bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychometric properties and validity of the Menopause Rating Scale in postmenopausal Portuguese women
Authors: Espírito Santo João , Marques de Loureiro Nuno Eduardo , Brandão-Loureiro Vânia , Aibar-Almazán Agustín , Hita-Contreras Fidel 
Published: January 2023

Abstract

Objective
The aim of the study is to analyze the reliability and validity of the Portuguese version of the Menopause Rating Scale (MRS) among postmenopausal Portuguese women.

Methods
A total of 184 postmenopausal women completed the Portuguese MRS. Internal consistency and test-retest reliability were studied. Construct, convergent, and concurrent validity were assessed. The 10-item Cervantes Scale and the Hospital Anxiety and Depression Scale were used to determine convergent and concurrent validity, respectively. The ability and accuracy of the Portuguese MRS to discriminate between women with and without anxiety and depression cases were evaluated, and a receiver operating characteristic curve analysis was used.

Results
The Portuguese MRS showed an appropriate level of internal consistency (Cronbach α, 0.84 for MRS total score) and test-retest reliability (MRS total score; intraclass correlation coefficient, 0.92; 95% confidence interval, 0.85–0.96). Factor analysis (construct validity) revealed a 3-factor structure (explained variance of 62.08%). The MRS total score and its 3 factors showed good convergent (10-item Cervantes Scale) and concurrent (Hospital Anxiety and Depression Scale anxiety and depression) validity (all P < 0.001). The Portuguese MRS total score was significantly able to discriminate between postmenopausal women with and without anxiety (P < 0.001) and depression (P = 0.001), with a cutoff point of 15.50 (80.00% sensitivity and 63.70% specificity) for detecting depression and a cutoff point of 16.50 (82.35% sensitivity and 78.57% specificity) for identifying anxiety.

Conclusions
The Portuguese MRS has been shown to be a valid and reliable questionnaire for assessing the severity of menopausal symptoms and discriminating among postmenopausal women with and without anxiety and depression.
Cytological characteristics of premalignant cervical epithelial lesions in postmenopausal women based on endocrine indices and parakeratosis
Authors: Sugisawa Akiyuki , Toyoda Zensei , Tanabe Yasuka , Uehara Karina , Oshiro Aya , Yamazato Reo , Sakamoto Chiharu , Yogi Shohei , Kurima Kiyoto , Kina Shinichiro , Sakiyama Michiyo , Kinjo Takao 
Published: January 2023

Abstract

Objective
To identify useful cytological findings for detecting premalignant lesions in postmenopausal women, cervicovaginal smear samples were analyzed and compared between women with or without premalignant lesions based on endocrine indices and presence of parakeratosis (PK).

Methods
The cervicovaginal smear samples of postmenopausal women with premalignant lesions (n = 94) and those who were without (n = 344), who were diagnosed between 2012 and 2014 were retrieved and analyzed. Women cytologically diagnosed with malignancy or those with suspicion of malignancy were excluded from this study. Cytological endocrine indices, such as the maturation index (MI) and eosinophilic index (EI) and the prevalence of PK were compared between the groups and analyzed using the 2 × 2 χ2 test. The association of endocrine indices combined with the presence of PK and histological findings was also evaluated.

Results
Postmenopausal women with premalignant lesions had higher endocrine indices (EI of ≥11%; 65% vs. 43%, P < 0.01, f = 0.18) and a higher prevalence of PK positivity (PK ≥ 1; 46% vs. 7%, P < 0.01, f = 0.44) than those without lesions. Further analysis indicated that the combination of high EI and the presence of PK in postmenopausal women with cytological premalignant cases was highly associated with histological squamous intraepithelial lesions (SIL) (86% in women with premalignant lesions vs. 53% in those without; P = 0.01, f = 0.34).

Conclusion
Our research demonstrated that high EI and PK positivity were correlated with SIL in postmenopausal women. These cytological findings could provide potential diagnostic clues for detecting dysplasia.
Salivary Cortisol Dynamics After Mild Traumatic Brain Injury
Authors: Musacchio Sophia , Kallenbach Madeline D. , Huber Daniel L. , Raff Hershel , Johnson Blair D. , Leddy John , McCrea Michael A. , Meier Timothy B. , Nelson Lindsay D. 
Published: January 2023

Objective:
To assess mild traumatic brain injury (mTBI)-related alterations in baseline (resting) salivary cortisol and cortisol reactivity to cognitive and exercise stressors, which are frequently encountered during mTBI rehabilitation and recovery.

