bluuebunny/crossref_metadata_2025 huggingface dataset:
Porosity Volumetrics and Pore Typing
Authors: Doveton John H.
Published: November 2020

The primary objective of porosity estimations based on measurements made either from petrophysical logs or core is the volume of pore space within the rock, given simply by the equation: . . . Φ = Vp/Vb . . . The Greek letter, phi, is the standard symbol for porosity and is expressed in this equation as the ratio of the volume of void space (Vp) to the bulk volume of the rock (Vb). The simplest concepts of porosity are generally explained in terms of the packing of spheres as the sum of the pore volume of the space between the spheres. There are five basic arrangements of uniform-sized spheres that can be constructed: simple cubic, orthorhombic, double-nested, face-centered cubic, and rhombohedral packing (Hook, 2003). Each has a geometrically defined pore volume that represents an upper limit for granular rocks whose constituent grains have a variety of sizes and shapes and whose pore volumes have been reduced by compaction and diagenetic cements. This intergranular model is a useful starting point for the characterization of pores in clastic rocks and will be considered first, before reviewing the additional complexities of pore geometry introduced by dissolution in carbonate rocks. The solid framework of a sandstone consists of a nonconductive “matrix” dominated by quartz, but commonly with accessory nonconductive minerals, and conductive clay minerals, whose electrical properties are caused by cation exchange with ions in saline formation water. It is important to distinguish between connected and unconnected pores, as well as larger pores that sustain fluid movement in contrast to smaller pores filled with capillary-bound water. A graphic presentation of these components is widely used in the petrophysical literature as a reference basis to disentangle terminology that can be confusing and contradictory. In particular, the term “effective porosity” has different meanings that vary from one technical discipline to another. In their review of porosity terms, Wu and Berg (2003) concluded that many core analysts considered all porosity to be effective, log analysts excluded clay-bound water, while petroleum engineers excluded both clay-bound and capillary-bound from porosity consideration, thereby restricting effective porosity to pores occupied by mobile fluids.
Compositional Analysis of Mineralogy
Authors: Doveton John H.
Published: November 2020

Formation lithologies that are composed of several minerals require multiple porosity logs to be run in combination in order to evaluate volumetric porosity. In the most simple solution model, the proportions of multiple components together with porosity can be estimated from a set of simultaneous equations for the measured log responses. These equations can be written in matrix algebra form as: . . . CV = L . . . where C is a matrix of the component petrophysical properties, V is a vector of the component unknown proportions, and L is a vector of the log responses of the evaluated zone. The equation set describes a linear model that links the log measurements with the component mineral properties. Although porosity represents the proportion of voids within the rock, the pore space is filled with a fluid whose physical properties make it a “mineral” component. If the minerals, their petrophysical properties, and their proportions are either known or hypothesized, then log responses can be computed. In this case, the procedure is one of forward-modeling and is useful in situations of highly complex formations, where geological models are used to generate alternative log-response scenarios that can be matched with actual logging measurements in a search for the best reconciliation between composition and logs. However, more commonly, the set of equations is solved as an “inverse problem,” in which the rock composition is deduced from the logging measurements. Probably the earliest application of the compositional analysis of a formation by the inverse procedure applied to logs was by petrophysicists working in Permian carbonates of West Texas, who were frustrated by complex mineralogy in their attempts to obtain reliable porosity estimates from logs, as described by Savre (1963). Up to that time, porosities had been commonly evaluated from neutron logs, but the values were excessively high in zones that contained gypsum, caused by the hydrogen within the water of crystallization. The substitution of the density log for the porosity estimation was compromised by the occurrence of anhydrite as well as gypsum.
Petrophysical Rocks: Electrofacies and Lithofacies
Authors: Doveton John H.
Published: November 2020

Many years ago, the classification of sedimentary rocks was largely descriptive and relied primarily on petrographic methods for composition and granulometry for particle size. The compositional aspect broadly matches the goals of the previous chapter in estimating mineral content from petrophysical logs. With the development of sedimentology, sedimentary rocks were now considered in terms of the depositional environment in which they originated. Uniformitarianism, the doctrine that the present is the key to the past, linked the formation of sediments in the modern day to their ancient lithified equivalents. Classification was now structured in terms of genesis and formalized in the concept of “facies.” A widely quoted definition of facies was given by Reading (1978) who stated, “A facies should ideally be a distinctive rock that forms under certain conditions of sedimentation reflecting a particular process or environment.” This concept identifies facies as process products which, when lithified in the subsurface, form genetic units that can be correlated with well control to establish the geological architecture of a field. The matching of facies with modern depositional analogs means that dimensional measures, such as shape and lateral extent, can be used to condition reasonable geomodels, particularly when well control is sparse or nonuniform. Most wells are logged rather than cored, so that the identification of facies in cores usually provides only a modicum of information to characterize the architecture of an entire field. Consequently, many studies have been made to predict lithofacies from log measurements in order to augment core observations in the development of a satisfactory geomodel that describes the structure of genetic layers across a field. The term “electrofacies” was introduced by Serra and Abbott (1980) as a way to characterize collective associations of log responses that are linked with geological attributes. They defined electrofacies to be “the set of log responses which characterizes a bed and permits it to be distinguished from the others.” Electrofacies are clearly determined by geology, because physical properties of rocks. The intent of electrofacies identification is generally to match them with lithofacies identified in the core or an outcrop.
Starting with Stories of Success: The Initial Psychiatric Consultation
Authors: Hamkins SuEllen
Published: November 2020

