bluuebunny/crossref_metadata_2025_split huggingface dataset:
Septum-Based Nasal Tip Plasty: A Comparative Study between Septal Extension Graft and Double-Layered Conchal Cartilage Extension Graft
Authors: Suh Young Chul , Jeong Woo Shik , Choi Jong Woo 
Published: September 2017

Background:
The septal extension graft is currently the most commonly used primary and secondary rhinoplasty technique in Asia because it provides maximal tip projection and rotational controllability. The authors compared the tip projection amount and rotational controllability of the tip support between the septal extension graft based on the L-strut septum and double-layer conchal cartilage graft based on the full septum at the nasal tip.

Methods:
Twenty-seven consecutive patients who underwent nasal tip plasty with the septal extension graft or double-layer conchal cartilage graft for purely aesthetic reasons between March of 2014 and July of 2016 were included. The nasal tip projection and columellar labial angle preoperatively (time 0), immediately postoperatively (time 1, an average of 2 weeks after the operation), and postoperatively (time 2, an average of 7 months after the operation) were analyzed with clinical photography.

Results:
Fourteen patients (group A) underwent septal extension graft surgery and 13 (group B) underwent double-layer conchal cartilage graft surgery. Changes of 61 and 74 percent in tip projection ratio were immediately achieved and were maintained after surgery for groups A and B, respectively (time 2 versus time 0 dividing time 1 versus time 0; p = 0.722 for groups A and B). Therefore, the relapse ratio of this technique was 39 and 26 percent for groups A and B, respectively.

Conclusions:
This comparative study between the septal extension graft and double-layer conchal cartilage graft showed that both nasal tip plasties are similar in terms of stability. Considering the fact that the double-layer conchal cartilage graft could preserve septal support, this technique could become an effective and safe alternative option for rhinoplasty.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Metacarpal-Like Hand: Classification and Treatment Guidelines for Microsurgical Reconstruction with Toe Transplantation
Authors: Wei Fu-Chan , AL Deek Nidal F. , Lin Yu-Te , Hsu Chung-Chen , Lin Cheng-Hung 
Published: September 2017

Summary:
The metacarpal-like hand is a severe hand injury, never addressed before. It describes a hand that has lost a significant degree of prehension through a wide array of amputations, involving all digits proximal to the functional length except in one finger or in two digits, including the thumb. The thumb condition can be used to differentiate between two types. In type I, the thumb is intact or amputated at or distal to the interphalangeal joint (functional length); therefore, the reconstruction is focused mainly on fingers. In type II, the thumb is amputated proximal to the interphalangeal joint; therefore, the reconstruction is focused on both the thumb and fingers. Thumb amputation level, integrity of the first basal joint, and functionality of the thenar muscles can be used to subdivide type II. Functional reconstruction should consider the patient’s desire and vocational needs. The finger left with adequate functional length is assessed for its location, level of amputation, and joint motion, especially the proximal interphalangeal joint. The goal is to use the reliable techniques of toe-to-hand surgery to reconstruct more opposable units, at least two fingers, whether adjacent to each other or not, and the thumb, when needed, to achieve a functionally and aesthetically better hand instead of a functionally adequate hand, with a more acceptable to ideally natural hand cascade. Strategic, individualized toe transfer(s) is the key element in fulfilling the goals of this operation whether single or multiple toes are transplanted.
Nocardia infections in solid organ and hematopoietic stem cell transplant recipients
Authors: Coussement Julien , Lebeaux David , Rouzaud Claire , Lortholary Olivier 
Published: September 2017

Purpose of review

Nocardia spp. is a gram-positive bacteria that may cause infections in humans. Nocardiosis has been described since the early years of transplantation. This review aims to provide an overview of present knowledge regarding posttransplant nocardiosis, with a focus on recent findings.

Recent findings
Nocardiosis is not rare among transplant recipients, especially after thoracic transplantation and/or in case of intense immunosuppressive regimen or use of tacrolimus. Low-dose cotrimoxazole is not effective to prevent nocardiosis. Although lung is the most common site of infection, more than 40% of organ transplant patients have a disseminated infection. As central nervous system involvement is frequent (about 1/3 of the patients) and possibly asymptomatic, brain imaging is mandatory. Diagnosis relies on direct examination and culture; molecular species identification is useful to guide treatment. Although cotrimoxazole is the drug for which we have the strongest clinical experience, other antibiotics such as linezolid, parenteral cephalosporins, carbapenems, and amikacin can be used to treat nocardiosis. Although treatment duration has historically been set to at least 6 months, shorter durations (<120 days) seem associated with a good outcome in selected patients.

