bluuebunny/crossref_metadata_2025_split huggingface dataset:
The versatile free medial sural artery perforator flap: An institutional experience for reconstruction of the head and neck, upper and lower extremities
Authors: Sue Gloria R. , Kao Huang‐Kai , Borrelli Mimi R. , Cheng Ming‐Huei 
Published: December 2019

BackgroundThe medial sural artery perforator (MSAP) flap is an increasingly versatile and reliable flap for soft tissue reconstruction. This study investigates complication rates and long‐term outcomes of the MSAP flap.MethodsA retrospective review was performed on consecutive patients undergoing MSAP flap reconstruction at Chang Gung Memorial Hospital from 2006 through 2017. Patient demographics were assessed. Flap failure and wound complications were the outcome measures.ResultsIn the cohort of 246 patients that underwent a total of 248 MSAP flap reconstructions were identified. The average age was 47.5 years (range 15–76). Of the 248 flaps, 170 were used for reconstruction of the head and neck, 48 for upper extremity reconstruction, and 30 for lower extremity reconstruction. The average MSAP flap size was 5.2 × 11.8 cm. 31 (12.5%) of the flaps developed arterial occlusion, venous insufficiency, or a hematoma postoperatively requiring re‐exploration. Nineteen were successfully salvaged, yielding an overall failure rate of 4.8%. Minor complications included the need for flap debridement in 18 cases (7.3%) and need for donor site debridement in eight cases (3.2%).ConclusionsThe MSAP flap can be used in a versatile fashion to reconstruct defects of the head and neck, upper extremity, and lower extremity with minimal complication rates.
Are there different patterns of detrusor overactivity which are clinically relevant? ICI‐RS 2018
Authors: Gajewski Jerzy B. , Gammie Andrew , Speich John , Kirschner‐Hermanns Ruth , De Wachter Stefan , Schurch Brigitte , Korstanje Cees , Valentini Francoise , Rahnama’i Mohammad Sajjad 
Published: December 2019

AbstractIntroductionDifferent patterns of detrusor overactivity (DO) have been described and included in several standardization terminology documents. However, it is unclear if these different patterns have any clinical significance.MethodsThis is a report of the proceedings of Proposal 3: “Are there different patterns of detrusor overactivity which are clinically relevant?” from the annual International Consultation on Incontinence—Research Society (ICIRS) meeting, which took place from 14 to 16 June 2018, in Bristol, UK.ResultsWe have collected and discussed, as a committee, the evidence about different urodynamic (UD) patterns of detrusor overactivity and their potential clinical significance. We reviewed the important previous basic research and clinical studies and compiled summaries. The discussion focused on clinical relevance of different UD patterns of DO and what further research is required.ConclusionsThere are several UD definitions of patterns of detrusor overactivity, however the clinical relevance of these definitions remains unclear. Future research should concentrate on defining the pattern of DO in relation to clinical diagnosis, gender, age, and treatment outcomes.
Do we need better information to advise women with stress incontinence on their choice of surgery? Report from the ICI‐RS 2018
Authors: Giarenis Ilias , Malde Sachin , Harding Christopher , Robinson Dudley , Gajewski Jerzy , Rahnamai Mohammad , Cardozo Linda 
Published: December 2019

AbstractAimsThe regulatory warnings about the safety of the synthetic midurethral slings (MUS) had a significant effect on how patients and physicians approach surgical management of stress urinary incontinence (SUI). In this changing landscape, the purpose of this research Think Tank (TT) was to provide an update of the current knowledge about the safety and efficacy of SUI surgery, to review patient goals and expectations and to identify factors affecting the decision making for surgery.MethodsThis is a consensus report of the proceedings of TT3: “Do we need better information to advise women with stress incontinence on their choice of surgery?” from the annual International Consultation on Incontinence‐Research Society (ICI‐RS), June 2018.ResultsDespite the body of evidence supporting the continued use of MUS, the short follow‐up of most of the studies and the lack of “real life” data regarding pain and sexual dysfunction make the development of recommendations challenging. Women with SUI are often happy to “trade” efficacy for a procedure with less associated morbidity and therefore it is not always the procedure with the highest success rate that is ultimately chosen. However, a number of factors influence treatment decision and there is limited evidence about what level of all these factors women are willing to tolerate for a given success rate, or how much success they are willing to trade for a lower complication rate.ConclusionsThe ICI‐RS proposed research questions which may be able to assist in improving the counseling and management of women with SUI.
Stem cells and lower urinary tract dysfunction: Has its potential finally reached clinical maturity? ICI‐RS2018
Authors: Chermansky Christopher , Mitsogiannis Iraklis , Abrams Paul , Apostolidis Apostolos 
Published: December 2019

