bluuebunny/crossref_metadata_2025_split huggingface dataset:
Updated Retrospective Single‐Center Comparative Analysis of Peripheral Nerve Block Complications Using Landmark Peripheral Nerve Stimulation Versus Ultrasound Guidance as a Primary Means of Nerve Localization
Authors: Melnyk Vladyslav , Ibinson James W. , Kentor Michael L. , Orebaugh Steven L. 
Published: March 2018

ObjectivesThe purpose of this study was to perform an updated analysis of complications associated with upper and lower extremity peripheral nerve blocks (PNBs) performed with ultrasound (US) guidance versus the landmark approach.MethodsWe conducted a single‐center retrospective cohort analysis to compare the incidence of PNB complications between the techniques. The primary outcome was local anesthetic systemic toxicity (LAST), whereas the secondary outcomes included short‐ and long‐term nerve injuries. The current query included cases performed between 2012 and 2015. A combined analysis included data extending to 2006. The Statistical examination relied on the χ2 test.ResultsDuring this 4‐year period, we performed 7789 US‐guided and 498 landmark‐guided blocks with no statistically significant difference in the incidence of nerve injury or LAST between the groups. Our 10‐year analysis, however, revealed a significant increase (P < .01) in the rate of LAST with the landmark technique: 7 of 5932 versus 0 of 16,858 cases. The combined data also revealed a significant increase (P < .01) in short‐term injuries associated with the landmark approach (30 of 5932 versus 33 of 16,858) but no significant difference in the incidence of long‐term injuries.ConclusionsOur analysis supports a conclusion that the use of US guidance during PNBs leads to a significant reduction in the incidence of LAST, adding to growing evidence from similar investigations. The impact of US on the incidence of nerve injuries remains unclear, considering that the nature of transient deficits is thought to be multifactorial, and the frequency of lasting injuries did not differ significantly in this study.
Effect of Emergency Physician–Performed Point‐of‐Care Ultrasound and Radiology Department–Performed Ultrasound Examinations on the Emergency Department Length of Stay Among Pregnant Women at Less Than 20 Weeks' Gestation
Authors: Morgan Brian B. , Kao Amanda , Trent Stacy A. , Hurst Nicole , Oliveira Lauren , Austin Andrea L. , Kendall John L. 
Published: March 2018

ObjectivesWe sought to confirm retrospective studies that measured an approximately 20% reduction in emergency department (ED) length of stay (LOS) in early‐gestation pregnant women who receive emergency physician–performed point‐of‐care ultrasound (US) examinations rather than radiology department–performed US examinations for evaluation of intrauterine pregnancy (IUP).MethodsA randomized controlled clinical trial was performed at an urban academic safety net hospital and 2 Naval medical centers in the United States. The allocation was concealed before enrollment. Clinically stable adult pregnant women at less than 20 weeks' gestation who presented to the ED with abdominal pain or vaginal bleeding were randomized to receive a point‐of‐care or radiology US to assess for IUP. The primary outcome measure was the ED LOS.ResultsA total of 224 patients (point‐of‐care US, n = 118; radiology US, n = 106) were included for the analysis. The ED LOS was 20 minutes shorter in the point‐of‐care US arm (95% confidence interval [CI], –54 to 7 minutes). Adjusting for variability due to the location, the ED LOS was calculated to be 31 minutes shorter (95% CI, –64 to 1 minute) than for patients in the radiology US arm. Excluding patients in the point‐of‐care US arm who crossed over to radiology US after an inconclusive point‐of‐care US examination, the ED LOS was 75 minutes shorter than in the radiology US arm (95% CI, –97 to –53 minutes).ConclusionsEarly‐gestation pregnant ED patients requiring pelvic US were discharged earlier when point‐of‐care US was used rather than radiology US; however, this trial did not achieve our target of 30 minutes. Nevertheless, our data support the routine use of ED point‐of‐care US for IUP, saving the most time if a conclusive IUP is identified.
Determination of Normal Skin Elasticity by Using Real‐time Shear Wave Elastography
Authors: Yang Yujia , Wang Liyun , Yan Feng , Xiang Xi , Tang Yuanjiao , Zhang Lingyan , Liu Jibin , Qiu Li 
Published: March 2018

