bluuebunny/crossref_metadata_2025_split huggingface dataset:
Customized Pre-Epiglottic Baton Plate—A Practical Guide for Successful, Patient-Specific, Noninvasive Treatment of Neonates With Robin Sequence
Authors: Schmidt Gül , Hirschfelder Anke , Heiland Max , Matuschek Carsten 
Published: November 2020

Objective: Despite its efficiency and benefits in treating patients with Robin sequence (RS), the pre-epiglottic baton plate (PEBP) is not widely used. However, its acceptance might improve with specific defined parameters for indication and proper design of the velar extension. We present our 13-year, single-center experience in treating infants with RS using PEBP, focusing on the description and insertion of an endoscopically guided PEBP design along with its complications and limitations. Design and Innovation: We recommend PEBP as primary treatment for RS, suggesting a new approach of design adjustment based on endoscopic findings of multilevel upper airway obstruction. Setting: Department of cleft lip and palate. Patients: Infants with isolated or syndromic RS, period 2010 to 2019. Interventions: Pre-epiglottic baton plate treatment, intravelar veloplasty, and hard palate closure after initial PEBP treatment. Results: We treated 132 infants (isolated RS, 111; syndromic RS, 21) with PEBP. All infants with isolated RS were discharged within an average of 8 days of PEBP therapy. For them, no tracheotomy or tongue–lip adhesion procedures were needed. Only 4 of the 20 infants discharged with a nasogastric tube needed it for >2 weeks. Intravelar veloplasty and palate closure were performed after 3 and 6 months of initiating PEBP treatment, respectively. Conclusions: Application of an orthodontic device in RS therapy has not been accepted worldwide. We hope that our learning curve and recommendations about PEBP will help the implementation of this highly effective and nonsurgical treatment option.
Dural venous sinus thrombosis after lumbar puncture in a patient with idiopathic intracranial hypertension
Authors: Garg Anubhav , Rajendram Phavalan , Muccilli Alexandra , Noel de tilly Lyne , Micieli Jonathan A 
Published: November 2020

Introduction: Idiopathic intracranial hypertension (IIH) is one of the most common causes of papilloedema seen by ophthalmologists and neurologists. Patients with IIH routinely undergo lumbar puncture (LP) for diagnosis. Dural venous sinus thrombosis (DVST) is a rare complication of cerebrospinal fluid pressure (CSF)-lowering procedures such as lumbar puncture and epidural and may be an intracranial complication of IIH. Case Description: A 29-year-old obese woman was diagnosed with severe idiopathic intracranial hypertension (IIH) after she presented with new-onset headache, pulsatile tinnitus and blurred vision. Magnetic resonance imaging (MRI) and venography (MRV) were normal apart from signs of intracranial hypertension. Lumbar puncture (LP) revealed an opening pressure of 40 cm of water. Due to the severity of the papilloedema and vision loss, she was referred for a ventriculoperitoneal shunt and found to have venous sinus thrombosis involving the superior sagittal sinus on the pre-operative computed tomography (CT) head 5 days after the LP. CT venography (CTV) one day later and MRV 3 days later showed significant worsening as the thrombosis extended into the deep venous system. She was started on therapeutic heparin and her symptoms and vision improved and she did not develop any neurological complications. Conclusions: DVST should be considered in IIH patients who have worsening papilloedema or symptoms of intracranial hypertension. Repeat venous imaging can prevent devastating consequences such as venous infarcts of haemorrhage in these patients.
Conjunctival bleb tearing by XEN gel stent after conjunctival compression sutures
Authors: Montolío-Marzo Santiago , Lanzagorta-Aresti Aitor , Piá-Ludeña Jose Vicente , Davó-Cabrera Juan María 
Published: November 2020

Purpose: As minimally invasive glaucoma surgery devices emerge, newer complications are reported. XEN gel stent is safer than classic glaucoma surgery but may also lead to severe adverse effects as hypotony. Compression conjunctival sutures are a useful treatment for overfiltration hypotony after XEN gel stent implantation, but might force bleb tearing by the implant as it gets tightly close to the sutured conjunctiva. This complication has not been previously reported. Methods: We report a patient with overfiltration hypotony after XEN gel implantation. Conjunctival compression sutures and implant relocation ab interno were performed obtaining a good outcome. As conjunctiva got tightly close to the stent, the device eroded the bleb so leakage and implant extrusion were found. Results: Bleb reconstruction by conjunctival autograft was performed in order to avoid hypotony due to continuous conjunctival leakage. Conclusion: Conjunctival compression sutures may be used for overfiltration control after XEN gel implantation but we must be aware of potential conjunctival damage due to implant erosion even if it is correctly positioned. Close follow-up and early suture release may be convenient in these patients.
Goniosynechialysis combined with multiple surgeries for secondary glaucoma in nanophthalmos: A case report
Authors: Li Ruoshi , Li Mei , Zhang Shijie 
Published: November 2020

