bluuebunny/crossref_metadata_2025 huggingface dataset:
Modulation of the bitterness of pea and potato proteins by a complex coacervation method
Authors: Zeeb Benjamin , Yavuz-Düzgun Merve , Dreher Johannes , Evert Jacob , Stressler Timo , Fischer Lutz , Özcelik Beraat , Weiss Jochen
Published: February 2018

The incorporation of novel plant-based proteins into foods is often challenging due to an unacceptable bitter sensation.
High-performance deep ultraviolet photodetectors based on few-layer hexagonal boron nitride
Authors: Liu Heng , Meng Junhua , Zhang Xingwang , Chen Yanan , Yin Zhigang , Wang Denggui , Wang Ye , You Jingbi , Gao Menglei , Jin Peng
Published: February 2018

The deep ultraviolet photodetectors based on 2D h-BN show a high on/off ratio of >103 and good spectral selectivity.
Mechanism investigation on the reactions of ClF3O and n-decane by combining density functional theory and spontaneous emission spectroscopy
Authors: Liu Xinghua , Yan Hua , Wang Daxi , Ma Yue , Li Shuyuan , Luo Yongfeng , Xu Shengli
Published: February 2018

The mechanism for the reactions of ClF3O and n-decane was studied using experimental and theoretical methods.
A p-type multi-wall carbon nanotube/Te nanorod composite with enhanced thermoelectric performance
Authors: Park Dabin , Ju Hyun , Oh Taeseob , Kim Jooheon
Published: February 2018

In this study, multi-walled carbon nanotube (MWCNT)/tellurium (Te) nanorod composites with various MWCNT contents are prepared and their thermoelectric properties are investigated.
Intrinsic structural distortion and exchange interactions in SmFexCr1−xO3 compounds
Authors: Xiang Zhongcheng , Li Wenping , Cui Yimin
Published: February 2018

The relationship between intrinsic structural distortions and exchange interactions in SmFexCr1−xO3 compounds was studied.
Thein vivofates of plant viral nanoparticles camouflaged using self-proteins: overcoming immune recognition
Authors: Gulati N. M. , Pitek A. S. , Czapar A. E. , Stewart P. L. , Steinmetz N. F.
Published: February 2018

Nanoparticle camouflage with serum albumin is formulation specific, does not produce antibodies against the coating, and shields nanoparticle antibody recognition.
Mesoporous silica nanoparticles engineered for ultrasound-induced uptake by cancer cells
Authors: Paris Juan L. , Manzano Miguel , Cabañas M. Victoria , Vallet-Regí María
Published: February 2018

Ultrasound-induced detachment of PEG chains from the surface of mesoporous silica nanoparticles enables their uptake by human osteosarcoma cells.
Metal Acetylacetonate–Bidentate Ligand Interaction (MABLI) as highly efficient free radical generating systems for polymer synthesis
Authors: Garra P. , Morlet-Savary F. , Graff B. , Dumur F. , Monnier V. , Dietlin C. , Gigmes D. , Fouassier J. P. , Lalevée J.
Published: February 2018

Metal Acetylacetonate–Bidentate Ligand Interaction (MABLI) is presented here as a new chemical mechanism for the highly efficient generation of free radicals for polymer synthesis.
Effects of polymers on the properties of hydrogels constructed using sodium deoxycholate and amino acid
Authors: Guo Yi , Wang Ruijin , Shang Yazhuo , Liu Honglai
Published: February 2018

Polymer can participate in the formation of hydrogel network structure and provide a lot of binding sites, leading to an enhancement of the mechanical strength of the hydrogels.
Prediction of the targets of the main components in blood after oral administration ofXanthii Fructus: a network pharmacology study
Authors: Zhuang Yanshuang , Qin Kunming , Yang Bing , Liu Xiao , Cai Baochang , Cai Hao
Published: February 2018

This paper developed a network pharmacology method to predict the potential pathways targeted by oral administration of XF extract.
Correction: Solution-processable, niobium-doped titanium oxide nanorods for application in low-voltage, large-area electronic devices
Authors: Alharthi F. A. , Cheng F. , Verrelli E. , Kemp N. T. , Lee A. F. , Isaacs M. A. , O’Neill M. , Kelly S. M.
Published: February 2018

Correction for ‘Solution-processable, niobium-doped titanium oxide nanorods for application in low-voltage, large-area electronic devices’ by F. A. Alharthi et al., J. Mater. Chem. C, 2018, 6, 1038–1047.
Language Assessment for Children With a Range of Neurodevelopmental Disorders Across Four Languages in South Africa
Authors: Romski MaryAnn , Bornman Juan , Sevcik Rose A. , Tönsing Kerstin , Barton-Hulsey Andrea , Morwane Refilwe , Whitmore Ani , White Robyn
Published: February 2018

Purpose

The purpose of this study is (a) to examine the applicability of a culturally and linguistically adapted measure to assess the receptive and expressive language skills of children with neurodevelopmental disorders (NDDs) in South Africa and then (b) to explore the contributions of 2 additional language measures.

Method

In Part 1, 100 children with NDD who spoke Afrikaans, isiZulu, Setswana, or South African English were assessed on the culturally and linguistically adapted Mullen Scales of Early Learning (MSEL). Clinicians independently rated the children's language skills on a 3-point scale. In Part 2, the final 20 children to be recruited participated in a caregiver-led interaction, after which the caregiver completed a rating scale about their perceptions of their children's language.

