bluuebunny/crossref_metadata_2025_split huggingface dataset:
Environmentally Friendly Measurement of Airborne Radon Using a Nonvolatile Liquid Scintillation Absorbent
Authors: Kato Takahisa , Janik Miroslaw , Kanda Reiko , Ishikawa Tetsuo , Kawase Masaya , Kawamoto Takuo 
Published: June 2018

Abstract
The practicality of using a liquid scintillation method with a nonvolatile liquid scintillation absorbent for the measurement of airborne 222Rn (radon) in a residence was examined. The relationship between the radioactivity absorbed by the liquid scintillation absorbent and the radon concentration in the air was investigated in a calibrated walk-in radon chamber. The equivalent radioactivity of radon was calculated for 214Po radioactivity immediately after radioactive equilibrium was attained using successive decay equations via alpha-particle spectrometry based on the 1 h, indirect, selective measurement of the 214Po alpha-particle spectrum generated after sampling radon. We confirmed that the amounts of radon absorbed in the liquid scintillation absorbent were proportional to the radon concentration in the air. The calibration curve that exhibited reliable quantitative linearity from 500 to 8,000 Bq m−3 in air was extrapolated to the region between 0 and 500 Bq m−3 using the least-squares method with data from 500 to 8,000 Bq m−3. The validity of the extrapolated curve at less than 500 Bq m−3 was confirmed by comparison of the measured radon concentrations in the room and atmosphere with those determined using an existing ionization chamber. Variations in the absorption of radon were observed due to changes in temperature and humidity. The health and environmental safety of nonvolatile liquid scintillation absorbent was also considered.
Effectiveness of an Imaging Plate System in Emergency 131I Thyroid Monitoring
Authors: Deji Shizuhiko , Li Xiaojuan , Ito Shigeki , Hirota Masahiro , Saze Takuya , Nishizawa Kunihide 
Published: June 2018

Abstract
The effect of temperature and shielding on the lower detection limit of a thyroid 131I monitoring system was investigated in an anthropomorphic thyroid-neck phantom fitted with an imaging plate. The phantom was loaded with an 131I aqueous solution and monitored with the imaging plate for 10 min. After exposure, the plates were incubated with or without the shield at 0, 10, 20, 25, 30, or 40°C. The latent image was read out at 0 min to 7 d after exposure. The thyroid equivalent doses corresponding to the detection limit were calculated in six age categories, using the inhalation equivalent dose coefficients recommended by the International Commission on Radiological Protection. The detection limit was distributed between 0.13 and 4.2 kBq, and depended on the age of subjects, elapsed time, temperature, and shielding provision. The maximum detection limit of 4.2 kBq was below the emergency screening level of 30 kBq in Japan. The thyroid equivalent dose corresponding to the detection limit ranged from 0.17 to 46 mSv. From the maximum equivalent dose of 46 mSv, the effective dose was estimated as 1.8 mSv, lower than the annual effective dose limit of 20 mSv for radiation workers. At 2 d after exposure, the measured dose was below the annual effective dose limit of 1 mSv for the public, regardless of age, temperature, and shielding provision. The imaging plate system effectively monitors the 131I thyroid levels in emergency situations.
RESOLUTION, DEPTH OF FIELD, AND PHYSICIAN SATISFACTION DURING DIGITALLY ASSISTED VITREORETINAL SURGERY
Authors: Freeman William R. , Chen Kevin C. , Ho Joseph , Chao Daniel L. , Ferreyra Henry A. , Tripathi A. Burton , Nudleman Eric , Bartsch Dirk-Uwe 
Published: June 2018

Purpose:
To evaluate depth of field, lateral resolution, and image quality of a heads-up 3D visualization system for vitreoretinal surgery using physician survey and optical measurement outcomes.

Methods:
Depth of field and lateral resolution were compared between the standard ocular viewing system and the digital 3D system at ×5, ×13, and ×18 magnification by 6 retinal surgeons. Optical techniques were used as well as a survey of surgeon impression. Surgeon impression surveys were performed after 6 weeks of surgical use of the device.

Results:
Physician questionnaire survey scores for depth of field at high magnification were better for the digital 3D system and equivalent for all other categories. Measured lateral resolution was 36.7 mm and 16.6 mm at ×5 magnification (P < 0.001), 14.3 mm and 6.4 mm at ×13 magnification (P < 0.001), and 9.8 mm and 4.2 mm (P < 0.001) at ×18 magnification for the digital 3D and oculars, respectively. Measured depth of field was 4.00 mm and 6.78 mm at ×5 magnification (P = 0.027), 0.72 mm and 0.86 mm at ×13 (P = 0.311), and 0.28 mm and 0.40 mm at ×18 magnification (P = 0.235) for the oculars and digital 3D, respectively.

