bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards an Interoperable Ecosystem of Research Cohort and Real-world Data Catalogues Enabling Multi-center Studies
Authors: Swertz Morris , van Enckevort Esther , Oliveira José Luis , Fortier Isabel , Bergeron Julie , Thurin Nicolas H. , Hyde Eleanor , Kellmann Alexander , Pahoueshnja Romin , Sturkenboom Miriam , Cunnington Marianne , Nybo Andersen Anne-Marie , Marcon Yannick , Gonçalves Gonçalo , Gini Rosa
Published: December 2022

Objectives: Existing individual-level human data cover large populations on many dimensions such as lifestyle, demography, laboratory measures, clinical parameters, etc. Recent years have seen large investments in data catalogues to FAIRify data descriptions to capitalise on this great promise, i.e. make catalogue contents more Findable, Accessible, Interoperable and Reusable. However, their valuable diversity also created heterogeneity, which poses challenges to optimally exploit their richness.

Methods: In this opinion review, we analyse catalogues for human subject research ranging from cohort studies to surveillance, administrative and healthcare records.

Results: We observe that while these catalogues are heterogeneous, have various scopes, and use different terminologies, still the underlying concepts seem potentially harmonizable. We propose a unified framework to enable catalogue data sharing, with catalogues of multi-center cohorts nested as a special case in catalogues of real-world data sources. Moreover, we list recommendations to create an integrated community of metadata catalogues and an open catalogue ecosystem to sustain these efforts and maximise impact.

Conclusions: We propose to embrace the autonomy of motivated catalogue teams and invest in their collaboration via minimal standardisation efforts such as clear data licensing, persistent identifiers for linking same records between catalogues, minimal metadata ‘common data elements’ using shared ontologies, symmetric architectures for data sharing (push/pull) with clear provenance tracks to process updates and acknowledge original contributors. And most importantly, we encourage the creation of environments for collaboration and resource sharing between catalogue developers, building on international networks such as OpenAIRE and research data alliance, as well as domain specific ESFRIs such as BBMRI and ELIXIR.
Novelty in Public Health and Epidemiology Informatics
Authors: Diallo Gayo , Bordea Georgeta
Published: December 2022

Objectives: To highlight novelty studies and current trends in Public Health and Epidemiology Informatics (PHEI).

Methods: Similar to last year’s edition, a PubMed search of 2021 scientific publications on PHEI has been conducted. The resulting references were reviewed by the two section editors. Then, 11 candidate best papers were selected from the initial 782 references. These papers were then peer-reviewed by selected external reviewers. They included at least two senior researchers, to allow the Editorial Committee of the 2022 IMIA Yearbook edition to make an informed decision for selecting the best papers of the PHEI section.

Results: Among the 782 references retrieved from PubMed, two were selected as the best papers. The first best paper reports a study which performed a comprehensive comparison of traditional statistical approaches (e.g., Cox Proportional Hazards models) vs. machine learning techniques in a large, real-world dataset for predicting breast cancer survival, with a focus on explainability. The second paper describes the engineering of deep learning models to establish associations between ocular features and major hepatobiliary diseases and to advance automated screening and identification of hepatobiliary diseases from ocular images.

Conclusion: Overall, from this year edition, we observed that the number of studies related to PHEI has decreased. The findings of the two studies selected as best papers on the topic suggest that a significant effort is still being made by the community to compare traditional learning methods with deep learning methods. Using multimodality datasets (images, texts) could improve approaches for tackling public health issues
Clinical Decision Support Systems: Contributions from 2021
Authors: Borbolla Damian , Colicchio Tiago K.
Published: December 2022

Objectives: To summarize significant research contributions published in 2021 in the field of clinical decision support (CDS) systems and select the best papers for the Decision Support section of the International Medical Informatics Association (IMIA) Yearbook.

Methods: The authors searched the MEDLINE® database for papers focused on clinical decision support (CDS) systems. From search results, section editors established a list of candidate best papers, which were then peer-reviewed by at least three external reviewers. The IMIA Yearbook editorial committee selected the best papers on the basis of all reviews including the section editors’ evaluation.

Results: A total of 337 articles were retrieved from which 13 candidate papers were identified. Finally, from the candidate papers, the top three papers were selected. The first paper introduces an innovative evaluation approach to CDS systems, the second compares six health institutions on how they are measuring CDS alert fatigue and the last one adds new evidence on how CDS can help to reduce unnecessary interventions.
Clinical Research Informatics
Authors: Daniel Christel , Tannier Xavier , Kalra Dipak
Published: December 2022

Objectives: To summarize key contributions to current research in the field of Clinical Research Informatics (CRI) and to select best papers published in 2021.

Method: Using PubMed, we did a bibliographic search using a combination of MeSH descriptors and free-text terms on CRI, followed by a double-blind review in order to select a list of candidate best papers to be peer-reviewed by external reviewers. After peer-review ranking, three section editors met for a consensus meeting and the editorial team was organized to finally conclude on the selected three best papers.

