bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergent Literacy in Thai Preschoolers: A Preliminary Study
Authors: Yampratoom Ramorn , Aroonyadech Nawarat , Ruangdaraganon Nichara , Roongpraiwan Rawiwan , Kositprapa Jariya 
Published: June 2017

ABSTRACT:

Objective:
To investigate emergent literacy skills, including phonological awareness when presented with an initial phoneme-matching task and letter knowledge when presented with a letter-naming task in Thai preschoolers, and to identify key factors associated with those skills.

Methods:
Four hundred twelve typically developing children in their final kindergarten year were enrolled in this study. Their emergent reading skills were measured by initial phoneme-matching and letter-naming tasks. Determinant variables, such as parents' education and teachers' perception, were collected by self-report questionnaires.

Results:
The mean score of the initial phoneme-matching task was 4.5 (45% of a total of 10 scores). The mean score of the letter-naming task without a picture representing the target letter name was 30.2 (68.6% of a total of 44 scores), which increased to 38.8 (88.2% of a total of 44 scores) in the letter-naming task when a picture representing the target letter name was provided. Both initial phoneme-matching and letter-naming abilities were associated with the mother's education and household income. Letter-naming ability was also influenced by home reading activities and gender.

Conclusion:
This was a preliminary study into emergent literacy skills of Thai preschoolers. The findings supported the importance of focusing on phonological awareness and phonics, especially in the socioeconomic disadvantaged group.
Urrets-Zavalia Syndrome After Diode Laser Transscleral Cyclophotocoagulation
Authors: Vieira Geraldo M. , Vieira Fernando J. , Ritch Robert 
Published: June 2017

Objective:
To report the occurrence of 5 cases of Urrets-Zavalia syndrome after transscleral diode laser cyclophotocoagulation (TSCPC).

Design:
Retrospective cases series.

Methods:
A review of the charts of 5 patients treated with TSCPC as primary glaucoma surgery who developed Urrets-Zavalia syndrome.

Results:
A total of 8 eyes of 5 patients developed a fixed and dilated pupil after TSCPC, unresponsive to light. A mydriatic pupil could still be observed at least 6 months after treatment in 7 of 8 eyes; however, it was asymptomatic.

Conclusions:
Urrets-Zavalia syndrome is a possible complication of TSCPC, as well as of other 360-degree thermal laser procedures.
Testing a Holistic Meditation Intervention to Address Psychosocial Distress in Patients With Heart Failure
Authors: Heo Seongkum , McSweeney Jean , Ounpraseuth Songthip , Shaw-Devine Allison , Fier Audrey , Moser Debra K. 
Published: June 2017

Background:
Many patients with heart failure (HF) experience persistent symptoms and poor health-related quality of life (HRQOL). Psychosocial distress is common and adversely affects HF symptoms and HRQOL. A holistic meditation (HOME) intervention that combines mindfulness, compassionate meditation, and self-management may reduce psychosocial distress.

Purpose:
The aims of this study were to examine the feasibility and acceptability of the HOME intervention in patients with HF and to obtain preliminary data about its effects on psychosocial factors (depressive symptoms, perceived control, and social support), HF symptoms, and HRQOL.

Methods:
Weekly 90-minute intervention sessions were delivered to 11 patients with HF for 12 weeks. Data on feasibility and acceptability were collected for 12 weeks, and data on psychosocial factors, HF symptoms, and HRQOL were collected at baseline and after the intervention.

Results:
Eleven of 13 enrolled patients completed all intervention sessions; 2 withdrew because of family health issues. Mean acceptability scores for all sessions ranged from 98% to 100%. In paired t test analyses, perceived control (P = .02, Cohen d = 0.82) and social support (P = .008, Cohen d = 1.00) increased, severity of depressive symptoms (P < .001, Cohen d = 1.54) and HF symptoms (P < .001, Cohen d = 1.91) decreased, and HRQOL was improved (P < .001, Cohen d = 1.82).

