bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revising Our Concepts about Stoma Covering a Low Rectal Anastomosis
Authors: Lotfy Wael E. , Abdel Fattah Ahmed Raafat , Eltih Osama A. , Wasef Peter H. , Ashour Hassan R. 
Published: July 2021

Abstract
Introduction There has been conclusive evidence that defunctioning stoma with either transverse colostomy or ileostomy mitigates the serious consequences of anastomotic leakage. However, whether transverse colostomy or ileostomy is preferred for defunctioning a rectal anastomosis remains controversial. The present study was designed to identify the best defunctioning stoma for colorectal anastomosis.
Objective To improve the quality of life in patients with rectal resection and anastomosis and reduce the morbidity before and after closure of the stoma.
Patients and Methods The present study included 48 patients with elective colorectal resection who were randomly arranged into 2 equal groups, with 24 patients each. Group I consisted of patients who underwent ileostomy, and group II consisted of patients who underwent colostomy as a defunctioning stoma for a low rectal anastomosis. All surviving patients were readmitted to have their stoma closed and were followed-up for 6 months after closure of their stomas. All data regarding local and general complications of construction and closure of the stoma of the two groups were recorded and blotted against each other to clarify the most safe and tolerable procedure.
Results We found that all nutritional deficiencies, dehydration, electrolytes imbalance, peristomal dermatitis, and frequent change of appliances are statistically more common in the ileostomy group, while stomal retraction and wound infection after closure of the stoma were statistically more common in the colostomy group. There were no statistically significant differences regarding the total hospital stay and mortality between the two groups.
Conclusion and Recommendation Ileostomy has much higher morbidities than colostomy and it also has a potential risk of mortality; therefore, we recommend colostomy as the ideal method for defunctioning a distal colorectal anastomosis.
The “Flip-Flap” Technique for Laparoscopic Port-Site Closure—Description of a Novel, Cost-Effective Technique with Review of Literature
Authors: Wani Ajaz Ahmed , Khuroo Suhail , Jain Saurabh Kumar , Heer Vikas Kumar , Rajput Deepak , Maqsood Shadab 
Published: July 2021

AbstractOverview Laparoscopic approach has changed the face of surgical care offered to patients. Almost all surgical procedures across specialties are now undertaken by the laparoscopic approach. Closure of port sites to prevent trocar-site hernias (TSHs) forms an integral part of the laparoscopic procedure. TSH is an area of preventable surgical morbidity. We hereby report our technique that is easily applicable, simple, safe, and highly cost-effective. It requires no additional instruments or retractors, is easy to learn, and has a very favorable safety profile.Materials and Methods This prospective case series enrolled a total of 454 port-site closures in 255 patients undergoing different laparoscopic procedures over a period of 2 years. The intraperitoneal tissue forceps were used in the reverse direction to lift the fascia up and a right-angled retractor was used to retract back the skin and subcutaneous tissue. The port-site closure is done under vision and no adverse events were reported.Results This technique was used in 454 port sites in 255 patients. No intraoperative incidents were noted. There is no requirement of any specialized instruments or retractors. No additional tissue trauma or dissection is required. There is no extension of operative time. The technique is simple to learn and easy to teach. No bowel injuries or TSHs were reported during a follow-up of 26 months.Conclusion The described technique is easy, simple, cost-effective, and has a good safety profile.
A Novel Technique for the Treatment of a Case of Verneuil's Disease of Perineum and Axillary Regions
Authors: El-Helou Etienne , Kansoun Alaa , Abi Fadel Elissa , Nassif Ali , Mazraani Houssam Bashir , Neaime Georges Robert , Kassem Moussa Houssein Amin , Bassil Georges , Ibrahim Serge , Assaf Georges R. , Alam Houssam 
Published: July 2021

AbstractHidradenitis suppurativa (HS) is a chronic inflammatory disease involving apocrine glands of the skin. It carries out an important burden on the daily life of the patient. Unfortunately, it presents a major concern for medical care management in the absence of clear guidelines for proper medical and surgical treatment. Hence, we report a case of concomitant axillary and perianal HS. We opted for surgical management using a novel technique, which proved efficacy for a year of follow-up recurrence free.
Diagnostic Performance of Ankle-Brachial Pressure Index in Lower Extremity Arterial Disease
Authors: Alagha Mohammed , Aherne Thomas M. , Hassanin Ahmed , Zafar Adeel S. , Joyce Doireann P. , Mahmood Waqas , Tubassam Muhammad , Walsh Stewart R. 
Published: July 2021

