bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetic risk in chronic pancreatitis: the misfolding-dependent pathway
Authors: Sahin-Tóth Miklós 
Published: June 2017

Purpose of review
Genetic risk in chronic pancreatitis is partly due to mutations that cause misfolding of digestive enzymes and elicit endoplasmic reticulum stress. This review examines recent developments in this concept.

Recent findings
The best characterized misfolding variants in the highly expressed digestive proteases cationic trypsinogen (PRSS1) and carboxypeptidase A1 (CPA1) are strong, causative risk factors for chronic pancreatitis and may be associated with autosomal dominant hereditary pancreatitis.

Summary
Properties of misfolding digestive enzyme mutants indicate that endoplasmic reticulum stress is a highly relevant pathological mechanism and a potential therapeutic target in chronic pancreatitis.
Update on classification and diagnosis of vascular malformations
Authors: McCuaig Catherine C. 
Published: June 2017

Purpose of reviewThis review provides an update of the classification in the classification of vascular anomalies since April 2014 at the International Society for the Study of Vascular Anomalies meeting in Melbourne, Australia.Recent findingsThe reader will become familiar with how to diagnose the major vascular malformations, including capillary, venous, arteriovenous, and lymphatic and combinations thereof. In addition, vascular malformation syndromes, including those with overgrowth, will be clarified.SummaryVascular malformations are common. Capillary malformations are now better understood through an updated classification. Verrucous hemangioma is truly a venulocapillary malformation that extends into the subcutis.PIK3Ca-Related Overgrowth Syndromes encompass Klippel–Trenaunay, Congenital Lipomatous Asymmetric Overgrowth of the Trunk with Lymphatic, Capillary, Venous, and Combined-Type Vascular Malformations, Epidermal Nevi, Scoliosis/Skeletal and Spinal Anomalies, Megalencephaly–Capillary Malformation–Polymicrogyria Syndrome (M-CAP), fibroadipose hyperplasia, and macrodactyly. Yet another syndrome should be highlighted: Capillary Malformation of the Lower Lip, Lymphatic Malformation of the Face and Neck, Asymmetry and Partial/Generalized Overgrowth. Knowledge of the genetic basis of vascular malformations will lead to future treatments.
Knowledge Translation in Rehabilitation: A Shared Vision
Authors: Moore Jennifer L. , Shikako-Thomas Keiko , Backus Deborah 
Published: June 2017

Purpose:
Advances in rehabilitation provide the infrastructure for research and clinical data to improve care and patient outcomes. However, gaps between research and practice are prevalent. Knowledge translation (KT) aims to decrease the gap between research and its clinical use. This special communication summarizes KT-related proceedings from the 2016 IV STEP conference, describes current KT in rehabilitation science, and provides suggestions for its application in clinical care.

Summary of Key Points:
We propose a vision for rehabilitation clinical practice and research that includes the development, adaptation, and implementation of evidence-based practice recommendations, which will contribute to a learning health care system. A clinical research culture that supports this vision and methods to engage key stakeholders to innovate rehabilitation science and practice are described.

Conclusions:
Through implementation of this vision, we can lead an evolution in rehabilitation practice to ultimately prevent disabilities, predict better outcomes, exploit plasticity, and promote participation.
Goal Attainment Scaling to Evaluate Intervention on Individual Gains for Children Born Extremely Preterm
Authors: Brown Laura , Burns Yvonne R. , Watter Pauline , Gray Peter H. 
Published: June 2017

Purpose:
To investigate the effect of group-based physical therapy on individual gains among preterm and/or extremely low-birth-weight children with minimal or mild impairment at 4 years using Goal Attainment Scaling (GAS). To explore the relationship between GAS with motor and postural outcomes and effect of gender on GAS scores.

Methods:
Twenty-four 4-year-old children (born <28 weeks' gestation and/or birth weight <1000 g) with minimal or mild motor impairment completed 6 group-based weekly intervention sessions and a goal-based home program. Assessments included GAS, Movement Assessment Battery for Children-Second Edition (MABC-2), postural stability, and limb strength after intervention.

Results:
GAS group T score improved, exceeding expected goal of “0” score after intervention (mean = 58.2, standard deviation = 0.82). GAS mean T-score and MABC-2 percentile were moderately correlated (r = 0.42, P = .04). Females improved more than males (P = .05).

