bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of a cost-effective appendicectomy model for surgical training
Authors: Yiasemidou Marina , Glassman Daniel , Khan Khalid , Downing Justine , Sivakumar Rangasamy , Fawole Adeshina , Biyani Chandra Shekhar 
Published: January 2020

Background Appendicitis is a commonly occurring condition worldwide. The gold standard treatment is appendicectomy. Although training models are commercially available for this procedure, they are often associated with high cost. Here we present a cost-effective model. Aim To establish construct validity of a cost-effective laparoscopic appendicectomy simulation model. Methods Three groups of surgeons were recruited; novices ( n = 31), of intermediate expertise ( n = 13) and experts ( n = 5) and asked to perform a simulated laparoscopic appendicectomy using the new model. Their performance was assessed by a faculty member and compared between the three groups using a validated scoring system (Global Operative Assessment of Laparoscopic Skills [GOALS] score). Results One-way ANOVA test showed a significant difference in task performance between groups ( p < 0.0001). Post-hoc comparisons after the application of Bonferroni correction (statistically significant p value <0.017) demonstrate a significant difference in performance between all groups for all GOALS categories as well as the total score. Effect size calculations showed that experience level had moderate (Eta-squared >0.5 and <0.8) and significant (>0.8) impact on the performance of the simulated procedure. Conclusion The model described in this study is cost-effective, valid and can adequately simulate appendicectomy. The authors recommend inclusion of this model to postgraduate surgical training.
ENT Mentorship Program for Preclinical Medical Students
Authors: Sethia Rishabh , Sheehan Cameron C. , Danforth Douglas , Essig Garth , Teknos Theodoros N. , Elmaraghy Charles A. 
Published: January 2020

ObjectiveTo provide preclinical medical students early access to otolaryngologists to learn about the specialty, facilitate acquisition of clinical skills, and provide one‐on‐one mentorship.MethodsStudents are matched with a single otolaryngology faculty mentor from The Ohio State University/Nationwide Children’s Hospital and attend 8 hours per month in the clinic or operating room, monthly lectures, and rounds, and they give a final presentation. Mentors complete performance evaluations, and surveys are administered longitudinally until Match Day.ResultsThirty‐five students and 17 faculty members have participated in the program since 2015. All mentors and students found the program to be a valuable experience. When compared to nonparticipating students, participants had significantly higher confidence scores for clinical performance, knowledge of anatomy, and familiarity with the department of interest. All students felt the program prepared them well for third and fourth years, and all 8 of the initial program participants successfully matched into residency with 4 entering otolaryngology.DiscussionMedical students face a competitive residency application process in otolaryngology with limited exposure, which creates an opportunity for guidance in the pursuit of matching into this field. This novel preclinical mentorship program prepares students for their clinical years and residency by facilitating acquisition of various competencies. Students gain hands‐on clinical exposure in a field of interest and support for navigating the application process.Implications for PracticeThe structure of this program can be applied to other medical schools or specialties if the individual departments contain adequate resources of teaching faculty willing to participate.
Occlusion and Functional Outcomes after Complete Temporomandibular Joint Resection with Soft Tissue Reconstruction
Authors: Lee Jake J. , Lander Daniel P. , Jackson Ryan S. , Zenga Joseph , Pipkorn Patrik 
Published: January 2020

Reconstructive outcomes after complete temporomandibular joint (TMJ) resection, including the condyle and glenoid fossa bone, are poorly defined in the literature. We described our technique and reviewed occlusion and functional outcomes of 6 consecutive patients undergoing complete TMJ resection and reconstruction with anterolateral thigh free tissue transfer and intermaxillary fixation with elastic bands for 6 to 8 weeks. At median follow‐up of 14 months, median Mandibular Function Impairment Questionnaire score was 32 (range, 4‐38), indicating mild to moderate impairment. Subjective occlusion was normal in 4 of 6 patients. Premature occlusal contact was seen in 2 of 6 patients. Maximal interincisor distance and horizontal mandibular shift with jaw abduction ranged from 29 to 40 mm and 5 to 8 mm, respectively. Four of 6 tolerated regular diets while 2 adhered to mechanical soft diets; no patients were feeding tube dependent. Soft tissue–only reconstruction after complete TMJ resection resulted in good subjective and objective occlusion in 4 of 6 patients and no cases of severe functional impairment.
Effect of Diabetes on the Prognosis of Sudden Sensorineural Hearing Loss: Propensity Score Matching Analysis
Authors: Seo Hee Won , Chung Jae Ho , Byun Hayoung , Jeong Jin‐Hyeok , Lee Seung Hwan 
Published: January 2020

