bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Accuracy and Validity of Modus Trex Activity Monitor in Determining Functional Level in Veterans with Transtibial Amputations
Authors: Godfrey Bradeigh , Berdan Jeffery , Kirk Melissa Nuntapreda , Chou Teri Rosenbaum 
Published: October 2017

ABSTRACT

Introduction
The objective of this study was to investigate the accuracy and reliability of Modus Trex–derived K-level to differentiate between Medicare Functional Classification levels (K-levels) in individuals with lower-limb amputation.

Methods
This study was a prospective study monitoring walking behavior. Subjects were recruited from an outpatient clinic for persons with amputation at a Veterans Affairs medical center. Subjects were blinded to results of the Global Positioning System and activity data. Physicians were blinded to Modus Trex–derived K-level, 6-minute walk test (6MWT), and Amputee Mobility Predictor with Prosthesis (AMPPRO) results.
The study enrolled 29 subjects with transtibial amputation. Twenty-seven subjects were included in the data analysis. Two subjects were excluded due to incomplete or unreliable data. Patients were eligible if they were at least 1 year postamputation surgery and could walk with a well-fitting and functioning prosthesis. Patients were excluded if they had other musculoskeletal injuries that impacted their ambulation ability.
A clinical K-level, 6MWT, and AMPPRO were obtained. An activity monitor and Global Positioning System device were attached to the prosthesis to record activity for 2 weeks. Study physicians used number of steps in community, steps per day, peak cadence, and environmental barriers traversed in the subjects' first 6 to 10 days, as well as clinical judgement, to determine a Modified Clinical K-level (MCK-level) for each subject. The MCK-level was the criterion to which all other measures were compared.

Results
The Modus Trex–derived K-level correlated most strongly with the MCK-levels (r = 0.96, P < 0.001) with 85% accuracy/sensitivity. Repeat (week 1 to week 2) was excellent (interclass correlation coefficient = 0.92). Other outcome measures also correlated to MCK-levels: AMPPRO (r = 0.93), 6MWT (r = 0.89), peak cadence (r = 0.89), and daily steps (r = 0.76).

Conclusions
The Modus Trex–derived K-level was reliable and accurate at estimating MCK-levels and can be useful as a component in K-level evaluation.
Exploring Gaps in Concussion Knowledge and Knowledge Translation Among Coaches of Youth Female Hockey
Authors: Guo David , Verweel Lee , Reed Nick 
Published: October 2017

Objective:
To better understand the level of concussion knowledge of youth female hockey coaches and to identify preferred methods of knowledge translation for this population.

Design:
Cross-sectional survey.

Setting:
Participants independently completed written surveys before in-person concussion information sessions or online surveys through link provided in emails.

Participants:
Convenience sampling yielded 130 coaches of youth female hockey from Canada.

Main Outcome Measures:
Knowledge level on concussion, resources from which coaches obtained information on concussion, opinions on the current level of concussion knowledge, and knowledge translation.

Results:
Coaches demonstrated adequate knowledge on concussion, achieving 84% correct on true–false questions and 92% correct on symptom identification accuracy. However, coaches showed limited awareness of concussion specific to mechanisms for injury (identification) and postconcussion symptoms. Internet resources were rated as the most used resources for concussion yet were not rated very helpful. Nonetheless, coaches indicated online courses and web sites as the most preferred method for concussion knowledge translation.

Conclusions:
Youth female hockey coaches have overall adequate knowledge of concussion; however, gaps in knowledge do exist. Future efforts to raise the concussion knowledge among coaches of female youth hockey should include information specific to the mechanism of injury, along with sign and symptom identification, with particular attention paid to emotional symptoms. Given the reported preferences and the widespread availability of the Internet, further exploration and research validation of online courses and web sites tailored to the youth female hockey community is encouraged.
Using Clinical Notes and Natural Language Processing for Automated HIV Risk Assessment
Authors: Feller Daniel J. , Zucker Jason , Yin Michael T. , Gordon Peter , Elhadad Noémie 
Published: October 2017

Objective:
Universal HIV screening programs are costly, labor intensive, and often fail to identify high-risk individuals. Automated risk assessment methods that leverage longitudinal electronic health records (EHRs) could catalyze targeted screening programs. Although social and behavioral determinants of health are typically captured in narrative documentation, previous analyses have considered only structured EHR fields. We examined whether natural language processing (NLP) would improve predictive models of HIV diagnosis.

