bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of Prostate Imaging Reporting and Data System Version 2.1 for Diagnosis of Prostate Cancer: A Systematic Review and Meta‐Analysis
Authors: Park Kye Jin , Choi Sang Hyun , Kim Mi‐hyun , Kim Jeong Kon , Jeong In Gab
Published: February 2021

Background

The Prostate Imaging Reporting and Data System (PI‐RADS) was introduced in 2012 and updated to version 2.1 (v2.1) in early 2019 to improve diagnostic performance and interreader reliability.

Purpose

To evaluate the diagnostic performance of PI‐RADS v2.1 in comparison with v2.

Methods

A systematic review and meta‐analysis of the literature was performed using MEDLINE, EMBASE, and Cochrane databases to identify studies evaluating the diagnostic performance of PI‐RADS v2.1 for diagnosing clinically significant prostate cancer (csPCa).

Study Type

Systematic review and meta‐analysis.

Subject

One thousand two hundred forty‐eight patients with 1406 lesions from 10 eligible articles.

Field Strength/sequence

Conventional MR sequences at 1.5 T and 3 T.

Assessment

Two reviewers independently identified and reviewed the original articles reporting diagnostic performance of PI‐RADS v2.1.

Statistical Tests

Meta‐analytic summary sensitivity and specificity were calculated using a bivariate random effects model. Meta‐analytic sensitivity and specificity between PI‐RADS v2 and v2.1 were compared.

Results

The pooled sensitivity and specificity of PI‐RADS v2.1 were 87% (95% confidence intervals, 82–91%) and 74% (63–82%), respectively. In five studies available for a head‐to‐head comparison between PI‐RADS v2.1 and v2, there were no significant differences in either sensitivity (90% [86–94%] vs. 88% [83–93%], respectively) or specificity (76% [59–93%] vs. 61% [39–83%], respectively; P = 0.37). The sensitivity and specificity were 81% (73–87%) and 82% (68–91%), respectively, for a PI‐RADS score cutoff of ≥4, and 94% (88–97%) and 56% (35–97%) for ≥3. Regarding the zonal location, the sensitivity and specificity for the transitional zone only were 90% (84–96%) and 76% (62–90%) respectively, whereas for the whole gland they were 85% (79–91%) and 71% (57–85%).

Data Conclusion

PI‐RADS v2.1 demonstrated good overall performance for the diagnosis of csPCa. PI‐RADS v2.1 tended to show higher specificity than v2, but the difference lacked statistical significance.

Level of Evidence

3

Technical Efficacy Stage

3
DC and transient models of the MSET device
Authors: Peled Assaf , Amrani Ofer , Rosenwaks Yossi
Published: February 2021

As a multigate device, the multiple‐state electrostatically formed nanowire transistor (MSET) exhibits a rather complex characteristic on account of the coupling between each of its two adjacent terminals. The MSET has shown promise across a steadily growing range of applications and integrated circuit components. However, an analytical model of the MSET has not been formulated. The objective of this work was to develop practical DC and transient models of the MSET. The modeling approach comprises two stages: the first stage consists of a bottom‐up derivation of the I–V characteristics from the fundamental physical level using the physical processes within the device to derive equations that describe its steady‐state behavior; the second stage proposes a set of analytical equations more applicable to simulation environments. A transient model that considers device parasitic capacitance is also established. The models are validated against robust model simulations in TCAD Sentaurus and Cadence Virtuoso.
Advances in microfluidic in vitro systems for neurological disease modeling
Authors: Holloway Paul M. , Willaime‐Morawek Sandrine , Siow Richard , Barber Melissa , Owens Róisín M. , Sharma Anup D. , Rowan Wendy , Hill Eric , Zagnoni Michele
Published: February 2021

Neurological disorders are the leading cause of disability and the second largest cause of death worldwide. Despite significant research efforts, neurology remains one of the most failure‐prone areas of drug development. The complexity of the human brain, boundaries to examining the brain directly in vivo, and the significant evolutionary gap between animal models and humans, all serve to hamper translational success. Recent advances in microfluidic in vitro models have provided new opportunities to study human cells with enhanced physiological relevance. The ability to precisely micro‐engineer cell‐scale architecture, tailoring form and function, has allowed for detailed dissection of cell biology using microphysiological systems (MPS) of varying complexities from single cell systems to “Organ‐on‐chip” models. Simplified neuronal networks have allowed for unique insights into neuronal transport and neurogenesis, while more complex 3D heterotypic cellular models such as neurovascular unit mimetics and “Organ‐on‐chip” systems have enabled new understanding of metabolic coupling and blood–brain barrier transport. These systems are now being developed beyond MPS toward disease specific micro‐pathophysiological systems, moving from “Organ‐on‐chip” to “Disease‐on‐chip.” This review gives an outline of current state of the art in microfluidic technologies for neurological disease research, discussing the challenges and limitations while highlighting the benefits and potential of integrating technologies. We provide examples of where such toolsets have enabled novel insights and how these technologies may empower future investigation into neurological diseases.
The beneficial role of the synthetic microneurotrophin BNN20 in a focal demyelination model
Authors: Kalafatakis Ilias , Patellis Alexandros , Charalampopoulos Ioannis , Gravanis Achille , Karagogeos Domna
Published: February 2021