Results: Among the 1,096 papers (published in 2021) returned by the search and in the scope of the various areas of CRI, the full review process selected three best papers. The first best paper describes an operational and scalable framework for generating EHR datasets based on a detailed clinical model with an application in the domain of the COVID-19 pandemics. The authors of the second best paper present a secure and scalable platform for the preprocessing of biomedical data for deep data-driven health management applied for the detection of pre-symptomatic COVID-19 cases and for biological characterization of insulin-resistance heterogeneity. The third best paper provides a contribution to the integration of care and research activities with the REDCap Clinical Data and Interoperability sServices (CDIS) module improving the accuracy and efficiency of data collection.

Conclusions: The COVID-19 pandemic is still significantly stimulating research efforts in the CRI field to improve the process deeply and widely for conducting real-world studies as well as for optimizing clinical trials, the duration and cost of which are constantly increasing. The current health crisis highlights the need for healthcare institutions to continue the development and deployment of Big Data spaces, to strengthen their expertise in data science and to implement efficient data quality evaluation and improvement programs.
“All Quiet on the Western Front” - Clinical Information Systems Research in the Year 2021
Authors: Hackl Werner O. , Hoerbst Alexander
Published: December 2022

Objectives: In this synopsis, we give an overview of recent research and propose a selection of best papers published in 2021 in the field of Clinical Information Systems (CIS).

Method: As CIS section editors, we annually apply a systematic process to retrieve articles for the IMIA Yearbook of Medical Informatics. For eight years now, we use the same query to find relevant publications in the CIS field. Each year we retrieve more than 2,400 papers which we categorize in a multi-pass review to distill a preselection of up to 15 candidate papers. External reviewers and yearbook editors then assess the selected candidate papers. Based on the review results, the IMIA Yearbook editorial board chooses up to four best publications for the section at a selection meeting. To get a comprehensive overview of the content of the retrieved articles, we use text mining and term co-occurrence mapping techniques.

Results: We carried out the query in mid-January 2022 and retrieved a deduplicated result set of 2,688 articles from 1,062 different journals. This year, we nominated ten papers as candidates and finally selected two of them as the best papers in the CIS section. As in the previous years, the content analysis of the articles revealed the broad spectrum of topics covered by CIS research, but - on the other side – no real innovations or new upcoming research trends. However, the significant impact of COVID-19 on CIS research was observable also this year.

Conclusions: The trends in CIS research, as seen in recent years, continue to be observable. The content analysis revealed nothing really new in the CIS domain. What was very visible was the impact of the COVID-19 pandemic, which still effects our lives and also CIS.
Findings from the 2022 Yearbook Section on Health Information Exchange
Authors: Bloomrosen Meryl , Berner Eta S.
Published: December 2022

Objectives: To summarize the recent literature and research and present a selection of the best papers published in 2021 related to health information exchange (HIE).

Methods: A systematic review of the literature was performed by the two section editors with the help of a medical librarian. We searched bibliographic databases for HIE-related papers using both MeSH headings and keywords in titles and abstracts. A shortlist of candidate 15 best papers was first selected by section editors before being peer-reviewed by independent external reviewers.

Results: Major themes of the set of 15 articles included the issues to be addressed in building and maintaining HIEs, HIE implementation barriers and facilitators, and the outcomes of using HIEs. The outcomes of using HIE encompassed the impact on patient care and the ability of HIEs to provide a repository of data for further research.

Conclusions: The growth of HIE has followed a course very similar to the growth of electronic health records (EHRs). Initial foci of research included technical issues in the deployment, followed by research on barriers to use. Now that EHRs are more widely implemented and used, the newer research involves the use of the electronic data contained in them. Although HIEs are currently at an earlier stage of maturity and development than EHRs and most of the articles in this review focused on implementation barriers, we have seen the beginning of research on the large amount of longitudinal and diverse data that HIEs can make available. As the implementation and use of HIEs continue to increase and become more widely deployed, we can expect that research about HIE and leveraging HIEs and the data they collect, will continue to increase.
Special Section on Inclusive Digital Health: Notable Papers on Addressing Bias, Equity, and Literacy to Strengthen Health Systems
Authors: Dixon Brian E. , Holmes John H.
Published: December 2022

Objective: To summarize significant research contributions on addressing bias, equity, and literacy in health delivery systems published in 2021.

Methods: An extensive search using PubMed and Scopus was conducted to identify peer-reviewed articles published in 2021 that examined ways that informatics methods, approaches, and tools could address bias, equity, and literacy in health systems and care delivery processes. The selection process comprised three steps: (1) 15 candidate best papers were first selected by the two section editors; (2) external reviewers from internationally renowned research teams reviewed each candidate best paper; and (3) the final selection of three best papers was conducted by the editorial committee of the Yearbook.