If compassionate connection is the heart of narrative psychiatry, then eliciting healing stories is its soul. In narrative psychiatry, we begin seeking stories of strength and meaning from the very first appointment. As we listen to the story a patient brings to us, we also listen for the untold stories implicit in their narrative that may support their well-being. Fleshing out these stories, making them alive with detail, vivid with language and compelling with plot, strengthens them and gives them purchase to eclipse a disempowering, problem-dominated story. What we can know about a patient depends on what we are listening for. The openings for story development that we hear and the questions we ask in the first appointment lead to the cocreation of the narrative of the patient’s life that informs our understanding of the problem and our treatment options. By eliciting narratives that lead to a more nuanced, colorful, and balanced portrait of the patient and a more contextualized view of the problem, we can understand the nature of the problem and the patient with more depth, clarity and subtlety. Tall and thin with a short spiky haircut, and carrying a canvas messenger bag, Amanda Riley spoke earnestly when she first came in to see me for treatment of depression. A sophomore in college, she was mired in a story of how she was making bad decisions and wasn’t living her life right. Amanda had been referred to me by a psychotherapist at the college counseling service where I consulted due to concerns about panic attacks and depressed mood. The hope was that I would be able to help Amanda clarify the nature of the problem and determine if medication might be helpful, a typical workaday situation for many psychiatrists in today’s world. So how would a narrative psychiatrist approach his or her first meeting with Amanda? At the start of my initial conversation with Amanda, I asked her what year of school she was in and what she was studying. She told me she was a sophomore in college, majoring in Chinese and art.
Finding One’s Voice: Recovering from Trauma
Authors: Hamkins SuEllen
Published: November 2020

Vivian Owusu, a stunning twenty-one-year-old African woman who grew up in Ghana, was about to walk out of the university counseling center when I went to the waiting room to get her for our initial appointment. Her first psychiatric provider had retired a year after meeting her and her next one took a different job six months later, so I was her third psychiatrist in less than a year. Vivian had not shown for her first two appointments with me and now, due to a double-booking error that was my fault, I was thirty minutes late. I apologized and asked if she had time to stay and meet with me. I could see her anger and agitation. “I suppose.” Irritated but still poised, Vivian followed me down the hall to my office. What an unfortunate beginning, I thought, feeling harried. We had been short-staff ed for months and I had been squeezing patients in as best I could, feeling like I wasn’t doing my best work. Vivian settled herself upright on my couch and looked at me coolly. She had big dark eyes, flawless brown skin, beautifully braided hair, a button nose, and a hostile expression. In response to my questions, she told me she was a junior, pre-law. She hadn’t slept for three or four days. Depression had been plaguing her and she had been having thoughts of killing herself. Her expression of hostility briefly showed a trace of sadness. “I don’t trust people,” she said. “I take things personally and I get annoyed.” She often felt emotionally volatile and easily got upset with people if she felt they were rejecting her. I had skimmed her medical record prior to the appointment and saw that she had had multiple emergency contacts with our clinicians and two psychiatric hospitalizations, the second five months earlier. She said she wasn’t having suicidal thoughts currently and would call us if she did. What she wanted from me was a refill of medicines she was taking to help with the depression and anxiety.
Verticillium Wilt Evaluation of Olive Breeding Selections Under Semi-Controlled Conditions
Authors: Serrano A. , Rodríguez-Jurado D. , Román B. , Bejarano-Alcázar J. , De la Rosa R. , León L.
Published: November 2020

Genetic resistance is the most recommended measure to control verticillium wilt in olive (VWO), a vascular disease caused by the soil-borne fungus Verticillium dahliae, which has promoted the development of olive breeding programs aimed at obtaining new resistant and highly yielding cultivars in recent years. Screening has been commonly performed under controlled conditions in grow chamber after artificial inoculation during the early stage of breeding programs, but additional evaluation is necessary to confirm previous results as well as to test for additional agronomic traits. During this study, 20 breeding selections initially classified as resistant to the disease have been re-evaluated in artificially infested soils under natural environmental conditions. The maximum disease incidence (52.6%) was reached at 26 months after planting, and the disease intensity index reached the maximum value of 38.5% at 29 months after planting. Nine breeding selections consistently confirmed the previous results regarding resistance to V. dahliae infection; however, contradictory results, compared with those of previous evaluations under controlled conditions in grow chambers, were obtained for the rest of selections tested, thereby underlining the need for long-term experimentation under natural environmental conditions. Additional positive agronomic traits, such as early bearing, were also observed for some of the resistant selections, but plant vigor varied. Some seem highly promising for release as new cultivars when characterization of other important agronomic traits is completed in the future.
Advances in Understanding Fungicide Resistance in Botrytis cinerea in China
Authors: Shao Wenyong , Zhao Youfu , Ma Zhonghua
Published: November 2020