ObjectivesTo define the reference ranges of normal skin elasticity measurements associated with shear wave elastography (SWE) in healthy volunteers and analyze the factors that may affect SWE.MethodsMean skin thickness and elastic modulus values from 90 healthy volunteers were evaluated with B‐mode ultrasonography and SWE in the right fingers and forearms, anterior chest, and abdominal walls. Reference ranges of normal skin elasticity were calculated by using lower and upper limits at the 2.5th and 97.5th percentiles. To investigate the effects of potential factors (site, sex, age, body mass index, and skin thickness) on skin elasticity measurements, a 1‐way analysis of variance, the Student t test, and the Pearson correlation test were performed.ResultsSkin elasticity was significantly different at different sites (P < .05). Mean elastic modulus values were 30.3 kPa for the finger, 14.8 kPa for the forearm, 17.8 kPa for the chest wall, and 9.5 kPa for the abdominal wall, and reference ranges of normal skin elasticity were 12.1 to 48.4kPa for the finger, 3.5 to 26.0 kPa for the forearm, 6.6 to 28.9 kPa for the chest wall, and 3.5 to 15.5 kPa for the abdominal wall. Our study revealed that men had higher skin elasticity measurements than women (P < .05), and they were more elevated in participants aged 20 to 50 years than in the other groups at the finger (P < .05). The body mass index and skin thickness had a negligible impact on skin elasticity measurements (P > .05).ConclusionsThis study revealed that the site, sex, and age should be taken into account when determining the reference ranges of normal skin elasticity by skin elasticity measurements.
Accuracy of Medical Students in Detecting Pleural Effusion Using Lung Ultrasound as an Adjunct to the Physical Examination
Authors: Steinmetz Peter , Oleskevich Sharon , Dyachenko Alina , McCusker Jane , Lewis John 
Published: March 2018

ObjectivesThis study compared the accuracy of medical students in identifying pleural effusion in hospitalized patients using the physical examination versus lung ultrasound (US).MethodsFourth‐year medical students (n = 14) received 20 hours of general practical US training (including 2 hours of specialized lung US training) plus theoretical and video documentation. The students used the physical examination alone versus the physical examination plus lung US to document the presence or absence of pleural effusion in the right and left hemithoraces of hospitalized patients (n = 11 patients; 22 hemithoraces examined 544 times in total). The reference standard for identification of pleural effusion was a lung US examination by 2 expert point‐of‐care sonographers.ResultsThe odds of correctly identifying the presence versus absence of pleural effusion was 5 times greater with lung US as an adjunct to the physical examination compared to the physical examination alone (odds ratio [OR], 5.1 from multivariate logistic regression; 95% confidence interval, 3.3–8.0). The addition of lung US to the physical examination resulted in an increase in sensitivity from 48% to 90%, in specificity from 73% to 86%, and in accuracy from 60% to 88%. The benefits of using US were greater when pleural effusion was present versus absent (OR, 10.8 versus 2.4) and when examining older versus younger patients (OR, 10.2 versus 2.8).ConclusionsThese results demonstrate that medical students' ability to detect the presence or absence of pleural effusion is superior when using lung US as an adjunct to the physical examination than when using the physical examination alone.
Comparison of the Diagnostic Efficacy of Ultrasound‐Guided Core Needle Biopsy With 18‐ Versus 20‐Gauge Needles for Thyroid Nodules
Authors: Ahn Hye Shin , Seo Mirinae , Ha Su Min , Kim Hee Sung 
Published: March 2018

ObjectivesTo compare the diagnostic efficacy, complication rate, and core needle biopsy (CNB) specimen yield in 18‐ versus 20‐gauge ultrasound (US)‐guided CNB for diagnosis of thyroid nodules.MethodsWe included 81 consecutive thyroid nodules with US‐guided biopsy by a 20‐gauge core needle and 86 consecutive thyroid nodules with US‐guided biopsy by an 18‐gauge core needle during 2 years. The rate of inconclusive results, including nondiagnostic or atypia/follicular lesion of undetermined significance, was compared. The diagnostic performance for malignancy was assessed in nodules with a final diagnosis. The complication rate and CNB specimen yield were also compared.ResultsEighteen‐gauge CNB showed a lower rate of nondiagnostic results (1.2% versus 8.6%; P = .024) than 20‐gauge CNB; however, the rates of atypia/follicular lesion of undetermined significance and inconclusive results were not significantly different between the groups (P > .05). In addition, 18‐gauge CNB showed higher sensitivity (75.0% versus 66.7%), a higher negative predictive value (83.9% versus 75.9%), and higher accuracy (78.3% versus 74.4%) for detecting malignancy than 20‐gauge CNB, although the results did not achieve statistical significance. No major complications occurred in either of the CNB groups. The 18‐gauge needle group had significantly fewer CNBs and larger specimen diameters (P < .001).ConclusionsCore needle biopsy with an 18‐gauge needle could be more effective for the diagnosis of thyroid nodules than CNB with a 20‐gauge needle.
Influence of hunting on movements of moose near roads
Authors: Neumann Wiebke , Ericsson Göran 
Published: March 2018

