bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of persistent urine leak after partial nephrectomy: A case series
Authors: Guliev Bakhman , Komyakov Boris , Shevnin Maksim , Agagyulov Murad , Talyshinskii Ali 
Published: August 2022

Abstract
Urinary leak is one of the most significant complications after partial nephrectomy. In case of persistent urine leaks, placement of a ureteral stent is effective but not always sufficient. This study included 5 patients with persistent urinary leak after partial nephrectomy. The patients underwent flexible ureteroscopy wherein we identified the damaged calyx. Subsequently, we performed percutaneous puncture targeting the distal end of the endoscope at this calyx and installed a nephrostomy tube. Then, the endoscope was removed, and the ureter was drained with a stent. Ureteral stenting ensures elimination of urinary leak in most patients after partial nephrectomy. In patients with persistent urinary leak, retrograde endoscopic percutaneous drainage of the pelvicalyceal system is the method of choice because it allows for rapid and effective treatment of urinary fistulas.
The Oticon Ponto System in Adults With Severe-to-Profound and Mixed Hearing Loss: Audiologic Outcomes and Patient Satisfaction
Authors: Skarzynski Piotr Henryk , Dziendziel Beata , Wlodarczyk Elzbieta , Skarzynski Henryk 
Published: August 2022

Objective
To measure audiologic outcomes and self-assessed satisfaction with the Ponto system in a group of patients who had severe to profound and mixed hearing loss.

Study Design
Retrospective case review.

Setting
Tertiary referral center.

Patients
Sixteen patients aged 21 to 74 years with severe-to-profound and mixed hearing loss (bone conduction thresholds, ≥45 dB HL).

Interventions
Ponto implant surgery.

Main Outcome Measure(s)
Pure-tone audiometry, free-field hearing thresholds, effective gain, word recognition score in quiet, and speech reception threshold (SRT) in noise were assessed. Patient-reported outcomes were collected using the Clinical Global Impression Scale, Glasgow Benefit Inventory, and Abbreviated Profile of Hearing Aid Benefit. Information concerning any medical complications was also gathered.

Results
Both word recognition score and SRT were significantly better after 12 months compared with before surgery. At normal speech level (65 dB SPL), 12 of 16 users had speech discrimination ≥70%. However, at the 12-month follow-up, the average effective gain was −6.2 dB. In general, the self-report outcomes showed good satisfaction in most patients. Postoperatively, skin complications were noted in six patients, of whom two underwent reoperation. All patients were still using the Ponto after an average observation time of 2.7 years.

Conclusion
Although skin complications were not uncommon, the Ponto system seems to be an effective method of improving hearing performance and provides subjective satisfaction in real-life situations in patients with severe-to-profound and mixed hearing loss. However, considering the significantly increased bone conduction thresholds and the risk of their further deterioration, long-term follow-up is still needed.
Predictive Value of Transimpedance Matrix Measurements to Detect Electrode Tip Foldover
Authors: Kay-Rivest Emily , McMenomey Sean O. , Jethanamest Daniel , Shapiro William H. , Friedmann David R. , Waltzman Susan B. , Roland J. Thomas 
Published: August 2022

Objective
To evaluate the ability of the transimpedance matrix (TIM) measurement to detect cochlear implant electrode tip foldover by comparing results to a “gold standard,” the intraoperative plain film radiograph.

Study Design
Retrospective case series.

Setting
Tertiary referral hospital.

Patients
One hundred three patients who underwent cochlear implantation between June 2020 and August 2021.

Interventions
Intraoperative electrophysiologic monitoring (electrode impedances, neural response telemetry, and TIM measurement) and modified Stenver's view plain film radiographs.

Main Outcome Measures
Identification of tip foldover on both TIM and plain films.

Results
In total, 103 patients (117 ears) had both a TIM measurement and intraoperative X-ray available for review, including 68 adults and 35 children. One hundred patients (85%) received the Cochlear Slim Modiolar electrode. Tip foldovers were noted in three of 117 implants (2.5%). In all cases, TIM was able to detect the foldover, and the electrode arrays were reinserted with the patients still under anesthesia, with repeat X-ray demonstrating a normal configuration. Two other abnormal TIM patterns were identified. One was in a patient with an obstructed cochlea in whom only 10 electrodes could be inserted, the other was in a patient with a common cavity abnormality. One additional patient underwent electrode repositioning intraoperatively because of overinsertion. In this patient, the TIM appeared to be within normal limits, but the over-insertion was apparent on X-ray. Overall, the sensitivity and specificity of TIM measurements in detecting electrode tip foldover were both 100%.