ObjectiveThe aim of this study was to investigate the clinical implications of diabetes for the management of idiopathic sudden sensorineural hearing loss (ISSNHL).Study DesignRetrospective study.SettingTertiary referral center.Subjects and MethodsISSNHL patients (N = 403) who received inpatient management between January 2015 and December 2018 were analyzed. All were managed by a uniform treatment protocol of high‐dose steroid therapy and salvage intratympanic steroid injections. Treatment results were evaluated according to the American Academy of Otolaryngology—Head and Neck Surgery’s criteria 3 months after the start of treatment. We compared the clinical parameters and treatment outcomes of ISSNHL with and without diabetes. We also evaluated the influence of diabetes on the prognosis of ISSNHL by propensity score matching.ResultsOverall, of the 403 ISSNHL patients, 94 (23.3%) had diabetes, and 11 were newly diagnosed with diabetes. The patients with diabetes were older than those without diabetes (P <. 001), and their initial hearing threshold was significantly higher (P <. 001). The diabetic patients were hospitalized for a longer period, and their hearing recovery rate was lower. However, when age, sex, and initial hearing level were adjusted by propensity score matching, the diabetic patients and matched controls yielded similar treatment results.ConclusionsISSNHL with diabetes usually presents with severe hearing loss and requires longer hospitalization. However, diabetes itself may not influence the prognosis of ISSNHL. Proper management must be provided in ISSNHL with diabetes.
The Influence of Smile Arc by Bracket Position Modification: A Prospective Clinical Study
Authors: F. Yunus Amin , R. Priya , R. Devaki Vijayalakshmi , Karthik L. 
Published: January 2020

Objective: The purpose of this study was to assess the effects of McLaughlin, Bennett, and Trevisi Bracket Positioning in patients with ideal smile arc and to assess the efficacy of McLaughlin, Bennett, and Trevisi by modifying anterior bracket position among patients with flat smile arc in pretreatment and postalignment phases. Methodology: A total of 30 subjects divided into 2 groups (group A: 15 subjects with ideal smile arc, and group B: 15 subjects with flat smile arc) were made to participate in this study. A flat smile arc was converted to an ideal smile arc in group B subjects by bracket position modification, and an ideal smile arc was maintained in group A subjects. While paired student t test was performed to find the level of significance in tip and torque values, Mann–Whitney test was used to find the mean difference in intercanine width and visual analogue scale. Results: Wilcoxon signed ranks test was used to determine the statistically significant changes observed in torque in relation to all the maxillary anteriors. The results showed that tip values in maxillary lateral incisors and torque values in maxillary canines of group B were statistically significant. Conclusion: A good amount of intrusion was seen in maxillary canines, which helped in the correction of the smile arc.
Trends in the Intake of Fatty Acids and Their Food Source According to Obese Status Among Korean Adult Population Using KNHANES 2007-2017
Authors: Ahn Jaeouk , Kim Nam Soo , Lee Byung-Kook , Park Kim Sunmin 
Published: January 2020

