bluuebunny/crossref_metadata_2025_split huggingface dataset:
Le Deep Learning en orthodontie : vers une relation patient-praticien repensée…
Authors: Foucart Jean-Michel , Gillibert Luc , Chavanne Augustin , Ripoche Xavier 
Published: February 2021

Depuis une dizaine d’année, l’Intelligence artificielle (IA) transforme progressivement les pratiques, la médecine aussi bien que l’orthodontie n’échappent pas à cette règle. Dès lors, se pose la question de la place de cette technologie au sein de la pratique quotidienne; et ce à toutes les étapes de la prise en charge thérapeutique.
Cette technologie simplifie l’analyse du nombre croissant de données de plus en plus complexes dont nous disposons, notamment à travers le scanner optique intra-oral, le scanner facial ou la radiographie 3D. Pour savoir l’exploiter, il est nécessaire d’en connaître ses différents principes.
L’objectif de ce travail est, après avoir introduit les bases du Deep Learning qui s’appuie les réseaux neuronaux virtuels, d’aborder quelles sont les applications actuelles de cette technologie en médecine bucco-dentaire et en orthodontie.
La connaissance des dernières recherches et des derniers résultats obtenus permet alors d’envisager la future relation praticien-machine dans le cadre d’une approche personnalisée et repensée autour du patient.
Akutes Nierenversagen bei Neugeborenen als Risikofaktor für die chronische Niereninsuffizienz
Authors: Scheerer Moritz , Oh Jun 
Published: February 2021

ZUSAMMENFASSUNGDie akute Nierenschädigung (AKI) stellt ein Risiko für Frühgeborene und Säuglinge mit sehr niedrigem Geburtsgewicht dar. Durch die seit 2013 genutzte, einheitliche Definition der Kidney Disease: Improving Global Outcomes (KDIGO) 1 konnten in den letzten Jahren das Verständnis über die Prävalenz und Konsequenzen von AKI deutlich verbessert werden. So können nicht nur validere Aussagen zur akuten Mortalität und Verlängerung von Krankenhausaufenthalten getätigt werden. Gerade auch das erhöhte Risiko für die Entwicklung eines chronischen Nierenversagens mit den einhergehenden Komplikationen rückt im Rahmen aktueller Studien immer weiter in den Fokus 2. Daher möchten wir das Bewusstsein für die potenziellen Konsequenzen einer AKI schärfen, um die Nachsorge und damit auch die Versorgung dieser besonders gefährdeten Patienten zu verbessern.
Heimdialyse
Authors: Taylan Christina , Weber Lutz Thorsten 
Published: February 2021

ZUSAMMENFASSUNGIn der Pädiatrie ist die Heimdialyse in Form von Peritonealdialyse seit Langem ein wesentlicher Bestandteil der Behandlung und wird bei der überwiegenden Anzahl, insbesondere bei sehr kleinen Kindern, eingesetzt. Trotz der Risiken, die eine Heimdialysebehandlung beinhaltet, überwiegen die Vorteile. Die Heimhämodialyse hingegen hat aktuell keinen großen Stellenwert in der Behandlung pädiatrischer Dialysepatienten, die Gründe hierfür sind vielfältig. Sie sollte aber in Zukunft mehr Berücksichtigung finden. Der vielfach bewiesene Vorteil der intensivierten Hämodialyse, die im Gegensatz zur Zentrumsdialyse als Heimdialyse logistisch einfacher durchzuführen ist, sollte dazu führen, in Zukunft die Heimdialyseverfahren durch einfacher zu bedienende, kleinere Geräte sowie unterstützende Systeme wie, z. B. Remote-controlled Patientenmanagement-Programme, weiter zu entwickeln.
Gelenksonografie im Treat-to-Target-Konzept bei der juvenilen idiopathischen Arthritis
Authors: Gohar Faekah , Windschall Daniel 
Published: February 2021