Gray mold, caused by Botrytis cinerea, is a devastating disease that causes significant yield losses in various economically important plants. Fungicide application is one of the main strategies for management of gray mold; however, B. cinerea has developed resistance to various groups of fungicide. In China, benzimidazole-, dicarboximide-, and quinone outside inhibitor-resistant populations of B. cinerea have become dominant. Substitute mutations in fungicide target genes are responsible for resistance in B. cinerea. Based on known resistance mechanisms, molecular methods including loop-mediated isothermal amplification have been developed for rapid detection of resistant isolates of B. cinerea. Because B. cinerea is able to quickly develop resistance to various fungicides, various integrated strategies have been implemented in the last decade, including biological and agricultural practices, to manage fungicide resistance in B. cinerea.
Long-Term Clinical and Radiological Results After Hook Plate Osteosynthesis of Lateral Clavicle Fractures
Authors: Baunach Daniel , Eid Karim , Ricks Matthew , Borbas Paul
Published: November 2020

Objectives:

To assess both clinical and radiological long-term outcomes after hook plate osteosynthesis for Neer type II lateral clavicle fractures.

Design:

Retrospective case series.

Setting:

Level-1 trauma center.

Patients/Participants:

Patients who underwent open reduction internal fixation with a hook plate for displaced fractures of the lateral third of the clavicle (Neer type II) at a single trauma hospital were identified.

Intervention:

Lateral clavicle open reduction internal fixation with a hook plate.

Main Outcome Measures:

At the first of 2 long-term follow-up appointments, bilateral magnetic resonance imaging (MRI) scans and strength measurements were performed, Constant–Murley score, subjective shoulder value (SSV), and Oxford shoulder score (OSS) of both shoulders were obtained. At the second follow-up, specific acromioclavicular (AC) score, SSV, and OSS were obtained.

Results:

Twenty-one patients (mean age, 29.5 ± 9.7 years) could be included who were available for at least 1 of 2 follow-ups after 7.4 years (±2.3) and 13.9 years (±2.2). Bony union was achieved in all patients (100%) at an average of 3.4 months (±1.4). The hook plate was removed at an average of 5.5 months (±3.3) after initial surgery in all patients. No significant side-to-side differences were found in OSS, Constant–Murley score, SSV, and specific AC score and for strength testing and MRI scans.

Conclusions:

Long-term outcome after hook plate fixation of Neer type II lateral clavicle fractures demonstrated good clinical results and shoulder strength without higher radiographic rates of AC joint osteoarthritis, subacromial impingement, or rotator cuff lesions. That may be related to a standardized early plate removal after bony fracture union.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
The Effect of a Multifaceted Family Participation Program in an Adult Cardiovascular Surgery ICU*
Authors: Yoo Hye Jin , Shim JaeLan
Published: November 2020

OBJECTIVES:

To develop and implement a patient- and family-centered care program for patients in a cardiovascular surgery ICU.

DESIGN:

Prospective, pre- and postintervention evaluations were conducted.

SETTING:

The cardiovascular surgery ICU was located in a tertiary hospital.

PARTICIPANTS:

Participants included 56 family members of patients in cardiovascular surgery ICU between May and July 2019.

INTERVENTIONS:

Providing personalized treatment plans for patients by: 1) providing an ICU diary, 2) communicating with the medical staff, 3) providing personal care using ICU visitation kit, and 4) guiding bedside range of motion exercises. The experimental group received a guided ICU diary and education program from a nurse, including the application of a family participation visitation program. Family members were provided with customized information from the ICU diary and communicated with the medical staff for approximately 10 minutes. Family members were instructed on how to perform personal care using an “ICU visitation kit” during visitation hours when permitted to participate in bedside activities for approximately 10-minute intervals.

MEASUREMENTS AND MAIN RESULTS:

Scores for satisfaction with the provided care and information increased significantly for the experimental group compared with the control group (t = 8.62; p < 0.001). Anxiety levels decreased significantly after intervention in both groups (t = –7.05; p < 0.001 and t = –12.94; p < 0.001) with a significant association observed between group and time point (F = 20.50; p < 0.001). However, no significant change was observed in satisfaction with decision-making following intervention in either group, and no significant association was noted between groups and time points for this variable (F = 0.24; p = 0.626).

CONCLUSIONS:

This set of implemented family participation processes significantly improved satisfaction and reduced anxiety in family members of critically ill patients.
The Effect of Acupressure on Blood Pressure Level and Pulse Rate in Individuals With Essential Hypertension
Authors: Biçer Sevil , Ünsal Ayla , Taşcı Sultan , Demir Gökçe , Ceyhan Yasemin Şadiye
Published: November 2020

A total of 91 people including 47 in the intervention group and 44 in the placebo group were included to a randomized controlled study. It can be asserted that acupressure, applied to the Neiguan (PC 6) acupuncture point in individuals with essential hypertension, provides blood pressure regulation and is effective for management of numerous hypertension-related symptoms.
Reframing Holistic Patient Care in Nursing Homes Through the Lens of Relational Autonomy
Authors: Abbate Skya
Published: November 2020

In nursing facilities, patient autonomy is more effective when it is reframed under the rubric of relational autonomy. Through this lens, patients, family, and staff, especially nurses, can share conversations that lead to effective decision-making that acknowledges the needs of the whole person within the nexus of the institutional setting.
Mortality and use of angiotensin-converting enzyme inhibitors in COVID 19 disease: a systematic review
Authors: Nunes José Pedro L.
Published: November 2020

Background:

Interest exists concerning the use of angiotensin-converting enzyme inhibitors (ACEis) in patients with COVID-19 disease.

