bluuebunny/crossref_metadata_2025 huggingface dataset:
Orbital Aspergillosis, a great masquerader: a series of three unusual cases and a review of the literature
Authors: Agrawal Sahil , Modaboyina Sujeeth , Das Deepsekhar , Sen Seema , Bajaj Mandeep Singh , Gupta Saloni
Published: March 2022

Fungal infections of the orbit are infrequent. They typically affect immunocompromised individuals but, in some instances, can also affect an immunocompetent person. They mimic much orbital pathology clinically. Ours is a series of three patients eventually diagnosed with orbital aspergillosis but who, initially, were thought to have some other pathology.
A Case of Sclerosing Polycystic Adenoma of the Parotid Gland
Authors: Olson Birk , Thomas Sumi , Imanguli Matin
Published: March 2022

Sclerosing polycystic adenoma (SPA) is a rare salivary gland tumor with about 100 cases reported in the literature. We describe a case of SPA in the parotid gland and review the diagnostic tools used for identifying SPA. A 24-year-old male with a two-year history of right-sided face mass, initially thought to be pleomorphic adenoma of the parotid gland after fine needle aspiration (FNA). Following superficial parotidectomy, histologic features were consistent with SPA. This case illustrates the challenge of pre-operative assessment for SPA. Recent study has suggested SPA is a neoplasm and definitive treatment is surgical excision.
Deep learning for automatic segmentation of paraspinal muscle on computed tomography
Authors: Yao Ning , Li Xintong , Wang Ling , Cheng Xiaoguang , Yu Aihong , Li Chenwei , Wu Ke
Published: March 2022

Background

Muscle quantification is an essential step in sarcopenia evaluation.

Purpose

To develop and evaluate an automated machine learning (ML) algorithm for segmenting the paraspinous muscles on either abdominal or lumbar (L) computed tomography (CT) scans.

Material and Methods

A novel deep neural network algorithm for automated segmentation of paraspinous muscle was developed, CT scans of 504 consecutive patients conducted between January 2019 and February 2020 were assembled. The muscle was manually segmented at L3 vertebra level by three radiologists as ground truth, divided into training and testing subgroups. Muscle cross-sectional area (CSA) was recorded. Dice similarity coefficients (DSCs) and CSA errors were calculated to evaluate system performance. The degree of muscle fat infiltration (MFI) recording by percentage value was the fat area within the region of interest divided by the muscle area. An analysis of the factors influencing the performance of the V-net-based segmentation system was also implemented.

Results

The mean DSCs for paraspinous muscles were high for both the training (0.963, 0.970, 0.941, and 0.968, respectively) and testing (0.950, 0.960, 0.929, and 0.961, respectively) datasets, while the CSA errors were low for both training (1.9%, 1.6%, 3.1%, and 1.3%, respectively) and testing (3.4%, 3.0%, 4.6%, and 1.9%, respectively) datasets. MFI and muscle area index (MI) were major factors affecting DSCs of the posterior paraspinous and paraspinous muscle groups.

Conclusion

The ML algorithm for the measurement of paraspinous muscles was compared favorably to manual ground truth measurements.
Size, weight, and expectations
Authors: Smeets Jeroen B.J. , Vos Kim , Abbink Emma , Plaisier Myrthe
Published: March 2022

The size-weight illusion is well-known: if two equally heavy objects differ in size, the large one feels lighter than the small one. Most explanations for this illusion assume that because the information about the relevant attribute (weight itself) is unreliable, information about an irrelevant but correlated attribute (size) is used as well. If such reasoning is correct, one would expect that the illusion can be inverted: if size information is unreliable, weight information will be used to judge size. We explored whether such a weight-size illusion exists by asking participants to lift Styrofoam balls that were coated with glow in the dark paint. The balls (2 sizes, 3 weights) were lifted using a pulley system in complete darkness at 2 distances. Participants reported the size using free magnitude estimation. The visual size information was indeed unreliable: balls that were presented at a 20% larger distance were judged 15% smaller. Nevertheless, the judgments of size were not systematically affected by the 20% weight change (differences < 0.5%). We conclude that because the weight-size illusion does not exist, the mechanism behind the size-weight illusion is specific for judging heaviness.
Similar tactile distance anisotropy across segments of the arm
Authors: Chang Kai-Chien , Longo Matthew R.
Published: March 2022

A substantial literature has described anisotropy of tactile distance perception across many body parts. In general, the distance between two touches is felt as larger when the touches are oriented with the mediolateral axis of the limbs than when oriented with the proximodistal axis. In this study, we investigated tactile distance perception across the arm, measuring anisotropy on the upper arm, forearm, and hand dorsum. Participants made forced-choice judgments of which of two pairs of tactile distances felt larger and anisotropy was measured using the method of constant stimuli. Clear anisotropy was found on all three regions of the arm. There was no apparent difference in the magnitude of anisotropy across segments of the arm. We further measured the physical curvature of the arm and show that this cannot account of the perceptual anisotropy observed.
Sexual Fantasies and Harmful Sexual Interests: Exploring Differences in Sexual Memory Intensity and Sexual Fantasy Characteristics
Authors: Allen Andrew , Millear Prudence , McKillop Nadine , Katsikitis Mary
Published: March 2022

