bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shilla Growth Guidance Compared With Magnetically Controlled Growing Rods in the Treatment of Neuromuscular and Syndromic Early-onset Scoliosis
Authors: Haapala Hermanni , Saarinen Antti J. , Salonen Anne , Helenius Ilkka 
Published: August 2020

Study Design.
Retrospective review of consecutive series of patients treated at two institutions.

Objective.
The aim of this study was to compare the health-related quality of life (HRQoL) and surgical outcomes of Shilla growth guidance and magnetically controlled growing rod (MCGR) treatment in patients with syndromic and neuromuscular early-onset scoliosis (EOS).

Summary of Background Data.
Knowledge of the outcomes of Shilla instrumentation is limited.

Methods.
We identified 13 children treated with Shilla and 18 children treated with MCGR with syndromic or neuromuscular EOS (major curve ≥45 degree) before the age of 10 years with minimum 2-year follow-up. Outcome parameters included clinical data, radiographic as well as HRQoL outcomes (EOSQ-24 questionnaire).

Results.
Mean preoperative major curves were 64 degree (range, 45–108 degree) in the Shilla group and 58 degree (range, 45–85 degree) in the MCGR group (P = 0.151). At final follow-up, mean major curves were 31 degree (range, 9.4–54 degree ) and 30 degree (range, 16–53 degree), respectively (P = 0.392). The mean major curve correction was 45% in the Shilla group and 48% in the MCGR group during the follow-up (P = 0.383). Spinal (T1-S1) and T1-T12 growth were significantly better (P = 0.006 and 0.042) in the MCGR than in the Shilla group during the distraction period. At final follow-up, 11 (85%) children in the Shilla group and 17 (94%) in the MCGR group had achieved T1-T12 length of ≥18 cm (P = 0.202). There were significantly more surgical procedures in the MCGR group (mean 2.6 vs. 1.4, P = 0.034) with no difference in the number of complications (P = 0.768). EOSQ24 domains were similar at final follow-up.

Conclusion.
Shilla growth guidance provided similar correction of spinal deformity, equal number of complications, but with significantly less surgical procedures in patients treated for EOS when compared with MCGR instrumentation. MCGR provided with slightly better spinal growth during the distraction period. There were no significant differences between the quality of life assessments.

Level of Evidence: 3
Corneal Scheimpflug Densitometry in Photorefractive Keratectomy Candidates
Authors: Pakbin Mojgan , Khabazkhoob Mehdi , Pakravan Mohammad , Fotouhi Akbar , Jafarzadehpur Ebrahim , Aghamirsalim Mohamadreza , Hashemi Hassan 
Published: August 2020

Purpose:
To describe the normative data of corneal densitometry in photorefractive Keratectomy (PRK) candidates by using a Scheimpflug camera.

Methods:
Five hundred twenty-two eyes of 261 PRK candidates that underwent comprehensive optometric and ophthalmic examinations were enrolled in this study. Corneal densitometry values were obtained using a Scheimpflug camera (Pentacam HR; Oculus Optikgeräte GmbH, Wetzlar, Germany) and displayed in grayscale units (GSU).

Results:
Of 261 participants, 187 (71.6%) were women. The mean age of the participants was 28.79 ± 5.02 years (range: 21–40 years). The mean entire corneal densitometry was 14.86 ± 2.37 GSU. According to corneal depth, maximum and minimum densitometry values were seen in the anterior (30.28 ± 7.42 GSU) and posterior (9.86 ± 2.08 GSU) layers, respectively (P < 0.001). Based on the annulus over the cornea, the highest and lowest densitometry values were seen in the 10- to 12-mm (21.31 ± 4.26 GSU) and 2- to 6-mm zones (13.26 ± 2.34 GSU), respectively. However, this difference was not seen after 35 years of age. Individuals aged 30 to 35 years showed higher corneal densitometry values compared with subjects aged 20 to 25 years old (P < 0.001). In generalized linear models, the corneal thickness was associated with the densitometry value in the central and posterior corneal layers. There were no significant differences in sex and refractive errors among participants.

