bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radioactive Iodine Ablation Decrease Recurrences in Papillary Thyroid Microcarcinoma with Lateral Lymph Node Metastasis in Chinese Patients
Authors: Xue Shuai , Wang Peisong , Liu Jia , Chen Guang 
Published: July 2017

AbstractIntroductionWe aimed to carry out a retrospective study from a single institution to determine whether radioactive iodine (RAI) ablation decreases the risk of recurrence of papillary thyroid microcarcinoma (PTMC) patients that presented with lateral lymph node metastasis (LLNM).MethodsWe retrospectively analyzed a total of 6361 consecutive PTMC patients who initially underwent surgery for the treatment of thyroid carcinoma at the First Hospital of Jilin University, between January 2005 and February 2015. Altogether, 137 patients with PTMC with LLNM have been enrolled in our study.ResultsThe disease‐free survival period was significantly shorter for the RAI (−) patients than for the RAI (+) patients (p = 0.0074 by the log‐rank test). The disease‐free survival rates at 5 and 10 years were 93.02 and 87.5%, respectively, in the RAI (−) group and 100 and 96.81%, respectively, in the RAI (+) group. CLNM ratio and LLNM ratio were factors identified for multivariate analysis by Cox’s proportional hazards method yielding risk ratios of 7.281 [CI 1.804–17.554; p = 0.010] and 1.157 [CI 1.0125–9.381; p = 0.048] in the RAI (−) group.ConclusionTaken together, RAI may be beneficial for PTMC with LLNM, especially when CLNM ratio or LLNM ratio was greater than 0.5.
Systematic Review and Meta‐Analysis of Epidural Analgesia Versus Different Analgesic Regimes Following Oesophagogastric Resection
Authors: Hughes Michael , Yim Ivan , Deans D. A. Christopher , Couper Graeme W. , Lamb Peter J. , Skipworth Richard J. E. 
Published: July 2017

AbstractIntroductionEffective analgesia following open oesophagogastric (OG) resection is considered a key determinant of recovery. This review aimed to compare epidural to alternative analgesic techniques in patients undergoing major open resection for OG cancer.MethodsA systematic review and meta‐analysis was conducted of randomized controlled trials comparing epidural with alternative analgesic methods in open OG surgery. Primary outcome was the overall post‐operative morbidity rate. Secondary outcomes included pulmonary complication rates, length of stay (LOS) and pain scores at 24 h.
ResultsSix trials which comprised of 249 patients were identified (3 following gastrectomy and 3 following oesophagectomy). Following gastrectomy, secondary outcomes including pulmonary complications and dynamic pain scores at 24 h were improved in the epidural groups. No difference was observed in overall morbidity rates or LOS. Following oesophagectomy, overall morbidity rates were not reported at all. LOS was not shortened, and rest pain was not significantly different in the epidural group, but dynamic pain scores were reported to be improved.ConclusionFew trials of analgesic regimen have been performed following open OG resection. In those trials that have been performed, epidural analgesia has not been shown to reduce overall morbidity. Epidural is associated with reduced pulmonary complications after gastrectomy, but no benefit has been shown after oesophagectomy. Whilst widespread investigation of minimally invasive OG techniques currently takes place, it is clear that the most effective patient pathway following open OG surgery, particularly oesophagectomy, is still not proven. Further trials are required.
Significance of Body Mass Index for Postoperative Outcomes after Lung Cancer Surgery in Elderly Patients
Authors: Matsuoka Katsunari , Yamada Tetsu , Matsuoka Takahisa , Nagai Shinjiro , Ueda Mitsuhiro , Miyamoto Yoshihiro 
Published: July 2017

