bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of the Change Patterns of Sagittal Alignment Values After Selective Thoracic Fusion in Lenke 1 Adolescent Idiopathic Scoliosis According to Preoperative Thoracic Kyphosis Status
Authors: Park Se-Jun , Lee Chong-Suh , Lee Kyung-Joon , Lee Ji-Woon , Park Jin-Sung 
Published: March 2020

Study Design:
This was a retrospective study.

Objective:
The objective of this study was to demonstrate the different change patterns in reciprocal sagittal alignment values after selective thoracic fusion (STF) in Lenke type 1 adolescent idiopathic scoliosis (AIS) according to preoperative thoracic kyphosis (TK).

Summary of Background Data:
Several studies have found significant increase in TK after STF, while other studies have reported decrease in TK postoperatively. Similar inconclusive results on changes in lumbar lordosis (LL) have been reported, showing LL increase, decrease, or no change.

Materials and Methods:
Ninety-three patients presenting with Lenke type 1 AIS treated by posterior STF with a minimum follow-up of 2 years were included in this study. Using whole spine radiographs, sagittal parameters including TK, LL, and upper lumbar lordosis (ULL) were compared preoperatively and at the last follow-up between a hypokyphosis group (preoperative TK<20 degrees) and a normokyphosis group (preoperative TK≥20 degrees). Health-related quality of life (HRQOL) was assessed using scoliosis research society health-related quality of life-30 (SRS-30) and short from health survey-36 questionnaire at the last visit.

Results:
The mean follow-up duration was 74.9 months. In the hypokyphosis group (35 patients), TK, LL, and ULL statistically significantly increased after surgery by mean 7.7, 5.1, and 3.7 degrees (P<0.001, <0.001, and 0.001). In the normokyphosis group (58 patients), these parameters did not show significant changes after STF. Final TK was significantly lower in hypokyphosis group than that in the normokyphosis group (21.2 vs. 30.9 degrees, P<0.001) while final LL did not differ between 2 groups (52.4 vs. 54.6 degrees, P=0.194). HRQOL did not differ significantly between the 2 groups.

Conclusions:
After STF in Lenke 1 AIS, TK, and LL statistically significantly increased through an increase in the mean ULL in the hypokyphosis group while those mean values did not change in the normokyphosis group. Despite the final mean value of the TK in the hypokyphosis group increasing by 7.7 degrees, it was statistically significantly lower than the final mean TK value in the normokyphosis group which did not increase after STF surgery by posterior approach. However, HRQOL showed no significant difference between the 2 groups.
Two Cases of the Vascular Territory of a Single-pedicled Deep Inferior Epigastric Perforator Flap with a Vertical Midline Abdominal Scar
Authors: Morita Daiki , Numajiri Toshiaki , Nakamura Hiroko , Yamochi Ryo , Tsujiko Shoko , Sowa Yoshihiro , Moriguchi Yoshio 
Published: March 2020

Summary
: The deep inferior epigastric perforator (DIEP) flap is becoming the gold standard for breast reconstruction using autologous tissue. If there are scars in the abdomen from previous surgery, it is necessary to judge the indication for using this flap carefully. Particularly in cases with vertical midline scars, the blood flow supply to the zone II can be compromised. Even when patients have a median abdominal scar, it has been reported that the blood flow can extend beyond the scar and reach several centimeters to about half of zone II. We performed breast reconstruction using DIEP flaps for 2 patients with vertical midline scars in the lower abdomen. Indocyanine green angiography was conducted intraoperatively to confirm the vascular territory with a single pedicle before cutting off the flap. One patient showed fluorescence contrast on the contralateral side across the midline scar. However, the fluorescence contrast was absent across the midline scar in the other patient. Based on this result, we investigated the possible vascular territory of a single pedicled DIEP flap in patients with vertical midline abdominal scars. We suggest that successful blood supply to zone II of a single-pedicled DIEP flap in a patient with a vertical midline abdominal scar is related to the location of the perforator and the property of the tissue in the midline near the perforator. However, because it is difficult to predict the vascular territory of a single pedicle before surgery, intraoperative evaluation using such techniques such as indocyanine green fluorescence imaging is important.
Customized Precision Facial Assessment: An AI-assisted Analysis of Facial Microexpressions for Advanced Aesthetic Treatment
Authors: Li Chih-Wei , Wang Chao-Chin , Chou Che-Yi , Lin Chrang-Shi 
Published: March 2020

