bluuebunny/crossref_metadata_2025_split huggingface dataset:
Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition
Authors: Compher Charlene , Bingham Angela L. , McCall Michele , Patel Jayshil , Rice Todd W. , Braunschweig Carol , McKeever Liam 
Published: November 2021

AbstractBackgroundThis guideline updates recommendations from the 2016 American Society for Parenteral and Enteral Nutrition (ASPEN)/Society of Critical Care Medicine (SCCM) critical care nutrition guideline for five foundational questions central to critical care nutrition support.MethodsThe Grading of Recommendations, Assessment, Development and Evaluation (GRADE) process was used to develop and summarize evidence for clinical practice recommendations. Clinical outcomes were assessed for (1) higher vs lower energy dose, (2) higher vs lower protein dose, (3) exclusive isocaloric parenteral nutrition (PN) vs enteral nutrition (EN), (4) supplemental PN (SPN) plus EN vs EN alone, (5A) mixed‐oil lipid injectable emulsions (ILEs) vs soybean oil, and (5B) fish oil (FO)–containing ILE vs non‐FO ILE. To assess safety, weight‐based energy intake and protein were plotted against hospital mortality.ResultsBetween January 1, 2001, and July 15, 2020, 2320 citations were identified and data were abstracted from 36 trials including 20,578 participants. Patients receiving FO had decreased pneumonia rates of uncertain clinical significance. Otherwise, there were no differences for any outcome in any question. Owing to a lack of certainty regarding harm, the energy prescription recommendation was decreased to 12–25 kcal/kg/day.ConclusionNo differences in clinical outcomes were identified among numerous nutrition interventions, including higher energy or protein intake, isocaloric PN or EN, SPN, or different ILEs. As more consistent critical care nutrition support data become available, more precise recommendations will be possible. In the meantime, clinical judgment and close monitoring are needed. This paper was approved by the ASPEN Board of Directors.
Abrupt intrinsic and extrinsic responses of southwestern Iberian vegetation to millennial‐scale variability over the past 28 ka
Authors: Cutmore Anna , Ausín Blanca , Maslin Mark , Eglinton Timothy , Hodell David , Muschitiello Francesco , Menviel Laurie , Haghipour Negar , Martrat Belen , Margari Vasiliki , Tzedakis Polychronis C. 
Published: November 2021

ABSTRACTWe present new high‐resolution pollen records combined with palaeoceanographic proxies from the same samples in deep‐sea cores SHAK06‐5K and MD01‐2444 on the southwestern Iberian Margin, documenting regional vegetation responses to orbital and millennial‐scale climate changes over the last 28 ka. The chronology of these records is based on high‐resolution radiocarbon dates of monospecific samples of the planktonic foraminifera Globigerina bulloides, measured from SHAK06‐5K and MD01‐2444 and aligned using an automated stratigraphical alignment method. Changes in temperate and steppe vegetation during Marine Isotope Stage 2 are closely coupled with sea surface temperature (SST) and global ice‐volume changes. The peak expansion of thermophilous woodland between ~10.1 and 8.4 cal ka bp lags behind the boreal summer insolation maximum by ~2 ka, possibly arising from residual high‐latitude ice‐sheets into the Holocene. Rapid changes in pollen percentages are coeval with abrupt transitions in SSTs, precipitation and winter temperature at the onset and end of Heinrich Stadial 2, the ice‐rafted debris event and end of Heinrich Stadial 1, and the onset of the Younger Dryas, suggesting extrinsically forced southwestern Iberian ecosystem changes by abrupt North Atlantic climate events. In contrast, the abrupt decline in thermophilous elements at ~7.8 cal ka bp indicates an intrinsically mediated abrupt vegetation response to the gradually declining boreal insolation, potentially resulting from the crossing of a seasonality of precipitation threshold.
Simultaneous quantification of anthraquinone glycosides, aglycones, and glucuronic acid metabolites in rat plasma and tissues after oral administration of raw and steamed rhubarb in blood stasis rats by UHPLC‐MS/MS
Authors: Zhou Ping , Zhang Jing , Xu Yudi , Zhang Peng , Xiao Yongqing , Liu Ying 
Published: November 2021

