bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term Deleterious Impact of Surgeon Care Fragmentation After Colorectal Surgery on Survival: Continuity of Care Continues to Count
Authors: Justiniano Carla F. , Xu Zhaomin , Becerra Adan Z. , Aquina Christopher T. , Boodry Courtney I. , Swanger Alex , Temple Larissa K. , Fleming Fergal J. 
Published: October 2017

BACKGROUND:
Surgical care fragmentation at readmission impacts short-term outcomes. However, the long-term impact of surgical care fragmentation is unknown.

OBJECTIVE:
The purpose was to evaluate the impact of surgical care fragmentation, encompassing both surgeon and hospital care, at readmission after colorectal surgery on 1-year survival.

DESIGN:
This was a retrospective cohort study.

SETTING:
The study included patients undergoing colorectal resection in New York State from 2004 to 2014.

PATIENTS:
Included were 20,016 patients undergoing colorectal resection who were readmitted within 30 days of discharge and categorized by source-of-care fragmentation. Each readmission was classified by the source of fragmentation: readmission to the index hospital and managed by another provider, readmission to another hospital by the index surgeon, and readmission to another hospital by another provider. Patients readmitted to the index hospital and managed by the index surgeon served as controls.

MAIN OUTCOME MEASURES:
One-year overall survival and 1-year colorectal cancer-specific survival were the outcomes measured.

RESULTS:
After propensity adjustment, surgeon care fragmentation was independently associated with decreased survival. In comparison with patients without surgical care fragmentation (patients readmitted to the index hospital and managed by the index surgeon), patients readmitted to the index hospital and managed by another provider had over a 2-fold risk (HR, 2.33; 95% CI, 2.10–2.60) and patients readmitted to another hospital by another provider had almost a 2-fold risk (HR, 1.91; 95% CI, 1.63–2.25) of 1-year mortality. Among 9545 patients with a colorectal cancer diagnosis, surgical care fragmentation was once again associated with decreased survival with patients readmitted to the index hospital and managed by another provider having a HR of 2.12 (95% CI, 1.76–2.56) and patients readmitted to another hospital by another provider having a HR of 1.57 (95% CI, 1.17–2.11) compared with patients readmitted to the index hospital and managed by the index surgeon.

LIMITATIONS:
Limitations include possible miscoding of data, retrospective design, and selection bias.

CONCLUSIONS:
After accounting for patient, index hospital, index surgeon, and readmission factors, there is a significant 2-fold decrease in survival associated with surgeon care fragmentation regardless of hospital continuity. See Video Abstract at http://links.lww.com/DCR/A431.
Patient-Reported Outcomes following Split-Face Injection of 2 Volumizing Fillers in the Upper Cheeks
Authors: Prager Welf , Agsten Karla , Kerscher Martina 
Published: October 2017

Background:
Patient-reported outcomes are important measures when assessing the efficacy of aesthetic procedures.

Objective:
To compare outcomes between 2 volumizing hyaluronic acid fillers.

Materials and Methods:
Subjects with moderate-to-severe volume loss in the cheeks were randomized in a split-face design to malar enhancement with Cohesive Polydensified Matrix 26 mg/ml HA (CPM-26) and Vycross 20 mg/ml HA (VYC-20). The same injection technique and injection volume were applied for both sides of the face. Anesthetics, overcorrection, and touch-ups were not permitted. Blinded subjects assessed aesthetic improvements using the Global Aesthetic Improvement Scale and treatment satisfaction by confirming their willingness to repeat treatment or recommend it to friends. Follow-up was 18 months.

Results:
A total of 45 subjects received a single 2 mL injection of CPM-26 on one side and VYC-20 on the contralateral side of the face. The proportion of subjects reporting improvement on the Global Aesthetic Improvement Scale compared with baseline for CPM-26 and VYC-20 was 97.7% and 88.6%, respectively, at 3 months, 73.8% and 71.1% at 12 months, and 61.0% and 56.7% at 18 months. Treatment satisfaction was high, with the majority of subjects stating that they would repeat treatment and recommend it to friends, but at each time point, a higher proportion of subjects was more satisfied with the CPM-26-treated side of the face.

