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Tissue Expanders in Staged Calvarial Reconstruction: A Systematic Review

  • Andrea Y. Lo;Roy P. Yu;Anjali C. Raghuram;Michael N. Cooper;Holly J. Thompson;Charles Y. Liu;Alex K. Wong
    • Archives of Plastic Surgery
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    • 제49권6호
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    • pp.729-739
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    • 2022
  • Cranioplasties are common procedures in plastic surgery. The use of tissue expansion (TE) in staged cranioplasties is less common. We present two cases of cranioplasties with TE and systematically review literature describing the use of TE in staged cranioplasties and postoperative outcomes. A systematic review was performed by querying multiple databases. Eligible articles include published case series, retrospective reviews, and systematic reviews that described use of TE for staged bony cranioplasty. Data regarding study size, patient demographics, preoperative characteristics, staged procedure characteristics, and postoperative outcomes were collected. Of 755 identified publications, 26 met inclusion criteria. 85 patients underwent a staged cranioplasty with TE. Average defect size was 122 cm2, and 30.9% of patients received a previous reconstruction. Average expansion period was 14.2 weeks. The most common soft tissue closures were performed with skin expansion only (75.3%), free/pedicled flap (20.1%), and skin graft (4.7%). The mean postoperative follow-up time was 23.9 months. Overall infection and local complication rates were 3.53 and 9.41%, respectively. The most common complications were cerebrospinal fluid leak (7.1%), hematoma (7.1%), implant exposure (3.5%), and infection (3.5%). Factors associated with higher complication rates include the following: use of alloplastic calvarial implants and defects of congenital etiology (p = 0.023 and 0.035, respectively). This is the first comprehensive review to describe current practices and outcomes in staged cranioplasty with TE. Adequate soft tissue coverage contributes to successful cranioplasties and TE can play a safe and effective role in selected cases.

A comparison of tests for homoscedasticity using simulation and empirical data

  • Anastasios Katsileros;Nikolaos Antonetsis;Paschalis Mouzaidis;Eleni Tani;Penelope J. Bebeli;Alex Karagrigoriou
    • Communications for Statistical Applications and Methods
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    • 제31권1호
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    • pp.1-35
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    • 2024
  • The assumption of homoscedasticity is one of the most crucial assumptions for many parametric tests used in the biological sciences. The aim of this paper is to compare the empirical probability of type I error and the power of ten parametric and two non-parametric tests for homoscedasticity with simulations under different types of distributions, number of groups, number of samples per group, variance ratio and significance levels, as well as through empirical data from an agricultural experiment. According to the findings of the simulation study, when there is no violation of the assumption of normality and the groups have equal variances and equal number of samples, the Bhandary-Dai, Cochran's C, Hartley's Fmax, Levene (trimmed mean) and Bartlett tests are considered robust. The Levene (absolute and square deviations) tests show a high probability of type I error in a small number of samples, which increases as the number of groups rises. When data groups display a nonnormal distribution, researchers should utilize the Levene (trimmed mean), O'Brien and Brown-Forsythe tests. On the other hand, if the assumption of normality is not violated but diagnostic plots indicate unequal variances between groups, researchers are advised to use the Bartlett, Z-variance, Bhandary-Dai and Levene (trimmed mean) tests. Assessing the tests being considered, the test that stands out as the most well-rounded choice is the Levene's test (trimmed mean), which provides satisfactory type I error control and relatively high power. According to the findings of the study and for the scenarios considered, the two non-parametric tests are not recommended. In conclusion, it is suggested to initially check for normality and consider the number of samples per group before choosing the most appropriate test for homoscedasticity.

A comparison of deep-learning models to the forecast of the daily solar flare occurrence using various solar images

