bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Skills Feedback and myTIPreport
Authors: Connolly AnnaMarie , Blanchard Anita , Goepfert Alice , Donnellan Nicole , Buys Elizabeth , Uribe Richard , Kenton Kimberly 
Published: September 2017

OBJECTIVE:
To initiate construct validity testing of myTIPreport for procedural skill assessment in a prospective multicenter evaluation study.

METHODS:
Teachers and learners from a convenience-based site selection of obstetrics and gynecology (OBGYN) and female pelvic medicine and reconstructive surgery (FPMRS) training programs performed procedural assessments in myTIPreport. The specifically defined 5-point Dreyfus rating scale describing ability levels from novice to expert was used. Defined as the degree to which a test or measure assesses what it was designed to measure, construct validity of myTIPreport was tested by comparing the medians of procedure-specific overall assessments, by both teachers and learners themselves, of senior learners with junior learners. To minimize type I error, comparisons were performed only when a threshold of 10 or greater feedback encounters per learner group was met. Correlation of teacher assessments and learner self-assessments was examined for myTIPreport.

RESULTS:
From November 2014 to May 2016, 12 OBGYN and 7 FPMRS training programs participated. There were 440 learners and 443 teachers. Feedback was recorded on 5,093 surgical procedures; 4,567 for OBGYN residents and 526 for FPMRS fellows. Each OBGYN procedure had two categories of teacher and learner assessments comparing postgraduate year (PGY)-4 with PGY-1 learner performance. This yielded 48 possible assessment comparisons for the included 24 OBGYN procedures. In all, 28 of these 48 (58%) met the threshold number of observations per learner group. In 28 of these 28 (100%) comparison categories, PGY-4s rated significantly higher than PGY-1s. Similarly, in 16 of 18 (89%) comparison categories meeting inclusion criteria, FPMRS PGY-7s rated significantly higher than FPMRS PGY-5s. Strong correlation was noted of teacher assessments and learner self-assessments in myTIPreport with a Spearman correlation coefficient of 0.89 (P<.001).

CONCLUSION:
As noted for the majority of compared teacher assessments and learner self-assessments, myTIPreport appeared to detect differences between senior and junior learners. These data support the emerging construct validity of myTIPreport for procedural skills assessment.
Percutaneous Application of a Medial Plate for Dual Plate Stabilization of Supracondylar Femur Fractures
Authors: Swentik Andrew , Tucker Michael , Jones Thomas 
Published: September 2017

Summary:
Supracondylar femur fractures with segmental defects can be difficult fractures to treat. When associated with open wounds, these injuries can be associated with numerous complications including nonunion, malunion, infection, and arthrofibrosis. In this article, we review our algorithm for treating these fractures and highlight critical aspects of the process which differs from previous techniques described. We feel that this technique has specific benefits that mitigate infection risk and minimize additional soft-tissue insult without compromising stability. Our results demonstrate good postoperative knee range of motion, a high union rate, with low complication rates.
Epidemiology of Anterior Tibial Spine Fractures in Young Patients: A Retrospective Cohort Study of 122 Cases
Authors: Axibal Derek P. , Mitchell Justin J. , Mayo Meredith H. , Chahla Jorge , Dean Chase S. , Palmer Claire E. , Campbell Kristen , Vidal Armando F. , Rhodes Jason T. 
Published: September 2017

Background:
Historically, bicycle accidents were described as the most common mechanism for pediatric anterior tibial spine fractures (ATSFs). There is a paucity of current literature examining the demographic factors associated with these injuries. The purpose of this cohort study was to characterize the epidemiology of ATSFs presenting to a single tertiary referral pediatric hospital.

Methods:
A consecutive cohort of 122 pediatric patients with ATSFs between 1996 and 2014 were reviewed. Radiographic variables, classification of fractures (Meyers and McKeever type), age, sex, height, weight, body mass index, and mechanism of injury were retrieved. Categories of mechanism of injury included organized sports (football, soccer, basketball, lacrosse, wrestling, and gymnastics), bicycling, outdoor sports (skiing, skateboarding, and sledding), fall, motor vehicle collision/pedestrian versus motor vehicle, and trampoline.

Results:
Organized sports-related injuries represented the most common cause of ATSFs (36%). Other common mechanisms of injury included bicycle accidents (25%), outdoor sports (18%), and falls (11%). There was a higher proportion of males (69%) compared with females (31%). Males (mean age, 11.6 y) were significantly older than females (mean age, 9.8 y) (P=0.004). Younger patients (aged 11.5 y and below) were more likely to have displaced fractures (type III), whereas type I and type II were more common in patients above 11.5 years (P=0.02). Patients with fracture type I were significantly taller than patients with fracture type III. No other variables were found to differ significantly according to fracture severity, including sex, weight, and body mass index.