Conclusion
TIM measurements were able to accurately identify tip foldovers. More research is needed to define the adjunctive role of TIM as an intraoperative measure.
Outcome of Water Exchange and Air Insufflation Colonoscopy Performed by Supervised Trainee and Their Assessment of the Training Experience
Authors: Leung Felix W. 
Published: August 2022

Goals:
The hypotheses that supervised trainees would provide a more favorable assessment of the learning experience and could achieve superior results with water exchange (WE) compared with air insufflation were tested.

Background:
WE decreased pain, increased cecal intubation rate (CIR), and polyp detection rate (PDR).

Study:
In a prospective pilot observational study, the trainees were taught WE in unsedated and WE and air insufflation in alternating order in sedated veterans. Trainee scores and procedural outcomes were tracked.

Results:
83 air insufflation and 119 WE cases were included. Trainee evaluations of the respective methods were scored based on a 5-point scale [1 (strongly agree) to 5 (strongly disagree, with lower scores being more favorable]. Evaluation scores [mean (SD)] were as follows: my colonoscopy experience was better than expected: WE 2.02 (1.00) versus air insufflation 2.43 (1.19), P=0.0087; I was confident with my technical skills using this method: WE 2.76 (0.91) versus air insufflation 2.85 (0.87), P=0.4822. Insertion time was 40 (21) min for WE and 30 (20) min for air insufflation (P=0.0008). CIR were 95% (WE, unsedated); 99% (WE, overall), and 89% (air insufflation, overall). WE showed significantly higher CIR (99% vs. 89%, P=0.0031) and PDR (54% vs. 32%, P=0.0447).

Conclusions:
The long air insufflation insertion time indicated the trainees were inexperienced. The significantly longer WE insertion time confirmed that learning WE required extra time. This pilot study revealed that supervised trainees reported more favorable learning experience with WE and equivalent confidence in technical skills scores. They completed both unsedated and sedated colonoscopy in over 89% of cases achieved significantly higher CIR and PDR with WE than air insufflation. It appeared that trainee education in WE might be an acceptable alternative to augment air insufflation to meet the challenges of training posed by traditional air insufflation colonoscopy.
Differences between spinal cord injury and cervical compressive myelopathy in intramedullary high-intensity lesions on T2-weighted magnetic resonance imaging: A retrospective study
Authors: Kamei Naosuke , Nakanishi Kazuyoshi , Nakamae Toshio , Tamura Takayuki , Tsuchikawa Yuji , Moisakos Taiki , Harada Takahiro , Maruyama Toshiaki , Adachi Nobuo 
Published: August 2022

Increases in aging populations have raised the number of patients with cervical spinal cord injury (SCI) without fractures due to compression of the cervical spinal cord. In such patients, it is necessary to clarify whether SCI or cervical compressive myelopathy (CCM) is the cause of disability after trauma. This study aimed to clarify the differences in magnetic resonance imaging (MRI) features between SCI and CCM.
Overall, 60 SCI patients and 60 CCM patients with intramedullary high-intensity lesions on T2-weighted MRI were included in this study. The longitudinal lengths of the intramedullary T2 high-intensity lesions were measured using sagittal MRI sections. Snake-eye appearance on axial sections was assessed as a characteristic finding of CCM. The T2 values of the high-intensity lesions and normal spinal cords at the first thoracic vertebra level were measured, and the contrast ratio was calculated using these values.
The longitudinal length of T2 high-intensity lesions was significantly longer in SCI patients than in CCM patients. Snake-eye appearance was found in 26 of the 60 CCM patients, but not in SCI patients. On both the sagittal and axial images, the contrast ratio was significantly higher in the SCI group than in the CCM group. Based on these results, a diagnostic scale was created. This scale made it possible to distinguish between SCI and CCM with approximately 90% accuracy.
Postoperative discal pseudocyst after percutaneous endoscopic transforaminal discectomy treated by drainage: Case report
Authors: Wang Shuai , Yang Yang , Yu Xiuchun , Chang Zhengqi 
Published: August 2022

Rationale:
This article reports 2 cases of symptomatic postoperative discal pseudocysts (PDP), a rare complication of percutaneous endoscopic transforaminal lumbar discectomy (PELD). In this report, we propose a possible mechanism of PDP and introduce an effective therapeutic strategy. To our knowledge, there have been no reports of the use of indwelling drainage techniques for the PDP treatment after PELD.

