bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rib-based Distraction Device Implantation Before Age 3 Associated With Higher Unplanned Rate of Return to the Operating Room
Authors: Johnson Mitchell A. , Lott Carina , Qiu Catherine , Galagedera Nirupa , Flynn John M. , Cahill Patrick J. , Anari Jason B. 
Published: March 2021

Background:
Surgical treatment of early-onset scoliosis (EOS) with rib-based implants such as the vertical expandable prosthetic titanium rib (VEPTR) is associated with a high rate of complications including surgical site infection, skin breakdown, and implant migration. Many of these complications warrant the need for unplanned reoperations, increasing the burden on an already vulnerable patient population, and introducing the further risk of infection. To provide insight into the risks of early intervention, we investigate the relationship between initial device implantation before the age of 3 and the rate of unplanned reoperation.

Methods:
A retrospective review was performed of all patients at a single institution who had undergone VEPTR insertion for EOS with at least a 2-year follow-up from 2007 to 2016. Patients were stratified into the case-cohort (0 to 2 y of age) or the comparison cohort (3 to 10 y of age) based on age at the time of device implantation. Multivariate regression accounting for age and scoliosis etiology was performed to identify factors predictive of unplanned reoperation.

Results:
A total of 137 of 185 patients treated with VEPTR were identified with 76 (56%) undergoing at least 1 unplanned reoperation during the study time period. There were 68 and 69 patients in the age 0- to 2-year and 3- to 10-year cohorts, respectively. Patients aged 0 to 2 years underwent a higher number of total procedures compared with those aged 3 to 10 (13.1±6.5 vs. 10.6±4.8, P=0.032). A significant difference was found in the rate of unplanned reoperation between the 2 cohorts with 44 (65%) patients aged 0 to 2 and 32 (46%) patients aged 3 to 10 undergoing at least 1 unplanned reoperation (P=0.031). Binary logistic multivariate regression accounting for age and scoliosis etiology demonstrated that patients aged 0 to 2 had a significantly greater odds of undergoing an unplanned reoperation (odds ratio=3.050; 95% confidence interval: 1.285-7.241; P=0.011) compared with patients aged 3 to 10 years.

Conclusion:
Overall, EOS patients aged 0 to 2 at initial VEPTR implantation are up to 3 times higher risk of undergoing an unplanned reoperation compared with those aged 3 to 10.

Level of Evidence:
Level III.
Trends and Complications in Spinopelvic Fixation for Deformity for Spinal Surgeons in Early Independent Practice
Authors: Yeung Caleb M. , Schoenfeld Andrew J. , Lightsey Harry M. , Kang James D. , Makhni Melvin C. 
Published: March 2021

Study Design:
Retrospective case series study.

Objective:
Evaluate trends and complications following posterior spinal instrumented fusion for deformity with/without pelvic fixation using the American Board of Orthopaedic Surgery Part II Oral Examination Candidate Case List data from 2008 to 2017.

Summary of Background Data:
Complication rates for cases with pelvic fixation are widely reported in spine deformity literature but are typically derived from practices of senior surgeons. As surgical experience and clinical volume are shown to decrease complication rates, spine surgeons newly in practice may have higher risks of such events.

Materials and Methods:
Surgical cases submitted by candidates taking the American Board of Orthopaedic Surgery Part II Oral Examination between 2008 and 2017 with a self-designated sub-specialty of spine surgery were retrospectively reviewed. Mortality, readmission/reoperation data, and complications as reported by candidates were tracked over time. Bivariate testing and multivariable Poisson analyses, respectively, were used to assess complication rates and time-related trends.

Results:
A total of 37,539 cases were submitted between 2008 and 2017. Four hundred sixty-one cases (1.2%) were for deformity; of these, 60 cases included pelvic fixation (13% of deformity cases). For all deformity cases, we noted medical, surgical, and overall complication rates to be 17%, 22.3%, and 31.5%. Multivariable analyses demonstrated no difference in surgical/overall complication rates between spinopelvic and nonspinopelvic instrumented groups, but showed a consistently low number of cases using spinopelvic fixation over time.

