bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rapid evolution of tolerance to toxic Microcystis in two cladoceran grazers
Authors: Jiang Xiaodong , Gao Han , Zhang Lihua , Liang Huishuang , Zhu Xiao 
Published: April 2016

AbstractEvolutionary adaptation could assist organisms to cope with environmental changes, yet few experimental systems allow us to directly track evolutionary trajectory. Using experimental evolution, evolutionary tolerance to Microcystis aeruginosa was investigated in two cladocerans (Daphnia pulex and Simocephalus vetulus) to test the hypothesis that cladoceran grazers rapidly adapt to toxic cyanobacteria. After exposure for either three or six months, both grazers evolved a higher tolerance. The intrinsic rate of population increases in S. vetulus feeding on cyanobacteria was negatively correlated with that on green algae, which suggests that evolutionary adaptation in tolerance would carry a cost in the absence of cyanobacteria. However, the cyanobacterial selection resulted in a general increase in D. pulex when fed both cyanobacteria and green algae. Following a three-month relaxation of selection, S. vetulus in the selection line exhibited reverse evolution back to their original state when their diets were switched back to pure green algae. The present experimental evolution, both forwards and reverse, not only demonstrates the evolutionary responses of cladoceran grazers to toxic cyanobacterial cells in the laboratory, but also indicates that the grazer-cyanobacteria interaction would be an effective system to empirically study rapid evolution to environmental changes.
Fully differential switching topology for mm‐wave dual‐mode LO‐distribution circuitry
Authors: Hamidian A. , Barbin S.E. , Boeck G. 
Published: April 2016

A novel switching circuitry for fully differential millimetre‐wave applications is presented. The structure of the proposed switching architecture includes 90 nm CMOS transistors and a distributed‐active‐transformer. To minimise the chip size, an innovative topology based on lumped components is investigated, resulting a total size of <0.025 mm2. The performance of the designed switch is validated within a dual‐mode local oscillator‐distribution circuitry of a V‐band transceiver.
Thyroid Hormone in the Pediatric Intensive Care Unit
Authors: Radman Monique , Portman Michael 
Published: April 2016

AbstractThyroid hormones are key factors necessary for normal growth and development in children. They have tight control of metabolic rate and, as a result, frequently become altered in their synthesis and/or release during times of stress or critical illness. Disturbances in thyroid hormone homeostasis have been well described in several pathologic states, including sepsis/septic shock, renal failure, trauma, severe malnutrition, and following cardiopulmonary bypass. Specifically, a decrease in serum triiodothyronine (T3) and a concomitant increase in reverse triiodothyronine (rT3) levels are the most common changes observed. It is further noteworthy that serum thyroxine (T4), rT3, and T3 levels change in relation to severity of nonthyroidal illness. Many past investigators have speculated that these alterations are a teleological adaptation to severe illness and the increased metabolic demands that critical illness bears. However, this paradigm has been challenged through multiple avenues and has lost support over the past few years. Instead the “inflammatory hypothesis” has emerged implicating a cytokine surge as the mediator of thyroid hormone disruption. Overall, the demonstrated association between low thyroid hormone levels and poor clinical outcomes, the beneficial effects of thyroid hormone supplementation in multiple critically ill subpopulations, and the well-established safety profile of T3 therapy make thyroid hormone supplementation in the pediatric ICU worth consideration.
Hybrid Instrumentation in Lumbar Spinal Fusion
Authors: Obid Peter , Danyali Reza , Kueny Rebecca , Huber Gerd , Reichl Michael , Richter Alexander , Niemeyer Thomas , Morlock Michael , Püschel Klaus , Übeyli Hüseyin 
Published: April 2016