AbstractRhubarb is a widely used herbal medicine. To achieve different effects, rhubarb is usually steamed with rice wine (steamed rhubarb). This steaming treatment increases the blood‐activating and stasis‐removing effects of rhubarb. A specific and accurate ultra high performance liquid chromatography with tandem mass spectrometry method was established for simultaneous determination of anthraquinone glycosides, aglycones, and glucuronic acid metabolites in plasma and tissues after administration of raw rhubarb and steamed rhubarb in blood stasis rats. Chromatographic separation was performed on ACQUITY UPLC BEH Shield RP 18 column using the mobile phase consisting of water and acetonitrile both containing 0.1% formic acid. Satisfactory linearity, precision, accuracy, extraction recovery, and matrix effect have been achieved. From pharmacokinetic study, it showed that glucuronic acid metabolites were found abundantly in plasma as bioactive components. The lower area under concentration‐time curve, maximum concentration, and higher apparent volume of distribution (P < 0.01), body clearance (P < 0.01) values in steamed rhubarb showed that most components of steamed rhubarb have lower bioavailability in plasma compared with raw rhubarb. But it found these components were mainly distributed in spleen and liver with large blood flow and perfusion rates. The pharmacokinetics and tissue distribution studies of anthraquinone components will provide helpful information for clinical application of steamed rhubarb and raw rhubarb.
Evaluating Strength of Evidence of Pediatric Otolaryngology Research Literature: A 20‐Year Review
Authors: Silver Jennifer A. , Yeung Jeffrey C. , Almutawa Deema , Szwimer Rachel , Nguyen Lily H. P. 
Published: November 2021

Objectives/HypothesisQuantity and quality of Otolaryngology‐Head and Neck Surgery (OTL‐HNS) research are increasing, yet patterns within Pediatric OTL‐HNS publications are unknown. This study examines trends in the level of evidence of pediatric OTL‐HNS articles over a 20‐year period to quantify the growth and characterize contributing factors.Study DesignReview article.MethodsA retrospective review was conducted on 12 peer‐reviewed OTL‐HNS journals at three time‐points: 1996, 2006, and 2016. Pediatric‐specific OTL‐HNS journals were selected; all were among the top 10 highest impact factor journals, with one pediatric‐specific and one Canadian journal. Publication details, author characteristics, and study focus were collected. Papers were classified based on the Oxford Centre for Evidence‐Based Medicine Levels of Evidence by two independent reviewers.ResultsOf the 1,733 articles reviewed, 727 met inclusion criteria. A greater absolute number of pediatric OTL‐HNS articles were published over the years studied: from 95 in 1996 to 359 in 2016 (P < .001). As well, the absolute number of high‐quality studies has increased over the study period, from 28 articles in 1996 to 100 articles in 2016. However, the relative percentage of high‐quality papers remained stable between 27.9% and 32.2% with an average of 29.7% (P = .89). Higher impact factor journals did not tend to publish higher‐quality pediatric OTL‐HNS articles (P = .48).ConclusionsOver the past 20 years, there is no appreciable improvement in the proportion of high‐quality publications in pediatric OTL‐HNS; however, there is an overall greater number of high‐quality papers within OTL‐HNS literature. These findings likely relate to challenges of research within pediatric surgical specialties.Level of EvidenceNA Laryngoscope, 132:1869–1876, 2022
Development and clinical validation of a droplet digital PCR assay for detecting Acinetobacter baumannii and Klebsiella pneumoniae in patients with suspected bloodstream infections
Authors: Zheng Yang , Jin Jun , Shao Ziqiang , Liu Jingquan , Zhang Run , Sun Renhua , Hu Bangchuan 
Published: November 2021

