bluuebunny/crossref_metadata_2025_split huggingface dataset:
Memory Deficits Precede Increases in Depressive Symptoms in Later Adulthood
Authors: Aichele Stephen , Ghisletta Paolo 
Published: December 2017

AbstractObjectivesWe examined bidirectional, time-ordered associations between age-related changes in depressive symptoms and memory.MethodData came from 107,599 community-dwelling adults, aged 49–90 years, who participated in the Survey of Health, Ageing, and Retirement in Europe (SHARE). Depressive symptoms were measured with the EURO-D inventory, and memory was evaluated as delayed recall of a 10-word list. Participants were assessed up to five times at 2-year intervals. Dynamic structural equation models were used to estimate longitudinal and time-ordered (lead-lag) relations between depressive symptoms and memory performance.ResultsDepressive symptoms increased and memory scores decreased across the observed age range, with worsening mostly evident after age 62 years. These long-term changes were moderately negatively correlated (r = −.53, p &lt; .001). A time-ordered effect emerged such that age-specific memory deficits preceded shorter-term increases in depression symptoms. This effect can be translated such that each 1-point decrement on a 10-point memory scale at a given age predicted a 14.5% increased risk for depression two years later. Statistical adjustment for covariates (sex, education, re-test, smoking, and body mass index) had little influence on these associations.ConclusionIn later adulthood, lower memory performance at a given age predicts subsequent 2-year increases in depressive symptoms.
Astheno–Kähler and Balanced Structures on Fibrations
Authors: Fino Anna , Grantcharov Gueo , Vezzoni Luigi 
Published: December 2017

AbstractWe study the existence of three classes of Hermitian metrics on certain types of compact complex manifolds. More precisely, we consider balanced, strong Kähler with torsion (SKT), and astheno-Kähler metrics. We prove that the twistor spaces of compact hyperkähler and negative quaternionic-Kähler manifolds do not admit astheno-Kähler metrics. Then we provide a construction of astheno-Kähler structures on torus bundles over Kähler manifolds leading to new examples. In particular, we find examples of compact complex non-Kähler manifolds which admit a balanced and an astheno-Kähler metric, thus answering to a question in [52] (see also [24]). One of these examples is simply connected. We also show that the Lie groups SU(3) and G2 admit SKT and astheno-Kähler metrics, which are different. Furthermore, we investigate the existence of balanced metrics on compact complex homogeneous spaces with an invariant volume form, showing in particular that if a compact complex homogeneous space M with invariant volume admits a balanced metric, then its first Chern class c1(M) does not vanish. Finally we characterize Wang C-spaces admitting SKT metrics.
Microvascular Decompression of the VII/VIII Cranial Nerve Complex for the Treatment of Intermediate Nerve Neuralgia: A Retrospective Case Series
Authors: Goulin Lippi Fernandes Eric , van Doormaal Tristan , de Ru Sander , Miller Kai , Han Kuo Sen 
Published: December 2017

Abstract

BACKGROUND
Intermediate nerve neuralgia (INN) is a rare and often overlooked form of primary otalgia. The pathophysiological mechanism is unknown, although one of the possible contributing factors is a neurovascular conflict at the root entry zone of the intermediate nerve. The pain can be severely debilitating, and the palette of treatment options is small.

OBJECTIVE
To assess the outcome of microvascular decompression (MVD) of the VII/VIII cranial nerve complex for treating INN.

METHODS
We retrospectively reviewed the records of a group of 8 consecutive patients with INN who underwent MVD of the VII/VIII cranial nerve complex in the period 1994 to 2015.

RESULTS
In total, 7 of the 8 patients experienced almost immediate and complete relief of pain, which remained at long-term follow-up (mean 35 mo ± 24 mo, range 8-84 mo). Postoperatively, 1 patient had a cerebrospinal fluid (CSF) leak, 3 patients experienced permanent ipsilateral hearing loss, and 3 patients had temporary complaints associated with excessive drainage of CSF.

CONCLUSION
This study suggests MVD as a valid treatment for medically refractory INN. MVD carries surgical risk, but given the severity of complaints of these patients, we believe the treatment benefits outweigh the associated complications.
Piezosurgery—A Safe Technique to Perform Lateral Suboccipital Craniotomy?
Authors: Grauvogel Juergen , Masalha Waseem , Heiland Dieter Henrik , Jarc Nadja , Grauvogel Tanja Daniela , Scheiwe Christian 
Published: December 2017

Abstract

BACKGROUND
Piezosurgery (PS) is a relatively new technique based on microvibrations generated by the piezoelectric effect. It selectively cuts bone tissue and preserves the surrounding soft tissue.

