bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association Between the Utilization of Traction and Postoperative Complications Following Growing Rod Instrumentation for Early-onset Scoliosis
Authors: Roye Benjamin D. , Fields Michael W. , Matsumoto Hiroko , Sponseller Paul , Pérez-Grueso Francisco J.S. , Boachie-Adjei Oheneba , Hammerberg Kim , Welborn Michelle C. , Vitale Michael G. 
Published: July 2020

Background:
Preoperative and/or intraoperative traction have been proposed as adjunctive methods to limit complications associated with growth-friendly instrumentation for early-onset scoliosis (EOS). By gradually correcting the deformity before instrumentation, traction can, theoretically, allow for better overall correction without the complications associated with the immediate intraoperative correction. The purpose of this multicenter study was to investigate the association between preoperative/intraoperative traction and complications following growth-friendly instrumentation for EOS.

Methods:
Patients with EOS who underwent growth rod instrumentation before 2017 were identified from 2 registries. Patients were divided into 2 groups: preoperative traction group versus no preoperative traction group. A subgroup analysis was done to compare intraoperative traction only versus no traction. Data was collected on any postoperative complication from implantation to up to 2 years postimplantation.

Results:
Of 381 patients identified, 57 (15%) and 69 (18%) patients received preoperative and intraoperative traction, respectively. After adjusting for etiology and degree of kyphosis, there was no evidence to suggest that preoperative halo traction reduced the risk of any complication following surgical intervention. Although not statistically significant, a subgroup analysis of patients with severe curves demonstrated a trend toward a markedly reduced hardware failure rate in patients undergoing preoperative halo traction [preoperative traction: 1 (3.1%) vs. no preoperative traction: 11 (14.7%), P=0.083]. Nonidiopathic, hyperkyphotic patients treated with intraoperative traction were 61% less likely to experience any postoperative complication (P=0.067) and were 74% (P=0.091) less likely to experience an unplanned return to the operating room when compared with patients treated without traction.

Conclusions:
This multicenter study with a large sample size provides the best evidence to date of the association between the use of traction and postoperative complications. Our results justify the need for future Level I studies aimed at characterizing the complete benefit and risk profile for the use of traction in surgical intervention for EOS.

Level of Evidence:
Level III.
What’s New in Congenital Hand Surgery
Authors: Pino Paula A. , Zlotolow Dan A. , Kozin Scott H. 
Published: July 2020

Background:
Congenital conditions of the hand and upper extremity are a frequent source of consultation among pediatric orthopaedists and hand surgeons. Advances in the fields of molecular biology and genetics have helped to better understand some of these conditions and redefine previous classification systems. New outcome measurement tools have been used to assess surgical results and have brought into focus a different aspect of the patients’ experience.

Methods:
We searched PubMed database for papers related to the treatment of congenital hand anomalies published from January 1, 2015 to October 31, 2018. The search was limited to English articles yielding 207 papers. Three pediatric hand surgeons selected the articles based upon the criteria that the topic was germane, the article fell under the subheadings within the manuscript, and the conclusions were meaningful.

Results:
A total of 40 papers were selected for review, based upon their quality and new findings. Research articles with significant findings were included for syndactyly, symbrachydactyly, cleft hand, polydactyly, radial longitudinal deficiency, congenital radio-ulnar synostosis, and macrodactyly.

Conclusions:
Our knowledge of the embryology and pathophysiology of congenital upper extremity conditions continues to evolve. Functional assessments combined with patient and parent-reported outcomes have our understanding of the results following surgical procedures. Further research and standardization of our scientific data will provide better answers and higher quality of evidence.

Level of Evidence:
Level V—literature review and expert opinion.
Pediatric Chondroblastoma and the Need for Lung Staging at Presentation
Authors: Arkader Alexandre , Williams Amy , Binitie Odion , Thacker Mihir M. , Farfalli German L. 
Published: July 2020

Purpose:
Chondroblastoma is a benign, but potentially locally aggressive, bone tumor with predilection for the epiphysis of long bones in growing children. Historically, there is a reported 2% risk of lung metastasis, however these cases are mostly in the form of isolated single reports and the vast majority in adults. The purpose of this study was to identify the “true” risk of lung metastases at presentation in skeletally immature patients with a benign chondroblastoma, and therefore revisit the need for routine chest staging.