Results

Performance on the MSEL was consistent with clinician-rated child language skills. The 2 additional measures confirmed and enriched the description of the child's performance on the MSEL.

Conclusions

The translated MSEL and the supplemental measures successfully characterize the language profiles and related skills in children with NDD in multilingual South Africa. Together, these assessment tools can serve a valuable function in guiding the choice of intervention and also may serve as a way to monitor progress.
Masked Repetition Priming Treatment for Anomia
Authors: Silkes JoAnn P.
Published: February 2018

Purpose

Masked priming has been suggested as a way to directly target implicit lexical retrieval processes in aphasia. This study was designed to investigate repeated use of masked repetition priming to improve picture naming in individuals with anomia due to aphasia.

Method

A single-subject, multiple-baseline design was used across 6 people with aphasia. Training involved repeated exposure to pictures that were paired with masked identity primes or sham primes. Two semantic categories were trained in series for each participant. Analyses assessed treatment effects, generalization within and across semantic categories, and effects on broader language skills, immediately and 3 months after treatment.

Results

Four of the 6 participants improved in naming trained items immediately after treatment. Improvements were generally greater for items that were presented in training with masked identity primes than items that were presented repeatedly during training with masked sham primes. Generalization within and across semantic categories was limited. Generalization to broader language skills was inconsistent.

Conclusion

Masked repetition priming may improve naming for some individuals with anomia due to aphasia. A number of methodological and theoretical insights into further development of this treatment approach are discussed.
An Initial Investigation of the Neural Correlates of Word Processing in Preschoolers With Specific Language Impairment
Authors: Haebig Eileen , Leonard Laurence , Usler Evan , Deevy Patricia , Weber Christine
Published: February 2018

Purpose

Previous behavioral studies have found deficits in lexical–semantic abilities in children with specific language impairment (SLI), including reduced depth and breadth of word knowledge. This study explored the neural correlates of early emerging familiar word processing in preschoolers with SLI and typical development.

Method

Fifteen preschoolers with typical development and 15 preschoolers with SLI were presented with pictures followed after a brief delay by an auditory label that did or did not match. Event-related brain potentials were time locked to the onset of the auditory labels. Children provided verbal judgments of whether the label matched the picture.

Results

There were no group differences in the accuracy of identifying when pictures and labels matched or mismatched. Event-related brain potential data revealed that mismatch trials elicited a robust N400 in both groups, with no group differences in mean amplitude or peak latency. However, the typically developing group demonstrated a more robust late positive component, elicited by mismatch trials.

Conclusions

These initial findings indicate that lexical–semantic access of early acquired words, indexed by the N400, does not differ between preschoolers with SLI and typical development when highly familiar words are presented in isolation. However, the typically developing group demonstrated a more mature profile of postlexical reanalysis and integration, indexed by an emerging late positive component. The findings lay the necessary groundwork for better understanding processing of newly learned words in children with SLI.
Error analysis and compensation of an optical linear encoder
Authors: Hu Feng , Chen Xindu , Cai Nian , Lin Ya Ju , Zhang Fangjian , Wang Han
Published: February 2018

Optical linear encoder error is of a great concern for its wide applications. Temperature plays an important role in the realistic environment error factors, and influences the encoder's accuracy. In this study, an incremental optical linear encoder error model is built and estimated by a prior analysis, error processing of least‐square fitting, empirical mode decomposition and cross‐correlation methods. The errors of the different temperatures can be used for error separation during the cross‐correlation calculation. The experimental measurement with different temperatures is carried out, and analysed by the authors’ model. Finally, an ‘ad hoc’ compensation formula is obtained and demonstrated.
Impact of young stellar components on quiescent galaxies: deconstructing cosmic chronometers
Authors: López-Corredoira M. , Vazdekis A.
Published: February 2018

Context. Cosmic chronometers may be used to measure the age difference between passively evolving galaxy populations to calculate the Hubble parameter H(z) as a function of redshift z. The age estimator emerges from the relationship between the amplitude of the rest frame Balmer break at 4000 Å and the age of a galaxy, assuming that there is one single stellar population within each galaxy.

Aims. First, we analyze the effect on the age estimates from the possible contamination (< 2.4% of the stellar mass in our high-redshift sample) of a young component of ≲ 100 Myr embedded within the predominantly old population of the quiescent galaxy. Recent literature has shown this combination to be present in very massive passively evolving galaxies. Second, we evaluate how the available data compare with the predictions of nine different cosmological models.

Methods. For the first task, we calculated the average flux contamination due to a young component in the Balmer break from the data of 20 galaxies at z > 2 that included photometry from the far-ultraviolet to near-infrared at rest. For the second task, we compared the data with the predictions of each model, using a new approach of distinguishing between systematic and statistical errors. In previous work with cosmic chronometers, these have simply been added in quadrature. We also evaluated the effects of contamination by a young stellar component.

Results. The ages inferred using cosmic chronometers represent a galaxy-wide average rather than a characteristic of the oldest population alone. The average contribution from the young component to the rest luminosity at 4000 Å may constitute a third of the luminosity in some samples, which means that this is far from negligible. This ratio is significantly dependent on stellar mass, proportional to M−07. Consequently, the measurements of the absolute value of the age or the differential age between different redshifts are at least partially incorrect and make the calculation of H(z) very inaccurate. Some cosmological models, such as the Einstein-de Sitter model or quasi-steady state cosmology, which are rejected under the assumption of a purely old population, can be made compatible with the predicted ages of the Universe as a function of redshift if we take this contamination into account. However, the static Universe models are rejected by these H(z) measurements, even when this contamination is taken into account.
A Multilayered Technique for Repair of the Suboccipital Retrosigmoid Craniotomy
Authors: Goodarzi Amir , Ahmadpour Arjang , Toussi Atrin , Shahlaie Kiarash
Published: February 2018

Objective Our primary objective was to retrospectively review our single institution experience using an anatomic multilayered repair of the retrosigmoid suboccipital craniotomy. Our secondary objective was to review the existing body of literature on the repair of this craniotomy and compare our outcomes to previous results.