Conclusions:
The HOME intervention was feasible and acceptable and had positive effects on psychosocial variables, HF symptoms, and HRQOL for patients with HF. Our results indicate that treatment effects should be tested in a larger, controlled clinical trial.
Validation of a Questionnaire to Delineate the Clinical Trial Nursing Roles in Korea
Authors: Choi In Jung , Park Hye-Ja 
Published: June 2017

Background:
In clinical trials, research nurses play a particularly important role in promoting cancer care best practices. However, no Korean questionnaire has been developed to define the clinical trial nursing roles based on Good Clinical Practice standards.

Objective:
The aim of this study was to cross-culturally evaluate the reliability and validity of a Korean version of the Clinical Trials Nursing Questionnaire (CTNQ) among Korean clinical research nurses.

Methods:
Cross-cultural adaptation was performed, with forward and backward translation, a pilot test (linguistic validation), and a field test. Validation was performed by questioning 53 clinical research nurses who were working in clinical cancer centers at 5 tertiary university hospitals. The distribution of the item responses and internal consistency reliability were assessed using the ceiling and floor effects, Cronbach’s α, and the item-total correlation. Construct validity was assessed using Spearman correlation analysis and principal-component factor analysis.

Results:
The distributions of the item responses and the item-total correlation were generally appropriate. The Cronbach’s α values for the frequency scale and the importance scale were 0.852 and 0.899, respectively. Eight sections of the Korean CTNQ were generally correlated with each other. The frequency subscale loaded on 1 factor, and the importance subscale loaded on 2 factors, with broadly similar factor loadings.

Conclusion:
The Korean version of the CTNQ is reliable, valid, and interchangeable with the original CTNQ.

Implications for Practice:
The Korean version of the CTNQ can be used to validly and reliably assess the clinical trial nursing roles in Korea.
Measuring Provider Performance for Physicians Participating in the Merit-Based Incentive Payment System
Authors: Squitieri Lee , Chung Kevin C. 
Published: June 2017

Summary:
In 2017, the Centers for Medicare and Medicaid Services began requiring all eligible providers to participate in the Quality Payment Program or face financial reimbursement penalty. The Quality Payment Program outlines two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. For the first performance period beginning in January of 2017, the Centers for Medicare and Medicaid Services estimates that approximately 83 to 90 percent of eligible providers will not qualify for participation in an Advanced Alternative Payment Model and therefore must participate in the Merit-Based Incentive Payment System program. The Merit-Based Incentive Payment System path replaces existing quality-reporting programs and adds several new measures to evaluate providers using four categories of data: (1) quality, (2) cost/resource use, (3) improvement activities, and (4) advancing care information. These categories will be combined to calculate a weighted composite score for each provider or provider group. Composite Merit-Based Incentive Payment System scores based on 2017 performance data will be used to adjust reimbursed payment in 2019. In this article, the authors provide relevant background for understanding value-based provider performance measurement. The authors also discuss Merit-Based Incentive Payment System reporting requirements and scoring methodology to provide plastic surgeons with the necessary information to critically evaluate their own practice capabilities in the context of current performance metrics under the Quality Payment Program.
Assessment of the Efficacy of Cryolipolysis on Saddlebags: A Prospective Study of 53 Patients
Authors: Adjadj Lucille , SidAhmed-Mezi Mounia , Mondoloni Marine , Meningaud Jean Paul , Hersant Barbara 
Published: June 2017

Background:
Cryolipolysis is a noninvasive subcutaneous fat removal technique. Its efficacy has been demonstrated on various fatty areas but not yet on saddlebags. The main objective of this study was to demonstrate the efficacy, patient tolerance, and safety of cryolipolysis on the saddlebags.

