bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extracorporeal Membrane Oxygenation Support for Pediatric Burn Patients: Is It Worth the Risk?*
Authors: Thompson Kelly B. , Dawoud Fakhry , Castle Shannon , Pietsch John B. , Danko Melissa E. , Bridges Brian C. 
Published: March 2020

Objectives:
Examine the outcomes of pediatric burn patients requiring extracorporeal membrane oxygenation to determine whether extracorporeal membrane oxygenation should be considered in this special population.

Design:
Retrospective cohort study.

Setting:
All extracorporeal membrane oxygenation centers reporting to the Extracorporeal Life Support Organization.

Subjects:
Pediatric patients (birth to younger than 18 yr) who were supported with extracorporeal membrane oxygenation with a burn diagnosis between 1990 and 2016.

Interventions:
None.

Measurements and Main Results:
A total of 113 patients were identified from the registry by inclusion criteria. Patients cannulated for respiratory failure had the highest survival (55.7%, n = 97) compared to those supported for cardiac failure (33.3%, n = 6) or extracorporeal cardiopulmonary resuscitation (30%, n = 10). Patients supported on venovenous extracorporeal membrane oxygenation for respiratory failure had the best overall survival at 62.2% (n = 37). Important for the burn population, rates of surgical site bleeding were similar to other surgical patients placed on extracorporeal membrane oxygenation at 22.1%. Cardiac arrest prior to cannulation was associated with increased hospital mortality (odds ratio, 3.41; 95% CI, 0.16–1.01; p = 0.048). Following cannulation, complications including the need for inotropes (odds ratio, 2.64; 95% CI, 1.24–5.65; p = 0.011), presence of gastrointestinal hemorrhage (p = 0.049), and hyperglycemia (glucose > 240 mg/dL) (odds ratio, 3.42; 95% CI, 1.13–10.38; p = 0.024) were associated with increased mortality. Of patients with documented burn percentage of total body surface area (n = 19), survival was 70% when less than 60% total body surface area was involved.

Conclusions:
Extracorporeal membrane oxygenation could be considered as an additional level of support for the pediatric burn population, especially in the setting of respiratory failure. Additional studies are necessary to determine the optimal timing of cannulation and other patient characteristics that may impact outcomes.
Role of Salivary Biomarkers in Predicting Significant Traumatic Brain Injury
Authors: Yeung Claudia , Bhatia Rahul , Bhattarai Bikash , Sinha Madhumita 
Published: March 2020

Objectives
The highest rates of traumatic brain injury (TBI)–related morbidity and mortality occur in young children and adolescents. The objective of this study was to describe the levels of 3 biomarkers (S100B, glial fibrillary acidic protein, neuron-specific enolase) in saliva of children with TBI requiring inpatient admission at a pediatric trauma center and compare these levels in children without TBI.

Methods
A convenience sample of 24 children aged 0 to 18 years, presenting with acute isolated TBI, was enrolled prospectively. The non-TBI comparison groups consisted of patients with medical complaints and musculoskeletal injuries only. Salivary specimens were collected, and biomarkers were measured using quantitative enzyme-linked immunosorbent assay method. Demographic, clinical data, and brain imaging findings were obtained.

Results
Seventy-four children were enrolled. Twenty-four had TBI (mean age, 5.07 years; SD, 4.8 years); 14 subjects (58.3%) with TBI were found to have significant traumatic brain injury (SBI) on computed tomography scan. S100B levels were significantly higher in TBI group compared with those with musculoskeletal injury only (median, 113.2 pg/mL vs 18 pg/mL; P = 0.021). Area under the receiver operating characteristic curve for S100B in predicting SBI was 0.675; the optimum threshold for S100B to achieve the optimum sensitivity and specificity of SBI was at 86.9 pg/mL for SBI versus no injury group.

Conclusions
S100B levels in saliva were higher in children with TBI and may be predictive of SBI identified by presence of computed tomography abnormalities. Larger studies are needed to replicate our findings in using a noninvasive diagnostic measure for children with TBI and SBI.
Quantification of Avoidable Radiation Exposure in Interventional Fluoroscopy With Eye Tracking Technology
Authors: Zimmermann Jan Michael , Vicentini Luca , Van Story David , Pozzoli Alberto , Taramasso Maurizio , Lohmeyer Quentin , Maisano Francesco , Meboldt Mirko 
Published: March 2020

Objectives
Reducing avoidable radiation exposure during medical procedures is a top priority. The purpose of this study was to quantify, for the first time, the percentage of avoidable radiation during fluoroscopically guided cardiovascular interventions using eye tracking technologies.

