bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicopathological analysis of 67 cases of esophageal neuroendocrine carcinoma and the effect of postoperative adjuvant therapy on prognosis
Authors: Liu Shenxiang , Ge Xiaolin , Gao Zhenzhen , Zhou Qing , Shi Yu , Jiang Wangrong , Yang Min , Sun Xinchen 
Published: October 2021

Abstract
The clinicopathological properties of esophageal neuroendocrine carcinoma (ENEC) and its optimal therapy have not been widely studied, as the disease is not common. Consequently, we conducted a retrospective study to analyze the clinical features as well as the prognosis of patients with surgically resected ENEC.
The clinicopathological data of patients with ENEC who underwent esophagostomy with regional lymphadenectomy at Jiangsu Province People's Hospital and Jiangsu Provincial Tumor Hospital starting January 2008 until December 2014 were collected.
Ninety-two cases of ENEC were part of this study. However, only 67 patients were analyzed and followed up. A univariate model for the Cox proportional hazards revealed that prognosis was associated with postoperative adjuvant therapy, age, and lymph node metastasis (P < .05); a multivariate Cox proportional hazards model showed that postoperative adjuvant therapy was a significant independent prognostic factor. Postoperative adjuvant therapy directly affected overall survival, with a significant disparity noted between the groups (P = .022). In this study, patients who received adjuvant therapy had an average time of survival of 39 months (interquartile range: 27.068–50.932 months), while those who did not receive adjuvant therapy had an average survival time of 13 months (interquartile range: 10.129–15.871 months). The survival time was longer in the treated group than in the untreated group (hazard ratio = 0.47; 95% confidence interval: 0.23–0.94; P = .034).
ENEC is a heterogeneous tumor with a very poor prognosis. Combining surgery with adjuvant and/or chemotherapy significantly prolongs the survival of patients, and the optimal treatment for ENEC should be determined with future prospective studies.
Speech Outcomes of Treatment for Velopharyngeal Insufficiency
Authors: Nam Seung Min , Kim Yong Bae , Park Kyong Chan , Park Eun Soo , Choi Chang Yong , Cha Han Gyu , Jung Se A. 
Published: October 2021

Background
Velopharyngeal insufficiency involving a large velopharyngeal gap and poor lateral wall movement is referred to as a “black hole” and remains a challenging problem for cleft surgeons. The effect of the pharyngeal flap on this form of velopharyngeal insufficiency is still debatable because a wide pharyngeal flap is associated with a high incidence of airway obstruction. The present study aimed to evaluate the speech outcomes of combined overlapping intravelar veloplasty and dynamic sphincter pharyngoplasty for the treatment of velopharyngeal insufficiency.

Methods
Between March 2016 and June 2019, 15 patients with velopharyngeal insufficiency were treated with a combination of overlapping intravelar veloplasty and dynamic sphincter pharyngoplasty. Preoperative speech evaluation was performed on the basis of perceptual speech evaluation, nasometry, and nasoendoscopy. Postoperative speech evaluation using the same approach as that used preoperatively was performed after completion of speech therapy.

Results
All 15 patients achieved satisfactory velopharyngeal port closure and speech phonation after completion of speech therapy. No additional procedures were performed to improve velopharyngeal port closure and speech production. The preoperative and postoperative results of perceptual speech evaluation, nasometry, and nasoendoscopy evaluation were significantly different (P < 0.01).

Conclusion
Combined treatment with overlapping intravelar veloplasty and dynamic sphincter pharyngoplasty can correct the velopharyngeal insufficiency “black hole” with highly reliable results and minimal risk of airway obstruction.
Use of the O-Z Flap to Repair Scalp Defects After Cancer Tumor Resection
Authors: Lin Jian , Wei Peng , Xu Yi , Wang Guoyao , Wu Kerong , Lin Bingjiang , Wang Yangjian 
Published: October 2021

Background:
Large benign and malignant tumors in the scalp cannot be sutured directly after resection. Instead, skin grafting or skin flap repair is the most commonly used techniques. Local tissue depression and lack of hair growth are some of the drawbacks associated with these techniques. The use of a modified local flap (the O-Z flap) may effectively overcome these issues.

