bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Antibiotic Prophylaxis for Acute Nonoperative Orbital Fractures
Authors: Esce Antoinette R. , Chavarri Vanina M. , Joshi Amar B. , Meiklejohn Duncan A. 
Published: January 2021

Purpose:
The use of antibiotic prophylaxis for the prevention of infection in nonoperative orbital fractures is controversial, with limited high-quality evidence and inconsistent recommendations in the current scientific literature. Our primary study objective was to identify the prophylactic antibiotic prescribing pattern at our institution for nonoperative orbital fractures and to determine the effect of antibiotic prophylaxis.

Methods:
We retrospectively reviewed 16 years of data from a single institution on patients with acute traumatic fractures of the orbital floor or medial orbital wall. Prophylactic administration of antibiotics and complication rates were evaluated, and complication rates and patient characteristics analyzed.

Results:
Of 154 patients with nonoperative orbital fractures, 17 patients (group 1) received IV or oral antibiotics and 137 patients (group 2) did not. No patient in either group had documented infectious orbital complications following their orbital injury. Patients receiving antibiotics were more likely to have a concurrent periorbital laceration (58.8% ± 11.9% vs. 28.5% ± 3.9%; P = 0.01).

Conclusion:
We present the largest cohort yet reported of patients managed without antibiotic prophylaxis for nonoperative orbital fractures, with no infectious complications identified. Currently there is no evidence of utility to prophylactic antibiotics in the setting of nonoperative traumatic orbital fractures. Rather than prescribing antibiotics, we recommend clinicians educate patients on return precautions and offer close follow up for the rare, but potentially severe infectious complications of orbital trauma.
Gut peptides and the microbiome: focus on ghrelin
Authors: Leeuwendaal Natasha K. , Cryan John F. , Schellekens Harriët 
Published: January 2021

Purpose of review
In this review, we present recent insights into the role of the gut microbiota on gastrointestinal (GI) peptide secretion and signalling, with a focus on the orexigenic hormone, ghrelin.

Recent findings
Evidence is accumulating suggesting that secretion of GI peptides is modulated by commensal bacteria present in our GI tract. Recent data shows that the gut microbiome impacts on ghrelinergic signalling through its metabolites, at the level of the ghrelin receptor (growth hormone secretagogue receptor) and highlights concomitant changes in circulating ghrelin levels with specific gut microbiota changes. However, the mechanisms by which the gut microbiota interacts with gut peptide secretion and signalling, including ghrelin, are still largely unknown.

Summary
The gut microbiota may directly or indirectly influence secretion of the orexigenic hormone, ghrelin, similar to the modulation of satiety inducing GI hormones. Although data demonstrating a role of the microbiota on ghrelinergic signalling is starting to emerge, future mechanistic studies are needed to understand the full impact of the microbiota-ghrelin axis on metabolism and central-regulated homeostatic and non-homeostatic controls of food intake.
Clinical utility of Ga68 DOTANOC PET/CT imaging in juvenile nasal angiofibroma and the PARIS protocol: a preliminary report
Authors: Thakar Alok , Sakthivel Pirabu , Arunraj Sreedharan T. , Bhalla Ashu S. , Prashanth Arun , Kumar Rakesh , Sharma Suresh C. , Kumar Rakesh 
Published: January 2021

Objectives
Juvenile nasopharyngeal angiofibroma (JNA) expresses different somatostatin cell surface receptors and Ga68 [DOTA, 1-Nal3]-octreotide (DOTANOC)-PET/computed tomography (CT) scan may be used for its imaging. Also, functional imaging with DOTANOC-PET/CT may promise of greater accuracy in the detection or exclusion of recurrent/residual JNA.

Methods
In this prospective study, five JNA patients who underwent a DOTANOC-PET-CT scan both preoperatively and postoperatively during June 2018–March 2020 were included. Postcontrast enhancement of a definite lesion was considered residual/recurrent tumor in contrast-enhanced MRI (CEMRI). In DOTANOC-PET/CT, any abnormal uptake apart from physiological sites was considered as residual lesions. Radiological results were categorized as negative, suspicious or definite residual/recurrent tumors. Any discrepancy was resolved by endoscopic biopsies.

Results
Preoperatively all five cases of JNA showed avid DOTANOC expression in the tumor. The mean (SD) value of DOTANOC standardised uptake value in the tumor was 4.3 (1.4) (range = 2.1–6.2). In postoperative CEMRI evaluation, three of five patients had residual tumors and two had normal scans. On DOTANOC-PET/CT, two of five patients had residual tumors and three had normal scans. In one patient with residual tumor, the discrepancy with regard to tumor extent was noted in two scans, and further biopsy confirmed the findings of DOTANOC-PET/CT as accurate.