  • Shin, Seulki;Moon, Yong-Jae;Chu, Hyoungseok
    • 천문학회보
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    • 제42권2호
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    • pp.61.1-61.1
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    • 2017
  • As the application of deep-learning methods has been succeeded in various fields, they have a high potential to be applied to space weather forecasting. Convolutional neural network, one of deep learning methods, is specialized in image recognition. In this study, we apply the AlexNet architecture, which is a winner of Imagenet Large Scale Virtual Recognition Challenge (ILSVRC) 2012, to the forecast of daily solar flare occurrence using the MatConvNet software of MATLAB. Our input images are SOHO/MDI, EIT $195{\AA}$, and $304{\AA}$ from January 1996 to December 2010, and output ones are yes or no of flare occurrence. We consider other input images which consist of last two images and their difference image. We select training dataset from Jan 1996 to Dec 2000 and from Jan 2003 to Dec 2008. Testing dataset is chosen from Jan 2001 to Dec 2002 and from Jan 2009 to Dec 2010 in order to consider the solar cycle effect. In training dataset, we randomly select one fifth of training data for validation dataset to avoid the over-fitting problem. Our model successfully forecasts the flare occurrence with about 0.90 probability of detection (POD) for common flares (C-, M-, and X-class). While POD of major flares (M- and X-class) forecasting is 0.96, false alarm rate (FAR) also scores relatively high(0.60). We also present several statistical parameters such as critical success index (CSI) and true skill statistics (TSS). All statistical parameters do not strongly depend on the number of input data sets. Our model can immediately be applied to automatic forecasting service when image data are available.

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Hematological characteristics and endocrine profiles of cloned dromedary camels (Camelus dromedaries)

  • Young-Bum Son;Mohammad Shamim Hossein;Yeon Ik Jeong;Mina Kang;Huijeong Kim;Yura Bae;Kung Ik Hwang;Alex Tinson;Singh Rajesh;Al Shamsi Noura;Woo Suk Hwang
    • 한국동물생명공학회지
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    • 제39권1호
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    • pp.12-18
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    • 2024
  • Background: Somatic cell nuclear transfer (SCNT) is a prominent technology that can preserve superior genetic traits of animals and expand the population in a short time. Hematological characters and endocrine profiles are important elements that demonstrate the stability of the physiological state of cloned animals. To date, several studies regarding cloned camels with superior genes have been conducted. However, detailed hemato-physiological assessments to prove that cloned camels are physiologically normal are limited. In this study, We evaluated the hemato-physiological characteristics of cloned male and female dromedary camels (Camelus dromedaries). Methods: Therefore, we analyzed variations in hematological characteristics and endocrine profiles between cloned and non-cloned age-matched male and female dromedary camels (Camelus dromedaries). Two groups each of male and female cloned and non-cloned camels were monitored to investigate the differences in hemato-physiological characteristics. Results: All the animals were evaluated by performing complete blood count (CBC), serum chemistry, and endocrinological tests. We found no significant difference between the cloned and non-cloned camels. Furthermore, the blood chemistry and endocrine profiles in male and female camels before maturity were similar. Conclusions: These results suggest that cloned and non-cloned camels have similar hematological characteristics and endocrine parameters.

Variability in physical therapy protocols following total shoulder arthroplasty

  • Samuel Schick;Alex Dombrowsky;Jamal Egbaria;Kyle D. Paul;Eugene Brabston;Amit Momaya;Brent Ponce
    • Clinics in Shoulder and Elbow
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    • 제26권3호
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    • pp.267-275
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    • 2023
  • Background: Physical therapy (PT) plays an important role in the recovery of function following anatomic total shoulder arthroplasty (aTSA). While several PT protocols have been published for these patients, there is no standardized protocol for aTSA rehabilitation. This lack of standardization may lead to confusion between patients and physicians, possibly resulting in suboptimal outcomes. This study examines how PT protocols provided by academic orthopedic surgery programs vary regarding therapeutic goals and activities following aTSA. Methods: PT protocols for aTSA available online from the Accreditation Council for Graduate Medical Education accredited orthopedic surgery programs were included for review. Each protocol was analyzed to evaluate it for differences in recommendation of length of immobilization, range of motion (ROM) goals, start time for and progression of therapeutic exercises, and timing for return to functional activity. Results: Of 175 accredited programs, 25 (14.2%) had protocols publicly available, programs (92%) recommended sling immobilization outside of therapy for an average of 4.4±2.0 weeks. Most protocols gave recommendations on starting active forward flexion (24 protocols, range 1-7 weeks), external rotation (22 protocols, range 1-7 weeks), and internal rotation (18 protocols, range 4-7 weeks). Full passive ROM was recommended at 10.8±5.7 weeks, and active ROM was 13.3±3.9 weeks, on average. ROM goals were inconsistent among protocols, with significant variations in recommended ROM and resistance exercise start times. Only 13 protocols (52%) gave recommendations on resuming recreational activities (mean, 17.4±4.4 weeks). Conclusions: Publicly available PT protocols for aTSA rehabilitation are highly variable. Level of evidence: IV.

