bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of Automatic Planning of Fronto-orbital Advancement for the Surgical Correction of Metopic Craniosynostosis
Authors: García-Mato David , Porras Antonio R. , Ochandiano Santiago , Rogers Gary F. , García-Leal Roberto , Salmerón José I. , Pascau Javier , Linguraru Marius George 
Published: November 2021

Background:
The surgical correction of metopic craniosynostosis usually relies on the subjective judgment of surgeons to determine the configuration of the cranial bone fragments and the degree of overcorrection. This study evaluates the effectiveness of a new approach for automatic planning of fronto-orbital advancement based on statistical shape models and including overcorrection.

Methods:
This study presents a planning software to automatically estimate osteotomies in the fronto-orbital region and calculate the optimal configuration of the bone fragments required to achieve an optimal postoperative shape. The optimal cranial shape is obtained using a statistical head shape model built from 201 healthy subjects (age 23 ± 20 months; 89 girls). Automatic virtual plans were computed for nine patients (age 10.68 ± 1.73 months; four girls) with different degrees of overcorrection, and compared with manual plans designed by experienced surgeons.

Results:
Postoperative cranial shapes generated by automatic interventional plans present accurate matching with normative morphology and enable to reduce the malformations in the fronto-orbital region by 82.01 ± 6.07%. The system took on average 19.22 seconds to provide the automatic plan, and allows for personalized levels of overcorrection. The automatic plans with an overcorrection of 7 mm in minimal frontal breadth provided the closest match (no significant difference) to the manual plans.

Conclusions:
The automatic software technology effectively achieves correct cranial morphometrics and volumetrics with respect to normative cranial shapes. The automatic approach has the potential to reduce the duration of preoperative planning, reduce inter-surgeon variability, and provide consistent surgical outcomes.
INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE WITHOUT POSTOPERATIVE FACE-DOWN POSITIONING FOR MACULAR HOLE REPAIR
Authors: Ruparelia Sunil , Tuli Raman , Park John S.Y. , Shoham-Hazon Nir , Berco Efraim 
Published: November 2021

Purpose:
To describe the outcomes of the inverted internal limiting membrane flap technique without postoperative face-down positioning for macular hole (MH) closure.

Methods:
This retrospective longitudinal study identified patients who had undergone surgical repair for large (>400 µm), idiopathic MHs and did not maintain face-down positioning postoperatively. Outcome measures included anatomical success, defined as confirmation of hole closure by the optical coherence tomography scan and functional success and defined as improved best-corrected visual acuity from baseline at the last follow-up.

Results:
Of the 63 eyes enrolled in the study, 94% patients (59 of 63) achieved anatomical success and 91% patients (57 of 63) achieved functional success. Fifteen (15) of these patients presented with a MH >600 µm. This subgroup achieved an anatomical success rate of 93% and a functional success rate of 87%. Statistically significant improvement in best-corrected visual acuity was demonstrated for all subgroups of MH size (P < 0.001).

Conclusion:
We report a high success rate of large, idiopathic MH closure with the inverted internal limiting membrane flap technique without postoperative face-down positioning. The results described in this study are favorable. However, larger studies with prospective design are warranted to explore this further.
Outcomes of Penetrating Keratoplasty After Open Globe Injury
Authors: Li Katie X. , Durrani Asad F. , Zhou Yunshu , Zhao Peter Y. , Tannen Bradford L. , Mian Shahzad I. , Musch David C. , Zacks David N. 
Published: November 2021

Purpose:
The purpose of this study was to investigate the clinical features, surgical outcomes, and prognostic factors of penetrating keratoplasty (PKP) after open globe injury (OGI).

Methods:
A retrospective review of all patients treated for OGI between January 2000 and July 2017 was conducted. Demographic, preoperative, perioperative, and postoperative data were collected for those who underwent PKP after OGI. The predictive value of each preoperative variable on graft failure was assessed using univariate and multivariable Cox proportional hazards models, and the predictive value of variables on post-PKP visual outcome was assessed using both univariate and multivariable logistic regression models. All eyes that underwent PKP after OGI were included unless they had less than 365 days of follow-up.

