bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Choice of Abdominal Flap Used in Breast Reconstruction Surgery
Authors: McVeigh James , Kalu Peter 
Published: February 2020

The incidence of breast cancer has been progressively increasing to the current level where 1 in 8 women now develop the disease. The National Breast Screening Programme has enabled us to diagnose many breast cancers at a much earlier stage. Coupled with an improved understanding of the oncoplastic approach to breast cancer surgery, genomics, hormone and targeted therapies as well as chemotherapy we now anticipate better outcomes.
Despite the many advances in breast cancer there remains a significant cohort of women who are diagnosed with advanced forms of the disease that necessitates mastectomy i.e. the removal of all breast tissue. For many, reconstruction maybe immediately possible at the same time as mastectomy using either non-autologous (man-made) options such as breast implants and tissue expanders or autologous options using the latissimus-dorsi, abdominal or non-abdominal based flaps sited on thigh, buttock or lower flank tissue.
Abdominal based reconstructions have evolved from crude operative procedures in which large parts of the lower anterior abdominal wall were harvested while remaining attached to the feeding vascular supply. This ‘flap’ of tissue is then rotated upon the pedicle of vessels into the new location in the breast. Pedicled Transverse Rectus Abdominus Myocutaneous (TRAM) flaps were often complicated by under-perfusion of the transferred flap resulting in fat necrosis. There were also issues with abdominal wall bulges and hernias as a result of the loss of the rectus abdominus muscle.
With improvements in microsurgery the advent of free flap surgery was ushered in. Skin and fat were transplanted from the lower anterior abdominal wall using one of the rectus abdominus muscles and the perfusing artery and draining vein (donor-site). This free TRAM flap could be transplanted in the recipient-site after re-joining (re-anastomosing) the artery and vein using microsurgery. Aided by better anatomical knowledge, surgeons have been able to reduce the amount of rectus muscle sacrificed resulting in the muscle sparing-TRAM (MS-TRAM) and more latterly the deep inferior epigastric perforator (DIEP) flap which has no muscle included. The advantages of this muscle sparing approach are speedier recovery and reduced morbidity while maintaining operative cosmetic outcomes.
Vascularised Sentinel Skin Flaps for Immune Monitoring in Solid Organ Transplantation
Authors: Stark Helen , Et al.  
Published: February 2020

HL Stark, CS Honeyman, J Hester, F Issa, H Giele
Background
The long-term outcomes of lung, intestine and pancreas transplants are severely limited by high rates of rejection that predispose to later transplant dysfunction or failure. Despite this, there are no specific tests currently available that diagnose rejection accurately without the need for a biopsy. Due to the invasive nature of this, monitoring is intermittent and infrequent, only performed when there is a clinical suspicion of rejection. Vascularised sentinel skin flaps (SSFs) may provide a method for non-invasive transplant monitoring.
Aim
To develop continuous, patient-driven monitoring for acute rejection in solid organ transplants with the use of SSFs. To use this model to analyse very early rejection samples in order to identify immunological pathways, biomarkers and potential therapeutic targets that may predict, diagnose and prevent rejection.
Methods
I have access to an already collected biobank of blood and tissue samples from patients who have had a pancreas or intestine transplant and sentinel skin flap in Oxford. I will use these samples as my initial discovery set, with the aim of identifying a profile (SSF and immunological changes) of acute rejection that correlates to solid organ rejection. I will then test this profile in patients undergoing lung transplantation with SSF.
Conclusion
SSFs are an attractive method for transplant rejection monitoring. In this presentation I will discuss the rationale for SSF-based immune monitoring in transplantation and how I am planning on identifying a biomarker profile of acute rejection.
Comparative Analysis of Atherosclerotic Disease in the Carotid and Femoral Arteries
Authors: Hurst Katherine , Et al.  
Published: February 2020