Conclusions:
To our knowledge, our study represents both the largest (n=122) and most up-to-date epidemiological ATSF study in pediatric patients. A higher rate of ATSF occurs due to organized sports rather than bicycling or motor vehicle collision. This 18-year data collection represents a change in the paradigm, and is likely multifactorial, including increased participation in youth sports and early sport specialization.

Level of Evidence:
Level IV—retrospective, cohort study.
A Novel Funnel-Shaped Flap for Reconstruction Surgery after Total Laryngopharyngectomy with Total Glossectomy
Authors: Kurosawa Koreyuki , Asada Yukinori , Matsumoto Ko , Imai Takayuki , Matsuura Kazuto , Goto Takahiro 
Published: September 2017

Summary:
Reconstruction following total laryngopharyngectomy with total glossectomy (TLPTG) is challenging. To reconstruct this extended range of mucosal defect, it is necessary to overcome the remarkable discrepancy of apertures of oral and esophageal sides. We report a case of reconstruction surgery for total laryngopharyngectomy with total glossectomy with a funnel-shaped rectus abdominis musclocutaneous flap. The patient recovered without major complications and could keep a relatively good swallowing function. We believe this simple method should contribute to cases with complicated ablation.
Severe Corneal Disorders Developed After Brimonidine Tartrate Ophthalmic Solution Use
Authors: Maruyama Yuko , Ikeda Yoko , Yokoi Norihiko , Mori Kazuhiko , Kato Hiroaki , Ueno Morio , Kinoshita Shigeru , Sotozono Chie 
Published: September 2017

Purpose:
The primary side effects associated with 0.1% brimonidine tartrate (BT) ophthalmic solution with sodium chlorite are allergic conjunctivitis, blepharitis, and conjunctival hyperemia. However, cornea-related side effects are rare. In this study, we report 2 similar cases in which corneal neovascularization, corneal infiltration, and corneal opacity developed after BT eye-drop use.

Methods:
Retrospective report of 2 cases of corneal infiltration after BT eye-drop use.

Results:
Case 1 involved a 78-year-old woman with follicular conjunctivitis, corneal neovascularization, and infiltration in her left eye after unilateral instillation of BT eye drops in that eye. Case 2 involved a 75-year-old woman with bilateral corneal neovascularization and infiltration after instillation of BT eye drops. In both cases, the corneal complications were deemed to be side effects of BT, so those eye drops were replaced with 0.1% fluorometholone eye drops. After replacement, blepharitis and corneal neovascularization successfully resolved; however, a layer of opacity remained across the transparent layer of the cornea in both cases.

Conclusions:
We encountered 2 cases of corneal and conjunctival complications that developed as side effects after BT eye-drop use, thus indicating that strict attention should be paid to the possibility of side effects after initiation of antiglaucoma eye-drop use.
Arthroscopic Versus Open Treatment for Acute Septic Arthritis of the Knee in Children
Authors: Johns Brenton , Loewenthal Mark , Ho Eric , Dewar David 
Published: September 2017

Background:
Acute septic arthritis of the knee in children may be treated by arthroscopic or open methods; however, pediatric data comparing these methods is limited regarding both short- and long-term outcomes. This study aimed to compare outcomes after arthroscopic versus open surgery for acute pediatric septic knee arthritis.

Methods:
Pediatric patients with acute knee septic arthritis treated at our institution from 1996 to 2016 were retrospectively assessed. The clinical presentations, operations, microorganisms, laboratory results, knee radiologic findings and antibiotics administered were compared. Patients’ long-term outcomes were assessed at mean 6.9 (range 1.1–20.3) years.

Results:
Twenty-four patients met the inclusion criteria. Eleven patients received arthroscopic irrigation and 13 had open irrigation. Five patients in the open group (38.5%) required a second irrigation compared with none in the arthroscopic group [95% confidence interval (CI): 12%–65%; P = 0.041]. Time to range the knee occurred earlier in the arthroscopic group (5.0 days; arthroscopic vs. 10.6 days; open, difference 5.6 days: 95% CI: 0.84–10.3, P = 0.023), as well as weight-bearing (2.7 days; arthroscopic vs. 10.3 days; open, difference 7.6 days: 95% CI: 2.3–12.9, P = 0.008). Eighty-three percent of patients attended follow-up. No infections recurred. No significant differences were found in Knee injury and Osteoarthritis Outcome Scores for children, Lysholm scores, range-of-motion, leg length, gait and radiologic findings.

