bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of Life after Face Transplantation: Outcomes, Assessment Tools, and Future Directions
Authors: Aycart Mario A. , Kiwanuka Harriet , Krezdorn Nicco , Alhefzi Muayyad , Bueno Ericka M. , Pomahac Bohdan , Oser Megan L. 
Published: December 2016

Background:
Face transplantation has emerged as a clinical reality for the restoration of complex facial defects. Critical to the advancement of the burgeoning field of reconstructive transplantation is the quality of the methods used to measure and report the impact of face transplantation on quality of life.

Methods:
A systematic search using PubMed and EMBASE was conducted for all studies matching the a priori inclusion criteria from 2005 through 2015. Bibliographies of included studies were also reviewed. Two authors (M.A.A and H.K) independently performed screening of titles.

Results:
The authors identified 17 articles reporting on quality-of-life outcomes among 14 face transplant recipients. Combinations of objective and subjective measures were used to assess quality of life. Instruments used to assess quality of life after face transplantation included over 25 different instruments. Four centers, comprising eight patients, have reported using prospective, systematic data with validated instruments. Overall, there is reported improvement in quality of life after face transplantation. Heterogeneity and a paucity of data between articles preclude a quantitative analysis.

Conclusions:
Anecdotal and subjective reports of improvements in quality of life after face transplantation constitute the majority of reported outcomes in the English peer-reviewed literature. Improved efforts in methods and standardization of collection and reporting of quality-of-life data after face transplantation are needed to better appreciate the impact of face transplantation on quality of life and justify lifelong immunosuppression and its attendant risks and morbidity.
Neurectomy for the Treatment of Chronic Postoperative Pain after Surgery of the Trunk
Authors: Nagarkar Purushottam , Ramanadham Smita , Chamseddin Khalil , Chhabra Avneesh , Rozen Shai M. 
Published: December 2016

Background:
Incidence of chronic postoperative neurogenic pain after open and laparoscopic trunk operations is reported between 1 and 20 percent, rendering a large population in the United States and worldwide. One possible treatment is selective surgical neurectomy.

Methods:
All patients who underwent neurectomy for chronic trunk or groin postoperative neurogenic pain were identified. Based on individual history and examination, patients underwent neurectomies of the ilioinguinal, iliohypogastric, genitofemoral, lateral-femoral cutaneous, or intercostal nerves. Recorded preoperative pain levels (Likert score ranging from 0 to 10) were compared to postoperative pain levels and quality-of-life indices were assessed.

Results:
Fifty-six patients (32 men and 24 women) were included. Mean age was 49 years. All patients underwent preoperative nerve blocks by either surgeon, radiologist, or referring physician, and had either complete or significant response defined as over 50 percent relief. Forty-five patients completed the survey. Median follow-up was 2.8 years (range, 1.0 to 5.7 years). Average pain level was 9.0 preoperatively and 3.5 postoperatively. Quality-of-life impairment improved from 8.3 preoperatively to 3.5 postoperatively. A subset of patients (n = 12) had minimal improvement, reporting a decrease in pain from 8.5 to 7.2 and quality-of-life improvement from 8.5 to 7.1.

Conclusions:
Complete avoidance of nerve injury during all trunk and groin operations is likely unattainable. When chronic postoperative neurogenic pain develops, neurectomy can be an effective means of treatment, significantly improving pain and quality of life in most patients. Better insight is necessary into a patient subset responding to nerve blocks yet experiencing minimal postoperative improvement.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Base Nasal Bone Resection versus Oblique Nasal Bone Resection: A Comparative Study of the Outcomes for the Deviated Nose
Authors: Ince Bilsev , Dadaci Mehmet 
Published: December 2016

Background:
The aim of this study was to compare the techniques used for resection of the long side of the base and the top of the bone based on the patient’s perspective, surgeon’s approach, aesthetic results, complications, and need for secondary surgery in patients with asymmetric nasal bones. This study also aimed to determine the perspective of another plastic surgeon who did not perform rhinoplasty in comparison with the perspective of the primary plastic surgeon.

