bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Outcome of Spinal Fusion for Osteogenesis Imperfecta With Scoliosis: Is the Hybrid System With Pedicle Screws Applicable to Weak, Tiny, and Fragile Vertebrae?
Authors: Ito Masaaki , Kakutani Kenichiro , Miyamoto Hiroshi , Suzuki Teppei , Yurube Takashi , Uno Koki 
Published: April 2021

Introduction:
Corrective surgery for spinal deformity associated with osteogenesis imperfecta (OI) is challenging due to the severe and rigid deformity combined with extreme bone fragility. However, surgical outcomes still remain unclear. In addition, the applicability of pedicle screws (PSs) to the tiny and fragile vertebrae in patients with OI is poorly understood. This study evaluated the surgical outcome, and the accuracy and safety of PS placement in patients with OI.

Methods:
Twenty-five patients with OI were included in this study. Mean age was 21.0±9.3 (10 to 49) years. Mean follow-up was 5.8±2.0 years. The Sillence classification showed 16 patients had the mildest type I, 1 patient had moderate type IV, and 8 patients had the most severe type III. Fifteen patients underwent anterior release followed by posterior fusion, and 10 patients underwent only posterior fusion. The accuracy of PS placement was evaluated with postoperative computed tomography.

Results:
Scoliosis was corrected from 95.6 to 65.8 degrees after surgery (correction rate 32.5%) and 68.1 degrees at final follow-up (both, P<0.01). Space available for the lung was improved from 76.3% to 84.9% (P<0.05). No implant dislodgement occurred after surgery. A total of 290 screws were placed, of which 213 screws (73.4%) were placed completely. However, 30 screws (10.3%) penetrated >2 mm. In particular, rates of >2 mm penetration was much higher in type III than type I and IV (27.8% vs. 3.0%; P<0.01). Complications related to spinal surgery included 2 transient neurological disturbances.

Conclusions:
PSs were applicable to spinal fusion surgery in patients with OI. However special care should be taken in placing PSs because of the weakness of the pedicle cortex, which was easily penetrated especially in Sillence type III.

Level of Evidence:
Level IV.
Long-term survival in an acute promyelocytic leukemia patient with recurrent granulocytic sarcomas
Authors: Zhou Xuehui , Li Chengwen 
Published: April 2021

Abstract

Rationale:
Granulocytic sarcoma (GS) is an extramedullary myeloid tumor composed of immature cells of the granulocytic series. It rarely occurs in acute promyelocytic leukemia (APL). No case of long-term survival in an APL patient with recurrent GS has been reported.

Patient concerns:
A 54-year-old female patient was diagnosed with APL in 1995 and has been in complete remission (CR) of bone marrow morphology for 24 years; however, recurrent GS occurred successively in ovary, breast, spine, body of sternum, lymph nodes, soft tissues from 2004 to 2019.

Diagnoses:
The immunohistochemistry confirmed the diagnosis of GS, and fluorescence in situ hybridization (FISH) revealed its origin from APL.

Interventions:
She received surgery, and had an excellent response to all-trans retinoic acid (ATRA), DA (daunorubicin combined with cytarabine) regimens, and arsenic trioxide (ATO).

Outcomes:
The patient achieved CR in March 2020 after radiotherapy followed by ATO and ATRA. So far, she is still in follow-up.

Lessons:
It is rare that recurrent GS at multiple sites is involved in APL patient with bone marrow morphology in CR. It is interesting to observe a long-term excellent response to ATRA, chemotherapy and ATO. Although multiple recurrence of GS in patients with APL is rare, the data in this case highlight the need for individualized treatment when such conditions occur.
Assessment of lesion-associated myocardial ischemia based on fusion coronary CT imaging – the FUSE-HEART study
Authors: Stanescu Alexandra Gorea , Benedek Imre , Opincariu Diana , Hodas Roxana , Ratiu Mihaela , Benedek Theodora 
Published: April 2021

Abstract

Introduction:
Multimodality assessment of coronary artery lesions has demonstrated superior effectiveness compared to the conventional approach, for assessing both anatomical and functional significance of a coronary stenosis. Multiple imaging modalities can be integrated into a fusion imaging tool to better assess myocardial ischemia.

