bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fundus image classification methods for the detection of glaucoma: A review
Authors: Saba Tanzila , Bokhari Syedia Tahseen Fatima , Sharif Muhammad , Yasmin Mussarat , Raza Mudassar 
Published: October 2018

AbstractGlaucoma is a neurodegenerative illness and is considered as a standout amongst the most widely recognized reasons for visual impairment. Nerve's degeneration is an irretrievable procedure, so the diagnosis of the illness at an early stage is an absolute requirement to stay away from lasting loss of vision. Glaucoma effected mainly because of increased intraocular pressure, if it is not distinguished and looked early, it can result in visual impairment. There are not generally evident side effects of glaucoma; thus, patients attempt to get treatment just when the seriousness of malady is advanced altogether. Determination of glaucoma often comprises of review of the basic crumbling of the nerve in conjunction with the examination of visual function capacity. This article shows the persistent illustration of glaucoma, its side effects, and the potential people inclined to this malady. The essence of this article is on different classification methods being utilized and proposed by various scientists for the identification of glaucoma. This article audits a few division and segmentation methodologies that are exceptionally useful for recognizable proof, identification, and diagnosis of glaucoma. The research related to the findings and the treatment is likewise evaluated in this article.
Diagnosis of Hirschsprung's disease in children: Preliminary evaluation of a novel endoscopic technique for rectal biopsy
Authors: Nabi Zaheer , Shava Upender , Sekharan Anuradha , Nageshwar Reddy Duvvur 
Published: October 2018

Background and AimThe diagnosis of Hirschsprung's disease (HD) relies on anorectal manometry and rectal biopsy. The role of endoscopic biopsy is uncertain for the diagnosis of HD in children. In this study, we evaluated the adequacy of biopsies procured by endoscopic mucosal resection (EMR) for the diagnosis of HD.MethodsConsecutive children with suspected HD from January 2013 to January 2018 were enrolled in the study. EMR was performed using the standard band ligation device at a distance of about 3 cm from dentate line in rectum. All samples were assessed macroscopically and microscopically. An adequate sample was defined as those measuring >3 mm and including adequate submucosa.ResultsA total of 132 children underwent evaluation for constipation in the study period. Of these, 10 children (median age, 4.25 years) underwent EMR using the band ligation device for the evaluation of HD. EMR was performed with and without submucosal lifting injection in four and six children, respectively. All the samples were adequate macroscopically (>3 mm). Absence of ganglion cells was noted in six children. Of these, three children underwent full‐thickness rectal biopsy followed by surgery. Three children did not undergo surgery. Ganglion cells were identified in four children, thereby excluding the diagnosis of HD.ConclusionRectal biopsy using EMR with a band ligation device is feasible, safe, and provides adequate sample for the evaluation of HD in children.
Hamiltonicity of planar graphs with a forbidden minor
Authors: Ellingham M. N. , Marshall Emily A. , Ozeki Kenta , Tsuchiya Shoichi 
Published: October 2018

AbstractTutte showed that ‐connected planar graphs are Hamiltonian, but it is well known that ‐connected planar graphs need not be Hamiltonian. We show that ‐minor‐free ‐connected planar graphs are Hamiltonian. This does not extend to ‐minor‐free ‐connected graphs in general, as shown by the Petersen graph, and does not extend to ‐minor‐free ‐connected planar graphs, as we show by an infinite family of examples.
Inducible nitric oxide synthase: An asset to neutrophils
Authors: Saini Rashmi , Singh Sarika 
Published: October 2018

AbstractNeutrophils play a key role in innate immune responses against foreign intrusion and influence the subsequent instigation of adaptive immune response. Nitric oxide (NO) synthesized by neutrophil nitric oxide synthase (NOS) profoundly modulates their diverse physiological responsibilities furthermore encompassing pathological implications. Neutrophils are the active participants in diverse inflammatory and cardiovascular disorders but neutrophil nitric oxide synthase (NOS) remains enigmatic on various aspects. This review focuses on inducible NOS (iNOS) and makes an attempt to address its potential impact in neutrophil pathophysiology, their differentiation, functionality, and survival. We described the scenario from its expressional modulation, by pro- and anti-inflammatory cytokines governing the extent and duration of neutrophil immune response, to iNOS catalysis, the intracellular compartmentalization, and protein–protein interactions determining its microenvironment, activity and its contribution as a potential signaling protein apart from its role as signal transducer. Further, the relevance of investigating the unexplored facets of iNOS biology in neutrophils and possible prototypes of iNOS regulation is also exemplified in related cellular systems.Review on expressional modulation, inducible catalysis, intracellular compartmentalization and protein-protein interactions of neutrophil NOS determining microenvironment, activity and its contribution as a potential signaling protein.
Effect of microscopic susceptibility gradients on chemical‐shift‐based fat fraction quantification in supraclavicular fat
Authors: McCallister Drew , Zhang Le , Burant Alex , Katz Laurence , Branca Rosa Tamara 
Published: October 2018

