bluuebunny/crossref_metadata_2025_split huggingface dataset:
Handmade Cranioplasty: An Obsolete Procedure or a Surgery That Is Still Useful?
Authors: Zoli Matteo , Di Gino Marco , Cuoci Andrea , Palandri Giorgio , Acciarri Nicola , Mazzatenta Diego 
Published: March 2020

Abstract
Custom made cranioplasty (CM CPL) represents the gold standard for cranial defect reconstruction, allowing an adequate protection of the brain with good cosmetic results. Nevertheless, it is an expensive procedure, requiring time for preparation of the prothesis. Aim of this study is to evaluate whether and in what cases handmade cranioplasty (HM CPL) still represents a valid alternative to CM CPL.
Therefore, all consecutive cranioplasties in our center from 2013 to 2019 have been analyzed. Size and location of cranial defect have been considered, as the cause of decompression. Morbidity rate and final outcome have been evaluated. Series includes 143 patients (61% males, mean age: 60 years, SD:16). HM CPL was performed in 59 cases (41.2%) and CM in the remaining 84 (58.8%). HM CPL was preferred for smaller cranial defects (p: 0.22), inferior to 100 cm2 (p: 0.01) located in fronto-parietal-occipital area (p: 0.01). Furthermore, HM CPL results in the first choice after removal of infiltrative tumors (p: 0.02). Surgical complications consisted in 14 (9%) infections, 8 hematomas (5.6%), and one cranioplasty displacement (0.7%). At follow-up, in 85.3% of cases the CPL is still in place with satisfactory cosmetic and functional outcome (86.5% of HM CPL, 84.5% of CM CPL).
HM CPL may still represent an effective and economic alternative procedure, when specific patient selection criteria are respected. This technique requires a long learning learning curve and demanding surgical maneuvers. Our handmade reconstruction technique with some hints to improve the esthetic result is presented.
Total Joint Replacement After Condylar Destruction Secondary to Long-Standing Dislocation of the Temporomandibular Joint
Authors: Sarlabous Mathilde , Psutka David J. 
Published: March 2020

Background:
To describe the treatment of 2 long-standing chronic dislocation of the temporomandibular joints (TMJs) and 1 chronic recurrent dislocation.

Methods:
This report describes the treatment of 3 patients; 2 with a long-standing chronic dislocation of the TMJ and 1 with a chronic recurrent dislocation. Duration of dislocation and anatomical considerations make the treatment challenging and controversial. The patients presented in this report all developed destruction of their condyles. They were successfully treated with total joint replacement with alloplastic devices.

Results:
All the 3 patients underwent successful surgery and recovery. Mandibular function and pain level were significantly improved.

Conclusion:
Long-standing dislocation of the TMJ is rare. This condition can be successfully treated by resection of the damaged condyles and reconstruction with alloplastic total TMJ replacements.
Applications of Computer-Aided Design/Manufacturing Technology in Treatment of Hemifacial Microsomia
Authors: Sun Yue , Du Wen , Xu Chunwei , Lin Yunfeng , Liu Xian , Luo En 
Published: March 2020

Abstract
Computer-aided surgery has been widely used in treatment of hemifacial microsomia and matured in recent decades. These techniques include the computer-aided design, virtual surgical planning, modeling surgery, rapid prototyping techniques, intraoperative navigation and so on. The purpose of this article is to summarize the current application of computer-aided design/computer-aided manufacturing technology in the treatment for hemifacial microsomia during the last 5 years, as well as the views and discussions on some topics, and finally introduce a method of our team. Our effort is that using the holes predrilled in cutting guides, the pre-bent titanium plates are easily placed. Avoiding potential bone autorotation caused by unfitness between conventional titanium plates and bone surface, which keeps the bone fixation precisely in line with the preoperative virtual plan and reduce the movement of bone segments due to the undesirable stress of the plates.
Ceftriaxone Combined With Metronidazole is Superior to Cefoxitin Alone in the Management of Uncomplicated Appendicitis in Children
Authors: Kashtan Mark A. , Graham Dionne A. , Melvin Patrice , Cameron Danielle B. , Anandalwar Seema P. , Hills-Dunlap Jonathan L. , Rangel Shawn J. 
Published: March 2020

Objective:
To compare rates of surgical site infection between the 2 most commonly utilized narrow-spectrum antibiotic regimens in children with uncomplicated appendicitis (ceftriaxone with metronidazole and cefoxitin alone).