Background: Management of secondary glaucoma in nanophthalmos has always been challenging, especially for patients with extremely short axial length and extensive angle synechia. This case report discusses a nanophthalmic patient with secondary glaucoma and extensive angle synechia. Case presentation: A 60-year-old woman was referred to our hospital with uncontrolled intraocular pressure (IOP) in her left eye (LE). Slitlamp examination revealed small cornea and shallow anterior chamber (AC) in both eyes. Extensive angle synechia was seen on gonioscopy, and the IOP and axial length were 36 mmHg/15.79 mm in the left eye. She was diagnosed with nanophthalmos and secondary angle-closure glaucoma LE. Laser peripheral iridectomy (LPI) was performed, but the IOP LE remained elevated and uncontrolled on brinzolamide and brimonidine. The IOP LE was then normalized with the application of 2% pilocarpine. During the follow-up period, the AC of the LE showed progressive shallowing, and 5 months post LPI the IOP became uncontrollable. Goniosynechialysis combined with phacoemulsification, lamellar sclerectomy, sclerostomy, peripheral iridectomy, capsulotomy, and anterior vitrectomy were performed LE. Immediately after surgery, the AC deepened and the IOP stabilized. However, the IOP rose again post-surgically at 1 week and again at 2 months. A generally shallow AC and obstructed capsule hole were present. YAG laser capsulotomy was performed, and the IOP normalized and the AC deepened. Eighteen months after surgery, the IOP LE was 12 mmHg and the AC remained stable. Conclusion: Goniosynechialysis combined with multiple surgical procedures could be considered an alternative treatment regimen for nanophthalmos patients with secondary glaucoma and extensive angle synechia.
Effectiveness of percutaneous posterior tibial nerve stimulation for the management of bowel dysfunction in multiple sclerosis patients
Authors: Sacco Rosaria , Braga Andrea , Disanto Giulio , Digesu Giuseppe Alessandro , Maino Paolo , Koetsier Eva , Caccia Giorgio , Serati Maurizio , Renard Julien , Gobbi Claudio , Zecca Chiara 
Published: November 2020

Background: Neurogenic bowel dysfunctions (NBDs) in the form of both fecal incontinence (FI) and functional constipation (FC) are frequent in multiple sclerosis (MS) patients and significantly affect their quality of life. Therapeutic options are limited. Objective: To investigate effectiveness of percutaneous posterior tibial nerve stimulation (PTNS) in MS patients suffering from FI and FC. Methods: Prevalence and severity of FI and FC were prospectively collected among MS patients undergoing 12 weeks of PTNS for neurogenic bladder. The Cleveland Clinic Fecal Incontinence Score (CCFIS) and the Rome III criteria were used to define FI and FC, respectively. Subjective treatment satisfaction was estimated using the Benefit Satisfaction and Willingness to Continue (BSWC) questionnaire. Results: A total of 60 patients undergoing PTNS suffered from NBDs (25 FI+/FC+, 5 FI+/FC–, 30 FI–/FC+). Median CCFIS decreased after PTNS from 12.0 (11.0–13.0) to 8.5 (7.0–11.0, p < 0.001), with particular improvements in liquid and flatal incontinence, pads’ need, and lifestyle restrictions. Seven patients became FC free after PTNS and no patients developed FC during the study ( p = 0.023). More than 50% of the patients were satisfied and willing to continue PTNS at study end. Conclusion: PTNS represents a valid minimally invasive alternative treatment for MS patients suffering from NBDs.
Signal intensity pattern of the normal oculomotor nerve on contrast-enhanced 3D FLAIR at 3.0 T MRI
Authors: Sananmuang Thiparom , Boonsiriwattanakul Chanonporn , Panyaping Theeraphol 
Published: November 2020

