bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wunschoperationen bei Jugendlichen am Beispiel der Mamma-Reduktionsplastik
Authors: Bruck Johannes C. , Wipper Anna-Kristine 
Published: December 2017

ZusammenfassungDie Kenntnis über medizinischen Möglichkeiten zur Optimierung des eigenen Körperbildes geht auch an Jugendlichen nicht spurlos vorüber. Auch
wenn der überwältigende Anteil an Operationen bei Jugendlichen sich auf das Anlegen von Ohren konzentriert, werden doch rund 4 % aller
Operationen an Jugendlichen an der Brust vorgenommen. Auch wenn die Menarche in den letzten Jahren kaum mehr verschoben wurde, scheint
Adipositas auch für die Entwicklung der Brüste junger Mädchen eine Rolle zu spielen. Angesichts der schwierigen Erfassung des Reifegrades
und der psychischen Belastbarkeit jugendlicher Patienten gerät der Plastische Chirurg leicht in ein besonderes Spannungsfeld zwischen dem
Wunsch ein nachvollziehbares Leid lindern zu wollen, einen nachhaltig befriedigenden Behandlungserfolg zu erzielen und in weiten Teilen
unsicheren rechtlichen Rahmenbedingungen zu genügen. In der Darstellung der Rechtsprechung und einschlägiger Gesetzgebung wird die besondere
rechtliche Situation Jugendlicher dargestellt und Empfehlungen zur Überbrückung juristischer Unsicherheiten gegeben. Ziel der
Indikationsstellung wird in diesen Fällen sein müssen, die Entscheidungsfindung auf möglichst breite Beine zu stellen und mögliche
Einflussnahmen durch Dritte in besonderer Weise zu berücksichtigen um ein dauerhaft befriedigendes Ergebnis für alle Beteiligten zu
erzielen.
The flesh and the bones of cohesive devices: towards a comprehensive model
Authors: Abu-Ayyash Emad A. S. , McKenny John 
Published: December 2017

ABSTRACT
Building on a 1976 model of cohesive devices, this article probes the literature on these linguistic tools with the aim of generating a comprehensive model of cohesion that can be used as an instrument for textual analysis across different text types. This article addresses two main questions: (1) what are the linguistic tools that can be incorporated into the 1976-model of cohesive devices in the creation of an operational model? and (2) what would such a comprehensive model of cohesive devices look like? The contributions of various scholars are examined to determine which elements might be considered as cohesive devices, apart from those introduced in the 1976 model. For almost all the categories within the lexico-grammar taxonomy presented in 1976, more elements are found that can play various cohesive roles in texts and that can be integrated into the 1976 model to form a more all-embracing one. To further illustrate this claim, examples from English and Arabic are used to present a new model of analysis applicable to various languages.
Cutaneous Hypersensitivity-Like Reactions Associated With Breast Implants: A Review
Authors: Labadie Jessica G. , Korta Dorota Z. , Barton Natalie , Mesinkovska Natasha A. 
Published: December 2017

BACKGROUND
Breast implantation is an increasingly common procedure for both cosmesis and reconstruction. Risk of cutaneous reactions to breast implants is low and typically described in postsurgical settings. Adverse skin hypersensitivity-like reactions to implants have also been reported but are not well described.

OBJECTIVE
To review the scientific literature on cutaneous hypersensitivity-like reactions to breast implants.

METHODS
A systematic literature review was conducted using PubMed. Articles pertaining to breast implants and cutaneous hypersensitivity-like reactions in humans were included.

RESULTS
In total, 10 studies on hypersensitivity-like reactions from breast implants were included in the review. Potential allergenic compounds in breast implants include silicone, polyurethane texturing, and acellular dermal matrix. Perivascular lymphocytic infiltrate was a common finding on histopathology. Patch testing and preoperative silicone cube implantation were used to determine sensitivity. Attempted treatments included topical and oral corticosteroids, montelukast and antibiotics. Most cases required implant removal for resolution of symptoms.