Conclusions:
In this first direct comparison of CPM-26 and VYC-20, the majority of subjects were satisfied with both treatments throughout the study. Patient-reported outcome measures identified a trend in favor of CPM-26.
Preliminary Study of PGA Fabric for Seromas at Latissimus Dorsi Flap Donor Sites
Authors: Itani Yoshihito , Hagiwara Akeo , Hashimoto Takahiro , Isogai Noritaka , Kusuhara Hirohisa 
Published: October 2017

Background:
Seroma formation is a major complication following latissimus dorsi (LD) flap transfer for breast reconstruction. We implanted a nonwoven polyglycolic acid (PGA) fabric—a biodegradable polymer—in the LD flap donor site and examined its effect on postoperative seroma formation and resolution in a comparative study on 38 patients undergoing primary 1-stage breast reconstruction by LD flap.

Method:
A PGA treatment group had a PGA fabric placed in the donor wound (PGA group, n = 20), whereas a second group was treated with standard donor site closure (control group, n = 18). The incidence of seromas was comparable between the groups.

Result:
There was a significant reduction in aspiration volume by needle aspiration after drain removal (P < 0.05) and in the time until seroma resolution (P < 0.01) in the PGA group compared with the control group.

Conclusion:
These results indicate that application of PGA at the LD donor site is useful in controlling postoperative seromas.
DIEP Flap Breast Reconstruction in Patients with Breast Ptosis: 2-Stage Reconstruction Using 3-Dimensional Surface Imaging and a Printed Mold
Authors: Tomita Koichi , Yano Kenji , Taminato Mifue , Nomori Michiko , Hosokawa Ko 
Published: October 2017

Background:
Autologous breast reconstruction can be performed for breasts with ptosis to a certain extent, but if patients desire to correct ptosis, mastopexy of the contralateral breast is indicated. However, accurate prediction of post-mastopexy breast shape is difficult to make, and symmetrical breast reconstruction requires certain experience. We have previously reported the use of three-dimensional (3D) imaging and printing technologies in deep inferior epigastric artery perforator (DIEP) flap breast reconstruction. In the present study, these technologies were applied to the reconstruction of breasts with ptosis.

Methods:
Eight breast cancer patients with ptotic breasts underwent two-stage unilateral DIEP flap breast reconstruction. In the initial surgery, tissue expander (TE) placement and contralateral mastopexy are performed simultaneously. Four to six months later, 3D bilateral breast imaging is performed after confirming that the shape of the contralateral breast (post-mastopexy) is somewhat stabilized, and a 3D-printed breast mold is created based on the mirror image of the shape of the contralateral breast acquired using analytical software. Then, DIEP flap surgery is performed, where the breast mold is used to determine the required flap volume and to shape the breast mound.

Results:
All flaps were engrafted without any major perioperative complications during both the initial and DIEP flap surgeries. Objective assessment of cosmetic outcome revealed that good breast symmetry was achieved in all cases.

Conclusions:
The method described here may allow even inexperienced surgeons to achieve reconstruction of symmetrical, non-ptotic breasts with ease and in a short time. While the requirement of two surgeries is a potential disadvantage, our method will be particularly useful in cases involving TEs, i.e., delayed reconstruction or immediate reconstruction involving significant skin resection.
Impact of Mother-Daughter Relationship on Hypertension Self-management and Quality of Life
Authors: Shawler Celeste , Edward Jean , Ling Jiying , Crawford Tim N. , Rayens Mary Kay 
Published: October 2017

Background:
Although hypertension (HTN) treatment rates are similar across age groups of women, effective control is significantly worse among older women. Only 20% of hypertensive women aged 70 to 79 years have controlled blood pressure.

Objectives:
The purpose of this longitudinal study was to test the effects of the quality of mother-daughter relationship, inner strength, and control on HTN self-management and health-related quality of life (HRQOL) for both members of the dyad at 6 months. The Actor-Partner Interdependence Model was used to examine the direct (“actor”) and indirect (“partner”) effects of 46 dyads.

