bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transfusion in Head and Neck Cancer Patients Undergoing Pedicled Flap Reconstruction
Authors: Abt Nicholas B. , Puram Sidharth V. , Sinha Sumi , Sethi Rosh K. V. , Goyal Neerav , Emerick Kevin S. , Lin Derrick T. , Deschler Daniel G. 
Published: September 2018

ObjectiveBlood product utilization is monitored to prevent unnecessary transfusions. Head‐and‐neck pedicled flap reconstruction transfusion‐related outcomes were assessed.MethodsOne hundred and thirty‐six pedicled flap patients were reviewed: 64 supraclavicular artery island flaps (SCAIF), 57 pectoralis major (PM) flaps, and 15 submental (SM) flaps. Outcome parameters included flap‐related complications, medical complications, length of stay (LOS), and flap survival. Multivariable logistic regression analyses were performed. Multivariable logistic regression analyses were performed to adjust for relevant pre‐ and perioperative factors.ResultsOf all head‐and‐neck pedicled flap patients included in our analyses (n = 136), 40 (29.4%) received blood transfusions. The average pretransfusion hematocrit (Hct) was 24.3% ± 0.5%, with 2.65 ± 0.33 units transfused and a posttransfusion Hct increase of 5.0% ± 0.6%. Transfusion rates differed with PM (47.4%), SCAIF (17.2%), and SM (13.3%) flaps (P < 0.005). Patients undergoing PM reconstruction trended toward higher transfusion requirements (PM 2.89 ± 0.47 units, SC 2.18 ± 0.28 units, and SM 2.00 ± 0.0 units), with transfusion occurring later in the postoperative course (4.9 ± 1.3 days vs. 2.4 ± 0.1 days for all other flaps; P = 0.08). Infection, dehiscence, fistula, or medical complications were not different. Transfusion thresholds of Hct < 21 versus Hct < 27 exhibited no difference in LOS, flap‐survival, or medical/flap‐related complications.ConclusionTransfusion is not associated with surgical or medical morbidity following head and neck pedicled flap reconstruction. There were no differences in outcomes between transfusion triggers of Hct < 21 versus Hct < 27, suggesting that a more conservative transfusion trigger may not precipitate adverse patient complications. Our data recapitulate findings in free flap patients and warrant further investigation of transfusion practices in head and neck flap reconstruction.Level of Evidence4. Laryngoscope, 128:E409–E415, 2018
Saliva Pepsin Detection and Proton Pump Inhibitor Response in Suspected Laryngopharyngeal Reflux
Authors: Wang Ching‐Ping , Wang Chen‐Chi , Lien Han‐Chung , Lin Wen‐Jiun , Wu Shang‐Heng , Liang Kai‐Li , Liu Shih‐An 
Published: September 2018

Objectives/HypothesisTo evaluate the prediction value of saliva pepsin detection for an 8‐week proton pump inhibitor (PPI) response in patients with a Reflux Symptoms Index (RSI) score ≥13, which indicates possible laryngopharyngeal reflux.Study DesignProspective individual single‐cohort study.MethodsPatients were recruited who had experienced chronic laryngopharyngeal symptoms (RSI score ≥13) for more than 3 months after excluding other etiologies. The patients received PPI (40 mg of esomeprazole once daily) treatment for 8 weeks. Prior to treatment, the patients submitted saliva/sputum samples that were collected during the time symptoms were observed. The samples were taken for pepsin detection, and performed using the commercially available Peptest lateral flow device. The association of the Peptest results and PPI response were statistically analyzed with the χ2 test.ResultsSeventy‐four patients completed the study, and upon completion of PPI treatment, the mean RSI score was significantly reduced from 19.22 ± 5.18 to 8.99 ± 5.69. Forty‐four (59.5%) patients exhibited a good response as defined by an RSI score reduction ≥50%. The results of the Peptest were semiquantitatively graded as 0, 1, 2, 3 (negative, weak positive, moderate positive and strong positive, respectively) based upon the visual intensity of the test sample line as compared to the control line. Twenty‐four patients (32.4%) exhibited grade 3 strong positive results. The Peptest strong positive results (P < .05) were significantly associated with a good PPI response, with the positive predictive value being 79.2%.ConclusionsAnalysis of strong positive results for pepsin detection in saliva/sputum samples may be a useful, noninvasive method for predicting better PPI response in patients with suspected reflux induced chronic laryngopharyngeal symptoms.Level of Evidence2 Laryngoscope, 129:709–714, 2019
An Evaluation of the Program‐Specific Paragraph in the Otolaryngology Residency Application
Authors: Stepan Katelyn O. , Kaul Vivian F. , Raquib Aaishah R. , Kozin Elliott D. , Sethi Rosh K. , Malkin Benjamin D. , Gray Stacey T. , Teng Marita S. 
Published: September 2018

