bluuebunny/crossref_metadata_2025_split huggingface dataset:
Right anterior insula is associated with pain generalization in patients with fibromyalgia
Authors: Liu Hung-Yu , Chou Kun-Hsien , Lee Pei-Lin , Wang Yen-Feng , Chen Shih-Pin , Lai Kuan-Lin , Lin Ching-Po , Wang Shuu-Jiun , Chen Wei-Ta 
Published: July 2021

Abstract
Despite diffuse tenderness, patients with fibromyalgia (FM) have reported a wide range of areas with musculoskeletal pain. This study investigated the neural structures and neuroanatomical networks associated with self-reported widespread pain in FM using magnetic resonance imaging. We collected clinical profiles and brain magnetic resonance imaging data of newly diagnosed patients with FM. A total of 138 patients with FM were divided into 3 subgroups based on the number of pain areas, with 3 to 8, 9 to 12, and 13 to 19 areas, respectively. Using voxel-based morphometry analysis, we first identified the neural structure that showed a trend of volumetric change across the 3 subgroups. We then used it as a candidate seed of interest with a seed-to-voxel analytical approach to explore the structural covariance (SC) networks of the whole brain. Finally, we studied the trend of changes in the distribution and strength of SC networks across subgroups of patients. We found a decreasing trend in the volumes of the right anterior insular cortex (rAIC) across the 3 subgroups that had an increased number of pain areas. An increasing trend in the number of neural substrates over the subcortical regions, especially the basal ganglion, showed SC to the rAIC, and a decreasing trend of SC strength was shown between the rAIC and the precuneus, frontal cortex, anterior and posterior cingulate, and lingual gyri, across the patient subgroups with increased pain areas. The rAIC and its altered connection with specific brain regions indicates widespread pain in patients with FM.
Functional outcomes following critical illness: epidemiology, current management strategies and the future priorities
Authors: McPeake Joanne , Sevin Carla M. , Mikkelsen Mark E. 
Published: July 2021

Purpose of review
Intensive care unit (ICU) survivorship has gained significant attention over the course of the COVID-19 pandemic. In this review, we summarize the contemporary literature in relation to the epidemiology and management of post-ICU problems.

Recent findings
Survivors of critical illness can have complex physical, social, emotional and cognitive needs in the months following hospital discharge. Emerging evidence has shown that pre-ICU characteristics such as educational attainment, alongside in-ICU factors such as delirium, may contribute to worsening outcomes. Evidence regarding the impact of post-ICU recovery services is evolving, but models such as post-ICU clinics and peer support programs are gaining rapid momentum.

Summary
Future research should focus on modifiable risk factors and how identification and treatment of these can improve outcomes. Furthermore, rigorous evaluation of postacute critical care recovery services is necessary.
Fixation of intertrochanteric femur fractures using the SIGN intramedullary nail augmented by a lateral plate in a resource-limited setting without intraoperative fluoroscopy: assessment of functional outcomes at one-year follow-up at Juba Teaching Hospital
Authors: Areu Mapuor M.M. , von Kaeppler Ericka P. , Madison Brian Billy , Aguto Akau A. , Alphones James , Zirkle Lewis G. , Morshed Saam , Shearer David W. 
Published: July 2021

Abstract

Objectives:
The incidence of hip fracture is high and increasing globally due to an aging population. Morbidity and mortality from these injuries are high at baseline and worse without prompt surgical treatment to facilitate early mobilization. Due to resource constraints, surgeons in low-income countries often must adapt available materials to meet these surgical needs. The objective of this study is to assess functional outcomes after surgical fixation of intertrochanteric femur fractures with the Surgical Implant Generation Network (SIGN) intramedullary nail augmented by a lateral SIGN plate.

Design:
Prospective case series

Setting:
Juba Teaching Hospital, Tertiary Referral Hospital for South Sudan

Participants:
Adult patients with intertrochanteric hip fractures

Intervention:
SIGN nail augmented by a lateral plate

Main Outcome Measurements:
Primary outcome was hip function as measured by a modified Harris Hip Score (mHHS) at 1-year after surgery. Secondary endpoints were the occurrence of reoperation or infection at 1-year after surgery.

Results:
Thirty patients were included, 16 (53%) men and 14 (47%) women, with a mean age of 62 years. Fractures were classified as AO/OTA Type 31A1 in 12 (40%) patients, 31A2 in 15 (50%) patients, and 31A3 in 3 (10%) patients. Mean mHHS at 1-year was 75.10 ± 21.2 with 76% categorized as excellent or good scores. There was 1 (3%) infection and 2 (7%) reoperations.