Results: Selected best papers represent studies that characterized significant challenges facing biomedical informatics with respect to equity and practices that support equity and literacy in the design of health information systems. Selected papers represent the full spectrum of this year’s yearbook theme. In general, papers identified in the search fell into one of the following categories: (1) descriptive accounts of algorithmic bias in medical software or machine learning approaches; (2) enabling health information systems to appropriately encode for gender identity and sex; (3) approaches to support health literacy among individuals who interact with information systems and mobile applications; and (4) approaches to engage diverse populations in the use of health information systems and the biomedical informatics workforce

Conclusions: Although the selected papers are notable, our collective efforts as a biomedical informatics community to address equity, literacy, and bias remain nascent. More work is needed to ensure health information systems are just in their use of advanced computing approaches and all persons have equal access to health care and informatics tools.
2021 Bioinformatics and Translational Informatics Best Papers
Authors: Benton Mary Lauren , McGrath Scott Patrick
Published: December 2022

Objectives: To identify and summarize the top bioinformatics and translational informatics papers published in 2021 for the IMIA Yearbook.

Methods: We performed a broad literature search to retrieve Bioinformatics and Translational Informatics (BTI) papers and coupled this with a series of editorial and peer reviews to identity the top papers in the area.

Results: We identified a final candidate list of 15 BTI papers for peer-review; from these candidates, the top three papers were chosen to highlight in this synopsis. These papers expand the integration of multi-omics data with electronic health records and use advanced machine learning approaches to tailor models to individual patients. In addition, our honorable mention paper foreshadows the growing impact of BTI research on precision medicine through the continued development of large clinical consortia.

Conclusion: In the top BTI papers this year, we observed several important trends, including the use of deep-learning approaches to analyse diverse data types, the development of integrative and web-accessible bioinformatics pipelines, and a continued focus on the power of individual genome sequencing for precision health.
Informatics as Science
Authors: Shortliffe Edward H.
Published: December 2022

The evolution of the informatics field, now with a well-accepted and crucial role in modern biomedicine and health care delivery, is the result of creative research over seven decades. The success is due in part to recognition that, throughout the process, investigators have documented not only what they have done but what they have learned, stimulating and guiding the next generation of projects. Such iterative experimentation, learning, sharing, and progressing is typical of all scientific disciplines. Yet progress depends on identifying key lessons, insights, and methods so that others can use them. This paper addresses the nature of scientific progress in informatics, recognizing that while the field is motivated by applications that can improve biomedicine and health, the scientific underpinnings must be identified and shared with others if the field is to progress optimally.
Equitable Research PRAXIS: A Framework for Health Informatics Methods
Authors: Veinot Tiffany C. , Clarke Phillipa J. , Romero Daniel M. , Buis Lorraine R. , Dillahunt Tawanna R. , Vydiswaran Vinod V.G. , Beals Ashley , Brown Lindsay , Richards Olivia , Williamson Alicia , Antonio Marcy G.
Published: December 2022

Objectives: There is growing attention to health equity in health informatics research. However, the literature lacks a comprehensive framework outlining critical considerations for health informatics research with marginalized groups.

Methods: Literature review and experiences from nine equity-focused health informatics conducted in the United States and Canada. Studies focus on disparities related to age, disability or chronic illness, gender/sex, place of residence (rural/urban), race/ethnicity, sexual orientation, and socioeconomic status.

Results: We found four key equity-related methodological considerations. To assist informaticists in addressing equity, we contribute a novel framework to synthesize these four considerations: PRAXIS (Participation and Representation, Appropriate methods and interventions, conteXtualization and structural competence, Investigation of Systematic differences). Participation and representation refers to the necessity for meaningful participation of marginalized groups in research, to elevate the voices of marginalized people, and to represent marginalized people as they are comfortable (e.g., asset-based versus deficit-based). Appropriate methods and interventions mean targeting methods, instruments, and interventions to reach and engage marginalized people. Contextualization and structural competence mean avoiding individualization of systematic disparities and targeting social conditions that (re-)produce inequities. Investigation of systematic differences highlights that experiences of people marginalized according to specific traits differ from those not so marginalized, and thus encourages studying the specificity of these differences and investigating and preventing intervention-generated inequality. We outline guidance for operationalizing these considerations at four research stages.

Conclusions: This framework can assist informaticists in systematically addressing these considerations in their research in four research stages: project initiation; sampling and recruitment; data collection; and data analysis. We encourage others to use these insights from multiple studies to advance health equity in informatics.
Best Papers in Human Factors and Sociotechnical Development
Authors: Senathirajah Yalini , Solomonides Anthony E.
Published: December 2022

Objectives: To select the best papers that made original and high impact contributions in human factors and organizational issues in biomedical informatics in 2021.

Methods: A rigorous extraction process based on queries from Web of Science® and PubMed/Medline was conducted to identify the scientific contributions published in 2021 that address human factors and organizational issues in biomedical informatics. The screening of papers on titles and abstracts independently by the two section editors led to a total of 3,206 papers. These papers were discussed for a selection of 12 finalist papers, which were then reviewed by the two section editors, two chief editors, and by three external reviewers from internationally renowned research teams.

