bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of a radiomics model based on T2WI images for preoperative prediction of microsatellite instability status in rectal cancer
Authors: Huang Zixing , Zhang Wei , He Du , Cui Xing , Tian Song , Yin Hongkun , Song Bin 
Published: March 2020

Abstract

Introduction:
Globally, colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females. Rectal cancer (RC) accounts for about 28% of all newly diagnosed CRC cases. The treatment of choice for locally advanced RC is a combination of surgical resection and chemotherapy and/or radiotherapy. These patients can potentially be cured, but the clinical outcome depends on the tumor biology. Microsatellite instability (MSI) is an important biomarker in CRC, with crucial diagnostic, prognostic, and predictive implications. It is important to develop a noninvasive, repeatable, and reproducible method to reflect the microsatellite status. Magnetic resonance imaging (MRI) has been recommended as the preferred imaging examination for RC in clinical practice by both the National Comprehensive Cancer Network and the European Society for Medical Oncology guidelines. T2WI is the core sequence of MRI scanning protocol for RC. Radiomics, the high-throughput mining of quantitative image features from standard-of-care medical imaging that enables data to be extracted and applied within clinical-decision support systems to improve diagnostic, prognostic, and predictive accuracy, is gaining importance in cancer research.
We proposed a hypothesis: A simple radiomics model based on only T2WI images can accurately evaluate the MSI status of RC preoperatively.

Objective:
To develop a radiomics model based on T2WI images for accurate preoperative diagnosis the MSI status of RC.

Method:
All patients with RC were retrospectively enrolled. The dataset was randomly split into training cohort (70% of all patients) and testing cohort (30% of all patients). The radiomics features will be extracted from T2WI–MR images of the entire primary tumor region. Least absolute shrinkage and selection operator was used to select the most predictive radiomics features. Logistic regression models were constructed in the training/validation cohort to discriminate the MSI status using clinical factors, radiomics features, or their integration. The diagnostic performance of these 3 models was evaluated in the testing cohort based on their area under the curve, sensitivity, specificity, and accuracy.

Discussion:
This study will help us know whether radiomics model based on T2WI images to preoperative identify MSI status of RC.
Surgical management of delayed Gartland type III supracondylar humeral fractures in children
Authors: Li Jin , Rai Saroj , Tang Xin , Ze Renhao , Liu Ruikang , Hong Pan 
Published: March 2020

Abstract
Radial external fixator has been proposed to treat delayed irreducible Gartland type III supracondylar humeral fracture, and this study aims to compare its effects with crossed pinning in a retrospective fashion. Delayed supracondylar humeral fracture is defined as more than 72 hours after injury, 2 or more than 2 times failed attempts of closed reduction can be deemed as irreducible fracture.
Between January 2010 and January 2017, patients of Gartland type III supracondylar fractures of the humerus receiving surgery were all selected and reviewed. Overall, 39 patients fitting the inclusion criteria were chosen for the External Fixator Group and patients for control group of crossed pinning with matched age, sex, and clinical parameters (fracture location, injured side, and fracture type) were selected from the database. Surgery duration, number of intraoperative X-ray images, incidence of ulnar nerve injury, postoperative redisplacement, and function of the elbow joint were recorded and analyzed.
In this study, 39 patients treated with radial external fixator had significantly shorter surgery duration, fewer intraoperative X-ray images, and lower incidence of ulnar nerve injury, and postoperative redisplacement than those receiving crossed pinning. Patients in 2 groups displayed similar range of motion for elbow joint at follow-up.
Radial external fixator is an effective and safe method to treat Gartland type III supracondylar fractures that were diagnosed late.
Do Prescriptions for Expedited Partner Therapy for Chlamydia Get Filled? Findings From a Multi-Jurisdictional Evaluation, United States, 2017–2019
Authors: Slutsker Jennifer Sanderson , Tsang Lai-yi Bella , Schillinger Julia A. 
Published: March 2020

Background
Expedited partner therapy (EPT) is commonly provided by prescription; however, the efficacy of this modality is unknown. We examined whether EPT prescriptions are filled when the cost barrier is removed.

