bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tissue sealants for the prevention of lymphoceles after radical inguinal lymph node dissection in patients with melanoma: A systematic review and individual patient data meta‐analysis
Authors: Gerken Andreas L. H. , Dobroschke Jakob , Reißfelder Christoph , Hetjens Svetlana , Braun Volker , Di Monta Gianlica , Jakob Jens , Hohenberger Peter , Nowak Kai , Herrle Florian 
Published: January 2019

Background and ObjectivesPostoperative lymphoceles and further wound complications occur frequently after radical inguinal lymph node dissection (ILND). In various studies, tissue sealants have shown to reduce the incidence of postoperative morbidity.MethodsA systematic review and meta‐analysis of randomized controlled trials (RCTs) investigating the effectiveness of tissue sealants in reducing the incidence of postoperative lymphoceles following ILND in patients with melanoma was conducted. Individual patient data was requested to pool the data for meta‐analysis appropriately.ResultsThousand seven hundred twenty‐nine manuscripts were screened for eligibility. Six RCTs published between 1986 and 2012 were identified including 194 patients for ILND. Only four RCTs were included in the meta‐analysis. No study properly defined the term “lymphocele.” Tissue sealants failed to influence the duration of drain placement (mean difference [MD] = −3.05 days; z = 1.18;
P = 0.24), total drainage volume (MD = 598.39 mL;
z = 1.49;
P = 0.14), the incidence of postoperative seroma, wound infection and skin necrosis.ConclusionsNo improvement was identified with the use of tissue sealants, however, a valid comparison of the results of included trials was difficult owing to the lack of a definition of the term “lymphocele.” Other surgical techniques and trials using validated endpoint definitions are required to reevaluate these findings.
Number of positive lymph nodes better predicts survival for oral cavity cancer
Authors: Lee Hojun , Roh Jong‐Lyel , Cho Kyung‐Ja , Choi Seung‐Ho , Nam Soon Yuhl , Kim Sang Yoon 
Published: January 2019

BackgroundWe compared the predictive ability of our proposed N classification with that of the American Joint Committee on Cancer (AJCC) nodal (N) classification for oral cavity squamous cell carcinoma (OCC).MethodsWe assessed 345 OCC patients who underwent primary tumor extirpation and neck lymph node (LN) dissection. N classification was analyzed by recursive partitioning analysis and compared with the AJCC N classification by c‐index. Cox proportional hazards regression analyses were used to determine associations between tumor or nodal factors and disease‐free survival (DFS) or overall survival (OS).ResultsPositive LNs were found in 149 patients (43.2%). In multivariate models, the number of positive LNs and LN ratio strongly associated with DFS and OS (P < 0.001). Our new N classification was proposed with four categories of N0, N1 (1 positive LN), N2 (2‐4 positive LNs or extranodal extension > 2 mm), and N3 (≥5 positive LNs). The c‐index for the proposed N classification showed improvement in survival predictions (0.735; 95% CI, 0.703‐0.767) compared with the AJCC N classification (0.701; 0.667‐0.735).ConclusionsThe number of positive LNs and LN ratios strongly associated with posttreatment recurrence and survival for OCC. Using positive LN numbers with the N classification improves OCC survival predictions.
Design, construction, and application of a regional ocean database: A case study in Jiaozhou Bay, China
Authors: Yuan Yuan , Jalón‐Rojas Isabel , Wang Xiao Hua , Song Dehai 
Published: January 2019

AbstractAccess to geophysical data poses a challenge in Oceanography and Marine Sciences. Ocean databases are an efficient solution to storing, standardizing, validating, and sharing marine and environmental data. However, ocean databases of regional seas and coastal systems are still rare. In this article, we describe a regional ocean database for Jiaozhou Bay, a coastal system affected by increasing anthropogenic activities, such as land reclamation, a cross‐bay bridge construction, and land‐based pollutant discharges. Understanding the impact of human activities on Jiaozhou Bay requires a comprehensive range of research on biogeochemical and physical changes, and on the current environmental state of the bay. The Jiaozhou Bay database described here aims to inform this key research and also to serve as a reference for the future development of regional ocean databases. It includes three kinds of variables: on‐site, satellite, and modeling data. The database structure is unified and incorporates file names, header information (including metadata), measured values and data‐quality flags, which facilitate data exchange and use. We propose a system of data‐quality flags, based on 13 checks that encompass quality control of the different kinds of variables (e.g., satellite 2D data and on‐site profile data). Three examples, one for each type of data, illustrate the use and value of the Jiaozhou Bay database in better understanding the oceanographic characteristics of this bay and the impact of intensive anthropogenic activities on its marine environment.
Highly Thermally Conductive Polyimide Composites via Constructing 3D Networks
Authors: Ding Dongliang , Wang Haitao , Wu Zhiqiang , Chen Yanhui , Zhang Qiuyu 
Published: January 2019