Results:
Forty-six eyes that underwent PKP met inclusion criteria. The median age was 46 years (interquartile range = 23.00–61.25), median follow-up was 78.5 months (interquartile range = 38.63–122.02), and 37 of 46 subjects (80.4%) were male. The observed 1- and 5-year graft survival estimates were 80.4% and 41.7%, respectively. Factors statistically associated with graft failure in multivariable analyses were rejection episode, hazard ratio (HR) = 3.29; retinal detachment (RD), HR = 3.47; and endophthalmitis, HR = 6.27. Fifteen of 42 eyes (35.7%) regained ambulatory vision (20/200 or better). The strongest predictors of vision worse than 20/200 at the last follow-up were RD, odds ratio (OR) = 43.88; graft rejection, OR = 12.42; and injury outside the workplace, OR = 25.05.

Conclusions:
Despite a high graft survival at 1 year, most of the patients did not regain ambulatory vision. Graft rejection, RD, and endophthalmitis were risk factors for graft failure. These factors should be considered when counseling patients regarding PKP after OGI.
A Novel Treatment of Painful Medial Collateral Ligament Calcification (Pellegrini–Stieda Syndrome): A Case Report
Authors: Greidanus Benjamin D. 
Published: November 2021

Abstract:
A 63-year-old healthy woman was diagnosed clinically and radiographically with Pellegrini–Stieda syndrome. She had failed to improve with 6 months of conservative management using oral anti-inflammatories and physiotherapy. Local corticosteroid injections were offered on 2 occasions, 4 months apart, and provided excellent but only temporary relief of symptoms. The patient agreed to undergo ultrasound-guided percutaneous lavage, followed by platelet-rich plasma infiltration of the Pellegrini–Stieda lesion instead of being referred for surgery. The patient was assessed clinically and radiographically at 12 weeks and 18 months postprocedure. At both appointments, the patient reported a significant reduction in pain and improvement in function as rated by the Lower Extremity Function Scale (improvement of 20 points at 12 weeks and an improvement of 16 points at 18 months postprocedure). Radiographically, the Pellegrini–Stieda lesion was no longer visible at either follow-up interval. In conclusion, ultrasound-guided percutaneous calcific lavage followed by autologous platelet-rich plasma infiltration may be an effective way to treat refractory cases of Pellegrini–Stieda syndrome.
Midseason Screening for Groin Pain, Severity, and Disability in 101 Elite American Youth Soccer Players: A Cross-Sectional Study
Authors: DeLang Matthew D. , Garrison J. Craig , Hannon Joseph P. , McGovern Ryan P. , Sheedy Philip J. , Christoforetti John J. , Thorborg Kristian 
Published: November 2021

Objective:
To (1) systematically screen for groin pain and type in young elite soccer players and (2) assess whether hip and groin-related severity and disability differed between players with different levels of groin pain and tenderness.

Design:
Cross-sectional observational.

Setting:
Elite American soccer academy at midseason.

Participants:
One hundred one academy soccer players (mean age 14.3 ± 1.8 years).

Intervention:
All players underwent clinical examinations to classify groin pain by the Doha agreement taxonomy.

Main Outcome Measures:
Tests for groin-related severity and disability included the Copenhagen 5-second squeeze test, Copenhagen Hip and Groin Outcome Score (HAGOS), and Hip Outcome Score (HOS). Players were stratified into 3 groups: those with groin pain, those with tenderness, and those with no groin pain or tenderness.

Results:
Twenty-two players (22%) reported groin pain. Adductor-related groin pain was the most common (n = 14), followed by iliopsoas-related (n = 3), and pubic-related (n = 2). Multiple locations were present in 3 players. Thirty-nine players (39%) did not have groin pain but were tender to palpation in 1 or more structures related to the Doha agreement taxonomy. Copenhagen 5-second squeeze test differentiated between players with and without groin pain (groin pain vs tenderness group: P = 0.011; groin pain vs no groin pain group P < 0.001). Four HAGOS subscales (pain, symptoms, sport/recreation, and quality of life) differentiated between players with and without groin pain (P < 0.05).

Conclusions:
One in five academy soccer players experiences groin pain with adductor-related most common during a midseason screening. Both Copenhagen 5-second squeeze test and HAGOS subscales can differentiate between players with and without groin pain.
Ischemic stroke in an adolescent as a sequelae of smear negative tuberculous meningitis
Authors: Acharya Ayushma , Bhattarai Suraj , Singh Pramod , Bhattarai Tulsi 
Published: November 2021

Abstract

Introduction:
Tuberculous meningitis (TBM) is fatal in approximately one-third of patients, and the sequelae of the disease in those who survive is challenging. It should be suspected in people residing in endemic areas with meningitis features. However, diagnosis of TBM is still a daunting challenge because it is usually based on clinical suspicion, cerebrospinal fluid findings, imaging techniques, and response to anti-tubercular therapy. Stroke is a rare complication of TBM, and it usually involves multiple areas supplied by perforating and cortical branches of the cerebral circulation rather than particular zones.

