bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Morphological Characteristics of the Human Ear in Young Adults
Authors: Rani Deepika , Krishan Kewal , Sahani Ramesh , Baryah Neha , Kanchan Tanuj 
Published: April 2020

Introduction and Objectives:
Human external ear is a morphologically complex structure and plays a vital role in the collection of sound. The present study would provide the information regarding the shape and size of the various morphological structures of the ear in normal individuals which may help the plastic surgeons to reconstruct the anatomy of the deformed ear and the physical and forensic anthropologists to study variations and establishing its use as a biometrics. The aim of the study was the morphological examination of the ear and its features to investigate the biological variations, sex differences, bilateral variations and further attempt to provide a database of external ears of a normal north Indian population.

Methods:
A cross-sectional sample of 71 males and 69 females aged between 18 to 25 years were collected from Nahan city of Sirmaur District in Himachal Pradesh state of North India. Various anthroposcopic parameters were considered and evaluated through personal observation such as ear shape, form of the helix, lobule shape and its attachment to the cheeks, strength of the anti-helix, etc and were sub-divided on the basis of form, shape, elevation, etc. The SPSS statistic (IBM, Armonk, NY) software version 16 was used to evaluate the sexual dimorphism and bilateral differences.

Results and Conclusion:
The frequencies of various morphological characters of the human external ear were calculated using Crosstabs. The results indicate the oval and round shaped ears were reported in 37.3%; 35.92% males and 23.92%; 38.41% females, respectively. Normally rolled helix was more frequent (73.24% in males and 84.06% in females) and possessed frequently occurring Darwin's tubercle with nodosity form (88.03% in males and 90.58% in females). Hypertrichosis was mostly present on the complete helix in case of males (66.20%). Single knob tragus (40.14% in males and 52.90% in females) and double knob tragus (33.10% in males and 36.23% in females) were found to be with higher frequency in the studied population. Partially free earlobes (53.52% in males and 46.38% in females) were more common than the attached one (38.03% in males and 47.83% in females) in case of males only. The present study provides a database of morphoscopy of the external ears of North Indian population. The database may be useful in the reconstruction of the deformed ears and in the anthropological and forensic research for comparison purposes. The study may also be utilized in the prediction of ear shape and size of the studied population for facial reconstruction in forensic examinations.
Surgical Outcomes of Endoscopic Conjunctivodacryocystorhinostomy Using a Castroviejo Double-Ended Lacrimal Dilator
Authors: Woo Minji , Yang Sungwon , Park Jinhwan , Lee Hwa , Baek Sehyun 
Published: April 2020

Purpose:
The aim of this study was to describe the surgical method of endoscopic conjunctivodacryocystorhinostomy with Jones tube insertion using a Castroviejo double-ended lacrimal dilator and to elucidate the surgical outcomes.

Methods:
Under general anesthesia and preoperative epinephrine soaking, a monopolar needle cautery instrument was used to remove the nasal mucosa over the lacrimal and maxillary bone junction. After the lacrimal and maxillary bone junction was exposed, an oval osteotomy was formed. A Castroviejo double-ended lacrimal dilator was then inserted to create a direct fistula from the conjunctiva to the nasal cavity through the bony ostium. The dilator was grasped and withdrawn using smooth forceps to determine the tube length. The selected tube was then inserted into the fistula with a guide probe. Following removal of the probe, the inserted tube was fixed with 7-0 Ethilon suturing.

Results:
Among 39 patients, a total of 49 cases were examined. The success rate was 73.4% (36/49 eyes). The average surgical time was 29.1 minutes for single-eye operations and 47.3 minutes for double-eye operations. Lateral migration (6/13; 46.2%), medial migration (3/13; 23.1%), granulation tissue obstruction (2/13; 15.4%), inflammation (1/13; 7.7%), and malpositioning (1/13; 7.7%) were the noted complications that led to reoperation.

Conclusions:
In conclusion, surgical management of endoscopic conjunctivodacryocystorhinostomy using a Castroviejo double-ended lacrimal dilator has several advantages. Using this device, easier surgical procedure, shorter surgical time, and more favorable success rate can be achieved without serious complications.
Characterization of the Upper Tarsal Plate Growth in Children: Implication in Pediatric Eyelid Surgery
Authors: Park Seo Yeon , Baek Sehyun , Lee Hwa 
Published: April 2020

Introduction:
To measure the height, length, and area of the upper tarsal plate in Korean children between 6 months and 13 years of age and analyze growth of the tarsal plate.

