bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification and preservation of External Branch of the Superior Laryngeal Nerve during thyroid surgeries at NMCTH
Authors: Joshi Rupesh Raj , Rijal Anupama Shah , Shrestha Kundhan Kumar , Dhungana Anup , Maharjan Shova 
Published: October 2017

Background & Objectives:The most common reason for thyroid surgery is the presence of benign or malignant nodules. Subjective voice disturbance after thyroidectomy is very common, even without injury to the recurrent laryngeal nerves. One possible cause for postoperative dysphonia is injury to the External branch of superior laryngeal nerve (EBSLN). Cernea classification, which we followed in this study, is one of the most popular worldwide classifications of the EBSLN. The study was conducted with objectives to identify and classify EBSLN according to Cernia classification in Nepalese population and help surgeons understand the anatomy of the EBSLN and to preserve the nerve during thyroidectomy. Materials & Methods:A prospective observational case series of seventy-nine patients, who were diagnosed with thyroid neoplasms and underwent thyroid surgeries at the tertiary centre of Kathmandu between 1st January 2015 to 31st December 2016. All procedures were performed by transverse collar incision. We classified the anatomy of the EBSLN using Cernea classification.  Results:There were total of 79 patients. Most common diagnosis and surgery were colloid goitre and hemithyroidectomies respectively. A total of 94 EBSLNs were evaluated. Cernia Type I was observed in 27.66%, type IIa in 46.80%, and type IIb in 14.89%. Incidences of types IIa and IIb, which put patients at greater risk for intra-operative injury, were observed in 61.69% in our study. The nerve could not be identified in 10.64%. Conclusion:It is possible to increase the rate of nerve identification and avoid the nerve injury even in the absence of sophisticated equipment.
Echocardiographic evaluation of simple versus complex congenital heart disease in a tertiary care Paediatrics Hospital
Authors: Sarkar Uttam Kumar , Chatterjee Anish , Basu Suprit , Pan Atanu , Periwal Sumit 
Published: October 2017

Background & Objectives:Congenital heart diseases are treatable either by catheter based intervention or open heart surgery according to their quality. In our study we aim to analyze congenital heart disease echocardiographically into simple versus complex heart disease at a tertiary care centre with a public health planning and policy making perspective.Materials & Methods:This hospital based study was done on 1010 patients, both from in-patient and out-patient, who were clinically suspected to have heart disease from January 2015 to September 2016 at Dr.B.C.Roy P.G.I.P.S. Kolkata and echocardiographically categorized.Results:A VSD was the commonest acyanotic heart disease (17. 08%).Tetralogy of Fallot (TOF) was commonest complex cyanotic heart disease (10.64%), VSD +ASD was the commonest combined lesion (8.12%). Simple heart lesions (63.1%) were commoner than complex (36.9%) congenital heart diseases.Conclusion:Health policy makers should give due care to manage Congenital Heart Disease either catheter based or surgically keeping in mind about 63.1% of the lesions are simple cardiac lesions and 36.9% lesions are complex cardiac lesion where complex surgery is required.
Conservation status of the forest beetles (Insecta, Coleoptera) from Azores, Portugal
Authors: Borges Paulo , Lamelas-López Lucas , Amorim Isabel , Danielczak Anja , Nunes Rui , Serrano Artur R.M. , Boieiro Mário , Rego Carla , Hochkirch Axel , Vieira Virgílio 
Published: October 2017

Island biodiversity is under considerable pressure due to the ongoing threats of invasive alien species, land use change or climate change. The few remnants of Azorean native forests harbour a unique set of endemic beetles, some of them possibly already extinct or under severe long term threat due to the small areas of the remaining habitats or climatic changes. In this contribution we present the IUCN Red List profiles of 54 forest adapted beetle species endemic to the Azorean archipelago, including species belonging to four speciose families: Zopheridae (12 species), Carabidae (11 species), Curculionidae (11 species) and Staphylinidae (10 species).
Most species have a restricted distribution (i.e. 66% occur in only one island) and a very small extent of occurrence (EOO) and area of occupancy (AOO). Also common to most of the species is the severe fragmentation of their populations, and a continuing decline in EOO, AOO, habitat quality, number of locations and subpopulations caused by the ongoing threat from pasture intensification, forestry, invasive species and future climatic changes. Therefore, we suggest as future measures of conservation: (1) a long-term monitoring plan for the species; (2) control of invasive species; (3) species-specific conservation action for the most highly threatened species.
Voir double, être double. Désir, appartenance, reconnaissance et évasion au cours du travail psychodynamique avec des immigrants
Authors: Boulanger Ghislaine , Dupont Judith 
Published: October 2017

