bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obstructive sleep apnea in patients with laryngeal cancer after supracricoid or vertical partial laryngectomy
Authors: Ouyang Lei , Yi Liang , Wang Lin , Tang Qinglai , Yang Xinming , Li Shisheng 
Published: June 2019

Objective To investigate whether partial laryngectomy is a risk factor for obstructive sleep apnea (OSA) and the effect of different partial laryngectomy methods on OSA. Method A prospective study was carried out involving 40 patients who underwent supracricoid partial laryngectomy (SCPL) (24) or vertical partial laryngectomy (VPL) (16) for carcinoma of the larynx. Apnea-hypopnea index (AHI) and oxygen saturation determined by polysomnography (PSG), Epworth sleepiness scale (ESS) score, and body mass index (BMI) were evaluated in patients before surgery, on the day of tracheal tube removal and three months later. In patients who developed apnea, laryngoscopy, Muller's test, computer tomography (CT) and dynamic sleep magnetic resonance imaging (MRI) were performed to assess the location of airway stenosis and collapse. Results The AHI ( P<0.001) increased and the lowest oxygen saturation ( P<0.001), ESS score ( P<0.001) and BMI ( P=0.017) decreased after extubation compared with before surgery. Three months after extubation, the same changes were found in AHI ( P<0.001) and the lowest oxygen saturation ( P<0.001), but the ESS score ( P<0.001) increased compared with that preoperatively. The AHI in the SCPL group was significantly higher than that in the VPL group post-operatively ( P=0.010), while the miniSpO2 in the SCPL group was lower than that of the VPL group ( P=0.022). Laryngoscopy showed that the patients with partial excision of the larynx had a narrowed retropalatal and retrolingual space post-operatively. Muller's test showed the collapse of the retropalatal and retrolingual space, and the CT scan showed that the tongue root was positioned lower in the SCPL group. Compared with the retropalatal and retrolingual space in the expiratory phase according to dynamic sleep MRI, the space in the inspiratory phase was clearly decreased. Conclusion Laryngeal function preservation surgery for laryngeal cancer results in the occurrence of OSA by altering the anatomical structure of the larynx and pharynx. OSA was more severe in patients undergoing SCPL than in patients undergoing VPL. The effect of partial laryngectomy on OSA may be related to the surgical method used.
Clinical indicators of treatment-resistant psychosis
Authors: Legge Sophie E. , Dennison Charlotte A. , Pardiñas Antonio F. , Rees Elliott , Lynham Amy J. , Hopkins Lucinda , Bates Lesley , Kirov George , Owen Michael J. , O'Donovan Michael C. , Walters James T.R. 
Published: June 2019

BackgroundAround 30% of individuals with schizophrenia remain symptomatic and significantly impaired despite antipsychotic treatment and are considered to be treatment resistant. Clinicians are currently unable to predict which patients are at higher risk of treatment resistance.AimsTo determine whether genetic liability for schizophrenia and/or clinical characteristics measurable at illness onset can prospectively indicate a higher risk of treatment-resistant psychosis (TRP).MethodIn 1070 individuals with schizophrenia or related psychotic disorders, schizophrenia polygenic risk scores (PRS) and large copy number variations (CNVs) were assessed for enrichment in TRP. Regression and machine-learning approaches were used to investigate the association of phenotypes related to demographics, family history, premorbid factors and illness onset with TRP.ResultsYounger age at onset (odds ratio 0.94,P= 7.79 × 10−13) and poor premorbid social adjustment (odds ratio 1.64,P= 2.41 × 10−4) increased risk of TRP in univariate regression analyses. These factors remained associated in multivariate regression analyses, which also found lower premorbid IQ (odds ratio 0.98,P= 7.76 × 10−3), younger father's age at birth (odds ratio 0.97,P= 0.015) and cannabis use (odds ratio 1.60,P= 0.025) increased the risk of TRP. Machine-learning approaches found age at onset to be the most important predictor and also identified premorbid IQ and poor social adjustment as predictors of TRP, mirroring findings from regression analyses. Genetic liability for schizophrenia was not associated with TRP.ConclusionsPeople with an earlier age at onset of psychosis and poor premorbid functioning are more likely to be treatment resistant. The genetic architecture of susceptibility to schizophrenia may be distinct from that of treatment outcomes.
Management of Multiple Sclerosis Symptoms and Comorbidities
Authors: Tobin W. Oliver 
Published: June 2019

ABSTRACT

PURPOSE OF REVIEW
This article discusses the prevalence, identification, and management of multiple sclerosis (MS)–related symptoms and associated comorbidities, including complications that can present at all stages of the disease course.