Objectives:

The aim of the study was to perform a systematic review on mortality associated to the use of ACEi in patients with COVID-19 disease.

Methods:

Search in Medline (PubMed), in ISI Web of Knowledge and in medRxiv database; use of other sources.

Results:

A total of 33 articles were evaluated. Concerning the papers used to produce the meta-analyses, 7 studies were selected, 5 of which were used. These 5 studies involved a total number of 944 patients treated with ACEi and 5173 not treated with ACEi. Increased mortality was seen in association to the use of ACEi in the context of COVID-19 disease (ACEi users vs nonusers; odds ratio, 1.48; 95% confidence interval, 1.02–2.15; P = .04). When compared to mortality in patients treated with angiotensin receptor blockers, mortality of patients treated with ACEi was not significantly different (odds ratio, 0.96; 95% confidence interval, 0.76–1.21; P = .74). Concerning the remaining reports, different types of data adjustments were used by several authors, after which increased mortality was not seen in association to the use of ACEi in this context.

Conclusions:

ACEi use could act as a marker of increased mortality risk in some but not all COVID-19 disease settings. The data now presented do not prove a causal relation but argue in favor of carrying out clinical trials studying ACEi in COVID-19 patients, to establish the safety of ACEi use in this context.
Tumor microenvironment-responsive contrast agents for specific cancer imaging: a narrative review
Authors: Wang Xianwen , Zhong Xiaoyan , Lei Huali , Yang Nailin , Gao Xiang , Cheng Liang
Published: November 2020

Molecular imaging is of great significance for early diagnosis and timely treatment of cancer and disease, as well as basic medical and biological research. As personalized cancer treatment has become increasingly popular, the demand for more advanced imaging technologies has also significantly increased. Taking advantage of differences between the tumor microenvironment and normal tissue cells, tumor microenvironment-responsive or "turn-on" contrast agents have a higher signal-to-noise ratio and lower background interference compared with "turn-off" probes, which can remarkably improve the performance of tumor diagnostics. Thus, tumor microenvironment-responsive contrast agents can not only detect changes in the tumor microenvironment, but also have important significance for tumor diagnosis, prediction of invasion potential, evaluation of treatment effectiveness, planning of therapeutic regimens, and tumor prognosis. Herein, this review focuses on recent research progress of tumor microenvironment-responsive intelligent probes, and highlights future research directions of tumor microenvironment-responsive contrast agents for precision diagnostics.
Comparison of the Metabolic Characteristics of Newer Second Generation Antipsychotics
Authors: Greger Jessica , Aladeen Traci , Lewandowski Emily , Wojcik Rachael , Westphal Erica , Rainka Michelle , Capote Horacio
Published: November 2020

Purpose/Background

Extensive research has been conducted comparing the metabolic characteristics of older second-generation antipsychotics (SGAs); minimal data exist comparing the long-term metabolic effects of SGAs approved in the last 10 years.

Methods/Procedures

A retrospective chart review of patients treated with brexpiprazole, lurasidone, asenapine, cariprazine, and iloperidone (newer SGAs) for at least 6 weeks at an outpatient psychiatric practice was conducted. Patients treated with olanzapine, an older SGA, were included as a comparator. Metabolic characteristics were collected at baseline, approximately 6 weeks, 12 weeks, and for up to 12 months.

Findings/Results

Of the newer SGAs, there were statistically significant increases in patients' average weight at 12 weeks and 1 year or less with brexpiprazole (2.48 lb, P = 0.02; 5.97 lb, P = 0.01) and iloperidone (4.54 lb, P < 0.01; 5.13 lb, P = 0.02). Brexpiprazole and iloperidone resulted in significant increases in body mass index, up to a 0.90-kg/m2 average increase in patients taking brexpiprazole at 1 year or less. Minimal weight gain was seen with cariprazine (4.25 lb, P = 0.42) and asenapine (1.80 lb, P = 0.62) at 1 year or less after treatment initiation. Although not statistically significant, lurasidone showed an average weight loss of up to 0.60 lb at 1 year or less (P = 0.56).

Implications/Conclusions

Although some weight gain was seen with the newer SGAs, all demonstrated significantly favorable metabolic characteristics compared with olanzapine. Monitoring of weight and metabolic parameters remain important in patients treated with SGAs.
Association Between Use of EHR-Generated Dashboards and Hospital Outcomes in 30-Day Heart Failure Readmissions
Authors: Gasoyan Hamlet , Aaronson William E.
Published: November 2020

EXECUTIVE SUMMARY

This study examined whether usage of clinical data from the electronic health record (EHR) to create organizational- and unit-level performance dashboards and assess adherence to clinical practice guidelines is associated with hospital outcomes in risk-adjusted 30-day readmissions for patients with a principal diagnosis of heart failure (HF). It further assesses the association between the metrics of hospital financial health and the usage of those EHR-generated tools.

A cross-sectional study design was used. The study used data from the 2016 American Hospital Association Annual Survey Information Technology Supplement, the Pennsylvania Health Care Cost Containment Council’s (PHC4’s) 2017 Hospital Performance Report, and the PHC4 General Acute Care Hospitals Financial Analysis Report for fiscal year 2017. Contingency tables, likelihood-ratio chi-square tests, and logistic regression were applied for data analysis.