Conclusion:
Lateral resolution of the digital 3D system was half that of the ocular viewing system and there was some improvement in depth of field with the digital system. Surgeon impression suggested that the digital system was superior when evaluating depth of field at high magnification.
Prosthetic Foot Selection for Individuals with Lower-Limb Amputation: A Clinical Practice Guideline
Authors: Stevens Phillip M. , Rheinstein John , Wurdeman Shane R. 
Published: June 2018

ABSTRACT

Introduction
This guideline was developed to present current evidence and to provide associated clinical recommendations on prosthetic foot selection for individuals with lower-limb amputation.

Materials
NA

Methods
The guideline is based upon the best available evidence as it relates prosthetic foot selection during the provision of definitive lower-limb prostheses. Where possible, recommendations are drawn from Cochrane Review, meta-analysis, systematic and narrative literature reviews, and published evidence-based guidelines. Where this standard is unavailable, alternate academic literature has been used to support individual recommendations.

Results
Recommendation 1: For patients ambulating at a single speed who require greater stability during weight acceptance because of weak knee extensors or poor balance, a single-axis foot should be considered. Recommendation 2: Patients at elevated risks for overuse injury (i.e., osteoarthritis) to the sound-side lower limb and lower back are indicated for an energy-storage-and-return (ESAR) foot to reduce the magnitude of the cyclical vertical impacts experienced during weight acceptance. Recommendation 3: Neither patient age nor amputation etiology should be viewed as primary considerations in prosthetic foot type. Recommendation 4: Patients capable of variable speed and/or community ambulation are indicated for ESAR feet.

Conclusions
These clinical practice guidelines summarize the available evidence related to prosthetic foot selection for individuals with lower limb amputation. The noted clinical practice guidelines are meant to serve only as “guides.” They may not apply to all patients and clinical situations.
Comparative Evaluation of Foveal Avascular Zone on Two Optical Coherence Tomography Angiography Devices
Authors: Dave Prachi A. , Dansingani Kunal K. , Jabeen Ayesha , Jabeen Asiya , Hasnat Ali M. , Vupparaboina Kiran Kumar , Peguda Hari Kumar , Pappurru Rajeev Reddy , Agrawal Rupesh , Chhablani Jay 
Published: June 2018

SIGNIFICANCE
This study compares foveal avascular zone (FAZ) geometry in healthy eyes as imaged by two commercially available optical coherence tomography angiography (OCTA) devices. Foveal avascular zone measurements are repeatable and reproducible with each OCTA device, but interdevice agreement was poor. We provide conversion factors between devices.

PURPOSE
The purpose of this study was to perform comparative evaluation of FAZ geometry in healthy eyes as imaged by two commercially available OCTA devices.

METHODS
Ninety-six eyes of 48 healthy subjects were imaged prospectively on each of two OCTA devices (DRI-OCT [Topcon Corporation, Tokyo, Japan]; Cirrus 5000 [Carl Zeiss Meditec Inc., Dublin, CA]). The FAZ was evaluated in the superficial capillary plexus layer of 6 × 6-mm foveal scans by two masked observers. Intraobserver and interobserver agreement was determined using intraclass correlation by using linear mixed models and Bland-Altman plots. K-means clustering was used to provide conversion values between two devices. Foveal avascular zone acircularity was calculated using scans from each device and compared.

RESULTS
The intraobserver repeatability for DRI-OCT was 0.95 (95% confidence interval [CI], 0.90 to 0.98) for observer A and 0.92 (95% CI, 0.83 to 0.96) for observer B. Intraobserver repeatability for Cirrus 5000 was 0.988 (95% CI, 0.972 to 0.995) for observer A and 0.993 (95% CI, 0.983 to 0.997) for observer B. The interobserver variability between observers A and B for DRI-OCT was 0.87 (0.73 to 0.94) and for Cirrus 5000 was 0.984 (95% CI, 0.964 to 0.993). Poor interdevice agreement (0.205 [95% CI, −0.202 to 0.554]) was noted, and conversion formulas were devised to convert FAZ area measurements from one device to another. No significant correlation was found when comparing FAZ acircularity indices between devices (P = .39).