Summary of Background Data:
Narrow-spectrum antibiotics have been found to be equivalent to extended-spectrum (antipseudomonal) agents in preventing surgical site infection (SSI) in children with uncomplicated appendicitis. The comparative effectiveness of different narrow-spectrum agents has not been reported.

Methods:
This was a multicenter retrospective cohort study using clinical data from the Pediatric National Surgical Quality Improvement Program Appendectomy Collaborative Pilot database merged with antibiotic utilization data from the Pediatric Health Information System database from January 2013 to June 2015. Multivariable logistic regression was used to compare outcomes between antibiotic treatment groups after adjusting for patient characteristics, surrogate measures of disease severity, and clustering of outcomes within hospitals.

Results:
Eight hundred forty-six patients from 14 hospitals were included in the final study cohort with an overall SSI rate of 1.3%. A total of 56.0% of patients received ceftriaxone with metronidazole (hospital range: 0%–100%) and 44.0% received cefoxitin (range: 0%–100%). In the multivariable model, ceftriaxone with metronidazole was associated with a 90% reduction in the odds of a SSI compared to cefoxitin [0.2% vs 2.7%; odds ratio: 0.10 (95% confidence interval 0.02–0.60); P = 0.01].

Conclusions:
Ceftriaxone combined with metronidazole is superior to cefoxitin alone in preventing SSIs in children with uncomplicated appendicitis.
Prognosis Based Definition of Resectability in Pancreatic Cancer
Authors: Oba Atsushi , Croce Chiara , Hosokawa Patrick , Meguid Cheryl , Torphy Robert J. , Al-Musawi Mohammed H. , Ahrendt Steven , Gleisner Ana , Schulick Richard D. , Del Chiaro Marco 
Published: March 2020

Objective:
To identify objective preoperative prognostic factors that are able to predict long-term survival of patients affected by PDAC.

Summary of Background Data:
In the modern era of improved systemic chemotherapy for PDAC, tumor biology, and response to chemotherapy are essential in defining prognosis and an improved approach is needed for classifying resectability beyond purely anatomic features.

Methods:
We queried the National Cancer Database regarding patients diagnosed with PDAC from 2010 to 2016. Cox proportional hazard models were used to select preoperative baseline factors significantly associated with survival; final models for overall survival (OS) were internally validated and formed the basis of the nomogram.

Results:
A total of 7849 patients with PDAC were included with a median follow-up of 19 months. On multivariable analysis, factors significantly associated with OS included carbohydrate antigen 19-9, neoadjuvant treatment, tumor size, age, facility type, Charlson/Deyo score, primary site, and sex; T4 stage was not independently associated with OS. The cumulative score was used to classify patients into 3 groups: good, intermediate, and poor prognosis, respectively. The strength of our model was validated by a highly significant randomization test, Log-rank test, and simple hazard ratio; the concordance index was 0.59.

Conclusion:
This new PDAC nomogram, based solely on preoperative variables, could be a useful tool to patients and counseling physicians in selecting therapy. This model suggests a new concept of resectability that is meant to reflect the biology of the tumor, thus partially overcoming existing definitions, that are mainly based on tumor anatomic features.
Increased Postoperative Use of Computed Tomography Following Emergency Surgery for Ileocaecal Crohn Disease
Authors: Caiazzo Anna , Flashman Karen , Celentano Valerio 
Published: March 2020

Introduction:
Multiple imaging modalities are often required for the relapsing nature of Crohn disease (CD). Computed tomography (CT) offers a rapid acquisition of images and shows high specificity and sensitivity. However, CT imaging exposes to a higher dose of ionizing radiation than other abdominal imaging modalities. The aim of this study was to compare the use of preoperative and postoperative CT scan in patients undergoing emergency and elective surgery for CD.

Methods:
All patients undergoing emergency and elective surgery for ileocaecal CD January 2014 to December 2018 were included in this prospective observational study. The study objective was to evaluate the frequency of use of CT scan perioperatively with the number and findings of preoperative and postoperative CT being the primary outcomes. The secondary outcomes were operating time, length of hospital stay, reoperations, and rehospitalization.