Objective:
To explore the application of O-Z flap in wound repair after excision of benign and malignant tumors of the scalp.

Methods:
Between April 2016 and November 2017, the authors treated 6 patients with scalp tumors. They underwent round or oval radical tumor resection with negative margins. Tumor specimens were diagnosed by cryosection during operation. According to the wound defect size and location, surrounding scalp looseness, and hair distribution, 2 rotating flaps in opposite directions were formed on the left and right sides or front and back of the wound. Subsequently, the skin flaps were rotated in opposite directions to repair the wound.

Results:
The scalp tumors comprised 2 cases of basal cell carcinoma, 2 cases of squamous cell carcinoma, 1 case of hair sheath carcinoma, and 1 case of epidermoid cyst. After complete tumor resection, the wound defect area was between 3.0 cm × 3.5 cm and 5.0 cm × 6.0 cm. After operation, approximately 6% of the tip of the skin flap was necrotized. The wounds healed after 4 weeks of dressing treatment. All skin flaps survived in stage I and no complications occurred. All patients were followed up for 3 to 12 months; the scalps were in good condition and no tumor recurrence was found.

Conclusions:
The use of the O-Z flap to repair scalp wounds offers flexible design, good blood circulation, uniform tension, and good hair growth after operation; thus, this technique is suitable for wound repair following scalp tumor resection.
Surgical Anatomy for Fibular Free Flap Focusing on the Inferior Tibiofibular Syndesmotic System: A Cadaveric Study and Case Series of 3-Dimensional Prefabricate Cutting Guided Fibular Free Flap
Authors: Ongsiriporn Mathee , Chaikangwan Irin , Piyaman Parkpoom , Khongchu Nachasa , Akaranuchat Nutthawut , Yodrabum Nutcha 
Published: October 2021

Abstract
Even though there are many options for mandibular reconstruction, a free fibula osteocutaneous flap is regarded as the most frequently used flap. Despite having some previous anatomical studies pertaining to syndesmotic ligaments, there is no study pointing out that surgical landmarks can be used while free fibula osteocutaneous flaps are performed and used for surgical landmarks in order to avoid syndesmotic ligament injuries. Therefore, this study investigates the characteristics and relationship between inferior syndesmotic ligaments and fibula in cadavers. A total of 140 legs were obtained from 83 embalmed cadavers as well as other soft ones, which were donated for the inferior tibiofibular syndes- motic system's study. Detailed dissection and measurement of each ligament's distance to the end of the fibula and lateral malleolus were performed. Distances from the distal end of the fibula to anterior inferior tibiofibular ligament, posterior inferior tibiofibular, and inferior transverse ligament, and the lower border of the interosseous membrane are 3.5 ± 0.4 cm, 3.4 ± 0.5 cm, 1.9 ± 0.4 cm, and 5 ± 1 cm (mean ± SD), respectively. Distance from the most distal part of the fibula to lateral malleolus is 1.6 ± 0.4 cm (mean ± SD). Thus, the remaining distance of the fibular should be left at least 4 cm without disrupting the syndesmotic ligament complex. It is argued that the lateral malleolus can be applied as a surgical landmark while harvesting fibula.
Analysis of Orbital Blowout Fracture Location and Hess Area Ratio
Authors: Osaki Takeo , Tamura Ryosuke , Sakakibara Shunsuke , Nomura Tadashi , Hashikawa Kazunobu , Terashi Hiroto 
Published: October 2021

Abstract
This study aimed to analyze the Hess area ratio (HAR%) in cases of blowout fracture treated in our department and clarify the outline of eye movement disorders in blowout fractures. Patients who underwent surgery for orbital blowout fractures in our department were included. Fracture locations were classified into 5 types (A, outside floor; B, C, anterior and posterior floor; and D, E, anterior and posterior medial wall). The HAR% was compared before and after surgery in eligible cases. The relationship between the fracture location and preoperative HAR% was investigated using multiple regression analysis. The study involved 85 patients. Hess area ratio was higher postoperatively than preoperatively (70.75 ± 18.26 versus 90.06 ± 13.99, P
< 0.01). The postoperative HAR% tended to be higher when the iliac bones were compared to other materials; however, this difference was not significant (90.73 ± 12.91 versus 80.30 ± 17.81, P = 0.178). Fracture locations C and E significantly contributed to the prediction of HAR% as negative regression coefficients (P = 0.024 and 0.013, respectively). The posterior fracture area on both the orbital floor and medial wall contributed to the decrease in preoperative HAR%. This observation indicates that the reconstruction of the posterior region is extremely crucial.
Hemodynamic Effect of Resuscitative Endovascular Balloon Occlusion of the Aorta in Hemodynamic Instability Secondary to Acute Cardiac Tamponade in a Porcine Model
Authors: McGreevy David T. , Björklund Janina , Nilsson Kristofer F. , Hörer Tal M. 
Published: October 2021

