bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Fluid Bolus Therapy on Extravascular Lung Water Measured by Lung Ultrasound in Children With a Presumptive Clinical Diagnosis of Sepsis
Authors: Long Elliot , O'Brien Adam , Duke Trevor , Oakley Ed , Babl Franz E. ,   on behalf of the Pediatric Research in Emergency Departments International Collaborative
Published: October 2018

ObjectivesFluid bolus therapy for the treatment of sepsis may lead to the accumulation of extravascular lung water (EVLW) and result in respiratory dysfunction. We aimed to assess changes in EVLW using lung ultrasound (US) in children with a presumptive clinical diagnosis of sepsis after fluid bolus therapy and correlate these changes with respiratory signs.MethodsThis work was a prospective observational study set in the emergency department of the Royal Children's Hospital. Children meeting international consensus criteria for sepsis receiving fluid bolus therapy were included. Respiratory signs were recorded, and lung US examinations were performed immediately before, 5 minutes after, and 60 minutes after fluid bolus therapy. A pediatric emergency physician blinded to the participants’ identities and timing of US calculated an EVLW score from lung US.Results—Fifty fluid boluses were recorded in 41 children. The lung US score (range, 0–8) increased over the study period: median, 1 (interquartile range, 0–2) before fluid bolus therapy, 1 (interquartile range, 0–3) 5 minutes after fluid bolus therapy, and 3 (interquartile range, 1–4) 60 minutes after fluid bolus therapy. Respiratory effort, but not the respiratory rate or the presence of rales, increased over the study period and was correlated with the lung US score (ρ = 0.33; P = .02).ConclusionsExtravascular lung water as measured by lung US increased after fluid bolus therapy in septic children and was correlated with an increase in the respiratory distress score. The respiratory rate and the presence of rales did not change over the study period. The role of lung US for titrating fluid bolus therapy in sepsis warrants further investigation.
Goat grazing reduces diversity and leads to functional, taxonomic, and phylogenetic homogenization in an arid shrubland
Authors: Salgado‐Luarte Cristian , Escobedo Víctor M. , Stotz Gisela C. , Rios Rodrigo S. , Arancio Gina , Gianoli Ernesto 
Published: October 2018

AbstractLivestock production is an important activity in drylands. However, lack of adequate regulation of ranching activities can lead to the degradation of plant communities, which in turn can impact ecosystem functioning. In the arid ecosystems of north‐central Chile, unregulated goat grazing is widespread. Because the vegetation has a relatively short evolutionary history of grazing, it is expected to be highly susceptible to this activity. In this study, we evaluated the effects of goat grazing on plant taxonomic, functional, and phylogenetic community structure by comparing 39‐year‐old grazing exclusion plots and unprotected plots in an arid shrubland in north‐central Chile. By integrating analyses of the impact of goat grazing on functional and phylogenetic diversity and dispersion, we studied the mechanisms behind goat impact and the potential consequences. Loss of functional and/or phylogenetic diversity can result in important losses in ecosystem function. As a measure of functional diversity, we recorded plant growth form, life span, and life form. We also reconstructed a phylogeny of all plant species found at the study site and determined the phylogenetic structure of the plant community in ungrazed and grazed areas. We found that goat grazing affected diversity and community composition, leading to taxonomic, functional, and phylogenetic biotic homogenization and causing overall community impoverishment. Goats acted as a habitat filter, increasing functional convergence and promoting the establishment of exotics plants, which can lead to further losses of biodiversity, decreased ecosystem function and overall lower ecosystem stability. Our results indicate that sustainable management strategies are necessary to prevent the further degradation of these ecosystems.
Fuelwood extraction intensity drives compensatory regrowth in African savanna communal lands
Authors: Mograbi Penelope J. , Witkowski Ed T.F. , Erasmus Barend F.N. , Asner Gregory P. , Fisher Jolene T. , Mathieu Renaud , Wessels Konrad J. 
Published: October 2018