BNN20, a C17‐spiroepoxy derivative of the neurosteroid dehydroepiandrosterone, has been shown to exhibit strong neuroprotective properties but its role in glial populations has not been assessed. Our aim was to investigate the effect of BNN20 on glial populations by using in vitro and in vivo approaches, taking advantage of the well‐established lysophosphatidylcholine (LPC)‐induced focal demyelination mouse model. Our in vivo studies, performed in male mice, showed that BNN20 treatment leads to an increased number of mature oligodendrocytes (OLs) in this model. It diminishes astrocytic accumulation during the demyelination phase leading to a faster remyelination process, while it does not affect oligodendrocyte precursor cell recruitment or microglia/macrophage accumulation. Additionally, our in vitro studies showed that BNN20 acts directly to OLs and enhances their maturation even after they were treated with LPC. This beneficial effect of BNN20 is mediated, primarily, through the neurotrophin receptor TrkA. In addition, BNN20 reduces microglial activation and their transition to their pro‐inflammatory state upon lipopolysaccharides stimulation in vitro. Taken together our results suggest that BNN20 could serve as an important molecule to develop blood–brain barrier‐permeable synthetic agonists of neurotrophin receptors that could reduce inflammation, protect and increase the number of functional OLs by promoting their differentiation/maturation.
Melanin and chromoblastomycosis agents: Characterization, functions, and relation with antifungals
Authors: Koehler Alessandra , Heidrich Daiane , Pagani Danielle M. , Corbellini Valeriano A. , Scroferneker Maria L.
Published: February 2021

Melanins are a diverse group of dark pigments with similar properties. In fungi, the most studied is the dihydroxynaphtalene (DHN)‐melanin, present in several species including all the chromoblastomycosis agents, a chronic, disabling, and recalcitrant subcutaneous mycosis. It is synthesized in a pathway known as the pentaketide pathway, which has the agrochemical tricyclazole as an inhibitor, widely used in in vitro studies because it does not prevent the growth of fungi. There are different methodologies for qualitative and quantitative analyses of DHN‐melanin, which made it possible to discover its important structural and antioxidant functions, with melanin acting as a protective factor against the host's immune system. Also, it can interact with some of the main antifungals of medical interest, reducing its activity and the susceptibility of fungi to these agents. This review aims to discuss the aspects of DHN‐melanin, focusing on chromoblastomycosis, bringing the main findings of the published scientific studies, and highlighting the need for further research to understand this important fungal pathogenicity and a virulence factor.
A dated volcano‐tectonic deformation event in Jan Mayen causing landlocking of Arctic charr
Authors: Larsen Eiliv , Lyså Astrid , Höskuldsson Ármann , Davidsen Jan G. , Nadeau Marie J. , Power Michael , Tassis Georgios , Wastegård Stefan
Published: February 2021

We provide the first documentation of tectonic deformation resulting from a volcanic eruption on the island of Jan Mayen. Vertical displacement of about 14 m southwest of the stratovolcano Beerenberg is associated with an eruption in ad 1732 on its southeastern flank. The age of the uplift event is bracketed by radiocarbon‐dated driftwood buried by material deposited due to uplift, and by tephra from this eruption. Constraints, inferred from radiocarbon ages alone, allow for the possibility that uplift was completed prior to the ad 1732 eruption. However, the occurrence of tephra in the sediment column indicates that some displacement was ongoing during the eruption but ceased before the eruption terminated. We attribute the tectonic deformation to intrusion of shallow magma associated with the volcanic eruption. Our results complement previous studies of volcanic activity on Jan Mayan by providing precise age constraints for past volcanic activity. Also, it raises new hypotheses regarding the nature, timing and prevalence of precursor tectonic events to Jan Mayan eruptions. The uplift caused the complete isolation of a coastal lake by closing its outlet to the sea, thus landlocking the facultative migratory fish species Arctic charr (Salvelinus alpinus).
Effects of dietary ferulic acid supplementation on growth performance and skeletal muscle fiber type conversion in weaned piglets
Authors: Wang Youxia , Chen Xiaoling , Huang Zhiqing , Chen Daiwen , Yu Bing , Chen Hong , Yu Jie , Luo Yuheng , Zheng Ping , He Jun
Published: February 2021

BACKGROUND

Ferulic acid (FA) is a common polyphenolic compound. The purpose of this study was to explore the effect of dietary FA supplementation on growth performance and muscle fiber type conversion in weaned piglets. In this study, eighteen 21‐day‐old DLY (Duroc × Landrace × Yorkshire) weaned piglets were randomly divided into control, 0.05% FA, and 0.45% FA groups.

RESULTS

Our study showed that dietary FA supplementation had no effect on growth performance, but it could upregulate the expression of slow myosin heavy chain (MyHC) protein, increase the activities of succinic dehydrogenase and malate dehydrogenase, and downregulate the expression of fast MyHC protein. Dietary FA supplementation also increased the expression levels of phosphorylated AMP‐activated protein kinase, sirtuin 1 (Sirt1), peroxisome proliferator‐activated receptor gamma coactivator 1‐alpha (PGC‐1α), myocyte enhancer factor 2C, and troponin I‐SS, increased the proportion of slow‐twitch fiber, and decreased the proportion of fast‐twitch fiber. In addition, our results showed that dietary FA supplementation increased the messenger RNA abundance of mitochondrial nuclear transcription genes, including ATP synthase membrane subunit c locus 1, cytochrome oxidase subunit 1, nuclear respiratory factor 1, mitochondrial transcription factor A, mitochondrial transcription factor B1, and cytochrome c.