Usage of the EHR to assess adherence to clinical practice guidelines and create EHR-generated unit-level performance dashboards, rather than organizational performance dashboards, was more strongly associated with the hospitals’ rating in risk-adjusted 30-day readmissions for HF patients. An increase in hospitals’ operating margin was associated with greater odds of the usage of the discussed EHR tools, after controlling for hospital control/ownership and the total number of beds.

Usage of some EHR-generated analytical tools may be more strongly associated with lower-than-expected 30-day hospital readmissions in HF patients than with other tools. Better hospital financial health is linked with greater uptake of the discussed analytical tools. Further research could help to determine which EHR-generated tools are more effective in improving hospital outcomes in HF.
The effect of using long-acting octreotide as adjuvant therapy for patients with grade 2 pancreatic neuroendocrine tumors after radical resection
Authors: Gao Suizhi , Shi Xiaohan , Ma Hongyun , Wang Huan , Li Bo , Song Bin , Guo Shiwei , Jin Gang
Published: November 2020

Objective:

To investigate the effect of long-acting octreotide as adjuvant therapy in the prevention of tumor recurrence in patients with grade 2 pancreatic neuroendocrine tumors (pNETs) after radical resection.

Methods:

The postoperative follow-up data of 130 patients with resectable G2 pNET treated in the Changhai Hospital from 2008 to 2018 were retrospectively analyzed: 59 patients received long-acting octreotide as adjuvant therapy for 6 to 12 months (Oct group) and 71 patients received active follow-up (control group), both of which began after the radical resection, with the primary observation endpoint of disease-free survival (DFS) and the secondary study endpoint of overall survival.

Results:

The median age of the patients in the Oct group and control group was 52 and 54 years, respectively. There were 28 male cases (47.5%) and 33 male cases (46.5%) in the 2 groups. The median maximum tumor diameter was 3.5 and 3.0 cm, respectively; lymph node metastasis was positive in 13 cases (22.0%) and 9 cases (12.7%); there was peripancreatic nerve invasion in 11 cases (18.6%) and 6 cases (8.5%). Survival analysis revealed that there were significant differences in 2-year DFS% (98.3% vs 88.7%, P = .0371) and 3-year DFS% (96.6% vs 85.9%, P = .0498) between the Oct group and control group. Long-acting octreotide treatment was found to reduce the risk of 3-year recurrence of G2 pNET after radical resection (HR = 0.2, P = .044) with the application of inverse-probability-of-treatment weighted to balance the limited data bias.

Conclusion:

Using long-acting octreotide as adjuvant therapy for G2 pNET patients after radical surgery may improve the rate of 3y-DFS, but the benefit needs to be confirmed in a well-designed random control clinical trial.
Efficacy of Ultrasonography in the Diagnosis of Transudative Pleural Fluids
Authors: Doğan Coşkun , Demirer Ersin
Published: November 2020

Aims:

We aimed to evaluate the efficacy of thoracic ultrasonography (USG) in diagnosis of pleural exudates and transudates using pleural thickness (PT) measurement.

Patients and Methods:

Patients who underwent investigations for pleural fluid between January 2018 and May 2018 were included in this prospective study. The patients were evaluated using radiologic imaging modalities to detect pleural fluid, and PT was measured using thoracic USG. The patients were then divided into 2 groups according to Light’s criteria as transudative pleural fluid (TPF) and exudative pleural fluid (EPF), and the results were compared between the groups.

Results:

A total of 73 patients were included in the study. The mean age was 62±15.1 years. Forty-eight patients (65.8%) had EPF and 25 (34.2%) had TPF. Thoracic USG revealed a mean PT of 0.3±0.1 cm in the TPF group and 0.6±0.3 cm in the EPF group (P<0.001). The optimal cut-off value for PT was 0.2 cm in the TPF group. The sensitivity and specificity of thoracic USG were calculated as 87.5% and 56%, respectively.

Conclusion:

The measurement of PT using thoracic USG in this study has a high sensitivity but low specificity for identifying transudates from exudates. This approach may be useful in patients who refuse thoracentesis or have a contraindication for the procedure, and in emergency and intensive care unit settings. We recommend further studies to determine the efficacy of thoracic USG studies in patients with pleural fluids.
Prevalence, Surgical Management, and Audiologic Impact of Sigmoid Sinus Dehiscence Causing Pulsatile Tinnitus
Authors: Ettyreddy Abhinav R. , Shew Matthew A. , Durakovic Nedim , Chole Richard A. , Herzog Jacques , Buchman Craig A. , Wick Cameron C.
Published: November 2020

Objective:

To evaluate the prevalence, surgical management, and audiologic impact of pulsatile tinnitus caused by sigmoid sinus dehiscence.

Study Design and Setting:

Retrospective chart review at a tertiary care hospital.

Patients:

Adults with unilateral pulsatile tinnitus attributable to sigmoid sinus dehiscence who underwent resurfacing between January 2010 and January 2020.

Interventions:

Transmastoid sigmoid resurfacing.

