bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biological Glue as an Alternative to Suction Drainage in Tissue-Expanded Flaps in Children
Authors: Bastard François , Seron Aurélie , Vitse Julian , de Berail Ambre , Brigly Thomas , Petiot Dominique , Galinier Philippe , Captier Guillaume 
Published: July 2020

Introduction
Biological glue is already used as a hemostatic agent and tissue adhesive in plastic surgery. This study evaluates the use of this glue as an alternative to suction drainage for the adhesion of tissue-expanded flaps in pediatric patients.

Methods
This is a retrospective, multicenter case-control study on 48 flap procedures conducted on 42 children (5 months–12 years of age) between 2004 and 2017, comparing a “glue” group (n = 24) with a control group (n = 24), in which a classic redon drain was used. The control patients were matched according to age, etiology, location of the lesion, and the size of the expander. The primary end point was the duration of hospital stay.

Results
The conditions were 24 cases of congenital nevus, 14 of cicatricial alopecia, and 10 of sebaceous hamartoma. Twenty-nine lesions were located on the scalp, 15 on the back, 2 on the thigh, and 2 on the buttocks.
The average surgical durations (48 ± 24 vs 63 ± 32 minutes, P = 0.13) and average room occupancy time (126 ± 21 vs 139 ± 44 minutes, P = 0.29) were similar between the glue group and the control group. However, the average duration of hospital stay was lower in the glue group (1.5 ± 1.5 days) than in the control group (3.6 ± 1.3 days, P < 0.0001). The complication rates between the groups were similar.

Conclusions
The application of glue on expanded flaps is as reliable as suction drainage with the advantage of reducing the duration of hospital stay and potentially enabling outpatient treatment for certain patients.
Opposite-Running Double Abdominal Flap on Single Pivot Point (Udaipur Flap) for Circumferential Coverage of Wrist and Hand
Authors: Petkar Kiran 
Published: July 2020

Abstract
Complete or near circumferential defects over wrist and hand are difficult situations. They need flaps so long that available adjacent, distant or free flaps often seem inadequate. Hence, this innovative solution was designed. Twin axial flaps were elevated along an oblique axis over abdomen, extending in opposite directions while being pedicled and pivoted at about the same transverse plane. The flaps wrapped the limb from either side and gave complete coverage. Donor sites were closed directly or skin grafted. Three weeks later flap division was done, often after a delay procedure. The technique was used in 6 cases. All patients were young males with history of electrical burns or trauma resulting in total or near circumferential defect. Required length of flaps ranged from 15 to 26 cm with length/breadth ratio ranging from 3:1 to 5:1. Double abdominal flaps could cover all the exposed structures. Limb positioning was comfortable. All flaps survived; all limbs were salvaged. The cover was soft, supple, and pinchable. This is a simple yet effective flap design to address the difficult problem of circumferential defects at hand. The conceptualization and success of this flap system may be attributed to the understanding of patterns of cutaneous vasculature discovered by Ian Taylor. When the vascular axes in a region are known, the same can be exploited to design more than 1 flap in desired orientation. In conclusion, this “Undulate-design Double Abdominal flaps Insertion-Pouch for Upper limb Reconstruction” is a new and effective solution for circumferential defects of wrist and hand.
Evaluating the Prevalence of Pelvic Floor Disorders in Women in Nonmetropolitan Communities
Authors: Khan Aqsa , Zhang Nan , Carolan Alexandra , Tay Kimberly , Wolter Christopher 
Published: July 2020

Introduction
Prevalence rates of pelvic floor disorders in women in nonmetropolitan communities compared with metropolitan communities are unknown. We hypothesize that the rates are higher in women in nonmetropolitan communities.

Methods
We accessed the health survey data from the NHANES (National Health and Nutrition Examination Survey) from 2009 to 2010 divided by geocodes into nonmetropolitan (<50,000 inhabitants) and metropolitan communities (>50,000). Responses were analyzed for the following conditions: urinary incontinence and nocturia, bowel urgency and anal incontinence, and symptomatic vaginal bulge. Age-adjusted prevalence rates were estimated using logistic regression.