Abstract
Introduction Ankle-brachial pressure indices (ABIs) continue to form the basis of diagnostics for lower extremity arterial disease (LEAD). However, there remains a paucity of data to support its accuracy. This study aims to evaluate its diagnostic sensitivity and specificity using established arterial-imaging modalities as a benchmark.
Methods In this retrospective study, a regional, prospectively maintained, vascular laboratory database was interrogated to identify referred patients with arterial disease who underwent concomitant assessment with ABI and lower limb arterial duplex ultrasound (DUS). Duplex acted as the reference standard. Those who had peripheral computed tomography angiogram (CTA) within 3 months of initial assessment were included in a subgroup analysis to correlate ABI with CTA. The primary end point was the sensitivity and specificity of ABI compared with DUS as the reference standard.
Results Concomitant assessment was performed in 438 limbs (250 patients) over a 27-month period. The ABI was normal (0.9 to 1.4) in 196 limbs (44.9%) and abnormal in the remaining 241 limbs (55.1%). False-positive results occurred in 83 out of 241 limbs (34.4%), and false-negative results occurred in 54 limbs out of 196 (27.5%). True-positive results were 158 out of 241 limbs (65.6%), whereas true-negative results were 142 out of 196 limbs (72.4%). ABI using DUS as a benchmark identified a sensitivity for peripheral artery disease of 72.3% and a specificity of 69.3%. Concomitant CTA imaging was available in 200 limbs. The sensitivity and specificity of ABI correlated with CTA were 65.5 and 68.8%, respectively.
Conclusion ABIs have a moderate predictive value in the diagnosis of LEAD. Normal range outcomes cannot be taken to infer the absence of LEAD and, as such, further arterial imaging in the form of DUS or angiography should be strongly considered in those with suspected underlying disease requiring intervention. Further noninvasive tests such as exercise studies or pulse volume waveforms should be considered, if diagnostic uncertainty exists, in those requiring nonoperative intervention and risk factor control.
Appendicitis Inflammatory Response Score in Comparison to Alvarado Score in Acute Appendicitis
Authors: Jose Toney , Rajesh PS 
Published: July 2021

AbstractAppendicitis is a common differential diagnosis of right lower quadrant pain. Clinical evaluation alone results in high negative appendicectomy rates. Alvarado scoring is the most commonly used clinical prediction rule. The study aimed to compare the recently developed appendicitis inflammatory response (AIR) score with the Alvarado score. This cross-sectional observational study included patients who underwent appendicectomy for clinical suspicion of appendicitis. The clinical and laboratory parameters required for obtaining Alvarado score and AIRS were gathered. Area under ROC curve was calculated for both Alvarado score and AIRS. The study included 130 patients (77 males and 53 females). The negative appendicectomy rate was 10.7%. The perforation rate was 10.3%. The area under ROC for Alvarado score was 0.821 and for AIR score was 0.901. The Alvarado score had a sensitivity of 72% and a specificity of 79% at score ≥6. The appendicitis inflammatory response score had a sensitivity of 98% for scores ≥5 and a specificity of 97% for score ≥6. The C-reactive protein (CRP) value was the best performing individual parameter with an area under ROC of 0.789, followed by WBC count with an area under ROC of 0.762. Appendicitis inflammatory response score is a recently developed score that outperforms the Alvarado score. AIR score has a higher specificity. The sound construction, gradation of parameters, the inclusion of CRP, and avoidance of subjective parameters make the AIR score an attractive clinical prediction rule which can decrease the rate of negative appendicectomy.
Arthroscopic Treatment of Capitate Nonunion: A New Technique
Authors: de Villeneuve Bargemon Jean-Baptiste , Jaloux Charlotte , Levet Paul , Levadoux Michel 
Published: July 2021

