bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long bone human anlage longitudinal and circumferential growth in the fetal period and comparison with the growth plate cartilage of the postnatal age
Authors: Pazzaglia Ugo E. , Reguzzoni Marcella , Casati Lavinia , Minini Andrea , Salvi Andrea G. , Sibilia Valeria 
Published: December 2018

AbstractThe patterns of longitudinal and peripheral growth were analyzed in human autopod cartilage anlagen (fetal developmental stage 20th–22nd week) through morphometric assessment of chondrocyte parameter size, shape, alignment and orientation between peripheral and central sectors of the anlage transition zone defined by primary ossification center and the epiphyseal basis. The aim was to correlate the chondrocyte dynamics with the longitudinal and peripheral growth. A further comparison was carried out between the corresponding sectors of the postnatal (3–5 months old) growth plate cartilage documenting: (1) the different chondrocyte framework and the new peripheral mechanism; (2) the opposite direction of fetal periosteal ossification versus the Lacroix bone bark. Measurement of multiple parameters (% lac area, % total matrix area, total lac density and mean single lac area), which characterize the cartilage Anlage growth, suggested the following correlations with chondrocyte duplication rate: (a) slow duplication rate ≈ coupled, intralacunar chondrocytes (in central epiphysis); (b) repeated/frequent cell duplications ≈ clusters (in the basal epiphyseal layer); (c) clusters of chondrocytes before becoming hypertrophic were stacked up on the top of each other (both in the Anlage transition zone or in the columns of metaphyseal growth plate); (d) enhanced osteoclastic resorption of the Lacroix bone bark lower end, extended to the more external metaphyseal trabeculae counterbalancing the discrepancy between the epiphyseal and the diaphyseal circumferential growth.
Usefulness of synchrotron radiation for three‐dimensional microstructure analysis of the mouse tibia
Authors: Kim Subok , Jang Sanghun , Lee Onseok 
Published: December 2018

AbstractThis study was to construct a quantitative analysis for the diagnosis and evaluation of osteoporosis by using synchrotron radiation based X‐ray, which can analyze the three‐dimensional microstructure of white mouse tibia. The anatomical structure and microstructure of the white mouse tibia was obtained through synchrotron radiation, and to achieve this, three‐dimensional structural analysis was performed. Then, we visualized the quantified analysis and microstructure information with high‐resolution imagery through the image data obtained by synchrotron radiation. In addition, it was confirmed that synchrotron radiation can obtain more reliable results through accurate observation than analysis by the mechanical method. The present invention can provide the diagnosis and evaluation associated with osteoporosis. It is expected that this will provide a basis for the evaluation and prevention of evidence‐based skeletal diseases.
Attaining landmark status: Rumelhart and McClelland's PDP Volumes and the Connectionist Paradigm
Authors: Gibbons Michelle 
Published: December 2018

AbstractIn 1986, David Rumelhart and James McClelland published their two‐volume work, Parallel distributed processing: Explorations in microcognition, Volume 1: Foundations and Volume 2: Psychological and biological models. These volumes soon become classic texts in both connectionism, specifically, and in the cognitive science field more generally. Drawing on oral histories, book reviews, translations, citation records, and close textual analysis, this paper analyzes how and why they attained landmark status. It argues that McClelland and Rumelhart's volumes became classics largely as a result of a confluence of rhetorical factors. Specifically, the PDP Volumes appeared at a kairotic moment in the history of connectionism, publishing dynamics that facilitated their circulation played an important role, and the volumes were ambiguous about the relationship between model and brain in a manner that enabled them to address an expansive audience. In so doing, this paper offers insight into both the history of cognitive science and rhetoric's role in establishing classic texts.
Development of high‐resolution 3D MR fingerprinting for detection and characterization of epileptic lesions
Authors: Ma Dan , Jones Stephen E. , Deshmane Anagha , Sakaie Ken , Pierre Eric Y. , Larvie Mykol , McGivney Debra , Blümcke Ingmar , Krishnan Balu , Lowe Mark , Gulani Vikas , Najm Imad , Griswold Mark A. , Wang Z. Irene 
Published: December 2018