AbstractAimsEfforts to engineer and repair genitourinary tissue to treat lower urinary tract dysfunction (LUTD) have recently increased thanks in part to advances in stem cell (SC) research. At the International Consultation on Incontinence‐Research Society meeting in Bristol in 2018 a proposal was convened to address the question: has the potential of SCs in treating LUTD reached clinical maturity?MethodsThe proposal conducted a literature review and an expert consensus meeting focusing on available data from animal models and clinical trials involving the use of SCs for LUTD.ResultsTo date, there are only small studies investigating bladder replacement using scaffolds with or without SC. Results have been conflicting because of the variability in cell numbers, biomaterials types, and graft surface differences. Similarly, preclinical results suggest a possible role of SC in bladder outlet obstruction (BOO); however, SC clinical trials for BOO are lacking. Research into the use of SC for female stress urinary incontinence (SUI) is close to reaching clinical maturity. In the Canadian phase 3 randomized controlled trial (RCT), a beneficial effect of adult muscle–derived cells (AMDC) over placebo was detected in reducing the frequency of incontinence episodes, especially after prior anti‐incontinence surgery. Only two small studies have been published on male SUI.ConclusionsQuestions remain regarding the mechanism of action of SC injected into the LUT and the viability of cells seeded onto grafts placed into the LUT. Also, the optimal time for intervention with SC therapy in the LUT remains to be elucidated.
Exploring the relation between obesity and urinary incontinence: Pathophysiology, clinical implications, and the effect of weight reduction, ICI‐RS 2018
Authors: Marcelissen Tom , Anding Ralf , Averbeck Marcio , Hanna‐Mitchell Ann , Rahnama'i Sajjad , Cardozo Linda 
Published: December 2019

AbstractAimsTo evaluate the relationship between obesity and urinary incontinence (UI) and to determine the effect of weight reduction on the severity of incontinence.MethodsThis is a consensus report of the proceedings of a Research Proposal from the annual International Consultation on Incontinence‐Research Society, 14 June to 16 June, 2018 (Bristol, UK): “What are the relationships between obesity and UI, and the effects of successful bariatric surgery?”ResultsObesity is an increasing problem worldwide and is associated with many adverse effects on health and quality of life. From both translational and clinical studies, there is a strong relationship between obesity and the occurrence of UI. Both mechanical and metabolic factors seem to play an important role including systemic inflammation and oxidative stress due to the release of cytokines in visceral adipose tissue. The success rate of anti‐incontinence surgery does not seem to be greatly affected by body mass index (BMI), although reliable data and long‐term follow‐up are currently lacking. Both weight reduction programs and bariatric surgery can result in amelioration of UI. Various studies have shown that weight loss (particularly that associated with bariatric surgery) can reduce incontinence, and the degree of weight loss is positively correlated with improvement in symptoms.ConclusionsObesity is strongly associated with an increased prevalence of both stress and urgency UI. The treatment outcome does not seem to be highly dependent on BMI. Weight reduction is positively correlated with improvement of incontinence symptoms and therefore should be advocated in the management.
Quantitative electrical pain threshold assessment in the lower urinary tract
Authors: van der Lely Stéphanie , Liechti Martina D. , Bachmann Lucas M. , Kessler Thomas M. , Mehnert Ulrich 
Published: December 2019