Materials and Methods
Mobile eye tracking glasses were used to measure precisely when the operators looked at a fluoroscopy screen during the interventions. A novel machine learning algorithm and image processing techniques were used to automatically analyze the data and compute the percentage of avoidable radiation. Based on this percentage, the amount of potentially avoidable radiation dose was computed.

Results
This study included 30 cardiovascular interventions performed by 5 different operators. A significant percentage of the administered radiation (mean [SD], 43.5% [12.6%]) was avoidable (t
29 = 18.86, P < 0.00001); that is, the operators were not looking at the fluoroscopy screen while the x-ray was on. On average, this corresponded to avoidable amounts of air kerma (mean [SD], 229 [66] mGy) and dose area product (mean [SD], 32,781 [9420] mGycm2), or more than 11 minutes of avoidable x-ray usage, per procedure.

Conclusions
A significant amount of the administered radiation during cardiovascular interventions is in fact avoidable.
18F-FDG PET/CT Findings in a Patient With Neutrophilic Leukemoid Reaction Associated With Multiple Myeloma
Authors: An Caixia , Zhai Luoping , Geng Huixia , Wang Pingzhi , Zhang Wanchun 
Published: March 2020

Abstract

18F-FDG PET/CT was performed on a 48-year-old woman with leukocytosis (white blood cell count 57.10 × 109/L, 84.0% neutrophils) and monoclonal gammopathy to investigate the possibility of reactive neutrophilia secondary to plasmacytoma. On the background of skeletal “superscan,” the maximum intensity projection image of PET demonstrated the highest metabolic region in the left sacrum, which was confirmed as an osteolytic lesion by CT. Biopsy of the sacral lesion revealed a plasma cell myeloma, indicating the diagnosis of neutrophilic leukemoid reaction associated with multiple myeloma. The white blood cell counts dramatically dropped to the normal level after 1 cycle of chemotherapy for multiple myeloma.
New Technique for Correcting Bony Deformity in Racquet Thumb
Authors: Du Zijing , Cui Yan , Hao Jiang , Cao Yi , Han Jialuan , Du Chao , Han Dong 
Published: March 2020

This article aims to present a new method for correcting bony deformity in racquet thumb.

Methods
We operated on 37 thumbs of 32 patients (age, 17–52 years) with racquet thumb using a procedure that included narrowing the nail bed, recreating the lateral nail fold, making a bone defect in the widened proximal base, and exposing more proximal nail bed. The ratio of the length to the width of the nail was calculated.

Results
The ratio of the length to the width of the nail increased from 0.55 before surgery to 0.78 at the final follow-up visit. Most patients were satisfied with the cosmetic and functional results.

Conclusions
This technique is simple, safe, and both cost- and time-effective and is a good option for the repair of racquet thumb.
Changes in Opioid Prescribing Patterns
Authors: Ovadia Steven A. , Garcia Onelio , Thaller Seth R. 
Published: March 2020

Introduction
With thousands of people in the United States dying of opioid overdose each month, the opioid epidemic has become a serious public health concern. Legislators have attempted to address this problem at various levels of the government. Evaluation of outcomes of these measures is a necessary part of resolving the epidemic. Our survey was designed to evaluate the impact of measures enacted in Florida State in 2018 upon prescribing practices of plastic surgeons.

Methods
The survey was prepared electronically using the online Qualtrics platform. Survey questions were multiple choice and inquired regarding changes in prescribing practices after enactment of mandatory query of the prescription drug monitoring program database and prescribing limits in Florida. The survey was distributed by e-mail 1 year after these laws took effect. Two survey reminder e-mails were sent at 2-week intervals after the initial message. Results were collected for an additional 3 weeks after the final correspondence.

