bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nautilus multi-grain model: Importance of cosmic-ray-induced desorption in determining the chemical abundances in the ISM
Authors: Iqbal Wasim , Wakelam Valentine 
Published: February 2018

Context. Species abundances in the interstellar medium (ISM) strongly depend on the chemistry occurring at the surfaces of the dust grains. To describe the complexity of the chemistry, various numerical models have been constructed. In most of these models, the grains are described by a single size of 0.1 μm.
Aims. We study the impact on the abundances of many species observed in the cold cores by considering several grain sizes in the Nautilus multi-grain model.
Methods. We used grain sizes with radii in the range of 0.005 μm to 0.25 μm. We sampled this range in many bins. We used the previously published, MRN and WD grain size distributions to calculate the number density of grains in each bin. Other parameters such as the grain surface temperature or the cosmic-ray-induced desorption rates also vary with grain sizes.
Results. We present the abundances of various molecules in the gas phase and also on the dust surface at different time intervals during the simulation. We present a comparative study of results obtained using the single grain and the multi-grain models. We also compare our results with the observed abundances in TMC-1 and L134N clouds.
Conclusions. We show that the grain size, the grain size dependent surface temperature and the peak surface temperature induced by cosmic ray collisions, play key roles in determining the ice and the gas phase abundances of various molecules. We also show that the differences between the MRN and the WD models are crucial for better fitting the observed abundances in different regions in the ISM. We show that the small grains play a very important role in the enrichment of the gas phase with the species which are mainly formed on the grain surface, as non-thermal desorption induced by collisions of cosmic ray particles is very efficient on the small grains.
Assessing the Safety and Efficacy of Regional Anesthesia for Lower Extremity Microvascular Reconstruction: Enhancing Recovery
Authors: Ruan Qing , Diamond Shawn , Zimmer Scott , Iorio Matthew 
Published: February 2018

Background Perioperative pain, increased sympathetic tone, and peripheral vasospasm may be safely managed with regional nerve blockade during microvascular reconstruction in the lower extremity. Limited reports exist in this setting; therefore, we evaluated our use of peripheral nerve catheters (PNCs) during microvascular limb salvage to determine safety and efficacy for both patient and flap.
Methods A single-institution, retrospective review of a prospectively maintained database on all patients with lower extremity free tissue transfers between 2012 and 2017 was completed. Patients were matched into groups based on PNC utilization. The use of intravenous narcotics including patient-controlled analgesia (PCA), oral narcotics, antiemetics, length of stay (LOS), associated pain scores, flap-related performance, and patient morbidity was recorded.
Results Of 48 patients who underwent lower extremity free tissue transfer, 35 satisfied criteria for comparison. Of these, PNC was utilized in 83%. The mean pain score in the immediate postoperative period was 3.84 ± 2.47 (10-point Likert scale). PCA and narcotic use were decreased in the PNC group, and no adverse effects of the catheter were identified. Microsurgical outcomes were not adversely affected in comparison.
Conclusion PNC utilization for lower extremity free flap transfer significantly reduced concurrent narcotic use and attained a shorter LOS. The technique provided for safe analgesia during lower extremity free flap reconstructions satisfying the microsurgeon and the anesthesiologist.
Risk of Venous Thrombosis in Antithrombin Deficiency: A Systematic Review and Bayesian Meta-analysis
Authors: Borjas-Howard Jaime , Nasserinejad Kazem , Leebeek Frank , Meijer Karina , Croles F. 
Published: February 2018

AbstractAntithrombin deficiency is a strong risk factor for venous thromboembolism (VTE), but the absolute risk of the first and recurrent VTE is unclear. The objective of this paper is to establish the absolute risks of the first and recurrent VTE and mortality in individuals with antithrombin deficiency. The databases Embase, Medline Ovid, Web of Science, the Cochrane Library, and Google Scholar were systematically searched for case–control and cohort studies. Bayesian random-effects meta-analysis was used to calculate odds ratios (ORs), absolute risks, and probabilities of ORs being above thresholds. Thirty-five publications were included in the systematic review and meta-analysis. Based on 19 studies, OR estimates for the first VTE showed a strongly increased risk for antithrombin deficient individuals, OR 14.0; 95% credible interval (CrI), 5.5 to 29.0. Based on 10 studies, meta-analysis showed that the annual VTE risk was significantly higher in antithrombin-deficient than in non-antithrombin-deficient individuals: 1.2% (95% CrI, 0.8–1.7) versus 0.07% (95% CrI, 0.01–0.14). In prospective studies, the annual VTE risk in antithrombin deficient individuals was as high as 2.3%; 95% CrI, 0.2–6.5%. Data on antithrombin deficiency subtypes are very limited for reliable risk-differentiation. The OR for recurrent VTE based on 10 studies was 2.1; 95% CrI, 0.2 to 4.0. The annual recurrence risk without long-term anticoagulant therapy based on 4 studies was 8.8% (95% CrI, 4.6–14.1) for antithrombin-deficient and 4.3% (95% CrI, 1.5–7.9) for non-antithrombin-deficient VTE patients. The probability of the recurrence risk being higher in antithrombin-deficient patients was 95%. The authors conclude that antithrombin deficient individuals have a high annual VTE risk, and a high annual recurrence risk. Antithrombin deficient patients with VTE require long-term anticoagulant therapy.
Gender Comparison of Medical Student Microsurgical Skills in a Laboratory Model
Authors: Sudario-Lumague Rowena , Chiang Yuan-Cheng , Lin Tsan-Shiun 
Published: February 2018