Results:
The mothers’ perceived relationship quality with daughters directly impacted their own self-management of HTN and HRQOL while also indirectly affecting their daughters’ self-management. Similarly, the daughters’ perceived strength of their relationship with their mothers directly influenced their self-management and HRQOL and indirectly affected their mothers’ self-management and HRQOL.
Vestibular Function Change in a Vasopressin-Induced Hydrops Model
Authors: Kim Minbum , Kim Kyu-Sung 
Published: October 2017

Hypothesis:
A vasopressin-induced endoymphatic hydrops model can represent an acute vertiginous attack in Menière's disease (MD).

Background:
Previous animal models are not appropriate to evaluate the efficacy of new treatments for hydrops because they cannot represent an acute attack of MD. Recently, a new dynamic model was introduced for acute hydrops exacerbation using the vasopressin type 2 receptor agonist, desmopressin (1-deamino-8-D-Arginine vasopressin, VP); however, resulting changes in vestibular function have not been investigated.

Methods:
A total of 37 guinea pigs were used. Two to 4 weeks after surgical ablation of endolymphatic sacs in 33 guinea pigs, acute exacerbation of hydrops was induced by a single VP injection in 18 animals (group A). Next, two VP injections at 1 hour interval were administered to investigate the effect of multiple VP doses on vestibular function in the other 15 animals (group B). In the remaining four animals, VP was injected without surgery for the control group (control). Bidirectional sinusoidal harmonic acceleration (SHA) tests of vestibular function were performed. “Type I response” was defined as when the maximum slow-phase velocity (SPV) during left rotation (toward the operated ear) was lower than that during right rotation (toward the normal ear). In contrast, “Type II response” was defined as when maximum SPV at the left rotation was higher than that at the right rotation. Vestibular symmetry scores were analyzed at baseline and after each of two VP injections given 1 hour apart.

Results:
Vestibular symmetry scores increased at 1 hour after VP injection in all 18 animals in group A (p < 0.001). Two hours after VP injection, symmetry score decreased to the initial score. Two different types of vestibular response were observed after VP. However, the symmetry scores between type I and II responses were not significantly different (p = 0.173). In all 15 animals of Group B, vestibular asymmetry was sustained over 3 hours when two VP injections were given 1 hour apart. In three of Group B, the type of vestibular response changed from type II response to type I response after the 2nd VP injection; however, no animal demonstrated a shift from type I to type II response.

Conclusion:
VP can transiently induce an acute exacerbation of hydrops and asymmetric vestibular dysfunction in guinea pigs. This model could help in studying new treatments for acute hydrops and in explaining the mechanism of bidirectional nystagmus in MD.
Petrous Apex Cholesterol Granulomas: Outcomes, Complications, and Hearing Results From Surgical and Wait-and-Scan Management
Authors: Grinblat Golda , Vashishth Ashish , Galetti Francesco , Caruso Antonio , Sanna Mario 
Published: October 2017

Objective:
1. To analyze the surgical outcomes in the management of petrous apex cholesterol granulomas (PACG) with a brief literature review.
2. To evaluate the importance of wait-and-scan management option.

Study Design:
Retrospective review.

Setting:
Quaternary referral center for otology and skull base surgery.

Subjects and Methods:
Charts of 55 patients with at least 12 months of follow-up were analyzed for demographic, clinical, audiometric, and radiological features. Patients were divided into surgical group (SG) (n = 31) and wait-and-scan (n = 24) (WS) group. Surgical approach was chosen as per hearing status and PACG extension and relation to nearby neurovascular structures and included either drainage by transmastoid-infralabyrinthine approach (TM-IL)/transcanal-infracochlear approach (TC-IC) or resection by infratemporal fossa type B approach (ITF-B). The combination of ITF-B with trans-otic (TO) approach or TO approach solely was used in unserviceable hearing cases. Postoperative outcomes and complications were evaluated in SG.

Results:
Postoperative symptom relief was observed in 24 patients (77.4%). Diplopia and paresthesia recovered in each case and improvement in headache, dizziness, tinnitus, and hearing loss was observed in 87.1% cases. Serviceable hearing was preserved in 24 of 26 cases. Postoperative complication rate was 32.2% including incidences of profound hearing loss, facial nerve paresis, carotid artery injury and intraoperative CSF leaks. Revision surgery was required in 3 (9.6%) cases, after TM-IL approach.