Summary
Physicians in charge of transplant patients should be aware of nocardiosis. Diagnosis and management of transplant recipients with nocardiosis require a multidisciplinary approach.
Spinal Metastasis Characterized on FDG PET/CT in Head and Neck Squamous Cell Carcinoma
Authors: Khan Shahroz , Son Hannah 
Published: September 2017

Abstract
Spinal metastases are rare in head and neck cancer. We present a rare case of vocal cord squamous cell cancer that metastasized to the spinal cord and cauda equina. A 63-year-old man presented with acute back pain and bilateral leg weakness 5 months after having a surgical treatment for moderately differentiated vocal cord squamous cell cancer (T2 N0 M0). Restaging 18F-FDG PET examination demonstrated a soft tissue mass with intense hypermetabolism in the distal spinal cord and a hypermetabolic leptomeningeal metastatic deposit at the L3 level. The findings were confirmed on MRI prior to treatment.
Differentiation of Malignant Thrombus From Bland Thrombus of the Portal Vein in Patient With Hepatocellular Carcinoma on 18F-FDG PET CT
Authors: Agarwal Krishan Kant , Shah Dipalkumar , Shah Neha , Mayank Manas 
Published: September 2017

Abstract
Hepatocellular carcinoma carries a high risk of invasion of the portal vein. Neoplastic and bland portal vein thrombi discrimination is of great clinical significance for determining the therapeutic approach, predicting survival, and assessing candidates for liver transplantation. 18F-FDG PET/CT may be helpful in discriminating between malignant and portal vein thrombi. We present the case of a 61-year old man who presented with hepatocellular carcinoma with portal vein involvement. 18F-FDG PET/CT has a role in differentiating malignant from benign portal vein thrombosis.
Cleft Lip and Palate: An Experience of a Developing Center in Egypt
Authors: Abulezz Tarek A. 
Published: September 2017

Background:
Cleft lip and palate is the most common congenital anomaly in the head and neck region. These clefts are not just a distortion of the normal appearance, but they may impose a major influence on the whole patient's life, both functionally and psychologically. Clefts affect feeding, teething, hearing, speech, and social communication. The incidence of cleft lip and palate is variable in different countries and different communities. The surgical correction of cleft lip and palate went through many evolutions, but still there is no single universal protocol of repair; however, many European countries have adopted national protocols and have established cleft centers for the management and follow up of affected population.

Patient and Methods:
In this study, the problem of cleft lip and palate in the area of upper Egypt was presented through the records of patients admitted to the Department of Plastic Surgery at the Sohag University Hospital in a 15-year period (2001–2015).

Results:
A total number of 1318 patients, who were admitted and had been operated upon in our department, were included in this study. The majority of patients presented to the department with a primary disease, yet 14.7% (194 patients) of them were first presented for a secondary interference after being operated upon elsewhere. A total number of 1923 surgical procedures were performed.
Fibular Graft-Effective Panorama for Prosthetic Rehabilitation of Resected Mandible
Authors: Kharade Pankaj , Islam Saidul , Verma Mahesh , Sharma Swati , Bodh Ranjeet 
Published: September 2017