Background Perceived gender-related differences in surgical skills could limit opportunities available for any aspiring surgeon. There should be more available literature and logical analysis of these observations. The objective of this study is to evaluate the microsurgical skills of male and female medical students using a standard scale in the laboratory.
Methods This study included medical students enrolled in the Kaohsiung Chang Gung Memorial Hospital from 2002 to 2015 who were evaluated by a senior consultant for their microsurgical skills. A standard numeric scale was used to evaluate their suturing technique after basic microsurgical training. Differences in the scores between male and female medical students were evaluated using statistical analysis.
Results A total of 578 medical students were included in the study. There were 393 males (68%) and 185 females (32%). Using statistical analysis, there is no significant difference in the distribution of scores (p-Value = 0.78) and mean scores (p-Value = 0.75) between the two groups.
Conclusions This study shows that microsurgical skills of male and female medical students are similar. Equal opportunities in the eventual pursuit of the surgical specialties should be available regardless of gender.
Algorithmic Approach for Intraoperative Salvage of Venous Congestion in DIEP Flaps
Authors: Bartlett Erica , Zavlin Dmitry , Menn Zachery , Spiegel Aldona 
Published: February 2018

Background Flap congestion is a frequently described intraoperative complication during autologous breast reconstruction with abdominal perforator flaps, which, if not addressed, can lead to detrimental results such as flap failure. Here, we describe our institution's algorithm of intraoperative salvage of congested flaps and present their outcomes.
Patients and Methods All patient charts from 2002 to 2016 of a single plastic surgeon were reviewed for patients who underwent deep inferior epigastric perforator flap breast reconstruction resulting in 602 patients and 831 flaps. Of those, 38 women (6.3%) with 40 congested flaps (4.8%) were included in this study. Based on the algorithm guiding the selection of additional venous anastomosis, the patients' surgical details, outcomes, as well as their demographic characteristics are evaluated.
Results Average age and body mass index of our cohort were 47.0 ± 8.0 years and 26.1 ± 3.9, respectively. Ten patients (26.3%) were current or former smokers while 20 (52.6%) required external radiation. Thirty-two congested flaps (80.0%) were predominantly salvaged with a superficial inferior epigastric vein (SIEV)-to-deep inferior epigastric vein (comitante) anastomosis. An SIEV-to-internal mammary vein comitante anastomosis was the second favorite option (5 flaps, 12.5%). Five patients suffered minor complications within a mean follow-up of 18.8 ± 12.3 months without flap failure, bleeding, or infection.
Conclusions Venous flap congestion is an uncommon intraoperative intricacy during free tissue transfer for autologous breast reconstruction. Our proposed algorithm primarily recommends adding an additional venous anastomosis between the superficial and deep drainage system and results and favorable outcomes without major complications.
Gastrointestinal Hemorrhage: A Review of Treatment Modalities and Emerging Therapies
Authors: Strong Andrew , El-Hayek Kevin , Landreneau Joshua 
Published: February 2018

AbstractGastrointestinal bleeding (GIB) may present as an acute or chronic condition. Acute GIB can carry significant risk of mortality. After stabilization and resuscitation, localization and control of active hemorrhage are paramount. Several modalities are available for localization. An increasing number of tools are available to interventional radiologists, endoscopists, and surgeons to intervene to achieve hemostasis. Here reviewed are an array of endoscopic, transarterial, and surgical methods to diagnose and treat GIB, with a focus on new and emerging technologies.
Illness Severity Predicts Death and Brain Injury in Asphyxiated Newborns Treated with Hypothermia
Authors: Wang Hui , Beltempo Marc , Rampakakis Emmanouil , Sanon Priscille-Nice , Barbosa Vargas Stephanie , Maluorni Julie , Saint-Martin Christine , Wintermark Pia 
Published: February 2018