AbstractAimsAssessing the reliability of electrical pain threshold (PT) and evaluating the impact of stimulation frequency at different locations in the healthy lower urinary tract (LUT).MethodsNinety subjects (age: 18.3‐35.8 years, 40 females, 50 males) were randomly allocated to one stimulation site (bladder dome [BD], trigone, proximal, membranous (only males), or distal urethra). Using 0.5 Hz/1.1 Hz/1.6 Hz electrical stimulation (square wave, pulse width:1 ms), current perception thresholds (CPTs), PTs and tolerance thresholds were assessed at two visits. Analyses were performed using linear mixed models, intraclass correlation coefficients (ICC) and Bland‐Altman method.ResultsPTs vary in relation to stimulation frequency, location and between genders. PT decreased with higher stimulation frequency. The highest PTs were measured at the BD and membranous urethra with males reporting higher PTs than females. Reliability of PT assessments according to ICC was good to excellent across all frequencies, locations, and genders (ICC = 0.61‐0.97), except for BD and distal urethra in females showing poor to fair reliability (BD: all frequencies, distal urethra: 0.5 Hz).ConclusionsPTs can be safely and reliably assessed from bladder and urethral locations. Semi‐objective PT assessment may provide additional information on functionality and sensitivity of the LUT slow fiber afferents and complement findings from urodynamic investigations and CPT assessments. In conclusion, the developed methodology may open new opportunities for using electrical stimulation paradigms for LUT PT assessments and diagnostics. All this allows a more precise, location‐specific characterization of pain origin and pain reaction towards therapy.
Interior‐point methods and preconditioning for PDE‐constrained optimization problems involving sparsity terms
Authors: Pearson John W. , Porcelli Margherita , Stoll Martin 
Published: December 2019

SummaryPartial differential equation (PDE)–constrained optimization problems with control or state constraints are challenging from an analytical and numerical perspective. The combination of these constraints with a sparsity‐promoting L1 term within the objective function requires sophisticated optimization methods. We propose the use of an interior‐point scheme applied to a smoothed reformulation of the discretized problem and illustrate that such a scheme exhibits robust performance with respect to parameter changes. To increase the potency of this method, we introduce fast and efficient preconditioners that enable us to solve problems from a number of PDE applications in low iteration numbers and CPU times, even when the parameters involved are altered dramatically.
Fetal fraction and noninvasive prenatal testing: What clinicians need to know
Authors: Hui Lisa , Bianchi Diana W. 
Published: December 2019

AbstractThe fetal fraction (FF) is a function of both biological factors and bioinformatics algorithms used to interpret DNA sequencing results. It is an essential quality control component of noninvasive prenatal testing (NIPT) results. Clinicians need to understand the biological influences on FF to be able to provide optimal post‐test counseling and clinical management. There are many different technologies available for the measurement of FF. Clinicians do not need to know the details behind the bioinformatics algorithms of FF measurements, but they do need to appreciate the significant variations between the different sequencing technologies used by different laboratories. There is no universal FF threshold that is applicable across all platforms and there have not been any differences demonstrated in NIPT performance by sequencing platform or method of FF calculation. Importantly, while FF should be routinely measured, there is not yet a consensus as to whether it should be routinely reported to the clinician. The clinician should know what to expect from a standard test report and whether reasons for failed NIPT results are revealed. Emerging solutions to the challenges of samples with low FF should reduce rates of failed NIPT in the future. In the meantime, having a “plan B" prepared for those patients for whom NIPT is unsuccessful is essential in today's clinical practice.
Distributions, conservation status, and abiotic stress tolerance potential of wild cucurbits (Cucurbita L.)
Authors: Khoury Colin K. , Carver Daniel , Kates Heather R. , Achicanoy Harold A. , van Zonneveld Maarten , Thomas Evert , Heinitz Claire , Jarret Robert , Labate Joanne A. , Reitsma Kathy , Nabhan Gary P. , Greene Stephanie L. 
Published: December 2019

Societal Impact StatementCrop wild relatives—wild species closely related to cultivated plants—are valuable genetic resources for crop improvement, but gaps in knowledge constrain their conservation and limit their further use. We develop new information on the distributions, potential breeding value, and conservation status of the 16 known wild relatives of cultivated pumpkins, squashes, zucchini, and gourds (Cucurbita L.). The taxa occur from the central USA to Central America, plus two South American species, with the greatest richness in central Mexico and the western borderlands between Mexico and the USA. We determine the majority of species are of medium priority for conservation, both with regard to collecting for ex situ maintenance, and for enhanced habitat protection.
Summary

Crop wild relatives are valuable genetic resources for crop improvement. Knowledge gaps, including with regard to taxonomy, distributions, and characterization for traits of interest constrain their use in plant breeding. These deficiencies also affect conservation planning, both with regard to in situ habitat protection, and further collection of novel diversity for ex situ maintenance.