Main Outcome Measures:

Resolution of pulsatile tinnitus; audiologic outcomes; complications; tinnitus etiologies.

Results:

Nineteen patients (89.4% women) had surgery for suspected sigmoid sinus dehiscence. The mean dehiscence size was 6.1 mm (range, 1–10.7 mm). Eight patients had concurrent sigmoid sinus diverticulum and one patient also had jugular bulb dehiscence. Only two patients (10.5%) had the defect identified by radiology. Low-frequency pure-tone average, measured at frequencies of 250 and 500 Hz, showed a significant median improvement of 8.8 dB following resurfacing (18.8 dB versus 10.0 dB, p = 0.02). The majority of patients had complete resolution of pulsatile tinnitus (16/19, 84.2%). Of those without complete resolution, two patients had partial response and one patient had no improvement. There were no significant complications. Of 41 consecutively tracked patients with a pulsatile tinnitus chief complaint, sigmoid pathology represented 32% of cases.

Conclusions:

Sigmoid sinus dehiscence represents a common vascular cause of pulsatile tinnitus that, if properly assessed, may be amenable to surgical intervention. Sigmoid sinus resurfacing is safe, does not require decompression, and may improve low-frequency hearing. Radiographic findings of dehiscence are often overlooked without a high index of clinical suspicion. Its relationship with transverse sinus pathology and idiopathic intracranial hypertension remain unclear.
Performance of artificial intelligence for prognostic prediction with the albumin-bilirubin and platelet-albumin-bilirubin for cirrhotic patients with acute variceal bleeding undergoing early transjugular intrahepatic portosystemic shunt
Authors: Zhong Bin-Yan , Tang Hao-Huan , Wang Wan-Sheng , Shen Jian , Zhang Shuai , Li Wan-Ci , Yin Yu , Yang Jun , Liu Fang , Ni Cai-Fang , Zhao Jian-Bo , Zhu Xiao-Li
Published: November 2020

Purpose

The aim of this study was to validate and compare the prognostic performance of the albumin-bilirubin (ALBI) grade, platelet-albumin-bilirubin (PALBI) grade, Child-Pugh (CP) grade, and Model for End-Stage Liver Disease (MELD) score in predicting the 1-year variceal rebleeding probability using artificial intelligence for patients with cirrhosis and variceal bleeding undergoing early transjugular intrahepatic portosystemic shunt (TIPS) procedures.

Materials and methods

This dual-center retrospective study included two cohorts, with patients enrolled between January 2016 and September 2018 in the training cohort and January 2017 and September 2018 in the validation cohort. In the training cohort, independent risk factors associated with the 1-year variceal rebleeding probability were identified using univariate and multivariate logistic analyses. ALBI-, PALBI-, Child-Pugh-, and MELD-based nomograms and an artificial neural network (ANN) model were established and validated internally in the training cohort and externally in the validation cohort, which included patients with variceal bleeding who were treated with preventive TIPS.

Results

A total of 259 patients were included. The median follow-up periods were 24.1 and 18.9 months, and the 1-year variceal rebleeding rates were 12.3% (14/114) and 10.3% (15/145) in the training and validation cohorts, respectively. In the training cohort, all four variables were identified as independent risk factors. Four nomograms were then established and showed comparable prognostic performances after internal (C-index: 0.879, 0.829, 0.874, and 0.798) and external (C-index: 0.720, 0.719, 0.718, and 0.703) validation. The ANN demonstrated that these four variables had comparable importance in predicting the 1-year variceal rebleeding probability.

Conclusion

None of the four variables are optimal in predicting the 1-year variceal rebleeding probability for patients with cirrhosis and variceal bleeding undergoing early TIPS.
Strengthening New Nurse Manager Leadership Skills Through a Transition-to-Practice Program
Authors: Lawson Crystal
Published: November 2020

The nurse manager role is increasingly complex, and oftentimes, leadership competencies are learned through experience rather than an effective role transition. The need for a transition-to-practice program for new nurse managers is frequently cited in the literature. This evidence-based practice project resulted in significant improvement in leadership competencies and was used in the development of an American Organization for Nursing Leadership nurse manager transition-to-practice program to be offered in 2021.
Upper Gastrointestinal Bleeding as the First Presentation of Eosinophilic Gastrointestinal Disease
Authors: Ozdogan Elif , Caglayan Latife Doganay , Mizikoglu Ozlem , Arikan Cigdem
Published: November 2020

Gastrointestinal bleeding is a rare but potentially life-threatening manifestation of eosinophilic gastrointestinal disorders (EGIDs). Here, we describe a case series comprising 5 pediatric patients between 7 and 12 years of age, who presented to the emergency department with hematemesis and were subsequently diagnosed with EGID. Accompanying allergic history, peripheral eosinophilia, and total IgE elevation were common. Despite a more severe presentation, response to medical and dietary therapy was favorable. A comprehensive review of the literature revealed 26 other cases with similar findings that reinforced the importance of prompt recognition and early dietary and immunomodulating therapy in the control of this disease.
Foreign-body Ingestions in Children During COVID-19 Pandemic in a Pediatric Referral Center
Authors: Pizzol Antonio , Rigazio Caterina , Calvo Pier Luigi , Scottoni Federico , Pane Alessandro , Gennari Fabrizio , Cisarò Fabio
Published: November 2020