CONCLUSION

We provided the first evidence that FA could promote muscle fiber type conversion from fast‐twitch to slow‐twitch via the Sirt1/AMP‐activated protein kinase/PGC‐1α signaling pathway and could improve the mitochondrial function in weaned piglets. This means that FA can be used as a dietary supplement to improve the quality of pork. © 2021 Society of Chemical Industry
Reassessing the impact of tumor size on operative approach in adrenocortical carcinoma
Authors: Hue Jonathan J. , Bingmer Katherine , Zhao Heming , Ammori John B. , Wilhelm Scott M. , Towe Christopher W. , Rothermel Luke D.
Published: February 2021

Background

Adrenocortical carcinoma (ACC) is often a contraindication to minimally invasive adrenalectomy (MIA). We used an administrative data set to analyze postoperative outcomes. We hypothesized that small tumors would have better short‐ and long‐term outcomes, independent of the operative approach.

Methods

The National Cancer Database (2010–2016) identified patients with ACC who underwent adrenalectomy. Tumors were grouped: <5 cm (n = 125), 5–10 cm (n = 431), and >10 cm (n = 443). The primary and secondary outcomes were margin positivity and overall survival, respectively.

Results

Nine hundred and ninety‐nine patients were analyzed: 37% MIA and 63% open adrenalectomy (OA). As the size increased, the rate of attempted MIA decreased. Larger tumors were associated with conversion to open. Although tumors with local invasion and those which required conversion to open were associated with an increased likelihood of a positive margin, tumor size was not. Although “complete” MIA (vs. OA) and tumor size were not associated with differences in survival, conversion (HR = 1.83, p = .02), positive margins (HR = 1.54, p = .01), and local invasion (HR = 1.84, p < .001) were associated with poor survival.

Conclusion

Positive margins are associated with poor survival in ACC. Tumors ≥ 5 cm were associated with an increased conversion rate and subsequent increase in margin positivity. MIA may be considered for select patients with small tumors but adequate oncologic resection is critical.
Acceptability of 3D‐printed breast models and their impact on the decisional conflict of breast cancer patients: A feasibility study
Authors: Santiago Lumarie , Volk Robert J. , Checka Cristina M. , Black Dalliah , Lee Joanna , Colen Jessica S. , Akay Catherine , Caudle Abigail , Kuerer Henry , Arribas Elsa M.
Published: February 2021

Purpose

To evaluate the acceptability and impact of 3D‐printed breast models (3D‐BMs) on treatment‐related decisional conflict (DC) of breast cancer patients.

Methods

Patients with breast cancer were accrued in a prospective institutional review board‐approved trial. All patients underwent contrast‐enhanced breast magnetic resonance imaging (MRI). A personalized 3D‐BM was derived from MRI. DC was evaluated pre‐ and post‐3D‐BM review. 3D‐BM acceptability was assessed post‐3D‐BM review.

Results

DC surveys before and after 3D‐BM review and 3D‐BM acceptability surveys were completed by 25 patients. 3D‐BM were generated in two patients with bilateral breast cancer. The mean patient age was 48.8 years (28−72). The tumor stage was Tis (7), 1 (8), 2 (8), and 3 (4). The nodal staging was 0 (19), 1 (7), and 3 (1). Tumors were unifocal (15), multifocal (8), or multicentric (4). Patients underwent mastectomy (13) and segmental mastectomy (14) with (20) or without (7) oncoplastic intervention. Neoadjuvant therapy was given to seven patients. Patients rated the acceptability of the 3D‐BM as good/excellent in understanding their condition (24/24), understanding disease size (25/25), 3D‐BM detail (22/25), understanding their surgical options (24/25), encouraging to ask questions (23/25), 3D‐BM size (24/25), and impartial to surgical options (17/24). There was a significant reduction in the overall DC post‐3D‐BM review, indicating patients became more assured of their treatment choice (p = 0.002). Reduction post‐3D‐BM review was also observed in the uncertainty (p = 0.012), feeling informed about options (p = 0.005), clarity about values (p = 0.032), and effective (p = 0.002) Decisional Conflict Scale subscales.

Conclusions

3D‐BMs are an acceptable tool to decrease DC in breast cancer patients.
A challenging playing field: Identifying the endogenous impediments to annulus fibrosus repair
Authors: Peredo Ana P. , Gullbrand Sarah E. , Mauck Robert L. , Smith Harvey E.
Published: February 2021

Intervertebral disc (IVD) herniations, caused by annulus fibrosus (AF) tears that enable disc tissue extrusion beyond the disc space, are very prevalent, especially among adults in the third to fifth decade of life. Symptomatic herniations, in which the extruded tissue compresses surrounding nerves, are characterized by back pain, numbness, and tingling and can cause extreme physical disability. Patients whose symptoms persist after nonoperative intervention may undergo surgical removal of the herniated tissue via microdiscectomy surgery. The AF, however, which has a poor endogenous healing ability, is left unrepaired increasing the risk for re‐herniation and pre‐disposing the IVD to degenerative disc disease. The lack of understanding of the mechanisms involved in native AF repair limits the design of repair systems that overcome the impediments to successful AF restoration. Moreover, the complexity of the AF structure and the challenging anatomy of the repair environment represents a significant challenge for the design of new repair devices. While progress has been made towards the development of an effective AF repair technique, these methods have yet to demonstrate long‐term repair and recovery of IVD biomechanics. In this review, the limitations of endogenous AF healing are discussed and key cellular events and factors involved are highlighted to identify potential therapeutic targets that can be integrated into AF repair methods. Clinical repair strategies and their limitations are described to further guide the design of repair approaches that effectively restore native tissue structure and function.
Resource Selection by Recolonizing American Black Bears
Authors: Lustig Elliot J. , Lyda Sara Bales , Leslie David M. , Luttbeg Barney , Fairbanks W. Sue
Published: February 2021