OBJECTIVE
To evaluate the use of PS for performing lateral suboccipital craniotomy.

METHODS
PS was used to perform a lateral suboccipital craniotomy in 22 patients who underwent surgery for different cerebellopontine angle (CPA) pathologies in the neurosurgical department. The applicability of PS for lateral suboccipital craniotomy was evaluated with respect to safety, preciseness of bone cutting, and in particular the preservation of the adjacent dura and sigmoid and transverse sinuses.

RESULTS
Lateral suboccipital craniotomy in 22 patients who underwent surgery for different CPA pathologies (13 vestibular schwannoma, 5 petrous bone meningioma, 1 petroclival meningioma, 2 epidermoid cysts, and 1 petrous bone cholesterol granuloma) was performed with PS without any complications. A burr hole was set before piezosurgical craniotomy in 6 patients, with no prior burr hole in 16 patients. Incidental durotomy during piezosurgical craniotomy occurred in 6 patients, and small lacerations of the sigmoid sinus caused by the piezosurgical device were observed in 3 patients.

CONCLUSION
Although PS is a safe and selective bone cutting technique that preserves the surrounding soft tissue, it can still lead to unintended dural tears during lateral suboccipital craniotomy. This must be kept in mind when using PS for craniotomies and relying on the selective bone cutting properties of PS.
Using a K-W-L Chart to Bridge the Theory-Practice Gap
Authors: Raines Deborah A. 
Published: December 2017

Abstract
As nursing is a practice discipline, theory and practice cannot be separated. Yet nursing education is traditionally divided into two components: classroom or theory-based learning and clinical or practice-based learning. The theory-practice gap is one of the most significant issues in nursing today, given the emphasis on evidence-based practice. This article describes the use of a K-W-L chart as an approach to bridge the theory-practice gap and encourage students to become self-directed and take ownership of their knowledge.
The Student Experience With Varying Immersion Levels of Virtual Reality Simulation
Authors: Farra Sharon L. , Smith Sherrill J. , Ulrich Deborah L. 
Published: December 2017

Abstract
With increasing use of virtual reality simulation (VRS) in nursing education and given the vast array of technologies available, a variety of levels of immersion and experiences can be provided to students. This study explored two different levels of immersive VRS capability. Study participants included baccalaureate nursing students from three universities across four campuses. Students were trained in the skill of decontamination using traditional methods or with VRS options of mouse and keyboard or head-mounted display technology. Results of focus group interviews reflect the student experience and satisfaction with two different immersive levels of VRS.
Consensus Recommendations for Treatment Strategies in Indians Using Botulinum Toxin and Hyaluronic Acid Fillers
Authors: Kapoor Krishan Mohan , Chatrath Vandana , Anand Chytra , Shetty Rashmi , Chhabra Chiranjiv , Singh Kuldeep , Vedamurthy Maya , Pai Jamuna , Sthalekar Bindu , Sheth Rekha 
Published: December 2017

Background:
Indians constitute one of the largest population groups in the world. Facial anthropometry, morphology, and age-related changes in Indians differ from those of other ethnic groups, necessitating a good understanding of their facial structure and the required aesthetic treatment strategies. However, published recommendations specific to Indians are few, particularly regarding combination treatment.

Methods:
The Indian Facial Aesthetics Expert Group (19 dermatologists, plastic surgeons, and aesthetic physicians with a mean 15.5 years’ aesthetic treatment experience) met to develop consensus recommendations for the cosmetic facial use of botulinum toxin and hyaluronic acid fillers, alone and in combination, in Indians. Treatment strategies and dosage recommendations (agreed by ≥ 75% of the group) were based on results of a premeeting survey, peer-reviewed literature, and the experts’ clinical experience.

Results:
The need for combination treatment increases with age. Tear trough deficiency is the most common midface indication in Indian women aged 20–40 years. In older women, malar volume loss and jowls are the most common aesthetic concerns. Excess medial soft tissue on a relatively smaller midface precedes age-related sagging. Hence, in older Indians, fillers should be used peripherally to achieve lift and conservatively in the medial zones to avoid adding bulk medially. The shorter, wider lower face requires 3-dimensional correction, including chin augmentation, to achieve increased facial height and the oval shape desired by most Indian women.

