bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgery-First Orthognathic Surgery for Severe Facial Asymmetry Combined With Mandibular Distraction Osteogenesis Using a Three-Dimensional Internal Distractor
Authors: Watanabe Yorikatsu , Sasaki Ryo , Matsuno Isao , Akizuki Tanetaka 
Published: December 2018

Abstract
Severe facial asymmetry in adults with hemifacial microsomia or other types of mandibular hypoplasia is challenging to treat with simultaneous maxillomandibular distraction osteogenesis using an external distractor combined with intermaxillary fixation (IMF). Using an external distractor also produces significant distress for patients for at least 8 weeks. Furthermore, mandibular-driven distraction tends to elongate the midface, with difficulty positioning of the center of the maxilla in the center of the face and horizontalization of the occlusal plane. To overcome these disadvantages, the authors performed repositioning of the Le Fort I segment intraoperatively to restore maxillary roll levering, followed by mandibular distraction using a 3-dimensional internal distractor with a variable angle for better control and tolerable postoperative distraction osteogenesis. This approach is based on the surgery-first concept. During the operation, the Le Fort I segment was fixed centrally in the center of the face and horizontally in the occlusal plane based on a computer-aided surgical simulation. Before mandibular corticotomy, a 3-dimensional internal distractor was placed on the affected side. Finally, vertical ramus osteotomy of the unaffected side was performed. After completion of distraction with IMF using elastic bands, IMF was released. The distractor was removed after a 6-month postoperative consolidation period. This method has been used in 5 patients with severe facial asymmetry, which were all successfully treated without complication. These cases show that this method can be used for severe facial asymmetry in adults, based on the surgery-first concept of minimizing the duration of orthodontic treatment and optimizing facial aesthetics.
Anatomic Landmarks in Transoral Oropharyngeal Surgery
Authors: Mirapeix Rosa M. , Tobed Secall Marc , Pollán Guisasola Carlos , Garcia Lorenzo Jacinto , Lluansí Planella Jordi , Viña Soria Constanza , Palau Viarnès Mar , Virós Porcuna David 
Published: December 2018

Introduction:
Minimally invasive transoral surgery for oropharyngeal cancer is a challenge for head and neck surgeons because of the inside-out anatomic presentation and the confined workspace. This study was performed to describe the main neurovascular and muscular landmarks in a transoral approach. The authors propose an anatomic stratification for this surgery.

Materials and Methods:
Lateral wall of the oropharynx and base of the tongue of 15 formalin-fixed heads (30 sides) and 5 fresh cadaveric heads (10 sides) sagittal sectioned were dissected from the inside outwards. Dissection of 7 fresh cadaveric heads via an endoscopic transoral approach was also performed.

Results:
The lateral oropharyngeal wall was divided into 3 layers from medial to lateral, based in the styloid muscle diaphragm. The first layer, medial to styloid muscles, includes the tonsillar vascularization and the lingual branch of the glossopharyngeal nerve. The second layer, lateral to constrictor muscles, includes the pharyngeal venous plexus, the glossopharyngeal nerve, and the lingual artery. The third layer, lateral to styloid diaphragm, includes the parapharyngeal and submandibular spaces, the carotid vessels and lingual, vagus, glossopharyngeal and hypoglossal nerves. The base of the tongue was divided into central and lateral parts, which contain the lingual artery and lingual branches of the glossopharyngeal nerve. The main landmarks to find the neurovascular structures in each layer are described.

Conclusion:
The authors propose an anatomic division, which helps to plan oropharynx and base of the tongue surgery. This anatomic stratification is useful to surgeons when performing a reconstruction of the oropharynx with a transoral approach.
Significance of Medial Osteotomy on the Olfactory Function in Patients Who Underwent Septorhinoplasty
Authors: Elbistanli Mustafa Suphi , Koçak Hasan Emre , Çelik Mustafa , Acipayam Harun , Alakhras Wesam M.E. , Koç Arzu Karaman , Evren Cenk 
Published: December 2018

Objective:
This study was designed to explore the impact of medial osteotomy on olfactory function.