Methods:
This was a multi-institution, international retrospective study of children and adolescents diagnosed and treated for a benign chondroblastoma. We focused on the screening and diagnosis of lung metastasis, type of staging utilized and the incidence of local recurrence. Detailed review of the available literature was also performed for comparison.

Results:
The final studied cohort included 130 children with an average age of 14.5 years (range: 6 to 18 y). There were 94 boys and 36 girls. Lesions more often involved the proximal humerus (32/130), proximal tibia (30/130), and proximal femur (28/130). At an average follow-up of 50 months, there were 15 local recurrences (11% rate) and no cases of lung metastasis. All patients underwent chest imaging at presentation. The overall reported lung metastases rate in the pulled literature review (larger series only) was 0.4% (7/1625), all patients were skeletally mature.

Conclusions:
This is the largest cohort of pediatric-exclusive chondroblastoma in the literature. Despite minor differences in management between the centers included, the recurrence rate was similar and there was no evidence of lung metastasis (0 in 130). The incidence of distant involvement in a true benign chondroblastoma in children is much lower than the 2% previously reported in the literature, and the need for routine chest staging should be revisited.

Level of Evidence:
Level III.
Humerus Rotation Has a Negligible Effect on Baumann Angle in a Wide Range of Rotational Positions
Authors: Segal David , Emery Kathleen , Zeitlinger Lauren , Rosenbaum Joseph A. , Little Kevin J. 
Published: July 2020

Background:
Rotation of the humerus out of the coronal plane is presumed to alter the Baumann angle (BA) value. Identifying the rotational limits of the humerus at which the BA can be accurately and reliably measured will circumvent repeated radiographs and unnecessary exposure to radiation, may improve patient comfort, and save time and medical resources.

Methods:
A retrospective chart review was performed to identify patients under the age of 18 who underwent an elbow computed tomography (CT) scan without any humeral pathology and with an open distal humeral physis. For each patient, a 3-dimensional (3D) computerized model was generated with 30% transparency to mimic a plain radiograph. These models were rotated in 10-degree increments and the BA was measured on each position. In addition, the measurements were taken on an anteroposterior radiograph for each patient. Analysis of variance and the Pearson tests were performed to locate differences and define associations.

Results:
Fifteen 3D CT reconstructions were generated from 14 patients. The mean BA on the neutral position was found to be 72.2±3 degrees, which correlated with the 70.6±5.91 degrees measurement obtained on radiographs. The most extreme rotational positions on which the BA values were consistent with the neutral position values were +40 external rotation (70.97±7.01 degrees, P=1) and −70 degrees internal rotation (68.4±7.47 degrees, P=0.14). A negative correlation was found between the BA values and the extent at which the humerus was rotated from the neutral position. The variability of the BA between patients, implied by the SD of measurements on each position increased with increasing rotation from the neutral position (r=1, P<0.05).

Conclusions:
On the basis of 3D CT images, the BA is the most accurate when the arm is positioned at an exact anteroposterior position. It is reliable to measure the BA when the humerus is rotated no more than +40 degrees external rotation to −70 degrees internal rotation. This range of rotation can act as an “accurate zone” and help avoiding multiple radiographs.

Level of Evidence:
Level III.
Analgesic dorsal root ganglionic field stimulation blocks conduction of afferent impulse trains selectively in nociceptive sensory afferents
Authors: Chao Dongman , Zhang Zhiyong , Mecca Christina M. , Hogan Quinn H. , Pan Bin 
Published: July 2020

Abstract
Increased excitability of primary sensory neurons after peripheral nerve injury may cause hyperalgesia and allodynia. Dorsal root ganglion field stimulation (GFS) is effective in relieving clinical pain associated with nerve injury and neuropathic pain in animal models. However, its mechanism has not been determined. We examined effects of GFS on transmission of action potentials (APs) from the peripheral to central processes by in vivo single-unit recording from lumbar dorsal roots in sham injured rats and rats with tibial nerve injury (TNI) in fiber types defined by conduction velocity. Transmission of APs directly generated by GFS (20 Hz) in C-type units progressively abated over 20 seconds, whereas GFS-induced Aβ activity persisted unabated, while Aδ showed an intermediate pattern. Activity generated peripherally by electrical stimulation of the sciatic nerve and punctate mechanical stimulation of the receptive field (glabrous skin) was likewise fully blocked by GFS within 20 seconds in C-type units, whereas Aβ units were minimally affected and a subpopulation of Aδ units was blocked. After TNI, the threshold to induce AP firing by punctate mechanical stimulation (von Frey) was reduced, which was reversed to normal during GFS. These results also suggest that C-type fibers, not Aβ, mainly contribute to mechanical and thermal hypersensitivity (von Frey, brush, acetone) after injury. Ganglion field stimulation produces use-dependent blocking of afferent AP trains, consistent with enhanced filtering of APs at the sensory neuron T-junction, particularly in nociceptive units.
Assessment of muscle mass in critically ill patients: role of the sarcopenia index and images studies
Authors: Lopez-Ruiz Arnaldo , Kashani Kianoush 
Published: July 2020