Summary:
We introduced a novel protocol based on an artificial intelligence (AI)-assisted analytic system for facial expressions, Customized Precision Facial Assessment (CPFA), to evaluate and quantify the microexpressions of aesthetic concern. With the help of CPFA, physicians may be able to conduct static and dynamic assessments for the microexpressions of the ir patients and perform quantitative measurements before and after the treatments. Through the detection of microexpressions and its active action units of facial muscles, physicians are more likely to optimize the treatment with minimal intervention by precise localization of the foci of aesthetic concern. We presented 3 cases who received neuromodulators and injectable fillers, and we showed the differences in the area of treatment and outcomes of procedures between the CPFA-oriented treatments and human-facilitated ones. We found negative facial expressions decreased in all 3 cases in the group of CPFA while they decreased in only case 1 and case 2 in the group of human facilitated treatment. The CPFA group has more significant decrease in negative facial expression scores than the human group. This pilot study demonstrates that CPFA can objectively recognize and quantify the facial action units associated with negative emotions, and the physician may be able to customize the treatment for individuals accordingly with promising results.
Determining and Comparing Neutron Spectra at Taiwan Photon Source before and after the Installation of Local Injection Shielding
Authors: Lin Yu-Chi , Chen Ang-Yu , Sheu Rong-Jiun 
Published: March 2020

Abstract
Accurate neutron spectrum measurements at light source facilities are difficult to perform because of relatively low and time-varying neutron intensities. A homemade Bonner cylinder spectrometer was used to determine the energy spectra of neutrons outside the lateral shielding wall of the Taiwan Photon Source before and after the installation of local injection shielding. The spectrometer, similar to the design of conventional Bonner spheres, features (1) highly sensitive neutron detection and (2) a wide-range response to neutrons with energies up to the GeV range. Neutron measurements were conducted by intentionally parking the injected 3-GeV electrons at the septum of the storage ring. On the basis of high-fidelity FLUKA simulations, neutron spectra at the measurement location under the experimental conditions were obtained and adopted as an initial guess for spectrum unfolding. The neutron spectra determined before and after the local shielding were comprehensively compared in terms of their intensities and characteristics. The local shielding resulted in overall reductions of approximately 44% and 38% in total neutron flux and dose rate, respectively. Both before and after the local shielding, high-energy neutrons (>10 MeV) were the dominant component of the radiation field, which contributed approximately 30% to 35% of the total neutron flux and 55% to 59% of the total neutron dose rate.
Radiation Safety Considerations in the Treatment of Canine Skeletal Conditions Using 153Sm, 90Y, and 117mSn
Authors: Wendt Richard E. , Selting Kimberly A. , Lattimer Jimmy C. , Wong Janine , Simón Jaime , Stevenson Nigel R. , Stearns Stanley D. 
Published: March 2020

Abstract
The treatment of pets, service animals, and pre-clinical research subjects with radionuclides raises concern for the safety of the people who interact with the animals after their treatment. Three treatments of skeletal conditions in dogs are considered in this study: 153Sm-1,4,7,10-tetraazacylcododecanetetramethylenephosphonic acid, which is a bone-seeking radiopharmaceutical; unencapsulated 90Y permanent interstitial implants, which are sometimes called “liquid brachytherapy”; and 117mSn radiosynoviorthesis, which is also called radiosynovectomy. External exposure rate readings of the 153Sm and 117mSn treatments, and Monte Carlo simulations of 117mSn at a distance of 1 m and of all three in direct contact with tissue were analyzed for doses. Dogs that have received any of these treatments using typically administered activities may be released from radiation safety isolation immediately after treatment from the standpoint of external exposure. People should avoid prolonged close proximity, such as sleeping with a treated dog, for three weeks following an 90Y interstitial implant or for a month following 117mSn radiosynoviorthesis. No such avoidance is necessary after treatment with 153Sm-1,4,7,10-tetraazacylcododecanetetramethylenephosphonic acid.
Haemophilus Species, a Rare Cause of Vertebral Osteomyelitis
Authors: Brooks Daniel R. , Zhou Shiwei , Kauffman Carol A. 
Published: March 2020