Methods:
One hundred eighty-one HIV+ individuals received care at New York Presbyterian Hospital before a confirmatory HIV diagnosis and 543 HIV negative controls were selected using propensity score matching and included in the study cohort. EHR data including demographics, laboratory tests, diagnosis codes, and unstructured notes before HIV diagnosis were extracted for modeling. Three predictive algorithms were developed using machine-learning algorithms: (1) a baseline model with only structured EHR data, (2) baseline plus NLP topics, and (3) baseline plus NLP clinical keywords.

Results:
Predictive models demonstrated a range of performance with F measures of 0.59 for the baseline model, 0.63 for the baseline + NLP topic model, and 0.74 for the baseline + NLP keyword model. The baseline + NLP keyword model yielded the highest precision by including keywords including “msm,” “unprotected,” “hiv,” and “methamphetamine,” and structured EHR data indicative of additional HIV risk factors.

Conclusions:
NLP improved the predictive performance of automated HIV risk assessment by extracting terms in clinical text indicative of high-risk behavior. Future studies should explore more advanced techniques for extracting social and behavioral determinants from clinical text.
Ring-Like Enhancement of Hepatocellular Carcinoma in Gadoxetic Acid–Enhanced Multiphasic Hepatic Arterial Phase Imaging With Differential Subsampling With Cartesian Ordering
Authors: Ichikawa Shintaro , Motosugi Utaroh , Oishi Naoki , Shimizu Tatsuya , Wakayama Tetsuya , Enomoto Nobuyuki , Matsuda Masanori , Onishi Hiroshi 
Published: October 2017

Objective
The aim of this study was to evaluate the efficacy of multiphasic hepatic arterial phase (HAP) imaging using DISCO (differential subsampling with Cartesian ordering) in increasing the confidence of diagnosis of hepatocellular carcinoma (HCC).

Materials and Methods
This retrospective study was approved by the institutional review board, and the requirement for informed patient consent was waived. Consecutive patients (from 2 study periods) with malignant liver nodules were examined by gadoxetic acid–enhanced magnetic resonance imaging using either multiphasic (6 phases; n = 135) or single (n = 230) HAP imaging, which revealed 519 liver nodules other than benign ones (HCC, 497; cholangiocarcinoma, 11; metastases, 10; and malignant lymphoma, 1). All nodules were scored in accordance with the Liver Imaging Reporting and Data System (LI-RADS v2014), with or without consideration of ring-like enhancement in multiphasic HAP images as a major feature.

Results
In the multiphasic HAP group, 178 of 191 HCCs were scored as LR-3 to LR-5 (3 [1.69%], 85 [47.8%], and 90 [50.6%], respectively). Upon considering ring-like enhancement in multiphasic HAP images as a major feature, 5 more HCCs were scored as LR-5 (95 [53.4%]), which was a significantly more confident diagnosis than that with single HAP images (295 of 306 HCCs scored as LR-3 to LR-5: 13 [4.41%], 147 [49.8%], and 135 [45.8%], respectively; P = 0.0296). There was no significant difference in false-positive or false-negative diagnoses between the multiphasic and single HAP groups (P = 0.8400 and 0.1043, respectively).

Conclusions
Multiphasic HAP imaging can improve the confidence of diagnosis of HCCs in gadoxetic acid–enhanced magnetic resonance imaging.
Pediatric Facial Fractures: An Assessment of Airway Management
Authors: Viviano Stephen L. , Hoppe Ian C. , Halsey Jordan N. , Chen Jeffrey S. , Russo Gerardo J. , Lee Edward S. , Granick Mark S. 
Published: October 2017

