bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity of laryngomalacia classification systems: A multi‐institutional agreement study
Authors: Sivarajah Shanmugappiriya , Isaac Andre , Anderson Shelaina , Mehta Deepak , Hong Paul , Alrajhi Yaser , El‐Hakim Hamdy 
Published: March 2020

AbstractObjectivesTo determine the agreement of paediatric otolaryngologists on classifying laryngomalacia (LM).DesignIntra‐ and interobserver agreement study of two classification systems.SettingThree tertiary referral paediatric centres.ParticipantsThree paediatric otolaryngologists, who were blinded to any clinical details, interpreted the videos of children diagnosed with LM using the Holinger and Olney classifications independently. They rated the videos twice with a washout period of at least 2 weeks.The main outcome measuresInter‐ and intra‐observer agreement measured by overall Fleiss kappa and unweighted Cohen's kappa coefficients. The secondary outcome measures were inter‐ and intra‐observer agreement on the individual anatomical subunits of the supraglottis affected by LM, characterised by the subcategories of the classifications.ResultsVideo records of infants and children <18 years who had an endoscopic diagnosis of LM from 2012 to 2017 were retrospectively chosen for inclusion (n = 73). The overall Fleiss kappa coefficient was 0.25 (95% CI 0.18‐0.32) amongst the raters using the Holinger classification and 0.31 (95% CI 0.21‐0.42) for the Olney classification. Intra‐observer agreement using the Holinger classification was 0.30 (95% CI 0.18‐0.42), 0.62 (95% CI 0.23‐0.85) and 0.84 (95% CI 0.75‐0.94], whilst the Olney classification yielded values of 0.41 (95% CI 0.26‐0.56), 0.51 (95% CI 0.29‐0.63) and 0.63 (95% CI 0.48‐0.78).ConclusionsThe agreement on types of LM between expert observers is modest using the Holinger and Olney classifications. This has significant implications for accurately diagnosing LM and exposes potential obstacles against credible pooling of data and extrapolation of information.
Robotic transanal minimally invasive surgery – technical, oncological and patient outcomes from a single institution
Authors: Baker E. J. , Waters P. S. , Peacock O. , Narasimhan V. , Larach T. , McCormick J. , Heriot A. G. , Warrier S. , Lynch C. 
Published: March 2020

AbstractAimRobotic transanal minimally invasive surgery (R‐TAMIS) is gaining traction around the globe as an alternative to laparoscopic conventional TAMIS for local excision of benign and early malignant rectal lesions. The aim was to analyse patient and oncological outcomes of R‐TAMIS for consecutive cases in a single centre.MethodsA prospective analysis of consecutive R‐TAMIS procedures over a 12‐month period was performed. Data were collated from hospital databases and theatre registers.ResultsEleven patients (six men, five women), mean age 69.81 years (51−92 years), underwent R‐TAMIS over 12 months utilizing a da Vinci Xi platform. The mean lesion size was 36 mm (20–60 mm) with a mean distance from the anal verge of 7.5 cm (3–14 cm). Five lesions were posterior in anatomical location, four anterior, one right lateral and one left lateral. All procedures were performed in the lithotomy position using a GelPOINT Path Platform. Mean operative time was 64 min (40–100 min). Complete resection was achieved in 10/11 patients with two patients being upgraded to a diagnosis of adenocarcinoma. Nine patients were diagnosed with dysplastic lesions. Four patients had a false positive diagnosis of an invasive tumour on MRI. Six patients required suturing for full‐thickness resections. One patient had a postoperative bleed requiring repeat endoscopy and clipping. One patient (full‐thickness resection of T3 tumour) proceeded to a formal resection without difficulty with no residual disease (T0N0, 0/22). One patient with a fully resected T2 tumour is undergoing a surveillance protocol. The mean length of stay was 1 day with two patients having a length of stay of 2 days and one patient of 4 days.ConclusionR‐TAMIS could potentially represent a safe novel approach for local resection of rectal lesions.
Aggressive utilization of liver allografts: Improved outcomes over time
Authors: Rana Abbas , Price Matthew Brent , Barrett Spencer C. , Lai Jennifer , Bakhtiyar Syed Shahyan , Kanwal Fasiha , Vierling John , Wu Mengfen , Galvan Nhu Thao , Goss John 
Published: March 2020

