bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic value of the International Ovarian Tumor Analysis (IOTA) simple rules versus pattern recognition to differentiate between malignant and benign ovarian masses
Authors: Dakhly Dina M.R. , Gaafar Hassan M. , Sediek Mona M. , Ibrahim Mohamed F. , Momtaz Mohamed
Published: September 2019

Objective

To compare the efficacy of the International Ovarian Tumor Analysis (IOTA) simple rules versus pattern recognition to differentiate between benign and malignant ovarian masses.

Methods

A prospective cross‐sectional study conducted at Kasr El Aini Hospital, Cairo, between April 2016 and October 2018 of 396 women with ovarian masses measuring more than 5 cm who were candidates for surgery. All patients underwent two‐dimensional transvaginal sonography: level 2 with IOTA simple rules followed by level 3 with pattern recognition. Patients subsequently underwent ovarian cystectomy or oophorectomy and the specimens were examined histopathologically. Accuracy was measured by comparing sensitivity, specificity, positive predictive value, negative predictive value, and accuracy.

Results

IOTA simple rules specified 44/50 cases as malignant and 220/242 as benign (sensitivity and specificity of 88.0% and 90.9%, respectively). Pattern recognition identified 83/94 cases as malignant and 281/302 as benign (sensitivity and specificity of 88.3% and 92.7%, respectively). No statistically significant difference in accuracy was found between the two methods.

Conclusion

IOTA simple rules are an effective tool for detecting ovarian malignancy when performed by nonexpert sonographers. When results are inconclusive, pattern recognition should be performed additionally by an expert sonographer.

Clinical trials registration

NCT02800031
Systematic review of areca (betel nut) use and adverse pregnancy outcomes
Authors: De Silva Manarangi , Panisi Leeanne , Brownfoot Fiona C. , Lindquist Anthea , Walker Susan P. , Tong Stephen , Hastie Roxanne
Published: September 2019

Background

Betel nut is the fourth most commonly abused substance worldwide and has been associated with significant adverse health outcomes. Little is known about its effects on the fetus.

Objective

To perform a systematic review of studies investigating prenatal betel nut use and adverse perinatal outcomes.

Search strategy

Pubmed, Embase, and Cochrane databases were searched from inception until July 2018 using the terms areca, betel nut, pregnancy, pregnancy complications, and infection.

Selection criteria

Eligible studies included case–control, cohort, and randomized control studies involving pregnant women.

Data collection and analysis

Where appropriate, bivariate meta‐analysis was performed, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.

Main results

In total, 28 studies were screened and eight studies (including 15 270 women) were included in the review and meta‐analysis. Preterm birth, low birthweight, and anemia were most commonly investigated. Meta‐analysis revealed a significant association between betel nut use and low birthweight, with a pooled OR of 1.75 (95% CI, 1.35–2.27).

Conclusions

The review identified only eight eligible studies, all based in the Asia–Pacific region. There was a significant association between low birthweight and betel nut exposure in pregnancy. Further prospective studies are needed to confirm this association.
Role of a novel circulatory RNA‐based biomarker panel expression in ovarian cancer
Authors: El‐Shal Amal S. , Matboli Marwa , Abdelaziz Ahmed M. , Morsy Ali A. , Abdelbary Eman H.
Published: September 2019

Ovarian cancer (OC) is considered the sixth commonest cancer affecting women globally. We choose novel integrated specific ovarian cancer RNA biomarker panel; pellino E3 ubiquitin protein ligase family member 3 (PELI3) gene expressions along with its selected epigenetic regulators (microRNA (miR‐361‐3p) and long noncoding RNA (lncRNA RP5‐837J1.2) by bioinformatic methods. Then, differential expressions of the selected panel in the sera of 50 OC patients, 42 cases with benign ovarian lesions, and among 45 controls were determined using real‐time polymerase chain reaction quantitative (qRT‐PCR). Furthermore, their expression was measured also in malignant ovarian tissues and adjacent nontumor tissues in 23 of 50 OC patients by quantitative qRT‐PCR. The current study reported, for the first time, upregulation of serum lncRNA RP5‐837J1.2 with concomitant downregulation of miR‐361‐3p and PELI3 mRNA in malignant group compared with benign and controls groups. There were associations of serum lncRNA RP5‐837J1.2 with the affected ovary and worse International Federation of Gynecology and Obstetrics staging; associations of miR‐361‐3p with tumor size, grade, stage, and presence of metastasis; as well as associations among PELI3 mRNA expression and tumor size, grade, stage, and presence of metastasis among the OC group. In tumor tissues, miR‐361‐3p and PELI3 mRNA levels were at a higher level than that of nontumor tissues; however, tumor tissue showed lower level of lncRNA RP5‐837J1.2 compared to normal tissue. There were positive correlations between serum and tissue level of RNA RP5‐837J1.2, miR‐361‐3p, and PELI3 mRNA, but they did not reach statistical significance. Receiver operating characteristics curve analyses showed that lncRNA RP5‐837J1.2, miR‐361‐3p, and PELI3 mRNA expression levels can discriminate among OC patient, cases with benign mass, and controls with an accuracy of 96, 76, and 83%, respectively; which increased if they are combined. This novel diagnostic RNA‐based panel biomarker could be helpful for OC diagnosis.
From embryogenesis to adulthood: Critical role for GATA factors in heart development and function
Authors: Whitcomb Jamieson , Gharibeh Lara , Nemer Mona
Published: September 2019