Conclusion

68Ga-DOTANOC-PET/CT uptake is universal in JNA and appears to be more specific in the identification of residual/recurrent JNA. In residual tumors, DOTANOC-PET/CT may have an advantage over CEMRI in the diagnosis, decision making and planning stereotactic radiation. However, these findings are to be validated in studies with larger patients.
The influence of colour scale in lesion detection and patient-based sensitivity in [68Ga]Ga-PSMA-PET/CT
Authors: Mingels Clemens , Sachpekidis Christos , Bohn Karl P. , Hünermund Jan-Niklas , Schepers Robin , Fech Viktor , Prenosil George , Rominger Axel , Afshar-Oromieh Ali , Alberts Ian 
Published: January 2021

Objective
To investigate the influence of colour scales on the interpretation of [68Ga]Ga-PSMA-11 PET/CT for the diagnosis of recurrent prostate cancer.

Methods
50 consecutive patients who underwent [68Ga]Ga-PSMA-11 PET/CT for recurrent prostate cancer were selected for this retrospective study. The scans were randomised, anonymised and read by five different readers first in the visually nonlinear colour scale ‘PET-rainbow’. Scans were then rerandomised and read in the visually linear colour scale ‘hot-metal new’. For each scan in each colour scale the numbers of pathological, equivocal and benign lesions were noted. Scans where the majority of readers (≥3) reported at least one PET-positive lesion were recorded as ‘pathological’. Patient-level sensitivity was obtained by composite standard with 14.8 ± 1.2 months of follow-up.

Results
Increased numbers of lesions per patient were reported for all readers in PET-rainbow compared to hot-metal new (37.4 ± 15.2 vs. 33.9 ± 16.4, respectively, P = 0.0005). On a per-patient basis, 43 scans were rated pathological in PET-rainbow, compared to 39 in hot-metal new. Follow-up was available for 30 patients confirming 26 pathological scans with positive follow-up in PET-rainbow, and 23 in hot-metal new. Three pathological scans were missed in hot-metal new. Patient-level sensitivity was higher for PET-rainbow (0.96) compared to hot-metal new (0.85). Inter-reader reliability was higher for hot-metal new (Fleiss κ = 0.76) compared to PET-rainbow (Fleiss κ = 0.60).

Conclusion
Use of PET-rainbow was associated with improved lesion detection and sensitivity compared to hot-metal new, although at cost of reduced inter-rater agreement. Consequently, the use of PET-rainbow for clinical routine and future studies involving [68Ga]Ga-PSMA-11 is recommended.
Diagnostic performance of 18F-FDG PET/CT for the detection of occult primary tumors in squamous cell carcinoma of unknown primary in the head and neck: a single-center retrospective study
Authors: Chen Bin , Zhang Haoran , Liu Dezhi , Wang Xueju , Ji Bin , Gao Shi 
Published: January 2021

Objective
To investigate the diagnostic performance of 18F-FDG PET/computed tomography (CT) for the detection of occult primary tumors in patients with squamous cell carcinoma of unknown primary (SCCUP) in the head and neck.

Patients
From March 2016 to January 2020, 37 patients diagnosed as SCCUP before PET/CT were retrospectively reviewed. The diagnosis of SCCUP was made when an overt primary tumor location could not be found for histologically proven squamous cell cervical lymphadenopathy after a complete diagnostic workup which includes full medical history, physical examinations, flexible rhinolaryngoscopy and CT or MRI. The PET/CT images were visually assessed by two nuclear medicine radiologists. Histopathological investigations after the PET scan served as the reference standard.

Results
The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT for SCCUP were 71.4, 43.8, 62.5, 53.9 and 59.5%, respectively. PET/CT allowed identification of previously undetected lesions in 40.5% of the SCCUP patients. A total of 24 PET/CT scans indicated a positive result. Among them, nine were categorized into false-positive because of negative results from subsequent targeted and random biopsies. There were 13 PET/CT scans with a negative result, six of which, however, were revealed to have a primary site by subsequent random biopsies.

