bluuebunny/crossref_metadata_2025 huggingface dataset:
Low drift visual inertial odometry with UWB aided for indoor localization
Authors: Gao Bo , Lian Baowang , Wang Dongjia , Tang Chengkai
Published: February 2022

Visual inertial odometry (VIO) would have an estimation drift problem in the process of long trajectory for indoor localization, especially in the absence of loop detection or in unknown complex scenes. To solve this problem, a low drift visual inertial odometry with ultra‐wideband (UWB) aided for indoor localization was proposed. Firstly, a single UWB anchor was dropped in an unknown position, and a cost function was formed by the position information output by VIO and the UWB ranging information to obtain the position of the anchor. Then, the single anchor position and the UWB ranging constraints were added to the tightly coupled visual inertial fusion algorithm framework, thereby improving the robustness of motion tracking and reducing the drift of the odometry. Finally, the effectiveness of the proposed method was verified in the actual indoor environment, and the experiment results demonstrated that, compared with state‐of‐the‐art localization methods, the positioning accuracy and robustness were improved significantly.
Gaussian estimation for non‐linear stochastic uncertain systems with time‐correlated additive noises and packet dropout compensations
Authors: Cheng Guo‐Rui , Ma Meng‐Chen , Tan Li‐Guo , Song Shen‐Min
Published: February 2022

This paper discusses the problem of state estimation for non‐linear stochastic uncertain systems with time‐correlated additive noise and packet dropout compensations. Both process noise and measurement noise are additive forms of noise that can be described as Gaussian first‐order Markov processes. The stochastic uncertainty of the system is described by synchronous correlated white multiplicative noise. When the measurement information from the current epoch is lost, a compensation strategy based on measurement information prediction is used. First, the state information, process noise, and measurement noise are augmented to enable the construction of a new vector to be estimated, and the filter, predictor, and smoother of the system are designed using a Gaussian iterative estimation algorithm based on innovation analysis. The multiplicative noise in the process equation is estimated in real time. Second, a numerical implementation of the proposed algorithm is derived based on the third‐degree spherical‐radial Cubature Kalman filter(CKF). Finally, the proposed algorithm is compared with an extended Kalman filter (EKF) based on Taylor series expansion. The effectiveness of the proposed algorithm is verified by comparing the simulation results.
Biologically engineered microbes for bioremediation of electronic waste: Wayposts, challenges and future directions
Authors: Han Ping , Teo Wei Zhe , Yew Wen Shan
Published: February 2022

In the face of a burgeoning stream of e‐waste globally, e‐waste recycling becomes increasingly imperative, not only to mitigate the environmental and health risks it poses but also as an urban mining strategy for resource recovery of precious metals, rare Earth elements, and even plastics. As part of the continual efforts to develop greener alternatives to conventional approaches of e‐waste recycling, biologically assisted degradation of e‐waste offers a promising recourse by capitalising on certain microorganisms' innate ability to interact with metals or degrade plastics. By harnessing emerging genetic tools in synthetic biology, the evolution of novel or enhanced capabilities needed to advance bioremediation and resource recovery could be potentially accelerated by improving enzyme catalytic abilities, modifying substrate specificities, and increasing toxicity tolerance. Yet, the management of e‐waste presents formidable challenges due to its massive volume, high component complexity, and associated toxicity. Several limitations will need to be addressed before nascent laboratory‐scale achievements in bioremediation can be translated to viable industrial applications. Nonetheless, vested groups, involving both start‐up and established companies, have taken visionary steps towards deploying microbes for commercial implementation in e‐waste recycling.
H‐infinity fault‐tolerant control for Markov jump system with actuator time delay
Authors: Weng Falu , Hou Leilei , Wei Hui , Huang Yongji , Ding Yuanchun
Published: February 2022

This study investigates H‐infinity fault‐tolerant control for Markov jump systems with actuator time delay. The main objective is to obtain some theorems such that the corresponding Markov jump systems with actuator time delay to be H‐infinity stable and with some fault‐tolerant performances. First, based on an integral transformation, the Markov jump systems with actuator time delay are described in a system description with a distributed time‐delay item. Second, based on utilizing the linear matrix inequality theory, a positive energy functional, which includes a double integral item, is constructed. Then, after some mathematical operations, a sufficient condition is obtained for the Markov jump systems with actuator time delay to be H‐infinity stable. If the condition is solvable, fault‐tolerant controller can be gotten to guarantee the controlled system to be H‐infinity stable no matter there are some actuator faults existing in the system or not. Finally, examples are given to show the usefulness of the obtained theorem.
Visualization of the Third Ventricle, the Future Cavum Septi Pellucidi, and the Cavum Veli Interpositi at 11+3 to 13+6 Gestational Weeks on 3D Transvaginal Ultrasound Including Normative Data
Authors: Altmann Reinhard , Scharnreitner Iris , Auer Christian , Hirtler Lena , Springer Claudia , Falschlehner Stephanie , Arzt Wolfgang
Published: February 2022