Design Retrospective review of 25 consecutive patients undergoing repair for the retrosigmoid craniotomy.

Setting University of California Davis Medical Center (2010–2016).

Participants A total of 25 consecutive patients who underwent retrosigmoid craniotomy and repair. Exclusion criteria included patients who were under the age of 18 years.

Main Outcome Measures Main outcomes included incidence of postoperative headache, cerebrospinal fluid leak, and wound infections.

Results Postoperative headache was reported in two patients in this series (8%). None of the patients in the series developed cerebrospinal fluid leak or wound infections. Mean follow-up period was 16 months.

Conclusion Our multilayered anatomic repair after retrosigmoid suboccipital craniotomy results in favorable clinical results and may help reduce the risks associated with this operation.
Endoscopic Endonasal Approach for Resection of a Pediatric Craniopharyngioma: Operative Video and Technical Nuances
Authors: Liu James , Eloy Jean
Published: February 2018

We present a pediatric case of a retrochiasmatic craniopharyngioma in the suprasellar region with third ventricular extension that was resected through a purely endoscopic endonasal approach (EEA) via the transplanum transtuberculum corridor. The patient is a 12-year-old boy who presented with progressive visual loss and panhypopituitarism. The EEA allows direct visualization of the undersurface of the optic chiasm and hypothalamus so that safe and meticulous tumor dissection can be performed to preserve these critical neurovascular structures. This video atlas demonstrates the operative technique and surgical nuances of the endoscopic skull base approach, microdissection of the tumor from the critical neurovascular structures, and multilayered reconstruction of the skull base defect with a nasoseptal flap. A gross total resection was achieved, and the patient was neurologically intact with improved visual acuity and visual fields. In summary, the EEA via the transplanum transtuberculum corridor is an important strategy in the armamentarium for surgical management of pediatric craniopharyngiomas.

The link to the video can be found at: https://youtu.be/bmgO_PMRHPk.
Neue Therapieoptionen bei Blasen- und Nierenzellkrebs
Authors: Schmale Ine
Published: February 2018

Fortschritte brachte der Kongress der European Society for Medical Oncology (ESMO) auch für Patienten mit urologischen Tumoren: So führt die zusätzliche Gabe des Angiogenesehemmers Ramucirumab zu Docetaxel bei Patienten mit platinrefraktärem Urothelkarzinom zu einer deutlichen Verbesserung von progressionsfreiem Überleben (PFS) und der Ansprechrate. Bei Patienten mit fortgeschrittenem Nierenzellkarzinom (RCC) und intermediärer oder schlechter Prognose hat sich die Checkpoint-Blockade mit Nivolumab/Ipilimumab der Erstlinientherapie mit einem Tyrosinkinase-Inhibitor (TKI) als überlegen erwiesen.
Selten, hochaggressiv und lebensbedrohlich
Authors: Beate Fessler
Published: February 2018

Lymphome im zentralen Nervensystem können sich primär und sekundär manifestieren. Sie sind zwar selten, aber nach wie vor eine Herausforderung für die Hämatologie. Denn sie gelten als hochaggressiv und lebensbedrohlich. Die Datenlage ist eingeschränkt, sowohl für die Prophylaxe als auch für die Therapie. Die Toxizität sowohl der medikamentösen als auch der radiologischen Therapie ist hoch; Spätschäden sind nicht selten. Über den aktuellen Kenntnisstand informierte ein Symposium auf der diesjährigen Jahrestagung der DGHO in Stuttgart.
Ärztliche Schweigepflicht im Leistungs- und Spitzensport
Authors: Striegel Heiko
Published: February 2018

Das Arzt-Patienten-Verhältnis ist ganz wesentlich durch die ärztliche Schweigepflicht geprägt. Danach hat der Arzt über alles zu Schweigen, was ihm als Arzt in diesem Zusammenhang bekannt geworden ist. Die Verletzung der ärztlichen Schweigepflicht stellt ein strafrechtlich und berufsrechtlich relevantes Fehlverhalten dar. Dies ist nur dann nicht rechtswidrig, wenn eine Offenbarungsbefugnis oder Offenbarungspflicht des Arztes besteht. Eine Offenbarungsbefugnis liegt dann vor, wenn der Patient den Arzt ausdrücklich oder durch schlüssiges Handeln von der Schweigepflicht entbindet. Ärzte, die Patienten parallel oder hintereinander behandeln, dürfen davon ausgehen, dass sie insoweit gegenüber ihren mitbehandelnden Kollegen von der Schweigepflicht entbunden sind. Darüber hinaus darf der Arzt die Schweigepflicht verletzen, wenn ein höherwertiges Interesse an der Offenbarung vorliegt. Diese Fallkonstellationen sind jedoch von der Rechtsprechung eng umgrenzt worden. Eine Offenbarungsbefugnis kann sich darüber hinaus aus gesetzlichen Regelungen ergeben. Offenbarungspflichten beschränken sich auf gesetzlich geregelte Fälle. Die ärztliche Schweigepflicht gilt auch bei der Behandlung von Sportlern uneingeschränkt. Es finden sich jedoch im Leistungs- und Spitzensport besondere Fallkonstellationen, in denen eine Offenbarungsbefugnis des Arztes besteht bzw. der Arzt davon ausgehen darf, dass der Sportler mit einer Weitergabe seiner Befunde an bestimmte Dritte einverstanden ist.
Einfluss eines Synbiotikums auf den Gewichtsverlauf
Authors: Axt-Gadermann Michaela , Lorenz Victoria
Published: February 2018