American black bears (Ursus americanus) were extirpated from Oklahoma, USA, in the early twentieth century but have since recolonized eastern portions of the state after immigrating from Arkansas, where they were successfully translocated. Within the last 2 decades, a population of black bears was detected in the Oklahoma Ozark region, prompting studies to determine population size, growth rate, and genetic makeup. To understand how black bears were recolonizing the human‐dominated landscape, we investigated resource selection at 2 scales. Between 2011 and 2016, we collected global positioning system collar spatial data for 10 males and 13 females. We calculated average kernel density home ranges on a seasonal scale for all collared bears. We used generalized linear mixed models to calculate resource selection functions at the study area, defined by locations of all radio‐collared black bears (second order) and the scale of individual black bear home ranges (third order). Resource selection did not differ significantly by sex. Black bears across seasons and scales selected riparian forest and moist oak (Quercus spp.) forest land cover types and mostly selected against indicators of human activity (e.g., pasture‐prairie, anthropogenic land cover types, roads, and areas of high human population density). Black bears also selected areas with rugged terrain at high elevations, although not consistently across seasons and scales. Black bear recolonization appeared to be negatively affected by areas and features characterized as human‐altered. Further expansion of the range of black bears may be limited by anthropogenic disturbance in the region. © 2021 The Wildlife Society.
Long‐Term Spatiotemporal Dynamics and Factors Associated with Trends in Bare‐Nosed Wombats
Authors: Carver Scott , Charleston Michael , Hocking Gregory , Gales Rosemary , Driessen Michael M.
Published: February 2021

Geographically widespread species present challenges for conservation assessment. We used long‐term spotlight surveys to assess spatiotemporal dynamics of bare‐nosed wombats (Vombatus ursinus), encompassing 34 years of surveys for the Tasmanian mainland sub‐species (V. u. tasmaniensis, 1985–2018) and 25 years for the Flinders Island sub‐species (V. u. ursinus, 1994–2018). Wombat populations increased on the Tasmanian mainland by 2.59 times and on Flinders Island by 3.51 times ( = 1.05 and 1.1 times increase/yr, respectively). At smaller spatial scales on mainland Tasmania, increases in wombat counts generally occurred within meteorological regions and regional zones, except for the Central North (West Tamar) region where a decrease in wombats is linked to a sarcoptic mange disease epizootic. We used generalized additive models to assess relationships between variables and wombat counts. The most supported variables at the mainland Tasmania scale were (in order of importance) year, positive associations with time‐lagged minimum temperature, Tasmanian devil (Sarcophilus harrisii) counts, and moonlight, and a negative association with time‐lagged rainfall. Among meteorological regions, variables associated with wombat counts exhibited some heterogeneity, with temperature and rainfall the most frequently associated variables. Our long‐term, large‐scale, and ecologically diverse analysis of bare‐nosed wombats supports spotlight monitoring as a valuable, relatively simple, and affordable survey method in Tasmania and beyond. © 2021 The Wildlife Society.
Efficacy of Initial Sirolimus Therapy for 27 Patients with Intractable Lymphatic Malformations
Authors: Zhang Xuexi , Wang Shengcai , Guo Yongli , Liu Yuanhu , Zhang Jie , Li Yanzhen , Liu Qiaoyin , Liu Zhiyong , Sun Nian , Li Xiaodan , Liu Yuwei , Du Jiangnan , Cheng Xiaoling , Wang Xiaoling , Tai Jun , Ni Xin
Published: February 2021

Objective/Hypothesis

To evaluate the efficacy of initial sirolimus therapy in the treatment of intractable head and neck lymphatic malformations (LMs) in children.

Study Design

Prospective open‐label study.

Methods

In this study, Twenty‐seven children diagnosed with LMs were given oral sirolimus as primary treatment over a minimum 6‐month trial. The major parameter to evaluate therapeutic outcome was percentage of lesion volume change compared with baseline. Average serum sirolimus concentrations, and adverse side effects, were monitored throughout the study period.

Results

Fifteen girls and twelve boys, average age 27 months (16 days–171 months), constitute the study group. Treatment was deemed effective for twenty‐three participants, judged as fair in seven, good in nine, and excellent in seven. Two patients had minimal improvement, and two had increased volume to some degree. Effectiveness differed among LMs subtypes with responsiveness of macrocystic LMs exceeding that of microcystic LMs (P < .05). Adverse drug reactions totaled 27 events in ten patients, the majority being mild with upper respiratory infections being most common.

Conclusions

Sirolimus as initial therapy is effective in decreasing lesion volume in intractable LMs in head and neck region, especially in macrocystic subtypes. Although most cases cannot be completely cured, side effects are few and tolerable.

Level of Evidence

4 Laryngoscope, 131:1902–1908, 2021
Extracranial/Intracranial Vascular Bypass in the Treatment of Head and Neck Cancer ‐ Related Carotid Blowout Syndrome
Authors: Wu Ping‐An , Yuan Guo‐Yan , Zhou Ru‐Ming , Ho Wilson Wai‐Shing , Lu Zhao‐Qun , Cai Ji‐Fu , Yang Si‐Yi , Tsang Raymond King‐Yin , Chan Jimmy Yu‐Wai
Published: February 2021

Objective/Hypothesis

To investigate the endovascular intervention or extracranial/intracranial (EC/IC) vascular bypass in the management of patients with head and neck cancer‐related carotid blowout syndrome (CBS).

Study Design

Retrospective case series.

Methods

Retrospective analysis of clinical data of patients with head and neck cancer‐related CBS treated by endovascular intervention and/or EC/IC vascular bypass, analysis of its bleeding control, neurological complications, and survival results.