Results:
A total of 75 patients were included, 33 in the emergency group (43%) and 44 in the elective group (57%). There was a higher use of preoperative CT scan in the emergency surgery group, with 14 patients (42%) having a CT scan before surgery compared with 2 (5%) in the elective group (P=0.14). Thirteen patients (39.4%) had a postoperative CT scan in the emergency surgery group, compared with 10 patients (23.8%) in the elective surgery group.

Conclusion:
Patients undergoing emergency surgery for CD are at increased risk of exposure to ionizing radiations due to high perioperative use of CT scan.
A Comparison of the Biomechanical Protection Provided by 2 Cyanoacrylate-Based Skin Protectants
Authors: Lee Jiye , Gibson Daniel J. 
Published: March 2020

PURPOSE:
The purpose of this study was to evaluate the in-gel strain and tear reduction provided by 2 skin protectant products that were applied as a liquid and allowed to dry, leaving behind a protective layer.

DESIGN:
Prospective, 3-group comparison cohort study using an in vitro model.

METHODS:
A fragile agar-based gel with an embedded bead was used in a custom device that applied variable interface pressures of 550, 1080, or 1600 Pa, respectively. The device then imparted 216 N of external shear force in 0.625-mm increments. The resulting strain in the gel was measured by digital image correlation. The strain at tearing was determined by observing the images of the gels and calculating the strain at that point. This approach was used to compare untreated gels to gels treated with one of 2 commercially available cyanoacrylate-based skin protectants. The results from the 3 groups were first analyzed by analysis of variance, followed by Tukey's Honestly Significant Difference test when indicated.

RESULTS:
We observed a proportional increase in interface pressure and strain that differed among the 3 groups. Specifically, the gels treated with a mixed polymer skin protectant had less pretearing strain than the control gel at both the 1080-Pa load (−15%, P = 3.64 × 10−4) and 1600 Pa-load (−20%, P = .03). The pure cyanoacrylate-treated gels had less strain than the control at 1080 Pa (−34%, P = 4.25 × 10−7) and 1600 Pa (−48%, P = 1.07 × 10−7); it also had less strain than the mixed polymer product at 1080 Pa (−19%, P = 5.38 × 10−6) and 1600 Pa (−28%, P = 3.88 × 10−3). In terms of protection from tearing, at an interface pressure of 1080 Pa, the control gel tore 80% of the time, the mixed polymer-treated gel tore 100% of the time, and the pure cyanoacrylate-treated gel did not tear (0/5, P = 8.84 × 10−5). Under a load of 1600 Pa, 100% of the control and mixed polymer-treated gels tore while none of the cyanoacrylate-treated gels did (P = 2.54 × 10−24).

CONCLUSION:
The pure cyanoacrylate-based skin protectant provided the most protection, with consistent reductions in both strain and tearing. Both skin protectants reduced the initial in-gel strain; however, only the pure cyanoacrylate-treated product protected the gel from tears under the conditions tested. These results indicate that cyanoacrylate-based skin protectants can reduce shear strain and tearing in fragile elastic materials.
The Price equation and evolutionary epidemiology
Authors: Day Troy , Parsons Todd , Lambert Amaury , Gandon Sylvain 
Published: March 2020

The Price equation has found widespread application in many areas of evolutionary biology, including the evolutionary epidemiology of infectious diseases. In this paper, we illustrate the utility of this approach to modelling disease evolution by first deriving a version of Price’s equation that can be applied in continuous time and to populations with overlapping generations. We then show how this version of Price’s equation provides an alternative perspective on pathogen evolution by considering the epidemiological meaning of each of its terms. Finally, we extend these results to the case where population size is small and generates demographic stochasticity. We show that the particular partitioning of evolutionary change given by Price’s equation is also a natural way to partition the evolutionary consequences of demographic stochasticity, and demonstrate how such stochasticity tends to weaken selection on birth rate (e.g. the transmission rate of an infectious disease) and enhance selection on mortality rate (e.g. factors, like virulence, that cause the end of an infection). In the long term, if there is a trade-off between virulence and transmission across parasite strains, the weaker selection on transmission and stronger selection on virulence that arises from demographic stochasticity will tend to drive the evolution of lower levels of virulence.
This article is part of the theme issue ‘Fifty years of the Price equation’.
Price's equation made clear
Authors: Gardner Andy 
Published: March 2020