Cardiac development is governed by a complex network of transcription factors (TFs) that regulate cell fates in a spatiotemporal manner. Among these, the GATA family of zinc finger TFs plays prominent roles in regulating the development of the myocardium, endocardium, and outflow tract. This family comprises six members three of which, GATA4, 5, and 6, are predominantly expressed in cardiac cells where they activate specific downstream gene targets via interactions with one another and with other TFs and signaling molecules. Their critical function in heart formation is evidenced by the phenotypes of animal models lacking these factors and by the broad spectrum of human congenital heart diseases associated with mutations in their genes. Similarly, in the postnatal heart, these proteins play significant and nonredundant roles in cardiac function, regulating adaptive stress responses including cardiomyocyte hypertrophy and survival, as well as endothelial homeostasis and angiogenesis. As such, decreased expression of either GATA4, 5, or 6 results in impaired cardiovascular homeostasis and increased risk of premature and serious cardiovascular events such as hypertension, arrhythmia, aortopathy, and heart failure. Although a great deal of progress has been made in understanding GATA‐dependent regulatory processes in the heart, the molecular mechanisms underlying the specificity of GATA factors and their upstream regulation remain incompletely understood. The knowledge and tools developed since their discovery 25 years ago should accelerate progress toward further elucidation of their mechanisms of action in health and disease. This in turn will greatly improve diagnosis and care for the millions of individuals affected by congenital and acquired cardiac disease worldwide.
A cell‐free approach with a supporting biomaterial in the form of dispersed microspheres induces hyaline cartilage formation in a rabbit knee model
Authors: Zurriaga Carda Javier , Lastra Maria L. , Antolinos‐Turpin Carmen M. , Morales‐Román Rosa M. , Sancho‐Tello María , Perea‐Ruiz Sofía , Milián Lara , Fernández Juan M. , Cortizo Ana M. , Carda Carmen , Gallego‐Ferrer Gloria , Gómez Ribelles José L.
Published: September 2019

The objective of this study was to test a regenerative medicine strategy for the regeneration of articular cartilage. This approach combines microfracture of the subchondral bone with the implant at the site of the cartilage defect of a supporting biomaterial in the form of microspheres aimed at creating an adequate biomechanical environment for the differentiation of the mesenchymal stem cells that migrate from the bone marrow. The possible inflammatory response to these biomaterials was previously studied by means of the culture of RAW264.7 macrophages. The microspheres were implanted in a 3 mm‐diameter defect in the trochlea of the femoral condyle of New Zealand rabbits, covering them with a poly(l‐lactic acid) (PLLA) membrane manufactured by electrospinning. Experimental groups included a group where exclusively PLLA microspheres were implanted, another group where a mixture of 50/50 microspheres of PLLA (hydrophobic and rigid) and others of chitosan (a hydrogel) were used, and a third group used as a control where no material was used and only the membrane was covering the defect. The histological characteristics of the regenerated tissue have been evaluated 3 months after the operation. We found that during the regeneration process the microspheres, and the membrane covering them, are displaced by the neoformed tissue in the regeneration space toward the subchondral bone region, leaving room for the formation of a tissue with the characteristics of hyaline cartilage.
Survey of preoperative management protocol for perihilar cholangiocarcinoma at 10 Japanese high‐volume centers with a combined experience of 2,778 cases
Authors: Chaudhary Rohan Jagat , Higuchi Ryota , Nagino Masato , Unno Michiaki , Ohtsuka Masayuki , Endo Itaru , Hirano Satoshi , Uesaka Katsuhiko , Hasegawa Kiyoshi , Wakai Toshifumi , Uemoto Shinji , Yamamoto Masakazu
Published: September 2019

Background

In Japan, strategies for preoperative management of perihilar cholangiocarcinoma (PHC) have evolved over the last decade; the operative mortality has significantly reduced to <5%.

Methods

A questionnaire was sent to 10 institutions based on their case volume. Questionnaire was based on: (1) preoperative biliary drainage, (2) bile replacement, (3) role of synbiotics, (4) remnant liver volume enhancement, (5) predicted remnant liver function, (6) imaging, (7) nutrition, and (8) role of Inchinkoto.

Results

The median case volume was 226 (range 105–889) cases, respectively. Eight institutions preferred endoscopic nasobiliary drainage and two preferred endoscopic biliary stenting for biliary drainage. Nine used bile replacement within 2–3 days of biliary drainage. Four used synbiotics preoperatively. The median cutoff value for future remnant liver volume and serum total bilirubin, at which portal vein embolization (PVE) is done, is <40% and <4 mg/dl. The median interval between PVE and surgery was 3–4 weeks. To predict remnant liver function, indocyanine green retention (n = 8) and clearance rate (n = 2) were mainly used. Five used Inchinkoto to improve liver function. Nine used multidetector computed tomography and direct cholangiography for surgical planning.

