bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilateral posterior fracture-dislocation of the shoulders
Authors: Wu Junwei , Li Lianxin , Wang Fengrui , Lu Shun , Liu Fanxiao , Jia Honglei , Yang Yongliang , Wang Fu , Hao Zhenhai , Xu Shihong , Wang Bomin 
Published: September 2020

Abstract

Rationale:
Bilateral posterior fracture-dislocation of the shoulders occurs rarely and the diagnosis is often challenging. This injury is often missed or delayed on initial presentation, leading to continuous pain, disability, and rising medical costs. Timely diagnosis and proper treatment are very important to restore shoulder function.

Patient concerns:
Here we report 2 rare cases. Case 1 was a 53-year-old physical worker with severe pain and limited shoulder movement after an unexpected fall. Case 2 was a 55-year-old man with pain in upper limbs and shoulders after an electric shock.

Diagnosis:
Both of them were diagnosed as bilateral posterior fracture-dislocation of the shoulders by computed tomography (CT) scan.

Intervention:
After systematic preoperative evaluation, both of them were treated with open reduction and internal fixation.

Outcomes:
After 16 months follow-up, case 1 was pain-free in both shoulders. He had returned to full activity and was satisfied with his level of function. At 24 months follow-up, both shoulders of case 2 were painless and stable with acceptable range of motion and he was able to carry out daily activities.

Lessons:
Our case reports highlight that bilateral posterior fracture-dislocation of the shoulders is easy to be missed; one way to prevent missing diagnosis is to suspect cases with pain and limited external rotation, especially those with a history of seizures, electric shock, or severe trauma; appropriate history inquiry, physical examination, proper shoulder images are the key to correct diagnosis.
Laparoscopic advanced intraoperative restaging for radiographic non-metastasis pancreatic cancer
Authors: Zheng Zhi , Li Ang , Cao Feng , Li Fei 
Published: September 2020

Abstract

Background:
Although surgical resection holds promise for curing pancreatic cancer, <20% of patients are suitable; however, early postoperative recurrence is common. Currently, radiographic examination is the primary method to determine whether pancreatic cancer has metastasized and to inform clinical staging before surgery. However, the method has a limited detection rate for micro-metastasis within the abdominal cavity; therefore, patients with advanced pancreatic cancer and existing micro-metastasis may receive unnecessary surgical treatment, delaying the timing of adjuvant chemotherapy and resulting in poor prognosis. Laparoscopic staging might be used as a supplement to detect micro-metastasis in patients with pancreatic cancer; however, there is no consistent standard to guide the use of this procedure. Therefore, it is necessary to conduct a trial to further explore the consistency and short-term and long-term efficacy of an intraoperative staging strategy for patients with radiographic non-metastasis.

Methods/design:
This is a single-center cross-sectional and follow-up study. Patients diagnosed with pancreatic cancer without metastasis by radiographic examination and histopathological biopsy, who received intraoperative restaging, will be enrolled. The total sample size required for the trial is approximately 125 patients from May 2020 to December 2022. First, radiographic examination staging will be used. Then, laparoscopic exploration will be performed for patients without definite metastatic lesions. Data collection will include preoperative blood examination, radiographic examination, surgical information, and postoperative recovery. The patients will undergo follow-up every 3 months after surgery until death. The primary endpoint is the metastasis-positive rate via laparoscopic exploration. The secondary endpoints are the consistency, sensitivity, and specificity of the intraoperative restaging strategy and radiographic examination, the incidence of postoperative complications within 30 days, the 6-month relapse-free survival rate, and perioperative indicators (total cost, hospital stay, length of surgery, and intraoperative blood loss).

Discussion:
We are conducting the trial to explore the metastasis-positive rate of intraoperative restaging strategy for diagnosing pancreatic cancer micro-metastasis. This new intraoperative restaging strategy would help pancreatic cancer patients with potential micro-metastasis avoid receiving unnecessary resection, allow systemic treatment as early as possible, and improve the prognosis of patients.
Association between neurodegenerative dementia and chronic rhinosinusitis
Authors: Wee Jee Hye , Yoo Dae Myoung , Byun Soo Hwan , Hong Seok Jin , Park Min Woo , Choi Hyo Geun 
Published: September 2020