Results: The query process resulted in 12 papers that reveal interesting and rigorous methods and important studies in human factors that move the field forward, particularly in clinical informatics and emerging technologies such as brain-computer interfaces and mobile health. This year three papers were clearly outstanding and help advance in the field. They provide examples of examining novel and important topics such as the nature of human-machine interaction behavior and norms, use of social-media based design for an electronic health record, and emerging topics such as brain-computer interfaces. thematic development of electronic health records and usability techniques, and condition-focused patient facing tools. Those concerning the Corona Virus Disease 2019 (COVID-19) were included as part of that section.

Conclusion: The selected papers make important contributions to human factors and organizational issues, expanding and deepening our knowledge of how to apply theory and applications of new technologies in health.
Year 2021: COVID-19, Information Extraction and BERTization among the Hottest Topics in Medical Natural Language Processing
Authors: Grabar Natalia , Grouin Cyril
Published: December 2022

Objectives: Analyze the content of publications within the medical natural language processing (NLP) domain in 2021.

Methods: Automatic and manual preselection of publications to be reviewed, and selection of the best NLP papers of the year. Analysis of the important issues.

Results: Four best papers have been selected in 2021. We also propose an analysis of the content of the NLP publications in 2021, all topics included.

Conclusions: The main issues addressed in 2021 are related to the investigation of COVID-related questions and to the further adaptation and use of transformer models. Besides, the trends from the past years continue, such as information extraction and use of information from social networks.
Transotic Approach for Resection of Expansile Endolymphatic Sac Tumor
Authors: Nunna Ravi S. , Wiet R Mark , Byrne Richard W.
Published: December 2022

Objectives and Design Endolymphatic sac tumors (ELSTs) are rare and indolent tumors that arise from the endolymphatic sac in the posterior petrous ridge. We present a video case report illustrating the use of a transotic approach for resection of an expansile ELST.

Setting and Participants A 25-year-old male presented with a multiyear history of worsening left-sided hearing loss, vertigo, and headaches. Otoscopy revealed a red mass behind an intact tympanic membrane. Computed tomography revealed a large, locally aggressive mass centered in the posterior petrous temporal bone. Magnetic resonance imaging demonstrated a heterogeneously enhancing 2.4 × 3.1 × 2.4 cm tumor that exerted mass effect on the cerebellar surface with extension into the jugular foramen, tympanic cavity, internal auditory canal, and cistern of the cerebellopontine angle. A transotic approach was planned to obtain the necessary generous exposure.

Main Outcome Measures and Results Preoperative angiography revealed arterial supply via the ascending pharyngeal and tumor embolization with Onyx was performed. Surgical resection began with a blind-sac closure created from the external auditory canal. The tympanic membrane and malleus were removed and the incustapedial joint was transected. A subtotal petrosectomy was performed for partial tumor exposure. The facial canal and sigmoid sinus were carefully skeletonized and a labrynthectomy was performed. The tumor was resected using a combination of bipolar cautery and blunt and sharp dissection. For closure, an abdominal fat graft was secured with overlying resorbable mesh followed by sequential closure of all skin layers. Histopathologic analysis revealed an ELST.

Conclusion The transotic approach offers wide exposure and facilitates large, complex tumor removal.

The link to the video can be found at https://youtu.be/YvhyN8iVi44.
Analytical Study of Ocular Surface Changes in Patients of Chronic Kidney Disease undergoing Hemodialysis and Peritoneal Dialysis
Authors: Ahuja Shashi , Jalwaniya Shilpa , Parameswaran Sreejith , Sarkar Sonali , Ananthkrishnan Ramesh , Gochhait Debasis
Published: December 2022

Objectives

The idiopathic group is a significant cause of chronic kidney disease (CKD) in developing countries. Literature available on ocular surface changes has predominantly been reported in patients undergoing hemodialysis. Little is known about the changes in patients undergoing peritoneal dialysis. The present study aimed to identify ocular surface changes in an idiopathic group of CKD undergoing dialysis.

Aim

To compare tear film disorders and the severity of ocular surface changes (goblet cell density, squamous metaplasia, and corneoconjunctival calcification) in patients of idiopathic etiology with CKD undergoing hemodialysis and peritoneal dialysis. This is an analytical study.

Materials and Methods

Asymptomatic adult patients of idiopathic CKD, on treatment with dialysis underwent comprehensive ophthalmic examination, including best-corrected visual acuity, slit-lamp examination, and a dilated fundus examination. Dry eye assessment was done by ocular surface staining score, Schirmer test, and tear breakup time (TBUT). Conjunctival impression cytology was studied to assess changes on ocular surface. Chest X-rays for aortic calcification were reviewed and data analyzed.

Results

Both eyes of 76 patients of hemodialysis and 32 patients of peritoneal dialysis were studied. Ocular surface staining (OSS) scores were low. Impression cytology showed a drop in goblet cell density, presence of squamous metaplasia, and conjunctival keratinization significantly more in the hemodialysis group. No correlation was seen between the presence of conjunctival calcification and aortic calcification.