Conclusion

With appropriate preoperative management of PHC, surgical morbidity and mortality can be reduced. This survey can provide recommendations to improve PHC perioperative outcomes.
Evaluating quality of life tools in North American patients with erythropoietic protoporphyria and X‐linked protoporphyria
Authors: Naik Hetanshi , Overbey Jessica R. , Desnick Robert J. , Anderson Karl E. , Bissell D. Montgomery , Bloomer Joseph , Bonkovsky Herbert L. , Phillips John D. , Wang Bruce , Singal Ashwani , Balwani Manisha
Published: September 2019

Background

Erythropoietic protoporphyria (EPP) and X‐linked Protoporphyria (XLP) are rare photodermatoses presenting with severe phototoxicity. Although anecdotally, providers who treat EPP patients acknowledge their life‐altering effects, tools that fully capture their impact on quality of life (QoL) are lacking.

Methods

Adult patients with EPP/XLP were given four validated QoL tools: the Patient Reported Outcomes Measurement Information System 57 (PROMIS‐57), the Hospital Anxiety and Depression Scale (HADS), the Illness Perception Questionnaire Revised (IPQR), and an EPP‐Specific tool. All patients received the PROMIS‐57 while the HADS, IPQR, and EPP‐Specific tools were introduced at a later date. Associations between responses and clinical phenotypes were explored.

Results

Two hundred and two patients were included; 193 completed PROMIS‐57, 104 completed IPQR, 103 completed HADS, and 107 completed the EPP‐Specific tool. The IPQR showed that patients strongly believed EPP/XLP had a negative impact on their lives. Mean scores in anxiety and depression domains of both HADS and PROMIS‐57 were normal; however, anxiety scores from HADS were borderline/abnormal in 20% of patients. The EPP‐Specific tool revealed a decreased QoL in most patients. The PROMIS‐57 showed that 21.8% of patients have clinically significant pain interference. Several tool domains correlated with measures of disease severity, most being from the PROMIS‐57.

Conclusions

Impaired QoL is an important consequence of EPP/XLP. PROMIS‐57 was most sensitive in evaluating impaired QoL in EPP/XLP. Further research is needed to compare the effectiveness of it for assessing response to treatment.
Characterization of Post‐Traumatic Osteoarthritis in Rats Following Anterior Cruciate Ligament Rupture by Non‐Invasive Knee Injury (NIKI)
Authors: Brown Shannon B. , Hornyak Jessica A. , Jungels Ryan R. , Shah Yash Y. , Yarmola Elena G. , Allen Kyle D. , Sharma Blanka
Published: September 2019

Small animal models are essential for studying anterior cruciate ligament (ACL) injury, one of the leading risk factors for post‐traumatic osteoarthritis (PTOA). Non‐surgical models of ACL rupture have recently surged as a new tool to study PTOA, as they circumvent the confounding effects of surgical disruption of the joint. These models primarily have been explored in mice and rabbits, but are relatively understudied in rats. The purpose of this work was to establish a non‐invasive, mechanical overload model of ACL rupture in the rat and to study the disease pathogenesis following the injury. ACL rupture was induced via non‐invasive tibial compression in Lewis rats. Disease state was characterized for 4 months after ACL rupture via histology, computed tomography, and biomarker capture from the synovial fluid. The non‐invasive knee injury (NIKI) model created consistent ACL ruptures without direct damage to other tissues and resulted in conventional OA pathology. NIKI knees exhibited structural changes as early as 4 weeks post‐injury, including regional structural changes to cartilage, chondrocyte and cartilage disorganization, changes to the bone architecture, synovial hyperplasia, and the increased presence of biomarkers of cartilage fragmentation and pro‐inflammatory cytokines. These results suggest that this model can be a valuable tool to study PTOA. By establishing the fundamental pathogenesis of this injury, additional opportunities are created to evaluate unique contributing factors and potential therapeutic interventions for this disease. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:356‐367, 2020
Peripheral Blood Stem Cell Therapy Does Not Improve Outcomes of Femoral Head Osteonecrosis With Cap‐Shaped Separated Cartilage Defect
Authors: Ying Jun , Wang Pinger , Ding Quanwei , Shen Jie , O'Keefe Regis J. , Chen Di , Tong Peijian , Jin Hongting
Published: September 2019

A combination treatment with porous tantalum rod implantation and intra‐arterial infusion of peripheral blood stem cells (PBSCs) provides a promise for treating early and intermediate stages of osteonecrosis of the femoral head (ONFH). However, its clinical indications and application restrictions remain unclear. This study aims to determine the clinical, histological, and radiological outcomes of a combination treatment using mechanical support and a targeted intra‐arterial infusion of PBSCs for painful ONFH with a cap‐shaped separation (CSS) cartilage defect. Compared with the standard pain management (control group), this combination treatment did not improve the Harris Hip Score (HHS) at 36 months. Micro‐CT and histologic analyses showed severe focal destruction in all CSS‐ONFH femoral heads in both the combination and control groups. Femoral heads showed a higher percentage of bone lesions in the combination treatment group than in the control group. There was no significant difference in osteoclast number in the subchondral bone areas between the two groups. A high level of expression of inflammatory cytokines, including tumor necrosis factor‐α and interleukin‐1β, was detected in blood vessels around the subchondral bone in both groups. The RANKL/OPG (receptor activator of the nuclear factor‐kB ligand/osteoprotegerin) ratio was also similar between the control and combination treatment groups. Our results indicate that this combination treatment is not an effective method for the treatment of patients with painful CSS‐ONFH. Moreover, this combination treatment did not inhibit inflammatory osteoclastogenesis in patients with more advanced disease. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:269‐276, 2020
Association of Superoxide‐Induced Oxidative Stress With Rotator Cuff Tears in Human Patients
Authors: Yoshida Keiichi , Itoigawa Yoshiaki , Wada Tomoki , Maruyama Yuichiro , Nojiri Hidetoshi , Kawasaki Takayuki , Kaneko Kazuo
Published: September 2019