Abstract
The aim of this case-control study was to evaluate the association between chronic rhinosinusitis (CRS) and neurodegenerative dementia in a large representative Korean population. The ≥ 50-year-old population was selected from the Korean Health Insurance Review and Assessment Service – National Sample Cohort from 2002 to 2015. A total of 17,634 neurodegenerative dementia patients were matched in a 1:4 ratio with 70,536 control participants for age, sex, income, and region of residence. Neurodegenerative dementia was defined using the ICD-10 codes G30 and F00. CRS was identified based on the ICD-10 code J32. Among the cohort, we selected participants who were treated ≥ 2 times and those who underwent head and neck computed tomography. The odds ratio (OR) for CRS in patients with dementia was analyzed using a conditional logistic regression model. Subgroup analyses were conducted according to age and sex. There was no difference in the prevalence of CRS with/without nasal polyps between the dementia (1.1%) and control (1.2%) groups (P = .825). CRS with/without nasal polyps was not significantly associated with dementia (adjusted OR = 0.96, 95% CI = 0.82–1.13, P = .653). In the subgroup analyses according to age and sex, the adjusted ORs for CRS with/without nasal polyps were not higher in the dementia group than in the control group. Previous CRS was not associated with neurodegenerative dementia in the Korean population.
Point-of-Care Ultrasound Diagnosis of Ureteropelvic Junction Obstruction in a Child With Recurrent Abdominal Pain and Vomiting
Authors: Fox Evan M. , Kasmire Kathryn E. 
Published: September 2020

Abstract
A case is described of a 4 year-old girl who presented with chronic episodic abdominal pain with vomiting. Physical examination was unremarkable aside from hypertension. Point-of-care renal ultrasound showed hydronephrosis, leading to a diagnosis of ureteropelvic junction obstruction presenting with Dietl crisis (episodic abdominal pain secondary to urinary tract obstruction). The clinical utility of point-of-care renal ultrasound in the evaluation of abdominal pain and ultrasound findings of ureteropelvic junction obstruction are highlighted.
Inappropriate Transfer of Burn Patients
Authors: Slavin Benjamin , Shoucair Sami , Klifto Kevin , Grzelak Michael , Shetty Pragna , Cox Carrie , Javia Vidhi , Asif Mohammed , Hultman C. Scott 
Published: September 2020

Objective
Burn injuries have an annual incidence exceeding 40,000. The Burn Center Referral Criteria published by the American Burn Association (ABA) serve to guide health centers in determining appropriateness of patient transfer to a specialized center. With inappropriate transfer rates reaching up to 77%, reliance on the ABA criteria is critical as the decision to transfer a patient can impose significant costs to both the patient and healthcare system. The aim of this study is to evaluate the appropriateness of all burn patient transfers to a single burn center over a 5-year period and assess the potential role of telemedicine to optimize the assessment and care of this patient population.

Methods
A 5-year retrospective review was conducted to all burn patients transferred or consulted for transfer to our burn center between January 2013 and January 2017. After application of inclusion and exclusion criteria, 767 cases were analyzed, with 612 ultimately being transferred. Outcome measures included basic clinical and demographic information, as well as logistical burn and transfer data such as percent total body surface area and transfer distance. After data collection, 5-year descriptive trends were analyzed, and the ABA criteria were applied to each patient case to evaluate appropriateness of transfer. Patients transferred despite not meeting at least one of the ABA criteria were classified as inappropriately transferred.

Results
A total of 25 patients (3.2%) were found to be inappropriate transfers. Statistical analysis compared appropriately transferred patients (n = 587) with those inappropriately transferred. Overall, inappropriately transferred patients were more likely to have superficial partial thickness burns (76% vs 46%, P = 0.05), were less likely to need surgery (4% vs 22%, P < 0.05), and had a higher incidence of upper extremity burns (32% vs 4%, P < 0.01).

Conclusions
Our study increases awareness of the most commonly seen presentation of inappropriately transferred burn patients over a 5-year period at our center. Given the advent of telemedicine, the ability of institutions to pinpoint a subset of patients most vulnerable to inappropriate transfer will allow for a streamlining of resources that will serve to benefit both patients and the health system.
Academic Productivity Among Plastic Surgery Subspecialty Fellowship Applicants
Authors: McGlone Katie L. , Ngaage Ledibabari M. , Steinberg Jordan P. , Lifchez Scott D. , Slezak Sheri , Rasko Yvonne M. 
Published: September 2020

Introduction
Plastic surgery subspecialty fellowships are highly competitive. Academic productivity is an objective metric that can be used to compare candidates. This study aims to evaluate intersubspecialty differences in academic profiles of plastic surgery fellows.