Methods
To track EPT prescription fill rates, we used single-use pharmacy vouchers that covered the cost of azithromycin, 1 g (chlamydia treatment). We recruited clinical sites to distribute vouchers to patients with chlamydia who would receive an EPT prescription under clinic policies. When distributing vouchers, sites recorded and retained: voucher unique identifier, sex and age of index patient, distribution date, and whether partner name was written on the EPT prescription. Pharmacists receiving vouchers entered the identifier, sex and age of presenting person, and redemption date into a standard pharmacy claim transmission system. Data for redeemed vouchers were retrieved from an industry portal and linked with data retained at clinical sites.

Results
Thirty-two clinical sites distributed 931 vouchers during September 2017 to January 2019; 382 (41%) were redeemed. Vouchers distributed to patients 18 years or younger (49 [30%] of 163) were less likely to be redeemed compared with those distributed to patients older than 18 years (322 [44%] of 736; P = 0.001). Just over half of vouchers were redeemed the same day (196 [56%] of 352) and 1 mile or less from the clinical site (188 [54%] of 349). After excluding an outlier site, vouchers accompanied by EPT prescriptions including a partner name (15 [56%] of 27) were more likely to be redeemed than those lacking a name (83 [34%] of 244; P = 0.03).

Conclusions
Less than half of EPT prescriptions were filled, even when medication was free. Whenever possible, EPT should be provided as drug-in-hand.
Expanding Faculty Development of Teaching Skills: A National Needs Assessment of Pediatric Critical Care Medicine Faculty
Authors: Bone Meredith F. , Mink Richard , Marcdante Karen , Czaja Angela S. , Storgion Stephanie A. , Turner David A. 
Published: March 2020

Objectives:
High-quality clinical teaching is an essential element in preparing trainees to become independently competent clinicians. In order to better understand the context-specific faculty development needs of teaching faculty in a specific community, we sought to determine the self-reported teaching skill deficits of pediatric critical care medicine faculty and their preferences and motivations regarding faculty development to enhance their teaching.

Design:
Modified Delphi technique was used to create an online survey in which respondents rated their need for education on a variety of teaching skills, their preferred learning modalities, and factors that motivate their participation in faculty development.

Setting:
Pediatric Critical Care Medicine divisions at the 64 sites in the United States with fellowship programs.

Subjects:
Five-hundred forty-five Pediatric Critical Care Medicine faculty who teach fellows and other trainees.

Interventions:
None.

Measurements and Main Results:
Response rate was 40%. Respondents reported a median of 8.5 years (interquartile range, 4–16 yr) as teaching faculty. The median age of faculty was 44.6 years (interquartile range, 38–50 yr). Only 20% of respondents indicated that improving their teaching was a low priority. Thirty-six percent of respondents had not participated in any formal teaching skill development as faculty. The most frequently cited factors motivating engagement in faculty development were education being included as part of regularly attended conferences, resources readily available when needed, and participation promoted by a supervisor. Preferred learning modalities included a brief discussion with a colleague, a 10-minute video, and a regular conference series.

Conclusions:
Pediatric Critical Care Medicine faculty reported they experience challenges in teaching and would benefit from faculty development training aimed at improving their knowledge and skills about being an educator. Preferred learning methods and motivating factors highlight the importance of efficiency in content delivery and endorsement by faculty supervisors. Consideration of these needs and preferences may be useful in creating context-focused, community of practice-based faculty development programs.
Treatment Outcomes of Pediatric Status Epilepticus in a Tertiary Pediatric Intensive Care Unit
Authors: Cavusoglu Dilek , Sınmaz Elif Esra , Dundar Nihal Olgac , Can Fulya Kamit , Anil Ayse Berna , Sarioglu Berrak 
Published: March 2020