AbstractThe relatively long turnaround time and low sensitivity of traditional blood culture‐based diagnosis may delay effective antibiotic therapy for patients with bloodstream infections (BSIs). A rapid and sensitive pathogen detection method is urgently required to reduce the morbidity and mortality associated with BSIs. Acinetobacter baumannii and Klebsiella pneumoniae are two major microorganisms that cause BSIs. Here we report a novel droplet digital polymerase chain reaction (ddPCR) assay that can detect A. baumannii and K. pneumoniae in blood samples within 4 h, with a specificity of 100% for each strain and a limit of detection at 0.93 copies/μl for A. baumannii and 0.27 copies/μl for K. pneumoniae. Clinical validation of 170 patients with suspected BSIs showed that compared to blood cultures that detected four (2.4%) A. baumannii cases and seven (4.1%) K. pneumoniae cases, ddPCR detected 23 (13.5%) A. baumannii cases, 26 (15.3%) K. pneumoniae cases, and four (2.4%) co‐infection cases, including the 11 cases detected via blood culture. In addition, patients who tested positive via ddPCR alone (n = 42) had significantly lower serum concentrations of procalcitonin and lactate, SOFA and APACHE II scores, and 28‐day mortality than those reported positive via both blood culture and ddPCR (n = 11), suggesting that patients with less severe symptoms can potentially benefit from ddPCR‐based diagnosis. In conclusion, our study suggests that ddPCR represents a sensitive and rapid method for identifying causal pathogens in blood samples and guiding treatment decisions in the early stages of BSIs.
A hybrid approach based on ELECTRE III‐genetic algorithm and TOPSIS method for selection of optimal COVID‐19 vaccines
Authors: Forestal Roberto Louis , Pi Shih‐Ming 
Published: November 2021

AbstractCOVID‐19 pandemic poses unprecedented challenges to the world health system, prompting academics and health professionals to develop appropriate solutions. Researchers reported different COVID‐19 vaccines introduced by institutions and companies around the globe, which are at different stages of development. However, research developing an integrated framework for selecting and ranking the optimal potential vaccine against COVID‐19 is minimal. This paper aimed to fill this gap by using a hybrid methodology based on ELimination Et Choice Translating REality III (ELECTRE III)–Genetic Algorithm (GA) and Technique of Order Preference Similarity to the Ideal Solution (TOPSIS) approach to select the optimal SARS‐CoV‐2 vaccine. ELECTRE III method yields a fathomable analysis of the concordance index, while GA is known for its ability to disaggregate decision‐making preferences from holistic decisions. TOPSIS is preferred for picking an ideal and an anti‐ideal solution. Thus, combining ELECTRE III‐GA and TOPSIS is considered the best model to assess vaccines against the pandemic. The results confirm that the best vaccines rely on a high level of safety, efficacy, and availability. Our developed evaluation framework can help healthcare professionals and researchers gain research information and make critical decisions regarding potential vaccines against the disease.
Outcome comparison between thoracodorsal artery perforator flap and muscle‐sparing latissimus dorsi flap in axillary reconstruction after hidradenitis suppurativa excision
Authors: El‐Shebly Ahmed M. , El‐Hadidy Mohamed R. , Shehabeldin Samy A. , El Din Ahmed Bahaa , Zeina Ahmed M. , Zayed Ahmed E. , El Fahar Mohammed H. 
Published: November 2021

AbstractBackgroundThoracodorsal artery perforator (TDAP) flap and muscle‐sparing latissimus dorsi (MSLD) flap have been frequently used for axillary coverage after hidradenitis suppurativa (HS) excision. However, none showed superiority to others. This study compared both flaps to define the ideal option, highlighting flap outcomes and functional and aesthetic results.MethodsA retrospective study was conducted to compare both flaps that were used for axillary reconstruction in nine patients with bilateral HS Hurley stage III between 2017 and 2020. Eight TDAP and 10 MSLD flaps underwent functional evaluation using shoulder abduction angle (SA); the Disabilities of the Arm, Shoulder, and Hand (DASH) score; visual analog scale (VAS) for pain; and the Dermatology Life Quality Index (DLQI) questionnaires. Aesthetic assessment included the Scar Cosmesis Assessment and Rating (SCAR) scale and arm–chest interval.ResultsThe mean operating time was 194.4 ± 51.58 and 128.5 ± 31.45 min for TDAP and MSLD (p = .009), respectively. Flap complications were significantly higher in the TDAP group (p = .034). There was no significant difference between both groups regarding SA; DASH, DLQI, VAS, and SCAR scale (p > .05). The mean arm–chest interval was significantly longer in the MSLD than in the TDAP group by 6.9 mm (p = .001).ConclusionsTDAP and MSLD are comparable versatile flaps to eradicate axillary HS with higher TDAP flap complications. Although the TDAP flap is less bulky than the MSLD flap, the MSLD flap shortens the harvesting time without a significant difference in functional outcomes and scar results.
Coronoidectomy, condylectomy, and free vascularized fibula osteomusculocutaneous flap transfer for severe trismus due to contracture of the oral mucosa and temporomandibular joint ankylosis after maxillectomy: A case report
Authors: Karakawa Ryo , Yoshimatsu Hidehiko , Yano Tomoyuki 
Published: November 2021