AbstractBackgroundAggressive acceptance of liver allografts has driven utilization of marginal allografts. Our aim was to assess the impact of the aggressive phenotype on transplant center outcomes over time.MethodsWe used a cohort of 148 361 candidates from the Organ Procurement and Transplantation Network for liver transplantation between 2002 and 2016 in 134 centers. Using the Discard Risk Index, we designated high probability discard allografts by the top 10th percentile for likelihood of discard. Aggressive phenotype was defined by usage of high probability discard (HPD) allografts (top 10th percentile). Our analysis of survival on waitlist and graft survival after transplantation included a comprehensive list of center level covariates across three equal time periods (2002‐2006, 2007‐2011, and 2012‐2016).ResultsAfter adjusting for recipient and center‐level factors, aggressive centers had improving graft survival over time. Aggressive vs non‐aggressive centers: 2002‐2006 HR 1.12 (1.05‐1.19), 2007‐2011 HR 1.13 (1.05‐1.22), 2012‐2016 HR 0.99 (0.89‐1.10). Aggressive centers had improved waitlist survival compared with non‐aggressive centers after adjusting for allograft disparity.ConclusionsAggressive phenotype had a positive impact on waitlist survival, and graft survival in aggressive centers have improved to benchmark levels over time. These findings serve as justification for aggressive utilization of allografts.
Transversus abdominis plane (TAP) block for laparoscopic live donor nephrectomy: Continuous catheter infusion provides no additional analgesic benefit over single‐injection ropivacaine
Authors: Yeap Yar L. , Wolfe John W. , Kroepfl Elizabeth , Fridell Jonathan , Powelson John A. 
Published: March 2020

AbstractBackgroundTransversus abdominis plane (TAP) blocks are useful for adjunctive pain control following laparoscopic live donor nephrectomy (LLDN). The objective was to determine if TAP catheter provides additional analgesia compared with single‐injection TAP block alone for kidney donors.MethodsIn this prospective, double‐blinded, randomized controlled trial, LLDN patients received a single TAP injection of 30 mL 0.2% ropivacaine and had a catheter inserted into the TAP space. Postoperatively, either 0.2% ropivacaine (TAP catheter group; TAP‐C) or saline (TAP saline group; TAP‐S) was infused at 10 mL/h. Pain scores, narcotic usage, nausea, and sedation were evaluated at 1, 12, 24, 36, 48, and 60 hours.ResultsThe study population included 70 patients (35 randomly assigned to each group). No differences in pain scores, narcotic usage, nausea, or sedation were observed at any time point (with the exception of lower median pain score for TAP‐S at 60 hours; 3.2 vs 3.9 for TAP‐C; P = .03).ConclusionsThe lower pain score for placebo group at 60‐hour postoperative is likely clinically insignificant. The TAP catheter infusion provided no benefit over a single‐injection TAP block; thus, the added risk and cost are not supported. Liposomal bupivacaine should be evaluated in future studies.
Describing barriers and facilitators for medication adherence and self‐management among kidney transplant recipients using the information‐motivation‐behavioral skills model
Authors: Ranahan Molly , Von Visger Jon , Kayler Liise K. 
Published: March 2020

AbstractBackgroundWe aimed to develop an adapted information‐motivation‐behavioral skills (IMB) model to describe barriers and facilitators for adherence and self‐management among kidney transplant recipients.MethodsWe conducted a review of literature about kidney transplant recipients' knowledge, perceptions, and experiences and organized our results using the IMB framework. We then conducted interviews with transplant recipients and transplant providers to supplement our literature search.ResultsOur proposed adaption of the IMB model describes informational, motivational, and behavioral skills barriers and facilitators for medication adherence and self‐management among kidney transplant recipients. Moderating factors influence not only behavioral skills, but also recipients' understanding of information and motivation to adhere and practice self‐management.ConclusionBy using the IMB model to organize current research and interviews with recipients and providers, we developed an adapted model for medication adherence and self‐management. Results are promising to impact future educational and behavioral interventions for kidney transplant recipients.
Environmental drivers of large‐scale movements of baleen whales in the mid‐North Atlantic Ocean
Authors: Pérez‐Jorge Sergi , Tobeña Marta , Prieto Rui , Vandeperre Frederic , Calmettes Beatriz , Lehodey Patrick , Silva Mónica A. 
Published: March 2020