Methods:
This nonrandomized, prospective study included 60 adult patients who underwent open technique septoplasty (group 1), rhinoplasty with only lateral osteotomy (group 2), and septorhinoplasty with medial and lateral osteotomies (group 3). Olfactory functions were evaluated by using the Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test. The CCCRC test includes the butanol threshold test and smell identification test using common smells. The butanol threshold test and smell identification test scores of each group were recorded preoperatively and at 1st and 4th months and compared.

Results:
Each group is consisted of 20 patients. The preoperative smell identification test and butanol threshold test scores were similar in each group. The smell identification test, butanol threshold test, and CCCRC olfactory test scores of the 1st month were statistically significantly low in group 3. There was no statistically significant difference between the groups at 4th month postoperatively.

Conclusion:
The present study is the first analysis of the effect of medial osteotomy on olfactory function. Medial osteotomy may decrease the olfactory function in early time, but afterwards olfaction could recover at preoperative levels.
A Novel Approach for the Reconstruction of Premaxilla by Archwise Distraction in Bilateral Cleft Lip and Palate
Authors: Yilmaz Hanife Nuray , Karabiber Gulden , Erverdi Nejat 
Published: December 2018

Abstract
Interdental distraction osteogenesis has been introduced as a successful treatment protocol for repairing large clefts. In this article, a new method for reconstruction of the premaxilla in 2 bilateral cleft lip and palate patients is introduced. The aim was to distract the lateral segments through the curve of the dental arch, achieve complete closure of the gaps, and use the premaxilla as a bone graft. Patient 1 (20-year-old female) had double jaw surgery before but presented residual alveolar cleft and small premaxilla. Patient 2 (21-year-old male) had anterior and posterior crossbite and caries of teeth on premaxilla. Following the preliminary fixed orthodontic treatment in both patients, archwise distraction protocol was performed. The distraction duration and the achieved amount of new bone per side were 4 weeks/22 mm and 5 weeks/25 mm in Patients 1 and 2, respectively. At the end of a 2-month retention period, docking side surgery was performed and premaxilla was used as the bone graft. The protocol was very effective for not only closure of the large cleft defects but also the reconstruction of the premaxilla. Anteroposterior relationship and the patients’ profiles were considerably and positively affected.
Comparison of the Effects of Two Different Analgesics on Bone Regeneration During Mandibular Distraction Osteogenesis
Authors: Sabuncuoglu Fidan Alakus , Ersahan Seyda , Amasyali Mihri , Avunduk Mustafa Cihat 
Published: December 2018

Introduction:
Mandibular distraction osteogenesis (DO) is frequently used in the management of bone defects and craniofacial deformities, with analgesics commonly administered to relieve acute postoperative pain. This experimental animal study investigated the effects of 2 analgesics, acetaminophen and acemetacin, on bone regeneration after DO.

Materials and methods:
This study was conducted with 14 mature male New Zealand rabbits (2.8–3.2 kg) randomized into 2 groups of 7. Mandibular osteotomies were performed under optimal operating conditions, and a custom-made distractor was applied to the mandible of each subject, with distraction initiated after a 5-day latency period at a rate of 1.0 mm/d (2 × 0.5 mm/d) for 10 days. Analgesics were administered via oral gavage during the latency period and for the first 5 days of the distraction period for 10 days in total, with group I receiving acetaminophen (200 mg/kg/d) and group II receiving acemetacin (5 mg/kg/d). Subjects were sacrificed and their mandibles dissected at the end of 4 weeks postoperatively. Bone mineral density (BMD) and bone mineral content (BMC) were measured using dual-energy X-ray absorptiometry (DEXA), and histomorphometric analysis was performed to evaluate the quality of newly formed bone. Paired group comparisons of non-normally distributed numerical variables were made using the Mann–Whitney U test, with a P value of <0.05 considered statistically significant.

Results:
No significant differences in BMC and BMD values of intact bone, newly formed bone, or bone around the pin site were observed between the 2 groups. Histometric analysis also indicated acetaminophen and acemetacin to have similar effects on bone regeneration during distraction.