Objective To determine if illness severity during the first days of life predicts adverse outcome in asphyxiated newborns treated with hypothermia.
Study Design We conducted a retrospective cohort study of asphyxiated newborns treated with hypothermia. Illness severity was calculated daily during the first 4 days of life using the Score for Neonatal Acute Physiology II (SNAP-II score). Adverse outcome (death and/or brain injury) was recorded. Differences in SNAP-II scores between the newborns with and without adverse outcome were assessed.
Result 214 newborns were treated with hypothermia. The average SNAP-II score over the first 4 days of life was significantly worse in newborns developing adverse outcome. The average SNAP-II score was an excellent predictor of death (area under the curve [AUC]: 0.93; p < 0.001) and a fair predictor of adverse outcome (AUC: 0.73; p < 0.001). The average SNAP-II score remained a significant predictor of adverse outcome (odds ratio [95% confidence interval]: 1.08 [1.04–1.12]; p < 0.001), after adjusting for baseline characteristics, degree of initial asphyxial event, and initial severity of encephalopathy.
Conclusion In asphyxiated newborns treated with hypothermia, not only the initial asphyxial event but also the illness severity during the first days of life was a significant predictor of death or brain injury.
Macular Edema in Childhood Uveitis
Authors: Garweg Justus 
Published: February 2018

Abstract
Background Pediatric uveitis is associated with a high incidence of severe and frequently permanent visual loss. This article summarizes the current understanding of the disease and the therapeutic options that are available to improve treatment outcomes.
Methods A Medline search spanning the last 10 years was undertaken using the key terms “pediatric uveitis” or “childhood uveitis” and “macular edema”. Articles which appertained to case reports or small case series were excluded from consideration, whereas those in which the opinions of experts were expressed, as well as reviews, were not. The information contained in these latter two forms of publication was particularly valuable, owing to the scarcity of prospective clinical data appertaining to the treatment of pediatric uveitis-associated macular edema.
Results Ten years ago, 34% of children who presented with uveitis manifested secondary complications at the time of diagnosis. During the ensuing 3 years of treatment, this rose to 86%. Heightening awareness of the disease with earlier referrals to expert centers, as well as the advent of therapeutic strategies involving anti-TNF agents and intravitreal corticosteroids, have led to a decrease in the incidence of legal blindness in the affected eyes from 18 – 69% to below 8% during a five-year course of treatment.
Conclusion Early diagnosis and strict control of inflammatory activity have led to a dramatic reduction in the incidence of vision-threatening secondary complications. In the majority of cases, it has also been possible to resolve cystoid macular edema, which, if insufficiently controlled by systemic therapy, usually responds well to intravitreal dexamethasone implants.
Effektivität und Sicherheit eines modifizierten Tipdesigns bei der torsionalen Phakoemulsifikation
Authors: Schmidt Sabine , Hubich Sophie , Vetter Jan , Wirbelauer Christopher 
Published: February 2018