AbstractAimUnderstanding the environmental drivers of movement and habitat use of highly migratory marine species is crucial to implement appropriate management and conservation measures. However, this requires quantitative information on their spatial and temporal presence, which is limited in the high seas. Here, we aimed to gain insights of the essential habitats of three baleen whale species around the mid‐North Atlantic (NA) region, linking their large‐scale movements with information on oceanographic and biological processes.LocationMid‐NA Ocean.MethodsWe present the first study combining data from 31 satellite tracks of baleen whales (15, 10 and 6 from fin, blue and sei whales, respectively) from March to July (2008–2016) with data on remotely sensed oceanography and mid‐ and lower trophic level biomass derived from the spatial ecosystem and population dynamics model (SEAPODYM). A Bayesian switching state‐space model was applied to obtain regular tracks and correct for location errors, and pseudo‐absences were created through simulated positions using a correlated random walk model. Based on the tracks and pseudo‐absences, we applied generalized additive mixed models (GAMMs) to determine the probability of occurrence and predict monthly distributions.ResultsThis study provides the most detailed research on the spatio‐temporal distribution of baleen whales in the mid‐NA, showing how dynamic biophysical processes determine their habitat preference. Movement patterns were mainly influenced by the interaction of temperature and the lower trophic level biomass; however, this relationship differed substantially among species. Best‐fit models suggest that movements of whales migrating towards more productive areas in northern latitudes were constrained by depth and eddy kinetic energy.Main conclusionsThese novel insights highlight the importance of integrating telemetry data with spatially explicit prey models to understand which factors shape the movement patterns of highly migratory species across large geographical scales. In addition, our outcomes could contribute to inform management of anthropogenic threats to baleen whales in sparsely surveyed region.
Data‐Driven Driver Dispatching System with Allocation Constraints and Operational Risk Management for a Ride‐Sharing Platform
Authors: Wang Tianyu , Wu Desheng 
Published: March 2020

ABSTRACTIn this article, we develop and analyze a driver dispatching system for a control center that aims to minimize passengers' waiting time. The system imposes allocation constraints that ensure a minimum number of drivers in different regions to manage operational risk. The data‐driven system is based on Rolling Time Horizon approach and utilizes knowledge learned from historical data. It incorporates a hybrid forecasting model and a heuristic algorithm to solve the off‐line problem in each iteration. We show that the NP‐hardness of the off‐line problem lies in allocation constraints. We test the performance of the system with a simulation study based on actual past taxi order data. The result suggests that the system markedly decreases the average waiting time and saves planning time in comparison with the request‐driven dispatching mode. The result also demonstrates that in nonextreme cases, the dispatching system finds an acceptable solution which approximately satisfies allocation constraints while guaranteeing a short increase in waiting time.
The changing epidemiology of the ageing thalassaemia populations: A position statement of the Thalassaemia International Federation
Authors: Farmakis Dimitrios , Giakoumis Anastasios , Angastiniotis Michael , Eleftheriou Androulla 
Published: March 2020

AbstractTherapeutic advances in β‐thalassaemia have gradually lead to a significant improvement in prognosis over the past few decades. As a result, patients living in areas where disease‐specific programmes offering access to modern therapy are in place experience a new era of prolonged survival that tends to reach that of the normal population. This ageing thalassaemia population, however, faces a new spectrum of comorbidities resulting from increasing age that may jeopardise the advances in prognosis provided by current therapy and thus poses new challenges in diagnosis, monitoring and treatment. In this position paper of the Thalassaemia International Federation, we review the changing epidemiology and clinical spectrum of patients with β‐thalassaemia and propose actions to be undertaken in order to address the emerging spectrum of comorbidities resulting from ageing.
Direction and magnitude of natural selection on body size differ among age‐classes of seaward‐migrating Pacific salmon
Authors: Ulaski Marta E. , Finkle Heather , Westley Peter A. H. 
Published: March 2020

