bluuebunny/crossref_metadata_2025_split huggingface dataset:
Translation and Validation of Kannada Version of the Dysphagia Handicap Index
Authors: Krishnamurthy Rahul , Balasubramanium Radish Kumar 
Published: January 2020

Background
The Dysphagia Handicap Index (DHI) is a 25-item questionnaire that assesses the quality of life among individuals with dysphagia. The aim of this study was to translate and validate the Kannada version of DHI (DHI-K).

Method
Eighty-eight individuals with dysphagia and an equal number of healthy individuals filled out the DHI-K. Internal consistency and test–retest reproducibility were used for reliability testing. Validity was established by comparing DHI-K scores of patients with dysphagia and healthy controls.

Results

The overall Cronbach's α for DHI-K was .81, indicating good internal consistency. Cohen's κ agreement for test–retest reliability of self-perceived severity was found to be .9. Correlation between subscales of DHI and self-perceived severity was analyzed using Spearman correlation coefficient and was found to very high. The control group has significantly lower scores for all scales when compared to the dysphagia group (physical:
t
(174) = 31.74,
p
< .001; functional:
t
(174) = 32.65,
p
< .001; emotional:
t
(174) = 36.3,
p
< .001; total:
t
(174) = 34.08,
p
< .001).

Conclusions
This study demonstrates that DHI-K has good internal consistency, test–retest reliability, and concurrent validity. The results of the study also reveal that it is a reliable and valid tool for assessment of handicap in Kannada-speaking dysphagia population.
Measuring Hyoid Excursion Across the Life Span: Anatomical Scaling to Control for Variation
Authors: Brates Danielle , Steele Catriona M. , Molfenter Sonja M. 
Published: January 2020

PurposeA method for controlling for sex-based differences in measures of hyoid movement using an internal anatomical scalar has been validated in young healthy individuals. Known anatomical changes with aging necessitate validation of this methodology in a mixed-age sample. The primary aim of this study was to validate a method for controlling for sex-based differences in measures of hyoid movement across the life span. Measurement error as a potential source of variability was addressed to inform best practice recommendations.MethodTwo distinct data sets previously collected using identical protocols were combined for this study to achieve a data set of young (< 40 years) and older (> 65 years) healthy adults. Data included videofluoroscopic swallow studies with three swallow trials each of 5 and 20 ml thin liquid barium. Previously reported methodology was replicated to validate the use of an anatomical scalar for measuring hyoid excursion in this sample. Hyoid movement was measured using 2 methods (rest-to-peak displacement and peak only) in 3 planes of movement (anterior, superior, and hypotenuse), was expressed in millimeters and individually scaled units relative to C4, and normalized using the C2–C4 vertebral distance. Mixed-model repeated-measures analyses of variance were run with each of the 6 hyoid measures as the dependent variable (in both millimeters and C2–C4 units), within-subject factors of sex and bolus volume, and a between-subjects factor of age group. We predicted that the C2–C4 scalar would adequately control for sex-based differences across age groups.ResultsSignificant differences in absolute hyoid movements (millimeters) were observed by sex, bolus volume, and age group. When measured in %C2–C4 units, all differences between males and females were neutralized. Significant differences between 5- and 20-ml boluses were found for all peak position measures. Significant differences between young and older individuals were found for all peak position measures.ConclusionExpressing hyoid excursion as a percentage of the C2–C4 distance appears valid for use across the life span. Peak position is preferable over displacement measures for quantifying hyoid excursion for research and clinical purposes.
Vocal Loudness Variation With Spectral Slope
Authors: Titze Ingo R. , Palaparthi Anil 
Published: January 2020

Objective
This investigation addresses the loudness variations in sones achievable with spectral slope variations (higher harmonic energy) in human vocalization and compares it to the sound pressure level (SPL) variations typically reported in the voice range profile (VRP).

Method
The primary methodology was computational. The ISO standard 226 was used to convert SPL values to sones for a 125- to 1000-Hz range of fundamental frequency and a –3 dB/octave to –12 dB/octave range of spectral slope. In addition, a retrospective analysis of human subjects' VRPs was conducted, and the experimental results were compared to the theoretical results.

Results
A very small range of SPL variation (less than 5 dB) in the VRP can produce a large range of loudness. The sensitivity can be on the order of 4 sones per dB SPL change.

