bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proposal for the Fusion of Ultrasound and Computed Tomography Images for Image Shift Correction in Craniomaxillofacial Soft Tissue Surgery
Authors: Yang Chengshuai , Zhang Yong , Wu Jinyang , Zhang Shilei 
Published: July 2021

Abstract
Surgical navigation has greatly improved the accuracy of craniomaxillofacial bone surgery and is widely used in the clinic. However, during surgery, craniomaxillofacial soft tissue is always deformed due to traction and compression, which leads to intraoperative image drift. This, in turn, impacts navigation accuracy. In order to improve navigation accuracy, this technical note presents a preliminary proposal for fusion imaging technology, which combines ultrasound and computed tomography to address navigational image drift in craniomaxillofacial soft tissue surgery.
Submandibular Gland Excision in Pediatric Patients
Authors: Kalmar Christopher L. , Patel Vijay A. , Zapatero Zachary D. , Kosyk Mychajlo S. , Taylor Jesse A. , Swanson Jordan W. 
Published: July 2021

Introduction:
Children who require submandibular gland excision for ptyalism often have multiple associated comorbidities, including neurodevelopmental disorders and respiratory risk factors. The purpose of this study is to utilize a large multicenter database to elucidate the perioperative profile of submandibular gland excision in children, with particular focus on children who require submandibular gland excision for ptyalism.

Methods:
The American College of Surgeons National Surgical Quality Improvement Program Pediatric dataset was queried for submandibular gland excision performed from 2012 through 2018. Indications were subclassified based on International Classification of Disease (ICD)-9 and ICD-10 codes. Complications, readmissions, and reoperations were analyzed with appropriate statistics.

Results:
During the study interval, 304 pediatric patients underwent submandibular gland excision, which was mostly performed for ptyalism (56.9%), followed by inflammatory conditions (20.7%). Patients requiring submandibular gland excision for ptyalism were significantly younger (P < 0.001) and underwent significantly longer procedures (P < 0.001). Ptyalism was associated with significantly higher related adverse events (P = 0.010), related readmission (P = 0.013), and medical complications (P = 0.013), which included a significantly higher risk of pneumonia (P = 0.050). Children with ptyalism had significantly higher rates of overall respiratory comorbidities (P < 0.001), including chronic lung disease (P < 0.001), supplemental oxygen support (P < 0.001), tracheostomy (P < 0.001), and ventilator dependence (P < 0.001). Patients undergoing submandibular gland excision for benign (P all ≥ 0.082) and malignant (P all ≥ 0.565) neoplasms did not have significantly higher rates of any indexed postoperative adverse event.

Conclusions:
Children requiring submandibular gland excision for ptyalism represent a unique cohort than those requiring excision for other indications, with significantly higher burden of preoperative risk factors, intraoperative durations, and postoperative adverse events.
Successful Microsurgical Scalp Replantation Utilizing Loupe Magnification
Authors: Chopan Mustafa , Leyngold Mark , Ching Jessica 
Published: July 2021

Abstract
Total scalp avulsion is a rare injury that poses a unique reconstructive challenge. Microsurgical replantation is considered the first-line choice; yet anastomotic efforts may be strained to find suitable recipient and target vessels. Concomitant injuries may also delay or hinder operative intervention. These complex scenarios are difficult to navigate and necessitate multidisciplinary input to optimize outcomes. As such, the authors present an illustrative case report of a total scalp avulsion injury that underwent successful microsurgical replantation. This report highlights the novel use of loupe magnification in scalp replantation and reviews technical and clinical nuances that facilitate a favorable reconstruction.
A Severe Case of Biparietal Thinning in a Medieval Skull From a Northern Italy Necropolis
Authors: Tonina Enrica , Larentis Omar , Tesi Chiara , Fusco Roberta , Campagnolo Monica , Licata Marta 
Published: July 2021

Abstract
This study aims at presenting a case of symmetrical and bilateral thinning observed in a skull belonging to the skeleton of a mature woman from the medieval cemetery of Caravate (north Italy). Macroscopical, radiological, and histological analyses were performed to investigate the condition. The analyses allowed us to detect a progressive loss of both the outer table and the diploe, and the sparing of the inner table. As a controversial condition in the clinical and paleopathological literature, this case poses some difficulties in discussing the differential diagnosis. However, the sex determination, estimation of the age-at-death and different characteristics observed at the level of the postcranial bones, in particular the fractures recorded on different vertebral bodies, allowed us to correlate the biparietal thinning found in this subject to ageing and osteoporosis.
Indications and Limitations of Carbonated Calcium Phosphate Cement for Secondary Contouring Cranioplasty: A Long-Term Institutional Experience
Authors: Shakir Sameer , Kalmar Christopher L. , Yang Robin , Taylor Jesse A. , Bartlett Scott P. 
Published: July 2021