Methods:
Children who underwent lower epiblepharon correction surgery and congenital nasolacrimal duct obstruction were included. Under general anesthesia, the upper eyelid was everted and a photograph was taken with a reference ruler using a digital camera. Tarsal plate central height, upper border length, lower border length, and area were measured using Image J software. Objectives were classified into 4 groups according to age. Mean analysis and comparison between groups were performed using the SPSS program.

Results:
One hundred two tarsal plates in 51 patients were measured. Mean central tarsal height was 6.92 ± 1.09 in the 0 to 3 years old group, 7.25 ± 0.81 in the 4 to 6 years old group, 7.64 ± 0.71 in the 7 to 9 years old group, and 8.11 ± 0.46 in the 10 to 13 years old group. The height and area of the tarsal plate gradually increased with age (P = 0.001), but the lower length of the 0 to 3 years old group differed from the other groups and showed abrupt increase between the 0 to 3 years and 4 to 6 years old groups (P < 0.001 by the Kruskall-Wallis test and post-hoc analysis). There was a statistically significant difference between the central tarsal height of 0 to 6 years old groups and that of the 10 to 13 years old groups (P = 0.001).

Conclusions:
The height and length of the tarsal plate increase in children with age and it reached adult size between the ages of 10 and 13 years. In the 0 to 3 years old group, tarsal height and length are shorter than that of the 10 to 13 years old group and this difference should be considered when performing upper lid surgery.
Delayed-Onset Familial Sagittal Suture Synostosis
Authors: Kitabata Reina , Sakamoto Yoshiaki , Miwa Tomoru , Yoshida Kazunari , Kishi Kazuo 
Published: April 2020

AbstractSagittal craniosynostosis is the most common of all craniosynostoses. Patients with sagittal craniosynostosis exhibit a typical cranial appearance, including scaphocephaly, and an elongated head, with a fused and ridged sagittal suture. Moreover, some recent reports described atypical sagittal craniosynostosis accompanied by autism, speech delay, and hyperactivity. This condition, known as delayed-onset craniosynostosis, is rarely reported, given that it is difficult to determine if the condition is congenital or has a delayed-onset.This report describes the clinical course and treatment of 2 brothers with atypical sagittal synostosis. The shapes of their heads were not indicative of scaphocephaly and the younger brother exhibited delayed-onset sagittal synostosis. Their father and paternal grandmother exhibited similar cranial morphologies. Therefore, we hypothesized the involvement of a familial factor in the etiology of atypical sagittal synostosis in these patients.
An Orbital Abscess Secondary to Intraoral Impalement
Authors: Glass Graeme Ewan , Neri Pedro Mattar , Abdulkader Faisal , Bradshaw Karen 
Published: April 2020

Abstract
Penetrating orbital trauma in the pediatric population is rare. Even more unusual is a secondary orbital infection following penetrating trauma. Here we present a highly unusual case of fulminant facial cellulitis with an orbital abscess in an otherwise healthy 3-year-old boy following a penetrating injury to the orbit from a point of entry on the gingiva-buccal sulcus, sustained during a fall while carrying a wooden lollipop stick. Examination of the retina revealed a focal injury at the inferior pole of the globe. The organisms cultured from pus sampled from the abscess and from the discharging intraoral wound revealed the same oral commensals while the MRI revealed a track in continuity with the orbital collection.
A three-tier Rescue stent improves outcomes over balloon occlusion in a porcine model of noncompressible hemorrhage
Authors: Go Catherine , Elsisy Moataz , Chun Youngjae , Thirumala Parthasarathy D. , Clark William W. , Cho Sung Kwon , Demetris Anthony J. , Tillman Bryan W. 
Published: April 2020

BACKGROUND
Noncompressible hemorrhage remains a high-mortality injury, and aortic balloon occlusion poses limitations in terms of distal ischemic injury. Our hypothesis was that a retrievable Rescue stent would confer improved outcome over aortic balloon occlusion.