Setting:
Persons with mTBI were recruited from a level 1 trauma center emergency department. Uninjured controls (UCs) were recruited from the community.

Participants:
Participants were 37 individuals with mTBI and 24 UCs. All patients with mTBI were enrolled at 7 ± 3 days post-injury, met the American Congress of Rehabilitation Medicine definition of mTBI, and had no acute intracranial findings on clinical neuroimaging (if performed).

Design:
A prospective cohort study design was used. All participants provided saliva samples 10 times during each of 2 visits spaced 3 weeks apart (1 week and 1 month post-injury for the mTBI group). Each visit included baseline saliva sampling and sampling to evaluate reactivity to a cognitive stressor (Paced Auditory Serial Addition Test) and physical stressor (Buffalo Concussion Treadmill Test [BCTT]).

Main Outcome Measure:
Natural log-transformed salivary cortisol was measured by enzyme immunoassay. Cortisol was predicted using a linear mixed-effects model by group (mTBI and UC), visit (1 week and 1 month), and saliva sample.

Results:
Mean salivary cortisol was higher in the mTBI group (1.67 nmol/L [95% CI 1.42-1.72]) than in controls (1.30 nmol/L [1.12-1.47]), without an mTBI × time interaction. At 1 week, the mTBI group had greater cortisol reactivity in response to the BCTT.

Conclusions:
Higher cortisol in individuals with mTBI at 1 week and 1 month post-injury extends previous findings into the subacute recovery period. Furthermore, the mTBI group demonstrated a greater cortisol response to mild-to-moderate aerobic exercise (BCTT) at 1 week post-injury. Given the increasing role of exercise in mTBI rehabilitation, further research is warranted to replicate these findings and identify the clinical implications, if any, of enhanced hypothalamic-pituitary-adrenal axis responses to exercise in civilians with recent mTBI.
EXCESSIVE GLIOSIS AFTER VITRECTOMY FOR THE HIGHLY MYOPIC MACULAR HOLE
Authors: Ye Xin , Wang Jun , Qiu Wangli , Chen Yiqi , Shen Lijun 
Published: January 2023

Purpose:
To investigate different modes of foveal regeneration after the closure of idiopathic macular hole (IMH) or highly myopic macular hole (HMMH) by vitrectomy with internal limiting membranes peeling or flap techniques.

Methods:
This retrospective observational study followed 47 IMH and 50 HMMH eyes for at least 6 months. Twenty four IMH and 25 HMMH eyes underwent internal limiting membrane peeling, whereas 23 IMH and 25 HMMH eyes received inverted internal limiting membrane flap technique. Spectral domain optical coherence tomography was used to analyze macular hole closure, foveal microstructures, and excessive gliosis as a foveal “peak-like” protuberance.

Results:
A single procedure closed all IMH (n = 47). For HMMH, the inverted group (n = 25, 100%) closed more macular hole than the peeling group (n = 14, 56.00%) (P < 0.001). Excessive gliosis only occurred in the inverted group, and there was a significant difference (P = 0.005) in incidence between IMH (three in 23 eyes, 13.04%) and HMMH (13 in 25 eyes, 52.00%). The axial length more than 29.985 mm enhanced the risk of excessive gliosis.

Conclusion:
The inverted internal limiting membrane flap efficiently treated refractory MHs but was prone to cause excessive gliosis in highly myopic eyes. Excessive elongation of the globe (axial length > 29.985 mm) was linked to excessive gliosis growth.
VOLUMETRIC ANALYSIS OF LAMELLAR MACULAR HOLE
Authors: Taşlıpınar Uzel Ayşe Güzin , Gelisken Faik , Kühlewein Laura , Neubauer Jonas 
Published: January 2023

Background:
To investigate the cavity of lamellar macular holes (LMH-CV) by using volumetric analysis of optical coherence tomography images.

Methods:
Single-center, retrospective, observational case series. The volume of the LMH-CV and epiretinal proliferation was determined. Best-corrected visual acuity, central macular thickness, maximum horizontal diameter and minimum horizontal diameter, and the presence of foveal bump and ellipsoid zone defect were noted.