Purpose The aim of this study was to depict the signal intensity pattern of the normal oculomotor nerve demonstrated on contrast-enhanced three-dimensional fluid-attenuated inversion recovery images. Materials and methods Eighty-one patients were included in the study. Contrast-enhanced three-dimensional fluid-attenuated inversion recovery images with magnetisation-prepared rapid acquisition were reconstructed and evaluated in the coronal plane. The signal intensity of the cisternal segment of the oculomotor nerve was graded into a visual scale of 1 to 5 as compared to the white matter, grey matter and the pituitary stalk. The signal intensity ratio of the oculomotor nerve was consequently measured. Results By using the visual scale, more than half of the oculomotor nerves showed higher signal intensity than the grey matter signal on contrast-enhanced three-dimensional fluid-attenuated inversion recovery images (59.3–80.2%). It can demonstrate a signal intensity similar to the pituitary stalk (14.8%) by visualisation. None of them showed signal intensity equal to the normal white matter signal. By signal intensity measurement, the mean signal intensity ratio of oculomotor nerves to white matter equals 1.54±0.20 (95% confidence interval (CI) 1.51–1.57); mean signal intensity ratio to grey matter equals 1.16±0.15 (95% CI 1.14–1.18); mean signal intensity ratio to the pituitary stalk equals 0.68±0.10 (95% CI 0.64–0.70). Conclusions The normal oculomotor nerve visualised on contrast-enhanced three-dimensional fluid-attenuated inversion recovery images has a higher signal intensity than the white matter and may have a signal intensity similar to the grey matter or the pituitary stalk. The high signal intensity of the oculomotor nerve in contrast-enhanced three-dimensional fluid-attenuated inversion recovery should not be misinterpreted as a pathology.
Seeker Uncinectomy: A Randomized Controlled Cadaveric Trial
Authors: Alromaih Saud , Sumaily Ibrahim , Alarifi Ibrahim , Alroqi Ahmad , Aloulah Mohammad , Ajlan Abdulrazag , Yaghmoor Faris , Alsaleh Saad 
Published: November 2020

Background Endoscopic sinus surgery is a common surgery, in which the uncinate process of the ethmoid is removed as the first surgical step. There are multiple techniques for uncinectomy. Herein we describe a new and simple uncinectomy technique. Methods We performed a randomised controlled trial with blinded assessors. Eight cadaveric heads were used to compare the new technique to the commonly used technique; retrograde uncinectomy. The procedures were performed by 2 rhinologists, and the findings were evaluated by 2 senior rhinologists blinded to the technique and the surgeon who did. They assessed the final view of the procedure and the complications. Thereafter, they assessed the procedure for the duration and ease of each technique for teaching purposes. Results Fifteen uncinectomies were performed, 7 using the retrograde technique, and 8 using the new technique. The mean durations were 5.64 min using the seeker uncinectomy and 7.57 min using the retrograde uncinectomy, p-value = 0.017. The completion was better in seeker uncinectomy; however, not significant statistically, p > 0.05. The complications with the new technique were inferior turbinate injury in 12.5% and natural ostium non-identification in 12.5%, p > 0.05. With retrograde uncinectomy, lacrimal injury occurred in 14.3%, p > 0.05. The ease of teaching scores was higher for the seeker uncinectomy. Conclusion Based on this cadaveric trial, seeker uncinectomy seems to be a safe and easy to perform technique. However, injury to the inferior turbinate and missing the natural ostium must be taken into consideration. These warrant further studies on the clinical application of this procedure.
Assessment of chronic bronchitis and risk factors in young adults: results from BAMSE
Authors: Wang Gang , Hallberg Jenny , Um Bergström Petra , Janson Christer , Pershagen Göran , Gruzieva Olena , van Hage Marianne , Georgelis Antonios , Bergström Anna , Kull Inger , Lindén Anders , Melén Erik 
Published: November 2020