Methods:
This prospective study enrolled 53 patients with saddlebags. Patients with a history of liposuction or other surgical procedure on the saddlebag area and those on diet pills were excluded. The primary endpoint was a decrease in fat thickness at 3 and 6 months, as assessed by thigh circumference measurement and by ultrasound evaluation of subcutaneous fat. Pain associated with cryolipolysis was assessed using a visual analogue scale. Body mass index at the different time points and adverse events were recorded. All patients completed a satisfaction questionnaire at the end of the study.

Results:
At 6 months, there was a mean decrease of 5.63 cm in thigh circumference; the mean decrease in fat layer thickness measured by ultrasound was 1.31 cm. The satisfaction questionnaire showed that 93.75 percent of patients were satisfied with the results. The mean visual analogue scale score was 1.66 of 10 after the session. Reversible skin changes such as postprocedure postinflammatory hyperpigmentation were observed in 8.33 percent of patients.

Conclusions:
Cryolipolysis is an effective technique for reducing saddlebag fat and is well tolerated by patients. A substantial risk of skin lesions, including postinflammatory hyperpigmentation that resolved after a few months, was observed. Cryolipolysis is a good alternative to liposuction in women with moderate, well-localized saddlebags.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Predictors, Classification, and Management of Umbilical Complications in DIEP Flap Breast Reconstruction
Authors: Cho Min-Jeong , Teotia Sumeet S. , Haddock Nicholas T. 
Published: June 2017

Background:
In recent years, the deep inferior epigastric perforator (DIEP) flap has become the workhorse flap for autologous breast reconstruction. Despite increased reports on DIEP flaps, umbilical complications have not been previously studied. The aesthetics of the umbilicus dictates the beauty of the abdomen, and it is critical for plastic surgeons to minimize the scarring of the umbilicus. In this study, we retrospectively reviewed patients who underwent DIEP flaps to determine the predictors of umbilical complications, and created a classification system of these wounds.

Methods:
Retrospective review of 323 patients who underwent DIEP flap surgery from 2009 to 2016 was performed. Umbilical stalk heights, widths of fascial diastasis, and abdominal wall thicknesses were measured from computed tomographic scans. Data regarding demographic and patient characteristics were collected.

Results:
Of the 323 patients, there were 58 patients that had umbilical complications (18 percent). These patients had statistically higher body mass indexes, heavier flaps, and thicker abdominal walls (p < 0.05). Also, they had statistically higher umbilical stalk heights (29.3 mm versus 18.7 mm), and analysis showed that the likelihood ratio of having umbilical complications was 2.05 at 20.1 mm, 3.05 at 25.4 mm, and 6.43 at 30 mm. Logistic regression analysis revealed that umbilical stalk height, fascial diastasis, age, procedure time, and flap weight were significant predictors (p < 0.05).

Conclusions:
Umbilical complications in patients undergoing DIEP flap surgery for breast reconstruction have not been previously studied. Our study shows that the umbilical stalk height plays a significant role, and umbilical wounds can be classified into five types: no wound, minor wound, wound dehiscence, partial necrosis, and total necrosis.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
The Efficacy of Perforator Flaps in the Treatment of Chronic Osteomyelitis
Authors: Hong Joon Pio (Jp) , Goh Terence L. H. , Choi Dong Hoon , Kim Jung Jae , Suh Hyun Suk 
Published: June 2017

Background:
Treatment of chronic osteomyelitis involves aggressive débridement followed by soft-tissue coverage. The dictum of muscle coverage being superior has been challenged by successful reports of coverage with skin flaps. The objective of this article is to evaluate the efficacy of perforator flaps for reconstruction of chronic osteomyelitis defects.

Methods:
A retrospective review of 120 patients with chronic osteomyelitis who underwent débridement and reconstruction using perforator flaps from April of 2000 to November of 2015 was conducted. Inclusion criteria were cases with chronic osteomyelitis for a minimum of 6 weeks and with a follow-up of at least 2 years after surgery. Correlation between recurrence and the following factors was analyzed: comorbidities, frequency of débridement, duration of chronic osteomyelitis, limb vascular status, and method of dead space obliteration. The outcomes analyzed were flap loss, recurrence rate, primary remission rate, secondary remission rate, and amputation rate.