Results
The 2009–2010 NHANES survey was completed nationwide by 302 women in nonmetropolitan communities and 2201 women in metropolitan communities. Overall, prevalence rates of PFDs did not significantly differ between groups. Prevalence rates of urinary incontinence and nocturia at least weekly were similar between metropolitan and nonmetropolitan groups (16.2% vs 14.6%, P = 0.47), with stress incontinence being more common than urgency and other types of incontinence (40% vs 23% and 8%). Women in metropolitan communities reported more bowel urgency than women in nonmetropolitan communities (33.3% vs 26.8%, P = 0.02); however, prevalence rates between both groups are similar with regards to anal incontinence at least once a month or more (9.2% vs 9.0%, P = 0.76). Prolapse symptoms were also not significantly different between the groups (2.4% in both). There was an increase in prevalence in each of the pelvic floor disorder symptoms with age.

Conclusions
Pelvic floor disorders are prevalent and increase with age in women in nonmetropolitan communities at rates similar to women in metropolitan communities.
Plastics as a materials system in a circular economy
Authors: Bucknall David G. 
Published: July 2020

Plastics have transformed our modern world. With a range of outstanding properties, they are used in an ever-widening range of applications. However, the linear economy of their use means that a large volume of plastics is discarded after use. It is believed that approximately 80% of the estimated total 6.3 Bt of plastics ever produced have been discarded, representing not only a huge loss of valuable resources, but mismanaged waste is also the origin of an ever-increasing environmental disaster. Strategies to prevent loss of materials resources and damage to the environment are elements of a circular plastics economy that aims to maintain plastics at their highest value for the longest time possible and at the same time improve the economy and prevent detrimental environmental impact. The latter in particular is driving recent changes in policies and legislation across the world that are rapidly being introduced in order to solve these environmental issues. The achievement of a circular economy will require not only innovative technical developments, but also major economic investment and changes to business practice coupled with significant changes in social behaviour. This paper summarizes the complex and highly interrelated technical issues and provides an overview of the major challenges, potential solutions and opportunities required to achieve and operate a circular plastics economy.
This article is part of a discussion meeting issue ‘Science to enable the circular economy’.
Biocatalysis and biomass conversion: enabling a circular economy
Authors: Sheldon Roger A. 
Published: July 2020

This paper is based on a lecture presented to the Royal Society in London on 24 June 2019. Two of the grand societal and technological challenges of the twenty-first century are the ‘greening' of chemicals manufacture and the ongoing transition to a sustainable, carbon neutral economy based on renewable biomass as the raw material, a so-called bio-based economy. These challenges are motivated by the need to eliminate environmental degradation and mitigate climate change. In a bio-based economy, ideally waste biomass, particularly agricultural and forestry residues and food supply chain waste, are converted to liquid fuels, commodity chemicals and biopolymers using clean, catalytic processes. Biocatalysis has the right credentials to achieve this goal. Enzymes are biocompatible, biodegradable and essentially non-hazardous. Additionally, they are derived from inexpensive renewable resources which are readily available and not subject to the large price fluctuations which undermine the long-term commercial viability of scarce precious metal catalysts. Thanks to spectacular advances in molecular biology the landscape of biocatalysis has dramatically changed in the last two decades. Developments in (meta)genomics in combination with ‘big data’ analysis have revolutionized new enzyme discovery and developments in protein engineering by directed evolution have enabled dramatic improvements in their performance. These developments have their confluence in the bio-based circular economy.This article is part of a discussion meeting issue ‘Science to enable the circular economy'.
Biomass hydrodeoxygenation catalysts innovation from atomistic activity predictors
Authors: Morteo-Flores Fabian , Engel Julien , Roldan Alberto 
Published: July 2020