Rotator cuff degeneration is one of the factors contributing to rotator cuff tears. Oxidative stress is involved in tendon degeneration, and superoxide‐induced oxidative stress plays a pathological role in regulating the balance between oxidation and reduction. The role of oxidative stress in rotator cuff tears, however, is unclear. This study, therefore, aimed to investigate the contribution of superoxide‐induced oxidative stress to rotator cuff tears. Seventy patients were recruited and divided into two groups: patients with (Ruptured group) and those without (Unruptured group) a rotator cuff tear. Specimens from both groups were collected during surgery. Degeneration morphology was classified according to the degeneration score. Superoxide‐induced oxidative stress was assessed according to dihydroethidium (DHE) relative fluorescence intensity, capacity for antioxidation according to superoxide dismutase (SOD) activity, and the balance between oxidation and reduction based on the redox ratio. Data were compared between groups. Correlations between the degeneration score and the oxidative stress factors were calculated. Degeneration score and DHE relative fluorescence intensity were significantly higher in the Ruptured than the Unruptured group. The SOD activity was not significantly different between groups. Degeneration score was positively correlated with both DHE relative fluorescence intensity and SOD activity. Thus, superoxide‐induced oxidative stress and tendon degeneration were greater in rotator cuff tear tissues than in those with no tear, suggesting that oxidative imbalance may be involved in degenerative rotator cuff tears. Clinical Relevance: Understanding the mechanisms of superoxide‐induced oxidative stress may lead to targeted tissue therapy for degenerative rotator cuff tears. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:212–218, 2020
An overview on enrichment methods for cell surface proteome profiling
Authors: Li Yanan , Qin Hongqiang , Ye Mingliang
Published: September 2019

Cell surface proteins are essential for many important biological processes, including cell–cell interactions, signal transduction, and molecular transportation. With the characteristics of low abundance, high hydrophobicity, and high heterogeneity, it is difficult to get a comprehensive view of cell surface proteome by direct analysis. Thus, it is important to selectively enrich the cell surface proteins before liquid chromatography with mass spectrometry analysis. In recent years, a variety of enrichment methods have been developed. Based on the separation mechanism, these methods could be mainly classified into three types. The first type is based on their difference in the physicochemical property, such as size, density, charge, and hydrophobicity. The second one is based on the bimolecular affinity interaction with lectin or antibody. And the third type is based on the chemical covalent coupling to free side groups of surface‐exposed proteins or carbohydrate chains, such as primary amines, carboxyl groups, glycan side chains. In addition, metabolic labeling and enzymatic reaction‐based methods have also been employed to selectively isolate cell surface proteins. In this review, we will provide a comprehensive overview of the enrichment methods for cell surface proteome profiling.
Surgical Treatment of Paranasal Sinus Osteomas: A Single Center Experience of 58 Cases
Authors: Wolf Axel , Safran Bettina , Pock Jakob , Tomazic Peter Valentin , Stammberger Heinz
Published: September 2019

Objectives

Osteomas are osseous tumors that primarily occur at the skull, in particular the paranasal sinus system. Surgical tumor resection is the “gold standard” treatment in symptomatic osteomas. The aim of this study was to investigate the use of surgical approaches (endoscopic, open, combined) and to provide a step‐by‐step approach for patients’ management.

Methods

Fifty‐eight patients (31 m, 27 f, 42.1 ± 15.3 years) that were treated between 2001 and 2015 at our department were included in this retrospective, single center study.

Results

In almost half of cases (n = 28, 48.3%) endoscopic, endonasal approaches were used for tumor resection while open (n = 11, 19%) or combined (n = 19, 32.8%) approaches were used in the rest of the cohort. Open or combined approaches were applied in patients suffering from osteomas localized in the maxillary or frontal sinuses only.

Conclusion

Beside interviews, clinical examination, nasal endoscopy, and computed tomography are crucial for diagnosis of paranasal sinus osteomas. Magnet resonance imaging can be useful in extensive pathologies. The preoperative selection of the optimal approach for osteoma resection might be most challenging in patients’ management. Although useful recommendations regarding the use of surgical approaches have been published, technical requirements and surgical experience of surgeons have to be considered in the limitations of endoscopic approaches. If there are doubts about the resectability of an osteoma by an endoscopic approach, the surgical procedure may be started endoscopically, and, if necessary, it can be combined with an external approach.