BackgroundConventional MRI can be limited in detecting subtle epileptic lesions or identifying active/epileptic lesions among widespread, multifocal lesions.PurposeWe developed a high‐resolution 3D MR fingerprinting (MRF) protocol to simultaneously provide quantitative T1, T2, proton density, and tissue fraction maps for detection and characterization of epileptic lesions.Study typeProspective.PopulationNational Institute of Standards and Technology (NIST) / International Society for Magnetic Resonance in Medicine (ISMRM) phantom, five healthy volunteers and 15 patients with medically intractable epilepsy undergoing presurgical evaluation with noninvasive or invasive electroclinical data.Field Strength/Sequence3D MRF scans and routine clinical epilepsy MR protocols were acquired at 3 T.AssessmentThe accuracy of the T1and T2values were first evaluated using the NIST/ISMRM phantom. The repeatability was then estimated with both phantom and volunteers based on the coefficient of variance (CV). For epilepsy patients, all the maps were qualitatively reviewed for lesion detection by three independent reviewers (S.E.J., M.L., I.N.) blinded to clinical data. Region of interest (ROI) analysis was performed on T1and T2maps to quantify the multiparametric signal differences between lesion and normal tissues. Findings from qualitative review and quantitative ROI analysis were compared with patients' electroclinical data to assess concordance.Statistical TestsPhantom results were compared using R‐squared, and patient results were compared using linear regression models.ResultsThe phantom study showed high accuracy with the standard values, with an R2of 0.99. The volunteer study showed high repeatability, with an average CV of 4.3% for T1and T2in various tissue regions. For the 15 patients, MRF showed additional findings in four patients, with the remaining 11 patients showing findings consistent with conventional MRI. The additional MRF findings were highly concordant with patients' electroclinical presentation.Data ConclusionThe 3D MRF protocol showed potential to identify otherwise inconspicuous epileptogenic lesions from the patients with negative conventional MRI diagnosis, as well as to correlate with different levels of epileptogenicity when widespread lesions were present.Level of Evidence:3.Technical Efficacy Stage:3.J. Magn. Reson. Imaging 2019;49:1333–1346.
Combined 5‐minute double‐echo in steady‐state with separated echoes and 2‐minute proton‐density‐weighted 2D FSE sequence for comprehensive whole‐joint knee MRI assessment
Authors: Chaudhari Akshay S. , Stevens Kathryn J. , Sveinsson Bragi , Wood Jeff P. , Beaulieu Christopher F. , Oei Edwin H.G. , Rosenberg Jarrett K. , Kogan Feliks , Alley Marcus T. , Gold Garry E. , Hargreaves Brian A. 
Published: December 2018

BackgroundClinical knee MRI protocols require upwards of 15 minutes of scan time.Purpose/HypothesisTo compare the imaging appearance of knee abnormalities depicted with a 5‐minute 3D double‐echo in steady‐state (DESS) sequence with separate echo images, with that of a routine clinical knee MRI protocol. A secondary goal was to compare the imaging appearance of knee abnormalities depicted with 5‐minute DESS paired with a 2‐minute coronal proton‐density fat‐saturated (PDFS) sequence.Study TypeProspective.SubjectsThirty‐six consecutive patients (19 male) referred for a routine knee MRI.Field Strength/SequencesDESS and PDFS at 3T.AssessmentFive musculoskeletal radiologists evaluated all images for the presence of internal knee derangement using DESS, DESS+PDFS, and the conventional imaging protocol, and their associated diagnostic confidence of the reading.Statistical TestsDifferences in positive and negative percent agreement (PPA and NPA, respectively) and 95% confidence intervals (CIs) for DESS and DESS+PDFS compared with the conventional protocol were calculated and tested using exact McNemar tests. The percentage of observations where DESS or DESS+PDFS had equivalent confidence ratings to DESS+Conv were tested with exact symmetry tests. Interreader agreement was calculated using Krippendorff's alpha.ResultsDESS had a PPA of 90% (88–92% CI) and NPA of 99% (99–99% CI). DESS+PDFS had increased PPA of 99% (95–99% CI) and NPA of 100% (99–100% CI) compared with DESS (both P < 0.001). DESS had equivalent diagnostic confidence to DESS+Conv in 94% of findings, whereas DESS+PDFS had equivalent diagnostic confidence in 99% of findings (both P < 0.001). All readers had moderate concordance for all three protocols (Krippendorff's alpha 47–48%).Data ConclusionBoth 1) 5‐minute 3D‐DESS with separated echoes and 2) 5‐minute 3D‐DESS paired with a 2‐minute coronal PDFS sequence depicted knee abnormalities similarly to a routine clinical knee MRI protocol, which may be a promising technique for abbreviated knee MRI.Level of Evidence: 2Technical Efficacy: Stage 2J. Magn. Reson. Imaging 2018.
Laterality of cerebellar afferent and efferent pathways in a healthy right‐handed population: A diffusion tensor imaging study
Authors: Kim Youngkook , Im Sun , Kim Se‐Hong , Park Geun‐Young 
Published: December 2018