Results

Thrity‐seven patients were included. Twenty‐five were associated with external carotid artery (ECA); twelve were associated with internal or common carotid artery (ICA/CCA). All patients with ECA hemorrhage were treated with endovascular embolization. Of the 12 patients with ICA/CCA hemorrhage, 9 underwent EC/IC bypass, 1 underwent endovascular embolization, and 3 underwent endovascular stenting. For patients with ECA‐related CBS, the median survival was 6 months, and the 90‐day, 1‐year, and 2‐year survival rates were 67.1%, 44.7%, and 33.6%, respectively; the estimated rebleeding risk at 1‐month, 6‐month, and 2‐year was 7.1%, 20.0%, and 31.6%, respectively. For patients with ICA/CCA‐related CBS, the median survival was 22.5 months, and the 90‐day, 1‐year, and 2‐year survival rates were 92.3%, 71.8%, and 41.0%, respectively; the estimated rebleeding risk at 1 month, 6 months, and 2 years is 7.7%,15.4%, and 15.4%, respectively. ICA/CCA‐related CBS patients have significantly longer survival time and lower risk of rebleeding, which may be related to the more use of EC/IC vascular bypass as a definite treatment.

Conclusions

For patients with ICA/CCA‐related CBS, if there is more stable hemodynamics, longer expected survival, EC/IC vascular bypass is preferred.

Level of Evidence

4 Laryngoscope, 131:1548–1556, 2021
Primary Orbital Melanoma: An Investigation of a Rare Malignancy Using the National Cancer Database
Authors: Caplan Ian F. , Prasad Aman , Carey Ryan M. , Brody Robert M. , Cannady Steven B. , Rajasekaran Karthik , Bur Andrés M. , Lukens John N. , Briceño César A. , Newman Jason G. , Brant Jason A.
Published: February 2021

Objectives

Primary orbital melanoma (POM) is a rare disease with limited data on survival and best treatment practices. Here we utilize the National Cancer Database (NCDB) to determine the overall survival (OS) and covariates that influence mortality.

Study Design: Retrospective cohort study.

Methods

All patients diagnosed with POM from 2004 to 2016 were identified in the NCDB. Patient and oncologic data were analyzed using the Kaplan–Meier method and multivariate models for the primary outcome of OS.

Results

A total of 129 patients were identified. Median OS was 36.9 months (95% confidence interval [CI] 24.1–78.7 months) with mean 5‐year survival of 42.0% (CI 33.2%–53.2%). Treatments received included surgery alone (43.4%), radiation alone (23.3%), and surgery followed by radiation (20.2%). The multivariate model demonstrated an increased risk of death associated with age over 80 years (hazard ratio [HR] 3.41, CI 1.31–8.86, P = .012), a Charlson‐Deyo comorbidity score of 2 or greater (HR 5.30, CI 1.87–15.03, P = .002), and no treatment (HR 2.28, CI 1.03–5.06, P = .042). For every 1 cm increase in tumor size, there was an increased risk of death (HR 1.06, CI 1.00–1.13, P = .039). When compared to surgery alone, no other treatment modality had an effect on OS.

Conclusions

This study leveraged multiyear data from the NCDB to provide prognostic and demographic information on the largest known cohort of POM cases. Increased age, increased comorbidities, not receiving treatment, and larger tumor size were associated with increased mortality. There was no clear survival advantage for specific treatments.

Level of Evidence

4 Laryngoscope, 131:1790–1797, 2021
A Comprehensive Analysis of Complications of Free Flaps for Oromandibular Reconstruction
Authors: Walia Amit , Mendoza Joshua , Bollig Craig A. , Craig Ethan J. , Jackson Ryan S. , Rich Jason T. , Puram Sidharth V. , Massa Sean T. , Pipkorn Patrik
Published: February 2021

Objectives/Hypothesis

To determine the frequency and management of short‐ and long‐term complications related to oromandibular free flap reconstruction and identify potentially predictive factors of hardware complications.

Study Design

Retrospective chart review.

Methods

A retrospective database from chart review was formed consisting of 266 oromandibular free flap reconstructions performed at a single institution over a 15‐year period. Data were collected on demographics, surgical treatment, complications, and management of complications. Subgroup univariate and multivariate analyses were performed to compare patients with hardware complications and those without.

Results

Eighty‐one of 266 patients (30.5%) that underwent oromandibular reconstruction had an early complication (<4 weeks after surgery), and the most common complications were cervical wound dehiscence (11.3%) and fistulas (9.40%). Eighty of 266 patients (30.1%) had a long‐term complication (>4 weeks after surgery) and the most common complication was plate exposure (26.7%). Univariate and multivariate analyses showed no association between whether there was hardware extrusion and fibula versus scapula, smoking history, virtual surgical planning (VSP), and dental implantation (P > .05). Only early complications (OR, 3.59, 95% CI, 1.83–7.05, P < .01) and patients undergoing oromandibular reconstruction for osteoradionecrosis (OR, 2.26, 95% CI, 1.10–4.64, P = .03) were strongly and independently associated with subsequent hardware extrusion on univariate analysis.

Conclusions

Both short‐ and long‐term complications are common after oromandibular reconstruction. The most important predictive factor for a late complication is an early complication and prior radiation. There was no difference of plate complications among the various free flap types. Dental implantation and use of VSP were not associated with hardware complications.