ObjectiveStatus epilepticus is associated with high rates of morbidity and mortality; thus, early diagnosis and proper treatment are crucial. We aimed to study the etiology, clinical features, and treatment among pediatric patients with convulsive status epilepticus.MethodsThe medical records of 100 patients were retrospectively obtained from pediatric intensive care unit. Etiology, clinical features, and treatment were interpreted by using Fisher exact test, χ2test, and Spearmanρcorrelation coefficient.ResultsSeizures had stopped with the first-, second-, and third-line treatment in 29%, 36%, and 35% of the patients, respectively. Only phenytoin treatment was efficient; it has 32.3% rate in second-line treatment. Whereas mortality rate was 10%, morbidity rate was 14% during the follow-up. Epilepsy, hemiparesis, spastic tetraparesis, and mental retardation developed. Mortality was significantly much more in the patients with refractory seizure and cerebral palsy. Development of mental retardation was much higher in the male sex.ConclusionsPhenytoin is still one of the most efficient antiepileptic drugs. If the duration of status epilepticus can be shortened by prompt treatment, neurological complications may be prevented.
Dexamethasone Versus Prednisone for Pediatric Acute Asthma Exacerbations
Authors: Peterson Robert , Young Kelly D. 
Published: March 2020

Background and Objective
Dexamethasone has emerged as a viable alternative to prednisone in the treatment of pediatric acute asthma exacerbations, with the potential for improved compliance secondary to decreased frequency of dosing, improved taste, and decreased cost. The objective of this study is to identify whether providers are prescribing dexamethasone for pediatric acute asthma exacerbations. Secondary objectives are to describe variation in practice between different specialties and to identify the commonly used dosing and frequency for dexamethasone.

Methods
We conducted a cross-sectional, descriptive study with an anonymous, web-based survey (surveymonkey.com). The survey population included all fellowship program directors listed on FRIEDA Online for pediatric emergency medicine, pediatric pulmonology, and allergy and immunology, and emergency medicine residency directors through the Council of Emergency Medicine Residency Directors listserv. Program directors were contacted via e-mail up to 5 times for 3 months.

Results
Overall, 300 respondents (70% of the program directors) completed the survey. Response rates by specialty varied from 60% to 94%. One third of providers are using dexamethasone, whereas just more than half of providers (51%) are prescribing a 5-day prednisone course. The preferred maximum dose for dexamethasone is 10 mg (45%), with 82% using a dose of 0.6 mg/kg.
Pediatric emergency medicine fellowship directors demonstrated a preference for dexamethasone (59%). Prednisone is favored by emergency medicine (56%), pediatric pulmonology (89%), and allergy and immunology (93%) program directors.

Conclusions
Although most pediatric emergency medicine academic physicians have transitioned to using dexamethasone to treat acute pediatric asthma exacerbations, other specialties continue to favor prednisone.
Perceived Barriers of Modified Ride-On Car Use of Young Children With Disabilities: A Content Analysis
Authors: Logan Samuel W. , Feldner Heather A. , Bogart Kathleen R. , Catena Michele A. , Hospodar Christina M. , Raja Vora Joseline , Smart William D. , Massey William V. 
Published: March 2020

Purpose:
Modified ride-on cars have emerged as an early powered mobility option for young children with disabilities. The purpose of this study was to identify, extract, and synthesize perceived barriers of modified ride-on car use reported in previous studies.

Methods:
This study was descriptive using a qualitative content analysis of previously published studies identified from a systematic literature search.

Results:
Categories of perceived barriers were identified: device, environmental, child-related perceived barriers regarding health, tolerance, and abilities, and caregiver-related perceived barriers regarding physical requirements, time, and motivation. Device and environmental perceived barriers were the most reported.

Conclusions:
Pediatric physical therapists play a critical role in working with families to promote their self-efficacy for using the modified ride-on car and their capacity for overcoming the inherent difficulties associated with use. Most of the reported perceived barriers are modifiable, at least to some degree, with likely effects on modified ride-on car use.
Segmental Spinal Myoclonus After a Cervical Transforaminal Epidural Steroid Injection
Authors: Boudier-Revéret Mathieu , Chang Min Cheol 
Published: March 2020