AbstractEasy and high efficient methods are in great demand to obtain polyimide (PI) composites with high thermal conductivity in the electronic packaging field. In this work, PI/boron nitride (BN) composites with high thermal conductivity are easily fabricated. Tightly connected and well‐arranged BN platelets construct effective 3D thermally conductive networks in the PI matrix upon hot pressing, after BN platelets are coated on the surface of PI granules by the help of a kind of PI adhesive. The thermal conductivity of the PI/BN composites reaches as high as 4.47 W mK–1at a low BN loading of 20 vol%, showing an enhancement of 2099%, compared to pure PI. Such enhancement of the thermal conductivity is the highest compared with the results in the open literature. Our work is a good example that utilized the sufficient physical connection (aggregates) of thermally conductive fillers to significantly promote the thermal conductivity of polymer composites.
Venous bypass grafts versus arteriovenous loops as recipient vessels for microvascular anastomosis in lower extremity reconstructions: A matched‐pair analysis
Authors: Henn Dominic , Bigdeli Amir K. , Horsch Miriam , Weiß Christel , Kühner Clemens , Hirche Christoph , Schmidt Volker J. , Kneser Ulrich 
Published: January 2019

BackgroundLimb salvage in patients with peripheral vascular disease (PVD) and soft tissue defects often requires both a restoration of blood flow to the lower extremity and soft tissue coverage. Outcomes of free tissue transfer may be affected by vein grafts, which can be used for the placement of an autologous venous bypass or an arteriovenous (AV) loop leading to different hemodynamic situations. The purpose of this study was to investigate whether free flap anastomosis to a bypass or an AV loop can be performed with comparable results.MethodsWe performed a matched‐pair analysis of 22 patients with PVD undergoing free flap reconstructions of the lower extremity with end‐to‐side anastomosis to an autologous venous bypass (n = 11, 1 female and 10 male patients) or an AV loop (n = 11, 2 female and 9 male patients). Defects caused by trauma, infection, ulcer, or fasciotomy were reconstructed in each group with 5 muscle‐based flaps, 3 parascapular flaps, 2 anterolateral thigh (ALT) flaps, and 1 conjoined latissimus dorsi and parascapular flap. Postoperative complications including thromboses, flap failures, wound complications, and hematomas were compared.ResultsPostoperative complication rates including 1 venous pedicle thrombosis (9%vs. 0%, P = 1.0), minor (18% vs. 9%, P = 1.0) and major wound complications (45% vs. 27%, P = .69) as well as hematomas (27% vs. 36%, P = 1.0) did not show relevant differences between the groups. Flap failures were absent in both groups.ConclusionIn patients with PVD, autologous venous bypass grafts may be used for end‐to‐side anastomoses of free flaps, with postoperative outcomes being comparable to AV loop reconstructions.
Beneficial Effects of Pomegranate on Lipid Metabolism in Metabolic Disorders
Authors: Hou Chen , Zhang Weimin , Li Jianke , Du Lin , Lv Ou , Zhao Shengjuan , Li Jia 
Published: January 2019

AbstractPomegranate (Punica granatum Linn) is used in the prevention and treatment of metabolic syndrome in recent decades. Imbalances in lipid metabolism are profound features of metabolic disorders. In vivo and in vitro studies have shown that extracts of different pomegranate fractions (peels, flowers, juice, and seeds) regulate lipid metabolism in metabolic‐disorder‐associated diseases such as atherosclerosis, nonalcoholic fatty liver disease, and type 2 diabetes, helping to alleviate the development of diseases. Amelioration of oxidative stress and the inflammatory response is considered an important reason underlying the regulation of lipid metabolism by pomegranate extracts. Mitochondria, the major cellular site for lipid oxidation, are strongly associated with cellular oxidative and inflammatory status and are likely to be a target for pomegranate extract action. This review summarizes the main findings about the effects of different pomegranate fraction extracts on lipid metabolism in metabolic‐disorder‐associated diseases and analyses how pomegranate extracts achieve their effects. Furthermore, it also provides an important basis for the research and development of pomegranate‐related nutrients or drugs.
Antihypertensive Potential of Coenzyme Q10 via Free Radical Scavenging and Enhanced Akt‐nNOS Signaling in the Nucleus Tractus Solitarii in Rats
Authors: Chen Hsin‐Hung , Yeh Tung‐Chen , Cheng Pei‐Wen , Ho Wen‐Yu , Ho Chiu‐Yi , Lai Chi‐Cheng , Sun Gwo‐Ching , Tseng Ching‐Jiunn 
Published: January 2019