BackgroundChronic bronchitis is associated with substantial morbidity among elderly adults, but little is known about its prevalence and risk factors in young adults. Our aim was to assess the prevalence and early-life risk factors for chronic bronchitis in young adults.MethodsQuestionnaire data and clinical measures from the 24-year follow-up of the Swedish BAMSE (Child (Barn), Allergy, Milieu, Stockholm, Epidemiological) cohort were used. We assessed chronic bronchitis (CB) as the combination of cough and mucus production in the morning during winter. Environmental and clinical data from birth and onwards were used for analyses of risk factors.ResultsAt the 24-year follow-up, 75% (n=3064) participants completed the questionnaire and 2030 performed spirometry. The overall prevalence of CB was 5.5% (n=158) with similar estimates in males and females. 49% of CB cases experienced more than three self-reported respiratory infections in the past year compared to 18% in non-CB subjects (p<0.001), and 37% of cases were current smokers (versus19% of non-CB cases). Statistically significant lower post-bronchodilator forced expiratory volume in 1 s/forced vital capacity were observed in CB compared to non-CB subjects (mean z-score −0.06versus0.13, p=0.027). Daily smoking (adjusted (a)OR 3.85, p<0.001), air pollution exposure (black carbon at ages 1–4 years aOR 1.71 per 1 μg·m−3increase, p=0.009) and exclusive breastfeeding for ≤4 months (aOR 0.66, p=0.044) were associated with CB.ConclusionChronic bronchitis in young adults is associated with recurrent respiratory infections. Besides smoking, our results support the role of early-life exposures, such as air pollution and exclusive breastfeeding, for respiratory health later in life.
Effect of thoracic paravertebral nerve block on the early postoperative rehabilitation in patients undergoing thoracoscopic radical lung cancer surgery
Authors: Kang Kang , Meng Xing , Li Bing , Yuan Jingli , Tian Erhu , Zhang Jiaqiang , Zhang Wei 
Published: November 2020

Abstract
Objective
To evaluate the effect of thoracic paravertebral nerve block on early postoperative rehabilitation in patients undergoing radical thoracoscopic surgery for lung cancer.

Methods
Ninety patients scheduled for elective video-assisted thoracoscopic lobectomy of lung cancer were divided into 2 groups: the general anesthesia group (GA group, n = 45) and the TPVB group (TP group, n = 45). The primary outcome was the decline rate of the 6-min walking test (6MWT); the second outcomes were as follows: absolute value and the completion rate of 6MWT, postoperative analgesia deficiency and pain scores, oxycodone consumption, sleep quality, the incidence of postoperative pulmonary complications, and the hospital stay.

Results
Compared with the GA group, the TP group had a lower decline rate of the 6MWT on POD1 and POD2. The walking distance on POD1 and POD2 in the TP group was significantly longer than that in the GA group; the completion rate at POD1 in the TP group was higher than that in the GA group. The pain scores and oxycodone consumption at POD1 in the TP group were lower than the GA group. The sleep quality in the TP group was higher than the GA group.

Conclusions
TPVB can significantly improve postoperative rehabilitation in patients undergoing thoracoscopic radical lung cancer surgery, which is helpful for promoting the early recovery of patients.

Trial registration
Chinese Clinical Trial Registry, ChiCTR1900026213. Registered 26 Sept. 2019, http://www.chictr.org.cn/showproj.aspx?proj=43733.
Construction of invariant solutions and conservation laws to the $(2+1)$-dimensional integrable coupling of the KdV equation
Authors: Gao Ben , Yin Qinglian 
Published: November 2020

AbstractUnder investigation in this paper is the $(2+1)$
(
2
+
1
)
-dimensional integrable coupling of the KdV equation which has applications in wave propagation on the surface of shallow water. Firstly, based on the Lie symmetry method, infinitesimal generators and an optimal system of the obtained symmetries are presented. At the same time, new analytical exact solutions are computed through the tanh method. In addition, based on Ibragimov’s approach, conservation laws are established. In the end, the objective figures of the solutions of the coupling of the KdV equation are performed.
The market for amino acids: understanding supply and demand of substrate for more efficient milk protein synthesis
Authors: Pszczolkowski Virginia L. , Arriola Apelo Sebastian I. 
Published: November 2020

AbstractFor dairy production systems, nitrogen is an expensive nutrient and potentially harmful waste product. With three quarters of fed nitrogen ending up in the manure, significant research efforts have focused on understanding and mitigating lactating dairy cows’ nitrogen losses. Recent changes proposed to the Nutrient Requirement System for Dairy Cattle in the US include variable efficiencies of absorbed essential AA for milk protein production. This first separation from a purely substrate-based system, standing on the old limiting AA theory, recognizes the ability of the cow to alter the metabolism of AA. In this review we summarize a compelling amount of evidence suggesting that AA requirements for milk protein synthesis are based on a demand-driven system. Milk protein synthesis is governed at mammary level by a set of transduction pathways, including the mechanistic target of rapamycin complex 1 (mTORC1), the integrated stress response (ISR), and the unfolded protein response (UPR). In tight coordination, these pathways not only control the rate of milk protein synthesis, setting the demand for AA, but also manipulate cellular AA transport and even blood flow to the mammary glands, securing the supply of those needed nutrients. These transduction pathways, specifically mTORC1, sense specific AA, as well as other physiological signals, including insulin, the canonical indicator of energy status. Insulin plays a key role on mTORC1 signaling, controlling its activation, once AA have determined mTORC1 localization to the lysosomal membrane. Based on this molecular model, AA and insulin signals need to be tightly coordinated to maximize milk protein synthesis rate. The evidence in lactating dairy cows supports this model, in which insulin and glucogenic energy potentiate the effect of AA on milk protein synthesis. Incorporating the effect of specific signaling AA and the differential role of energy sources on utilization of absorbed AA for milk protein synthesis seems like the evident following step in nutrient requirement systems to further improve N efficiency in lactating dairy cow rations.
A late Holocene record of marine high-energy events along the Atlantic coast of Morocco: new evidences from the Tahaddart estuary
Authors: Khalfaoui Otmane , Dezileau Laurent , Degeai Jean-Philippe , Snoussi Maria 
Published: November 2020