The perpetration of harmful sexual behavior is a global concern, with deviant sexual fantasies identified as a prominent etiological risk factor. However, the concepts of state sexual fantasy characteristics (e.g., vividness and emotionality) and associated trait sexual memory intensity have received minimal investigation concerning harmful sexual interests, formulating the impetus for this research. Two online surveys were conducted in community populations. Study 1 ( N = 414) aimed to validate the psychometric properties of a trait sexual memory intensity scale (SMIS) through principal components analysis, confirmatory factor analysis, and evaluation of concurrent validity. Study 2 ( N = 820) endeavored to explore associations between state sexual fantasy characteristics and cognitive-behavior variables (e.g., frequency of masturbation to a reported fantasy), and evaluate differences in fantasy characteristics and SMIS scores between participants with and without harmful sexual interests. Collectively, results supported the factor structure, concurrent validity, and internal consistency of the SMIS, while revealing significant associations between the SMIS, sexual fantasy characteristics, and several variables. Significant differences in sexual fantasy characteristics and SMIS scores were evident but variable among harmful sexual interests. Findings encourage the consideration and research of interventions focused on impairing mental imagery and memory in the management of harmful sexual interests.
Attachment state of mind and trauma in mother and baby home adoptees
Authors: Dalton Natasha , McLaughlin Marian , Cassidy Tony
Published: March 2022

This study has two aims: to explore the experiences and impact of adoption among five adults (three males and two females, all over the age of 55) adopted from mother and baby homes in the UK and Ireland, and to establish each participant’s state of mind (SOM) with regards to attachment using the Adult Attachment Interview (AAI) (George, Kaplan and Main, 1985–1996). It makes use of all information gained from the AAI by analysing the interview transcripts in two ways: (1) using the AAI scoring system ( Main, Goldwyn and Hesse, 2003 ) to assess SOM; and (2) thematic analysis of the transcripts to produce an inductive set of themes. It was found that all participants had an insecure SOM with regards to attachment. For four out of the five participants, this was unresolved/disorganised, and the category ‘preoccupied’ was the most prevalent underlying three-way classification. Qualitative analysis of transcripts identified four overarching themes: (1) identity and belonging; (2) trauma; (3) ‘silenced’ coping; and (4) adverse parenting which reflected their experiences of adoption. The findings indicate that the participants were highly susceptible to trauma associated with loss. They also highlight the importance of suitable adoption placements and vetting of potential adopters. The clinical and research implications of the results and their contribution to the broader discussion of trauma related to adoption are discussed.
Predictors for mortality and recovery in patients with acute renal injury receiving continuous renal replacement therapy
Authors: Yu Yang , Xu Hao , Jiang Shaowei , Gao Chengjin
Published: March 2022

Objective:

Despite continuous renal replacement therapy (CRRT) has been widely used in critically ill patients with acute kidney injury (AKI), the prognosis and recovery of renal function in these patients are still poor. Therefore, we aimed to identify the prognostic factors for the mortality and recovery of renal function in patients with AKI receiving CRRT.

Methods:

A total of 125 patients with AKI, treated with CRRT in the emergency intensive care unit (EICU) in an academic teaching hospital from January 2014 to December 2018 were enrolled in this retrospective study. The clinical data of these patients were collected. Univariate regression analysis and multivariate regression analysis were conducted to identify the predictors for the mortality and recovery of renal function.

Results:

The median age was 68.0 (56.5–79.0) years old, and from which 69.6% were males. Sixty-four patients (51.2%) survived and 50 patients (40%) recovered their renal function. Multivariate regression analysis showed that the independent risk factors for mortality were male (odds ratio [OR]:3.771, 95% confidence interval [CI]:1.063–13.372, p = 0.04), Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR: 1.187, 95% CI: 1.050–1.341, p = 0.006), mechanical ventilation (OR: 6.266, 95% CI: 1.771–22.167, p = 0.004) and vasopressor use (OR: 5.224, 95% CI: 1.546–17.657, p = 0.008). Moreover, the independent predictors for not recovering of renal function were male (OR: 3.440, 95% CI: 1.271–9.311, p = 0.015), pre-existing comorbidity of hypertension (OR: 4.207, 95% CI: 1.609-11.000, p = 0.003) and vasopressor use (OR: 5.280, 95% CI: 2.018–13.811, p = 0.001).

Conclusions:

Male, high APACHE II score, mechanical ventilation and vasopressor use were closely associated with the increased mortality, while male, pre-existing history of hypertension, and vasopressor use were the independent predictors for non-recovery of renal function.
Miles and Bars Between: The Tertiary Prisonization and Layered Liminality of Prison Visitation Transportation Services
Authors: Addison Dylan
Published: March 2022

Prison visitation transportation services perform an important yet understudied role in the process of prison visitation for many people with incarcerated loved ones. This article draws on the findings of an ethnographic study of the experiences of loved ones of incarcerated people using a small, Black-owned prison visitation transportation service. Prison visitation transportation services help to mitigate the carceral state’s inherent function to separate people from their incarcerated loved ones, but in turn these services are also subjected to intensive forms of carceral control themselves. As a result, prison visitation transportation services and their staff experience a form of tertiary prisonization. This ultimately results in the drivers of these services experiencing a heightened and enduring state of layered liminality, which becomes attached to them as individuals.
Understanding the Influence of Authentic Leadership and Employee-Organization Relationships on Employee Voice Behaviors in Response to Dissatisfying Events at Work
Authors: Kim Young , Lee Ejae , Kang Minjeong , Yang Sung-Un
Published: March 2022

