bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscope Affects Decision Making in Cholesteatoma Surgery
Authors: El‐Meselaty K. , Badr‐El‐Dine M. , Mandour M. , Mourad M. , Darweesh R. 
Published: September 2022

OBJECTIVEThe aim of the present study was to evaluate the use of intraoperative otoendoscopy as a factor that could influence surgical decisionmaking in cholesteatoma surgery.MATERIALS AND METHODSThe material of this study included 82 ears with acquired cholesteatoma that were operated on. They were divided into 4 groups according to the surgical technique chosen and the use of the endoscope. Group I included 22 ears that underwent canal wall‐down (CWD) tympanomastoid surgery, group II included 20 ears that underwent CWD tympanomastoid surgery with intraoperative use of endoscopy, group III included 20 ears that underwent canal wall‐up (CWU) tympanomastoid surgery, and group IV included 20 ears that underwent CWU tympanomastoid surgery with intraoperative use of endoscopy. Endoscopy was used as a complementary tool to microscopy. The follow‐up period ranged from 12 to 48 months.RESULTSIntraoperative remnants of cholesteatoma matrix were detected during both CWU and CWD by the use of the rigid endoscope. However, its incidence was higher in the CWU group (50%) than in the CWD (30%) group. Most of these remnants were in the sinus tympani (37.5%). The mean duration of follow‐up was 18.19 (±8.7) months. Postoperative residual cholesteatoma was much higher in the CWU group (25%) than in the CWD group (5%). All residuals were from groups of patients in whom intraoperative endoscopy was not used in the primary surgery.CONCLUSIONOur results showed that the use of the endoscope gave the surgeon better control over the pathology, thus achieving better eradication. Stated differently, the use of the endoscope raised the surgeon's confidence level about total removal and thus encouraged the surgeon to keep the canal wall intact while removing cholesteatoma in hidden areas. Therefore, the use of endoscope could be considered an additional tool that may affect decision‐making in cholesteatoma surgery.
Predictors of Survival in Early Oral Cancer
Authors: Sheahan Patrick , O'Keane Conor , Sheahan Jerome N. , O'Dwyer Tadhg P. 
Published: September 2022

OBJECTIVEDespite the substantial rate of neck conversion reported among patients with early oral cancer, a policy of routine elective neck dissection has been criticized on the grounds that it confers little survival advantage while subjecting many to potentially avoidable morbidity. However, the identification of factors predictive of survival may allow for the identification of those patients who are more likely to benefit from elective neck treatment.STUDY DESIGN AND SETTINGThe clinical and histologic material of 71 patients with stage I or II squamous carcinoma of the oral cavity were reviewed. Patients were followed up for a minimum of 3 years after their surgery, and the impact of these variables on 3‐year survival was assessed.RESULTSIncreased tumor thickness was significantly predictive of decreased survival (P = 0.030). Although having no prognostic value alone, when combined with thickness, both pattern of invasion and gender increased the significance of the latter in predicting outcome.CONCLUSION AND SIGNIFICANCEMeasuring tumor thickness and pattern of invasion in patients with early oral cancer may allow for the identification of those patients with more aggressive disease who are more likely to benefit from elective neck treatment.
Endoscopic Orbital Decompression Under Local Anesthesia
Authors: Metson Ralph , Shore John W. , Gliklich Richard E. , Dallow Richard L. 
Published: September 2022

Orbital decompression for Graves' disease has traditionally been performed with the patient under general anesthesia. Endoscopic instrumentation allows for removal of the medial orbital wall and floor through an intranasal approach with local anesthetic techniques. Twelve endoscopic orbital decompressions were performed on awake patients with uncovered eyes so that vision could be monitored throughout the procedure. Simultaneous lateral decompressions were performed in 11 cases. No intraoperative or postoperative complications occurred. Visual acuity remained stable or improved in all cases. Proptosis was reduced an average of 5.5 ± 1.6 mm. In a comparable series of 29 endoscopic decompressions performed with patients under general anesthesia, proptosis was reduced an average of 4.8 ± 2.0 mm. Endoscopic orbital decompression with patients under local anesthesia appears to be an effective technique that may provide an additional margin of safety in prevention of injury to the optic nerve.
Sinus Disease in the Bone Marrow Transplant Population: Incidence, Risk Factors, and Complications
Authors: Shibuya Terry Y. , Momin Feroze , Abella Esteban , Jacobs John R. , Karanes Chatchada , Ratanatharathorn Voravit , Sensenbrenner Lyle L. , Lum Lawrence G. 
Published: September 2022