Material and methods:
The FUSE-HEART trial is a single center, prospective, cohort study that will assess the impact of a coronary artery stenosis on myocardial function and viability, based on advanced fusion imaging technics derived from Cardiac Computed Tomography Angiography (CCTA). Moreover, the study will investigate the correlation between morphology and composition of the coronary plaques and myocardial ischemia in the territory irrigated by the same coronary artery. At the same time, imaging parameters will be correlated with inflammatory status of the subjects. The trial will include 100 subjects with coronary lesions found on CCTA examination. The study population will be divided into 2 groups: first group will consist of subjects with anatomically significant coronary lesions on native coronary arteries and the second one will include subjects surviving an acute myocardial infarction. The vulnerability score of the subjects will be calculated based on presence of CCTA vulnerability markers of the coronary plaques: napkin ring sign, positive remodeling, spotty calcifications, necrotic core, and low-density plaques. 3D fusion images of the coronary tree will be generated, integrating the images reflecting wall motion with the ones of coronary circulation. The fusion models will establish the correspondence between plaque composition and wall motion in the subtended myocardium of the coronary artery. The study primary outcome will be represented by the rate of major adverse cardiac events related to myocardial ischemia at 1-year post assessment, in correlation with the degree of coronary artery stenosis and myocardial ischemia or viability.
The secondary outcomes are represented by the rate of re-hospitalization, rate of survival and rate of major adverse cardiovascular events (including cardiovascular death or stroke), in correlation with the morphology and composition of atheromatous plaques located in a coronary artery, and myocardial ischemia in the territory irrigated by the same coronary artery.

Conclusion:
In conclusion, FUSE-HEART will be a study based on modern imaging tools that will investigate the impact of a coronary artery stenosis on myocardial function and viability, using advanced fusion imaging technics derived from CCTA, sighting to validate plaque composition and morphology, together with inflammatory biomarkers, as predictors to myocardial viability.
Association between MMP-2 gene polymorphism and cataract susceptibility
Authors: Jiang Huaiyan , Gao Yang , Chen Zhen , Xu Hongxia 
Published: April 2021

Abstract

Background:
Matrix metalloproteinase-2 (MMP-2) polymorphisms have been considered as risk factors of cataracts, but the results still remain controversial. In this study, we have performed a systematic meta-analysis to evaluate the association between MMP-2 polymorphisms and cataract risks.

Methods:
Published literature was retrieved from Wanfang, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Chongqing VIP Chinese Science and Technology Periodical Database, PubMed, Embase, and Web of Science databases. The case–control studies that explored the association between MMP-2 polymorphisms and cataract risks were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using random- or fixed-effects model.

Results:
This study could provide high-quality and evidence-based medical evidence for the correlation between MMP-2 polymorphisms and cataract risks

Conclusion:
The study could provide updated evidence for the evaluation of the relationship between MMP-2 polymorphism and cataract risk.

Ethics and dissemination:
The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not available. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF Registration Number:
DOI 10.17605/OSF.IO/KU9NE.
Associations of Common Depression Treatment Metrics With Patient-centered Outcomes
Authors: Carlo Andrew D. , Basu Anirban , Unützer Jürgen 
Published: April 2021

Background:
Various metrics predicated on Patient Health Questionnaire-9 (PHQ-9) scores denote depression “response” or “remission” over time, but few have been empirically validated. We compare the associations of depression response and remission metrics with concomitant clinical improvement in patient-centered outcomes (PCOs).

Subjects:
Secondary analysis of PHQ-9 and PCO data from the treatment arm (n=906) of the Improving Mood—Promoting Access to Collaborative Treatment (IMPACT) trial.

Research Design:
We conducted univariate correlations between 9 depression treatment metrics and 4 PCOs. For each PCO, we specified a multivariate linear fixed-effects regression model with penalized LASSO (least absolute shrinkage and selection operator) variable selection that included parameters for each incremental absolute PHQ-9 decrease between 0 and 16 points. Model predictive properties were assessed using a split sample analysis.

Results:
There was a notable variation in depression improvement rates across metrics. Each metric was significantly associated with PCOs in univariate analyses. In the multivariate models, the cumulative likelihood of PCO improvement was most improved by absolute PHQ-9 score decreases of 7–9 and 14–16 points. The multivariate models showed greater area under the curve (0.671–0.804) in out-of-sample predictions of PCO changes than the univariate models (0.529–0.649).