Objectives/HypothesisThe recent addition of mandatory program‐specific paragraphs within the personal statement during the otolaryngology match process has been controversial. It is unclear whether applicants customize these paragraphs for programs, or if they are largely uniform across applications. The objective of our study was to assess the degree of variability among program‐specific paragraphs.Study DesignRetrospective cohort analysis.MethodsAn analysis of deidentified program‐specific paragraphs of 2016 otolaryngology residency applicants at two institutions was performed. Applicants who applied to both and had program‐specific paragraphs were included. Paragraphs were assessed for 24 parameters, including quantitative content analysis. Subjective and objective similarity scores were assigned to each pair, using a five‐point scale and Levenshtein distance function respectively. Differences between institutions were calculated using χ2 and two‐sided t tests.ResultsTwo hundred eight‐five applications were reviewed, and 181 applied to both programs and had program‐specific paragraphs. The median subjective similarity score among all paragraphs was “mildly similar” (2/5). The mean objective similarity score was 0.59. There were statistical differences between institutions in 13 parameters. One institution garnered more applicants who mentioned interest in research or global surgery (71.3% vs. 57.5%, P = .006; 17.7% vs. 4.4%, P < .0001, respectively), whereas the other attracted mention of clinical aspects and geographical ties (80.0% vs. 45.3%, P < .0001; 72.4% vs. 45.3%, P < .0001, respectively).ConclusionsOur study suggests that applicants tailor program‐specific paragraphs to the individual residency programs. These findings may aid programs and students in understanding the role of this new element of the application.Level of Evidence4 Laryngoscope, 2508–2513, 2018
Mixing and internal dynamics of a medium‐size and deep lake near the Arctic Circle
Authors: Priet‐Mahéo M. C. , Ramón C. L. , Rueda F. J. , Andradóttir H. Ó. 
Published: September 2018

AbstractThe goal of the research was to identify the mixing features that distinguish wind forced, medium‐size fjord‐type lakes near the Arctic Circle from systems of similar geometry, but in a temperate climate. Experimental data and the results of 3D numerical hydrodynamic simulations were analyzed for Lake Lagarfljót (27 km long; 2 km wide; 110 m maximum depth; 65°N) during the 5‐month ice‐free period in 2009. The results showed that probably the most distinctive feature of arctic lakes is their low water column stability, one order of magnitude lower than that of mid‐latitude lakes, even in mid‐summer. The second characteristic is the high rate of energy imparted by wind in the Arctic, estimated as one order of magnitude larger than in a temperate climate. Frequent wind events with Lake and Wedderburn numbers below 1 occurred during the ice‐free period, leading to a strong shear at the base of the surface mixed‐layer and the upwelling of deep metalimnetic layers. As a result, nearly continuous density stratification developed in the shallowest 70 m of the water column, and longitudinal temperature gradients may therefore be very significant. On average, 15% of the wind forcing drove large‐scale internal motions. This energy was rapidly dissipated, partly as a result of stronger bottom velocities, nonlinear surges, and hydraulic jumps that repeatedly formed in the lake. The initial V1H1 setup rapidly evolved into spatially complex oscillatory modes, which, given the high latitude, are affected by the Earth's rotation, even in narrow basins.
Photoacclimation of Arctic Ocean phytoplankton to shifting light and nutrient limitation
Authors: Lewis K. M. , Arntsen A. E. , Coupel P. , Joy‐Warren H. , Lowry K. E. , Matsuoka A. , Mills M. M. , van Dijken G. L. , Selz V. , Arrigo K. R. 
Published: September 2018