BACKGROUND:Fever associated with sinus disease in the immunocompromised bone marrow transplant recipient requires prompt evaluation and therapy. Very little is known about the incidence, risk factors, and sequelae of nonsurgically treated sinus disease in this population.METHODS:A retrospective review of 107 consecutive allogeneic and autologous bone marrow transplant recipients from August 1987 to July 1989 was performed to determine (1) the overall incidence of sinus disease; (2) factors that influence the development of sinus disease; and (3) the sequelae of sinus disease treated nonsurgically.RESULTS:Overall 33 (31%) of 107 bone marrow transplant recipients had sinus disease defined as a radiographic abnormality with clinical symptoms. Eleven (10%) of 107 recipients had preexisting sinus disease. Sinus disease developed in 22 (21%) of 107 recipients after bone marrow trans‐plantation. Sinus abnormalities were significantly higher among allografted bone marrow transplant recipients than among autografted recipients (p= 0.027). The diagnosis, stage of disease, cytoreductive regimen, or graft‐vs.‐host disease were not different between recipients in whom sinus disease did and did not develop. There were no deaths as a result of sinus complications.CONCLUSIONS:Sinus disease developed in 21% of the studied population after bone marrow transplantation. Allogeneic recipients had a higher incidence of sinus disease than autologous recipients. There were no deaths attributed to sinus complications. All sinus disease in this bone marrow transplant population was treated medically. No patient required surgical intervention either before or after bone marrow transplantation.
Symptom outcome after functional endoscopic sinus surgery in patients with cystic fibrosis: A prospective study
Authors: Nishioka Gary J. , Barbero Giulio J. , König Peter , Parsons David S. , Cook Paul R. , Davis William E. 
Published: September 2022

Twenty‐nine consecutive patients with cystic fibrosis were offered functional endoscopic sinus surgery. Twenty‐six of these patients underwent surgery. A symptom questionnaire was obtained from the patient or parent before surgery. At the end of the study this symptom questionnaire was again administered to the same individual, and 21 completed it. There were 14 male and 7 female patients, with a mean age of 12.3 years and a median age of 8.7 years. Mean follow‐up was 34.3 months. Results for the following symptoms were significant: nasal airway obstruction was improved (p < 0.0002), olfactory function was improved (p < 0.0037), purulent nasal discharge was decreased (p < 0.001), and activity level was increased (p < 0.001). Other parameters are also reported in the text. In summary, this study prospectively studies the effects of functional endoscopic sinus surgery on symptoms in patients with cystic fibrosis. The study points out several significant areas of symptom improvement and supports the selective use of functional endoscopic sinus surgery in patients with cystic fibrosis. Indications for surgery are provided.
Use of the Guinea Pig Flank Flap in Skin Flap Research
Authors: Hirigoyen Martin B. , Zhang Wen X. , Lin Derrick , Weinberg Hubert , Mark L. Urken 
Published: September 2022

A variety of flaps in laboratory animals have been designed that propose to parallel the behavior of human skin under different experimental conditions. In the search for a readily available and affordable island skin flap model that combines reliable anatomy with a pedicle of substantial size, we have designed in the guinea pig a cutaneous flap based on the superficial circumflex iliac artery and vein. In 22 adult female Hartley guinea pigs, an 8 × 4 cm flank flap based on the superficial circumflex iliac pedicle was raised, and its characteristics were evaluated for applications to skin flap research. Dermofluorometric studies were performed that confirm the vascularity of this flap, and 100% survival of the flap was seen 5 days after surgery in all animals. Of particular benefit was the demonstration that both afferent and efferent blood samples can be taken from the pedicle directly, which allows for the direct quantification of plasma markers after physiologic insults to the skin flap, such as burn or ischemia. This anatomically reliable and easily dissected flap lends itself well to preliminary skin flap research and may contribute to standardization of a model for further studies examining the behavior of skin microcirculation under adverse physiologic conditions.
Head‐shake vestibulo‐ocular reflex testing: Comparison of results with rotational chair testing
Authors: Goebel Joel A. , Hanson Jason M. , Langhofer Laurn R. , Fishel Douglas G. 
Published: September 2022

