsorbable tacker fixation (NAT group, 45 patients) and absorbable tacker fixation (AT group, 45 patients). Intraoperative variables and postoperative outcomes were recorded and analyzed.

Results:
Patients in both the groups were comparable in terms of demographic profile and hernia characteristics. Mesh fixation time and operation time were also comparable. There was no significant difference in the incidence of immediate postoperative and chronic pain over a mean follow-up of 8.8 months. However, cost of the procedure was significantly higher in AT group (P<0.01) and NAT fixation was more cost effective as compared with AT. Postoperative quality of life outcomes and patient satisfaction scores were also comparable.

Conclusions:
NAT is a cost-effective method of mesh fixation in patients undergoing LIVHR with comparable early and late postoperative outcomes in terms of pain, quality of life, and patient satisfaction scores.
Colon Cancer Surgery: A Retrospective Study Based on a Large Administrative Database
Authors: Saia Mario , Buja Alessandra , Mantoan Domenico , Agresta Ferdinando , Baldo Vincenzo 
Published: November 2016

Introduction:
Laparoscopic colectomy (LC) for colon cancer is considered as safe and effective as open colectomy. It has many benefits in terms of postoperative pain, length of hospital stay, and esthetic results. There is evidence in the United States of a positive trend in the proportion of oncologic patients undergoing LC. Our aim is to confirm this trend in Europe and identify factors associated with a greater use of LC.

Materials and Methods:
A retrospective cohort study based on hospital discharge records (HDR) collected from 2008 to 2013 in a north-eastern Italian region (Veneto). The sample included all HDR with colon cancer as their principal or secondary diagnosis, treated with partial or total colectomy. To establish the overall regional trend of LC, we standardized cases by age, referring to the number of procedures performed by age group in 2010. We calculated the annual percent change from the slope of the regression model over a given time interval.

Results:
Out of 14,085 colectomies, 29% were completed laparoscopically. The age-adjusted rates of LC by year ranged from 23.8% (2008) to 36.0% (2013). The mean annual increase in the LC rate was 2.4% overall (P<0.001). Factors associated with a higher proportion of LC were younger age (39% LC in patients below 65 y vs. 25% in those above 65 y), public hospitals (odds ratio: 1.71; 95% confidence interval, 1.51-1.94; P<0.05) and elective admissions (odds ratio: 4.19; 95% confidence interval, 3.76-4.67; P<0.05).

Discussion:
Although the proportion of LC is growing, there are factors that influence the likelihood of this procedure being conducted. Future efforts to extend the use of LC to all eligible patients and avoid disparities should target both surgeons and patients, promoting the development and dissemination of appropriate guidelines.
The Efficacy of Intralesional Steroid Injection in the Treatment of Corrosive Esophageal Strictures in Children
Authors: Divarci Emre , Celtik Ulgen , Dokumcu Zafer , Ozcan Coskun , Erdener Ata 
Published: November 2016

Purpose of the Study:
Esophageal dilatation can be insufficient in the treatment of severe corrosive esophageal strictures. In this study, we aimed to present the efficacy of intralesional steroid injection as an adjunct to dilatation therapy.

Materials and Methods:
Retrospective analysis of children who underwent intralesional steroid injection between 2004 and 2014 was performed. Patients’ age, type of corrosive substance, length of stricture, number of injection and dilatation sessions and complications were reviewed. The success was evaluated by the comparison of number, frequency, and requirement of dilatation therapy before and after injection.

Results:
Intralesional steroid injection was performed to 32 children with a mean age of 3.6±2.5 years. The types of corrosive agents were alkali (24) or acid (8). Mean number of injection sessions was 2.5±1.1(1 to 6). Mean number of dilatation sessions was decreased from 10±8.8 to 5.4±4.6 after injection (P=0.003). Mean frequency of dilatations was extended from 3.6±0.9 weeks to 8.7±3.9 weeks (P=0.000). Dilatation treatment was successfully terminated in 25 of 27 children with short-segment strictures after injection (92%). Whereas all of the children with long-segment strictures could not resolved and finally required esophageal replacement (5 patients). One patient had transient cushingoid phenotype as a complication. There was not seen any major complication-like perforation. The mean follow-up period was 6±3 years.

Conclusions:
Intralesional steroid injection is an effective adjunct to dilatation in most of the children with short-segment strictures. It should be performed as a safe and efficient treatment option in patients with short-segment corrosive esophageal strictures resistant to dilatation therapy.
Efficacy of Laparoscopic Primary Repair in the Treatment of Colonic Perforation After Colonoscopy: A Review of 40,127 Patients
Authors: Zhong Wu , Qiu Chongrong , Liu Chuanyuan , Fang Chuanfa , Xia Laiyang , Liang Junlin , Zhang Seng , Chen Lisheng 
Published: November 2016

Background:
In recent years, increasing colonoscopy use increases the incidence of colonic perforation. Colonic perforation during colonoscopy is a rare but extremely serious complication. Traditionally, the management of colonic perforation is explorative laparotomy with bowel resection. Treatment using laparoscopic approach is a novel approach, and has been reported in some recent literatures. Nowadays, the using of laparoscopic primary repair in treatment of colonoscopic perforations has not been confirmed. This study retrospectively reviewed our experiences in treating colonoscopic perforations by laparoscopic primary repair.