Aktuelle Untersuchungen belegen die Bedeutung des intestinalen Mikrobioms für die menschliche Gesundheit. Eine
Dysbiose hat nicht nur lokale Auswirkungen im Darm, sondern kann den gesamten Organismus betreffen und
verschiedene Stoffwechselstörungen begünstigen. Wird die Zusammensetzung des Mikrobioms durch Pro- und
Präbiotika positiv verändert, kann sich dies u. a. auch in einem verringerten Körpergewicht zeigen.
Ceramic-on-Ceramic in Total Hip Replacement Revision
Authors: Cucchi Davide , Gathen Martin , Streicher Robert , Wirtz Dieter
Published: February 2018

Background The use of Ceramic-on-Ceramic (CoC) bearings in primary total hip arthroplasty (THA) is increasing and has been intensively analysed. This bearing plays a particularly relevant role in young, active patients and shows advantages over other bearings in biocompatibility, wear rate and lubrication properties. On the contrary, CoC bearings in revision THA are seldom used and scarcely analysed. The aim of this study is to systematically review the available literature on CoC bearings in revision THA.

Methods A systematic research in the English literature was performed to identify all studies reporting results of THA revisions using ceramic-on-ceramic bearing. The initial search strategy revealed 555 articles for consideration. On the basis of eligibility criteria, 26 studies were included in this review.

Results Twenty-six studies, accounting for 1846 procedures, were eligible and included in the review. No studies of Level I were identified. Eighteen studies reported on revisions of CoC implants for various reasons, performed either with CoC or different bearings. In 111 patients a CoC bearing was used for the revision. Six studies consistently reported outcome measures for CoC bearing THA revisions, so that a quantitative synthesis of the data was possible. The range of follow-up across the six studies varied between 2.1 and 19 years, with a cumulative avearage follow-up of 9.3 years. A good functional result was documented, with a cumulative weighted mean for postoperative Harris Hip Score (HHS) of 87 points. The rate of dislocation in this group was 3.45% and the risk of fracture of an alumina ceramic head was 0.35% (1 study). Squeaking was reported as complication of CoC bearing THA revisions in three studies, with a calculated incidence of 0.52%.

Conclusion Modern CoC bearings show advantages in preclinical and retrospective studies over other bearings also in revision cases and are therefore to be considered a promising alternative for this kind of operation. Reasonable indications for CoC bearing in revision THA are revisions for aseptic loosening or recurrent dislocation in young patients, fractures of ceramic components, large acetabular defects or in patients that are allergic to bone cement components. Nevertheless, prospectively designed or randomized studies are lacking and needed to confirm CoC as optimal solution for revision THA cases.
Konflikte am Lebensende
Authors: Marquard Sara , Garthaus Marcus , Wendelstein Britta , Remmers Hartmut , Kruse Andreas
Published: February 2018

Hintergrund Die palliative Begleitung schwer kranker und sterbender Menschen in ambulanten und stationären Einrichtungen der Alten- und Krankenpflege wie auch der spezialisierten palliativen Versorgung erfordert multiprofessionelle Zusammenarbeit. Aufgrund der besonderen Belastungssituationen sowie der Charakteristika verschiedener Sterbeorte sind die Beteiligten mit zahlreichen Kommunikationsschwierigkeiten und damit verbundenen Konfliktfeldern konfrontiert.

Methodik Ziel war es, die Bedürfnisse und Erwartungen von Menschen in Palliativsituationen in der Interaktion mit Pflegenden zu erheben und herauszufinden, inwieweit Konfliktsituationen auftreten und wie diesen begegnet wird. Im Rahmen eines qualitativen Forschungsansatzes wurden 58 problemzentrierte Interviews mit Menschen in einer Palliativsituation in fünf unterschiedlichen Versorgungssettings (Palliativstation, Hospiz, Onkologie, stationäre Einrichtung der Altenhilfe, ambulante Versorgung) geführt und mittels qualitativer Inhaltsanalyse ausgewertet.

Ergebnisse Die Mehrheit der Befragten beschreibt institutionelle und personelle Rahmenbedingungen sowie das Verhalten der Pflegenden als konfliktursächlich. Im Bereich von Informationsasymmetrien zeigen sich Konflikte, die sich primär auf eine wechselseitige fehlende Offenheit, Ehrlichkeit und Transparenz beziehen.