ScopeIn the Natural Medicines database, coenzyme Q10 (CoQ10) is classified as possibly effective for the treatment of hypertension. Patients with hypertension frequently have a significant deficiency of the antioxidant CoQ10. Furthermore, reactive oxygen species are overproduced in the nucleus tractus solitarii (NTS) during the cardiovascular regulation of hypertension in vivo. However, the molecular mechanisms by which CoQ10 modulates cardiovascular functions in the NTS are unclear. In this study, the effects of CoQ10 on superoxide generation, downstream NO signaling in the NTS, and blood pressure were evaluated in rats with fructose‐induced hypertension.Methods and ResultsTreatment with oral CoQ10 for 4 weeks abolished nicotinamide adenine dinucleotide phosphate‐oxidase (NADPH oxidase) activation, decreased p38 phosphorylation, and increased superoxide dismutase 2 production in the NTS of fructose‐fed rats. The serum levels of uric acid decrease in response to CoQ10 treatment in fructose‐fed rats. Oral CoQ10 reduced blood pressure by inducing Akt and nNOS phosphorylation in NTS of fructose‐induced hypertensive rats.ConclusionOral CoQ10 decreases blood pressure by negatively regulating fructose‐induced NADPH oxidase levels, abolishing ROS generation, reducing p38 phosphorylation, and enhancing the Akt‐nNOS pathway in the NTS. These results support the beneficial effects of CoQ10 in oxidative stressassociated hypertension.
The myotonic dystrophy experience: a North American cross‐sectional study
Authors: Hagerman Katharine A. , Howe Sarah J. , Heatwole Chad R. ,   the Christopher Project Reference Group
Published: January 2019

ABSTRACTIntroduction: Myotonic dystrophy (DM) is a chronic, multisystemic, neurological condition. Patients and caregivers are uniquely suited to identify what symptoms are most important and highlight the unmet needs that are most relevant to DM. Methods: We conducted a North American, cross‐sectional study of people with DM type‐1, congenital DM, and DM type‐2 and their family members. We sent patients and caregivers separate surveys to identify and quantitate the issues of greatest importance, examine the differences between groups, and identify the most important challenges experienced by this population. Results: 1,180 people with DM and 402 family members/caregivers responded to the surveys. They reported considerable physical and cognitive symptoms, extensive diagnostic delays, and varying clinical phenotypes on the basis of DM type. Discussion: Marked disease burden and numerous unmet needs exist in DM. These needs vary based on DM type and highlight the complex clinical phenotypes of these neurological disorders. Muscle Nerve 59:457–464, 2019
Analysis of pathology and activity‐related changes to the patellae of individuals from Tell Abraq
Authors: Osterholtz Anna J. , Harrod Ryan P. , Miller D. Shane 
Published: January 2019

AbstractThe examination of comingled ossuary collections creates unique analytical issues as bones are rarely articulated, requiring that the skeletal elements be examined on an individual basis. A result is that the estimation of crucial demographic information like age at death and sex becomes problematic and attempts to ascertain this information involve a high degree of error. Bearing these issues in mind, however, the focus of this project is to identify and interpret signs of osteoarthritis, osteochondritis dissecans, and osteochondral fracturing, as well as to score for the presence and degree of musculoskeletal markers, on patellae from the ossuary at Tell Abraq. A secondary goal of this project was to utilize the patellae to elicit both estimations of minimum number of individuals and the ratio of sex within the population.Preliminary results indicate a high prevalence of osteoarthritis, osteochondritis dissecans, and enchondral fracture that was not correlated to estimated sex. This lack of correlation may be due to several factors, including difficulty in sex estimation based on metric analysis of a single element, a skewed sex distribution, or an actual lack of correlation. Regardless of the difficulties of estimating sex in a comingled collection, it seems clear that both men and women were exposed to conditions that fostered the development of osteoarthritis and that trauma to the knee was a common occurrence for those ultimately interred in the ossuary.
Acts of life: Assessing entheseal change as an indicator of social differentiation in postmedieval Aalst (Belgium)
Authors: Palmer Jessica L.A. , Waters‐Rist Andrea L. 
Published: January 2019

