bluuebunny/crossref_metadata_2025_split huggingface dataset:
Know the Flow
Authors: Pados Britt Frisk , Park Jinhee , Dodrill Pamela 
Published: July 2018

Background:
Milk flow rate may play an important role in an infant's ability to safely and efficiently coordinate sucking, swallowing, and breathing during feeding.

Purpose:
To test milk flow rates from bottle nipples used in the hospital and after discharge.

Methods:
Bottle nipples used in hospitals (10 unique types) and available nationwide at major retailers (15 unique types) were identified. For each of the 25 nipple types, 15 nipples of that type were tested by measuring the amount of infant formula extracted in 1 minute by a breast pump. Mean milk flow rate (mL/min) and coefficient of variation (CV) were calculated for each nipple type. Comparisons between nipple types were made within brand and within category (eg, Slow, Standard). A cluster analysis was conducted to identify nipples of comparable flow.

Results:
A total of 375 individual nipples were tested. Milk flow rates varied widely, from 0.86 to 37.61 mL/min. There was also a wide range of CVs, from 0.03 to 0.35. Packing information did not accurately reflect the flow rates of bottle nipples. The cluster analysis revealed 5 clusters of nipples, with flow rates from Extra Slow to Very Fast.

Implications for Practice:
These data can be used to guide decisions regarding nipples to use for feeding infants with medical complexity in the hospital and after discharge.

Implications for Research:
Research on infant feeding should consider the flow rate and variability of nipples used, as these factors may impact findings.
Clinical and Radiological Outcome of a New Total Cervical Disc Replacement Design
Authors: Mehren Christoph , Heider Franziska , Sauer Daniel , Kothe Ralph , Korge Andreas , Hitzl Wolfgang , Wuertz-Kozak Karin 
Published: July 2018

Study Design.
A nonrandomized, prospective, and single-center clinical trial of the ProDisc Vivo prosthesis.

Objective.
The aim of this study was to investigate the clinical and radiological results of a refined total cervical disc replacement (cTDR), the ProDisc Vivo, with two years of follow-up (FU). The incidence of implant-related complications was recorded as a secondary outcome variable.

Summary of Background Data.
Previous generations of the ProDisc artificial cervical disc replacement generate high primary stability due to keel-based designs with opening of the anterior cortex during the implantation and subsequent high rates of heterotopic ossifications.

Methods.
Clinical outcome scores included the Neck Disability Index (NDI), Visual Analogue Scale (VAS), arm and neck pain self-assessment questionnaires. The radiological outcome included the range of motion (ROM) and the occurrence of heterotopic ossifications. The incidence of implant-related complications with new implant design was recorded as a secondary outcome variable.

Results.
A total of 55 patients received a single-level treatment with the ProDisc Vivo cTDR between C3/4 and C6/7, with a follow-up rate of 78%. The clinical outcome scores improved in all parameters significantly (P = 0.0001) (NDI: 68.3 → 17.4; VAS arm: 6.3 → 1.4; VAS neck: 4.9 → 1.6). The ROM of the index-segment did not show a significant change (P = 0.26) (7.9° → 9.2°). Heterotopic ossifications at the index segment was found as grade 0 in 58%, grade 1 in 22%, grade 2 in 10%, grade 3 (with functional impairment of the prosthesis) in 7%, and grade 4 in 3% of the cases. We observed three implant-related complications (5.5%), with two implant dislocations anteriorly and one low-grade infect.

Conclusion.
cTDR with ProDisc Vivo demonstrated a significant and sustained improvement of all clinical outcome parameters. A less invasive implantation mechanism with lower primary stability of the cTDR might be a reason for a higher dislocation rate than the keel-based previous generation ProDisc C.

Level of Evidence: 4
Ratio of Blood Glucose Level Change Measurement for Flap Monitoring
Authors: Karakawa Ryo , Yoshimatsu Hidehiko , Narushima Mitsunaga , Iida Takuya 
Published: July 2018

Background:
In a setting of flap congestion, early detection and rapid reexploration are important. Some studies described the efficacy of blood glucose measurement for flap monitoring.
1
However, the sensitivity and specificity of this method were not high enough to determine whether reexploration should be done or not. The purpose of this study was to evaluate and establish a method using the ratio of blood glucose level change (RBGC) measurement for detecting venous thrombosis and to propose an algorithm for flap salvage after congestion.