Conclusions:
Newly practicing spinal surgeons consistently performed low numbers of deformity cases with relatively high complication rates which remained stable over time.
Perspectives in pathomics in head and neck cancer
Authors: Classe Marion , Lerousseau Marvin , Scoazec Jean-Yves , Deutsch Eric 
Published: March 2021

Purpose of review
Pathology is the cornerstone of cancer care. Pathomics, which represents the use of artificial intelligence in digital pathology, is an emerging and promising field that will revolutionize medical and surgical pathology in the coming years. This review provides an overview of pathomics, its current and future applications and its most relevant applications in Head and Neck cancer care.

Recent findings
The number of studies investigating the use of artificial intelligence in pathology is rapidly growing, especially as the utilization of deep learning has shown great potential with Whole Slide Images. Even though numerous steps still remain before its clinical use, Pathomics has been used for varied applications comprising of computer-assisted diagnosis, molecular anomalies prediction, tumor microenvironment and biomarker identification as well as prognosis evaluation. The majority of studies were performed on the most frequent cancers, notably breast, prostate, and lung. Interesting results were also found in Head and Neck cancers.

Summary
Even if its use in Head and Neck cancer care is still low, Pathomics is a powerful tool to improve diagnosis, identify prognostic factors and new biomarkers. Important challenges lie ahead before its use in a clinical practice, notably the lack of information on how AI makes its decisions, the slow deployment of digital pathology, and the need for extensively validated data in order to obtain authorities approval. Regardless, pathomics will most likely improve pathology in general, including Head and Neck cancer care in the coming years.
Poor Parental Supervision Associated With Traumatic Brain Injury and Reactive Aggression in Young Offenders
Authors: Kent Hope , Williams W. Huw , Hinder Darren , Meadham Hannah , Hodges Emma , Agarwalla Vedika , Hogarth Lee , Mewse Avril J. 
Published: March 2021

Objective:
To establish whether poor parental supervision is associated with head injury and self-reported reactive aggression (ie, aggression in response to perceived provocation or threat) in adolescents in a Young Offender's Institute, by examining correlations between these variables. Understanding this population is important, as they are at a key pivotal age for intervention to prevent lifelong reoffending.

Methods:
Ninety-six male participants aged 16 to 18 years were recruited from a UK Young Offender's Institute. Self-report measures of remembered parenting, reactive aggression, and head injury history were administered during individual interviews.

Results:
Seventy-four percent of participants reported having experienced a lifetime traumatic brain injury (TBI), and 46% of participants reported experiencing at least 1 TBI leading to a loss of consciousness (LOC). We found that poor parental supervision, length of LOC following TBI, and self-reported reactive aggression were all positively correlated.

Conclusions:
Findings show that there are correlational relationships between poor parental supervision, length of LOC following lifetime TBI, and higher levels of self-reported reactive aggression. This suggests there may be pathways resulting from poor parental supervision leading to both TBI with LOC, and reactive aggression. We advocate for future research with longitudinal designs and larger samples to examine the nature of these interactions, and to establish whether poor parental supervision is a prospective risk factor for more TBIs leading to LOC, and reactive aggression. This is key to understanding whether parenting interventions could help to reduce the disabling effects of TBI in adolescents, and help to prevent contact with the law.
B-SCAN ULTRASONOGRAPHY OF VITREOUS DYNAMICS DURING INTRAVITREAL ADMINISTRATION OF ANTIANGIOGENICS
Authors: Sánchez-Martínez Daniel , Sánchez-López Sara , Sellés-Navarro Inmaculada 
Published: March 2021

Purpose:
To study the distribution of angiogenesis inhibitors (anti-Vascular Endothelial Growth Factor) injected into the vitreous cavity by means of simultaneous ultrasonography.

Methods:
Three hundred and thirty-two B-scan ultrasound sequences of 121 eyes from 95 patients were recorded simultaneously to the intravitreal anti-Vascular Endothelial Growth Factor administration. The dynamics of the injected substance and the presence of reflux were studied, associating them with the presence/absence of total posterior vitreous detachment.