ABSTRACTVehicle collisions with large wildlife provide a serious risk of severe personal injuries. In some countries, there is a common belief that hunting increases this risk because it leads to more active animals and increases roads crossings. We analyzed movements of moose (Alces alces) and frequency of moose road crossings during fall to test if moose altered their behavior during hunting periods compared to other times. We analyzed global positioning system (GPS) data from 172 free‐ranging adult moose (140 females, 32 males) between the end of August and the middle of October 2004–2013, in 7 different areas along Sweden's latitudinal gradient of 57°N–67°N. Female moose either decreased or did not change their movement rates as fall proceeded, and they did not cross roads more in any weeks of the hunting season. Male moose became more active between mid‐September and the beginning of October, which corresponds to the time before the hunting period in southern Sweden and the temporary hunting closure in northern Sweden. There was no overall change in moose movements in relation to hunting activity during fall regardless of region or sex. We found that number of road crossings correlated positively with the rutting period in male moose. Thus, the riskier periods for traffic during fall during the hunting period, based on moose movement, coincided with the rutting activity. We suggest that mitigation actions to reduce moose‐vehicle collisions should make drivers more aware of changes in movement behavior in moose during the rutting season, particularly in southern Sweden. © 2018 The Wildlife Society.
Habitat suitability modeling in different sperm whale social groups
Authors: Pace Daniela Silvia , Arcangeli Antonella , Mussi Barbara , Vivaldi Carlotta , Ledon Cristina , Lagorio Serena , Giacomini Giancarlo , Pavan Gianni , Ardizzone Giandomenico 
Published: March 2018

ABSTRACTThe identification of significant habitats for highly mobile marine vertebrates is essential for their conservation. Evidence is often difficult to obtain for deep‐diving species such as sperm whales (Physeter macrocephalus), where standard visual survey methods are not sufficient to detect the species. Sperm whales rely on sound for most of their activities, so acoustics is a crucial tool to locate them in the environment and collect information about their daily life. We used a maximum entropy (MaxEnt) modeling approach to predict potential habitats for sperm whales during 2007–2015 in an area of the Mediterranean Sea (characterized by submarine canyon systems) where sperm whale singletons, social units of females and calves, and clusters with immature males, were regularly encountered in sympatry. Models to test species’ distribution and the potential differences between groups of varying composition and life stages were based on 3 independent variables (depth, slope, and Euclidean distance from the nearest coast) and a combination of presence‐only visual and acoustic data from boat‐based surveys. One variable (depth) was the strongest predictor in all encounters (pooled data) and clusters, whereas distance from coast and slope best predicted encounters with singletons and social units, respectively. The model predicted suitable locations in areas that were well‐known sperm whale habitat and in new regions of previously overlooked habitat, which possibly represent key areas for this endangered species in the Mediterranean. This study highlights that consideration should be taken regarding type of social aggregation when using modeling techniques for generating suitable habitat maps for conservation purposes. © 2018 The Wildlife Society.
Black Sea dissolved organic matter dynamics: Insights from optical analyses
Authors: Margolin Andrew R. , Gonnelli Margherita , Hansell Dennis A. , Santinelli Chiara 
Published: March 2018