Purpose of review
Sarcopenia is a progressive generalized decline in skeletal muscle mass, strength, and function. This condition is highly prevalent in critically ill patients and is associated with poor outcomes in the ICU. In this review, we describe the use, evidence, and limitations of the most common validated imaging studies used to assess muscle mass in ICU, and we provide an overview of the benefits of using the sarcopenia index [(serum creatinine/serum cystatin C) × 100]) in the ICU.

Recent findings
Currently, the determination of muscle mass using anthropometric measurements and serum biomarkers is unreliable. Several new techniques, including a dual-energy X-ray absorptiometry, computed tomography scan, ultrasonography, and bioimpedance analysis, have been studied and validated for the diagnosis and prognosis of sarcopenia in the ICU. However, these techniques are often not accessible for the majority of critically ill patients. The sarcopenia index constitutes an accurate method to diagnose sarcopenia, predict ICU outcomes, and nutritional status in critically ill patients.

Summary
Diagnosis of sarcopenia has substantial implications in ICU patients. Choosing the correct test to identify patients who may need preventive or therapeutic support for this condition will favorably impact ICU outcomes.
Clinical trials in group 3 pulmonary hypertension
Authors: Harder Eileen M. , Waxman Aaron B. 
Published: July 2020

Purpose of review
Despite worse outcomes associated with the development of pulmonary hypertension in chronic lung disease, there are no approved treatments for this population. The present review summarizes the recent clinical trials in World Symposium on Pulmonary Hypertension (WSPH) Group 3 pulmonary hypertension, with a particular focus on the study of pulmonary arterial hypertension (PAH)-targeted therapy.

Recent findings
Multiple recent randomized controlled trials have studied a host of PAH-specific medications in the treatment of WSPH Group 3 pulmonary hypertension, including endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, and prostacyclins. In pulmonary hypertension associated with chronic obstructive lung disease (PH-COPD) and with interstitial lung disease (PH-ILD), most trials have shown conflicting or negative results, although they have been limited by variable patient populations and small sample sizes. Recent large-scale trial data demonstrate that inhaled treprostinil is associated with improved outcomes in the PH-ILD population.

Summary
Although most PAH medications have not shown consistent benefit in the WSPH Group 3 population, recent work suggests that inhaled treprostinil has an important role in the treatment of PH-ILD. Efforts are ongoing to evaluate the efficacy of other medications, identify optimal treatment candidates, and define clinically meaningful endpoints in WSPH Group 3 pulmonary hypertension.
Therapeutic options for chronic kidney disease-associated pulmonary hypertension
Authors: Edmonston Daniel L. , Sparks Matthew A. 
Published: July 2020

Purpose of review
Pulmonary hypertension is a common and devastating complication of chronic kidney disease (CKD). Traditionally considered a consequence of volume overload, recent findings now expand this paradigm. These novel mechanisms herald new treatment options. This review summarizes the current evidence to provide a theoretical model of the contributing factors for CKD-associated pulmonary hypertension. Along this framework, we highlight current and emerging therapeutic strategies for each putative factor.

Recent findings
A series of retrospective studies of right heart catheterization data provide insights into the potential hemodynamic profile of CKD-associated pulmonary hypertension. These studies suggest that elevated pulmonary vascular resistance may commonly contribute to pulmonary hypertension. In addition, preclinical models implicate an increasing array of CKD-associated factors which influence pulmonary vascular biology. Many of these factors also adversely affect kidney function and CKD progression. Clinical trial and other prospective data for treatments of CKD-associated pulmonary hypertension remain limited.