Conclusion

The hemodialysis group had mild subclinical dry eye but keratinization of conjunctiva was seen. Similarly, advanced squamous metaplasia was seen in the peritoneal dialysis group. These changes were positively correlated to decrease in goblet cell density.
CircRNA circCOL1A1 Acts as a Sponge of miR-30a-5p to Promote Vascular Smooth Cell Phenotype Switch through Regulation of Smad1 Expression
Authors: Ye Meng , Ni Qihong , Wang Han , Wang Yuli , Yao Yongjie , Li Yinan , Wang Weilun , Yang Shuofei , Chen Jiaquan , Lv Lei , Zhao Yiping , Xue Guanhua , Guo Xiangjiang , Zhang Lan
Published: December 2022

Phenotypic switch of vascular smooth muscle cells (VSMCs) plays an important role in the pathogenesis of atherosclerosis. The mRNA expression of the synthetic biomarker Collagen Type I Alpha 1 Chain (COL1A1) gene is upregulated during the switch of VSMCs from the contractile to the synthetic phenotype. The association of noncoding circular RNAs transcribed by the COL1A1 gene with VSMC phenotype alteration and atherogenesis remains unclear. Here we reported a COL1A1 circular RNA (circCOL1A1) which is specifically expressed in VSMCs and is upregulated during phenotype alteration of VSMCs. CircCOL1A1 is also detectable in the serum or plasma. Healthy vascular tissues have a low expression of CircCOL1A1, while it is upregulated in atherosclerosis patients. Through ex vivo and in vitro assays, we found that circCOL1A1 can promote VSMC phenotype switch. Mechanistic analysis showed that circCOL1A1 may exert its function as a competing endogenous RNA of miR-30a-5p. Upregulation of circCOL1A1 ameliorates the inhibitory effect of miR-30a-5p on its target SMAD1, which leads to suppression of transforming growth factor-β (TGF-β) signaling. Our findings demonstrate that circCOL1A1 promotes the phenotype switch of VSMCs through the miR-30a-5p/SMAD1/TGF-β axis and it may serve as a novel marker of atherogenesis or as a therapeutic target for atherosclerosis.
Thrombocytopenia after Implantation of the Perceval, Intuity, and Sapien Aortic Valve Prostheses
Authors: Haeussler Achim , Ntinopoulos Vasileios , Rings Laura , Papadopoulos Nestoras , Hoti Gojart , Fleckenstein Philine , Dzemali Omer
Published: December 2022

Background An increased incidence of thrombocytopenia was reported after implantation of the LivaNova Perceval and the Edwards Sapien aortic valve bioprostheses. Aim of this study is to assess the perioperative platelet count and bleeding complications in three different types of aortic valve bioprostheses intended for high-risk patients, the sutureless LivaNova Perceval, the rapid deployment Edwards Intuity, and the transcatheter Edwards Sapien.

Methods We performed a retrospective analysis of the perioperative data of patients receiving the Perceval, Intuity, and Sapien aortic valve bioprosthesis. The platelet count was collected preoperatively, at nadir postoperatively, and at discharge. The bioprostheses were compared for between-group differences in platelet count and postoperative bleeding complications.

Results Overall, 37 patients received the Perceval, 42 the Intuity, and 58 the Sapien bioprosthesis. There was no significant between-group difference in the preoperative platelet count [Perceval 203(178–246)G/l, Intuity 214(190–232)G/l, Sapien 201(178–275)G/l, p = 0.800]. There was a significant between-group difference in the postoperative platelet count, both at nadir value [Perceval 57(37–80)G/l, Intuity 91(73–109)G/l, Sapien 126(105–170)G/l, p < 0.0001] and at discharge [Perceval 150(83–257)G/l, Intuity 239(200–343)G/l, Sapien 232(179–284)G/l, p = 0.001]. There was no significant between-group difference regarding red blood cell transfusions (p = 0.242), platelet transfusions (p = 0.656), and rethoracotomy for bleeding (p = 0.847).

Conclusion We found a significant platelet count reduction in all three bioprostheses which was more marked in the Perceval group. The platelet count reduction was transient and fully recovered in the Intuity and Sapien groups, whereas the Perceval group showed only a partial platelet count recovery. However, bleeding complications were not different between the three bioprostheses.
Hemodynamic Comparison between the Avalus and the Perimount Magna Ease Aortic Bioprosthesis up to 5 Years
Authors: Burri Melchior , Bozini Nikoleta , Vitanova Keti , Mayr Benedikt , Lange Rüdiger , Günzinger Ralf
Published: December 2022

Background We aimed to compare hemodynamic performance of the Avalus (Medtronic) and the Perimount Magna Ease (PME, Edwards Lifesciences) bioprosthesis up to 5 years by serial echocardiographic examinations.