Circular economy emphasizes the idea of transforming products involving economic growth and improving the ecological system to reduce the negative consequences caused by the excessive use of raw materials. This can be achieved with the use of second-generation biomass that converts industrial and agricultural wastes into bulk chemicals. The use of catalytic processes is essential to achieve a viable upgrade of biofuels from the lignocellulosic biomass. We carried out density functional theory calculations to explore the relationship between 13 transition metals (TMs) properties, as catalysts, and their affinity for hydrogen and oxygen, as key species in the valourization of biomass. The relation of these parameters will define the trends of the hydrodeoxygenation (HDO) process on biomass-derived compounds. We found the hydrogen and oxygen adsorption energies in the most stable site have a linear relation with electronic properties of these metals that will rationalize the surface's ability to bind the biomass-derived compounds and break the C–O bonds. This will accelerate the catalyst innovation for low temperature and efficient HDO processes on biomass derivates, e.g. guaiacol and anisole, among others. Among the monometallic catalysts explored, the scaling relationship pointed out that Ni has a promising balance between hydrogen and oxygen affinities according to thed-band centre andd-band width models. The comparison of the calculated descriptors to the adsorption strength of guaiacol on the investigated surfaces indicates that thed-band properties alone are not best suited to describe the trend. Instead, we found that a linear combination of work function andd-band properties gives significantly better correlation.This article is part of a discussion meeting issue ‘Science to enable the circular economy’.
Ranking Radiology Residency Programs: What Medical Students Think is Important Versus What Residents Say is Important
Authors: Rios Florentino Saenz , Alwan Shadan , Nguyen Quan 
Published: July 2020

AbstractBackgroundMatching to a residency is a great success, but it is also a significant change in the lives of many graduating medical students. It is expected that during this time, many priorities may change, especially after participation in a residency program where residents are further exposed to the dynamics of the program.PurposeThere are no current studies that attempt to determine what factors residents prefer after the match.MethodsThis study was an anonymous study conducted through an online survey. The survey asked two open-ended questions asking the survey taker to list four factors in order of importance that they considered important in a program, one as an MS4 and one as a resident. Results were compiled, tallied, and categorized to find common themes between the applicant’s preferences through descriptive statistics.ResultsOf the 24 surveys sent out, a total of 15 applicants responded for a response rate of 62.5%. The most common preferences among both MS4s were “Work Environment” and “Location,” however, factors like “Education” and “Faculty: Resident Ratio” was seen as increasing in importance among residents.ConclusionWhile an increase was seen in some factors (Education, Faculty:Residency Ratio, and Program Size), the general trend of preferences going from MS4 to a resident was more spread-out in the distribution of what residents considered essential factors. Education involves both formal didactics and readout of dictated exams. Higher Faculty:Residency affects education because more faculty decreases the clinical workload of each faculty and leaves the faculty more time for teaching. Larger program size decreases the amount of call burdern per resident.
Maternal biomarkers for early prediction of the neural tube defects pregnancies
Authors: Yadav Upendra , Kumar Pradeep , Rai Vandana 
Published: July 2020

ABSTRACTNeural tube defects (NTD) are the most common congenital birth defects. The reason for the NTD cause is still not completely known, but it is believed that some genetic and environmental factors might play a role in its etiology. Among the genetic factors the polymorphism in the folate gene pathway is crucial. Numerous studies have suggested the possible role of maternal higher plasma concentration of homocysteine and low concentration of folate and cobalamin in the development of NTD but some negative studies are also published. So, in this study, authors tried to find out the exact relation between NTD and maternal biomarkers like folate, cobalamin and homocysteine by conducting a meta-analysis. Different electronic databases were searched for the eligible studies. Standardized mean difference (SMD) with 95% confidence interval (CI) was used to determine association between maternal markers as risk for NTD pregnancy. The p value <0.05 was considered statistically significant in all tests. All the statistical analyses were done in the Open Meta-Analyst program. The homocysteine is significantly associated with the increased risk of NTD (SMD= 0.57; 95% CI: 0.35-0.80, p= <0.001; I2= 93.01%), s-folate showed protective role in NTD (SMD= −0.48; 95% CI: −0.77 to −0.19, p= 0.001; I2= 95.73%), similarly cobalamin is also having protective role (SMD= −0.28; 95% CI: −0.43 to −0.13, p= <0.001; I2= 80.40%). In conclusion this study suggest that different maternal biomarkers may be used for the early prediction of the NTDs.
Improving US Virgin Islands’ heath system: “You get more benefits with your insurance in the States than you get here”
Authors: Wang Karen H. , Hendrickson Zoé M. , Friedman Hannah R. , Nunez Maxine A. , Nunez-Smith Marcella 
Published: July 2020