Abstract
Surgical management of extensive tumors in the mandibular region leads to massive disfigurement of the face. Also the prosthetic outcome of such patients rehabilitated with free soft tissue flaps is very poor. Reconstruction of extensive defects to overcome the disfigurement is a challenging procedure and can be achieved with free fibula flap. Free fibula graft provides sufficient length of bone for the reconstruction of the postsurgical defects. Excellent vascularity of fibula flap allows for easy uptake of the graft and osseointegration of the dental implants. The addition of a skin island allows for absolute tension-free intraoral closure that enhances tongue mobility. Fibula graft allows proper tissue support after mandibular reconstruction. After rehabilitation with free fibula graft we can plan for prosthodontic rehabilitation with implant retained prosthesis leading to improved masticatory function. It also helps to improve speech outcome as a stable prosthesis can be delivered with the help of implants retained in the fibula graft. It is essential to assess the outcome of surgical reconstruction with fibula graft followed by prosthetic rehabilitation with implant retained prosthesis for their recognition as a treatment of preference. This article details the clinical report along with various clinical parameters for implant retained prosthetic rehabilitation of the patient who had undergone mandibular resection and reconstruction with free fibula graft.
A Craniometric Analysis of Cranial Base and Cranial Vault Differences in Patients With Metopic Craniosynostosis
Authors: Naran Sanjay , Mazzaferro Daniel , Wes Ari , Vossough Arastoo , Bartlett Scott P. , Taylor Jesse A. 
Published: September 2017

Purpose:
The effect of synostosis is not confined to the immediate vicinity of the suture. The authors hypothesized metopic craniosynostosis results in migration of lateral structures from midline, and differences in segmental volume of the cranial fossa.

Methods:
A retrospective case-controlled cohort analysis of patients with nonsyndromic metopic craniosynostosis was performed. Craniometric angles, distances to landmarks from midline, cephalic index, and segmented volume ratios were calculated. A comparison group consisted of patients without cranial pathology or with mild positional plagiocephaly.

Results:
Twenty patients with metopic craniosynostosis and 19 controls were identified. The bifrontal angle was significantly more acute in metopic patients. Distance from midline to the medial carotid, the foramen ovale, and the hypoglossal canal were all significantly longer in metopic patients. Ratio of anterior third to total cranial vault volume was significantly smaller in metopic patients; however, ratio of middle third to total cranial vault volume was significantly larger. As the bifrontal angle decreased by 1°, the volume of the anterior third of the cranial vault was observed to decrease by 0.17% (P < 0.001).

Conclusions:
Patients with metopic craniosynostosis show a distinct and significant transverse lateralization of structures of the anterior skull base relative to midline, significant restriction of the anterior third of the cranial vault, and compensatory expansion of the middle third. There is a linear relationship between the bifrontal angle and the subsequent change in anterior third cranial vault volume.

Level of Evidence:
IV; Therapeutic
Maxillary Corticotomies With Bone-to-Bone Retraction and Mandibular Segmental Osteotomy for Correcting an Anterior Double Protrusion
Authors: Kim Kyung A. , Lee Baek-Soo , Akbulut Ayse Selenge , Kim Seong-Hun , Nelson Gerald 
Published: September 2017

Backgrounds:
This article presents maxillary corticotomies with bone-to-bone retraction and anterior segmental osteotomy (ASO) as an alternative to 2-jaw orthognathics in the bimaxilary protrusion patient with partially anchylosed maxillary anterior tooth.

Methods:
The 18-year-old male, complaining of anterior protrusion, with a trauma history to the maxillary central incisor, and requesting rapid treatment, was treated with maxillary corticotomies in 2 stages and ASO in the mandible. The mandibular ASO and palatal corticotomy were done under local anesthesia and 2 weeks later, labial corticotomy followed. The anterior segment was retracted bodily using buccal C-tubes and a combination of the C-lingual retractor and palatal C-plate.

Results:
Due to a concern about ankylosis of the maxillary right central incisor, retraction of the anterior bone/tooth segment was chosen over any attempt to move teeth through the bone. After bone-to-bone retraction, the remaining extraction space was closed by protraction of posteriors. The total treatment period was 18 months. There was good retraction of the anterior segment and retrusion of the lips.

Conclusions:
A combination of maxillary corticotomies with skeletal anchorage for bone-to-bone retraction and a mandibular ASO under local anesthesia might be an alternative treatment option for excellent profile change in a short treatment period.
Patient-Centered Outcome Spectrum
Authors: Ingraham Angela M. , Agarwal Suresh K. , Jung Hee Soo , Liepert Amy E. , O’Rourke Ann P. , Scarborough John E. 
Published: September 2017

Objective:
Our objective was to develop an alternate construct for reporting anticipated outcomes after emergency general surgery (EGS) that presents risk in terms of a composite measure.

