bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Reconstruction After Maxillectomy Defects Using Ultra Flex Mesh Plate and Rectus Abdominis Myocutaneous Free Flap Including Aponeurosis of External Abdominal Oblique Muscle
Authors: Ogino Akihiro , Onishi Kiyoshi , Nakamichi Miho 
Published: November 2018

Background:
In primary reconstruction after maxillectomy for cancer, simple and less invasive surgical techniques considering functionality and aesthetics are necessary. The authors performed reconstruction for tissue defects after maxillectomy using an Ultra flex mesh plate and a free rectus abdominis myocutaneous flap including the aponeurosis of the external abdominal oblique muscle.

Method:
A 72-year-old male with a maxillary squamous cell carcinoma underwent subtotal maxillectomy. For maxillary defects, including those in the orbital floor and hard palate, the authors performed rigid reconstruction using an Ultra flex mesh plate produced after simulation surgery using a 3-dimensional solid model, and palatal and soft tissue reconstruction using a free rectus abdominis myocutaneous flap including the aponeurosis of the external abdominal oblique muscle. After screw fixation of the mesh plate at the surrounding normal bone, the skinpaddle of the rectus abdominis flap was transferred to the oral defect. The surface of the mesh plate was completely covered with the aponeurosis of the external abdominal oblique muscle, and the remaining rectus abdominis flap was inserted into the maxillary sinus.

Results:
At present, 1 year after the operation, there is no recurrence, complications, such as infection, or titanium mesh breakage/exposure, and his facial shape is favorably maintained.

Conclusion:
Reconstruction using this method is simple and less invasive. Postoperative infection and plate exposure were prevented by the complete coverage of the mesh plate with the aponeurosis of the external abdominal oblique muscle and flap. Mesh plates, when properly used, are useful reconstruction materials, but are susceptible to infection compared with autologous tissue, requiring long-term follow-up.
Evaluation of Temporomandibular Joint Movement After Mandibular Reconstruction
Authors: Shiozaki Masataka , Terao Yasunobu , Taniguchi Koichiro 
Published: November 2018

Abstract
Mandibular head dislocation and problems with mouth opening may develop after mandibular reconstruction. The authors investigated dislocation of the mandibular head and amount of protrusive sliding (excursion) and their effect on mouth opening. The authors divided 55 mandibular reconstruction patients into 3 groups on the basis of the extent of masticatory muscle and mandibular resection and investigated mandibular head dislocation. On the other hand, the authors focused on mandibular head protrusive excursion as a function of a reconstructed mandible. Protrusive excursion was measured by plain radiography in 29 patients. The extent of mouth opening was measured between the central incisors. Fluoroscopy was performed in 9 patients and the motions of the mandible were analyzed with video-analysis software. Mandibular head dislocation was observed in 15 patients (27.2%) who underwent resection of the mandibular ramus and coronoid process. The extent of mouth opening did not vary significantly among the 3 groups but was lower than that in healthy persons. Mandibular excursion was restricted in patients with conserved temporalis and lateral pterygoid muscles. Protrusive excursion was correlated with the extent of mouth opening. Structural problems involving dislocation of the mandibular head are caused by severing the coronoid process and protrusive excursion disorders are important factors causing mouth opening problems. Physiological sliding and other motions were observed in reconstructed models. The authors believe that when the ramus is resected, there is a greater chance of articular head dislocation. These findings suggest that dislocation of the mandibular head and protrusive excursion disorders arise from imbalances of the remaining masticatory muscles.
Assessment of Simultaneous Surgery for Odontogenic Sinusitis: Endoscopic Sinus Surgery With Endoscopic Apicoectomy
Authors: Akiyama Kosuke , Nakai Yasuhiro , Samukawa Yasushi , Miyake Minoru , Hoshikawa Hiroshi 
Published: November 2018