Results:
Three well-defined patterns were distinguished. Pattern A: the medication penetrates the vitreous in a linear manner until reaching the retina (3.6%, n = 12). Pattern B: the medication adopts a globular shape and then moves down reaching the retrohyaloid space (37%, n = 123). Pattern C: the medication remains in a globular form (54%, n = 180). The pattern was not identified in 17 (5.1%) injections. Pattern A was only observed in vitrectomized eyes. The reflux (7.8%) was exclusive in eyes showing a C pattern. A relationship (P < 0.001) was observed between the presence/absence of total posterior vitreous detachment, the patterns, and the presence of reflux.

Conclusion:
This study document for the first time the behavior of antiangiogenic medication injected into the vitreous cavity and how its distribution and the presence of reflux is conditioned by the previous state of the vitreous body.
Late Onset Interface Calcium Deposition After Laser In Situ Keratomileusis
Authors: Chen Angela C. , Pelsor Nathaniel P. , Wang Kaidi , Glasgow Ben J. , Aldave Anthony J. 
Published: March 2021

Purpose:
The purpose of this study was to report a novel clinical entity characterized by bilateral calcium deposits in the flap interface after uncomplicated laser in situ keratomileusis (LASIK).

Methods:
Slit-lamp examination, anterior segment optical coherence tomography imaging, and histopathologic analysis of an interface opacity were performed to characterize and identify the origin of the interface opacities.

Results:
Two unrelated healthy young men who underwent LASIK in both eyes at 20 (case 1) and 44 (case 2) years of age were diagnosed with bilateral, white anterior stromal opacities 5 years after LASIK surgery. Slit-lamp examination and anterior segment optical coherence tomography imaging demonstrated that the opacities were located at the level of the LASIK interface in both eyes of both cases, with most of the opacities located at the temporal edge of the flap in each eye of case 2. An opacity from case 2 demonstrated birefringence using polarization microscopy and staining with Alizarin red, indicative of calcium deposition. The serum calcium level was borderline elevated in case 1 and within normal limits in case 2.

Conclusions:
Intrastromal calcium deposition can occur after LASIK surgery, with the deposits resembling dystrophic deposits located in the LASIK flap interface in individuals with granular corneal dystrophy type 2. Because the etiology and management of calcific and dystrophic interface deposition after LASIK are distinct, it is important for clinicians to differentiate the 2 entities based on the examination, diagnostic imaging, and, if necessary, molecular genetic analysis.
The “Quiet TED”—A Special Subgroup of Thyroid Eye Disease
Authors: Iñiguez-Ariza Nicole M. , Sharma Anu , Garrity James A. , Stan Marius N. 
Published: March 2021

Purpose:
Thyroid eye disease (TED) or Graves’ orbitopathy starts with an active inflammatory stage (active disease) followed by resolution of inflammation and progression to a fibrotic, inactive stage. In our practice, we have encountered cases that have not had active disease despite presence of fibrotic sequelae and disease progression. We aim to delineate the clinical characteristic of this unique group of patients.

Methods:
We conducted a single-center (Mayo Clinic Rochester) retrospective chart review of TED patients who throughout the course of their disease had only evidence for inactive TED, defined as clinical activity score <3.

Results:
Median age in the cohort (n = 19) was 54 years (IQR 47–61). 58% had a prior diagnosis of Graves’ disease (GD) before referral. 80% (n = 15) were euthyroid at the time of TED onset (median thyroid-stimulating hormone 1.7 mIU/L). The most common finding was diplopia (100%, n = 19) followed by proptosis (63%, n = 12). Interestingly the disease was asymmetric in 42% of cases. Overall median clinical activity score on presentation was 1 (IQR 0-1). Severity wise, 85% (n = 16) of patients were classified as moderate-to-severe during follow up. Orbital decompression was performed in only 1 case, while extraocular muscle surgery was performed in 13 cases.