Conclusions:
Goals were achieved above expected level after intervention and were related to motor coordination. Male gender is a risk factor for less favorable outcomes.
A Home-Based Body Weight-Supported Treadmill Program for Children With Cerebral Palsy: A Pilot Study
Authors: Visser Allie , Westman Marci , Otieno Sango , Kenyon Lisa 
Published: June 2017

Purpose:
The purpose of this pilot study was to explore the effect and feasibility of a home-based body weight-supported treadmill training (BWSTT) program on walking capacity and functional mobility in children with cerebral palsy (CP).

Methods:
A within-subjects, repeated-measures design was used. Ten children with CP ages 6 to 16 years participated in pre- and postintervention testing sessions, an initial home training session, and a 12-week home-based BWSTT program conducted 3 to 4 times per week by a parent or caregiver for up to 20 minutes each session. Multiple outcome measures for walking capacity and functional mobility were used.

Results:
As a group, participants demonstrated significant improvements in walking capacity and functional mobility at the completion the 12-week intervention program.

Conclusions:
Additional research regarding home-based BWSTT programs in children with CP is warranted and should focus on identifying specific parameters that promote achievement of optimal functional outcomes.
Stepping Up to Rethink the Future of Rehabilitation: IV STEP Considerations and Inspirations
Authors: Kimberley Teresa Jacobson , Novak Iona , Boyd Lara , Fowler Eileen , Larsen Deborah 
Published: June 2017

Background and Purpose:
The IV STEP conference challenged presenters and participants to consider the state of science in rehabilitation, highlighting key area of progress since the previous STEP conference related to prediction, prevention, plasticity, and participation in rehabilitation.

Key Points:
Emerging from the thought-provoking discussions was recognition of the progress we have made as a profession and a call for future growth. In this summary article, we present a recap of the key points and call for action. We review the information presented and the field at large as it relates to the 4 Ps: prediction, prevention, plasticity, and participation.

Recommendations for Practice:
Given that personalized medicine is an increasingly important approach that was clearly woven throughout the IV STEP presentations, we took the liberty of adding a fifth “P,” Personalized, in our discussion of the future direction of the profession.
Physical Exercise and Physical Activity for Children and Adolescents With Juvenile Idiopathic Arthritis: A Literature Review
Authors: Catania Hilenia , Fortini Viola , Cimaz Rolando 
Published: June 2017

Purpose:
This is a review of studies that investigate the efficacy of exercise therapy and physical activity for children with juvenile idiopathic arthritis since the 2008 Cochrane Review.

Method:
Studies were identified that investigated the use of physical activity and exercise therapy in the treatment of children and adolescents with juvenile idiopathic arthritis, excluding the Cochrane Review. Two reviewers individually analyzed the results of the search to determine the eligibility of studies. The randomized controlled trial study designs were evaluated using PEDro scales.

Conclusions and Recommendations for Clinical Practice:
Recent literature supports the importance of the combination of strengthening, stretching, proprioceptive, and balance exercises and activities in water. Many of the reviewed studies proposed an intensive program of physical activity and exercise therapy, conducted 3 times a week for 12 weeks.
Whole Blood Redox Potential Correlates With Progressive Accumulation of Oxygen Debt and Acts as A Marker of Resuscitation in A Swine Hemorrhagic Shock Model
Authors: Daniels Rodney C. , Jun Hyesun , Tiba Hakam , McCracken Brendan , Herrera-Fierro Pilar , Collinson Maryanne , Ward Kevin R. 
Published: June 2017

ABSTRACT

Introduction:
Oxidation-reduction reactions involve electron exchanges that require optimal balance for proper cell function. This balance is measured via redox potential and reflects oxidative stress. Despite the critical role of oxidative stress in critical illness and injury, little is known regarding redox potential. We hypothesize redox potential measurements will correlate with accumulation of O2 debt produced by hemorrhage over time.

Methods:
Ten swine were studied using a polytrauma hemorrhagic shock model. Whole blood and plasma redox potential measures were obtained at defined stages of O2 debt (20 mL/kg, 40 mL/kg, 60 mL/kg, 80 mL/kg), and through resuscitation. Redox potential was determined by measuring open circuit potential using novel gold nanoporous electrodes with Ag/AgCl reference.