Psychiquement, les immigrants vivent des vies doubles, demeurant simultanément dans le monde qu’ils ont quitté et le monde dans lequel ils vivent, et dans lequel la plupart essaient de s’intégrer pour échapper à l’expérience aliénante d’être « autre. Être double n’est pas un acte conscient, mais c’est un contrepoint préconscient à toute interaction sociale. Je soutiens qu’un traitement psychodynamique réussi permet aux immigrants de prendre le dédoublement comme assuré, en fait, voir double et être double. De cette façon, ils en viennent à privilégier sans effort un état du Soi par rapport à l’autre. La reconnaissance et l’acceptation d’états de Soi en compétition se montrent source de transformation dans tout traitement, mais jamais plus que dans le travail avec des immigrants qui se battent avec plusieurs Soi culturels rivaux dans leur vie quotidienne, et sont à la recherche d’une relation où tous peuvent être vus et entendus. Je décris le traitement d’une immigrante qui, lorsque j’ai commencé à travailler avec elle, excellait à voir double, mais être double lui posait un dilemme terrifiant. Au moins deux états de Soi étaient engagés dans une lutte acharnée ; elle craignait que le vainqueur ne prenne tout.
L’enterrement des placentas et ses enjeux dans la tradition africaine
Authors: Barry Aboubacar 
Published: October 2017

Ce texte examine les différentes modalités de traitement des placentas des enfants qui viennent de naître dans différentes sociétés africaines. Ces rituels peuvent parfois varier d’un groupe à l’autre et selon les régions, mais ils conservent un fond commun qui en permet une lecture anthropologique et clinique. Les anthropologues se sont intéressés, depuis toujours, à ces pratiques. Les psychanalystes, depuis Freud et Rank, en ont tiré des idées intéressantes à connaître. L’approche psychanalytique permet de penser que le placenta est « ex-time », selon l’heureuse expression de Jacques Lacan.
T Cell–Derived CD70 Delivers an Immune Checkpoint Function in Inflammatory T Cell Responses
Authors: O’Neill Rachel E. , Du Wei , Mohammadpour Hemn , Alqassim Emad , Qiu Jingxin , Chen George , McCarthy Philip L. , Lee Kelvin P. , Cao Xuefang 
Published: October 2017

Abstract
The CD27–CD70 pathway is known to provide a costimulatory signal, with CD70 expressed on APCs and CD27 functions on T cells. Although CD70 is also expressed on activated T cells, it remains unclear how T cell–derived CD70 affects T cell function. Therefore, we have assessed the role of T cell–derived CD70 using adoptive-transfer models, including autoimmune inflammatory bowel disease and allogeneic graft-versus-host disease. Surprisingly, compared with wild-type T cells, CD70−/− T cells caused more severe inflammatory bowel disease and graft-versus-host disease and produced higher levels of inflammatory cytokines. Mechanistic analyses reveal that IFN-γ induces CD70 expression in T cells, and CD70 limits T cell expansion via a regulatory T cell–independent mechanism that involves caspase-dependent T cell apoptosis and upregulation of inhibitory immune checkpoint molecules. Notably, T cell–intrinsic CD70 signaling contributes, as least in part, to the inhibitory checkpoint function. Overall, our findings demonstrate for the first time, to our knowledge, that T cell–derived CD70 plays a novel immune checkpoint role in inhibiting inflammatory T cell responses. This study suggests that T cell–derived CD70 performs a critical negative feedback function to downregulate inflammatory T cell responses.
The influence of mid-latitude cyclones on European background surface ozone
Authors: Knowland K. Emma , Doherty Ruth M. , Hodges Kevin I. , Ott Lesley E. 
Published: October 2017