Conclusion
For vocalization in the modal register, loudness variation is not well described by SPL change in dB, especially at high fundamental frequencies where the SPL range in the VRP becomes very small but sizeable loudness variations are still possible.
Why binary interaction does not necessarily dominate the formation of Wolf-Rayet stars at low metallicity
Authors: Shenar T. , Gilkis A. , Vink J. S. , Sana H. , Sander A. A. C. 
Published: January 2020

Context. Classical Wolf-Rayet (WR) stars are massive, hydrogen-depleted, post main-sequence stars that exhibit emission-line dominated spectra. For a given metallicity Z, stars exceeding a certain initial mass MsingleWR(Z) can reach the WR phase through intrinsic mass-loss or eruptions (single-star channel). In principle, stars of lower masses can reach the WR phase via stripping through binary interactions (binary channel). Because winds become weaker at low Z, it is commonly assumed that the binary channel dominates the formation of WR stars in environments with low metallicity such as the Small and Large Magellanic Clouds (SMC, LMC). However, the reported WR binary fractions of 30−40% in the SMC (Z = 0.002) and LMC (Z = 0.006) are comparable to that of the Galaxy (Z = 0.014), and no evidence for the dominance of the binary channel at low Z could be identified observationally. Here, we explain this apparent contradiction by considering the minimum initial mass MspecWR(Z) needed for the stripped product to appear as a WR star.
Aims. By constraining MspecWR(Z) and MsingleWR(Z), we estimate the importance of binaries in forming WR stars as a function of Z.
Methods. We calibrated MspecWR using the lowest-luminosity WR stars in the Magellanic Clouds and the Galaxy. A range of MsingleWR values were explored using various evolution codes. We estimated the additional contribution of the binary channel by considering the interval [MspecWR(Z), MsingleWR(Z)], which characterizes the initial-mass range in which the binary channel can form additional WR stars.
Results. The WR-phenomenon ceases below luminosities of log L ≈ 4.9, 5.25, and 5.6 [L⊙] in the Galaxy, the LMC, and the SMC, respectively, which translates to minimum He-star masses of 7.5, 11, 17 M⊙ and minimum initial masses of MspecWR = 18, 23, 37 M⊙. Stripped stars with lower initial masses in the respective galaxies would tend not to appear as WR stars. The minimum mass necessary for self-stripping, MsingleWR(Z), is strongly model-dependent, but it lies in the range 20−30, 30−60, and ≳40 M⊙ for the Galaxy, LMC, and SMC, respectively. We find that that the additional contribution of the binary channel is a non-trivial and model-dependent function of Z that cannot be conclusively claimed to be monotonically increasing with decreasing Z.
Conclusions. The WR spectral appearance arises from the presence of strong winds. Therefore, both MspecWR and MsingleWR increase with decreasing metallicity. Considering this, we show that one should not a-priori expect that binary interactions become increasingly important in forming WR stars at low Z, or that the WR binary fraction grows with decreasing Z.
Endoscopic sleeve gastroplasty in the management of weight regain after sleeve gastrectomy
Authors: de Moura Diogo Turiani Hourneaux , Barrichello Jr Sérgio , de Moura Eduardo Guimarães Hourneaux , de Souza Thiago Ferreira , dos Passos Galvão Neto Manoel , Grecco Eduardo , Sander Bruno , Hoff Anna Carolina , Matz Felipe , Ramos Flávio , de Lima João Henrique Felício , Teixeira Leonardo , Dib Victor , Falcão Marcelo , Potti Helmut , Baretta Giorgio , Jirapinyo Pichamol , Thompson Christopher C. 
Published: January 2020

