bluuebunny/crossref_metadata_2025_split huggingface dataset:
Salvage Treatments for Poor Voice Outcomes Following Autologous Fat Injection Laryngoplasty
Authors: Lin Yu-Hsuan , Wang Chi-Te 
Published: December 2022

Objective: Fat injection laryngoplasty (FIL) is a common procedure used to correct glottic insufficiency. Nevertheless, few studies have discussed potential treatments for cases with poor voice recovery after FIL. Methods: Eighteen patients with unfavorable vocal outcomes from FIL were analyzed. Each of these patients presented persistent dysphonia for more than 2 months following FIL, together with bulging vocal folds and poor mucosal wave. We applied microsurgery as the standard treatment to remove excessive fat. Vocal fold steroid injection (VFSI) was administered to patients that were hesitant or declined to undergo microsurgery. Voice outcomes were evaluated using the Voice Handicap Index-10 (VHI-10), grade-roughness-breathiness (GRB) scores, and smoothed cepstral peak prominence (CPPs). Results: Six patients underwent microsurgery directly, 6 patients received only VFSIs as a salvage treatment, and the remaining 6 patients received 1 to 3 courses of VFSIs before the decision to undergo microsurgery. Pathology reports were available for 10 patients, and contained 5 instances of adipose tissues, 3 of fat necrosis, 1 of chronic inflammation, and 1 of fibrosis. Seventeen patients reported satisfactory or improved outcomes. We found remarkable improvements in VHI-10, GRB, and CPPs (all P < .05) after salvage treatments for FIL. Subgroup analyses showed comparable voice outcomes for patients undergoing direct microsurgery, VFSI alone, and VFSI followed by microsurgery ( P > .05). Conclusions: This study demonstrated that fat overinjection and/or fibrotic change in the injected vocal folds may cause poor voice outcomes after FIL. Both microsurgery and VFSI could be applied as salvage treatments with good voice recovery profiles. Level of evidence: Level 4.
Acceptance and commitment therapy for autistic adults: A randomized controlled pilot study in a psychiatric outpatient setting
Authors: Pahnke Johan , Jansson-Fröjmark Markus , Andersson Gerhard , Bjureberg Johan , Jokinen Jussi , Bohman Benjamin , Lundgren Tobias 
Published: December 2022

Autistic adults are at risk of stress-related psychiatric disorders and reduced life quality due to social, cognitive, and perceptual challenges. Mental health interventions adapted to autistic adults are scarce. Acceptance and commitment therapy has preliminarily indicated health benefits in autistic adults, although it has not been robustly evaluated. Overall, 39 adults (21 males; 21–72 years) with autism spectrum disorder and normal intellectual ability ( IQ M = 108.5; SD = 13.5) were randomized to 14 weeks of adapted acceptance and commitment therapy group treatment (NeuroACT) or treatment as usual. The intervention was feasible. Perceived stress and quality of life (primary outcomes), alongside psychological inflexibility, cognitive fusion, cognitive and behavioral avoidance, and autistic mannerism were statistically significantly improved in NeuroACT compared with treatment as usual ( d = 0.70–0.90). Clinically significant changes in perceived stress and quality of life were in favor of NeuroACT. Between-group altered depression, anxiety, sleep problems, one quality of life measure, functional impairment, social aspects of autism, and executive difficulties were statistically non-significant. Dropout was slightly higher in NeuroACT. NeuroACT may be a promising treatment for autistic adults with co-existing stress and reduced quality of life. More extensive studies are warranted to evaluate NeuroACT further. Lay abstract Autistic adults are often stressed and feel depressed or anxious. However, mental health programs that are suited for autistic adults are few. Acceptance and commitment therapy is a psychotherapy method that seems to help people feel better, although not thoroughly evaluated in autistic individuals. In this study, 20 autistic adults had 14 weeks of acceptance and commitment therapy group treatment suited for autism (NeuroACT), while 19 autistic adults had ordinary care. The acceptance and commitment therapy group treatment program seemed logical and reasonable to the participants. Also, when comparing the participants in the NeuroACT group with those in the ordinary care group, the NeuroACT participants reported less stress and higher quality of life. Compared to the ordinary care group, they could also manage distressing thoughts better, perceived themselves as more flexible, and did not avoid stressful situations as much as before. However, there was no significant difference between the groups in depression, anxiety, sleep problems, social aspects of autism, everyday functioning, or executive challenges. Slightly more NeuroACT participants did not finish the treatment than ordinary care participants. In conclusion, the NeuroACT program may be a treatment for autistic adults who feel stressed and have reduced quality of life. More studies are needed to see how helpful the NeuroACT program is for autistic adults.
‘We are doing damage control’: Government stakeholder perspectives of educational and other services for children with autism spectrum disorder in South Africa
Authors: Pillay Sarosha , Duncan Madeleine , de Vries Petrus J 
Published: December 2022