Abstract. The relationship between springtime mid-latitude cyclones and background ozone (O3) is explored using a combination of observational and reanalysis data sets. First, the relationship between surface O3 observations at two rural monitoring sites on the west coast of Europe – Mace Head, Ireland, and Monte Velho, Portugal – and cyclone track frequency in the surrounding regions is examined. Second, detailed case study examination of four individual mid-latitude cyclones and the influence of the associated frontal passage on surface O3 is performed. Cyclone tracks have a greater influence on the O3 measurements at the more northern coastal European station, Mace Head, located within the main North Atlantic (NA) storm track. In particular, when cyclones track north of 53° N, there is a significant relationship with high levels of surface O3 (> 75th percentile). The further away a cyclone is from the NA storm track, the more likely it will be associated with both high and low (< 25th percentile) levels of O3 at the observation site during the cyclone's life cycle. The results of the four case studies demonstrate (a) the importance of the passage of a cyclone's cold front in relation to surface O3 measurements, (b) the ability of mid-latitude cyclones to bring down high levels of O3 from the stratosphere, and (c) that accompanying surface high-pressure systems and their associated transport pathways play an important role in the temporal variability of surface O3. The main source of high O3 to these two sites in springtime is from the stratosphere, either from direct injection into the cyclone or associated with aged airstreams from decaying downstream cyclones that can become entrained and descend toward the surface within new cyclones over the NA region.
Airborne DOAS retrievals of methane, carbon dioxide, and water vapor concentrations at high spatial resolution: application to AVIRIS-NG
Authors: Thorpe Andrew K. , Frankenberg Christian , Thompson David R. , Duren Riley M. , Aubrey Andrew D. , Bue Brian D. , Green Robert O. , Gerilowski Konstantin , Krings Thomas , Borchardt Jakob , Kort Eric A. , Sweeney Colm , Conley Stephen , Roberts Dar A. , Dennison Philip E. 
Published: October 2017

Abstract. At local scales, emissions of methane and carbon dioxide are highly uncertain. Localized sources of both trace gases can create strong local gradients in its columnar abundance, which can be discerned using absorption spectroscopy at high spatial resolution. In a previous study, more than 250 methane plumes were observed in the San Juan Basin near Four Corners during April 2015 using the next-generation Airborne Visible/Infrared Imaging Spectrometer (AVIRIS-NG) and a linearized matched filter. For the first time, we apply the iterative maximum a posteriori differential optical absorption spectroscopy (IMAP-DOAS) method to AVIRIS-NG data and generate gas concentration maps for methane, carbon dioxide, and water vapor plumes. This demonstrates a comprehensive greenhouse gas monitoring capability that targets methane and carbon dioxide, the two dominant anthropogenic climate-forcing agents. Water vapor results indicate the ability of these retrievals to distinguish between methane and water vapor despite spectral interference in the shortwave infrared. We focus on selected cases from anthropogenic and natural sources, including emissions from mine ventilation shafts, a gas processing plant, tank, pipeline leak, and natural seep. In addition, carbon dioxide emissions were mapped from the flue-gas stacks of two coal-fired power plants and a water vapor plume was observed from the combined sources of cooling towers and cooling ponds. Observed plumes were consistent with known and suspected emission sources verified by the true color AVIRIS-NG scenes and higher-resolution Google Earth imagery. Real-time detection and geolocation of methane plumes by AVIRIS-NG provided unambiguous identification of individual emission source locations and communication to a ground team for rapid follow-up. This permitted verification of a number of methane emission sources using a thermal camera, including a tank and buried natural gas pipeline.
Performance of ensemble streamflow forecasts under varied hydrometeorological conditions
Authors: Benninga Harm-Jan F. , Booij Martijn J. , Romanowicz Renata J. , Rientjes Tom H. M. 
Published: October 2017

Abstract. The paper presents a methodology that gives insight into the performance of ensemble streamflow-forecasting systems. We have developed an ensemble forecasting system for the Biała Tarnowska, a mountainous river catchment in southern Poland, and analysed the performance for lead times ranging from 1 to 10 days for low, medium and high streamflow and different hydrometeorological conditions. Precipitation and temperature forecasts from the European Centre for Medium-Range Weather Forecasts served as inputs to a deterministic lumped hydrological (HBV) model. Due to a non-homogeneous bias in time, pre- and post-processing of the meteorological and streamflow forecasts are not effective. The best forecast skill, relative to alternative forecasts based on meteorological climatology, is shown for high streamflow and snow accumulation low-streamflow events. Forecasts of medium-streamflow events and low-streamflow events under precipitation deficit conditions show less skill. To improve performance of the forecasting system for high-streamflow events, the meteorological forecasts are most important. Besides, it is recommended that the hydrological model be calibrated specifically on low-streamflow conditions and high-streamflow conditions. Further, it is recommended that the dispersion (reliability) of the ensemble streamflow forecasts is enlarged by including the uncertainties in the hydrological model parameters and the initial conditions, and by enlarging the dispersion of the meteorological input forecasts.
Variations in return value estimate of ocean surface waves – a study based on measured buoy data and ERA-Interim reanalysis data
Authors: Muhammed Naseef T. , Sanil Kumar V. 
Published: October 2017