Results:
Whole blood redox potential showed negative change as O2 debt accumulated, exhibiting positive response during resuscitation, and correlated with O2 debt across all animals (P < 0.001). Redox potential changes throughout O2 debt accrual were significant compared with baseline (P≤0.05), and at end resuscitation compared with O2 debt 60 mL/kg (P = 0.05) and 80 mL/kg (P = 0.02). Whole blood redox potential measures also correlated with oxygen extraction ratio, ScvO2, and lactic acid, appearing very sensitive to acute changes. Plasma redox potential showed no correlation with O2 debt.

Conclusions:
Whole blood redox potential demonstrates significant correlation to O2 debt at all stages in this model. These results set the stage for further study of redox potential as a direct measure of oxidative stress and potential clinical tool. Given redox potential plasma performance, these measures should be made in whole blood versus plasma.
Caring for Older Surgical Patients
Authors: Chesney Tyler R. , Pang George , Ahmed Najma 
Published: June 2017

Objective:
To gain contemporary insights from residents and surgeons regarding the care of older surgical patients.

Background Data:
With worldwide aging, efforts over the past decade have attempted to increase surgeons’ abilities to care for older adults, but a current understanding of attitudes, knowledge, practices, and needs is missing.

Methods:
Between July 2016 and September 2016 we conducted a national Web-based survey sampling all general surgery residents and academic general surgeons using a questionnaire designed and tested for this purpose. Summative scales within each domain (attitudes, knowledge, practices, and needs) were created and compared between groups. Open-ended responses were analyzed with thematic analysis.

Results:
Ninety-four of 172 invited residents (55%) and 80 of 243 invited surgeons (33%) across 14 general surgery programs responded with no missing data. Both groups had favorable attitudes (83% vs 68%, P = 0.02). However, 80% of residents and 76% of surgeons had medium-level knowledge test scores, and few had prior training. Most respondents reported only sometimes performing guideline-recommended practices (71% vs 73%, P = 0.55). Gaps in training and care delivery were identified. Residents wanted focused, high-yield materials and case-oriented practical skills training. Respondents reported further improvements may come from building surgeons’ capacity, enhancing collaboration including perioperative geriatric services, better preoperative assessment, increased adherence to perioperative guidelines, and greater community-based supports to recovery.

Conclusions:
Residents and surgeons have favorable attitudes, but only moderate geriatric-specific knowledge and only some guideline-adherent practices. We identified gaps in training and care delivery with targets for future knowledge translation and quality improvement initiatives.
Effect of Sleeve Gastrectomy on Thyroid Function in Chinese Euthyroid Obese Patients
Authors: Yang Jingge , Gao Zhiguang , Yang Wah , Zhou Xiangmao , Lee Shing , Wang Cunchuan 
Published: June 2017

Background:
Changes in thyroid function following bariatric surgery in euthyroid obese patients have yielded inconsistent results. Nevertheless, no data exist on changes in thyroid function after bariatric surgery in Chinese obese subjects.

Objectives:
The objective of this study is to evaluate the influence of weight reduction on thyroid function following laparoscopic sleeve gastrectomy (LSG) in patients with normal thyroid function.

Patients and Methods:
Serum free thyroxine (FT4), free triiodothyronine (FT3), and thyroid-stimulating hormone (TSH) levels were retrospectively analyzed before and 12 months after LSG in euthyroid patients with morbid obesity. Correlation between weight loss after LSG and changes in thyroid function were investigated.

Results:
In total, 16 patients who underwent LSG were included in the study. Mean BMI change from 35.78 to 23.66 kg/m2 (P<0.000) after LSG was associated with a mean reduction in the TSH from 2.31 to 1.54 mU/L (P=0.022), whereas FT4 (15.19±0.33 pmol/L at baseline and 14.85±0.58 pmol/L at 12 mo after LSG; P=0.583) and FT3 (4.98±0.15 pmol/L at baseline and 4.77±0.60 pmol/L at 12 mo after surgery; P=0.406) levels remained steady. Decrease in TSH was significantly correlated with decrease in BMI at 12 months after surgery but did not correlate with excess weight loss and total weight loss.

Conclusions:
Weight loss after LSG is accompanied by significant decrease in serum TSH level but no change in serum FT4 and FT3 levels. However, further work is required to elucidate the mechanism.
Ready or Not? Obstetrics and Gynecology Resident Preparedness for Female Pelvic Medicine and Reconstructive Surgery Training
Authors: Dune Tanaka J. , Blackwell Robert H. , Griffin Arianna , Taege Susanne , Sung Juliana , Mueller Elizabeth R. , Brubaker Linda 
Published: June 2017

Objective
The aim of this study was to assess the perception of female pelvic medicine and reconstructive surgery (FPMRS) program directors (PDs) and obstetrics and gynecology (OG) FMPRS fellows regarding the adequacy of OG residency as preparation for FPMRS fellowship.