AbstractIsolated fractures of the capitate are very rare which means that their nonunion is even rarer. Repair techniques have always been performed by open surgery which may result in loss of mobility due to the capsulotomy. The typically used surgical techniques such as arthrodesis of the carpal or wrist bones can have irreversible consequences on range of motion. No arthroscopic technique has ever been described for this condition. Here, we describe a case of isolated capitate nonunion without ligament tears or other carpal fractures in a 21-year-old male, following a capitate fracture 10 years prior. We describe our arthroscopic treatment technique for this capitate nonunion.
Partial Flap Loss in Gender Affirming Phalloplasty
Authors: Cylinder Isabel , Heston Aaron , Carboy Jourdan , Jedrzejewski Breanna , Peters Blair , Berli Jens Urs 
Published: July 2021

Abstract
Background Flaps used in phalloplasty are larger than described for other indications, with a design that is tubularized up to two times. While the incidence of partial flap loss (PFL) is well described, current literature lacks granularity comparing donor sites and techniques with minimal discussion of etiology and management. The purpose of this study was to review our experience with PFL in phalloplasty.
Methods This was a retrospective cohort study of patients who underwent phalloplasty by a single surgeon at a single institution between 2016 and 2020. PFL was defined as any patient requiring sharp excision of necrotic tissue and reconstruction. Patient variables (demographics, body mass index, American Society of Anesthesiologists physical status classification, comorbidities), flap variables (donor site, design, dimensions, perforator number) and intraoperative variables (use of vasopressors, intraoperative fluid volume) were collected.
Results Of 76 phalloplasties, 6 patients suffered PFL (7.9%). 5/6 patients were radial forearm free flap tube-within-tube (TWT) and 1/5 patients were pedicled anterolateral thigh TWT. 4/6 cases involved the shaft only and were treated with excision ± Integra and full-thickness skin grafting. 2 cases of PFL involved the urethral extension requiring excision of the necrotic segment.
Conclusion PFL occurred in 7.9% of cases and was solely found in the TWT cohort. The majority of cases involved the shaft, sparing the urethral segment. Cases in the acute postoperative period appeared to be related to macrovascular venous congestion, while cases in the subacute period appeared to be due to microvascular arterial ischemia.
Investigating Decreased Rates of Nulliparous Cesarean Deliveries during the COVID-19 Pandemic
Authors: Sinnott Colleen M. , Freret Taylor S. , Clapp Mark A. , Reiff Emily , Little Sarah E. 
Published: July 2021

Objective Preventing the first cesarean delivery (CD) is important as CD rates continue to rise. During the novel coronavirus disease 2019 (COVID-19) pandemic, quality improvement metrics at our hospital identified lower rates of CD. We sought to investigate this change and identify factors that may have contributed to the decrease.
Study Design We compared nulliparous singleton deliveries at a large academic hospital during the COVID-19 pandemic (April through July 2020 during a statewide “stay-at-home” order) to those in the same months 1 year prior to the pandemic (April through July 2019). The primary outcome, mode of delivery, was obtained from the electronic medical record system, along with indication for CD.
Results The cohort included 1,913 deliveries: 892 in 2019 and 1,021 in 2020. Patient characteristics (age, body mass index, race, ethnicity, and insurance type) did not differ between the groups. Median gestational age at delivery was the same in both groups. The CD rate decreased significantly during the COVID-19 pandemic compared with prior (28.9 vs. 33.6%; p = 0.03). There was a significant increase in the rate of labor induction (45.7 vs. 40.6%; p = 0.02), but no difference in the proportion of inductions that were elective (19.5 vs. 20.7%; p = 0.66). The rate of CD in labor was unchanged (15.9 vs. 16.3%; p = 0.82); however, more women attempted a trial of labor (87.0 vs. 82.6%; p = 0.01). Thus, the proportion of CD without a trial of labor decreased (25.1 vs. 33.0%; p = 0.04).
Conclusion There was a statistically significant decrease in CD during the COVID-19 pandemic at our hospital, driven by a decrease in CD without a trial of labor. The increased rate of attempted trial of labor suggests the presence of patient-level factors that warrant further investigation as potential targets for decreasing CD rates. Additionally, in a diverse and medically complex population, increased rates of labor induction were not associated with increased rates of CD.
Key Points
The effectiveness of using edublogs as an instructional and motivating tool in the context of higher education
Authors: Campillo-Ferrer José María , Miralles-Martínez Pedro , Sánchez-Ibáñez Raquel 
Published: July 2021