K Hurst1, R Choudhury2, A Handa1
1. Nuffield Department of Surgical Sciences, University of Oxford
2. Radcliffe Department of Medicine, University of Oxford
Introduction
The outcomes for patients with PAOD have remained unchanged for over 25 years, whereas primary prevention has made a marked difference to the incidence of stroke and MI. Why is treatment more effective for certain types of atherosclerotic plaques than others? Why do certain patients experience a stroke but never an amputation?
Methods
The study aims to use in vivo and ex vivo analysis of carotid and femoral atherosclerotic plaque from patients enrolled in the OxPVD study. Each participant will undergo pre-operative in vivo carotid and femoral vessel (ipsilateral) imaging using T1/T2 weighted MRI; inclusive of plaque, and ex vivo plaque analysis using micro CT, micro MRI and histological staining. Comparative analysis of the carotid versus femoral plaques will be completed using above techniques.
Results
Primary results from this study have shown that novel MRI DANTE sequences can successfully characterise femoral atherosclerotic plaque in vivo. Using micro CT and mass spectrometry techniques from micro MRI, we have further quantified the differences in composition of carotid and femoral disease. Finally, histological staining has implied that the disease processes behind femoral and carotid atherosclerosis may be different; with carotid narrowing by fat infiltration and statistically significant reduction in nuclei, compared to femoral plaque showing intra luminal calcium deposition without intimal destruction.
Conclusion
These preliminary results are beginning to highlight the key compositional differences between carotid and femoral atherosclerosis, and with these results it may be possible to trial different therapeutic targets, particularly in the context of PAOD.
Development of a Novel Index to Characterise Arterial Physiology Using Ultrasound Imaging
Authors: Ward Joel , Cheng Xinghao , Et al.  
Published: February 2020

Joel Ward1*, Xinhao Cheng2*, Pierfrancesco Lapolla1, Anirudh Chandrashekar1, Ashok Handa1, Robin Cleveland2# and Regent Lee2#
*, # Authors contributed equally

Nuffield Department of Surgical Sciences, University of Oxford
Department of Engineering Science, Unviersity of Oxford

Introduction
Abdominal aortic aneurysms (AAA) are associated with features of systemic inflammation and endothelial dysfunction. Flow mediated dilatation (FMD), measured remotely at the brachial artery, is a recognised non-invasive measurement for endothelial function. We had previously reported FMD to be a predictor of AAA growth. We hypothesised that other physical characteristics of the brachial artery wall correlate with AAA growth.
Methods
In a prospectively recruited cohort of patients with AAAs (Oxford Abdominal Aortic Aneurysm Study), brachial wall motion captured from ultrasound data was analysed. We developed a novel image analysis method (UK patent priority filing P255395GB) to extract a ‘brachial artery relaxation index’ (BARI), and examined BARI in the context of AAA and its correlation with future aneurysm growth.
Results
Preliminary results were promising with clear differentiation between patients at the extreme spectrum of prospective AAA growth. However, there was no difference in BARI between age and sex matched healthy volunteers and OxAAA patients (n=15 each, p=0.77). In the entire OxAAA Study cohort (n=126) no differences was observed in BARI between aneurysms of different diameters (30-40mm vs 40-55mm vs >55mm, ANOVA p=0.99). Furthermore, no correlation between BARI and future aneurysm growth was observed (p=0.5).
Discussion
Image based analyses of vasculature is important in the context of AAAs. We developed a novel analysis method to extract characteristics of arterial wall motion as a proposed biomarker and tested its utility in the context of AAA disease. This serves as a model for future collaborative research in an inter-disciplinary approach.
Potential application of lutetium-177-labeled prostate-specific membrane antigen-617 radioligand therapy for metastatic castration-resistant prostate cancer in a limited resource environment: Initial clinical experience after 2 years
Authors: Assadi Majid , Rezaei Samira , Jafari Esmail , Rekabpour Seyed Javad , Ravanbod Mohammad , Zohrabi Farshad , Amini AbdulLatif , Keshmiri Saeid , Dadgar Habibollah , Ahmadzadehfar Hojjat 
Published: February 2020