Conclusions:
Quiet TED is a subgroup of TED patients that defies the classic disease paradigm. It presents primarily with diplopia and proptosis. Further evaluation of this group might identify useful insights in TED pathophysiology and help optimize therapeutic choices.
Efficacy and Complications of External and Internal Pediatric Blepharoptosis Repair Techniques: A Systematic Review
Authors: Lim Hong Kai , Lau Ashton Z. , Charles Walton N. , Khajuria Ankur 
Published: March 2021

Purpose:
To review and evaluate the efficacy and complication rates of external and internal blepharoptosis repair techniques in pediatric patients.

Methods:
The systematic review protocol was published on PROSPERO (CRD42020197343). Embase, MEDLINE, CENTRAL, and ClinicalTrials.gov were searched without date limitations. Two independent reviewers evaluated the articles for inclusion. Study quality and risk of bias were assessed using GRADE and Cochrane’s ROBINS-I tool, respectively.

Results:
Of 2,228 articles screened, 23 studies involving 730 patients were included. There were 20 case series and 3 retrospective cohort studies, but no randomized controlled studies. Overall study quality was low with serious risk of bias according to the GRADE and ROBINS-I criteria, respectively. External levator resection was the most studied procedure, evaluated in 18 studies. Seven studies investigated internal approaches including the Fasanella-Servat procedure. There was no standardized evaluation of surgical efficacy. Reoperation rates were 16.6% (range 3.6–50.9%) for external levator resection compared with 22.2% (range 0.0–25.8%) for internal approaches. The commonest postoperative complications were not sight-threatening. The most consistently reported complication was undercorrection, occurring at rates of 8.4% (range 2.4–16.7%) and 15.3% (range 2.7–75.0%) for external levator resection and internal approaches, respectively. There were no consistently applied, validated patient-reported outcomes or cosmetic outcomes.

Conclusions:
External and internal approaches have been successfully employed in pediatric blepharoptosis repair. However, noncomparative designs and risk-of-bias limit existing studies. Thus, prospectively designed studies with standardized outcome measures are required to minimize reporting bias, facilitate evidence synthesis, and support clinical decision making.
Alteration of Smell Sensation: Brief Review With Implications for Nursing Care During the COVID-19 Pandemic
Authors: Mortimer Diane Schretzman , Duverneau-Salifu Moira 
Published: March 2021

ABSTRACT

BACKGROUND: Alteration in olfaction, the sense of smell, can lead to a surprisingly high level of functional disability. Effects can range from mild changes in nutrient intake to a significant decrease in quality of life. Olfactory dysfunction can follow clinical problems such as trauma to the brain and nose. During recent months, in the setting of the current worldwide pandemic of coronavirus disease 2019 (COVID-19), the infection caused by severe acute respiratory syndrome coronavirus 2, it has become clear that olfaction can also be damaged by viruses that enter the body through the nose. METHODS: To learn more about this important clinical problem, we reviewed the current literature about smell sensation and the contextual application of altered olfaction in the setting of COVID-19. Knowledge about this topic, along with other clinical aspects of COVID-19, is expanding quickly. CONCLUSION: Nurses perform assessments, assist with implementing treatment interventions, and provide vital education to patients and their families. These interventions help patients with olfactory dysfunction achieve the best possible functional outcome.
11C-Choline PET/CT Depiction of Rectal Gastrointestinal Stromal Tumor
Authors: Nguyen Ba D. 
Published: March 2021

Abstract

18F-FDG PET/CT is an established imaging modality for gastrointestinal stromal tumor evaluation and its posttherapeutic monitoring. 68Ga-PSMA has been recently reported with the incidental demonstration of this neoplasm on PET/CT. The author presents an uncommon case of this tumor detected by 11C-choline during the assessment of prostate cancer.
A Growing Inflammatory Mass of Gastrosplenic Ligament Mimicking Recurrent Colon Cancer on FDG PET/CT
Authors: Shen Guohua , Wang Rang , Kuang Anren 
Published: March 2021