Objectives To show the development of the third ventricle, commissural plate, future cavum septi pellucidi, and cavum veli interpositi in weeks 12–14 by transvaginal 3D ultrasound. Methods This is a prospective transvaginal 3D study carried out to define the third ventricle and the diencephalic midline structures surrounding it. 93 of 387 fetuses in which the commissural plate with the future cavum septi pellucidi, cavum veli interpositi, and the roof of the third ventricle could be well visualized, were selected with the choroid plexus of the third ventricle and the pituitary gland serving as leading structures. In a small number of fetuses, the optic chiasm could also be displayed. In addition, the following measurements were performed: third ventricle craniocaudal and anteroposterior, roof of the third ventricle/cavum veli interpositi, and fcsp. Results The sonomorphologic characteristics of the commissural plate, the future cavum septi pellucidi, and the cavum veli interpositi are described IN 9% OF THE FETUSES examined. Measurements of the third ventricle, cavum veli interpositi, and the roof of the third ventricle show the following results: 3rd V cc = 3.895 + 0.091*CRL mm; 3rd V ap = 4.175 + 0.036*CRL mm; CVI ap = 2.223 + 0.029*CRL mm; CVI cc = 0.139 + 0.02*CRL mm. Conclusion Transvaginal neurosonography enables visualization and measurement of the normal fetal third ventricle at 12–14 weeks of gestation including visualization of the future cavum septi pellucidi and the cavum veli interpositi. BEFORE USE IN PATIENTS CAN BE CONSIDERED, FURTHER SCIENTIFIC WORK IS REQUIRED.
Gründe und Einflussfaktoren für die Bereitschaft zur
Dokumentation von Präferenzen bezüglich Organspende. Ergebnisse
einer Online-Umfrage
Authors: Schildmann Jan , Nadolny Stephan , Führer Amand , Frese Thomas , Mau Wilfried , Meyer Gabriele , Richter Matthias , Steckelberg Anke , Mikolajczyk Rafael
Published: February 2022

Ziel der Studie Unterschiedliche Möglichkeiten zur Regelung der
Entscheidung über Organspende wurden im Vorfeld der parlamentarischen
Abstimmung am 16.01.2020 diskutiert. Das Ziel dieser Arbeit ist die Beschreibung
der Einstellungen der Bürger*innen zur Organspende und
Untersuchung der Prädiktoren für die (Dokumentation der)
Spendebereitschaft.

Methodik Querschnittserhebung via Onlinefragebogen in Berlin und
Sachsen-Anhalt im Zeitraum von 25.11.2019 bis 16.01.2020. Deskriptive Auswertung
und logistische Regressionsanalysen für den Einfluss von Alter,
Einkommen und Geschlecht auf Spendebereitschaft, Vorliegen eines
Spenderausweises sowie Faktenwissen.

Ergebnisse Es nahmen 676 von 20 020 eingeladenen
Bürger*innen (3,4%) an der Umfrage teil. Eine
Widerspruchslösung wurde von 54,9% (n=371)
befürwortet, wohingegen 49,4% (n=334) eine
Entscheidungslösung befürworteten. 63,3% waren
„bereit“ beziehungsweise „eher bereit“ ein Organ
zu spenden, 43,2% besaßen einen Organspendeausweis. Die
Organspendebereitschaft und die Wahrscheinlichkeit des Besitzes eines
Organspendeausweises nahmen mit zunehmendem Alter ab. Ein höherer
Bildungsstand war eher assoziiert mit dem Vorliegen eines Organspendeausweises.
Geschlecht, Einkommen, Bildungsstand und Faktenwissen zur Organspende waren
nicht mit der Spendebereitschaft assoziiert. 45,7% derjenigen mit
Spendebereitschaft aber ohne Ausweis hatten ihren Willen den Angehörigen
kommuniziert. Gründe für eine fehlende Dokumentation der
Organspendebereitschaft umfassen neben praktischen Aspekten auch
Befürchtungen bezüglich einer Festlegung sowie der medizinischen
Versorgung.

Diskussion Keine der diskutierten gesetzlichen Regelungen wird von einer
deutlichen Mehrheit der Antwortenden getragen. Differenzierte,
bevölkerungsbasierte Erhebungen können einen Ausgangspunkt
für die Entwicklung zielgruppenspezifischer Angebote zur
Erhöhung der Dokumentation des Willens bezüglich Organspende
nach Hirntod bilden.
Arzneimitteltherapiesicherheit bei ambulanten
Pflegediensten
Authors: Trutwin-Bornhöft Stephanie , Schumacher Julia , Döring Inge , Hennen Desirée
Published: February 2022

Einleitung Ältere Menschen sind aufgrund häufiger
Multimedikation besonders anfällig für unerwünschte
Arzneimittelwirkungen (UAW), welche die Hospitalisierungs- und
Mortalitätsrate erhöhen. Übernehmen speziell geschulte
Apotheker und Pflegefachkräfte mehr Verantwortung bei der Anwendung von
Arzneimitteln, können Risiken vermieden werden.

Methodik Es wurde eine auf Freiwilligkeit beruhende Befragung anhand eines
vorgegebenen Erhebungsbogens bei Pflegedienstleitungen von ambulanten
Pflegediensten (APD) durchgeführt sowie die gelagerten und gestellten
Arzneimittel untersucht.

Ergebnisse Bei 76% der untersuchten 104 APD wurden Arzneimittel
gelagert. In 63% der APD wurden dort vorrätige Arzneimittel
untersucht, in 55% fand ein Abgleich zwischen verordneten und gestellten
Arzneimitteln statt. Bei etwa der Hälfte der untersuchten Boxen und
Dosetts wurden Mängel festgestellt. Dabei wurden im Mittel pro
überprüfter Einheit 1,5 Fehler gefunden. 40% der
Pflegedienste lassen die Arzneimittel beim Transport zum Kunden 3 bis
6 h im Fahrzeug. Regelmäßige Besprechungen mit
Arztpraxen oder Apotheken führen weniger als 35% der APD durch.
Die Untersuchenden bewerteten bei 41 von 104 APD die Leistungen der
Pflegefachkräfte bei der Therapiebeobachtung positiv.