Patient concerns:
Herein, we report 2 cases of PDP after PELD in our hospital. Both patients had disc herniation at the L4/5 level, and the symptoms of low back pain and radiculopathy were significantly relieved after PELD. However, the signs in both 2 cases recurred 20 days after surgery. MRI indicated PDP in both 2 patients with high intensity on T1- and T2-weighted imaging in the primary surgical area.

Interventions:
Given the progressive symptoms in both cases, PELD was performed again and 3-lumen drainage catheters were placed at the surgical site for adequate drainage.

Outcomes:
The patient’s symptoms were significantly relieved after adequate drainage and disappeared 3 months after surgery. There was no clinical or MRI recurrence at the 6-month follow-up.

Conclusion:
According to operative findings, we found that PDP symptoms may not be attributable mainly to cyst compression but to the excessive accumulation of local inflammatory factors. Treatment of PELD combined with indwelling drainage is feasible and effective in treating PDP.
Bayesian network analysis of long-term oncologic outcomes of open, laparoscopic, and robot-assisted radical cystectomy for bladder cancer
Authors: Dong Lin , Xiaoli Feng , Ya Lu , Dan Wu , Jingwen Hu , Xun Liu , Shujin Chen , Zhijun Zhou , Tian Zhang , Hao Luo , Chuanlang Yi , Guangrong Chen , Xiaodong Wang , Gewen Luo , Yichi Zhang , Pei Cao , Yang Liu , Youliang Wang 
Published: August 2022

Background:
To understand the long-term oncologic outcomes of open radical cystectomy (ORC) versus laparoscopic radical cystectomy (LRC) versus robot-assisted radical cystectomy (RARC) for bladder cancer (BCa). Therefore, we performed the conventional meta-analysis and network meta-analysis to evaluate the long-term oncologic outcomes of ORC, LRC, and RARC for BCa.

Methods:
A systematic search of PubMed, Embase, Cochrane Library, Medline, and Web of science was performed up until July 1, 2021. Long-term oncologic outcomes include the 5-year overall survival (OS) rate, the 5-year recurrence-free survival (RFS) rate, and the 5-year cancer specific-survival (CSS) rate. The Bayesian network analysis has been registered in PROSPERO (CRD42020208396).

Results:
We found that 10 articles (including 3228 patients) were included in our Bayesian network analysis. No significant differences were found between ORC, LRC, and RARC in long-term oncologic outcomes in either direct meta-analysis or network meta-analysis. Therefore, the clinical effects of 5-year OS, RFS, and CSS of RARC, LRC, and ORC are similar. But LRC may be ranked first in 5-year OS, RFS, and CSS compared to other surgical approaches by probabilistic analysis ranking via Bayesian network analysis.

Conclusion:
We found that there were no statistical differences in the 3 surgical approaches of RAPC, LPC, and OPC for Bca in long-term oncologic outcomes by direct meta-analysis. However, Subtle differences between these surgical approaches can be concluded that LRC may be a better surgical approach than RARC or ORC in long-term oncologic outcomes by probabilistic analysis ranking via Bayesian network analysis. Moreover, we need a large sample size and more high-quality studies to improve and verify further.
Intra- and Inter-observer Agreement of High Resolution Antroduodenal Manometry in Pediatric Patients Among Single Center Experts
Authors: Valitutti Francesco , Lindley Keith , Saliakellis Efstratios , Chanpong Atchariya , Pesce Marcella , Rybak Anna , Thapar Nikhil , Borrelli Osvaldo 
Published: August 2022

Objectives:
Studies in adults have suggested that high-resolution technology increases the diagnostic yield of antroduodenal manometry (ADM). However, there is no study comparing high-resolution with low-resolution ADM recordings as well as comparing the 2 types of high-resolution display [conventional line plot (CLP) and pressure topographic plots (PTP)]. We hypothesized that high-resolution ADM is a superior diagnostic modality with higher inter-observer and intra-observer agreement compared with low-resolution recordings.