Methods:
One hundred sixty-six patients with nasal bone asymmetry between 2010 and 2015 were included in this study. Patients were divided into two groups: group 1, those treated with wedge resection of the bony nasal pyramid from the base of the nasal bone; and group 2, those treated with an oblique hump resection. Three different plastic surgeons and plastic surgery nurses who had no information regarding the randomization, patients, and primary plastic surgeon evaluated the surgical results.

Results:
The mean secondary surgery rate was significantly greater in group 2 than in group 1. The mean satisfaction ratio was significantly decreased with different plastic surgeons than with the primary plastic surgeon. Base nasal bone resection was more successful than oblique hump resection in patients with greater than or equal to 0.5-cm nasal bone asymmetry.

Conclusions:
Surgeons who did not perform the rhinoplasties can evaluate the results differently from the primary surgeon. Performing base bone resection may reduce the secondary surgery rate in patients with greater than or equal to 0.5-cm nasal bone asymmetry.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
Correction of Sagittal Craniosynostosis Using Distraction Osteogenesis Based on Strategic Categorization
Authors: Lee Myung Chul , Shim Kyu Won , Yun In Sik , Park Eun Kyung , Kim Yong Oock 
Published: December 2016

Background:
Distraction osteogenesis has been used to correct sagittal craniosynostosis in various ways. The purpose of this study was to introduce three distraction osteogenesis procedures by describing four objective measurements.

Methods:
Fifty-four patients with sagittal synostosis were recruited and assigned to one of three therapeutic groups: group 1, anteroposterior compression with bitemporal expansion (n = 35); group 2, bitemporal expansion (n = 9); and group 3, anteroposterior expansion with bitemporal expansion (n = 10). Distraction procedures were performed while maintaining dural attachment. Four indices—namely cranial index, head circumference, intracranial volume, and neurodevelopmental index (using the Bayley Scales of Infant Development II), were analyzed.

Results:
The preoperative cranial index of group 1 (68.51 ± 4.73) differed significantly from those of groups 2 (76.75 ± 2.4; p < 0.05) and 3 (86.8 ± 3.99; p < 0.05). Postoperative cranial index in all groups converged to the mesocephalic cranial index. Preoperative intracranial volume determinations were within the normal range for the majority of participants in groups 1 and 2; however, most fell below −1 SD in group 3 [n = 8 (80 percent)]. Postoperatively, 90 percent of group 3 participants had intracranial volume values within the normal range. The preoperative mental and psychomotor developmental indices of group 3 were significantly lower than those in the other two groups. The postoperative analysis showed significant improvement in these indices in groups 1 and 3 or when all patients were analyzed.

Conclusion:
Symmetric sagittal synostosis can be effectively treated with distraction osteogenesis reformation guided by strategic categorization.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Experimental Rat Skin Flap Model That Distinguishes between Venous Congestion and Arterial Ischemia: The Reverse U-Shaped Bipedicled Superficial Inferior Epigastric Artery and Venous System Flap
Authors: Matsumoto Noriko M. , Aoki Masayo , Nakao Junichi , Peng Wei-Xia , Takami Yoshihiro , Umezawa Hiroki , Akaishi Satoshi , Ohashi Ryuji , Naito Zenya , Ogawa Rei 
Published: December 2016

Background:
The commonly used flap models have drawbacks that limit their usefulness. In the random skin flap model, flap necrosis is caused by both arterial and venous insufficiency. In the axial skin flap model, flap viability is easily affected by the pedicle blood flow and can result in complete necrosis. This study aimed to establish a new rat skin flap model that has a consistent flap survival rate and in which venous congestion and arterial ischemia can be readily distinguished macroscopically.