Conclusion

18F-FDG PET/CT was shown to be useful in detecting a primary tumor for SCCUP, but had limitations in terms of both false-positive cases and false-negative cases. Therefore, histopathological investigations such as targeted and random biopsy should be viewed as necessary practice irrespective of PET/CT results.
How Mindfulness and Acceptance Could Help Psychiatrists Predict Alexithymia Among Students
Authors: Tamanaeifar Shima , Pirkashani Nikzad Ghanbari , Nooripour Roghieh 
Published: January 2021

Abstract
Mindfulness and acceptance have demonstrated associations with alexithymia facets. As a very limited body of research has explored the predictive strength among alexithymia-related constructs, this study aimed to investigate the prediction of alexithymia based on acceptance and mindfulness among students. The study group consisted of 586 university students, 237 (40.9%) females and 349 (59.1%) males. As for data collection, the five-factor mindfulness questionnaire, Acceptance and Commitment Questionnaire, and the Toronto Alexithymia Scale-2 were applied. A stepwise multiple linear regression was calculated to predict alexithymia based on components of commitment and action, mindfulness facets, and demographic variables (F[5,578] = 77.26, p ≤ 0.001), with an R
2 of 0.41. The predictive variables including description (B = −0.59, t = −8.02, p < 0.001), commitment and action (B = −0.13, t = −4.38, p < 0.001), observation (B = −0.15, t = −2.94, p < 0.01), and no judgment (B = −0.16, t = −2.56, p < 0.05) exhibited significant prediction effects on the adjusted index of alexithymia. The findings contribute to the potential mechanism between mindfulness and alexithymia in intervention that seeks to improve mindfulness and acceptance skills and could prove more effective in treating patients with alexithymia.
Serum Creatinine Monitoring After Acute Kidney Injury in the PICU*
Authors: Robinson Cal , Benisty Kelly , Cockovski Vedran , Joffe Ari R. , Garros Daniel , Riglea Teodora , Pizzi Michael , Palijan Ana , Chanchlani Rahul , Morgan Catherine , Zappitelli Michael 
Published: January 2021

Objectives:
It is unknown whether children with acute kidney injury during PICU admission have kidney function monitored after discharge. Objectives: 1) describe postdischarge serum creatinine monitoring after PICU acute kidney injury and 2) determine factors associated with postdischarge serum creatinine monitoring.

Design:
Secondary analysis of longitudinal cohort study data.

Setting:
Two PICUs in Montreal and Edmonton, Canada.

Patients:
Children (0–18 yr old) surviving PICU admission greater than or equal to 2 days from 2005 to 2011. Exclusions: postcardiac surgery and prior kidney disease. Exposure: acute kidney injury by Kidney Disease: Improving Global Outcomes serum creatinine definition.

Interventions:
None.

Measurements:
Primary outcome: postdischarge serum creatinine measured by 90 days, 1 year, and 5–7 years.

Secondary outcomes:
Healthcare events and nephrology follow-up.

ANALYSIS:
Proportions with outcomes; logistic regression to evaluate factors associated with the primary outcome. Kaplan-Meier analysis of time to serum creatinine measurement and healthcare events.

Main Results:
Of n = 277, 69 (25%) had acute kidney injury; 29/69 (42%), 34/69 (49%), and 51/69 (74%) had serum creatinine measured by 90 days, 1 year, and 5–7 year postdischarge, respectively. Acute kidney injury survivors were more likely to have serum creatinine measured versus nonacute kidney injury survivors at all time points (p ≤ 0.01). Factors associated with 90-day serum creatinine measurement were inpatient nephrology consultation (unadjusted odds ratio [95% CI], 14.9 [1.7–127.0]), stage 2–3 acute kidney injury (adjusted odds ratio, 3.4 [1.1–10.2]), and oncologic admission diagnosis (adjusted odds ratio, 10.0 [1.1–93.5]). A higher proportion of acute kidney injury versus nonacute kidney injury survivors were readmitted by 90 days (25 [36%] vs 44 [21%]; p = 0.01) and 1 year (33 [38%] vs 70 [34%]; p = 0.04). Of 24 acute kidney injury survivors diagnosed with chronic kidney disease or hypertension at 5–7 year follow-up, 16 (67%) had serum creatinine measurement and three (13%) had nephrology follow-up postdischarge.

Conclusions:
Half of PICU acute kidney injury survivors have serum creatinine measured within 1-year postdischarge and follow-up is suboptimal for children developing long-term kidney sequelae. Knowledge translation strategies should emphasize the importance of serum creatinine monitoring after childhood acute kidney injury.
Ultrasound-Guided Postpyloric Feeding Tube Placement in Critically Ill Pediatric Patients*
Authors: Osawa Ichiro , Tsuboi Norihiko , Nozawa Hisataka , Nishimura Nao , Nakagawa Satoshi 
Published: January 2021

OBJECTIVES:
Various methods to insert postpyloric feeding tubes at the bedside have been reported, but the optimal method remains controversial. The objective of this study was to evaluate the effect of ultrasound-guided postpyloric feeding tube placement in critically ill children.

