bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management and Follow‐up Results of Salivary Fistulas Treated With Botulinum Toxin
Authors: Send Thorsten , Bertlich Mattis , Eichhorn Klaus W. , Bootz Friedrich , Jakob Mark 
Published: August 2018

Objectives/HypothesisSalivary fistulas are a common minor complication of parotid surgery. botulinum toxin has repeatedly been reported to be an adequate treatment of this entity. To date, there is little scientific evidence for clinical decision making after appearance of a salivary fistula.Study DesignRetrospective chart analysis of 16 patients who had been treated with botulinum toxin for salivary fistula.MethodsAll patients who had been treated for salivary fistula at a tertiary referral hospital from 2010 to 2016 were included. Patient files were used to obtain characteristics of patients, treatment, and follow‐up.ResultsSixteen patients with salivary fistula received 27 injections of botulinum toxin. Nine patients required one injection for the fistula to heal, five patients needed two injections, and one patient needed three and four injections, respectively. No patient underwent additional surgery or radiotherapy. We observed no adverse effects in any patient treated with botulinum toxin.ConclusionsIn most cases of salivary fistula, injections of botulinum toxin are a valid treatment. If the initial injection is not successful, injections may be repeated once. Otherwise, revision surgery should be considered. In general, treatment with botulinum toxin should be commenced in an earlier stage and with higher dosages.Level of Evidence4 Laryngoscope, 129:403–408, 2019
Regionalization of head and neck cancer surgery may fragment care and impact overall survival
Authors: Chen Michelle M. , Megwalu Uchechukwu C. , Liew Jazmine , Sirjani Davud , Rosenthal Eben L. , Divi Vasu 
Published: August 2018

ObjectiveWhile surgical treatment concentrates in tertiary care centers, an increasing number of patients request postoperative radiation therapy (PORT) at a separate center closer to home. Our goal was to determine whether fragmentation of surgery and PORT were associated with poorer oncologic outcomes.MethodsWe conducted a retrospective cohort study of 32,813 head and neck cancer patients treated with surgery and PORT in the National Cancer Data Base. Our main outcome was overall survival (OS). Statistical analysis included χ2, t tests, Kaplan‐Meier, and Cox regression analysis.ResultsFragmented care was independently associated with increased risk of mortality (hazard ratio [HR], 1.08; 95% confidence interval [CI], 1.03–1.13), whereas distance to surgical center > 30 miles (HR, 0.92; 95% CI, 0.87–0.97) was associated with improved OS. On subgroup analysis, fragmented care was associated with decreased OS only among patients who had surgery at an academic center (HR, 1.10; 95% CI, 1.04–1.17). Within academic centers, greater distance from the surgical center was associated with improved survival only in patients who received PORT at the same facility (HR, 0.85; 95% CI, 0.78–0.93), but this effect was negated among patients who had fragmented care (HR, 0.97; 95% CI, 0.85–1.11).ConclusionWhen cancer care is fragmented, there is no longer a survival benefit for patients to travel for surgical care at academic medical centers. Fragmented care is independently associated with worse survival, and further research is needed to evaluate the causes of this difference in survival to determine if improving care coordination can mitigate this survival difference.Level of EvidenceNALaryngoscope, 129:1413–1419, 2019
Free Flap Transfer for Pediatric Head and Neck Reconstruction: What Factors Influence Flap Survival?
Authors: Liu Shuo , Zhang Wen‐bo , Yu Yao , Wang Yang , Mao Chi , Guo Chuan‐bin , Yu Guang‐yan , Peng Xin 
Published: August 2018