AbstractWoody biomass remains the primary energy source for domestic use in the developing world, raising concerns about woodland sustainability. Yet woodland regenerative capacity and the adaptive response of harvesters to localised fuelwood shortages are often underestimated or unaccounted for in fuelwood supply–demand models. Here, we explore the rates and patterns of height‐specific woody vegetation structural dynamics in three communal lands in a semiarid savanna in South Africa. Using repeat, airborne light detection and ranging, we measured height‐specific change in woody vegetation structure, and the relative influence of geology, fire, and ease of access to fuelwood. Monitoring 634,284 trees canopies over 4 years revealed high compensatory growth, particularly in the high wood extraction communal land: 34.1% of trees increased in height >1 m. Vegetation structural patterns were associated with ease of access to the communal land but were mediated by wood extraction intensity. In these communal lands, vegetation structural dynamics show rapid woody thickening as a response to repeat harvesting. However, loss of height in vegetation structure did not follow a gradient of wood extraction intensity. We propose a conceptual framework to better understand change in vegetation structural metrics and the paradoxical phenomenon of high growth in high wood extraction scenarios. We also show coadaptive responses of humans and woody vegetation to fuelwood harvesting in human–environment systems through patterns of regrowth response relative to ease of access to fuelwood resources.
Age‐dependent variations of scalp thickness in the area designated for a cochlear implant receiver stimulator
Authors: Ungar Omer J. , Amit Uri , Cavel Oren , Oron Yahav , Handzel Ophir 
Published: October 2018

ObjectiveThe integrity of the scalp overlying a cochlear implant receiver stimulator (RS) is critical for the long‐term survival of the implant. Exposure or extrusion of the device will likely result in the need for its removal. There is a global trend of acceleration of population aging, thus raising the prevalence of cochlear implantation (CI) in the elderly. The aim of this study was to define age‐dependent changes in scalp thickness and discuss the implication of that anatomical characteristic for CI in the geriatric population.MethodsScalp thickness over the location of the RS in the temporo‐parietal area was measured directly with a needle in patients of various ages.ResultsTwo‐hundred thirty‐six temporo‐parietal scalps were measured in patients aged 18 to 85 years. A strong inverse correlation was found between age and scalp thickness (rs = ‐0.723, P < .001). Scalp thickness decreased with age from a mean of 8 mm in the third decade of life to 5 mm in the ninth decade of life.ConclusionThe human scalp thins with age and most likely undergoes a reduction in its strength. As a consequence, implantable hearing devices that are shielded by the scalp can be at increased risk of exposure and extrusion in the aging recipient. This needs to be taken into account when considering an implantation procedure, the surgical approach and patient instructions on need for and venues for continuing care over time.Level of Evidence2B
Cast adrift: Physiology and dispersal of benthic Sargassum spinuligerum in surface rafts
Authors: van Hees Daniel H. , Olsen Ylva S. , Mattio Lydiane , Ruiz‐Montoya Leonardo , Wernberg Thomas , Kendrick Gary A. 
Published: October 2018

AbstractConnectivity of populations through the transfer of individuals is one of the key processes for maintaining ecosystem stability and resilience of coastal ecosystems. During reproduction, dislodged seaweeds of the genus Sargassum form large pelagic surface rafts that can persist for several weeks, and potentially act as a dispersal vector. In surface rafts, seaweeds are rapidly exposed to increased light, elevated temperatures, and altered hydrodynamic conditions. Acclimation to surface conditions is necessary for survival during the rafting phase, but there is limited knowledge of seaweed physiology in rafts. To understand the mechanisms for acclimation, we created rafts of floating Sargassum spinuligerum for 2 weeks and compared these experimental fronds to those attached to the seafloor. We measured nutrients, photosynthetic and nonphotosynthetic pigments, and phlorotannins to investigate their role in the persistence of mature Sargassum at the ocean surface as indicated by photosynthetic rates and reproductive status. We also studied potential surface movement of the rafted seaweed over 3‐weeks of particle tracking using an existing oceanographic model. Photosynthesis and reproductive status were similar between benthic and rafted seaweeds, indicating no change to overall metabolic processes during rafting. While phlorotannin concentrations and photosynthetic pigments were unchanged, photoprotective xanthophyll pigments were more abundant in rafted individuals, suggesting acclimation to surface light conditions. Our results suggest that, in the short term, S. spinuligerum employ chemical strategies to acclimate and maintain physiological processes in the rafting environment and potentially fix more carbon, allowing these rafts to act as dispersal vectors among populations over tens of kilometers apart.
Divergent developmental patterns of induced morphological defenses in rotifers and Daphnia: Ecological and evolutionary context
Authors: Riessen Howard P. , Gilbert John J. 
Published: October 2018

