bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Piezoelectric Surgery Really Harmless to Soft Tissue?
Authors: Demirbilek Nevzat , Evren Cenk 
Published: May 2019

Aim:
The aim of this study was to investigate the effect of piezoelectric surgery (piezosurgery) on soft tissue in open septorhinoplasty.

Methods:
A total of 30 patients (21 females, 9 males; mean age 29.16 ± 8.17 years; range, 18–43 years) who underwent open septorhinoplasty between January 2019 and February 2019 were randomly divided into 2 groups. After the nasal dorsum was opened in all groups, 1 mm3 tissue under the skin in radix region was taken as punch biopsy. In the first group (classical group, n =  15), the cartilage hump was resected with number 15 scalpel and the bone hump with the help of a chisel. Lateral and median osteotomies were conducted using 4 mm sharp osteotomes. Rasping was performed to dorsum to correct bone deformities. Then, 1 mm3 punch biopsy was taken from under the skin tissue of the nose back near the radix. In the second group (piezo group, n = 15) hump excision, osteotomies and rasping were performed by piezoelectric surgery. Then, 1 mm3 punch biopsy was taken from the subcutaneous tissue of the nose back near the radix. Biopsies were examined histopathologically in the light microscope for edema, necrosis, and inflammation.

Results:
Of the 30 patients presented in this series, 21 were female and 9 were male. In the classical group, edema in the soft tissue was seen in 86.7% of the cases after osteotomy, while this rate was 26.7% in the piezosurgery group. The difference was statistically significant (P < 0.05). Although necrosis was not seen prior to the osteotomy in both groups, the rate of necrosis in the classical group was 13.3% and in the piezo group it was 66.7%. Necrosis was significantly different in the piezosurgery group compared with the classical osteotomy group (P < 0.05).

Conclusion:
Piezosurgery is not completely harmless to soft tissue. A statistically significant increase in subcutaneous necrosis compared with the classical group can be explained by long-term soft tissue trauma caused by piezoelectric vibrations. We think that developing necrosis may cause problems in late period, especially in patients with thin skin.
The Association of Fever and Antipyretic Medication With Outcomes in Mechanically Ventilated Patients: A Cohort Study
Authors: Evans Emily M. , Doctor Rebecca J. , Gage Brian F. , Hotchkiss Richard S. , Fuller Brian M. , Drewry Anne M. 
Published: May 2019

ABSTRACT

Background:
Fever is common in mechanically ventilated patients and may be uniquely detrimental in those with lung injury because of its injurious effects on pulmonary vascular permeability and alveolar epithelium. We evaluated the association of fever and antipyretic medication with mortality in mechanically ventilated emergency department (ED) patients.

Methods:
This is a retrospective cohort study of 1,264 patients requiring mechanical ventilation initiated in the ED with subsequent admission to an intensive care unit. Maximum body temperature was recorded for the first 24 h after ED admission and categorized into four categories: <37°C, 37°C to 38.2°C, 38.3°C to 39.4°C, and ≥39.5°C. The primary outcome was 28-day mortality. We conducted a planned subgroup analysis of patients with sepsis at the time of intubation. Multivariable Cox proportional hazard ratios (HRs) were used to assess the relationship between temperature, antipyretics, and mortality.

Results:
Multivariable Cox proportional HRs demonstrated that a maximum temperature ≥39.5°C was associated with increased mortality (adjusted hazard ratio [aHR] 1.59 [95% confidence interval, CI, 1.05–2.39]). In the subgroup of patients with sepsis, a maximum temperature of 38.3°C to 39.4°C was associated with survival (aHR 0.61 [95% CI, 0.39–0.99]). There was no difference in 28-day mortality between patients who did and did not receive antipyretic medication in either the overall cohort or the septic subgroup.

Conclusion:
High fever (≥39.5°C) was associated with increased risk for mortality in mechanically ventilated patients. However, in patients with sepsis, moderate fever (38.3°C–39.4°C) was protective. Antipyretic medication was not associated with changes in outcome. This suggests that fever may have different implications in septic versus nonseptic mechanically ventilated patients.
Effect of Microvascular Invasion Risk on Early Recurrence of Hepatocellular Carcinoma After Surgery and Radiofrequency Ablation
Authors: Lee Sunyoung , Kang Tae Wook , Song Kyoung Doo , Lee Min Woo , Rhim Hyunchul , Lim Hyo Keun , Kim So Yeon , Sinn Dong Hyun , Kim Jong Man , Kim Kyunga , Ha Sang Yun 
Published: May 2019

Objective:
We compared surgical resection (SR) and radiofrequency ablation (RFA) as first-line treatment in patients with hepatocellular carcinoma (HCC) based on the risk of microvascular invasion (MVI).