CONCLUSION
Cutaneous hypersensitivity-like reactions to breast implants seem to be rare complications, sometimes necessitating implant removal. Future studies are needed to establish their incidence and etiology, and the diagnostic role of patch testing and preoperative screening.
Cardiovascular and metabolic morbidity after hysterectomy with ovarian conservation: a cohort study
Authors: Laughlin-Tommaso Shannon K. , Khan Zaraq , Weaver Amy L. , Smith Carin Y. , Rocca Walter A. , Stewart Elizabeth A. 
Published: December 2017

Abstract

Objective:
The aim of the study was to determine the long-term risk of cardiovascular disease and metabolic conditions in women undergoing hysterectomy with bilateral ovarian conservation compared with age-matched referent women.

Methods:
Using the Rochester Epidemiology Project records-linkage system, we identified 2,094 women who underwent hysterectomy with ovarian conservation for benign indications between 1980 and 2002 in Olmsted County, Minnesota. Each woman was age-matched (±1 y) to a referent woman residing in the same county who had not undergone prior hysterectomy or any oophorectomy. These two cohorts were followed historically to identify de novo cardiovascular or metabolic diagnoses. We estimated hazard ratios (HRs) and 95% CIs using Cox proportional hazards models adjusted for 20 preexisting chronic conditions and other potential confounders. We also calculated absolute risk increases and reductions from Kaplan–Meier estimates.

Results:
Over a median follow-up of 21.9 years, women who underwent hysterectomy experienced increased risks of de novo hyperlipidemia (HR 1.14; 95% CI, 1.05-1.25), hypertension (HR 1.13; 95% CI, 1.03-1.25), obesity (HR 1.18; 95% CI, 1.04-1.35), cardiac arrhythmias (HR 1.17; 95% CI, 1.05-1.32), and coronary artery disease (HR 1.33; 95% CI, 1.12-1.58). Women who underwent hysterectomy at age ≤35 years had a 4.6-fold increased risk of congestive heart failure and a 2.5-fold increased risk of coronary artery disease.

Conclusions:
Even with ovarian conservation, hysterectomy is associated with an increased long-term risk of cardiovascular and metabolic conditions, especially in women who undergo hysterectomy at age ≤35 years. If these associations are causal, alternatives to hysterectomy should be considered to treat benign gynecologic conditions.
A Modified Bilhaut–Cloquet Procedure for Zigzag Thumb Polydactyly Types III and IV
Authors: Al-Qattan Mohammad M. , Kattan Abdullah E. , Al-Lazzam Abdulmohsen , Gelidan Adnan G. 
Published: December 2017

Background:
A review of the English literature over the least 43 years revealed only a total of 53 cases of Wassel types III, IV, and VII treated by the Bilhaut–Cloquet (B–C) procedure. Furthermore, the detailed results and range of motion were only given in 2 series (a total of 9 cases).

Methods:
Four cases of Wassel types III and IV thumb duplications with zigzag deformity were treated with a modified B–C procedure. The main modification was minimal central resections at the joints aiming for joint preservation to improve the postoperative range of motion of the new thumb.

Results:
The results showed an excellent overall functional score (Tada score of 5 of 5 in all cases). The mean range of motion at the metacarpophalangeal joint was excellent (60°), but the mean at the interphalangeal joint was only 20°. Cosmetically, all thumbs were “too wide” and a panel of 3 hand surgeons scored the cosmetic result (0–10 scoring system) between 5.7 and 6.7. No secondary procedures were done, and all parents were “very satisfied” despite the wide thumbs and split nails. This was attributed to the presence of an ugly preoperative zigzag appearance, and hence the comparative postoperative appearance was satisfactory.