Level of Evidence

4 Laryngoscope, 131:1997–2005, 2021
Combined Transverse Cordotomy‐ Anteromedial Arytenoidectomy for Isolated Glottic Stenosis
Authors: Ghodke Ameer , Tracy Lauren F. , Hollis Alison , Adams Katherine , Shah Rupali N. , Buckmire Robert A.
Published: February 2021

Objectives/Hypothesis

Glottic stenosis is a discrete cause of airway compromise. We aimed to determine the surgical outcomes of transverse cordotomy with anteromedial arytenoidectomy (TCAMA), performed in the setting of isolated glottic stenosis resulting from two discrete etiologies: bilateral vocal fold paralysis (BVFP) and posterior glottic stenosis (PGS).

Study Design

Retrospective, analytic cohort study.

Methods

Twenty‐six patients with isolated glottic stenosis were treated with TCAMA between 2006 and 2019. A retrospective analysis determined decannulation rates and intervals, voice outcomes, swallowing outcomes, and reoperation rates postoperatively. Outcomes between the two etiologic cohorts were compared.

Results

Of the 26 patients, 16/26 patients were diagnosed with PGS and 10/26 with BVFP. Eighteen patients required tracheotomies during their clinical course (11/16 PGS, and 7/10 BVFP), and 100% were ultimately decannulated. The PGS cohort required two‐sided interventions more frequently than the BVFP cohort (45.5% vs. 0%, P = .066). Trach‐dependent PGS patients required a longer time to achieve decannulation than BVFP patients by a factor of 2.38, although the difference was not statistically significant (102.3 days vs. 42.9 days, respectively, P = .113). Patients demonstrated a significant change in maximum phonation time but no statistically significant differences with preoperative versus postoperative voice outcomes like voice‐related quality of life. All patients ultimately returned to their baseline swallow function postoperatively.

Conclusion

TCAMA is an effective treatment for surgical rehabilitation of glottic stenosis caused by both BVFP and PGS. Patient‐reported outcomes of postoperative vocal function remain consistent following surgical intervention. Additional, prospective studies with greater power are warranted to validate the contrasting outcomes observed when applying this discrete surgical technique across two distinct diagnostic cohorts in this retrospective study.

Level of Evidence

4. Laryngoscope, 131:2305–2311, 2021
Parental Perception of Weight Status for Adenotonsillectomy Patients
Authors: Herrmann Brian W. , Campbell Kristen , Meier Maxene , Haemer Matthew , Crowder Renee , Tholen Kaitlyn , Hoefner‐Notz Regina , Nguyen Thanh , Friedman Norman R.
Published: February 2021

Objective

Weight status can affect outcomes in pediatric adenotonsillectomy performed for obstructive sleep disordered breathing. Parents frequently underestimate their child's weight and are unaware weight status may affect adenotonsillectomy success. Accurate understanding of a child's weight status is important for shared decision making with the family and perioperative care. The purpose of this study is to analyze the accuracy of the parent's perception of their child's weight status.

Methods

A retrospective analysis was performed of prospective data collected from families of children undergoing adenotonsillectomy from June 2018 through June 2019.

Results

A total of 522 children met the inclusion criteria. Two hundred and thirty‐two children were either overweight (n = 46, 9%) or obese (n = 186, 36%). Among parents of this cohort whose children were overweight or obese, 74 (32%) erroneously reported that their child was normal weight. For the 290 nonoverweight children, 99% of parents accurately reported weight status. After adjusting for ethnicity, race, BMI%, and sex, for every 1‐year increase in age of the child, the odds of the parent correctly identifying their child as overweight increased by a factor of 1.18 (95% CI: 1.09, 1.27).

Conclusion

One‐third of families with children who were overweight or obese undergoing adenotonsillectomy for obstructive sleep disordered breathing underestimated their child's weight. This study highlights the need to facilitate family understanding of weight status' potential impact on both obstructive sleep disordered breathing severity and adenotonsillectomy success, especially for younger children.

Level of Evidence

4 Laryngoscope, 131:2121–2125, 2021
Quality characteristics, fatty acid profile and glycemic index of extrusion processed snacks enriched with the multicomponent mixture of cereals and legumes
Authors: Wani Sajad Ahmad , Ganie Nawaz Ahmad , Kumar Pradyuman
Published: February 2021

Extrudate snacks were prepared from base material (rice and corn) and optimized combination of ingredients were analyzed for effects of extrusion cooking on physical, functional, fatty acid profile, total dietary fiber, structural properties, and glycemic index. Physical and functional properties differ significantly (p ≤ 0.05). Increase in total dietary fiber content was observed by extrusion. Fatty acid profile did not show any significant variation. Snack prepared using base material had softer structure (10.02 N) than snack prepared using optimized combination (10.30 N). Total flavonoid content was reduced by extrusion cooking from 1003 to 802 μg(CE)/g). In pasting properties, higher value of cold viscosity was observed in extrudate snack (140 cP) than unextruded raw mixture (79 cP). In comparison to unextruded raw mixture the peak, final and setback viscosity of extrudate snacks was lower. These findings signify that extrusion is a cooking process. Glycemic index by in vitro analysis showed lower value of extrudate snacks made from optimized combination than extrudate snacks made from base material. Therefore, extrusion cooking and proper selection of ingredients can be successfully used for the production of extruded snacks with significant fatty acids retention, higher fiber content and low glycemic index.
Do interactions between patients’ psychological distress and adherence to dietary recommendation predict glycemic control among persons with type 2 diabetes in Ghana?
Authors: Doglikuu Be‐Ikuu Dominic , Abdulai Abubakari , Yaseri Mehdi , Shakibazadeh Elham , Djazayery Abolghassem , Mirzaei Khadijeh
Published: February 2021

Introduction

Psychological distress is a pervasive mental condition among persons with chronic noncommunicable diseases.

