bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Improved Winding-Angle Method to More Accurately Identify Mesoscale Eddies
Authors: Yan Danchen , Zhang Tianyu , Yu Shaomei , Li Yun , Wang YanQiang , Wang Bin 
Published: November 2017

AbstractThe winding-angle (WA) method is an automatic eddy detection method based on the geometric characteristics of instantaneous streamlines. The original WA method clusters closed streamlines using a predetermined threshold. It is difficult to obtain a common threshold for accurately clustering various mesoscale eddies with variable shapes and dimensions. Moreover, the original WA method is not suitable for detecting multicore structures. In this paper, an improved WA method was proposed to more accurately identify mesoscale eddies and to detect multicore structures. It does not depend on the previously used clustering threshold; rather, it is based on the spatial relationships of streamlines to detect mesoscale eddies of various types and dimensions. Streamlines are matched with possible eddy centers (PCs), which are then grouped into different “related groups” according to the containment relationships between them and the outermost streamlines of the groups. Each group represents a vortex structure, and the number of PCs in each group represents the number of eddy cores. The eddy boundaries and eddy cores of multicore structures represented by multi-PC groups are identified by topological relationships of the streamlines. The time requirement of the improved method is higher than that of the original algorithm, although it does not demand additional memory space and utilizes fewer CPU resources. More importantly, the improved method provides more accurate identification results and greatly refines the incorrect identifications from the original method induced by the predetermined threshold. Success metrics for the improved WA method are also more desirable relative to those for the original and other commonly used methods.
Structural Fat Grafting to Improve Outcomes of Vocal Folds’ Fat Augmentation: Long‐term Results
Authors: Cantarella Giovanna , Mazzola Riccardo F. , Gaffuri Michele , Iofrida Elisabetta , Biondetti Pietro , Forzenigo Laura V. , Pignataro Lorenzo , Torretta Sara 
Published: November 2017

ObjectiveEvaluating the long‐term outcomes of vocal fold structural fat grafting.Study DesignCase series with chart review.SettingUniversity hospital.Subjects and MethodsSeventy‐nine dysphonic patients (16‐82 years; 55 with unilateral laryngeal paralysis and 24 with vocal fold scarring) underwent vocal fold fat injection. Fat was harvested by low‐pressure liposuction and then processed by centrifugation. Refined fat aliquots were placed in the vocal fold and paraglottic space in multiple tunnels to enhance graft neovascularization. All patients were followed for 12 months, 15 for 3 years, and 5 for 10 years with videolaryngostroboscopy, maximal phonation time (MPT) measurement, Voice Handicap Index (VHI) questionnaire, and GRBAS (grade, roughness, breathiness, asthenia, strain) perceptual evaluation. Laryngeal computed tomography (CT) and/or magnetic resonance imaging (MRI) studies were performed in 16 patients 3 to 28 months postoperatively; MRI was repeated in 5 cases 12 to 18 months after the first radiological study.ResultsThe voice quality of all patients improved after surgery, and long‐term stability was confirmed by MPT, GRBAS, and VHI (P ranging between. 004 and <.001). The results achieved 1 year postoperatively remained stable at 3 and 10 years. Videolaryn‐gostroboscopy showed improved glottic closure in all patients despite a limited amount of fat resorption. CT and MRI demonstrated survival of the fat grafts in all of the 16 examined cases. Serial MRI scans showed no change in graft size over time.ConclusionsThe reported clinical and radiological data demonstrate that fat is an effective filler for permanent vocal fold augmentation if the refined micro‐aliquots are placed in multiple tunnels.
Staging Neck Dissection and Transoral Robotic Surgery Treatment Algorithm in Palatine Tonsil Cancer
Authors: Spellman Joseph , Sload Ryan , Kim Paul , Martin Peter , Calzada Gabriel 
Published: November 2017