Conclusions:
This study provided normal corneal densitometry data in PRK candidates. Corneal densitometry increased with age until 35 years of age and then decreased thereafter. This finding should be considered in patient selection for PRK and their postoperative examinations.
Concordance analysis of intrapartum cardiotocography between physicians and artificial intelligence-based technique using modified one-dimensional fully convolutional networks
Authors: Liu Li-Chun , Tsai Ya-Hui , Chou Yu-Ching , Jheng Ying-Chun , Lin Chi-Kang , Lyu Ning-Yuan , Chien Yueh , Yang Yi-Pin , Chang Kao-Jung , Chang Keng-Hao , Lee Yi-Liang , Wang Peng-Hui , Chu Ta-Wei , Chang Cheng-Chang 
Published: August 2020

Background:
Cardiotocography is a common method of electronic fetal monitoring (EFM) for fetal well-being. Data-driven analyses have shown potential for automated EFM assessment. For this preliminary study, we used a novel artificial intelligence method based on fully convolutional networks (FCNs), with deep learning for EFM evaluation and correct recognition, and its possible role in evaluation of nonreassuring fetal status.

Methods:
We retrospectively collected 3239 EFM labor records from 292 deliveries and neonatal Apgar scores between December 2018 and July 2019 at a single medical center. We analyzed these data using an FCN model and compared the results with clinical practice.

Results:
The FCN model recognized EFM traces like physicians, with an average Cohen’s kappa coefficient of agreement of 0.525 and average area under the receiver operating characteristic curve of 0.892 for six fetal heart rate (FHR) categories. The FCN model showed higher sensitivity for predicting fetal compromise (0.528 vs 0.132) but a higher false-positive rate (0.632 vs 0.012) compared with clinical practice.

Conclusion:
FCN is a modern technique that may be useful for EFM trace recognition based on its multiconvolutional layered analysis. Our model showed a competitive ability to identify FHR patterns and the potential for evaluation of nonreassuring fetal status.
Lessons From the Frontlines
Authors: Sagalowsky Selin Tuysuzoglu , Roskind Cindy Ganis , Fein Daniel M. , Teng David , Jamal Nazreen 
Published: August 2020

Abstract
The global pandemic novel coronavirus 2019 has upended healthcare and medical education, particularly in disease epicenters such as New York City. In this piece, we seek to describe the collective experiences and lessons learned by the New York City pediatric emergency medicine fellowship directors in clinical, educational, investigative, and psychological domains, in hopes of engendering conversation and informing future disaster response efforts.
The Inner Annulus Fibrosus Encroaches on the Nucleus Pulposus in the Injured Mouse Tail Intervertebral Disc
Authors: Wei Yulong , Tian Zuozhen , Tower Robert J. , E. Gullbrand Sarah , Yao Lutian , Shetye Snehal S. , Mauck Robert L. , Qin Ling , Zhang Yejia 
Published: August 2020

Objective
The aim was to identify the source of cells within the center of the abnormal fibrocartilage tissue of the degenerative intervertebral disc after injury.

Design
Cross-breeding of mice with an inducible type II promoter collagen construct (Col2CreER) to Rosa26-TdTomato mice has been shown to result in Cre-recombinase activity and Tomato expression in inner annulus fibrosus cells after tamoxifen injection. To investigate the role of the inner annulus fibrosus in the intervertebral disc injury response, tail intervertebral discs of Col2CreER/tdTomato mice were punctured with a needle and examined 1–4 wks after injury. N-cadherin was examined by immunostaining.

Results
After the injury, the fibrocartilage in the degenerative intervertebral disc consisted of residual diseased nucleus pulposus cells and encroaching inner annulus fibrosus cells. The residual nucleus pulposus cells had lost their epithelial cell–like morphology and instead became oval shaped, with reduced adhesion to neighboring nucleus pulposus cells. This change in cellular morphology coincided with a loss of N-cadherin, which contributes to maintenance of healthy nucleus pulposus cell morphology. As expected, injured tail intervertebral discs showed reduced compressive properties as determined by biomechanical assessments.

Conclusions
The cellular composition of the degenerative intervertebral disc has been defined here, which is an important step in developing future treatments.
Familial Tuberculum Sellae Meningiomas
Authors: Zhou Peng , Wei Li , Shi Jia , Shao Naiyuan 
Published: August 2020

Objectives:
The aim of this study was to study and explore the genetic mechanism of familial meningiomas through 3 cases of familial tuberculum sellae meningioma.