Level of Evidence

IV Laryngoscope, 130:2105–2113, 2020
Intensive management and declines in soil nutrients lead to serious exotic plant invasion inEucalyptusplantations under successive short‐rotation regimes
Authors: Zhou Xiaoguo , Zhu Hongguang , Wen Yuanguang , Goodale Uromi Manage , Zhu Yulin , Yu Sufang , Li Chaoting , Li Xiaoqiong
Published: September 2019

The ongoing expansion ofEucalyptusplantations is changing the development of the world's forests. But, it also threatens ecological security regionally and worldwide. The expansion effect on biodiversity and soil nutrients is a universal problem, which has always been heatedly debated. In order to evaluate the long‐term influence of intensive management ofEucalyptusplantations under successive short‐rotation regime on understory plant diversity, soil nutrients andEucalyptustree growth, we chose a chronosequence representing the first to the sixth rotation ofEucalyptusplantations arrayed in the majorEucalyptusplantation areas in southern China and analyzed plant diversity indices, composition of plant functional groups (PFGs), soil nutrient concentrations andEucalyptustree growth at the stand level. Our results reveal that intensive management exerts a long‐lasting negative effect on understory plant species diversity, soil nutrients andEucalyptustree growth over successive rotations. Changes in soil nutrient content related with C and P cycling and declines in soil total nitrogen and available phosphorus were related with understory PFGs degradation. Furthermore, the combination of declines in understory woody plants, grasses and soil N and P cycling indices led to serious exotic plant invasion in the understory. Our study suggests that serious alien plant invasions could threaten the biosecurity, soil and timber security inEucalyptusplantations. We suggest that reducing management intensity, converting mono‐culturedEucalyptusplantations into mixed plantations with indigenous tree species, and changing from successive short‐rotation to short‐, medium‐ and long‐term cyclic rotations are required to sustainably manage these plantations through improving plant diversity, restoring degraded soils and resisting plant invasions.
Metformin treatment in young children with fragile X syndrome
Authors: Biag Hazel Maridith B. , Potter Laura A. , Wilkins Victoria , Afzal Sumra , Rosvall Alexis , Salcedo‐Arellano Maria Jimena , Rajaratnam Akash , Manzano‐Nunez Ramiro , Schneider Andrea , Tassone Flora , Rivera Susan M. , Hagerman Randi J.
Published: September 2019

Background

Metformin is a drug commonly used in individuals with type 2 diabetes, obesity, and impaired glucose tolerance. It has a strong safety profile in both children and adults. Studies utilizing the Drosophila model and knock out mouse model of fragile X syndrome (FXS) have found metformin to rescue memory, social novelty deficits, and neuroanatomical abnormalities. These studies provided preliminary evidence that metformin could be used as a targeted treatment for the cognitive and behavioral problems associated with FXS. Previously, a case series of children and adults with FXS treated with metformin demonstrated improvements in irritability, social responsiveness, language, and hyperactivity.

Methods

Here, we present nine children with FXS between 2 and 7 years of age who were treated clinically with metformin and monitored for behavioral and metabolic changes.

Results

Parent reports and developmental testing before and after metformin are presented. There were improvements in language development and behavior (such as lethargy and stereotypy) in most of the patients.

Conclusion

These results support the need for a controlled trial of metformin in children with FXS under 7 years old whose brains are in a critical developmental window and thus may experience a greater degree of clinical benefit from metformin.
Comparisons of fascio‐cutaneous anterolateral thigh and sandwich fascial ALT free flap in the distal extremity reconstruction
Authors: Cherubino Mario , Stocco Chiara , Ronga Mario , Tamborini Federico , Maggiulli Francesca , Di Giovanna Danilo , Campisi Corrado , Di Summa Pietro , Valdatta Luigi
Published: September 2019

Introduction

The anterolateral thigh (ALT) flap is considered a workhorse reconstructive option; however, it is encumbered by its bulkiness that can result in poor final outcome and need for revision surgery. The aim of the present study was to compare the standard cutaneous ALT free flap and sandwich fascial ALT (SALT) free flap, raised harvesting between the Scarpa's fascia and the crural fascia, for distal extremity soft tissue reconstruction, including pre‐ intra‐ and post‐operative considerations and outcomes.

Patients and methods

A retrospective review of medical records from 2013 to 2018 of 24 patients who underwent distal extremity reconstruction with standard fascio‐cutaneous ALT flap (13 patients) and SALT flap (11 patients) was performed. The mean defect dimensions were 12 × 6.5 cm in group 1 and 12 × 6 in group 2. Surgical outcomes and quality of life were assessed (through the upper extremity functional scale and the lower extremity functional scale questionnaires.

Results

The mean flap dimensions were 13.1 × 7.1 in group 1 and 14.1 × 7.8 in group 2, the overall flap success rate was 100% (one microvascular venous thrombosis occurred in group 1), no statistically significant difference was recorded regarding microvascular thrombosis (one patient in group p = .369) and infections (one patient in group 1, p = .36) while a statistically significant difference was presence regarding the number of secondary/debulking procedures (6 patients vs. 0) (p = .0076) and the quality of life perception showed an overall better perception in group 2 with statistical significant difference (p = .03).

Conclusion

The SALT flap represents a valid option, as showed through our preliminary data, when a thin and robust reconstruction is required when dealing with distal extremities soft tissue reconstruction.
Dynamic focal plane estimation for dental panoramic radiography
Authors: Kim Seungeon , Ra Jong Beom
Published: September 2019

Purpose

The digital panoramic radiography is widely used in dental clinics and provides the anatomical information of the intraoral structure along the predefined arc‐shaped path. Since the intraoral structure varies depending on the patient, however, it is nearly impossible to design a common and static focal path or plane fitted to the dentition of all patients. In response, we introduce an imaging algorithm for digital panoramic radiography that can provide a focused panoramic radiographic image for all patients, by automatically estimating the best focal plane for each patient.