AbstractInduced morphological defenses commonly develop in some loricate rotifers as greatly increased spine development and in many species of the cladoceran genus Daphnia as an alteration in the shape and size of its head, producing helmets, crests, and neck spines. This restructuring of the shape of these animals during development, which reduces their vulnerability to a variety of planktonic predators, involves a series of developmental challenges and potential evolutionary constraints for each specific type of defense. In this review, we examine these challenges and the divergent developmental patterns that evolved in rotifers and Daphnia in response to the particular forms of predation pressure they face in their lake and pond environments. These patterns involve differences in the sensitivity of various developmental stages to predator kairomones, the timing of when the defense is present during postembryonic development, the ability to reverse the induced defense if the predator disappears from the community, and the effect of water temperature on the induction process. The type of developmental pattern associated with each induced defense appears to have been shaped by natural selection to effectively protect the animal, at minimal cost, from the specific kind of predation pressure to which it is commonly subjected.
Comparison of treatment options for small to medium congenital melanocytic nevi: A retrospective review of 119 cases
Authors: Lim Jung Min , Oh Yeongjoo , Lee Si‐Hyung , Cho Mi Yeon , Chung Kee Yang , Roh Mi Ryung 
Published: October 2018

ObjectivesFor small to medium sized congenital melanocytic nevi (CMN), the treatment of choice is staged surgical excision. Ablative lasers or pigment‐specific lasers have also been recommended for lesions difficult for surgical removal or to avoid surgery. In this study, we retrospectively analyzed the results of several treatment options for CMN to find out the optimal treatment method.MethodsPatients with small to medium sized CMN were retrospectively reviewed. Treatment options were categorized into four groups: (i) Excision only; (ii) Excision followed by scar laser; (iii) Excision followed by pigment‐specific laser; and (iv) Laser only. Treatment response was assessed by investigator's global assessment (IGA) score on a seven‐point scale.ResultsA total of 119 cases were included. Lesions were most commonly located on the face (59/119, 49.6%), measured 2 ∼ 10 cm in size (72/119, 60.5%), and treated with excision only (50/119, 42.0%). Among treatment options, excision followed by scar laser showed the highest IGA score of 6.38. Options including surgical methods showed higher IGA scores compared to laser‐only treatment (P < 0.01). Staged excisions and single excisions showed no difference in IGA scores. Patient satisfaction scores increased after scar laser treatment of the staged excision scar.ConclusionsFor the treatment of small to medium sized CMN, treatment strategies including surgical methods are cosmetically superior to laser‐only treatment. Also, the combination of surgical excision with scar laser has the potential for better clinical outcomes and patient satisfaction. Lasers Surg. Med. 51:62–67, 2019. © 2018 Wiley Periodicals, Inc.
Technical Note: Model‐based magnification/minification correction of patient size surrogates extracted from CT localizers
Authors: Burton Christiane Sarah , Malkus Annie , Ranallo Frank , Szczykutowicz Timothy P. 
Published: October 2018