AbstractBackgroundAlthough the frequency of elderly patients undergoing surgery for lung cancer has been increasing, indications for surgery in elderly patients are still controversial. Low body mass index is a significant predictor of poor prognosis in elderly patients with various medical conditions. Then, we examined the long‐term outcome of elderly patients who had undergone thoracic surgery for lung cancer, focusing especially on body mass index.Patients and methodsBetween January 2004 and March 2011, 1673 patients with lung cancer underwent surgical resection at our institution. Among these patients, we retrospectively examined 158 patients aged 80 years or older.ResultsPerioperative morbidity and mortality rates were 41.8 and 1.3%, respectively. Among 149 patients who were completely followed up, 80 patients (53.7%) died. The overall postoperative survival rates at 3 and 5 years were 66.9 and 49.9%, respectively. Univariate analysis demonstrated that sex (female), smoking index (pack‐years <20), histology (non‐squamous cell carcinoma), pathological stage (stage I) and BMI (within normal BMI) were statistically significant factors associated with better outcome. Multivariate analysis revealed that patients with a low (<18.5 kg/m2) or high (≥25 kg/m2) body mass index had a significantly and poorer prognosis than patients with a normal body mass index.ConclusionBody mass index is a more useful prognostic factor than other clinical factors including pathological stage in elderly patients. Because elderly patients with low and high body mass index have a significant poor prognosis, surgeons and pulmonologist should take this into account when consider surgical indication for such elderly patients.
Burr‐Hole Craniostomy for Chronic Subdural Hematomas by General Surgeons in Rural Kenya
Authors: Kanyi John K. , Ogada Timothy V. , Oloo Mark J. , Parker Robert K. 
Published: July 2017

AbstractIntroductionChronic subdural hematoma (cSDH) is a common condition that causes significant morbidity and mortality. In rural sub‐Saharan Africa, there are very few neurosurgeons. Yet, cSDH is treatable by relatively simple surgical intervention with potential for rapid clinical improvement.MethodsWe conducted a retrospective chart review of all patients with cSDH who underwent burr‐hole trephination at Tenwek Hospital, Kenya, between July 2014 and July 2016. We extracted and compared the clinical presentation, risk factors, operative details, and outcomes.ResultsA total of 119 patients were identified with a mean age of 61.3 years. The majority were men (80%). The main predisposing factors were trauma (54.6%) and alcohol intake (34.4%). Patients were generally managed with two burr‐holes, irrigation, and a subdural drain, remaining for a median of 2 days. Operations were assisted by general surgery residents under direct supervision of senior residents (46), general surgeons (65), and neurosurgeons (8). Complications included recurrence (5.2%), subdural empyema (2.5%), postoperative seizures (3.4%), and mortality (6.7%). Improvement of symptoms was noted in 91% of all patients.ConclusionOperative management of cSDH can be safely performed in rural facilities by general surgeons familiar with the procedure and with the institutional resources. The majority of patients had satisfactory outcomes.
How Safe is Performing Cholecystectomy in the Oldest Old? A 15‐year Retrospective Study from a Single Institution
Authors: Novello Matteo , Gori Davide , Di Saverio Salomone , Bianchin Matteo , Maestri Lorenzo , Mandarino Francesco Vito , Cavallari Giuseppe , Nardo Bruno 
Published: July 2017