This study demonstrates how authentic leadership and the quality of employee-organization relationships (EOR) influence employee behavioral reactions to dissatisfying events at work. We conducted a nationwide survey of 644 full-time employees in the United States. The results from the structural equation modeling (SEM) revealed that authentic leadership was positively and directly related to employees’ considerate voice but was not directly associated with other behavioral responses. Additionally, the quality of EOR was found to be a strong mediator between authentic leadership and employee behaviors—particularly in enhancing considerate voice and patience and reducing exit—in the context of dissatisfying workplace events. The implications of developing authentic leadership to build and maintain the quality of EOR are discussed.
Find, Pin, Discuss: Incorporating Pinterest to Foster Community and Collaboration in Online Advertising Classes
Authors: Huntington Heidi E.
Published: March 2022

Visual bookmarking app Pinterest, known for its aspirational and consumptive qualities of users' “pinning” work, has recently made concerted forays into the online advertising and marketing space. At the same time, its visual and collaborative qualities offer unique potential for application in pedagogy. This paper describes a pedagogical assessment study examining a Pinterest-based discussion board series. Results suggest Pinterest enhances students’ sense of learning through contributing to enjoyment, sense of community, and perceived collaborative learning. These results support the utility of Pinterest-oriented discussions to foster collaboration and learning in online digital advertising and media courses.
Dry eye in Sjögren's syndrome – characteristics and therapy
Authors: Caban Miłosz , Omulecki Wojciech , Latecka-Krajewska Beata
Published: March 2022

Background

Sjögren's syndrome is an autoimmune disease, and its important feature is the lymphocyte infiltration of exocrine glands, including lacrimal glands. It contributes to defects of their activity and causes that one of the main manifestation of Sjögren's syndrome is dry eye. Unfortunately, the discrimination between dry eye related and non-related to Sjögren's syndrome is difficult at the initial stages of diseases. In addition, the available agents for the treatment of Sjögren's syndrome-related dry eye have limited efficacy.

Aim

The purpose of this study was to describe and emphasize differences between Sjögren's Syndrome-related dry eye and non-Sjögren's Syndrome-related dry eye together with the determination of novel therapeutic options for Sjögren's Syndrome-related dry eye.

Method

A review of the relevant papers describing characteristics of Sjögren's Syndrome-related dry eye and its therapy was conducted. This article is based on both pre-clinical and clinical evidences.

Results

On the basis of our analysis, we indicated differences between Sjögren's Syndrome-related dry eye and non-Sjögren's Syndrome-related dry eye. Moreover, there are some novel markers that could be used in the diagnosis of Sjögren's Syndrome-related dry eye. In addition, expect artificial tear, other agents e.g. hydroxychloroquine can be effective in therapy of disease.

Conclusions

Sjögren's Syndrome-related dry eye is a disorder, whose diagnosis may be difficult and mistaken for non-Sjögren's Syndrome-related dry eye. However, Sjögren's Syndrome-related dry eye has some specific features. In addition, the development of newer and safer therapeutic agents for Sjögren's syndrome-related dry eye is needed, and therefore further clinical, randomized studies are necessary.
Assessing performance of artificial neural networks and re-sampling techniques for healthcare datasets
Authors: Saul Marcia , Rostami Shahin
Published: March 2022

Re-sampling methods to solve class imbalance problems have shown to improve classification accuracy by mitigating the bias introduced by differences in class size. However, it is possible that a model which uses a specific re-sampling technique prior to Artificial neural networks (ANN) training may not be suitable for aid in classifying varied datasets from the healthcare industry. Five healthcare-related datasets were used across three re-sampling conditions: under-sampling, over-sampling and combi-sampling. Within each condition, different algorithmic approaches were applied to the dataset and the results were statistically analysed for a significant difference in ANN performance. The combi-sampling condition showed that four out of the five datasets did not show significant consistency for the optimal re-sampling technique between the f1-score and Area Under the Receiver Operating Characteristic Curve performance evaluation methods. Contrarily, the over-sampling and under-sampling condition showed all five datasets put forward the same optimal algorithmic approach across performance evaluation methods. Furthermore, the optimal combi-sampling technique (under-, over-sampling and convergence point), were found to be consistent across evaluation measures in only two of the five datasets. This study exemplifies how discrete ANN performances on datasets from the same industry can occur in two ways: how the same re-sampling technique can generate varying ANN performance on different datasets, and how different re-sampling techniques can generate varying ANN performance on the same dataset.
Preparation of a novel bio-flame-retardant liquid for flame retardancy of natural fibers and their composites
Authors: Maksym Li , Prabhakar M N , Jung-il Song
Published: March 2022

The resistance of natural fibers toward flames is essential for their use in engineering applications. Hence, the present research focused on the preparation of a bio-flame-retardant liquid (BFL) to enrich the sustainability of natural fibers (kenaf fibers (KF), animal (WF), and cocoon (SF)) towards flame by employing a low cost, bio-waste chitosan and phosphoric acid (PA) through a chemical approach. Scanning electron microscopy, Fourier-transform infrared spectroscopy, thermogravimetric analysis, UL-94 testing, and microcalorimetry were conducted to evaluate the essential characteristics of the treated BFL on various natural fibers. The BFL altered the surface chemistry and exhibited remarkable fire-extinguishing properties (V-0 flammability rating in the UL-94 test and suppression of peak heat release rate of approximately 78%), as well as enhanced thermal stability (49 wt.% residue at 700°C) for the natural fibers without significant differences among them. Furthermore, the treated fibers were reinforced individually into vinyl ester (VE) matrix and manufactured respective composites, namely, VE_TKF, VE_TWF, and VE_TSF. The experimental results concluded that the BFL-treated fiber effectively improved the flame resistance (30% reduction in peak heat release rate) of VE composites. The findings of this study can be used to introduce flame retardancy in natural fibers to enable their use in the present and next-generation engineering applications.
Synergistic effect of screen-printed Al(OH)3 nanoparticles and phosphorylated cellulose nanofibrils on the thermophysiological comfort and high-intensive heat protection properties of flame-retardant fabric
Authors: Kolar Tjaša , Geršak Jelka , Knez Nataša , Kokol Vanja
Published: March 2022