Conclusions:
For acute pediatric septic knee arthritis, arthroscopic irrigation is associated with less repeat surgical irrigations and allows earlier knee ranging and weight-bearing compared with open irrigation. At long-term follow-up, no significant difference was found between groups.
A Randomized Controlled Study of Single-Dose Antibiotic Prophylaxis for Clean Surgeries
Authors: Yalagachin Gurushantappa Halappa , Raman Prashant , Huchchannavar Suresh 
Published: September 2017

ObjectivesThe aims of this study were to establish the use of single-dose prophylactic intravenous antibiotics in the prevention of postoperative wound infection following clean surgeries in a government setup in India and to assess the efficacy of single-dose prophylactic ceftriaxone in preventing surgical site infection following clean surgeries by a prospective randomized trial.MethodsA prospective study was done on patients in the Department of General Surgery in Karnataka Institute of Medical Sciences, Hubli, Karnataka, India, from January 2011 to December 2014. A total of 822 patients were divided into 2 groups. The first group (A), consisting of 406 patients, received a single-dose antibiotic prophylaxis, and the second group (B), consisting of 416 patients, received 3 days or more of postoperative doses of antibiotic therapy. Only clean procedures are included, and results were compared.ResultsIn the first group (A), the rate of infection was 4 of 406. In the second group (B), the rate of infection was 6 of 416. Overall wound infection rate was 0.95%; wound infection rate after administration of single-dose preoperative antibiotic was 0.96%, and in the routine postoperative group, it was 0.94% (P= 0.9).ConclusionsThis study concludes that single-dose preoperative antibiotic alone is as effective as the use of empiric antibiotics given for 3 days or more in clean surgeries. It will facilitate in decreasing superinfections among and resistance to bacterial strains, health care costs, and morbidity secondary to antibiotic administration (eg, drug toxicity, antibiotic-related diarrhea) in a developing country such as India.
Critical Care Resource Utilization and Outcomes of Children With Moderate Traumatic Brain Injury
Authors: Chandee Theerada , Lyons Vivian H. , Vavilala Monica S. , Krishnamoorthy Vijay , Chaikittisilpa Nophanan , Watanitanon Arraya , Lele Abhijit V. 
Published: September 2017

Objectives:
To characterize admission patterns, critical care resource utilization, and outcomes in moderate pediatric traumatic brain injury.

Design:
Retrospective cohort study.

Setting:
National Trauma Data Bank.

Patients:
Children under 18 years old with a diagnosis of moderate traumatic brain injury (admission Glasgow Coma Scale score of 9–13) in the National Trauma Data Bank between 2007 and 2014.

Measurement and Main Results:
We examined clinical characteristics, critical care resource utilization, and discharge outcomes. Poor outcomes were defined as discharge to hospice, skilled nursing facility, long-term acute care, or death. We examined 20,010 patient records. Patients were 9 years old (interquartile range, 2–15 yr), male (64%) with isolated traumatic brain injury (81%), Glasgow Coma Scale score of 12, head Abbreviated Injury Scale score of 3, and Injury Severity Score of 10. Majority (34%) were admitted to nontrauma hospitals. Critical care utilization was 58.7% including 11.5% mechanical ventilation and 3.2% intracranial pressure monitoring. Compared to patients with Glasgow Coma Scale score of 13, admission Glasgow Coma Scale score of 9 was associated with greater critical care resource utilization, such as ICU admission (72% vs 50%), intracranial pressure monitoring (7% vs 1.8%), mechanical ventilation (21% vs 6%), and intracranial surgery (10% vs 5%). Most patients (70%) were discharged to home, but up to one third had poor outcomes. Older age group had a higher risk of poor outcomes (10–14 yr; adjusted relative risk, 1.32; 95% CI, 1.13–1.54; 15–17 yr; adjusted relative risk, 2.39; 95% CI, 2.12–2.70). Poor outcomes occurred with lower Glasgow Coma Scale (Glasgow Coma Scale score of 9 vs Glasgow Coma Scale score of 13: adjusted relative risk, 2.89; 95% CI, 2.47–3.38), higher Injury Severity Score (Injury Severity Score of ≥ 16 vs Injury Severity Score of < 9: adjusted relative risk, 8.10; 95% CI 6.27–10.45), and polytrauma (adjusted relative risk, 1.40; 95% CI, 1.22–1.61).