BackgroundSusceptibility differences between fat and water can cause changes in the water‐fat frequency separation that can negatively affect the accuracy of fat fraction techniques. This may be especially relevant for brown adipose tissue, as MRI fat fraction techniques have been proposed for its detection.PurposeTo assess the effect of microscopic magnetic susceptibility gradients on the water‐fat frequency separation and its impact on chemical‐shift‐based fat fraction quantification techniques in the supraclavicular fat, where brown adipose tissue is commonly found in humans.Study TypeProspective.Population/Subjects/Phantom/Specimen/Animal ModelSubjects: 11 healthy volunteers, mean age of 26 and mean BMI of 23, three overweight volunteers, mean age of 38 and mean BMI of 33. Phantoms: bovine phantom and intralipid fat emulsion. Simulations: various water‐fat distributions.Field Strength/SequenceSix‐echo gradient echo chemical‐shift‐encoded sequence at 3T.AssessmentFat fraction values as obtained from a water‐fat spectral model accounting for susceptibility‐induced water‐fat frequency variations were directly compared to traditional spectral models that assume constant water‐fat frequency separation.Statistical TestsTwo‐tail t‐tests were used for significance testing (p < 0.05.) A Bayesian Information Criterion difference of 6 between fits was taken as strong evidence of an improved model.ResultsPhantom experiments and simulation results showed variations of the water‐fat frequency separation up to 0.4 ppm and 0.6 ppm, respectively. In the supraclavicular area, the water‐fat frequency separation produced by magnetic susceptibility gradients varied by as much as ±0.4 ppm, with a mean of 0.08 ± 0.14 ppm, producing a mean difference in fat fraction of –1.26 ± 5.26%.Data ConclusionIn the supraclavicular fat depot, microscopic susceptibility gradients that exist within a voxel between water and fat compartments can produce variations in the water‐fat frequency separation. These variations may produce fat fraction quantification errors of 5% when a spectral model with a fixed water‐fat frequency separation is applied, which could impact MR brown fat techniques.Level of Evidence: 1Technical Efficacy: Stage 1J. Magn. Reson. Imaging 2019;49:141–151.
Magnetic Resonance Elastography in the Assessment of Acute Effects of Kinesio Taping on Lumbar Paraspinal Muscles
Authors: Wang Chien‐Kuo , Fang Yu‐Hua Dean , Lin Liang‐Ching , Lin Cheng‐Feng , Kuo Li‐Chieh , Chiu Feng‐Mao , Chen Chia‐Hui 
Published: October 2018