RECENT FINDINGS
The impact of comorbidities on the outcome of MS is increasingly recognized. This presents an opportunity to impact the course and outcome of MS by identifying and treating associated comorbidities that may be more amenable to treatment than the underlying inflammatory and neurodegenerative disease. The identification of MS-related symptoms and comorbidities is facilitated by brief screening tools, ideally completed by the patient and automatically entered into the patient record, with therapeutic suggestions for the provider. The development of free, open-source screening tools that can be integrated with electronic health records provides opportunities to identify and treat MS-related symptoms and comorbidities at an early stage.

SUMMARY
Identification and management of MS-related symptoms and comorbidities can lead to improved outcomes, improved quality of life, and reduced disease activity. The use of brief patient-reported screening tools at or before the point of care can facilitate identification of symptoms and comorbidities that may be amenable to intervention.
Nasolaryngeal Distances in the Adult Population and an Evaluation of Commercially Available Nasotracheal Tubes
Authors: Massoth Christina , Schülke Christoph , Köppe Jeanette , Weiss Raphael , Pöpping Daniel , Dahrmann Michael , Zarbock Alexander , Wenk Manuel 
Published: June 2019

BACKGROUND:Preformed nasal endotracheal tubes (NETs) come with a predefined insertion depth due to their curved design. While size indication refers to internal diameter, there is a considerable variability in the corresponding lengths and proportions of same-sized tubes of different manufacturers which is probably based on the lack of data of nasolaryngeal distances (NLDs) in the adult population. Choosing the best-fitting NET is therefore difficult and carries the risk of endobronchial intubation or, on the contrary, cuff inflation at the vocal cord level. The aim of this study was to develop a prediction model for NLD and a selection guide to choose the appropriate NET based on a radiographic description of NLD in comparison to the measurements of available NETs of several manufacturers.METHODS:After institutional ethics board review, 388 computed tomography (CT) scan images of head, neck, and upper thorax in a heterogeneous adult cohort were included. Mean distances from the nares to the lower border of the thyroid cartilage were measured. NETs from different manufacturers were measured and compared to the NLD derived from the radiographic analysis. The patients’ sex, body height, and weight were considered as possible covariates in quantile regression models for predicting the NLD.RESULTS:Data from 200 patients were analyzed. NLD was associated with sex, body height, and weight. A simple quantile regression model using the body height as the only covariate sufficed to achieve accurate predictions of NLD. Validation on independent test data showed that 92.8% of the NLD predictions were closer than ±20 mm to the observed NLD values. Measurements of equal-sized NETs varied considerably in outer diameter, proportion, the nasopharyngeal part, and guide marks. Length differences of the bend-to-cuff distance, containing the anatomically NLD, ranged between 218 and 270 mm at same sizes.CONCLUSIONS:A reliable prediction of NLD can be obtained simply by body height, using the formula JOURNAL/asag/04.03/00000539-202004000-00031/inline-graphic1/v/2023-07-21T062325Z/r/image-tiff . As manufacturers’ tube lengths vary substantially, additional information about the bend-to-cuff distance as corresponding tube section would allow for more accurate tube selection.
Anti-tumour effects of antimicrobial peptides, components of the innate immune system, against haematopoietic tumours in Drosophila mxc mutants
Authors: Araki Mayo , Kurihara Massanori , Kinoshita Suzuko , Awane Rie , Sato Tetsuya , Ohkawa Yasuyuki , Inoue Yoshihiro H. 
Published: June 2019