Abstract
Pediatric facial fractures present unique and challenging management considerations, especially with regards to airway management. Anatomical differences in children increase both airway resistance and the difficulty of intubation. A surgical airway may be required if intubation is unable to be performed. The purpose of this study was to examine a single center's experience with pediatric facial fractures to determine the frequency of advanced airway use, as well as the risk factors that may predispose a patient to requiring an advanced airway. A retrospective review of all facial fractures at a level 1 trauma center was performed from 2000 to 2012. Patients age 18 years and younger were included. Patient demographics were collected, as well as location of fractures, concomitant injuries, services consulted, and surgical management strategies. Information was collected regarding the need for an advanced airway, including intubation and the need for a surgical airway. A total of 285 patients met inclusion criteria. Of these, 57 patients (20%) required emergency intubation and 5 (1.8%) required a surgical airway. Intubation was significantly related to fractures of the midface, frontal sinuses, spine, skull, and pelvis, as well as depressed Glasgow coma scores and traumatic brain injury. The need for a surgical airway is extremely uncommon (1.8%), and tracheostomy was only needed in the setting of penetrating head trauma. Both emergent intubation and tracheostomy are associated with complications, but these complications must be weighed against the potentially life-saving measure of securing an airway.
Comparison of Postoperative Outcomes Between Monitored Anesthesia Care and General Anesthesia in Closed Reduction of Nasal Fracture
Authors: Kyung Hyunwoo , Choi Jae-Ik , Song Seung-Han , Oh Sang-Ha , Kang Nakheon 
Published: October 2017

Abstract
Fracture of nasal bone is among the most common facial bone fractures. Reduction of nasal bone fracture is able to be performed under local or general anesthesia. The aim of this study is to compare monitored anesthetic care (MAC) and general anesthesia (GA) based on intraoperative vital signs, and the adverse effects after closed reduction of nasal bone fractures.
The authors performed a retrospective study of 45 patients who underwent a closed reduction of nasal bone fracture between January 1, 2016 and December 31, 2016. Patients are divided into an MAC group (n = 17) or GA group (n = 28). A sore throat, postoperative pain scores, nausea, vomiting, hospital stay, operation time, and the result of surgery are compared between the groups. All the patients have interviewed their satisfaction of aesthetic and functional outcome.
The operation time and hospital stay were lower in the MAC group. There is no difference in a sore throat, postoperative pain score, and the result of surgery significantly. In the MAC and GA groups, there was no statistically significant difference in the postoperative cosmetic and functional satisfaction scores.
Closed reduction of nasal bone fracture using MAC is as safe and efficient as GA. However, MAC anesthesia may not be feasible if airway discomfort due to bleeding is expected, or fracture is severe and multiple manipulations are required. Therefore, MAC is considered to be a good alternative when patients undergoing short-term or small operations do not prefer general anesthesia.
The Effect of Unilateral Concha Bullosa on Olfactory Bulb Volume: an Assessment by Magnetic Resonance Imaging
Authors: Özkiriş Mahmut , Gencer Zeliha Kapusuz , Saydam Levent 
Published: October 2017

Background:
In this study, the authors compared the right and left olfactory bulb volumes by magnetic resonance image findings of patients with unilateral concha bullosa (CB).

Methods:
The cranial magnetic resonance imaging studies of 24 patients having unilateral CB were reviewed. There were 10 males and 14 females ranging in age from 29 to 51 years (mean age, 29 ± 15.2 years). The volumes of both olfactory bulbs (contralateral and ipsilateral to the concha bullosa side) were calculated by using the computer program.

Results:
The average values for olfactory bulb volumes were 46.57 ± 8.03 mm3 in the CB side of the nasal cavity and 54.80 ± 10.031 mm3 in the normal side of the nasal cavity. We found a statistically significant difference in olfactory bulb volume between the contralateral and ipsilateral to the concha bullosa side of the patients (t = −3.08 and P < 0.01 for CB side, t = −3.47 and P < 0.01 for left normal side).

Conclusion:
Our results may point out a possible relationship between CB and ipsilateral decreased olfactory bulb volume, yet the exact mechanism still remains unclear. Decreased nasal air flow on the CB side may be attributed to the pathophysiologic mechanism of this finding. Also, the significant reduction in olfactory bulb volumes ipsilateral to CB compared with the contralateral olfactory bulb volumes seems to support our hypothesis.
Effect of Irrigation Time of Antiseptic Solutions on Bone Cell Viability and Growth Factor Release
Authors: Sawada Kosaku , Nakahara Ken , Haga-Tsujimura Maiko , Fujioka-Kobayashi Masako , Iizuka Tateyuki , Miron Richard J. 
Published: October 2017