The currently accepted “gold standard” for rotational testing of the vestibulo‐ocular reflex uses a servo‐controlled chair for sinusoidal whole‐body rotation. Previous work in our laboratory has shown good concordance between conventional rotational chair testing and head‐on‐body (or “head‐shake”) testing for gain and phase values of the vestibulo‐ocular reflex as recorded and analyzed on our rotational chair system's software. In this article we describe results obtained from 10 normal subjects and 20 patients with reduced caloric responses using a portable system being developed in our laboratory that allows an examiner to generate both whole‐body and head‐on‐body rotational stimuli. Test frequencies within the range 0.25 to 1.0 Hz were chosen for comparison with results obtained by conventional rotational chair testing. Visual conditions for all tests included both visually enhanced vestibulo‐ocular reflex (real earth‐fixed target) and mentally enhanced vestibulo‐ocular reflex (imagined earth‐fixed target, in darkness or with vision obscured) paradigms. Our results show general agreement between head‐shake and rotational chair testing and both manual whole‐body rotation and head‐shake testing on our portable system for vestibulo‐ocular reflex gain and phase testing, with the largest differences noted at 1.0 Hz. Portable rotational testing was well tolerated by young and elderly subjects alike. We expect manual whole‐body rotation and head‐shake testing will be useful adjuncts for examining vestibulo‐ocular reflex function when more formal rotational chair testing is not possible.
Propofol‐based anesthesia as compared with standard anesthetic techniques for middle ear surgery
Authors: Jellish W. Scott , Leonetti John P. , Murdoch John R. , Fowles Susan 
Published: September 2022

OBJECTIVETo determine whether a totally intravenous technique with propofol and fentanyl is superior to isoflurane anesthesia in patients undergoing middle ear surgery.DESIGNProspective randomized study.SETTINGInpatient otolaryngology service at a university medical center.PATIENTSPhysical status 1 and 2 nonobese patients with no significant history of diabetes, chronic cholecystitis, neuropathy, or neuromuscular disorders that could produce delayed gastric emptying. One hundred two patients were admitted to the study and randomly divided into three equal groups.INTERVENTIONSIntravenous thiopental, 5 mg/kg, was administered for induction of anesthesia followed by 60% air/O2 with isoflurane, 1% to 2% end tidal, for maintenance anesthesia (group 1), The same anesthetic with the addition of droperidol, 25 μg/kg, was given after induction (group 2). Propofol, 2 mg/kg, was administered intravenously for induction of anesthesia and followed by propofol, 50 to 250 μg/kg/min, for maintenance anesthesia. All groups received fentanyl, 3 μg/kg intravenously, after induction.MEASUREMENTS AND MAIN RESULTSSurgical duration, induction, maintenance, and total anesthesia times were recorded together with eye opening and extubation. Intergroup comparisons of postoperative nausea, vomiting, and pain, and recovery scores, we made by use of the Steward system. Patients receiving propofol, compared with the isoflurane‐only group, had significantly less nausea (4/34 vs 12/34 patients, respectively; p < 0.05) and as vomiting (2/34 vs 8/34 patients, respectively; p < 0.05). Immediate recovery scores were significantly better for propofol compared with the isoflurane‐droperidol group. Recovery scores at 30 minutes were also faster with propofol compared with isoflurane or isoflurane‐droperidol (5.7 ± 0.1 vs 5.1 ± 0.2 and 5.2 ± 0.2; p < 0.05).
Cerebrospinal Fluid Fistulae in a Canine Model
Authors: Syms Charles A. , Syms Mark J. , Murphy Terrence P. , Massey Samuel O. 
Published: September 2022