ABSTRACT
The innate immune response is the first line of defence against microbial infections. In Drosophila, two major pathways of the innate immune system (the Toll- and Imd-mediated pathways) induce the synthesis of antimicrobial peptides (AMPs) within the fat body. Recently, it has been reported that certain cationic AMPs exhibit selective cytotoxicity against human cancer cells; however, little is known about their anti-tumour effects. Drosophila mxcmbn1 mutants exhibit malignant hyperplasia in a larval haematopoietic organ called the lymph gland (LG). Here, using RNA-seq analysis, we found many immunoresponsive genes, including those encoding AMPs, to be upregulated in these mutants. Downregulation of these pathways by either a Toll or imd mutation enhanced the tumour phenotype of the mxc mutants. Conversely, ectopic expression of each of five different AMPs in the fat body significantly suppressed the LG hyperplasia phenotype in the mutants. Thus, we propose that the Drosophila innate immune system can suppress the progression of haematopoietic tumours by inducing AMP gene expression. Overexpression of any one of the five AMPs studied resulted in enhanced apoptosis in mutant LGs, whereas no apoptotic signals were detected in controls. We observed that two AMPs, Drosomycin and Defensin, were taken up by circulating haemocyte-like cells, which were associated with the LG regions and showed reduced cell-to-cell adhesion in the mutants. By contrast, the AMP Diptericin was directly localised at the tumour site without intermediating haemocytes. These results suggest that AMPs have a specific cytotoxic effect that enhances apoptosis exclusively in the tumour cells.
New medical device regulations: the regulator’s view
Authors: Melvin Tom , Torre Marina 
Published: June 2019

Advances in medical device technology have been dramatic in recent years resulting in both an increased number of medical devices and an increase in the invasiveness and critical function which devices perform. Two new regulations entered into force in Europe in May 2017, the Medical Device Regulation (MDR) and the In Vitro Diagnostic Device Regulation (IVDR). These regulations will replace the current directives over the coming years. These regulations, for the first time introduce requirements relating to registries. Medical device manufacturers are required to have systematic methods for examining their devices once available on the market, by systematically gathering, recording and analysing data on safety and performance. Registries can assist public health protection in very practical ways, for example, to help urgently identify patients or devices. Registries can also be powerful tools for collecting and appraising real-world clinical evidence concerning medical devices. Clinical investigations are limited in terms of the sample size and the duration of follow-up which can reasonably be expected. Registries may also be the only available tool to examine rare adverse effects, sub-populations or for time durations which it is not possible or feasible to study in a clinical investigation. By ensuring that a core dataset is collected which can be compared to other registries or trial data, it is possible to pool data to better examine outcomes. There are a range of excellent initiatives which have aimed at ensuring the appropriate regulatory application of registry data. Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180061
Orthopaedic registries – the UK view (National Joint Registry): impact on practice
Authors: Porter Martyn , Armstrong Richard , Howard Peter , Porteous Matthew , Wilkinson J. Mark 
Published: June 2019

The National Joint Registry (NJR) was established in 2002 as the result of an unexpectedly high failure rate of a cemented total hip replacement. Initial compliance with the Registry was low until data entry was mandated. Current case ascertainment is approximately 95% for primary procedures and 90% for revision procedures. The NJR links to other data sources to enrich the reporting processes. The NJR provides several web-based and open-access reports to the public and detailed confidential performance reports to individual surgeons, hospitals and industry bodies. A transparency and accountability process ensures that device and surgical performance are actively monitored on a six-monthly basis, and adverse variation is dealt with in an appropriate way that underpins patient safety. The NJR also manages a comprehensive research-ready database and data protection compliant access system that enables external researchers to use the dataset and perform independent analyses for patient benefit. Moving forwards, the NJR intends to look at factors that lead to better outcomes so that good practice can be embedded into routine care.Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180084
Impact of hip arthroplasty registers on orthopaedic practice and perspectives for the future
Authors: Varnum Claus , Pedersen Alma Bečić , Rolfson Ola , Rogmark Cecilia , Furnes Ove , Hallan Geir , Mäkelä Keijo , de Steiger Richard , Porter Martyn , Overgaard Søren 
Published: June 2019