Results
Thirty-two survey responses were received after distribution to the 156 members of the Florida Society of Plastic Surgeons, for a response rate of 20.5%. Twenty-two respondents reported changing their prescribing practices. The most common change reported was decreased number of tablets prescribed. Most respondents reported they believe that mandatory prescription drug monitoring program query and prescribing limits will be effective. This included 17 (53.1%) and 18 (56.3%) respondents, respectively.

Conclusions
Results from our survey indicate that Florida plastic surgeons have adjusted their prescribing practices in response to recently enacted legislation. Most plastic surgeons reported decreased number of tablets of opioids prescribed. Many also reported incorporating nonopioid analgesics. Further study will be necessary to determine the impact of these changes on rates of opioid overdose.
Evaluation of the Accuracy of Three-Dimensional Virtual Surgical Planning for Reconstruction of Mandibular Defects Using Free Fibular Flap
Authors: Elsharabasy Ibrahim Mohamed , Elhafez Heba Abd Elwahed Abd , Ahmed Salah Abd Elfattah , Ayad Wael Mohamed 
Published: March 2020

Background:
Mandibular reconstruction is considered one of the most complex reconstructive surgeries in the field of craniomaxillofacial surgery. With the introduction of microvascular reconstructive surgery, free fibula flap become the gold standard for reconstruction of mandibular defects. For optimum restoration of the patient's esthetics and function, the free fibular flap should be recontoured to follow the natural premorbid state of the mandible. Virtual surgical planning using preoperative computed tomographic (CT) data can be rendered into 3-dimensional (3D) model for digitalized simulation of the bony resection and reconstruction with reported high accuracy.

Methods:
Ten patients were included in the study for delayed mandibular reconstruction using free fibular flap. For all the patients, preoperative CT scan for the skull and lower limbs were obtained and integrated into the software for virtual planning and guides fabrications. Postoperative CT was obtained and rendered 3D model to be superimposed on the preoperative record for assessment of the virtual planning accuracy by different linear and angular measurements.

Results:
No statistically significant difference was found between virtual group and postoperative group where P = 0.067, regarding average of linear measurements of all patients. Statistically significant difference was found between virtual group and postoperative group in measurements from axial plane where P = 0.004. No statistically significant difference was found between virtual group and postoperative group where P = 0.723, regarding angles between fibular segments.

Conclusion:
Virtual surgical planning for mandibular reconstruction offers high reproducibility and precision, reducing the side errors, besides its time saving advantage for both the operator and the patient.
Selection of Guiding Plate Combined With Surgical Navigation for Microsurgical Mandibular Reconstruction
Authors: Yu Yao , Zhang Wen-Bo , Liu Xiao-Jing , Guo Chuan-Bin , Yu Guang-Yan , Peng Xin 
Published: March 2020

Purpose:
The present study summarized selection of guiding plate combined with surgical navigation for microsurgical mandibular reconstruction.

Methods:
Data from preoperative maxillofacial enhanced computed tomography (CT) scans were imported to ProPlan CMF. The authors performed virtual mandibulectomy and superimposed 3-dimensional (3D) iliac images on mandibular defects. Guiding plates including mandibular fixation device, reconstruction plate, guiding model, and occlusal splint for various mandibular hemimandibular central lateral (HCL) defects were fabricated to fix bilateral residual mandible. The model was scanned, and data were imported into ProPlan CMF and the intraoperative navigation system. Through landmark points upon the guiding plate, position of the residual mandible was determined during surgical navigation. Intraoperative navigation was used to implement the virtual plan. Sagittal, coronal, axial, and 3D reconstruction images displayed by the navigation system were used to accurately determine osteotomy sites and osteotomy trajectory during surgery. Surgical probe guidance was used to mark the osteotomy line and transfer the virtual procedure to real-time surgery. Accuracy was evaluated using chromatographic analysis.

Results:
Different guiding plates combined with surgical navigation could be used for various mandibular defects, including mandibular fixation devices for LCL defects, reconstruction plates for LC/L/C defects, and guiding models and occlusal splints for H/L/LC defects (including mandibular ramus). In our study, average and largest shift of the mandible and osteotomy site was <5 mm.