AbstractBackgroundGlobally, the number of people aged 80 years or over, the “oldest old,” is the fastest growing population group. Because of the strong association between age and gallstone disease, both prevalence and incidence of this disease are increasing. The feasibility of the cholecystectomy in octogenarians has been evaluated in several studies that confirmed the safety of the operation. However, the safety of this procedure in nonagenarians is still controversial. The aim of this study was to evaluate the safety of cholecystectomies in nonagenarians and identify related predictors for postoperative hospital length of stay (LOS) and in‐hospital mortality up to 30 days postoperatively.MethodsMore than 500 cholecystectomies, both open and laparoscopic, were performed between January 2000 and September 2015 at our institution in patients 80 years and older. These statistics include both elective and emergent admissions. A retrospective review of charts over the last 15 years was conducted to compare mortality and length of postoperative stay among two patient groups: 319 octogenarians and 36 nonagenarians. Parameters evaluated include demographics, surgical presentation, American Society of Anesthesiologists (ASA) score, main diagnosis, comorbidities, type of surgery performed, LOS and in‐hospital mortality. All data were analyzed with STATA (v.13) software, using a multivariate logistic regression after determining the statistically significant variables through a stepwise regression.ConclusionsWe found out that being nonagenarian, compared to octogenarian, is not a significant risk factor in terms of LOS and in‐hospital mortality within 30 days postoperatively. Despite that, the mortality rate among nonagenarians is still remarkably high as almost every patient was admitted in an emergent setting. The most remarkable predictor for mortality among the two groups was an “afternoon/night emergency” surgical presentation (OR 25.5, CI 1.53–42.35, p = 0.02). Thus, the surgical emergency management for gallbladder disease at our institution should be critically reevaluated. Performing the procedure in laparoscopy predicted a significant reduction (−5 days, CI −8.5 to −1.4, p = 0.006) of LOS, while presenting with “gallbladder and bile duct stones” (+6.3 days, CI 1.5–11.1, p = 0.01) or “acalculous cholecystitis” (+4.7 days, CI 0.4–9.2, p = 0.03) had the opposite effect. Despite the remarkable mortality rate of our series, being nonagenarian should not be considered as a reason to avoid gallbladder surgery in case of need. Our study suggests that nonagenarians are more suitable surgical candidates than may have previously expected.
Changes in appetite, energy intake, body composition, and circulating ghrelin constituents during an incremental trekking ascent to high altitude
Authors: Matu Jamie , O’Hara John , Hill Neil , Clarke Sarah , Boos Christopher , Newman Caroline , Holdsworth David , Ispoglou Theocharis , Duckworth Lauren , Woods David , Mellor Adrian , Deighton Kevin 
Published: July 2017

Abstract
Purpose
Circulating acylated ghrelin concentrations are associated with altitude-induced anorexia in laboratory environments, but have never been measured at terrestrial altitude. This study examined time course changes in appetite, energy intake, body composition, and ghrelin constituents during a high-altitude trek.

Methods
Twelve participants [age: 28(4) years, BMI 23.0(2.1) kg m−2] completed a 14-day trek in the Himalayas. Energy intake, appetite perceptions, body composition, and circulating acylated, des-acylated, and total ghrelin concentrations were assessed at baseline (113 m, 12 days prior to departure) and at three fixed research camps during the trek (3619 m, day 7; 4600 m, day 10; 5140 m, day 12).

Results
Relative to baseline, energy intake was lower at 3619 m (P = 0.038) and 5140 m (P = 0.016) and tended to be lower at 4600 m (P = 0.056). Appetite perceptions were lower at 5140 m (P = 0.027) compared with baseline. Acylated ghrelin concentrations were lower at 3619 m (P = 0.046) and 4600 m (P = 0.038), and tended to be lower at 5140 m (P = 0.070), compared with baseline. Des-acylated ghrelin concentrations did not significantly change during the trek (P = 0.177). Total ghrelin concentrations decreased from baseline to 4600 m (P = 0.045). Skinfold thickness was lower at all points during the trek compared with baseline (P ≤ 0.001) and calf girth decreased incrementally during the trek (P = 0.010).

Conclusions
Changes in plasma acylated and total ghrelin concentrations may contribute to the suppression of appetite and energy intake at altitude, but differences in the time course of these responses suggest that additional factors are also involved. Interventions are required to maintain appetite and energy balance during trekking at terrestrial altitudes.
Marker-assisted breeding to develop the drought-tolerant version of Sabitri, a popular variety from Nepal
Authors: Dixit Shalabh , Yadaw Ram Baran , Mishra Krishna Kumar , Kumar Arvind 
Published: July 2017