Methods In patients undergoing aortic valve replacement, 58 received PME prostheses between October 2007 and October 2008, and another 60 received Avalus prostheses between October 2014 and November 2015. To ensure similar baseline characteristics, we performed a propensity score matching based on left ventricular ejection fraction, age, body surface area, and aortic annulus diameter measured by intraoperative transesophageal echocardiography. Thereafter, 48 patients remained in each group. Mean age at operation was 67 ± 6 years and mean EuroSCORE-II was 1.7 ± 1.1. Both values did not differ significantly between the two groups.

Results At 1 year the mean pressure gradient (MPG) was 15.4 ± 4.3 mm Hg in the PME group and 14.7 ± 5.1 mm Hg in the Avalus group (p = 0.32). The effective orifice area (EOA) was 1.65 ± 0.45 cm2 in the PME group and 1.62 ± 0.45 cm2 in the Avalus group (p = 0.79). At 5 years the MPG was 16.6 ± 5.1 mm Hg in the PME group and 14.7 ± 7.1 mm Hg in the Avalus group (p = 0.20). The EOA was 1.60 ± 0.49 cm2 in the PME group and 1.51 ± 0.40 cm2 in the Avalus group (p = 0.38). Five-year survival was 88% in the PME group and 91% in the Avalus group (p = 0.5). In the PME group, there were no reoperations on the aortic valve, whereas in the Avalus group three patients required a reoperation due to endocarditis.

Conclusion Both bioprostheses exhibit similar hemodynamic performance during a 5-year follow-up.
Evaluating Resource Utilization with Free or Pedicled Perforator Flaps in Distal Leg Reconstruction
Authors: Hsiao Jo-Chun , Zelenski Nicole A. , Tseng Yi-Ju , Hsu Chung-Chen , Chen Shih-Heng , Lin Chih-Hung , Lin Cheng-Hung
Published: December 2022

Background The decision between local and free tissue coverage for distal lower leg defects has long been dictated by the location and size of defects. Recent reports of distal defects treated successfully with pedicled perforator flaps demonstrate equivalent clinical outcomes; however, the complication rate can be high. The goal of this study was to evaluate the cost equivalence of free versus pedicled perforator flap to assist decision-making and guide clinical care.

Methods The institutional database was searched for patients with acute injury over the distal lower extremity requiring free or pedicled perforator flap. Demographic, clinical, and total resource cost was gathered. Patients were matched to Gustilo–Anderson or Arbeitsgemeinschaft fur Osteosynthesefragen classification as well as size of defect and outcomes, and cost compared.

Results We have included 108 free flaps and 22 pedicled perforator flaps in the study. There was no difference in complication rate between groups. Free flaps had significantly more reoperations, required longer operative time, and had longer intensive care unit (ICU) care with higher cost of surgery and overall cost than pedicled flaps. When controlling for size of defect, surgical cost remained significantly different between groups (p = 0.013), but overall cost did not. Multivariable regression analysis indicated flap type to be the primary driver of cost of surgery, while body mass index elevated the total cost.

Conclusion Pedicled perforator flap coverage for small to medium-sized defects (< 70 cm2) is a viable and cost-effective option for distal lower leg soft tissue reconstruction after acute traumatic injury with similar clinical outcomes and shorter operative duration and ICU stay.
Bilateral Native Kidney Papillary Renal Cell Carcinomas in a 11-Year-Old Renal Transplant Patient
Authors: Durakbaşa Çiğdem Ulukaya , Ugurlu Deniz , Bozbeyoglu Sabriye Gulcin , Aydoner Sinem , Seneldir Hatice , Candir Mehmet Onur , Candan Cengiz , Gemici Atilla
Published: December 2022

Renal cell carcinomas (RCCs) are the most common renal tumors in adults and are usually sporadic and unilateral. Renal transplant recipients have an increased risk of developing RCC. RCC development after kidney transplantation is very rarely reported in children. We present a 11-year-old boy who had cadaveric kidney transplantation for kidney failure 2 years ago. He was under immunosuppressive therapy and presented with microscopic hematuria. An ultrasound (US) revealed bilateral solid renal masses. Further cross-sectional imaging showed a 60 × 70 × 60-mm right renal mass with claw sign and a 5 × 6 × 6-mm mass in the left renal lower pole. A bilateral radical nephroureterectomy of native kidneys was performed. The pathology revealed bilateral papillary RCC without TFE3 upregulation. The patient was kept on low-dose immunosuppressive therapy in the perioperative period. He received no chemotherapy but a close radiological surveillance was undertaken. He is tumor-free 2 years after the operation. RCC is a rare tumor for children and bilateralism is even rarer. The child had a history of chronic kidney disease, peritoneal dialysis, and immunosuppressive therapy. As there are no standardized protocols regarding imaging in transplanted kidneys routine surveillance, US follow-up should also focus on detecting malignancy.
The Management of Salivary Fistulas
Authors: Belcastro Alexandra , Reed William , Puscas Liana
Published: December 2022