AbstractBackgroundThe US Virgin Islands (USVI) are actively rebuilding their healthcare delivery system following destruction by Hurricanes Irma and Maria in 2017.MethodsIn 2013, we conducted a qualitative study in the US Virgin Islands using semi-structured one-on-one interviews to explore individuals’ decision-making regarding healthcare-seeking off-island. The coding team analyzed the transcripts using a constant comparative analysis, and Atlas.ti to organize our emerging thematic analysis.ResultsFive themes emerged from 19 interviews that illustrate healthcare system level factors that influence participants’ decisions about seeking healthcare off-island: 1) limited availability of services and desire for options, 2) limited accessibility of services, 3) healthcare system interactions and experiences, 4) healthcare system policies, and 5) trust in healthcare systems.ConclusionsThe experiences of care seeking off-island for our sample highlight several mechanisms through which the USVI healthcare delivery system could improve, including the adoption of telemedicine, changes in insurance, and healthcare workforce policies.
Artificial Intelligence-Enabled, Fully Automated Detection of Cardiac Amyloidosis Using Electrocardiograms and Echocardiograms
Authors: Goto Shinichi , Mahara Keitaro , Beussink-Nelson Lauren , Ikura Hidehiko , Katsumata Yoshinori , Endo Jin , Gaggin Hanna K. , Shah Sanjiv J. , Itabashi Yuji , MacRae Calum A , Deo Rahul C 
Published: July 2020

AbstractAlthough individually uncommon, rare diseases collectively affect over 350 million patients worldwide and are increasingly the target of therapeutic development efforts1. Unfortunately, the pursuit and use of such therapies have been hindered by a common challenge: patients with specific rare diseases are difficult to identify, especially if the conditions resemble more prevalent disorders. Cardiac amyloidosis is one such rare disease, which is characterized by deposition of misfolded proteins within the heart muscle resulting in heart failure and death2–4. In recent years, specific therapies have emerged for cardiac amyloidosis5,6and several more are under investigation7–9, but because cardiac amyloidosis is mistaken for common forms of heart failure, it is typically diagnosed late in its course. As a possible solution, artificial intelligence methods could enable automated detection of rare diseases, but model performance must address low disease prevalence. Here we present an automated multi-modality pipeline for cardiac amyloidosis detection using two neural-network models; one using electrocardiograms (ECG) and the second using echocardiographic videos as input. These models were trained and validated on 3 and 5 academic medical centers (AMC), respectively, in the United States and Japan. Both models had excellent accuracy for detecting cardiac amyloidosis with C-statistics of 0.85-0.92 and 0.91-1.00 for the ECG and echocardiography models, respectively, with the latter outperforming expert diagnosis. Simulating deployment on 13,906 and 7,775 patients with ECG-echocardiography paired data for AMC2 and AMC3 indicated a positive predictive value (PPV) for the ECG model of 4% and 3% at 61% and 54% recall, respectively. Pre-screening with ECG enhanced the echocardiography model performance from PPV 23% and 20% to PPV 58% and 53% at 64% recall, respectively for AMC2 and AMC3. In conclusion, we have developed a robust pipeline to augment detection of cardiac amyloidosis, which should serve as a generalizable strategy for other rare and intermediate frequency cardiac diseases with established or emerging therapies.
Impact of Viz LVO on Time-to-Treatment and Clinical Outcomes in Large Vessel Occlusion Stroke Patients Presenting to Primary Stroke Centers
Authors: Morey Jacob R. , Fiano Emily , Yaeger Kurt A. , Zhang Xiangnan , Fifi Johanna T. 
Published: July 2020