Here we model the potential ranges of all 16 known wild cucurbit taxa (Cucurbita L.), use ecogeographic information to infer their potential adaptations to abiotic stresses, and assess their ex situ and in situ conservation status.

The taxa occur from the central USA to Central America, plus two South American species. Predicted taxon richness was highest in central Mexico and in the western borderlands between Mexico and the USA. We find substantial ecogeographic variation both across taxa and among populations within taxa, with regard to low temperatures, high and low precipitation, and other adaptations of potential interest for crop breeding.

We categorize 13 of the taxa medium priority for further conservation as a combination of the ex situ and in situ assessments, two low priority, and one sufficiently conserved. Further action across the distributions of the taxa, with emphasis on taxonomic richness hotspots, is needed to comprehensively conserve wild Cucurbita populations.
Challenging scenarios in nontuberculous mycobacterial infection in cystic fibrosis
Authors: Martiniano Stacey L. , Esther Charles R. , Haworth Charles S. , Kasperbauer Shannon H. , Zemanick Edith T. , Caverly Lindsay J. 
Published: December 2019

AbstractThis review summarizes the discussion of a session held during the 2018 North American Cystic Fibrosis (CF) Conference titled “Challenging Cases in Nontuberculous Mycobacterial (NTM) Management.” In this session, a multidisciplinary panel of NTM experts discussed clinical challenges related to the management of NTM infection in people with CF in which decision‐making falls outside of the Cystic Fibrosis Foundation/European Cystic Fibrosis Society NTM guidelines. Topics discussed included managing newly acquired NTM infection, selecting and monitoring treatment regimens, determining treatment endpoints, and caring for patients after NTM treatment.
Clinical outcome of whole‐body gamma‐knife combined with pemetrexed concurrent chemoradiotherapy in elderly patients with locally advanced lung adenocarcinoma
Authors: Pang Jun , Chen Yan , Hao Guang‐yuan 
Published: December 2019

AbstractObjectiveCurrently, concurrent chemoradiotherapy has become the standard treatment for locally advanced non‐small cell lung cancer, but it is often difficult for elderly patients to tolerate. In this study, we evaluated the curative effect, acute radiation reaction, and clinical application of stereotactic radiotherapy with whole‐body gamma‐knife combined with pemetrexed treatment in elderly patients with locally advanced lung adenocarcinoma.MethodsA total of 37 elderly patients with lung adenocarcinoma from Hubei Provincial Armed Police Corps Hospital from 2 January 2013 to 30 December 2015, who were treated with stereotactic radiotherapy with super‐gamma‐knife, were included in the study. The radiotherapy plan was made according to the patient's physical condition, tumor location and size, and therapeutic purpose. A dose of 3.5–5 Gy was administered by 50–70% isodose curve, with a total dose range of peripheral irradiation 35–45 Gy. In the same period, pemetrexed was administered at 500 mg/m2, the first day of chemotherapy (d1), intravenous drip, with 21 days as one cycle, and the number of cycles was more than two.ResultsThe median follow‐up duration was 18 months, and the 1‐, 2‐, and 3‐year follow‐up rates were 86.49% (32/37), 59.46% (33/37), and 21.62% (8/37), respectively. There were no missing cases. After 2–3 months of treatment, computed tomography showed that 13 patients (35.14%) had complete remission, 22 patients (59.46%) had partial remission, one patient (2.70%) achieved a stable status, and one patient (2.70%) still had progression, and the total response rate was 94.59%. The 1‐year local control rate was 67.57%. The 1‐, 2‐, and 3‐year overall survival rates were 86.49%, 45.45%, and 25.00%, respectively. The median overall survival time was 17.0 months (95% CI 14.5–21.3 months); the progression‐free survival time was 12.0 months (95% CI 11.6–12.8 months). Multivariate analysis showed that lymph node stage N ≥2 and radiotherapy biological effective dose <60 Gy were the adverse prognostic indicators of overall survival (P = 0.016 and P = 0.032, respectively). The 1‐year local control rate and median survival time were 62.50% and 71.43%, and 19 and 17 months in the gross tumor volume ≥120 cm3 subgroup and gross tumor volume <120 cm3 subgroup, respectively. There was no significant statistical difference (P = 0.061 and P = 0.400, respectively). The incidence rates of grade 3–4 neutropenia and thrombocytopenia were 10.81% (4/37) and 5.41% (2/37), respectively, during the period of concurrent chemoradiotherapy. The incidence of grade 2 radiation‐induced pneumonitis and esophagitis was 13.51% and 16.22%, respectively. No grade >2 acute or late lung and esophagus toxicity was observed.ConclusionsIn elderly patients with lung adenocarcinoma, stereotactic body radiotherapy with super‐gamma‐knife combined with pemetrexed treatment is safe and definitive, with mild adverse effects.
Effects of monocyte chemoattractant protein‐1, macrophage inflammatory protein‐1α, and interferon‐α2a on P450 enzymes in human hepatocytes in vitro
Authors: Czerwiński Maciej , Gilligan Krystal , Westland Kevin , Ogilvie Brian W. 
Published: December 2019