Summary
Volume overload and left-ventricular dysfunction are the predominant focus of CKD-associated pulmonary hypertension treatment for most patients. However, new findings suggest that treatments targeting pulmonary vascular vasoconstriction and remodeling may be promising treatment options for select patients. Clinical trials are needed for all therapeutic strategies for CKD-associated pulmonary hypertension.
Efficacy and Toxicity of 5-Fluorouracil–Oxaliplatin in Gastroenteropancreatic Neuroendocrine Neoplasms
Authors: Merola Elettra , Dal Buono Arianna , Denecke Timm , Arsenic Ruza , Pape Ulrich-Frank , Jann Henning , Wiedenmann Bertram , Pavel Marianne E. 
Published: July 2020

Objectives
The objective of this study was to investigate the efficacy and tolerability of 5-fluorouracil–oxaliplatin (FOLFOX) in advanced gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs).

Methods
Retrospective analysis of consecutive 72 advanced GEP-NENs treated with FOLFOX between 2005 and 2016 at a single German referral center for NENs was performed. We assessed treatment response by response evaluation criteria in solid tumors 1.0 criteria, progression-free survival by Kaplan-Meyer method, and risk factor analysis by Cox-regression model.

Results
Patients were 44.5% G1/G2, 55.5% G3, receiving a median of 7 treatment cycles (range, 2–21), and had a median of 18 months of follow-up (range, 3–111 months). Disease control was achieved in 75.0% of cases but 91.3% in the 23 patients receiving FOLFOX as first line (P = 0.04). Median progression-free survival of the overall population was 8 months. A better outcome was significantly related to treatment duration (P = 0.02) and grade of histological differentiation for G3 patients (well differentiated vs poorly differentiated, P = 0.03). Adverse events occurred in 88.8% of patients, mostly grade 1 and 2 hematotoxicity and chemotherapy-induced peripheral sensory neuropathy (84.1% and 50.0% of patients, respectively).

Conclusions
Our results support FOLFOX as therapeutic option in advanced GEP-NENs with poor prognosis, either at first or further therapy line. Longer duration of therapy was associated with a more durable benefit.
Functional β-Cell Differentiation of Small-Tail Han Sheep Pancreatic Mesenchymal Stem Cells and the Therapeutic Potential in Type 1 Diabetic Mice
Authors: Zhang Shuang , Yin Jiahui , Ji Hongbing , Wang Qi , Yang Qin , Lai Junhui , Sun Yuchen , Guan Weijun , Chen Peijie 
Published: July 2020

ObjectivesThis study aims to investigate the characteristics of sheep pancreatic mesenchymal stem cells (PSCs) and therapeutic potential of differentiated β-like cells in streptozotocin-induced diabetic mice.MethodsPancreatic mesenchymal stem cells were isolated from 3- to 4-month-old sheep embryos, and their biological characteristics were explored. The function and therapeutic potential of differentiated β-like insulin-producing cells were also investigated in vitro and in vivo. Differentiated cells were identified through dithizone staining and immunofluorescence staining. Insulin secretion was analyzed using an enzyme-linked immunosorbent assay kit. The preliminary therapeutic potential of induced β-like cells in diabetic mice was detected by blood glucose and body weight.ResultsPrimary PSCs were isolated and subcultured up to passage 36. Immunofluorescence staining presented PSC-expressed important markers such as Pdx1, Nkx6-1, Ngn3, and Nestin. Primary PSCs could be induced into functional pancreatic β-like islet cells with a 3-step protocol. The induced β-like islet cells could ameliorate blood glucose in diabetic mice.ConclusionsThe method proposed for generating pancreatic islet β cells provided a preliminary phenotypic investigation of induced cell treatment in diabetic mice, and also laid a foundation in the identification of pharmaceutical targets to treat insulin-dependent diabetes.
Diagnostic Value of Serum Amylase Levels Indicating Computed Tomography–Defined Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis
Authors: Inatomi Osamu , Bamba Shigeki , Nakai Yoshitaka , Kusumoto Kiyonori , Kawakami Takumi , Suzuki Takahiro , Suzuki Azumi , Endoh Bunji , Ota Shinichi , Inoue Akitoshi , Itokawa Yoshio , Chikugo Koki , Andoh Akira , Mizumoto Yoshinori , Tanaka Kiyohito 
Published: July 2020

Objective
Post–endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis involves persistent serum amylase levels of 3 times or more the standard upper limit. However, these criteria were mostly based on retrospective studies and not necessarily supported by diagnostic imaging. Our prospective study aimed to investigate cutoff serum amylase levels suggesting post-ERCP pancreatitis using computed tomography as the criterion standard.