Abstract
In clinical practice, cervical transforaminal epidural steroid injection is commonly used for alleviating pain. We report a case of segmental spinal myoclonus that developed after cervical transforaminal local anesthetic and steroid injection. A 39-yr-old man presented involuntary movements of the bilateral upper trapezius muscles after cervical transforaminal epidural steroid injection on the right C6 and C7 roots with a 5 mg of dexamethasone injectate mixed with 0.5 ml of 1% lidocaine and 0.5 ml of normal saline at each level. His myoclonus was semirhythmic and continuously persisted at a frequency of approximately 30 episodes per minute. The myoclonus continued even at rest and during sleep. In addition, it was resistive to stimulus, such as touch and voluntary action. Based on the clinical features, the patient was diagnosed as having a segmental spinal myoclonus. Clonazepam 0.25 mg was administered three times daily. The myoclonus gradually improved and resolved completely within 2 wks. Segmental spinal myoclonus is one of rare complications after cervical transforaminal epidural steroid injection. Clinicians should be aware of the likelihood of this potential complication.
Quality and Safety in Healthcare, Part LXVII
Authors: Harolds Jay A. 
Published: March 2020

Abstract
There are many approaches to improving the well-being of medical students such as having a wellness curriculum including emphasizing the importance of keeping a balance in life between work and other activities, encouraging mindfulness and other stress reduction techniques, getting adequate sleep and exercise, and learning about the signs of burnout and depression. It is also important to have mentoring services and discussion groups available and to offer counseling for monetary management. Mental health services must be made available, and the students should be advised that seeking treatment will not adversely affect their ability to get a license or a good residency. The students should be counseled that being employed while in medical school is associated with a greater chance of burnout.
Colon Sarcoidosis Mimicking Cancer at 18F-FDG PET/CT
Authors: Mei Riccardo , Prediletto Irene , Nava Stefano , Fanti Stefano , Ambrosini Valentina 
Published: March 2020

Abstract
This 68-year-old woman with a 9-year history of skin sarcoidosis presented with abdominal pain, bloating, and diarrhea. Following positive occult fecal blood, a diagnosis of ascending colon sarcoidosis was pathologically confirmed after colonoscopy. FDG PET/CT was performed for sarcoid staging, and the ascending colon demonstrated the only focal site of active sarcoidosis (SUVmax = 10).
National Trends in Hospitalization Charges for Autologous Free Flap Breast Reconstruction
Authors: Cai Yida , Boas Samuel R. , Summerville Lesley , Kumar Anand 
Published: March 2020

Background
There is significant cost variation among patients undergoing autologous free flap breast reconstruction. Previous studies hypothesize that factors like length of stay and hospital volume are key drivers of cost; however, how these factors have affected cost have not been well studied. Our study analyzes the factors influencing hospital charges relating to these procedures and their trends over a multiyear time frame.

Methods
The Healthcare Cost and Utilization Project's National Inpatient Sample database was analyzed from January 2009 to December 2014. All female patients who were diagnosed with breast cancer or at a high risk for breast cancer who underwent autologous free flap breast reconstruction were included. Variables of interest included demographic data, hospital characteristics, hospitalization data, and total hospital charges. Univariate and generalized linear models were used to examine associations between selected variables and the hospitalization charges, as well as trends in these factors over the years included.

Results
There were 659,220 female patients diagnosed with breast cancer or had a high risk of breast cancer between 2009 and 2014. Of these patients, 20,050 (3.0%) received autologous free flap breast reconstruction and were included. The mean total hospital charge was US $98,839.33 (SD = US $61,532.04). Regression analysis showed that the proportion of procedures to the total population of potential patients significantly increased over the selected time frame (P = 0.02). The average total charges also increased significantly (P < 0.01), despite a decrease in length of stay (P = 0.05). Procedures performed in the west were associated with significantly higher charges when compared with other regions (US $147,855.42, P < 0.001). Higher hospital charges were also associated with urban hospitals, regardless of teaching status.

Conclusions
The overall demand for the autologous free flap breast reconstruction is increasing within the patient population, in conjunction with increasing associated hospital charges. This increase in cost is seen despite an overall decrease in length of stay, originally thought to be the main contributor to regional cost variation. Further studies should be done to develop strategies to better target increased hospitalization charges, because the overall health care burden of this procedure is expected to rise if current trends continue.
Sclerotherapy for Venous Malformations of the Pharynx or the Tongue Base Without Tracheostomy: Treatment Protocol With Intubation and Outcomes
Authors: Iwashina Yuki , Ozaki Mine , Wong Manzhi , Ihara Aki , Fujiki Masahide , Takushima Akihiko , Harii Kiyonori 
Published: March 2020