ZUSAMMENFASSUNGIn unserem Artikel werden aktuelle Bedeutung und Entwicklung der Gelenksonografie als fester Bestandteil eines „Treat-to-Target“-Konzeptes bei der Behandlung der juvenilen idiopathischen Arthritis (JIA) dargestellt und diskutiert. Dabei nimmt die Gelenksonografie neben der klinischen Untersuchung eine entscheidende Rolle in der frühen Diagnosestellung einer JIA ein mit dem Ziel, dem Patienten so früh wie möglich eine effiziente Therapie zukommen zu lassen (Window of Opportunity). Zusätzlich kann die Gelenksonografie, eingebettet in das „Treat-to-Target“-Konzept, eine wichtige Rolle in der Verlaufskontrolle und Evaluation einer subklinischen Entzündungsaktivität spielen. Bisherige etablierte Diagnose-, Verlaufs- und auch Remissionskriterien einer JIA lassen stringente und objektivierbare bildgebende Kriterien vermissen, obwohl sich Qualität und Erfahrung bei der Gelenksonografie stetig verbessern. Neben den sonografischen Kriterien haben sich inzwischen auch verschiedene Biomarker zur Beurteilung der Krankheitsaktivität etabliert. Mit der Entwicklung der Sonografie und sicheren Testung von Biomarkern könnte sich in Zukunft zur frühen Diagnosestellung und sicheren Remissionseinschätzung eine Kombination aus immunologischen und sonografischen Kriterien etablieren, die das bisherige „Treat-to-Target“-Konzept bei der JIA unterstützen und verbessern.
CRPS und Inaktivitätsosteoporose
Authors: Schultz Katharina 
Published: February 2021

ZUSAMMENFASSUNGDas komplexe regionale Schmerzsyndrom (CRPS) und die Inaktivitätsosteoporose rufen am Knochen eine lokalisierte Osteoporose hervor. Radiologisch ähneln sich die Entitäten stark, wenngleich die Veränderungen beim CRPS deutlich stärker vorhanden sind als bei der Inaktivitätsosteoporose. Entscheidendes Merkmal zur Differenzierung sind Anamnese und klinischer Befund – hier vor allem die Weichteilveränderungen wie Schwellung, Überwärmung, Hyperhidrose, Verfärbung der Haut, die in dieser Form bei einer Inaktivitätsosteoporose nicht zu erwarten sind. Therapeutisch kommt bei beiden Krankheitsbildern eine multifaktorielle Therapie in Betracht, bestehend aus frühfunktioneller Beübung und Mobilisation, Training der Muskulatur sowie ergänzender medikamentöser Therapie mit Bisphosphonaten. Insbesondere beim CRPS spielen auch die Säulen der multimodalen Schmerz- und Verhaltenstherapie eine wichtige Rolle.
Rectal dose-sparing effect with bioabsorbable spacer placement in carbon ion radiotherapy for sacral chordoma: dosimetric comparison of a simulation study
Authors: Shiba Shintaro , Okamoto Masahiko , Tashiro Mutsumi , Ogawa Hiroomi , Osone Katsuya , Yanagawa Takashi , Kohama Isaku , Okazaki Shohei , Miyasaka Yuhei , Osu Naoto , Chikuda Hirotaka , Saeki Hiroshi , Ohno Tatsuya 
Published: February 2021

Abstract
It is difficult to treat patients with an inoperable sarcoma adjacent to the gastrointestinal (GI) tract using carbon ion radiotherapy (C-ion RT), owing to the possible development of serious GI toxicities. In such cases, spacer placement may be useful in physically separating the tumor and the GI tract. We aimed to evaluate the usefulness of spacer placement by conducting a simulation study of dosimetric comparison in a patient with sacral chordoma adjacent to the rectum treated with C-ion RT. The sacral chordoma was located in the third to fourth sacral spinal segments, in extensive contact with and compressing the rectum. Conventional C-ion RT was not indicated because the rectal dose would exceed the tolerance dose. Because we chose spacer placement surgery to physically separate the tumor and the rectum before C-ion RT, bioabsorbable spacer sheets were inserted by open surgery. After spacer placement, 67.2 Gy [relative biological effectiveness (RBE)] of C-ion RT was administered. The thickness of the spacer was stable at 13–14 mm during C-ion RT. Comparing the dose–volume histogram (DVH) parameters, Dmax for the rectum was reduced from 67 Gy (RBE) in the no spacer plan (simulation plan) to 45 Gy (RBE) in the spacer placement plan (actual plan) when a prescribed dose was administered to the tumor. Spacer placement was advantageous for irradiating the tumor and the rectum, demonstrated using the DVH parameter analysis.
Emergence and characterization of a putative novel human adenovirus recombinant HAdV-C104 causing pneumonia in Southern China
Authors: Ji Tianxing , Li Ling , Li Wenrui , Zheng Xuehua , Ye Xianmiao , Chen Hongliang , Zhou Qiang , Jia Hongyun , Chen Bo , Lin Zhen , Chen Haoyu , Huang Shiwen , Seto Donald , Chen Ling , Feng Liqiang 
Published: February 2021