Study Design Ex vivo human cadaveric study. Objective The development or progression of adjacent segment disease (ASD) after spine stabilization and fusion is a major problem in spine surgery. Apart from optimal balancing of the sagittal profile, dynamic instrumentation is often suggested to prevent or impede ASD. Hybrid instrumentation is used to gain stabilization while allowing motion to avoid hypermobility in the adjacent segment. In this biomechanical study, the effects of two different hybrid instrumentations on human cadaver spines were evaluated and compared with a rigid instrumentation. Methods Eighteen human cadaver spines (T11–L5) were subdivided into three groups: rigid, dynamic, and hook comprising six spines each. Clinical parameters and initial mechanical characteristics were consistent among groups. All specimens received rigid fixation from L3–L5 followed by application of a free bending load of extension and flexion. The range of motion (ROM) for every segment was evaluated. For the rigid group, further rigid fixation from L1–L5 was applied. A dynamic Elaspine system (Spinelab AG, Winterthur, Switzerland) was applied from L1 to L3 for the dynamic group, and the hook group was instrumented with additional laminar hooks at L1–L3. ROM was then evaluated again. Results There was no significant difference in ROM among the three instrumentation techniques. Conclusion Based on this data, the intended advantage of a hybrid or dynamic instrumentation might not be achieved.
Development and usage of wiki-based software for point-of-care emergency medical information
Authors: Donaldson Ross I , Ostermayer Daniel G , Banuelos Rosa , Singh Manpreet 
Published: April 2016

Abstract
Objective To describe the creation and evaluate the usage of the first medical wiki linked to dedicated mobile applications.
Methods With the support of multiple current and past contributors, we developed an emergency medicine wiki linked to offline mobile applications (WikEM) in 2009. First deployment was at the Harbor-UCLA Medical Center emergency medicine residency program, with the wiki later opened to public use. To evaluate the project, we performed a post hoc analysis of system use and surveyed 8 years of current and past residents. Outcomes included website and application analytics, as well as survey analysis by composite response categories.
Results Over the 6-year period of this project, the wiki grew to over 7250 pages and 45 500 edits. The website receives more than 85 000 user sessions per month, with over 150 million page views to date. There have been over 200 000 installs of the mobile applications, progressing to produce over 5000 mobile sessions daily. Of potential survey respondents, 87.7% (107) completed the Internet-based survey. Among those who contributed to the wiki, 74.6% reported that it benefited their understanding of core emergency medicine content. Of program graduates, the vast majority reported use of the wiki as a resource after residency (93.8%) along with improvement in clinical efficiency (89.7%). Residents reported higher use and a more favorable opinion of wiki usefulness compared to graduates ( P &lt; .001).
Conclusions A wiki paired with mobile applications is beneficial for resident education and useful in post-residency clinical practice.
Adult orbital wall fracture repair
Authors: Burnham Richard , Bridle Christopher 
Published: April 2016

Abstract
The orbit, consisting of the outer frame and inner pyramidal vault, provides support and protection for the orbital contents. Any disruption to this structure may result in the loss of normal binocular vision. We present a case of a fracture of the orbital floor and medial orbital wall. The chapter discusses current thinking on the paradigm shift from ‘safe distances’ to the use of anatomical structures within the orbit to guide reconstruction. Emphasis is placed on the early diagnosis of orbital compartment syndrome that represents a maxillofacial emergency and requires expedient surgical treatment. The close liaison with ophthalmology and orthoptic colleagues is also vital in order to achieve optimum outcomes.
High-energy ballistic injuries to the face
Authors: Breeze John , Parmar Sat , Monaghan Andrew 
Published: April 2016

Abstract
High-velocity bullets damage the facial skeleton both as a result of their direct tissue crushing effect as well as high-energy transfer. This produces wounds that may be unfamiliar to the practice of many maxillofacial surgeons. We describe the case of a UK soldier hit in the face by a high-velocity bullet resulting in a complex mandibular fracture with overlying soft tissue maceration. Following securing of the airway by surgical tracheostomy, his mandible was reduced and stabilized using an external fixator. Subsequent rehabilitation involved an iliac bone graft to enable implant placement followed by vestibuloplasty to improve vestibular contour. These types of battle wounds are unusual in civilian practice and we believe this case illustrates some of the diagnostic and treatment decisions required to produce a successful outcome.
Low-energy explosive fragmentation injuries to the neck and face
Authors: Breeze John , Gibbons Andrew , Sharp Ian 
Published: April 2016