AbstractSabitri is a rice variety grown in a large part of the rainfed areas of Nepal. It was originally developed for irrigated condition; hence, this variety suffers high yield decline under drought. Two QTLs, qDTY
3.2
and qDTY
12.1
, with large effects on grain yield under drought were identified in the Sabitri background in separate QTL mapping studies. The present study reports the development of Sabitri near isogenic lines (NILs) with combinations of these two QTLs and their characterization under drought. To do so, marker-assisted backcross breeding (MABB) was combined with phenotypic selection to develop high-yielding drought-tolerant NILs with Sabitri grain type. Apart from this, drought-tolerant variants for grain type with high yield under non-stress were identified among the developed NILs. Early days to flowering of up to 13 days and reduction in plant height of up to 13 cm as compared to Sabitri were observed in the developed NILs. Some of these NILs showed higher yield compared to Sabitri and relatively higher tolerance to drought, indicating the capture of positive alleles and interactions during the course of selection. The developed NILs possessed high yield potential which make them suitable materials for the testing of water-saving technologies in irrigated areas. Based on their performance, these NILs can be deployed in rainfed areas in Nepal and other countries of South Asia to increase yield stability.
The Network Survival Method for Estimating Adult Mortality: Evidence From a Survey Experiment in Rwanda
Authors: Feehan Dennis M. , Mahy Mary , Salganik Matthew J. 
Published: July 2017

AbstractAdult death rates are a critical indicator of population health and well-being. Wealthy countries have high-quality vital registration systems, but poor countries lack this infrastructure and must rely on estimates that are often problematic. In this article, we introduce the network survival method, a new approach for estimating adult death rates. We derive the precise conditions under which it produces consistent and unbiased estimates. Further, we develop an analytical framework for sensitivity analysis. To assess the performance of the network survival method in a realistic setting, we conducted a nationally representative survey experiment in Rwanda (n = 4,669). Network survival estimates were similar to estimates from other methods, even though the network survival estimates were made with substantially smaller samples and are based entirely on data from Rwanda, with no need for model life tables or pooling of data from other countries. Our analytic results demonstrate that the network survival method has attractive properties, and our empirical results show that this method can be used in countries where reliable estimates of adult death rates are sorely needed.
Aerodynamic investigation of S-duct intake for high power turboprop installed on a channel wing
Authors: Atalayer Ç. , Friedrichs J. , Wulff D. 
Published: July 2017

ABSTRACTInstallation effects on the S-duct intakes of a high power turboprop were investigated by comparing three different nacelle configurations as the channel wing, over-the-wing and conventional tractor wing using computational fluid dynamic methods. The interaction of the propeller, the wing, and the nacelle on the scoop type turboprop intakes were identified in terms of recovery and distortion on the aerodynamic interface planes. An actuator disc model was used to simulate the propeller downstream effects. The channel wing installation of S-ducts showed approximately 2% higher total pressure recovery than the other configurations. The channel wing configuration with a wrap-around S-duct experienced a 2% lower circumferential distortion intensity, whereas over-the-wing had an increase by 3% in comparison to the tractor wing. It was also observed that the S-duct type had a greater influence on the radial distortion intensity than the installation type. The swirl coefficient distribution showed that multiple peaks occurred as opposed to swirl results based on a single sector of the aerodynamic interface plane. The difference between swirl peaks of shaft penetration S-duct was reduced by 14% when installed on channel wing, whereas the peaks of wrap-around experienced 90° phase shift, and their difference showed 10% increase on channel wing.
High-order detached-eddy simulation of external aerodynamics over an SAE notchback model
Authors: Islam A. , Thornber B. 
Published: July 2017

ABSTRACTThis research explores the modification and implementation of a Detached-Eddy Simulation (DES) in a high-order compressible solver and its application to automotive aerodynamics. This was conducted on a 20° SAE Reference Notchback Model with a Reynolds number of 2.23 × 105. This DES algorithm implemented within FLAMENCO, which is finite-volume research code operating over multi-block meshes, was used for all the simulations. The primary objectives were to capture unsteady flow features, separated coherent structures and also relax the meshing requirements to improve accessibility to turbulence-resolving methods for realistic configurations. This also aims to better understand the separated flow physics, especially around the base surfaces of the car. Simulations for three mesh refinement levels were compared to wind-tunnel measurements. Even on relatively coarse meshes (~7 m cells) for DES, time-averagedCpwas obtained with maximum errors of <8%.
A multisite study of performance drivers among institutional review boards
Authors: Caligiuri Michael , Allen Karen , Buscher Nate , Denney Lisa , Gates Cynthia , Kantelo Kip , Magit Anthony , Sak Rachael , Firestein Gary S. , Fontanesi John 
Published: July 2017