Al(OH)3 nanoparticles (ATH NPs) and phosphorylated cellulose nanofibrils (PCNFs) were used as user-friendly and comfortable coating components on flame-retardant fabric to improve its thermophysiological comfort and high-intensive heat protection properties. The effect of the PCNF imprinting and its attachment after the post-printing of a hydrophobic polyacrylate (AP) on the same (back side) or the other (front) side of the fabric, with and without the addition of ATH NPs, was considered, to maintain the front side (facing the wearer) as hydrophilic while keeping the back side (facing the outside) hydrophobic. The amount of coatings applied and their patterning were studied, varied with the ATH NPs’ concentration (1.7, 3.3 and 6.7 wt%) and screen mesh size used (60 and 135), based on the coating’ mass, fabric’s air permeability, thickness and microstructure. The reduced moisture build-up (55%), increased the water vapour (13%) and heat (12%) transfer from the skin, were assessed by applying PCNF under the AP, being more pronounced in the case of using a 135 mesh-sized screen, given the smaller, more densely distributed, thinner and imprinted pattern coatings. These effects were further improved by the addition of nanoporous ATH NPs, which allowed more homogeneous spreading of the moisture and its faster transport. Such a treatment also shifted the fabric’s degradation temperature towards higher values (up to 15°C), retained up to 30% of high-heat flux (21 kW/m2), prolonged the time to ignition by 11 s and reduced the total heat released by up to 60%, thereby providing better protection when exposed to the heat, due to the presence of the phosphorous (PCNF) promoted generation of an Al2O3 char acting as a barrier layer, while also reducing the production of heat and generation of smoke by 75%.
Emotion Processing Dysfunction in Alzheimer’s Disease: An Overview of Behavioral Findings, Systems Neural Correlates, and Underlying Neural Biology
Authors: Chaudhary Shefali , Zhornitsky Simon , Chao Herta H. , van Dyck Christopher H. , Li Chiang-Shan R.
Published: March 2022

We described behavioral studies to highlight emotional processing deficits in Alzheimer’s disease (AD). The findings suggest prominent deficit in recognizing negative emotions, pronounced effect of positive emotion on enhancing memory, and a critical role of cognitive deficits in manifesting emotional processing dysfunction in AD. We reviewed imaging studies to highlight morphometric and functional markers of hippocampal circuit dysfunction in emotional processing deficits. Despite amygdala reactivity to emotional stimuli, hippocampal dysfunction conduces to deficits in emotional memory. Finally, the reviewed studies implicating major neurotransmitter systems in anxiety and depression in AD supported altered cholinergic and noradrenergic signaling in AD emotional disorders. Overall, the studies showed altered emotions early in the course of illness and suggest the need of multimodal imaging for further investigations. Particularly, longitudinal studies with multiple behavioral paradigms translatable between preclinical and clinical models would provide data to elucidate the time course and underlying neurobiology of emotion processing dysfunction in AD.
Targeting Vascular endothelial growth factor A with soluble vascular endothelial growth factor receptor 1 ameliorates nerve injury-induced neuropathic pain
Authors: Peng Zhe , Yang Fan , Huang Siting , Tang Yang , Wan Li
Published: March 2022

Neuropathic pain is a distressing medical condition with few effective treatments. The role of Vascular endothelial growth factor A (VEGFA) in inflammation pain has been confirmed in many researches. However, the mechanism of VEGFA affects neuropathic pain remains unclear. In this study, we demonstrated that VEGFA plays an important role in spare nerve injury (SNI)-induced neuropathic pain, which is mediated by enhanced expression and colocalized of VEGFA, p-AKT and TRPV1 in SNI-induced neuropathic pain model. Soluble VEGFR1 (sFlt1) not only relieved mechanical hyperalgesia and the expression of inflammatory markers, but ameliorated the expression of VEGFA, VEGFR2, p-AKT, and TRPV1 in spinal cord. However, these effects of sFlt1 can be blocked by rpVEGFA and by 740 Y-P. Therefore, our study indication that targeting VEGFA with sFlt1 reduces neuropathic pain development via the AKT/TRPV1 pathway in SNI-induced nerve injury. This study elucidates a new therapeutic target for neuropathic pain.
Technical and physical performance across five consecutive seasons in elite European Soccer
Authors: Morgans Ryland , Orme Patrick , Bezuglov Eduard , Di Michele Rocco
Published: March 2022