Methods:
A retrospective analysis of clinical data of 3 cases of familial tuberculum sellae meningioma patients, and the pathological results of types and immunohistochemical results of the 3 patients were compare.

Reults:
Three cases of postoperative pathology were meningiomas (mixed type), immunohistochemical examination showed that Vimentin, epithelial membrain antigen , and Ki67 were positive.

Conclusions:
The occurrence of meningiomas is associated with ≥1 chromosomal deletions, and the absence of certain tumor suppressor genes may be the genetic basis for the familial growth of meningiomas.
Cranioplasty for Skull Defect With Polypropylene Abdominal Wall Mesh
Authors: Abuzayed Bashar , Al-Abadi Husesein , Jamous Osama , Said Anas , Alawneh Khaled 
Published: August 2020

Abstract
Cranioplasty is a routine procedure in the practice in neurosurgery and craniofacial surgery. For the closure of the cranial defect, it may be difficult or impossible to split the bone sufficiently to obtain enough bone for complete closure of the defect in younger children. Thus, sometimes there is the need to use allografts, which may not be widely available in rural practice. We present 2 cases of cranioplasty with widely available and used polypropylene abdominal wall mesh. To add rigidity to the construct, the mesh was organized in a multilayered fashion. Postoperative follow-up showed good functional and cosmetic results.
Pre-Planned Cranioplasty Using Computer-Assisted Designed Temporalis Muscle Augmentation in Patients With Decompressive Craniectomy Involving Resection of the Temporalis Muscle
Authors: Park Gwangtae , Kim Jonghoon , Chang Chulhoon , Jung Youngjin 
Published: August 2020

Background:Decompressive craniectomy (DC) is the last-resort surgical procedure to reduce intracranial pressure and prevent secondary brain injury. Additional resection of the temporalis muscle and fascia can achieve a higher extracranial herniation volume compared to the standard DC technique at the expense of cosmetic problems for the patients. Various methods have been used to augment temporal fossa hollowing.Methods:To improve the cosmetic outcome, the authors report a patient who had a skull defect restored using a precisely shaped implant engineered via a computer using the opposite temporalis muscle as a mirror image. Polyether-ether-ketone cranioplasty was performed for the 52-year-old man with temporal hollowing after DC with resection of the temporalis muscle and fascia, due to a ruptured cerebral arteriovenous fistula.Results:The shape of the patient's surgical side was restored and not asymmetrical. The patient was very satisfiedConclusion:In the case of cranioplasty (CP) in patients with DC with resection of the temporalis muscle, CP with implants that include the opposite muscle may increase patient satisfaction without the risk of additional complications.
Bone Morophogenetic Protein Application as Grafting Materials for Bone Regeneration in Craniofacial Surgery: Current Application and Future Directions
Authors: Cicciù Marco , Fiorillo Luca , Cervino Gabriele , Habal Mutaz B. 
Published: August 2020

Abstract
Rebuilding atrophied alveolar ridges can present a significant challenge for the maxillofacial surgeons. A multitude of treatment options including guided bone regeneration, onlay block grafting, and distraction osteogenesis are today available as safe procedures.
The recent Food and Drug Administration approval of recombinant human bone morphogenetic proteins (rhBMPs) has given clinicians an added treatment option for reconstructing localized and large jaw defects. Currently, several patients have been successfully treated with the combination of bone graft and rhBMP-2 and the results have been documented as predictable and safe by clinical and radiologic examinations follow-up. In this study, a literature review was conducted using Medline, Medpilot, and Cochrane Database of Systematic Reviews. It was concentrated on manuscripts and overviews published in the last 20 years (2000–2020). The key terms employed were platelet-rich plasma, rhBMPs, and their combinations with the common scaffolds used for bone regeneration techniques. The results of clinical studies and animal trials were especially emphasized. The statements from the literature were compared with authors’ own clinical data.
The potential to reconstruct these large bone defects with a growth factor thus limiting or even avoiding a secondary harvest site is exciting and it represents a new frontier in the field of surgery. This study data confirm how there are excellent documents about the possible combination of using substitute materials and growth factor for treating large and minor craniofacial bone defects.
Relationship Between Health Care Spending and Clinical Outcomes in Bariatric Surgery
Authors: Chhabra Karan R. , Ghaferi Amir A. , Yang Jie , Thumma Jyothi R. , Dimick Justin B. , Tsai Thomas C. 
Published: August 2020

Objective:
To evaluate sources of 90-day episode spending variation in Medicare patients undergoing bariatric surgery and whether spending variation was related to quality of care.