Various diagnostic techniques currently are used to detect the presence of a cerebrospinal fluid fistula. High resolution computerized tomography scanning with the instillation of an intrathecal nonionic contrast medium yields the most accurate diagnostic results. Occasionally, even with optimal conditions, little information is gained other than the confirmation of the presence of a fistula. Intrathecal fluorescein can provide accurate information on the exact location of the fistula. The current study was designed to refine the clinical examination for cerebrospinal fluid fistulae with the use of intrathecal fluorescein. The canine model that we used also served as a vehicle to investigate the histopathologic effects of fluorescein on the central nervous system. We modified a commonly used xenon light source to enable examination with 490 nm light. In the canine model, this allowed accurate visualization of surgically created fistulae using very low doses of intrathecal fluorescein. An examination of the histopathologic features of the central nervous system of the canine model after acute instillation of a higher dose of fluorescein revealed microscopic changes consistent with the introduction of an irritant material. The changes induced by the chemical trauma may explain the serious neurologic sequelae sometimes seen in patients after the instillation of intrathecal fluorescein. Recommendations on the correct dosage of intrathecal fluorescein for diagnosis of cerebrospinal fluid fistulae are proposed.
Value of Preoperative Prothrombin Time/Partial Thromboplastin Time as a Predictor of Postoperative Hemorrhage in Pediatric Patients Undergoing Tonsillectomy
Authors: Howells R. charles , Wax Mark K. , Ramadan Hassan H. 
Published: September 2022

OBJECTIVEHemorrhage after tonsillectomy is a potentially lethal complication. Preoperative assessment consisting of prothrombin time (PT) and activated partial thromboplastin time (PTT) has been used to identify patients at risk for hemorrhage after tonsillectomy and adenoidectomy. We sought to assess the value of PT/PTT screening as a predictor of posttonsillectomy hemorrhage.DESIGNA retrospective chart review was carried out with a minimum of 1 month follow‐up.SETTINGTertiary academic referral center.PATIENTSBetween January 1992 and June 1995, 382 patients undergoing tonsillectomy were examined; 339 patients with a minimum of 1 month follow‐up were reviewed for this study.MAIN OUTCOME MEASURENormal and prolonged PT/PTT values were examined. Bleeding in the intraoperative, immediate postoperative, and delayed phases of healing was examined.RESULTSTwo‐hundred and twenty‐two patients had normal PT/PTT, 39 had prolonged PT/PTT, and 78 had no preoperative studies performed. Bleeding occurred in 2.7%, 2.6%, and 3.3%, respectively, of patients. Eight patients had positive family histories of bleeding tendencies. One patient (12.5%) with a normal PT/PTT experienced a delayed posttonsillectomy bleed. Of 39 patients with abnormal coagulation studies, 30 were borderline elevations with no repeat studies done; one patient experienced postoperative hemorrhage. Nine abnormal results were repeated; three returned to normal, three remained prolonged but underwent tonsillectomy with no intervention, and three received hematology consultations. One patient had lupus anticoagulant, one had Hageman Factor deficiency, and one was cleared for surgery with no diagnosis. All patients underwent tonsillectomy with no episodes of postoperative bleeding.CONCLUSIONSPreoperative PT/PTT provides no additional information than does a bleeding history for the general pediatric population undergoing tonsillectomy. This should only be done in selective cases where warranted by history.
Conceptual design and application research of a corrugated flexible skin with high bending stiffness
Authors: Lei P. , Li Y. , Li D. , Li B. 
Published: September 2022

AbstractIn this paper, sliding panels are used to increase the bending stiffness of the classic corrugated flexible skin, and the corresponding application procedure for aircraft structures is developed. After the conceptual design of the corrugated flexible skin with sliding panels is proposed, the analytical models to calculate the equivalent tensile and bending properties are investigated. At the same time, its flexibility in the corrugation direction and the load-bearing capacity (is proportional to the bending stiffness) in the direction perpendicular to corrugation are studied by numerical simulation and experiment. The application procedure is established based on geometric analysis and strain definition, and according to this procedure, the corrugated flexible skin with sliding panels is applied to the drooping leading edge to eliminate the gap on the upper skin. The results show that the corrugated flexible skin with sliding panels has more bending stiffness than the classic corrugated flexible skin in the direction perpendicular to corrugation while maintaining the deform ability in the corrugation direction, and the application procedure is effective and can be applied to other parts of the aircraft structure.
Diversity of protein food sources, protein adequacy and amino acid profiles in Indonesia diets: Socio-Cultural Research in Protein Transition (SCRiPT)
Authors: Khusun Helda , Monsivais Pablo , Anggraini Roselynne , Februhartanty Judhiastuty , Mognard Elise , Alem Yasmine , Noor Mohd Ismail , Karim Norimah , Laporte Cyrille , Poulain Jean-Pierre , Drewnowski Adam 
Published: September 2022