CONCLUSIONS
Repeatable and reproducible FAZ area measurements were obtained with each respective OCTA device, but interdevice agreement was poor, yet quantifiable and systematic with calculable conversion factors between devices.
Monocular Ghost Image Offset Thresholds: Dependent on Target Size and Ghost Image Relative Brightness
Authors: Webster Anna B. , Lyon Georgia M. , Blowers Kathryn A. , Roth Gillian N. , Deacon Jacinta A. , Baan Cassandra L. , Carkeet Andrew 
Published: June 2018

SIGNIFICANCE
This is the first report of monocular ghost image offset thresholds measured using O optotypes. Monocular diplopia is a complaint of patients and is the result of a variety of etiologies. Furthermore, monocular image doubling also can be a confounding variable of vectographic stereoacuity tests, warranting an investigation of ghost image offset thresholds.

PURPOSE
To measure ghost image offset thresholds of normal observers and how they are affected by offset orientation, target size, and ghost image relative luminance.

METHODS
Participants were five individuals without ocular abnormalities aged 21 to 32 years. Stimuli were viewed monocularly and consisted of Sloan “O” optotypes generated on a computer monitor with varying levels of image doubling. Ghost image offset thresholds were determined using a spatial 2-alternative forced-choice paradigm and probit analysis of the frequency of seeing data.

RESULTS
Under close-to-optimal conditions, monocular ghost image offset thresholds ranged between 14 and 22 arc seconds, a level that might be considered a hyperacuity. Ghost image offset detection thresholds demonstrated a U-shaped relationship with optotype size, with optimum thresholds occurring for optotypes sizes of approximately −0.15 logarithmic minimum angle of resolution. There was no measurable effect of offset orientation on ghost image offset detection thresholds. Monocular ghost image offset detection thresholds decreased as ghost image relative luminance increased.

CONCLUSIONS
Ghost image offset detection thresholds can be quite low even when viewing under monocular conditions and relatively low ghost image relative luminance. This should be considered when designing and interpreting the results of vectographic stereoacuity tests.
Do Adolescents with Gynecomastia Require Routine Evaluation by Endocrinology?
Authors: Malhotra Armaan K. , Amed Shazhan , Bucevska Marija , Bush Kevin L. , Arneja Jugpal S. 
Published: June 2018

Background:
Primary evidence for the role of endocrinologic investigations in patients with adolescent gynecomastia is lacking in the current literature. The objective of this study was to assess the yield of endocrinologic investigations in the evaluation of adolescent gynecomastia to inform current practice for this common condition.

Methods:
A 26-year retrospective review was conducted. Data collection included patients with gynecomastia presenting to endocrinology at a quaternary children's hospital with a catchment area of 1 million. Clinical metrics, endocrinologic results, treatments, and costs were reviewed.

Results:
One hundred ninety-seven patients met inclusion criteria. Ninety-eight (50 percent) were overweight or obese and 29 (15 percent) had a positive family history. The median age at onset was 11.5 years; 25 cases (13 percent) were prepubertal. A total of 15 patients (7.6 percent) were diagnosed with secondary gynecomastia (10 related to exogenous substance use). Endocrine investigations were performed in 173 patients (87 percent), with positive findings in three cases (1.7 percent). One hundred one patients were observed, with a median age at resolution of 14.6 years; 86 patients underwent surgery at a median age of 16.5 years. The case-cost of endocrine evaluation was $389.

Conclusions:
Endocrinologic workup identified secondary gynecomastia in 7.6 percent of patients, of which only 1.7 percent were evident on blood work. This workup is associated with an avoidable case-cost burden to the health care system and largely unnecessary testing for the child. Because a majority of secondary gynecomastia cases (67 percent) were drug-induced, we do not suggest routine endocrinology workup, as it adds little value. The authors’ data suggest that referral for surgery is warranted if gynecomastia persists beyond 16 years of age.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Diagnostic, IV.
Personal Safety of the Plastic Surgeon: Keeping Yourself Healthy While You Work
Authors: Nagarkar Purushottam 
Published: June 2018

Learning Objectives:
After reading this study, the participant should be able to: 1. Recognize the primary physical and mental risks faced by the practicing plastic surgeon. 2. State the primary risk factors for cervical spine disease and back pain. 3. State the critical steps for protection from ionizing and nonionizing radiation. 4. List the characteristics of a surgeon exhibiting signs of burnout. 5. Develop a plan for mitigating personal risk of musculoskeletal, exposure, and other injuries.