ObjectiveThis study introduces a treatment algorithm based on staging neck dissection to identify patients with palatine tonsil squamous cell carcinoma who can be effectively treated with single‐modality transoral robotic surgery while maintaining quality of life.Study DesignRetrospective case series.SettingKaiser Permanente Southern California Medical Group from 2012 to 2017.Subjects and MethodsPatients with early‐stage (T1/2) palatine tonsil squamous cell carcinoma with clinically and radiographically N0 necks underwent staging neck dissection. Those with pN2/3 disease or extracapsular extension on final pathology were triaged to definitive chemoradiation treatment. Patients with confirmed pN0/1 necks without extracapsular extension were treated definitively with transoral robotic surgery.ResultsNineteen patients with cN0 disease underwent selective neck dissection. All were p16 positive. Of these, 14 had pathologically confirmed N0/1 necks without extracapsular extension and were treated with primary surgical resection via transoral robotic surgery. Clear margins were obtained on all patients. There were no significant intra‐ or postoperative complications. No patients required gastrostomy tube or tracheostomy placement. Mean and median follow‐up was 28 months with no recurrences to date.ConclusionUp‐front staging neck dissection accurately triages low‐risk patients, determining candidates for single‐modality definitive treatment with transoral robotic surgery. This approach provides excellent survival outcomes and minimal morbidity and maintains quality of life among appropriately selected patients with palatine tonsil cancer.
Patient Preferences in Subglottic Stenosis Treatment: A Discrete Choice Experiment
Authors: Naunheim Matthew R. , Naunheim Margaret L. , Rathi Vinay K. , Franco Ramon A. , Shrime Mark G. , Song Phillip C. 
Published: November 2017

ObjectivesSubglottic stenosis can be addressed with several different surgical techniques, but patient preferences for these treatment modalities are poorly understood. Economic methods are increasingly being used to understand how patients make decisions. The objective of this pilot study was to assess preferences in subglottic stenosis treatment using patient‐centric stated preference techniques.Study DesignDiscrete choice experiment (DCE).SettingAcademic research facility.Subjects and MethodsA computer‐based DCE was administered in a monitored setting to volunteers from the general population. Signs and symptoms of subglottic stenosis were described, and participants were asked to imagine they had subglottic stenosis. Hypothetical treatments were offered, with 5 systematically varied attributes: need for external incision, length of hospital stay, postoperative voice quality, likelihood of repeat procedures, and risk of complication. A conditional logistic model was used to assess the relative attribute importance.ResultsIn total, 162 participants were included. Attributes with the greatest impact on decision making included potential need for repeat procedures (importance 30.2%; P <. 001), amount of operative risk (importance 28.1%; P <. 001), and postoperative voice quality (importance 27.7%; P <. 001), whereas presence of incision (importance 5.0%; P =. 001) was less important, and hospital stay was not (importance 9.0%; P =. 089). Based on aggregate responses for these attributes, the model demonstrated that most participants (80.4%) would prefer endoscopic surgery for subglottic stenosis as opposed to open tracheal resection (19.6%).ConclusionIn this pilot population, most participants preferred voice‐sparing, low‐risk procedures as treatment for subglottic stenosis, consistent with an endoscopic approach, even if multiple procedures were required.
Resection-Induced Leveling of Elevated Plug Cartilage in Osteochondral Autologous Transplantation of the Knee Achieves Acceptable Clinical Results
Authors: Nishitani Kohei , Nakagawa Yasuaki , Nakamura Shinichiro , Mukai Shogo , Kuriyama Shinichi , Matsuda Shuichi 
Published: November 2017