AbstractAs the physical environment of the Arctic Ocean shifts seasonally from ice‐covered to open water, the limiting resource for phytoplankton growth shifts from light to nutrients. To understand the phytoplankton photophysiological responses to these environmental changes, we evaluated photoacclimation strategies of phytoplankton during the low‐light, high‐nutrient, ice‐covered spring and the high‐light, low‐nutrient, ice‐free summer. Field results show that phytoplankton effectively acclimated to reduced irradiance beneath the sea ice by maximizing light absorption and photosynthetic capacity. In fact, exceptionally high maximum photosynthetic rates and efficiency observed during the spring demonstrate that abundant nutrients enable prebloom phytoplankton to become “primed” for increases in irradiance. This ability to quickly exploit increasing irradiance can help explain the ability of phytoplankton to generate massive blooms beneath sea ice. In comparison, phytoplankton growth and photosynthetic rates are reduced postbloom due to severe nutrient limitation. These results advance our knowledge of photoacclimation by polar phytoplankton in extreme environmental conditions and indicate how phytoplankton may acclimate to future changes in light and nutrient resources under continued climate change.
Feature characterization of scarring and non‐scarring types of alopecia by multiphoton microscopy
Authors: Lin Jessica , Saknite Inga , Valdebran Manuel , Balu Mihaela , Lentsch Griffin , Williams Joshua N. , Koenig Karsten , Tromberg Bruce J. , Atanaskova Mesinkovska Natasha 
Published: September 2018

ObjectivesNon‐invasive visualization of hair follicles is important for proper diagnosis and management of alopecia; however, histological assessment remains the gold standard. Laser imaging technologies have made possible noninvasive in vivo evaluation of skin and hair follicle. The aim of this study was to evaluate the ability of multiphoton microscopy (MPM) to non‐invasively identify morphological features that can distinguish scarring from non‐scarring alopecia.MethodsMPM images were obtained from areas on the scalp affected by alopecia. Investigators blinded to the diagnosis analyzed hair follicle and shaft sizes. Patients were recruited and imaged at the UC Irvine Health Medical Center and the University of California, Irvine Beckman Laser Institute. Patients with androgenetic alopecia (AGA) and alopecia areata (AA), and scarring alopecia, in particular frontal fibrosing alopecia (FFA) were recruited and imaged from July 2016 to July 2017.ResultsWe imaged 5 normal scalp subjects and 12 patients affected by non‐scarring (7 subjects) and scarring (5 subjects) alopecia. In normal and non‐scarring alopecia patients, MPM identified presence of sebaceous glands associated with hair follicles. MPM images of scarring alopecia were characterized by the presence of inflammatory cells surrounding hair follicles. Measurements of hair follicle diameter sizes were found to be significantly smaller in scarring alopecia patients compared to normal (P < 0.001) and compared to non‐scarring alopecia patients (P = 0.046); non‐scarring hair follicles were also significantly smaller than normal hair follicles (P = 0.043).ConclusionsThis study shows that MPM imaging can non‐invasively identify morphological features that distinguish scarring from non‐scarring alopecia. Further studies are needed to validate this technique and evaluate its potential to be used as an aid for guiding treatment. Lasers Surg. Med. 51:95–103, 2019. © 2018 Wiley Periodicals, Inc.
Scope and Limitations of the Dehydrogenative Generation of Graphenic Nanoribbons from Methylene‐Bridged, Aromatic Ladder Polymers
Authors: Ockfen Marie‐Claire , Forster Michael , Scherf Ullrich 
Published: September 2018

AbstractA synthetic route to solubilized graphenic nanoribbons (GNRs) by oxidation of methylene‐bridged, aromatic ladder polymers is presented. Hereby, the ladder polymer precursors are finally 2,3‐dichloro‐5,6‐dicyano‐1,4‐benzoquinone (or DDQ) oxidized into the desired GNRs. However, a detailed UV–vis analysis shows already partial oxidation/dehydrogenation during aqueous work‐up under loss of ≈50% of the bridgehead hydrogens as well as some indications for overoxidation with DDQ under formation of quinoid carbonyl defects, additionally driven by a reduction of the number of quinoid (quinodimethane) structural units.
The algorithmic detection of pulse thunderstorms within a large, mostly non‐severe sample
Authors: Miller Paul W. , Mote Thomas L. 
Published: September 2018