ObjectivesThe objective of this study was to identify the factors that influence free flap survival after head and neck reconstructive surgery in pediatric patients.MethodsOne hundred thirty consecutive cases of head and neck reconstruction with free flaps in pediatric patients at the Department of Oral and Maxillofacial Surgery at Peking University School and Hospital of Stomatology, Beijing, People's Republic of China, between 1999 and 2017 were reviewed. A single head and neck surgical team performed all the included surgeries. Demographic and surgical patient data with possible associations with free flap survival were recorded. Relevant influencing factors were determined using the χ2 test and logistic regression analysis.ResultsThere were 135 free flap transfers performed in the patients, with an overall success rate of 95.6%. Free flap failure occurred in six flaps (4.4%). Arterial crisis was the main cause of flap failure. The overall complication rate was 7.0%. Patient age (5–9 years old; odds ratio, 13.397; 95% confidence interval, 1.167–153.838; P = 0.037) was a statistically significant risk factor influencing free flap survival. Donor site, defect region, recipient vessel, and surgery time were not associated with free flap outcome.ConclusionFree flap transfer for head and neck reconstruction in pediatric patients is safe and reliable. However, special attention should be paid to pediatric patients under 9 years of age when performing head and neck reconstruction.Level of Evidence4Laryngoscope, 129:1915–1921, 2019
Outcome measures for pediatric laryngotracheal reconstruction: International consensus statement
Authors: Balakrishnan Karthik , Sidell Douglas R. , Bauman Nancy M. , Bellia‐Munzon Gaston F. , Boesch R. Paul , Bromwich Matthew , Cofer Shelagh A. , Daines Cori , de Alarcon Alessandro , Garabedian Nöel , Hart Catherine K. , Ida Jonathan B. , Leboulanger Nicolas , Manning Peter B. , Mehta Deepak K. , Monnier Philippe , Myer Charles M. , Prager Jeremy D. , Preciado Diego , Propst Evan J. , Rahbar Reza , Russell John , Rutter Michael J. , Thierry Briac , Thompson Dana M. , Torre Michele , Varela Patricio , Vijayasekaran Shyan , White David R. , Wineland Andre M. , Wood Robert E. , Wootten Christopher T. , Zur Karen , Cotton Robin T. 
Published: August 2018

ObjectivesDevelop multidisciplinary and international consensus on patient, disease, procedural, and perioperative factors, as well as key outcome measures and complications, to be reported for pediatric airway reconstruction studies.MethodsStandard Delphi methods were applied. Participants proposed items in three categories: 1) patient/disease characteristics, 2) procedural/intraoperative/perioperative factors, and 3) outcome measures and complications. Both general and anatomic site‐specific measures were elicited. Participants also suggested specific operations to be encompassed by this project. We then used iterative ranking and review to develop consensus lists via a priori Delphi consensus criteria.ResultsThirty‐three pediatric airway experts from eight countries in North and South America, Europe, and Australia participated, representing otolaryngology (including International Pediatric Otolaryngology Group members), pulmonology, general surgery, and cardiothoracic surgery. Consensus led to inclusion of 19 operations comprising open expansion, resection, and slide procedures of the larynx, trachea, and bronchi as well as three endoscopic procedures. Consensus was achieved on multiple patient/comorbidity (10), disease/stenosis (7), perioperative‐/intraoperative‐/procedure‐related (16) factors. Consensus was reached on multiple outcome and complication measures, both general and site‐specific (8 general, 13 supraglottic, 15 glottic, 17 subglottic, 8 cervical tracheal, 12 thoracic tracheal). The group was able to clarify how each outcome should be measured, with specific instruments defined where applicable.ConclusionThis consensus statement provides a framework to communicate results consistently and reproducibly, facilitating meta‐analyses, quality improvement, transfer of information, and surgeon self‐assessment. It also clarifies expert opinion on which patient, disease, procedural, and outcome measures may be important to consider in any pediatric airway reconstruction patient.Level of Evidence5 Laryngoscope, 129:244–255, 2019
Objectively Measuring Observer Attention in Severe Thyroid‐Associated Orbitopathy: A 3D Study
Authors: Liao David , Ishii Masaru , Darrach Halley M. , Bater Kristin L. , Smith Jane , Joseph Andrew W. , Douglas Raymond S. , Joseph Shannon S. , Ishii Lisa E. 
Published: August 2018

ObjectiveMeasure the attentional distraction of facial deformity related to severe thyroid‐associated orbitopathy using three‐dimensional (3D) images and eye‐tracking technology.MethodsObservers recruited at an academic tertiary referral center viewed 3D facial images of patients with severe thyroid‐associated orbitopathy (TAO) and controls without TAO. An infrared eye‐tracking monitor recorded their eye movements and fixations in real time. Multivariate Hotelling's analysis, followed by planned posthypothesis testing, was used to compare fixation durations for predefined regions of interest, including the eyes, nose, mouth, central triangle, and remaining face without the central triangle between severe TAO patients and controls.ResultsOne hundred sixteen observers (mean age 26.4 years, 51% female) successfully completed the eye‐tracking experiment. The majority of their attention was directed toward the central triangle (eyes, nose, mouth). On multivariate analysis, there were significant differences in the distribution of attention between control and severe TAO faces (T2 = 49.37; F(5,922) = 9.8314, P < 0.0001). On planned posthypothesis testing, observers attended significantly more to the eyes (0.77 seconds, P < 0.0001, 95% confidence interval [CI], 0.51, 1.03 seconds) and less to the nose (−0.42 seconds, P < 0.0001, 95% CI, −0.23, −0.62 seconds) in severe TAO patients. There was no significant difference in time spent on the mouth, the total time spent on the central triangle, or time spent in the remaining face between the two groups.ConclusionSevere TAO distracted observer attention toward the eyes compared to control patients. These data lend insight into how TAO may alter observers' perceptions of these patients. Future studies should investigate how these changes in observer gaze patterns may reflect the social perception of TAO patients.Level of EvidenceNA Laryngoscope, 129:1250–1254, 2019
Probe‐based confocal laser endomicroscopy for diagnosis of nasopharyngeal carcinoma in vivo
Authors: Wu Lingjie , Yu Huiqian , Zhou Ren , Luo Jiqin , Zhao Jieli , Li Yimeng , Wang Kang , Wang Yunfeng , Li Huawei 
Published: August 2018