AbstractTo obtain qualitative information on the Black Sea's dissolved organic matter (DOM) pool, the optical properties (absorption and fluorescence) were measured in 111 samples collected across the basin. Chromophoric dissolved organic matter (CDOM) was considered at three wavelengths (254 nm, 280 nm, and 325 nm), along with the spectral slope between 275 nm and 295 nm (S275–295) and the specific ultraviolet absorbance at 254 nm (SUVA254). Using parallel factor analysis, a five‐component model identified three humic‐like components, a protein‐like component, and a polycyclic aromatic hydrocarbon‐like component. In the basin's oxic layer (upper ∼ 100 m), protein‐like CDOM was elevated, likely due to the production of this labile material, while humic‐like material was low, suggesting its removal by photo‐oxidation. In the underlying waters, the protein‐like material decreased, perhaps due to the utilization of this nitrogen‐containing DOM, while humic‐like material increased, suggesting its production at depth. In the anoxic layer (lower ∼ 2000 m), dissolved organic carbon (DOC) varied by only ∼ 10% while CDOM increased with depth by a factor of approximately two; the optical properties correlated well with the H2S‐equivalence of mineralization, referred to here as apparent carbon mineralization (ACM), while DOC did not. The strong correlation between CDOM and ACM is similar to correlations previously identified in the open ocean that compared CDOM with apparent oxygen utilization, suggesting that CDOM accumulates as a function of mineralization, independently of the oxidizing agent (i.e., oxygen or sulfate).
Preventive effect of polynucleotide on post‐thyroidectomy scars: A randomized, double‐blinded, controlled trial
Authors: Kim Ji Hee , Jeong Jong Ju , Lee Young In , Lee Won Jai , Lee Chorok , Chung Woong Youn , Nam Kee‐Hyun , Lee Ju Hee 
Published: March 2018

Background and ObjectivePolynucleotide (PN) provides a structural scaffold to induce anti‐inflammatory and enhanced wound healing properties, and this study aimed to assess the efficacy of PN administration in the prevention of post‐operative scars after conventional open total thyroidectomy.Study Design Materials and MethodsForty‐two patients with thyroid carcinoma who underwent total thyroidectomy were randomly assigned to the study (PN administration) or control (normal saline) group. All patients underwent a single session of combined ablative and non‐ablative fractional laser. The Vancouver Scar Scale (VSS), global photographic assessment, and objective scar were assessed using three‐dimensional (3D) camera at baseline and at 2, 4, 8, and 16 weeks after surgery.ResultsPatients who underwent PN injection demonstrated better surgical scar quality outcome. Participants in the PN administration group had lower VSS scores than the control group (2.09 ± 0.47 vs. 4.01 ± 0.55, respectively) and lower scar height (0.23 ± 0.03 vs. 0.29 ± 0.03, respectively), as measured using 3D imaging. Furthermore, in the PN injected group, the degree of erythema, and pigmentation of the scar were less prominent. No patient developed hypertrophic scar or keloids on the surgical site. No other adverse events, including post‐inflammatory hyperpigmentation, scarring, or infection, were observed.ConclusionAdjuvant administration of PN along with conventional fractional laser treatment led to more favorable effect in wound healing and post‐operative scar prevention after thyroidectomy. Lasers Surg. Med. 50:755–762, 2018. © 2018 Wiley Periodicals, Inc.
High speed ink aggregates are ejected from tattoos during Q‐switched Nd:YAG laser treatments
Authors: Murphy Michael J. 
Published: March 2018

IntroductionDark material has been observed embedded within glass slides following Q‐switched Nd:YAG laser treatment of tattoos. It appears that these fragments are ejected at high speed from the skin during the treatment.MethodLight microscopic analysis of the slides reveals aggregates of dark fragmented material, presumably tattoo ink, with evidence of fractured/melted glass. Photomicrographs reveal that the sizes of these aggregates are in the range 12 μm to 0.5 mm.ResultsTattoo ink fragments were clearly observed on the surface and embedded within glass slides. Surface aggregates were observed as a fine dust and were easily washed off while deeper fragments remained in situ. The embedded fragments were not visible to the unaided eye. Some fragments appeared to have melted yielding an “insect‐like” appearance. These were found to be located between approximately 0.2 and 1 mm deep in the glass.ConclusionGiven the particle masses and kinetic energies attained by some of these aggregates their velocities, when leaving the skin, may be hundreds to thousands of metres per second. However, the masses of the aggregates are minuscule meaning that laser operators may be subjected to these high‐speed aggregates without their knowledge. These high‐speed fragments of ink may pose a contamination risk to laser operators. Lasers Surg. Med. 50:711–717, 2018. © 2018 Wiley Periodicals, Inc.
Sequential Coating of Insulin Secreting Beta Cells within Multilayers of Polysaccharide Nanogels
Authors: Bal Tugba , Oran Dilem Ceren , Sasaki Yoshihiro , Akiyoshi Kazunari , Kizilel Seda 
Published: March 2018

