bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Affecting Pedicle Screw Insertional Torque in Spine Deformity Surgery
Authors: Oda Kotaro , Ohba Tetsuro , Hiroshi Yokomichi , Fujita Koji , Tanaka Nobuki , Koyma Kensuke , Haro Hirotaka 
Published: March 2021

Study Design.
Retrospective observational study of consecutive patients.

Objective.
We sought to: (1) clarify the key factors predominantly associated with the insertional torque of pedicle screws; (2) compare the optimal factors for pedicle screw insertion to obtain rigid screw fixation in patients with adult spinal deformity (ASD) and in those with adolescent idiopathic scoliosis (AIS); (3) determine the optimal screw/pedicle ratio (S/P) to obtain rigid pedicle screw fixation.

Summary of Background Data.
Rigid pedicle screw fixation is mandatory to perform corrections for spinal deformities properly and to allow successful fusion after surgery. The fixation depends mainly on screw position accuracy and patient bone quality. Traditionally, spinal surgeons have decided the screw size, trajectory, and tapping size based on their intuition. Insertional torque has been indicated as useful to predict screw fixation strength, and is correlated with screw pullout strength and frequency of postoperative screw loosening.

Methods.
We compared insertion torque at L1–L3 levels of 324 screws in 68 patients with ASD and 58 screws in 32 patients with AIS. We assessed the association between screw/pedicle ratio and insertion torque by constructing a spline curve.

Results.
Pedicle and screw diameter correlated positively with insertion torque in patients with either ASD or AIS. The optimal screw/pedicle ratio to obtain rigid pedicle screw fixation in patients with ASD was close to, but less than one, and, by contrast, was about 1 to 1.25 in patients with AIS.

Conclusion.
We propose the concept of an optimal S/P ratio for obtaining rigid pedicle screw fixation during spinal corrective surgery, which is different for patients with ASD and patients with AIS. The S/P ratio is useful for deciding the appropriate diameter screw for each case in preoperative planning.

Level of Evidence: 4
Using Simulation to Prepare Students for Medical Mission Trips
Authors: Woods Ashleigh , Mumbower Rachael , Mumba Mercy N. 
Published: March 2021

ABSTRACT:
Simulation is a valuable tool in nursing education, including during preparation for students going on medical mission trips. Faculty assessed the learning and management of expectations of undergraduate nursing students who participated in a simulation prior to an international medical mission experience. Through student focus groups postsimulation and posttrip, faculty discovered three learning themes and student recommendations for future simulation use
Simulating the Refugee Experience to Cultivate Cultural Competence and Sensitivity
Authors: Harvey Nina R. , Wynn Stephanie T. 
Published: March 2021

ABSTRACT:
Although the United States has offered refuge to millions of immigrants, healthcare providers still lack sufficient understanding of social and ethnic issues in this population. Sociocultural barriers inhibit service accessibility and compromise the quality and appropriateness of care for resettled refugees. To address this issue, faculty from a school of nursing pioneered a spiritually and culturally centered simulation experience to enhance prelicensure students' cultural competence and sensitivity in caring for refugees.
Obsessive-Compulsive Personality Disorder Co-occurring in Individuals with Obsessive-Compulsive Disorder: A Systematic Review and Meta-analysis
Authors: Pozza Andrea , Starcevic Vladan , Ferretti Fabio , Pedani Carolina , Crispino Roberta , Governi Guido , Luchi Simonetta , Gallorini Antonella , Lochner Christine , Coluccia Anna 
Published: March 2021

Learning objectives
After participating in this activity, learners should be better able to:
• Assess the rates of co-occurring obsessive-compulsive personality disorder (OCPD) in patients with obsessive-compulsive disorder (OCD)
• Identify characteristics related to OCD with co-occurring OCPD