AbstractLower levels of physical activity are often linked to higher socio‐economic status (SES) in past societies. As an activity marker, changes at muscle attachment sites known as entheseal changes (ECs) have been used with varying efficacy. This study investigates this proposed link between EC as a physical activity marker and SES within one well‐defined temporo‐geographic context. EC data from 16 entheses in three skeletal collections from the postmedieval town of Aalst, Belgium, were evaluated using the Coimbra method. The skeletal assemblages represent distinct socio‐economic groups, evidenced by historical and dietary isotope data. The Louis D'Haeseleerstraat sample represents lower class individuals (n = 46), the Hopmarkt sample middle‐class individuals (n = 110), and the Saint Martin's church (n = 13) higher class individuals. EC data are tested for correlation to status, age, and sex. EC patterns did not differ significantly between the SES groups at any entheses except the musculus (M.) iliopsoas and common extensor, where the higher class showed more EC. Within the populations, at the Hopmarkt, sexual differences were only observed in the Achilles tendon attachment, whereas at the Louis D'Haeseleerstraat, sexual differences were present in the M. triceps brachii, M. brachioradialis, and quadriceps entheses. Only some entheses showed a significant correlation with age, and these were inconsistent between populations. ECs are not a reliable indicator of SES in postmedieval Aalst. This could suggest that the hypothesis that the wealthy were less physically active oversimplifies the lives of people in the past. It could also suggest that EC is not a suitable proxy for physical activity, or that it cannot be used without in‐depth knowledge of the types of activities performed by various socio‐economic groups in addition to consideration of all other aetiological factors. This study illustrates the caution necessary when using EC as a proxy for social status in past societies.
Black woodpecker (Dryocopus martius L.) in the archaeozoological context of the Savvatiev Pustyn', a medieval rural Russian monastery
Authors: Zinoviev Andrei V. 
Published: January 2019

AbstractHere we report a discovery of a bone of the black woodpecker (Dryocopus martius L.) in medieval layers of the rural Savvatiev Monastery (Tver Region, Russia). Deposited in the wooden house, presumably refectory, subfloor, the woodpecker's remains could be associated with an activity of the cat. A complex of bones, associated with the find, characterizes the place as a monastery.
Estimating Effect of Obesity on Stroke Using G‐Estimation: The ARIC study
Authors: Shakiba Maryam , Mansournia Mohammad Ali , Kaufman Jay S. 
Published: January 2019

Objective
This study quantified the obesity‐stroke relationship by appropriately adjusting for time‐varying confounders using G‐estimation.
Methods
A total of 13,975 participants in the Atherosclerosis Risk in Communities (ARIC) study were included. General obesity (GOB) was defined as BMI ≥ 30 kg/m2; abdominal obesity (AOB) was defined as waist circumference  ≥ 102 cm in men and ≥ 88 cm in women and waist to hip ratio  ≥ 0.9 in men and ≥ 0.85 in women. The effects of obesity on stroke were estimated using G‐estimation and compared with accelerated failure time models using three modeling strategies.
Results
The first accelerated failure time model adjusted for baseline covariates excluding metabolic mediators of obesity showed increased risk of stroke for all measures of obesity. Further adjustment for hypertension, diabetes mellitus, and lipid profiles resulted in decreasing hazard ratios (HRs) with intervals that included the null value for all measures of obesity. G‐estimated HRs were 1.60 (95% CI: 1.08‐2.40), 1.43 (95% CI: 1.14‐1.99), and 1.99 (95% CI: 1.50‐2.91) for GOB and AOB based on waist circumference and waist to hip ratio.
Conclusions
Both GOB and AOB affected the risk of stroke. The magnitude of the estimates was larger when modeled by G‐estimation than when using standard models, suggesting that bias from mishandling of time‐varying confounding was toward the null.
Association between maternal education and survival after childhood cancer
Authors: Isaevska Elena , Popovic Maja , Alessi Daniela , Mosso Maria Luisa , Sacerdote Carlotta , Magnani Corrado , Pastore Guido , Rosso Tiziana , Zengarini Nicolás , Dockerty John , Merletti Franco , Maule Milena 
Published: January 2019