AbstractThe cerebellum communicates with the cerebral cortex through the cortico‐ponto‐cerebellar tract (CPCT, cerebellar afferent) and the dentato‐rubro‐thalamo‐cortical tract (DRTCT, cerebellar efferent). This study explored the laterality of CPCT and DRTCT in a right‐handed population. Forty healthy right‐handed subjects (18 males and 22 females with age range of 26–79 years old) who underwent diffusion tensor imaging (DTI) were retrospectively enrolled. Bilateral CPCT, DRTCT, and the corticospinal tract (CST) were reconstructed using probabilistic diffusion tensor tractography (DTT). Tract volume (TV) and fractional anisotropy (FA) were compared between dominant and non‐dominant tracts. Subjects were divided into age groups (20–40, 41–60, and 61–80 years), and the DTI‐derived parameters of the groups were compared to determine age‐related differences. TV and FA of non‐dominant CPCT were higher than those of dominant CPCT, and the dominant CST was higher than the non‐dominant CST. The TV and FA of DRTCT showed no side‐to‐side difference. The 61–80 years age group had the highest TV of the dominant and non‐dominant DRTCT among the three groups and the highest FA of the non‐dominant CPCT and DRTCT. The results revealed the structural characteristics of CPCT and DRTCT using probabilistic DTT. Normal asymmetric patterns and age‐related changes in cerebellar white matter tracts may be important to researchers investigating cerebro‐cerebellar structural connectivity.
A separation of innate and learned vocal behaviors defines the symptomatology of spasmodic dysphonia
Authors: Guiry Samantha , Worthley Alexis , Simonyan Kristina 
Published: December 2018

ObjectiveSpasmodic dysphonia (SD) is a neurological disorder characterized by involuntary spasms in the laryngeal muscles. It is thought to selectively affect speaking; other vocal behaviors remain intact. However, the patients' own perspective on their symptoms is largely missing, leading to partial understanding of the full spectrum of voice alterations in SD.MethodsA cohort of 178 SD patients rated their symptoms on the visual analog scale based on the level of effort required for speaking, singing, shouting, whispering, crying, laughing, and yawning. Statistical differences between the effort for speaking and the effort for other vocal behaviors were assessed using nonparametric Wilcoxon rank‐sum tests within the overall SD cohort as well as within different subgroups of SD.ResultsSpeech production was found to be the most impaired behavior, ranking as the most effortful type of voice production in all SD patients. In addition, singing required nearly similar effort as speaking, ranking as the second most altered vocal behavior. Shouting showed a range of variability in its alterations, being especially difficult to produce for patients with adductor form, co‐occurring voice tremor, late onset of disorder, and familial history of dystonia. Other vocal behaviors, such as crying, laughing, whispering, and yawning, were within the normal ranges across all SD patients.ConclusionOur findings widen the symptomatology of SD, which has predominantly been focused on selective speech impairments. We suggest that a separation of SD symptoms is rooted in selective aberrations of the neural circuitry controlling learned but not innate vocal behaviors.Level of Evidence4Laryngoscope, 129:1627–1633, 2019
Critical care resources utilized in high‐risk adenotonsillectomy patients
Authors: Lavin Jennifer M. , Smith Craig , Harris Zena Leah , Thompson Dana M. 
Published: December 2018