METHODS
A three-tier, retrievable stent graft was laser welded from nitinol and polytetrafluoroethylene to provide rapid thoracic and abdominal coverage with an interval bare metal segment to preserve visceral flow. Anesthetized swine had injury of the thoracic or abdominal aorta followed by balloon occlusion or a Rescue stent. A 1-hour long damage-control phase with blood repletion was used to simulate the prolonged interval between injury and repair, especially in the battlefield setting. Following the damage-control phase, the balloon or stent were retrieved followed by vascular repair and recovery to 48 hours. Animals were compared in terms of hemodynamics, blood loss, neurophysiologic spinal cord ischemia, ischemic organ injury, and survival.

RESULTS
Despite antegrade hemorrhage control, balloon occlusion averaged 3.5 L of retrograde hemorrhage, loss of visceral perfusion, and permanent spinal cord ischemia by neurophysiology in six of seven animals. After permanent repair, all balloon occlusion animals died with only a single short term (5 hours) survivor. Conversely, Rescue stent animals revealed rapid hemorrhage control (in under 2 minutes) whether the injury was thoracic or abdominal with improved hemodynamics, preserved visceral flow, reduced spinal cord ischemia, negligible histologic organ injury and survival to end of study in all abdominal injured animals (n = 6) and four of six thoracic injured animals, with two deaths related to arrhythmia.

CONCLUSION
Compared with aortic balloon occlusion, a Rescue stent offers superior hemorrhage control and survival by virtue of reduced ischemic injury and direct control of the hemorrhagic injury. The Rescue stent may become a useful tool for damage control, especially on the battlefield where definitive repair presents logistical challenges.
Fresh frozen plasma attenuates lung injury in a novel model of prolonged hypotensive resuscitation
Authors: Chipman Amanda M. , Wu Feng , Pati Shibani , Burdette Alexander J. , Glaser Jacob J. , Kozar Rosemary A. 
Published: April 2020

BACKGROUND
Hemorrhagic shock remains a leading cause of early death among severely injured in both civilian and military settings. As future military operations will require strategies allowing prolonged field care of the injured, we sought to develop an in vivo model of prolonged hypotensive resuscitation (PHR) and to evaluate the role of plasma-based resuscitation in this model. We hypothesized that resuscitation with fresh frozen plasma (FFP) would mitigate lung injury when compared with Hextend in a rodent model of PHR.

METHODS
Mice underwent laparotomy and hemorrhagic shock (mean arterial blood pressure, 35 ± 5 mm Hg × 90 minutes) followed by PHR with either FFP or Hextend to maintain a mean arterial blood pressure of 55 mm Hg to 60 mm Hg for 6 hours. Sham animals underwent cannulation only. At the end of 6 hours, animals were euthanized, and lung tissue harvested for measurement of histopathologic injury, inflammation and permeability using hematoxylin and eosin staining, myeloperoxidase immunofluorescence staining and Evans Blue dye. Pulmonary syndecan-1 immunostaining was assessed as an indicator of endothelial cell integrity.

RESULTS
All animals in the FFP, Hextend, and sham groups survived to the end of resuscitation. Resuscitation with FFP mitigated lung histopathologic injury compared with Hextend (histologic injury score of 4.38 ± 2.07 vs. 7.5 ± 0.93, scale of 0–9, p = 0.002) and was comparable to shams (histologic injury score of 4.0 ± 1.93, scale of 0–9, p = 0.99). Fresh frozen plasma also reduced lung inflammation (0.116 ± 0.044 vs. 0.308 ± 0.054 relative fluorescence of myeloperoxidase, p = 0.002) and restored pulmonary syndecan-1 (0.514 ± 0.061 vs. 0.059 ± 0.021, relative syndecan-1 fluorescence, p < 0.001) when compared with Hextend. Consistently, FFP mitigated lung hyperpermeability compared with Hextend (7.30 ± 1.34 μg vs. 14.91 ± 5.55 μg Evans blue/100 mg lung tissue, p = 0.005).

CONCLUSION
We have presented a novel model of PHR of military relevance to the prolonged field care environment. In this model, FFP maintains its pulmonary protective effects using a PHR strategy compared with Hextend, which supports the need for further development and implementation of plasma-based resuscitation in the forward environment.

LEVEL OF EVIDENCE
Basic science.
Neuro-Ophthalmic Manifestations of Intracranial Malignancies
Authors: Dermarkarian Christopher R. , Kini Ashwini T. , Al Othman Bayan A. , Lee Andrew G. 
Published: April 2020

Background:
To describe the various neuro-ophthalmic presentations, key exam features, and clinical findings associated with 5 common primary and secondary intracranial malignancies.