Abstract
In 2017, a survey of the molecular epidemiology of human adenovirus (HAdV) infections in Southern China based on hexon and fiber genotype demonstrated that the most prevalent genotypes of HAdV were HAdV-3 (n = 62), HAdV-2 (n = 21), and HAdV-7 (n = 16). In addition, two patients were co-infected with two genotypes of HAdV. Interestingly, a novel human adenovirus C recombinant genotype strain was isolated from one of the pneumonia patients in this survey. Phylogenetic, recombination, and proteotyping analysis showed that this novel pathogen originated from the recombination of parental viruses harboring the HAdV-1 penton and hexon gene, and the HAdV-2 fiber gene. It was named ‘P1H1F2’ and was assigned as HAdV-C104 based on the nomenclature protocol of using three major capsid proteins for characterization. Subsequent in vitro experiments demonstrated that HAdV-C104 had comparable proliferation capacity to HAdV-1, HAdV-2, and another recombination genotype P1H2F2. In addition, the HAdV-C104 infected patient was diagnosed with pneumonia and recovered after antiviral therapy. This report strengthens the hypothesis of recombination as a major pathway for the molecular evolution of HAdV-C species.
Valaciclovir to Prevent Vertical Transmission of Cytomegalovirus After Maternal Primary Infection During Pregnancy: A Randomized, Double-blind, Placebo-Controlled Trial
Authors: Shahar-Nissan Keren , Pardo Joseph , Peled Orit , Krause Irit , Bilavsky Efraim , Wiznitzer Arnon , Hadar Eran , Amir Jacob 
Published: February 2021

(Abstracted from Lancet 2020;396:779–785)
Cytomegalovirus (CMV) is a congenital infection that has a high rate of maternal morbidity after infection. There is a relatively high rate of vertical transmission to the fetus following a maternal infection of 30% to 40%.
Breaking Barriers: Studying Fracture Healing in the BONES Program
Authors: Mack Christina D. , Pavesio Alessandra , Kelly Kim , Irwin Debra E. , Maislin Greg , Jones John , Wester Tawana , Zura Robert 
Published: February 2021

Summary:
The Bioventus Observational Noninterventional EXOGEN Studies (BONES) Program includes 3 concurrent studies designed to estimate the incidence of fracture nonunions in patients treated with the EXOGEN Ultrasound Bone Healing System compared with those receiving standard fracture care. This article outlines the design and methodology within the fifth metatarsal fracture study; similar approaches are taken in the second and third BONES Program studies, which examine nonunions of the tibia and scaphoid. The BONES Program is an external comparator design and incorporates several unique, fit-for-purpose components to strengthen the approach and allow it to be submitted to the US Food and Drug Administration (FDA) to be considered for a label expansion. BONES consisted of 2 cohorts: (1) EXOGEN-treated patients recruited into a patient registry and (2) comparator patients from a large administrative health claims database. The study used International Classification of Diseases, Tenth Revision, nonunion diagnosis codes reported by the treating clinician for the primary outcome measure. Many data sources (medical and billing records, patient-reported health data, usage data from the device itself, and commercial product complaint system) were used on the registry side, alongside insurance claims data to source the external comparator cohort, to achieve broader understanding of factors predisposing patients to the development of nonunions. In step with the FDA's increasing acceptance of real-world evidence for use in regulatory decision making and coupled with the infeasibility of a randomized clinical trial in this setting, the innovative study design of the BONES Program allowed for both an evaluation of the effect of EXOGEN in mitigating nonunions in a real-world setting and an assessment of the patient experience with EXOGEN treatment.
The Prognostic Value of Intraoperative Neuromonitoring by Combining Somatosensory- and Motor-Evoked Potentials for Thoracic Spinal Decompression Surgery in Patients with Neurological Deficit
Authors: Liu Tun , Dong Buhuai , Qi Huaguang , Yan Liang , Zhao Songchuan , Liu Zhian , Liu Xuemei , Wang Fei , Li Liang , Cai Wenbo , Luo Zhenguo , Wang Gang 
Published: February 2021