AbstractBackgroundSeveral nonbiological factors, including socioeconomic status indicators and other family characteristics, influence survival from childhood cancers. Our study explores the association between parental education and childhood cancer survival.MethodsThe specialized Childhood Cancer Registry of the Piedmont region in Italy provided data on all the cases (aged 0–14) diagnosed with cancer in the period 1976–2011 who resided in the city of Turin (capital of the Piedmont region) at least once since 1971. Information on parental education was extracted from the Turin Longitudinal Study by record linkage. The association between parental educational level and survival was estimated using Cox regression.ResultsThe study included 949 children. We observed a disadvantage in the overall survival for children of less educated mothers. No such effect was observed for paternal education. The effect of maternal education was particularly strong for central nervous system tumors (hazard ratios, 2.9; 95% confidence interval, 1.1–8.0). A similar effect, though smaller in magnitude, was observed for leukemia and embryonal tumors, whereas the estimates for lymphoma were imprecise.ConclusionsOur study shows an association between maternal educational level and survival in children with central nervous system tumors, a diagnosis that often requires long‐lasting treatment and special care. Giving support to the families of affected children to provide them the optimal care has the potential to improve children's cancer treatment outcomes.
Effect of Neuromuscular Blocking Agents on Sedation Requirements in Trauma Patients with an Open Abdomen
Authors: Smith Susan E. , Hamblin Susan E. , Dennis Bradley M. 
Published: January 2019

The appropriate level of sedation in patients with an open abdomen following damage control laparotomy (DCL) is debated. Chemical paralysis with neuromuscular blocking agents (NMBAs) has been used to decrease time to abdominal closure. We sought to evaluate the effect of NMBA use on sedation requirements in patients with an open abdomen and to determine the effect of sedation on patient outcomes. A retrospective cohort study was conducted at an American College of Surgeons’ verified level 1 trauma center. Adult trauma patients who underwent DCL between 2009 and 2015 were included. Patients with an intensive care unit length of stay of less than 48 hours and those who died before abdominal closure were excluded. The NMBA+ group received continuous NMBA within 24 hours of DCL; the NMBA− group did not. The primary outcome was cumulative sedation dose during the 7 days following DCL. Secondary outcomes included Richmond Agitation‐Sedation Scale (RASS) score, mechanical ventilation‐free days, and delirium‐coma‐free days. Delirium‐coma‐free days were analyzed with linear regression. A total of 222 patients were included (NMBA+ 125; NMBA− 97). Demographics were similar between groups including age, Injury Severity Score, and mechanism of injury. The median time to closure in the overall cohort was 2 days (interquartile range [IQR] 1–2 days). Propofol and fentanyl were the primary sedatives used. The NMBA+ group received higher cumulative doses of propofol (NMBA+ 5405 mg, IQR 3103–10,573 mg; NMBA− 3601 mg, IQR 1605–6887 mg; p=0.007), but not of fentanyl. Time to abdominal closure, but not NMBA use, was associated with a higher cumulative propofol dose on multivariate analysis. The NMBA+ group had significantly lower RASS scores on the first 3 days following DCL. Mechanical ventilation‐free days (NMBA+ 20 days vs NMBA− 18 days, p=0.960) and delirium‐coma‐free days (NMBA+ 18 days vs NMBA− 18 days, p=0.610) were similar between the groups. On linear regression, cumulative propofol dose was associated with fewer delirium‐coma‐free days (β‐coefficient −0.007, 95% confidence interval −0.015 to −0.003). In trauma patients managed with DCL, higher cumulative sedative doses were administered in patients who received adjunctive NMBA, although NMBA therapy was not associated with a higher cumulative propofol dose on multivariate analysis. Consideration must be given to the potential effect of sedation on delirium and awakening following DCL.
What really matters for students’ school satisfaction in Bangladesh?
Authors: Hossain Saira , O’Neill Sue C. , Strnadová Iva 
Published: January 2019

AbstractSchool satisfaction is the reflection of students’ comprehensive evaluation of their school experience. This study reports the level of school satisfaction among students in Grades 6 and 8 in Bangladesh to perceive and the factors that might contribute to it using a cross‐sectional research design. A 61‐item survey questionnaire was utilized to collect data. The students’ mean score on the school satisfaction subscale of the Multidimensional Students’ Life Satisfaction Scale equated to a slightly positive attitude towards school. Three demographic factors including students’ academic achievement, gender, and grade level; and two school climate factors of perceived teacher–student relationship, and perceived academic support, emerged from the multiple regression analysis. The study findings are discussed from the perspective of self‐determination theory with implications for practice and avenues for future research offered.