Background: Plug protuberance occasionally occurs in osteochondral autologous transplantation (OAT). The incongruity of plugs results in poor clinical outcomes, especially in cases of protuberance. However, a surgical procedure to deal with this problem has not been reported. Purpose/Hypothesis: The purpose was to evaluate the efficacy and safety of cartilage resection of elevated plugs, with the hypothesis that patients whose elevated plugs were resected and leveled would achieve clinical outcomes equivalent to those of patients with flush plugs. Study Design: Cohort study; Level of evidence, 3. Methods: Cases (group P) included 22 patients who underwent OAT of the knee and whose plugs showed protuberance greater than 1 mm that was resected with a scalpel to obtain smooth congruity, while controls (group C) included 22 background-matched patients who did not require plug resection. The International Knee Documentation Committee (IKDC) subjective score, IKDC objective grade, and Japanese Orthopaedic Association score for knee osteoarthritis (JOA knee score) were used preoperatively and at the final follow-up (mean ± SD, 49.3 ± 18.1 months). International Cartilage Repair Society (ICRS) Cartilage Repair Assessment was used to evaluate lesion healing during the second-look arthroscopy. Results: IKDC subjective scores of group C (82.5 ± 11.8) and group P (82.1± 15.1) showed no difference at the final follow-up. On postoperative IKDC objective grading, 86% of group C and 82% of group P patients were graded as “nearly normal” or better ( P = .639). The mean JOA knee scores of group C (90.9 ± 8.9) and group P (90.1 ± 9.5) did not differ significantly ( P = .647). Nine second-look arthroscopies were performed in group C versus 8 in group P, and all patients had plugs that were graded as “nearly normal” or better by the ICRS Cartilage Repair Assessment. Larger plugs tended to be used in those patients who required resection. Conclusion: Resection of the elevated plug surface did not negatively affect patient outcomes in the midterm follow-up period.
Autologous Matrix-Induced Chondrogenesis: A Systematic Review of the Clinical Evidence
Authors: Gao Liang , Orth Patrick , Cucchiarini Magali , Madry Henning 
Published: November 2017

Background: The addition of a type I/III collagen membrane in cartilage defects treated with microfracture has been advocated for cartilage repair, termed “autologous matrix-induced chondrogenesis” (AMIC). Purpose: To examine the current clinical evidence regarding AMIC for focal chondral defects. Study Design: Systematic review. Methods: A systematic review was performed by searching PubMed, ScienceDirect, and Cochrane Library databases. Inclusion criteria were clinical studies of AMIC for articular cartilage repair, written in English. Relative data were extracted and critically analyzed. PRISMA guidelines were applied, the methodological quality of the included studies was assessed by the modified Coleman Methodology Score (CMS), and aggregate data were generated. Results: Twenty-eight clinical articles were included: 12 studies (245 patients) of knee cartilage defects, 12 studies (214 patients) of ankle cartilage defects, and 4 studies (308 patients) of hip cartilage defects. The CMS demonstrated a suboptimal study design in the majority of published studies (knee, 57.8; ankle, 55.3; hip, 57.7). For the knee, 1 study reported significant clinical improvements for AMIC compared with microfracture for medium-sized cartilage defects (mean defect size 3.6 cm2) after 5 years (level of evidence, 1). No study compared AMIC with matrix-assisted autologous chondrocyte implantation (ACI) in the knee. For the ankle, no clinical trial was available comparing AMIC versus microfracture or ACI. In the hip, only one analysis (level of evidence, 3) compared AMIC with microfracture for acetabular lesions. For medium-sized acetabular defects, one study (level of evidence, 3) found no significant differences between AMIC and ACI at 5 years. Specific aspects not appropriately discussed in the currently available literature include patient-related factors, membrane fixation, and defect properties. No treatment-related adverse events were reported. Conclusion: This systematic review reveals a paucity of high-quality, randomized controlled studies testing the AMIC technique versus established procedures such as microfracture or ACI. Evidence is insufficient to recommend joint-specific indications for AMIC. Additional nonbiased, high-powered, randomized controlled clinical trials will provide better clinical and structural long-term evidence, thus helping to define possible indications for this technique.
Family-Centered Breastfeeding Education to Promote Primiparas’ Exclusive Breastfeeding in China
Authors: Ke Jian , Ouyang Yan-Qiong , Redding Sharon R. 
Published: November 2017