Methods:
Rats underwent reverse U-shaped bipedicled superficial epigastric artery flap elevation. The right superficial epigastric vessels formed the pedicle. In the control rats (n = 3), the left superficial epigastric vessels were left intact. In the ischemia group (n = 10), the left superficial epigastric artery was ligated. In the congestion group (n = 10), the left superficial epigastric vein was ligated. The flap was returned to the original site and sutured. The surrounding neovascularization was blocked by polyurethane film. Flap survival rates were evaluated on postoperative day 3.

Results:
The flaps in the ischemia and congestion groups were noticeably pale and violet, respectively. Flap necrosis was noted in the contralateral distal zone only. It started on postoperative day 2 in the ischemia and congestion groups. The mean flap survival rates of the control, ischemia, and congestion groups were 100 percent, 61.8 percent (range, 56.9 to 67.1 percent), and 42.3 percent (35.7 to 48.7 percent), respectively (all p < 0.001).

Conclusions:
The flap facilitated discrimination of the effects of ischemia and congestion. This new rat skin flap model is simple and easy to construct, and has a consistent flap survival rate.
Use of Poly-4-Hydroxybutyrate Mesh to Optimize Soft-Tissue Support in Mastopexy: A Single-Site Study
Authors: Adams William P. , Moses Arikha C. 
Published: December 2016

Background:
The ptotic breast is surgically rejuvenated through a mastopexy procedure. Recurrent ptosis or other negative changes to the breast shape are not uncommon following mastopexy, as the tissue laxity and skin quality that contributed to ptosis are not surgically corrected. The purpose of this study was to assess the postsurgical changes in the breasts of patients who underwent a primary mastopexy procedure with soft-tissue reinforcement using a long-term poly-4-hydroxybutyrate resorbable scaffold (i.e., GalaFLEX).

Methods:
From July of 2012 to January of 2014, 11 consecutive patients underwent a central mound mastopexy with soft-tissue reinforcement in the lower pole using a poly-4-hydroxybutyrate resorbable scaffold. Patients returned for postoperative follow-up visits that included three-dimensional scans of their breasts at months 1, 3, 6, and 12.

Results:
There were no major complications in the study. Changes in the breast shape defined by distances between predefined landmarks between months 1 and 12 ranged from 1.5 to 9.6 percent. Some postoperative breast settlement occurred between months 1 and 3. The mean change in the nipple-to–inframammary fold distance from months 1 to 12 was 8 mm. Lower pole stretch was 5 percent.

Conclusions:
Initial findings suggest that central mound mastopexy with soft-tissue reinforcement in the lower pole performed on difficult larger breasts yields a relatively stable result for 1 year after surgery. There was no statistically significant change between months 3 and 12 from the sternal notch to lowest point on the breast as determined by established three-dimensional imaging techniques.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Evaluation and Implementation of a High-Fidelity Cleft Palate Simulator
Authors: Podolsky Dale J. , Fisher David M. , Wong Karen W. , Looi Thomas , Drake James M. , Forrest Christopher R. 
Published: December 2016

Background:
Cleft palate repair is a challenging procedure to learn because of the delicate tissue handling required and the small confines of the infant oral cavity. As a result, cleft palate simulators have previously been described to augment cleft palate repair training. Although valuable, they lack the fidelity for this complex procedure.

Methods:
A high-fidelity cleft palate simulator was evaluated by staff and fellows in pediatric plastic surgery who provided feedback on its realism, anatomical accuracy, and effectiveness as a training tool. The simulator was implemented within a training workshop following a didactic session on cleft palate repair and anatomy. A test was administered to each participant before and immediately after the workshop to assess knowledge transfer. Perceived confidence of performing a repair following the workshop was also assessed, as was the workshop’s effectiveness.

Results:
Overall, participants agreed that the simulator is anatomically accurate and realistic and strongly agreed that the simulator is a valuable training tool. The average test score increased from 25 percent before the workshop to 77.27 percent after the workshop. Overall, participants of the workshop felt more confident performing a repair and strongly agreed that the workshop was valuable and effective.