Summary of Background Data:
Medicare's bundled payments for care improvement-advanced program includes the first large-scale episodic bundling program for bariatric surgery. This voluntary program will pay bariatric programs a bonus if 90-day spending after surgery falls below a predetermined target. It is unclear what share of bariatric episode spending may be due to unnecessary variation and thus modifiable through care improvement.

Methods:
Retrospective analysis of fee-for-service Medicare claims data from 761 acute care hospitals providing inpatient bariatric surgery between January 1, 2011 and September 30, 2016. We measured associations between patient and hospital factors, clinical outcomes, and total Medicare spending for the 90-day bariatric surgery episode using multivariable regression models.

Results:
Of 64,537 patients, 46% underwent sleeve gastrectomy, 22% revisited the emergency department (ED) within 90 days, and 12.5% were readmitted. Average 90-day episode payments were $14,124, ranging from $12,220 at the lowest-spending quintile of hospitals to $16,887 at the highest-spending quintile. After risk adjustment, 90-day episode spending was $11,447 at the lowest quintile versus $15,380 at the highest quintile (difference $3932, P < 0.001). The largest components of spending variation were readmissions (44% of variation, or $2043 per episode), post-acute care (19% or $871), and index professional fees (15% or $450). The lowest spending hospitals had the lowest complication, ED visit, post-acute utilization, and readmission rates (P < 0.001).

Conclusions and Relevance:
In this retrospective analysis of Medicare patients undergoing bariatric surgery, the largest components of 90-day episode spending variation are readmissions, inpatient professional fees, and post-acute care utilization. Hospitals with lower spending were associated with lower rates of complications, ED visits, post-acute utilization, and readmissions. Incentives for improving outcomes and reducing spending seem to be well-aligned in Medicare's bundled payment initiative for bariatric surgery.
Surgical Outcomes After Neoadjuvant Chemoradiation Followed by Curative Surgery in Patients With Esophageal Cancer
Authors: von Holzen Urs , Schmidt Sven , Hayoz Stefanie , Steffen Thomas , Grieder Felix , Bartsch Detlef , Schnider Annelies , Knoefel Wolfram-Trudo , Piessen Guillaume , Kettelhack Christoph , Marti Walter R. , Schäfer Markus , Függer Reinhold , Köigsrainer Alfred , Gloor Beat , Furrer Markus , Gérard Marie-Aline , Hawle Hanne , Walz Martin K. , Alesina Piero , Ruhstaller Thomas 
Published: August 2020

Objective:
To assess the impact of surgical technique in regard to morbidity and mortality after neoadjuvant treatment for esophageal cancer.

Background:
The SAKK trial 75/08 was a multicenter phase III trial (NCT01107639) comparing induction chemotherapy followed by chemoradiation and surgery in patients with locally advanced esophageal cancer.

Methods:
Patients in the control arm received induction chemotherapy with cisplatin and docetaxel, followed by concomitant chemoradiation therapy with cisplatin, docetaxel, and 45Gy. In the experimental arm, the same regimen was used with addition of cetuximab. After completion of neoadjuvant treatment, patients underwent esophagectomy. The experimental arm received adjuvant cetuximab. Surgical outcomes and complications were prospectively recorded and analyzed.

Results:
Total of 259 patients underwent esophagectomy. Overall complication rate was 56% and reoperation rate was 15% with no difference in complication rates for transthoracic versus transhiatal resections (56% vs 54%, P = 0.77), nor for video assisted thoracic surgeries (VATS) versus open transthoracic resections (67% vs 55%, P = 0.32). There was a trend to higher overall complication rates in squamous cell carcinoma versus adenocarcinoma (65% vs 51%, P = 0.035), and a significant difference in ARDS in squamous cell carcinoma with 14% versus 2% in adenocarcinoma (P = 0.0002). For patients with involved lymph nodes, a lymph node ratio of ≥0.1 was an independent predictor of PFS (HR 2.5, P = 0.01) and OS (HR 2.2, P = 0.03).