Schlussfolgerung Gestützt auf Erkenntnisse des explorativen Forschungsprojekts soll im Rahmen eines geplanten Theorie-Praxis-Transferprojekts ein Beitrag zur Verbesserung der Versorgungsqualität am Lebensende geleistet werden.
Akupunktur bei Allergien – Erfahrungsheilkunde auf dem Weg zur Evidenz
Authors: Wullinger Michael
Published: February 2018

Großangelegte multizentrische Studien weisen die Akupunktur als evidenzbasierte Therapie der allergischen Rhinitis aus. Der Artikel beschreibt das Konzept der Traditionellen Chinesischen Medizin (TCM) bei der Behandlung des Heuschnupfens. Im Anschluss wird das modifizierte Vorgehen bei der Therapie einer Hausstaubmilbenallergie sowie einer Tierhaarallergie dargestellt. Es werden wichtige Studien zur Behandlung allergischer Erkrankungen mit Akupunktur sowie Konsequenzen, die sich daraus für die Behandlung in der Praxis ziehen lassen, beschrieben. Abschließend werden Möglichkeiten und Grenzen der Akupunktur und anderer Therapieverfahren der TCM bei der Behandlung von Heuschnupfen, Asthma und atopischem Ekzem aufgezeigt.
Eigenbluttherapie bei Allergie
Authors: Gündling Peter W
Published: February 2018

Die Eigenbluttherapie wird seit vielen Jahren zur Regulation des Immunsystems nicht nur bei Allergien, sondern auch bei akuten und chronischen Infektionen bzw. Infektanfälligkeit erfolgreich eingesetzt. Die Eigenbluttherapie arbeitet mit dosierten Reizen, um eine Stärkung oder Adaptation des Immunsystems zu bewirken. Durch die Behandlung werden Abwehrmaßnahmen im Sinne einer Entzündung ausgelöst, was zur Aktivierung der Selbstheilungskräfte des Organismus führt. Zwar ist die wissenschaftliche Datenlage dieser Therapiemaßnahme noch relativ dünn, klinische Studien zur Behandlung von Neurodermitis und chronischer Urtikaria bestätigen jedoch die positiven Erfahrungen vieler Ärzte, Therapeuten und Patienten bei der Anwendung dieser Methode.
Enhanced long-distance transport of periodic electron beams in an advanced double layer cone-channel target
Authors: Ji Yanling , Duan Tao , Zhou Weimin , Li Boyuan , Wu Fengjuan , Zhang Zhimeng , Ye Bin , Wang Rong , Wu Chunrong , Tang Yongjian
Published: February 2018

An enhanced long-distance transport of periodic electron beams in an advanced double layer cone-channel target is investigated using two-dimensional particle-in-cell simulations. The target consists of a cone attached to a double-layer hollow channel with a near-critical-density inner layer. The periodic electron beams are generated by the combination of ponderomotive force and longitudinal laser electric field. Then a stable electron propagation is achieved in the double-layer channel over a much longer distance without evident divergency, compared with a normal cone-channel target. Detailed simulations show that the much better long-distance collimation and guidance of energetic electrons is attributed to the much stronger electromagnetic fields at the inner wall surfaces. Furthermore, a continuous electron acceleration is obtained by the more intense laser electric fields and extended electron acceleration length in the channel. Our investigation shows that by employing this advanced target, both the forward-going electron energy flux in the channel and the energy coupling efficiency from laser to electrons are about threefold increased in comparison with the normal case.
A simple turn gets the most from rutile tin dioxide
Authors: Bardi Jason Socrates
Published: February 2018

Taking advantage of the natural anisotropy of SnO 2  may help component performance for next-generation electronic devices.
Effect of Preoperative Atrial Fibrillation on Patients with Chronic Heart Failure Who Undergo Long-Term Continuous-Flow LVAD Implantation
Authors: Kurihara Chitaru , Critsinelis Andre , Kawabori Masashi , Sugiura Tadahisa , Civitello Andrew B. , Morgan Jeffrey A.
Published: February 2018

Although preoperative atrial fibrillation (AF) is common in patients undergoing continuous-flow left ventricular assist device (CF-LVAD) implantation, how AF affects outcomes remains unclear. We analyzed our single-center experience with CF-LVAD implantation to determine whether preoperative AF was associated with inferior outcomes. From November 2003 through March 2016, 526 patients with chronic heart failure underwent implantation with the HeartMate II (HMII; n = 403) or HeartWare VAD (HVAD; n = 123). We identified 229 patients (165 HMII, 65 HVAD) who had preoperative AF and compared them with non–preoperative AF patients regarding the incidence of postoperative stroke, as well as long-term survival. After implantation, 139 patients had a stroke (78 non–preoperative AF patients [26.2%], 61 preoperative AF patients [26.6%]; p = 0.84). The rate of events per patient-year was 0.19 in non–preoperative AF patients and 0.22 in preoperative AF patients (p = 0.84). Survival was not significantly different between the two groups (p = 0.60). In Cox regression, preoperative AF was not associated with postoperative stroke (odds ratio: 1.13; 95% confidence interval [CI]: 0.74–1.74; p = 0.55) or survival (hazard ratio: 0.93; 95% CI: 0.71–1.25; p = 0.66). We conclude that in CF-LVAD recipients, preoperative AF did not diminish perioperative or long-term survival or increase the risk of postoperative stroke. These findings suggest that performing concomitant AF ablation during CF-LVAD implantation may be unnecessary.
Development and validation of a scoring index to predict the presence of lesions in capsule endoscopy in patients with suspected Crohn’s disease of the small bowel: a Spanish multicenter study
Authors: Egea-Valenzuela Juan , González Suárez Begoña , Sierra Bernal Cristian , Juanmartiñena Fernández José Francisco , Luján-Sanchís Marisol , San Juan Acosta Mileidis , Martínez Andrés Blanca , Pons Beltrán Vicente , Sastre Lozano Violeta , Carretero Ribón Cristina , de Vera Almenar Félix , Sánchez Cuenca Joaquín , Alberca de las Parras Fernando , Rodríguez de Miguel Cristina , Valle Muñoz Julio , Férnandez-Urién Sainz Ignacio , Torres González Carolina , Borque Barrera Pilar , Pérez-Cuadrado Robles Enrique , Alonso Lázaro Noelia , Martínez García Pilar , Prieto de Frías César , Carballo Álvarez Fernando
Published: February 2018

Background

Capsule endoscopy (CE) is the first-line investigation in cases of suspected Crohn’s disease (CD) of the small bowel, but the factors associated with a higher diagnostic yield remain unclear.