Autism spectrum disorder is a growing public health concern in low-and middle-income countries that has prompted a World Health Organization resolution on ‘ comprehensive and coordinated efforts for management of autism spectrum disorder’. Despite being a signatory of the resolution, South Africa does not have any national policies to guide the management of autism spectrum disorder services. This study explored the perspectives of key government stakeholders on educational and other services for children with autism spectrum disorder in the Western Cape Province of South Africa and their proposed solutions to meet the needs of autistic children and their families. The overarching theme that emerged was ‘We are doing damage control’. Government stakeholders acknowledged that autism spectrum disorder services were falling between the ‘cracks’ caused by competing societal demands on government resources. Participants shared perspectives about autism spectrum disorder services in three categories: a cracked society, siloed service systems and gap-filling strategies. Findings from this study highlighted the need for collaborative efforts between government departments and civil society to develop a strategy for autism spectrum disorder in line with the World Health Organization resolution. Multistakeholder engagement to break down barriers, strengthen systems and develop innovative solutions to improving services for children with autism spectrum disorder and their families is recommended. Lay abstract Autism spectrum disorder is a growing public health concern in low- and middle-income countries like South Africa where there are no plans or policies in place for autism spectrum disorder management. Many children with autism spectrum disorder in South Africa are out of schools and waiting for school placement to become available. This study explored the perspectives of key government stakeholders on educational and other services for children with autism spectrum disorder in the Western Cape Province of South Africa and their suggestion for improving services for these children and their families. Semi-structured interviews were conducted with government stakeholders from the Western Cape Department of Education, Department of Health and the Department of Social development. The main theme that emerged was ‘We are doing damage control’. Government stakeholders acknowledged that autism spectrum disorder services were being overlooked because of other demands on government resources. Finding from this study highlighted the need for government departments to work together to develop a strategy for autism spectrum disorder management. Engagement between government and civil society to break down barriers, strengthen systems and develop solutions to improving access to services for children with autism spectrum disorder and their families is recommended.
The Value of Scientific Publications in Surgical Device Innovation
Authors: Song Alfred , Rensi Stefano E. , Tarquinio Abigail G. , Cahan Eli , de Ruijter Vivian E. , Wall James K. 
Published: December 2022

Background Clinical trials represent a significant risk in the commercialization of surgical technologies. There is incentive for companies to mitigate their regulatory risk by targeting 510K over Premarket Approval (PMA) pathways in order to limit the scope, complexity and cost of clinical trials. As such, not all companies will publish clinical data in the scientific literature. Purpose We set out to investigate the relationship between scientific publication by surgical device companies and the impact it has on company valuation. We hypothesize that publishing in the scientific literature correlates with success of the surgical device companies as measured by funding. Research Design We first obtained a list of surgical device startup companies and their financial deals using the Pitchbook database. Those companies were then cross referenced with the FDA database and the Dimensions database for product registrations and peer reviewed publications, respectively. Analysis was then performed using these query results. Study Sample and Data Collection We obtained a list of US surgical device startups financing deals closed between 2010 and 2020 from the Pitchbook database. We queried the Pitchbook for deal dates from January 1, 2010 to January 1, 2020 for deal types spanning early stage investment to IPO. Deals were limited to those conducted in the United States and to the surgical device industry. We queried the FDA database for product registration information associated with each of the companies involved in the deals. We tabulated the number of journal articles associated with surgical device companies using the Dimensions Search API as well as a manual confirmation. Results Five hundred thirty five (535) deals from 222 companies were found in Pitchbook that met our criteria. Querying the FDA database resulted in 578 registrations associated with these companies. Publications per company ranged widely. Conclusions Companies that are able to generate a more numerous publications had correspondingly higher valuations during funding rounds. A subset of outstanding companies were analyzed and at least four factors affect: direct value of publications, indirect valve of publications, survivorship bias, and adoption share; each of which will be discussed in this manuscript.
Feasibility of Nerve Transfer to Palmaris Longus in Forearm-Level TMR: Anatomic Study and Clinical Series
Authors: Hysong Alexander A. , Melamed Eitan , Delarosa Matthew R. , Daley Dane N. , Loeffler Bryan J. , Gaston R. Glenn 
Published: December 2022