Abstract
The current literature discloses discrepant findings regarding the rates of co-occurring obsessive-compulsive personality disorder (OCPD) in patients with obsessive-compulsive disorder (OCD). In addition, it is not clear which characteristics are related specifically to OCD with co-occurring OCPD. We conducted the first systematic review and meta-analysis of the studies of the prevalence of OCPD in patients with OCD. We also investigated potential moderators of the prevalence, including OCD severity, age of onset of OCD, sex, current age, methodological quality, and publication date of the studies. Electronic databases and gray literature were searched by two independent reviewers. A PRISMA systematic review with a random-effect meta-analysis was conducted. Thirty-four studies were included. A significant mean effect size of 0.25 without publication bias indicated that OCPD was present in 25% of patients with OCD, suggesting that the two conditions are distinct clinical entities. This prevalence was higher than the rates found in the literature for any other personality disorders among OCD patients. OCPD that occurs in the context of OCD was more likely to be present in males and to be characterized by a later age of onset of OCD, older age at assessment, and less severe OCD symptoms. Clinicians should consider these findings when assessing and planning treatment of OCD with co-occurring OCPD.
Validation of the PHILIPS DL8760 upper arm blood pressure monitor, in oscillometry mode, for self-measurement in a general population, according to the European Society of Hypertension International Protocol revision 2010
Authors: Chahine Mirna N. , Bou Harb Souad , Saad Abdel Rahman , Sarkis Patrick , Azaki Alaa , Harb Aya , Allouch Ali , Asmar Roland 
Published: March 2021

Objective
The aim of this study was to determine the accuracy of the PHILIPS DL8760, an oscillometric blood pressure (BP) measuring device designed for self-measurement in the general population according to the European Society of Hypertension International Protocol (ESH-IP) revision 2010.

Participants and Methods
The PHILIPS DL8760 measures BP at the brachial level. The validation was performed in 33 subjects. The mean age of the participants was 55.8 ± 14 years. SBP 146.1 ± 26 mmHg (range: 103–193), DBP was 86.8 ± 17.0 mmHg (range: 47–123), and arm circumference was 28.3 ± 4.0 cm (range: 22–39).

Results
The PHILIPS DL8760 fulfilled the criteria of the ESH-IP by passing phases one and two for both SBP measurements and DBP measurements. The device overestimated SBP by 1.5 ± 5.0 mmHg and underestimated DBP by 0.7 ± 3.9 mmHg.

Conclusion
The PHILIPS DL8760 BP device, with its specially designed cuff covering a broad range of arm circumferences, fulfilled the requirements of the International Protocol Revision 2010.
Natural History of Chronic Hepatitis B Infection Among Chinese Children and Young Adults
Authors: Mo Shirley , Au Loretta , Huang Sherry , Malik Preeti , Pan Debra H. 
Published: March 2021

ABSTRACTObjectives:There are limited data on the natural history of chronic hepatitis B virus (HBV) infection in Asian American children. The aim of the present study was to describe a single‐center experience of chronic HBV infection in Chinese American patients in New York City.Methods:A retrospective chart review was conducted for patients with chronic HBV infection who had pediatric visits from 2006 to 2017. Clinical and laboratory data were collected to characterize the status of HBV infection and its disease course both cross‐sectionally and longitudinally. Available maternal charts were reviewed.Results:Of the total 353 patients, 72 patients (20%) were US‐born. Positive hepatitis B envelope antigen (HBeAg) was documented in 208 patients (58%). Three phases of chronic HBV infection were categorized for 329 patients: immune‐tolerant 112 (34%), HBeAg‐positive immune‐active 47 (14%), and inactive carrier 82 (25%). The remaining 88 patients (27%) did not fit into a particular category with 26 of 88 patients meeting the criteria for inactive carrier except for mildly elevated alanine aminotransferase. Age and liver enzyme levels were significantly different between HBeAg‐positive and HBeAg‐negative groups (P < 0.05). Among 179 patients followed for ≥5 years, the spontaneous seroconversion rate was 38%. In eight patients with linked maternal data, all children completed the HBV vaccine series and seven of eight received hepatitis B immunoglobulin. All mothers were HBeAg‐positive with high HBV DNA and had no anti‐viral therapy during pregnancy.Conclusions:Both immune‐tolerant and inactive carrier phases were common for chronic HBV infection with a spontaneous seroconversion rate of 38%. All US‐born patients were born in the era of implemented universal immune‐prophylaxis.
Successful Treatment of Gaucher Disease With Matched Sibling Hematopoietic Stem Cell Transplantation: A Case Report and Literature Review
Authors: Chavananon Shevachut , Sripornsawan Pornpun , Songthawee Natsaruth , Chotsampancharoen Thirachit 
Published: March 2021