Abstract
Explosively propelled fragments cause significant damage to unprotected areas of the body, producing wounds that may be unfamiliar to the practice of many maxillofacial surgeons. We describe the case of a UK soldier who stood on an improvised explosive device. He sustained traumatic amputation of both legs and multiple fragments penetrating the face and neck with a partial avulsive injury to the right side of his mandible. Following serial debridement of the wounds both in Afghanistan and back in the UK, a custom-made reconstruction plate was used to support the comminuted mandible. A bone graft was contraindicated due to his limb injuries and therefore distraction osteogenesis was used to generate bone for subsequent implant placement. These types of battle wounds are unusual in civilian practice and we believe this case illustrates some of the diagnostic and treatment decisions required to produce a successful outcome.
Management of the Wilkes Grade III temporomandibular joint
Authors: Mihalache Grigore , Messahel Ahmed 
Published: April 2016

Abstract
Temporomandibular joint (TMJ) dysfunction is a broad and multifactorial topic. It occurs more commonly in men than women with the average age of presentation being around 30 years of age. Internal derangement of the TMJ has been very eloquently classified by Wilkes according to the degree of clinical, radiological, and surgical abnormality. We present a case of a 28-year-old female with a 12-month history of pain and clicking from her right TMJ. Cross-sectional imaging demonstrated anterior displacement of the disc with reduction. This chapter predominantly describes non-surgical management of this disease process. However, acknowledgement is given to those cases where surgical intervention is required.
Sagittal split osteotomy for the removal of a lower third molar
Authors: Idle Matthew , Dover Stephen 
Published: April 2016

Abstract
In the UK the National Institute for Health and Care Excellence has provided comprehensive guidance for removal of third molars. These have been compiled to prevent unnecessary morbidity to the patient in the form of inferior alveolar and lingual nerve injuries. We present a case of a 48-year-old male with recurrent episodes of pericoronitis around the lower eight necessitating its removal. An orthopantomogram and computed tomogram demonstrated that the tooth was deeply buried in the ramus of the mandible and in close proximity to the inferior alveolar nerve. Thus a sagittal split osteotomy was performed to allow removal of this source of infection. Despite this being an unconventional technique oral and maxillofacial surgeons should be familiar with this as a potential treatment option.
Is there an exoplanet in the Solar system?
Authors: Mustill Alexander J. , Raymond Sean N. , Davies Melvyn B. 
Published: April 2016

Abstract
We investigate the prospects for the capture of the proposed Planet 9 from other stars in the Sun's birth cluster. Any capture scenario must satisfy three conditions: the encounter must be more distant than ∼150 au to avoid perturbing the Kuiper belt; the other star must have a wide-orbit planet (a ≳ 100 au); the planet must be captured on to an appropriate orbit to sculpt the orbital distribution of wide-orbit Solar system bodies. Here we use N-body simulations to show that these criteria may be simultaneously satisfied. In a few per cent of slow close encounters in a cluster, bodies are captured on to heliocentric, Planet 9-like orbits. During the ∼100 Myr cluster phase, many stars are likely to host planets on highly eccentric orbits with apastron distances beyond 100 au if Neptune-sized planets are common and susceptible to planet–planet scattering. While the existence of Planet 9 remains unproven, we consider capture from one of the Sun's young brethren a plausible route to explain such an object's orbit. Capture appears to predict a large population of trans-Neptunian objects (TNOs) whose orbits are aligned with the captured planet, and we propose that different formation mechanisms will be distinguishable based on their imprint on the distribution of TNOs.
Structure and superconductivity of hydrides at high pressures
Authors: Duan Defang , Liu Yunxian , Ma Yanbin , Shao Ziji , Liu Bingbing , Cui Tian 
Published: April 2016