Objective

Our aim is to develop and validate a scoring index to assess the risk of the patients in this setting on the basis of biomarkers.

Patients and methods

Data on fecal calprotectin, C-reactive protein, and other biomarkers from a population of 124 patients with suspected CD of the small bowel studied by CE and included in a PhD study were used to build a scoring index. This was first used on this population (internal validation process) and after that on a different set of patients from a multicenter study (external validation process).

Results

An index was designed in which every biomarker is assigned a score. Three risk groups have been established (low, intermediate, and high). In the internal validation analysis (124 individuals), patients had a 10, 46.5, and 81% probability of showing inflammatory lesions in CE in the low-risk, intermediate-risk, and high-risk groups, respectively. In the external validation analysis, including 410 patients from 12 Spanish hospitals, this probability was 15.8, 49.7, and 80.6% for the low-risk, intermediate-risk, and high-risk groups, respectively.

Conclusion

Results from the internal validation process show that the scoring index is coherent, and results from the external validation process confirm its reliability. This index can be a useful tool for selecting patients before CE studies in cases of suspected CD of the small bowel.
The Black-White Disparity in Sexually Transmitted Diseases During Pregnancy: How Do Racial Segregation and Income Inequality Matter?
Authors: Noah Aggie J. , Yang Tse-Chuan , Wang Wei-lin
Published: February 2018

Background

We investigate the roles of residential racial segregation and income inequality for the black-white disparity in acquiring sexually transmitted diseases (STD) during pregnancy in a multilevel framework.

Methods

The analytic sample consisted of non-Hispanic white (n = 79,271) and non-Hispanic black (n = 17,669) mothers from 2012 population birth data from Pennsylvania. We used the 2009 to 2013 American Community Survey for neighborhood characteristics of mothers; we used multilevel models.

Results

First, neighborhood-level factors are important for understanding this disparity because racial segregation and income inequality are significantly associated with acquiring STD during pregnancy, regardless of race. Second, racial segregation moderates the relationships between race/ethnicity and the acquisition of STD during pregnancy. White mothers are more vulnerable to neighborhood segregation than black mothers, and black mothers are less likely to acquire STD during pregnancy than white mothers if they reside with co-ethnics. Third, mothers residing in the most socioeconomically disadvantaged neighborhoods—as indicated by both absolute and relative measures of income inequality—have the highest odds of acquiring STD during pregnancy, regardless of race.

Conclusions

Neighborhood-level segregation and income inequality are important for understanding the acquisition of STDs during pregnancy. Our findings have important implications for future research and for place-specific prevention and intervention to reduce the racial disparity in STD during pregnancy.
Detection of Perforators for Free Flap Planning Using Smartphone Thermal Imaging: A Concordance Study with Computed Tomographic Angiography in 120 Perforators
Authors: Pereira Nicolás , Valenzuela Diego , Mangelsdorff Günther , Kufeke Matías , Roa Ricardo
Published: February 2018

Design and preoperative planning of microsurgical flaps are fundamental steps for successful surgery. Currently, computed tomographic angiography is considered the gold standard, and new technologies such as thermography could complement its usefulness. The aim of this study was to determine the concordance between thermographic images obtained with a smartphone thermal camera and computed tomographic angiography for detecting perforators using the anterolateral thigh flap area as a model. A concordance study of diagnostic tests was performed in patients who underwent limb reconstruction in 2016. Perforators identified in thigh computed tomographic angiographic images and hotspots on thermographic images obtained by means of the FLIR ONE smartphone camera were compared based on the distance from the anterior superior iliac spine. The authors studied 20 patients, including 38 anterolateral thigh flap territories in total, and identified 117 perforators by computed tomographic angiography and 120 hotspots by thermography. The average mean distance from the anterior superior iliac spine using these methods was 193.14 mm, and the mean difference in distance was 2.37 mm, with both measurements being obtained within a radius of 20 mm, with a concordance kappa index of 0.975 (p < 0.001). Thermographic imaging presented a sensitivity of 100 percent and a specificity of 98 percent in detecting perforators. Thermographic images obtained with a smartphone thermal camera have a high concordance with the method considered the gold standard for perforator detection. In addition, its sensitivity and specificity are comparable to those of computed tomographic angiography, which makes it a very useful method for mapping perforators in free flap planning.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Diagnostic, II.
Consensus of Leaders in Plastic Surgery: Identifying Procedural Competencies for Canadian Plastic Surgery Residency Training Using a Modified Delphi Technique
Authors: Knox Aaron D. C. , Shih Jessica G. , Warren Richard J. , Gilardino Mirko S. , Anastakis Dimitri J.
Published: February 2018

Background:

Transitioning to competency-based surgical training will require consensus regarding the scope of plastic surgery and expectations of operative ability for graduating residents. Identifying surgical procedures experts deemed most important in preparing graduates for independent practice (i.e., “core” procedures), and those that are less important or deemed more appropriate for fellowship training (i.e., “noncore” procedures), will focus instructional and assessment efforts.