Study Design.
Retrospective study.

Objective.
To explore a relation between somatosensory- and motor-evoked potential (SEPs, MEPs) and corresponding thoracic cord function for thoracic spinal decompression surgery (TSDS) in patients with neurological deficit.

Summary of Background Data.
Although SEPs and MEPs monitoring has been developed as an essential technique in spinal surgery. There are limited data on the reliability of using SEPs and MEPs for TSDS and its prognosis.

Methods.
One hundred twenty patients underwent TSDS in our hospital, 91 patients completed the trial. All the patients were divided into three subgroups according to the changes of MEPs and SEPs: neither SEPs nor MEP deteriorated -. Simply MEP deteriorated and both SEPs and MEP deteriorated -. Bispectral (BIS) was used to monitor the depth of sedation, which ranged from 40 to 60 by varying the infusion speed of anesthetics. The pre- and postoperative spinal function was assessed by muscle strength and Japanese Orthopaedic Association (JOA) score at three time points:1) before surgery; 2) immediately after general anesthesia recovery; 3) after 3-month follow-up.

Results.
Sixty-nine cases showed neither SEPs nor MEP deteriorated -, 10 cases showed only MEP deteriorated, and 12 cases showed both SEPs and MEP deteriorated -. The patients in the group where neither SEPs nor MEP deteriorated had the best recovery of the extremity muscle strength, the shortest recovery time (8.10 ± 1.60, P < 0.05), and toe movement time (8.50 ± 1.60, P < 0.05). There is a strong correlation between SEPs variability ratio at T4 time point and JOA recovery ratio (JOA RR) in the 3-month follow-up.

Conclusion.
Combined SEPs and MEPs monitoring are important for TSDS in patients with neurological deficit and it is helpful for evaluating postoperative prognosis. It is more accurate to record SEPs at T4 time point to predict the patients’ prognosis.

Level of Evidence: 3
Does Matching Roussouly Spinal Shape and Improvement in SRS-Schwab Modifier Contribute to Improved Patient-reported Outcomes?
Authors: Passias Peter G. , Pierce Katherine E. , Raman Tina , Bortz Cole , Alas Haddy , Brown Avery , Ahmad Waleed , Naessig Sara , Krol Oscar , Passfall Lara , Kummer Nicholas A. , Lafage Renaud , Lafage Virginie 
Published: February 2021

Study Design.
Retrospective review.

Objective.
The aim of this study was to evaluate outcomes of matching Roussouly and improving in Schwab modifier following adult spinal deformity (ASD) surgery.

Summary of Background Data.
The Roussouly Classification system of sagittal spinal shape and the SRS-Schwab classification system have become important indicators of spine deformity. No previous studies have examined the outcomes of matching both Roussouly type and improving in Schwab modifiers postoperatively.

Methods.
Surgical ASD patients with available baseline (BL) and 1 year (1Y) radiographic data were isolated in the single-center spine database. Patients were classified by their “theoretical” and “current” Roussouly types as previously published. Patients were considered a “Match” if their theoretical and current Roussouly types were the same, or a “Mismatch” if the types differed. Patients were noted as improved if they were Roussouly “Mismatch” preoperatively, and “Match” at 1Y postop. Schwab modifiers at BL were categorized as follows: no deformity (0), moderate deformity (+), and severe deformity (++) for PT, SVA, and PI-LL. Improvement in SRS-Schwab was defined as a decrease in any modifier severity at 1Y.