Results:
Forty-nine eyes of 46 patients (20 women) were included in the baseline analysis. The natural course group consisted of 25 patients (27 eyes) with a mean follow-up of 19.2 ± 15.7 months. The volume of LMH-CV was found to be a predictive factor for baseline best-corrected visual acuity (P = 0.038, ß-coefficient = 0.338, 95% CI: 0.275–8.893). Whereas no significant change at the last visit was observed in central macular thickness, minimum horizontal diameter, and maximum horizontal diameter, the LMH-CV and epiretinal proliferation volume increased significantly (P = 0.036, P < 0.001, respectively). Eyes with foveal bump had larger minimum horizontal diameter, maximum horizontal diameter, and LMH-CV volume (P = 0.008, P < 0.001, P = 0.024, respectively). Eyes with ellipsoid zone defect showed larger LMH-CV and epiretinal proliferation volume, but thinner central macular thickness (P = 0.038, P = 0.004, P = 0.012, respectively).

Conclusion:
Volumetric analysis of LMH-CV detects changes in the natural course of lamellar macular hole earlier than the measurement of horizontal diameters. Further studies will clarify whether volumetric analysis of the lamellar macular hole is useful as an additional biomarker in the management of lamellar macular hole.
FULL-THICKNESS MACULAR HOLE WITH PERSISTENT BROAD VITREOMACULAR ATTACHMENT
Authors: Uemura Akinori , Yamakiri Keita , Santo Kyoko , Hamada Takuto , Miyake Shoki , Sakamoto Taiji 
Published: January 2023

Purpose:
To describe the characteristics and surgical outcomes of full-thickness macular holes (FTMHs) with persistent broad vitreomacular attachment.

Methods:
This was a retrospective, observational case series. Consecutive patients undergoing pars plana vitrectomy for FTMHs with persistent broad vitreomacular attachment (study group) were reviewed. Clinical charts, optical coherence tomography (OCT) features of macular holes, and surgical outcomes were reviewed and compared with those with typical FTMH with focal vitreomacular traction (control group).

Results:
A total of 15 eyes of 14 consecutive patients (eight males and six females with a mean age of 60.6 years) were included in the study group. OCT showed a zone of at least 1,500 µm all around the circumference of the fovea where the vitreous was attached. On OCT, epiretinal membrane and epiretinal proliferation were observed in 73% and 87% of cases, respectively. Compared with the control group, the study group was younger (P = 0.027) and had better preoperative visual acuity (P = 0.007). All FTMHs closed after one surgery in both groups, and the postoperative visual acuity of the study group was better than that of the control group (P = 0.002).

Conclusion:
Full-thickness macular holes may have developed under the condition that the vitreous cortex was broadly attached around the hole. These FTMHs were associated with younger age, better baseline visual acuity, and a higher incidence of epiretinal membranes and epiretinal proliferations compared with macular hole with focal vitreomacular traction. The surgical outcome was favorable, but the pathogenesis of FTMH development remains unclear.
Review of the National Quality Forum's Measure Endorsement Process
Authors: Ramachandran Sujith , Maharjan Shishir , Nsiah Irene , Urick Benjamin Y. , Carr Alexcia , Foster Matthew 
Published: January 2023

ABSTRACT
The National Quality Forum (NQF) evaluates healthcare performance measures for endorsement based on a broad set of criteria. We extracted data from NQF technical reports released between spring 2018 and spring 2019. Measures were commonly stewarded by federal agencies (44.29%), evaluated for maintenance (67.14%), classified as outcome (42.14%) or process (39.29%) measures, and used a statistical model for risk adjustment (48.57%). For 80% of the measures reviewed, a patient advocate was present on the reviewing committee. Validity was evaluated using face validity (65.00%) or score-level empirical validity (67.14%), and reliability was frequently evaluated using score-level testing (71.43%). Although 91.56% of all reviewed measures were endorsed, most standing committee members voted moderate rather than high support on key assessment criteria like measure validity, measure reliability, feasibility of use, and whether the measure addresses a key performance gap. Results show that although the Consensus Development Process includes multidisciplinary stakeholder input and thorough evaluations of measures, continued work to identify and describe appropriate and robust methods for reliability and validity testing is needed. Further work is needed to study the extent to which stakeholder input is truly representative of diverse viewpoints and improve processes for considering social factors when risk adjusting.
Zeroing a Transducer on an External Ventricular Drain
Authors: Malloy Rachel 
Published: January 2023