Schlussfolgerungen Therapiebeobachtung und Zusammenarbeit der APD mit
anderen Heilberuflern, v. a. mit Pharmazeuten, sollten verbessert
werden. Vor allem beim Stellen der Medikamente sollte mehr Sorgfalt und
Kontrolle (z. B. durch das Vier-Augen-Prinzip) erfolgen. In Zukunft
sollten weitere präzise durchgeführte und repräsentative
Erhebungen zu Medikationsprozessen in der ambulanten Pflege durchgeführt
werden. Analog zu bereits vorhandenen Untersuchungen zeigten sich Hinweise auf
Qualitäts- und Kommunikationsprobleme sowie Schwächen in der
Therapiebeobachtung bei APD. Fehlerquellen zeigten sich v. a. bei
Lagerung, Transport sowie beim patientenindividuellen Stellen. Aufgrund der
fehlenden Teilnahmeverpflichtungen sind die Ergebnisse der Untersuchung
limitiert.
Der Erfinder der „Triage“ – Dominique-Jean Larrey (1766–1842), Napoleons oberster Militärchirurg
Authors: Koehler Ulrich , Conradt Regina
Published: February 2022

Dominique-Jean Larrey (1766–1842) war leitender Chirurg der französischen Armee unter Kaiser Napoleon I. Er ist als Vater der modernen Militärchirurgie sowie der Entwicklung des „Triagesystems“ bekannt geworden. Larrey war ein hervorragender und engagierter Arzt, der nicht nur die eigenen, sondern auch die Soldaten der gegnerischen Truppen medizinisch versorgt hat. Beim Fehlen einer zuverlässigen Analgesie und Anästhesie war zu damaliger Zeit die Geschwindigkeit und das Können das hervorstechendste Merkmal eines Chirurgen. Gegen den Widerstand der Administration hat Larrey eine Erstversorgung auf dem Schlachtfeld sowie eine schnelle Bergung der Verwundeten mithilfe der „fliegenden Ambulanzen“ möglich gemacht. Er galt als großer Freund der Soldaten.
Efficacy of endoscopic ligation with O-ring closure for prevention of bleeding after gastric endoscopic submucosal dissection under antithrombotic therapy: a prospective observational study
Authors: Nishiyama Noriko , Kobara Hideki , Kobayashi Nobuya , Chiyo Taiga , Tada Naoya , Kozuka Kazuhiro , Matsui Takanori , Yachida Tatsuo , Fujihara Shintaro , Shi Tingting , Masaki Tsutomu
Published: February 2022

Background We examined the efficacy of a novel endoscopic ligation technique with O-ring closure (E-LOC) to prevent bleeding after gastric endoscopic submucosal dissection (ESD) under antithrombotic therapy.

Methods This single-center prospective study involved consecutive patients who were taking antithrombotic agents and underwent gastric ESD. E-LOC was performed by anchoring the nylon loop with hemoclips on both defect edges and/or the exposed muscle layer, and using O-ring band ligation around these deployed clips. The primary outcome was post-ESD bleeding rate. Secondary outcomes were complete closure rate, procedure time, sustained closure rate, and complications.

Results 48 patients were finally analyzed. The post-ESD bleeding rate was 0 %, the complete closure rate was 97.9 %, and the mean closure time was 29.9 minutes. The sustained closure rate was 95.8 % at postoperative day 2–3 and 33.3 % at postoperative day 10–11. No complications occurred.

Conclusion E-LOC may be an effective option for closing mucosal defects after gastric ESD under antithrombotic therapy. However, the preventive effect on post-ESD bleeding should be further investigated in high risk groups.
Association of Single-Nucleotide Polymorphisms of MAFB Gene with Nonsyndromic Cleft Lip with or without Cleft Palate in Kinh Vietnamese Patients
Authors: Phan Hoanh Duy Ba , Phuong Lam Hoai , Vu Hoang Anh
Published: February 2022

Background Cleft lip with or without palate (CL/P) is the most common orofacial birth defect. Single-nucleotide polymorphisms (SNPs) in MAFB gene (V-Maf avian musculoaponeurotic fibrosarcoma oncogene homolog B) were identified as susceptible to this defect in a genome-wide association study. To further evaluate its role in this birth defect, we conducted this study with the aim of identifying allele frequencies, genotype frequencies, and association of SNPs rs13041247, rs6065259, and rs6072081 of MAFB gene with nonsyndromic cleft lip/palate (NCL/P) in Kinh Vietnamese patients.

Methods We performed case–control study involved 79 patients with NCL/P and 77 healthy controls. DNAs were extracted from participants' saliva and tetra-amplification refractory mutation system polymerase chain reaction (tetra-ARMS PCR) was used for genotyping SNPs.

Results SNPs of MAFB gene were genotyped using the Tetra-ARMS PCR method. We found that genotype CT of rs13041247 was associated with an increased risk of NCL/P in Kinh Vietnamese (odds ratioTCTT [ORTC/TT] = 1.63, 95% confidence interval [CI] = 0.83–3.19, p = 0.17). The G allele genotypes of SNP rs6072081 increase high risk for the malformation, statistically significant result (ORGG/AA = 7.06, 95% CI = 2.13–23.42, p < 0.001). There is no clear association between rs6065259 and CL/P (ORAA/GG = 0.75, 95% CI = 0.22–2.50, p = 0.32; ORAG/GG = 1.53, 95% CI = 0.79–2.97, p = 0.32). When the patients were divided into the phenotypic subgroups, there was a similar significant trend between the patients and controls for all SNPs.