Patient concerns:
A 17-year-old male presented to the outpatient unit with fever and headache for 7 days, and altered sensorium for 1 day. The patient was unable to recognize his friends and family for 1 day and occasionally showed aggressive behavior. On examination, the patient had neck rigidity, positive Kernig's sign, and diminished breath sounds in the right lower zone of the right lung.

Diagnosis:
The patient was diagnosed with smear-negative TBM with pulmonary focus, which later developed into an ischemic stroke.

Outcomes:
The patient was treated with antitubercular therapy as per the national tuberculosis management protocol. Aspirin was added for stroke prevention and levetiracetam for seizure control.

Conclusion:
Stroke due to cerebral infarction can develop in a significant proportion of TBM patients, including adolescents. Hence, clinicians should have a high degree of clinical suspicion of TBM in endemic settings to prevent fatal complications such as stroke that may arise due to delayed diagnosis and treatment.
Lymphangitis Carcinomatosa in Neck Soft Tissue: Computed Tomography Findings With Emphasis on Differentiation From Cellulitis
Authors: Kim Dae Geun , Yoon Dae Young , Hong Ji Hyun , Moon Ji Yoon , Yun Eun Joo , Kim Eun Soo , Lee Yul 
Published: November 2021

Objective
Lymphangitis carcinomatosa (LC) is a rare form of metastasis. The purposes of this study were to evaluate computed tomography (CT) findings associated with LC in neck soft tissue and to determine those that were useful in distinguishing LC from cellulitis.

Methods
Contrast-enhanced CT images of 26 patients with pathologically confirmed LC (n = 5) and clinically proven cellulitis (n = 21) were reviewed retrospectively. The following CT findings were evaluated and compared between the 2 groups: subcutaneous fat infiltration, enlargement of muscle, thick irregular enhancement of the superficial cervical fascia, grouping of micronodules, focal intramuscular enhancement, localized fluid collection, and nodular skin thickening.

Results
Thick irregular enhancement of the superficial cervical fascia (80.0% vs 0%, P < 0.0005), grouping of micronodules (60.0% vs 0%, P < 0.005), and focal intramuscular enhancement (60.0% vs 4.8%, P < 0.05) were significantly more frequent in LC than in cellulitis. Other findings did not show statistical significance between both groups.

Conclusions
When soft tissue swelling is present in the neck with either thick irregular enhancement of the superficial cervical fascia, grouping of micronodules, or focal intramuscular enhancement, the possibility of LC should be considered especially in patients with underlying malignancy.
Application of Contrast-Enhanced 3-Dimensional T2-Weighted Volume Isotropic Turbo Spin Echo Acquisition Sequence in the Diagnosis of Prolactin-Secreting Pituitary Microadenomas
Authors: Guo Rui , Wu Yue , Guo Guangcheng , Zhou Haiyang , Liu Shoutang , Yao Zhenwei , Xiao Yunping 
Published: November 2021

Objective
This study aimed to investigate the value of contrast-enhanced 3-dimensional (3D) T2-weighted (T2W) Volume Isotropic Turbo Spin Echo Acquisition (VISTA) sequence in prolactin-secreting pituitary adenoma diagnosis.

Methods
We enrolled 158 patients with hyperprolactinemia. Coronal dynamic contrast-enhanced (DCE) T1 spin echo and T2W VISTA sequences were performed. The detection of pituitary microadenomas in 3 imaging groups (DCE magnetic resonance imaging [MRI], VISTA, and DCE MRI + VISTA) were compared using McNemar test and χ2 test.

Results
The DCE MRI + VISTA group detected 28 more pituitary microlesions than DCE MRI alone. Among these, 20 lesions were clearly observed on VISTA images but were negative on DCE MRI. The combined sequences showed higher sensitivity (85.3%) and diagnostic accuracy (89.2%) for adenoma detection than any of the sequences alone (P < 0.01). We noted that in 65.7% of the patients with adenoma (46 of 70), a “hypointense rim” was present around the lesion on the VISTA images. Of them, 11 patients underwent surgery. Histopathology confirmed that the “hypointense rim” was a pseudocapsular structure at the edge of the adenoma.