Background: Increasing obesity rates are related to energy intake with carbohydrate and fat ratio. Using Korean National Health and Nutrition Examination Survey 2007-2017 data, we examined the hypothesis that the fat intake and food sources of dietary fats had changed over the last 10 years according to gender and obesity status in adult population ≥19 years. Methods: The food intake of each participant was collected by the 24-hour recall method, and nutrient intake including different fatty acids was calculated. The fatty acid intakes from 7 food groups were determined according to gender and obesity status. Results: Body mass index increased in both genders of the obese group over the decade, but it decreased in the normal-weight group. In men, energy intake was higher in the obese group than in the lean group, but the opposite trend was shown in women. Total fat intake including various fatty acids continuously and sharply increased in both men and women until 2016, then slightly declined only in men. The source of saturated fatty acid (SFA) intake was mainly from the animal food group in men and women regardless of obese status, and SFA and monounsaturated fatty acid from the animal food group gradually increased over time in both genders. N-3 fatty acid intake markedly decreased from fish and crabs and increased from sauces and nuts regardless of genders and the obese status from 2008 to 2017. Polyunsaturated fatty acid and N-6 fatty acid intake increased from bread, cookies, sauces, and nuts regardless of genders and obesity status. Conclusion: Fat intake was higher in obese men, but this was opposite in women. The N-3 fatty acid intake from seafood should increase, and the fat composition in sauce needs to be modulated to increase N-3 fatty acids.
Gut Microbiome Patterns Associated With Treatment Response in Patients With Major Depressive Disorder: Changements du microbiote intestinal associés à la réponse au traitement chez des patients souffrant de trouble dépressif majeur
Authors: Bharwani Aadil , Bala Asem , Surette Michael , Bienenstock John , Vigod Simone N. , Taylor Valerie H. 
Published: January 2020

Objectives: Compelling animal data exists examining the impact of the gut microbiome on the brain, but work is required to translate these findings in a clinical population. We sought to do this by exploring the effects of antidepressant medications on the gut microbiota, and establishing a baseline Major Depressive Disorder (MDD) gut phenotype. Methods: Participants with a primary diagnosis of MDD (n = 15) who were nonmedicated were recruited and followed over 6 months. Stool samples were collected prior to treatment initiation and 3 and 6 months following treatment. 16S rRNA sequencing was employed in order to analyze the gut microbial community profile. Symptom severity was measured by the Beck Depression Inventory. Alpha diversity metrics revealed no significant difference in the community diversity across any of the time-points. Results: Comparison of within-group versus between-group distances revealed a lack of clustering of samples based on time-point, suggesting no significant change in the microbiota across treatment duration. When analyzed based on treatment response, however, patients in the responder group exhibited greater phylogenetic diversity than non-responders (Mann-Whitney U = 5, p = 0.026). At 3-months, 35 Operational Taxonomic Units (OTUs) were significantly different between groups and at 6-months, 42 OTUs were significantly different between responders and non-responders. Conclusions: These observations indicate that antidepressant medications alter the gut microbiota of patients with MDD, with disparate effects in responders versus non responders. This supports the concept of a microbiota phenotype associate with treatment response in MDD.
Alexis Retractor: Institutional Experience of Its Applications in Head and Neck Surgery and Review of the Literature
Authors: Lee Jasmine , Yu Jason W. , Lee Z-Hye , Levine Jamie P. , Jacobson Adam S. 
Published: January 2020

Background: The Alexis retractor is a device that provides simultaneous radial retraction and wound protection during surgical procedures. Although typically used in abdominal and pelvic surgeries, there has been increased development of novel operative techniques utilizing the Alexis retractors in head and neck surgeries. Methods: We describe 2 cases of utilizing the Alexis retractor to attain transoral exposure in the setting of free flap reconstruction of intraoral defects. Results: In both cases, the Alexis retractor provided improved retraction, decreasing the number of instruments required for adequate exposure. Additionally, the polyurethane sheath component acted as a protective membrane over the lips and mucosa. Conclusions: The Alexis retractor can be a powerful retraction tool for certain surgical procedures involving the head and neck regions.
Ongoing microstructural changes in the cervical cord underpin disability progression in early primary progressive multiple sclerosis
Authors: Cortese Rosa , Tur Carmen , Prados Ferran , Schneider Torben , Kanber Baris , Moccia Marcello , Wheeler-Kingshott Claudia AM Gandini , Thompson Alan J , Barkhof Frederik , Ciccarelli Olga 
Published: January 2020