Background:
Gaucher disease (GD) is the most common lysosomal storage disease and requires long-term enzyme replacement therapy (ERT), which is costly and inconvenient for resource-limited countries such as Thailand. The authors present the case of a 1-year-old boy who was diagnosed with GD type 1 with a homozygous mutation at c.1448 T>C (L444P). He was treated with ERT and matched sibling hematopoietic stem cell transplantation (HSCT) was performed 6 months after the ERT was initiated. At a 3-year follow-up after the HSCT, he had full engraftment and the Lyso-GL1 levels were also at an acceptable level, which indicated disease remission. In conclusion, the authors suggest HSCT for long-term remission of GD in children.
Oligometastatic Bone Disease in Castration-Sensitive Prostate Cancer Patients Treated With Stereotactic Body Radiotherapy Using 68Ga-PSMA PET/CT
Authors: Onal Cem , Ozyigit Gokhan , Akgun Zuleyha , Atalar Banu , Igdem Sefik , Oymak Ezgi , Agaoglu Fulya , Selek Ugur , Guler Ozan Cem , Hurmuz Pervin , Mustafayev Teuto Zoto , Akyol Fadil 
Published: March 2021

Purpose
To evaluate the outcomes of metastasis-directed treatment (MDT) using stereotactic body radiotherapy (SBRT) for bone-only oligometastasis (OM) detected with gallium prostate-specific membrane antigen (68Ga-PSMA) PET/CT in castration-sensitive prostate cancer (PC) patients.

Methods
In this multi-institutional study, clinical data of 74 PC patients with 153 bone lesions who were undergoing MDT were retrospectively evaluated. Twenty-seven patients (36.5%) had synchronous, and 47 (63.5%) had metachronous OM. All patients had PC with 5 metastases or fewer detected by 68Ga-PSMA PET/CT and treated using SBRT with a median dose of 20 Gy. The prognostic factors for PC-specific survival (PCSS) and progression-free survival (PFS) were analyzed.

Results
The median follow-up was 27.3 months. Patients with synchronous OM were older and received higher rates of androgen deprivation therapy after SBRT compared with patients with metachronous OM. The 2-year PCSS and PFS rates were 92.0% and 72.0%, respectively. A prostate-specific antigen (PSA) decline was observed in 56 patients (75.7%), and 48 (64.9%) had a PSA response defined as at least 25% decrease of PSA after MDT. The 2-year local control rate per lesion was 95.4%. In multivariate analysis, single OM and PSA response after MDT were significant predictors for better PCSS and PFS. In-field recurrence was observed in 4 patients (6.5%) with 10 lesions at a median of 13.1 months after MDT completion. No serious late toxicity was observed.

Conclusions
We demonstrated that SBRT is an efficient and well-tolerated treatment option for PC patients with 5 bone-only oligometastases or fewer detected with 68Ga-PSMA PET/CT.
18F-Fluorothymidine PET for Functional Response Assessment Following Radiation Therapy for Extramedullary Hematopoiesis
Authors: Campbell Belinda A. , Callahan Jason , Cole-Sinclair Merrole , MacManus Michael , Hofman Michael S. 
Published: March 2021

Abstract
As a marker of cellular proliferation, 18F-fluorothymidine (FLT) PET can detect the distribution of proliferating hematopoiesis and has an emerging role in the investigation of hematopoietic disorders. These images demonstrate the novel utility of 18F-FLT PET for imaging sites of extramedullary hematopoiesis (EMH) in a patient with Chuvash-type polycythemia and suggest a role for 18F-FLT PET in response assessment following radiotherapy. Further, the discordant response observed in the irradiated marrow and sites of EMH is a unique discovery, possibly suggesting the influence of the microenvironment favoring more rapid recovery of proliferative function within EMH sites.
Detection of Cauda Equine Syndrome With 18F-FDG PET/CT and Leptomeningeal Metastasis by 68Ga-DOTATATE in the Same Patient With Large Cell Neuroendocrine Carcinoma of Lung
Authors: Arslan Esra , Erol Özge , Beyhan Ediz , Şahin Rahime , Çermik Tevfik Fikret 
Published: March 2021