Background: Targeted muscle re-innervation (TMR) is increasingly being used for treatment of postamputation pain and myoelectric prosthesis (MYP) control. Palmaris longus (PL) is a potential target following transradial amputation. The purpose of this study was to determine the branching pattern of the median nerve (MN) as it pertains to the PL motor branch entry point (MEP) and to present clinical results of patients who had PL used as a target. Methods: Eight cadaveric arms were dissected and branching patterns of the MN were documented. Additionally, we reviewed adult patients from a prospectively collected database who underwent TMR using PL. We recorded patient-reported outcomes and signal strength generated by the PL. Results: The average distance from the medial epicondyle to PL MEP was 53 mm. All palmaris motor branches passed through a chiasm within the flexor digitorum superficialis muscle belly, which was a mean of 18 mm away from the MN proper. Patients with long-term follow-up reported an average Pain visual analog scale of 3.3 and Disabilities of the Arm, Shoulder and Hand of 46.2. All but one patient were using an MYP, and all generated at least 10 mV of signal from the PL, which is ample signal for surface electrode detection and MYP control. There were no postoperative neuromas and only one patient-reported postoperative phantom limb pain. Conclusions: Palmaris longus is a suitable target for TMR. Our objective measurements and anatomic relationships may help surgeons consistently find the PL’s motor branch. Our series of patients reveal sufficient signal strength and acceptable clinical outcomes following TMR using the PL.
Observation on the clinical efficacy and side effects of EGFR-TKI ± chemotherapy in the treatment of EGFR mutation-positive advanced lung adenocarcinoma
Authors: Zheng Jianping , Cui Tongjian , Li Ting 
Published: December 2022

Objective To assess the clinical efficacy and side effects of EGFR-TKI with or without chemotherapy in the treatment of EGFR mutation-positive advanced lung adenocarcinoma. Methods A total of 103 IIIB or IV EGFR mutation-positive lung adenocarcinoma patients admitted to the oncology department of Fujian Provincial Hospital from January 2017 to October 2020 were selected. According to genetic mutation status, patients were divided into the following groups: 19del alone, 19del combined with TP53 or other co-mutations, L858R mutation alone, and L858R mutation combined with TP53 or other co-mutations. Targeted drugs or targeted drugs combined with chemotherapy were respectively administered in the four groups. In patients with simple 19 deletion, only targeted drugs with no combined therapy were applied, resulting in seven total groups. The difference between short-term treatment and long-term treatment effects and the occurrence of adverse reactions was calculated and compared. Results There was no statistical significance of difference in the incidence of adverse reactions in seven groups ( p > 0.05). The short-term disease control rate of the combination group was higher than the targeted drug group with the difference yielding statistical significance ( p < 0.001). The short-term objective response rate of the combination group was higher than the targeted drug group, also yielding statistical significance ( p < 0.001). By October 2020, the median progression-free survival (PFS) was 16 months in the EGFR-TKI-targeted combined with chemotherapy group and 10 months in the single-drug EGFR-TKI group, and the PFS time was longer in the combination group than in the single targeted drug group, the difference being statistically significant ( p = 0.001). Conclusions In the treatment of advanced lung adenocarcinoma patients with EGFR-gene sensitive mutations, compared with single EGFR-TKI-targeted therapy, EGFR-TKI-targeted drug combined chemotherapy can control the disease progression more effectively, and does not increase adverse reactions.
Surgical Experience With Crossed and Anomalous Origin of the Pulmonary Arteries From the Pulmonary Trunk: A Single Center Report of 24 Cases
Authors: Said Sameh M , Hoggard Eric , Narasimhan Shanti 
Published: December 2022