Summary:
Health care workers are exposed to significant occupational hazards, and have a risk of injury similar to that of construction, mining, and manufacturing employees. Plastic surgeons must have a clear understanding of the types of risks they face and the techniques for mitigating them. Exposure to some risks is attributable to unavoidable occupational conditions, but others can be avoided completely. The sources of injury risk from musculoskeletal, exposure, and other causes are discussed in this article, and evidence-based recommendations to ameliorate these risks are presented.
Treatment of Paradoxical Adipose Hyperplasia following Cryolipolysis: A Single-Center Experience
Authors: Kelly Michael E. , Rodríguez-Feliz Jose , Torres Carolina , Kelly Emma 
Published: June 2018

Summary:
Paradoxical adipose hyperplasia is a rare adverse event associated with cryolipolysis. No evidence of spontaneous resolution has been described and little has been written about its treatment. The purpose of this report is to share the authors’ experience treating patients with paradoxical adipose hyperplasia after cryolipolysis. A retrospective chart review was performed for all paradoxical adipose hyperplasia patients seen in the authors’ practice between May of 2013 and May of 2016. The treatment parameters, demographics, onset of findings, and subsequent treatment were chronicled. Eleven cases of paradoxical adipose hyperplasia were identified (eight men and three women). All patients were of Hispanic background. Seven patients were treated surgically (six cases of liposuction alone and one case of liposuction and abdominoplasty). Average follow-up was 9.6 months (range, 2 to 32 months). Three of the patients treated with liposuction required a secondary procedure. All surgically treated patients were very satisfied with their final appearance. Paradoxical adipose hyperplasia is a rare complication of cryolipolysis that may occur more frequently than in the manufacturer’s reported data. Treatment is best delayed until the affected area has softened, which normally occurs in 6 to 9 months after the initial cryolipolysis procedure. Power-assisted liposuction is the preferred method of treatment, but in some cases, abdominoplasty may be necessary. Secondary treatments might be needed for recurrence or persistent bulge. One must be sensitive to heightened patient concerns when offering an invasive procedure to correct the complications from a noninvasive one.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Longitudinal Follow-up of Patients With Tracheobronchomalacia After Undergoing Tracheobronchoplasty
Authors: Bezuidenhout Abraham F. , Boiselle Phillip M. , Heidinger Benedikt H. , Alape Daniel , Buitrago Daniel H. , Majid Adnan , Gangadharan Sidhu P. , Litmanovich Diana E. 
Published: June 2018

Purpose:
The purpose of this study was to evaluate intermediate and long-term changes in expiratory tracheal collapsibility by computed tomography (CT) in patients with tracheobronchomalacia following surgical treatment with tracheobronchoplasty and to correlate CT findings with clinical findings.

Materials and Methods:
Between 2003 and 2016, 18 patients with tracheobronchomalacia underwent tracheobronchoplasty and were imaged preoperatively and postoperatively at both intermediate and long-term intervals. Imaging included end-inspiratory and dynamic expiratory phase scans. The cross-sectional area of the airway lumen was measured at 2 standard levels (1 cm above the aortic arch and carina). These measurements were used to calculate % collapsibility. Clinical findings recorded included a questionnaire on symptomatology and a 6-minute walk test.

Results:
Before surgery, expiratory collapsibility of the upper trachea was 72%±25% (mean±SD) and that of the lower trachea was 68%±22%. On intermediate follow-up (mean, 1.5 y), collapsibility significantly decreased to 37%±21% at the upper trachea and 35%±19% at the lower trachea (P<0.001). On long-term follow-up (mean, 6 y), collapsibility increased to 51%±20% at the upper trachea and 47%±17% at the lower trachea and was significantly worse than on intermediate follow-up (P=0.002). However, collapsibility on long-term follow-up remained significantly lower than preoperative collapsibility (P=0.015). Clinical findings showed a similar trend as quantitative CT measurements.

Conclusion:
Expiratory tracheal collapsibility substantially decreases after tracheobronchoplasty on intermediate follow-up. At long-term follow-up, tracheal collapsibility shows a modest increase, but remains significantly lower than the preoperative baseline. Quantitative measurements from dynamic CT have the potential to play an important role as imaging biomarkers for assessing response to tracheobronchoplasty.
A Comparison of Outcomes of Trauma Patients With Ventilator-Associated Events by Diagnostic Criteria Set
Authors: Younan Duraid , Griffin Russell , Zaky Ahmed , Pittet Jean-Francois , Camins Bernard 
Published: June 2018

ABSTRACT

Background:
The Centers for Disease Control and Prevention replaced the definition for ventilator-associated pneumonia with an algorithm comprised of three categories: ventilator-associated condition (VAC), infection-related ventilator associated complication (IVAC), and possible ventilator-associated pneumonia (PVAP). We sought to compare the outcome of trauma patients with VAEs to those with no VAEs.