Results.
103 operative ASD patients (61.8 years, 63.1% female, 30 kg/m2) were included. At baseline, breakdown of “current” Roussouly type was: 28% Type 1, 25.3% Type 2, 32.0% Type 3, 14.7% Type 4. 65.3% of patients were classified as Roussouly “Mismatch” at BL. Breakdown of BL Schwab modifier severity: PT (+: 41.7%, ++: 49.5%), SVA (+: 20.3%, ++: 50%), PI-LL (+: 25.2%, ++: 46.6%). At 1 year postop, 19.2% of patients had Roussouly “Match”. Analysis of Schwab modifiers showed that 12.6% improved in SVA, 42.7% in PI-LL, and 45.6% in PT. Count of patients who both had a Roussouly type “Match” at 1Y and improved in Schwab modifier severity: nine PT (8.7%), eight PI-LL (7.8%), and two SVA (1.9%). There were two patients (1.9%) who met their Roussouly type and improved in all three Schwab. 1Y matched Roussouly patients improved more in health-related quality of life scores (minimal clinically important difference [MCID] for Oswestry Disability Index [ODI], EuroQol-5D-3L [EQ5D], Visual Analogue Score Leg/Back Pain), compared to mismatched, but was not significant (P > 0.05). Match Roussouly and improvement in PT Schwab met MCID for EQ5D more (P = 0.050). Matched Roussouly and improvement in SVA Schwab met MCID for ODI more (P = 0.024).

Conclusion.
Patients who both matched Roussouly sagittal spinal type and improved in SRS-Schwab modifiers had superior patient-reported outcomes. Utilizing both classification systems in surgical decision-making can optimize postop outcomes.

Level of Evidence: 3
The Comparison of Spinopelvic Parameters, Complications, and Clinical Outcomes After Spinal Fusion to S1 with or without Additional Sacropelvic Fixation for Adult Spinal Deformity
Authors: Han Bo , Yin Peng , Hai Yong , Cheng Yunzhong , Guan Li , Liu Yuzeng 
Published: February 2021

Study Design.
Systematic review and meta-analysis.

Objective.
The purpose of the study was to compare the outcomes and after spinal fusion with or without iliac screw (IS) insertion for patients with adult spinal deformity (ASD).

Summary of Background Data.
The number of patients undergoing multilevel spinal stabilization for the treatment of ASD is growing. However, the selection of spinopelvic fixation for ASD patients with long fusion is controversial.

Methods.
A comprehensive literature search was performed without time restriction according to the guidelines from the Cochrane Collaboration in May 2020 using PubMed, EMBASE, and the Cochrane Library. The comparison of the two types of fixation was evaluated by spinopelvic parameters, incidence rate of complications, rate of revision, and clinical outcomes at the last follow-up.

Results.
The literature search identified 422 records, of which eight studies were included for meta-analysis with a total of 439 patients. All the included studies provided level III evidence. There was no significant difference in the sagittal vertical axis, pelvic incidence, the proximal junctional kyphosis rates, the pseudarthrosis rates, the revision rates, and the clinical outcomes at the last follow-up between those who receive sacrum fixation and sacropelvic fixation. Nevertheless, greater lumbar lordosis (LL) (weighted mean difference [WMD], 4.15; 95% confidence interval [CI] 2.46–5.84, P < 0.01), greater sacral slope (SS) (WMD, 2.32; 95% CI 1.21–3.43, P < 0.01), and lower rate of the distal instrumentation instability (odds ratio, 0.25; 95% CI 0.10–0.61, P = 0.002) were observed in IS group between the comparison.

Conclusion.
The clinical outcomes in the IS group were similar to those in the non-IS group, but the application of the IS significantly restored LL, prevented decompensation, and reduced the occurrence of the distal instrumentation instability. Therefore, the IS may be a good choice for the operative treatment of ASD patients with sagittal malalignment and other risks of lumbosacral fracture, metal breakage, and screw pullout.