Background Anomalies of the pulmonary origin of the pulmonary arteries are uncommon; however, the true incidence is unknown and may be underestimated. We sought to review our experience with this unusual pathology and examine its surgical implications. Methods We reviewed medical records between 2011 and 2022. Results A total of 24 patients were identified. Genetic syndromes were present in 12 patients (50%). The patients were divided into two main groups. Those with septal defects (14 patients,58.3%), and those without (10 patients, 41.7%). Aortic arch hypoplasia with/without coarctation was present in nine patients (37.5%). Pulmonary arterial branch hypoplasia and/or obstruction was present in six patients (25%) with resultant preoperative systemic or suprasystemic right ventricular pressure. Four patients (16.7%) underwent pulmonary artery branch and/or right ventricular outflow tract interventions prior to surgery. All patients underwent surgical interventions for their associated cardiac defects. The crossed pulmonary arteries were uncrossed for those four patients (16.7%) who required concomitant pulmonary arterioplasties and pulmonary arterial branch rehabilitation and who had elevated right ventricular pressures preoperatively. No early or late mortalities. One Alagille's syndrome underwent liver transplant prior to discharge. Late transcatheter interventions were needed in four (16.7%) during the follow-up period, while four patients required repeat aortic arch augmentation for recurrent arch obstruction. Conclusions Anomalous origin of the pulmonary arteries from the pulmonary trunk including crossed pulmonary arteries is an uncommon anomaly that may be underrecognized. It can occur in isolation or in association with other heart defects. Recognition of this malpositional anomaly is important as it has specific surgical and/or transcatheter implications.
A lightweight hierarchical convolution network for brain tumor segmentation
Authors: Wang Yuhu , Cao Yuzhen , Li Jinqiu , Wu Hongtao , Wang Shuo , Dong Xinming , Yu Hui 
Published: December 2022

Abstract
Background
Brain tumor segmentation plays a significant role in clinical treatment and surgical planning. Recently, several deep convolutional networks have been proposed for brain tumor segmentation and have achieved impressive performance. However, most state-of-the-art models use 3D convolution networks, which require high computational costs. This makes it difficult to apply these models to medical equipment in the future. Additionally, due to the large diversity of the brain tumor and uncertain boundaries between sub-regions, some models cannot well-segment multiple tumors in the brain at the same time.

Results
In this paper, we proposed a lightweight hierarchical convolution network, called LHC-Net. Our network uses a multi-scale strategy which the common 3D convolution is replaced by the hierarchical convolution with residual-like connections. It improves the ability of multi-scale feature extraction and greatly reduces parameters and computation resources. On the BraTS2020 dataset, LHC-Net achieves the Dice scores of 76.38%, 90.01% and 83.32% for ET, WT and TC, respectively, which is better than that of 3D U-Net with 73.50%, 89.42% and 81.92%. Especially on the multi-tumor set, our model shows significant performance improvement. In addition, LHC-Net has 1.65M parameters and 35.58G FLOPs, which is two times fewer parameters and three times less computation compared with 3D U-Net.

Conclusion
Our proposed method achieves automatic segmentation of tumor sub-regions from four-modal brain MRI images. LHC-Net achieves competitive segmentation performance with fewer parameters and less computation than the state-of-the-art models. It means that our model can be applied under limited medical computing resources. By using the multi-scale strategy on channels, LHC-Net can well-segment multiple tumors in the patient’s brain. It has great potential for application to other multi-scale segmentation tasks.
Genome-wide characterization of the Triplophysa dalaica slc4 gene family and expression profiles in response to salinity changes
Authors: Zhou Chuanjiang , Hu Bo , Tang Yongtao , Chen Xin , Ma Zhigang , Ding Qiqi , Nie Guoxing 
Published: December 2022

Abstract
Background
The solute carrier 4 (SLC4) gene family is involved in a variety of physiological processes in organisms and is essential for maintaining acid-base balance in the body. The slc4 genes have been extensively studied in mammals, and they play important roles in intracellular and extracellular pH regulation and in the secretion and uptake of HCO3− and other ions (Na+ and Cl−) between transepithelial cells in different tissues. This study identified and characterized the entire slc4 gene family of Triplophysa dalaica.