Conclusion:
Acemetacin may be an alternative to acetaminophen for treating pain associated with DO, given the similarities in the effects of the 2 analgesics on bone regeneration. However, this finding should be supported by further experimental and human studies.
Use of Modified Islanded Paramedian Forehead Flap for Complex Periocular Facial Reconstruction
Authors: Tripathy Satyaswarup , Garg Akhil , John Jerry R. , Sharma Ramesh Kumar 
Published: December 2018

Abstract
The paramedian forehead flap is a workhorse flap for reconstructing the nose and periorbital regions. Many variants are described including an islanded flap. However, eyebrow reconstruction is not usually performed with these flaps. The authors describe a patient suffering from postburn scarring medial to the left eye, including loss of the left eyebrow. He underwent a single-stage transfer of the paramedian forehead flap. The flap incorporated scalp hair, which restored the missing eyebrow hair after transfer. The donor defect closed primarily. The paramedian forehead flap is amenable to customization by including a segment of hair-bearing scalp to concomitantly reconstruct the nasal dorsum and eyebrow.
Using Computer-Aided Design/Computer-Aided Manufacturing for Autogenous, Split Calvarial Bone Graft-based Cranioplasty: Optimizing Reconstruction of Large, Complex Skull Defects
Authors: Musavi Leila , Macmillan Alexandra , Lopez Joseph , Dorafshar Amir H. 
Published: December 2018

Background:
While autologous split calvarial bone is an ideal graft material in cranioplasty, selection of a donor site can be challenging and limited in the reconstruction of complicated cranial defects. Computer-aided design and manufacturing (CAD/CAM) may improve donor-site harvest and contouring and mitigate operative complications in split calvarial bone graft-based cranioplasty for complex patients, but has not previously been studied in this unique setting.

Methods:
In this study, a retrospective review of patients who presented to the institution and underwent split-calvarial bone graft-based cranioplasty using CAD/CAM to optimize reconstruction of full-thickness cranial defects ≥30 cm2 was performed. Patient demographics, complications from past operations, intraoperative variables, and immediate and long-term postoperative outcomes were recorded. The CAD/CAM predicted and actual postoperative graft measurements were compared.

Results:
Five patients were identified who fulfilled inclusion criteria. Mean age at operation was 43 years and mean size of cranial defect was 69 cm2. Mean operative time was 443 minutes and mean estimated blood loss was 450 mL. There were no dural tears, sagittal sinus bleeds, or other intraoperative complications. There were no immediate postoperative complications requiring extended hospital stay or reoperation. The postoperative graft surface areas were on average within 2.1% of the planned graft and this difference was not statistically significant (P = 0.28). All patients expressed satisfaction with cranial contour postoperatively.

Conclusion:
Based on the early experience, the use of CAD/CAM enhances calvarial graft selection and improves contour accuracy in the reconstruction of complex skull defects with minimal complications.
Anterior Cranial Vault Reconstruction With Distraction for Primary and Secondary Craniosynostosis Repair
Authors: Barrientos Stephan , Miller Jason 
Published: December 2018

Abstract
Traditional fronto-orbital advancement continues to be a useful operation for correction of craniosynostosis involving the coronal or metopic sutures. Recently, distraction osteogenesis has been used to correct a variety of cranial deformities. Studies have mostly focused on posterior vault distraction due to its simplicity and greater volume gain when compared with anterior vault distraction. However, certain patients are not candidates for posterior distraction due to anterior deformity and need for expansion of the frontal skull. The authors have developed a technique that allows for both reshaping as well as distraction of the anterior cranial vault.
This was a retrospective chart review performed between March 2012 and October 2016 at a single institution by a single plastic surgeon. Thirty-nine (39) patients were included in this study. The indications for surgical intervention were signs of increased intracranial pressure or severe anterior skull deformity in the setting of craniosynostosis. The authors reviewed patient characteristics, length of follow-up, number of previous and subsequent surgeries, complications, and rate of relapse.
The average age of patients undergoing the procedure was 5.2 years (range 6 months–15 years). Twenty-four (24) patients had 1 previous surgery, 3 had 2 previous surgeries, 1 had 3 previous surgeries, and 11 had no previous surgeries. The average follow-up was 2.5 years (range 6 months–4 years). One patient had a broken activation wire requiring return to the operating room. Three (3) patients (2 Apert and 1 Crouzon) underwent subsequent posterior vault distraction surgery. All patients demonstrated significant improvement in forehead cosmesis.
Anterior cranial vault reconstruction with distraction is a safe alternative to traditional cranial vault reconstruction. It can improve forehead shape and position in older children who have had previous surgery as well as patients with severe anterior skull deformity associated with craniosynostosis.
Postoperative Visual Loss: A Report of One Patient With Unilateral Blindness After Orthognathic Surgery
Authors: Delmotte Constance , Depeyre Arnaud , Barthelemy Isabelle , Ferri Joel 
Published: December 2018