Conclusions:
The SIGN nail augmented by a lateral plate achieved good or excellent hip function in the majority of patients with intertrochanteric hip fractures. This may be a suitable alternative to conventional implants for hip fracture patients in low-resource settings to allow mobilization.
Review: Head and Eye Movements and Gaze Tracking in Baseball Batting
Authors: Toole Andrew J. , Fogt Nick 
Published: July 2021

SIGNIFICANCE
After a 30-year gap, several studies on head and eye movements and gaze tracking in baseball batting have been performed in the last decade. These baseball studies may lead to training protocols for batting. Here we review these studies and compare the tracking behaviors with those in other sports.
Baseball batters are often instructed to “keep your eye on the ball.” Until recently, the evidence regarding whether batters follow this instruction and if there are benefits to following this instruction was limited. Baseball batting studies demonstrate that batters tend to move the head more than the eyes in the direction of the ball at least until a saccade occurs. Foveal gaze tracking is often maintained on the ball through the early portion of the pitch, so it can be said that baseball batters do keep the eyes on the ball. While batters place gaze at or near the point of bat-ball contact, the way this is accomplished varies. In some studies, foveal gaze tracking continues late in the pitch trajectory, whereas in other studies, anticipatory saccades occur. The relative advantages of these discrepant gaze strategies on perceptual processing and motor planning speed and accuracy are discussed, and other variables that may influence anticipatory saccades including the predictability of the pitch and the level of batter expertise are described. Further studies involving larger groups with different levels of expertise under game conditions are required to determine which gaze tracking strategies are most beneficial for baseball batting.
Association between Clinical Vision Measures and Visual Perception and Soccer Referees' On-field Performance
Authors: Baptista Antonio M. G. , Serra Pedro M. , Faisal Muhammad , Barrett Brendan T. 
Published: July 2021

SIGNIFICANCE
The decisions taken by soccer officials are critically important to game management. Understanding the underlying processes that mediate expert performance in soccer refereeing may lead to a better standard of officiating. Vision is the dominant source of incoming information upon which officials rely to make their on-field decisions.

PURPOSE
We tested the hypothesis that performance on generic tests of vision and visual perception predicts domain-specific performance in elite-level soccer referees (R) and assistant referees (AR).

METHODS
We assessed the vision of R and AR who officiate at the highest level in Portugal. To be eligible for inclusion, R and AR had to have officiated for at least two consecutive seasons across the 2014/2015, 2015/2016, and 2016/2017 seasons. A single, rank-order list of the performance of eligible officials was created based on the rank-order list for each season that was made by the Portuguese Soccer Federation. Clinical vision measures included visual acuity and stereoacuity, and visual perception measures were gathered using the Test of Visual Perceptual Skills, Third Edition.

RESULTS
A total of 59 officials participated (21 R, 38 AR), 17 of whom officiated at the international level. The R and AR groups did not differ in vision or visual perception measures. We found that better stereoacuity (P < .001) and visual memory (P = .001) are associated with a higher rank order of on-field performance after adjusting for the age, experience, the national/international status, and the regional affiliation of the officials. Together, these two measures explain 22% of the variance in rank-order performance.

CONCLUSIONS
This is the first study to show a link between the vision of officials and their on-field performance. The origin and significance of these findings remain to be established, and further work is required to establish whether they are component skills in the domain of soccer refereeing.
Eliminating Lumbar Puncture for Low-Risk Febrile Infants
Authors: Gala Payal K. , Scarfone Richard J. , Murray Ashlee , Balamuth Fran 
Published: July 2021

Background
Bacterial meningitis in low-risk febrile young infants (FYIs) aged >28 days has become increasingly rare. Routine performance of lumbar puncture (LP) in these infants is associated with adverse consequences and may be unnecessary. We modified our clinical practice guideline (CPG) to reduce the number of FYIs 29 to 56 days old who receive LP.

Methods
This quality improvement project sought to modify a preexisting CPG to diagnose and manage FYIs 0 to 56 days old that eliminated routine performance of LP in children 29 to 56 days old who were considered low-risk for serious bacterial infection. The change was implemented by making adjustments to the online CPG. A statistical process control chart was used to assess the affect of the initiative on our primary outcome of LP rate in this population of FYIs.