AbstractDue to the mediating role of body size in determining fitness, the “bigger‐is‐better” hypothesis still pervades evolutionary ecology despite evidence that natural selection on phenotypic traits varies in time and space. For Pacific salmon (genus Oncorhynchus), most individual studies quantify selection across a narrow range of sizes and ages; therefore, uncertainties remain concerning how selection on size may differ among diverse life histories. Here, we quantify the direction and magnitude of natural selection on body size among age‐classes of multiple marine cohorts of O. nerka (sockeye salmon). Across four cohorts of seaward migrants, we calculated standardized selection differentials by comparing observed size distributions of out‐migrating juvenile salmon to back‐calculated smolt length from the scales of surviving, returning adults. Results reveal the magnitude of selection on size was very strong (>90th percentile compared to a database of 3,759 linear selection differentials) and consistent among years. However, the direction of selection on size consistently varied among age‐classes. Selection was positive for fish migrating to sea after two years in freshwater (age 2) and in their first year of life (age 0), but negative for fish migrating after 1 year in freshwater (age 1). The absolute magnitude of selection was negatively correlated to mean ocean‐entry timing, which may underpin negative selection favoring small age‐1 fish, given associations between size and timing of seaward migration. Collectively, these results indicate that “bigger is not always better” in terms of survival and emphasize trade‐offs that may exist between fitness components for organisms with similarly diverse migratory life histories.
Genetic data and climate niche suitability models highlight the vulnerability of a functionally important plant species from south‐eastern Australia
Authors: Miller Adam D. , Nitschke Craig , Weeks Andrew R. , Weatherly William L. , Heyes Simon D. , Sinclair Steve J. , Holland Owen J. , Stevenson Aggie , Broadhurst Linda , Hoebee Susan E. , Sherman Craig D. H. , Morgan John W. 
Published: March 2020

AbstractHabitat fragmentation imperils the persistence of many functionally important species, with climate change a new threat to local persistence due to climate niche mismatching. Predicting the evolutionary trajectory of species essential to ecosystem function under future climates is challenging but necessary for prioritizing conservation investments. We use a combination of population genetics and niche suitability models to assess the trajectory of a functionally important, but highly fragmented, plant species from south‐eastern Australia (Banksia marginata, Proteaceae). We demonstrate significant genetic structuring among, and high level of relatedness within, fragmented remnant populations, highlighting imminent risks of inbreeding. Population simulations, controlling for effective population size (Ne), suggest that many remnant populations will suffer rapid declines in genetic diversity due to drift in the absence of intervention. Simulations were used to demonstrate how inbreeding and drift processes might be suppressed by assisted migration and population mixing approaches that enhance the size and connectivity of remnant populations. These analyses were complemented by niche suitability models that predicted substantial reductions of suitable habitat by 2080; ~30% of the current distribution of the species climate niche overlaps with the projected distribution of the species climate niche in the geographic region by the 2080s. Our study highlights the importance of conserving remnant populations and establishing new populations in areas likely to support B. marginata in the future, and adopting seed sourcing strategies that can help populations overcome the risks of inbreeding and maladaptation. We also argue that ecological replacement of B. marginata using climatically suited plant species might be needed in the future to maintain ecosystem processes where B. marginata cannot persist. We recommend the need for progressive revegetation policies and practices to prevent further deterioration of species such as B. marginata and the ecosystems they support.
Rapid adaptation (or not) in restored plant populations
Authors: Magnoli Susan M. 
Published: March 2020