Methods:

Canadian plastic surgery program directors, the Canadian Society of Plastic Surgeons Executive Committee, and peer-nominated experts participated in an online, multiround, modified Delphi consensus exercise. Over three rounds, panelists were asked to sort 288 procedural competencies into five predetermined categories within core and noncore procedures, reflecting increasing expectations of ability. Eighty percent agreement was chosen to indicate consensus.

Results:

Two hundred eighty-eight procedures spanning 13 domains were identified. Invitations were sent to 49 experts; 37 responded (75.5 percent), and 31 participated (83.8 percent of respondents). Procedures reaching 80 percent consensus increased from 101 (35 percent) during round 1, to 159 (55 percent) in round 2, and to 199 (69 percent) in round 3. The domain “burns” had the highest rate of agreement, whereas “lower extremity” had the lowest agreement. Final consensus categories included 154 core, essential; 23 core, nonessential; three noncore, experience; and 19 noncore, fellowship.

Conclusions:

This study provides clarity regarding which procedures plastic surgery experts deem most important for preparing graduates for independent practice. The list represents a snapshot of expert opinion regarding the current training environment. As our specialty grows and changes, this information will need to be periodically revisited.
Nipple-Areola Complex Reconstruction
Authors: Gougoutas Alexander J. , Said Hakim K. , Um Grace , Chapin Anne , Mathes David W.
Published: February 2018

Learning Objectives:

After studying this article, the participant should be able to: 1. Understand how to determine nipple-areola complex positioning on the reconstructed breast. 2. Understand the multitude of local flap and distant graft options for nipple-areola complex reconstruction. 3. Draw at least three fundamental nipple-areola complex reconstruction patterns. 4. Understand the forces that are responsible for flattening of the reconstructed papule. 5. Understand the current techniques used in secondary nipple-areola complex reconstructions.

Nipple-areola complex reconstruction and tattooing represent the final two stages of breast reconstruction. Nipple-areola complex reconstruction is typically accomplished with the use of local flaps, local flaps with augmentation grafts, or a combination thereof. Regardless of the technique used, however, all nipple-areola complex reconstructions lose a degree of projection over time. Options for secondary reconstruction include the use of local tissue flaps alone or in combination with acellular biological matrices.
The Infratip Lobule Butterfly Graft: Balancing the Transition from the Tip Lobule to the Alar Lobule
Authors: Rohrich Rod J. , Afrooz Paul N.
Published: February 2018

The nasal alae and the soft-tissue triangles are delicate structures, the contours of which are largely dependent on soft tissue and the indirect influence of the lower lateral cartilages. Creating appropriate and continuous contour from the tip lobule to the alar lobule can be challenging. The alar contour graft is one reliable method of achieving predictable contour. However, alar contour grafts of ideal length may be scarce. The butterfly graft is a simple, reliable, and predictable method of providing support in the region of the soft triangle, and spans the region between the tip lobule and alar lobule, thereby balancing the transition between these regions.
FDG PET/CT Findings in a Localized Reactive Lymphoid Hyperplasia of the Spleen
Authors: Ito Yoshiaki , Nakahara Tadaki , Nishihara Yuichi , Shiraishi Junichi , Jinzaki Masahiro
Published: February 2018

A 38-year-old man with sigmoid colon cancer underwent a preoperative contrast-enhanced CT which incidentally revealed a modestly enhancing splenic mass. FDG PET/CT showed mildly increased uptake in the splenic lesion in contrast to prominently increased uptake in the colonic tumor. In addition, the splenic mass demonstrated only slightly increased signal intensity in diffusion-weighted MRI, suggesting low probability of metastasis. Splenectomy nonetheless was performed at surgery of the colon cancer. The histopathologic examination showed aggregated lymphoid follicles with germinal centers in the splenic lesion and made the diagnosis of localized reactive lymphoid hyperplasia a rare benign lymphoid tumor.
BSREM Reconstruction for Improved Detection of In-Transit Metastases With Digital FDG-PET/CT in Patients With Malignant Melanoma
Authors: Aljared Arwa , Alharbi Abdullah Awad , Huellner Martin W.
Published: February 2018

Block sequential regularized expectation maximization (BSREM) is a Bayesian penalized-likelihood reconstruction algorithm for PET, which reaches full convergence without the detriment of deteriorating the image quality by noise. Therefore, BSREM might have implications particularly for the detection of small lesions, which may be beneficial in melanoma patients. Our case of a 70-year-old man with metastasized malignant melanoma illustrates the impact of such a novel iterative PET reconstruction algorithm. Whereas the lymph node metastases are seen with the latest generation ordered subset expectation maximization reconstruction, the in-transit metastases are identified straightforward only with BSREM reconstruction.
18F-FDG PET/CT for Molecular Imaging of Hepatoblastoma in Beckwith-Wiedemann Syndrome
Authors: Derlin Thorsten , Hartung Dagmar , Hueper Katja
Published: February 2018

Beckwith-Wiedemann syndrome (BWS) is a rare congenital overgrowth disorder variably characterized by macrosomia, macroglossia, congenital hypoglycemia, and hemihyperplasia. The BWS predisposes affected individuals to embryonal tumors during childhood. The BWS is caused by abnormal gene regulation in a particular region of chromosome 11. We present the case of a 1-year-old boy with BWS who underwent an 18F-FDG PET/CT scan for restaging of hepatoblastoma. On the 18F-FDG PET scan, increased tracer accumulation was observed in hepatoblastoma lesions. In addition, marked hemihyperplasia was noted. This case highlights the usefulness of 18F-FDG PET/CT for restaging of hepatoblastoma in BWS.
Does the Degree of the Mastoid Pneumatization Affect the Side of Bell Palsy?
Authors: Güneş Selçuk , Çelik Mustafa , Çolak Ceylan , Olgun Burak
Published: February 2018

Objective:

The aim is to investigate the impact of degree of mastoid pneumatization on the affected side of Bell palsy (BP).