Aim

To examine whether interactions between patients’ psychological distress and adherence to dietary recommendations predict glycemic controls among persons with type 2 diabetes mellitus in Ghana.

Methods

 Facility‐based cross‐sectional study involving 530 persons with type 2 diabetes mellitus was conducted between October 2018 and September 2019. Six health facilities were randomly selected and normal‐weight persons with type 2 diabetes mellitus (T2DM) at baseline consecutively recruited from patients’ registers. Structured questionnaires were used to collect sociodemographic data. Glycemic control was the main outcome variable, and was determined using HbA1c%. Statistical Package for Social Sciences version 22 was used in data analysis.

Results

Systolic blood pressure (mm Hg), diastolic blood pressure (mm Hg), total cholesterol, and fasting blood sugar were statistically significant for glycemic control (HbA1c%) (p‐value < 0.05). After adjusting for confounding variables, low adherence and moderate adherence to dietary recommendations were independently significant for poor glycemic control (high HbA1c%). Interaction between low psychological distress and low adherence to dietary recommendations was statistically significant for poor glycemic control (high HbA1c%). Interaction between low psychological distress and moderate adherence to dietary recommendations was also statistically significant for poor glycemic control (high HbA1c%), whereas interaction between moderate psychological distress and high adherence to dietary recommendations was statistically significant for poor glycemic control (high HbA1c%).

Conclusion

Interaction between psychological distress and adherence to dietary recommendations can influence glycemic controls among persons with T2DM.
How hydrology and anthropogenic activity influence the molecular composition and export of dissolved organic matter: Observations along a large river continuum
Authors: Zhou Yongqiang , Yao Xiaolong , Zhou Lei , Zhao Zhonghua , Wang Xiaolong , Jang Kyoung‐Soon , Tian Wei , Zhang Yunlin , Podgorski David C. , Spencer Robert G. M. , Kothawala Dolly N. , Jeppesen Erik , Wu Fengchang
Published: February 2021

Large rivers are the main arteries for transportation of carbon to the ocean; yet, how hydrology and anthropogenic disturbances may change the composition and export of dissolved organic matter along large river continuums is largely unknown. The Yangtze River has a watershed area of 1.80 × 106 km2. It originates from the Qinghai‐Tibet Plateau and flows 6300 km eastward through the center of China. We collected samples (n = 271) along the river continuum and analyzed weekly samples at the most downstream situated gauging station in 2017–2018 and gathered long‐term (2006–2018) water quality data. We found higher gross domestic product, population density, and urban and agricultural land use downstream than upstream of the Three Gorges Dam, coinciding with higher dissolved organic carbon (DOC), UV absorption (a254), specific ultraviolet absorbance (SUVA254), parallel factor analysis‐derived C1–C5, aliphatic compounds, and lower a250:a365 and spectral slope (S275–295). Chemical oxygen demand, humic‐like C1–C2 and C6, and protein‐like C4 and C7 increased, while dissolved oxygen and ammonium decreased with increasing discharge at most of the sites studied, including the intensively monitored downstream site. The annual DOC fluxes were ca. 1.5–1.8 Tg yr−1, and 12–18% was biodegradable in a 28‐d bio‐incubation. Our results highlight that urbanization and stormwater periods enhanced the export of both terrestrial organic‐rich substances and household effluents from nearshore residential areas. Our study emphasizes the continued need to protect the Yangtze River watershed as increased organic carbon loading or altered composition and bio‐lability may change the ecosystem function and carbon cycling.
Demarcating the Exact Midplane of the Liver Using Indocyanine Green Near‐Infrared Fluorescence Imaging During Laparoscopic Donor Hepatectomy
Authors: Kim Jeesun , Hong Suk Kyun , Lim Jieun , Lee Jeong‐Moo , Cho Jae‐Hyung , Choi YoungRok , Yi Nam‐Joon , Lee Kwang‐Woong , Suh Kyung‐Suk
Published: February 2021

Indocyanine green (ICG) near‐infrared fluoroscopy has been recently implemented in pure laparoscopic donor hepatectomy (PLDH). This study aims to quantitatively evaluate the effectiveness of ICG fluoroscopy during liver midplane dissection in PLDH and to demonstrate that a single injection of ICG is adequate for both midplane dissection and bile duct division. Retrospective analysis was done with images acquired from recordings of PLDH performed without ICG (pre‐ICG group) from November 2015 to May 2016 and with ICG (post‐ICG group) from June 2016 to May 2017. 30 donors from the pre‐ICG group were compared with 46 donors from the post‐ICG group. The operation time was shorter (P = 0.002) and postoperative peak aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were lower (P = 0.031 and P = 0.019, respectively) in the post‐ICG group than the pre‐ICG group. Within the post‐ICG group, the color intensity differences between the clamped versus nonclamped regions in the natural, black‐and‐white, and fluorescent modes were 39.7 ± 36.2, 89.6 ± 46.9, and 19.1 ± 36.8 (mean ± SD, P < 0.001), respectively. The luminosity differences were 37.2 ± 34.5, 93.8 ± 32.1, and 26.7 ± 25.7 (P < 0.001), respectively. Meanwhile, the time from when ICG was injected to when the near‐infrared camera was turned on for bile duct visualization was 85.6 ± 25.8 minutes. All grafts received from the 46 donors were successfully transplanted. In conclusion, ICG fluoroscopy helps to reduce operation time and lower postoperative AST/ALT levels. ICG injection visualized with black‐and‐white imaging is most effective for demarcating the liver midplane during PLDH. A single intravenous injection of ICG is sufficient for midplane dissection as well as bile duct division.
Behavior of copper‐containing high‐entropy alloys in harsh metal‐dusting environments
Authors: Galetz Mathias C. , Schlereth Clara , White Emma M. H.
Published: February 2021