Methods:
Blood glucose level was measured in 36 free tissue transfers over time postoperatively and RBGC was calculated. When flap congestion was suspected, frequent blood glucose measurement and some countermeasures were performed complying with an algorithm. If the venous thrombus was suspected, the reexploration was performed. The RBGCs at the points in time when the venous thrombosis was detected were compared with those at the points in time when the flap demonstrated no venous thrombosis.

Results:
Of the 36 flaps, 30 flaps demonstrated no venous thrombosis and 6 flaps demonstrated venous thrombosis. Four flaps demonstrated signs of congestion but improved after the reexploration. The mean RBGCs at the points in time when the venous thrombosis was detected was −7.61 mg/dl h and those at times when the flap demonstrated no venous thrombosis was 0.10 mg/dl h, the former being significantly lower than the latter.

Conclusion:
Using the flap monitoring method using RBGC measurement, we could salvage some flaps from the congestion due to the venous thrombosis without unnecessary reexploration.
SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FINDINGS IN WAARDENBURG SYNDROME
Authors: Hsiao Andrew Matthew , Choudhry Netan 
Published: July 2018

Purpose:
Waardenburg syndrome (WS) is a rare condition characterized by six main features. It has been previously observed that WS is also associated with hypopigmentation of the choroid through multimodal imaging. To our knowledge, this is the first report of using swept-source optical coherence tomography angiography (OCTA) on a patient with known WS.

Methods:
Report of a single case. The swept-source OCT images were captured using Topcon DRI OCT Triton (Topcon, Inc, Tokyo, Japan), whereas swept-source OCTA images were captured by Optovue AngioVue (Optovue, Inc, Fremont, CA) using DualTrack Motion Correction Technology.

Results:
In this case, OCTA demonstrated evidence of normal vasculature of all layers (superficial, deep, and choricocapillaris), a normal foveal avascular zone measuring 0.267 mm2 in the right eye and 0.307 mm2 in the left eye, and a normal capillary density measuring 49.8% in the right eye and 52.6% in the left eye.

Conclusion:
There are many conditions that may mimic the hypopigmentation of the choroid associated with WS; it has been documented that these similar conditions such as choroidal nevus, choroidal melanoma, and Vogt–Koyanagi–Harada syndrome all demonstrated abnormal OCTA findings. Unlike these conditions, our patient with WS had unremarkable OCTA findings.
Comparison of Visual Acuity Outcomes Between Nanothin Descemet Stripping Automated Endothelial Keratoplasty and Descemet Membrane Endothelial Keratoplasty
Authors: Kurji Khaliq H. , Cheung Albert Y. , Eslani Medi , Rolfes Erin J. , Chachare Deepali Y. , Auteri Nicholas J. , Nordlund Michael L. , Holland Edward J. 
Published: July 2018

Purpose:
To compare the visual outcomes and complications between nanothin Descemet stripping automated endothelial keratoplasty (NT-DSAEK) and Descemet membrane endothelial keratoplasty (DMEK).

Methods:
A prospective comparative case series of 28 consecutive cases of NT-DSAEK (less than or equal to 50 μm) and DMEK was undertaken. Inclusion criteria were a diagnosis of Fuchs dystrophy, presence of pseudophakia, or planned combined cataract surgery/endothelial keratoplasty, with a minimum of 6-month follow-up. Exclusion criteria were any concurrent ocular comorbidities. Primary outcomes measures were best spectacle-corrected visual acuity (BSCVA) and complications.

Results:
Mean thickness of NT-DSAEK grafts was 41.0 ± 7.5 μm (range 26–50 μm). At 1 month postoperatively, the DMEK group had significantly better mean BSCVA of 0.18 ± 0.20 logarithm of the minimum angle of resolution (logMAR) (20/33) compared with 0.28 ± 0.16 logMAR (20/40) for NT-NSAEK (P = 0.049). At 3, 6, and 12 months postoperatively, mean BSCVA was comparable between both groups [3 months: NT-DSAEK 0.17 ± 0.12 logMAR (20/30) versus DMEK 0.13 ± 0.17 (20/27), P = 0.31; 6 months: NT-DSAEK 0.11 ± 0.10 logMAR (20/26) versus DMEK 0.09 ± 0.10 (20/25), P = 0.63; 12 months: NT-DSAEK 0.07 ± 0.09 logMAR (20/24) versus DMEK 0.07 ± 0.11 logMAR (20/24), P = 0.95]. Other than 1 NT-DSAEK graft that was successfully rebubbled, no other complications were encountered in either group.