Conclusions Our study provides further evidence of role of MAFB gene variations with NCL/P defect in Kinh Vietnamese.
Exposure of Skin Homografts from Related Living Donors to Radiotherapy and Its Effects on Acute Rejection and Wound Healing in Children with Deep Burns: A Randomized Controlled Trial
Authors: Megahed Mohammed Ahmed , Kashty Sherief Mohamed El , Nassar Ahmed Tharwat , Aboulfetouh Mohamed , AboShaban Mohammed Saad
Published: February 2022

Background The ideal skin substitute should be more similar to normal skin function while causing fewer reactions. The purpose of this study was to assess the effect of radiotherapy on minimizing acute rejection and enhancing wound healing in children with deep burns.

Patients and Methods A prospective randomized control study included 34 children admitted to the burn unit with deep burns under the age of 12 years. Through the tomotherapy device, a skin homograft from a related living donor was exposed to a local dose of radiotherapy of 500 centigray (cGy). It was immediately used for coverage of the prepared bed after the irradiation was completed.

Results The mean values of the laboratory parameters (ESR, CRP, IL-6, and TNF) for all burn patients in the study showed a significant difference, with p < 0.001. The mean ± standard deviation (SD) of the time from homograft coverage to the appearance of rejection was 9.62 ± 1.45 in group 1 and 14.35 ± 2.8 in group 2, with p < 0.001 (highly significant difference), indicating that exposure to radiotherapy can reduce graft rejection.

Conclusions The exposure of skin homografts from related living donors to a local low dose of radiotherapy can reduce a graft's ability to initiate inflammatory and immunological reactions, thereby minimizing rejection of a graft and enhancing epithelialization in children with deep second- and third-degree burns.
An Innovative Skin Simulation Model to Augment Competency-based Training in Facial Plastic Surgery
Authors: Tripathy Satyaswarup , Mohapatra Devi Prasad , Thiruvoth Friji Meethale , Sharma Ramesh Kumar , Reddy Likhitha , Thomas Neljo
Published: February 2022

Introduction Competency-based medical education (CBME) approach in the medical curriculum has been introduced globally with the goal of providing flexibility, accountability, and learner-centeredness among medical learners. Traditional surgical skill training in most places has relied on “see one, do one, teach one model,” while simulation model-based training has been shown to improve competencies in surgical trainees. We wanted to assess the usefulness of a hydrophilic barrier adhesive foam wound dressing as a novel skin simulation model for learning biomechanics and practice of cutaneous flaps among plastic surgical resident trainees at our institute.

Materials and Methods An absorbent, soft polyurethane foam pad located centrally upon a larger polyurethane membrane, coated with a hydrocolloid adhesive, forming an island dressing, was used as a simulation model for this study. It was obtained from the hospital store either after or nearing their expiry dates of clinical use. Plastic surgery residents in different years of training were invited to participate in a simulation workshop, using this novel model, and give their feedback.

Results Seventeen residents in different plastic surgery training levels participated in the workshop and gave their feedback on the skin flap simulation model. The simulation model received extremely high (100%) scores on two parameters, namely, utility for flap and suture practice and high scores (88%–94%) for texture, ability to mark, and improving confidence among trainees.

Conclusions Adhesive bilayer polyurethane foam can be used as a novel cutaneous skin flap simulation model for understanding the biomechanics of skin flaps and cutaneous flap practice.
Primary Prevention of Cancer-Related Lymphedema Using Preventive Lymphatic Surgery: Systematic Review and Meta-analysis
Authors: Ciudad Pedro , Escandón Joseph M. , Bustos Valeria P. , Manrique Oscar J. , Kaciulyte Juste
Published: February 2022

Background Several studies have proven prophylactic lymphovenous anastomosis (LVA) performed after lymphadenectomy can potentially reduce the risk of cancer-related lymphedema (CRL) without compromising the oncological treatment. We present a systematic review of the current evidence on the primary prevention of CRL using preventive lymphatic surgery (PLS).

Patients and Methods A comprehensive search across PubMed, Cochrane-EBMR, Web of Science, Ovid Medline (R) and in-process, SCOPUS, and ScienceDirect was performed through December 2020. A meta-analysis with a random-effect method was accomplished.

Results Twenty-four studies including 1547 patients fulfilled the inclusion criteria. Overall, 830 prophylactic LVA procedures were performed after oncological treatment, of which 61 developed lymphedema.

The pooled cumulative rate of upper extremity lymphedema after axillary lymph node dissection (ALND) and PLS was 5.15% (95% CI, 2.9%–7.5%; p < 0.01). The pooled cumulative rate of lower extremity lymphedema after oncological surgical treatment and PLS was 6.66% (95% CI < 1–13.4%, p-value = 0.5). Pooled analysis showed that PLS reduced the incidence of upper and lower limb lymphedema after lymph node dissection by 18.7 per 100 patients treated (risk difference [RD] – 18.7%, 95% CI – 29.5% to – 7.9%; p < 0.001) and by 30.3 per 100 patients treated (RD – 30.3%, 95% CI – 46.5% to – 14%; p < 0.001), respectively, versus no prophylactic lymphatic reconstruction.