AbstractThe ongoing nutrition transition in lower- and middle-income countries (LMIC) in South East Asia may have a positive impact on protein nutrition. This study assessed the diversity of plant and animal protein food sources in relation to essential amino acid (EAA) adequacy in a population-based sample (N1665) in Indonesia. Dietary intakes from in-person 24 h recalls provided data on energy and protein intakes (in g/d) from plants (grains, legumes), meat, poultry and fish, and eggs and dairy. Protein diversity scores were based on the number of protein food sources over 24 h. EAA scores were the ratio of amino acid intakes to recommended values. Protein diversity and EAA scores were then compared across multiple socio-demographic indices. Analysis of variance andχ2tests were used to test for differences among groups. Energy intakes were 1678 kcal/d for men and 1435 kcal/d for women. Average protein intakes (and prevalence of inadequacy) were 59⋅4 g/d (41⋅7 %) for men and 51⋅5 g/d (51⋅1 %) for women. In regression analyses, higher protein diversity scores were associated with higher protein intakes, more animal protein and less plant protein and with higher EAA scores. Lower protein diversity scores were associated with lower intakes of lysine, leucine and valine relative to requirements, as well as with lower EAA, rural settings, less wealth and less modernisation. Greater diversity of animal protein food sources, observed among groups of higher socio-economic status, was linked to better amino acid adequacy and protein nutrition.
A Bayesian multifactor spatio-temporal model for estimating time-varying network interdependence
Authors: Liu Licheng , Pang Xun 
Published: September 2022

AbstractThis paper proposes a Bayesian multilevel spatio-temporal model with a time-varying spatial autoregressive coefficient to estimate temporally heterogeneous network interdependence. To tackle the classic reflection problem, we use multiple factors to control for confounding caused by latent homophily and common exposures. We develop a Markov Chain Monte Carlo algorithm to estimate parameters and adopt Bayesian shrinkage to determine the number of factors. Tests on simulated and empirical data show that the proposed model improves identification of network interdependence and is robust to misspecification. Our method is applicable to various types of networks and provides a simpler and more flexible alternative to coevolution models.
Keeping it in the family: Relationships between Polar medallists
Authors: Dartnall Herbert J. G. 
Published: September 2022

Abstract
During the 19th century, members of British Arctic expeditions received one of two silver Arctic medals. In 1904, the British Polar Medal was established in both silver and bronze to returning members of the British National Antarctic Expedition. Subsequently awarded to members of both Arctic and Antarctic expeditions, the medal in silver is still awarded today. This paper explores the family links of the recipients from 1904 to the present. Polar medallists related by blood comprise five pairs of brothers, five father-and-son pairs, one grandfather-and-grandson pair, one uncle-and-nephew pair and six pairs of cousins including one male-to-female pair. A female-to-female link has yet to be recorded. Family links resulting from marriage include six husband-and-wife pairs and four pairs of brothers-in-law.
Fuzzy radial-based impedance controller design for lower limb exoskeleton robot
Authors: Zhang Peng , Zhang Junxia , Elsabbagh Ahmed 
Published: September 2022

AbstractThe lower extremity rehabilitation exoskeleton is mainly used to help patients with movement disorders complete rehabilitation training. For the human-machine interaction problem of the lower limb rehabilitation exoskeleton, a fuzzy radial-based impedance (RBF-FVI) controller is proposed in this study. A six degree of freedom (DOF) lower extremity rehabilitation exoskeleton was developed, and the human-machine coupling dynamics model was established. To realize the compliance control of the human-machine coupling system, a novel RBF-FVI controller is designed, which includes an inner-loop fuzzy position control module and an outer-loop impedance control module. The inner-loop fuzzy position control module is mainly used to achieve the tracking control of the desired training trajectory and position adjustment amount. The outer-loop impedance control module regulates the impedance parameters and compensates for the uncertainty terms. The superiority of the proposed controller in trajectory following is verified through simulation and comparison tests. The hardware test of the human-machine coupling system was carried out, and the test results showed that the subject and the exoskeleton system could realize a coordinated and smooth movement.