Abstract
A 64-year-old man diagnosed with colon cancer underwent left hemicolectomy 1 year ago. The postoperative pathological stage was T4a N0 M0. Serial follow-up CT scans revealed a growing soft-tissue mass in the gastrosplenic ligament. FDG PET/CT was then performed for further restaging, and intense FDG uptake was observed inside the lesion, whereas no other abnormal uptake was seen. A solitary recurrence was suspected, and he underwent surgical resection. Histopathologic findings confirmed the diagnosis of chronic inflammation. This case demonstrates how a growing FDG-avid inflammatory mass of surgical site could easily be mistaken for recurrence.
Atypical Unilateral Lower-Limb Relapse of Breast Cancer
Authors: Alexandra Noeuveglise , Stephanie Becker , Pierre Vera , David Tonnelet 
Published: March 2021

Abstract
In July 2017, an 84-year-old woman was treated for grade III, RH+, HER2− infiltrative ductal carcinoma breast cancer by right mastectomy, adjuvant radiotherapy, and hormone therapy. In April 2020, moderated elevation of the CA-15.3 tumor marker was observed at 53 UI/mL (normal, <25.5 UI/mL). Clinical examination and CT TAP scan showed no argument for relapse. In August 2020, patient presented pain in her left foot. 99mTc-DPD bone scintigraphy showed multiple uptakes regarding osteolytic lesion of the left lower limb with no other pathological uptake. Echo-guided tibial biopsies confirmed breast origin adenocarcinoma, in favor of relapse of the originally treated cancer.
Identification of Isolated Hepatic Sarcoidosis With 18F-FDG PET/CT and MRI
Authors: Arnfield Evyn , Pattison David A. 
Published: March 2021

Abstract
A 69-year-old woman presented with symptomatic hypercalcemia and deranged liver function. 18F-FDG PET/CT showed intense confluent avidity throughout the hepatic parenchyma, which was an isolated abnormality. Subsequent MRI demonstrated a diffuse infiltrative hepatic abnormality, with percutaneous liver biopsy findings consistent with hepatic sarcoidosis.
Spurious Uptake on 68Ga–Prostate-Specific Membrane Antigen PET/CT Due to Ankylosing Spondylitis; A Rare Pitfall in Imaging of Biochemical Recurrence of Prostate Cancer
Authors: Heaney Roisin M. , Johnston Ciaran , Nasoodi Afshin 
Published: March 2021

Abstract
Bone is one of the most common sites of prostate cancer recurrence, and 68Ga–prostate-specific membrane antigen (PSMA) uptake by benign bone entities poses a diagnostic dilemma. We describe the case of a 60-year-old man with recurrence in a small presacral node on 68Ga-PSMA PET/CT. Of note, the images also demonstrated bilateral asymmetrical sacroiliac joint uptake. A history of ankylosing spondylitis was subsequently elicited, confirming the radiographic suspicion of sacroiliitis, therefore confirming the nonmalignant nature of 68Ga-PSMA uptake related to sacroiliitis rather than osseous recurrence from prostate carcinoma. 68Ga-PSMA uptake may indicate angioneogenesis in sacroiliitis and consequently may be helpful in assessing disease activity and therapy response.
Discordant Uptake Between Diagnostic 68Ga-HA-DOTATATE PET/CT and Posttherapy 177Lu-HA-DOTATATE SPECT/CT in Patients With Neuroendocrine Tumors
Authors: Huizing Daphne M.V. , Aalbersberg Else A. , van der Hiel Bernies , Stokkel Marcel P.M. , Versleijen Michelle W.J. 
Published: March 2021

Abstract
Patients with unresectable or metastasized neuroendocrine tumors are assumed eligible for PRRT (peptide receptor radionuclide therapy) with 177Lu-HA-DOTATATE if tumor uptake on somatostatin receptor imaging is higher than normal liver tissue. In our clinic, 2 patients presented with sufficient uptake of 68Ga-HA-DOTATATE in most metastases but with limited uptake in liver lesions. Posttherapy 177Lu imaging, however, showed good uptake in all neuroendocrine tumor lesions, including all liver metastases. Therefore, the presence of liver metastases in which the uptake of 68Ga-HA-DOTATATE is not or only slightly higher than in surrounding normal liver tissue should not be an absolute contraindication for PRRT.