bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peroral cholangioscopy‐guided forceps biopsy versus fluoroscopy‐guided forceps biopsy for extrahepatic biliary lesions
Authors: Onoyama Takumi , Hamamoto Wataru , Sakamoto Yuri , Kawahara Shiho , Yamashita Taro , Koda Hiroki , Kawata Soichiro , Takeda Yohei , Matsumoto Kazuya , Isomoto Hajime 
Published: August 2020

AbstractBackground and AimEndoscopic retrograde cholangiopancreatography (ERCP)‐related tissue acquisition, including fluoroscopy‐guided forceps biopsy (F‐FB), is a common technique in diagnosing indeterminate biliary lesions. Recently, peroral cholangioscopy (POCS) and POCS‐guided forceps biopsy (POCS‐FB) has also been used for the diagnosis of indeterminate biliary lesions. However, it is uncertain which of those techniques were superior for the diagnosis of extrahepatic cholangiocarcinoma (ECC). We aimed to evaluate the diagnostic yield and safety of F‐FB for indeterminate biliary lesions compared with POCS‐FB.MethodsPatients who underwent F‐FB or POCS‐FB to evaluate indeterminate biliary lesions between October 2011 and August 2019 were enrolled retrospectively. We carried out propensity score matching to balance these clinical differences between the F‐FB group and POCS‐FB group. In the propensity score‐matched cohort, we compared the diagnostic performance of F‐FB with that of POCS‐FB based on the pathological evaluation. We also evaluate adverse events associated with F‐FB and POCS‐FB.ResultsWe enrolled 113 patients with biliary diseases, and 62 patients were analyzed in the propensity score‐matched cohort. Sensitivity, specificity, and accuracy of F‐FB were 82.4, 100, and 90.3%, and for POCS‐FB, those values were 83.3, 100, and 90.3%, respectively. There were no significant differences in the diagnostic performance between F‐FB and POCS‐FB. There were also no significant differences in the occurrence of adverse events between F‐FB and POCS‐FB (41.9 vs 29.0%, P = 0.289).ConclusionsThe diagnostic yield of F‐FB for ECC is similar to that of POCS‐FB. POCS‐FB is not necessary for the initial pathological diagnosis of indeterminate biliary lesions.
Diagnostic utility of the serum–ascites albumin gradient in Mexican patients with ascites related to portal hypertension
Authors: Cervantes Pérez Enrique , Cervantes Guevara Gabino , Cervantes Pérez Gabino , Cervantes Cardona Guillermo Alonso , Fuentes Orozco Clotilde , Pintor Belmontes Kevin Josué , Guzmán Ramírez Bertha Georgina , Reyes Aguirre Laura Lizeth , Barbosa Camacho Francisco José , Bernal Hernández Aldo , González Ojeda Alejandro 
Published: August 2020

AbstractBackground and AimAnalysis of ascitic fluid is necessary to determine the etiology and to distinguish portal hypertension (PH)‐related and unrelated ascites. Numerous diagnostic parameters have been studied, but no single parameter has completely distinguished these. We aimed to validate the serum albumin–ascites gradient (SAAG) for the diagnosis of ascites secondary to PH and to establish cutoff points to predict PH using its sensitivity and specificity.MethodsThis was a cross‐sectional study conducted on patients diagnosed with ascites of any etiology. The SAAG and albumin concentration in ascitic fluid (AFA) were measured to establish their sensitivity and specificity for determining the presence or absence of PH. Cutoff points and levels of statistical significance were established based on the area under the curve.ResultsEighty‐seven patients were evaluated, of whom 74 (84%) were men, with an average age of 54.0 ± 13.6 years. Seventy‐two (83%) were diagnosed at admission with PH‐related ascites and 15 (17%) with non‐PH‐related ascites. SAAG correctly classified 48 (67%) patients, but 24 (33%) were classified incorrectly, while AFA classified 59 (82%) correctly and only 13 (17%) incorrectly. The diagnostic accuracy of SAAG was 57 versus 73% for AFA. AFA had a sensitivity of 82% and specificity of 66% (95% confidence interval [CI]: 0.63–0.93), while SAAG had a sensitivity of 66% but a specificity of 86% (95% CI: 0.72–0.95).ConclusionsThe SAAG showed poor diagnostic performance with low sensitivity but high specificity. The diagnostic accuracy of AFA is superior to that of SAAG in discriminating between PH and non‐PH ascites.
Pain management with opioids in adults
Authors: Montgomery Lori S. 
Published: August 2020