Background:
The best curative treatment modality between SR and RFA in patients with HCC with MVI remains unclear.

Methods:
Data from 2 academic cancer center-based cohorts of patients with a single, small (≤3 cm) HCC who underwent SR were used to derive (n = 276) and validate (n = 101) prediction models for MVI using clinical and imaging variables. The MVI prediction model was developed using multivariable logistic regression analysis and externally validated. Early recurrence (<2 years) based on risk stratification between SR (n = 276) and RFA (n = 240) was evaluated via propensity score matching.

Results:
In the multivariable analysis, alpha-fetoprotein (≥15 ng/mL), protein induced by vitamin K absence-II (≥48 mAU/mL), arterial peritumoral enhancement, and hepatobiliary peritumoral hypointensity on magnetic resonance imaging were associated with MVI. Incorporating these factors, the area under the receiver operating characteristic curve of the predictive model was 0.87 (95% confidence interval: 0.82–0.92) and 0.82 (95% confidence interval: 0.74–0.90) in the derivation and validation cohorts, respectively. SR was associated with a lower rate of early recurrence than RFA based on the risk of MVI after propensity score matching (P < 0.05).

Conclusions:
Our model predicted the risk of MVI in patients with a small (≤ 3 cm) HCC with high accuracy. Patients with MVI who had undergone RFA were more vulnerable to recurrence than those who had undergone SR.
Prevalence and Risk Factors for Chronic Abdominal Pain After Roux-en-Y Gastric Bypass Surgery
Authors: Gormsen Johanne , Burcharth Jakob , Gögenur Ismail , Helgstrand Frederik 
Published: May 2019

Objective:
To investigate the prevalence and risk factors for chronic abdominal pain after Roux-en-Y gastric bypass (RYGB) surgery.

Summary Background Data:
Abdominal pain is a frequent postoperative complication after RYGB surgery. Even if there have been defined several long-term complications, the literature regarding patients with unexplained chronic abdominal pain is sparse.

Methods:
A single-center register-based cohort study with inclusion of all patients who underwent RYGB surgery between 2010 and 2015. Data from multiple registries, medical records, and a questionnaire were used. Patients with chronic abdominal pain were defined as those using strong analgesics, diagnosed with chronic pain, or referred to a specialized pain clinic. Patients with severe self-reported abdominal pain were defined as those reporting abdominal pain more than 2 times weekly within the last month.

Results:
A total of 787 patients were followed for a median of 63 months. The prevalence of postoperative chronic abdominal pain was 11% and the prevalence of severe self-reported abdominal pain was 21%. Preoperative use of strong analgesics was a risk factor for chronic abdominal pain (OR, 2.26; 95% CI, 1.59–3.23) and severe self-reported abdominal pain (OR 2.82, 95% CI 1.64–4.84). Further risk factors for severe self-reported pain were unemployment or retirement (OR 1.80, 95% CI 1.09–2.93), postoperative complications (OR 2.75, 95% CI 1.44–5.22), and smoking (OR 1.80, 95% CI 1.09–2.96).

Conclusions:
One in 10 patients undergoing RYGB surgery developed chronic abdominal pain requiring strong analgesics, and one in five suffered from severe abdominal pain. Risk factors were preoperative use of strong analgesics, unemployment, postoperative complications, and smoking.
Randomized Controlled Phase 2a Study of RPh201 in Previous Nonarteritic Anterior Ischemic Optic Neuropathy
Authors: Rath Eitan Z. , Hazan Zadik , Adamsky Konstantin , Solomon Arieh , Segal Zvi I. , Levin Leonard A. 
Published: May 2019

Background:
No proven treatment exists for nonarteritic anterior ischemic optic neuropathy (NAION), either in the acute or late phase.

Objective:
To assess safety and changes in visual function and structure after RPh201/placebo treatment in participants with previous NAION.