Zusammenfassung
Hintergrund Die torsionale Phakoemulsifikation hat durch eine veränderte Bewegung des Phakotips eine effektivere Kernfragmentierung zur Folge. In dieser klinischen Untersuchung sollten die Auswirkungen einer modifizierten Spitze des Phakoemulsifikationshandgriffs und einer aktiven Flüssigkeitssteuerung auf die Effektivität der Phakoemulsifikation sowie die Sicherheit des Hornhautendothels überprüft werden.
Material und Methoden Es wurde eine prospektiv randomisierte 2 : 1-Studie durchgeführt, bei der 40 Patienten mit dem Mini-flared Kelman Tipp und dem Infiniti®-System (Gruppe 1) und 20 Patienten mit dem Intrepid® Balanced Tipp und dem Centurion®-System (Gruppe 2) operiert wurden. Die Studie wurde von der Qualitätskommission der Augenklinik Marzahn genehmigt. Wir analysierten die kumulative Energie sowie das Hornhautendothel mit der Endothelmikroskopie (CEM 530, Nidek) prä- und postoperativ in beiden Gruppen.
Ergebnisse Die Gruppen unterschieden sich präoperativ nicht hinsichtlich Visus, Alter, Geschlecht, Bulbuslänge, Hornhautendothelzahl und Kernhärte (LOCS3). Alle Operationen verliefen komplikationslos. Die kumulative Energie war in Gruppe 1 (Mini-flared Kelman Tipp, Infiniti-System) um 38% signifikant höher als in Gruppe 2 (Balanced Tipp, Centurion-System; p < 0,05). Der Hornhautendothelzellverlust betrug 8% in Gruppe 1 und 10,3% in Gruppe 2 (p > 0,05). Die Größe der Zellen (Polymegatismus) nahm in beiden Gruppen postoperativ signifikant zu, in Gruppe 1 um + 37 µm (p < 0,05) und in Gruppe 2 um + 54 µm (p < 0,05). Es bestand jedoch kein Unterschied zwischen den Gruppen (p > 0,05). Die Anzahl der hexagonalen Zellen (Pleomorphismus) und die Hornhautdicke (Pachymetrie) unterschied sich weder prä- noch postoperativ zwischen beiden Gruppen (p > 0,05).
Schlussfolgerung Im Vergleich zur torsionalen Phakoemulsifikation mit dem Mini-flared Kelman Tipp und standardisiertem Flüssigkeitsdruck ist die torsionale Phakoemulsifikation mit einem modifizierten Tipdesign und aktiver Flüssigkeitssteuerung um 38% effektiver hinsichtlich der kumulativen Energie. Der Verlust der Hornhautendothelzellen unterscheidet sich bei der Operation zwischen den beiden Systemen nicht. Die Zellgröße (Polymegatismus) nahm in beiden Gruppen signifikant zu, die Anzahl der hexagonalen Zellen (Pleomorphismus) und die Hornhautdicke bleiben bei der Operation mit beiden Systemen gleich, sodass das Verfahren in Bezug auf das Hornhautendothel in etwa gleichermaßen sicher ist.
Mut zur Bewegung – ein Fallbeispiel
Authors: de Ruijter Renée 
Published: February 2018

ZusammenfassungFrau Meier
1
hat zunehmend Angst vor Bewegung, da dann ihre
Schmerzen unerträglich werden. Aber auch nachts findet sie keine Ruhe. Die an sich unternehmenslustige
Patientin zieht sich immer mehr aus ihrem sozialen Umfeld zurück. Eine sorgfältige Anamnese und Untersuchung
führen die Therapeutin Renée de Ruijter auf den richtigen Behandlungspfad. Eine verbesserte eigene Kontrolle
der Patientin über ihre Beschwerden entpuppt sich dabei als Schlüssel zu mehr Lebensqualität.
Der Effekt von Manueller Therapie auf Kokzygodynie
Authors: Harlacher Anne , Möller Dirk , von Piekartz Harry 
Published: February 2018

ZusammenfassungFür die Schmerzentstehung von Kokzygodynie können sowohl lokale als auch entfernte Strukturen verantwortlich
sein. Deshalb gilt es, die Quellen der Symptome für jeden Einzelfall zu identifizieren und durch Clinical
Reasoning zu untermauern. Da keine Korrelation zwischen den Symptomen und dem Grad der Steißbeinkrümmung
besteht, lässt sich ein Behandlungserfolg nicht mit der Korrektur der Steißbeinstellung erklären. Der
Therapieverlauf muss durch andere Parameter kontrolliert werden, wie z. B. Schmerzreduktion und Verbesserung
der funktionalen Beeinträchtigungen. Da die Kokzygodynie eng mit psychosozialen Prozessen in Verbindung zu
stehen scheint, ist bei Kindern und chronischen Schmerzgeschehen besondere Aufmerksamkeit geboten.Eine gängige Behandlungsoption bei Kokzygodynie stellt die muskuloskeletale Therapie dar, über deren
Wirksamkeit allerdings wenig bekannt ist. Aus diesem Grund ging dieser systematische Literaturreview der
Forschungsfrage nach, ob sich Kokzygodynie mit muskuloskeletaler Therapie effektiv behandeln lässt. Obwohl die
Validität der ausgewählten Studien eher gering ausfiel, waren ihre Ergebnisse durchweg positiv. Insgesamt
erwies sich muskuloskeletale Therapie bei Kokzygodynie als effektive Behandlungsform.
Botulinum Toxin for the Treatment of Cyclic Strabismus in Children: Three Case Reports
Authors: Wipf Monika , Bok-Beaube Corinne , Palmowski-Wolfe Anja 
Published: February 2018

AbstractCyclic strabismus is a rare disease of unknown origin. If untreated, it leads to manifest strabismus with the risk of amblyopia in children. Treatment is generally surgical. Here we report on three children in whom cyclic esotropia was successfully treated with one bimedial injection of 5 IU Botox®. All patients remained orthotropic with good stereo functions at the last follow-ups at 16, 11, and 8 months. Botulinum toxin offered a minimally invasive treatment option in these patients.
Select and resequence reveals relative fitness of bacteria in symbiotic and free-living environments
Authors: Burghardt Liana T. , Epstein Brendan , Guhlin Joseph , Nelson Matt S. , Taylor Margaret R. , Young Nevin D. , Sadowsky Michael J. , Tiffin Peter 
Published: February 2018