AbstractGiven the ubiquitous nature of opioids in the treatment of pain, it is an interesting paradox that this class of medications also represents one of the least understood components of clinical pain medicine. For many years, there has been intense interest in the mechanisms of opioid activity, but this has not resulted in a corresponding increase in convincing clinical data. This review focuses primarily on the evidence surrounding the long‐term use of opioids in chronic pain, but discussions of this research are often conflated with the very different data governing acute and cancer‐related pain, where evidence of efficacy is clearer. It is therefore important to clarify the evidence‐based indications for opioid therapy. There remains very little evidence that opioids improve function or quality of life beyond 3 months in people with chronic pain conditions. In all three patient populations, the development of tolerance, dependence, hyperalgesia and withdrawal are key phenomena that affect the patient experience, and in particular the decision to remain on opioids in the long term. This is a common thread that connects the opioid literature in all of these spheres, and justifies the burgeoning interest in these phenomena in the basic science literature. There is an urgent need to address these negative consequences of opioid use, in order to maximize the therapeutic benefit that opioids can offer.
Modelling global impacts of climate variability and trend on maize yield during 1980–2010
Authors: Yin Xiaomeng , Leng Guoyong 
Published: August 2020

AbstractEnhanced understanding of historical climate impacts on crop yield is critical for adaptation and mitigations within the context of global warming. Previous impact assessments rely on statistical or process‐based models, each with its own strength and weakness. To date, a global‐scale comparison between process‐based and statistical models in assessing climate impacts on yield variability and trends is lacking. Here, we leverage both statistical and process models to estimate global impacts of climate variability and trend on maize yield between 1980 and 2010. To allow for reasonable comparability, we develop a novel emulator to mimic each of eight global process‐based maize models, based on which the common set of climate scenarios are used for driving both statistical and process models. Results show that climate variability controls 42% of global maize yield variations in statistical model, while large discrepancy is found in process‐based models with R2 ranging from 0.22 to 0.61, especially at the country scale. Both statistical and most process models suggest that historical climate trend has led to a yield loss by 1.51–3.80% during the period 1980–1990. As for the period 1991–2000, however, the observed negative climate impacts are only captured by two process models. In contrast to the positive climate impact in statistical model, most of process‐based models simulated negative climate effects for the period 2001–2010, due to large yield sensitivity to maximum temperature in process models. This study highlights the large discrepancies not only among the eight process‐based models but also between statistical and process‐based models in simulating yield response to climate variation and trends, which has great implications for projecting future crop yields under climate change.
Comparison of Variations Between Spectral Doppler and Gaussian Surface Integration Methods for Umbilical Vein Blood Volume Flow
Authors: Rubin Jonathan M. , Li Sibo , Fowlkes J. Brian , Sethuraman Shriram , Kripfgans Oliver D. , Shi William , Treadwell Marjorie C. , Jago James R. , Leichner Ronald D. , Pinter Stephen Z. 
Published: August 2020

ObjectivesWe are studying a new method for estimating blood volume flow that uses 3‐dimensional ultrasound to measure the total integrated flux through an ultrasound‐generated Gaussian surface that intersects the umbilical cord. This method makes none of the assumptions typically required with standard 1‐dimensional spectral Doppler volume flow estimates. We compared the variations in volume flow estimates between techniques in the umbilical vein.MethodsThe study was Institutional Review Board approved, and all 12 patients gave informed consent. Because we had no reference standard for the true umbilical vein volume flow, we compared the variations of the measurements for the flow measurement techniques. At least 3 separate spectral Doppler and 3 separate Gaussian surface measurements were made along the umbilical vein. Means, standard deviations, and coefficients of variation (standard deviation/mean) for the flow estimation techniques were calculated for each patient. P < .05 was considered significant.ResultsThe ranges of the mean volume flow estimates were 174 to 577 mL/min for the spectral Doppler method and 100 to 341 mL/min for the Gaussian surface integration (GSI) method. The mean standard deviations (mean ± SD) were 161 ± 95 and 45 ± 48 mL/min for the spectral Doppler and GSI methods, respectively (P < .003). The mean coefficients of variation were 0.46 ± 0.17 and 0.18 ± 0.14 for the spectral Doppler and GSI methods respectively (P < 0.002).ConclusionsThe new volume flow estimation method using 3‐dimensional ultrasound appears to have significantly less variation in estimates than the standard 1‐dimensional spectral Doppler method.
Obstetric Ultrasound Screening in a Rural Area of Lebanon One Small Step With a Promising Major Impact
Authors: Snaifer Elie , Hassan Hala , Daher Lea , Sabbagh Anthony , Farah Marwan , Farekh Issa , Chalouhi Gihad E. 
Published: August 2020