AbstractVertebral osteomyelitis secondary toHaemophilusspecies is rare. We report a case ofHaemophilus parainfluenzaevertebral osteomyelitis and review the English-language literature for cases ofH. parainfluenzaeandHaemophilus influenzaevertebral osteomyelitis. Fourteen previously reported cases are described alongside our case. The median age was 66 years. Twelve patients (80%) had infection involving the lumbar/sacral vertebrae. Nine (60%) had a possible predisposing factor, including prior respiratory infections and procedures involving mucosal surfaces. Only 4 patients were febrile, and another 4 had symptoms suggesting cord compression. The diagnosis was established by growth of the organism in samples obtained by percutaneous aspiration/biopsy of involved vertebrae in all but 1 patient.Haemophilus parainfluenzaewas associated with a faster clinical progression thanH. influenzae. Antibiotics alone were curative in 11 of the 15 patients; 4 also underwent a surgical procedure. Three of 5 patients withH. parainfluenzaeinfection required surgery. The infection was cured in all patients, including 1 patient who had a relapse after the initial course of antibiotics; only 1 patient had residual neurological symptoms of finger numbness.
Fungal Osteomyelitis of the Temporal Bone and the Importance of Prompt Histopathologic Evaluation in Diagnosis
Authors: Soleiman Aron , Farhat Nada , Cosetti Maura 
Published: March 2020

Abstract
Fungal skull-base osteomyelitis of the temporal bone is an extremely rare condition associated with significant morbidity and mortality. Challenges in diagnosis, specifically accurate identification of pathogens, can complicate and delay appropriate treatment. This is a case of an 82-year-old man with a history of chronic kidney disease, prostate cancer, and type 2 diabetes mellitus. He had a history Bell palsy with complete facial paralysis 1 year prior and a 9-month history of worsening otalgia and otorrhea. Noncontrast computed tomography of the temporal bone revealed a well-developed, opacified mastoid with bone erosion in the stylomastoid foramen, mastoid tip, and extending into the temporomandibular joint. Decision for urgent surgical intervention was made. Histopathologic examination of intraoperative frozen section revealed diffuse fungal forms without bacteria or malignancy. Intraoperative specimens were analyzed with Gram stain (no bacteria identified), as well bacterial (aerobic and anaerobic) and fungal cultures, all with no growth. The cornerstone of diagnosis was pathologic visualization of fungus.
Relationship between non–high-density lipoprotein cholesterol/apolipoprotein A-I and monocyte/high-density lipoprotein cholesterol ratio and coronary heart disease
Authors: Li Ya , Li Shu , Ma Yulin , Li Jialing , Lin Mingying , Wan Jing 
Published: March 2020

Objective
To investigate the association between non–high-density lipoprotein cholesterol/apolipoprotein A-I and monocyte/high-density lipoprotein cholesterol ratio and degree of coronary artery stenosis proven by coronary angiography.

Methods
A total of 1867 patients were enrolled into this study and analyzed retrospectively. Three hundred eighty-five non-coronary artery disease hospitalized patients were selected as control group, 1482 patients diagnosed as coronary artery disease were classified into three subgroups according to the tertiles of their SYNTAX score. We compared the level of non–high-density lipoprotein cholesterol/apolipoprotein A-I and monocyte/high-density lipoprotein cholesterol ratio among the three subgroups. The Spearman correlation was used to analyze the correlation between non–high-density lipoprotein cholesterol/apolipoprotein A-I and monocyte/high-density lipoprotein cholesterol ratio and SYNTAX, logistic regression was used for analyzing independent predictors of coronary artery disease.

Results
The level of non–high-density lipoprotein cholesterol/apolipoprotein A-I and monocyte/high-density lipoprotein cholesterol ratio was higher in coronary artery disease group compared with non-coronary artery disease group (P < 0.01). The Spearman correlation analysis showed that non–high-density lipoprotein cholesterol/apolipoprotein A-I and monocyte/high-density lipoprotein cholesterol ratio were significantly correlated with SYNTAX score (r = 0.081, P < 0.001; r = 0.216, P < 0.001). In multivariate logistic regression analysis showed that non–high-density lipoprotein cholesterol/apolipoprotein A-I and monocyte/high-density lipoprotein cholesterol ratio were independent predictors of coronary artery disease (odds ratio = 3.645, 95% confidence interval, 1.267–10.486; OR = 2.096, 95% confidence interval, 1.438–3.054).