Abstract
The authors describe our long-term institutional experience utilizing carbonated calcium phosphate (CCP) cement for secondary cranioplasty refinements with the goals to
The authors conducted a retrospective cohort study of patients undergoing secondary cranioplasty for forehead reshaping utilizing CCP between June 2007 and August 2018. Exclusion criteria included < 3-month follow-up. The primary outcome was aesthetic forehead correction determined by Whitaker classification, while secondary outcomes included complications and reoperations. In total, 107 patients met inclusion with a median age of 15.5 years. The majority of bony deficits were limited to the frontal region (90.7%), required onlay application (87.7%) of large (96.0 cm2) partial thickness (85.7%) cranial defects, in a clean setting (99.0%), and ASA grade II (69.7%). Median Whitaker classification decreased from 2.3 [IQR: 2, 2.3] preoperatively to 1.0 [1.0, 1.3] postoperatively (P < 0.01). There was no difference in Whitaker classification between early and late postoperative timepoints (P < 0.17). The complication rate was 13.2%, with the majority related to infection (5/14). Factors associated with complications included frontal sinus proximity (OR 3.6, P < 0.04) and the use of interposition titanium mesh for full-thickness reconstruction (OR 6.4, P < 0.02). CCP remains an effective alloplastic bone substitute with a complication rate of 13.2% in patients undergoing secondary, onlay cranioplasty. Early postoperative Whitaker classification may predict long-term aesthetic results. Complications may arise years following implantation, warranting long-term follow-up.
One-Year Stability of LeFort I Advancement in Patients With Complete Cleft Lip and Palate Using a Standardized Clinical and Surgical Protocol
Authors: Parikh Vrajkumar , Gonchar Marina , Gibson Travis L. , Grayson Barry H. , Cutting Court B. , Shetye Pradip R. 
Published: July 2021

Aim:
To assess treatment outcome and 1-year stability of LeFort I advancement in patients with complete cleft lip and palate.

Methods:
Thirty-five patients (age 20.65 ± 2.20 years) with unilateral (n = 25) or bilateral (n = 10) complete cleft lip and palate who underwent LeFort I advancement were included.
Lateral cephalograms before surgery (T1), immediately postsurgery (T2), and at 1-year follow-up (T3) were superimposed, and the position of anterior nasal spine (ANS), A-point, and U1 Tip assessed using an x, y coordinate system. Differences between landmark positions at the 3-time points were analyzed using paired sample t-tests, with a significance defined as α ≤ 0.05.

Results:
The mean surgical advancement in the horizontal direction (T2-T1) was 6.50 ± 2.62 mm at ANS (P < 0.001) and 7.05 ± 2.51 mm at A-point (P < 0.001). At a 1-year follow-up (T3-T2), the mean horizontal relapse at ANS was –1.41 ± 1.89 mm (P < 0.001) and –0.79 ± 1.48 mm at A-point (P 0.003). Mean horizontal relapse was 21.7% and 11% of surgical advancement when assessed at ANS and A-point, respectively. The central incisor tip position remained stable during the postsurgical period (0.12 ± 2.11 mm, P 0.732). At A-point, the mean vertical surgical change (T2–T1) was –0.96 ± 2.57 mm (P < 0.001). No significant post-treatment (T3–T2) vertical changes were detected at ANS or A-point. Phenotypic stability was excellent, with all patients maintaining positive overjet at 1-year follow-up.

Conclusions:
LeFort I advancement in complete cleft lip and palate is stable, with less than a 2 mm relapse after 1-year. Surgical overcorrection by 10% to 20% is recommended to compensate for the expected skeletal relapse.
Local Skull Thinning is One of Risks for the Ruptured Arachnoid Cysts With Chronic Subdural Hematoma in Adults: Thirty-two Clinical Reports
Authors: Mao Xiang , Xu Long , Liu Weiming , Hao Shuyu , Liu Baiyun 
Published: July 2021

Objective:
Chronic subdural hematomas (CSDHs) in young people are uncommon, rupture of arachnoid cysts (ACs) is one of the reasons for young patients. The detailed features of CSDHs associated with ACs remain poorly understood. The objective of this study is to analyze the characteristics of risks for the rupture of ACs with CSDH in Adults.