In February 2020, the COVID-19 pandemic overwhelmed Italy. We retrospectively reviewed all attendances and emergency (A&E) admissions due to foreign-body ingestions (FBIs) to an Italian pediatric referral hospital, from February 24 to April 24, 2020, COVID-19 lockdown and compared them with the same period in the previous 4 years. A total of 101 cases were recorded. Mean age of admission was 4.6 years. Groups did not differ for gender (P = 0.4) or age (P = 0.3). Among FBIs ingestions, 24.0% occurred in children with <2 years of age and 47.5% in children from 2 to 6 years of age. In the 2020 study period, 9 patients were seen for batteries ingestion compared with a median value of one among compared periods. The rates of batteries ingestions increased significantly over the observational period (P < 0.001). We report a dramatic increase in batteries ingestions in children, a potentially fatal event, during the COVID-19 pandemic lockdown.
Progressive Postnatal Pansynostosis in Crouzon Syndrome
Authors: Geisler Emily L. , Hallac Rami R. , Perez Jeyna K. , Kane Alex A.
Published: November 2020

Crouzon syndrome is a known craniosynostosis syndrome with a heterogenous presentation. Suture closure can rapidly develop postnatally and involve multiple sutures, requiring vigilant clinical monitoring to prevent delay in diagnosis and developing intracranial hypertension. The authors present the case of a male patient with Crouzon syndrome who developed postnatal pansynostosis at 18 months of age when several missed appointments led to diagnosis after complete closure of all sutures and signs of elevated intracranial pressure. Posterior cranial vault distraction was performed soon after, and the patient improved clinically. There is a need for improved monitoring and management of these patients to prevent delay in diagnosis and potential permanent sequelae as well as minimizing radiation exposure through watchful CT scanning.
Surgical Treatment of Brooke-Spiegler Syndrome
Authors: Engels Patricia Esther , Fritsche Elmar , Pabst Gunther , Hug Urs
Published: November 2020

Brooke-Spiegler Syndrome (BSS) is a very rare autosomal dominant hereditary disease which arises from heterozygous mutations in the CYLD gene. Patients with BSS are predisposed to multiple skin appendage tumors such as cylindromas, which are benign tumors occurring mainly on the scalp. The tumors mostly appear around puberty and usually show slow growth throughout life. Malignant cylindroma formation in BSS patients has been reported. Apart from the skin, major and minor salivary glands have rarely been involved.

We here report a case of a 46-year-old female patient with BSS presenting with multiple aesthetically and functionally unpleasing cylindromas covering almost her entire hair-bearing scalp with further tumors on her face. Interestingly, her parotid glands were enlarged and showed multiple lesions with a diameter up to 18 to 20 mm. She was successfully treated by total subgaleal scalp excision and coverage through a dermal substitute and split thickness skin graft. Constant follow-up imaging was initiated to prevent unhindered tumor growth of salivary glands.
The Effectiveness of Preoperative Correction Techniques in Improving Nasal Deformity in Children With Unilateral Complete Cleft Lip and Palate
Authors: Tang Shengyu , Zhong Yuxiang , Liao Lishu , Liang Li , Xiang Li , Li Liqi , Li Yijun , Li Wanshan
Published: November 2020

Objective:

Unilateral complete cleft lip and palate (UCCLP) is associated with apparent nasal deformities before the cheilorrhaphy. The aim of this study was to determine whether preoperative correction techniques are effective in the treatment of nasal deformities in infant with unilateral UCCLP used by the systematic review and meta-analysis.

Methods:

We searched Medline, Cochrane Library, EMBASE, PubMed, and Chinese BioMedical Literature Database (CBM) until January 31, 2019, to identify studies that compared the effectiveness of preoperative correction techniques in the treatment of nasal deformities in infant with UCCLP. Two authors individually extracted the data and performed the quality assessments. The height of nasal columella, the width of the affected side nasal ala and the inclination of the nasal columella were evaluated.

Results:

Seven articles were incorporated into the systematic review, and 5 (274 participants) in the meta-analysis according to the inclusion criteria. The preoperative correction could increase the height of nasal columella in children with UCCLP [SMD: 2.64 mm; 95% confidence intervals (CI); (1.35 mm, 3.94 mm); P < 0.0001]. Moreover, the preoperative correction resulted in reduced width of the affected side nasal ala [SMD: −5.14 mm; 95% CI; (−8.96 mm, −1.31 mm); P = 0.008]; However, the evidence was insufficient to determine a significant effect on the inclination of the nasal columella [SMD: −3.48 degrees; 95% CI; (−7.56 degrees, 0.59 degrees); P = 0.09].