Conclusions:
A high-fidelity cleft palate simulator has been evaluated as realistic, anatomically accurate, and valuable as a training tool. The simulator was successfully integrated into a training workshop, which resulted in significant knowledge increase on anatomy and the procedure and perceived confidence and comfort in performing a cleft palate repair.
Assessment of Biopsychosocial Complexity and Health Care Needs: Measurement Properties of the INTERMED Self-Assessment Version
Authors: van Reedt Dortland Arianne K.B. , Peters Lilian L. , Boenink Annette D. , Smit Jan H. , Slaets Joris P.J. , Hoogendoorn Adriaan W. , Joos Andreas , Latour Corine H.M. , Stiefel Friedrich , Burrus Cyrille , Guitteny-Collas Marie , Ferrari Silvia 
Published: December 2016

ABSTRACT

Objective
The INTERMED Self-Assessment questionnaire (IMSA) was developed as an alternative to the observer-rated INTERMED (IM) to assess biopsychosocial complexity and health care needs. We studied feasibility, reliability, and validity of the IMSA within a large and heterogeneous international sample of adult hospital inpatients and outpatients as well as its predictive value for health care use (HCU) and quality of life (QoL).

Methods
A total of 850 participants aged 17 to 90 years from five countries completed the IMSA and were evaluated with the IM. The following measurement properties were determined: feasibility by percentages of missing values; reliability by Cronbach α; interrater agreement by intraclass correlation coefficients; convergent validity of IMSA scores with mental health (Short Form 36 emotional well-being subscale and Hospital Anxiety and Depression Scale), medical health (Cumulative Illness Rating Scale) and QoL (Euroqol-5D) by Spearman rank correlations; and predictive validity of IMSA scores with HCU and QoL by (generalized) linear mixed models.

Results
Feasibility, face validity, and reliability (Cronbach α = 0.80) were satisfactory. Intraclass correlation coefficient between IMSA and IM total scores was .78 (95% CI = .75–.81). Correlations of the IMSA with the Short Form 36, Hospital Anxiety and Depression Scale, Cumulative Illness Rating Scale, and Euroqol-5D (convergent validity) were −.65, .15, .28, and −.59, respectively. The IMSA significantly predicted QoL and also HCU (emergency department visits, hospitalization, outpatient visits, and diagnostic examinations) after 3- and 6-month follow-up. Results were comparable between hospital sites, inpatients and outpatients, as well as age groups.

Conclusions
The IMSA is a generic and time-efficient method to assess biopsychosocial complexity and to provide guidance for multidisciplinary care trajectories in adult patients, with good reliability and validity across different cultures.
CpG traffic lights are markers of regulatory regions in humans
Authors: Khamis Abdullah M. , Lioznova Anna V. , Artemov Artem V. , Ramensky Vasily , Bajic Vladimir B. , Medvedeva Yulia A. 
Published: December 2016

AbstractDNA methylation is involved in regulation of gene expression. Although modern methods profile DNA methylation at single CpG sites, methylation levels are usually averaged over genomic regions in the downstream analyses. In this study we demonstrate that single CpG methylation can serve as a more accurate predictor of gene expression compared to average promoter / gene body methylation. CpG positions with significant correlation between methylation and expression of a gene nearby (named CpG traffic lights) are evolutionary conserved and enriched for exact TSS positions and active enhancers. Among all promoter types, CpG traffic lights are especially enriched in poised promoters. Genes that harbor CpG traffic lights are associated with development and signal transduction. Methylation levels of individual CpG traffic lights vary between cell types dramatically with the increased frequency of intermediate methylation levels, indicating cell population heterogeneity in CpG methylation levels. Being in line with the concept of the inherited stochastic epigenetic variation, methylation of such CpG positions might contribute to transcriptional regulation. Alternatively, one can hypothesize that traffic lights are markers of absent gene expression resulting from inactivation of their regulatory elements. The CpG traffic lights provide a promising insight into mechanisms of enhancer activity and gene regulation linking methylation of single CpG to expression.
Viral Quasispecies Reconstruction via Correlation Clustering
Authors: Barik Somsubhra , Das Shreepriya , Vikalo Haris 
Published: December 2016