Background: Few breastfeeding education programs focus on primiparas and the importance of family members on exclusive breastfeeding in China. Research aim: This study aimed to explore the influence of a family-centered breastfeeding education program in promoting exclusive breastfeeding up to 6 months postpartum and to improve women’s attitude and knowledge, family members’ knowledge, and family support. Methods: This was a two-group quasi-experimental design with multiple comparisons. Participants ( N = 59) were randomized to either the intervention ( n = 29) or the control ( n = 30) group. The intervention group received two prenatal breastfeeding education lectures that included important family members, three home visits, eight telephone calls, text or video/audio support, and quality online resources during lactation. The control group received in-hospital care and follow-up by community nurses after discharge. Results: Compared with the control group, the intervention group was more likely to exclusively breastfeed in the first 6 months, odds ratio = 0.44, 95% confidence interval [0.20, 0.98]. The mean knowledge level of the intervention group improved more across time ( p < .05) and was higher than the control group ( p < .05). Perceived family support within the intervention group was significantly higher than the control group from 1 to 6 months ( p < .05). Conclusion: The breastfeeding education program is an effective strategy to promote exclusive breastfeeding in China.
Signed family physician reminder letters to women overdue for screening mammography: A randomized clinical trial
Authors: Chan Elisa K , Wilson Christine , Tyldesley Scott , Olivotto Ivo A , Lai Anky , Sam Janette , Harry Ritinder , Nichol Alan 
Published: November 2017

Objective To determine whether signed family physician reminder letters to women overdue for screening mammography prompts rescreening. Methods A randomized double-blind trial conducted in 2013 among women aged 51–73 and overdue for screening by 6–24 months. The study was carried out by the publicly funded British Columbia Cancer Agency Screening Mammography Program, which routinely sends standard reminder postcards to women who are due for mammography. Participating family physicians signed letters for the overdue women in their practices. The overdue women were mailed either the signed reminder letter and the standard reminder postcard, or the standard reminder postcard alone. The primary endpoint was the proportion of overdue women that attended a screening mammogram appointment within six months of mailing the study letters. The analysis was by intention to treat. Results In total, 822 family physicians participated and 5638 women were randomized. Mammography attendance by six months after mailing the reminders was 34.4% (947/2749) for women in the signed family physician letter arm, compared with 24.0% (660/2749) for women in the control arm (p < 0.0001). Adjusting for age, number of previous screening mammograms, and months overdue, women in the signed letter arm were significantly more likely to return for screening than women in the control arm (RR 1.41; 95% confidence interval: 1.30–1.54). Conclusion A signed family physician reminder letter improved mammography attendance for women who were overdue for screening mammography.
A comparison of multi-component systems approaches to suicide prevention
Authors: Baker Simon TE , Nicholas Jennifer , Shand Fiona , Green Rachel , Christensen Helen 
Published: November 2017

Objective: To describe the new Australian approach to suicide prevention, LifeSpan, and compare it to other multi-component intervention models. Method: The components, implementation strategies and effectiveness of three multi-component intervention models are described and compared in a narrative review. Results: The LifeSpan, European Alliance Against Depression (EAAD), and Zero Suicide models emphasise the provision of evidence-based interventions and continuity of care. Only LifeSpan and EAAD include community-based interventions at the population level, and LifeSpan is the only model to include school-based interventions. Zero Suicide focuses on healthcare settings. Implementation of LifeSpan and EAAD involves the convening of multi-stakeholder teams at the local level. To date, there is some, albeit mixed, evidence in support of EAAD, while LifeSpan and Zero Suicide await further evaluation. Conclusions: Although multi-component approaches to suicide prevention share similar components, there are some important differences. Multiple interventions implemented at the same time and tailored to the local community context are likely to be the most effective way of reducing the rate of suicide. There is growing evidence for the effectiveness of multi-component systems approaches to suicide prevention; however, further evaluation is required.
A Review of Perioperative Complications of Outpatient Total Ankle Arthroplasty
Authors: Borenstein Todd R. , Anand Kapil , Li Quanlin , Charlton Timothy P. , Thordarson David B. 
Published: November 2017