Conclusion:
The modified B–C procedure gives a satisfactory function, but the cosmetic outcome is suboptimal.
No Vertical Scar Breast Weight Transfer
Authors: Horndeski Gary M. , Gonzalez Elisa 
Published: December 2017

Summary:
Women desire beautiful breasts that are functional, pain free, and without foreign material. Vertical scars, insufficient elevation, inadequate upper pole fullness, nipple numbness, and loss of breast feeding are undesirable. Relieving pain attributed to enlarged breasts has required significant tissue removal. Software analysis of chest images, physical measurements, and desires are combined to generate a surgical blueprint. The breast is divided horizontally into two components preserving the neurovascular supply and major lactiferous ducts. The skin flap cephalad to the areola provides external coverage. The areola remains attached to a deepithelialized mound, which is rotated into a cone. Dermal straps originating from the base of the cone are looped through the pectoralis major muscle and the cone repeatedly. Weight transfer to the pectoralis major muscles eliminates pain in 54% and decreases pain in 38%. Incisions are concealed at the areola cutaneous junction and in the shadow of the breast. Upper pole fullness increased in 86% without implants or fat transfer. Nipple sensation was increased in 37% and unchanged in 44%. Overall results were excellent in 50% and good in 36%. Complications consisted of dog-ears, periareolar infection, and fat necrosis. No patient required a return to the operation room. Combing computer-aided design with plastic surgical principles creates beautiful, functional breasts without foreign material. Vertical scars are avoided, and weight transfer relieves pain.
Orthognathic Relevant Scales of FACE-Q: Translation and Validation for Hong Kong Chinese Patients
Authors: Tan Su Keng , Leung Wai Keung , Tang Alexander Tin Hong , Tse Edward Chi Man , Zwahlen Roger Arthur 
Published: December 2017

Background:
A validated questionnaire is needed to study a more holistic outcome assessment including postsurgical aesthetic satisfaction and psychosocial changes in orthognathic patients. The aim of this study was to determine the reliability and validity of 9 orthognathically relevant translated FACE-Q scales among Hong Kong Chinese orthognathic patients.

Methods:
Two hundred fifty adult Cantonese-speaking patients of 18 years or older who underwent orthognathic treatment were recruited in the Prince Philip Dental Hospital of Hong Kong. Nine of an overall of 40 independent FACE-Q scales were selected and translated into Hong Kong Chinese. The reliability, validity, and test–retest reliability were examined using Cronbach’s alpha, paired t test and Pearson’s correlation coefficients.

Results:
The Hong Kong Chinese version of the 9 FACE-Q scales was obtained by forward-backward translation. One hundred eight male (mean age, 25.57 ± 4.49) and 142 female (mean age, 24.61 ± 4.54) patients were recruited for the reliability and validation process. The internal consistency (0.89–0.97) and the test–retest reliability (0.73–0.90) were found to be high. The validity of the translated questionnaires was comparable with that of the original FACE-Q.

Conclusion:
The results presented here prove that the 9 translated FACE-Q scales are reliable and valid instruments for research and clinical purposes in Hong Kong Chinese orthognathic patients.
Prepectoral Implant-Based Breast Reconstruction and Postmastectomy Radiotherapy: Short-Term Outcomes
Authors: Sigalove Steven , Maxwell G. Patrick , Sigalove Noemi M. , Storm-Dickerson Toni L. , Pope Nicole , Rice Jami , Gabriel Allen 
Published: December 2017

Background:
Prosthetic breast reconstruction in the setting of radiotherapy is associated with poor outcomes. Until recently, prosthetic breast reconstruction was predominantly performed by placing the prosthesis in a subpectoral space. Placement of the prosthesis in a prepectoral space is currently emerging as a simpler, alternative approach to subpectoral placement. The impact of postmastectomy radiotherapy (PMRT) on prepectoral reconstruction has not yet been specifically assessed. This study compared the outcomes of patients who underwent immediate, direct-to-implant, or 2-staged, prepectoral breast reconstruction followed by PMRT with those from patients who did not receive PMRT.

Methods:
Patients with well-perfused skin flaps and without contraindications, including uncontrolled diabetes-mellitus, previous irradiation, and current tobacco use, were offered the prepectoral approach. Following implant or expander placement, patients underwent planned or unplanned radiotherapy. Complications after each stage of reconstruction were recorded.