Postoperative salivary fistula is an especially undesirable complication because it can be difficult to address, may delay postoperative radiation, and always delays enteral nutrition. Patients who are malnourished, have already undergone radiotherapy, or are hypothyroid are at higher risk of developing this problem. Conservative measures work in most patients, but a significant percentage of patients require intervention beyond pressure dressings and tincture of time. Medications, hyperbaric oxygen therapy, and surgical intervention may be required when fistulas do not heal in a timely manner. Decisions about the approach and timing of more aggressive interventions are part of the art of medicine since definitive scientific protocols are lacking.
Management of the Failing Flap
Authors: Slijepcevic Allison A. , Yang Sara , Petrisor Daniel , Chandra Srinivasa R. , Wax Mark K.
Published: December 2022

Free tissue transfer has become the reconstructive modality of choice for replacing composite tissue defects. While the success rate in high-volume centers is reported to be greater than 95%, up to 10% of patients will require revision of their vascular anastomosis secondary to thrombosis or compromise to flow. In the intraoperative setting, immediate revision is successful in the majority of cases. Rarely, the flap cannot be revascularized and a secondary option must be used. In the perioperative setting revision is successful if the patient can be brought back to the operating room in a timely fashion. Revision rates up to 70% are reported. A small number of these patients may then suffer a second episode of compromise where revision is less successful at 30%. In these cases, consideration should be given to secondary reconstruction rather than attempting salvage. Finally, there are a small number of patients whose flaps will fail following discharge from the hospital. These patients can rarely be salvaged and secondary reconstructive options should be explored.
Identification of flow structures in a closed chamber in the presence of a needle plasma actuator
Authors: Mehdi Ghazanfar , Bonuso Sara , De Giorgi Maria Grazia
Published: December 2022

This study deals with the experimental characterization of the induced flow dynamics by a disk-needle-type plasma actuator driven by a sinusoidal generator and located in a rectangular cross-section burner. Flow characterization was performed using different plasma actuation conditions and standoff distances. Experiments were conducted under non-reactive flow conditions. Electrical characterization was carried out. Airflow behavior was also analyzed using smoke flow visualization. Smoke flow visualization showed the dynamic behavior of the plasma-induced flow. Post-processing of high-quality images was performed by using Proper Orthogonal Decomposition (POD) technique to recognize the dominant flow vortexes and coherent structures. This could support the design of plasma actuation devices in real combustors and be useful for the implementation of numerical models. Moreover, it has been concluded that flow dynamics can be controlled by a variation of the plasma power or the gap distance between two electrodes. Laser Droplet Velocimetry (LDV) was used to investigate the distribution of flow velocities and turbulent kinetic energy (TKE) at different plasma power values of the sinusoidal alternating current generator and standoff distances. From POD and LDV analyses, it has been observed that there is quite a linear relation between the POD energy of the first mode and the maximum TKE. The POD method could be used to identify motions in the flow field carrying the most TKE. TKE peaks are present in the area with the most energetic flow structures, as identified by the POD.
Effect of dissolved gas on the tensile strength of water
Authors: Mukherjee Saikat , Gomez Hector
Published: December 2022

While theoretical estimates suggest that cavitation of water should occur when pressure falls much below −25 MPa at room temperature, in experiments, we commonly observe conversion to vapor at pressures of the order of 3 kPa. The commonly accepted explanation for this discrepancy is that water usually contains nanometer-sized cavitation nuclei. When the pressure decreases, these nuclei expand and become visible to the naked eye. However, the origin of these cavitation nuclei is not well understood. An earlier work in this field has mainly focused on the inception of nuclei which are purely composed of water vapor, whereas experimental data suggest that these nuclei are mainly composed of air. In this Letter, we develop a theoretical approach to study the inception of cavitation nuclei in water with uniformly dissolved air, using a diffuse interface approach. We derive equations which govern the transition of water with uniformly dissolved air to a critical state. Our results show that the dissolved air decreases the free energy barrier from the initial to the critical state, thereby aiding the formation of cavitation nuclei. This study opens up possibilities to explore cavitation inception in fluids containing dissolved gases.
Analytic theory of nonlinearly coupled electrokinetics in nanochannels
Authors: Uematsu Yuki
Published: December 2022

The nonlinear electrokinetic response of ionic solutions is important in nanofluidics. However, quantitatively understanding the mechanisms is still a challenging problem because of a lack of analytic approaches. Here, a general framework for calculating the nonlinear electrokinetic coefficients of strongly confined electrolytes is constructed using a perturbation scheme of the pressure and voltage differences across a nanochannel. The theory is applied to an electrically neutral nanochannel filled with electrolytes, and analytic expressions for the first- and third-order electrokinetic coefficients are obtained. We demonstrate that the combination of high hydrodynamic permeability and ion–wall friction plays an essential role in nonlinear electrokinetics. Furthermore, we analytically demonstrate that the external flow induces uniform excess charge inside the nanochannel.
Influences of trailing-edge synthetic jets on longitudinal aerodynamic characteristics of a flying wing aircraft
Authors: Zhao Zhijie , Luo Zhenbing , Deng Xiong , Li Shiqing , Zhang Jianyuan , Liu Jiefu
Published: December 2022