Conclusion:
The authors summarized different ways of combining guiding plates with surgical navigation for reconstruction of various mandibular defects, which could improve clinical outcomes of this procedure with high accuracy.
Findings, Phenotypes, Diagnostic Accuracy, and Treatment in Freeman-Burian Syndrome
Authors: Poling Mikaela I. , Dufresne Craig R. , Chamberlain Robert L. 
Published: March 2020

Abstract
Freeman-Burian syndrome (FBS) is a rare congenital myopathic craniofacial syndrome. Since publication of the genotype-correlated clinical diagnostic criteria, no complete survey of the literature has been accomplished. As part of the clinical practice guideline development, we evaluate diagnostic accuracy for FBS from 1938 to 2019 and range of findings, complications, treatments, and outcomes. Published manuscripts in PubMed, Google Scholar, and OMIM describing cases with a reported diagnosis of FBS, Sheldon-Hall syndrome, and distal arthrogryposes type 1 and 3 are initially included. Articles with sufficient case-level data for diagnosis verification are analyzed further. Of 724 unique papers considered, 188 papers describing 304 unique patients are included; 101 papers and 119 patients reflect an FBS diagnosis, with 80 patients meeting the full diagnostic criteria. Most cases are re-screened as distal arthrogryposis type 1. Among all cases re-screened as FBS, the presence of FBS pathognomonic craniofacial findings is not correlated with other physical findings. There are no significant differences between patients meeting the full diagnostic criteria and those not, but both are distinct from other diagnoses. Plastic surgery demonstrates the highest cumulative diagnostic accuracy for FBS overall (86.66%), while orthopedic surgery shows the lowest (44.83%). No statistically usable treatment-related or psychosocial data are available. Quality of case reports and patient data vary widely, reducing the statistical strength and significance. Major knowledge gaps exist in treatment, psychosocial, and longitudinal outcomes. At this point, it is impossible to derive clinical practice guidelines exclusively from the literature.
Malignant Lymphoma Mimicking Medial Fat Pad Prolapse: A Pitfall for Upper Eyelid Rejuvenation
Authors: Vaidya Aric , Kakizaki Hirohiko , Takahashi Yasuhiro 
Published: March 2020

Abstract
Two patients with malignant lymphoma in the medial area of the upper eyelid mimicking medial fat pad prolapse have been reported. Both of them did not notice any eyelid/orbital mass before presentation to us. They were managed with a complete excisional biopsy of the mass, respectively. In both the patients, pathologic results were compatible with extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue. Neither any other lesion was detected nor any recurrence was seen, without the need of further treatment in either of them. Although the medial fat pad prolapse can be easily diagnosed by inspection only, the results of our study elucidate the importance of palpation for its definite diagnosis.
Predictive validity of a DNA methylation-based screening panel for postpartum depression
Authors: Lapato Dana M. , Roberson-Nay Roxann , Kinser Patricia A. , York Timothy P. 
Published: March 2020

AbstractPrenatal maternal depression increases the risk of negative maternal-infant health outcomes but often goes unrecognized. As a result, biomarker screening tests capable of identifying women at risk for depression are highly desirable. This study tested how demographic and clinical factors affect the predictive validity of a DNA methylation-based screening test for postpartum major depression (MD) using data from a longitudinal study of birth outcomes. Lifetime history of MD and current levels of postpartum depressive symptoms were assessed using an extended self-report version of the Composite International Diagnostic Interview Short Form and the Edinburgh Postnatal Depression Scale (EPDS), respectively. Predictive validity of the test was estimated in the PREG cohort using the area under the receiver operator characteristic curve (AUC), and sensitivity analyses were performed to assess the impact of self-reported race, age, and pre-pregnancy history of MD. Data for N=103 pregnant participants (African-American=49; European-American=54) were available. The prediction model identified women who would develop high levels of postpartum depressive symptoms better within the subset of women with previous histories of MD (AUC = 0.94, 95% CI 0.79-1.00) compared to the full pregnant cohort (AUC = 0.62, 95% CI 0.46-0.79). This observation prompted secondary analyses to test the model specificity for postpartum depression. The model predicted lifetime history of MD moderately well in never-pregnant, mixed-sex cohort of adolescents (N=150; ages 15-20; AUC = 0.75, 95% CI 0.57-0.92) and performed slightly better in males versus females. Additional sensitivity analyses are needed to determine the extent of the model’s specificity for MD subtypes and if demographic or clinical factors influence the predictive validity of this model.
Does The Reformed Cancer Drug Fund Generate Evidence On Effectiveness? A Cross-sectional Analysis On Publicly Accessible Documentation
Authors: Macdonald Helen , Goldacre Ben 
Published: March 2020