AbstractThe aim of this research is to study the impact of blogs on improving self-reported motivation and learning in a higher education context. A quasi-experimental study was carried out in a social science core unit of the Primary Education degree at the University of Murcia, Spain. The study involved two groups of student teachers, with a total of 101 participants, who created their own blogs as a framework for exchanging their views and sharing their ideas on a variety of contemporary issues related to social science teaching. Data were collected through pre- and post-tests to measure whether the expected changes had occurred as a result of using this digital information platform. The results indicate that the use of blogs helped students to develop their digital literacy, to enhance their social and civic skills, and increase their self-perceived motivation. It is therefore worth updating the current communication processes with regard to online learning with a view to promoting digital access to information and fostering a meaningful learning network through these web resources.
Everyone does it—differently: A window into emerging adults’ smartphone use
Authors: Griffioen Nastasia , Scholten Hanneke , Lichtwarck-Aschoff Anna , van Rooij Marieke , Granic Isabela 
Published: July 2021

AbstractConcerns regarding smartphones’ and social media’s impact on youth remain high amidst a growing realization that current research is not designed to confirm (or refute) such concerns. This study aims to answer fundamental questions regarding youths’ use of smartphones, by implementing a novel user-centric research method. The smartphone use of 114 emerging adults was recorded, followed by in-depth interviews that incorporated the recording and in-app information to help participants recall their behaviours, motivations, and feelings. Results indicate that smartphone use is indeed ubiquitous; 88 out of 114 participants started using their smartphone as soon as they were left alone. However, the findings of this study also demonstrate great diversity in smartphone use, in e.g. social media platforms used and motivations for using different apps. These results illustrate that it no longer seems sensible to refer to “screen time” as if it represents a homogeneous phenomenon across youth. Additionally, preliminary indications have been found of relationships between individual differences in mental health indices and variations in smartphone use. The current study provides new insights into youths’ smartphone use and its relationship with wellbeing.
Effective-medium-clad Bragg grating filters
Authors: Gao Weijie , Lee Wendy S. L. , Fumeaux Christophe , Withayachumnankul Withawat 
Published: July 2021

We propose a series of integrated Bragg grating filters with performance enhancement via the concept of effective medium. The bandstop filters are built in a high-resistivity silicon wafer and operated over the WR-3.4 band (220–330 GHz) with in-plane polarization. The proposed designs use an additional degree of freedom in controlling the effective refractive index so as to fully use the potential of the Bragg grating structures. As a result, the high insertion loss typically observed at the low-frequency bound of the filters due to weak wave confinement can be reduced, while radiation caused by the leaky-wave effect at the high-frequency bound is minimized, allowing for a 40% operation fractional bandwidth. These features are not achievable with conventional waveguide Bragg grating filters. All-silicon prototypes of filter samples are experimentally validated, demonstrating promising performance for a wide range of terahertz applications. The techniques to improve the filter characteristics by controlling the effective medium can be adopted in both microwave and optics domains.
Microbe-dependent heterosis in maize
Authors: Wagner Maggie R. , Tang Clara , Salvato Fernanda , Clouse Kayla M. , Bartlett Alexandria , Vintila Simina , Phillips Laura , Sermons Shannon , Hoffmann Mark , Balint-Kurti Peter J. , Kleiner Manuel 
Published: July 2021

Significance
Almost all grain crops grown on commercial farms are hybrid cultivars because these hybrid plants are reliably healthier, larger, and more productive than their inbred parent lines. The widespread and valuable phenomenon of hybrid superiority is called heterosis. Despite over a century of intensive research into heterosis, it is unclear how or why hybrid genomes give rise to superior phenotypes. Most hypotheses and research thus far have focused on genetic and physiological mechanisms of heterosis. In contrast, this article presents evidence for a microbe-driven mechanism of heterosis, whereby the activity of live soil microbes affects the expression of heterosis. This finding will open lines of research that could advance our understanding of heterosis.
Reward-specific satiety affects subjective value signals in orbitofrontal cortex during multicomponent economic choice
Authors: Pastor-Bernier Alexandre , Stasiak Arkadiusz , Schultz Wolfram 
Published: July 2021