The accurate differentiation of pulse thunderstorms from benign weakly forced thunderstorms (WFTs) is both a historical and contemporary forecasting challenge. Little research has been directed toward WFTs, and the few existing efforts are characterized by small sample sizes and inflated proportions of pulse thunderstorms. The purpose of this study was to determine whether pulse thunderstorms can be successfully differentiated from non‐severe WFTs within a large, mostly non‐severe sample, a more operationally realistic scenario. Random forests, a decision‐tree‐based machine learning technique, was applied to radar, total lightning and environmental parameters of >84,000 WFTs, of which <1% were pulse thunderstorms. In particular, differential reflectivity (ZDR) fields were mined for occurrences of ZDR troughs, suggested by recent work as a reliable indication of impending downbursts.The random forest identified pulse thunderstorms from the 84,000 storm sample with a critical success index (CSI) of 0.29. The CSI improved to 0.50 in a subset of the most active geographical regions and convective environments, outperforming the US National Weather Service (CSI = 0.35) for warnings issued on pulse thunderstorms. Unfortunately, the presence of ZDR troughs contributed little skill to the random forest. Although forming at higher rates in pulse thunderstorms (61%) than non‐severe WFTs (5.1%), trough‐possessing non‐severe WFTs were roughly 9× more common than pulse thunderstorms with the same feature.Overall, the random forest shows promise as a potential decision aid for identifying pulse thunderstorms. Performance may be further improved if collinearity amongst the radar parameters and probable under‐reporting of severe weather can be overcome.
Data Curation can Improve the Prediction Accuracy of Metabolic Intrinsic Clearance
Authors: Esaki Tsuyoshi , Watanabe Reiko , Kawashima Hitoshi , Ohashi Rikiya , Natsume‐Kitatani Yayoi , Nagao Chioko , Mizuguchi Kenji 
Published: September 2018

AbstractA key consideration at the screening stages of drug discovery is in vitro metabolic stability, often measured in human liver microsomes. Computational prediction models can be built using a large quantity of experimental data available from public databases, but these databases typically contain data measured using various protocols in different laboratories, raising the issue of data quality. In this study, we retrieved the intrinsic clearance (CLint) measurements from an open database and performed extensive manual curation. Then, chemical descriptors were calculated using freely available software, and prediction models were built using machine learning algorithms. The models trained on the curated data showed better performance than those trained on the non‐curated data and achieved performance comparable to previously published models, showing the importance of manual curation in data preparation. The curated data were made available, to make our models fully reproducible.
Dictionary‐based electric properties tomography
Authors: Hampe Nils , Herrmann Max , Amthor Thomas , Findeklee Christian , Doneva Mariya , Katscher Ulrich 
Published: September 2018

PurposeTo develop and validate a new algorithm called “dictionary‐based electric properties tomography” (dbEPT) for deriving tissue electric properties from measured B1 maps.MethodsInspired by Magnetic Resonance fingerprinting, dbEPT uses a dictionary of local patterns (“atoms”) of B1 maps and corresponding electric properties distributions, derived from electromagnetic field simulations. For reconstruction, a pattern from a measured B1 map is compared with the B1 atoms of the dictionary. The B1 atom showing the best match with the measured B1 pattern yields the optimum electric properties pattern that is chosen for reconstruction. Matching was performed through machine learning algorithms. Two dictionaries, using transmit and transceive phases, were evaluated. The spatial distribution of local matching distance between optimal atom and measured pattern yielded a reconstruction reliability map. The method was applied to reconstruct conductivity of 4 volunteers’ brains. A conventional, Helmholtz‐based Electric properties tomography (EPT) reconstruction was performed for reference. Noise performance was studied through phantom simulations.ResultsQuantitative values of conductivity agree with literature values. Results of the 2 dictionaries exhibit only minor differences. Somewhat larger differences are visible between dbEPT and Helmholtz‐based EPT. Quantified by the correlation between conductivity and anatomic images, dbEPT depicts brain details more clearly than Helmholtz‐based EPT. Matching distance is minimal in homogeneous brain ventricles and increases with tissue heterogeneity. Central processing unit time was approximately 2 minutes per dictionary training and 3 minutes per brain conductivity reconstruction using standard hardware equipment.ConclusionA new, dictionary‐based approach for reconstructing electric properties is presented. Its conductivity reconstruction is able to overcome the EPT transceive‐phase problem.
Bladder changes after catheterizable channel creation in adults with cerebral palsy who are in chronic urinary retention
Authors: Narayan Vikram M. , Pariser Joseph J. , Gor Ronak A. , Katorski Jenna , Elliott Sean P. 
Published: September 2018