Conclusions:

Preoperative correction for children with UCCLP can increase the height of nasal columella, reduce the width of the affected side nasal ala, improve the nasal symmetry, and reduce nasal deformity, however, no significant effect could be observed for the inclination of the nasal columella.
Clinical Outcomes After Total Pancreatectomy
Authors: Latenstein Anouk E.J. , Scholten Lianne , Al-Saffar Hasan Ahmad , Björnsson Bergthor , Butturini Giovanni , Capretti Giovanni , Chatzizacharias Nikolaos A. , Dervenis Chris , Frigerio Isabella , Gallagher Tom K. , Gasteiger Silvia , Halimi Asif , Labori Knut J. , Montagnini Greta , Muñoz-Bellvis Luis , Nappo Gennaro , Nikov Andrej , Pando Elizabeth , Pastena Matteo de , Peña-Moral Jesús M. de la , Radenkovic Dejan , Roberts Keith J. , Salvia Roberto , Sanchez-Bueno Francisco , Scandavini Chiara , Serradilla-Martin Mario , Stättner Stefan , Tomazic Ales , Varga Martin , Zavrtanik Hana , Zerbi Alessandro , Erkan Mert , Kleeff Jörg , Lesurtel Mickaël , Besselink Marc G. , Ramia-Angel Jose M. ,   for the Scientific, Research Committee of the European-African Hepato-Pancreato-Biliary Association (E-AHPBA)
Published: November 2020

Objective:

To assess outcomes among patients undergoing total pancreatectomy (TP) including predictors for complications and in-hospital mortality.

Background:

Current studies on TP mostly originate from high-volume centers and span long time periods and therefore may not reflect daily practice.

Methods:

This prospective pan-European snapshot study included patients who underwent elective (primary or completion) TP in 43 centers in 16 European countries (June 2018–June 2019). Subgroup analysis included cutoff values for annual volume of pancreatoduodenectomies (<60 vs ≥60).

Predictors for major complications and in-hospital mortality were assessed in multivariable logistic regression.

Results:

In total, 277 patients underwent TP, mostly for malignant disease (73%). Major postoperative complications occurred in 70 patients (25%). Median hospital stay was 12 days (IQR 9–18) and 40 patients were readmitted (15%). In-hospital mortality was 5% and 90-day mortality 8%. In the subgroup analysis, in-hospital mortality was lower in patients operated in centers with ≥60 pancreatoduodenectomies compared <60 (4% vs 10%, P = 0.046). In multivariable analysis, annual volume <60 pancreatoduodenectomies (OR 3.78, 95% CI 1.18–12.16, P = 0.026), age (OR 1.07, 95% CI 1.01–1.14, P = 0.046), and estimated blood loss ≥2L (OR 11.89, 95% CI 2.64–53.61, P = 0.001) were associated with in-hospital mortality. ASA ≥3 (OR 2.87, 95% CI 1.56–5.26, P = 0.001) and estimated blood loss ≥2L (OR 3.52, 95% CI 1.25–9.90, P = 0.017) were associated with major complications.

Conclusion:

This pan-European prospective snapshot study found a 5% inhospital mortality after TP. The identified predictors for mortality, including low-volume centers, age, and increased blood loss, may be used to improve outcomes.
Post-buckling analysis of functionally graded multilayer graphene platelet reinforced composite cylindrical shells under axial compression
Authors: Sun Jiabin , Zhu Shengbo , Tong Zhenzhen , Zhou Zhenhuan , Xu Xinsheng
Published: November 2020

Axially compressed composite cylindrical shells can attain multiple bifurcation points in their post-buckling procedure because of the natural transverse deformation restraint provided by their geometry. In this paper, the post-buckling analysis of functionally graded (FG) multilayer graphene platelets reinforced composite (GPLRC) cylindrical shells under axial compression is carried out to investigate the stability of such shells. Rather than the critical buckling limit, the focus of the present study is to obtain convergence post-buckling response curves of axially compressed FG multilayer GPLRC cylindrical shells. By introducing a unified shell theory, the nonlinear large deflection governing equations for post-buckling of FG multilayer GPLRC cylindrical shells with wide range of thickness are established, which can be easily changed into three widely used shell theories. Load-shortening curves for both symmetric and asymmetric post-buckling modes are obtained by Galerkin's method. Numerical results illustrate that the present solutions agree well with the existing theoretical and experimental data. The effects of geometries and material properties on the post-buckling behaviours of FG multilayer GPLRC cylindrical shells are investigated. The differences in the three shell theories and their scopes are discussed also.
Host behaviour alteration by its parasite: from brain gene expression to functional test
Authors: Grecias Lucie , Hebert Francois Olivier , Alves Verônica Angelica , Barber Iain , Aubin-Horth Nadia
Published: November 2020

Many parasites with complex life cycles modify their intermediate hosts' behaviour, presumably to increase transmission to their final host. The threespine stickleback (Gasterosteus aculeatus) is an intermediate host in the cestodeSchistocephalus soliduslife cycle, which ends in an avian host, and shows increased risky behaviours when infected. We studied brain gene expression profiles of sticklebacks infected withS. solidusto determine the proximal causes of these behavioural alterations. We show that infected fish have altered expression levels in genes involved in the inositol pathway. We thus tested the functional implication of this pathway and successfully rescued normal behaviours in infected sticklebacks using lithium exposure. We also show that exposed but uninfected fish have a distinct gene expression profile from both infected fish and control individuals, allowing us to separate gene activity related to parasite exposure from consequences of a successful infection. Finally, we find that selective serotonin reuptake inhibitor-treated sticklebacks and infected fish do not have similarly altered gene expression, despite their comparable behaviours, suggesting that the serotonin pathway is probably not the main driver of phenotypic changes in infected sticklebacks. Taken together, our results allow us to predict that ifS. solidusdirectly manipulates its host, it could target the inositol pathway.