Methods

The aim of this study is to improve the image quality of dental panoramic radiography based on a three‐dimensional (3D) dynamic focal plane. The plane is newly introduced to represent the arbitrary 3D intraoral structure of each patient. The proposed algorithm consists of three steps: preprocessing, focal plane estimation, and image reconstruction. We first perform preprocessing to improve the accuracy of focal plane estimation. The 3D dynamic focal plane is then estimated by adjusting the position of the image plane so that object boundaries in the neighboring projection data are aligned or focused on the plane. Finally, a panoramic radiographic image is reconstructed using the estimated dynamic focal plane.

Results

The proposed algorithm is evaluated using a numerical phantom dataset and four clinical human datasets. In order to examine the image quality improvement owing to the proposed algorithm, we generate panoramic radiographic images based on a conventional static focal plane and estimated 3D dynamic focal planes, respectively. Experimental results show that the image quality is dramatically improved for all datasets using the 3D dynamic focal planes that are estimated from the proposed algorithm.

Conclusions

We propose an imaging algorithm for digital panoramic radiography that provides improved image quality by estimating dynamic focal planes fitted to each individual patient’s intraoral structure.
Nerve ultrasound normal values in children and young adults
Authors: Druzhinin Dmitry , Naumova Еugeniia , Nikitin Sergey
Published: September 2019

Background

The objective of the study was to determine the reference values for cross‐sectional area (CSA) of the nerves in healthy subjects between the age of 2 and 30 years.

Methods

High‐resolution ultrasonography (HRU) of the median, ulnar, tibial, sural, peroneal and spinal nerves C5‐C7 was performed in 72 healthy subjects.

Results

The CSA of peripheral nerves demonstrated an age‐dependent increase in size at all measurement sites in children up to around 14 years of age. This was most pronounced for large lower limb nerves and least for small nerves. Intra‐nerve and inter‐nerve variability of nerve CSA did not change with age.

Conclusions

This study provides normative values for HRU of peripheral nerves in children and young adults. Adult reference values should not be used for children under the age of 14 years.
Clinical and genetic characteristics of childhood‐onset myotonic dystrophy
Authors: Stokes Mathew , Varughese Natasha , Iannaccone Susan , Castro Diana
Published: September 2019

Introduction

Myotonic dystrophy type 1 (DM1) is caused by a CTG (cytosine‐thymine‐guanine) trinucleotide repeat expansion. Congenital DM (CDM) presents in the first month of life, whereas individuals with infantile and juvenile DM1 have later onset of symptoms.

Methods

We performed a retrospective chart review of patients with childhood‐onset DM1 seen at one of three locations in Dallas, Texas between 1990 and 2018. Symptoms, disease course, cognitive features, and family history were reviewed.

Results

Seventy‐four patients were included; CDM was diagnosed in 52 patients. There was maternal inheritance in 74% of patients. CTG repeat number ranged from 143 to 2300. Neuropsychiatric and cognitive deficits were common. Over half of the patients had GI disturbances, and orthopedic complications were common.

Discussion

Myotonic dystrophy type 1 in children requires a multidisciplinary approach to management. Presenting symptoms vary, and repeat expansion size does not necessarily directly relate to severity of symptoms. A consensus for outcome measures is required.
Hybrid systems of three‐dimensional carbon nanostructures with low dimensional fillers for piezoresistive sensors
Authors: Ke Kai , Sang Zhen , Manas‐Zloczower Ica
Published: September 2019

As an alternative of single filler system, hybrid fillers system is beneficial for the fabrication of elastomer‐based piezoresistive strain sensors with high strain sensitivity for structural health monitoring and human motion detection. However, a comprehensive understanding for the effect of the secondary filler dimensionality on piezoresistive strain sensor sensitivity by hybrid carbon nanofillers strategy is missing. Here, we report a comparative study about the effect of branched carbon nanostructures (CNS, three‐dimensional, 3D) combined with carbon black (CB, 0D) or carbon nanotubes (CNT, 1D) on the piezoresistive behavior of thermoplastic polyurethane (TPU)‐based composites. At either the same total filler content or similar electrical resistivity, using CNS‐CB hybrid is more efficient than using CNS alone or CNS‐CNT hybrid for improving piezoresistive sensitivity of the TPU composites. For instance, the composite 1.5CNS‐1CB has a gauge factor (GF) of 21 and 99 at strain ε = 50 and 100%, respectively, while the composites 2.5CNS and 1.5CNS‐1CNT have GF values of 4.3 and 9.1 at strain ε = 50% and 14 and 20 at strain ε = 100%, respectively. Besides, the TPU composite with CNS‐CB shows a larger response to finger bending (50° on an index finger) by comparison with that contains only CNS, indicating potential applications for human motion detection. This study introduces a facile way to fabricate strain‐sensitive sensors aimed at strain of 50%–100%, strengthening understanding the selection of hybrid carbon nanofillers with different dimensionalities to optimize piezoresistive sensor design.
Injection molding of delamination‐free ultra‐high‐molecular‐weight polyethylene
Authors: Yilmaz Galip , Yang Huaguang , Turng Lih‐Sheng
Published: September 2019