Spatial and temporal dynamics of the abundance of crustose calcareous algae on the southernmost coral reefs of the western Atlantic (Abrolhos Bank, Brazil)

  • Amado-Filho, Gilberto M.;Bahia, Ricardo G.;Mariath, Rodrigo;Jesionek, Michel B.;Moura, Rodrigo Leao;Bastos, Alex C.;Pereira-Filho, Guilherme Henrique;Francini-Filho, Ronaldo Bastos
    • ALGAE
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    • 제33권1호
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    • pp.85-99
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    • 2018
  • Crustose calcareous algae (CCA) constitute one of the main reef builders on the Abrolhos Bank, Brazil. Once CCA taxonomy is locally understood, differences in growth-forms may be useful for the delimitation of taxa using characteristics such as the presence or absence of surface protuberances. Here, growth-forms were used to identify and quantify the most common CCA taxa on the shallow reefs (3-10 m) of the Abrolhos Bank to determine possible changes in the CCA community over a period of 10 years, and the ecological significance of CCA to local reefs was interpreted. The CCA assemblages were surveyed from 2006-2015 by using fixed photoquadrats at four sites in the inner (10-20 km from the mainland) and mid-shelf reefs (40-75 km from the mainland). The five most common CCA taxa were Pneophyllum conicum, the Lithophyllum kaiserii / Lithophyllum sp. complex, Melyvonnea erubescens, the Hydrolithon boergesenii / Porolithon onkodes complex and Peyssonelia sp. The overall mean CCA cover on the reefs was 20%. A comparison with a previous monitoring study in the same region indicated that the CCA cover nearly doubled from 2003-2008 to 2006-2015. This study reveals that the coral-killing species P. conicum dominated CCA flora on the shallow Abrolhos reefs in the last decade, and the local specific abundance of CCA slightly fluctuated over time and was species- and site-specific. The information obtained in this study contributes to the understanding of the ecology of the key calcifying components of the Abrolhos reefs and provides a useful baseline for exploring the responses of CCA to future environmental changes.

Demographics, Social Media Use and Perceived Academic Stress of Secondary School Students in St. Thomas Aquinas College, Akure, Nigeria

  • Igbinovia, Magnus Osahon;Idhalama, Ogagaoghene Uzezi;Alex-Nmecha, Juliet C.
    • International Journal of Knowledge Content Development & Technology
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    • 제9권4호
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    • pp.7-29
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    • 2019
  • The study was carried out to investigate the influence of demographics and social media use on perceived academic stress of secondary school students in St. Thomas Aquinas College, Akure, Nigeria. This was achieved using five research questions and four null hypotheses. The population of the study consisted of 1,107 students at ISCED level 3, out of which 286 were selected based on the Israel (2003) model for determining sample size. The Ex-Post Facto (EPT) research design of the correlational type was employed to investigate the study while questionnaire was used for data elicitation. Out of the 286 copies distributed, 192 (67% response rate) were retrieved and analyzed using descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (correlation and multiple regression). The findings revealed that there is high frequency of social media use among secondary school students, majorly for meeting new friends and chatting. The perceived academic stress (PAS) of the students was found to be moderate. Of the three demographics considered, only class had significant influence on PAS. Use of social media did not have significantly influence on PAS of the students. When combined, demographics and social media use predicted PAS; and when considered relatively, of the independent variables, only class as an aspect of demographics predicted PAS. Therefore, the authors concluded that PAS of secondary school students is not directly influenced by demographics (except for class) and social media use. Based on the study's conclusion, recommendations were made.

The development of food image detection and recognition model of Korean food for mobile dietary management

  • Park, Seon-Joo;Palvanov, Akmaljon;Lee, Chang-Ho;Jeong, Nanoom;Cho, Young-Im;Lee, Hae-Jeung
    • Nutrition Research and Practice
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    • 제13권6호
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    • pp.521-528
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    • 2019
  • BACKGROUND/OBJECTIVES: The aim of this study was to develop Korean food image detection and recognition model for use in mobile devices for accurate estimation of dietary intake. MATERIALS/METHODS: We collected food images by taking pictures or by searching web images and built an image dataset for use in training a complex recognition model for Korean food. Augmentation techniques were performed in order to increase the dataset size. The dataset for training contained more than 92,000 images categorized into 23 groups of Korean food. All images were down-sampled to a fixed resolution of $150{\times}150$ and then randomly divided into training and testing groups at a ratio of 3:1, resulting in 69,000 training images and 23,000 test images. We used a Deep Convolutional Neural Network (DCNN) for the complex recognition model and compared the results with those of other networks: AlexNet, GoogLeNet, Very Deep Convolutional Neural Network, VGG and ResNet, for large-scale image recognition. RESULTS: Our complex food recognition model, K-foodNet, had higher test accuracy (91.3%) and faster recognition time (0.4 ms) than those of the other networks. CONCLUSION: The results showed that K-foodNet achieved better performance in detecting and recognizing Korean food compared to other state-of-the-art models.