Conclusions:
Compared with DMEK, NT-DSAEK provides comparable visual outcomes and complications rates.
Intratympanic Gentamicin for Small Vestibular Schwannomas With Intractable Vertigo
Authors: Yang Jie , Jia Huan , Li Gen , Huang Meiping , Zhu Weidong , Wang Zhaoyan , Li Yun , Wu Hao 
Published: July 2018

Objective:
To evaluate the objective and subjective effects of intratympanic gentamicin treatment in patients with small vestibular schwannomas who exhibit intractable vertigo.

Patients:
Individuals diagnosed with small vestibular schwannomas who exhibited intractable vertigo were retrospectively reviewed.

Interventions:
Intratympanic gentamicin injection.

Main Outcome Measures:
Vertigo control.

Results:
Eight patients were included in the study. All patients achieved complete or substantial control of vertigo attacks while six patients reported residual imbalance. Three patients experienced significant hearing loss during therapy and follow-up. Only one patient showed a drop from Class B to Class C. Caloric tests and vestibular evoked myogenic potentials showed that all patients exhibited impaired peripheral vestibular function before treatment and that unilateral vestibular deafferentation was achieved during follow-up. Dizziness Handicap Inventory scores decreased over time, indicating an increase in the quality of life.

Conclusions:
Intratympanic gentamicin could provide an efficient approach to control intractable vertigo caused by small vestibular schwannoma. Before treatment, a complete physical examination, hearing level evaluation, vestibular function evaluation, and appropriate patient expectations are indispensable.
Diagnosis of nonventilated hospital-acquired pneumonia: how much do we know?
Authors: Ranzani Otavio T. , De Pascale Gennaro , Park Marcelo 
Published: July 2018

Purpose of review
To describe the current knowledge about clinical and microbiological diagnosis of nonventilated hospital-acquired pneumonia (NV-HAP).

Recent findings
NV-HAP is emerging as a new challenge for clinicians, particularly because VAP incidence has been decreasing. The clinical diagnosis of NV-HAP uses the classical clinical symptoms and signs. However standard evaluation of their accuracy and the evaluation of new criterion (e.g. lung ultrasound) must be conducted particularly in NV-HAP patients. The use of sputum must be encouraged in patients with NV-HAP, assuring its lower respiratory tract representativeness and quality. It is not clear that invasive approaches (e.g. BAL) are associated with improvements in patient-centred outcomes, and further research is needed to assure their correct indication, guaranteeing safety. Rapid diagnosis methods are promising in NV-HAP, particularly for the quick results and information about antibiotic resistance.

Summary
NV-HAP poses several barriers for diagnosis compared with VAP, and the available knowledge is limited. A call for further research in diagnosis of nonventilated HAP is urgent.
Validity Evidence for Direct Observation of Procedural Skills in Paediatric Gastroscopy
Authors: Siau Keith , Levi Rachel , Howarth Lucy , Broughton Raphael , Feeney Mark , Beales Ian L.P. , Tzivinikos Christos , Narula Priya 
Published: July 2018