BackgroundKinesio tape (KT) is an elastic therapeutic tape used for treating sports‐related injuries and a number of other disorders. To date, the objective evidence to link pathophysiological effects and actual reactions triggered by KT is limited.PurposeTo explore the effect of KT on the lumbar paraspinal muscles by magnetic resonance (MR) elastography.Study TypeProspective observational study.PopulationSixty‐six asymptomatic volunteers with 31 women and 35 men.Field Strength/Sequence3.0T MRI and elastography with vibration frequency of 120 Hz.AssessmentThe 5‐cm‐width KT with full tension was placed on a single side of the lumbar paraspinal muscle. The taping side and adhering direction were randomly decided. Two rectangular regions of interest (ROIs) of 5‐ and 2.5‐cm‐width were positioned at the bilateral paraspinal regions from the L2 to L4 level on the confidence map of MR elastography before and after KT taping. The mean shear stiffness values of the ROIs at the superficial, middle, and deep depths were recorded; then the differences between the taping and reference sides were calculated.Statistical TestsPaired t‐test and Pearson correlations were used to evaluate the stiffness changes after KT application and intraoperator errors of the stiffness measures on the reference side, respectively.ResultsA significant decrease in the muscle stiffness value between taping and reference sides (–0.71 kPa ± 0.60 with KT and –0.25 kPa ± 0.78 without KT, P < 0.0001 for 5‐cm ROI; –0.67 kPa ± 1.12 with KT and –0.16 kPa ± 1.17 without KT, P = 0.0004 for 2.5‐cm ROI) was found in the superficial depth, but no significant differences in the middle and deep depths (P = 0.25 and P = 0.79 for 5‐cm ROI; P = 0.09 and P = 0.67 for 2.5‐cm ROI, respectively). There were no significant differences of muscle stiffness differences between gender (P = 0.11 for superficial, P = 0.37 for middle, P = 0.78 for deep) and taping direction (P = 0.18 for superficial, P = 0.13 for middle, P = 0.15 for deep).Data ConclusionOur results demonstrate that KT can reduce the MR elastography‐derived shear stiffness in the superficial depth of paraspinal muscles.Level of Evidence: 2Technical Efficacy: Stage 2J. Magn. Reson. Imaging 2019;49:1039–1045.
Preserving the thyroidal isthmus during low tracheostomy with creation of a Björk flap
Authors: Janik Stefan , Kliman Jonathan , Hacker Philipp , Erovic Boban M. 
Published: October 2018

Objectives/HypothesisSurgical tracheostomy (ST) with creation of an inferiorly based U‐shaped tracheal flap, known as the Björk flap, is the most commonly performed. The purpose of this study was to evaluate whether outcome was different in patients who underwent low ST with retraction and preservation of the thyroid isthmus compared to those who underwent high ST with ligation of the thyroid isthmus.Study DesignRetrospective cohort study.MethodsWe included 1,143 patients who underwent ST with creation of a Björk flap between 2008 and 2015. Different outcome parameters, including complications, decannulation, inpatient mortality, and surgical characteristics, such as length of surgery and height of tracheal incision, were assessed comparing low and high ST.ResultsComplications occurred in 7.7% of patients, of which persistent stoma (4.1%) and hemorrhages (2.7%) were the most common. Low tracheostomy with retraction and preservation of thyroid isthmus was done in 31.4% of cases. Complications did not significantly differ between low and high tracheostomies (8.0% vs. 7.0%, P = .468). Moreover, decannulation rate and inpatient mortality were also not significantly different in low compared to high tracheostomies (P = .816 and P = .152, respectively). However, low tracheostomies were associated with significantly shorter operation times (33.0 ± 0.8 min vs. 38.7 ± 0.5 min, P < .001) and lower tracheal incisions for creation of a Björk flap (P < .001) compared to high tracheostomies.ConclusionsLow tracheostomies are as safe as high tracheostomies regarding complications. Due to the fact that low tracheostomies are associated with shorter operation times and lower tracheal incisions, we recommend performong low tracheostomies whenever feasible.Level of Evidence4 Laryngoscope, 128:2783–2789, 2018
The Impact of Duty‐Hour Restrictions on Complication Rates Following Major Head and Neck Procedures
Authors: Crippen Meghan M. , Barinsky Gregory L. , Reddy Renuka K. , Elias Marcus L. , Eloy Jean Anderson , Baredes Soly , Park Richard Chan Woo 
Published: October 2018