Objectives/HypothesisProbe‐based confocal laser endomicroscopy (pCLE) is a novel technique allowing real‐time evaluation of the histological features of tissues in vivo at the cellular level. This study aimed to evaluate the feasibility of using pCLE in the diagnosis of nasopharyngeal carcinoma (NPC).Study DesignFeasibility study.MethodsIn this study, the pCLE images of the lesions, as well as the surrounding or contralateral normal mucosa of the lesions, were acquired in vivo from each patient after intravenous injecting of 2.5 mL fluorescein. Biopsy specimens were collected at the imaged sites followed by a histopathological diagnosis by the pathologists, which was used as the gold standard. The pCLE images were compared to histopathological diagnosis of visualized sites by using sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV).ResultsDiagnoses based on pCLE images correlated well with the gold standard diagnoses based on tissue histology. The overall sensitivity, specificity, PPV, and NPV for diagnosis of carcinoma versus nondysplasia were 93.8% (67.7%‐99.7%), 90.5% (68.2%‐98.3%), 88.2% (62.3%‐97.9%), and 95.0% (73.1%‐99.7%), respectively, and the four indices for pCLE diagnosis of dysplasia versus nondysplasia were 60.0% (17.0%‐92.7%), 80.9% (57.4%‐93.7%), 42.9% (11.8%‐79.8%), and 89.5% (65.5%‐98.2%), respectively. The overall sensitivity for diagnosis of carcinoma versus dysplasia was 93.8% (67.7%‐99.7%), specificity was 40% (7.3%‐83.0%), PPV was 83.3% (57.7%‐95.6%), and the NPV was 66.7% (12.5%‐98.2%).ConclusionsCLE is a suitable and valid method for otolaryngologists to diagnose of NPC in vivo.Level of EvidenceNA Laryngoscope, 129:897–902, 2019
Long‐term analysis of transorally resected p16 + Oropharynx cancer: Outcomes and prognostic factors
Authors: Sinha Parul , Haughey Bruce H. , Kallogjeri Dorina , Jackson Ryan S. 
Published: August 2018

ObjectiveWe observed high survival in a previous report of a p16‐positive, oropharyngeal carcinoma (OPC) cohort treated primarily with transoral laser microsurgery (TLM) ± adjuvant therapy and followed for ≥ 12 months. To address long‐term outcomes of primary transoral surgery for this unique disease, we present an updated analysis of our cohort with extended follow‐up.MethodsA prospectively assembled TLM cohort of 171 OPC patients was analyzed for disease‐free, disease‐specific, and overall survival (disease‐free survival [DFS], disease‐specific survival [DSS], overall survival [OS]) and functional outcomes, with a minimum follow‐up of 60 months or to death.ResultsMedian follow‐up was 103 (60–201) months. Five‐year DFS, DSS, and OS estimates were 85% (95% confidence interval [CI]: 80%–91%), 93% (95% CI: 89%–97%), and 90% (95% CI: 86%–95%). Recurrence occurred in 20 (12%; 7 locoregional, 13 distant); median time to recurrence was 18.8 months; and 90% occurred within 48 months. Age, smoking, American Joint Committee on Cancer 8th edition clinical tumor‐category, pathologic tumor (pT)‐category, pathologic tumor‐node‐metastasis (pTNM), and any adjuvant were significantly associated with disease‐free survival in multivariable analyses, whereas pT‐category, pN‐category, TNM grouping, and angioinvasion were associated with DSS. A second primary developed in six (3.5%) patients. Indications for gastrostomy were recurrence/second primary (11), postadjuvant esophageal stenosis (6), comorbidities (3), and osteo/chondroradionecrosis (3); only seven (4%) had a gastrostomy tube in the absence of these factors, all of whom received adjuvant therapy. Two had a tracheostomy tube [chondoradionecrosis (1), recurrence (1)].ConclusionHigh 5‐year survival and locoregional control were observed, with recurrence occurring more commonly as distant metastasis. The observed time to recurrence suggests posttreatment oncologic surveillance for at least 48 months. Identified prognosticators will inform adjuvant treatment considerations, trial planning, and patient counseling for long‐term outcomes. Laryngoscope, 2018Level of Evidence2b Laryngoscope, 129:1141–1149, 2019
Sarcomatoid Carcinoma in the Parotid Gland: A Review of 30 Years of Experience
Authors: Niu Xingyu 
Published: August 2018