Significance
Ongoing consumption reduces the subjective value of rewards to different degrees depending on their individual properties, a phenomenon referred to as sensory-specific satiety. Such value change should be manifested in economic choices, and neuronal signals for subjective economic reward value should be sensitive to reward-specific satiety. We tested monkeys during the choice between two options that each contained two different rewards (“bundles”); the two rewards were prone to different degrees of satiety. Ongoing reward consumption affected choices in a way that indicated satiety-induced reward-specific change of subjective economic value. Neuronal responses in the monkey orbitofrontal cortex (OFC) followed the differential reduction of subjective economic value. These results satisfy a crucial requirement for subjective reward value coding in OFC neurons.
Active liquid crystals powered by force-sensing DNA-motor clusters
Authors: Tayar Alexandra M. , Hagan Michael F. , Dogic Zvonimir 
Published: July 2021

Significance
Single-molecule techniques have elucidated how isolated molecular motors generate piconewton forces with unprecedented detail. However, in diverse biological and synthetic settings, force-generating proteins collectively power nonequilibrium dynamics, including continuous large-scale rearrangements and persistent fluid flows. Characterizing motor-generated forces in these dense and dynamical environments remains a challenge. We assembled a reversible DNA-based force-sensing probe that, by an optical readout, reveals the molecular arrangements and the force loads experienced by kinesin motors. These probes provide insight into motor-generated forces that collectively power the unique dynamics of microtubule-based active nematics, a noteworthy example of an internally driven active matter system. DNA-based force probes can be extended to study forces and stresses in various synthetic systems as well as diverse cellular environments.
Grain boundary formation through particle detachment during coarsening of nanoporous metals
Authors: Elder Kate L. M. , Andrews W. Beck , Ziehmer Markus , Mameka Nadiia , Kirchlechner Christoph , Davydok Anton , Micha Jean-Sébastien , Chadwick Alexander F. , Lilleodden Erica T. , Thornton Katsuyo , Voorhees Peter W. 
Published: July 2021

Significance
Nanoporous metals are prototypical bicontinuous structures that have a large surface area and many applications. We demonstrate that an in-grain orientation spread develops during coarsening in nanoporous metals, leading to the formation of a nanocrystalline–nanoporous structure. The process of particles detaching and reattaching as the structure coarsens is identified as a mechanism of grain boundary formation. Coarsening the structure results in significant particle detachment with detachment rates that vary drastically with changes in the volume fraction and volume fraction inhomogeneities in the nanostructure. These results demonstrate that particle detachment must be understood to have full control of the nanocrystalline–nanoporous structure and improve material properties.
Effects of lightning strokes on underground gravitational waves observatories
Authors: Washimi T. , Yokozawa T. , Nakano M. , Tanaka T. , Kaihotsu K. , Mori Y. , Narita T. 
Published: July 2021

Abstract
For ground-based gravitational wave (GW) detectors, lightning strokes in the atmosphere are sources of environmental noise.
Some GW detectors are built or planned in underground facilities, and knowledge of how lightning strokes affect them is of interest.
In this paper, the lightning detection system in KAGRA is introduced, and the properties of the magnetic field measured inside and outside the KAGRA tunnel are shown.
One lightning-induced event in the GW channel of the KAGRA main interferometer is also showed.
Finally, possible applications of lightning events for the GW experiments are discussed.
Quenching factor measurements of sodium nuclear recoils in NaI:Tl determined by spectrum fitting
Authors: Bignell L.J. , Mahmood I. , Nuti F. , Lane G.J. , Akber A. , Barberio E. , Baroncelli T. , Coombes B.J. , Dix W. , Dowie J.T.H. , Eriksen T. , Gerathy M.S.M. , Gray T.J. , McCormick B.P. , Mitchell A.J. , Rahman M.S. , Scutti F. , Spinks N.J. , Stuchbery A.E. , Timmers H. , Urquijo P. , Wang L. , Zhong Y.Y. , Zurowski M.J. 
Published: July 2021

Abstract
We have performed measurements of sodium nuclear recoils in NaI:Tl crystals, following scattering by neutrons produced in a 7Li(p,n)7Be reaction. Understanding the light output from such recoils, which is reduced relative to electrons of equivalent energy by the quenching factor, is critical to interpret dark matter experiments that search for nuclear scattering interactions. We have developed a spectrum-fitting methodology to extract the quenching factor from our measurements, and report quenching factors for nuclear recoil energies between 36 and 401 keV. Our results agree with other recent quenching factor measurements that use quasi-monoenergetic neutron sources. The new method will be applied in the future to the NaI:Tl crystals used in the SABRE experiment.