The technical and physical demands of elite soccer match-play may vary considerably across a season and from season-to-season in relation to a myriad of factors. The aim of this study was to investigate the technical and physical performance trends over five consecutive seasons (2016–2021) for twenty-two soccer players from a team participating in an elite European league, the Russian Premier League (RPL). Match data were recorded and analysed via an Optical Tracking System, and a selection of technical and physical performance variables were examined. From matches analysed, we observed small within-season changes (ES 0.17 to 0.37) for technical performance variables, and small to moderate changes (ES 0.31 to 0.86) for physical performance variables. Dribbles, percentage of successful dribbles, total distance covered, high-intensity and sprint distances, and maximal acceleration showed an average increase from the 2016–2017 to the 2018–2019 season, followed by a decrease in the subsequent seasons. Conversely, tackles, high-intensity accelerations and peak acceleration showed a decreasing trend from the 2016–2017 to the 2020–2021 season. Moderate to large correlations (r = −0.58 to 0.46) were apparent between changes in technical and physical variables. In summary, we observed between-season changes in match technical and physical variables in a RPL team, while there were no differences between the first and second phases of the season. The present findings may provide coaches with knowledge about long-term variations in technical and physical match performance, that can be practically useful to assess and interpret change in individual and team performance.
Severe Lacerations in Alpine Ski Racing: A Case Series and Review of the Literature
Authors: Holden William M. , Barnum Michael S. , Tarka Mitchell C. , Niederhauser Christoph A. , Jewell Ryan P. , Endres Nathan K.
Published: March 2022

Lacerations in alpine ski racers caused by the sharp metal edge of the ski are potentially severe and even life-threatening injuries. To date, there has been little published on these injuries. This case series reports on 5 cases of severe lacerations in alpine ski racers and details slope side management, initial evaluation, and definitive treatment. By publishing this case series, it is hoped to promote further investigation into the mechanism of these injuries and strategies for prevention.

Study Design:

Case series.

Level of evidence:

Level 4C.
Treatment of Large Cartilage Defects in the Knee by Hydrogel-Based Autologous Chondrocyte Implantation: Two-Year Results of a Prospective, Multicenter, Single-Arm Phase III Trial
Authors: Niemeyer P. , Hanus M. , Belickas J. , László T. , Gudas R. , Fiodorovas M. , Cebatorius A. , Pastucha M. , Hoza P. , Magos K. , Izadpanah K. , Paša L. , Vásárhelyi G. , Sisák K. , Mohyla M. , Farkas C. , Kessler O. , Kybal S. , Spiro R. , Köhler A. , Kirner A. , Trattnig S. , Gaissmaier C.
Published: March 2022

Objective

To evaluate the clinical outcome of a hydrogel-based autologous chondrocyte implantation (ACI) for large articular cartilage defects in the knee joint.

Design

Prospective, multicenter, single-arm, phase III clinical trial. ACI was performed in 100 patients with focal full-thickness cartilage defects ranging from 4 to 12 cm2 in size. The primary outcome measure was the responder rate at 2 years using the Knee Injury and Osteoarthritis Outcome Score (KOOS).

Results

Two years after ACI treatment, 93% of patients were KOOS responders having improved by ≥10 points compared with their pre-operative level. The primary endpoint of the study was met and demonstrated that the KOOS response rate is markedly greater than 40% with a lower 95% CI (confidence interval) of 86.1, more than twice the pre-specified no-effect level. KOOS improvement (least squares mean) was 42.0 ± 1.8 points (95% CI between 38.4 and 45.7). Mean changes from baseline were significant in the overall KOOS and in all 5 KOOS subscores from Month 3 (first measurement) to Month 24 (inclusive) ( P < 0.0001). The mean MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) score after 24 months reached 80.0 points (95% CI: 70.0-90.0 points) and 92.1 points in lesions ≤ 5 cm2.

Conclusions

Overall, hydrogel-based ACI proved to be a valuable treatment option for patients with large cartilage defects in the knee as demonstrated by early, statistically significant, and clinically meaningful improvement up to 2 years follow-up. Parallel to the clinical improvements, MRI analyses suggested increasing maturation, re-organization, and integration of the repair tissue.

Trial Registration

NCT03319797; EudraCT No.: 2016-002817-22.
SMARCA4-Deficient Undifferentiated Tumor of Lung Mass—A Rare Tumor With the Rarer Occurrence of Brain Metastasis: A Case Report and Review of the Literature
Authors: Yadav Ruchi , Sun Lishi , Salyana Muhammad , Eric Minkin , Gotlieb Vladimir , Wang Jen C.
Published: March 2022

Among thoracic tumors, these include subsets of a relatively newly described and yet to be fully characterized tumor entity: SMARCA4-deficient Undifferentiated Tumor (SMARCA4-dUT). Mutations of SMARCA4 (SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily A, member 4) gene and loss of BRG1 (Brahma-related gene-1) is the underlying molecular hallmark of SMARCA4-dUT. They mostly involved the mediastinum, lung, and/or pleura showing undifferentiated round cell or rhabdoid morphology associated with aggressive clinical behavior. The pathogenesis of these tumors is still not clear. Morphologically, SMARAC4-dUT is differentiated from SMARCA4-dNSCLC by the presence of squamous and solid components in the latter. Immunohistochemically SMARC4-dUT has characteristic loss of SMARCA4 and SMARCA2 and strong expression of SOX2, CD34, and SALL4. Common sites of metastasis include lymph nodes, bones, and adrenal glands but rarely brain metastasis. We present a unique and rare case of a 76-year-old male with a right lung mass with documented pathology of SMARCA4-dUT and was found to have multiple brain metastases.
Pulmonary Giant Cavitary Coccidioides With Fungal Ball and Hemoptysis
Authors: Narang Vishal K. , Dao Kevin , Jaratanian Sara , D’Assumpcao Carlos , Kuran Rasha , Munoz Augustine , Heidari Arash
Published: March 2022