Abstract
Odontogenic sinusitis (OS) is a disease commonly encountered by otolaryngologists and oral surgeons. There is currently no standard consensus for the management of the causative teeth of OS, and the therapeutic outcomes of endodontic surgery remain unclear. The authors herein report the outcomes of simultaneous surgery for OS, endoscopic sinus surgery (ESS) with endoscopic apicoectomy. Twenty-one OS patients who underwent ESS were included in the intent-to-treat population. Eleven patients who simultaneously underwent endoscopic apicoectomy were included as the study group, and another 10 patients who were subjected to the extraction of the causative teeth preceding or during surgery were included as the control group. The postoperative tooth course after surgery in the study group was assessed as the primary outcome by periodic radiographs. The postoperative sinus course was compared between the 2 groups as the secondary outcome. Seventeen teeth were subjected to endoscopic apicoectomy concurrently with ESS, and the treatment success rate for periapical lesions was 94.1% (16 out of 17 teeth), which was consistent with previously reported outcomes for endodontic microsurgery. Ten of 11 patients (90.9%) had good postoperative sinus courses, and the mean wound-healing period of the sinus mucosa was 6.9 ± 3.5 weeks. These results were not significantly different from those obtained for the control group (90% and 6.1 ± 3.2 weeks). This surgical procedure may contribute to the preservation of causative teeth without having an impact on the successful treatment of sinusitis. A comprehensive surgical approach by otolaryngologists and oral surgeons is desirable for the treatment of OS.
Guidelines for a system-wide multidisciplinary approach to institutional resuscitative endovascular balloon occlusion of the aorta implementation
Authors: Zakaluzny Scott A. , Beldowicz Brian C. , Salcedo Edgardo S. , DuBose Joseph J. , Moore Laura J. , Brenner Megan 
Published: November 2018

ABSTRACT
Resuscitative endovascular occlusion of the aorta (REBOA) is a rapidly evolving technology which requires careful system-wide multidisciplinary implementation for optimal success. These guidelines developed by experienced REBOA practitioners provide a framework for a key practitioner to use in the development of a REBOA program in their institution. They detail the importance of involving doctors, nurses, and staff across departments and disciplines in the application of this technique.
Emergency general surgery in geriatric patients: How should we evaluate hospital experience?
Authors: Mehta Ambar , Varma Sanskriti , Efron David T. , Joseph Bellal A. , Lunardi Nicole , Haut Elliott R. , Cooper Zara , Sakran Joseph V. 
Published: November 2018

INTRODUCTION
As the aging American population poses unique challenges to acute care services, we determined if either hospital proportion or annual volume of geriatric patients undergoing emergency general surgery (EGS) procedures is associated with outcomes.

METHODS
Using criteria from the American Association of the Surgery of Trauma, we identified five EGS procedures in the 2012–2015 Nationwide Inpatient Sample common in geriatric patients (65+ years). We defined hospital proportion as the fraction of geriatric EGS patients divided by all EGS patients, where volume was the raw number of geriatric EGS patients. We then divided hospitals into quartiles both by proportion and then by volume of geriatric patients. Multivariable logistic regressions compared four outcomes between these quartiles: mortality, complications, failure to rescue (FTR; death after a complication), and extended length of stay (LOS; procedure-specific top decile of patients).

RESULTS
We identified 25,084 complex EGS procedures in geriatric patients at 3,528 hospitals (mortality, 10.6%; complications, 30.5%; FTR, 27.7%; extended LOS, 9.1%). The median hospital proportion of geriatric patients among EGS procedures was 42.8% (interquartile range, 33.3–52.2%), whereas the median hospital geriatric EGS volume after nationwide weighting was 40 per year (interquartile range, 20–70/year). After adjustment, the lowest hospital proportion quartile relative to the highest was associated with adverse outcomes: mortality (odds ratio, 1.21 [95% confidence interval, 1.03–1.44]), complications (1.16 [1.05–1.29]), FTR (1.32 [1.08–1.63]), and extended LOS (1.30 [1.12–1.50]). The lowest volume quartile relative to the highest was not associated with adverse outcomes. As the hospital proportion of geriatric patients increased by 10%, the odds of all adverse outcomes decreased: mortality by 7%, complications by 4%, FTR by 9%, and extended LOS by 8%.

CONCLUSION
When accounting for both, hospital proportion of geriatric EGS patients but not hospital volume is associated with postoperative outcomes, having important implications for quality improvement initiatives, benchmarking endeavors, and health services research.