AbstractIn recent years, lutetium-177 (177Lu)-labeled prostate-specific membrane antigen (PSMA)-617 has become a promising new therapeutic agent in patients with metastatic castration-resistant prostate cancer (mCRPC). In this study, we report on an early experience of177Lu-PSMA therapy with an evaluation of its efficacy and safety in mCRPC patients. Twenty-one mCRPC patients with a mean age of 70.3 ± 9.6 (54–88)-year-old were treated with one to four therapy cycles (median two cycles) and administered activity of 3.7–29.6 GBq (mean of 15.4 GBq). A prostate-specific antigen (PSA) decline ≥ 50% was considered to be a biochemical response (BCR). To evaluate the clinical response, the Eastern Cooperative Oncology Group (ECOG) status was used. Within 2 weeks before and 1 and 2 months after each therapy cycle, hematology, renal function, liver status, alkaline phosphatase, and PSA were checked. The Common Terminology Criteria for Adverse Events was used for grading adverse events induced by 177Lu-PSMA. Furthermore, overall survival (OS) was calculated and analyzed. During the treatment, a BCR was seen in 62% of patients; 19% of patients showed progression and 19% of patients showed stable disease. ECOG status was improved after treatment, and OS was 62.7 weeks. After the treatment, two patients showed Grade II toxicity of white blood cells, Grade I thrombocytopenia was observed in two patients, one patient showed Grade II toxicity in serum creatinine and transient Grade I toxicity in creatinine was seen in two patients. In total, our initial experience demonstrates that 177Lu-PSMA therapy has the potential to positively affect the development and maturation of radioligand practices in selected mCRPC patients, even in resource limited, developing country environments. However, some challenges, such as practitioner training, poor initial acceptance by colleagues and financial concerns, particularly in developing nations, still exist.
Unusual presentation of a curve-shaped Meckel's diverticulum detected on technetium-99m Meckel's scintigraphy
Authors: Anitha Dharmalingam , Shwetal Pawar , Suruchi Shetye , Mangala Ghorpade 
Published: February 2020

AbstractComplicated Meckel's diverticulum (MD) in pediatric age group may not present with classic symptoms or signs. The routine modalities of investigations for the detection of MD are ultrasonography (US), computerized tomography, and air enema. However, these may miss the diagnosis in cases of atypical patterns of presentation. In such situations, the radionuclide Meckel scan helps to narrow down the diagnosis. The objective of this case report was to present an unusual presentation of MD where the diagnosis was established by a radionuclide scan against other methods which were equivocal. An 8-year-old boy was admitted with features of intestinal obstruction.99mTc-pertechnetate Meckel's scintigraphy showed localization of tracer in ectopic gastric mucosa. The surgical exploration after the Meckel's scan revealed a curve-shaped MD localized 50 cm proximal to the ileocecal valve. The surgery was completed after a diverticulectomy, and the patient was relived of symptoms. MD scintigraphy can help detect ectopic gastric mucosa in cases of unusual presentation by considering the atypical presentation, variation in shape, and location on Meckel's scan and improve the disease management.
Incorporation of pollen data in source maps is vital for pollen dispersion models
Authors: Kurganskiy Alexander , Skjøth Carsten Ambelas , Baklanov Alexander , Sofiev Mikhail , Saarto Annika , Severova Elena , Smyshlyaev Sergei , Kaas Eigil 
Published: February 2020

Abstract. Information about distribution of pollen sources, i.e. their presence and abundance in a specific region, is important, especially when atmospheric transport models are applied to forecast pollen concentrations. The goal of this study is to evaluate three pollen source maps using an atmospheric transport model and study the effect on the model results by combining these source maps with pollen data.
Here we evaluate three maps for the birch taxon: (1) a map derived by combining a land cover data and forest inventory, (2) a map obtained from land cover data and calibrated using model simulations and pollen observations, and (3) a statistical map resulting from analysis of forest inventory and forest plot data.
The maps were introduced to the Enviro-HIRLAM (Environment – High Resolution Limited Area Model) as input data to simulate birch pollen concentrations over Europe for the birch pollen season 2006. A total of 18 model runs were performed using each of the selected maps in turn with and without calibration with observed pollen data from 2006. The model results were compared with the pollen observation data at 12 measurement sites located in Finland, Denmark, and Russia.
We show that calibration of the maps using pollen observations significantly improved the model performance for all three maps. The findings also indicate the large sensitivity of the model results to the source maps and agree well with other studies on birch showing that pollen or hybrid-based source maps provide the best model performance.
This study highlights the importance of including pollen data in the production of source maps for pollen dispersion modelling and for exposure studies.
CHLSOC: the Chilean Soil Organic Carbon database, a multi-institutional collaborative effort
Authors: Pfeiffer Marco , Padarian José , Osorio Rodrigo , Bustamante Nelson , Olmedo Guillermo Federico , Guevara Mario , Aburto Felipe , Albornoz Francisco , Antilén Monica , Araya Elías , Arellano Eduardo , Barret Maialen , Barrera Juan , Boeckx Pascal , Briceño Margarita , Bunning Sally , Cabrol Lea , Casanova Manuel , Cornejo Pablo , Corradini Fabio , Curaqueo Gustavo , Doetterl Sebastian , Duran Paola , Escudey Mauricio , Espinoza Angelina , Francke Samuel , Fuentes Juan Pablo , Fuentes Marcel , Gajardo Gonzalo , García Rafael , Gallaud Audrey , Galleguillos Mauricio , Gomez Andrés , Hidalgo Marcela , Ivelic-Sáez Jorge , Mashalaba Lwando , Matus Francisco , Meza Francisco , Mora Maria de la Luz , Mora Jorge , Muñoz Cristina , Norambuena Pablo , Olivera Carolina , Ovalle Carlos , Panichini Marcelo , Pauchard Aníbal , Pérez-Quezada Jorge F. , Radic Sergio , Ramirez José , Riveras Nicolás , Ruiz Germán , Salazar Osvaldo , Salgado Iván , Seguel Oscar , Sepúlveda Maria , Sierra Carlos , Tapia Yasna , Tapia Francisco , Toledo Balfredo , Torrico José Miguel , Valle Susana , Vargas Ronald , Wolff Michael , Zagal Erick 
Published: February 2020