AbstractMismatches between the traits of a colonizing population and a novel habitat can generate strong selection, potentially resulting in rapid adaptation. However, for most colonization events, it can be difficult to detect rapid adaptation or distinguish it from nonadaptive evolutionary changes. Here, I take advantage of a replicated prairie restoration experiment to compare recently established plant populations in two closely located restored prairies to each other and to their shared source population to test for rapid adaptation. Using a reciprocal transplant experiment six years after the populations were established, I found that one restored plant population showed evidence of adaptation, outperforming the other restored population when grown at its home site. In contrast, I detected no evidence for adaptation at the other site. These findings demonstrate that while rapid adaptation can occur in colonizing plant populations, it may not be the rule. Better understanding of when adaptation may or may not occur in these contexts may help us use evolution to our advantage, potentially improving establishment of desirable species in restored habitats.
Genomic insights into historical population dynamics, local adaptation, and climate change vulnerability of the East Asian Tertiary relict Euptelea (Eupteleaceae)
Authors: Cao Ya‐Nan , Zhu Shan‐Shan , Chen Jun , Comes Hans P. , Wang Ian J. , Chen Lu‐Yao , Sakaguchi Shota , Qiu Ying‐Xiong 
Published: March 2020

AbstractThe warm‐temperate and subtropical climate zones of East Asia are a hotspot of plant species richness and endemism, including a noticeable number of species‐poor Tertiary relict tree genera. However, little is understood about when East Asian Tertiary relict plants diversified, how they responded demographically to past environmental change, and to what extent their current genomic composition (and adaptive capacity) might mitigate the effects of global warming. Here, we obtained genomic (RAD‐SNP) data for 171 samples from two extant species of Euptelea in China (24 E. pleiosperma populations) and Japan (11 E. polyandra populations) to elucidate their divergence and demographic histories, genome‐wide associations with current environmental variables, and genomic vulnerability to future climate change. Our results indicate that Late Miocene changes in climate and/or sea level promoted species divergence, whereas Late Pliocene uplifting in southwest China likely fostered lineage divergence within E. pleiosperma. Its subsequent range expansion into central/east (CE) China bears genomic signatures of climate‐driven selection, yet extant CE populations are predicted to be most vulnerable to future climate change. For E. polyandra, geography was the only significant predictor of genomic variation. Our findings indicate a profound impact of Late Neogene geological and climate change on the evolutionary history of Euptelea, with much stronger signals of local adaptation left in China than in Japan. This study deepens our understanding of the complex evolutionary forces that influence the distribution of genetic variation of Tertiary relict trees, and provides insights into their susceptibility to global change and potential for adaptive responses. Our results lay the groundwork for future conservation and restoration programs for Euptelea.
Surgical management of a sinonasal angiomatous polyp and associated cyst involving the paranasal sinuses and nasal cavity via standing axial rhinotomy
Authors: Rowley K. J. , Fiske‐Jackson A. R. , Williams J. M. , Jones A. L. , Townsend N. B. 
Published: March 2020

SummaryThis case report describes the successful surgical management of a sinonasal angiomatous polyp involving the dorsal conchal bullae, dorsal conchal sinus, ventral conchal sinus, ventral conchal bullae and ventral conchal recess of the left nasal cavity resulting in a secondary sinusitis and compression of the nasal passage.
Stability in reproductive timing and habitat usage of Chinook salmon across six years of varying environmental conditions and abundance
Authors: Peterson Matthew L. , Lee Dana J. , Montgomery John , Hellmair Michael , Fuller Andrea , Demko Doug 
Published: March 2020

AbstractThe spatial and temporal distribution of spawning activity by autumn‐run Chinook salmon Oncorhynchus tshawytscha (Walbaum) was examined across multiple years. The study period included two years of extreme drought conditions when water temperatures in the spawning reach of the Stanislaus River were considered sub‐optimal for spawning and egg incubation. Despite varying levels of superimposition, redd counts and densities remained stable and positively associated with river location, indicating that superimposition may be driven by habitat preference rather than the absence of suitable spawning locations. Spawning occurred slightly later during drought years (6–10 days later compared with wetter years). This delay was attributable to deferred migration instead of deferred spawning, and the majority of redds were constructed at water temperatures exceeding the optimal temperature range. As a consequence, estimates of juvenile production during 2014 and 2015 were among the lowest on record. These findings may be related in part to the high hatchery contribution to the population, above‐average temperatures during spawning and incubation, and superimposition rates. Management recommendations include adequate cold‐water storage in the upstream reservoir, refined spawning habitat restoration techniques in the light of superimposition rates and, on a broader system scale, actions that reduce the amount of stray hatchery Chinook salmon.