PurposePatient size‐specific dose estimate (SSDE) calculations require knowledge of a patient’s size. Errors in patient size propagate through SSDE calculations. AAPM Reports 204 and 220 recommend that a magnification correction be applied to patient size surrogates extracted from CT localizer radiographs. This technical note presents a novel approach for such a magnification correction.MethodsIn our model‐based magnification correction, we assume that the patient’s cross sections are elliptical with minor and major axes defined using the anterior–posterior (AP) and lateral (LAT) patient dimensions. We parameterize the problem by modeling a line emanating from the source, grazing the patient (i.e., the ellipse), and then terminating onto the detector plane. We model tangent lines on each side of the ellipse on both the LAT and AP CT localizer radiographs. We also account for vertical mispositioning with table offset. We compared our correction model to the actual AP and LAT dimensions to the vendor‐supplied CT localizer images that only received a geometric magnification correction, and to other methods described in the literature. We compare our model to the others using direct size to size comparisons as well as SSDE conversion factor.ResultsOur model‐based method provides consistent accurate results (less than 1.8% error for absolute size and 1.2% error for SSDE for all measurement conditions) for all positions and patient sizes. Existing literature‐based methods had maximum errors for absolute size and SSDE of 7.5% and 5.2%, and for the vendor, they were 30.9% and 17.0%, respectively.ConclusionWe presented a new model‐based geometric size correction method that outperforms a simple geometric correction as well as other methods presented in the literature. By modeling the patient cross section and beam geometry using information all derived from the DICOM header and CT localizer views, we demonstrated SSDE correction factor improvements from 17.0% (vendor correction) to 1.2% (model base). These changes correspond directly into changes in SSDE itself and also represent clinically realistic patient sizes and mispositioning amounts.
Translation of Carbon‐13 EPI for hyperpolarized MR molecular imaging of prostate and brain cancer patients
Authors: Gordon Jeremy W. , Chen Hsin‐Yu , Autry Adam , Park Ilwoo , Van Criekinge Mark , Mammoli Daniele , Milshteyn Eugene , Bok Robert , Xu Duan , Li Yan , Aggarwal Rahul , Chang Susan , Slater James B. , Ferrone Marcus , Nelson Sarah , Kurhanewicz John , Larson Peder E.Z. , Vigneron Daniel B. 
Published: October 2018

PurposeTo develop and translate a metabolite‐specific imaging sequence using a symmetric echo planar readout for clinical hyperpolarized (HP) Carbon‐13 (13C) applications.MethodsInitial data were acquired from patients with prostate cancer (N = 3) and high‐grade brain tumors (N = 3) on a 3T scanner. Samples of [1‐13C]pyruvate were polarized for at least 2 h using a 5T SPINlab system operating at 0.8 K. Following injection of the HP substrate, pyruvate, lactate, and bicarbonate (for brain studies) were sequentially excited with a singleband spectral‐spatial RF pulse and signal was rapidly encoded with a single‐shot echo planar readout on a slice‐by‐slice basis. Data were acquired dynamically with a temporal resolution of 2 s for prostate studies and 3 s for brain studies.ResultsHigh pyruvate signal was seen throughout the prostate and brain, with conversion to lactate being shown across studies, whereas bicarbonate production was also detected in the brain. No Nyquist ghost artifacts or obvious geometric distortion from the echo planar readout were observed. The average error in center frequency was 1.2 ± 17.0 and 4.5 ± 1.4 Hz for prostate and brain studies, respectively, below the threshold for spatial shift because of bulk off‐resonance.ConclusionThis study demonstrated the feasibility of symmetric EPI to acquire HP 13C metabolite maps in a clinical setting. As an advance over prior single‐slice dynamic or single time point volumetric spectroscopic imaging approaches, this metabolite‐specific EPI acquisition provided robust whole‐organ coverage for brain and prostate studies while retaining high SNR, spatial resolution, and dynamic temporal resolution.
May perioperative ultrasound‐guided pelvic floor muscle training promote early recovery of urinary continence after robot‐assisted radical prostatectomy?
Authors: Yoshida Mikako , Matsunaga Akiko , Igawa Yasuhiko , Fujimura Tetsuya , Shinoda Yusuke , Aizawa Naoki , Sato Yusuke , Kume Haruki , Homma Yukio , Haga Nobuhiko , Sanada Hiromi 
Published: October 2018