Abstract
Hydrogen atoms can provide high phonon frequencies and strong electron–phonon coupling in hydrogen-rich materials, which are believed to be potential high-temperature superconductors at lower pressure than metallic hydrogen. Especially, recently both of theoretical and experimental reports on sulfur hydrides under pressure exhibiting superconductivity at temperatures as high as 200 K have further stimulated an intense search for room-temperature superconductors in hydrides. This review focuses on crystal structures, stabilities, pressure-induced transformations, metallization, and superconductivity of hydrogen-rich materials at high pressures.
Neither Neoplasia Nor Tuberculosis, but Francisella
Authors: Mambie Adeline , Wallet Frédéric , Scherman Laurine , Armand Sylvie , Vervelle Christine , Faure Karine , Guery Benoit , Titécat Marie , Loïez Caroline 
Published: April 2016

Abstract
Tularaemia is an emerging anthropozoonosis transmitted by contact with infected animals and through arthropod bites, inhalation, or ingestion. We describe a pulmonary nodule suggesting cancer in a 70-year-old man. Histological analysis excluded neoplasia, and bacteriological culture excluded tuberculosis. Serological testing and PCR Francisella were positive for this hunter patient, then treated by ciprofloxacin with a favourable outcome.
Cellular Dynamics of Mouse Trophoblast Stem Cells: Identification of a Persistent Stem Cell Type1
Authors: Motomura Kaori , Oikawa Mami , Hirose Michiko , Honda Arata , Togayachi Sumie , Miyoshi Hiroyuki , Ohinata Yasuhide , Sugimoto Michihiko , Abe Kuniya , Inoue Kimiko , Ogura Atsuo 
Published: April 2016

Abstract
Mouse trophoblast stem cells (TSCs) proliferate indefinitely in vitro, despite their highly heterogeneous nature. In this study, we sought to characterize TSC colony types by using methods based on cell biology and biochemistry for a better understanding of how TSCs are maintained over multiple passages. Colonies of TSCs could be classified into four major types: type 1 is compact and dome-shaped, type 4 is flattened but with a large multilayered cell cluster, and types 2 and 3 are their intermediates. A time-lapse analysis indicated that type 1 colonies predominantly appeared after passaging, and a single type 1 colony gave rise to all other types. These colony transitions were irreversible, but at least some type 1 colonies persisted throughout culture. The typical cells comprising type 1 colonies were small and highly motile, and they aggregated together to form primary colonies. A hierarchical clustering based on global gene expression profiles suggested that a TSC line containing more type 1 colony cells was similar to in vivo extraembryonic tissues. Among the known TSC genes examined, Elf5 showed a differential expression pattern according to colony type, indicating that this gene might be a reliable marker of undifferentiated TSCs. When aggregated with fertilized embryos, cells from types 1 and 2, but not from type 4, distributed to the polar trophectoderm in blastocysts. These findings indicate that cells typically found in type 1 colonies can persist indefinitely as stem cells and are responsible for the maintenance of TSC lines. They may provide key information for future improvements in the quality of TSC lines.
A Comparison of Three C-Arm Draping Techniques to Minimize Contamination of the Surgical Field
Authors: Gershkovich Grigory E. , Tiedeken Nathan C. , Hampton David , Budacki Ross , Samuel Solomon P. , Saing Minn 
Published: April 2016

Summary:
The use of intraoperative fluoroscopy has become a routine and useful adjunct within orthopaedic surgery. However, the fluoroscopy machine may become an additional source of contamination in the operating room, particularly when maneuvering from the anterior–posterior position to the lateral position. Consequently, draping techniques were developed to maintain sterility of the operative field and surgeon. Despite a variety of methods, no studies exist to compare the sterility of these techniques specifically when the fluoroscopy machine is in the lateral imaging position. We evaluated the sterility of 3 c-arm draping techniques in a simulated operative environment. The 3 techniques consisted of a traditional 3-quarter sterile sheet attached to the side of the operative table, a modified clip-drape method, and a commercially available sterile pouch. Our study demonstrated that the traditional method poses a high risk for sterile field contamination, whereas the modified clip-drape method and commercially available sterile pouch kept floor contamination furthest from the surgical field. With the current data, we urge surgeons to use modified techniques rather than the traditional draping method.
The Association of Central-Line–Associated Bloodstream Infections With Central-Line Utilization Rate and Maintenance Bundle Compliance Among Types of PICUs*
Authors: Affolter Jeremy T. , Huskins W. Charles , Moss Michele , Kuhn Evelyn M. , Gedeit Rainer , Rice Thomas B. 
Published: April 2016

Objective:
Central-line–associated bloodstream infections comprise 25% of device-associated infections. Compared with other units, PICUs demonstrate a higher central-line–associated bloodstream infections prevalence. Prior studies have not investigated the association of central-line–associated bloodstream infections prevalence, central-line utilization, or maintenance bundle compliance between specific types of PICUs.