Evidence Acquisition:
Retrospective PubMed search and review of published case reports, case series, observational studies, book chapters, and review articles examining the neuro-ophthalmic features of intracranial malignancies including primary glial neoplasms (e.g., glioblastoma multiforme), primary and secondary lymphoma, intracranial metastases, carcinomatous/lymphomatous meningitis, and intracranial germ cell tumors. The search strategy used to perform the retrospective review included the aforementioned tumor type (e.g., glioblastoma multiforme) and the following terms and Boolean operators: AND (“visual loss” OR “papilledema” OR “diplopia” OR “ophthalmoplegia” or “neuro-ophthalmology” OR “proptosis”).

Results:
The rate of growth and the location of an intracranial tumor are essential factors in determining the neuro-ophthalmic presentation of certain intracranial malignancies. Primary malignant brain glial neoplasms commonly present with visual afferent complaints (e.g., unilateral or bilateral visual acuity or visual field defects, bitemporal or homonymous hemianopsia), pupil abnormalities (relative afferent pupillary defect), and optic atrophy or papilledema. Primary intraocular lymphoma (with or without central nervous system lymphoma) typically presents as a painless bilateral vitritis. Secondary intracranial malignancies have variable afferent and efferent visual pathway presentations. Carcinomatous/lymphomatous meningitis is associated with diplopia (e.g., multiple ocular motor cranial neuropathies with or without vision loss from papilledema or compressive/infiltrative optic neuropathy). Intracranial germ cell tumors can present with a chiasmal syndrome or dorsal midbrain syndrome.

Conclusion:
Intracranial malignancies can present with neuro-ophthalmic symptoms or signs depending on topographical localization. Specific neuro-ophthalmic presentations are associated with different malignant intracranial tumors. Clinicians should be aware of the common malignant intracranial tumors and their associated clinical presentations in neuro-ophthalmology.
Does circadian rhythm disruption during their early development have lasting effects on cognition of the elder rats?
Authors: Zhang Yuge , Wang Wenzhu , Li Yi , Shen Jiayi , Zhang Tong 
Published: April 2020

Objectives
This study aimed to investigate the changes in learning and memory after chronic circadian disruption followed by a long period of circadian recovery.

Materials and methods
Eleven adult male spontaneously hypertensive rats were randomly divided into control group, 12-h light/12-h dark circadian disruption group (12L/12D) and 6-h light/6-h dark circadian disruption group (6L/6D). Rats in control group remained under the original 12-h light/12-h dark cycle throughout the experiment; rats in the 12L/12D group were exposed to 12-h light/12-h dark cycle with light–dark order changed every 3 days; rats in the 6L/6D group were exposed to 6-h light/6-h dark cycle. The disruption period continued for 18 weeks. Then after 8 weeks and 32 weeks of circadian re-entrainment, all animals were tested by Morris Water Maze (MWM), respectively, followed by an MRI examination.

Results
Rats in the 12L/12D group demonstrated longer escape latency and swim distance in the MWM test than rats in the other two groups (P < 0.05). The MRI results showed volume% reduction and concentration% decrease of brain regions in the two circadian disruptive groups, while the changes were more significant and comprehensive in the 12L/12D group (P < 0.05).

Conclusions
Circadian disruption during early life accelerates cognition decline in later life in rats. Frequent light–dark order shift is more harmful.
Distinct clinicopathological differences between early gastric cardiac and non-cardiac carcinomas: A single-center retrospective study of 329 radical resection cases
Authors: Wang Yao Hui , Li Xiu Qing , Gao Li Li , Wang Chen Xi , Zhang Yi Fen , Huang Qin 
Published: April 2020