For realizing the nice aerodynamic maneuverability of flying wing aircrafts (FWAs), a longitudinal aerodynamic control technology based on circulation control (CC) using trailing-edge synthetic jet actuators was proposed. Influences on longitudinal characteristics of a FWA were investigated. Results show that synthetic jets could improve the lift, drag, and nose-down moment, having potential of flight control at entire area of attack of angles (AOAs). Cl increment dips and then rises with the growth of AOAs, reaching the minimum at AOA of 12°. The maximum percentage of Cl enhancement and ΔCl/Cμ is separately 64.5% and 50.74%, respectively. Before 12°, synthetic jets could narrow the area of “dead zone,” improve flow velocities along the upper surface, and then move the trailing-edge separation point and the leading-edge (LE) stagnation point downward, enhancing the circulation. Moreover, synthetic jets grow rapidly through entrainment of the local flow, leading to the improvement of valid camber and, hence, the increase in Cl. CC efficiency decreases with the augmentation of AOAs, and leading-edge vortex (LEV) is weakened, causing the drop of Cl increment. After 12°, synthetic jets could enhance the longitudinal velocity of LEV and reduce the swirling number, improving the strength and stability of LEV, which results in larger suction near the leading edge. Moreover, the strengthened LEV could promote flow mixing and then weaken reverse pressure gradients along the wing section, thus improving flow velocities and CC efficiency at the wing section. It is above two factors that make Cl increment rise after 12°.
Pore-scale modeling of multiphase flow in porous media using a conditional generative adversarial network (cGAN)
Authors: Wang Zhongzheng , Jeong Hyogu , Gan Yixiang , Pereira Jean-Michel , Gu Yuantong , Sauret Emilie
Published: December 2022

Multiphase flow in porous media is involved in various natural and industrial applications, including water infiltration into soils, carbon geosequestration, and underground hydrogen storage. Understanding the invasion morphology at the pore scale is critical for better prediction of flow properties at the continuum scale in partially saturated permeable media. The deep learning method, as a promising technique to estimate the flow transport processes in porous media, has gained significant attention. However, existing works have mainly focused on single-phase flow, whereas the capability of data-driven techniques has yet to be applied to the pore-scale modeling of fluid–fluid displacement in porous media. Here, the conditional generative adversarial network is applied for pore-scale modeling of multiphase flow in two-dimensional porous media. The network is trained based on a data set of porous media generated using a particle-deposition method, with the corresponding invasion morphologies after the displacement processes calculated using a recently developed interface tracking algorithm. The results demonstrate the capability of data-driven techniques in predicting both fluid saturation and spatial distribution. It is also shown that the method can be generalized to estimate fluid distribution under different wetting conditions and particle shapes. This work represents the first effort at the application of the deep learning method for pore-scale modeling of immiscible fluid displacement and highlights the strength of data-driven techniques for surrogate modeling of multiphase flow in porous media.
Predicting the extent to which excess lipid is deposited in the physical components of a broiler when dietary protein content is reduced
Authors: Reis Matheus P. , Sakomura Nilva K. , Azevedo Jefferson M. , Viana Gabriel S. , Dorigam Juliano César P. , Fernandes Joao Batista K. , Gous Robert M.
Published: December 2022

Context The weight of each of the physical parts of the body of broilers, predicted using their allometric relationship with feather-free body protein, differs with the level of dietary protein offered. Aims The objective of this study was to account for the excess lipid that is deposited differentially in the physical parts of the body of broilers when dietary protein content is decreased. Methods In total, 2496 day-old Cobb 500® and Ross 308® broilers, equally divided between males and females, were used in a 56-day feeding trial. The experimental design used was a response experiment with six balanced protein concentrations (0.60, 0.70, 0.85, 1.00, 1.15 and 1.30 of the recommendation), with two factors (males and females) and two strains (Cobb and Ross). On Days 14, 28, 42 and 56 post-hatch, eight broilers from each feed × sex × strain combination were euthanised and partitioned into breast, legs, wings, and remainder. Each component was weighed and subsequentially analysed for water, protein and lipid. Allometric equations between the component weights and body protein weight were fitted to describe the responses. Key results In the allometric equations used to describe the additional weight of each component, at a given body protein weight, resulting from the additional amount of lipid that is deposited in the component as a result of reducing the dietary protein content, only the constant terms were affected. By expressing these constant terms as a proportional increase above the genetically determined level of fatness, described by males on the highest dietary protein feed, equations were derived that described the rate of increase in lipid weight with a change in dietary protein content. Conclusions When predicting the weights of different components in the body by using the allometric relationships between the component weight and body protein weight, equations are now available to correct the weights of the respective components of broilers for the additional amount of lipid that would be deposited as a result of feeding dietary protein contents below that required to achieve the genetically desired level of fatness in each component. Implications With the equations presented herein, one can predict the weights of commercial broiler parts, considering the extra fat deposited due to the dietary balanced protein offered, which may lead to decisions that increase the economic return of poultry production.