Methods:
Twenty-four anonymized ADM studies were blindly analyzed by 3 experienced pediatric neurogastroenterologists. All studies had been performed using a low-compliance water-perfused system with a 20-channels catheter. Data were displayed as CLP, as both high-resolution and low-resolution, and PTP in different sessions with at least 6-week interval. Accuracy was evaluated using previous established diagnosis and specific pre-prandial and post-prandial manometric patterns. Inter-observer and intra-observer agreements were calculated.

Results:
Analysis with high-resolution CLP revealed a substantial inter-observer agreement among the 3 observers regarding the diagnosis (Krippendorff’s alpha: 0.832; average pairwise percentage agreement: 88.9%). Conversely, PTP and low-resolution CLP showed poor agreement for diagnoses (Krippendorff’s alpha: 0.600; average pairwise percentage agreement: 75.3%; Krippendorff’s alpha: 0.390; average pairwise percentage agreement: 60.2%, respectively). For the intra-observer agreement, Krippendorff’s alpha ranges were 0.891–1 for CLP and 0.19393–0.34621 for PTP.

Conclusions:
Our study demonstrated higher diagnostic accuracy for high-resolution ADM compared to the low-resolution recordings. However, although it is well established for other motility investigations, PTP is not yet reliable in assessing foregut motor patterns. Advanced and more sophisticated software are clearly required for analyzing PTP display.
Myxoid Pseudotumor Involving the Renal Sinus
Authors: Hogan Kevin , McKenney Jesse K. , Cox Roni M. , Nguyen Jane K. , Shah Rajal B. , Billings Steven D. , Przybycin Christopher G. 
Published: August 2022

We describe 33 cases of myxoid pseudotumor involving the renal sinus from 31 patients. Patients included 21 men and 10 women, ages 30 to 95 years. Twenty-seven cases (82%) had an associated malignancy, including urothelial carcinoma of the renal pelvis (22 cases), clear cell renal cell carcinoma (3 cases), urothelial carcinoma of the bladder (1 case), and poorly differentiated carcinoma of uncertain lineage (1 case). The remaining 6 (18%) had no associated malignancy and included 3 nephrectomies for ureteral stricture, 2 ureteropelvic junction repairs, and 1 resection of a “periureteral mass” (subsequently shown to be myxoid pseudotumor). Myxoid pseudotumor was identified by preoperative computed tomography imaging in 2 patients (6%) and identified by the gross dissector in 9 cases (27%). The mean size was 14 mm (range: 5 to 38 mm). All cases had an admixture of adipocytes, myxoid stromal matrix, variable collagenization, and a hypocellular population of bland spindled and stellate stromal cells. No multilobated atypical stromal cells were present. Clinical follow-up was available for 28 patients (90%), ranging from 1 to 132 months (mean: 24.6 mo). No patients had adverse events related to the myxoid pseudotumor. Myxoid pseudotumor of the renal sinus is often associated with a variety of adjacent neoplastic and non-neoplastic conditions and may present as a mass lesion detectable by imaging and/or gross inspection. Awareness of this benign process is important to avoid confusion with a neoplasm, especially liposarcoma.
Improving Estimation of Intervention Impact on Antibody Titer Increase in the Presence of Missing Values: A Proposed Method for Addressing Limit of Detection Issues
Authors: Ge Yang , Zane Billings W. , Skarlupka Amanda L. , Cao Wannan , Dobbin Kevin K. , Ross Ted M. , Handel Andreas , Shen Ye 
Published: August 2022

AbstractIn many laboratory assays that measure immunological quantities, a portion of the measured values fall below a limit of detection (LOD). This is also the case for the hemagglutination inhibition assay (HAI), a common method used to quantify antibodies in influenza research. The conventional approach is to treat values below the LOD as either equal to the LOD or LOD/2, which can introduce potential biases. These biases can become more pronounced when calculating compound measures such as the difference between post-vaccination and pre-vaccination antibody titers (titer increase). To address this issue, we conducted simulations using LOD measurements with LOD/2 values as the standard imputation. We then developed a new method to adjust coefficient estimates that account for the censored nature of measurements below the LOD. Applying this new method to data from an influenza vaccine cohort study, we compared the impact of vaccine dose on the titer increase of HAI.Author SummaryAnalysis of measurements obtained from widely used antibody assays frequently overlooks the underlying data structure, leading to potential biases in the results. To address this issue, we have developed a method that effectively reduces these biases.
Re-assessing niche partitioning in MacArthur’s Warblers: foraging behavior, morphology, and diet metabarcoding in a phylogenetic context
Authors: Miller Eliot T. , Wood Andrew , Baiz Marcella D. , Welch Andreanna J. , Fleischer Robert C. , Dale Adrienne S. , Toews David P. L. 
Published: August 2022