Results
Postimplementation of the CPG initiative, 71% of FYIs 29 to 56 days old did not receive LP, compared with 42% preimplementation. This practice change was also associated with fewer hospitalizations, lower median emergency department (ED) length of stay, and fewer 72-hour ED revisits. Over 3 years of sustained practice, 1/713 (0.1%; 95% confidence interval, 0%–0.8%) low-risk FYI returned within 72 hours and was subsequently treated for probable bacterial meningitis, although cerebrospinal fluid culture was negative for bacterial growth.

Conclusions
A change in CPG reduced the number of LPs performed in febrile infants 29 to 56 days old. This change resulted in fewer LPs, hospitalizations, ED revisits, and a lower ED length of stay for FYIs 29 to 56 days old.
A Comparison of Surgical Complications in Patients Undergoing Delayed versus Staged Tissue-Expander and Free-Flap Breast Reconstruction
Authors: Shammas Ronnie L. , Cason Roger W. , Sergesketter Amanda R. , Glener Adam D. , Broadwater Gloria , Hollins Andrew , Le Elliot , Marks Caitlin , Atia Andrew N. , Orr Jonah P. , Hollenbeck Scott T. 
Published: July 2021

Background:
Patients undergoing mastectomy may not be candidates for immediate free-flap breast reconstruction because of medical comorbidities or postmastectomy radiation therapy. In this setting, flap reconstruction may be intentionally delayed or staged with tissue expander placement (“delayed-immediate” reconstruction). The optimal reconstructive choice and incidence of complications for these approaches remain unclear.

Methods:
The authors retrospectively identified patients who underwent delayed [n = 140 (72 percent)] or staged [n = 54 (28 percent)] abdominal free-flap breast reconstruction between 2010 and 2018 and compared the incidence of postoperative complications.

Results:
Patients undergoing staged reconstruction had a higher overall incidence of perioperative complications, including surgical-site infection (40.7 percent versus 6.5 percent; p < 0.001), wound healing complications (29.6 percent versus 12.3 percent; p = 0.004), hematoma (11.1 percent versus 0.7 percent; p < 0.001), and return to the operating room (27.8 percent versus 4.4 percent; p < 0.0001). These complications occurred predominately during the expansion stage, resulting in an 18.5 percent (n = 10) rate of tissue expander failure. Mean time from mastectomy to flap reconstruction was 476.8 days (delayed, 536.4 days; staged, 322.4 days; p < 0.001). At the time of flap reconstruction, there was no significant difference in the incidence of complications between the staged cohort versus the delayed cohort, including microsurgical complications (1.9 percent versus 4.3 percent; p = 0.415), total flap loss (0 percent versus 2.1 percent; p = 0.278), or fat necrosis (5.6 percent versus 5.0 percent; p = 0.875).

Conclusions:
The aesthetic and psychosocial benefits of staged free-flap breast reconstruction should be balanced with the increased risk of perioperative complications as compared to a delayed approach. Complications related to definitive flap reconstruction do not appear to be affected by the approach taken at the time of mastectomy.

Clinical Question/Level of Evidence:
Therapeutic, III.
Relationship between level of daily activity and upper-body aerobic capacity in adults with a lower limb amputation
Authors: Mellema Mirjam , Mirtaheri Peyman , Gjøvaag Terje 
Published: July 2021

Background:
Previous studies show that people with lower limb amputation (LLA) have a sedentary lifestyle, reduced walking capacity, and low cardiorespiratory fitness (VO2peak). There is, however, no knowledge on the relationship between cardiorespiratory fitness and objectively measured level of physical activity in daily life.

Objectives:
To investigate the relationship between upper-body VO2peak, physical activity levels, and walking capacity in persons with LLA.

Study design:
Correlational and descriptive study.

Methods:
Fourteen participants with LLA performed an assessment of VO2peak on an arm-crank ergometer and walking capacity (preferred walking speed and 2-minute walking test). Level of physical activity was measured over 7 days with a step activity monitor (number of steps; sedentary time; and proportion of low-intensity, moderate-intensity, high-intensity, and peak-intensity activity level).

Results:
VO2peak correlated significantly with number of steps per day (r = 0.696, p = 0.006), sedentary time (r = −0.618, p = 0.019), high-intensity activity level (r = 0.769, p = 0.001), and peak-intensity activity level (r = 0.674, p = 0.008). After correcting for age, correlations were still large and significant. Large correlations were also found between VO2peak, preferred walking speed (r = 0.586, p = 0.027), and 2-minute walking test (r = 0.649, p = 0.012).