Background:
Currently available prediction tools generate risk outputs for discrete as opposed to composite measures of postoperative outcomes. A construct to synthesize multiple discrete estimates into a global understanding of a patient's likely postoperative health status is lacking and could augment shared decision-making conversations.

Methods:
Using the 2012 to 2014 American College of Surgeons National Surgical Quality Improvement Program Participant Use File, we developed the Patient-Centered Outcomes Spectrum (PCOS) for patients ≥65 years old who underwent an EGS operation. The PCOS defines 3 exclusive types of global outcomes (good, intermediate, and bad outcomes) and allows patients to be prospectively stratified by both their EGS diagnosis and preoperative surgical risk profile.

Results:
Of the patients in our study population, 13,330 (46.4%) experienced a 30-day postoperative course considered a good outcome. Conversely, 3791 (13.2%) of study patients experienced a bad outcome. The remainder of patients (11,617; 40.4%) were classified as experiencing an intermediate outcome. The incidence of good, intermediate, and bad outcomes was 69.7%, 28.2%, and 2.1% for low-risk patients, and 22.0%, 48.9%, and 29.1% for high-risk patients. Diagnosis-specific PCOS constructs are also provided.

Conclusions:
Consistent with the goals of shared decision-making, the PCOS provides an evidence-based construct based upon a composite outcome measure for patients and providers as they weigh the risks of undergoing EGS.
The role of vitamin D in cancer cachexia
Authors: Penna Fabio , Camperi Andrea , Muscaritoli Maurizio , Filigheddu Nicoletta , Costelli Paola 
Published: September 2017

Purpose of review
The possibility to use vitamin D supplementation to improve muscle wasting, with particular focus on cancer cachexia, is discussed.

Recent findings
Vitamin D exerts biological actions on myogenic precursor proliferation and differentiation, impinging on muscle regeneration. However, the effects of VitD supplementation in diseases associated with muscle atrophy, such as cancer cachexia, are poorly investigated. Data obtained in experimental models of cancer cachexia show that the administration of vitamin D to tumor-bearing animals is not able to prevent or delay both muscle wasting and adipose tissue depletion, despite increased expression of muscle vitamin D receptor. Not just vitamin D supplementation impairs muscle damage-induced regeneration, suggesting that upregulation of vitamin D receptor signaling could contribute to muscle wasting.

Summary
Vitamin D supplementation is likely beneficial to reduce or delay aging-related sarcopenia and osteoporosis, although the available data still put in evidence significant discrepancies. By contrast, VitD supplementation to tumor-bearing animals or to rats with arthritis was shown to be totally ineffective. In this regard, the adoption of VitD treatment in patients with cancer cachexia or other chronic diseases should be carefully evaluated, in particular whenever a regenerative process might be involved.
Health professionals’ quality of life in relation to end of life care
Authors: Linzitto Juan P. , Grance Gladys 
Published: September 2017

Purpose of review
Palliative care professionals are frequently exposed to stressful and demanding situations in the assistance of patients and their families, therefore research related to their quality of life is a relevant topic to provide evidence on interventions oriented to professional self-care.

Recent findings
Research about professionals’ quality of life is having a profuse development with core concepts being under review.

Summary
Currently, burnout syndrome and compassion fatigue are considered relevant determinants of professionals’ quality of life. Self-awareness-based interventions could bring positive influence on the context of a multidimensional approach to professionals’ self-care. Self-care topics should be considered to be included in professional training programmes.
Estimated Blood Loss During Vaginal Hysterectomy and Adnexal Surgery Described With an Intraoperative Pictographic Tool
Authors: Nelson Nancy C. , Ostby Stuart A. , Weaver Amy L. , McGree Michaela E. , Gebhart John B. , Bakkum-Gamez Jamie N. 
Published: September 2017

Objective
We describe a novel way to calculate estimated blood loss (EBL) using an intraoperative pictographic tool in gynecologic surgery.

Methods
A pictographic tool to estimate sponge saturation was developed to calculate EBL during surgery. A prospective cohort of women 18 years or older undergoing benign vaginal hysterectomy with planned adnexal surgery at Mayo Clinic were consented for use of the pictographic tool. Demographic, preoperative, intraoperative, and postoperative data were abstracted. Estimated blood loss was compared among surgeons, anesthesia providers, and the pictographic tool and then correlated with change in hemoglobin.