Abstract
The Atlantic coast of Morocco has been exposed to marine submersion events from storm surges and tsunamis which have resulted in human and economic losses. The absence of long term records for these hazards makes it difficult to trace their behavior through time, which is the first step to prepare proactive adaptation strategies for events that may happen in the future. In this paper, we present a late Holocene record of marine submersion events along the Atlantic coast of Morocco using a 2.7 m sediment core sampled from the Tahaddart estuary. The sedimentological and geochemical analyses conducted on this geological archive showed a mud-dominated sequence with 14 allochthonous sandy layers (E1-E14) left by marine high-energy events. The deposition age of three layers (E1, E13 and E14) has been determined using conventional dating methods (210Pbex, 137Cs and 14C). The first layer, introduced as E1 seems to fit with the great Lisbon tsunami in 1755 CE (Common Era), an event dated for the first time along the Atlantic coast of Morocco. The other two layers, referred to as E13 and E14, were dated between 3464 and 2837 cal BP (calibrated years Before Present) and chronologically correlated with marine high-energy deposits found on the Spanish Atlantic coast. This correlation confirms the existence of another regional event around 3200 BP.
Characterization of the interatrial septum by high-field cardiac MRI: a comparison with multi-slice computed tomography
Authors: Elagha Abdalla , Othman Yaseen , Darweesh Reham , Awadein Ghada , Hashad Assem 
Published: November 2020

Abstract
Background
Assessment of the interatrial septum (IAS) has become an attractive area of interest for a variety of important interventional procedures. Newer imaging modalities like multi-slice computed tomography (MSCT) and cardiac MRI (CMR) can provide higher resolution and wider field of view than echocardiography. Moreover, high-field (3-Tesla) CMR can even enhance spatial and temporal resolution.
The characteristics of the interatrial septum were retrospectively studied in 371 consecutive subjects (201 men, 31–73 years old) in whom MSCT was performed primarily for non-invasive evaluation of the coronary arteries. All subjects underwent both MSCT and MRI scans within 0–30 day’s interval. A 3D volume covering the whole heart was acquired across the heart with and without contrast enhancement. Also, patients underwent cardiac MSCT examinations using 64-row MSCT scanners.

Results
The mean scan time of MSCT was 10.4 ± 2.8 s and 9.7 ± 2.9 min for CMR. The mean length of IAS by CMR and CT was 39.65 ± 4.6 mm and 39.28 ± 4.7 mm, respectively. The mean maximal thickness of IAS by CMR and CT was 3.1 ± 0.97 mm and 3.15 ± 0.95 mm, respectively. The mean thickness of fossa ovalis by CMR and CT was 1.04 ± 0.36 mm and 1.04 ± 0.44 mm, respectively. The mean length of fossa ovalis by CMR and CT was 12.8 ± 3.7 mm and 12.8 ± 3.5 mm, respectively. Finally, the mean angle of IAS by CMR and CT was identical (155 ± 9.2°). Measurements of various morphological features of IAS showed no statistically significant difference between CMR and CT, with an excellent correlation and close relationship regarding IAS length, maximal IAS thickness, fossa ovalis thickness, fossa ovalis length, and IAS angle (r = 0.98, 0.98, 0.95, 0.96, and 0.92, respectively).

Conclusion
Whole-heart 3D acquisition at 3-T MRI using a free-breathing technique provides a valuable non-invasive imaging tool for excellent assessment of the interatrial septum—as compared to MSCT—that may have significant clinical implication for diagnostic purposes and therapeutic interventional procedures, as it may facilitate planning, improve outcome, and shorten its duration.