Level of Evidence: 3
Venoarterial Extracorporeal Membrane Oxygenation in Massive Pulmonary Embolism-Related Cardiac Arrest: A Systematic Review*
Authors: Scott John Harwood , Gordon Matthew , Vender Robert , Pettigrew Samantha , Desai Parag , Marchetti Nathaniel , Mamary Albert James , Panaro Joseph , Cohen Gary , Bashir Riyaz , Lakhter Vladimir , Roth Stephanie , Zhao Huaqing , Toyoda Yoshiya , Criner Gerard , Moores Lisa , Rali Parth 
Published: February 2021

OBJECTIVE:
Management of patients experiencing massive pulmonary embolism-related cardiac arrest is controversial. Venoarterial extracorporeal membranous oxygenation has emerged as a potential therapeutic option for these patients. We performed a systematic review assessing survival and predictors of mortality in patients with massive PE-related cardiac arrest with venoarterial extracorporeal membranous oxygenation use.

DATA SOURCES:
A literature search was started on February 16, 2020, and completed on March 16, 2020, using PubMed, Embase, Cochrane Central, Cinahl, and Web of Science.

STUDY SELECTION:
We included all available literature that reported survival to discharge in patients managed with venoarterial extracorporeal membranous oxygenation for massive PE-related cardiac arrest.

DATA EXTRACTION:
We extracted patient characteristics, treatment details, and outcomes.

DATA SYNTHESIS:
About 301 patients were included in our systemic review from 77 selected articles (total screened, n = 1,115). About 183 out of 301 patients (61%) survived to discharge. Patients (n = 51) who received systemic thrombolysis prior to cannulation had similar survival compared with patients who did not (67% vs 61%, respectively; p = 0.48). There was no significant difference in risk of death if PE was the primary reason for admission or not (odds ratio, 1.62; p = 0.35) and if extracorporeal membranous oxygenation cannulation occurred in the emergency department versus other hospital locations (odds ratio, 2.52; p = 0.16). About 53 of 60 patients (88%) were neurologically intact at discharge or follow-up. Multivariate analysis demonstrated three-fold increase in the risk of death for patients greater than 65 years old (adjusted odds ratio, 3.08; p = 0.03) and six-fold increase if cannulation occurred during cardiopulmonary resuscitation (adjusted odds ratio, 5.67; p = 0.03).

CONCLUSIONS:
Venoarterial extracorporeal membranous oxygenation has an emerging role in the management of massive PE-related cardiac arrest with 61% survival. Systemic thrombolysis preceding venoarterial extracorporeal membranous oxygenation did not confer a statistically significant increase in risk of death, yet age greater than 65 and cannulation during cardiopulmonary resuscitation were associated with a three- and six-fold risks of death, respectively.
Minimally Invasive Transungual Tumors Enucleation With Nail Preservation for Subungual Glomus Tumors
Authors: Yu Yi-Hsiang , Lee Chih-Hung , Lin Shang-Hung 
Published: February 2021

BACKGROUND
Glomus tumors are benign neurovascular neoplasms, most commonly located in the subungual region. These subcutaneous nodules are characterized by intense pain and temperature sensitivity. Although surgical excision is the curative treatment, permanent nail deformity and recurrence are not uncommon after conventional surgery.

OBJECTIVE
This study evaluated the long-term efficacy of a modified transungual approach with nail preservation for removing subungual glomus tumors.

MATERIAL AND METHODS
Thirty-nine patients with clinically diagnosed and histopathologically proven glomus tumors treated at a medical center over a 13-year period (2007–2019) were retrospectively evaluated.

RESULTS
The 39 patients included 28 women and 11 men (ratio, 2.5:1), with a mean age of 48.9 years. Thirty-four tumors were located in the fingers and 5 in the toes. All patients returned to normal activity soon after the surgery. At a mean follow-up of 28.8 months, all were pain free or experienced minimal pain and were satisfied with treatment outcomes. One patient (2.6%) experienced recurrence. No nail deformity was observed.

CONCLUSION
The transungual approach with nail plate preservation is a novel and effective method for removing subungual glomus tumors with reduced postoperative pain and rapid healing, while preserving or improving the configuration of the nail.