Methods:
The CT scans of 1231 patients who were diagnosed as CSDH were reviewed between Jan 2009 and Jan 2019 in the Department of Neurotrauma in Beijing Tian Tan Hospital, Capital Medical University/China National Clinical Research Center for Neurological Diseases. The clinical features, treatments, and prognosis of 32 patients with ACs were analyzed.

Results:
Ruptured ACs with CSDH were diagnosed in 32 patients in 1231 CSDH cases, which account for 2.60%. Headache was the commonest presenting symptom. According to the Takizawa’ classification, there were 22 cases for Type A, 9 for Type B and 1 for Type C. Thinning or external convex of the calvarium was demonstrated in 17/32 cases (53.1%). Thirty-one patients were treated with burr hole irrigation. Favorable outcomes were achieved in all patients.

Conclusions:
The presence of ACs should be taken into consideration in young and middle-aged patients with CSDH. For those patients were found ACs in conventional medical examination, especially those whose imaging examinations demonstrated thinning or external convex of the calvarium, it was crucial to remind them to avoid the occurrence of traumatic brain injury (TBI). Burr hole irrigation is still the preferred treatment for ruptured ACs with CSDH.
HPi: A Novel Parameter to Predict Graft-related Outcome in Adult Living Donor Liver Transplant
Authors: Singh Akanand , Singhal Saurabh , Venuthurimilli Arun , Pareek Shishir , Maung Pyone Maung , Aung Thet Htoo , Garg Hitendra Kumar , Vohra Sandeep , Sahni Reeti , Goyal Neerav 
Published: July 2021

Background.
Portal hyperperfusion is frequently associated with early allograft dysfunction (EAD). It is imperative to identify patients who would require portal inflow modulation. We aimed to identify factors associated with hyperperfusion-related graft injury and develop a predictive index for the same.

Methods.
Prospectively maintained database was queried to identify 135 adult living donor liver transplant recipients between September 2016 and July 2020. According to the calculated sample size, 96 patients were randomly selected for “test cohort”. The remaining 39 patients made the “validation cohort.” EAD was defined according to the A2ALL study. “Hyperperfusion index (HPi),” defined as posttransplant portal pressure gradient (ΔP
post)/graft-to-recipient splenic volume ratio (GRSVR), was devised on the basis of laws of flow dynamics and regression analysis.

Results.
Overall, 40 patients (29.6%) had EAD, six 90-d mortalities (4.4%) were attributable to EAD. In the test cohort, EAD patients (n = 29, 30.2%) had lower GRSVR (1.00 versus 2.22, P < 0.001), higher ΔP
post (14.8 versus 11.9, P = 0.004), and HPi (20.89 versus 8.67, P < 0.001). Multivariate analysis revealed GRSVR, ΔP
post, and HPi as significant factors to predict EAD. Receiver operating characteristic determined cutoff of HPi ≥9.97 could predict EAD with sensitivity of 90% and specificity of 73% (F-score = 0.712). HPi ≥16.25 predicted 90-d mortality with sensitivity of 100% and specificity of 78.9%. Patients with higher HPi had delayed graft-related recovery. Non-EAD patients had a higher 1-y (96% versus 79%) and 2-y (88% versus 79%) survival. The cutoff of HPi was validated well in the validation cohort (F-score = 0.645) (Hosmer-Lemeshow test, P = 0.89).

Conclusions.
While predicted GRSVR may help identify at-risk patients preoperatively, intraoperatively calculated HPi is more accurate in identifying patients who would require portal inflow modulation. Achieving an HPi below target cutoff significantly decreases the risk of EAD even in low-GRSVR patients.
Scalable parametric encoding of multiple modalities
Authors: Banh David , Huang Alan 
Published: July 2021

AbstractA flexible model is introduced which shares ideas with the Autoencoder, Canonical Correlation Analysis, Singular Value Decomposition, and Procrustes Analysis. It is proposed to find relevant maps to transform multiple datasets of various types from one modality to another. Here, the Generative Encoder is used to transform spatial gene expression from breast tissue, to the images of histology tissue measured with Spatial Transcriptomics. The model is directly interpretable given all parameters are linked to the data space. It is scalable on Big Data, training reasonably on several thousand RGB images of 100 by 100 pixels in under an hour, which equates to 30,000 pixel features per sample image.
Online queries as a criterion for evaluation of the epidemiological status and effectiveness of COVID-19 epidemic control measures
Authors: Momynaliev K. T. , Khoroshun D. K. , Akimkin V. G. 
Published: July 2021