Conclusion
Non–high-density lipoprotein cholesterol/apolipoprotein A-I and monocyte/high-density lipoprotein cholesterol ratio were associated with the severity of coronary artery lesions, which can be used as a biomarker for the evaluation of severity of coronary artery disease.
Psychometric Properties of the Vietnamese Catquest-9 Short Form Questionnaire
Authors: To Quyen G. , Huynh Van Anh Ngoc , Do Dung Van , Do Vu Quoc , Congdon Nathan , Dingle Kaeleen , Hong Hiep Van , Nguyen Ho The , To Kien G. 
Published: March 2020

SIGNIFICANCE
The Catquest-9 Short Form (SF) has good psychometric properties but was not available in Vietnamese. This study provides the Vietnamese Catquest-9SF and evidence supporting for its use in hospital settings along with clinical assessment to evaluate visual function.

PURPOSE
The purpose of this study was to evaluate the psychometric properties of the Vietnamese Catquest-9SF.

METHODS
Literate patients with unilateral/bilateral cataract, without severe systemic and ocular comorbidities, aged 50+ years, and scheduled for first-eye surgery were screened and recruited at the University of Medicine and Pharmacy at Ho Chi Minh City and Trung Vuong Hospital. Age, sex, and education were self-reported. The Catquest-9SF and the 25-item National Eye Institute Visual Function Questionnaire were used to assess vision-related quality of life (VRQOL). Best-corrected unilateral and bilateral log of the minimum angle of resolution (logMAR) visual acuity was measured, as was best-corrected Pelli-Robson contrast sensitivity. Rasch analysis was performed on the Vietnamese version of the Catquest-9SF. Criterion validity and convergent validity were also evaluated.

RESULTS
Andrich thresholds and response categories on each Catquest-9SF item were ordered, indicating that patients were able to discriminate VRQOL levels. Person separation index and reliability were 2.51 and 0.86, respectively, indicating that the Catquest-9SF was able to distinguish between patients with low- and high-vision difficulties. The tool was unidimensional, with all items fitting well within the construct. There was no evidence of differential item functioning by sex, age group, or cataract status. The tool also showed criterion validity, correlating significantly with visual acuity in the better eye (r = −0.46), the worse eye (r = −0.39), and both eyes (r = −0.44), and with contrast sensitivity for the better eye (r = 0.41), the worse eye (r = 0.32), and both eyes (r = 0.39). A strong correlation between the Catquest-9SF and the 25-item National Eye Institute Visual Function Questionnaire (r = 0.87) indicated convergent validity.

CONCLUSIONS
The Vietnamese Catquest-9SF is valid and psychometrically robust for assessing VRQOL among cataract patients.
Use and Outcomes of Nasotracheal Intubation Among Patients Requiring Mechanical Ventilation Across U.S. PICUs*
Authors: Christian Claire E. , Thompson Nathan E. , Wakeham Martin K. 
Published: March 2020

Objectives:
The use and outcomes of nasotracheal intubation in pediatric patients requiring mechanical ventilation have not been quantified. Our goal is to identify prevalence of use, associated factors, and outcomes of nasotracheal versus orotracheal intubation in patients requiring mechanical ventilation.

Design:
Retrospective cohort study using deidentified data from the Virtual Pediatric Systems database. Data from PICU admissions from January 1, 2015, to December 31, 2016 were analyzed.

Setting:
One hundred twenty-one PICUs located within the United States.

Patients:
PICU admissions requiring an endotracheal tube—either nasotracheal or orotracheal—were included. Those with a tracheostomy tube present at admission were excluded from the study.

Interventions:
Not applicable.

Measurements and Main Results:
Among the 121 PICUs included in the study, 64 PICUs (53%) had zero nasotracheal intubations during the reviewed time period. There were 12,088 endotracheal intubations analyzed, and 680 of them (5.6%) were nasotracheal. Of those patients nasotracheally intubated, most were under 2 years old (88.1%), and 82.2% of them were classified as a cardiac patient. Among these young cardiac patients, the rate of unplanned extubation was 0% in the nasotracheal intubated versus 2.1% in the orotracheal intubated group (p < 0.001)

Conclusions:
Nasotracheal intubation is used in a minority of U.S. PICUs and mainly among young cardiac patients. Nasotracheal intubation is associated with a lower rate of unplanned extubations in this patient population. Future prospective studies analyzing the benefits and complications of nasotracheal versus orotracheal intubation in pediatric patients requiring mechanical ventilation are indicated.
Epidemiology of Community-Onset Severe Bacterial Infections in Children and Its Evolution: A Population-Based Study in France*
Authors: Lorton Fleur , Chalumeau Martin , Martinot Alain , Assathiany Rémy , Roué Jean-Michel , Bourgoin Pierre , Chantreuil Julie , Boussicault Gérald , Gaillot Théophile , Saulnier Jean-Pascal , Caillon Jocelyne , Levy Corinne , Cohen Robert , Gras-Le Guen Christèle , Launay Elise 
Published: March 2020

Objectives:
To describe the epidemiology of community-onset severe bacterial infections in children and its recent evolution.