Abstract. A critical aspect of predicting soil organic carbon (SOC) concentrations is
the lack of available soil information; where information on soil
characteristics is available, it is usually focused on regions of high
agricultural interest. To date, in Chile, a large proportion of the SOC
data have been collected in areas of intensive agricultural or forestry use;
however, vast areas beyond these forms of land use have few or no soil data
available. Here we present a new SOC database for the country, which is the result of
an unprecedented national effort under the framework of the Global Soil
Partnership. This partnership has helped build the largest database of SOC
to date in Chile, named the Chilean Soil Organic Carbon database (CHLSOC),
comprising 13 612 data points compiled from numerous sources, including
unpublished and difficult-to-access data. The database will allow users to
fill spatial gaps where no SOC estimates were publicly available previously.
Presented values of SOC range from 6×10-5 % to 83.3 %,
reflecting the variety of ecosystems that exist in Chile. The database has the potential to inform and test current models that predict
SOC stocks and dynamics at larger spatial scales, thus enabling benefits
from the richness of geochemical, topographic and climatic variability in
Chile. The database is freely available to registered users at
https://doi.org/10.17605/OSF.IO/NMYS3 (Pfeiffer et al., 2019b) under the
Creative Commons Attribution 4.0 International Public License.
Making sense of Rwanda’s remarkable vaccine coverage success
Authors: Robson Julia , Bao James , Wang Alissa , McAlister Heather , Uwizihiwe Jean-Paul , Sayinzoga Felix , Sibomana Hassan , Koswin Kirstyn , Wong Joseph , Zlotkin Stanley 
Published: February 2020

After the Rwandan genocide in 1994, vaccine coverage was close to zero. Several factors, including extreme poverty, rural populations and mountainous geography affect Rwandans’ access to immunizations. Post-conflict, various other factors were identified, including the lack of immunization program infrastructure, and lack of population-level knowledge and demand. In recent years, Rwanda is one of few countries that has demonstrated a sustained increase to near universal vaccination coverage, with a current rate of 98%. Our aim was to ask why and how Rwanda achieved this success so that it could potentially be replicated in other countries.Literature searches of scientific and grey literature, as well as other background research, was conducted from September 2016 through August 2017, including primary fieldwork in Rwanda. We determined that four factors have had a major influence on the Rwandan vaccine program, including strong central government leadership (political will), a culture of accountability, local ownership and a strong health value chain. Rwanda’s national immunization program is rooted in a political landscape shaped by unique aspects of Rwandan history and culture. Rwanda has a strong central government and a hierarchical chain of command supported by decentralized implementation bodies. A culture of accountability transcends the entire health system and there is local-level ownership of the immunization program, including the role of engaged community health workers and a strong health information system. Together, these four factors likely account for Rwanda’s vaccination coverage success.
Stand Where You Stand on Omelas
Authors: Burgess Olivia ,   Society for Ethics Across the Curriculum
Published: February 2020