AbstractMonitoring online queries can provide early and accurate information about the spread of COVID-19 in the population and about the effectiveness of COVID-19 epidemic control measures.The purpose of the studyAssessment of significance of online queries regarding smell impairment to evaluate the epidemiological status and effectiveness of COVID-19 epidemic control measures.Materials and methodsWeekly online queries from Yandex Russian users regarding smell impairment were analysed in regions and large cities of Russia from 16/3/2020 to 21/2/2021. A total of 81 regions of Russia and several large cities, such as Moscow, St. Petersburg, and Nizhny Novgorod, were included in the study.ResultsA strong positive direct correlation (r>0.7) was found between the number of smell-related queries in Yandex new cases of COVID-19 in 59 out of 85 Russian regions and large cities (70%). During the “first” peak of COVID-19 incidence in Russia (April-May 2020), the increase in the number of smell-related queries outpaced the increase in the number of new cases by 1-2 weeks in 23 out of 59 regions of Russia. During the “second” peak of COVID-19 incidence in Russia (October-December 2020), the increase in the number of smell-related queries outpaced the increase in the number of new cases by 1-2 weeks in 36 regions of Russia, including Moscow. We also estimated the increase in the query/new case ratio during the “second” peak of incidence for 45 regions. It was found that the query/new case ratio increased by more than 100% in 24 regions. The regions where the increase in queries was more than 160% compared to new infection cases during the “second” peak of incidence demonstrated significantly higher search activity related to levofloxacin than the regions where the increase in queries was lower than 160% compared to the increase in new infection cases.ConclusionThe sudden interest in smell impairment and growing frequency of online queries among the population can be used as an indicator of the spread of coronavirus infection among the population as well as for evaluation of the effectiveness of COVID-19 epidemic control measures.
A reinforcement learning model to inform optimal decision paths for HIV elimination1
Authors: Khatami Seyedeh N. , Gopalappa Chaitra 
Published: July 2021

AbstractThe ‘Ending the HIV Epidemic (EHE)’ national plan aims to reduce annual HIV incidence in the United States from 38,000 in 2015 to 9,300 by 2025 and 3,300 by 2030. Diagnosis and treatment are two most effective interventions, and thus, identifying corresponding optimal combinations of testing and retention-in-care rates would help inform implementation of relevant programs. Considering the dynamic and stochastic complexity of the disease and the time dynamics of decision-making, solving for optimal combinations using commonly used methods of parametric optimization or exhaustive evaluation of pre-selected options are infeasible. Reinforcement learning (RL), an artificial intelligence method, is ideal; however, training RL algorithms and ensuring convergence to optimality are computationally challenging for large-scale stochastic problems. We evaluate its feasibility in the context of the EHE goal.We trained an RL algorithm to identify a ‘sequence’ of combinations of HIV-testing and retention-in-care rates at 5-year intervals over 2015-2070, which optimally leads towards HIV elimination. We defined optimality as a sequence that maximizes quality-adjusted-life-years lived and minimizes HIV-testing and care-and-treatment costs. We show that solving for testing and retention-in-care rates through appropriate reformulation using proxy decision-metrics overcomes the computational challenges of RL. We used a stochastic agent-based simulation to train the RL algorithm. As there is variability in support-programs needed to address barriers to care-access, we evaluated the sensitivity of optimal decisions to three cost-functions.The model suggests to scale-up retention-in-care programs to achieve and maintain high annual retention-rates while initiating with a high testing-frequency but relaxing it over a 10-year period as incidence decreases. Results were mainly robust to the uncertainty in costs. However, testing and retention-in-care alone did not achieve the 2030 EHE targets, suggesting the need for additional interventions. The results from the model demonstrated convergence. RL is suitable for evaluating phased public health decisions for infectious disease control.
CLPTM1L is a lipid scramblase involved in glycosylphosphatidylinositol biosynthesis
Authors: Wang Yicheng , Menon Anant K. , Maki Yuta , Liu Yi-Shi , Iwasaki Yugo , Fujita Morihisa , Guerrero Paula A. , Varón Silva Daniel , Seeberger Peter H. , Murakami Yoshiko , Kinoshita Taroh 
Published: July 2021