Design and Setting:
Phase 2a, single-site, prospective, randomized, placebo-controlled, double-masked trial (registration NCT02045212).

Main Outcomes Measures:
Early Treatment Diabetic Retinopathy Study best-corrected visual acuity (BCVA), visual fields, retinal nerve fiber layer, and visual evoked potential at weeks 13, 26, and after a 13-week wash-out (“off-drug”) period; and safety.

Study Population:
Twenty-two participants aged 18 years or older with previous NAION.

Intervention(s):
RPh201 (20 mg) or placebo (cottonseed oil vehicle) administered subcutaneously twice weekly at the study site.

Results:
Thirteen men and 9 women were randomized, of which 20 completed all visits. The mean (±SD) age was 61.0 ± 7.6 years. In a post hoc analysis, after 26 weeks of treatment, BCVA improved by ≥15 letters in 4/11 (36.4%) eyes with RPh201, compared to 1/8 (12.5%) eyes with placebo (P = 0.24). Overall, 7/11 (63.6%) of participants on RPh201 showed some improvement in BCVA, compared with 3/8 (37.5%) on placebo (P = 0.26). Improvement in BCVA from a calculated baseline was 14.8 ± 15.8 letters for RPh201 and 6.6 ± 15.3 for placebo (P = 0.27). Of the 154 adverse effects (AEs), 52 were considered related to the study procedures/treatment. Across the study and 1,017 injections, the most frequently reported AE was injection site pain (23 events in 5 participants). There were no clinically significant changes in vital signs or laboratory values.

Conclusions:
This Phase 2a was designed to assess safety, feasibility, and explore potential efficacy signals in treating previous NAION with RPh201. No safety concerns were raised. The results support a larger trial in patients with previous NAION.
Continuous EEG Monitoring Predicts a Clinically Meaningful Recovery Among Adult Inpatients
Authors: Selioutski Olga , Roberts Debra , Hamilton Ross , Ghosh Hia , Nickels Jean , Konig Toro Francesca , Kruppenbacher Matthew , Auinger Peggy , Kaplan Peter W. , Birbeck Gretchen L. 
Published: May 2019

Purpose:
Continuous EEG (cEEG) monitoring is primarily used for diagnosing seizures and status epilepticus, and for prognostication after cardiorespiratory arrest. The purpose of this study was to investigate whether cEEG could predict survival and meaningful recovery.

Methods:
The authors reviewed inpatient cEEG reports obtained between January 2013 and November 2015 and recorded demographics, preadmission modified Rankin Scale, history of preexisting epilepsy, Glasgow Coma Scale for those admitted to the intensive care unit, and EEG data (posterior dominant rhythm, reactivity, epileptiform discharges, seizures, and status epilepticus). Associations between clinical outcomes (death vs. survival or clinically meaningful recovery [inpatient rehabilitation, home-based rehabilitation, or home] vs. other [death, skilled nursing facility]) and cEEG findings were assessed with logistic regression models. P < 0.05 was considered significant.

Results:
For 218 cEEG reports (197 intensive care unit admits), the presence of at least a unilateral posterior dominant rhythm was associated with survival (odds ratio for death, 0.38; 95% confidence interval, 0.19–0.77; P = 0.01) and with a clinically meaningful outcome (odds ratio, 3.26; 95% confidence interval, 1.79–5.93; P < 0.001); posterior dominant rhythm remained significant after adjusting for preadmission disability. Those with preexisting epilepsy had better odds of a meaningful recovery (odds ratio, 3.31; 95% CI, 1.34–8.17; P = 0.001). Treated seizures and status epilepticus were not associated with a worse mortality (P = 0.6) or disposition (P = 0.6). High Glasgow Coma Scale (≥12) at intensive care unit admission was associated with a clinically meaningful recovery (odds ratio, 16.40; 95% confidence interval, 1.58–170.19; P = 0.02).