Abstract
Background Sleeve gastrectomy is a well-standardized surgical treatment for obesity. However, rates of weight regain after sleeve gastrectomy in long-term follow-up are relatively high. This multicenter study is the first to evaluate the use of an endoscopic sleeve gastroplasty (ESG) technique for the management of this population.
Methods This was a multicenter retrospective study, including patients with weight regain following sleeve gastrectomy who underwent ESG for weight loss. Primary outcomes included absolute weight loss, percent total weight loss (%TWL), change in body mass index (BMI), percent excess weight loss (%EWL) at 6 and 12 months, and safety profile. Clinical success was defined as achieving ≥ 25 % EWL at 1 year, ≤ 5 % serious adverse event (SAE) rate following society-recommended thresholds, and %TWL ≥ 10 %.
Results 34 patients underwent ESG after sleeve gastrectomy. Technical success was 100 %. At 1 year, 82.4 % and 100 % of patients achieved ≥ 10 %TWL and ≥ 25 % EWL, respectively. Mean (SD) %TWL was 13.2 % (3.9) and 18.3 % (5.5), and %EWL was 51.9 % (19.1) and 69.9 % (29.9) at 6 months and 1 year, respectively. Mean (SD) %TWL was 14.2 % (12.5), 19.3 % (5.3), 17.5 % (5.2), and 20.4 % (3.3), and %EWL was 88.5 % (52.8), 84.4 % (22.4), 55.4 % (14.8), and 47.8 % (11.2) for BMI categories of overweight and obesity class I, II, and III, respectively, at 1 year. No predictors of success were identified in the multivariable regression analysis. No SAEs were reported.
Conclusion ESG appears to be safe and effective in the management of weight regain following sleeve gastrectomy.
Comparison of preoperative infraorbital block with peri-incisional infiltration for postoperative pain relief in cleft lip surgeries
Authors: Gaonkar V. , Daftary Swati R. 
Published: January 2020

ABSTRACTIn this prospective, randomized study, children undergoing cleft lip surgery were either given infra-orbital nerve block (n=25) or peri-incisional infiltration (n=25) pre-operatively with 0.25% bupivacaine in 1:2,00,000 adrenaline.The overall course of anesthesia in both the groups was smooth, with excellent hemodynamic stability, indicating better pain relief during the intra-operative period. The concentration of the anesthetic agent required was reduced and recovery from anesthesia was rapid and complete. There was excellent postoperative analgesia. The children were calm and comfortable postoperatively.We conclude that infra-orbital nerve block with 0.25% bupivacaine with adrenaline provides more prolonged analgesia than peri-incisional infiltration in cleft lip repair. Infra-orbital block given by modified approach is easy to perform and free of side-effects.
Profile of Laryngeal Microsurgeries in Patients Over 60 Years Old
Authors: Rimoli Caroline Fernandes , Macedo Filho Evaldo Dacheux , Patrial Maria Theresa Costa Ramos Oliveira , Klas Cynthia Fontoura , Nascimento Giovana Aryane 
Published: January 2020

Abstract
Introduction The increase in life expectancy is an incentive to the development of researches with the elderly population aiming at actions that may ensure healthy and active aging.
Objective To analyze the profile of laryngeal microsurgery performed in patients > 60 years old.
Methods A retrospective observational study, with a cross-sectional design. A retrospective analysis of the medical records of elderly patients submitted to laryngeal microsurgery was performed at a private hospital in Curitiba, state of Paraná, Brazil, between January 2004 and December 2016. Were included all of the patients > 60 years old that underwent laryngeal microsurgery during this period.
Results During the studied period, 213 laryngeal microsurgeries were performed in 181 patients > 60 years old. There was a preponderance of male patients. The mean age was 67.6 years old. Squamous cell carcinoma (SCC) was the most prevalent disorder (26%), followed by Reinke edema (20%), papillomatosis (14%), polyps (11%), leukoplakia (8%), minor structural alterations (8%), associated lesions (9%), and others (4%). Men presented a higher probability of SCC diagnosis, regardless of the age group, while Reinke edema was more frequently observed in women. A directly proportional relation between the frequency of laryngeal cancer and age increase was also observed. No significant differences were observed in professional voice users.
Conclusion Further researches are required to properly comprehend the factors associated with laryngeal lesions and determine prevention and treatment approaches.
Circumferential skin defect - Ilizarov technique in plastic surgery
Authors: Madhuri Vrisha , Kurpad R Shankar , Nithyananth Manasseh , Jepegnanam S Thilak , Titus V. T.K. , Dhanraj Prema 
Published: January 2020