ABSTRACT

BACKGROUND: External ventricular drains (EVDs) are commonly used in severely brain-injured patients to diagnose intracranial hypertension. The accuracy of the intracranial pressure reading is dependent on zeroing the external transducer to air. Recent concern about zeroing techniques has been identified in the neuroscience community. The open method requires removing the nonvented cap, and the closed method requires zeroing through the filter at the top of the burette. This critical appraisal seeks to explore whether zeroing a transducer on an EVD through the filter of the burette provides the same baseline zero as opening the transducer to air. METHODS: Independent searches in CINAHL, PubMed, and Web of Science were conducted using “external ventricular drain* OR EVD AND transducer”; secondary search terms included “zero AND transducer” AND “ventric.” RESULTS: Database search produced 1 single observation study and 2 clinical practice guidelines from neuroscience professional organizations. The single observation study provided no evidence of equivalence between the 2 zeroing methods; the 2 clinical practice guidelines reference the open method. The transducer manufacturer's instructions for use direct the clinician to open the transducer to air by removing the nonvented cap. CONCLUSION: The question “Does zeroing the transducer on an EVD through the filter of the burette provide the same baseline zero as opening the transducer to air?” cannot be answered with the results of this appraisal. However, evidence found in the literature does suggest an open method to ensure the most accurate physiological value for treatment decisions.
Revisiting Reduction Mammaplasty: Complications of Oncoplastic and Symptomatic Macromastia Reductions
Authors: Morrison Kerry A. , Frey Jordan D. , Karp Nolan , Choi Mihye 
Published: January 2023

Background:
Oncoplastic breast reduction has been shown to be an effective and safe approach to breast conservation surgery in women with macromastia. However, there remains a paucity of data investigating the comparative outcomes. This study seeks to delineate the complication profiles for oncoplastic and symmetrizing breast reductions versus mammaplasty for benign macromastia.

Methods:
A retrospective review was conducted of all consecutively performed reduction mammaplasty cases at a single institution by two plastic surgeons over a 2-year period.

Results:
A total of 632 breasts were analyzed: 502 reduction mammaplasties, 85 symmetrizing reductions, and 45 oncoplastic reductions in 342 patients. Mean age was 43.9 ± 15.93 years, mean body mass index was 29.15 ± 5.66 kg/m2, and mean reduction weight was 610.03 ± 313.13 g. Regarding surgical technique, a medial pedicle was used in 86% of cases. There were similar postoperative complication outcomes for nipple necrosis, wound healing, scar revision, fat necrosis, seroma, hematoma, and overall complication rates for all procedures. However, the rate of postoperative revision among reduction mammaplasty (2%), oncoplastic reduction (6.7%), and symmetrizing reduction (5.9%) was significantly different (P = 0.027). In univariate analysis, diabetes (P = 0.011), smoking (P = 0.007), higher body mass index (P = 0.003), larger reduction weight (P = 0.011), longer nipple-to–inframammary fold measurement (P = 0.014), and longer sternal notch–to-nipple measurement (P = 0.039) were all significant risk factors for a surgical complication in reductions performed for any indication. Using a multivariate logistic regression model, diabetes (P = 0.047), smoking (P = 0.025), and higher body mass index (P = 0.002) were all retained as statistically significant risk factors.

Conclusion:
The complication profiles for both oncoplastic breast reductions and breast reductions for symptomatic macromastia are similar and acceptably low.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Male Face-Lift Finesse
Authors: Rohrich Rod J. , Novak Matthew 
Published: January 2023

Summary:
Male face lifts account for approximately 10% of the total number of face-lift procedures performed annually in the United States. Although many face-lift principles apply universally, there are certain characteristics of the male face that make the management and surgical procedure unique. A systematic and patient-specific approach to the preoperative markings, facial analysis, and surgical technique in the male face lift will ensure safe, consistent, and natural appearing results.
Paradoxical Changes of Cutaneous Microcirculation and Sympathetic Fibers of Rat Hind Limbs after Sciatic Nerve Compression
Authors: Peng Yi , Lu Junren , Lu Shunyi , Zou Jiapeng , Fu Tengfei , Jiang Libo , Wang Jiayi , Meng Dehua , Chen Zenggan , Zhang Jian 
Published: January 2023

Background:
Recent studies show evidence that surgical nerve decompression could improve cutaneous blood flow (CBF), which might benefit ulcer healing. However, the change of CBF and sympathetic fibers after nerve compression is poorly understood. In the current study, a unilateral sciatic nerve compression model was created in Sprague-Dawley rats.

Methods:
A laser Doppler imaging system was applied to assess the CBF of the regions below the ankles. Immunohistochemistry and transmission electron microscopy were used to investigate the histopathologic changes of sympathetic fibers in sciatic nerve samples.