LEVEL OF EVIDENCE
Care management, level IV; prognostic, level III.
mTOR Inhibitor Everolimus in Regulatory T Cell Expansion for Clinical Application in Transplantation
Authors: Gedaly Roberto , De Stefano Felice , Turcios Lilia , Hill Marita , Hidalgo Giovanna , Mitov Mihail I. , Alstott Michael C. , Butterfield D. Allan , Mitchell Hunter C. , Hart Jeremy , Al-Attar Ahmad , Jennings Chester D. , Marti Francesc 
Published: November 2018

Background.Experimental and preclinical evidence suggest that adoptive transfer of regulatory T (Treg) cells could be an appropriate therapeutic strategy to induce tolerance and improve graft survival in transplanted patients. The University of Kentucky Transplant Service Line is developing a novel phase I/II clinical trial with ex vivo expanded autologous Treg cells as an adoptive cellular therapy in renal transplant recipients who are using everolimus (EVR)-based immunosuppressive regimen.Methods.The aim of this study was to determine the mechanisms of action and efficacy of EVR for the development of functionally competent Treg cell-based adoptive immunotherapy in transplantation to integrate a common EVR-based regimen in vivo (in the patient) and ex vivo (in the expansion of autologous Treg cells). CD25+Treg cells were selected from leukapheresis product with a GMP-compliant cell separation system and placed in 5-day (short) or 21-day (long) culture with EVR or rapamycin (RAPA). Multi-parametric flow cytometry analyses were used to monitor the expansion rates, phenotype, autophagic flux, and suppressor function of the cells. phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin signaling pathway profiles of treated cells were analyzed by Western blot and cell bioenergetic parameters by extracellular flux analysis.Results.EVR-treated cells showed temporary slower growth, lower metabolic rates, and reduced phosphorylation of protein kinase B compared with RAPA-treated cells. In spite of these differences, the expansion rates, phenotype, and suppressor function of long-term Treg cells in culture with EVR were similar to those with RAPA.Conclusions.Our results support the feasibility of EVR to expand functionally competent Treg cells for their clinical use.
Deceased Brain Dead Donor Liver Transplantation and Utilization in the United States: Nighttime and Weekend Effects
Authors: Carpenter Dustin J. , Chiles Mariana C. , Verna Elizabeth C. , Halazun Karim J. , Emond Jean C. , Ratner Lloyd E. , Mohan Sumit 
Published: November 2018

Background.
Understanding factors that contribute to liver discards and nonusage is urgently needed to improve organ utilization.

Methods.
Using Scientific Registry of Transplant Recipient data, we studied a national cohort of all US adult, deceased brain dead donor, isolated livers available for transplantation from 2003 to 2016, including organ-specific and system-wide factors that may affect organ procurement and discard rates.

Results.
Of 73 686 available livers, 65 316 (88.64%) were recovered for transplant, of which 6454 (9.88%) were ultimately discarded. Livers that were not procured or, on recovery, discarded were more frequently from older, heavier, hepatitis B virus (HCV)+, and more comorbid donors (P < 0.001). However, even after adjustment for organ quality, the odds of liver nonusage were 11% higher on the weekend (defined as donor procurements with cross-clamping occurring from 5:00 pm Friday until 11:59 am Sunday) compared with weekdays (P < 0.001). Nonuse rates were also higher at night (P < 0.001), defined as donor procurements with cross-clamping occurring from 5:00 pm to 5:00 am; however, weekend nights had significantly higher nonuse rates compared with weekday nights (P = 0.005). After Share 35, weekend nonusage rates decreased from 21.77% to 19.51% but were still higher than weekday nonusage rates (P = 0.065). Weekend liver nonusage was higher in all 11 United Network of Organ Sharing regions, with an absolute average of 2.00% fewer available livers being used on the weekend compared with weekdays.