When ultra‐high‐molecular‐weight polyethylene (UHMWPE) in powder form is injection molded, the so‐called delamination layering occurs near the skin of the parts. This layering defect hampers UHMWPE's superior wear resistance property and part surface quality. The delamination layer was caused by a combination of excessive shear stress near the part surface and high degree of molecular entanglement of UHMWPE. A mold insulation method that delays the rapid cooling of UHMWPE to reduce the shear stress and improve the polymer chain “interdiffusion” across the entangled chain bundles was used to eliminate the delamination layer. When the insulation layer thickness and mold temperature were optimized, the delamination layer was eliminated completely while still maintaining a reasonable cooling/cycle time. The delamination‐free parts were found to regain UHMWPE's superior impact resistance and tensile properties. POLYM. ENG. SCI., 59:2313–2322, 2019. © 2019 Society of Plastics Engineers
Neurophysiological and behavioral measures of pain during neonatal hip examination
Authors: Pettersson Miriam , Olsson Emma , Ohlin Andreas , Eriksson Mats
Published: September 2019

Introduction

The aim of this study was to test the hypothesis that neonatal hip examination causes pain in newborns. Pain assessment using instruments such as the Premature Infant Pain Profile‐Revised (PIPP‐R) scale is recommended, but recently physiological and neurophysiological measures, for example, near‐infrared spectroscopy (NIRS) and galvanic skin response (GSR), have been used as well.

Methods

Heart auscultation and hip examination were performed, and the response of the newborn was registered by NIRS optodes, GSR electrodes, and a pulse oximeter probe attached to the infant. The face of the newborn was filmed. Heart auscultation was used as a nonpainful reference.

Results

The pain scores for hip examination were higher than for the heart auscultation. Near‐infrared spectroscopy showed a significant higher increase from baseline in oxygenated hemoglobin (HbO2) on both sides of the cortex at hip examination compared with at heart auscultation (P = .011 and P = .017). Mean PIPP‐R scores for the hip examination compared with heart auscultation increased from 3.0 to 8.1 (P = .000). The GSR analyses of hip examination compared with heart auscultation showed a significant increase in area under small peaks during the hip examination (P = .016), however, not when measured in peaks per second (P = .104). Interrater reliability was calculated for the NIRS interpretations, with an intraclass correlation coefficient (ICC) range of 0.93‐1.0 (P = .000).

Discussion

Pain in newborns can have negative consequences, and pain prevention and treatment are therefore important. We conclude that neonatal hip examinations are painful and that the pain should be treated, for example, with oral sweet solution. This is a change from present routines during neonatal hip examination and is hoped to lead to a change in national guidelines.
Facile one‐shot synthesis of functional star‐shaped polymers by domino‐type living cationic copolymerization
Authors: Yamada Mayuka , Yoshizaki Tomoya , Kanazawa Arihiro , Kanaoka Shokyoku , Aoshima Sadahito
Published: September 2019

This article describes the syntheses of various functional star‐shaped polymers via monomer‐selective living cationic polymerization of a vinyl ether (VE) and a divinyl compound with alkoxystyrene moieties by a one‐shot method. An aqueous solution of the resulting star‐shaped polymers with oxyethylene pendants exhibits thermally induced phase separation behavior. To achieve domino synthesis from various monomers, we investigated the optimum reactivity difference using a functional VE and a monofunctional alkoxystyrene. Moreover, the one‐shot copolymerization of a bifunctional VE and an alkoxystyrene is also conducted to yield a star‐shaped polymer via the core‐first method. © 2019 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2019, 57, 2166–2174
A pilot study of a telehealth family‐focused melanoma preventive intervention for children with a family history of melanoma
Authors: Wu Yelena P. , Boucher Kenneth , Hu Nan , Hay Jennifer , Kohlmann Wendy , Aspinwall Lisa G. , Bowen Deborah J. , Parsons Bridget G. , Nagelhout Elizabeth S. , Grossman Douglas , Mooney Kathi , Leachman Sancy A. , Tercyak Kenneth P.
Published: September 2019

Objective

Melanoma preventive interventions for children with familial risk are critically needed because ultraviolet radiation (UVR) exposure and sunburn occurrence early in life are the primary modifiable risk factors for melanoma. The current study examined the feasibility and acceptability of a new, family‐focused telehealth intervention for children with familial risk for melanoma and their parents. The study also explored changes in child sun protection and risk behaviors, sunburn occurrence, and objectively measured UVR exposure.

Methods

This was a prospective study with a single‐group design (n = 21 parent‐child dyads, children ages 8‐17). Dyads were asked to participate in three in‐person assessments and three live video teleconference intervention sessions.

Results

The intervention was feasibly delivered, and the intervention content was acceptable to parents and children. The intervention was associated with improvements in child use of certain sun protection strategies over time and declines in child UVR exposure.