ABSTRACTA young man had an open fracture of the tibia with bone and soft tissue loss in the distal part of the left leg following a crush injury. The circumferential skin defect was successfully treated with controlled lengthening of the distal skin by the Ilizarov technique using nylon wires and skin staples to apply traction. This was combined with limb reconstruction done simultaneously using orthofix external fixator. This case report highlights the use of an orthopaedic technique to provide skin cover in distal leg.
Large lateral thoracic defect by chondrosarcoma resection chest wall reconstruction using myocutaneous latissimus dorsal flap without parietal rigid repair
Authors: Guerrissi Jorge O 
Published: January 2020

ABSTRACTA case of a 66 year-old women, with a large chondrosarcoma arising from right lateral chest wall is presented. Parietal pleura, 3rd, 4th, 5th and 6th ribs (lateral arch), underlying muscle, subcutaneous tissues and the right breast were also involved by the tumor. Surgical resection was planned including skin, right breast, 3rd, 4th, 5th and 6th lateral rib arches and parietal pleura; a wide defect was created with exposure of lung. Reconstruction was planned by means of an extensive myocutaneous dorsal flap pedicled on right thoracodorsal vessels; alloplastic mesh for parietal chest wall reconstruction was not used. Two years postoperative results showed no local recurrence and excellent aesthetic and functional results were evident; respiratory function remained unaltered.The progressive rigidity reached by the reconstructed lateral chest wall, allowed us to conclude that the use of myocutaneous flap is enough to avoid paradoxical respiratory movements and any type of alloplastic mesh is unnecessary.
Mammograms in cosmetic breast surgery
Authors: Shiffman M A 
Published: January 2020

ABSTRACTMammograms are necessary as preoperative preparation for breast surgery in certain patients. There is a definite need for mammograms preoperatively in patients over 40 who should be obtaining mammograms on an annual basis. Under the age of 40 mammograms are up to the discretion of the surgeon. Postoperative mammograms should be obtained as a baseline 6-12 months after breast surgery.
Wound coverage of plantar metatarsal ulcers in leprosy using a toe web flap
Authors: Joshua J , Chakraborthy V 
Published: January 2020

ABSTRACTPlantar metatarsal ulcers and sinuses are frequently seen problems in anaesthetic feet in leprosy. They may occur singly or as multiple sinuses. Many flaps have been described in the management of small defects of the forefoot. During the course of four years, from March 2000 to February 2004, a total of 708 plantar metatarsal ulcers in anaesthetic feet due to leprosy were seen. 280 surgeries were performed on 257 cases. Most of these were debridement and or excision of the metatarsophalangeal joints through a dorsal incision. Thirteen cases were dealt with by a toe web flap, using the plantar metatarsal artery as the source of supply to the flap. Nine were to cover defects under the 1st metatarsophalangeal joint. Three were to cover defects under the second and third metatarsophalangeal joints and one involved coverage of a defect under the 5th metatarsophalangeal joint. In all cases except the last, the big toe contributed the flap. In the last case the fourth toe was the donor. In all cases the flaps survived and did well. The secondary defects were covered with split thickness skin graft. Wound dehiscence was seen in one case and recurrence of a sinus, was seen in one case. Hyperkeratosis of the secondary defect was seen in three cases. Follow up ranged from 3 years to six months. We found this flap to be durable and safe with little chance of recurrence when used to cover plantar metatarsal ulcers.
′Sure closure′-skin stretching system, our clinical experience
Authors: Subramania K I , Mohit S , Sasidharan P R , Abraham M K , Arun P , Kekatpure V 
Published: January 2020

ABSTRACT
Objective: In clinical practice of reconstructive surgery one of the problems one routinely comes across is skin and soft tissue defects, which require coverage. Coverage of such wounds requires primary/secondary closure, skin grafting or flaps. The objective of our clinical series was to assess the efficacy of sure closure skin stretching system for closure of defects which otherwise would have required major flap cover or skin grafting.
Methods: Our series included five patients with different causes and types of wound defects namely:1. Post-traumatic soft tissue defect on dorsum of hand.2. Post fasciotomy wound on leg (anterolateral aspect).3. Abdominal wound dehiscence following surgery for enterocutaneous fistula.4. Leg soft tissue defect following dehiscence of fasciocutaneous flap.5. Secondary defect following harvesting a lateral arm/forearm free flap.The device was applied to skin edges after preparing the wound under local anesthesia and the skin edges were brought together by turning the skin-stretching knob. After adequate approximation of the edges of the wound it was sutured by conventional suturing techniques.Results: All the wounds could be successfully closed using the skin stretching system in our series. The time taken for the closure ranged from 2 to 48 h.
Conclusions: Sure closure skin stretching system is an effective device for closing some of the skin defects which otherwise would have required skin flaps or grafts. In all the patients wound closure could be achieved by this method and was carried out under local anesthesia. Use of this technique is simple and helps to reduce the morbidity and cost of treatment by allowing the reconstructive surgeon to avoid using major flaps or grafts.
Giant trochanteric pressure sore: Use of a pedicled chimeric perforator flap for cover
Authors: Mehrotra Sandeep 
Published: January 2020