Total hip arthroplasty (THA) registers are established in several countries to collect data aiming to improve the results after THA. Monitoring of adverse outcomes after THA has focused mainly on revision surgery, but patient-reported outcomes have also been investigated. Several surgery-related factors influencing the survival of the THA have been thoroughly investigated and have changed clinical practice. These factors include surgical approach, specific implants, the size of the components, type of fixation and different bone cements. Register data have been used to examine the risk of venous thromboembolism and bleeding after THA. These investigations have resulted in shorter duration of thromboprophylaxis and a reduced frequency of blood transfusion. Registers may provide specific information to surgeons on the outcome of all THAs that they have performed with a detailed analysis of revisions rates and reasons for the revisions. A number of other stakeholders can use register data to provide benchmarks. The National Joint Registry for England, Wales, Northern Ireland and the Isle of Man supplies data to the Orthopaedic Device Evaluation Panel (ODEP), which provides benchmarks at 3, 5, 7, 10, and 13 years graded from A*, A, B and C. Future perspectives: National registers have to play a major role in documenting the quality of THA in order to describe best practice and report implant outliers. The registers have to be used for research and post-market surveillance and register data may be a source for intelligent decision tools.Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180091
Fixation of ankle fractures – a major trauma centre’s experience in improving quality
Authors: Whitehouse S , Mason LW , Jayatilaka L , Molloy AP 
Published: June 2019

Background Ankle fracture malreduction has been shown to result in poor long-term functional outcomes. Varying methods can be used to change practice and thereby outcomes. We present over four years’ worth of results with the effects of different techniques for change. Methods Two audit cycles were performed incorporating three audit data collections; an initial standard setting audit in 2013, with re-audits in 2015 and 2017. Between the first and second audit was a period of education and reflection. Between the second and third audit there was a change in process in ankle fracture management supported by education. Image intensifier films were reviewed on the hospital picture archiving and communication system, by at least two blinded observers in each cycle. These were scored based on the criteria published by Pettrone et al. Results In the initial audit in 2013, there were 94 patients, with a malreduction rate of 33%. In the second audit in 2015, there were 68 patients, with an increase in malreduction rate to 43.8%. In the third audit in 2017, there were 205 patients, with a significant decrease in malreduction rate to 2.4%. The final major complication rate was 0.98%. The rate of deep infection was 0.5%. Conclusions By recognising and addressing the need to improve the quality of ankle fracture fixation, we have made significant improvements in radiological outcomes. Education alone, without system change, was not successful in our department in achieving improved outcomes.
Combining Common Sense Rules and Machine Learning to Understand Object Manipulation
Authors: Sárkány András , Csákvári Máté , Olasz Mike 
Published: June 2019

Automatic situation understanding in videos has improved remarkably in recent years. However, state-of-the-art methods still have considerable shortcomings: they usually require training data for each object class present and may have high false positive or false negative rates, making them impractical for general applications. We study a case that has a limited goal in a narrow context and argue about the complexity of the general problem. We suggest to solve this problem by including common sense rules and by exploiting various state-of-the art deep neural networks (DNNs) as the detectors of the conditions of those rules.
We want to deal with the manipulation of unknown objects at a remote table. We have two action types to be detected: `picking up an object from the table' and `putting an object onto the table' and due to remote monitoring, we consider monocular observation. We quantitatively evaluate the performance of the system on manually annotated video segments, present precision and recall scores. We also discuss issues on machine reasoning. We conclude that the proposed neural-symbolic approach a) diminishes the required size of training data and b) enables new applications where labeled data are difficult or expensive to get.
The Discharge Mechanism for Solid-State Lithium-Sulfur Batteries
Authors: Erika Nagai , Arthur Timothy S. , Bonnick Patrick , Suto Koji , John Muldoon 
Published: June 2019

AbstractThe electrochemical discharge mechanism is reported for all-solid lithium sulfur batteries. Upon milling with carbon fibers, the solid electrolyte used within the cathode composite becomes electrochemically active. Analysis with Raman spectroscopy and XPS revealed the importance of bridging S-S bond formation and breaking in lithium polysulfidophosphates during electrochemical lithiation of the active solid electrolyte. Remarkably, when sulfur is introduced as an active material in the cathode composite, lithium polysulfides are formed as an intermediate product before full lithiation into lithium sulfide. The synthesis of materials based on bridging S-S bonds is an important avenue to the design of new cathodes for allsolid batteries.
Acolorir l'Olivera
Authors: Griera Padrosa Rafel 
Published: June 2019