Results
Eighty-one patients met inclusion with mean age of 45.3 ± 8.7 years. Successful vaginal hysterectomy was achieved in all patients with successful completion of planned adnexectomy in 69 (85.2%). Mean EBL among surgeons, anesthesia providers, and pictographic estimates, respectively, was as follows: 199.4 ± 81.9 mL, 195.5 ± 152.2 mL, and 288.5 ± 186.6 mL, with concordance correlation coefficients for surgeons and anesthesia providers versus pictographic tool of 0.40 (95% confidence interval, 0.29–0.51) and 0.68 (95% confidence interval, 0.57–0.79), respectively. The mean postoperative change in hemoglobin was −1.8 g/dL; there were no postoperative transfusions. Change in hemoglobin was more correlated with blood loss estimates from surgeons (r = −0.31, P = 0.008) and anesthesia providers (r = −0.37, P = 0.003) than the pictographic tool (r = −0.19, P = 0.11).

Conclusions
Use of a pictographic tool to objectively estimate blood loss demonstrated significant overestimations compared with both anesthesia providers’ and surgeons’ estimates because the pictographic tool was less correlated with postoperative change in hemoglobin than anesthesia provider and surgeon estimates.
Expanding heterochromatin reveals discrete subtelomeric domains delimited by chromatin landscape transitions
Authors: Hocher Antoine , Ruault Myriam , Kaferle Petra , Descrimes Marc , Garnier Mickael , Morillon Antonin , Taddei Angela 
Published: September 2017

AbstractThe eukaryotic genome is divided into chromosomal domains of heterochromatin and euchromatin. Transcriptionally silent heterochromatin is found at subtelomeric regions, leading to the telomeric position effect (TPE) in yeast, fly and man. Heterochromatin generally initiates and spreads from defined loci, and diverse mechanisms prevent the ectopic spread of heterochromatin into euchromatin. Here, we overexpressed the silencing factor Sir3 at various levels in yeast, and found that Sir3 spreading into Extended Silent Domains (ESD) eventually reached saturation at subtelomeres. We observed that Sir3 spreading into ESDs covered zone associated with specific histone marks in wild-type cells and stopped at zones of histone mark transitions including H3K79 tri-methylation levels. The conserved enzyme Dot1 deposits H3K79 methylation, and we found that it is essential for viability upon overexpression of Sir3, but not of a spreading-defective mutant Sir3A2Q. These data suggest that H3K79 methylation actively blocks Sir3 spreading. Lastly, our meta-analysis uncovers previously uncharacterized discrete subtelomeric domains associated with specific chromatin features offering a new viewpoint on how to separate subtelomeres from the core chromosome.
Controller for microfluidic large-scale integration
Authors: White Jonathan A , Streets Aaron M 
Published: September 2017

AbstractMicrofluidic devices with integrated valves provide precise, programmable fluid handling platforms for high-throughput biological or chemical assays. However, setting up the infrastructure to control such platforms often requires specific engineering expertise or expensive commercial solutions. To address these obstacles, we present a Kit for Arduino-based Transistor Array Actuation (KATARA), an open-source and low-cost Arduino-based controller that can drive 70 solenoid valves to pneumatically actuate integrated microfluidic valves. We include a python package with a GUI to control the KATARA from a personal computer. No programming experience is required.
Minor allele frequency thresholds dramatically affect population structure inference with genomic datasets
Authors: Linck Ethan , Battey C.J. 
Published: September 2017

AbstractOne common method of minimizing errors in large DNA sequence datasets is to drop variable sites with a minor allele frequency below some specified threshold. Though widespread, this procedure has the potential to alter downstream population genetic inferences and has received relatively little rigorous analysis. Here we use simulations and an empirical SNP dataset to demonstrate the impacts of minor allele frequency (MAF) thresholds on inference of population structure. We find that model-based inference of population structure is confounded when singletons are included in the alignment, and that both model-based and multivariate analyses infer less distinct clusters when more stringent MAF cutoffs are applied. We propose that this behavior is caused by the combination of a drop in the total size of the data matrix and by correlations between allele frequencies and mutational age. We recommend a set of best practices for applying MAF filters in studies seeking to describe population structure with genomic data.