Background: Pathology in the spinal cord of patients with primary progressive multiple sclerosis (PPMS) contributes to disability progression. We previously reported abnormal Q-space imaging (QSI)-derived indices in the spinal cord at baseline in patients with early PPMS, suggesting early neurodegeneration. Objective: The aim was to investigate whether changes in spinal cord QSI over 3 years in the same cohort are associated with disability progression and if baseline QSI metrics predict clinical outcome. Methods: Twenty-three PPMS patients and 23 healthy controls recruited at baseline were invited for follow-up cervical cord 3T magnetic resonance imaging (MRI) and clinical assessment after 1 year and 3 years. Cord cross-sectional area (CSA) and QSI measures were obtained, together with standard brain MRI measures. Mixed-effect models assessed MRI changes over time and their association with clinical changes. Linear regression identified baseline MRI indices associated with disability at 3 years. Results: Over time, patients deteriorated clinically and showed an increase in cord QSI indices of perpendicular diffusivity that was associated with disability worsening, independently of the decrease in CSA. Higher perpendicular diffusivity and lower CSA at baseline predicted worse disability at 3 years. Conclusion: Increasing spinal cord perpendicular diffusivity may indicate ongoing neurodegeneration, which underpins disability progression in PPMS, independently of the development of spinal cord atrophy.
Fabrication of High-Quality and Strain-Relaxed GeSn Microdisks by Integrating Selective Epitaxial Growth and Selective Wet Etching Methods
Authors: Zhu Guangjian , Liu Tao , Zhong Zhenyang , Yang Xinju , Wang Liming , Jiang Zuimin 
Published: January 2020

AbstractGeSn is a promising material for the fabrication of on-chip photonic and nanoelectronic devices. Processing techniques dedicated to GeSn have thus been developed, including epitaxy, annealing, ion implantation, and etching. In this work, suspended, strain-relaxed, and high-quality GeSn microdisks are realized by a new approach without any etching to GeSn alloy. The GeSn alloy was grown on pre-patterned Ge (001) substrate by molecular beam epitaxy at low temperatures. The transmission electron microscopy and scanning electron microscopy were carried out to determine the microstructures of the GeSn samples. The microdisks with different diameters of Ge pedestals were fabricated by controlling the selective wet etching time, and micro-Raman results show that the microdisks with different dimensions of the remaining Ge pedestals have different extents of strain relaxation. The compressive strain of microdisks is almost completely relaxed under suitable conditions. The semiconductor processing technology presented in this work can be an alternative method to fabricate innovative GeSn and other materials based micro/nano-structures for a range of Si-compatible photonics, 3D-MOSFETs, and microelectromechanical device applications.
Comparison of CRISPR-Cas9/Cas12a Ribonucleoprotein Complexes for Genome Editing Efficiency in the Rice Phytoene Desaturase (OsPDS) Gene
Authors: Banakar Raviraj , Schubert Mollie , Collingwood Michael , Vakulskas Christopher , Eggenberger Alan L. , Wang Kan 
Published: January 2020

Abstract
Background
Delivery of CRISPR reagents into cells as ribonucleoprotein (RNP) complexes enables transient editing, and avoids CRISPR reagent integration in the genomes. Another technical advantage is that RNP delivery can bypass the need of cloning and vector construction steps. In this work we compared efficacies and types of edits for three Cas9 (WT Cas9 nuclease, HiFi Cas9 nuclease, Cas9 D10A nickase) and two Cas12a nucleases (AsCas12a and LbCas12a), using the rice phytoene desaturase (PDS) gene as a target site.

Findings
Delivery of two Cas9 nucleases (WT Cas9, and HiFi Cas9) and one Cas12a nuclease (LbCas12a) resulted in targeted mutagenesis of the PDS gene. LbCas12a had a higher editing efficiency than that of WT Cas9 and HiFi Cas9. Editing by Cas9 enzymes resulted in indels (1–2 bp) or larger deletions between 20-bp to 30-bp, which included the loss of the PAM site; whereas LbCas12a editing resulted in deletions ranging between 2 bp to 20 bp without the loss of the PAM site.