Conclusions:
Choice of depression response metric impacts observed response and remission rates, though PCOs tend to improve with depression improvement regardless of metric choice. Absolute incremental PHQ-9 score decreases are broadly associated with an increased likelihood of favorable PCO scores. Our findings support a novel PHQ-9 metric defined by an absolute score change of 8 points or greater.
Higher colorectal tissue HIV infectivity in cisgender women compared with MSM before and during oral preexposure prophylaxis
Authors: Sekabira Rogers , McGowan Ian , Yuhas Krista , Brand Rhonda M. , Marzinke Mark A. , Manabe Yukari C. , Frank Ian , Eron Joseph , Landovitz Raphael J. , Anton Peter , Cranston Ross D. , Anderson Peter , Mayer Kenneth H. , Amico K. Rivet , Wilkin Timothy J. , Chege Wairimu , Kekitiinwa Adeodata R. , McCauley Marybeth , Gulick Roy M. , Hendrix Craig W. 
Published: April 2021

Objective:
The objective of this study was to compare HIV-negative cisgender women (CGW) with MSM for mucosal tissue differences in pharmacokinetics, HIV infectivity and cell phenotype.

Design:
A substudy of HPTN 069/ACTG A5305, 48-week study of three oral candidate preexposure prophylaxis regimens: maraviroc, maraviroc/emtricitabine and maraviroc/tenofovir disoproxil fumarate (TDF) compared with a TDF/emtricitabine control group.

Methods:
Plasma, peripheral blood mononuclear cells and cervical and colorectal tissue biopsies were collected at Baseline (no drug), Week 24 and 48 (on drug), and Week 49 (1-week postdrug). Drug concentrations were assessed in all matrices. HIV infectivity was assessed using tissue biopsy ‘explants’ challenged with HIV ex vivo followed by HIV p24 measurement. Flow cytometry evaluated colorectal cell phenotype.

Results:
Thirty-seven CGW and 54 MSM participated. CGW's colorectal explant p24 was higher than MSM before (0.31 log10, P = 0.046), during (1.01-1.19 log10, P = 0.016) and one week after (0.61 log10, P = 0.011) study drug dosing. Pooling regimens, cervical explant p24 did not differ among visits. CGW had higher plasma maraviroc and colorectal tissue tenofovir diphosphate and lower colorectal tissue emtricitabine (all P < 0.005) compared with MSM. Each study drug's cervical tissue concentrations were more than 10-fold below paired colorectal concentrations (P < 0.001). Cell phenotype sex differences included 4% higher CD38+/CD8+ cells at baseline and 3–7% higher CD69+/CD8+ cells throughout Weeks 24–49 in CGW compared with MSM (P < 0.05).

Conclusion:
Colorectal explants in CGW demonstrated greater HIV infectivity than MSM with and without study drugs. Small differences in adherence, drug concentration and colorectal tissue flow cytometry cannot fully explain this difference.
Incident obstructive lung disease and mortality among people with HIV and a history of injecting drugs
Authors: Kalmin Mariah M. , Westreich Daniel , Drummond Bradley M. , Sun Jing , Mehta Shruti H. , Kirk Gregory D. 
Published: April 2021

Objective:
People with HIV (PWH) experience increased prevalence of obstructive lung disease (OLD), regardless of greater observed smoking behaviors. We investigated whether the effect of incident OLD on mortality differed by HIV and HIV viral suppression among persons who inject drugs (PWID) and report smoking history.

Design:
ALIVE is a longitudinal, observational cohort study of HIV-positive and seronegative PWID. This analysis included participants who had at least one spirometry measure to assess OLD between 2007 and 2016, excluding those who never smoked (5%, n = 62) or had baseline OLD (17%, n = 269).

Methods:
Incident OLD occurred when the first prebronchodilator forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) less than 0.70 during follow-up. The effect of incident OLD on all-cause mortality was estimated in PWH and seronegative participants using inverse-probability-of-treatment-weighted marginal structural models controlling for baseline (age, race, sex, calendar year, smoking pack-years) and time-varying (smoking intensity, viral suppression, and calendar time) confounders.

Results:
Among 1204 participants, 269 (22.3%) and 157 (13.0%) experienced incident OLD and death, respectively, over a median of five person-years of follow-up. There was no effect of OLD on mortality among seronegative participants [hazard ratio = 0.84, 95% confidence interval (CI): 0.47–1.48]; however, PWH diagnosed with OLD experienced an increased mortality risk (hazard ratio = 1.71, 95% CI: 1.04–2.80) during follow-up. HIV viral suppression did not confound or modify the effect of OLD on mortality among PWH.