ABSTRACT

Background:
The pre-hospital use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is increasing, although it remains controversial, in part because of suggested contraindications such as acute cardiac tamponade (ACT). As both the pre-hospital and in-hospital use of REBOA might potentially occur with concurrent ACT, knowledge of the hemodynamic effect of REBOA in this setting is crucial. This study, therefore, aimed at investigating the physiological effects of REBOA in hemodynamic instability secondary to ACT in a porcine model. We hypothesize that REBOA can temporarily increase systemic blood pressure and carotid blood flow, and prolong survival, in hemodynamic shock caused by ACT.

Methods:
Fourteen pigs (24–38 kg) underwent ACT, through true cardiac injury and hemorrhage into the pericardial space, and were allowed to hemodynamically deteriorate. At a systolic blood pressure (SBP) of 50 mm Hg (SBP50) they were randomized to total occlusion REBOA in zone 1 or to a control group. Survival, hemodynamic parameters, carotid blood flow (CBF), femoral blood flow (FBF), cardiac output (CO), end-tidal CO2, and arterial blood gas parameters were analyzed.

Results:
REBOA intervention was associated with a significant increase in SBP (50 mm Hg to 74 mm Hg, P = 0.016) and CBF (110 mL/min to 195 mL/min, P = 0.031), with no change in CO, compared to the control group. At 20 min after SBP50, the survival rate in the intervention group was 86% and in the control group 14%, with time to death being significantly longer in the intervention group.

Conclusions:
This randomized animal study demonstrates that REBOA can help provide hemodynamic stabilization and prolong survival in hemodynamic shock provoked by ACT. It is important to stress that our study does not change the fact that urgent pericardiocentesis or cardiac surgery is, and should remain, the standard optimal treatment for ACT.

Level of evidence: Prospective, randomized, experimental animal study. Basic science study, therapeutic.
A systematic review of enteric pathogens and antibiotic resistance genes in outdoor urban aerosols
Authors: Ginn Olivia , Lowry Sarah , Brown Joe 
Published: October 2021

ABSTRACTAerosol transport of enteric microbiota including fecal pathogens and antimicrobial resistance genes (ARGs) has been documented in a range of settings but remains poorly understood outside indoor environments. We conducted a systematic review of the peer-reviewed literature to summarize evidence on specific enteric microbiota including enteric pathogens and ARGs that have been measured in aerosol samples in urban settings where the risks of outdoor exposure and antibiotic resistance (AR) spread may be highest. Following PRISMA guidelines, we conducted a key word search for articles published within the years 1990-2020 using relevant data sources. Two authors independently conducted the keyword searches of databases and conducted primary and secondary screenings before merging results. To be included, studies contained extractable data on enteric microbes and AR in outdoor aerosols regardless of source confirmation and reported on qualitative, quantitative, or viability data on enteric microbes or AR. Qualitative analyses and metric summaries revealed that enteric microbes and AR have been consistently reported in outdoor aerosols, generally via relative abundance measures, though gaps remain preventing full understanding of the role of the aeromicrobiological pathway in the fate and transport of enteric associated outdoor aerosols. We identified remaining gaps in the evidence base including a need for broad characterization of enteric pathogens in bioaerosols beyond bacterial genera, a need for greater sampling in locations of high enteric disease risk, and a need for quantitative estimation of microbial and nucleic acid densities that may be applied to fate and transport models and in quantitative microbial risk assessment.FUNDINGThis study was funded by the National Science Foundation under grant number 1653226. This funding source had no role in the design of this study and had no role during its execution, analyses, interpretation of the data, or decision to submit results.
The Persistence of Neutralising Antibodies up to 11 months after SARS-CoV-2 Infection in the Southern Region of New Zealand
Authors: McGregor Reuben , Craigie Alyson , Jack Susan , Upton Arlo , Moreland Nicole J. , Ussher James 
Published: October 2021