Conclusions:
Continuous EEG findings can be used to prognosticate survival and functional recovery, and provide guidance in establishing goals of care.
Updated Database and Evolutionary Dynamics of U12-Type Introns
Authors: Moyer Devlin C. , Larue Graham E. , Hershberger Courtney E. , Roy Scott W. , Padgett Richard A. 
Published: May 2019

ABSTRACTDuring nuclear maturation of most eukaryotic pre-messenger RNAs and long non-coding RNAs, introns are removed through the process of RNA splicing. Different classes of introns are excised by the U2-type or the U12-type spliceosomes, large complexes of small nuclear ribonucleoprotein particles and associated proteins. We created intronIC, a program for assigning intron class to all introns in a given genome, and used it on 24 eukaryotic genomes to create the Intron Annotation and Orthology Database (IAOD). We then used the data in the IAOD to revisit several hypotheses concerning the evolution of the two classes of spliceosomal introns, finding support for the class conversion model explaining the low abundance of U12-type introns in modern genomes.
Multi-Scale, Patient-Specific Computational Flow Dynamics Models Predict Formation of Neointimal Hyperplasia in Saphenous Vein Grafts
Authors: Donadoni Francesca , Pichardo-Almarza Cesar , Homer-Vanniasinkam Shervanthi , Dardik Alan , Díaz-Zuccarini Vanessa 
Published: May 2019

AbstractBypass occlusion due to neointimal hyperplasia (NIH) is among the major causes of peripheral graft failure. Its link to abnormal hemodynamics in the graft is complex, and isolated use of hemodynamic markers insufficient to fully capture its progression. Here, a computational model of NIH growth is presented, establishing a link between computational fluid dynamics (CFD) simulations of flow in the lumen, with a biochemical model representing NIH growth mechanisms inside the vessel wall. For all 3 patients analyzed, NIH at proximal and distal anastomoses was simulated by the model, with values of stenosis comparable to the computed tomography (CT) scans.
Non-production vegetation has a positive effect on ecological processes in agroecosystems
Authors: Case Bradley S. , Pannell Jennifer L. , Stanley Margaret C. , Norton David A. , Brugman Anoek , Funaki Matt , Mathieu Chloé , Songling Cao , Suryaningrum Febyana , Buckley Hannah L. 
Published: May 2019

AbstractAn ever-expanding human population, ongoing global climatic changes, and the spread of intensive farming practices is putting increasing pressure on agroecosystems and the inherent biodiversity they contain. Non-production vegetation elements, such as woody patches, riparian margins, and inter-crop and restoration plantings, are vital for conserving biodiversity in agroecosystems and are therefore considered key to sustaining the biotic and abiotic processes underpinning sustainable and resilient agroecosystems. Despite this critical role, there is a surprising lack of synthesis of which types of non-production vegetation elements drive and/or support ecological processes and the mechanisms by which this occurs. Using a systematic, quantitative literature review of 342 articles, we asked: what are the effects of non-production vegetation elements on agroecosystem processes and how are these processes measured within global agroecosystems? Our literature search focussed on the effects of non-production vegetation related to faunal, weed, disease, and abiotic processes. The majority (61%) of studies showed positive effects on ecological processes: non-production vegetation increased the presence, level or rate of the studied process. However, rather than directly measuring ecosystem processes, 83% of studies inferred processes using proxies for ecosystem function, such as biodiversity and soil physicochemical properties. Studies that directly measured non-production vegetation effects focussed on a limited number of vegetation effects including comparisons of vegetation types, farm-scale configuration, and proximity to vegetation. Moreover, studies directly measuring ecosystem processes were similarly limited, dominated by invertebrate biocontrol, predator and natural enemy spillover, animal movement, and ecosystem cycling. We identify research gaps and present a pathway for future research in understanding the ecosystem components and processes that build resilient, sustainable agroecosystems.
Corticothalamic gating of population auditory thalamocortical transmission in mouse
Authors: Ibrahim Baher A. , Murphy Caitlin , Muscioni Guido , Taheri Aynaz , Yudintsev Georgiy , Kenyon Robert V. , Berger-Wolf Tanya , Banks Matthew I. , Llano Daniel A. 
Published: May 2019