Abstract
Venous malformations (VMs) occurring in the tongue base or pharynx are rare, but can cause airway obstruction. Considering the potential issues or morbidity related to surgical resection in the tongue or pharynx region, sclerotherapy is often preferred. We perform sclerotherapy for such lesions without conducting tracheotomy, but keep patients intubated for a certain period. Outcomes of sclerotherapy, and benefits and cautions related with our protocol were investigated.
Our subjects were 10 cases in 9 patients who underwent sclerotherapy for VMs of the tongue base (6 patients) or pharynx (3 patients) from 2008 to 2017. One patient underwent treatment sessions twice. The sclerosants used were absolute ethanol (ET) (3 cases), 5% ethanolamine oleate (EO) (4 cases), or both ET and 5%EO (3 cases).
In 5 of 9 patients, postoperative MRI was performed, which revealed lesion volume reduction by 12% to 47%. The intubation period varied according to the sclerosant used: ET, 5 to 11 days; 5% EO, 2 to 12 days; and combination of ET and 5% EO, 8 days. Postoperative complications included fever of unknown (n = 2), acute psychosis (n = 3), vocal cord paralysis (n = 2), and bradycardia induced from the use of a sedative agent (n = 1). One patient complained of mild transient swallowing difficulty that lasted for a month postoperatively.
Although our method mandatorily requires careful postoperative management in an ICU, including sedation with anesthetic agents and artificial respiration by intubation for a certain period of time, no serious complications or post-therapeutic morbidities occurred.
Abnormal Formation of External Jugular Vein and its Repercussions
Authors: Singh Rajani 
Published: March 2020

Abstract
External jugular vein is formed by joining of posterior division of retromandibular vein and posterior auricular vein and common facial vein drain into internal jugular vein.
Variations are not uncommon and these are more often observed in veins than in arteries. Aim of the study is to report the prevalence of unique variation of formation of external jugular vein.
Head and neck of 6 cadavers (12 sides) fixed in 10% formalin were dissected in the department of anatomy AIIMS Rishikesh for the variant formation of external jugular vein.
Abnormal formation of external jugular vein was detected in 1 cadaver on left side. The mean age of the cadavers was 70 years. The retromandibular vein divided into anterior and posterior divisions 2.5 cm below the angle of mandible. The facial, after travelling for 6 cm below the mandible, along with anterior and posterior divisions abnormally joined to form the external jugular vein. This is unique and rare finding.
External jugular vein is used for assessment of venous pressure in right atrium and for catheterization. The variation may give false value of pressure due to facial vein draining into it, also create difficulty in catheterization. In addition to this, these veins are also used for various other procedures like carotid endarterectomy and for oral reconstruction surgeries. Thus facial vein and external jugular vein variations are of paramount importance to head and neck surgeons, anatomists and anesthetist.
The Superior Ophthalmic Vein: Anatomical Perspective for Transvenous Access to the Cavernous Sinus
Authors: Tsutsumi Satoshi , Ono Hideo , Yasumoto Yukimasa , Ishii Hisato 
Published: March 2020

Abstract
The anatomical characteristics of the superior ophthalmic vein (SOV), which is crucial when performing craniofacial surgeries and transvenous access to the cavernous sinus, have not been documented. The present study aimed to explore them using magnetic resonance angiography (MRA). A volumetric, phase-contrast MRA was performed in 74 outpatients not bearing vascular or tumorous pathologies in the face, orbit, and cavernous sinus. The entire course of the SOV was delineated in 46 patients (62%), for 76% on the right side and 83% on the left. These SOVs consistently showed a characteristic morphology with a laterally coursing proximal segment and a medially coursing distal segment. The latter segment was connected to the angular, supraorbital, supratrochlear, facial, and external nasal veins that were inconsistently delineated. The angular vein was tortuous in 51% of the patients on the right and 53% on the left. The morphology of the proximal part of the SOV was also variable and involved a tortuous segment in 11% of the patients on the right and in 7% on the left. Furthermore, in 4 patients (8.7%), a fenestration was found in the right SOVs. Inconsistent tributaries of the SOV, tortuous angular vein, and possible tortuous segment and fenestration of the SOV can make orbital transvenous access to the cavernous sinus difficult.