SummaryDuring the first wave of SARS-CoV-2 infection in New Zealand a cohort of 78 PCR-confirmed COVID-19 cases was recruited in the Southern District Health Board region. Here we report on this unique cohort nearly 1-year after infection. There was no known community transmission in the region over the study period due to New Zealand’s elimination status at the time, nor had any participants received a COVID-19 vaccine. In the absence of re-exposure, antibody reactivity to the viral spike protein, as well as neutralising antibodies to both the ancestral strain and the delta variant remained relatively stable between 8 and 11 months post-infection. This suggests long-lived antibody responses can be generated from a single natural infection event. However, given the risks of serious disease associated with SARS-CoV-2 infection, vaccination is still strongly recommended.
Combining Navigator and Optical Prospective Motion Correction for High-Quality 500 μm Resolution Quantitative Multi-Parameter Mapping at 7T
Authors: Vaculčiaková Lenka , Podranski Kornelius , Edwards Luke J. , Ocal Dilek , Veale Thomas , Fox Nick C. , Haak Rainer , Ehses Philipp , Callaghan Martina F. , Pine Kerrin J. , Weiskopf Nikolaus 
Published: October 2021

AbstractPURPOSEHigh-resolution quantitative multi-parameter mapping shows promise for non-invasively characterizing human brain microstructure but is limited by physiological artifacts. We implemented corrections for rigid head movement and respiration-related B0-fluctuations and evaluated them in healthy volunteers and dementia patients.METHODSCamera-based optical prospective motion correction (PMC) and free-induction decay (FID) navigator correction were implemented in a gradient and RF-spoiled multi-echo 3D gradient echo sequence for mapping proton density (PD), longitudinal relaxation rate (R1) and effective transverse relaxation rate (R2*). We studied their effectiveness separately and in concert in young volunteers and then evaluated the navigator correction (NAVcor) with PMC in a group of elderly volunteers and dementia patients. We used spatial homogeneity within white matter (WM) and gray matter (GM) and scan-rescan measures as quality metrics.RESULTSNAVcor and PMC reduced artifacts and improved the homogeneity and reproducibility of parameter maps. In elderly participants, NAVcor improved scan-rescan reproducibility of parameter maps (coefficient of variation decreased by 14.7% and 11.9% within WM and GM respectively). Spurious inhomogeneities within WM were reduced more in the elderly than in the young cohort (by 9% vs 2%). PMC increased regional GM/WM contrast and was especially important in the elderly cohort, which moved twice as much as the young cohort. We did not find a significant interaction between the two corrections.CONCLUSIONNavigator correction and PMC significantly improved the quality of PD, R1 and R2* maps, particularly in less compliant elderly volunteers and dementia patients.
Deep autoencoder for interpretable tissue-adaptive deconvolution and cell-type-specific gene analysis
Authors: Chen Yanshuo , Wang Yixuan , Chen Yuelong , Cheng Yuqi , Wei Yumeng , Li Yunxiang , Wang Jiuming , Wei Yingying , Chan Ting-Fung , Li Yu 
Published: October 2021

AbstractSingle-cell RNA-sequencing has become a powerful tool to study biologically significant characteristics at explicitly high resolution. However, its application on emerging data is currently limited by its intrinsic techniques. Here, we introduce Tissue-AdaPtive autoEncoder (TAPE), a deep learning method connecting bulk RNA-seq and single-cell RNA-seq to achieve precise deconvolution in a short time. By constructing an interpretable decoder and training under a unique scheme, TAPE can predict cell-type fractions and cell-type-specific gene expression tissue-adaptively. Compared with popular methods on several datasets, TAPE has a better overall performance and comparable accuracy at cell type level. Additionally, it is more robust among different cell types, faster, and sensitive to provide biologically meaningful predictions. Moreover, through the analysis of clinical data, TAPE shows its ability to predict cell-type-specific gene expression profiles with biological significance. We believe that TAPE will enable and accelerate the precise analysis of high-throughput clinical data in a wide range.
Transcriptomic profiling of sex-specific olfactory neurons reveals subset-specific receptor expression inCaenorhabditis elegans
Authors: Reilly Douglas K. , Schwarz Erich M. , Muirhead Caroline S. , Robidoux Annalise N. , Narayan Anusha , Doma Meenakshi K. , Sternberg Paul W. , Srinivasan Jagan 
Published: October 2021