AbstractPancreatic islet transplantation has emerged as a promising treatment for type‐1 diabetes (T1D); however, its clinical application is still limited by the life‐long use of immunosuppressive drugs, insufficient number of islets to achieve normoglycemia, and large transplantation volume. This paper reports a unique approach for nanothin coating of insulin secreting beta cell aggregates. The coating is based on hydrophobic and covalent interactions between natural acrylate modified cholesterol bearing pullulan (CHPOA) nanogels and MIN6 beta cell aggregates. Beta cell aggregates are prepared as spheroids through hanging drop method, which is optimized with respect to hanging drop volume and initial number of beta cells. These aggregates, defined as pseudoislets, are coated with sequential layers of nanogels and are evaluated as viable and functional for insulin secretion. Coating experiments are carried out using physiologically compatible medium, where pseudoislets are not brought in contact with toxic prepolymer solutions used in existing approaches. This study offers new opportunities through coating of islets with advanced functional materials under completely physiological conditions for clinical translation of cell transplantation technology. The technique developed here will establish a new paradigm for creating tolerable grafts for other chronic diseases such as anemia, cancer, central nervous system (CNS) diseases.
Synthesis from Molecule into 3D Polyamide 6 Microspheres Stacked Polyhedrons via Self‐Assembly
Authors: Liu Yan , Duan Jianping , Xia Housheng , Xu Jian , Yang Guisheng 
Published: March 2018

AbstractSelf‐assembly provides the basis for a procedure used to organize larger objects into regular, 3D microsphere stacked polyhedrons. A novel approach is described for the fabrication of 3D structured micrometer‐scale polyhedrons which are packed with nanosized spheres in the order of 400 nm by in situ polymerization using phase inversion technology. The extended polyhedrons can assemble into decimeter‐level ordered materials. The side length of an individual polyhedron can be effectively tuned from 10 to 100 µm through several ways. This method realizes directly self‐assembly from molecule to regular extended polyhedrons materials. The process is primarily based on in situ anion polymerization of lactam in two‐phase system whose self‐assembly is driven by hydrogen bonds' force and polyethylene glycol stepwise crystallization synergistically. The results suggest that this strategy for self‐assembly can be applied to design nonplanar complex geometric structure materials. In the future, polyhedrons packed with microspheres may be possible to build more complex 3D, self‐assembly device modules for advanced materials.
Biodegradable Polyester Thermogelling System as Emerging Materials for Therapeutic Applications
Authors: Shan Andrew Huayang , Jiang Lu , Li Zibiao 
Published: March 2018

AbstractPolyesters comprise the earliest and most extensive investigation as biomaterials. The integration of polyester into thermogelling system is one of the most recent trends in the development of hydrogel research. In this review, the most recent development of polyester based thermogelling systems is summarized with respect to different types of polyester materials, including poly(lactic acid), polycaprolactone, polyhydroxyalkanoates, poly(glycerol sebacate), and the combination of different types of polyesters in various architectures. The insights on the involvement of polyester in the improvement of gel function and property, as well as the underlying mechanism and structure–performance correlation, are provided. The emerging applications of using these newly developed sophisticated biodegradable polymeric thermogelling systems in therapeutic deliveries and tissue engineering are also summarized.
Polyelectrolyte–Graphene Oxide Multilayer Composites for Array of Microchambers which are Mechanically Robust and Responsive to NIR Light
Authors: Ermakov Alexey , Lim Su Hui , Gorelik Sergey , Kauling Alan P. , de Oliveira Ricardo V. B. , Castro Neto A. H. , Glukhovskoy Evgeniy , Gorin Dmitry A. , Sukhorukov Gleb B. , Kiryukhin Maxim V. 
Published: March 2018

AbstractDevelopment of composite polymer/graphene oxide (GO) materials attracts significant attention due to their unique properties. In this work, highly ordered arrays of hollow microchambers made of composite polyelectrolyte/GO multilayers (PEGOMs) are successfully fabricated via layer‐by‐layer assembly on sacrificial or sustainable templates having imprinted patterns of microwells on their surface. Mechanical and optical properties of PEGOMs are studied by nanoindentation and near‐infrared (NIR) absorption spectroscopy. Incorporation of three GO layers in between the polyelectrolyte multilayer stacks increases Young's modulus and critical stress of the microchambers by a factor of 5.6 and 2.6, respectively. Optical density of this PEGOM film is found to decrease gradually from 0.14 at λ = 800 nm to 0.06 at λ = 1500 nm. Remote opening of PEGOM microchambers with NIR laser beam is also demonstrated. One of the possible applications of the developed structures includes micropackaging and delivery systems in biological tissues with remote triggering.