Abstract
Leptomeningeal metastasis is the metastatic spread of the disease to leptomeninges from solid tumors such as breast, lung cancer, and melanoma. Cauda equine syndrome is a neurological condition caused by compression of the cauda equine. The incidence of large cell neuroendocrine carcinoma in resected lung cancers appears to be 2.1% and 3.5%. The incidence of clinically diagnosed leptomeningeal metastasis in patients with solid tumors is approximately 5%. Here, we present cauda equine syndrome caused by the metastasis of large cell neuroendocrine carcinoma detected by 18F-FDG PET/CT and also 68Ga-DOTATATE PET/CT.
FDG PET/CT to Detect Incidental Findings in Patients With Hepatocellular Carcinoma—Additional Benefit for Patients Considered for Liver Transplantation?
Authors: Winkens Thomas , Rudakoff William , Rauchfuss Falk , Malessa Christina , Settmacher Utz , Freesmeyer Martin 
Published: March 2021

Purpose
FDG PET/CT has been described for noninvasive grading, detection of extrahepatic spread, and recurrence in hepatocellular carcinoma (HCC). As compared with localized imaging approaches (MRI, ultrasonography), FDG PET/CT not only focuses on the liver, but covers a long field of view from the base of the skull to the thighs, visualizing pathologic findings not related to HCC. The aims of this retrospective study were to (1) describe the frequency of relevant incidental findings on FDG PET/CT in HCC patients, (2) evaluate the impact on treatment strategy in HCC patients considered for liver transplantation, and (3) to discuss the role of FDG PET/CT in patients considered for transplantation in general.

Methods
Four hundred thirty-nine FDG PET/CT examinations of 345 HCC patients were screened for incidental findings. The clinical information system was searched for examinations performed after FDG PET/CT and aimed at verification of incidental findings. Of 345 HCC patients, 81 patients were considered for liver transplantation. The impact of incidental findings was recorded separately for this subgroup.

Results
One hundred one patients with incidental findings in 439 FDG PET/CT examinations were identified. The incidental findings comprised 22 neoplasms (9 malignant) and 52 inflammations. Liver transplantation was not performed because of an incidental finding on FDG PET/CT in 9 (11.1%) of 81 patients.

Conclusions
FDG PET/CT is capable of identifying relevant incidental findings (ie, secondary malignancy, benign tumors, and inflammation) in HCC patients and HCC patients considered for liver transplantation and thus influencing HCC patient management. FDG PET/CT might also be beneficial in patients considered for transplantation of different organs.
Superb Microvascular Imaging in Assessment of Synovitis and Tenosynovitis in Juvenile Idiopathic Arthritis
Authors: Kandemirli Sedat Giray , Cicek Fatih , Erdemli Gursel Basak , Bilgin Cem , Kilic Sara Sebnem , Yazici Zeynep 
Published: March 2021

Abstract
The aim of this study is to evaluate the diagnostic utility of superb microvascular imaging (SMI) in assessment of synovitis/tenosynovitis in juvenile idiopathic arthritis in comparison to power Doppler ultrasound. Thirty juvenile idiopathic arthritis cases with active clinical findings and ultrasound features of effusion and/or tenosynovitis were further imaged with power Doppler and SMI. For classification of synovial inflammation, a semiquantitative scale (4 points) adopted by Outcome Measures in Rheumatology was used.
A total of 35 knee, 2 hip, 2 ankle, 2 wrist, 2 elbow joints, and 6 flexor hallucis longus/tibialis posterior tenosynovitis were assessed. In knee joint, power Doppler and SMI scales were the same for 23 (65.7%) joints, SMI upgraded scale from 0 to 2 in single joint (2.9%); 1 to 2 (14.3%) in 5 joints; and 2 to 3 (17.1%) in 6 joints. For other joints, power Doppler and SMI scales were the same for 5 (62.5%) joints. Superb microvascular imaging upgraded scale from 1 to 2 (25%) in 2 joints and 1 to 3 (12.5%) in a single joint. For flexor hallucis longus/tibialis posterior tenosynovitis, power Doppler and SMI scales were the same for two cases (33.3%). Superb microvascular imaging upgraded scale from 0 to 2 in two cases (33.3%); and 2 to 3 (33.3%) in 2 cases. There was no case of SMI scale downgraded compared with power Doppler scale.
Superb microvascular imaging is a feasible technique in the assessment of synovial inflammation and tenosynovitis in juvenile idiopathic arthritis. Superb microvascular imaging has higher sensitivity compared with power Doppler ultrasound in depiction of increased vascularity.
Imaging Findings of Mammary Myofibroblastoma
Authors: Sun Xiaoyuan , Sui Xulei , Liu Ying , Zhang Hongxia , Wang Yunqin , Tang Xiaofeng , Liang Peng 
Published: March 2021