AbstractSevere trismus often causes significant compromise in quality of life due to severe impairment of oral functions. Treatment of trismus needs to be tailored to the cause. Here, we report the case of a successful treatment for severe trismus after maxillectomy using coronoidectomy, condylectomy, and vascularized fibula flap transfer. A 65‐year‐old female suffered from severe trismus due to temporomandibular joint (TMJ) ankylosis and contracture of the oral mucosa 5 years after partial maxillectomy for a squamous cell carcinoma. Surgical release including a masticatory muscle myotomy, a coronoidectomy, and a condylectomy was performed. After the surgical release, the size of the defect of the oral mucosa was 5 × 10 cm. Then a free vascularized fibula osteomusculocutaneous flap with a 5 × 12 cm skin paddle and a 5 cm fibula bone was transferred. The fibula bone was fixed to the hard palate and zygomatic body. The intraoperative final interincisal distance achieved 30 mm. The postoperative course was uneventful and the free fibula osteomusculocuateous flap survived completely. At 32‐month follow‐up, although the interincisal distance had regressed to 25 mm, the patient maintained an improvement in the patient's quality of life. Combined treatment with coronoidectomy, condylectomy and free tissue transfer may be effective for severe trismus having multiple causes: oral mucosa contracture and TMJ ankylosis.
A miniaturizedquasi‐Yagiantenna using defected ground structure and double dog‐bone driver
Authors: Turan Goksel , Odabasi Hayrettin 
Published: November 2021

AbstractA miniaturized quasi‐Yagi antenna is presented using a defected ground structure and double dog‐bone driver. The antenna has a simplified feeding structure. With the help of the dog‐bone driver and slotted ground structure antenna's resonance frequency is lowered. Thus, the miniaturization is achieved. Additional angled dog‐bone driver and circular patches in the ground improve impedance matching and bandwidth characteristics. The overall size of the proposed miniaturized quasi‐Yagi antenna is , where is the wavelength at the lowest operating frequency( dB). The antenna achieves dB between and GHz in the simulation, and GHz in the measurement. The antenna has a gain of 3.8–5.4 dBi, over total efficiency, and stable end‐fire radiation characteristics in the frequency range of operation. The proposed antenna is a good candidate for compact portable wireless communication systems.
Assessment of measurement precision in single‐voxel spectroscopy at 7 T: Toward minimal detectable changes of metabolite concentrations in the human brain in vivo
Authors: Riemann Layla Tabea , Aigner Christoph Stefan , Ellison Stephen L. R. , Brühl Rüdiger , Mekle Ralf , Schmitter Sebastian , Speck Oliver , Rose Georg , Ittermann Bernd , Fillmer Ariane 
Published: November 2021

PurposeTo introduce a study design and statistical analysis framework to assess the repeatability, reproducibility, and minimal detectable changes (MDCs) of metabolite concentrations determined by in vivo MRS.MethodsAn unbalanced nested study design was chosen to acquire in vivo MRS data within different repeatability and reproducibility scenarios. A spin‐echo, full‐intensity acquired localized (SPECIAL) sequence was employed at 7 T utlizing three different inversion pulses: a hyperbolic secant (HS), a gradient offset independent adiabaticity (GOIA), and a wideband, uniform rate, smooth truncation (WURST) pulse. Metabolite concentrations, Cramér‐Rao lower bounds (CRLBs) and coefficients of variation (CVs) were calculated. Both Bland‐Altman analysis and a restricted maximum‐likelihood estimation (REML) analysis were performed to estimate the different variance contributions of the repeatability and reproducibility of the measured concentration. A Bland‐Altmann analysis of the spectral shape was performed to assess the variance of the spectral shape, independent of quantification model influences.ResultsFor the used setup, minimal detectable changes of brain metabolite concentrations were found to be between 0.40 µmol/g and 2.23 µmol/g. CRLBs account for only 16 % to 74 % of the total variance of the metabolite concentrations. The application of gradient‐modulated inversion pulses in SPECIAL led to slightly improved repeatability, but overall reproducibility appeared to be limited by differences in positioning, calibration, and other day‐to‐day variations throughout different sessions.ConclusionA framework is introduced to estimate the precision of metabolite concentrations obtained by MRS in vivo, and the minimal detectable changes for 13 metabolite concentrations measured at 7 T using SPECIAL are obtained.
High‐dose vitamin C therapy for symptomatic deficiency in a patient with myasthenia gravis and Crohn's disease
Authors: Murphree Jill , Mulherin Diana Wells , Morton Colleen , Adams Dawn 
Published: November 2021