Methods
We performed a cross-sectional analysis of the plastic surgery fellows in the United States from 2015 to 2019. We used the San Francisco Match website and individual program websites to obtain details of fellowship programs (microsurgery, aesthetic, hand, and craniofacial) and plastic surgery fellows. Bibliometric data at the time of fellowship application were obtained for each fellow.

Results
A total of 235 fellows were included. There was a significant difference in the median number of publications (P = 0.0067) and h-index (P = 0.0229) across subspecialties. Multivariate analysis demonstrated that dedicated research time was predictive for a high publication count (odds ratio [OR], 3.59; P = 0.0007) and h-index (OR, 4.88; P < 0.0001) at the time of fellowship application. Although international residency and aesthetic fellowship application were predictive of a reduced number of publications (OR, 0.17; P < 0.0001, and OR, 0.43; P = 0.0190, respectively), H-index was increased by possession of an advanced degree (OR, 2.00; P = 0.0291) and decreased with international residency (OR, 0.26, P = 0.0021).

Conclusions
All plastic surgery fellows have highly qualified academic profiles at the time of fellowship application. Academic productivity differs between subspecialty fellowships. Those wishing to match into competitive subspecialties should consider taking dedicated time for research or attaining an advanced degree.
Quantitative Augmented Reality-Assisted Free-Hand Orthognathic Surgery Using Electromagnetic Tracking and Skin-Attached Dynamic Reference
Authors: Kim Seong-Ha , Lee Sang-Jeong , Choi Min-Hyuk , Yang Hoon Joo , Kim Jo-Eun , Huh Kyung-Hoe , Lee Sam-Sun , Heo Min-Suk , Hwang Soon Jung , Yi Won-Jin 
Published: September 2020

Abstract
The purpose of this study was to develop a quantitative AR-assisted free-hand orthognathic surgery method using electromagnetic (EM) tracking and skin-attached dynamic reference. The authors proposed a novel, simplified, and convenient workflow for augmented reality (AR)-assisted orthognathic surgery based on optical marker-less tracking, a comfortable display, and a non-invasive, skin-attached dynamic reference frame. The 2 registrations between the physical (EM tracking) and CT image spaces and between the physical and AR camera spaces, essential processes in AR-assisted surgery, were pre-operatively performed using the registration body complex and 3D depth camera. The intraoperative model of the maxillary bone segment (MBS) was superimposed on the real patient image with the simulated goal model on a flat-panel display, and the MBS was freely handled for repositioning with respect to the skin-attached dynamic reference tool (SRT) with quantitative visualization of landmarks of interest using only EM tracking. To evaluate the accuracy of AR-assisted Le Fort I surgery, the MBS of the phantom was simulated and repositioned by 6 translational and three rotational movements. The mean absolute deviations (MADs) between the simulation and post-operative positions of MBS landmarks by the SRT were 0.20, 0.34, 0.29, and 0.55 mm in x- (left lateral, right lateral), y- (setback, advance), and z- (impaction, elongation) directions, and RMS, respectively, while those by the BRT were 0.23, 0.37, 0.30, and 0.60 mm. There were no significant differences between the translation and rotation surgeries or among surgeries in the x-, y-, and z-axes for the SRT. The MADs in the x-, y-, and z-axes exhibited no significant differences between the SRT and BRT. The developed method showed high accuracy and reliability in free-hand orthognathic surgery using EM tracking and skin-attached dynamic reference.
Lip Shapes Over the Last Century (1948–2012)
Authors: Hwang Kun , Yun Seon Mi 
Published: September 2020