Introduction:
Blindness after orthognathic surgery may be the result of the surgical procedure itself or the consequence of factors induced by general anesthesia. However, the exact mechanism between is not known. The purpose of this article is to present a case of a postoperative visual loss after orthognathic surgery under general anesthesia concluding with a brief literature review about this topic.

Report of case:
We report the case of a patient who suffered unilateral blindness with homolateral frontal paresthesia after orthognathic procedure in 2 steps. He presented intraoperative bradycardia with a potential undiagnosed hypertension, associated with significant blood loss and volume resuscitation by colloids and cristalloids.
Postoperative examination concluded to posterior ischemic optic neuropathy.

Discussion and Conclusion:
By a systematic literature review, we discuss about surgical and anesthesic causes of postoperative visual loss, and particularly pathophysiology mechanism of posterior ischemic optic neuropathy. Some predisposition and risk factors have been identified and need to be taken into account.
A distributed lattice of aligned atoms exists in a protein structure: A hierarchical clustering study of displacement parameters in bovine trypsin
Authors: Gagnér Viktor Ahlberg , Lundholm Ida , Garcia-Bonete Maria-Jose , Rodilla Helena , Friedman Ran , Zhaunerchyk Vitali , Bourenkov Gleb , Schneider Thomas , Stake Jan , Katona Gergely 
Published: December 2018

AbstractLow-frequency vibrations are crucial for protein structure and function, but only a few experimental techniques can shine light on them. The main challenge when addressing protein dynamics in the terahertz domain is the ubiquitous water that exhibit strong absorption. In this paper, we observe the protein atoms directly using X-ray crystallography in bovine trypsin at 100 K while irradiating the crystals with 0.5 THz radiation alternating on and off states. We observed that the anisotropy of atomic displacements increases upon terahertz irradiation. Atomic displacement similarities develop between chemically related atoms and between atoms of the catalytic machinery. This pattern likely arise from delocalized polar vibrational modes rather than delocalized elastic deformations or rigid-body displacements. This method can ultimately reveal how the alignment of chemically related atoms and the underlying polar vibrational dynamics make a protein structure stable.
A Hybrid Model for the Effects of Treatment and Demography on Malaria Superinfection
Authors: Henry John M. 
Published: December 2018

AbstractAs standard mathematical models for the transmission of vector-borne pathogens with weak or no apparent sterilizing immunity, Susceptible-Infected-Susceptible (SIS) systems such as the Ross-Macdonald equations are a useful starting point for modeling the impacts of interventions on prevalence for diseases that cannot superinfect their hosts. In particular, they are parameterizable from quantities we can estimate such as the force of infection (FOI), the rate of natural recovery from a single infection, the treatment rate, and the rate of demographic turnover. However, malaria parasites can superinfect their host which has the effect of increasing the duration of infection before total recovery. Queueing theory has been applied to capture this behavior, but a problem with current queueing models is the exclusion of factors such as demographic turnover and treatment. These factors in particular can affect the entire shape of the distribution of the multiplicity of infection (MOI) generated by the superinfection process, its transient dynamics, and the population mean recovery rate. Here we show the distribution of MOI can be described by an alternative hyper-Poisson distribution. We then couple our resulting equations to a simple vector transmission model, extending previous Ross-Macdonald theory.
Determinants of high residual post-PCV13 pneumococcal vaccine type carriage in Blantyre, Malawi: a modelling study
Authors: Lourenço J. , Obolski U. , Swarthout T.D. , Gori A. , Bar-Zeev N. , Everett D. , Kamng’ona A.W. , Mwalukomo T.S. , Mataya A.A. , Mwansambo C. , Banda M. , Gupta S. , French N. , Heyderman R.S. 
Published: December 2018