Conclusions:
This trial showed no difference in surgical complication rates between transthoracic and transhiatal resections. For patients with involved lymph nodes, lymph node ratio was an independent predictor of progression free survival and overall survival.
Lithium Use During Pregnancy in a Patient With Bipolar Disorder and Multiple Sclerosis
Authors: Lorettu Liliana , Carpita Barbara , Nivoli Alessandra , Milia Paolo , De Iorio Giovanni , Cremone Ivan Mirko , Dell'Osso Liliana 
Published: August 2020

Abstract
Although lithium is widely used as a first-line treatment for mood disorders, its mood-stabilizing effects remain not fully understood. A growing body of data are stressing that lithium seems to show broader properties, including neuroprotective effects. Lithium's ability to inhibit glycogen synthase kinase 3β, an enzyme that participates in the phosphorylation of τ, a microtubule-associated protein, stimulated interest in its possible therapeutic role in Alzheimer disease and other neurodegenerative disorders. Preliminary data also support exploration of lithium's potential therapeutic role in multiple sclerosis, an autoimmune disorder that is associated with co-occurring mood disorders. Lithium is associated with teratogenic risks to the developing fetus; however, recently revised downward estimates of its teratogenic risk of causing fetal cardiac malformation suggest that its potential therapeutic benefit to both mothers with bipolar disorder and their offspring should be considered in at least some cases. A 43-year-old woman previously diagnosed with bipolar disorder and MS was treated with lithium and thyroid hormone supplementation as her sole medications during her pregnancy. The patient remained euthymic throughout her pregnancy and over the course of her 5-year follow-up evaluations on this medication regimen. In addition to her stable mood, there has been no symptomatic progression or relapse of her MS, and her daughter continues to develop normally.
The case supports consideration of balancing lithium's mood-stabilizing benefit with its known teratogenic risk during pregnancy. The case also supports exploration of possible additional benefit in the context of MS co-occurring with bipolar disorder.
Key themes in recent research on interpersonal functioning in borderline personality disorder
Authors: Michael John , van Baal Simon 
Published: August 2020

Purpose of review
We provide an overview of new ideas and directions of research on interpersonal functioning in borderline personality disorder (BPD).

Recent findings
We highlight the following key themes emerging in recent and ongoing research: investigation of the cognitive and motivational mechanisms which underpin impairments of interpersonal functioning in BPD, tracking BPD across the lifespan with earlier interventions and longitudinal studies, expansion of the scope of interest to family members of individuals with BPD and to people in the general population with levels of BPD traits, and investigating BPD online, not only by using internet-based testing platforms but also by studying the social media use of individuals with BPD.

Summary
The concise discussion of recent research on BPD provided here, together with the identification of key themes emerging from this work, provides a snapshot of ongoing work devoted to better understanding interpersonal functioning in borderline personality disorder.
Three-dimensionally preserved ‘Stage IIIb’ fossil down feather supports developmental modularity in feather evolution
Authors: Roy Arindam , Miller Case V. , Pittman Michael , Kaye Thomas G. , Peretti Adolf 
Published: August 2020

AbstractWe describe a unique three-dimensionally preserved fossil down feather from the Late Cretaceous of Myanmar. It’s morphology is highly congruent with Stage IIIb of the widely accepted Prum and Brush model of feather evolution-development. This makes the new specimen the first evidence of this developmental stage in the fossil record. The Stage IIIb diagnosis is robustly supported by the absence of a central rachis and by its paired barbules emanating from radially positioned barbs that are attached to a short calamus. Prum and Brush’s model hypothesises a bifurcation in the evolution-development pathway at Stage III. Stage IIIa involves rachis development and branching into barbs. Stage IIIb involves branching of the barbs from the calamus and then further branching of the barbules from the barbs. These two pathways then converge into Stage IIIa+b where feathers produce a rachis, barbs and barbules in nested order, finally leading to Stage IV. Evolution-development studies on the morphogenesis of feathers have unequivocally shown that such feather branching can be controlled by BMP, Noggin, Shh and several other proteins. Therefore, molecular crosstalk can convert a barb into a rachis and vice versa. The topology of this down feather, consistent with specific patterns of modular protein-protein signalling already observed, provides the first definitive evidence that such signalling was responsible for the evolution of a diverse inventory of feather morphologies in non-avialan dinosaurs and early birds since the middle Jurassic.