ABSTRACTObjectives:Direct observation of procedural skills (DOPS) are competence‐assessment tools in endoscopy. Formative paediatric gastroscopy DOPS were implemented into the UK curriculum in 2016 but lack validity evidence; we aimed to assess validity evidence using a recognised contemporary validity framework.Methods:We performed a prospective UK‐wide analysis of formative paediatric gastroscopy DOPS submitted to the e‐Portfolio over 1 year. Internal structure validity was assessed using interitem correlations between DOPS items, average domain, and skillset scores and with the overall competency rating. Overall competence scores and mean DOPS scores were compared by trainee seniority and procedure count (discriminative validity). Receiver operating characteristic curve analysis was performed to explore if DOPS scores could be used to delineate procedural competency (consequential validity).Results:A total of 157 DOPS assessments were completed by 20 trainers for 17 trainees. Strengths of correlations varied between DOPS components, with overall competency correlating most with technical‐predominant items, domains and skillsets. Both the overall assessor's rating and mean DOPS scores increased with trainee seniority (P < 0.001) and lifetime procedure count (P < 0.001). Overall competency could be delineated using mean DOPS scores (area under receiver operating characteristic curve 0.95, P < 0.001), with a threshold of 3.9 providing optimal sensitivity (94.4%) and specificity (89.7%).Conclusions:Competencies in paediatric gastroscopy, as assessed using DOPS, vary in their correlation with overall competence and increase with trainee experience. Formative DOPS thresholds could be used to indicate readiness for summative assessment. Our study therefore provides evidence of internal structure, discriminative, and consequential validity in support of formative paediatric gastroscopy DOPS.
Growth, Body Composition, and Micronutrient Abnormalities During and After Weaning Off Home Parenteral Nutrition
Authors: Neelis Esther , Olieman Joanne , Rizopoulos Dimitris , Wijnen René , Rings Edmond , de Koning Barbara , Hulst Jessie 
Published: July 2018

ABSTRACTObjectives:The aim of the study is to assess growth, body composition, and micronutrient abnormalities in children with intestinal failure (IF) over time, both during and after weaning off parenteral nutrition (PN).Methods:Retrospective study in children on home PN between 2001 and 2015. Weight‐for‐age (WFA) and height‐for‐age (HFA) SD scores (SDS) were calculated, as well as fat mass (FM) and fat‐free mass (FFM) SDS obtained by dual energy x‐ray absorptiometry. The course of growth parameters and body composition was analyzed with linear‐mixed models. All micronutrient measurements during the study period were obtained.Results:Fifty‐two patients were included with a median follow‐up of 3.4 years. Seventy‐one percent weaned off after a median PN duration of 0.9 years. One year after the start of PN, 28 patients were still PN‐dependent with median WFA‐SDS of −0.66 and median HFA‐SDS of −0.96, both significantly lower than zero. Catch‐up growth was achieved during PN, but HFA‐SDS decreased after weaning (P = 0.0001). At a median age of 6.2 years, median %FM SDS was 0.30 and FFM SDS was −1.21, the latter significantly lower than zero. Frequent micronutrient abnormalities during PN were vitamin A (90%), zinc (87%), and iron (76%) and after weaning vitamin A (94%), E (61%), and 25‐OH vitamin D (59%).Conclusions:Children with IF demonstrate abnormal growth and body composition and frequent micronutrient abnormalities. Longitudinal evaluation showed that catch‐up growth occurs during PN, but height SDS decreases after weaning. This underlines the need for close monitoring, also after reaching enteral autonomy.
A 2018 Reference Guide to the Banff Classification of Renal Allograft Pathology
Authors: Roufosse Candice , Simmonds Naomi , Clahsen-van Groningen Marian , Haas Mark , Henriksen Kammi J. , Horsfield Catherine , Loupy Alexandre , Mengel Michael , Perkowska-Ptasińska Agnieszka , Rabant Marion , Racusen Lorraine C. , Solez Kim , Becker Jan U. 
Published: July 2018

Abstract
The Banff Classification of Allograft Pathology is an international consensus classification for the reporting of biopsies from solid organ transplants. Since its initial conception in 1991 for renal transplants, it has undergone review every 2 years, with attendant updated publications. The rapid expansion of knowledge in the field has led to numerous revisions of the classification. The resultant dispersal of relevant content makes it difficult for novices and experienced pathologists to faithfully apply the classification in routine diagnostic work and in clinical trials. This review shall provide a complete and simple illustrated reference guide of the Banff Classification of Kidney Allograft Pathology based on all publications including the 2017 update. It is intended as a concise desktop reference for pathologists and clinicians, providing definitions, Banff Lesion Scores and Banff Diagnostic Categories. An online website reference guide hosted by the Banff Foundation for Allograft Pathology (www.banfffoundation.org) is being developed, which will be updated with future refinement of the Banff Classification from 2019 onward.
RecNW: A fast pairwise aligner for targeted sequencing
Authors: Yahi Alexandre , Lappalainen Tuuli , Mohammadi Pejman , Tatonetti Nicholas P. 
Published: July 2018