Results:
Thirty-three patients underwent 52 breast reconstructions via the prepectoral approach. Sixty-five percentage of the breasts were irradiated, including 21% after expander and 44% after implant placement. Patients were followed for a mean of 25.1 ± 6.4 months. Complication rate in irradiated breasts was 5.9% (1 incidence of seroma and 1 incidence of wound dehiscence followed by expander removal) and 0% in nonirradiated breasts. Capsular contracture rate was 0% in both irradiated and nonirradiated breasts.

Conclusions:
Immediate implant-based prepectoral breast reconstruction followed by PMRT appears to be well tolerated, with no excess risk of adverse outcomes, at least in the short term. Longer follow-up is needed to better understand the risk of PMRT in prepectorally reconstructed breasts.
Effectiveness of a Clinical Reasoning Course on Willingness to Think Critically and Skills of Self-Reflection
Authors: Huhn Karen 
Published: December 2017

Background and Purpose.
One may possess the skills of good critical thinking but may be unwilling to use them in certain situations, and conversely one may have the habits of the mind of good critical thinking but may fail to possess the requisite skills to use them effectively. Students entering a Doctor of Physical Therapy (DPT) program are most likely already quite good at conceptualizing, analyzing, and synthesizing information. However, during a curriculum review, the faculty of a DPT program agreed that students failed to exhibit sufficient higher-order thinking required for clinical reasoning, one of the primary intended outcomes of the curriculum. The faculty members hypothesized that making the skills and attributes of clinical reasoning more explicit early in the program would help set the stage for improving students' clinical reasoning skills throughout the rest of the DPT curriculum.

Case Description.
A course entitled “Critical Reasoning” was created as an introduction to the habits of the mind and traits required for good critical thinking and reflective skills. The intentions of the course were to provide a framework for the development of clinical reasoning skills and to make these skills, attributes, and habits of good clinical thinking explicit. The purpose of this study was to explore the effectiveness of this Critical Reasoning course on increasing students' awareness of and willingness to think and reflect critically.

Outcomes.
There was a statistically significant increase from pre- to post-intervention in students' willingness to think critically as measured by the California Critical Thinking Disposition Inventory. The Self Reflection and Insight Scale also indicated improvement in students' insight into their thinking and their reflective skills.

Discussion and Conclusion.
It would seem that, given the statistically significant improvement in both outcome measures, the course may have had a positive effect on improving students' willingness and ability to think about their thinking. Making the habits of the mind and the skills of critical reflection explicit early in a curriculum can lead to improvements in students' willingness to think and reflect critically. However, the course's effect on students' overall clinical reasoning skills cannot be assumed without further investigation.
Student Physical Therapists Achieve Similar Patient Outcomes as Licensed Physical Therapists: A Retrospective Comparison of Outcomes of Patients With Low Back Pain
Authors: Rindflesch Aaron B. , Calley Darren Q. , Dobson Benjamin J. , Steele Tess G. , Yonkovich Sarah E. , Hollman John H. 
Published: December 2017

Introduction.
Third-party payer reimbursement for outpatient physical therapy services is typically fee for service. For many payers, services delivered by supervised student physical therapists (SPTs) that meet legal and regulatory guidelines are reimbursed equivalently to services delivered by licensed physical therapists (PTs). Few studies have compared patient outcomes for physical therapy services provided by SPTs with those provided by licensed PTs. Therefore, we compared outcomes of patients with low back pain (LBP) treated primarily by supervised SPTs with those of patients treated primarily by PTs. We hypothesized that each patient group would have similar outcomes.

Methods.
From 2012 through 2015, 128 patients treated for LBP were selected for review by convenience sampling: 67 primarily by a PT and 61 primarily by a supervised SPT. We conducted a retrospective cohort study using electronic health records at an outpatient orthopedic clinic in the Midwest. A mixed-model analysis of covariance was used to analyze differences in outcomes between patients treated by SPTs and PTs (α = .05).