Abstract. An assessment of extreme wave characteristics during the design of marine facilities not only helps to ensure their safety but also assess the economic aspects. In this study, return levels of significant wave height (Hs) for different periods are estimated using the generalized extreme value distribution (GEV) and generalized Pareto distribution (GPD) based on the Waverider buoy data spanning 8 years and the ERA-Interim reanalysis data spanning 38 years. The analysis is carried out for wind-sea, swell and total Hs separately for buoy data. Seasonality of the prevailing wave climate is also considered in the analysis to provide return levels for short-term activities in the location. The study shows that the initial distribution method (IDM) underestimates return levels compared to GPD. The maximum return levels estimated by the GPD corresponding to 100 years are 5.10 m for the monsoon season (JJAS), 2.66 m for the pre-monsoon season (FMAM) and 4.28 m for the post-monsoon season (ONDJ). The intercomparison of return levels by block maxima (annual, seasonal and monthly maxima) and the r-largest method for GEV theory shows that the maximum return level for 100 years is 7.20 m in the r-largest series followed by monthly maxima (6.02 m) and annual maxima (AM) (5.66 m) series. The analysis is also carried out to understand the sensitivity of the number of observations for the GEV annual maxima estimates. It indicates that the variations in the standard deviation of the series caused by changes in the number of observations are positively correlated with the return level estimates. The 100-year return level results of Hs using the GEV method are comparable for short-term (2008 to 2016) buoy data (4.18 m) and long-term (1979 to 2016) ERA-Interim shallow data (4.39 m). The 6 h interval data tend to miss high values of Hs, and hence there is a significant difference in the 100-year return level Hs obtained using 6 h interval data compared to data at 0.5 h interval. The study shows that a single storm can cause a large difference in the 100-year Hs value.
Long-term remission of ocular cicatricial pemphigoid off immunomodulatory therapy
Authors: You Caiyun , Ma Lina , Anesi Stephen D. , Stephen Foster C. 
Published: October 2017

Purpose: To evaluate whether long-term remission of ocular cicatricial pemphigoid (OCP) after withdrawal of immunomodulatory therapy (IMT) is possible. Methods: A total of 34 of 464 presenting patients (66 eyes) with biopsy-proven OCP in long-term remission off IMT were identified after finishing a 2-year IMT regimen without active disease (2005-2015). Long-term remission off IMT for OCP was defined as patients withdrawn from IMT ≥1 year lacking clinically detectable progressive scarring according to Foster staging and subjective assessment. Results: All 34 patients achieved ≥1 year of clinical remission without IMT following 2 years IMT lacking active disease. Mean onset age of OCP was 67.0 years, and median follow-up time was 63.4 months. Mean duration between OCP onset and IMT initiation was 29.5 months, with a mean sustained remission time of 36.0 months off IMT. The mean duration of IMT prior to remission off IMT was 34.8 months (median 32 months, IQR 27-39.5 months). Commonly, methotrexate was used prior to OCP remission (19 patients; 55.9%). Two patients experienced mild flare-up postremission off IMT at months 25 and 37 and a course of topical steroid appeared to resolve the inflammation. Another patient had active inflammation at last office visit 5 years after discontinuation of IMT and will restart IMT. Conclusions: Long-term remission for OCP off IMT may be achieved after stepladder IMT is implemented and withdrawn. Longer follow-up and more sensitive measures of scarring and inflammation are needed to generate a consensus on the definition of complete remission and on cessation of systemic IMT for OCP.
Large choroidal excavation in a patient with rubella retinopathy
Authors: Parodi Maurizio Battaglia , Romano Francesco , Montagna Marco , Bandello Francesco 
Published: October 2017