Conclusions:
Critical care resources are used in more than half of all moderate pediatric traumatic brain injury, and many receive care at nontrauma hospitals. Up to one third of moderate pediatric traumatic brain injury have poor outcomes, risk factors for which include age greater than 10 years, lower admission Glasgow Coma Scale, higher Injury Severity Score, and polytrauma. There is urgent need to optimize triage, care, and outcomes in this vulnerable population.
Quality and Safety in Health Care, Part XXXIII
Authors: Harolds Jay A. 
Published: September 2017

Abstract
The transcatheter mitral valve procedure with the MitraClip device has been clinically available in much of Europe since 2008. In 2013, the Food and Drug Administration permitted MitraClip procedures to be done commercially for those patients with primary severe mitral regurgitation who were not surgical candidates. The COAPT trial is designed to see if the MitraClip procedure should be approved in the United States for those with secondary mitral regurgitation, although it has been used for that purpose in much of Europe for years.
The Uncinate Process First Approach in Laparoscopic Pancreaticoduodenectomy: A Single-institution Experience
Authors: Zhang Yue , Sun Dong-Lin , Chen Xue-Min 
Published: September 2017

Background:
Limited studies regarding the uncinate process first in laparoscopic pancreaticoduodenectomy (LPD) have been reported. The objective of this study was to evaluate the feasibility, safety, and efficacy of LPD using the uncinate process first approach.

Methods:
This is a retrospective study of selected patients who underwent LPD using the uncinate process first approach at our center between between June 2015 and January 2017. Clinical characteristics and intraoperative and postoperative data were retrospectively analyzed.

Results:
LPD was performed successfully in 45 patients. The median operative time was 410±68 minutes and the median loss of blood was 258±50 mL. Intraoperative frozen section histologic analyses revealed that margin-negative resections were negative in all cases. The median first flatus time was 2±1 day, and median diet start time was 3±1.5 day. The median postoperative hospital stay was 13±4 day. There were no deaths within 30 days following LPD. The mean number of lymph nodes removed was 20±5. The overall morbidity rate was 20%.

Conclusion:
LPD with the uncinate process first approach well combines the benefits of laparoscopy with low risk of postoperative complications and high rate of curative resection.
Aging Of Antiviral CD8+Memory T Cells Fosters Increased Survival, Metabolic Adaptations And Lymphoid Tissue Homing
Authors: Davenport Bennett , Eberlein Jens , van der Heide Verena , Jhun Kevin , Nguyen Tom T. , Victorino Francisco , Trotta Andrew , Chipuk Jerry , Yi Zhengzi , Zhang Weijia , Clambey Eric T. , Scott Donald K. , Homann Dirk 
Published: September 2017

ABSTRACTAging of established antiviral T cell memory fosters a series of progressive adaptations that paradoxically improve rather than compromise protective CD8+T cell immunity. We now provide evidence that this gradual evolution, the pace of which is contingent on the precise context of the primary response, also impinges on the molecular mechanisms that regulate CD8+memory T cell (CD8+TM) homeostasis. Over time, CD8+TMbecome more resistant to apoptosis and acquire enhanced cytokine responsiveness without adjusting their homeostatic proliferation rates; concurrent metabolic adaptations promote increased CD8+TMquiescence and fitness but also impart the re-acquisition of a partial effector-like metabolic profile; and a gradual redistribution of aging CD8+TMfrom blood and nonlymphoid tissues to lymphatic organs results in CD8+TMaccumulations in bone marrow, splenic white pulp and particularly lymph nodes. Altogether, these data demonstrate how temporal alterations of fundamental homeostatic determinants converge to render aged CD8+TMpoised for greater recall responses.ABBREVIATIONSATadoptive transferATGLadipose triglyceride lipaseBMPblood and marginated poolFA, FAO, FAS, FASNfatty acid, fatty acid oxidation, fatty acid synthesis, fatty acid synthaseFSC, SSCforward scatter, side scatterGMFIgeometric mean of fluorescence intensityGP, NPglycoprotein, nucleoproteinGSEAgene set enrichment analysisGSHglutathioneIo, IIoprimary, secondaryKEGGKyoto Encyclopedia of Genes and GenomesLALlysosomal acid lipase (LIPA)LCMVlymphocytic choriomeningitis virusNESnormalized enrichment scoreNLTsnonlymphoid tissuesO, Yold, youngOxPhosoxidative phosphorylationp14 cellsTCRtg CD8+T cells specific for the LCMV-GP33-41determinantRP, WPred pulp, white pulp (spleen)T cell subsetsTEeffector T cellsTCMcentral memory T cells (CD62Lhi)TEMeffector memory T cells (CD62Llo)TEMRAterminally differentiated CD45RA+effector memory T cells (human)TMmemory T cellsTMPmemory-phenotype T cells (CD44hi)TNnaïve T cells (CD44lo)TRMresident memory T cells (CD69/CD103-enriched)TCRtgT cell receptor transgenicTSLPThymic stromal lymphopoietin
Working Memory Load Modulates Neuronal Coupling
Authors: Pinotsis Dimitris A. , Buschman Timothy J. , Miller Earl K. 
Published: September 2017