Abstract
Mammary myofibroblastoma (MFB) is a rare benign stromal neoplasm; its imaging features are rarely reported and nonspecific. We retrospectively analyzed a case of pathologically proved breast MFB that revealed indistinct high-density mass in mammography and hypoechoic ill-defined breast tumor in ultrasonography. Meanwhile, hypointense appearance on T2-weighted imaging of magnetic resonance imaging and containing fat tissue might be very valuable characteristics in the differential diagnosis of breast MFB.
Predicting Response to Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer After the Second Cycle of Chemotherapy Using Shear-Wave Elastography—A Preliminary Evaluation
Authors: Singh Tulika , Kumar Niraj , Sandhu Manavjit , Singla Veenu , Singh Gurpreet , Bal Amanjit 
Published: March 2021

Abstract
The primary objective of the study was to determine whether shear wave elastography can be used to predict the response of neoadjuvant chemotherapy (NACT) in women having invasive breast cancer. A prospective study involving 28 patients having invasive breast cancer and undergoing NACT followed by surgery was done after institutional review board approval. All the patients underwent 2-dimensional B-mode ultrasound and 2-dimensional shear wave elastography before the start of chemotherapy and after 2 cycles of completion of chemotherapy, and mean stiffness was recorded. The patients were segregated to responders and nonresponders based on residual cancer burden scoring. Difference in mean elasticity was compared between the 2 groups. The results showed that the mean stiffness after 2 cycles was significantly different between the responders and nonresponders and so was the change in the mean stiffness after 2 cycles of NACT. Using a cutoff value of 45.5 kPa (20.53%), change in mean elasticity after 2 cycles of NACT, sensitivity of 76.9%, and specificity of 80% with negative predictive value of 80.1 was attained. Responders show greater change in mean stiffness after 2 cycles of NACT as compared with nonresponders on shear wave elastography; thus, it can be used to predict response to NACT after 2 cycles.
A Systematic Review of Intra-abdominal Tissue Expansion for the Treatment of Exomphalos Major and a Case Report Describing a Refinement of the Technique
Authors: Alexander William , Nightingale Michael , Penington Anthony , Coombs Christopher 
Published: March 2021

Abstract
The management of complex exomphalos major is difficult, and traditional techniques fail to address the visceroabdominal disproportion in the most severe cases. Intra-abdominal tissue expansion is a novel technique and has been used in a small number of patients to safely increase the intra-abdominal volume and allow the reduction of viscera and subsequent closure of the abdominal domain. We review 7 published reports of this technique and add a case report describing our refinement of the technique. We propose that the use of multiple expanders placed in the intra-abdominal preperitoneal space, when expanded slowly, can allow safe reduction of viscera and immediate direct closure of the musculofascial layer of the abdomen.
Social Media and Instant Messaging
Authors: Bilal Biader Samih , Chen Philip Kuo-Ting 
Published: March 2021

Background
Social media and instant messaging can improve patient education, follow-up, and outcome. The utilization of these modalities in cleft lip/palate care is not fully described. We formed an online platform consisting of a dedicated website, Facebook group and LINE group through which we provide information and counseling to our patient population. Our objective is to evaluate the impact and patient satisfaction of our online platform.

Methods
In this retrospective study, we designed a questionnaire aimed at evaluating the quality of information and patient satisfaction of the online platform. The questionnaire was distributed online to 732 cases connected to us through the LINE application.

Results
The response rate was 26%. Website information was found very necessary and sufficient by 75% and 46% of the cases, respectively. Regarding Facebook, the medical team's response was found very professional and practical by 81% and 68% of the cases, respectively. Patient-patient interaction was helpful to 96% of the cases. Regarding the LINE application, the medical team's response was found very immediate and helpful in 73% of the cases, and 91% felt that LINE saved them time from returning to the clinic on unscheduled occasions. The website, Facebook and LINE were used over 10 times per month by 17%, 32%, and 50% of the cases, respectively. A decrease in unscheduled “pop-up” visits to the clinic (from 25 to 6 per month) was registered.

Conclusions
Adapting social media and instant messaging into our cleft lip/palate care has been welcomed with high satisfaction among our patient population, increasing their knowledge, saving them time from returning to the clinic, and allowing them beneficial interaction with other families coping with similar conditions.