Objectives/HypothesisTo assess the impact of resident duty‐hour restrictions (DHR) in otolaryngology via comparison of postoperative outcomes between otolaryngology teaching hospitals (Oto‐TH) and nonteaching hospitals (NTH) before and after complete implementation.Study DesignRetrospective database review.MethodsThe Nationwide Inpatient Sample was queried for all major head and neck cases between 2000 and 2002 (n = 34,064) and 2008 and 2010 (n = 33,094). Cases were stratified into Oto‐TH (n = 28,771) and NTH (n = 38,387) and assessed for procedure type, patient comorbidities, and complications. A subpopulation matched by procedure type was generated for direct comparison of complication rates using χ2 and binary logistic regression analyses.ResultsIn the years following DHR, total case volume and average case complexity increased at Oto‐TH only. Using a case‐matched subpopulation, regression analysis found Oto‐TH status to be protective for medical complications both before (odds ratio [OR]: 0.60, P < .001) and after (OR: 0.76, P = .001) DHR. In contrast, Oto‐TH cases had lower risk for surgical complications in 2000 to 2002 (OR: 0.77, P < .001) but not 2008 to 2010 (OR: 1.07, P = .275). When comparing time periods, the years following DHR were associated with a significant decrease in medical complications and mortality across hospital cohorts. For surgical complications, rates significantly improved at NTH only (OR: 0.82, P = .002), with no difference at Oto‐TH (OR: 0.95, P = .450).ConclusionsIn the years following DHR, rates of medical complications, surgical complications, and mortality have significantly improved at NTH. At Oto‐TH, there has been a lack of similar improvement in surgical complications, even after accounting for increasing case volume and complexity in more recent years. While the cause is likely multifactorial, DHR in otolaryngology residency may play a role.Level of Evidence4 Laryngoscope, 128:2804–2810, 2018
Incidence and Treatment Outcomes of Vocal Fold Movement Impairment After Total Arch Replacement
Authors: Fullmer Tanner , Wang David C. , Price Matt D. , LeMaire Scott A. , Coselli Joseph S. , Gregorio Casar J. , Donovan Donald T. , Eddie Liou N. , Ongkasuwan Julina 
Published: October 2018

BackgroundVocal fold movement impairment (VFMI) secondary to neuronal injury is a known risk after aortic surgery. Total arch replacement is technically challenging, and the incidence of vocal fold movement impairment secondary to neuronal injury after this surgery is unknown. This study examined the incidence of VFMI after total arch replacement and medialization treatment outcomes.Study DesignRetrospective cohort study.MethodsAll patients who underwent total arch replacement at a tertiary care center over 11 years (2006–2017) were identified through an institutional database. End points included evidence of VFMI on flexible laryngoscopy, time to diagnosis, time to treatment, need for reintubation, and intensive care unit (ICU) and hospital length of stay.ResultsOf the 358 patients who underwent total arch replacement, 63 (20%) were diagnosed with VFMI during their initial inpatient stay. Fifty patients (79%) VFMIs were left‐sided, nine (14%) were right‐sided, and four (6%) were bilateral. Thirty‐nine patients (62%) underwent inpatient vocal fold medialization: 28 (72%) by injection laryngoplasty and 11 (28%) by type 1 thyroplasty. Those with unilateral VFMI had longer ICU (8.9 days) and hospital (19.4 days) than those with no VFMI (5.7 and 16.1 days). Among patients with unilateral VFMI, those who underwent inpatient vocal fold medialization trended toward shorter ICU (6.2 vs. 14.4 days, P = .03) and hospital stays (20.1 vs. 23.3 days, P = .4) than patients who did not have a medialization procedure.ConclusionThe overall incidence of VFMI after total arch replacement in our series was 20%. Both the right and left vocal folds are potentially at risk from a total arch replacement; consequently, the distribution of injury in our cohort was more heterogeneous than in other series.Level of Evidence3 Laryngoscope, 129:699–703, 2019
Intratympanic Therapies in Ménière Disease: Evaluation of Outcomes and Early Vertigo Control
Authors: Naples James G. , Henry Laura , Brant Jason A. , Eliades Steven J. , Ruckenstein Michael J. 
Published: October 2018

ObjectiveTo evaluate outcomes of intratympanic (IT) dexamethasone and gentamicin in Ménière Disease (MD).MethodsCharts of adult patients with unilateral definite MD receiving IT gentamicin or dexamethasone from 2005 to 2017 were retrospectively reviewed. All patients had at least 6 months follow‐up. Failure in each group was defined as the need for more aggressive therapy.Prior to 2011, all patient received IT gentamicin, administered as primary therapy after failure of conservative treatment measures. Gentamicin was administered every 2 weeks, up to three injections, until vertigo control was achieved. Beginning in 2011, the treatment protocol shifted to IT dexamethasone as initial treatment, with gentamicin used for dexamethasone failures. Dexamethasone was administered weekly for up to three injections. Treatments could be repeated if symptoms recurred.ResultsThirty‐three patients received IT dexamethasone, and 70 patients received IT gentamicin. Dexamethasone patients received a mean of 3.3 injections compared to 2.7 in the gentamicin group (P = 0.011). There were 12 (38%) failures in the dexamethasone group and only seven (10%) gentamicin failures (P = 0.025). No patients failed both treatments. The mean time to failure in the dexamethasone group was 5 months, whereas in the gentamicin group it was 27 months. Change in pure tone audiometry from baseline was not different between treatment groups (P = 0.30).ConclusionSubjects receiving IT gentamicin required fewer injections and had a significantly longer time to failure than IT dexamethasone. Audiometric outcomes were similar between the groups. The use of IT gentamicin as initial therapy for early and long‐term control of MD is safe and effective.Level of Evidence3 Laryngoscope, 129:216–221, 2019
Comparison of Modern Rigid Fixation Plating Outcomes for Segmental Mandibular Microvascular Reconstruction
Authors: McCann Adam C. , Shnayder Yelizaveta , Przylecki Wojciech H. , Kakarala Kiran , Nazir Niaman , Girod Douglas A. , Andrews Brian T. 
Published: October 2018