Conclusion:
Surgical drainage is preferable to more aggressive resection procedures, with the latter reserved for recurrent lesions or lesions with severe hearing loss/involvement of critical neurovascular structures. ITF-B approach provides adequate cyst and neurovascular control for resection, while avoiding brain retraction. An initial wait-and-scan approach can be used in most patients where symptoms and imaging justify so.
A Follow-Up Study on Music and Lexical Tone Perception in Adult Mandarin-Speaking Cochlear Implant Users
Authors: Gu Xin , Liu Bo , Liu Ziye , Qi Beier , Wang Shuo , Dong Ruijuan , Chen Xueqing , Zhou Qian 
Published: October 2017

Objective:
The aim was to evaluate the development of music and lexical tone perception in Mandarin-speaking adult cochlear implant (CI) users over a period of 1 year.

Study Design:
Prospective patient series.

Setting:
Tertiary hospital and research institute.

Patients:
Twenty five adult CI users, with ages ranging from 19 to 75 years old, participated in a year-long follow-up evaluation. There were also 40 normal hearing adult subjects who participated as a control group to provide the normal value range.

Interventions:
Musical sounds in cochlear implants (Mu.S.I.C.) test battery was undertaken to evaluate music perception ability. Mandarin Tone Identification in Noise Test (M-TINT) was used to assess lexical tone recognition. The tests for CI users were completed at 1, 3, 6, and 12 months after the CI switch-on.

Main Outcomes Measures:
Quantitative and statistical analysis of their results from music and tone perception tests.

Results:
The performance of music perception and tone recognition both demonstrated an overall improvement in outcomes during the entire 1-year follow-up process. The increasing trends were obvious in the early period especially in the first 6 months after switch-on. There was a significant improvement in the melody discrimination (p < 0.01), timbre identification (p < 0.001), tone recognition in quiet (p < 0.0001), and in noise (p < 0.0001).

Conclusions:
Adult Mandarin-speaking CI users show an increasingly improved performance on music and tone perception during the 1-year follow-up. The improvement was the most prominent in the first 6 months of CI use. It is essential to strengthen the rehabilitation training within the first 6 months.
Pediatric cancer genetics
Authors: Dean Sarah J. , Farmer Meagan 
Published: October 2017

Purpose of review
The current review will focus on the current knowledge of the contribution of both germline and somatic mutations to the development and management of cancer in pediatric patients.

Recent findings
It has long been thought that genetic mutations in both germline and somatic cells can contribute to the development of cancer in pediatric patients. With the recent advances in genomic technologies, there are now over 500 known cancer predisposition genes. Recent studies have confirmed an 8.5–14% germline mutation rate in cancer predisposition genes in pediatric cancer patients.

Summary
The discovery of both germline and somatic cells mutation(s) in pediatric cancer patients not only aids in the management of current disease, but can also have direct implications for future management as well as the medical management of family members.
Enhancing Outcomes for Outpatient Percutaneous Coronary Interventions
Authors: Spruce Kevin , Butler Chondra 
Published: October 2017

Purpose and Objectives:A quality improvement project was conducted to create a sustainable continuum of care for increased volumes of outpatients receiving percutaneous coronary interventions. Dramatic growth exposed system vulnerabilities and left staff overwhelmed. Four postinterventional project objectives included reducing preprocedural preparation times, reducing bleeding complications, reducing hospital length of stay, and collectively increasing patient satisfaction.Description of the Project:Amidst creating a specialized postintervention coronary recovery area and acquiring and training existing preregistration and recovery nurses, a fragmented system of care was united. The clinical nurse specialist–led project used a systematic and evidence-based implementation process to harmoniously acclimate perioperative staff. An evaluation process further defined new opportunities to support a growing service line.Outcomes:Postimplementation data were collected over a 3-month period. An overall improvement was found in all targeted objectives, despite an upsurge in case volumes. A moderately significant correlation (r[105] = 0.424,P< .001) was found between bleeding occurrences and hospital length of stay.Conclusion:The synergy between interdepartmental collaboration and strategic staffing reallocation was shown to be invaluable to alleviate procedural areas of service, such as the cardiac catheterization laboratory. As a project champion, the clinical nurse specialist is an essential catalyst to identify and creatively surmount system-level challenges.
Non–Vaccine-Type Human Papillomavirus Prevalence After Vaccine Introduction: No Evidence for Type Replacement but Evidence for Cross-Protection
Authors: Saccucci Mónica , Franco Eduardo L. , Ding Lili , Bernstein David I. , Brown Darron , Kahn Jessica A. 
Published: October 2017