Study Design:

Retrospective study in tertiary academic hospital.

Methods:

In total, 52 patients who were diagnosed with as BP were included in the study. Each patient was staged using House–Brackmann (HB) staging system. All patients underwent temporal bone computed tomography imaging. House–Brackmann scores, side of the BP, and mastoid pneumatization of all of patients were evaluated in the present study.

Results:

Regarding the degree of the mastoid pneumatization, there were no significant differences between the affected side and the unaffected side (P = 0.439). The degree of the mastoid pneumatization of the affected side and the unaffected side did not differ between males and females (P = 0.918 for the affected side, P = 0.765 for the unaffected side, respectively). A negative correlation between the age and mastoid pneumatization of each side was found (P = 0.001, P = 0.025, respectively). There was no significant correlation between HB score and the degree of the mastoid pneumatization of each side (P = 0.789, P = 0.703).

Conclusion:

As a conclusion, the degree of the mastoid pneumatization is not one of the risk factors for BP. Further randomized studies with larger numbers of patients are needed to confirm these findings.
Scanning Electron Microscopy Evaluation of Root Surfaces After Instrumentation With Two Piezoelectric Devices
Authors: Rotundo Roberto , Cozzolino Valerio , Mortellaro Carmen , Scarano Antonio
Published: February 2018

Scanning electron microscopy evaluation of root surfaces after ultrasonic instrumentation was performed with 2 different metallic tips on piezoelectric devices. Fresh extracted teeth were collected for experimental observation and randomly divided into 2 groups: Test Group, where the root surfaces were treated using an iron, rough, double nano-structural coated (T-Black), corindone-treated tip, and Control Group where the root surfaces were treated with a conventional iron smooth tip. A scanning electronic microscope analysis was performed and the surface roughness and the amount of residual debris were evaluated. Descriptive and inferential statistics were performed. Twenty specimens were analyzed, 10 per group and a total of 21.4 × 106 μm2 has been observed. On treated area percentage of debris after ultrasonic scaling in Test Group was 1.9 ± 1.8%, while in Control Group it was 5.7 ± 4.3%. Within the limits of the study, it seems that the efficacy of the novel iron, rough, double nano-structural coated (T-Black), corindone-treated structure tip showed greater performance in terms of root surface debridement than the conventional iron smooth tip. The possibility to use a single tool (ultrasonic device with a specific tip) for the root planing procedure within the nonsurgical mechanical therapy may represent a significant advantage for the clinicians. The tested novel tip seems to be able to show the requested ideal characteristics. However, further clinical studies are needed to demonstrate the in vitro results.
Large-Scale Skin Resurfacing of the Upper Extremity in Pediatric Patients Using a Pre-Expanded Intercostal Artery Perforator Flap
Authors: Wei Jiao , Herrler Tanja , Gu Bin , Yang Mei , Li Qingfeng , Dai Chuanchang , Xie Feng
Published: February 2018

Background:

The repair of extensive upper limb skin lesions in pediatric patients is extremely challenging due to substantial limitations of flap size and donor-site morbidity. We aimed to create an oversize preexpanded flap based on intercostal artery perforators for large-scale resurfacing of the upper extremity in children.

Method:

Between March 2013 and August 2016, 11 patients underwent reconstructive treatment for extensive skin lesions in the upper extremity using a preexpanded intercostal artery perforator flap. Preoperatively, 2 to 4 candidate perforators were selected as potential pedicle vessels based on duplex ultrasound examination. After tissue expander implantation in the thoracodorsal area, regular saline injections were performed until the expanded flap was sufficient in size. Then, a pedicled flap was formed to resurface the skin lesion of the upper limb. The pedicles were transected 3 weeks after flap transfer. Flap survival, complications, and long-term outcome were evaluated.

Result:

The average time of tissue expansion was 133 days with a mean final volume of 1713 mL. The thoracoabdominal flaps were based on 2 to 6 pedicles and used to resurface a mean skin defect area of 238 cm2 ranging from 180 to 357 cm2. In all cases, primary donor-site closure was achieved. Marginal necrosis was seen in 5 cases. The reconstructed limbs showed satisfactory outcome in both aesthetic and functional aspects.

Conclusion:

The preexpanded intercostal artery perforator flap enables 1-block repair of extensive upper limb skin lesions. Due to limited donor-site morbidity and a pedicled technique, this resurfacing approach represents a useful tool especially in pediatric patients.
Locally Aggressive Fibrous Dysplasia Mimicking Malign Calvarial Lesion
Authors: Ogul Hayri , Keskin Emine
Published: February 2018

Fibrous dysplasia is an unusual benign bone tumor. It is divided into 3 groups as monostotic, polyostotic, and craniofacial form. The authors reported an unusual patient with fibrous dysplasia with an aggressive radiologic appearance.