Conclusions:
These recommendations give physicians treating Indians worldwide a better understanding of their unique facial characteristics and provide treatment strategies to achieve optimal aesthetic outcomes.
Examining Length of Hospital Stay after Microsurgical Breast Reconstruction: Evaluation in a Case-Control Study
Authors: Frey Jordan D. , Salibian Ara A. , Karp Nolan S. , Choi Mihye 
Published: December 2017

Background:
While possessing numerous benefits, microsurgical breast reconstruction is associated with longer operative times and post-operative hospital length of stay compared to implant-based reconstruction. We therefore evaluate factors associated with increased length of stay (LOS) after microsurgical breast reconstruction with a case-control study design.

Methods:
All patients undergoing immediate or delayed abdominally-based microsurgical breast reconstruction over a two-year time period were identified. Risk factors associated with LOS greater than or equal to 5 days were identified.

Results:
A total of 116 patients undergoing immediate or delayed abdominally-based microsurgical breast reconstruction were identified. Of these, 86 (74.1%) had a LOS of 4 days or less (mean: 3.70 days) while 30 (25.9%) had a LOS of 5 days or greater (mean: 5.50 days).
With regards to patient demographics and intra-operative factors, patients with a LOS of 5 days or greater were significantly more likely to have diabetes mellitus (p < 0.0001), undergo bilateral reconstruction (p = 0.0003) and total mastectomy (p < 0.0001), and have a longer operative time (p < 0.0001) while significantly less likely to undergo post-operative radiation (p = 0.0421). Notably, there was no significant difference between the groups in terms of follow-up time, or time since breast reconstruction (p = 0.0600).
With regards to reconstructive complications, patients with LOS of 5 days of greater were significantly more likely to experience abdominal donor site abscess (p < 0.0001), breast hematoma (p = 0.0186), and return to the operating room for flap compromise (p < 0.0001).

Conclusions:
Multiple patient-specific, intra-operative, and post-operative outcomes factors are associated with increased length of stay with immediate and delayed microsurgical breast reconstruction.
Laterality and Left-sidedness in the Nose, Face, and Body: A New Finding
Authors: Hafezi Farhad , Javdani Ali , Naghibzadeh Bijan , Ashtiani Abbas Kazemi 
Published: December 2017

Background:
Asymmetry is a common occurrence in bilaterian animals, particularly human beings. Through examination of patients and their photographs during rhinoplasty, we noted wider left-sided nasal and facial features in most patients. This observation led us to hypothesize that this might be consistent to the whole body.

Methods:
We conducted a study in 3 parts to test the question above. First, we analyzed operating notes of 50 rhinoplasty patients to determine the wider side of the upper, middle, and lower thirds of the nose. Second, we analyzed the width of the face and chest wall in 31 patients to discern any correlation between facial and bodily asymmetry. Third, computerized tomographic scans of the thorax and body of 48 patients were studied to measure the width of the hemithorax and hemipelvic bone.

Results:
(1) Upper vault width was wider on left side (78%). Left middle vault width was wider (88%). The lower lateral cartilage, lateral crura convexity was more prominent on left side (48%), and a wider scroll area was found and trimmed in 21 (left) and 0 (right) cases. The alar base was wider on left side (56%). (2) In the body and face analysis, 64.5% had a wider left-sided face and body. (3) In the computed tomographic scan analysis, same-sided thorax and pelvis asymmetry was seen (85.35%), 33 and 7 of which were left- and right-sided, respectively.