Conclusions.
Although unused livers frequently have unfavorable donor characteristics, there are also systemic and operational factors, including time of day and day of the week a liver becomes available, that impact the chance of liver nonprocurement and discard.
Utilizing comprehensive and mini-kinome panels to optimize the selectivity of quinoline inhibitors for cyclin G associated kinase (GAK)
Authors: Asquith Christopher R. M. , Hopkins Caleb , Treiber Daniel K. , Zuercher William J. 
Published: November 2018

AbstractWe demonstrate an innovative approach utilising both fit-for-purpose kinase mini-panels and kinome-wide panels to progress discovery programs in the optimization of inhibitor potency and selectivity. We present a focused case study on development of a selective inhibitor of cyclin G associated kinase (GAK) using the quin(az)oline inhibitor chemotype. These results exemplify a versatile, efficient approach to drive kinome selectivity during inhibitor development programs.
Altered cortical brain structure and increased risk for disease seen decades after perinatal exposure to maternal smoking: A study of 9,000 adults in the UK Biobank
Authors: Salminen Lauren E. , Wilcox Rand R. , Zhu Alyssa H. , Riedel Brandalyn C. , Ching Christopher R. K. , Rashid Faisal , Thomopoulos Sophia I. , Saremi Arvin , Harrison Marc B. , Ragothaman Anjanibhargavi , Knight Victoria , Boyle Christina P. , Medland Sarah E. , Thompson Paul M. , Jahanshad Neda 
Published: November 2018

AbstractSecondhand smoke exposure is a major public health risk that is especially harmful to the developing brain, but it is unclear if early exposure affects brain structure during middle age and older adulthood. Here we analyzed brain MRI data from the UK Biobank in a population-based sample of individuals (ages 44-80) who were exposed (n=2,510) or unexposed (n=6,079) to smoking around birth. We used robust statistical models, including quantile regressions, to test the effect of perinatal smoke exposure (PSE) on cortical surface area (SA), thickness, and subcortical volume. We hypothesized that PSE would be associated with cortical disruption in primary sensory areas compared to unexposed (PSE-) adults. After adjusting for multiple comparisons, SA was significantly lower in the pericalcarine (PCAL), inferior parietal (IPL), and regions of the temporal and frontal cortex of PSE+adults; these abnormalities were associated with increased risk for several diseases, including circulatory and endocrine conditions. Sensitivity analyses conducted in a hold-out group of healthy participants (exposed, n=109, unexposed, n=315) replicated the effect of PSE on SA in the PCAL and IPL. Collectively our results show a negative, long term effect of PSE on sensory cortices that may increase risk for disease later in life.
Plant Extracellular Vesicles Contain Diverse Small RNA Species and Are Enriched in 10 to 17 Nucleotide “Tiny” RNAs
Authors: Baldrich Patricia , Rutter Brian D. , Zandkarimi Hana , Podicheti Ram , Meyers Blake C. , Innes Roger W. 
Published: November 2018

ABSTRACTSmall RNAs (sRNAs) that are 21 to 24 nucleotides (nt) in length are found in most eukaryotic organisms and regulate numerous biological functions, including transposon silencing, development, reproduction, and stress responses, typically via control of the stability and/or translation of target mRNAs. Major classes of sRNAs in plants include microRNAs (miRNAs) and small interfering RNAs (siRNAs); sRNAs are known to travel as a silencing signal from cell to cell, root to shoot, and even between host and pathogen. In mammals, sRNAs are transported inside extracellular vesicles (EVs), which are mobile lipid compartments that participate in intercellular communication. In addition to sRNAs, EVs carry proteins, lipids, metabolites, and potentially other types of nucleic acids. Here we report that plant EVs also contain diverse species of sRNA. We found that specific miRNAs and siRNAs are preferentially loaded into plant EVs. We also report a previously overlooked class of “tiny RNAs” (10 to 17 nt) that are highly enriched in EVs. This new RNA category of unknown function has a broad and very diverse genome origin and might correspond to degradation products.
Plant functional groups mediate drought resistance and recovery in a multisite grassland experiment
Authors: Mackie Kathleen A. , Zeiter Michaela , Bloor Juliette M. G. , Stampfli Andreas 
Published: November 2018

Abstract

Climate change predictions suggest that summer droughts will become more intense and recurrent in Europe. While drought‐induced reductions in grassland primary productivity are well documented, the drivers behind drought resistance (the capacity to withstand change) and recovery (the capacity for recovery of function) of above‐ and below‐ground biomass remain poorly understood.