AbstractBackgroundIn November 2011, Malawi introduced the 13-valent pneumococcal conjugate vaccine (PCV13) into the routine infant schedule. Four to seven years after introduction (2015-2018), rolling prospective nasopharyngeal carriage surveys were performed in the city of Blantyre. Carriage of Streptococcus pneumoniae vaccine serotypes (VT) remained higher than reported in developed countries, and VT impact was surprisingly asymmetric across age-groups. A dynamic transmission model was fit to survey data using a Bayesian Markov-chain Monte Carlo approach, to obtain insights into the determinants of post-PCV13 age-specific VT carriage.ResultsAccumulation of naturally acquired immunity with age and age-specific transmission potential were both key to reproducing the observed data. VT carriage reduction peaked sequentially over time, earlier in younger and later in older age-groups. Estimated vaccine efficacy (protection against carriage) was 66.87% (95% CI 50.49-82.26%), similar to previous estimates. Ten-year projected vaccine impact (VT carriage reduction) among 0-9 years old was lower than observed in other settings, at 76.23% (CI 95% 68.02-81.96%), with sensitivity analyses demonstrating this to be mainly driven by a high local force of infection.ConclusionsWe have identified both vaccine-related and host-related determinants of post-PCV13 pneumococcal VT transmission in Blantyre with vaccine impact determined by age-related characteristics of the local force of infection. These findings are likely to be generalisable to other Sub-Saharan African countries in which PCV impact has been lower than desired, and have implications for the interpretation of post-PCV carriage studies and future vaccination programs.
Plasma proteome profiling to detect and avoid sample-related biases in biomarker studies
Authors: Geyer Philipp E. , Voytik Eugenia , Treit Peter V. , Doll Sophia , Kleinhempel Alisa , Niu Lili , Müller Johannes B. , Bader Jakob , Teupser Daniel , Holdt Lesca M. , Mann Matthias 
Published: December 2018

AbstractPlasma and serum are rich sources of information regarding an individual’s health state and protein tests inform medical decision making. Despite major investments, few new biomarkers have reached the clinic. Mass spectrometry (MS)-based proteomics now allows highly specific and quantitative read-out of the plasma proteome. Here we employ Plasma Proteome Profiling to define contamination marker panels to assess plasma samples and the likelihood that suggested biomarkers are instead artifacts related to sample handling and processing. We acquire deep reference proteomes of erythrocytes, platelets, plasma and whole blood of 20 individuals (>6000 proteins), and compare serum and plasma proteomes. Based on spike-in experiments we determine contamination-associated proteins, many of which have been reported as biomarker candidates as revealed by a comprehensive literature survey. We provide sample preparation guidelines and an online resource (www.plasmaproteomeprofiling.org) to assess overall sample-related bias in clinical studies and to prevent costly miss-assignment of biomarker candidates.
Generating an Artificial Nest Building Pufferfish in a Cellular Automaton Through Behavior Decomposition
Authors: Portegys Thomas E. 
Published: December 2018

AbstractA species of pufferfish builds fascinating circular nests on the sea floor to attract mates. This project simulates the nest building behavior in a cellular automaton using the Morphognosis model. The model features hierarchical spatial and temporal contexts that output motor responses from sensory inputs. By considering the biological neural network of the pufferfish as a black box, decomposing only its external behavior, an artificial counterpart can be generated. In this way a complex biological system producing a behavior can be filtered into a system containing only functions that are essential to reproduce the behavior. The derived system not only has intrinsic value as an artificial entity but also might help to ascertain how the biological system produces the behavior.