Results
Fifteen slc4 genes were identified in the whole genome of Triplophysa dalaica in this study, including five copies of Na+-independent Cl−/HCO3− transporters, eight members of Na+-dependent HCO3− transporters, and two genes coding Na+-coupled borate transporters. The chromosomal location information, isoelectric points, and molecular weights of the 15 slc4 genes were analyzed. The results for gene structure, domain analysis, and phylogenetic relationships of this gene family showed that the slc4 genes (except for slc4a9, which is missing in teleosts) are significantly expanded in teleosts compared to higher vertebrates. This phenomenon suggests that the slc4 gene family played an important role in the transition from aquatic to terrestrial animals. RT-PCR results showed that different slc4 genes showed diversified expression patterns in the tissues of T. dalaica. For osmotic pressure regulating organs, slc4a1b, slc4a4b, slc4a7, and slc4a11a were highly expressed in gills. In the kidney, slc4a1a, slc4a3, and slc4a10b were highly expressed, suggesting that the slc4 genes play a specific role in the salinity adaptation of T. dalaica. Our study has deciphered the biological roles of the slc4 genes in maintaining ionic and acid-base homeostasis in teleost fishes and provides a foundation for future exploration of the highly differentiated gene family in Triplophysa.

Conclusions
The results are relevant for the breeding of alkali-tolerant varieties in saline-alkali areas for aquaculture. Our findings have important implications for the adaptation process of freshwater species to saline-alkali water.
Isolation, characterization and genome analysis of an orphan phage FoX4 of the new Foxquatrovirus genus
Authors: Holtappels D. , Fortuna K. J. , Vallino M. , Lavigne R. , Wagemans J. 
Published: December 2022

Abstract
The growing interest in the therapeutic application of bacteriophages leads to a drastic increase in the number of sequenced genomes. Luckily, recent insights in phage taxonomy facilitate the classification of phages in a comprehensive and data-driven manner as recently proposed by the International Committee on Taxonomy of Viruses. In this research, we present the taxonomical classification of a novel, narrow host range Xanthomonas phage FoX4, isolated from a Brussels sprouts field in Belgium infested with Xanthomonas campestris pv. campestris. The phage has a limited ability to lyse a bacterial culture, yet adsorbs efficiently to its host. Based on its genome sequence and low similarity to previously described phages, the phage comprises the novel phage genus Foxquatrovirus.
Copper selects for siderophore-mediated virulence in Pseudomonas aeruginosa
Authors: Lear Luke , Hesse Elze , Buckling Angus , Vos Michiel 
Published: December 2022

Abstract
Background
Iron is essential for almost all bacterial pathogens and consequently it is actively withheld by their hosts. However, the production of extracellular siderophores enables iron sequestration by pathogens, increasing their virulence. Another function of siderophores is extracellular detoxification of non-ferrous metals. Here, we experimentally link the detoxification and virulence roles of siderophores by testing whether the opportunistic pathogen Pseudomonas aeruginosa displays greater virulence after exposure to copper. To do this, we incubated P. aeruginosa under different environmentally relevant copper regimes for either two or twelve days. Subsequent growth in a copper-free environment removed phenotypic effects, before we quantified pyoverdine production (the primary siderophore produced by P. aeruginosa), and virulence using the Galleria mellonella infection model.

Results
Copper selected for increased pyoverdine production, which was positively correlated with virulence. This effect increased with time, such that populations incubated with high copper for twelve days were the most virulent. Replication of the experiment with a non-pyoverdine producing strain of P. aeruginosa demonstrated that pyoverdine production was largely responsible for the change in virulence.

Conclusions
We here show a direct link between metal stress and bacterial virulence, highlighting another dimension of the detrimental effects of metal pollution on human health.