SummaryThe nematodeCaenorhabditis elegansutilizes chemosensation to navigate an ever-changing environment for its survival. A class of secreted small-molecule pheromones, termed ascarosides, play an important role in olfactory perception by affecting biological functions ranging from development to behavior. The ascaroside ascr#8 mediates sex-specific behaviors, driving avoidance in hermaphrodites and attraction in males. Males sense ascr#8 via the ciliated male-specific cephalic sensory (CEM) neurons, which exhibit radial symmetry along dorsal-ventral and left-right axes. Calcium imaging studies suggest a complex neural coding mechanism that translates stochastic physiological responses in these neurons to reliable behavioral outputs. To test the hypothesis that neurophysiological complexity arises from differential expression of genes, we performed cell-specific transcriptomic profiling; this revealed between 18 and 62 genes with at least two-fold higher expression in a specific CEM neuron type versus both other CEM neurons and adult males. These included two G protein coupled receptor (GPCR) genes,srw-97anddmsr-12, that were specifically expressed in non-overlapping subsets of CEM neurons and whose expression was confirmed by GFP reporter analysis. Single CRISPR-Cas9 knockouts of eithersrw-97ordmsr-12resulted in partial defects, while a double knockout of bothsrw-97anddmsr-12completely abolished the attractive response to ascr#8. Together, our results suggest that the evolutionarily distinct GPCRs SRW-97 and DMSR-12 act non-redundantly in discrete olfactory neurons to facilitate male-specific sensation of ascr#8.
Techniques to Produce and Evaluate Realistic Multivariate Synthetic Data
Authors: Heine John , Fowler Erin E.E. , Berglund Anders , Schell Michael J. , Eschrich Steven 
Published: October 2021

AbstractBackgroundData modeling in biomedical-healthcare research requires a sufficient sample size for exploration and reproducibility purposes. A small sample size can inhibit model performance evaluations (i.e., the small sample problem).ObjectiveA synthetic data generation technique addressing the small sample size problem is evaluated. We show: (1) from the space of arbitrarily distributed samples, a subgroup (class) has a latent multivariatenormal characteristic; (2) synthetic populations (SPs) ofunlimitedsize can be generated from this class with univariate kernel density estimation (uKDE) followed by standard normal random variable generation techniques; and (3) samples drawn from these SPs are statistically like their respective samples.MethodsThree samples (n = 667), selectedpseudo-randomly,were investigated each with 10 input variables (i.e., X). uKDE (optimized with differential evolution) was used to augment the sample size in X (i.e., the input variables). The enhanced sample size was used to construct maps that produced univariate normally distributed variables in Y (mapped input variables). Principal component analysis in Y produced uncorrelated variables in T, where the univariate probability density functions (pdfs) were approximated as normal with specific variances; a given SP in T was generated with normally distributed independent random variables with these specified variances. Reversing each step produced the respective SPs in Y and X. Synthetic samples of the same size were drawn from these SPs for comparisons with their respective samples. Multiple tests were deployed: to assess univariate and multivariate normality; to compare univariate and multivariate pdfs; and to compare covariance matrices.ResultsOne sample was approximately multivariate normal in X and all samples were approximately multivariate normal in Y, permitting the generation ofunlimitedsized SPs. Uni/multivariate pdf and covariance comparisons (in X, Y and T) showed similarity between samples and synthetic samples.ConclusionsThe work shows that a class of multivariate samples has a latentnormal characteristic; for such samples, our technique is a simplifying mechanism that offers an approximate solution to the small sample problem by generating similar synthetic data. Further studies are required to understand this latent normal class, as two samples exhibited this characteristic in the study.