AimsThe efficacy of perioperative pelvic floor muscle training (PFMT) for continence recovery after robot‐assisted radical prostatectomy (RARP) remains unclear. Visualization of the bladder neck and urethra using transperineal ultrasound (US) may promote self‐recognition of urethral closure during PFM contraction. This study aimed to examine whether transperineal US‐guided PFMT promotes early recovery of post‐RARP incontinence.MethodsThis prospective cohort study included 116 men undergoing RARP. All men were offered to undergo transperineal US‐guided PFMT, and 36 men agreed. The protocol consisted of biofeedback PFMT using transperineal US before RARP and 1‐month after RARP with verbal instruction of PFMT immediately after urethral catheter removal. The remaining 80 patients received verbal instruction for PFMT alone. Continence recovery was defined as the number of days requiring a small pad (20 g) per day by self‐report.ResultsNo differences were observed in demographic or peri‐operative parameters between the two groups except the longer operative time in the US‐guided PFMT group. The mean time until continence recovery was significantly shorter in the US‐guided PFMT group (75.6 ± 100.0 days) than in the verbal‐PFMT group (121.8 ± 132.0 days, P = 0.037). Continence recovery rates within 30 days were 52.8% (19/36) and 35.4% (28/80) in the US‐guided PFMT and verbal‐PFMT groups, respectively (P = 0.081). US‐guided PFMT was associated with better postoperative continence status (adjusted hazard ratio [95% confidence interval]: 0.550 [0.336‐0.900], P = 0.017).ConclusionsThe results showed that transperineal US‐guided PFMT perioperatively was associated with early recovery of urinary continence after RARP.
The drug‐resistant pudendal neuralgia management: A systematic review
Authors: Tricard Thibault , Munier Pierre , Story Fleur , Lang Hervé , Saussine Christian 
Published: October 2018

AimsPudendal neuralgia (PN) due to pudendal nerve entrapment is a well‐known disease in medical community but both diagnostic and treatment may be delayed for patients. The goal of this study was to achieve a systematic review of the published treatments of PN in order to help physician to take their decision to treat PN.MethodsA Systematic review based on MEDLINE, Embase, and Cochrane databases was performed to identify articles related to PN. Studies involving ≥ 10 patients presenting PN according to Nantes's criteria who were managed with an intervention for their pain were reviewed. Data were extracted manually for qualitative analysis.ResultsFifteen studies involving 672 patients (mean age 53.2 +/−5.1, SD 95%) were included. Nine different types of treatments were evaluated. Effectiveness of the treatments was heterogeneously assessed. Pain improvement was achieved in 41% to 100%, 13.4% to 100%, 60% to 100%, 12.2% to 100% in immediate, 3‐month, 6‐month, and 1‐year post procedure, respectively. Complications reported were all grade ≤ II of Dindo‐Clavien classification's. Given the heterogeneity of the outcomes measures and the lack of homogeneous prospective studies, no recommendation could be established to choose in between treatments. Methodological quality of the studies was heterogeneous.ConclusionMany treatments seems available for drug‐resistant PN. Given the heterogeneity of the outcomes measures and the lack of homogeneous prospective studies, no recommendation could be established to determine the best management strategy. Further studies about PN management are needed and should have common endpoint and follow‐up.
An ideal e‐health system for pelvic floor muscle training adherence: Systematic review
Authors: Latorre Gustavo F. S. , de Fraga Rogério , Seleme Maura R. , Mueller Cláudia V. , Berghmans Bary 
Published: October 2018

BackgroundNowadays, Pelvic Floor Muscle Training (PFMT) is a first line, level 1 evidence‐based treatment for urinary incontinence (UI), but adherence to PFMT is often problematic. Today, there are several mobile applications (mApps) for PFMT, but many lack specific strategies for enhancing adherence.AimsTo review available mApps for improvement of adherence to PFMT, and to introduce a new App so called iPelvis.MethodsReview study all available mApps for PFMT and relevant literature regarding adherence by electronic search through the databases Pubmed, Embase, CINAHL, LILACS, PEDro, and Scielo. Based on these results, development of a mApp, called “iPelvis” for Apple™ and Android™ systems, implementing relevant strategies to improve adherence.ResultsBased on the current adherence literature we were able to identify 12 variables helping to create the optimal mApp for PFMT. None of the identified 61 mApps found for Android™ and 16 for Apple™ has all these 12 variables. iPelvis mApp and websites were constructed taking into consideration those 12 variables and its construct is now being subject to ongoing validation studies.ConclusionMApps for PFMT are an essential part of first‐line, efficient interventions of UI and have potentials to improve adherence, in case these respect the principles of PFMT, motor learning and adherence to PFMT. iPelvis has been constructed respecting all essential variables related to adherence to PFMT and may enhance the effects of UI treatment.