Across eight grasslands differing in plant community productivity (CP), we investigated the effects of summer drought on plant and soil microbial variables, plant nutrient content, and soil nitrogen (N) availability. We examined the linkages between CP, soil N, drought responses of plant and microbial communities, and relative drought responses of plant and microbial biomass. Plant and microbial variables were recorded at the end of a 3‐month rainfall exclusion period. Plant variables were also assessed during a 10‐month drought recovery period.

Experimental drought decreased plant biomass and increased plant C:N ratios, but had no effect on total microbial biomass across sites. Instead, drought caused shifts in plant and microbial community structures as well as an increase in arbuscular mycorrhiza fungi biomass. Overall, plant biomass drought resistance was unrelated to CP or microbial community structure but was positively related to drought resistance of forbs.

In the month after rewetting, soil N availability increased in droughted plots across sites. Two months post‐rewetting, droughted plots had higher plant N concentration, but lower plant N use efficiency. The short‐term drought recovery of plant biomass was unrelated to CP or soil N availability, but positively related to the response of grass biomass, reflecting incomplete recovery at high CP. Ten months after rewetting, drought effects on plant biomass and plant N content were no longer apparent.

Synthesis. Our results suggest that drought resistance and recovery are more sensitive to plant community composition than to community productivity. Short‐term recovery of plant biomass may also benefit from increased soil N availability after drought and from a high abundance of soil fungi in low productivity sites. Our findings underline the importance of plant functional groups for the stability of permanent grasslands in a changing climate with more frequent drought.
Grazer movements exacerbate grass declines during drought in an African savanna
Authors: Staver A. Carla , Wigley‐Coetsee Corli , Botha Judith 
Published: November 2018

Abstract

Rainfall variability, including drought, consistently translates into variation in grass productivity in savanna ecosystems. These variations in grass availability can impact grazer populations, which can in turn shape grass responses to drought.

However, despite clear evidence that grazers move freely in response to forage and water availability, drought ecologists have mostly failed to consider how these landscape‐scale processes influence vegetation responses to drought.

Here, we ask how rainfall variability and drought, in interaction with population dynamics and movement of large grazers, shape grass layer responses in extant savanna landscapes in Kruger National Park in South Africa.

We found that grass biomass was highly responsive to rainfall variability; notably, grass declines during drought were especially severe—even more severe than previously documented elsewhere.

Grazing probably contributed, exacerbating drought effects in droughted regions and spatially extending them into non‐droughted refugia, where grass biomass also declined. Moreover, the existence of these refugia potentially prevented a grazer population crash.

Synthesis. Our current focus on the physiological effects of drought is probably insufficient for understanding vegetation responses to drought. A renewed focus on landscape processes, including animal movement, will be critical to predicting savanna responses to increasingly frequent extreme events.
Omission of Final ‐S In Latin Inscriptions: Time and Space
Authors: Marotta Giovanna , Tamponi Lucia 
Published: November 2018

AbstractThe paper focuses on the omission of final‐sin Latin inscriptions found in the corpus CLaSSES (Corpus for Latin Sociolinguistic Studies on Epigraphic textS,http://classes-latin-linguistics.fileli.unipi.it) from 350bctill 50ad.The distribution of final‐shas been examined in the endings of the second declension with respect to several variables, such as the dating and the place of provenance of the inscription.The results show that the restoration of the grapheme spread from Rome starting from the mid‐third centurybc, when the city was the political and economic centre of the conquered territories. Therefore, the Latin of Rome was perceived as prestigious by Roman citizens. The process of‐srestoration was completed by the mid‐first centurybcand appears to be strictly related with the raising o > u in final syllable.Therefore, the omissions of final‐sfound in inscriptions outside Rome in the second and first centurybccan be considered to be residuals of the ancient pronunciation in areas not yet completely reached by the innovation, whereas in Rome they can be considered as forms of a low sociolinguistic level.