Conclusions Low-quality studies and a high risk of bias halt the formulating of strong recommendations in favor of PLS, despite preliminary reports theoretically indicating that the inclusion of PLS may significantly decrease the incidence of CRL.
First Successful Separation of Craniopagus Twins in India—Plastic Surgical Considerations
Authors: Singhal Maneesh , Sabapathy Shanmuganathan Raja , Gupta Deepak , Mahapatra A. K. , Chauhan Shashank , Tiwari Raja , Venkatramani Hari , Kedia Shweta , Saha Shivangi , Sahu Shamendra Anand Anand , Dash Suvashis , Sodhi Megha
Published: February 2022

Separation of total vertical craniopagus with shared venous sinuses poses multiple challenges. Provision of soft-tissue cover to the exposed brains at the time of total separation is one of them, due to the large size of the defect and paucity of local tissues. Staged separation of twins is advised with partial venous and parenchymal disconnection in the first stage and total separation in the second stage. Tissue expanders are inserted in the first stage, and second stage planned to coincide with the period of adequate expansion. In the child being reported, emergency second stage was done due to the deteriorating general condition of the children. Left with inadequate expanded skin, the critical defect in a twin was managed with bilateral trapezius myocutaneous flaps. High ionotropic support of the postoperative period resulted in superficial necrosis of the flap, which was managed by debridement, allograft application and autograft later. Both twins had well-healed wounds by 3 months.
Barbie Doll Forehead: CAD Design from Silicon Block
Authors: Marwah Shruti , Handa Arjun
Published: February 2022

The forehead is an important determinant of masculine or feminine look of the face. There are many methods described to achieve forehead augmentation for a more feminine face, and they include fillers, autologous fat grafting, silicone implant or methyl methacrylate. We present a case of a “Barbie doll forehead,” which is an interesting trend in Asian countries. Availability of silicone implants of various sizes are not uniform and currently unavailable in India. Alternatively, we devised carved silicone block using computer-aided design (CAD). We also discuss the various methods described for forehead augmentation with their advantages and disadvantages.
Vascularized Ribs in the Treatment of Posterior Instrumentation Infection after Thoracic Vertebrectomy. Case Report
Authors: Cavadas Pedro C. , Baklinska Magdalena , Téllez Daniela
Published: February 2022

Isolated vertebral mestastases can be successfully treated by surgical removal of the affected vertebral body and stabilization with alloplastic material. The bone union between the upper and lower vertebra is expected, yet a relatively high rate of a non-union has been reported. In case of infection, bone consolidation is altered, and removal of alloplastic material is recommended, which decreases spinal stability and is a devastating complication.

This case report of delayed infection and exposure of posterior hardware after thoracic vertebrectomy without an interbody osseous union, authors present a successful treatment with vascularized rib flaps through an anterior approach followed by hardware removal.
Osseous Metaplasia of the Transverse Humeral Ligament in a 10-Year-Old Bengal Cat
Authors: Rodiño Tilve Verónica , Maddox Thomas , Ressel Lorenzo , Pettitt Rob
Published: February 2022

This report is of an osseous metaplasia of the transverse humeral ligament and secondary bicipital tenosynovitis in a 10-year-old Bengal cat. Computed tomography revealed the presence of an osseous bridge enclosing the bicipital groove, with ultrasonography confirming partial tear and inflammation of the bicipital tendon. Initial conservative management with intra-articular long-acting steroids failed to provide long-term improvement of clinical signs. Surgical excision of the osseous lesion resulted in complete resolution of lameness after surgery, confirmed by a 1-year follow-up. Histopathology of this lesion confirmed a well-differentiated osseous metaplasia of the transverse humeral ligament.
Endovascular Stent Graft Placement and Coil Embolization for Splenic Artery Aneurysm with an Anatomical Variant
Authors: Kuwada Noriaki , Akagi Daisuke , Watanabe Yoshiko , Kanaoka Yuji , Tanemoto Kazuo
Published: February 2022

A 62-year-old woman with abdominal pain was diagnosed with a splenic artery aneurysm (SAA) and an anatomical variant in the splenic artery (SA) arising from the superior mesenteric artery (SMA) as its first branch. To treat the SAA, the draining artery and a small branch of the SAA were embolized, and then small-diameter stent grafts were deployed from SMA orifice, covering the aberrant origin of the SA and preserving the second branch of SMA. Intraoperative angiography confirmed successful exclusion of the SAA without endoleak or arterial dissection. The stent graft was patent and the aneurysm had shrunk 3.5 years after the operation.
Value of Office-Based Labs to an Interventional Radiology Practice
Authors: Lee Shimwoo , Srinivasa Ravi N. , Patel Prital , Genshaft Scott , Enzmann Dieter R.
Published: February 2022

Purpose Office-based laboratories (OBLs), or outpatient interventional suites, are rapidly gaining traction with both patients and interventionalists. Compared with hospitals, OBLs can provide greater convenience for patients, allow physicians greater autonomy, and potentially generate more revenue under a lower cost structure. The aim of this article is to discuss logistics and finances of running an OBL using the authors' institution as a guide for interventional radiologists seeking to establish their own OBL.

Materials and Methods Interventional radiology (IR) procedures performed at an OBL from the authors' academic institution were reviewed from January 2017 to December 2020. Yearly revenues and expenses related to IR procedures were recorded.

Results The number and complexity of IR procedures performed in the OBL increased over time with nearly 10-fold growth of revenue from 2017 to 2020.

Conclusion Most IR procedures performed in the hospital are feasible in the OBL setting, and by increasing patient volume and variety over time, an individual OBL can develop into a robust patient care center capable of generating revenue.
The Use of Biologic Wound Agents in Pediatric Reconstructions
Authors: May Jessica M. , Depani Monal , Ferry Andrew M. , Koshy John C. , Thornton James F.
Published: February 2022

The indications for using biologic wound agents have expanded greatly since first being employed for acute burn management. The majority of the literature details the use of said agents in the adult population; however, there is little representation regarding their uses for reconstructing defects typically observed in the pediatric population. Ironically, children, and to a lesser extent adolescents, greatly benefit from their use given the reduced skin laxity and amount of surrounding tissue available for locoregional tissue transfer when compared with adults. Herein, we detail the use of acellular and cellular biologic wound agents in the pediatric population.
Technical Refinements with the Use of Biologic Healing Agents
Authors: Dibbs Rami P. , Depani Monal , Thornton James F.
Published: February 2022