Science fiction is gaining academic recognition as a tool for teaching ethics and engaging potentially resistant students in communication and critical thinking, but there are not many lesson plans available for how to implement science fiction in the classroom. I hope to address that gap by sharing a successful lesson plan I developed while teaching a first-year composition and ethics course at the Colorado School of Mines. “Stand Where You Stand on Omelas” combines writing, communication, and ethical decision making by asking students to defend what they would do as a citizen in Ursula K. Le Guin’s short story, “The Ones Who Walk Away from Omelas,” where a young child’s torment ensures the prosperity and happiness of society as a whole.
Effect of PP Nanocomposite Multi-layered Film on Physicochemical Properties of Ready-To-Cook (RTC) Idli Batter and Prepared Idli Cake
Authors: Gaikwad P. S. , Yadav B. K. , Anandakumar S. , Loganathan M. , Shanmugasundaram S. 
Published: February 2020

Aim: The current study focuses on the effect of PP nanocomposite multi-layered film on physicochemical properties of stored idli batter and prepared idli cakes.
Place and Duration of Study: Department of Food Packaging and System Development at Indian Institute of Food Processing Technology, Thanjavur, Tamil Nadu, India, between Aug 2018 and Dec 2019.
Methodology: The developed PP nanocomposite multi-layered film composed with depositing silicon dioxide (SiO2) on polypropylene (PP) film (0.010 mm) and attached with ethylene-vinyl alcohol (EVOH 32%) film (0.066 mm). The Physico-chemical properties of developed multi-layered and commercial PP film stored idli batter with different blend ratios of rice to black gram (3:1 and 4:1) were evaluated in terms of pH, percent titrable acidity (% TA), colour value (∆E), viscosity (cP) and volume measurement (ml). Idli cake prepared with batter stored in multi-layered film and evaluated in terms of colour, texture and percent pore characteristics. The percent pore presents in per square inches of prepared idli cake with different blend ratios and fermentation time were analysed using the grayscale image in MATLAB.
Results and Discussion: The pH value of stored batter ranges from 6.7 to 4.5 or lower, to reach pH below 4.5 or lower commercially stored batter took 24 h and batter stored in the multi-layered film took 36 h at ambient temperature. The multi-layered stored batter showed better results of physicochemical properties in terms of fermentation time. Idli cake prepared with 3:1 blend ratio showed good results in terms of textural properties with compared to 4:1 blend ratio. Idli cake prepared with 3:1 blend ratio showed more pore percentage (21.88-36.80%) as compared to 4:1 blend ratio (18-32.98%) in per square inch. Due to higher barrier properties of the multi-layered film, the bacterial count increases at a slow rate and help to extend the shelf life of packaged batter more than 30 h at ambient temperature.
Novel MS vital sign: multi‐sensor captures upper and lower limb dysfunction
Authors: Akhbardeh Alireza , Arjona Jennifer K. , Krysko Kristen M. , Nourbakhsh Bardia , Gourraud Pierre Antoine , Graves Jennifer S. 
Published: February 2020

AbstractObjectiveTo create a novel neurological vital sign and reliably capture MS‐related limb disability in less than 5 min.MethodsConsecutive patients meeting the 2010 MS diagnostic criteria and healthy controls were offered enrollment. Participants completed finger and foot taps wearing the MYO‐band© (accelerometer, gyroscope, and surface electromyogram sensors). Signal processing was performed to extract spatiotemporal features from raw sensor data. Intraclass correlation coefficients (ICC) assessed intertest reproducibility. Spearman correlation and multivariable regression methods compared extracted features to physician‐ and patient‐reported disability outcomes. Partial least squares regression identified the most informative extracted textural features.ResultsBaseline data for 117 participants with MS (EDSS 1.0–7.0) and 30 healthy controls were analyzed. ICCs for final selected features ranged from 0.80 to 0.87. Time‐based features distinguished cases from controls (P = 0.002). The most informative combination of extracted features from all three sensors strongly correlated with physician EDSS (finger taps rs = 0.77, P < 0.0001; foot taps rs = 0.82, P < 0.0001) and had equally strong associations with patient‐reported outcomes (WHODAS, finger taps rs = 0.82, P < 0.0001; foot taps rs = 0.82, P < 0.0001). Associations remained with multivariable modeling adjusted for age and sex.ConclusionsExtracted features from the multi‐sensor demonstrate striking correlations with gold standard outcomes. Ideal for future generalizability, the assessments take only a few minutes, can be performed by nonclinical personnel, and wearing the band is nondisruptive to routine practice. This novel paradigm holds promise as a new neurological vital sign.