AbstractIntroductionRandomized controlled trials have demonstrated the importance of time-to-treatment on clinical outcomes in large vessel occlusion (LVO) stroke. Delays in interventional radiology (INR) consultation are associated with a significant delay in overall time to endovascular treatment (EVT). Delays in EVT are particularly prevalent in Primary Stroke Centers (PSC), hospitals without thrombectomy capability onsite, where the patient requires transfer to a Thrombectomy Capable or Comprehensive Stroke Center for EVT. A novel computer aided triage system, Viz LVO, assists in early notification of the PSC stroke team and affiliated INR team. This platform includes an image viewer, communication system, and an artificial intelligence algorithm that automatically identifies suspected LVO strokes on CTA imaging and rapidly triggers alerts.HypothesisViz LVO will decrease time-to-treatment and improve clinical outcomes.MethodsA prospectively maintained database was assessed for all patients who presented to a PSC currently utilizing Viz LVO in the Mount Sinai Health System in New York and underwent EVT following transfer for LVO stroke between October 1, 2018 and March 15, 2020. There were 42 patients who fit the inclusion criteria and divided into pre- and post-Viz ContaCT implementation by comparing the periods of October 1, 2018, to March 15, 2019, “Pre-Viz”, and October 1, 2019, to March 15, 2020, “Post-Viz.” Time intervals and clinical outcomes were collected and compared.ResultsThe Pre- and Post-Viz cohorts were similar in terms of gender, age, proportion receiving IV-tPA, and proportion with revascularization of TICI > 2B. The presenting NIHSS and pre-stroke mRS scores were not statistically different.The median initial door-to-INR notification was significantly faster in the post-Viz cohort (21.5 minutes vs 36 minutes; p=0.02). The median initial door-to-puncture time interval was 20 minutes shorter in the Post-Viz cohort, but this was not statistically significant (p=0.20).The 5-day NIHSS and discharge mRS were both significantly lower in the Post-Viz cohort (p=0.02 and p=0.03, respectively). The median 90-day mRS scores were also significantly lower post-Viz implementation, although a similar proportion received a good outcome (mRS score ≤ 2) (p=0.02 and p=0.42, respectively).ConclusionsEVT is a time-sensitive intervention that is only available at select stroke centers. Significant delays in time-to-treatment are present when patients require transfer from PSCs to a EVT capable stroke center. In a large health care system, we have shown that Viz LVO implementation is associated with improved time to INR notification and clinical outcomes. Viz LVO has the potential for wide-spread improvement in clinical outcomes with implementation across large hub and stroke systems across the country.
The sensitivity of respiratory tract specimens for the detection of SARS-CoV-2: A protocol for a living systematic review and meta-analysis
Authors: Moore Adam J. , Nakahata Maura I. , Kalinich Chaney C. , Nyhan Kate , Bromberg Daniel J. , Shi Xiaoting , Ko Albert I. , Grubaugh Nathan D. , Casanovas-Massana Arnau , Wyllie Anne L. 
Published: July 2020

AbstractBackgroundHighly sensitive, non-invasive, and easily accessible diagnostics for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) are essential for the control of the Coronavirus Disease 2019 (COVID-19) pandemic. There is a clear need to establish a gold standard diagnostic for SARS-CoV-2 infection in humans using respiratory tract specimens.MethodsSearches will be conducted in the bibliographic databases Medline, Embase, bioRxiv, medRxiv, F1000, ChemRxiv, PeerJ Preprints, Preprints.org, Beilstein Archive, and Research Square. Relevant government documents and grey literature will be sought on the FDA’s Emergency Use Authorizations website, the ECDC’s website, and the website of the Foundation for Innovative New Diagnostics. Finally, papers categorized as diagnosis papers by the EPPI Centre’s COVID-19 living systematic map will be added to our screening process; those papers are tagged with the diagnosis topic based on human review, rather than database searches, and thus this set of papers might include ones that have not been captured by our search strategy.