Abstract
Antiseptic solutions are commonly utilized to treat local infection in the oral and maxillofacial region. However, surrounding vital bone is also exposed to antiseptic agents during irrigation and may have a potential negative impact on bone survival. The aim of the present study was therefore to investigate the effect of rinsing time with various antiseptic solutions on bone cell viability, as well as their subsequent release of growth factors important for bone regeneration. The bone samples collected from porcine mandible were rinsed in the following commonly utilized antiseptic solutions; povidone-iodine (0.5%), chlorhexidine digluconate (CHX, 0.2%), hydrogen peroxide (1%), and sodium hypochlorite (0.25%) for 1, 5, 10, 20, 30, or 60 minutes and assessed for cell viability and release of growth factors including vascular endothelial growth factor, transforming growth factor beta 1, bone morphogenetic protein 2, receptor activator of nuclear factor kappa-B ligand, and interleukin-1 beta by enzyme-linked immunosorbent assay. It was found in all the tested groups that the long exposure of any of the tested antiseptic solutions drastically promoted higher cell death. Sodium hypochlorite demonstrated the significantly highest cell death and at all time points. Interestingly, bone cell viability was highest in the CHX group post short-term rinsing of 1, 5, or 10 minutes when compared with the other 4 tested groups. A similar trend was also observed in subsequent growth factor release. The present study demonstrated that of the 4 tested antiseptic solutions, short-term CHX rinsing (ideally within 1 minute) favored bone cell viability and growth factor release. Clinical protocols should be adapted accordingly.
A Review of Randomized Controlled Trials in Cleft and Craniofacial Surgery
Authors: Bekisz Jonathan M. , Fryml Elise , Flores Roberto L. 
Published: October 2017

Abstract
This study presents a systematic review of randomized controlled trials (RCTs) in cleft and craniofacial surgery. All studies reporting on RCTs in cleft and craniofacial surgery were identified on PubMed using the search terms “cleft,” “velopharyngeal insufficiency,” “velopharyngeal dysfunction,” “nasoalveolar molding,” “gingivoperiosteoplasty,” “Pierre Robin sequence,” “craniofacial,” “craniosynostosis,” “craniofacial microsomia,” “hemifacial microsomia,” “hypertelorism,” “Le Fort,” “monobloc,” “distraction osteogenesis,” “Treacher Collins,” and “Goldenhar.” Studies were excluded if they were not randomized, did not focus primarily on topics related to cleft or craniofacial surgery, included repeat publications of data, or were unavailable in English. Studies were evaluated on demographic and bibliometric data, study size, specific area of focus, and findings reported. Four hundred forty-seven unique studies were identified. One hundred eighty-three papers met inclusion criteria (115 cleft lip and palate, 65 craniofacial, and 3 spanning both disciplines). Sixty-six (36%) were dedicated to topics related to surgical techniques. There were no studies comparing current cleft lip or soft palate repair techniques and no studies on cleft rhinoplasty. The most frequently reported surgical topic was cleft palate. There were several studies on orthognathic techniques which compared distraction osteogenesis to traditional advancement. Most craniofacial operations, such as cranial vault remodeling and frontofacial advancement/distraction, were not represented. Several standard operations in cleft and craniofacial surgery are not supported by Level I evidence from randomized controlled trials. Our community should consider methods by which more RCTs can be performed, or redefine the acceptable standards of evidence to guide our clinical decisions.
De Novo Circulating Antidonor's Cell Antibodies During Induced Acute Rejection of Allogeneic Myofibers in Myogenic Cell Transplantation: A Study in Nonhuman Primates
Authors: Skuk Daniel , Tremblay Jacques P. 
Published: October 2017

Background
Transplantation of myogenic cells has potential applications in the treatment of muscle pathologies. Excluding purely autologous cell transplantation, graft viability depends on an adequate control of acute rejection (AR). To contribute in understanding AR in this context, we analyzed whether de novo circulating antibodies against donor’s cells are detected during induced AR of graft-derived myofibers in nonhuman primates.

Methods
We allotransplanted satellite cell-derived myoblasts in macaques immunosuppressed with tacrolimus. To induce AR of graft-derived myofibers, we administered tacrolimus for 4 weeks to allow complete myofiber formation, and then we stopped tacrolimus administration. Cell-grafted sites were biopsied at tacrolimus withdrawal and then every 2 weeks and analyzed by histology until AR completion. Blood samples were taken before immunosuppression, at tacrolimus withdrawal and then every 2 weeks to detect antibodies against the donor’s cells by flow cytometry.