Methods
Electronic invitations to complete a modified version of a validated survey were extended to FPMRS PDs and their second- and third-year OG FPMRS fellows who had just completed their first or second year of FPMRS fellowship, respectively. The survey consisted of 5 domains; qualitative questions and recommendations for improvement were elicited.

Results
Program directors (33%, 16/48) and second-year (64%, 29/45) and third-year (53%, 26/49) fellows completed the surveys. While incoming fellows were deemed professional, serious surgical skill competency issues were identified: (1) PDs felt they could not leave their incoming fellow to operate independently on a major case for 30 minutes while in the next room compared with fellow responses (PDs: 33.3% vs second-year fellows: 67.9%; P = 0.03); (2) no PDs felt their fellows could suture laparoscopically; and (3) there was group consensus that incoming fellows were not proficient at cystoscopy (PDs: 40.0%, second-year fellows: 39.3%, third-year fellows: 32.0%; P = 0.82). Mostly, fellows could clinically evaluate and manage patients. Program directors thought their fellows had better understanding of statistics than fellows believed of themselves (P = 0.05). Increasing FPMRS exposure during residency was favored as the method to better prepare OG residents for fellowship.

Conclusions
Quantitative and emerging qualitative outcomes highlight that fellows are professional and are largely able to evaluate and care for patients but that achieving independence, surgical skills, and scholarship requires further training.
Pudendal Neuromodulation as a Treatment for Persistent Genital Arousal Disorder—A Case Series
Authors: Gaines Natalie , Odom Brian D. , Killinger Kim A. , Peters Kenneth M. 
Published: June 2017

Background
Persistent genital arousal disorder (PGAD) is a rare life-altering condition characterized by unwanted, uncomfortable genital sensations or spontaneous orgasms without physical or emotional stimulation. Its etiology remains unclear, and a variety of treatments have been attempted with incomplete resolution. We propose that chronic pudendal neuromodulation (CPN) may be a useful treatment for PGAD symptoms.

Methods
A retrospective chart review was performed for women older than 18 years with a diagnosis of PGAD that had staged neuromodulation with placement of a tined lead at the pudendal nerve. Demographic, operative, and postoperative data were collected. A survey was then sent to these women to assess additional demographic data, preoperative and postoperative symptoms, and patient satisfaction. Descriptive statistics were performed.

Results
Six women underwent CPN for PGAD. Mean age was 52 (SD, 9) years. Five (83%) of 6 were still implanted at time of survey, at a mean of 38 months after implantation; 1 device was removed for nonuse. Four of 6 completed surveys and were still using their device. Three of 4 had met their treatment goals and were satisfied with CPN; 3 of 4 felt CPN was the most useful treatment modality they had used overall. Chronic pudendal neuromodulation also improved chronic pelvic pain (4/4), bowel function (3/4), and bladder function (3/4).

Conclusions
Chronic pudendal neuromodulation can be an effective treatment for decreasing frequency of PGAD symptoms and providing symptom relief.
Women's Perception of Their Vulvar Appearance in a Predominantly Low-Income, Minority Population
Authors: Truong Christina , Amaya Stephanie , Yazdany Tajnoos 
Published: June 2017

Objectives
The aim of this study was to investigate the effect of certain predictors, such as age and media exposure, on a woman's perception of her vulva anatomy.

Methods
We recruited 346 female visitors from a county teaching hospital to complete questionnaires that determine the following: demographics, satisfaction with their vulvar appearance, whether they consider their vulvar anatomy to be normal, exposure to media (namely having had Internet access or learned about genitalia from the Internet or any type of pornography), and consideration of cosmetic vulvar surgery for themselves. The participants were divided into 2 age groups; group I (45 years or older) and group II (18–44 years). Personal satisfaction, self-perceived normality, and one's consideration of cosmetic vulvar surgery were then compared between the 2 groups.