Conclusions
In this work, when a single target site of the rice gene OsPDS was evaluated, the LbCas12a RNP complex achieved a higher targeted mutagenesis frequency than the AsCas12a or Cas9 RNPs.
A potential new mechanism for pregnancy loss: considering the role of LINE-1 retrotransposons in early spontaneous miscarriage
Authors: Lou Chao , Goodier John L. , Qiang Rong 
Published: January 2020

AbstractLINE1 retrotransposons are mobile DNA elements that copy and paste themselves into new sites in the genome. To ensure their evolutionary success, heritable new LINE-1 insertions accumulate in cells that can transmit genetic information to the next generation (i.e., germ cells and embryonic stem cells). It is our hypothesis that LINE1 retrotransposons, insertional mutagens that affect expression of genes, may be causal agents of early miscarriage in humans. The cell has evolved various defenses restricting retrotransposition-caused mutation, but these are occasionally relaxed in certain somatic cell types, including those of the early embryo. We predict that reduced suppression of L1s in germ cells or early-stage embryos may lead to excessive genome mutation by retrotransposon insertion, or to the induction of an inflammatory response or apoptosis due to increased expression of L1-derived nucleic acids and proteins, and so disrupt gene function important for embryogenesis. If correct, a novel threat to normal human development is revealed, and reverse transcriptase therapy could be one future strategy for controlling this cause of embryonic damage in patients with recurrent miscarriages.
White matter inflammation and cognitive function in a co-morbid metabolic syndrome and prodromal Alzheimer’s disease rat model
Authors: Ivanova Nadezda , Liu Qingfan , Agca Cansu , Agca Yuksel , Noble Earl G. , Whitehead Shawn Narain , Cechetto David Floyd 
Published: January 2020

Abstract
Background
Metabolic syndrome, the development of which is associated with high-caloric Western diet (HCD) intake, represent a risk factor for mild cognitive impairment (MCI) and dementia including Alzheimer’s disease (AD) later in life. This study aimed to investigate the effect of diet-induced metabolic disturbances on white matter neuroinflammation and cognitive function in a transgenic (TG) Fischer 344 rat carrying a human β-amyloid precursor protein (APP) gene with Swedish and Indiana mutations (APP21 TG), a model of pre-AD and MCI.

Methods
TG and wildtype (WT) rats received either a HCD with 40% kJ from fat supplemented with 20% corn syrup drink or a standard diet for 12 weeks. Body weight, caloric intake, and blood pressure were measured repeatedly. End-point changes in glucose and lipid metabolism were also assessed. Open field task was used for assessment of activity; Morris water maze was used to assess spatial learning and memory. Cerebral white matter microglia and astrocytes, hippocampal neurons, and neuronal synapses were examined using immunohistochemistry.

Results
Rats maintained on the HCD developed significant obesity, visceral adiposity, dyslipidemia, and hyperinsulinemia, but did not become hypertensive. Impaired glucose tolerance was observed only in WT rats on the HCD. Total microglia number, activated OX-6+ microglia, as well as GFAP+ astrocytes located predominantly in the white matter were greater in the APP21 TG rat model in comparison to WT rats. HCD-driven metabolic perturbations further exacerbated white matter microgliosis and microglia cell activation in the APP21 TG rats and led to detectable changes in spatial reference memory in the comorbid prodromal AD and metabolic syndrome group compared to WT control rats. Neuronal density in the CA1 subregion of the hippocampus was not different between the experimental groups. Synaptic density in the CA1 and CA3 hippocampal subregions was lower in the TG rats compared to WT rats; however, there was no additional effect of the co-morbidity on this measure.

Conclusions
These results suggest that white matter neuroinflammation might be one of the possible processes of early interaction of metabolic syndrome with MCI and pre-AD and could be one of the early brain pathologies contributing to cognitive deficits observed in mild cognitive impairment and dementia, including AD cases.