Results:
The flap loss rate was 4.2 percent flap, the recurrence rate was 8.3 percent, the primary remission rate was 91.6 percent, the secondary remission rate was 98.3 percent, and the amputation rate was 1 percent. Significant predictors of recurrence were peripheral vascular disease and major vessel compromise, which had 5.1 times higher odds of recurrence (p < 0.05).

Conclusions:
Used with adequate débridement, bone reconstruction, and obliteration of dead space, a primary remission rate of 91.6 percent and a secondary remission rate of 98.3 percent were achieved using perforator flap. The predictors of chronic osteomyelitis recurrence were peripheral vascular disease and major vascular compromise.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Evidence-Based Medicine: Management of Metacarpal Fractures
Authors: Wong Victor W. , Higgins James P. 
Published: June 2017

Learning Objectives:
After reading this article, the participant should be able to: 1. Understand metacarpal anatomy and its role in fracture pathology. 2. Determine when surgical intervention is needed for metacarpal fractures. 3. Understand the various treatment options for surgical fixation of metacarpal fractures. 4. Describe the role for external fixation in managing difficult metacarpal fractures.

Background:
Metacarpal fractures are common injuries that plastic surgeons should be able to evaluate and treat. The goal of this review is to highlight current evidence for managing metacarpal fractures. This Continuing Medical Education article consists of a literature review, illustrations, videos, and an online Continuing Medical Education examination.

Methods:
The authors reviewed the scientific literature from 2000 to 2015 regarding treatment of metacarpal fractures. Cadaver models were used for instructional videography demonstrating common surgical techniques. Multiple-choice questions were created to review pertinent topics. A discussion and references are provided.

Results:
Numerous treatment options have been described for metacarpal fractures, including splinting, percutaneous fixation, open reduction with internal fixation, and external fixation. All modalities are acceptable strategies for treating metacarpal fractures. The ultimate goal is to maximize hand function with minimal morbidity.

Conclusions:
A thorough understanding of treatment modalities is helpful in evaluating and managing metacarpal fractures. Although the current literature supports a wide array of treatment strategies, high-level evidence to guide fracture management remains lacking.
The Classification and Prognosis of Periocular Complications Related to Blindness following Cosmetic Filler Injection
Authors: Myung Yujin , Yim Sangjun , Jeong Jae Hoon , Kim Baek-Kyu , Heo Chan-Yeong , Baek Rong-Min , Pak Chang-Sik 
Published: June 2017

Summary:
Common side effects during hyaluronic acid filler injections are typically mild and reversible, but several reports of blindness have received attention. The present study focused on orbital symptoms combined with blindness, aiming to classify affected patients and predict their disease course and prognosis. From September of 2012 to August of 2015, nine patients with vision loss after filler injection were retrospectively reviewed. Ptosis, ophthalmoplegia, and enophthalmos were recorded over a 6-month follow-up, and patients were classified into four types according to periocular symptom manifestation. Two patients were categorized as type I (blindness without ptosis or ophthalmoplegia), two patients as type II (blindness and ptosis without ophthalmoplegia), two patients as type III (blindness and ophthalmoplegia without ptosis), and three patients as type IV (blindness with ptosis and ophthalmoplegia). The present study includes previously unpublished information about orbital symptom manifestations and prognosis combined with blindness caused by retinal artery occlusion after cosmetic filler injection.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
Evidence-Based Medicine: Alloplastic Breast Reconstruction
Authors: Lennox Peter A. , Bovill Esta S. , Macadam Sheina A. 
Published: June 2017

Learning Objectives:
After studying this article, the participant should be able to: 1. Understand the different advances that have resulted in improved outcomes in implant-based reconstruction. 2. Gain knowledge about specific techniques that have evolved rapidly in recent years and how to implement these. 3. Gain an understanding of controversies associated with alloplastic reconstruction. 4. Recognize undesirable outcomes in implant-based breast reconstruction and understand strategies for correction.