ObjectiveChildren at high risk for respiratory complication after adenotonsillectomy are often admitted to a pediatric intensive care unit (PICU) postoperatively. Although many patients receive care in such units, it is unknown how many utilize critical care resources.MethodsA review was conducted to audit intensive care needs of postadenotonsillectomy patients admitted to the PICU at a tertiary, academic, pediatric hospital between July 2013, and March 2017. Demographic information, ICU indication, polysomnogram results, and comorbidities were collected. Patients were defined as needing ICU resources based on supplemental oxygen requirements greater than 2 L between 2 to 24 hours postoperatively, more than two desaturation events in a 2‐hour period, or more than hourly nursing intervention. Factors associated with utilization of ICU resources were assessed.ResultsOne hundred and ten patients were admitted to the PICU after adenotonsillectomy. Median age was 4.2 years, median body mass index was 90.8 percentile, and median apnea hypopnea index (AHI) was 34.3. Twenty patients (18.2%) utilized ICU resources by criteria defined. Of these patients, 14 were known to need such resources by 2 hours postoperatively (70%, negative predictive value 93.8%). Neither AHI nor obesity status was correlated with need for resources; however, resource need was associated with young age, gastrostomy tube status, and neuromuscular disorders (P = 0.048, P = 0.002 and 0.013, respectively).ConclusionMost high‐risk adenotonsillectomy patients do not utilize critical care resources despite their increased perioperative risk. Patients with respiratory complications are frequently identifiable within the first 2 hours of surgery.Level of Evidence4 Laryngoscope, 129:1229–1234, 2019
Diagnosis of a maxillary sinus fungus ball without intralesional hyperdensity on computed tomography
Authors: Ho Che‐Fang , Lee Ta‐Jen , Wu Pei‐Wen , Huang Chi‐Che , Chang Po‐Hung , Huang Yen‐Lin , Lee Yueh‐Lin , Huang Chien‐Chia 
Published: December 2018

Objectives/HypothesisMaxillary sinus fungus ball (MSFB) is the most common type of noninvasive fungal rhinosinusitis. Surgical removal of the ball achieves good outcomes. Making a rapid and accurate diagnosis is important to avoid unnecessary medical therapy. Intralesional hyperdensity (IH) on computed tomography (CT) is reportedly a good indicator. The aim of this study was to evaluate the diagnostic features of MSFB without IH on preoperative CT images.Study DesignRetrospective database review.MethodsTwo hundred fifty‐eight patients with histopathological evidence of a sinus fungal ball were retrospectively investigated. Forty‐seven of 222 patients with MSFB did not show IH on preoperative CT images and were enrolled in the MSFB group. Forty‐one patients with unilateral nonfungal chronic rhinosinusitis were enrolled in a control group. CT features previously reported to have diagnostic significance were evaluated.ResultsSclerosis of the lateral sinus wall, erosion of the inner sinus wall, and irregular surface of the material were significantly more common in the MSFB group than in the control group. In the subgroup of patients with total opacification in the maxillary sinus, the sensitivity, specificity, and positive and negative predictive values for erosion of the inner sinus wall were more than 90%. In the subgroup with partial opacification, the sensitivity, specificity, and positive predictive value of an irregular surface of the material were more than 80%.ConclusionsWe have devised an algorithm to help diagnose MSFB without IH on preoperative CT images. Use of this algorithm would improve the diagnostic accuracy and ensure appropriate treatment.Level of Evidence4 Laryngoscope, 129:1041–1045, 2019
Opioid prescription patterns and use among patients undergoing endoscopic sinus surgery
Authors: Sethi Rosh K. V. , Miller Ashley L. , Bartholomew Ryan A. , Lehmann Ashton E. , Bergmark Regan W. , Sedaghat Ahmad R. , Gray Stacey T. 
Published: December 2018

Objectives/HypothesisOpioid‐related deaths in the United States have increased 200% since 2000, in part due to prescription diversion from patients who had a surgical procedure. The purpose of this study was to characterize provider prescription patterns and assess patient‐reported opioid use after endoscopic sinus surgery (ESS).Study DesignRetrospective chart review.MethodsPatients who underwent ESS between May 2017 and May 2018 were included. Opioid prescription, operative details, and postoperative opioid use data were extracted. The Massachusetts Prescription Awareness Tool (MassPAT) was queried to determine if patients filled their prescription.ResultsOne hundred fifty‐five patients were included. Nearly all patients received an opioid prescription (94.8%). An average of 15.6 tablets was prescribed per patient. Among 116 patients with MassPAT data, 91.4% filled their prescription. Among 67 patients who reported the number of tablets they had used at the time of first follow‐up appointment, 73.1% reported taking no opioids. Mean number of tablets prescribed was significantly greater among patients who underwent primary versus revision surgery (16.5 vs. 13.5, P = .0111) and those who had splints placed (21.5 vs. 15.1, P = .0037). Predictors of opioid use included concurrent turbinate reduction (58.3% vs. 14.3%, P < .0001) and concurrent septoplasty (45.5% vs. 21.6%, P = .039).ConclusionsNearly all patients who underwent ESS were prescribed an opioid, and nearly all patients filled their prescription. However, the vast majority of patients did not require any opioid medication for postoperative pain control. As the opioid epidemic continues to persist, these findings have immediate relevance to current prescribing patterns and pain management practices.Level of Evidence4 Laryngoscope, 129:1046–1052, 2019
Systemic safety of serial intralesional steroid injection for subglottic stenosis
Authors: Woliansky Jonathan , Phyland Debra , Paddle Paul 
Published: December 2018