AbstractVitamin C (ascorbic acid) is an essential water‐soluble antioxidant, and deficiency (ie, plasma level <11 μmol/L) can result in scurvy. People at the highest risk for vitamin C deficiency (ie, scurvy) are those with inadequate intake, such as patients with alcohol abuse disorder, malnutrition, psychiatric disorders, restrictive eating habits, and food insecurity, as well as those with malabsorptive syndromes. We present a case of a 26‐year‐old woman with Crohn's colitis, myasthenia gravis, and juvenile rheumatoid arthritis who presented with frequent bruising, epistaxis, and excessive bleeding from small cuts and who was found to be deficient in vitamin C. Plasma levels initially normalized with oral vitamin C supplementation, but bleeding symptoms eventually returned despite high‐dose oral supplementation with 2000 mg daily. She ultimately required routine intravenous supplementation in the home setting for the normalization of levels and the resolution of symptoms. Case reports of vitamin C deficiency typically involve patients with an inadequate intake of vitamin C–containing foods or inadequate absorption. In contrast, our patient reported a regular intake of vitamin C–containing foods, in addition to oral supplementation, but continued to have difficulty maintaining normal vitamin C levels. Scurvy should be considered for any patient with symptoms of bleeding, petechiae, or ecchymosis and, although it can typically be treated with oral vitamin C, intravenous repletion may be necessary in some cases.
Hybrid approach to predict the effective properties of heterogeneous materials using artificial neural networks and micromechanical models
Authors: Danoun Aymen , Pruliére Etienne , Chemisky Yves 
Published: November 2021

AbstractIn this article, an investigation was carried out to verify hybrid models capabilities to predict the effective properties of heterogeneous materials. A hybrid model is developed by combining artificial neural networks and micromechanical modeling. The homogenization approach used in this study is mainly based on Eshelby's inclusion problem. The model, once trained on an Eshelby's tensors database, showed an excellent predictive capabilities of the effective mechanical behavior and local stresses in heterogeneous materials. The obtained results with are compared to numerical estimations which are often costly in terms of computational time. The results presented in this work show that the developed hybrid model can provide a significant computational time saving by a factor up to 2000 for phases while maintaining its accuracy and reliability.
A tracking strategy for multi‐branched crack tips in phase‐field modeling of dynamic fractures
Authors: Zeng Jun , Zhang Mengnan , Yang Erjie , Tian Fucheng , Li Liangbin 
Published: November 2021

AbstractThe well‐received phase‐field method smears the discrete cracks in the damaged bands, blurring the explicit crack tip. However, identifying the location of the crack tip is sometimes vital. The widely used scheme at present considers the forefront of a phase‐field contour as the crack tip. Such a method, to our best knowledge, is inapplicable for branched cracks, which motivates us to develop a novel stepwise identification strategy for multi‐branched crack tips termed si‐MCT. Instead of searching for crack tips globally, the proposed si‐MCT realizes this in the chosen deliberately local regions (searching regions), and then automatically updates these regions as the cracks propagate. For the robust implementation of si‐MCT, a novel concept of active crack tip zone is also proposed to cope with the extreme circumstances where adjacent crack paths are too close to interfere with identifying the crack tip. Furthermore, the core algorithms and specific procedures of the proposed strategy are also elaborated. Moreover, several representative tests are studied, showing the bright prospect of si‐MCT in dynamic multi‐branch crack tracking and adaptive mesh algorithm.