Conclusions:
We provide the first evidence of the strong relationships between upper-body VO2peak, sedentary behavior, high-intensity activity level, and walking capacity in persons with LLA. Further research is needed to investigate the potential effect of upper-body cardiorespiratory fitness on the level of activity in daily life, or vice versa.
Spindle Cell Lipoma Revisited: Common and Unusual Magnetic Resonance Imaging Findings in 54 Patients With New Observations
Authors: Kumar Rajendra , Lefkowitz Robert A. , Agaram Narasimhan P. , Amini Behrang , Satcher Robert L. , Wang Wei-Lien 
Published: July 2021

Abstract
The aims of the study were to study demographic data of patients with spindle cell lipoma and describe a spectrum of magnetic resonance imaging features of the tumor.
Radiomics-Based Machine Learning Classification for Glioma Grading Using Diffusion- and Perfusion-Weighted Magnetic Resonance Imaging
Authors: Hashido Takashi , Saito Shigeyoshi , Ishida Takayuki 
Published: July 2021

Objective
The aim of this study was to evaluate various radiomics-based machine learning classification models using the apparent diffusion coefficient (ADC) and cerebral blood flow (CBF) maps for differentiating between low-grade gliomas (LGGs) and high-grade gliomas (HGGs).

Methods
Fifty-two glioma patients, including 18 LGGs (grade II) and 34 HGGs (grade III/IV), were examined using a 3.0-T magnetic resonance scanner. The ADC and CBF maps were obtained from diffusion-weighted imaging and pseudo-continuous arterial spin labeling perfusion-weighted imaging, respectively. A total of 91 radiomic features were extracted from each of the tumor volume on the ADC and CBF maps. We constructed 4 types of machine learning classifiers based on (1) least absolute shrinkage and selection operator regularized logistic regression (LASSO-LR), (2) random forest (RF), (3) support vector machine (SVM) with the radial basis function kernel (SVM-RBF), and (4) SVM with the linear kernel (SVM-L). A training set with 36 gliomas (70%) was used to select the important radiomic features and train each model using 5-fold cross-validation. The remaining 16 gliomas (30%) were used as a test set. Receiver operating characteristic analysis was performed to evaluate the model performance.

Results
A radiomic feature, ADC first-order-based skewness, was selected as an important variable in all classification models. According to the receiver operating characteristic analysis, the areas under the curve of the LASSO-LR, RF, SVM-RBF, and SVM-L models for the training set were 0.965, 1.000, 0.979, and 0.969, respectively. For the test set, the areas under the curve of the LASSO-LR, RF, SVM-RBF, and SVM-L models were 0.883, 0.917, 0.717, and 0.917, respectively. All classification models showed sufficient diagnostic performance on the test set.

Conclusions
Radiomics-based machine learning classifiers using the quantitative ADC and CBF maps are useful for differentiating HGGs from LGGs.
Collaborative Writing Projects: Set Yourself up for Success
Authors: Catanzano Tara , Robbins Jessica B. , Schwartz Fides R. , Rajiah Prabhakar , Wang Sherry S. , Nandwana Sadhna , Soloff Erik V. , Folio Les R. 
Published: July 2021

Abstract
This article will review critical components for the successful completion of a multi-institution, multiauthor collaborative paper. Best practices for the creation and publication of a collaborative paper will be addressed.
Usefulness of Virtual Monochromatic Images and Iodine Maps Derived from Dual-Energy Computed Tomography for Diagnosing Deep Neck Abscesses
Authors: Hattori Youhei , Azuma Minako , Nakada Hiroshi , Kimura Aya , Khant Zaw Aung , Tono Tetsuya , Hirai Toshinori 
Published: July 2021

Objective
We aimed to determine whether dual-energy computed tomography (CT) is useful for evaluating deep neck abscesses.

Methods
This study included 22 consecutive patients who were clinically suspected of having a deep neck abscess and underwent dual-energy CT. Conventional 120-kVp images, 70- and 40-keV virtual monochromatic images (VMIs), and iodine maps were inspected to calculate the contrast ratio of the abscess rim (AR) to the abscess center (AC) or to the adjacent muscle (M). The diagnostic certainty of abscesses was assessed on these images.

Results
Twenty (91%) of 22 patients had a definitive diagnosis. The contrast ratio for AR/AC and AR/M was significantly higher on 40-keV VMIs and iodine maps than on 120-kVp images and 70-keV VMIs (P < 0.05). On both 40-keV VMIs and iodine maps, the diagnostic certainty of abscess improved in 3 (15%) cases compared with 120-kVp images and 70-keV VMIs.