ObjectiveThe goal of this study was to analyze the results of clinical treatment of sarcomatoid carcinoma in the parotid gland by reviewing 30 years of experience.MethodsThirty‐five patients were enrolled in this study. The Kaplan‐Meier methods were used to calculate the recurrence‐free survival (RFS) and disease‐specific survival (DSS) rates. The Cox model was used to determine the independent risk factor.ResultsMean age at presentation was 57.8 years, and most of the patients were staged as tumor (T)3 or T4. Perineural invasion was noted in 15 (42.9%) patients. Fifteen (42.9%) patients received neck dissection due to clinically suspicious nodes. Of those, three patients had pathologically positive nodes. Recurrence was noted in 14 patients; the most common pattern of treatment failure was local recurrence, and only 40% of the patients could receive salvaged surgical treatment. Disease‐specific death was noted in 10 patients. The 5‐year RFS and DSS rates were 67.3% and 65.7%, respectively. In a multivariate analysis, only the factor of perineural invasion was independently correlated with death.ConclusionParotid sarcomatoid carcinoma carries a poor prognosis, and perineural invasion was the most important predictive factor.Level of Evidence2b Laryngoscope, 129:1137–1140, 2019
A novel approach to skull‐base and orbital osteotomies through virtual planning and navigation
Authors: Franz Leonardo , Isola Miriam , Bagatto Daniele , Tuniz Francesco , Robiony Massimo 
Published: August 2018

ObjectiveComputer‐assisted planning of osteotomy lines, coupled with navigation‐guided performance of planned osteotomies, is a highly innovative approach to skull‐base and orbital surgery.The aim of this pilot study is to provide an assessment of the accuracy of this novel approach in guiding the correct positioning of osteotomy lines in frontal, temporal, and orbital regions, defining the agreement between the spatial position of the planned and performed osteotomies.MethodsFifteen patients with orbital, frontal sinus, and lateral skull‐base diseases underwent virtual surgical planning. Osteotomies to access the orbit, frontal sinus, and lateral skull base were planned on computer tomography‐based three‐dimensional models. The planned osteotomies were reproduced on the operating field using a navigation system. The positions of the performed and planned osteotomies were compared. The results were described as the mean positional difference between planned and performed osteotomies and as Lin's concordance coefficient, and Bland‐Altman limits of agreement were also defined.ResultsThe overall mean difference was 0.719 mm (95% confidence interval [CI]: 0.472 to 0.965 mm). Overall, Lin's concordance coefficient was 0.997 (95% CI: 0.996 to 0.998), and overall Bland‐Altman limits of agreement ranged from −1.407 to 2.844 mm.The smallest mean difference (0.587 mm, 95% CI: 0.244 to 0.931 mm) was calculated in the orbit group, whereas the highest mean difference (0.904 mm, 95% CI: 0.428 to 1.379 mm) was described in the lateral skull‐base group.ConclusionThis study's results support the use of this novel planning and navigation protocol for guiding osteotomy in anterior and lateral skull‐base surgery, providing a clinical validation of this technique.Level of Evidence4 Laryngoscope, 00:1–9, 2018 Laryngoscope, 129:823–831, 2019
Transporting the Optical Chirality through the Dynamical Barriers in Optical Microcavities
Authors: Liu Shuai , Wiersig Jan , Sun Wenzhao , Fan Yubin , Ge Li , Yang Jinkyu , Xiao Shumin , Song Qinghai , Cao Hui 
Published: August 2018

AbstractIn mixed phase space structures, the stable islands and chaotic sea are separated by dynamical barriers. Considering the small tunneling rate, intuitively, the properties of long‐lived resonances within stable islands are supposed to be less affected by the perturbations in chaotic sea. Here, the modifications on the chaotic sea which can be transported through dynamical barriers and strongly affect long‐lived resonances within stable islands are experimentally demonstrated. In waveguide‐connected quadruple microdisks (WCQMs), the finite orbital angular momentum and the propagation directions of long‐lived resonances within stable islands could be changed and controlled by the waveguides connecting to the chaotic sea. The numerical calculations and the corresponding 4 × 4 non‐Hermitian Hamiltonian theoretical model match the experimental results well and demonstrate the essential roles of asymmetrical scattering in the chaotic sea and chaotic‐to‐regular tunneling. This research will be interesting for fundamental studies on quantum chaos and practical applications in optical sensing.
Accelerating chemical exchange saturation transfer MRI with parallel blind compressed sensing
Authors: She Huajun , Greer Joshua S. , Zhang Shu , Li Bian , Keupp Jochen , Madhuranthakam Ananth J. , Dimitrov Ivan E. , Lenkinski Robert E. , Vinogradov Elena 
Published: August 2018