Price's equation provides a very simple—and very general—encapsulation of evolutionary change. It forms the mathematical foundations of several topics in evolutionary biology, and has also been applied outwith evolutionary biology to a wide range of other scientific disciplines. However, the equation's combination of simplicity and generality has led to a number of misapprehensions as to what it is saying and how it is supposed to be used. Here, I give a simple account of what Price's equation is, how it is derived, what it is saying and why this is useful. In particular, I suggest that Price's equation is useful not primarily as a predictor of evolutionary change but because it provides a general theory of selection. As an illustration, I discuss some of the insights Price's equation has brought to the study of social evolution.
This article is part of the theme issue ‘Fifty years of the Price equation’.
The spectrum of antibacterial activity of human defensins and cathelicidin against gram-positive and gram-negative bacterial strains isolated from hospitalized patients
Authors: Bolatchiev Albert 
Published: March 2020

AbstractBackgroundTo date, there is a spread of resistance of microorganisms to antibiotics. To solve this problem, the search and development of new drugs with antibacterial activity is necessary. Antimicrobial peptides (AMPs) have pronounced antibacterial activity and may be promising candidates for the role of new drugs. Besides, AMPs can be used to overcome conventional antibiotics resistance due to the possible synergistic effect. In this work, the combined effect of some AMPs (human defensins, HNP-1, hBD-1, hBD-3 and cathelicidin, LL-37) with conventional antibiotics (vancomycin and imipenem) against gram-positive (Enterococcus faecalis; Staphylococcus aureus, methicillin-sensitive, MSSA, and methicillin-resistant, MRSA) and gram-negative (Escherichia coli; Klebsiella pneumoniae; Pseudomonas aeruginosa) bacterial strains was investigated.MethodsBacterial strains were isolated from hospitalized patients of the intensive care unit. Commercially available AMPs (HNP-1, hBD-1, hBD-3, LL-37 by Cloud-Clone Corp., USA) and antibiotics, vancomycin (Sandoz, Slovenia) and imipenem (Merck Sharp and Dohme, USA) were used. Antibiotic resistance phenotypes of isolated bacterial strains were carried out using the disk diffusion method. The standard checkerboard assays were used to study minimum inhibitory concentrations (MIC) of antimicrobials. The combined microbicidal effect of two substances (AMP+conventional antibiotic) was assessed by the fractional inhibitory concentration index (FICI). If FICI ≤ 0,5, then it was considered that two substances showed synergism of action; if 0.5 < FICI < 4 – no interaction; if FICI > 4 – antagonism.ResultsAll studied AMPs had antibacterial activity against the studied strains. hBD-3 showed the lowest MICs compared to other AMPs. MIC of hBD-3 against S. aureus (MSSA and MRSA), E. coli, K. pneumoniae was the same – 0.5 mg/L, and against P. aeruginosa it was 2 mg/L. The combinations HNP-1+vancomycin (against E. faecalis) and hBD-3+imipenem (against E. coli, K. pneumoniae, P. aeruginosa) according to FICI values have shown the synergistic effect. The results of this study can be used to develop novel antibiotics based on AMPs. Also, in some cases, AMPs can help to overcome resistance to conventional antibiotics.
Comparison of severe and non-severe COVID-19 pneumonia: review and meta-analysis
Authors: Ji Weiping , Zhang Jing , Bishnu Gautam , Du Xudong , Chen Xinxin , Xu Hui , Guo Xiaoling , Cai Zhenzhai , Shen Xian 
Published: March 2020