Conclusions
For patients with hyperprolactinemia, the 3D T2W VISTA sequence is an important supplement to DCE MRI, because it could improve the detection rate of pituitary microadenomas.
Normal Magnetic Resonance Imaging Appearance of Marrow Adjacent to the Sacroiliac Joints in Children During Development
Authors: Storey Troy , Borgia Roberto Ezequiel , Merritt Parker , Woolnough Leandra 
Published: November 2021

Objective
On magnetic resonance imaging (MRI) for sacroiliitis, increased T2 marrow signal can be misinterpreted as marrow edema. We hypothesize that a changing but predictable pattern for marrow signal intensity adjacent to the sacroiliac joints is present from infancy through skeletal maturity. The purpose of our study is to characterize the distribution of increased T2 signal intensity within the marrow adjacent to the sacroiliac joints in healthy children.

Subjects and Methods
A retrospective review of the electronic health record identified 345 children who underwent MRI examination of the sacrum, sacroiliac joints, or pelvis. Those with underlying disease that may potentially alter sacroiliac marrow signal were excluded. Sixty children, 30 girls and 30 boys, were assessed for T2 marrow signal intensity greater than the interforaminal sacrum and less than or equivalent to the primary spongiosa of the posterior iliac crests at the S1, S2, and S3 levels. The width of increased T2 signal intensity at each sacral level, right and left sides, ilium, and sacrum was measured (mm). The Mann-Whitney U test was used to determine if there were differences between skeletally immature and skeletally mature subjects; defined as aged 15 years for girls and 17 years for boys.

Results
When 30 girls and 30 boys are assessed, the width of increased T2 marrow signal adjacent to the sacroiliac joints is significantly greater in skeletally immature than in skeletal mature female subjects for right S1 sacral side (P = 0.0100), left S1 sacral side (P = 0.0119), right S2 sacral side (P = 0.037), left S2 sacral side (P = 0.0020), and in male subjects for the right S2 sacral side (P = 0.0178), right S2 iliac side (P = 0.0415), right S3 sacral side (P = 0.0024), and left S3 sacral side (P = 0.0037). There were insufficient subjects for whom the ilii extended beyond the S2 sacral segments to assess for the S3 iliac sides.

Conclusions
Healthy children and adolescents have increased T2 signal intensity within the sacral marrow adjacent to the sacroiliac joints, likely the vascular primary spongiosum, which is greater in adolescence compared with skeletal maturity. Knowledge of this normal pattern is beneficial in interpreting MRI examinations for the presence of sacroiliitis.
Age-related Changes in Computed Tomography Density of Thyroid Gland in Children: A Single-Center Retrospective Study in Northern China
Authors: Yi Xiaoli , Zhao Pengfei , Song Qinwei , Yuan Xinyu , Wang Zhenchang 
Published: November 2021

Objective
The thyroid gland normally presents as a hyperdense organ on noncontrast computed tomography (CT) in adults. The correlation between thyroid gland CT density and its functional status has been studied; however, little is known regarding its density in children with normal thyroid functions. We aimed to assess the correlation between thyroid gland CT density and age in children with normal thyroid functions.

Methods
From April 2017 to March 2021, we enrolled 74 patients who had normal thyroid functions within 1 month before or after undergoing neck or cervical spine CT for trauma, neck masses, congenital diseases, and airway stenosis. Their CT images were retrospectively analyzed by 2 independent radiologists. Based on age, patients were divided into 4 groups: infant, preschool-aged, school-aged, and adolescence groups.

Results
Patients with thyroid gland hypodensity in the infant group (70%, 14 of 20) were significantly more numerous than those in preschool-aged (25%, 4 of 16), school-aged (20%, 5 of 25), and adolescence (15.4%, 2 of 13) groups (P = 0.007, 0.001, and 0.002, respectively, Fisher exact test). The mean CT density of the thyroid gland was also lower in the infant group compared with the densities in other age groups. There was a weak positive correlation between thyroid CT density and age (r = 0.264, P = 0.023, linear regression analysis).