Conclusion:
We observed generalized asymmetry of the face and body with left-sided predominance.
Successfully Closing an Acquired Palatal-fistula Using a Turnover Flap from a Previously Transferred Forearm-free-flap
Authors: Ashville Jason , Panchal Hina , Rosen Evan B. , Matros Evan 
Published: December 2017

Summary:
Palatal fistula between the oral and nasal cavities occurs in about 20% of palatal repairs after oncologic resection. Although healing by secondary intention may be employed as an initial strategy, persistent nonhealing symptomatic fistula necessitates intervention. Folded free flap used for primary repair of palatectomy defects enables placement of epithelialized tissue on both the oral and nasal cavities. In case of acquired palatal fistula, a turnover flap can be easily created, based on the free margin of the folded forearm free flap to serve as a reconstructive lifeboat.
Intentional Lower Pole Rotation of Anatomic Breast Implants in Chest Wall Deformities
Authors: Thuerlimann Alice , Tremp Mathias , Oranges Carlo M. , Schaefer Dirk J. , Kalbermatten Daniel F. 
Published: December 2017

Summary:
Several methods have been described for the correction of congenital thoracic wall deformities. Our aim was to investigate the feasibility and clinical results of using standard anatomic breast implants with modified anatomic positioning according to the defect in congenital thoracic wall deformities. Between 2014 and 2015, 5 patients diagnosed with pectus excavatum (PE, n = 4) or pectus carinatum (PC, n = 1) and breast asymmetry or hypoplasia were evaluated. In all patients, a submammary incision and dual-plane subpectoral placement of texturized, anatomic implants were performed. In patients with PE, the lower pole of the implant was positioned medially to compensate for the caved chest. In patients with PC, the lower pole of the anatomic implant was positioned laterally to compensate for the prominent sternum. Outcome measures were satisfaction, minor and major complications, and morbidity. The mean surgery time was 95 ± 14 minutes, and the mean implant volume was 287 ± 56 cm3 (273 ± 60 cm3 on the right side and 305 ± 60 cm3 on the left side). After a median follow-up of 25 months (range: 2–35), all patients healed uneventfully, and a satisfactory correction of the thoracic wall deformity was achieved. Thus, by adjusting the lower pole of anatomic breast implants in a horizontal plane according to the thoracic defect, we showed satisfactory results. Our technique has a low complication rate and can be recommended for the correction of mild to moderate PE or PC.
Aesthetic Refinements after Radial Free Flap Phalloplasty: Optimizing the Donor Site and the Phallus
Authors: Mañero Iván , Labanca Trinidad , Triviño José M. 
Published: December 2017

Background:
Phalloplasty with radial forearm flap is the gold standard for female-to-male sex reassignment surgery. However, it leaves a stigmatizing forearm scar, and as the new phallus is created with the forearm’s skin and fat, it does not look like that of a biological man. The aesthetic appearance of the donor site and the neophallus can be optimized after phalloplasty. In this study, we review refinement techniques (RTs) performed after radial forearm flap phalloplasty.

Methods:
We present a historical cohort of patients who underwent the following RTs: forearm fat grafting and localized laser in the forearm’s scars, and micropigmentation of the neophallus. Patient’s aesthetic satisfaction was evaluated using the Patient and Observer Scar Assessment Scale for the forearm’s refinements and the Male Genital Self-Image Scale for the neophallus.

Results:
Between January 2014 and January 2016, 8 patients underwent forearm fat grafting with localized laser, and 7 patients micropigmentation of the neophallus after radial flap phalloplasties. All Patient and Observer Scar Assessment Scale parameters showed a statistically significant reduction between preoperative and postoperative values. Male Genital Self-Image Scale survey showed that all patients felt positively about their genitals after micropigmentation. Patients who underwent refinement procedures were highly satisfied with the aesthetic outcome and felt more confident. They also claim that they would choose to have the refinement procedure done again.

Conclusions:
The proposed RTs are minimally invasive interventions to complement and enhance female-to-male sex reassignment surgery with very few complications and excellent aesthetic results of both the forearm scars and the constructed phallus.
Efficacy of Vancomycin-based Continuous Triple Antibiotic Irrigation in Immediate, Implant-based Breast Reconstruction
Authors: Hunsicker Lisa M. , Chavez-Abraham Victor , Berry Colleen , McEwen David 
Published: December 2017

Background:
Single irrigation of the peri-implant space with a cefazolin-based triple antibiotic solution is a routine antibiotic prophylaxis measure during implant-based breast augmentation and reconstruction. Cefazolin, however, is less efficacious against resistant Staphylococcus species, which are the predominant bacterial species isolated from the peri-implant space. Vancomycin is effective against resistant Staphylococcus species and may be a more appropriate prophylactic agent. The availability of single-injection long-acting anesthetic agents allows the novel use of the elastomeric infusion pump for continuous irrigation of antibiotic solution into the peri-implant space. The efficacy of continuous irrigation with a vancomycin-based solution is evaluated here.