AbstractRNA viruses are characterized by high mutation rates that give rise to populations of closely related viral genomes, the so-called viral quasispecies. The underlying genetic heterogeneity occurring as a result of natural mutation-selection process enables the virus to adapt and proliferate in face of changing conditions over the course of an infection. Determining genetic diversity (i.e., inferring viral haplotypes and their proportions in the population) of an RNA virus is essential for the understanding of its origin and mutation patterns, and the development of effective drug treatments. In this paper we present QSdpR, a novel correlation clustering formulation of the quasispecies reconstruction problem which relies on semidefinite programming to accurately estimate the sub-species and their frequencies in a mixed population. Extensive comparisons with existing methods are presented on both synthetic and real data, demonstrating efficacy and superior performance of QSdpR.
Highly-efficient Cpf1-mediated gene targeting in mice following high concentration pronuclear injection
Authors: Watkins-Chow Dawn E. , Varshney Gaurav K. , Garrett Lisa J. , Chen Zelin , Jimenez Erin A. , Rivas Cecilia , Bishop Kevin S. , Sood Raman , Harper Ursula L. , Pavan William J. , Burgess Shawn M. 
Published: December 2016

ABSTRACTCpf1 has emerged as an alternative to the Cas9 RNA-guided nuclease. Here we show that gene targeting rates in mice using Cpf1 can meet or even surpass Cas9 targeting rates (approaching 100% targeting) but require higher concentrations of mRNA and guide. We also demonstrate that co-injecting two guides with close targeting sites can result in synergistic genomic cutting, even if one of the guides has minimal cutting activity.
Hong Kong’s curriculum reform: intentions, perceptions and practices
Authors: Lo Joe Tin-yau , Cheng Irene Nga-yee , Wong Emmy Man-yee 
Published: December 2016

PurposeThe purpose of this paper is to analyze the complex, intricate relationships between the central (intended) curriculum, teachers’ perceived curriculums, and the enacted/assessed curriculum in classroom contexts. To do this, the authors have used Hong Kong’s new core senior-secondary liberal studies (LS) curriculum as a case study, with a special focus on its key pedagogical component – inquiry teaching/learning.Design/methodology/approachThis study’s objects are two teachers (from two local schools), each with a LS teacher’s education. Documentary analysis, lesson observation, and focus interviews were used to triangulate data for interpretation and analysis.FindingsThe findings illuminate: how LS teachers’ perceptions of inquiry teaching/learning relate to and align with the advocacy embodied in the intended curriculum, the relationships between teachers’ perceptions and practices of inquiry learning and teaching, and how this aspect of the intended curriculum reform can be made more relevant to the classroom context.Originality/valueThis paper contributes to the under-researched area of curriculum gaps and (mis)alignments in Hong Kong’s LS curriculum reform.
The Summer 2014 protests in Macau: their contexts and continuities
Authors: Wong Hio Hei Albert 
Published: December 2016

Purpose
The purpose of this paper is to provide the historical and social contexts for the three protests in Macau in the Summer of 2014, while examining the popular discourse of the protests. These include simultaneous eruptions toward immediate issues, the political apathy of Macau residents and Castell’s model of “networked social networks.” It also discusses the competition for youth after the protests.

Design/methodology/approach
This paper first reviews the history of Macau, in particular the people’s struggle against corruption and privilege, and its little-discussed history of protest. Its innovation in communications, political structure and education development are also explained to illustrate the foundations which make possible protests against an obsolete social structure.

Findings
The author finds that the history of Macau since the nineteenth century does not lack protests, with goals ranging from protests against colonialism to national and local demands. Macau youth are now more able and willing to mobilize themselves to make demands on the administration, and activists find it necessary to pass down such experience for generations to come.

Originality/value
The paper deconstructs the traditional image of Macau’s politics, by appealing to the linkage between continuity and contemporary events, and calls for the reader’s attention toward its social activism.