Conclusions
Thyroid CT density is related to age in children. The thyroid gland normally has a low density on noncontrast CT in most infants with normal thyroid function.
Toward an Intravoxel Incoherent Motion 2-in-1 Magnetic Resonance Imaging Sequence for Ischemic Stroke Diagnosis? An Initial Clinical Experience With 1.5T Magnetic Resonance
Authors: Pavilla Aude , Gambarota Giulio , Arrigo Alessandro , Saint-Jalmes Hervé , Mejdoubi Mehdi 
Published: November 2021

Objective
This initial study aimed to investigate the feasibility of simultaneously measuring perfusion and diffusion including kurtosis features in acute ischemic stroke with the combined intravoxel incoherent motion and non-Gaussian diffusional kurtosis imaging (DKI-IVIM).

Material and Methods
Five ischemic stroke patients underwent a 4-minute diffusion weighted imaging (DWI) protocol, using 8 b values chosen with the Cramer-Rao-Lower-Bound optimization approach, in addition to conventional DWI and arterial spin labeling sequences. Regions of interest in pathological and control regions were analyzed with DKI-IVIM, and parametric maps were reconstructed.

Results
The IVIM diffusion coefficient (D) decreased (P < 0.0001) in the infarcted areas, whereas higher kurtosis coefficient values were found (P = 0.0002). Regarding the perfusion, the individual IVIM perfusion fraction f decreased in 3 matching cases with the cerebral blood flow estimated through arterial spin labeling and the fD* decreased only in 2 patients of those.

Conclusions
When compared with conventional stroke imaging protocol, DKI-IVIM 4-minute 2-in-1 acquisition can provide diffusion results comparable with conventional DWI with complementary kurtosis estimations but a limited robustness regarding perfusion estimations for clinical purpose.
Intravascular Papillary Endothelial Hyperplasia of the Mandible: A Rare Entity
Authors: Luigi Laino , Diana Russo , Luca Fiorillo , Pierluigi Mariani , Gregorio Laino , Cicciù Marco 
Published: November 2021

Abstract
Intravascular papillary endothelial hyperplasia (IPEH) is a lesion characterized by the proliferation of endothelial cells within the lumen of the vessel, it was first described by Masson in 1923.
The pathogenesis of Masson's tumor is still unknown, currently the most accredited hypothesis is the reactive 1. Clinically and symptomatologically it can have different presentations, it is, therefore, of fundamental importance to make a correct differential diagnosis. Diagnosis is mainly based on histological criteria. Intravascular papillary endothelial hyperplasia usually occurs in the skin and subcutaneous tissues, less commonly in the skeleton. The present is the fifth case of intravascular papillary endothelial hyperplasia of the mandible.
Pseudomonas tohonis sp. nov., isolated from the skin of a patient with burn wounds in Japan
Authors: Yamada Kageto , Sasaki Masakazu , Aoki Kotaro , Nagasawa Tatsuya , Murakami Hinako , Ishii Mayumi , Shibuya Kazutoshi , Morita Toshisuke , Ishii Yoshikazu , Tateda Kazuhiro 
Published: November 2021

Strain TUM18999T was isolated from the skin of a patient with burn wounds in Japan. The strain was successfully cultured at 20–42 °C (optimum, 30–35 °C) in 1.0–4.0% NaCl (w/v) and at pH 5.5–9.5, optimum pH 5.5–8.5. The phylogenetic tree reconstructed using 16S rRNA, gyrB, rpoB and rpoD gene sequences indicated that strain TUM18999T is closely related to

Pseudomonas otitidis

MCC10330T. Although the partial 16S rRNA gene sequence (1412 bp) of TUM18999T exhibits high similarity to those of

Pseudomonas alcaligenes

NBRC 14159T (99.08 %) and

Pseudomonas otitidis

MCC10330T (98.51 %), multi-locus sequence analysis using 16S rRNA, gyrB, rpoB and rpoD genes reveals a clear distinction between TUM18999T and other

Pseudomonas

species. In addition, an average nucleotide identity >90 % was not observed in the

P. aeruginosa

group. Moreover, TUM18999T and

P. otitidis

can be distinguished based on the minimum inhibitory concentration for carbapenem. Meanwhile, the cellular fatty acids are enriched with C18 : 1
ω7c/C18 : 1
ω6c (34.35 %), C16 : 1
ω7c/C16 : 1
ω6c (24.22 %), C16 : 0 (19.79 %) and C12 : 0 (8.25 %). Based on this evidence, strain TUM18999T can be defined as representing a novel

Pseudomonas

species, with the proposed name Pseudomonas tohonis sp. nov. The type strain is TUM18999T (GTC 22698T=NCTC 14580T).