Design:
This study analyzed monthly aggregate data regarding central-line–associated bloodstream infections prevalence, central-line utilization, and maintenance bundle compliance between three types of PICUs: 1) PICUs that do not care for cardiac patients (PICU); 2) PICUs that provide care for cardiac and noncardiac patients (C/PICU); or 3) designated cardiac ICUs (CICU).

Setting:
The included units submitted data as part of The Children’s Hospital Association PICU central-line–associated bloodstream infections collaborative from January 1, 2011, to December 31, 2013.

Patients:
Patients admitted to PICUs in collaborative institutions.

Interventions:
None.

Measurements and Main Results:
The overall central-line–associated bloodstream infections prevalence was low (1.37 central-line–associated bloodstream infections events/1,000 central-line days) and decreased over the time of the study. Central-line–associated bloodstream infections prevalence was not related to the type of PICU although C/PICU tended to have a higher central-line–associated bloodstream infections prevalence (p = 0.055). CICU demonstrated a significantly higher central-line utilization ratio (p < 0.001). However, when examined on a unit level, central-line utilization was not related to the central-line–associated bloodstream infections prevalence. The central-line maintenance bundle compliance rate was not associated with central line–associated bloodstream infections prevalence in this unit-level investigation. Neither utilization rate nor compliance rate changed significantly over time in any of the types of units.

Conclusions:
Although this unit-level analysis did not demonstrate an association between central-line–associated bloodstream infections prevalence and central-line utilization and maintenance bundle compliance, optimization of both should continue, further decreasing central-line–associated bloodstream infections prevalence. In addition, investigation of patient-specific factors may aid in further central-line–associated bloodstream infections eradication.
Volumetric Planning Using Computed Tomographic Angiography Improves Clinical Outcomes in DIEP Flap Breast Reconstruction
Authors: Lee Kyeong-Tae , Mun Goo-Hyun 
Published: April 2016

Background:
The present study evaluated outcomes of deep inferior epigastric perforator (DIEP) flap breast reconstruction using volumetric planning—which is preoperative planning based on volumetric data of the breast and flap estimated from computed tomographic angiography.

Methods:
A prospective review of three patient cohorts undergoing DIEP flap breast reconstruction from June of 2009 to February of 2015 was performed. Cohort 1 comprised 48 cases in which no volumetric planning was used. Cohort 2 included the next 101 consecutive cases undergoing breast reconstruction according to an algorithm based on volumetric planning. Cohort 3 consisted of the next 109 consecutive cases using a modified algorithm. The inset rate (weight ratio of the inset flap to harvested flap) was estimated during volumetric planning, and specific surgical strategies, such as incorporating multiple perforators, conducting venous augmentation (cohort 2), or harvesting bipedicled flaps (cohort 3), were used with reference to it. Rates of perfusion-related complications were compared.

Results:
All but one flap survived completely. Fat necrosis occurred in 9.7 percent. Overall, the perfusion-related complication rate was 22.9 percent of cohort 1, 10.9 percent in cohort 2, and 5.6 percent in cohort 3 (p = 0.006). The fat necrosis rates were 19.1, 9.9, and 5.6 percent in cohorts 1, 2, and 3, respectively (p = 0.032). A multivariate analysis demonstrated that volumetric planning had independent benefits for preventing perfusion-related complications (p = 0.003).

Conclusion:
The authors’ results suggest that volumetric planning can facilitate elaborate planning and reduce perfusion-related complications, enabling reliable breast reconstruction using DIEP flaps.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.