Soft tissue defects resulting from trauma, vascular disease, burns, and postoncologic resections require reconstructive surgery for appropriate wound coverage and support. Dermal substitutes have been applied to a vast array of reconstructive settings across nearly all anatomical areas with demonstrable success. However, they require meticulous handling and operative technical expertise to optimize management of these soft tissue defects. In this review, we will address three dermal substitutes, their operative techniques, and their surgical applications.
Predictive Mortality Factors after Decompressive Craniectomy in Ischemic Stroke
Authors: Leite Maria Luísa Brito Almino , Leite Matheus Silva , Barbosa Fernando Diogo , Kessler Iruena Moraes
Published: February 2022

Background Decompressive craniectomy is a consolidated method for the treatment of malignant ischemic stroke (iS) in the territory of the middle cerebral artery. Thus, factors contributing to mortality constitute an important area of investigation.

Objective To evaluate the epidemiological clinical profile and predictors of mortality in a single-center population of patients undergoing decompressive craniectomy for the treatment of malignant iS.

Methods A single-center retrospective study was performed in 87 patients with malignant iS subjected to emergency decompressive craniectomy from January 2014 to December 2017. Age, gender, laterality, aphasia, time interval between disease onset and treatment, and clinical and neurological outcomes using the Glasgow coma scale were assessed. The patients were stratified by age: a group of participants 60 years old or younger, and a group of participants older than 60 years old for assessment of survival and mortality by the Kaplan-Meier test and log-rank comparison. The intensity of the association between demographic and clinical variables was evaluated by multivariate Cox regression.

Results Ischemic stroke was prevalent in patients with hypertension (63.29%). Seventy-seven (84%) patients had some type of postoperative complication, mostly pneumonia (42.8%). The risk of death was 2.71 (p = 0.0041) and 1.93 (p = 0.0411) times higher in patients older than 60 and with less than 8 points on the Glasgow coma scale, respectively.

Conclusion Malignant iS has a significant mortality rate. Age above 60 years and Glasgow coma scale values below 8 were statistically correlated with unfavorable prognosis.
Venous Size Discrepancy Is a Critical Factor When Using Superficial Temporal Vessels as Recipient Vessels for Free Flaps
Authors: Mata Ribeiro Luís , Tsao Chung-Kan , Hung Yu-Liang , Chu Chun-Hui , Lin Li-Ching , Lin Mo-Han , Peng Chi , Cheong David Chon-Fok , Hung Shao-Yu , Liao Chun-Ta
Published: February 2022

Background Superficial temporal vessels have been used successfully as recipient vessels for head and neck reconstruction. This study evaluates the impact of several treatment variables on flap failure and take-back rate when using these recipient vessels.

Methods We conducted a retrospective study of all microsurgical reconstructions using superficial temporal vessels as recipient vessels in a period of 10 years. Variables collected included previous treatments (radiotherapy, chemotherapy, neck dissection, free flap reconstruction), type of flaps used (soft tissue, osteocutaneous), and vessel size discrepancy between donor and recipient vessels.

Results A total of 132 patients were included in the study. The flap success rate was 98.5%. The take-back rate was 10.6%. The most frequent reason for take-back was venous congestion secondary to thrombosis. None of the studied variables was associated with flap failure. Reconstructions using osteocutaneous flaps and vein diameter discrepancy (ratio ≥ 2:1) had significantly higher take-back rates.

Conclusion Flaps with a significant size discrepancy between donor and recipient veins (ratio ≥ 2:1) and fibula flaps (compared with soft tissue flaps) were associated with a higher risk of take-back. It is crucial to minimize venous engorgement during flap harvest and anastomosis, and limit vein redundancy during flap in-setting.
Evaluation of the Cariogenic Potential and Total Antioxidant Capacity of Saliva after the Consumption of Candies and Paneer: An In Vivo Study
Authors: Shah Tanvi J. , R. Manju , Joshi Aum B. , Reenayai Ngangbam
Published: February 2022

Aim The present study was performed to assess and compare the changes in pH, calcium, phosphorus, alkaline phosphatase, and the total antioxidant capacity (TAC) of saliva after consuming candies, followed by rinsing with water and consumption of paneer.

Materials and Methods Baseline saliva of 5 mL was collected from 60 children and they were asked to chew on candies. After 10 minutes of intake of candies, 5 mL of saliva was collected. They were then divided into two groups of 30 each and test products were given. Group 1: rinse with water and group 2: chew 20 g of paneer and swallow. Saliva of % mL was collected after 10, 20, and, 30 minutes from the study groups. The saliva samples collected were assessed for pH, calcium, phosphorus, alkaline phosphatase, and TAC. The data were analyzed using the paired t-test and post hoc Tukey's test.

Results The pH, calcium, phosphorus, and alkaline phosphatase decreased from baseline values after consuming candies significantly (p < 0.001). These increased after rinsing with water and consumption of paneer which was statistically significant (p < 0.001). The TAC values increased significantly after consuming candies and decreased after rinsing with water and consumption of paneer which was substantial for both the groups.