Differences in Nutrient Intake with Homemade versus Chef-Prepared Specific Carbohydrate Diet Therapy in Inflammatory Bowel Disease: Insights into Dietary Research

  • Morrison, Alex;Braly, Kimberly;Singh, Namita;Suskind, David L.;Lee, Dale
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제24권5호
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    • pp.432-442
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    • 2021
  • Purpose: The aim of this study was to evaluate the nutrient content consumed by children and adolescents on home-prepared versus chef-prepared specific carbohydrate diets (SCD) as therapy for inflammatory bowel disease (IBD). Methods: Dietary intake of two cohorts with active IBD initiating the SCD over 12 weeks was assessed. The home-prepared cohort received detailed guidance from dietitians on implementation of the SCD. The chef in the other cohort was knowledgeable in the SCD and prepared meals from a fixed set of recipes. Data from 3-day diet diaries at 4 different time points were collected. US Recommended Daily Allowances (RDA) were calculated for macronutrients, vitamins, and minerals. Results: Eight participants on the homemade SCD and 5 participants on the chef-prepared SCD were included in analysis. Mean % RDA for energy intake was 115% and 87% for homemade and chef-prepared groups (p<0.01). Mean % RDA for protein intake was 337% for homemade SCD and 216% for chef-prepared SCD (p<0.01). The homemade SCD group had higher mean % RDA values for vitamin A and iron, while the chef-prepared SCD group had higher intake of vitamins B1, B2, D, phosphorus and zinc (p<0.01 for all). Conclusion: The SCD implemented homemade versus chef-prepared can result in significantly different intake of nutrients and this may influence efficacy of this dietary therapy. Meal preparation dynamics and the motivation of families who pursue dietary treatment may play an important role on the foods consumed and the outcomes on dietary therapy with the SCD.

Development and pregnancy rates of Camelus dromedarius-cloned embryos derived from in vivo- and in vitro-matured oocytes

  • Son, Young-Bum;Jeong, Yeon Ik;Jeong, Yeon Woo;Olsson, Per Olof;Hossein, Mohammad Shamim;Cai, Lian;Kim, Sun;Choi, Eun Ji;Sakaguchi, Kenichiro;Tinson, Alex;Singh, Kuhad Kuldip;Rajesh, Singh;Noura, Al Shamsi;Hwang, Woo Suk
    • Animal Bioscience
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    • 제35권2호
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    • pp.177-183
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    • 2022
  • Objective: The present study evaluated the efficiency of embryo development and pregnancy of somatic cell nuclear transfer (SCNT) embryos using different source-matured oocytes in Camelus dromedarius. Methods: Camelus dromedarius embryos were produced by SCNT using in vivo- and in vitro- matured oocytes. In vitro embryo developmental capacity of reconstructed embryos was evaluated. To confirm the efficiency of pregnancy and live birth rates, a total of 72 blastocysts using in vitro- matured oocytes transferred into 45 surrogates and 95 blastocysts using in vivo- matured oocytes were transferred into 62 surrogates by transvaginal method. Results: The collected oocytes derived from ovum pick up showed higher maturation potential into metaphase II oocytes than oocytes from the slaughterhouse. The competence of cleavage, and blastocyst were also significantly higher in in vivo- matured oocytes than in vitro- matured oocytes. After embryo transfer, 11 pregnant and 10 live births were confirmed in in vivo- matured oocytes group, and 2 pregnant and 1 live birth were confirmed in in vitro- matured oocytes group. Furthermore, blastocysts produced by in vivo-matured oocytes resulted in significantly higher early pregnancy and live birth rates than in vitro-matured oocytes. Conclusion: In this study, SCNT embryos using in vivo- and in vitro-matured camel oocytes were successfully developed, and pregnancy was established in recipient camels. We also confirmed that in vivo-matured oocytes improved the development of embryos and the pregnancy capacity using the blastocyst embryo transfer method.