DESIGN:
Single-center retrospective observational study.

SETTING:
PICU of tertiary children’s hospital.

PATIENTS:
Children under the age of 16 who underwent postpyloric feeding tube placement in our PICU between September 2017 and August 2019.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
A total of 115 patients were included in this study: 30 patients underwent ultrasound-guided postpyloric feeding tube placement and 85 patients underwent blind postpyloric feeding tube placement; the insertion attempts were 32 and 93, respectively. There were no significant differences in patient demographics between the ultrasound-guided group and the blind group. The first-pass success rate of the ultrasound-guided group was higher than that of the blind group (94% [30/32] vs 57% [53/93]; p < 0.001). The median insertion time in the ultrasound-guided group with successful postpyloric feeding tube insertion was 18 minutes (interquartile range, 15–25; range, 8–45; n = 21). There were no complications or adverse events during the placement.

CONCLUSIONS:
In this single-center study, ultrasound-guided postpyloric feeding tube placement was feasible and a significantly high first-pass success rate was observed for critically ill children. Additional investigation with a larger pool of operators and randomized controlled patient assignment is required.
Clinical updates on phantom limb pain
Authors: Erlenwein Joachim , Diers Martin , Ernst Jennifer , Schulz Friederike , Petzke Frank 
Published: January 2021

Abstract

Introduction:
Most patients with amputation (up to 80%) suffer from phantom limb pain postsurgery. These are often multimorbid patients who also have multiple risk factors for the development of chronic pain from a pain medicine perspective. Surgical removal of the body part and sectioning of peripheral nerves result in a lack of afferent feedback, followed by neuroplastic changes in the sensorimotor cortex. The experience of severe pain, peripheral, spinal, and cortical sensitization mechanisms, and changes in the body scheme contribute to chronic phantom limb pain. Psychosocial factors may also affect the course and the severity of the pain. Modern amputation medicine is an interdisciplinary responsibility.

Methods:
This review aims to provide an interdisciplinary overview of recent evidence-based and clinical knowledge.

Results:
The scientific evidence for best practice is weak and contrasted by various clinical reports describing the polypragmatic use of drugs and interventional techniques. Approaches to restore the body scheme and integration of sensorimotor input are of importance. Modern techniques, including apps and virtual reality, offer an exciting supplement to already established approaches based on mirror therapy. Targeted prosthesis care helps to obtain or restore limb function and at the same time plays an important role reshaping the body scheme.

Discussion:
Consequent prevention and treatment of severe postoperative pain and early integration of pharmacological and nonpharmacological interventions are required to reduce severe phantom limb pain. To obtain or restore body function, foresighted surgical planning and technique as well as an appropriate interdisciplinary management is needed.
Delayed Gadolinium Leakage in Ocular Structures
Authors: Galmiche Chloé , Moal Bertrand , Marnat Gaultier , Sagnier Sharmila , Schweitzer Cédric , Dousset Vincent , Sibon Igor , Tourdias Thomas 
Published: January 2021

Background
Gadolinium leakage in ocular structures (GLOS) was recently observed in fluid-attenuated inversion recovery (FLAIR) images obtained the day after an initial gadolinium injection in stroke patients. The specificity of GLOS to stroke and its mechanisms remain unclear.

Objective
We investigated the factors associated with GLOS in a cohort of patients presenting with acute neurological deficits.

Materials and Methods
This retrospective study included consecutive patients admitted to our stroke unit for acute neurological deficit between July 2017 and August 2018 who underwent baseline brain magnetic resonance imaging with the injection of a macrocyclic gadolinium agent and another scan without injection within 72 hours. The patients were separated into a stroke group and a stroke mimic group based on diffusion-weighted images. Gadolinium leakage in ocular structures was defined as a bright signal in the vitreous in follow-up FLAIR compared with baseline FLAIR (pregadolinium). Clinical data were collected together with imaging features from the baseline scans, including the volume of the infarct and of hypoperfusion if applicable, white matter hyperintensities, the number of lacunes, and the number of microbleeds, which were combined to yield a small vessel disease (SVD) score. We compared the prevalence of GLOS in both groups using the χ2 test. In the entire cohort, univariate and multivariate regression models were used to test the associations between GLOS and the collected data.