Results
There was an increase of antibodies against the donor’s cells related to AR in all monkeys. This increase was variable in intensity, and preceded, coincided or followed the histological evidence of AR (focal accumulations of lymphocytes) and/or the loss of myofibers of donor origin, and remained until the end of the follow-up (up to 8 weeks after tacrolimus withdrawal).

Conclusions
Flow cytometry detection of de novo circulating antibodies against the donor’s cells was consistently associated with AR. A clear increase in this antibody detection indicated current or recent AR. Smaller increases in comparison to the preimmunosuppression values were not associated with AR.
Rituximab and Monitoring Strategies for Late Antibody-Mediated Rejection After Kidney Transplantation
Authors: Parajuli Sandesh , Mandelbrot Didier A. , Muth Brenda , Mohamed Maha , Garg Neetika , Aziz Fahad , Redfield Robert R. , Zhong Weixiong , Astor Brad C. , Djamali Arjang 
Published: October 2017

Background
There is limited information on treatment strategies and monitoring strategies for late antibody-mediated rejection (ABMR) after kidney transplantation.

Methods
In this observational and nonrandomized study, we compared 78 patients diagnosed with late ABMR (>3 months after transplant) who were treated with standard of care steroids/IVIG (n = 38) ± rituximab (n = 40) at our center between March 1, 2013 and December 31, 2016. All patients had follow-up biopsy and donor-specific antibodies (DSA) monitoring within 3 to 12 weeks.

Results
Patients had biopsy 7.3 ± 7 years after transplant and were followed for 15.9 ± 9.6 months after ABMR was diagnosed. Both treatment strategies were associated with a significant decline in DSA, microvascular inflammation (peritubular capillaritis + glomerulitis), and C4d Banff scores. In univariate regression analyses, rituximab, estimated glomerular filtration rate (eGFR), Banff i, t, v, chronicity (interstitial fibrosis + tubular atrophy + fibrous intimal thickening + allograft glomerulopathy) scores on the first biopsy, and eGFR and Banff v score on follow-up biopsy were associated with graft loss. Multivariate analyses retained only rituximab (hazard ratio, 0.23; 95% confidence interval, 0.06-0.84; P = 0.03) and eGFR at follow-up biopsy (0.84; 95% confidence interval, 0.76-0.92; P < 0.001) as significant predictors of graft loss. Kaplan-Meier analyses demonstrated that the benefit associated with rituximab was apparent after 1 year (15% vs 32% graft loss, P = 0.02).

Conclusion
Treatment of late ABMR with steroids/IVIG ± rituximab was effective in reducing DSA and microcirculation inflammation. The addition of rituximab was associated with better graft survival. Follow-up biopsies could be considered in the management of acute rejection to monitor the effect of therapy. Randomized studies on the best therapeutic options for ABMR are needed.
Sequence Transfer Learning for Neural Decoding
Authors: Elango Venkatesh , Patel Aashish N , Miller Kai J , Gilja Vikash 
Published: October 2017

AbstractA fundamental challenge in designing brain-computer interfaces (BCIs) is decoding behavior from time-varying neural oscillations. in typical applications, decoders are constructed for individual subjects and with limited data leading to restrictions on the types of models that can be utilized. currently, the best performing decoders are typically linear models capable of utilizing rigid timing constraints with limited training data. Here we demonstrate the use of Long Short-Term Memory (LSTM) networks to take advantage of the temporal information present in sequential neural data collected from subjects implanted with electrocorticographic (ECoG) electrode arrays performing a finger flexion task. our constructed models are capable of achieving accuracies that are comparable to existing techniques while also being robust to variation in sample data size. Moreover, we utilize the LSTM networks and an affine transformation layer to construct a novel architecture for transfer learning. We demonstrate that in scenarios where only the affine transform is learned for a new subject, it is possible to achieve results comparable to existing state-of-the-art techniques. The notable advantage is the increased stability of the model during training on novel subjects. Relaxing the constraint of only training the affine transformation, we establish our model as capable of exceeding performance of current models across all training data sizes. Overall, this work demonstrates that LSTMS are a versatile model that can accurately capture temporal patterns in neural data and can provide a foundation for transfer learning in neural decoding.