Conclusion Consumption of candies created a cariogenic milieu. Both the study groups were effective in the reversal of the cariogenic potential. The consumption of paneer caused remineralizing properties and showed superior results than rinsing with water.
Predictors of Disparities in Patient-Reported Outcomes before and after Arthroscopic Meniscectomy
Authors: Bloise Christopher , Fong Bronson , Jeffers Kirk , Bronstone Amy , Leonardi Claudia , Veale Todd , Poche John , Dasa Vinod
Published: February 2022

The purpose of this study is to identify predictors of disparities in patient-reported outcome measures (PROMs) before and after arthroscopic meniscectomy. Knee injury and Osteoarthritis Outcome Score (KOOS) was used in this study. All patients who underwent single-knee arthroscopic meniscectomy from January 2012 to March 2018 performed by a single surgeon at an academic safety-net hospital were identified. We excluded patients who had undergone ipsilateral previous knee surgery, bilateral meniscectomy, or concomitant ligament, cartilage, or osteotomy procedures, and those with severe radiographic osteoarthritis in the operated knee, missing preoperative data, or military insurance. Data abstracted from medical records included demographics (age, sex, race, insurance type), clinical characteristics (body mass index, Charlson comorbidity index, and Kellgren-Lawrence [KL] grade), procedure codes, and KOOS assessed before and 90 days after surgery. Multivariable analyses investigated the associations between patient characteristics and the KOOS Pain, other Symptoms, and Function in activities of daily living (ADL) subscales. Among 251 eligible patients, most were female (65.5%), half were of nonwhite race (50.2%), and almost one third were insured by Medicaid (28.6%). Medicaid and black race were statistically significant (p < 0.05) predictors of worse preoperative values for all three KOOS subscales. Medicaid insurance also predicted a lower likelihood of successful surgery, defined as meeting the 10-point minimal clinically important difference, for the KOOS symptoms (p < 0.05) and KOOS ADL (p < 0.05) subscales. Compared with patients without definitive evidence of radiographic osteoarthrosis (KL grade 1), those with moderate radiographic osteoarthritis (KL grade 3) were less likely to have a successful surgical outcome (p < 0.05 for all subscales). Worse preoperative KOOS values predicted worse postoperative KOOS values (p < 0.001 for all subscales) and a lower likelihood of surgical success (p < 0.01 for all subscales). Insurance-based disparities in access to orthopaedic care for meniscus tears may explain worse preoperative PROMs and lower success rates of meniscectomy among Medicaid patients. Patients with meniscus tears and radiological and/or magnetic resonance imaging evidence of osteoarthritis should be carefully evaluated to determine the appropriateness of arthroscopic meniscectomy.
Mannose-Binding Lectin 2 Gene Polymorphism during Pandemic: COVID-19 Family
Authors: Tukek Tufan , Pehlivan Sacide , Oyaci Yasemin , Isoglu-Alkac Ummuhan
Published: February 2022

Mannose-binding lectin 2 (MBL2) is a serine protease which is believed to be an important factor in the inherited immune system. In this article, we present a coronavirus disease 2019 (COVID-19) family of five patients: a 56-year-old father, a 51-year-old mother, two sons aged 23 and 21 years, and a 15-year-old daughter. According to the results of MBL2
rs1800450 variant analysis performed, the father had homozygous mutant, the mother had homozygous normal, and the three children had heterozygous mutant genotype. When we compared the clinical parameters and genotypes, MBL2 gene polymorphism plays a very important role in COVID-19 susceptibility and severe disease. The family, which makes up our study, is the proof of this situation, and it contains important implications for host factors and COVID-19.
Psoriasis: An Immunogenetic Perspective
Authors: Kocaaga Ayca , Kocaaga Mustafa
Published: February 2022

Psoriasis is an erythematous-squamous dermatosis with a polygenic inheritance history. Both environmental and genetic factors play a role in the etiology of the disease. Over the past two decades, numerous linkage analyzes and genome-wide association studies have been conducted to investigate the role of genetic variation in disease pathogenesis and progression. To date, >70 psoriasis susceptibility loci have been identified, including HLA-Cw6, IL12B, IL23R, and LCE3B/3C. Some genetic markers are used in clinical diagnosis, prognosis, treatment, and personalized new drug development that can further explain the pathogenesis of psoriasis. This review summarizes the immunological mechanisms involved in the etiopathogenesis of psoriasis and recent advances in susceptibility genes and highlights new potential targets for therapeutic intervention.
Genetic Variants in Interleukin-10 Gene Association with Susceptibility and Cervical Cancer Development: A Case Control Study
Authors: Pratap Pushpendra D. , Raza Syed Tasleem , Zaidi Ghazala , Kunwar Shipra , Ahmad Sharique , Charles Mark Rector , Eba Ale , Rajput Muneshwar
Published: February 2022

Objectives Cervical cancer (CC) is one of the most destructive disease caused by persistent HPV infection which affects women worldwide, especially in developing countries. The genetic basis of host immune response especially cytokine function has been shown to influence CC susceptibility. Studies have demonstrated that IL-10 gene polymorphism have been associated with numerous malignancies, but in context to CC results were inconclusive. Though, aim of our study to investigate the association between IL-10 -1082A/G and -819C/T promoter polymorphism and CC susceptibility.

Material and Methods This study comprised 192 women with CC and 200 controls. HPV detection was done by RT-PCR and genotyping was assessed through PCR-RFLP method. Serum concentration of IL-10 measured by ELISA.

Results Women with AG and AG+GG genotypes of IL-10 -1082A/G had two-fold increased risk of CC [OR, 2.35 (95% CI, 1.54–3.58), p = 0.005], [OR, 2.03 (95% CI, 1.36–3.04), p = 0.0005] compared to controls. Women with G allele of -1082A/G polymorphism had linked with CC susceptibility [OR, 1.39 (95% CI, 1.02–1.88), p = 0.036] compared to controls. No significant difference was found between patients and controls in the genotype or allele frequencies of IL–10 -819C/T polymorphism [OR, 1.00 (95% CI, 0.63–1.58), p = 0.99]. The level of serum concentration of IL-10 was significantly higher in cases compared to controls.