AbstractThere is a severe limitation in the number of items that can be held in working memory. However, the neurophysiological limits remain unknown. We asked whether the capacity limit might be explained by differences in neuronal coupling. We developed a theoretical model based on Predictive Coding and used it to analyze Cross Spectral Density data from the prefrontal cortex (PFC), frontal eye fields (FEF) and lateral intraparietal area (LIP). Monkeys performed a change detection task (Buschman et al., 2011). The number of objects that had to be remembered (memory load) was varied (1-3 objects in the same visual hemifield). Changes in memory load changed the connectivity in the PFC-FEF-LIP network. Feedback (top-down) coupling broke down when the number of objects exceeded cognitive capacity. Thus, impaired behavioral performance coincided with a break-down of Prediction signals. This provides new insights into the neuronal underpinnings of cognitive capacity and how coupling in a distributed working memory network is affected by memory load.
Stimulus familiarity and expectation jointly modulate neural activity in the visual ventral stream
Authors: Manahova Mariya E. , Mostert Pim , Kok Peter , Schoffelen Jan-Mathijs , de Lange Floris P. 
Published: September 2017

AbstractPrior knowledge about the visual world can change how a visual stimulus is processed. Two forms of prior knowledge are often distinguished: stimulus familiarity (i.e., whether a stimulus has been seen before) and stimulus expectation (i.e., whether a stimulus is expected to occur, based on the context). Neurophysiological studies in monkeys have shown suppression of spiking activity both for expected and for familiar items in object-selective inferotemporal cortex (IT). It is an open question, however, if and how these types of knowledge interact in their modulatory effects on the sensory response. In order to address this issue and to examine whether previous findings generalize to non-invasively measured neural activity in humans of both sexes, we separately manipulated stimulus familiarity and expectation, while non-invasively recording human brain activity using magnetoencephalography (MEG). We observed independent suppression of neural activity by familiarity and expectation, specifically in the lateral occipital complex (LOC), the putative human homologue of monkey IT. Familiarity also led to sharpened response dynamics, which was predominantly observed in early visual cortex. Together, these results show that distinct types of sensory knowledge jointly determine the amount of neural resources dedicated to object processing in the visual ventral stream.
Cold-hearted bats: Cardiac function and metabolism of small bats during torpor at subzero temperatures
Authors: Currie Shannon E. , Stawski Clare , Geiser Fritz 
Published: September 2017

AbstractDespite their small size and large relative surface area, many hibernating bats have the ability to thermoregulate and defend their body temperature (Tb) often below 10°C by an increase in metabolic rate. Above a critical temperature (Tcrit) animals usually thermoconform. We investigated the physiological responses above and below Tcritfor a small tree dwelling bat (Chalinolobus gouldii, ∼14g) that is often exposed to subzero temperatures during winter. Through simultaneous measurement of heart rate (HR) and oxygen consumption () we show that the relationship between oxygen transport and cardiac function is substantially altered in thermoregulating torpid bats down to −2°C, compared with thermoconforming torpid bats at mild ambient temperatures (Ta5-20°C). Tcritfor this species was Ta0.7 ± 0.4°C, with a corresponding Tbof 1.8 ± 1.2°C. Below this Tcritanimals began to thermoregulate, indicated by a considerable but disproportionate increase in both HR and. The maximum increase in HR was only 4-fold greater than the average thermoconforming minimum, compared to a 46-fold increase in. The differential response of HR andto low Tawas represented by a 15-fold increase in oxygen delivery per heart beat (cardiac oxygen pulse). During torpor at low Ta, thermoregulating bats maintain a relatively slow HR and compensate for increased metabolic demands by significantly increasing stroke volume and tissue oxygen extraction. Our study provides valuable new information on the relationship between metabolism and HR in an unstudied physiological state and further advances our knowledge of the thermogenic capacity of small bats.