AbstractSome immunomodulatory agents stimulate the release of cytokines capable of suppressing P450 enzymes and potentially affecting pharmacokinetics of coadministered medications. Cytokines released in response to an immunomodulator in the blood ex vivo can be used to screen for the potential for drug‐drug interactions. Tilsotolimod, an investigational agonist of Toll‐like receptor 9, stimulated the release of macrophage chemoattractant protein‐1 (MCP‐1), macrophage inflammatory protein‐1α (MIP‐1α), and interferon‐α2a (INF‐α2a) in blood obtained from healthy donors. Although tilsotolimod did not directly affect CYP1A2, CYP2B6, or CYP3A4 expression or activity, the cytokines stimulated by the drug reduced CYP1A2 and CYP2B6 enzyme activities in cultured human hepatocytes. This study sought to identify which cytokines were responsible for tilsotolimod's indirect effects on P450 enzymes in vitro. A 72‐h treatment with recombinant human chemokines MCP‐1 and MIP‐1α did not alter CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP3A4, or signal transducer and activator of transcription 1 (STAT1) mRNA expression or CYP1A2, CYP2B6, or CYP3A4/5 enzyme activity in cocultures of human hepatocytes and Kupffer cells. INF‐α2a, at 2.5 ng/mL but not at the lower concentrations applied to the cells, increased CYP1A2 and STAT1 mRNA by 2.4‐ and 5.2‐fold, respectively, and reduced CYP2B6 enzyme activity to 46% of control. This study established that INF‐α2a, but not MCP‐1 or MIP‐1α, mediated tilsotolimod effects on CYP1A2 and CYP2B6 expression in human hepatocytes.
Analysis on the work safety level in different provinces and regions of China
Authors: Wu Daming 
Published: December 2019

AbstractThe work safety level is a reflection of the work safety situation, but in the past, we simply used a single absolute indicator or a single relative indicator to measure the work safety level, which is inadequate. This paper chooses five relative indicators and uses grey fixed weight clustering method to give a comprehensive evaluation of the work safety level in different provinces. According to the evaluation results, we grade the work safety level of geographic and economic regions, and find the gap in different provinces and regions. Our analysis suggests that the work safety level in different provinces and regions basically accords with the stage of industrialization process, but the fluctuated data analysis indicates that the theory of the relationship between the work safety and industrialization process has its defects, and the warped‐tail phenomenon of work safety level in the final and mature stage of industrialization process is thus pointed out. Taking the comparison between Henan and Shanghai as an example of the analysis of the warped‐tail phenomenon, the factors related to the work safety level in the final and mature stage of industrialization process are discussed.