AbstractIntroductionThe Cancer Drugs Fund (CDF) was reformed in 2016 with an ambition to generate new evidence on effectiveness, and to review existing drugs in the fund. We set out to evaluate: whether drugs transitioning from the old CDF were re-reviewed as planned; whether new drugs have a “data collection arrangement” (DCA) as planned; and whether evidence generated under the DCA using routine data from the “Systemic Anti-Cancer Treatment” (SACT) database was of high quality.MethodsWe accessed documents from NHS England, Public Health England and NICE at August 2018. We calculated the proportion of old CDF drugs re-reviewed, and of new drugs and indications with a DCA. We described key features of the DCAs. For all SACT studies we set out to obtain a protocol in order to analyse the quality of the planned methods.Results47 old drugs and indications transitioned to the new CDF. For 14 there was no evidence of a re-review; 9 of these remain under CDF at August 2019 (all off-label uses). 33 had marketing authorisations: 22 of these had a review completed by September 2017 as planned (67%). 20 new drugs and indications entered the CDF by August 2018: 19 had a DCA; one (off-label) had no DCA or equivalent. All DCAs identify uncertainty about overall survival; all express an intent to conduct observational analysis using SACT data; SACT data was central to decision-making for 6 (32%). We were able to find 0 protocols of the 19 planned SACT studies (0). Following Freedom of Information requests we were told these protocols are prepared after the data are collected, and posted with the reappraisal: however we could not locate any protocol for either of the two published re-appraisals. We were therefore unable to assess the quality of the methods in any of the proposed SACT studies.ConclusionsThe revised CDF has not been implemented as planned. Reporting of observational analyses in SACT data fall substantially short of best practice, and the full methods used cannot be established. There is very little information in the public domain around evaluation of off-label uses. Lastly, SACT data itself does not appear to be able to support clinical decision-making in the manner suggested by the CDF policy documents. NHS England should review the conduct of the fund, but also the planning, as unrealistic commitments may have been made.
The Evaluation of Sleep Disturbances for Chinese Frontline Medical Workers under the Outbreak of COVID-19
Authors: Qi Jing , Xu Jing , Li Bozhi , Huang Jinsha , Yang Yuan , Zhang Zhentao , Yao Dongai , Liu Qunhui , Jia Min , Gong Daokai , Ni Xiaohong , Zhang Qimei , Shang Furong , Xiong Nian , Zhu Chunli , Wang Tao , Zhang Xi 
Published: March 2020

SummaryBackgroundThe outbreak of coronavirus disease 2019 in China remains to be a serious challenge for frontline medical workers (fMW). They are under high risk of being infected and high mental stress, which may lead to sleep disturbances, anxiety, and depression.MethodsWe conducted a cross-sectional study to evaluate sleep disturbances of fMW and made a comparison with non-fMW. The medical workers from multiple hospitals in Hubei Province, China, were volunteered to participate. An online questionnaire, including Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), and Visual Analogue Scale (VAS), was used to evaluate sleep disturbances and mental status of fMW. Sleep disturbances were defined as PSQI>7 points or/and AIS>6 points. We compared the scores of PSQI, AIS, anxiety and depression VAS, and prevalence of sleep disturbances between fMW and non-fMW. Subgroup analysis for different gender in fMW was conducted.FindingsA total of 1306 subjects (including 801 fMW and 505 non-fMW) were enrolled. Compared to non-fMW, fMW had significantly higher scores of PSQI (p< 0.0001), AIS (p<0.0001), anxiety (p<0.0001) and depression (p=0.0010), and higher prevalence of sleep disturbances with PSQI > 7 points (p<0.0001) and AIS > 6 points (p<0.0001). In subgroup analysis, compared to male fMW, female fMW had significantly higher scores of PSQI (p=0.022) and higher prevalence of sleep disturbances with PSQI > 7 points (p<0.0001).InterpretationfMW had higher prevalence of sleep disturbances and worse sleep quality than non-fMW. Female fMW were more vulnerable to having sleep disturbances than male fMW.FundingNone.