IntroductionThe time required to obtain Institutional Review Board (IRB) approval is a frequent subject of efforts to reduce unnecessary delays in initiating clinical trials. This study was conducted by and for IRB directors to better understand factors affecting approval times as a first step in developing a quality improvement framework.Methods807 IRB-approved clinical trials from 5 University of California campuses were analyzed to identify operational and clinical trial characteristics influencing IRB approval times.ResultsHigh workloads, low staff ratios, limited training, and the number and types of ancillary reviews resulted in longer approval times. Biosafety reviews and the need for billing coverage analysis were ancillary reviews that contributed to the longest delays. Federally funded and multisite clinical trials had shorter approval times. Variability in between individual committees at each institution reviewing phase 3 multisite clinical trials also contributed to delays for some protocols. Accreditation was not associated with shorter approval times.ConclusionsReducing unnecessary delays in obtaining IRB approval will require a quality improvement framework that considers operational and study characteristics as well as the larger institutional regulatory environment.
Attitudes and reported practice of paediatricians and child psychiatrists regarding the assessment and treatment of ADHD in Ireland
Authors: Honorio Neto F. , Tatlow-Golden M. , Mulligan A. , Gavin B. , McNicholas F. 
Published: July 2017

ObjectivesThis mixed-method national survey has obtained original data on attention deficit hyperactivity disorder (ADHD) attitudes, assessment and treatment regimes reported by paediatricians and child psychiatrists; and has compared their clinics. It has examined the extent of involvement of Irish paediatricians in the management of ADHD.MethodsA questionnaire was designed, based on a review of literature and ADHD guidelines, and piloted by expert clinicians. Universal recruitment was conducted among Child and Adolescent Mental Health Services (CAMHS) consultants (n=71) and community/general paediatric consultants (n=72). Quantitative and qualitative data was collected and analysed.ResultsThere was an overall response rate of 43%. A dedicated ADHD clinic is offered in 79% of CAMHS services, but only in one paediatric service. Participants reported that the assessment of ADHD involves multidisciplinary work and this was only established in CAMHS clinics. Medication is initiated by 82% of child psychiatrists and only 22% of paediatricians.ConclusionsThis first national study of ADHD attitudes and practices presents comprehensive data regarding the management of children with ADHD in CAMHS and paediatric settings in Ireland. Paediatricians reported a minor role in managing ADHD. Study limitations are related to subjective reporting rather than case note audit, and a moderate response rate for the paediatricians’ participants.
Investigation on Propeller Slipstream by Using an Unstructured Rans Solver Based on Overlapping Grids
Authors: Gong X. Q. , Ma M. S. , Zhang J. , Tang J. 
Published: July 2017

AbstractBased on unstructured hybrid grid and dynamic overlapping grid technique, numerical simulations of Unsteady Reynolds Averaged Navier-Stokes equations were performed and investigation on isolated propeller aerodynamic characteristics and effects of propeller slipstream on turboprops were undertaken. The computational grid consisted of rotational subzone of propeller and stationary major-zone of aircraft, and walls criterion was used in the automatic hole-cutting procedure. Distance weight interpolation and tri-linear interpolation were developed to transfer information between the rotational and stationary subzones. The boundaries of overlapping grids were optimized for fixed axis rotation. The governing equations were solved by dual-time method and Lower Upper-Symmetric Gauss-Seidel method. The method and grid technique were verified by isolated propeller configuration and the computational results were in well agreement with the experimental data. The grid independence was studied to establish the numerical results. Finally, the flow around a turboprop case was simulated and the influence of propeller slipstream was presented by analyzing the surface pressure contours, profile pressure distribution, vorticity contours and profile streamline. It's indicated that the slipstream accelerates and rotates the free stream flow, changing the local angle of attack, enhancing the downwash effects, affecting the pressure distribution on wing and horizontal tail, as well as increasing the drag coefficient, pitching moment coefficient and the slope of lift coefficient.