Methods
We prospectively followed 2078 cases. Computed tomography was performed in patients whose serum amylase levels exceeded the institutional upper limit 12 to 24 hours after ERCP. Two expert radiologists blindly assessed the images and judged the presence or absence of pancreatitis. Correlations between serum amylase levels with pancreatitis were investigated using receiver operating characteristic analysis.

Results
Amylase levels increased in 416 (23.2%) of 1789 cases included, and 350 cases were analyzed using computed tomography. Post–endoscopic retrograde cholangiopancreatography pancreatitis was diagnosed in 12.0% (214/1789). The cutoff amylase levels for judging pancreatitis after 12 to 24 hours was 2.75 times higher than the institutional upper limit, with an area under the curve of 0.77.

Conclusions
The appropriate cutoff serum amylase level for judging post-ERCP pancreatitis at 12 to 24 hours after ERCP was 2.75 times higher than the institutional upper limit. These results may clarify the definition of post-ERCP pancreatitis.
Angiotensin-(1–7) Treatment Restores Pancreatic Microcirculation Profiles
Authors: Wang Xueyan , Liu Mingming , Hu Weikai , Cui Tianyu , Yu Xiaozheng , Liu Ruixia , Yin Chenghong 
Published: July 2020

ObjectivesThe aim of this study was to investigate the changes of pancreatic microvascular vasomotion and blood distribution pattern in acute pancreatitis (AP), and whether Angiotensin (Ang)-(1–7) treatment could restore pancreatic microcirculation profiles.MethodsMice were randomly separated into control, AP, and Ang-(1–7)-treated AP (A-AP) group. Acute pancreatitis was induced in mice by intraperitoneal injection of cerulein and lipopolysaccharide. Pancreatitis was confirmed by histopathology, serum amylase, and high-sensitive C-reactive protein. Pancreatic microvascular vasomotion and blood distribution pattern in AP progression were assessed by laser Doppler. Meanwhile, ultrastructural changes of pancreatic microcirculation, including microvascular cavity and wall and endothelial mitochondria, were evaluated by transmission electron microscopy.ResultsAcute pancreatitis mice exhibited pathological pancreatic injuries with lower blood distribution pattern and decreased average blood perfusion, relative velocity, effective frequency, and amplitude of microvascular vasomotion. The pancreatic pathological injuries in Ang-(1–7)-treated mice were significantly alleviated. Consistently, Ang-(1–7) treatment led to a restoration in pancreatic microcirculation profiles. Furthermore, non–Ang-(1–7)-treated mice showed an irregular microvascular wall, narrow cavity, and swelling mitochondria, and these ultrastructural impairments were reversed by Ang-(1–7) administration.ConclusionsPancreatic microcirculation profiles are abnormal in the progression of AP. Angiotensin-(1–7) administration could restore functional status of pancreatic microcirculation.
Intimate Partner Violence Among Patients Diagnosed With Severe Mental Disorder
Authors: Tasa-Vinyals Elisabet , Álvarez María-José , Puigoriol-Juvanteny Emma , Roura-Poch Pere , García-Eslava Jairo Santiago , Escoté-Llobet Santiago 
Published: July 2020

Abstract
Intimate partner violence (IPV) has a remarkable impact on mental health and is common in people diagnosed with severe mental disorders (SMDs). Data of 102 outpatients were collected from clinical records and the Traumatic Life Events Questionnaire (TLEQ). Global estimation of lifetime IPV exposure was obtained by combining answers to selected TLEQ questions about physical, psychological, and sexual IPV. Overall, 24.5% of the participants reported at least one lifetime episode of IPV victimization. Female gender (odds ratio [OR] = 3.15, p = 0.016) and childhood trauma (OR = 4.7, p = 0.002) significantly increased the likelihood of IPV victimization. Conversely, posttraumatic stress disorder was not significantly increased in IPV victims. These findings are in line with current literature and suggest a remarkable and transdiagnostic prevalence of lifetime IPV victimization in SMD. Gender, childhood trauma, and SMD are relevant factors in IPV analysis and prevention. Diathesis of trauma, psychosocial vulnerability to revictimization and intersectional feminist theory help explain our results.