Metal dusting is still an unresolved issue at high temperatures. Currently, two material‐related strategies to mitigate metal dusting are described in the literature. On the one hand, highly alloyed materials are used, which contain large amounts of protective oxide‐forming elements, such as Cr, Al, and Si. The second mitigation strategy is based on inhibiting the catalytic effect of Fe, Ni, and Co. These elements all strongly catalyze the formation of solid carbon from the gas phase. Combining the catalytic protection of Cu alloying for metal dusting with protection by a classical alumina/chromia barrier is a native feature that high‐entropy alloys (HEAs) can offer. In this study, the behavior of different equiatomic HEAs with and without Al and/or Cu are studied when exposed at 620°C in a highly aggressive metal‐dusting environment.
Genetic Variations and Neuropathologic Features of Patients with PRKN Mutations
Authors: Seike Naohiko , Yokoseki Akio , Takeuchi Ryoko , Saito Kento , Miyahara Hiroaki , Miyashita Akinori , Ikeda Tetsuhiko , Aida Izumi , Nakajima Takashi , Kanazawa Masato , Wakabayashi Masatoshi , Toyoshima Yasuko , Takahashi Hitoshi , Matsumoto Riki , Toda Tatsushi , Onodera Osamu , Ishikawa Atsushi , Ikeuchi Takeshi , Kakita Akiyoshi
Published: February 2021

Background

Mutations in PRKN are the most common cause of autosomal recessive juvenile parkinsonism. The objective of this study was to investigate the association between genotype and pathology in patients with PRKN mutations.

Methods

We performed a sequence and copy number variation analysis of PRKN, mRNA transcripts, Parkin protein expression, and neuropathology in 8 autopsied patients.

Results

All the patients harbored biallelic PRKN mutations. Two patients were homozygous and heterozygous, respectively, for the missense mutation p.C431F. Seven patients had exon rearrangements, including 2 patients from a single family who harbored a homozygous deletion of exon 4, and 3 patients who carried a homozygous duplication of exons 6–7, a homozygous duplication of exons 10–11, and a heterozygous duplication of exons 2–4. In the other 2 patients, we found a compound heterozygous duplication of exon 2, deletion of exon 3, and a heterozygous duplication of exon 2. However, sequencing of cDNA prepared from mRNA revealed 2 different transcripts derived from triplication of exon 2 and deletion of exons 2–3 and from duplication of exons 2–4 and deletion of exons 3–4. Western blotting and immunohistochemistry revealed faint or no expression of Parkin in their brains. In the substantia nigra pars compacta, a subfield‐specific pattern of neuronal loss and mild gliosis were evident. Lewy bodies were found in 3 patients. Peripheral sensory neuronopathy was a feature.

Conclusions

Genomic and mRNA analysis is needed to identify the PRKN mutations. Variable mutations may result in no or little production of mature Parkin and the histopathologic features may be similar. © 2021 International Parkinson and Movement Disorder Society
Disability advocates ask HHS secretary‐designate to support priorities
Authors: Canady Valerie A.
Published: February 2021

Noting that COVID‐19 has had dire consequences for people with disabilities, disability advocates have penned a letter to HHS Secretary‐Designate Xavier Becerra, President Biden's nominee to serve as the next secretary of the U.S. Department of Health and Human Services urging a number of key recommendations to save lives, change trends for COVID‐19 and continue to advance civil rights and community integration for everyone.
Accretive Darboux growth in Lorentz–Minkowski spacetime
Authors: Tuğ Gül , Özdemir Zehra , Gök İsmail
Published: February 2021

It is known that the geometric methods are used in most fields in natural sciences. Kinematics on curves and surfaces as one of these methods is an essential tool for investigating the growth of some biological objects. In this study, the time‐dependent and quaternionic models of accretive growth are considered. For this, first, it is defined as a growth velocity in the direction of the Darboux vector at every point on a spatial non‐null curve in three‐dimensional Lorentz–Minkowski spacetime. Second, accretive surface growth is presented through quaternions. With the help of the quaternionic form of the growth model, we reach that a point (cell tract) on the accretive surface makes a homothetic motion. Also, several examples and visualizations are given to support the theory.
Natural convection in an open ended nanofluid filled cavity with fins in the presence of partial magnetic field and thermal radiation
Authors: Pekmen Geridonmez Bengisen , Oztop Hakan F.
Published: February 2021

In this paper, the effect of uniform partial magnetic field is studied on natural convection flow in an open ended square cavity considering thermal radiation and the presence of two fins as well as a uniform partial magnetic field. The polyharmonic spline radial basis function pseudo‐spectral method is implemented on nonuniform grids for numerical simulation of the problem. The dimensionless governing equations are adopted in stream function‐vorticity formulation. In the geometry of the problem as a unit square cavity, the right wall is open, the top wall is the cold wall including a cold fin, the bottom wall is the hot wall involving a hot fin, and the left wall is adiabatic. The uniform partial magnetic field is assumed to be vertically applied. The presence of both fins and the partial magnetic field reduces the convective heat transfer. The rise in both Hartmann number and radiation parameter suppresses the temperature gradient along the right bottom part of the cavity. Fins and partial magnetic field can be used as controlling structures for fluid flow and heat transfer in such a Rayleigh‐Benard type problem.