Objective:
The aim of this study was to evaluate the safety and efficacy of the laparoscopic primary repair in the treatment of colonic perforations during colonoscopy.

Methods:
Between January 2003 and December 2014, data were collected retrospectively on all patients who underwent colonoscopy and compared the recovery parameters and morbidity of patients who underwent laparoscopic primary repair versus those who had open surgery.

Results:
A total of 40,127 colonoscopies were performed during the study period. There were 24 patients who underwent primary repair [13 underwent laparoscopic surgery (LS) and 8 underwent open surgery (OS)]. There were no demographic differences between the LS and OS groups (P>0.05). Compared with OS group, patients who underwent laparoscopic repair had a significantly shorter incision length (LS: 3.15±0.35 mm vs. OS: 12.60±2.87 mm, P=0.000), fewer blood loss (LS: 28.54±10.82 mL vs. OS: 159.25±46.90 mL, P=0.000), shorter postoperative hospital stay (LS: 8.31±1.93 d vs. OS: 12.38±1.41 d, P=0.000), and shorter postoperative fasting time (LS: 3.38±0.7 d vs. OS: 5.25±0.71 d, P=0.000). The operative time of LS group was a little longer than OS group, but there were no significant differences (LS: 86.31±22.22 min vs. OS: 75.125 ±14.24 min, P=NS).

Conclusions:
Laparoscopic primary repair is safe and effective in resolving colonic perforation due to colonoscopy, and it might offer benefits over the open approach.
Increased Telomere Attrition After Renal Transplantation—Impact of Antimetabolite Therapy
Authors: Luttropp Karin , Nordfors Louise , McGuinness Dagmara , Wennberg Lars , Curley Hannah , Quasim Tara , Genberg Helena , Sandberg John , Sönnerborg Isabella , Schalling Martin , Qureshi Abdul Rashid , Bárány Peter , Shiels Paul G. , Stenvinkel Peter 
Published: November 2016

Background
The uremic milieu exposes chronic kidney disease (CKD) patients to premature ageing processes. The impact of renal replacement therapy (dialysis and renal transplantation [RTx]) or immunosuppressive treatment regimens on ageing biomarkers has scarcely been studied.

Methods
In this study telomere length in whole blood cells was measured in 49 dialysis patients and 47 RTx patients close to therapy initiation and again after 12 months. Forty-three non-CKD patients were included as controls.

Results
Non-CKD patients had significantly (P ≤ 0.01) longer telomeres than CKD patients. Telomere attrition after 12 months was significantly greater in RTx patients compared to dialysis patients (P = 0.008). RTx patients receiving mycophenolate mofetil (MMF) had a greater (P = 0.007) degree of telomere attrition compared to those treated with azathioprine. After 12 months, folate was significantly higher in RTx patients than in dialysis patients (P < 0.0001), whereas the opposite was true for homocysteine (P < 0.0001). The azathioprine group had lower levels of folate after 12 months than the MMF group (P = 0.003).

Conclusions
The associations between immunosuppressive therapy, telomere attrition, and changes in folate indicate a link between methyl donor potential, immunosuppressive drugs, and biological ageing. The hypothesis that the increased telomere attrition, observed in the MMF group after RTx, is driven by the immunosuppressive treatment, deserves further attention.
Central Trochlear Palsy: Report of Two Patients With Ipsilesional Palsy and Review of the Literature
Authors: Jeong Seong-Hae , Kim Sung-Hee , Lee Seung-Han , Park Seong-Ho , Kim Hyo-Jung , Kim Ji-Soo 
Published: November 2016

Background:
The trochlear (fourth) nerve is the only cranial nerve that decussates before emerging from the posterior aspect of the brainstem. Lesions involving the trochlear nucleus or fascicles mostly give rise to contralesional superior oblique palsy (SOP).

Methods:
We report 2 patients with SOP on the side of intraaxial lesions with a literature review on central trochlear palsy.

Results:
The lesions are more commonly located posterior to the cerebral aqueduct in patients with ipsilesional SOP than in those with contralesional SOP.

Conclusions:
Intraaxial lesions may cause ipsilesional or contralesional SOP depending on the lesion location along the course of trochlear fascicle in the brainstem.
Compelling truth: legal protection of the infosphere against big data spills
Authors: Schafer Burkhard 
Published: November 2016

The paper explores whether legal and ethical concepts that have been used to protect the natural environment can also be leveraged to protect the ‘infosphere’, a neologism used by Luciano Floridi to characterize the totality of the informational environment. We focus, in particular, on the interaction between allocation of (intellectual) property rights and ‘communication duties’, in particular, data breach notification duties.This article is part of the themed issue ‘The ethical impact of data science’.