Summary:
There have been multiple advances in implant-based breast reconstruction. Many of these have resulted in improvements in patient outcomes and care. Understanding new techniques and technologies ensures competence in providing care for the alloplastic breast reconstruction patient. This article was prepared to accompany practice-based assessment with ongoing surgical education for the Maintenance of Certification for the American Board of Plastic Surgery. It is structured to outline the care of the patient with the postmastectomy breast deformity.
Evidence-Based Medicine: The Bilateral Cleft Lip Repair
Authors: Zhang Jacques X. , Arneja Jugpal S. 
Published: June 2017

Learning Objectives:
After reading this article, the participant should be able to: 1. Understand the epidemiology, abnormal embryology, anatomy, and etiopathogenesis of cleft lip. 2. Be able to classify and describe bilateral cleft lip. 3. Recognize the importance of preoperative management of bilateral cleft lip. 4. Recognize the large breadth of differing management options. 5. Describe key steps and tenets of the surgical repair.

Summary:
This fourth Maintenance of Certification/Continuing Medical Education article on cleft lip focuses on the topic of bilateral cleft lip. Previous articles placed an emphasis on the unilateral cleft lip, velopharyngeal insufficiency, or cleft lip and palate management. The authors focus on summarizing key points from previous articles and describing the importance of preoperative management and surgical repair of the bilateral cleft lip.
Evidence-Based Medicine: Surgical Management of Flexor Tendon Lacerations
Authors: Kamal Robin N. , Yao Jeffrey 
Published: June 2017

Learning Objectives:
After reading this article, the participant should be able to: 1. Accurately diagnose a flexor tendon injury. 2. Develop a surgical approach with regard to timing, tendon repair technique, and rehabilitation protocol. 3. List the potential complications following tendon repair.

Summary:
Flexor tendon lacerations are complex injuries that require a thorough history and physical examination for accurate diagnosis and management. Knowledge of operative approaches and potential concomitant injuries allows the surgeon to be prepared for various findings during exploration. Understanding the biomechanical principles behind tendon lacerations and repair techniques aids the surgeon in selecting the optimal repair technique and postoperative rehabilitation.
Evidence-Based Medicine: Current Evidence in the Diagnosis and Management of Carpal Tunnel Syndrome
Authors: Hermiz Steven J. , Kalliainen Loree K. 
Published: June 2017

Learning Objectives:After studying this article, the participant should be able to: 1. Create a safe and effective plan for management of carpal tunnel syndrome. 2. Support his or her rationale for the use of diagnostic tests. 3. Discuss elements of management that have been controversial, including anesthesia, the use of a tourniquet, postoperative pain control, and cost of care.Summary:This is the fourth MOC-PS CME article on carpal tunnel syndrome. Each of the prior three has had a slightly different focus, and the reader is invited to review all to generate a comprehensive view of the management of this common, and often controversial, topic. The operative goal—to release the transverse carpal ligament—is straightforward: diagnosis, cause, and technique have generated more vibrant discussions.
Evidence-Based Medicine: Breast Augmentation
Authors: Schwartz Michael R. 
Published: June 2017

Learning Objectives:
After reading this article, the participant should be able to: 1. Understand the key decisions in patient evaluation for cosmetic breast augmentation. 2. Cite key decisions in preoperative planning. 3. Discuss the risks and complications, and key patient education points in breast augmentation.

Summary:
Breast augmentation remains one of the most popular procedures in plastic surgery. The integral information necessary for proper patient selection, preoperative assessment, and surgical approaches are discussed. Current data regarding long term safety and complications are presented to guide the plastic surgeon to an evidence-based approach to the patient seeking breast enhancement to obtain optimal results.