Purpose: To describe a case of rubella retinopathy complicated by bilateral choroidal neovascularization (CNV) and late development of large choroidal excavation (LCE). Methods: A 19-year-old woman with a diagnosis of rubella retinopathy underwent her annual ophthalmologic examination, including visual acuity testing and slit-lamp biomicroscopy with dilated fundus examination. Color fundus photography, spectral-domain optical coherence tomography (SD-OCT) scans, and optical coherence tomography angiography were acquired to complete the investigation of her ocular condition. The main findings are described in this case report. Results: This woman came to our attention in 2010 with a history of rubella retinopathy, complicated by bilateral CNV and treated with photodynamic therapy (PDT) in 2006. After 6 years of annual follow-up examinations, her visual acuity remained stable in both eyes (20/100), whereas SD-OCT scans uncovered the development of a bilateral LCE in the macular area, associated with a macular hole in the right eye. Optical coherence tomography angiography revealed a vascular network surrounding the choroidal excavation. Conclusions: Large choroidal excavation is a rare finding that has been described in few chorioretinal diseases, e.g., North Carolina macular dystrophy and toxoplasmosis. We propose to include rubella retinopathy complicated by CNV in the differential diagnosis of LCE, although we recognize the possibility that PDT might have induced or facilitated its formation.
Diagnostic precision of a microscope-integrated intraoperative OCT device in patients with epiretinal membranes
Authors: Leisser Christoph , Hirnschall Nino , Hackl Christoph , Döller Birgit , Varsits Ralph , Findl Oliver 
Published: October 2017

Purpose: Preoperative and postoperative optical coherence tomography (OCT) of macular pathologies can be regarded as the gold standard diagnostic technique, providing detailed information on the microstructures of the macula for planning the surgical procedure and comparing improvements after surgery in the follow-up period. Intraoperative use of OCT is a novel application to support surgeons during macular surgery. The aim of this study was to examine the diagnostic precision of a microscope-integrated intraoperative spectral-domain OCT (i-OCT) device and compare imaging results to a stand-alone spectral-domain OCT (SD-OCT) device. Methods: This prospective study included 41 eyes of 41 patients scheduled for pars plana vitrectomy with membrane peeling due to an idiopathic epiretinal membrane (ERM). Intraoperative imaging with the i-OCT device was performed at the beginning of the surgery and compared to preoperative SD-OCT images. Results: Preoperative and intraoperative SD-OCT evaluations showed high intraobserver and interobserver reproducibility for the presence of ERM, lamellar macular hole, and vitreomacular traction. For intraretinal cystoid changes, intraobserver and interobserver reproducibility for both OCTs was rather poor, mainly due to microcystic changes. Conclusions: Intraoperative spectral-domain OCT offers high reproducibility regarding the visibility of ERM, lamellar macular holes, and vitreomacular traction. Microcystic changes cause discrepancies in interpretation, often simply diagnosed as retinal thickening.
The direct anterior minimal invasive approach in total hip replacement: a prospective departmental study on the learning curve
Authors: Brun Ole-Christian L. , Månsson Lukas , Nordsletten Lars 
Published: October 2017

Introduction: Introduction of new surgical techniques is normal, but seldom monitored in real time. The purpose of this study was to monitor the learning curve when introducing a new surgical technique to a department. We did a prospective evaluation of the learning curve when introducing the minimally invasive direct anterior approach in total hip arthroplasty. We wish to investigate whether there is a learning curve for the direct anterior minimal invasive approach in total hip replacement and what are the early complications to this approach. Methods: The department changed from the direct lateral approach to the minimally invasive direct anterior approach. We monitored the first 522 patients operated using this approach with regards to patient outcome scores and complications 6 months postoperatively. Results: The last 250 patients operated all had significantly better results with regard to patient outcome scores and cup placement. We investigated 100 patients at a time and compared them with the rest of the patient and found the same pattern. This pattern ends when we reach patients somewhere between 200-300. Discussions: We established the learning curve on a departmental level with regards to introduction of the minimal invasive direct anterior approach. We see a steady improvement in scores with regards to patient outcome scores and cup positioning until we reach a steady-state. The learning curve here flattens out. Departments must understand that one should expect early complications and somewhat less than optimal results at first when introducing this new surgical technique.