Abstract
The aim of this study was to analyze lip shapes as represented in the British edition of Vogue over the last century (1916–2015). Photographs containing distinguishable lips were selected from a book entitled Vogue 100: A Century of Style. A total of 98 frontal pictures (20 males, 78 females) in which the lips and mouth were identifiable were included and analyzed in terms of 4 lip-related ratios (lip thickness-to-width ratio [LTW]; upper-to-lower vermillion ratio [ULR]; upper vermillion thickness-to-upper lip height ratio [VUL]; and lip-to-nose width ratio [LNW]). The LTW was 0.39 ± 0.07, and did not vary significantly over time (P = 0.261 [linear regression analysis]). The LTW of women (0.41 ± 0.07) was significantly greater than that of men (0.34 ± 0.05) (P < 0.001 [independent 2-samples t-test]). The ULR was 0.74 ± 0.16, and did not vary significantly over time (P = 0.647). There was no significant difference in the ULR between men (0.75 ± 0.10) and women (0.74 ± 0.17) (P = 0.769). The VUL was 0.43 ± 0.09, and did not vary significantly over time (P = 0.550). The VUL of women (0.44 ± 0.09) was significantly greater than that of men (0.37 ± 0.06) (P = 0.001). The LNW was 1.49 ± 0.19, and did not vary significantly over time (P = 0.619). There was no significant difference in the LNW between men (1.43 ± 0.16) and women (1.51 ± 0.19) (P = 0.082). The results of this study may be useful for planning facial rejuvenation operations, as well as for clinical practitioners dealing with brow esthetics or lip tattooing.
Novel Surgical Approach to Acalvaria
Authors: Caycedo Diego J. , Castillo-Huila Juan P. , Zapata-Copete James A. , Santacruz Luis Fernando 
Published: September 2020

Abstract
Acalvaria, also known as acrania, is a rare congenital anomaly which is characterized by a complete or partial defect of the calvarium. Due to the low number of patients reported, there is no a standard for the treatment of this condition; thereby, the objective is to present a new surviving patient with acalvaria and a novel surgical approach to treat it, giving craniofacial surgeons and neurosurgeons more tools to face it. In this article, the authors present a reproducible surgical approach in patients with partial acalvaria, which consist in use the present bone as a graft to cover the defect, giving a temporal but stable coverture. No other calvaria graft has been published along the available literature, since only around 4 patients are acalvaria survivors worldwide. However, the authors need to make a longer follow-up to establish the usefulness of the technique in long term. Other limitation is the future procedures needed to a better function and aesthetic.
Altered DNA methylation profiles in blood from patients with sporadic Creutzfeldt-Jakob disease
Authors: Dabin Luke , Guntoro Fernando , Campbell Tracy , Bélicard Tony , Smith Adam R. , Smith Rebecca G. , Raybould Rachel , Schott Jonathan M. , Lunnon Katie , Sarkies Peter , Collinge John , Mead Simon , Viré Emmanuelle 
Published: September 2020

AbstractPrion diseases are fatal and transmissible neurodegenerative disorders caused by the misfolding and aggregation of prion protein. Although recent studies have implicated epigenetic variation in common neurodegenerative disorders, no study has yet explored their role in human prion diseases. Here we profiled genome-wide blood DNA methylation in the most common human prion disease, sporadic Creutzfeldt-Jakob disease (sCJD). Our case-control study (n=219), when accounting for differences in cell type composition between individuals, identified 38 probes at genome-wide significance (p < 1.24×0-7). Nine of these sites were taken forward in a replication study, performed in an independent case-control (n=186) cohort using pyrosequencing. Sites in or close to FKBP5, AIM2 (2 probes), UHRF1, KCNAB2, PRNP, ANK1 successfully replicated. The blood-based DNA methylation signal was tissue- and disease-specific, in that the replicated probe signals were unchanged in case-control studies using sCJD frontal-cortex (n=84), blood samples from patients with Alzheimer’s disease, and from inherited and acquired prion diseases. Machine learning algorithms using blood DNA methylation array profiles accurately distinguished sCJD patients and controls. Finally, we identified sites whose methylation levels associated with prolonged survival in sCJD patients. Altogether, this study has identified a peripheral DNA methylation signature of sCJD with a variety of potential biomarker applications.
CD38+CD27− on Mtb-specific CD4+ T cells distinguishes latent from active tuberculosis
Authors: Acharya Muthya Pragun , Pradeep Sai Pallavi , Murthy Venkataramappa Srinivasa , Chikkannaiah Panduranga , Kambar Vivekanand , Narayanashetty Satyanarayana , Nagaraja Sharath Burugina , Niveditha  , Yoganand Raksha , Satchidanandam Vijaya 
Published: September 2020