ObjectivesOur aim was to evaluate the conditions and to weigh the potential impact of an obstetrical ultrasound screening intervention on pregnant patients in an underserved area of Lebanon with the presence of refugees.MethodsWe performed a cross‐sectional study in a rural region in North Lebanon. Monthly second‐trimester obstetrical ultrasound scans were offered to patients. A thorough analysis of the population's characteristics was done, the anomalies discovered were documented and follow up recommendations were offered.Results268 screening ultrasounds were performed over a one‐year period. The patients' mean age was 27.5 ± 8.5 years with a 35% consanguinity rate. A positive personal history of abnormalities was recognized in 34% of cases, and a positive family history in 21% of them. The average gestational age was of 23.3 ± 1.4 weeks of gestation. We found a rate of 8.6% inaccurate dating, 20% growth abnormalities, and 12% morphological abnormalities requiring follow‐up. These latter included defects affecting multiple organ systems among which renal, neurological, and cardiac structures were the most frequently affected (2.5%, 2%, and 1.6% respectively). Overall, 35.8% of the screened cases required a follow‐up for 1 or more abnormal findings.ConclusionsThe findings confirmed the necessity to introduce a prenatal ultrasound screening program in rural areas of Lebanon where refugees are settled. The lack of adequate ultrasound screening in these regions presents major threats that can hinder any pregnancy. Our simple intervention tackles the burden of diagnosis of these risks in up to 35.8% of pregnancies and thus can help improve outcomes.
Seasonal Use of Latrines by Bobcats: Implications for Monitoring Programs
Authors: Hilts Dylan J. , Gehring Thomas M. , Nielsen Clayton K. , Etter Dwayne R. , Brown Shelby M. , Truax Robert R. 
Published: August 2020

ABSTRACTLatrines serve as important communication networks among felids for transmitting information relative to social dominance, reproductive status, and defense of hunting areas. During January 2011–August 2012, we monitored 10 bobcat (Lynx rufus) latrines in the northern Lower Peninsula (NLP) of Michigan, USA, using motion‐sensitive cameras to estimate bobcat visitation and scat deposition rates among 3 biological seasons (mating, kitten‐rearing, non‐mating). Bobcat visitation rates differed among the 3 seasons. We found equal number of visits during the mating and kitten‐rearing seasons, and lower visitation rates during the non‐mating season. Scat deposition rates differed among the 3 seasons. We found a net gain of scats deposited during the mating and non‐mating seasons, whereas there was a net loss of scats during the kitten‐rearing season. An artificial latrine protocol we developed yielded visitation at 4 of 12 artificial latrine sites. Monitoring natural and artificial latrines during the mating and kitten‐rearing seasons could provide valuable data for managing bobcat populations. © 2020 The Wildlife Society.
Distinct Clinical Pathology and Microbiota in Chronic Rhinosinusitis With Nasal Polyps Endotypes
Authors: Abbas Elrayah E. , Li Chuan , Xie Ao , Lu Shan , Tang Li , Liu Yinhui , Elfadil Ayman , Wen Shu 
Published: August 2020

Objectives/HypothesisEosinophilic and noneosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP and NECRSwNP) show distinguished clinical pathology, but their underlying mechanism remains unclear. We aimed to investigate the clinical, hematological, and histopathological changes in chronic rhinosinusitis with nasal polyps (CRSwNP) endotypes and its association with microbiota.Study DesignA comparative cross‐sectional study.MethodsA comparative study of 46 patients with CRSwNP (34.69 ± 16.39 years old) who underwent endoscopic sinus surgery were recruited and subdivided into ECRSwNP and NECRSwNP groups based on eosinophilic tissue inflammation; 12 healthy controls were also included. A structured histopathological analysis was conducted, and complete blood count was determined in patients. Endoscopic‐guided middle meatus swabs and fecal samples were collected from the patients and controls and subsequently subjected to 16S rRNA gene sequencing on Illumina MiSeq.ResultsCompared to NECRSwNP, ECRSwNP showed a statistically significant increase in the computed tomography score, endoscopic score, blood eosinophil percentage, tissue eosinophil count, inflammation degree, subepithelial edema, and eosinophil aggregation. Airway microbiota communities differed among the three groups. The abundance of Moraxella and Parvimonas was significantly higher in the ECRSwNP group. Distinct microbiota dysbiosis in CRSwNP endotypes was found to be correlated with different clinical pathologies. Moreover, the gut microbiota in ECRSwNP and NECRSwNP showed dysbiosis, that is, significant decrease in the abundance of Actinobacteria in the former and significant increase in the abundance of Enterobacterales and several genera in NECRSwNP.ConclusionsSignificant clinical pathology and microbiota changes were evident in patients with ECRSwNP and NECRSwNP. Distinct microbiota dysbiosis was correlated with different clinical pathologies. Understanding these differences may improve the prognosis and treatment of chronic rhinosinusitis.Level of Evidence4 Laryngoscope, 131:E34–E44, 2021
Inflammatory Effects of Thickened Water on the Lungs in a Murine Model of Recurrent Aspiration
Authors: Nativ‐Zeltzer Nogah , Ueha Rumi , Nachalon Yuval , Ma Betty , Pastenkos Gabrielle , Swackhamer Clay , Bornhorst Gail M. , Lefton‐Greif Maureen A. , Anderson Johnathon D. , Belafsky Peter C. 
Published: August 2020