Results
Among the 467 patients included in the study, GLOS was observed in similar proportions in the stroke group (32.2%, 136/422) and the stroke mimic group (28.9%, 13/45; mean difference, 3.3%; 95% confidence interval, −10.9 to 17.6; P = 0.65). In univariate analysis, GLOS was associated with older age, increased prevalence of vascular risk factors, brain imaging features of SVD (white matter hyperintensities, lacunes, microbleeds), as well as with impairment of renal function and increased dose of gadolinium. No associations were found with factors related to stroke, such as its volume, acute treatment, or rate of recanalization. Multivariate analyses showed that aging (P < 0.001), diabetes (P = 0.010), severe renal failure (P = 0.004), and increased dose of gadolinium (P < 0.001) were independent contributors to GLOS.

Conclusions
Gadolinium leakage in ocular structures, which occurs more commonly at higher concentrations of gadolinium, is not specific to stroke and may represent increased permeability of the blood-retinal barrier associated with age- and vascular risk factor‐related SVD.
Activation of the XBP1s/O-GlcNAcylation Pathway Improves Functional Outcome After Cardiac Arrest and Resuscitation in Young and Aged Mice
Authors: Li Ran , Shen Yuntian , Li Xuan , Lu Liping , Wang Zhuoran , Sheng Huaxin , Hoffmann Ulrike , Yang Wei 
Published: January 2021

ABSTRACT
After cardiac arrest (CA) and resuscitation, the unfolded protein response (UPR) is activated in various organs including the brain. However, the role of the UPR in CA outcome remains largely unknown. One UPR branch involves spliced X-box-binding protein-1 (XBP1s). Notably, XBP1s, a transcriptional factor, can upregulate expression of specific enzymes related to glucose metabolism, and subsequently boost O-linked β-N-acetylglucosamine modification (O-GlcNAcylation). The current study is focused on effects of the XBP1 UPR branch and its downstream O-GlcNAcylation on CA outcome. Using both loss-of-function and gain-of-function mouse genetic tools, we provide the first evidence that activation of the XBP1 UPR branch in the post-CA brain is neuroprotective. Specifically, neuron-specific Xbp1 knockout mice had worse CA outcome, while mice with neuron-specific expression of Xbp1s in the brain had better CA outcome. Since it has been shown that the protective role of the XBP1s signaling pathway under ischemic conditions is mediated by increasing O-GlcNAcylation, we then treated young mice with glucosamine, and found that functional deficits were mitigated on day 3 post CA. Finally, after confirming that glucosamine can boost O-GlcNAcylation in the aged brain, we subjected aged mice to 8 min CA, and then treated them with glucosamine. We found that glucosamine-treated aged mice performed significantly better in behavioral tests. Together, our data indicate that the XBP1s/O-GlcNAc pathway is a promising target for CA therapy.
Outcomes of Pediatric Liver Transplantation in Japan: A Report from the Registry of the Japanese Liver Transplantation Society
Authors: Kasahara Mureo , Umeshita Koji , Eguchi Susumu , Eguchi Hidetoshi , Sakamoto Seisuke , Fukuda Akinari , Egawa Hiroto , Haga Hironori , Kokudo Norihiro , Sakisaka Shotaro , Takada Yasutsugu , Tanaka Eiji , Uemoto Shinji , Ohdan Hideki 
Published: January 2021

Background.
The Japanese Liver Transplantation Society (JLTS), a cooperative research consortium, was established in 1980 to characterize and follow trends in patient characteristics and graft survival among all liver transplant patients in Japan. This study analyzed factors that may affect the current outcomes of pediatric patients who undergo liver transplantation (LT) by evaluating one of the largest pediatric LT cohorts in the world.

Methods.
Between November 1989 and December 2018, 3347 pediatric patients underwent LT in Japan. The survival outcomes of each donor and recipient variant were evaluated.

Results.
The procedures performed during the study period included living donor LT (LDLT; n = 3271), deceased donor LT (DDLT; n = 69), and domino LT (n = 7). There were 1510 male (45.1%) and 1837 female (54.9%) recipients with a median age of 1.7 y (range: 9 d to 17.9 y). The graft survival rates at 1, 10, 20, and 30 y were 88.9%, 82.2%, 77.1%, and 75.4%, respectively. Donor age, donor BMI, blood type incompatibility, recipient age, etiology of liver disease, transplant type, center experience, and transplant era were found to be significant predictors of overall graft survival. LDLT is a major treatment modality for the end-stage liver disease in children; DDLT and domino LT were applied as alternative treatments for LDLT in patients with specific pediatric liver diseases that are considered to have a poor prognosis following LDLT.

Conclusions.
Satisfactory long-term pediatric patient survival outcomes were achieved in the JLTS series, and we should continue to promote the deceased donor organ transplantation program in Japan.