Coccidioidomycosis (CM) is a fungal disease that results from inhalation of spores of Coccidioides immitis and C posadasii. If symptomatic, disease primarily manifests as community-acquired pneumonia; however, additional pulmonary manifestations such as pleural effusion, empyema, and cavitation may occur. Diabetic patients have an increased risk of severe and cavitary CM. Cavitary disease may erode vasculature and pulmonary parenchyma leading to further complications. Furthermore, chronic cavities can become colonized as well and develop superimposed infections. This is a case of cavitary CM in uncontrolled diabetic nonadherent to treatment presenting with hemoptysis and mycetoma.
Acute anterolateral knee instability in adults: combined proximal ACL and ALL injury repair is not inferior to standard ACL reconstruction with LET in 2 years.
Authors: Ferretti Andrea , Carrozzo Alessandro , Annibaldi Alessandro , Monaco Edoardo
Published: March 2022

Objectives:

The objective was to compare the clinical results of ACL and ALL repair with those of standard ACL reconstruction + LET. The hypothesis was that combined repair is non-inferior to standard reconstruction + LET in adults with acute anterolateral knee instability.

Methods:

Patients with severe acute anterolateral instability (ACL + ALL injuries) who underwent early ACL surgery (injury-to-surgery interval < 14 days), a total of 58 patients, were prospectively enrolled in the study. ACL injuries were classified according to the Sherman classification. Patients with a proximal injury (types 1 and 2) were assigned to receive ACL repair (ACLrep) (n = 37), patients with types 3 and 4 and moderate tissue quality (n = 21) were assigned to receive ACL reconstruction (ACLrec) + lateral extra-articular tenodesis (LET). Repair consisted of transosseous suture of the stump to the anatomic origin of the ACL and direct repair of the ALL. Reconstruction consisted of standard ACL reconstruction by semitendinosus-gracilis (STG) autograft + LET. PROMs included IKDC, Lysholm, KOOS, and assessment of anteroposterior (AP) knee laxity in 2 years.

Results:

A sample size calculation showed that 21 patients in each group were needed for a 95% power (with a 95% CI) to show non-inferiority of the repair group considering an arthrometric side-to-side difference of at least +1.5. Patients in the ACLrep group showed better results on all scales: mean IKDC was 95.51 ± 52.4 versus 86.92 ± 13.92 (p = 0.02); mean KOOS was 97.49 ± 2.71 versus 93.50 ± 7.05 (p = 0.009); and mean Lysholm was 96.98 ± 5.14 versus 91.69 ± 10.08 (p = 0.02). There was no difference in the KT1000 measurement (ACLrep: 1.70 ± 1.02; ACLrec: 2.21 ± 0.80; p = 0.11). The one-sided 95% CI was 1.7 (to 2.02) (< at the 3.01 limit for non-inferiority) for ACLrep and 2.21 (to 2.46) for ACLrec, p = 0.147. Therefore, non-inferiority was proven

Conclusion:

In acute knee instability resulting from a combined ACL and ALL injury, direct repair is non-inferior in terms of PROM and knee laxity compared to standard ACL + LET reconstruction in 2 years.
Outcomes of lateral meniscus posterior root tear repair combined with anterior cruciate ligament reconstruction after at least two years of follow-up
Authors: Thaunat Mathieu , Deleissegues Tristan , Fayard1 Jean-Marie
Published: March 2022

Objectives:

The purpose of this study was to review the outcomes of lateral meniscus posterior root tear (LMPRT) repair at a minimum follow-up of two years. It was hypothesized that LMPRT repair would result in a low rate of surgical revision with good knee laxity control and satisfactory objective and subjective scores.

Methods:

This was a retrospective study analyzing prospectively collected data. All patients who underwent primary ACL reconstruction from March 2015 to August 2018, performed by two surgeons (blinded), were considered for study eligibility. Clinical evaluations were performed at 3, 6,12 and 24 months. Patients were assessed pre- and postoperatively with the objective and subjective International Knee Documentation Committee (IKDC) evaluation form, the Lysholm score and the Tegner Activity Scale (TAS). Complications and revision surgeries were also recorded.

Results:

The final study population comprised 99 LMPRT repairs. Ten (10.1%) patients underwent ipsilateral revision surgery at a mean follow-up of 42 months, for a total of 11 procedures. There was one graft failure with concomitant LMPRT at 25 months follow-up due to a high-risk sport trauma in a professional athlete. Postoperative side-to-side laxity significantly decreased at the last follow-up with a mean of 0.6 ± 0.7 mm (p <0.0001). The mean preoperative subjective IKDC score was 56.2 ± 13.9 and increased to 86.9 ± 7.6 postoperatively (p <0.0001). The Lysholm score was 61.6 ± 13.1 before surgery and 90.7 ± 6.7 after surgery (p <0.0001). The mean preoperative TAS was 7.1 ± 1.1 and decreased to 6.6 ± 1.3 postoperatively (p <0.006). Arthroscopic healing was obtained for the ten patients who underwent revision surgery. Nine of these patients (90%) had arthroscopic proof of a fully healed LMPRT. One patient did not heal completely and required arthroscopic resection.