Methods:
Patients admitted from 2013 to 2017 were identified from trauma registry. Logistic regression was performed for the association between VAEs and mortality.

Results:
Two thousand six hundred eighty patients were admitted to our trauma center, 2,290 had no VAE, 100 had VACs, 85 had IVACs, and 205 had PVAPs. Adjusted for race, sex, blunt injury mechanisms, and Injury Severity Score, all VAEs had a longer hospital length of stay, intensive care unit stay, and days of ventilator support when compared with those with no VAE (all P < 0.0001). Nosocomial complication rates were not different by VAE group. Compared with patients with no VAE, an over 2-fold increased mortality odds was observed for VAC (OR 2.39, 95% CI 1.50–3.80) and IVAC patients (OR 2.07, 95% CI 1.23–3.47), and a 50% mortality increased was observed for PVAP patients (OR 1.46, 95% CI 1.00–2.12). These associations became similar with an approximate 2.5-fold increased mortality odds among patients with at least 1 week on ventilator support.

Conclusion:
VAEs increase the odds of mortality, particularly for patients with VACs and IVACs. Among patients on ventilator support for at least a week, the associations are similar among VAE types, suggesting no single VAE type is more severe than others.
Classification of mouse ultrasonic vocalizations using deep learning
Authors: Ivanenko A. , Watkins P. , van Gerven M. A. J. , Hammerschmidt K. , Englitz B. 
Published: June 2018

AbstractVocalizations are a widespread means of communication in the animal kingdom. Mice use a large repertoire of ultrasonic vocalizations (USVs) in different social contexts, for instance courtship, territorial dispute, dominance and mother-pup interaction. Previous studies have pointed to differences in the USVs in different context, sexes, strains and individuals, however, in many cases the outcomes of the analyses remained inconclusive.We here provide a more general approach to automatically classify USVs using deep neural networks (DNN). We classified the sex of the emitting mouse (C57Bl/6) based on the vocalization’s spectrogram, reaching unprecedented performance (~84% correct) in comparison with other techniques (Support Vector Machines: 64%, Ridge regression: 52%). Vocalization characteristics of individual mice only contribute mildly, and sex-only classification reaches ~78%. The performance can only partially be explained by a set of classical shape features, with duration, volume and bandwidth being the most useful predictors. Splitting estimation into two DNNs, from spectrograms to features (57-82%) and features to sex (67%) does not reach the single-step performance.In summary, the emitter’s sex can be successfully predicted from their spectrograms using DNNs, excelling over other classification techniques. In contrast to previous research, this suggests that male and female vocalizations differ in their spectrotemporal structure, recognizable even in single vocalizations.
KRASG12D and TP53R167H Cooperate to Induce Pancreatic Ductal Adenocarcinoma in Sus Scrofa Pigs
Authors: Principe Daniel R. , Overgaard Nana Haahr , Park Alex J. , Diaz Andrew M. , Torres Carolina , McKinney Ronald , Dorman Matthew J. , Castellanos Karla , Schwind Regina , Dawson David W. , Rana Ajay , Maker Ajay , Munshi Hidayatullah G. , Rund Laurie A. , Grippo Paul J. , Schook Lawrence B. 
Published: June 2018

AbstractAlthough survival has improved in recent years, the prognosis of patients with advanced pancreatic ductal adenocarcinoma (PDAC) remains poor. Despite substantial differences in anatomy, physiology, genetics, and metabolism, the overwhelming majority of preclinical testing relies on transgenic mice. Hence, while mice have allowed for tremendous advances in cancer biology, they have been a poor predictor of drug performance/toxicity in the clinic. Given the greater similarity of sus scrofa pigs to humans, we engineered transgenic sus scrofa expressing a LSL-KRASG12D-TP53R167H cassette. By applying Adeno-Cre to pancreatic duct cells in vitro, cells self-immortalized and established tumors in immunocompromised mice. When Adeno-Cre was administered to the main pancreaticduct in vivo, pigs developed extensive PDAC at the injection site hallmarked by excessive proliferation and desmoplastic stroma. This serves as the first large animal model of pancreatic carcinogenesis, and may allow for insight into new avenues of translational research not before possible in rodents.