Conclusions
Dual-energy CT-based 40-keV VMIs and iodine maps are useful for evaluating deep neck abscesses and may improve diagnostic certainty.
Therapeutic Computed Tomography–Guided Pericardiocentesis: Lessons Learned Based on a 7-Year Single-Center Experience
Authors: Khashper Alla , Shelef Ilan , Taragin Benjamin Hyatt , Smolikov Alexander 
Published: July 2021

Objective
Pericardiocentesis is a well-known procedure commonly performed by either image-guided intervention or surgical approaches. Computed tomography (CT)–guided pericardiocentesis is not widely used, but provides certain advantages. In the article we will discuss our technique of CT-guided therapeutic pericardiocentesis, including advantages and disadvantages, patient selection, possible approaches, and complications.

Methods
The retrospective study included 121 therapeutic pericardial drainages performed under CT guidance. Demographic data of the patients, entry site, and needle orientation were recorded. Procedure complications and their significance were analyzed.

Results
One hundred and twenty-one pericardial drainages with catheter insertion were performed under CT guidance on 119 patients presenting with clinically significant pericardial effusion. The most common approach was at the left anterior chest wall. The rate of minor complications was 5.8%, no major complications occurred.

Conclusions
Therapeutic pericardiocentesis can be obtained under CT guidance in a safe and effective manner. Recommendations for building a patient-centered protocol with an interdisciplinary team are discussed. Patient selection, procedural guidance, and lessons to avoid complications are reviewed.
Increased 68Ga-FAPI Uptake in Ankylosing Spondylitis in a Patient With Rectal Cancer
Authors: Yao Lanlin , Zhao Long , Pang Yizhen , Shang Qihang , Chen Haojun 
Published: July 2021

Abstract
Ankylosing spondylitis represents an inflammatory arthropathy with a predilection for the axial skeleton. We reported 68Ga-FAPI PET/CT finding of ankylosing spondylitis in a 65-year-old patient with rectal cancer. In addition to accumulating in primary tumor and metastatic lymph nodes, increased 68Ga-FAPI uptake was also observed in the sacroiliac and costovertebral joints, indicating sacroiliitis and spondylitis. However, no abnormal 18F-FDG uptake was observed in the inflammatory lesions. This case highlighted that 68Ga-FAPI PET/CT is useful for the evaluation of inflammatory conditions in ankylosing spondylitis.
Feasibility and Therapeutic Potential of 177Lu–Fibroblast Activation Protein Inhibitor–46 for Patients With Relapsed or Refractory Cancers
Authors: Assadi Majid , Rekabpour Seyed Javad , Jafari Esmail , Divband GhasemAli , Nikkholgh Babak , Amini Hamidreza , Kamali Hassan , Ebrahimi Sakineh , Shakibazad Nader , Jokar Narges , Nabipour Iraj , Ahmadzadehfar Hojjat 
Published: July 2021

Introduction
Fibroblast activation protein (FAP) is a member of the serine protease family and has a high expression in the stroma of approximately 90% of epithelial malignancies. The present investigation aimed to assess the feasibility, safety, and dosimetry data of 177Lu-FAPI-46 in diverse malignancies.

Patients and Methods
Patients with advanced cancers with nonoperable tumors, or tumors refractory to conventional therapies, were enrolled. Treatment included escalating doses of 177Lu-FAPI-46 (1.85–4.44 GBq) per cycle using a combination of clinical and statistical expertise design, and intervals of 4 to 6 weeks were considered between the cycles. Biodistribution and dosimetry were examined by whole-body scans. We applied the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03 to measure peptide-targeted radionuclide therapy (PTRT)–associated toxicity.

Results
A total of 21 patients (11 females and 10 males) with a median age of 50 years (range, 6–79 years) were investigated. Of 21 participants, 18 cases were selected for PTRT. Overall, 36 PTRT cycles were performed. The median number of PTRT cycles and the median injected amount of activity in each cycle were 2 and 3.7 GBq, respectively. The dosimetric analysis revealed median absorbed doses of 0.026, 0.136, 0.886, and 0.02 with ranges of 0.023–0.034, 0.001–0.2, 0.076–1.39, and 0.002–0.2 mGy/MBq for the whole body, liver, kidneys, and spleen, respectively. The therapy was well tolerated in almost all patients.

Conclusions
The findings of this preliminary investigation might indicate the potential feasibility and safety of PTRT using 177Lu-FAPI-46 for different aggressive tumors. Moreover, the current study could be beneficial in determining the suitable amount of activity for a phase 2 study.