ObjectiveLiquid thickeners are commonly recommended in individuals with dysphagia and recurrent aspiration as a strategy for pneumonia prevention. The goal of this study was to examine the effects of small amounts of aspirated liquid thickener on the lungs.Study designAnimal model. Prospective small animal clinical trial.MethodsAdult Sprague Dawley rats (n = 19) were divided into two groups and underwent three intratracheal instillations of either xanthan gum‐based nectar‐thick water (0.1–0.25 mL/kg) or water‐only control over the course of 8 days. Blood was collected from a peripheral vein on days 1 and 8 and submitted for complete blood count (CBC) analysis. Rats were euthanized 10 days after the last instillation, and the lungs were harvested. Histopathology was conducted on lung specimens by a blinded licensed veterinary pathologist and scored for evidence of lung injury and pneumonia.ResultsFifteen animals (8 nectar‐thickener group, 7 control group) survived until the endpoint of the study (day 18). Serum CBC did not show abnormalities at any timepoint in either group. Histological evidence of lung inflammation and edema were significantly greater in the nectar‐thick group compared to controls (P < .05). Signs of inflammation included aggregates of foamy macrophages, expansion of bronchiolar lymphoid tissue, and large numbers of eosinophilic intraalveolar crystals. Histiocytic and neutrophilic pneumonia was noted in one animal that received thickened liquids.ConclusionRecurrent aspiration of small amounts of thickened water resulted in significant pulmonary inflammation in a murine model of aspiration. Results of this study support the need for further investigation of liquid thickener safety and its efficacy in reducing the pulmonary complications of swallowing disorders.Level of EvidenceNA Laryngoscope, 131:1223–1228, 2021
Oncological and Functional Outcomes of Primary and Salvage Total Laryngectomy
Authors: Bertolin Andy , Lionello Marco , Zanotti Claudia , Franz Leonardo , Giacomelli Luciano , Rizzotto Giuseppe , Marioni Gino 
Published: August 2020

ObjectivesTo evaluate and compare the oncological and functional outcomes of total laryngectomies (TL) performed as first line treatment or for salvage after failure of conservative approaches for treating advanced laryngeal carcinoma (LSCC).Study DesignA retrospective cohort study.MethodsA cohort of 217 patients who underwent TL was divided according to whether the procedure was for primary treatment of their LSCC (101 patients) or for recurrences after conservative surgery or chemo‐radiotherapy (116 patients).ResultsThe overall survival rate and disease‐specific survival rate were significantly higher in the primary TL group than in the salvage TL group (P = .04 and P = .01, respectively). The recurrence rate was significantly higher and the disease‐free survival (in months) was shorter for patients who had salvage TL than for those who had primary TL (P = .00 and P = .01, respectively). The salvage TL group also included significantly more cases of postoperative pharyngo‐cutaneous fistula needing salivary stent positioning, and experienced significantly longer hospital stays than the primary TL group (P = .04 and P = .03, respectively).ConclusionOncological and functional outcomes of primary TL were significantly better than after salvage TL. If salvage TL was performed after conservative surgery had failed, the oncological and functional results were better than after the failure of organ‐preserving protocols. This could justify a first attempt at conservative surgery for intermediate‐advanced LSCC in selected cases, reserving chemo‐radiotherapy only for patients unsuitable for surgery.Level of Evidence4 Laryngoscope, 131:E569–E575, 2021
Biliary Reconstruction in Adult Living Donor Liver Transplantation: The All‐Knots‐Outside Technique
Authors: Pamecha Viniyendra , Sasturkar Shridhar Vasantrao , Sinha Piyush Kumar , Mohapatra Nihar , Patil Nilesh 
Published: August 2020