Results
A large percentage of women considered their vulva to be “normal,” 93.1% of group I versus 96.0% of group II (P = 0.24). For group I, 87.5% were satisfied with their vulva versus 91.5% of group II (P = 0.24). The participants with media exposure report self-perceived normal-appearing vulvas at higher rates than those not exposed to media (96.7% vs 90.8%, respectively; P = 0.03). Of those who were satisfied with their vulvar appearance, 92.3% were exposed to media, whereas 84.5% were not exposed (P = 0.03). However, of the participants who reported consideration of vulvar surgery, 74.4% of them had exposure to media, whereas 25.6% had no media exposure (P = 0.034).

Conclusions
Age does not play a significant role in determining a woman's acceptance of the appearance of her vulvar anatomy. However, media exposure was a significant determinant for self-perception, satisfaction, and desire for cosmetic vulvar surgery.
Long-Term Outcomes After Ventral Rectopexy With Sacrocolpo- or Hysteropexy for the Treatment of Concurrent Rectal and Pelvic Organ Prolapse
Authors: Jallad Karl , Ridgeway Beri , Paraiso Marie Fidela R. , Gurland Brooke , Unger Cecile A. 
Published: June 2017

Objective
The primary objective is to describe the long-term anatomic and subjective outcomes in women undergoing ventral rectopexy with sacrocolpo- or hysteropexy. The secondary objective is to describe the perioperative adverse events.

Methods
This is a retrospective cohort of women who underwent ventral rectopexy with either concurrent sacrocolpo- or hysteropexy at a tertiary care center between 2009 and 2015. A composite outcome for recurrent pelvic organ prolapse and rectal prolapse was defined as subjective failure (vaginal or rectal prolapse symptoms), objective failure (prolapse to or beyond the hymen or full thickness rectal prolapse), or any retreatment for prolapse. Patient's Global Impression of Change was recorded at baseline and at all follow-up visits. Perioperative adverse events were defined a priori and collected up to 6 weeks after surgery.

Result
A total of 59 patients underwent a ventral rectopexy, either a sacrocolpopexy (48/59, 81.3%) or sacrohysteropexy (11/59, 18.6%). The median follow-up after surgery for all patients was 17 months (range, 1–76) with a composite success rate for both pelvic organ prolapse and rectal prolapse (estimated by Kaplan-Meier method) of 57.4%. Forty (91%) of 44 patients reported a Patient's Global Impression of Change score of 6 or 7, indicating significant improvement after surgery. Of the patients, 15 (25.4%) experienced a perioperative adverse event. Use of biologic graft was associated with a higher rate of adverse event (40.0% [95% confidence interval, 24.6–57.5] vs 10.3% [95% confidence interval, 3.6–26.3]; P < 0.01).

Conclusions
Ventral rectopexy with sacrocolpo- or hysteropexy is associated with significant improvement in anatomic and subjective outcomes. One in 4 women experienced a perioperative adverse event.
Trends and Clinical Practice Patterns of Sacral Neuromodulation for Overactive Bladder
Authors: Elterman Dean S. , Chughtai Bilal , Vertosick Emily , Thomas Dominique , Eastham James , Sandhu Jaspreet 
Published: June 2017

Objectives
The aim of this study was to investigate surgical practice patterns of American urologists treating refractory overactive bladder (OAB) over the past decade. Refractory OAB remains a management challenge to urologists. When multiple medical therapies have failed, treatment options may include sacral neuromodulation (SNM) or surgery such as augmentation cystoplasty (AC).

Methods
Data on SNM and AC performed between 2003 and 2012 by certifying and recertifying urologists were obtained in the form of annualized case logs from the American Board of Urology (ABU). Associations between surgeon characteristics (type of certification, annual volume, practice type, and location) and these procedures were evaluated.

Results
Over the past decade, 756 of 6355 urologists certified with the ABU performed SNM or AC for the treatment of refractory OAB. Forty-five (6%) of these surgeons completed fellowships in female urology and 71 surgeons (9%) completed another type of fellowship program. Surgeons recertifying with ABU performed 76% of all SNM procedures. Although SNM and AC have increased from 64 to 2086 between 2003 and 2012, however, this is mainly driven by the increase of SNM from 48 to 2068 cases. Rates of AC have remained stable with 14 to 38 cases reported annually. However, they have declined relative to the total, from 25% in 2003 to less than 1% in 2012.

Conclusions
Sacral neuromodulation has increased dramatically over the past decade in surgeons certified with the ABU. This is in contrast to AC, which while remaining stable in number of procedures.