Background: Total ankle arthroplasty (TAA) is commonly pursued for patients with painful arthritis. Outpatient TAA are increasingly common and have been shown to decrease costs compared to inpatient surgery. However, there are very few studies examining the safety of outpatient TAA. In this study, we retrospectively reviewed 65 consecutive patients who received outpatient TAA to identify complication rates. Methods: The medical records of 65 consecutive outpatient TAA from October 2012 to May 2016 with a minimum 6-month follow-up were reviewed. All patients received popliteal and saphenous blocks prior to surgery and were managed with oral pain medication postoperatively. All received a STAR total ankle. Demographics, comorbidities, American Society of Anesthesiologists (ASA) class, and perioperative complications including wound breakdown, infection, revision, and nonrevision surgeries were observed. Mean follow-up was 16.6 ± 9.1 months (range, 6-42 months). Results: There were no readmissions for pain control and 1 patient had a wound infection. The overall complication rate was 15.4%. One ankle (1.5%) had a wound breakdown requiring debridement and flap coverage. This patient thrombosed a popliteal artery stent 1 month postop. The 1 ankle (1.5%) with a wound infection occurred in a patient with diabetes, obesity, hypertension, and rheumatoid arthritis. Conclusion: This study demonstrates the safety of outpatient TAA. The combination of regional anesthesia and oral narcotics provided a satisfactory experience with no readmissions for pain control and 1 wound infection. The 1 wound breakdown complication (1.5%) was attributed to arterial occlusion and not outpatient management. Level of Evidence: Level IV, retrospective case series.
Postoperative Analgesia Using Peripheral Anesthetic Block of the Foot and Ankle
Authors: Stéfani Kelly Cristina , Ferreira Gabriel Ferraz , Pereira Filho Miguel Viana 
Published: November 2017

Background: Anesthetic block of the peripheral nerves in the foot and ankle is generally used as anesthesia. The increased use of anesthetic blocks has made this technique an increasingly safe method, and its use has been expanded to postoperative analgesia in foot and ankle surgeries. The objective of this study was to evaluate the analgesia time and pain intensity, using objective scores, after peripheral nerve block in foot and ankle surgeries. Methods: Patients who underwent surgery by the foot and ankle group of our institution from March 2016 to January 2017 were invited to participate in this prospective, randomized, and blinded study after signing an informed consent form. The study was approved by the local ethics committee. In total, 57 patients and 59 feet (2 bilateral surgeries) were subjected to spinal anesthesia and were randomized into the group receiving peripheral nerve block in the foot and ankle (7.5 mg/mL ropivacaine) and the control group. The patients answered a questionnaire, administered by phone during the postoperative period, regarding measurement of pain intensity, using the visual analog scale (VAS), and the time of onset of pain. Results: Improved pain was noted in patients who received a supplemental peripheral nerve block in relation to the duration of postoperative analgesia and the intensity of pain during the immediate postoperative period. No significant difference was found between the 2 groups in terms of pain intensity on the first or second postoperative day. Conclusion: Peripheral nerve block in the foot and ankle region can be used effectively as postoperative analgesia to reduce pain intensity during the immediate postoperative period and prolong analgesia. Level of Evidence: Level I, high-quality prospective randomized clinical trial.
Neural correlates of effort-dependent and effort-independent cognitive fatigue components in patients with multiple sclerosis
Authors: Spiteri Stefan , Hassa Thomas , Claros-Salinas Dolores , Dettmers Christian , Schoenfeld Mircea Ariel 
Published: November 2017

Background: Among patients with multiple sclerosis (MS), fatigue is the most commonly reported symptom. It can be subdivided into an effort-dependent (fatigability) and an effort-independent component (trait-fatigue). Objective: The objective was to disentangle activity changes associated with effort-independent “trait-fatigue” from those associated with effort-dependent fatigability in MS patients. Methods: This study employed behavioral measures and functional magnetic imaging to investigate neural changes in MS patients associated with fatigue. A total of 40 MS patients and 22 age-matched healthy controls performed in a fatigue-inducing N-back task. Effort-independent fatigue was assessed using the Fatigue Scale of Motor and Cognition (FSMC) questionnaire. Results: Effort-independent fatigue was observed to be reflected by activity increases in fronto-striatal-subcortical networks primarily involved in the maintenance of homeostatic processes and in motor and cognitive control. Effort-dependent fatigue (fatigability) leads to activity decreases in attention-related cortical and subcortical networks. Conclusion: These results indicate that effort-independent (fatigue) and effort-dependent fatigue (fatigability) in MS patients have functionally related but fundamentally different neural correlates. Fatigue in MS as a general phenomenon is reflected by complex interactions of activity increases in control networks (effort-independent component) and activity reductions in executive networks (effort-dependent component) of brain areas.