Conclusion:
There was an apparent effect of OLD on all-cause mortality irrespective of viral suppression among PWH but not among seronegative persons, after accounting for baseline and time-varying confounders. These results highlight the need for enhanced screening and management of OLD among PWH.
Uncovering an Optic Nerve Sheath Meningioma Using 68Ga-DOTATATE PET/CT
Authors: Vay Sabine Ulrike , Werner Jan-Michael , Kabbasch Christoph , Schmidt Matthias , Drzezga Alexander , Fink Gereon R. , Galldiks Norbert , Warnke Clemens 
Published: April 2021

Abstract
A 56-year-old woman was initially diagnosed with optic neuritis. However, several “red flags” were present: older age at presentation, no multiple sclerosis suspicious findings on MRI, and negative oligoclonal bands. 68Ga-DOTATATE PET/CT confirmed the differential diagnosis of an optic sheath meningioma. Our case stresses the value of the somatostatin receptor ligand PET/CT in patients with suspected optic neuritis if the diagnostic workup does not support immune-mediated pathogenesis.
Elevated 68Ga-FAPI Activity in the Plasmacytoma of the Ribs
Authors: Tang Wenxin , Wang Qixin , Yang Songsong , Chen Yue 
Published: April 2021

Abstract

68Ga-labeled quinoline-based fibroblast activation protein inhibitors (68Ga-FAPIs) has been used in the evaluation of a variety of malignancies. We report the case of a patient with rib plasmacytoma, which showed elevated 68Ga-FAPI activity. This case indicated fibroblast activation protein overexpression and some degree of fibrosis in the plasmacytoma lesion. Therefore, 68Ga-FAPI can be a potential tracer in the evaluation of plasmacytoma.
68Ga-FAPI Uptake of Thyroiditis in a Patient With Breast Cancer
Authors: Can Canan , Gündoğan Cihan , Güzel Yunus , Kaplan İhsan , Kömek Halil 
Published: April 2021

Abstract

68Ga–fibroblast activation protein–specific inhibitor (FAPI)-04 PET/CT was performed in a 49-year-old woman diagnosed with breast cancer. In PET/CT imaging, intense 68Ga-FAPI uptake was observed in the primary tumor, axillary lymph nodes, and also in the thyroid gland, whereas pathological 18F-FDG uptake was not observed in the thyroid gland. On thyroid ultrasonography, parenchyma was heterogeneous, and an area of focal thyroiditis was observed in the superior part of the right lobe. Biochemical parameters were found to be consistent with thyroiditis. This case shows that FAPI uptake in the thyroid gland may be associated with thyroiditis and should be evaluated clinically.
Elevated 68Ga-FAPI Activity in Splenic Hemangioma and Pneumonia
Authors: Liu Huipan , Wang Yingwei , Zhang Wei , Cai Liang , Chen Yue 
Published: April 2021

Abstract
A 59-year-old woman with newly diagnosed pulmonary nodules underwent both 18F-FDG and 68Ga-FAPI PET/CT. Both studies showed similarly increased uptake in pneumonia. However, only 68Ga-FAPI PET/CT showed increased uptake in splenic hemangioma, whereas FDG uptake in the splenic lesion is low. Our case illustrates that splenic hemangioma can also reveal increased FAPI activity.
68Ga-PSMA PET/CT Scan on Postoperative Assessment of Sinonasal Glomangiopericytoma
Authors: Sakthivel Pirabu , Kumar Arunav , Arunraj Sreedharan Thankarajan , Singh Chirom Amit , Kumar Rakesh 
Published: April 2021

Abstract
Prostate-specific membrane antigen (PSMA) is expressed on the endothelial cells of tumor-associated neovasculature of various nonprostatic benign and malignant neoplasms. Positive intense uptake on PET/CT imaging with 68Ga-labeled PSMA is noted in a patient with sinonasal glomangiopericytoma, and the same is noted to be absent following complete surgical excision. 68Ga-PSMA PET/CT may be a useful tool for early recurrence identification, differentiating recurrence from surgical site reparative tissues, and peptide receptor radionuclide therapy of residual lesions.
Magnetic Resonance Imaging of the Oral Cavity and Oropharynx
Authors: Varghese Jerrin , Kirsch Claudia 
Published: April 2021