Biliary complications (BCs) following living donor liver transplantation (LDLT) can lead to significant morbidity and occasional mortality. The present study describes our experience of the all‐knots‐outside technique (AKOT) of biliary reconstruction (BR) and its impact on BCs. A retrospective analysis was performed using prospectively collected data of 330 consecutive adult patients undergoing LDLT from July 2011 to February 2018 with a minimal follow‐up of 24 months. Only 2.8% required hepaticojejunostomy and were excluded. In an initial 122 patients, BR was performed with the standard technique (ST), and AKOT was performed in the subsequent 208 patients. In the AKOT group, a single anastomosis was attempted even for multiple ducts whenever feasible. A major BC was defined as requiring endoscopic, percutaneous, or surgical interventions. In the AKOT group, significantly more patients received a left lobe graft (5.7% versus 18.3%; P = 0.001), had shorter warm ischemia time (44.6 versus 27 minutes; P < 0.001), and had a left hepatic artery (LHA) in the right lobe that was used for arterial reconstruction (48 [39.3%] versus 122 [58.6%]; P = 0.003). The incidence of BCs in the entire cohort was 47 (14.2%). For the ST versus AKOT groups, the overall BCs (27/122 [22.1%] versus 20/208 [9.6%]; P = 0.003) and major BCs (20.5% versus 6.7%; P < 0.001) decreased significantly. In the multivariate analysis, the number of bile ducts (hazard ratio [HR], 4.18; 95% confidence interval [CI], 1.62‐10.78; P = 0.003), number of anastomoses (HR, 2.03; 95% CI, 1.03‐4.02; P = 0.04), and technique of anastomosis (HR, 0.36; 95% CI, 0.19‐0.68; P = 0.002) predicted BCs. In conclusion, in adult LDLT, with standardization of the donor and recipient surgery, preferential use of LHA for right lobe arterial reconstruction, reduction in the number of anastomoses, and AKOT for BR significantly decreased the incidence of BCs.
Setting behaviour, mechanical properties and heat generation under alternate current magnetic fields of Fe3O4/TiO2/PMMA composite bone cement
Authors: Kubota Moe , Yokoi Taishi , Ogawa Tomoyuki , Saito Shin , Furuya Maiko , Yokota Kotone , Kanetaka Hiroyasu , Jeyadevan Balachandran , Kawashita Masakazu 
Published: August 2020

AbstractPoly(methyl methacrylate) (PMMA) bone cement has excellent mechanical properties and is injectable; therefore, it is widely used as a filler for bone defects. To realize further effective treatment of bone defects, the design of PMMA cement containing magnetite (Fe3O4) and titania (TiO2), with good bone‐bonding properties and potential for application in magnetic hyperthermia treatment, is proposed. The ceramic content of the PMMA composite bone cements was varied from 20 mass% to 45 mass%. The setting behaviour, microstructure, compressive strength and heat generation under alternate current (AC) magnetic fields of the PMMA composite bone cements were evaluated. Determination of the setting temperature and time for the PMMA composite cements revealed that the maximum temperature during setting decreased with increasing Fe3O4 and TiO2 content while the setting time increased. The PMMA composite cements had dense microstructures regardless of the ceramic content. The nominal compressive strength for the samples ranged between 83 MPa and 94 MPa, which is sufficient for bone‐filling applications. Furthermore, the PMMA composite cement containing 25 mass% Fe3O4 generated heat under AC magnetic field, and its temperature reached 42.3°C after 10 min. Therefore, our findings contribute to the development of novel PMMA bone cements using functional ceramic components.
Laser‐pyrolysed paper electrodes for the square‐wave anodic stripping voltammetric detection of lead
Authors: Tasić Nikola , de Sousa de Oliveira Lucas , Paixão Thiago R. L. C. , Moreira Gonçalves Luís 
Published: August 2020

AbstractSingle‐use screen‐printed electrodes are relatively economical, still, they may not be cheap enough for low‐income countries when including shipping costs, places where often in situ water analysis is of great relevance. This work displays the proof of concept of applying laser‐pyrolysed paper electrodes (LPPEs) for lead (Pb) quantification. By simply and carefully burning ordinary cardboard with a commercially available CO2 laser, it was possible to fabricate low‐cost electrodes with a carbon‐based material as the electroactive surface. By means of square‐wave anodic stripping voltammetry (SWASV), and using zinc (Zn) as an internal standard (Ep = −1.02 vs. Ag), a limit of detection (LOD) of 6 ppb was attained for lead (Ep = −0.46 V vs. Ag) along with other suitable analytical performance parameters, such as 4% of repeatability and 5% of reproducibility.