Conclusion:

LMPRT occurs concomitantly with ACL injury in 6 to 12% of the cases and repair should be routine. This is supported by excellent postoperative results after LMPRT repair at a minimum follow-up of 2 years.
Biceps-related complications after tenotomy associated with arthroscopic rotator cuff repair: risk factors and clinical impact
Authors: Ranieri Riccardo , Nabergoj Marko , Le Coz Pierre , Lädermann Alexandre , Collin Philippe
Published: March 2022

Objectives:

Many studies have investigated the differences between tenotomy and tenodesis, while only a few have specifically examined the results of tenotomy associated with rotator cuff repair (RCR). Our aim is to report the rate of biceps-related complications after long head of biceps (LHB) tenotomy associated with RCR.

Methods:

A single-center prospective observational study was conducted between 2015 and 2017 on consecutive patients who underwent RCR associated with LHB tenotomy. Patients were clinically evaluated preoperatively, at 6 months (also by ultrasound) and 1 year, and screened for postoperative Popeye deformity, cramps and bicipital discomfort. Each complication was analyzed for the following risk factors: age, gender, BMI, dominant arm, manual work, type of tear, tendon healing. Finally, clinical outcome was compared between patients with at least one complication and those with none.

Results:

207 patients were analyzed. Cramps, Popeye deformity, and discomfort, were, respectively, present in 16 (7.7%), 38 (18.4%) and 52 (25.1%) cases at 6 months and 17 (8.2%), 18 (8.7%) and 24 (11.6%) cases at 1 year. Cramps were associated with lower age (1 year-increase OR = 0.88-95% CI, 0.81-0.96-), higher BMI (1 point-increase OR = 1.1-95% CI, 1.02 -1.23-), single tendon tear (P = 0.0168), manual work (OR = 5.0-95% CI, 1.5-16.0-) at 6 months and manual work (OR = 2.9-95% CI, 1.1-8.3-) at 1 year. Objective Popeye deformity was associated with male gender at 6 months (OR = 6.9-95% CI, 3.0-15.5-). Discomfort was associated with lower age (OR = 0.94-95% CI, 0.90-0.98-), manual work (OR = 2.3 -95% CI, 1.2-4.3-), Popeye deformity (OR = 2.3-95% CI, 1.1-4.9-) at 6 months and manual work (OR = 2.8-95% CI, 1.1-6.6-), single tendon tear (OR = 4.9 -95% CI, 1.1-21.3-) and Popeye deformity (OR = 3.4 -95% CI, 1.1-10.7-) at 1 year. Patients without complications showed a significantly higher Constant, pain and SSV score (75.4 vs 70.4, P = .00252; 0.9 vs 1.9, P <0.00001; 80.2 vs 76.4; P =.00124) at 6 months, and pain and SSV score (0.6 vs 2.0; P = 0.00044; 91.1 vs 77.8; P = <0.00001) at 1 year.

Conclusion:

Younger age, higher BMI, manual work and single tendon tears are risk factors associated with biceps-related symptoms during the first year. Popeye deformity occurs more frequently in males and is associated with discomfort. Nevertheless, the short-term clinical influence of biceps complications on shoulder outcome is very limited.
Is the popliteal tendon an adequate anchor for lateral meniscus repairs? A cadaveric study
Authors: Séguineau Arthur , Pujol Nicolas , Noailles Thibaut
Published: March 2022

Objectives:

Arthroscopic lateral meniscus repairs are performed in the Cabot test position. Anchor fixation to the popliteal tendon is often the primary anchor. Our hypothesis was that the mobility of the popliteal tendon in flexion-extension leads to significant stress or even early loosening of sutures.

Methods:

Twenty-two fresh adult human cadaveric knees were used. A vertical stitch was made arthroscopically with "all-internal" implants in the popliteal tendon through the lateral meniscus. The knee was taken from the Cabot test position and placed in full extension at the end of the procedure. The condition of the suture was then assessed under arthroscopy. Sutures were considered to have failed if they had sufficient slack to pass the arthroscope through the hiatus, if the knot had passed through the meniscus, or if the thread was broken.

Results:

59.9% (n = 9) of the stitches were tight and 40.1% were loose (n = 9). 18.2% (n = 4) were relaxed, for 18.2% (n = 4) the knot had passed through the meniscus, and 4.5% (n = 1) had a break in the suture.

Conclusion:

Sutures placed between the lateral meniscus and the popliteal tendon failed after a single cycle of knee flexion and extension in 40% of the cases. A single stitch in this manner is not an adequate means of repairing lateral meniscal injuries.
The combination of a tibial slope correction osteotomy with ACL revision at a mean follow-up of 10 years provides good clinical results without revision surgery
Authors: Rozinthe Anouk , Demey Guillaume , Van Rooij Floris , Saffarini Mo , Dejour David
Published: March 2022

Objectives:

The objective is to discover the long-term outcome of ACL reconstruction associated with tibial slope correction osteotomy for a second ACL tear. This study is preceded by an initial publication with a 4-year follow-up. The hypothesis was stable functional scores and the absence of osteoarthritis progression.

Methods:

The initial consecutive retrospective series included 9 patients who had a revision surgery for ACL reconstruction associated with single-stage OTDF. They were reviewed by an independent observer for a second follow-up with a minimum retrospect of 7 years. The analysis was based on IKDC-SKF and Lysholm scores, and radiographic analysis.