AbstractObjectiveTo compare the difference between severe and non-severe COVID-19 pneumonia and figure out the potential symptoms lead to severity.MethodsArticles from PubMed, Embase, Cochrane database, and google up-to 24 February 2020 were systematically reviewed. Eighteen Literatures were identified with cases of COVID-19 pneumonia. The extracted data includes clinical symptoms, age, gender, sample size and region et al were systematic reviewed and meta analyzed.Results14 eligible studies including 1,424 patients were analyzed. Symptoms like fever (89.2%), cough (67.2%), fatigue (43.6%) were common, dizziness, hemoptysis, abdominal pain and conjunctival congestion/conjunctivitis were rare. Polypnea/dyspnea in severe patients were significantly higher than non-severe (42.7% vs.16.3%, P<0.0001). Fever and diarrhea were higher in severe patients(p=0.0374and0.0267). Further meta-analysis showed incidence of fever(OR1.70,95%CI 1.01-2.87), polypnea/dyspnea(OR3.53, 95%CI 1.95-6.38) and diarrhea(OR1.80,95%CI 1.06-3.03) was higher in severe patients, which meant the severe risk of patients with fever, polypnea/dyspnea, diarrhea were 1.70, 3.53, 1.80 times higher than those with no corresponding symptoms.ConclusionsFever, cough and fatigue are common symptoms in COVID-19 pneumonia. Compared with non-severe patients, the symptoms as fever, polypnea/dyspnea and diarrhea are potential symptoms lead to severity.
The effect of depth context in the segmentation of the colon in MRI volumes
Authors: Benson Ezenwoko , Rier Lukas , Millican Isawan , Pritchard Sue , Costigan Carolyn , Pound Michael , Major Giles , French Andrew , Gowland Penny , Pridmore Tony , Hoad Caroline 
Published: March 2020

ABSTRACTColonic volume content measurements can provide important information about the digestive tract physiology. Development of automated analyses will accelerate the translation of these measurements into clinical practice. In this paper, we test the effect of data dimension on the success of deep learning approaches to segment colons from MRI data. Deep learning network models were developed which used either 2D slices, complete 3D volumes and 2.5D partial volumes. These represent variations in the trade-off between the size and complexity of a network and its training regime, and the limitation of only being able to use a small section of the data at a time: full 3D networks, for example, have more image context available for decision making but require more powerful hardware to implement. For the datasets utilised here, 3D data was found to outperform 2.5D data, which in turn performed better than 2D datasets. The maximum Dice scores achieved by the networks were 0.898, 0.834 and 0.794 respectively. We also considered the effect of ablating varying amounts of data on the ability of the networks to label images correctly. We achieve dice scores of 0.829, 0.827 and 0.389 for 3D single slices ablation, 3D multi-slice ablation and 2.5D middle slice ablation.In addition, we examined another practical consideration of deep learning, that of how well a network performs on data from another acquisition device. Networks trained on images from a Philips Achieva MRI system yielded Dice scores of up to 0.77 in the 3D case when tested on images captured from a GE Medical Systems HDxt (both 1.5 Tesla) without any retraining. We also considered the effect of single versus multimodal MRI data showing that single modality dice scores can be boosted from 0.825 to 0.898 when adding an extra modality.
Differential B-cell receptor signaling requirement for adhesion of mantle cell lymphoma cells to stromal cells
Authors: Sadeghi Laia , Arvidsson Gustav , Merrien Magali , Wasik Agata M. , Görgens André , Smith C.I. Edvard , Sander Birgitta , Wright Anthony P. 
Published: March 2020

AbstractInteractions between lymphoma cells and stromal cells play a key role in promoting tumor survival and development of drug resistance. We identified differences in key signaling pathways between the JeKo-1 and REC-1 mantle cell lymphoma (MCL) cell lines, which exhibited different patterns of stromal cell adhesion and chemotactic migration towards stroma-conditioned medium. The identified adhesion-regulated genes reciprocated important aspects of microenvironment-mediated gene modulation in MCL patients. 590 genes were differently regulated between the cell lines upon adhesion to stromal cells, while 32 genes were similarly regulated in both cell lines. Regulation of B-cell Receptor (BCR) signature genes in adherent cells was specific for JeKo-1. Inhibition of BCR signaling by siRNA or clinically approved inhibitors, Ibrutinib and Acalabrutinib, decreased adhesion of JeKo-1 but not REC-1 cells to stromal cells. Cell surface levels of CXCR4 were higher in JeKo-1 cells and CXCR4 was important for migration and adhesion of JeKo-1 but not REC-1 cells. Surface levels of ICAM1 adhesion protein differ for REC-1 and JeKo-1. While ICAM1 plays a positive role in adherence of both cell lines to stromal cells, S1PR1 had an inhibitory effect. The results presented here provide a model framework for further investigation of mechanistic differences in patient-response to new pathway-specific drugs.