L'Olívia no té prejudicis, ni por al ridícul. Crec que és la persona més lliure que conec. Intenta fer el que li rota però no sempre li deixen, és clar. Aquest control de la sevallibertat, que amb els anys esdevindrà autocontrol -si no decideix ser artista, diria el seu pare- no l'accepta bé, però de moment, o a mi m'ho sembla, li passa aviat. Sir KenRobinson va fer un estudi on es demostrava la pèrdua d'imaginació que es va perdent any rere any amb un sistema educatiu -el nostre- hereu de la revolució industrial. Lescoses potser estan canviant i l'Olívia potser no perdrà capacitat imaginativa, ni l'atraparan les pors i els prejudicis. Així ho desitjo. Si em baso en gran part delsalumnes que ens arriben a la facultat, però, només puc enyorar aquells anys on tot era un joc. No va ser aquesta la raó per la qual vaig voler ser artista, però ara ho tinc clar,un dels avantatges de ser artista és poder jugar com un nen.
FRAMING THE SOCIAL RESPONSIBILITY ROLE OF ISLAMIC FINANCIAL INSTITUTIONS WITHIN A THREE-SECTOR ECONOMIC MODEL
Authors: Barom Mohd Nizam 
Published: June 2019

Purpose: This paper examines and reflects the ongoing debate on the social responsibility role of Islamic financial institutions (IFIs) in the light of the literature in the area of third sector and three-sector economic model. Subsequently, it seeks to develop a framework that can be used to conceptualise the potential interaction between the different sectors in the economy in relation to social welfare issues and locate the social responsibility role of IFIs within this framework.
Methodology: The paper uses an integrative analysis of Islamic finance and third sector literature, particularly on the American and European conceptions of the interactions between the three main sectors in the economy, i.e. public, private and ‘third’ sectors.
Results: The paper develops a modified circular flow of income and expenditure model as a basis for the integrative framework for social welfare provision within a three-sector economic model. Subsequently, it locates the social responsibility role of IFIs within this framework with the understanding that social welfare burden is a collective responsibility and therefore shared among the various potential welfare providers in the economy.
Implications: The integrative framework of social welfare provision within a three-sector economic model as conceptualised in this paper highlights a multi-institutional approach towards promoting socio-economic justice and society's well-being in an Islamic economy, and hence provides a proper and reasonable context for social responsibility roles expected of IFIs.
Impact of IL-4 polymorphisms on head and neck cancer susceptibility in the Chinese Han population
Authors: Li Huajing , Duan Na , Zhang Qing , Shao Yuan 
Published: June 2019

Abstract
Background: Head and neck cancer (HNC) is the sixth most frequent malignancy in the world. Interleukin 4 (IL-4) has been proved to be closely related to the occurrence and development of cancer. The objective of this research was to assess the association of IL-4 genetic polymorphisms with HNC risk in Chinese Han population.
Methods: Six single nucleotide polymorphisms (SNPs) of IL-4 gene were successfully genotyped using Agena MassARRY in 535 HNC patients and 538 healthy controls. Under multiple genetic models, stratification analysis and haplotype analysis, odds ratio (OR) and 95% confidence interval (CI) were calculated to assess the association between SNPs and HNC risk.
Results: The polymorphism, rs2243250, in the IL-4 gene was significantly associated with an increased HNC risk in the allele model (P < 0.05). In the genetic model, the polymorphisms rs2243250, rs2243267 and rs2243270 in IL-4 gene conferred an increased risk of HNC (P < 0.05). Gender stratification analysis showed that in males, rs2243250, rs2243267, rs2243270 and rs2243289 were associated with an increased risk of HNC (P < 0.05), while rs2243283 was associated with a decreased risk of HNC in males (P < 0.05). Besides, we have not found any association between six SNPs in IL-4 gene and HNC risk in females. Further haplotype analysis revealed that the haplotype CTGAC was significantly associated with a decreased risk of HNC.
Conclusion: This study provides an evidence for polymorphism of IL-4 gene associated with the development of HNC in the Chinese Han population.