Abstract
Understanding oral cavity and oropharyngeal anatomy is important to identify various pathologies that may afflict them. This article reviews normal magnetic resonance imaging anatomy of these vital spaces and structures, with special attention to the complex musculature, mucosal surfaces, relevant osseous structures, salivary glands, and nerves. Anatomic awareness of these spaces and critical potential pathways for perineural tumoral spread are important to recognize to improve diagnostic evaluation and treatment.
Autologous Fat Grafting and the Occurrence of Radiation-Induced Capsular Contracture
Authors: Martin Shanique , Cai Lawrence , Beniwal Amit , Tevlin Ruth , Lee Gordon , Nazerali Rahim S. 
Published: April 2021

Introduction
Radiation therapy is a known risk factor for capsular contracture formation after implant-based breast reconstruction. Although autologous fat grafting (AFG) has been shown to reverse radiation-induced tissue fibrosis, its use as a prophylactic agent against capsular contraction has not been assessed in the clinical setting. In the setting of 2-stage implant-based reconstruction and postmastectomy radiation therapy, we explored the effect AFG has on the prevalence of capsular contracture.

Materials and Methods
A retrospective chart review of patients who underwent immediate tissue expander (TE) placement followed by postmastectomy radiation therapy and secondary implant-based reconstruction at our institution between January 2012 and December 2019 was performed. Patients were divided into 2 cohorts based on whether or not AFG was performed at the time of secondary reconstruction. The primary outcome of interest was the occurrence of capsular contracture after TE exchange.

Results
Overall 57 patients (57 breasts) were included, 33 of whom received AFG at the time of TE exchange. All but 1 patient underwent submuscular implant placement, and the mean follow-up was 1.96 years. There was no significant difference in the prevalence of medical comorbidities between the study groups.
Capsular contracture occurred in 24 patients (42.1%). Seventeen of these patients had undergone AFG at the time of TE exchange (17/33 patients, 51.5%), and 7 of these patients had not (7/24 patients, 29.2%). Most of the capsular contracture cases were Baker grades III or IV (14 patients, 58.3%), and 50% of patients with capsular contracture of any grade ultimately required operative intervention. Multivariate logistic regression analysis demonstrated that AFG did not significantly influence the occurrence or severity of capsular contracture, or did not impact the need for operative intervention in this patient population.

Conclusions
Implant-based reconstruction of the irradiated breast is associated with high postoperative capsular contracture rates. Although AFG has shown promise in reversing radiation-induced dermal fibrosis, no protective effect on the development of capsular contracture after stage 2 reconstruction was observed in this study population. Further investigation in the form of randomized, prospective studies is needed to better assess the utility of AFG in preventing capsular contracture in irradiated patients.
Evaluation of Research Opportunities and Limitations for Plastic Surgery Residents
Authors: Navia Alfonso , Berner Juan Enrique , Ramirez Joaquin , Will Patrick , Tejos Rodrigo , Dagnino Bruno , Searle Susana , Cuadra Alvaro 
Published: April 2021

Background
Conducting research during specialty training provides an opportunity to develop critical thinking and leadership skills along with a better understanding of the scientific literature. However, trainees often find it difficult to undertake research, in the context of labor-intensive surgical training. The aim of this study is to evaluate the research output and limitations of plastic surgery residents in different countries.

Methods
An international cross-sectional study involving plastic surgery trainees and recent postgraduates from Brazil, Chile, Germany, and the United Kingdom was conducted. A survey inquiring into academic productivity, limitations to conducting research, and working-hours patterns was distributed among eligible participants.

Results
From September to December 2019, 106 surveys were retrieved. Most respondents declared having participated in at least 1 project that resulted in a presentation or publication during their training (90.6% in national presentations, 68% international presentations, 67% in national publications, and 66% international publications). Having completed a previous research fellowship was associated with a statistically higher academic output (P < 0.05). Seventy-nine percent of respondents felt that their participation in research activities would have been greater if limiting factors had been addressed, including lack of time (72.5%) and insufficient supervision and mentoring (55%).

Conclusions
Optimizing plastic surgery trainees' participation in scientific research is beneficial both for residents and their mentors. Research fellowships can provide an opportunity for academically oriented trainees to further develop their research skills. Protected time and adequate mentoring can help not only to increase residents' research output, but also to recruit the next generation of academic plastic surgeons.