AbstractSince the discovery of the receptive field, scientists have tracked receptive field structure to gain insights about mechanisms of sensory processing. At the level of the thalamus and cortex, this linear filter approach has been challenged by findings that populations of cortical neurons respond in a stereotyped fashion to sensory stimuli. Here, we elucidate a possible mechanism by which gating of cortical representations occurs. All-or-none population responses (here called “ON” and “OFF” responses) were observed in vivo and in vitro in the mouse auditory cortex at near-threshold acoustic or electrical stimulation. ON-responses were associated with previously-described UP states in the auditory cortex. OFF-responses in the cortex were only eliminated by blocking GABAergic inhibition in the thalamus. Opto- and chemogenetic silencing of NTSR-positive corticothalamic layer 6 (CTL6) neurons as well as the pharmacological blocking of the thalamic reticular nucleus (TRN) retrieved the missing cortical responses, suggesting that the corticothalamic feedback inhibition via TRN controls the gating of thalamocortical activity. Moreover, the oscillation of the pre-stimulus activity of corticothalamic cells predicted the cortical ON vs. OFF responses, suggesting that underlying cortical oscillation controls thalamocortical gating. These data suggest that the thalamus may recruit cortical ensembles rather than linearly encoding ascending stimuli and that corticothalamic projections play a key role in selecting cortical ensembles for activation.
Partial migration in a subtropical wading bird in the Southeastern U.S.
Authors: Picardi Simona , Frederick Peter C. , Borkhataria Rena R. , Basille Mathieu 
Published: May 2019

ABSTRACTThe function of migration is to allow exploitation of resources whose availability is heterogeneous in space and time. Much effort has been historically directed to studying migration as a response to seasonal, predictable fluctuations in resource availability in temperate species. A deeper understanding of how different migration patterns emerge in response to different patterns of resource variation requires focusing on species inhabiting less predictable environments, especially in tropical and subtropical areas. We provide the first individual-based, quantitative description of migratory patterns in a subtropical wading bird in the Southeastern U.S., the wood stork (Mycteria americana). Using GPS tracking data for 64 individuals tracked between 2004 and 2017, we classified migratory behavior at the individual-year level using information theory-based model selection on non-linear models of net squared displacement. We found that the wood stork population is partially migratory, with 59% of individuals seasonally commuting between winter ranges in Florida and summer ranges elsewhere in the population range (migrants), and 28% remaining in a single area in Florida year-round (residents). Additionally, 13% of storks act as facultative migrants, migrating in some years but not in others. Comparing the distribution of residents and migrants suggests that different migratory strategies might be associated with the use of different or differently distributed resources, possibly including food supplementation from human activities. The existence of facultative migrants shows the potential for plastic change of migratory patterns. Partial migration in wood storks may be an adaptation to high heterogeneity and unpredictability of food resources. We suggest that future research should focus on wading birds as model species for the study of partial migration as an adaptation to heterogeneous and unpredictable environments, by comparing populations of the same species across different wetland systems and sympatric populations of species that differ in their resource acquisition mechanisms.
Screening human embryos for polygenic traits has limited utility
Authors: Karavani Ehud , Zuk Or , Zeevi Danny , Atzmon Gil , Barzilai Nir , Stefanis Nikos C. , Hatzimanolis Alex , Smyrnis Nikolaos , Avramopoulos Dimitrios , Kruglyak Leonid , Lam Max , Lencz Todd , Carmi Shai 
Published: May 2019

AbstractGenome-wide association studies have led to the development of polygenic score (PS) predictors that explain increasing proportions of the variance in human complex traits. In parallel, progress in preimplantation genetic testing now allows genome-wide genotyping of embryos generated viain vitrofertilization (IVF). Jointly, these developments suggest the possibility of screening embryos for polygenic traits such as height or cognitive function. There are clear ethical, legal, and societal concerns regarding such a procedure, but these cannot be properly discussed in the absence of data on the expected outcomes of screening. Here, we use theory, simulations, and real data to evaluate the potential gain of PS-based embryo selection, defined as the expected difference in trait value between the top-scoring embryo and an average, unselected embryo. We observe that the gain increases very slowly with the number of embryos, but more rapidly with increased variance explained by the PS. Given currently available polygenic predictors and typical IVF yields, the average gain due to selection would be ≈2.5cm if selecting for height, and ≈2.5 IQ (intelligence quotient) points if selecting for cognitive function. These mean values are accompanied by wide confidence intervals; in real data drawn from nuclear families with up to 20 offspring each, we observe that the offspring with the highest PS for height was the tallest only in 25% of the families. We discuss prospects and limitations of PS-based embryo selection for the foreseeable future.