Objectives/HypothesisNew advances in osseous microvascular mandibular rigid fixation are being employed at many institutions. These include standardized prebent/preformed reconstruction plates as well as computer‐aided design/computer‐aided manufacturing (CAD/CAM) custom plates that are patient specific. Our goal was to assess and compare the outcomes of both of these new technologies when utilized for mandibular microvascular reconstruction.Study DesignRetrospective chart review.MethodsSubjects were categorized into two groups according to their mandibular rigid fixation technique: group 1 = prebent/preformed plates and group 2 = CAD/CAM custom plates. Primary outcome measures were 1) perioperative complications (defined as deep tissue infection, wound dehiscence resulting in bone exposure, and/or plate exposure) and 2) reoperation rates for mandibular hardware failure/explantation. Statistical analysis consisted of χ2, Fisher exact test, and multivariable regression models.ResultsA total of 142 subjects underwent microvascular mandibular reconstruction in a 6‐year period. Eighty‐nine subjects utilized prebent/preformed plates, and 53 employed CAD/CAM custom plates. Perioperative complications occurred in 32 of 89 (35.9%) subjects with prebent/preformed plates and 11 of 53 (20.7%) subjects using CAD/CAM custom plates. Reoperation requiring hardware explantation occurred in 18 of 89 (20.2%) subjects and three of 53 (5.6%) using CAD/CAM custom plates. Statistical comparison of perioperative complications between the two groups approached significance (P = .0556), and the rate of reoperation was significant favoring CAD/CAM implants (P = .0180).ConclusionsIn our experience, CAD/CAM custom plates utilized for rigid fixation during microvascular mandibular reconstruction demonstrated fewer complications and statistically lower reoperation rates when compared with prebent/preformed plates.Level of Evidence2c Laryngoscope, 129:1081–1086, 2019
Appropriateness Criteria for Surgery in the Management of Adult Recurrent Acute Rhinosinusitis
Authors: Rudmik Luke , Beswick Daniel M. , Alt Jeremiah A. , Bhattacharyya Neil , Chester Alexander C. , Gray Stacey T. , Poetker David M. , Stewart Michael G. , Smith Timothy L. 
Published: October 2018

Objectives/HypothesisEndoscopic sinus surgery (ESS) is frequently performed for recurrent acute rhinosinusitis (RARS). Appropriate indications for surgery among patients with RARS have not yet been rigorously determined. The objective of this study was to define appropriateness criteria for ESS in the management of adult RARS.Study DesignApplication of RAND‐UCLA appropriateness methodology.MethodsA panel of nine multidisciplinary experts in RARS was formed to evaluate RARS scenarios generated from current evidence. The panel completed two rounds of a modified Delphi‐ranking process and a teleconference.ResultsA total of 32 clinical scenarios were ranked in each round. For adult patients with RARS, ESS can appropriately be offered as a treatment option when patients experience ≥ four annual episodes, and there is confirmation of at least one episode via computed tomography or nasal endoscopy, and the patient and clinician jointly participate in shared decision making, and the patient has either failed a trial of topical nasal steroids or experienced RARS‐related productivity loss.ConclusionsThis study has defined appropriateness criteria for ESS as a management option for adult patients with RARS. These criteria are intended to represent a minimum threshold for which ESS should be considered in the treatment of RARS and do not suggest that all patients who meet these criteria should undergo surgery. These criteria may serve as a baseline set of indications for ESS in patients with RARS.Level of EvidenceNA Laryngoscope, 129:37–44, 2019