Design:
Prospective, observational, population-based study from 2009 to 2014.

Setting:
An administrative area accounting for 13% of the French pediatric population.

Patients:
All children 1 month to 16 years old who died before admission or were admitted to a PICU for a community-onset severe bacterial infection.

Interventions:
None.

Measurements and Main Results:
The incidence and mortality rate of community-onset severe bacterial infections were compared with data from a reference population-based study conducted between 2000 and 2006, that is, before national recommendations for antimeningococcal C and antipneumococcal generalized vaccinations. Among the 261 children included (median age 25 mo), 28 (10.7%) died. The main diagnoses were meningitis (n = 85; 32%) and purpura fulminans (n = 59; 22%). The most common isolated bacteria were Neisseria meningitidis (n = 75; 29%), including 47 (63%) cases of serogroup B and 15 (20%) serogroup C, Streptococcus pneumoniae (n = 49, 19%), and Staphylococcus aureus (n = 15; 6%). The incidence of community-onset severe bacterial infections was three per 100,000 person-years (95% CI, 2.6–3.3) and had decreased by 53% from the reference period. Mortality rate was 0.3 per 100,000 person-years (95% CI, 0.2–0.4) and had decreased by 73% from the reference period. The incidence of community-onset severe bacterial infections caused by N. meningitidis and S. pneumoniae was 0.8 and 0.5 per 100,000 person-years and had decreased by 70% and 67% from the reference period. The incidence of community-onset severe bacterial infections–related to Staphylococcus aureus was 0.16 per 100,000 person-years and had increased by 220% from the reference period.

Conclusions:
The incidence and mortality rate of community-onset severe bacterial infections, except for S. aureus infection, have decreased in France. N. meningitidis and S. pneumoniae continue to account for many infections, which indicates the need for better vaccination coverage and spectrum.
Energy Expenditure in Mechanically Ventilated Korean Children: Single-Center Evaluation of a New Estimation Equation*
Authors: Jhang Won Kyoung , Park Seong Jong 
Published: March 2020

Objectives:Accurate assessments of energy expenditure are vital for determining optimal nutritional support, especially in critically ill children. We evaluated current methods for energy expenditure prediction, in comparison with indirect calorimetry, and developed a new estimation equation for mechanically ventilated, critically ill Korean children.Design:Single-center retrospective study.Setting:Fourteen-bed pediatric medical ICU in a tertiary care children’s hospital.Patients:Pediatric patients admitted to the PICU between October 2017 and September 2019 with a measured energy expenditure by indirect calorimetry.Interventions:None.Measurements and Main Results:A total 95 pediatric patients (70 in derivation cohort for development of a new predictive equation and 25 in validation cohort) were included. Mean measured energy expenditure of group A was 66.20 ± 15.35 kcal/kg/d. All previously established predictive equations underestimated the predicted energy expenditure, compared with the measured energy expenditure, except the Food and Agriculture/World Health Organization/United Nations University equation. The Schofield-Height and Weight equation showed the best performance among the tested predictive equations for the entire cohort (least bias, –68.58 kcal/d; best percentage, 108.46% ± 33.60%) compared with the measured energy expenditure. It was also the best performing predictive equation in subgroup analysis by age, sex, nutritional status, and organ failure. Because some discrepancies remained between the measured energy expenditure and predicted energy expenditures, we developed a new estimation equation using multiple regression analysis and those variables significantly associated with our current measured energy expenditures: Energy expenditure = –321.264 + 72.152 × (body weight, kg)–1.396 × (body weight)2+ 5.668 × height (cm) + organ dysfunction* (*hematologic, 76.699; neurologic, –87.984). This new estimation equation showed the least bias and best percentage compared with previous predictive equations (least bias, 15.51 kcal/d; best percentage, 102.30% ± 28.10%).Conclusions:There are significant disparities between measured and calculated energy expenditures. We developed a new estimation equation based on measured energy expenditure data that shows better performance in mechanically ventilated Korean children than other equations. This new estimation equation requires further prospective validation in pediatric series with a range in body habitus.