Significance
We describe an empirical approach to measure the outcomes of selection and competition in bacterial populations. This approach differs from others in that it examines selection acting on naturally occurring variation rather than new mutations. We demonstrate this method by examining selection on rhizobial bacteria living both in symbiosis with leguminous plants and independently in the soil. We identify fitness correlations across environments that could affect the maintenance of the mutualism and natural genomic variants underlying bacterial fitness. Identifying selection inside and outside of hosts may lead to future manipulation of the mutualism to increase agricultural yields.
Molecular signatures of circulating melanoma cells for monitoring early response to immune checkpoint therapy
Authors: Hong Xin , Sullivan Ryan J. , Kalinich Mark , Kwan Tanya Todorova , Giobbie-Hurder Anita , Pan Shiwei , LiCausi Joseph A. , Milner John D. , Nieman Linda T. , Wittner Ben S. , Ho Uyen , Chen Tianqi , Kapur Ravi , Lawrence Donald P. , Flaherty Keith T. , Sequist Lecia V. , Ramaswamy Sridhar , Miyamoto David T. , Lawrence Michael , Toner Mehmet , Isselbacher Kurt J. , Maheswaran Shyamala , Haber Daniel A. 
Published: February 2018

Significance
Identifying predictive biomarkers of therapeutic response for melanoma patients treated with immune checkpoint inhibitors is a major challenge. By combining microfluidic enrichment for melanoma circulating tumor cells (CTCs) together with RNA-based droplet digital PCR quantitation, we have established a highly sensitive and robust platform for noninvasive, blood-based monitoring of tumor burden. Serial monitoring of melanoma patients treated with immune checkpoint inhibitors shows rapid changes in CTC score, which precede standard clinical assessment and are highly predictive of long-term clinical outcome. Early on-treatment digital monitoring of CTC dynamics may thus help identify patients likely to benefit from immune checkpoint inhibition therapy.
Jasmonic acid facilitates flower opening and floral organ development through the upregulated expression of SlMYB21 transcription factor in tomato
Authors: Niwa Tomoko , Suzuki Takamasa , Takebayashi Yumiko , Ishiguro Rie , Higashiyama Tetsuya , Sakakibara Hitoshi , Ishiguro Sumie 
Published: February 2018

AbstractPlants coordinate the timing of flower opening with pollen and gynoecium maturation to achieve successful pollination. However, little is known about how the coordination is executed. We found that flower bud development was paused immediately before flower opening in a jasmonic acid (JA)-insensitive tomato mutant, jai1-1. Phytohormone measurement and RNA analysis in flower buds revealed that newly synthesised JA peaked at two days before flower opening and the expression of a transcription factor gene SlMYB21 delayed in jai1-1. Buds of transgenic tomato plants expressing an artificial repressor, AtMYB24-SRDX, which was expected to impede the function of SlMYB21, aborted flower opening and resembled those of jai1-1. Furthermore, the AtMYB24-SRDX plants produced abnormal pollen grains deficient in germination and pistils that did not support pollen tube elongation. We concluded that JA facilitates the expression of SlMYB21, which coordinates flower opening, pollen maturation, and gynoecium function in tomato.
The effect of discovery learning and problem-based learning on middle school students’ self-regulated learning
Authors: Miatun A , Muntazhimah  
Published: February 2018

Abstract
The aim of this research was to determine the effect of learning models on mathematics achievement viewed from student’s self-regulated learning. The learning model compared were discovery learning and problem-based learning. The population was all students at the grade VIII of Junior High School in Boyolali regency. The samples were students of SMPN 4 Boyolali, SMPN 6 Boyolali, and SMPN 4 Mojosongo. The instruments used were mathematics achievement tests and self-regulated learning questionnaire. The data were analyzed using unbalanced two-ways Anova. The conclusion was as follows: (1) discovery learning gives better achievement than problem-based learning. (2) Achievement of students who have high self-regulated learning was better than students who have medium and low self-regulated learning. (3) For discovery learning, achievement of students who have high self-regulated learning was better than students who have medium and low self-regulated learning. For problem-based learning, students who have high and medium self-regulated learning have the same achievement. (4) For students who have high self-regulated learning, discovery learning gives better achievement than problem-based learning. Students who have medium and low self-regulated learning, both learning models give the same achievement.