ABSTRACTDue in large part to MacArthur’s classic 1958 paper, wood-warblers (Parulidae) are ecological icons, textbook protagonists of a story of competition and niche partitioning. As the story goes, subtle differences in foraging behavior are the principal means by which these nearly morphologically indistinguishable species are able to co-occur and avoid extinction. Yet, MacArthur’s study was in fact quite limited in scale, and he said little about the relevance of evolution to the study system. Here, we reassess MacArthur’s conclusions across an expanded set of syntopic warbler species in a forest in northern New York. We combine morphometrics, quantitative foraging data, and fecal metabarcoding—a direct measure of warbler diet—to study competition and niche partitioning in an evolutionary framework. We find close and kinematically realistic relationships between morphology and foraging behavior, but little connection between warbler ecomorphology and the 2,882 invertebrate taxa detected in their diets. Instead, diet remains phylogenetically conserved—closely related warblers eat similar suites of invertebrates, regardless of where they forage. Finally, we present evidence that these species not only partition niche space in the present day, but that competition has shaped their behaviors over evolutionary time. MacArthur (1958) may have drawn a few incorrect inferences, but his overall conclusion that evolved differences in foraging position, driven by competition among close relatives, does indeed appear to be a key reason these warblers can occur in such close sympatry.
A computational framework linking synaptic adaptation to circuit behaviors in the early visual system
Authors: He Liuyuan , He Yutao , Lun Kehuan , Ma Lei , Du Kai , Huang Tiejun 
Published: August 2022

AbstractRetina ribbon synapses are the first synapses in the visual system. Unlike the conventional synapses in the central nervous system triggered by action potentials, ribbon synapses are uniquely driven by graded membrane potentials and are thought to transfer early sensory information faithfully. However, how ribbon synapses compress the visual signals and contribute to visual adaptation in retina circuits is less understood. To this end, we introduce a physiologically constrained module for the ribbon synapse, termed Ribbon Adaptive Block (RAB), and an extended “hierarchical Linear-Nonlinear-Synapse” (hLNS) framework for the retina circuit. Our models can elegantly reproduce a wide range of experimental recordings on synaptic and circuit-level adaptive behaviors across different cell types and species. In particular, it shows strong robustness to unseen stimulus protocols. Intriguingly, when using the hLNS framework to fit intra-cellular recordings from the retina circuit under stimuli similar to natural conditions, we revealed rich and diverse adaptive time constants of ribbon synapses. Furthermore, we predicted a frequency-sensitive gain-control strategy for the synapse between the photoreceptor and the CX bipolar cell, which differ from the classic contrast-based strategy in retina circuits. Overall, our framework provides a powerful analytical tool for exploring synaptic adaptation mechanisms in early sensory coding.
Increased ozone levels disrupt insect sexual communication
Authors: Jiang Nan-Ji , Chang Hetan , Weisflog Jerrit , Eberl Franziska , Veit Daniel , Weniger Kerstin , Hansson Bill S. , Knaden Markus 
Published: August 2022

AbstractInsect sexual communication often relies upon sex pheromones1-3. Most insect pheromones, however, contain carbon-carbon double bonds and potentially degrade by oxidation4. Here, we show that already frequently reported increased levels of Anthropocenic ozone can oxidize all described male-specific pheromones of Drosophila melanogaster5-7, resulting in reduced amounts of e.g. cis-Vaccenyl Acetate and (Z)-7-Tricosene. At the same time female acceptance of ozone-exposed males is significantly delayed. Interestingly, groups of ozonized males also exhibit unnaturally high levels of male-male courtship behavior. When repeating similar experiments with nine other drosophilid species, we observe pheromone degradation and/or corrupted sex recognition in eight of them. Our data suggest that Anthropocenic levels of ozone can oxidize double bonds in a variety of insect pheromones extensively, thereby leading to deviations in sexual recognition.