Objectives/HypothesisSerial intralesional steroid injection (SILSI) has recently been proposed as an effective scar‐modifying therapy for subglottic stenosis (SGS). We aimed to explore the systemic absorption of steroid following SILSI and to characterize the magnitude and chronicity of any effect observed. Specifically, we aimed to show that any effect resolves prior to the next intralesional injection.Study DesignProspective, observational pilot study.MethodsPatients were injected intralesionally with 40 to 200 mg triamcinolone. Serum cortisol, as well as white cell counts and inflammatory markers were measured at day 0 (baseline), 1, 7, and 28. Salivary cortisol was measured at baseline and for 7 consecutive days following injection.ResultsSix patients with idiopathic SGS were recruited. At baseline, serum cortisol measured 284.0 ± 61.4 nmol/L and fell significantly to 15.5 ± 4.3 nmol/L 1 day following triamcinolone injection (P = .03). At day 7, serum steroid levels showed significant recovery to 221.8 ± 78.9 nmol/L (P = .03) and further rose to 279.5 ± 29.9 nmol/L at 28 days (P = .07). Salivary cortisol exhibited a similar pattern with significant recovery by day 6 (P = .04) and suggestion of exponential clearance of triamcinolone systemically. White cell counts were also affected by systemic absorption of exogenous steroid. No significant change in inflammatory markers was observed.ConclusionsOur findings demonstrate systemic absorption of steroid following SILSI, with acute hypothalamic–pituitary–adrenal (HPA) axis suppression. However, normalization of HPA axis function by day 7 suggests that although acute steroid side effects should be discussed with patients, no cumulative systemic steroid side effect would occur with serial injections.Level of Evidence2Laryngoscope, 129:1634–1639, 2019
Implication of Fusobacterium necrophorum in recurrence of peritonsillar abscess
Authors: Ali S. Ahmed , Kovatch Kevin J. , Smith Josh , Bellile Emily L. , Hanks John E. , Hoff Paul T. 
Published: December 2018

ObjectivePeritonsillar abscess (PTA) is a common infectious complication of pharyngeal infection managed by otolaryngologists and emergency room physicians. Streptococcus and Fusobacterium (e.g., Fusobacterium necrophorum, FN) species are commonly isolated pathogens. The aim of this study was to determine the implication of culture results on abscess recurrence following drainage.MethodsSingle‐institution retrospective review of patients treated at the University of Michigan between 2000 and 2017. Demographic and clinical outcome data were analyzed, including treatment details, culture data, and recurrence.ResultsOne hundred fifty‐six of the 990 patients in our study developed recurrence of their abscess (16%). The age ranges most susceptible to recurrence included adolescent (22.9%) and young adult groups (17.1%). Recurrent patients were more likely to have experienced acute progression of symptoms (79% vs. 71%, P = 0.03), trismus (67% vs. 55%, P = 0.006), voice changes (65% vs. 57%, P = 0.04), and dysphagia (72% vs. 61%, P = 0.01) compared to nonrecurrent patients. They were also more likely to have clinical lymphadenopathy noted on initial examination (67% vs. 56%, P = 0.009). Culture data was sent for 852 patients (86%). The presence of FN was significantly more prevalent in the recurrent group (P < 0.0001).ConclusionThere is a high observed prevalence of FN species within PTA aspirates in the recurrent PTA population. PTA aspirate should be sent for anaerobic growth to screen for Fusobacterium species. In addition, follow‐up and lower threshold for subsequent tonsillectomy should be considered in this at‐risk group.Level of Evidence3Laryngoscope, 129:1567–1571, 2019