ABSTRACTRATIONALEEarly and accurate diagnosis followed by timely treatment are the key prerequisites to fight tuberculosis (TB) and reduce its global burden. Despite scientific advances, the rapid and correct diagnosis of both pulmonary and extrapulmonary tuberculosis remains a challenge due to traditional reliance on detection of the elusive bacilli. Mycobacterium tuberculosis (Mtb)-specific host immune activation and cytokine production has shown significant promise as an alternative means of detecting and distinguishing active disease from latent infection.OBJECTIVEPhenotypic characteristics of Mtb-specific cytokine-producing immune cell subsets were investigated and queried for their diagnostic ability in identifying active tuberculosis.METHODSSubjects belonging to the following groups were recruited – pulmonary, extrapulmonary, latent TB, cured TB, sick controls and healthy controls. Polychromatic flow cytometry was used to identify host immune biomarkers in an exploratory cohort comprising 56 subjects using peripheral blood mononuclear cells. Clinical performance of the identified biomarker was evaluated using whole blood in a blinded validation cohort comprising 165 individuals.FINDINGSFrequencies of Mtb-specific CD4+ T cells of the phenotype CD38+CD27− clearly distinguished patients with active tuberculosis from individuals without the disease. CD38+CD27−CD4+ T cells secreting TNF-α upon stimulation with ESAT6/CFP10 peptides had the best diagnostic accuracy at a cut-off of 9.91% [exploratory: 96.67% specificity, 88.46% sensitivity; validation: 96.15% specificity, 90.16% sensitivity]. Additionally, this subset differentiated treatment-naive TB patients from individuals cured of TB following completion of anti-tuberculosis therapy.INTERPRETATIONMtb-specific CD38+CD27−TNF-α+CD4+ T cell subset is a robust biomarker for TB diagnosis and can determine cure.IMPACT OF THIS RESEARCHWe identified and validated CD38+CD27−TNF-α+ as a robust biomarker with diagnostic accuracies >90% in both PBMCs and whole blood that can be translated into a reliable and cost-effective in vitro diagnostic test with ease. By not removing samples with insignificant immune response and instead classifying them as negative, our study represents a truly realistic assessment of the diagnostic accuracy of the identified biomarker in a clinical setting.
Racial and workplace disparities in seroprevalence of SARS-CoV-2 in Baton Rouge, Louisiana, July 15-31, 2020
Authors: Feehan Amy K. , Velasco Cruz , Fort Daniel , Burton Jeffrey H. , Price-Haywood Eboni , Katzmarzyk Peter T. , Garcia-Diaz Julia , Seoane Leonardo 
Published: September 2020

AbstractUsing paired molecular and antibody testing for SARS-CoV-2 infection, we determined point prevalence and seroprevalence in a municipality in Louisiana, USA during the second phase of reopening. Infections were highly variable by race, work environment, and ZIP code. Census-weighted seroprevalence and point prevalence were 3.6% and 3.0%, respectively.
Gradient Boosting Decision Tree Algorithm for the Prediction of Postoperative Intraocular Lens Position in Cataract Surgery
Authors: Li Tingyang , Yang Kevin , Stein Joshua D. , Nallasamy Nambi 
Published: September 2020

AbstractPurposeTo develop a method for predicting postoperative anterior chamber depth (ACD) in cataract surgery patients based on preoperative biometry, demographics, and intraocular lens (IOL) power.MethodsPatients who underwent cataract surgery and had both preoperative and postoperative biometry measurements were included. Patient demographics and IOL power were collected from the Sight Outcomes Research Collaborative (SOURCE) database. A gradient boosting decision tree model was developed to predict the postoperative ACD. The mean absolute error (MAE) and median absolute error (MedAE) were used as evaluation metrics. The performance of the proposed method was compared to five existing formulas.Results847 patients were assigned randomly in a 4:1 ratio to a training/validation set (678 patients) and a testing set (169 patients). Using preoperative biometry and patient sex as predictors, the presented method achieved an MAE of 0.106 ± 0.098 (SD) on the testing set, and a MedAE of 0.082. MAE was significantly lower than that of the five existing methods (p < 0.01). When keratometry was excluded, our method attained an MAE of 0.123 ± 0.109, and a MedAE of 0.093. When IOL power was used as an additional predictor, our method achieved an MAE of 0.105 ± 0.091 and a MedAE of 0.080.ConclusionsThe presented machine learning method achieved accuracy surpassing that of previously reported methods in the prediction of postoperative ACD.Translational RelevanceIncreasing accuracy of postoperative ACD prediction with the presented algorithm has the potential to improve refractive outcomes in cataract surgery.