AbstractMotivationTargeted sequencing aims at in-depth analysis of specific genomic loci through high-throughput sequencing for applications such as resequencing or CRISPR gene editing. These applications require exact pairwise alignment algorithms to fully characterize large amounts of reads by comparison to the targeted locus, or reference. Optimal solutions to this alignment problem are provided by classic implementations of the global and semi-global versions of Needleman-Wunsch algorithms, but they remain computationally expensive due to their quadratic complexity in time and space.ImplementationIn this paper we present RecNW, an open source C++ exact aligner packaged for Python that implements the semi-global version of the Needleman-Wunsch algorithm with affine gap penalty. RecNW utilizes low complexity of targeted sequencing libraries by aligning only unique reads, and recurrently using blocs of the alignment matrix between reads based on their similarities. Through this, RecNW performs exact alignment on average more than four times faster than gold standard comparable software.Softwarehttps://github.com/AYahi/recNW
FleN contributes to heterogeneous swimming at high temperatures inPseudomonas syringae
Authors: Hockett Kevin L. , Lindow Steven E. 
Published: July 2018

SUMMARYMotility is generally conserved among many animal and plant pathogens. Environmental conditions, however, significantly impact expression of the motile phenotype. In this study, we describe a novel heterogeneous motility phenotype inPseudomonas syringae, where under normally suppressive incubation conditions (30°C) punctate colonies arise that are spatially isolated from the point of inoculation, giving rise to a motility pattern we term constellation swimming (CS). We demonstrate that this phenotype is reproducible, reversible, and dependent on a functioning flagellum. Mirroring the heterogeneous motility phenotype, we demonstrate the existence of a sub-population of cells under non-permissive conditions that express flagellin (fliC) at levels similar to cells incubated under permissive conditions using both quantitative single cell microscopy and flow cytometry. To understand the genetics underlying the CS phenotype, we selected for naturally arising mutants that exhibited a normal swimming phenotype at the warmer incubation temperature. Sequencing these mutants recovered several independent non-synonymous mutations within FleN (also known as FlhG) as well as mutations within the promoter region of FleQ, the master flagellum regulator inPseudomonas. We further show that nutrient depletion is the likely underlying cause of CS, as reduced nutrients will stimulate bothfliCexpression and a normal swimming phenotype at 30 °C.
Simultaneous multi-area recordings suggest that attention improves performance by reshaping stimulus representations
Authors: Ruff Douglas A. , Cohen Marlene R. 
Published: July 2018

AbstractVisual attention dramatically improves subjects’ ability to see and also modulates the responses of neurons in every known visual and oculomotor area, but whether those modulations can account for perceptual improvements remains unclear. We measured the relationship between populations of visual neurons, oculomotor neurons, and behavior during detection and discrimination tasks. We found that neither of the two prominent hypothesized neuronal mechanisms underlying attention (which concern changes in information coding and the way sensory information is read out) provide a satisfying account of the observed behavioral improvements. Instead, our results are more consistent with the novel hypothesis that attention reshapes the representation of attended stimuli to more effectively influence behavior. Our results suggest a path toward understanding the neural underpinnings of perception and cognition in health and disease by analyzing neuronal responses in ways that are constrained by behavior and interactions between brain areas.
Dispersers are more likely to follow mucus trails in the land snailCornu aspersum
Authors: Vong Alexandre , Ansart Armelle , Dahirel Maxime 
Published: July 2018

AbstractDispersal, i.e. movement leading to gene flow, is a fundamental although costly life history trait. The use of indirect social information may help mitigate these costs, yet in many cases little is known about the proximate sources of such information, and how dispersers and residents may differ in their information use. Land gastropods, which have a high cost of movement and obligatorily leave information potentially exploitable by conspecifics during movement (through mucus trails), are a good model to investigate links between dispersal costs and information use. We used Y-mazes to see whether dispersers and residents differed in their trail-following propensity, in the snailCornu aspersum. Dispersers followed mucus trails more frequently than expected by chance, contrary to non-dispersers. Ignoring dispersal status during tests would lead to falsely conclude to no trail-following for the majority of ecologically realistic scenarios. Trail following by dispersers may reduce dispersal costs by reducing energy expenditure and helping snails find existing patches. Finally, we point that ignoring the potential for collective dispersal provided by trail-following abilities may lead to wrong inferences on the demographic and genetic consequences of dispersal.