AbstractBackgroundEarly gastric carcinoma is heterogeneous and can be divided into early gastric cardiac carcinoma (EGCC) and early gastric non-cardiac carcinoma (EGNCC) groups. At present, differences in clinicopathology remains obscure between EGCC and EGNCC fundus-corpus and antrum-angularis-pylorus subgroups, especially between EGCC with and without esophageal invasion.MethodsIn this study, we studied 329 consecutive early gastric carcinoma radical gastrectomies with 70 EGCCs and 259 EGNCCs.ResultsCompared to the EGNCC antrum-angularis-pylorus (n=181), but not fundus-corpus (n=78), sub-group, EGCC showed significantly older age, lower prevalence of the grossly depressed pattern, better tumor differentiation, higher percentage of tubular/papillary adenocarcinoma, but lower frequency of mixed poorly cohesive carcinoma with tubular/papillary adenocarcinoma, and absence of LNM in tumors with invasion up to superficial submucosa (SM1). In contrast, pure poorly cohesive carcinoma was less frequently seen in EGCCs than in EGNCCs, but mixed poorly cohesive carcinoma with tubular/papillary adenocarcinomas was significantly more common in the EGNCC antrum-angularis-pylorus sub-group than in any other group. No significant differences were found between EGCC and EGNCC sub-groups in gender, tumor size,H. pyloriinfection rate, and lymphovascular/perineural invasion. EGCC with oesophageal invasion (n=22), compared to EGCC without (n=48), showed no significant differences in theH. pyloriinfection rate and oesophageal columnar, intestinal, or pancreatic metaplasia, except for a higher percentage of the former in size > 2 cm and tubular differentiation.ConclusionsThere exist distinct clinicopathologic features between EGCC and EGNCC sub-groups; EGCC was indeed of gastric origin. Further investigations with larger samples are needed to validate these findings.
Quantify the Requirements to Achieve Grain Zn Biofortification of High-yield Wheat on Calcareous Soils
Authors: Wang Sen , Wang Zhaohui , Li Shasha , Diao Chaopeng , Liu Lu , Huang Ning , Huang Ming , Hui Xiaoli , Luo Laichao , He Gang , Cao Hanbing 
Published: April 2020

AbstractThe solution to address global human Zn deficiency is Zn biofortification of staple food crops, aimed at high grain Zn concentration as well as high yield. However, the desired high grain Zn concentration above 40 mg kg-1is rarely observed for high-yield wheat on worldwide calcareous soils, due to inadequate Zn uptake or Zn distribution to grain. The present study aims to investigate how much Zn uptake or distribution is adequate to achieve the Zn.t of high-yield wheat on calcareous soils with low available Zn (∼ 0.5 mg kg-1). Of the 123 cultivars tested in a three-year field experiment, 19 high-yield cultivars were identified with similar yields around 7.0 t ha-1and various grain Zn concentrations from 9.3 to 26.7 mg kg-1. The adequate Zn distribution to grain was defined from the view of Zn biofortification, as the situation where the Zn distribution to grain (Zn harvest index) increased to the observed maximum of ∼ 91.0% and the Zn concentration of vegetative parts (straw Zn concentration) decreased to the observed minimum of ∼ 1.5 mg kg-1(Zn.m). Under the assumed condition of adequate Zn distribution to grain (∼ 91.0%), all the extra Zn above Zn.m was remobilized from straw to grain and the grain Zn concentration would be increased to its highest attainable level, which was 14.5 ∼ 31.3 mg kg-1for the 19 high-yield cultivars but still lower than 40 mg kg-1. Thus, even with the adequate Zn distribution to grain, the current Zn uptake is still not adequate and needs to be increased to 308 g ha-1or higher to achieve Zn.t for high-yield wheat (7.0 t ha-1) on low-Zn calcareous soils. Besides, the established method here can also provide the priority measures and quantitative guidelines to achieve Zn biofortification in other wheat production regions.
Reactive flow simulations for a LOX/CH4 rocket engine
Authors: French Ainslie , Cutrone Luigi , Schettino Antonio , Marini Marco , Battista Francesco , Natale Pasquale 
Published: April 2020

Purpose
This paper aims to detail the reactive flow simulations of a LOX/CH4 multi-element rocket engine. The work has been conducted within the framework of the HYPROB-BREAD project whose main objective is the design, manufacture and testing of a LOX/LCH4 regeneratively cooled ground demonstrator.

Design/methodology/approach
Numerical simulations have been carried out with both commercial software and CIRA software developed in house. Two sets of boundary conditions, nominal and experimental, have been applied from which a code-to-code validation has been effected with the former and a code-to-experiment validation with the latter.

Findings
The results presented include both flow data and heat fluxes as well as parameters associated with engine performance, and indicate an excellent agreement with experimental data of a LOX/CH4 multi-element rocket engine.

Originality/value
The research is unique as the CIRA code Numerical Experimental Tool (NExT) has been validated with the commercial software FLUENT as well as with experimental values from the firing of the LOX/CH4 rocket engine demonstrator.