ABSTRACTPressure sores are increasing in frequency commensurate with an ageing population with multi-system disorders and trauma. Numerous classic options are described for providing stable wound cover. With the burgeoning knowledge on perforator anatomy, recent approaches focus on the use of perforator-based flaps in bedsore surgery. A giant neglected trochanteric pressure sore in a paraplegic is presented. Since conventional options of reconstruction appeared remote, the massive ulcer was successfully managed by a chimeric perforator-based flap. The combined muscle and fasciocutaneous flaps were raised as separate paddles based on the anterolateral thigh perforator branches and provided stable cover without complications. Perforators allow versatility in managing complex wounds without compromising on established principles.
An Internet-based discussion forum as a useful resource for the discussion of clinical cases and an educational tool
Authors: Foong Deborah P. S. , McGrouther Duncan A. 
Published: January 2020

ABSTRACT
Introduction: An Internet-based group of plastic surgeons was formed in India in February 2001. It has 1290 members and seeks to facilitate online discussion. These discussions were reviewed to assess their value in education and aiding patient management. Materials and Methods: All messages and discussions between August 2007 and July 2008 were examined retrospectively. Data were collected regarding topics, replies, and use of clinical images. Results: A total of 2217 messages were exchanged within 330 separate discussions (mean = 6.7 messages per discussion, range = 0–45). A total of 164 discussions contained photographs (50%). Mean number of photographs per discussion was five (range = 0–34). Discussions included requests for advice on complex cases (40%), interesting cases and their management/outcome (25%) and courses/conferences (30%). Topics discussed include training/courses (26.7%), cleft (15.4%), aesthetics (13.1%), trauma (12.5%), head and neck (8.4%), cutaneous (6.4%), perineal/genital reconstruction (6.1%), and scar management (4.7%). Discussion: Forums like this facilitate discussion between individuals in remote locations. They provide easy access to the expertise of a large cohort of highly experienced surgeons. Most discussions were clinical, involving challenging situations. The discussions are open and nonjudgmental, hence encouraging contribution and healthy debate. We encourage its use as an educational tool and a platform for discussion.
“Nara” knot for suturing of cleft lip in children to make removal easy
Authors: Obaidullah G , Mohammed Aslam 
Published: January 2020

AbstractCleft patients usually go through a lifetime of repeated hospital admissions and multiple procedures. Suture removal at a tender age and on a sensitive area like the lip becomes a challenge for the nursing staff. It is also emotionally demanding on the part of the parents. Hence, in most centres these patients are at least sedated if not anaesthetised. We have been using a simple knot and running prolene material so that undoing of the knot becomes easy and suture removal more or less atraumatic. We would like to share our experience with readers through this article. An analysis of 53 cleft lip repairs has shown that this knot is safe and easily removable.
A contrastive analysis of reports on North Korea’s missile program
Authors: Liang Weishan 
Published: January 2020

Abstract
The paper compares the representation of the November 2017 missile test in news reports by The New York
Times and China Daily. The U.S. reports embody to some extent a Cold War mindset by tending to
internationalize the issue and make itself appear as a victim of the crisis. Through the attribution of blame, the U.S. seeks to
evade its responsibilities and maintain its hegemonic status. The Chinese reports intimate that the crisis is mainly a problem
between the U.S. and the Korean Peninsula. These reports tend to present China as a responsible stakeholder seeking to help solve
the issue through communication and dialogue. The analysis of these differences is informed theoretically by perceived differences
in culture. The paper concludes that the discourse patterns of these reports index a rising China and a shift in the balance of
power in international politics.