Conclusions

A telehealth‐delivered,family‐focused melanoma preventive intervention was feasibly delivered and was acceptable to parent‐child dyads. Future melanoma preventive interventions for this at‐risk population could incorporate eHealth technologies to facilitate improvements in use of sun protection and monitoring of UVR exposure. This trial was registered with Clinicaltrials.gov, number NCT02846714.
Analysis of Temperature‐Dependent Functional and Dynamic Crosstalk Noise in Adjacent Interconnects of Doped Multilayer Graphene Nanoribbon with Armchair and Zigzag Edges
Authors: Kaur Tajinder , Rai Mayank Kumar , Khanna Rajesh
Published: September 2019

Multilayer graphene nanoribbon (MLGNR) is a potential candidate in nanoscale very large scale integration (VLSI) interconnects. A detailed analysis emphasizing the impact of GNR's edge shape in an armchair (ac) and zigzag (zz) structures on crosstalk performance considering undoped and doped (intercalated with AsF5 and FeCl3) MLGNR interconnects is presented. A capacitively‐coupled driver‐interconnect‐load (DIL) line configuration is used to analyze both the functional and dynamic crosstalk at 14 nm technology node for global interconnects. A temperature‐dependent equivalent single conductor (TD‐ESC) model is considered. It is observed that over a temperature range from 300 to 500 K, crosstalk‐induced low noise peaks in doped MLGNRs are obtained with zz‐edges as compared with undoped MLGNR, whereas, the time duration of crosstalk‐induced noise is small for doped MLGNRs with ac‐edges. Similar findings are obtained in terms of propagation delay and crosstalk‐induced delay for single and coupled interconnects, respectively, that is, the delays obtained in both kinds are small for doped MLGNR with ac‐edges. It is also observed that AsF5‐doped MLGNR outperforms FeCl3‐doped MLGNR in terms of crosstalk‐induced noise and delay. The results of MLGNR are also compared with the mixed carbon‐nanotube bundle (MCB).
Computer Simulations of X‐Ray Spherical Wave Laue Diffraction in a Thick Perfect Crystal with a Triangular Cutout on the Exit Surface
Authors: Kohn Victor Germanovich , Smirnova Irina A.
Published: September 2019

The results of computer simulations of X‐ray spherical wave dynamical Laue diffraction in a perfect crystal of a special shape are presented. Namely, the crystal has a triangular cutout on the exit surface with the angle 2θ less than 2θB, where θB is the Bragg angle. The effect of a strong increase in the intensity near the triangular cutout is found in the case of a thick crystal. It is demonstrated that the X‐ray beam intensity can be increased up to seven times under the conditions of the Borrmann effect. The fast Fourier transform (FFT) algorithm is used at the first step where simulations of spherical wave Laue diffraction in a perfect crystal slab are performed. Thus, the X‐ray fields are obtained in front of the triangular cutout which are used as boundary conditions for the second step. At the second step, a direct numerical solution of the Takagi equations is used. The effect of a strong increase in intensity is observed for all source‐to‐crystal distances including the distance of diffraction focusing. This effect is explained in terms of a crystal propagator.
Order in the ground state of a simple cubic dipole lattice in an external field
Authors: Ashhab Sahel , Carignano Marcelo , Madjet Mohamed E.
Published: September 2019

Motivated by the presence of a lattice of rotating molecular dipoles in the high temperature phase of methylammonium lead iodide, we investigate the ground state of a simple cubic lattice of dipoles interacting with each other via the dipole‐dipole interaction and with an external field via the standard, linear dipole‐field interaction. In the absence of an external field, the ground state is infinitely degenerate, and all the configurations in the ground state manifold are periodic along the three lattice axes with a period of two lattice sites. Using a 1000‐dipole lattice as a unit cell in numerical simulations of an infinite simple cubic lattice, we determine the ground state dipole configurations in the presence of an external field. We then analyze the polarization, dipole orientation statistics and correlations in these configurations. Our calculations show that for some special directions of the external field the two‐site periodicity in the dipole configurations is preserved, while in the general case this periodicity is lost and complex dipole configurations form under the influence of the external field. More specifically, for a general field direction, a sudden transition from two‐site‐periodic configurations to irregular configurations occurs at a finite value of the applied field strength.
Molecular characterization of polyethylene oxide based oligomers by surface‐assisted laser desorption/ionization mass spectrometry using a through‐hole alumina membrane as active substrate
Authors: Sato Hiroaki , Nakamura Sayaka , Fouquet Thierry , Ohmura Takayuki , Kotani Masahiro , Naito Yasuhide
Published: September 2019

Rationale

Molecular characterization of industrial oligomeric products is performed using surface‐assisted laser desorption/ionization mass spectrometry (SALDI‐MS), termed desorption ionization using a through‐hole alumina membrane (DIUTHAME). This paper describes the unique feature of a DIUTHAME chip applying active SALDI, which generates specific types of fragments of polyglycol samples.

Methods

Polyethylene oxide (PEO) and PEO‐based materials were subjected to SALDI‐MS. The influence of the presence or absence of a cationization salt on the mass spectrum was investigated. The resulting mass spectra composed of fragment ions were compared with those obtained by collision‐induced dissociation (CID)‐MS/MS. The specific fragment ions generated using the DIUTHAME chip were further subjected to high‐energy CID‐MS/MS.

Results

The addition of a cationization salt resulted in SALDI mass spectra with fewer fragment peaks. The mass spectra obtained without adding the cationization salt were composed of many more fragment ions caused by in‐source decay. The fragmentation pattern was similar to that seen with low‐energy CID. The resulting fragment ions were formed by selective cleavage at the C‐O bond. High‐energy CID‐MS/MS can be performed for the specific fragment ions generated by in‐source decay fragmentation.

Conclusions

Molecular characterization of PEO‐based oligomers by SALDI‐MS using the DIUTHAME chip was successfully demonstrated. The selective fragmentation and high‐energy CID‐MS/MS of the in‐source decay fragments made it possible to provide more detailed structural information. This unique feature of DIUTHAME gives it potential for use in new molecular characterization techniques.