Methods:
Study patients (N = 163; group 1) who underwent immediate, direct-to-implant breast reconstruction received continuous infusion of a vancomycin-based triple antibiotic solution. Patients also received a single injection of liposomal bupivacaine in the pectoralis major/minor muscles for pain control. A historic control group (N = 113; group II) received ropivacaine local anesthetic via the infusion pump and a single intraoperative irrigation of the peri-implant space with the vancomycin-based triple antibiotic solution. Incidence of postsurgical infection during the 6 weeks after surgery was compared between the groups.

Results:
Group I patients had a statistically significant lower incidence of infections (1.9%) than group II patients (6.4%) (P = 0.007). There were no vancomycin-related adverse effects.

Conclusions:
Continuous breast irrigation with a vancomycin-based triple antibiotic solution is a safe and effective accompaniment for immediate implant reconstruction. Use of intramuscular anesthetic injection for postoperative pain control allows the elastomeric infusion pump to be available for local tissue antibiotic irrigation.
Monobloc Reconstruction of Dome, Medial Crura, and Columella with Gamma-Shaped Costal Cartilage Graft
Authors: Çerçi Özkan Aret , Bilgili Ahmet Mert , Güven Erdem 
Published: December 2017

Summary:
In severe nasal deformities, the original cartilages are removed, or they become unusable because of previous operations. Costal cartilage (CC) is one of the most important tools for the replacement of deficient nasal osteocartilaginous framework. In 4 secondary and 1 tertiary rhinoplasty cases with severe deformities of medial and lateral crura of the lower lateral cartilages, we have prepared a long strut graft from a CC and then split the graft tip 5–6 mm vertically into 2 equal halves to create a gamma (ϒ)-shaped strut graft. We have sutured the base of this graft to the nasal spine and/or the bases of the medial crural remnants. Then, we have prepared lateral crural grafts and secured the grafts over lateral crural remnants. Then we curved the split tip winglets of the ϒ-shaped strut graft to both sides and sutured them to lateral crural grafts in order to create a new dome. Splitting of the CC strut graft reduces the need for extensive suturing at the tip, obtains smoother contours and ensures graft economy, and provides an original and stable dome shape. The bending capacity of the CC is limited in middle-aged patients. Costal allografts from a young cadaver can be a good alternative. ϒ-shaped costal crural graft is useful for medial crural and domal monobloc reconstruction in secondary and tertiary cases.
FIVE-YEAR INCIDENCE AND RISK FACTORS FOR IDIOPATHIC EPIRETINAL MEMBRANES
Authors: Bae Jeong Hun , Song Su Jeong , Lee Mi Yeon 
Published: December 2017

Purpose:
The aim of this was to determine the 5-year incidence of idiopathic epiretinal membrane (ERM) and its risk factors in Korean adults.

Methods:
A total of 2,152 participants aged 50 years or older enrolled in a health screening program. All participants underwent baseline ophthalmic and systemic examinations in 2006, and were reexamined after 5 years. Epiretinal membranes were diagnosed using fundus photographs taken at baseline and at the 5-year follow-up. The incidence of idiopathic ERM was calculated in this study cohort, and then age-standardized to the 2010 Korean Census. Epiretinal membranes were classified as preretinal macular fibrosis with prominent retinal folds or cellophane macular reflex without retinal folds. Associated risk factors for idiopathic ERM were also analyzed.

Results:
Idiopathic ERM developed in 82 of 2,152 participants who had no previous ERM in either eye at baseline. The overall age-standardized incidence was 3.8% (95% confidence interval, 2.8–4.8), including 2.3% with cellophane macular reflex and 1.5% with preretinal macular fibrosis. Multivariate logistic regression analyses revealed that the factors related to the development of idiopathic ERM were age (adjusted odds ratio, 1.04; 95% confidence interval, 1.00–1.08) and hypertriglyceridemia (250 mg/dL or more; adjusted odds ratio, 3.16; 95% confidence interval, 1.54–6.49) after adjusting for confounding factors.

Conclusion:
Our results suggest that the 5-year incidence of idiopathic ERM in Korean adults is relatively similar to that in similar-aged white persons. Age and hypertriglyceridemia may increase the risk of developing idiopathic ERM.