Conclusion These findings help to understand that polymorphism of IL-10 -1082A/G gene is associated with increased risk of CC development and can serve as a marker of genetic susceptibility to CC.
A Novel Interactive Virtual Medical Student Clinical Rotation for Ophthalmology
Authors: Frisbie James , Cornman Hannah , Swamy Ramya , Alexander Janet Leath , Kemp Pavlina S. , Friedrich Rebekah , Driscoll Colleen A. Hughes , Levin Moran R.
Published: February 2022

Objective This article describes a novel clinical rotation that uses technology to create a remote ophthalmology learning experience with the goal of improving virtual exposure to medical and surgical ophthalmic training for medical students.

Methods Our unique curriculum incorporates mobile-mounted tablets which allow students to virtually participate in inpatient consults, clinic, and ophthalmic surgery. An adaptable mounting device attached to the slit lamp allows students to observe examinations in real time, enhancing recognition of ocular pathologies. Students participate in a robust curriculum that includes independent learning modules, video lectures, interactive modules, podcasts, and surgical video rounds. Students engage with residents and faculty in interactive-guided lectures and case-based discussions that focus on the American Academy of Ophthalmology white paper teaching objectives. Students are mailed surgical instruments and participate in surgical modules and faculty-led virtual wet laboratories.

Results Our unique virtual curriculum combines didactic learning, interactive content, and novel technology applications such as mobile tablets, slit lamp-mounted devices, and faculty-led virtual wet laboratories.

Conclusion Virtual technologies can be utilized to enhance ophthalmology medical student education in a safe and effective way during the coronavirus disease 2019 pandemic, and to improve educational access in the future.
An Academic Ophthalmology Curriculum as a Model for Introducing Preprofessional Students to Careers in Ophthalmology
Authors: Succar Tony , Lee Virginia A. , Karmonik Christopher , Lee Andrew G.
Published: February 2022

Ophthalmology is one of the most rewarding and fulfilling medical careers in medicine due to the broad practice scope (including a combination of medicine and surgery); patient population (treatment of pediatric and adult patients); diverse patient and pathology mix (healthy eye exams, refractions, and pathology); high patient and provider satisfaction rates; and highly specialized technology and treatments. Unfortunately, academic exposure to ophthalmology as a career in medical school curricula has had a global decline for decades. While most of the evidence-based interventions found in the literature have resulted in enhanced educational outcomes, ophthalmology exposure should be initiated earlier which provided an impetus for developing and implementing a structured curriculum for introducing preprofessional students to careers in ophthalmology. Educational programs offered in the pipeline from high school to college can reach students who are still undecided about higher education and career choices, thus providing an opportunity for increasing the numbers of students in medical and health professions. We describe a structured, academic curriculum model for pregraduate and undergraduate students to enhance interest and to increase academic exposure to basic clinical, research, and educational domains in ophthalmology. The Houston Methodist Hospital (HMH) Academic Institute offers an unparalleled 10-week summer student research program that matches HMH faculty members with students from multiple levels (e.g., high school, college undergraduates, and medical school). Students undergo prerequisite virtual training; attend weekly didactic lectures given by mentors, invited speakers, and other local leaders; shadow health care providers in active clinical settings as observers; participate in active research projects; present at local conferences; and are encouraged to eventually publish their work. We describe the structured curriculum from our first Summer Internship Program for High Schoolers in ophthalmology. To our knowledge an ophthalmology internship program for preprofessional students has not been previously published in the literature.
Genetic Variants and Drug Efficacy in Tuberculosis: A Step toward Personalized Therapy
Authors: Khan Almas , Abbas Mohammad , Verma Sushma , Verma Shrikant , Rizvi Aliya Abbas , Haider Fareya , Raza Syed Tasleem , Mahdi Farzana
Published: February 2022

Tuberculosis (TB) continues to be a major infectious disease affecting individuals worldwide. Current TB treatment strategy recommends the standard short-course chemotherapy regimen containing first-line drug, i.e., isoniazid, rifampicin, pyrazinamide, and ethambutol to treat patients suffering from drug-susceptible TB. Although Mycobacterium tuberculosis, the causing agent, is susceptible to drugs, some patients do not respond to the treatment or treatment may result in serious adverse reactions. Many studies revealed that anti-TB drug-related toxicity is associated with genetic variations, and these variations may also influence attaining maximum drug concentration. Thus, inter-individual diversities play a characteristic role by influencing the genes involved in drug metabolism pathways. The development of pharmacogenomics could bring a revolution in the field of treatment, and the understanding of germline variants may give rise to optimized targeted treatments and refine the response to standard therapy. In this review, we briefly introduced the field of pharmacogenomics with the evolution in genetics and discussed the pharmacogenetic impact of genetic variations on genes involved in the activities, such as anti-TB drug transportation, metabolism, and gene regulation.
The Human Genetics of Dental Anomalies
Authors: Khan Mahamad Irfanulla , Ahmed Nadeem , Neela Praveen Kumar , Unnisa Nayeem
Published: February 2022

The development of tooth is a highly complex procedure and mastered by specific genetic programs. Genetic alterations, environmental factors, and developmental timing can disturb the execution of these programs, and result in various dental anomalies like hypodontia/oligodontia, and supernumerary teeth, which are commonly seen in our clinical practice. Advances in molecular research enabled the identification of various genes involved in the pathogenesis of dental anomalies. In the near future, it will help provide a more accurate diagnosis and biological-based treatment for these anomalies. In this article, we present the molecular phenomenon of tooth development and the genetics of various dental anomalies.