PurposeChemical exchange saturation transfer is a novel and promising MRI contrast method, but it can be time‐consuming. Common parallel imaging methods, like SENSE, can lead to reduced quality of CEST. Here, parallel blind compressed sensing (PBCS), combining blind compressed sensing (BCS) and parallel imaging, is evaluated for the acceleration of CEST in brain and breast.MethodsThe CEST data were collected in phantoms, brain (N = 3), and breast (N = 2). Retrospective Cartesian undersampling was implemented and the reconstruction results of PBCS‐CEST were compared with BCS‐CEST and k‐t sparse‐SENSE CEST. The normalized RMSE and the high‐frequency error norm were used for quantitative comparison.ResultsIn phantom and in vivo brain experiments, the acceleration factor of R = 10 (24 k‐space lines) was achieved and in breast R = 5 (30 k‐space lines), without compromising the quality of the PBCS‐reconstructed magnetization transfer rate asymmetry maps and Z‐spectra. Parallel BCS provides better reconstruction quality when compared with BCS, k‐t sparse‐SENSE, and SENSE methods using the same number of samples. Parallel BCS overperforms BCS, indicating that the inclusion of coil sensitivity improves the reconstruction of the CEST data.ConclusionThe PBCS method accelerates CEST without compromising its quality. Compressed sensing in combination with parallel imaging can provide a valuable alternative to parallel imaging alone for accelerating CEST experiments.
Cytosolic expression, solution structures, and molecular dynamics simulation of genetically encodable disulfide‐rich de novo designed peptides
Authors: Buchko Garry W. , Pulavarti Surya V.S.R.K. , Ovchinnikov Victor , Shaw Elizabeth A. , Rettie Stephen A. , Myler Peter J. , Karplus Martin , Szyperski Thomas , Baker David , Bahl Christopher D. 
Published: August 2018

AbstractDisulfide‐rich peptides represent an important protein family with broad pharmacological potential. Recent advances in computational methods have made it possible to design new peptides which adopt a stable conformation de novo. Here, we describe a system to produce disulfide‐rich de novo peptides using Escherichia coli as the expression host. The advantage of this system is that it enables production of uniformly 13C‐ and 15N‐labeled peptides for solution nuclear magnetic resonance (NMR) studies. This expression system was used to isotopically label two previously reported de novo designed peptides, and to determine their solution structures using NMR. The ensemble of NMR structures calculated for both peptides agreed well with the design models, further confirming the accuracy of the design protocol. Collection of NMR data on the peptides under reducing conditions revealed a dependency on disulfide bonds to maintain stability. Furthermore, we performed long‐time molecular dynamics (MD) simulations with tempering to assess the stability of two families of de novo designed peptides. Initial designs which exhibited a stable structure during simulations were more likely to adopt a stable structure in vitro, but attempts to utilize this method to redesign unstable peptides to fold into a stable state were unsuccessful. Further work is therefore needed to assess the utility of MD simulation techniques for de novo protein design.
Efficient and wash‐free labeling of membrane proteins using engineered Npu DnaE split‐inteins
Authors: Lee Euiyeon , Min Kyoungmi , Chang Young‐Tae , Kwon Youngeun 
Published: August 2018

AbstractAn efficient and wash‐free method to conjugate a fluorescent tag to a target membrane protein is developed, using engineered Npu DnaE split‐inteins. This approach allowed fast labeling while avoiding the strenuous synthesis of a long polypeptide. Two different modes of labeling, namely specific binding and covalent conjugation, are observed. The covalent labeling was monitored within 5 min, without background staining.
The ECMWF ensemble prediction system: Looking back (more than) 25 years and projecting forward 25 years
Authors: Palmer Tim 
Published: August 2018

This paper has been written to mark 25 years of operational medium‐range ensemble forecasting. The origins of the ECMWF Ensemble Prediction System are outlined, including the development of the precursor real‐time Met Office monthly ensemble forecast system. In particular, the reasons for the development of singular vectors and stochastic physics – particular features of the ECMWF Ensemble Prediction System ‐ are discussed. The author speculates about the development and use of ensemble prediction in the next 25 years.