Background
We examined non–vaccine-type human papillomavirus (HPV) prevalence in a community before and during the first 8 years after vaccine introduction, to assess for (1) type replacement with any non–vaccine-type HPV and (2) cross-protection with non–vaccine types genetically related to vaccine-type HPV.

Methods
Sexually experienced 13- to- 26-year-old women were recruited for 3 cross-sectional studies from 2006 to 2014 (N = 1180). Outcome variables were as follows: (1) prevalence of at least 1 of 32 anogenital non–vaccine-type HPVs and (2) prevalence of at least 1 HPV type genetically related to HPV-16 and HPV-18. We determined changes in proportions of non–vaccine-type HPV prevalence across the study waves using logistic regression with propensity score inverse probability weighting.

Results
Vaccine initiation rates increased from 0% to 71.3%. Logistic regression demonstrated that from 2006 to 2014, there was no increase in non–vaccine-type HPV among vaccinated women (adjusted odds ratio [AOR], 1.02; 95% confidence interval [CI], 0.73–1.42), but an increase among unvaccinated women (AOR, 1.88; 95% CI, 1.16–3.04). Conversely, there was a decrease in types genetically related to HPV-16 among vaccinated (AOR, 0.57; 95% CI, 0.38–0.88) but not unvaccinated women (AOR, 1.33; 95% CI, 0.81–2.17).

Conclusions
We did not find evidence of type replacement, but did find evidence of cross-protection against types genetically related to HPV-16. These findings have implications for cost-effectiveness analyses, which may impact vaccine-related policies, and provide information to assess the differential risk for cervical cancer in unvaccinated and vaccinated women, which may influence clinical screening recommendations. The findings also have implications for public health programs, such as health messaging for adolescents, parents, and clinicians about HPV vaccination.
Case Report: In Vivo Confocal Microscopic Appearance of Corneal Argyrosis
Authors: Wu Mengliang , Wang Xiaochun , Shao Tingting , Wang Yan 
Published: October 2017

SIGNIFICANCE
This report details the natural history of corneal argyrosis over 3 years using in vivo confocal microscopy to document regression of hyperreflective deposits, as well as effects on corneal nerves and endothelial cell morphology.

PURPOSE
To report the in vivo confocal microscopic features and clinical characteristics of a case of bilateral corneal argyrosis.

CASE REPORT
A 52-year-old man referred to us 3 months following cautery of the palpebral conjunctiva of both eyes with a silver nitrate stick was observed over the course of 3 years, during which slit-lamp photography and in vivo confocal microscopy were performed. At the first visit, slit-lamp examination showed a light blue-green discoloration and a thick, yellow, oval discoloration in the right and left cornea, respectively. One year later, under slit-lamp examination, the right cornea appeared nearly transparent, and the discoloration in the left cornea had remarkably regressed. In vivo confocal microscopy done at that time showed highly reflective deposits in Descemet membrane of the right cornea and throughout Bowman layer, the stroma, and Descemet membrane of the left cornea. Three years later, no accumulation of silver was observed during slit-lamp examination of either eye. In vivo confocal microscopy of the right cornea did not reveal any silver deposits, and the corneal structure appeared normal. In the left cornea, some silver deposits were still evident in Descemet membrane, and alterations of corneal nerve and endothelial cell morphology were also evident.

CONCLUSIONS
This report reviews the 3-year natural history of a patient with corneal argyrosis. In vivo confocal microscopy demonstrates that over time the corneal argyrosis gradually resolves without any treatment. However, the presence of silver in the cornea may impact the corneal nerves and endothelial cells.