Results.
For both groups, outcomes measured using the Patient-Specific Functional Scale improved from the initial to final session during the episode of care (P < .001). No significant difference existed in the initial and final Patient-Specific Functional Scale scores between groups (P = .74).

Discussion and Conclusion.
For outpatients with LBP, the plan of care designed and delivered by supervised SPTs was as effective as that of licensed PTs. This study shows that use of properly supervised SPTs does not decrease the effectiveness of outpatient physical therapy services for patients with LBP. Additional research is needed in other clinical settings.
Looking Outside Health Care to Teach Innovation in Physical Therapy Business Practice: Use of Harvard Business School Cases at Emory University
Authors: Kapasi Zoher F. , Davis Beth P. 
Published: December 2017

Background and Purpose.
With profound changes in health care and the need for innovation to deliver exceptional value to patients receiving physical therapy, it is incumbent that students are prepared to look outside health care to adopt business practices from other industries and foster innovation as they begin to practice physical therapy. The purpose of this paper is to describe how the case-based analysis of Harvard Business School (HBS) cases from a variety of industries was implemented to teach business disciplines and promote innovative thinking in Doctor of Physical Therapy students at Emory University.

Method/Model Description and Evaluation.
The process for developing the course including course content and objectives, pedagogical, methods, student assessment including course evaluation and alumni survey at Emory University is described in this study. In addition, quantitative and qualitative analysis of students' course evaluation outcomes has been described in this paper.

Outcomes.
A total of 57 students participated in the elective course over the past 4 academic years. Class participation, written assignments, and quantitative analysis of course evaluations indicate that students agree the course objectives were met. Qualitative analysis of anonymous student comments revealed core themes of innovative course format and innovative learning, showing that the course instilled an innovation mindset in our students. Finally, 94% of course alumni survey respondents agreed that the course created an entrepreneurial and innovative mindset that impacted their practice of physical therapy.

Discussion and Conclusion.
We successfully introduced a course in a physical therapist education program to include training in innovation using HBS cases. To deliver exceptional value to patients receiving physical therapy, we must innovate. Thus, preparation of physical therapist practitioners who can innovate is critical to achieve our vision of optimizing movement to improve human experience and thereby transform society.
Predicting Academic and Licensure Examination Success Among Physical Therapist Assistant Students
Authors: Kabiri Laura S. , Voight Michele , Gleeson Peggy B. , Mitchell Katy 
Published: December 2017

Introduction.
Identifying and admitting students most likely to succeed is key to physical therapist assistant (PTA) student and program success. However, there is currently no information available regarding admission criteria outcomes among PTA students. The purpose of this research was to examine quantitative PTA program admission criteria and their ability to predict student academic and National Physical Therapy Examination (NPTE) success.

Methods.
All CAPTE-accredited PTA programs were asked to return data for each student admitted to the program since 2009 including those who graduated, were dismissed, or left the program. Data on 2809 PTA students from 31 programs in 24 states were used for this research. Predictor variables included prerequisite course grades, overall prerequisite GPA, and standardized test scores. Outcome variables included dichotomized academic success (academic difficulty/no academic difficulty) based on research by Utzman et al and ultimate NPTE status (pass/fail). Binary logistic regression with multiple models was used for data analysis.

Results.
A&P I grade (academic: odds ratio = 1.44, P = .0005; NPTE: odds ratio = 1.72, P = .007), overall prerequisite GPA (academic: odds ratio = 2.02, P = .0005; NPTE: odds ratio = 2.14, P = .0005), and TEAS total score (academic: odds ratio = 1.05, P = .0005; NPTE: odds ratio = 1.06, P = .006) were the only significant predictors of both academic and NPTE success. For both outcomes, A&P I, GPA, and TEAS remained the significant predictors regardless of the program type (public/private/for-profit), students' sex, and students' ethnicity.

Discussion and Conclusion.
When establishing the PTA program admission criteria, A&P I grade, overall prerequisite GPA, and TEAS total score offer predictive values for both academic and NPTE success regardless of the program type, students' sex, and students' ethnicity. These scores should be important contributors to admission decisions for PTA education.