Results:

Of the original 9 patients, 7 were seen again, 1 was only interviewed by telephone, and 1 was lost to follow-up. At the last follow-up of 9.9 ± 3.0 years, all 8 patients had stable or improved functional scores compared to the previous follow-up. The mean Lysholm score increased from 73.8 ± 5.8 (65-82) to 84.5 ± 11.9 (59-95) and the mean IKDC-SKF score increased from 71.6 ± 6.2 (62-79) to 82.9 ± 12.1 (61-98). Of the six patients who already had proof of osteoarthritis at the previous follow-up, the grade of osteoarthritis increased for two (with a history of meniscectomy, from grade 2 to grade 3 and from grade 1 to grade 3) but remained stable for three patients and could not be assessed for one.

Conclusion:

At 7-15 years (mean: 9.9 years), patients’ functional scores were stable or improving compared to the previous 2-8 year follow-up period, with no new tear or revision surgery. This validates tibial slope correction after recurrent ACL tears with an increase in the tibial slope
Meniscal tears and entrapment in intercondylar eminence fractures in children: a systematic review of the literature
Authors: Severyns Mathieu , Arthur Renault , Plawecki Stéphane
Published: March 2022

Objectives:

Although they may be related to ACL tears in adults, there are few publications on meniscal injuries after intercondylar eminence fractures in children.

Methods:

The main objective of this systematic review of the literature was to measure the incidence of meniscal injuries as well as concomitant tissue involvement in tibial eminence fractures (TEF) in children. The secondary objectives were to determine a diagnostic and therapeutic strategy to anticipate difficulties in reduction and to treat associated meniscal tears. The PubMed and Scopus database subject search included MeSH indexing terms: "intercondylar tibial fracture*" OR "tibial spine fracture*" OR “tibial spinal fracture” OR "tibial eminence fracture*" OR "intercondylar eminence fracture*". Only series of pediatric tibial eminence fractures with the presence of data on possible meniscal damage were selected. Case reports, mixed adult and child series and duplicates were excluded.

Results:

789 references were chosen with 91 eligible articles. Only 26 articles reported on the rates of meniscal tears and entrapment after these fractures. Of a total of 997 cases, 227 (22.8%) had a concomitant injury (osteochondral, ACL, PCL and/or meniscal), including 180 cases of meniscal tears (18.1%). Meniscal or intermeniscal ligament entrapment was present in 20.1% (n = 201) of the patients. 2 groups of diagnostic analyses of these injuries were compared: during the arthroscopy, or previously on MRI imaging. Meniscal tears were present in 20.9% of the patients in the arthroscopy group, compared with 26.1% in the group with a prior MRI (p = .06), and the proportion of meniscal tears was 18.6% in the arthroscopy group alone compared to 17.1% in the MRI group (p = .55). However, statistically, the proportion of entrapment noted was significantly higher in the arthroscopy group (17.8% vs 6.2%; p <.0001).

Conclusion:

This review of the literature reports a high incidence of meniscal tears and tissue entrapment in children. Although it would appear that MRI tends to improve the assessment of associated injuries, the rate of meniscal or intermeniscal ligament entrapment is low compared to the rate reported by arthroscopic diagnosis.
Validity and reproducibility of the PPLP score in the follow-up of anterior cruciate ligament reconstruction in athletes
Authors: Laboute Eric , Garrigou Pierre , Ucay Olivier , Verhaeghe Emmanuel
Published: March 2022

Objectives:

In a context where psychological scores appear to have an increasing influence on the resumption of sports, it would also appear to be essential to evaluate the relevance of global scores with multiple criteria. The PPLP score (Psychological Physical Ligament Predictive score) enables an analysis of subjective, clinical and isokinetic muscle assessment items.

Methods:

We prospectively followed anterior cruciate ligament (ACL) reconstructions in several series for which we analyzed the validity of the score (763 patients), the reproducibility, the sensitivity to change, the relevance in the follow-up of ligamentoplasty (3,296 ligamentoplasties followed postoperatively) as well as the predictive nature in the resumption of sports (258 patients). The PPLP score has two parts: one (PPLP1) based on 100 points for postoperative follow-up and the other also based on 100 points (PPLP2) which is added to the first score for follow-up at a certain period of time after surgery to determine a new score of 200 points. We also tried to identify correlations with other scores in the literature (OAK, Lysholm, Tegner, KOOS, Arpeggio, IKDC Subjective and the Psychovitality Test).

Results:

We demonstrated the distinction of the items (r coefficient of 0.20) for construct validity. Intra-examiner and extra-examiner reproducibility was excellent, ranging from 0.92 to 1. The PPLP score changed in a statistically significant way during hospitalization and according to the operating lead time with phases of higher variation. Complicated clinical changes manifested in a low score, in particular neuro-algodystrophies (1.9%) with a mean PPLP1 of 80.33 while changes without complications (80.8%) had a mean score of 94.28 with a significant difference (p < 0.0001). The PPLP2 score correlated significantly with the resumption of competition (p = 0.012). A high score was associated with faster recovery. The optimal cut-off score was 176 (sensitivity 79.7% and specificity 49.3%). The results of the PPLP score were correlated with the other scores.

Conclusion:

The PPLP score was validated in terms of construction, reproducibility, and sensitivity in the follow-up of ACL ligamentoplasties. It provides indications on the quality of change and the possibilities of resuming sports. It is the only score that incorporates isokinetic assessments.