Results:
Laser Doppler imaging revealed decreased CBF of both the lesional limb and the contralesional limb, which occurred earlier in the lesional side, indicating an enhanced sympathetic tone on vasomotor function. Intraneural density of sympathetic fibers decreased on both sides and the ultrastructure of unmyelinated fibers of both sides degenerated in a nonsynchronized manner.

Conclusions:
The study revealed nonsynchronized reduced CBF of bilateral hind limbs with paradoxically degenerated and diminished sympathetic fibers in bilateral sciatic nerves after unilateral sciatic nerve compression. These results may validate the importance of and broaden the indications for surgical nerve decompression in preventing or treating foot ulcers.
Quantifying the Severity of Metopic Craniosynostosis Using Unsupervised Machine Learning
Authors: Anstadt Erin E. , Tao Wenzheng , Guo Ejay , Dvoracek Lucas , Bruce Madeleine K. , Grosse Philip J. , Wang Li , Kavan Ladislav , Whitaker Ross , Goldstein Jesse A. 
Published: January 2023

Background:
Quantifying the severity of head shape deformity and establishing a threshold for operative intervention remains challenging in patients with metopic craniosynostosis (MCS). This study combines three-dimensional skull shape analysis with an unsupervised machine-learning algorithm to generate a quantitative shape severity score (cranial morphology deviation) and provide an operative threshold score.

Methods:
Head computed tomography scans from subjects with MCS and normal controls (5 to 15 months of age) were used for objective three-dimensional shape analysis using ShapeWorks software and in a survey for craniofacial surgeons to rate head-shape deformity and report whether they would offer surgical correction based on head shape alone. An unsupervised machine-learning algorithm was developed to quantify the degree of shape abnormality of MCS skulls compared to controls.

Results:
One hundred twenty-four computed tomography scans were used to develop the model; 50 (24% MCS, 76% controls) were rated by 36 craniofacial surgeons, with an average of 20.8 ratings per skull. The interrater reliability was high (intraclass correlation coefficient, 0.988). The algorithm performed accurately and correlates closely with the surgeons assigned severity ratings (Spearman correlation coefficient, r = 0.817). The median cranial morphology deviation for affected skulls was 155.0 (interquartile range, 136.4 to 194.6; maximum, 231.3). Skulls with ratings of 150.2 or higher were very likely to be offered surgery by the experts in this study.

Conclusions:
This study describes a novel metric to quantify the head shape deformity associated with MCS and contextualizes the results using clinical assessments of head shapes by craniofacial experts. This metric may be useful in supporting clinical decision making around operative intervention and in describing outcomes and comparing patient population across centers.
Long-Term Clinical Results of Two-Stage Total Ear Reconstruction of Microtia Using Autologous Cell-Engineered Chondrocytes
Authors: Sakahara Daisuke , Yanaga Hiroko , Noto Mariko , Fujimoto Takuya , Imai Keisuke 
Published: January 2023

Background:
Microtia repair requires a large volume of reconstruction material.
In pediatric patients, the collectable volume of autologous cartilage is limited, and the impact of surgical invasion and donor-site morbidity can be particularly severe. The authors developed a new treatment method using cultured autologous human auricular chondrocytes that provides a sufficiently large volume of reconstruction material.

Methods:
Approximately 1 cm2 of auricular cartilage was collected from the affected site. Chondrocytes were isolated and cultured with autologous serum to accelerate cell proliferation. The cells were subcultured and formed a gel-form mass without a scaffold. In our two-stage implantation, the cultured chondrocytes were first injected into the patient’s lower abdomen, where the cells grew into a large, newly generated cartilage in 6 months. Thereafter, this cartilage was sculpted into an ear framework and subcutaneously reimplanted into the new ear location. Clinical outcomes were assessed over a long-term follow-up.

Results:
Eight patients underwent surgery using cultured autologous auricular chondrocytes from 2002 to 2008. The patients’ ages ranged from 6 to 10 years. The follow-up period ranged from 11 to 18 years. None of the patients experienced absorption of cultured chondrocytes after the second stage. Complications included one case of absorption and one case of allergic reaction in the first stage.

Conclusions:
The authors’ patients represent the first successful cases of regenerative surgery for microtia using cultured chondrocytes. No malignant transformation, change in size, deformation, or other abnormalities were observed during the long-term follow-up, demonstrating the safety of cultured cartilage. No major complications occurred.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.