AbstractGlycosylphosphatidylinositols (GPIs) are membrane anchors of many eukaryotic cell surface proteins. Biosynthesis of GPIs is initiated at the cytosolic face of the endoplasmic reticulum (ER) and the second intermediate, glucosaminyl-phosphatidylinositol (GlcN-PI), is translocated across the membrane to the lumenal face for later biosynthetic steps and attachment to proteins. The mechanism of the lumenal translocation of GlcN-PI is unclear. We report that Cleft lip and palate transmembrane protein 1-like protein (CLPTM1L), an ER membrane protein of unknown function, is a lipid scramblase involved in GPI biosynthesis. Purified CLPTM1L scrambles GlcN-PI, PI, and several other phospholipids in vitro. Knockout of CLPTM1L gene in mammalian cultured cells partially decreased GPI-anchored proteins due to impaired usage of GlcN-PI, suggesting a major role of CLPTM1L in lumenal translocation of GlcN-PI.One-Sentence SummaryCLPTM1L translocates glucosaminyl-phosphatidylinositol across the membrane during glycosylphosphatidylinositol biosynthesis.
Electronic “photoreceptors” enable prosthetic vision with acuity matching the natural resolution in rats
Authors: Wang Bing-Yi , Chen Zhijie Charles , Bhuckory Mohajeet , Huang Tiffany , Shin Andrew , Zuckerman Valentina , Ho Elton , Rosenfeld Ethan , Galambos Ludwig , Kamins Theodore , Mathieson Keith , Palanker Daniel 
Published: July 2021

AbstractLocalized stimulation of the inner retinal neurons for high-acuity prosthetic vision requires small pixels and minimal cross-talk from neighboring electrodes. Local return electrodes within each pixel limit crosstalk, but can over-constrain the electric field, thus precluding efficient stimulation with subretinal pixels smaller than 50 μm. Here we demonstrate high-resolution prosthetic vision based on a novel design of a photovoltaic array, where field confinement is achieved dynamically, leveraging the adjustable conductivity of the diodes under forward bias to turn the designated pixels into transient returns. We validated computational modeling of the field confinement in such an optically-controlled circuit by ex-vivo and in-vivo measurements. Most importantly, using this strategy, we demonstrated that the grating acuity with 40 μm pixels matches the pixel pitch, while with 20 μm pixels, it reaches the 28 μm limit of the natural visual resolution in rats. This method enables customized field shaping based on individual retinal thickness and distance from the implant, paving the way to prosthetic vision with acuity as high as 20/80 in atrophic macular degeneration.
Core bone diameter in an organic implant-less technique affecting the biomechanical properties of the anterior cruciate ligament fixation; an in-vitro study
Authors: Mohseni Mahdi , Nourani Amir , Korani Hossein , Moeinnia Hadi , Borjali Amirhossein , Ghias Narges , Chizari Mahmoud 
Published: July 2021

AbstractBackgroundBone and site hold tendon inside (BASHTI) is an implant-less technique that can solve some of the problems associated with other anterior cruciate ligament (ACL) reconstructive methods. This study aims to investigate the effect of core bone diameter variation on the biomechanical properties of a reconstructed ACL using BASHTI technique.MethodsA number of 15 laboratory samples of reconstructed ACL were built using bovine digital tendons and Sawbones blocks. Samples were divided into three groups with different core bone diameters of 8 mm, 8.5 mm, and 9 mm. The double-stranded tendon size and bone tunnel diameter were 8 mm and 10 mm, respectively. A loading scenario consisting of two cyclic loadings followed by a single cycle pull-out loading was applied to the samples simulating the after-surgery loading conditions to observe the fixation strength.ResultsResults showed that the core bone diameter had a significant effect on the failure mode of the samples (P = 0.006) and their fixation strength (P < 0.001). Also, it was observed that the engaging length and the average cyclic stiffness (ACS) of them were influenced by the core bone diameter significantly (engaging length: P = 0.001, ACS: P = 0.007), but its effect on the average pull-out stiffness was not significant (P = 0.053).ConclusionsIt was concluded that core bone diameter variation has a significant impact on the mechanical properties of ACL reconstruction when BASHTI technique is used, and it should be noted for surgeons who use BASHTI technique.Abstract FigureHighlightsA new implant-less technique was used to reconstruct anterior cruciate ligament.Artificial bone and fresh animal soft tissue used to simulate the fixation process.Loading condition were carefully chosen to simulate the post-operation.Components geometry had direct effect on biomechanical properties of the fixation.Optimum geometry was found trough an experimental examination.