AimsCerebral palsy (CP) is characterized by motor impairments as a result of brain injury during development. Patients can have neurogenic bladder dysfunction and are often unable to catheterize through their native urethra. Catheterizable channel (CC) creation can facilitate clean intermittent catheterization (CIC). We have observed that patients with large capacity, low‐pressure bladders can develop de novo neurogenic detrusor overactivity (NDO) postoperatively. We sought to better characterize this finding.MethodsWe reviewed the charts of patients 17 years or older with CP seen between 2006 and 2017. Patients undergoing creation of any type of CC without augmentation cystoplasty, due to adequate storage on pre‐operative urodynamics (UDS), were included. Pre‐ and post‐operative UDS were reviewed. Frequency of incontinence and use of anticholinergics or intravesical injections of onabotulinum toxin A (Btx) were reviewed.ResultsEight patients with CP underwent CC creation without augmentation. Preoperatively, six of eight patients were in chronic retention with two others performing CIC. Following CC creation, patients in retention required additional NDO management with anticholinergics, mirabegron, or onabotulinumtoxin A. Among those with complete UDS data, 67% demonstrated lower maximum cystometric capacity postoperatively. Median follow‐up was 25 months.ConclusionsCC creation facilitates CIC in adults with CP who are in chronic retention due to pseudodyssynergia. Despite preoperative UDS suggesting an adequate capacity, low‐pressure bladder, such patients often manifest de novo NDO and worsening incontinence upon initiation of CIC after surgery. These findings should be considered when determining whether to perform augmentation at the time of CC in adults with CP.
Amyloid self‐assembling peptides: Potential applications in nanovaccine engineering and biosensing
Authors: Al‐Halifa Soultan , Babych Margaryta , Zottig Ximena , Archambault Denis , Bourgault Steve 
Published: September 2018

AbstractLiving organisms are an inestimable source of inspiration for the design of biomaterials and nanostructures for medical and technological applications. Amyloids, which were historically associated with diseases, have recently been recognized as a biological structure that performs vital physiological functions in host organisms, highlighting their potential as life‐inspired assemblies. Amyloids are highly organized proteinaceous assemblies characterized by a cross‐β‐sheet quaternary conformation. The mechanical, physical, and biological properties of amyloids suggest that these nanostructures hold great potential as soft materials, nanoparticles, and biomatrices. This potential is associated with many characteristics, including the spontaneous self‐assembly of many polypeptide sequences, high mechanical resistance, biocompatibility, biodegradability as well as thermal, chemical, and enzymatic stability. Moreover, peptide‐based amyloid assemblies can efficiently be obtained by standard solid phase peptide synthesis and orthogonally functionalized with a wide range of biomolecules, such as large proteins and DNA. In this review, after briefly introducing the amyloid structure and the mechanisms of self‐assembly, we describe approaches to identify and design short self‐assembling amyloidogenic peptides. Afterward, we introduce strategies used to functionalize amyloid materials and we highlight some relevant examples in the development of nanovaccines and biosensors.
Formal analysis of the kinematic Jacobian in screw theory
Authors: Shi Zhiping , Wu Aixuan , Yang Xiumei , Guan Yong , Li Yongdong , Song Xiaoyu 
Published: September 2018

Abstract
As robotic systems flourish, reliability has become a topic of paramount importance in the human–robot relationship. The Jacobian matrix in screw theory underpins the design and optimization of robotic manipulators. Kernel properties of robotic manipulators, including dexterity and singularity, are characterized with the Jacobian matrix. The accurate specification and the rigorous analysis of the Jacobian matrix are indispensable in guaranteeing correct evaluation of the kinematics performance of manipulators. In this paper, a formal method for analyzing the Jacobian matrix in screw theory is presented using the higher-order logic theorem prover HOL4. Formalizations of twists and the forward kinematics are performed using the product of exponentials formula and the theory of functional matrices. To the best of our knowledge, this work is the first to formally analyze the kinematic Jacobian using theorem proving. The formal modeling and analysis of the Stanford manipulator demonstrate the effectiveness and applicability of the proposed approach to the formal verification of the kinematic properties of robotic manipulators.