bluuebunny/crossref_metadata_2025_split huggingface dataset:
P085 Chronic recurrent multifocal osteomyelitis: about 2 cases
Authors: Miladi Saoussen , Makhlouf Yasmine , Fazaa Alia , Sellami Mariem , Ouenniche Kmar , Souabni Leila , Kassab Selma , Chekili Selma , Ben Abdelghani Kawther , Laatar Ahmed 
Published: November 2021

Abstract

Background
Chronic recurrent multifocal osteomyelitis (CRMO) also known as aseptic osteomyelitis is a rare auto-inflammatory disease with an incidence estimated at 4/100 000 population [1]. The aim of our work was to report two cases of CRMO that illustrate challenges in the diagnosis of this rare disease.

Method
We report the case of two patients diagnosed with CRMO. Clinical, biological and radiological data as well as disease outcomes were described. We also collected data about treatment modalities.

Results
Two patients aged of 7 and 10 years respectively, without any notable pathological history, presented recurrent episodes multifocal painful swelling of limbs. In the first case, the symptoms concerned the left ankle and knee as well as the left hip, all associated with lameness and an altered general condition, with neither fever nor skin manifestations. In the second case, the swelling involved the right shoulder, right hip and the left ankle. There was no elevated CRP or ESR in any of patients. Immunological status (RF, anti-CCP, AAN) as well as the HLA-B27 antigen test were negative. In the first patient, standard radiographs showed lytic lesions of the proximal metaphysis of the tibia, the greater trochanter and the left lateral malleolus. MRI of the pelvis, knee, and sternum of the first patient revealed edematous involvement of the left greater trochanter, the right ilium, the proximal metaphyseal region of the tibia and the right edge of the sternum, whereas in the second patient, a whole-body MRI showed inflammatory signs over the left greater trochanter, the insertion of the gluteus medius and obturator externus, right trochanteric bursitis and oedema of the entire right ilium. In the first patient, bone scintigraphy showed intense uptake of radioisotopes in the left ilium, the 7 th right costo-vertebral junction, the trochanteric mass, the upper end of the tibia and the lower end of the left fibula. Bone biopsy showed bone remodeling in both cases without evidence of infection or tumor. The diagnosis of CRMO was retained, supported by the prompt response to NSAIDs and short-term corticosteroid therapy. However, the second patient presented, 8 years later, pain in the sterno-clavicular joint as well as the right hip. A relapse of the disease was confirmed by MRI. Therapeutic escalation with zoledronic acid 0.025 mg/kg intravenous infusion every six months allowed the resolution of the symptoms.

Conclusion
These observations illustrated a rare disorder in children, characterized by lytic lesions predominantly in the metaphysis of long bones. Bone scintigraphy allowed an early assessment of disease extension and histological examination ruled out a malignant tumor and an infection. The first-line treatment is anti-inflammatory drugs. In case of failure, bisphosphonates seem to be effective.
P096 Munchmeyer's disease: an unknown pathology
Authors: Chentouf Amina , Daoud Souad 
Published: November 2021

Abstract

Background
Munchmeyer's disease (MM) or Fibrodysplasia ossificans progressivais an extremely rare genetic disorder characterized by heterotopic ossification of muscle and connective tissue during flare-ups, which can lead to the creation of a true second skeleton. we report an original observation with diagnostic difficulty.

Observation
We report the case of 37-year-old women who consulted for cervical stiffness with painful hypertrophy of the left sternocleidomastoid muscle, dorsal scoliosis, tendon retractions in limbs with a semi-flexion attitude. In addition, she presented a deformity of the forefoot with hallux valgus and a triangular shape.
X-ray of the right arm showed ossification of the biceps brachii and that of the foot showed interphalangeal ankyloses with agenesis of a phalanx of the big toe. X-rays of the cervical spine revealed posterior arch ankyloses with fusion of some vertebrae. Despite the late onset of symptoms, the diagnosis of MM was suggested and confirmed by a genetic study which revealed a heterozygous c.617G&gt; A [p. Arg206His] mutation, located in exon 6 of the gene.

Conclusion
MM is an extremely rare but disabling condition. It should be considered in unexplained muscle enlargement occurring at any age particularly if associated with congenital malformations of the Hallux. The discovery of the ACVR1 gene mutation offers hope for the development of therapies for this hitherto incurable disease.
Optimization of Adipose Tissue Cryopreservation Techniques in a Murine Model
Authors: Villaverde-Doménech María Eloísa , Moltó-García Roberto , Gonzalez-Alonso Virina , Aracil-Kessler Juan Pablo , Carda-Batalla Carmen , Novella-Maestre Edurne 
Published: November 2021

Background:
The aim of this study was to develop an adipose tissue (AT) cryopreservation protocol that is effective, simple, and maintains the functionality and viability of AT after thawing and transplantation.

Methods:
Two cryopreservation temperatures (T°), −20°C and −80°C, and two cryoprotective agents (CPAs), trehalose and hydroxyethyl starch (HES), were compared first in an experimental study, using a slowfreezing protocol. The five experimental groups were the following: (a) Fresh AT (control group), (b) T = −20°C, 10%HES, (c) T = −80°C, 10%HES, (d) T = −20°C, 0.35M trehalose, (e) T = −80°C, 0.35M trehalose. We evaluated the morphology (histological studies) and tissue viability by glyceraldehyde 3-phosphate dehydrogenase (GAPDH) genic expression. Based on the results of the preliminary study, an in vivo study was performed, choosing as cryopreservation T° −20°C. HES and trehalose were compared as cryoprotective agents and with a control group (fresh AT). AT grafts were transplanted into immunodeficient mice. After 1 month of inoculation, animals were euthanized and samples were recovered. Samples were weighted and processed for histological study, viability study (GAPDH genic expression), and vascularization study (VEGF genic expression).

Results:
The initial histological study demonstrated that all AT cryopreserved group samples showed typical histological features of AT, similar to that of the control group. Statistically significant differences were not observed (P > 0.05) in GAPDH expression between different groups related to temperature or CPA. Referring to the in vivo studies, cryopreserved groups showed good take of the graft and normal AT architectural preservation, as well as a clear vascular network. Statistically significant differences were not found (P > 0.05) with regard to graft take (%), GAPDH, or VEGF expression.

Conclusion:
Slow freezing at −20°C using trehalose, and −20°C using HES as cryoprotective agents are both straightforward and easy AT cryopreservation procedures, with results similar to those of fresh AT in terms of tissue viability and morphohistological characteristics.
Implications of Diagnostic Drops on Scheimpflug Tomography: The Proper Order for Clinical Testing
Authors: Padmanabhan Prema , Belin Michael W. , Sudhir Rachapalle Reddi , Mukundan Deepa , Chidambaram Hemalatha , Ambrósio Renato 
Published: November 2021

Purpose:
The purpose of this article was to study the impact of instillation of 1% fluorescein and mydriatics on measurements made by Scheimpflug imaging.

Methods:
This was a cross-sectional study of patients who had measurements of corneal shape (maximum keratometry and best fit sphere of anterior and posterior corneal surfaces), pachymetry (at the pupil center, corneal apex, and thinnest location), and anterior chamber parameters (depth, volume, and angle of anterior chamber and corneal volume) using the Pentacam HR before and after the instillation of fluorescein and mydriatics. Group A had baseline measurements that were repeated 1.5 hours after the instillation of 1% fluorescein and 0.8% tropicamide+ 5% phenylephrine eye drops. Group B had baseline measurements that were repeated 10 minutes after the instillation of 1% fluorescein, and group C had baseline measurements that were repeated 1.5 hours after the instillation of mydriatics.

Results:
Overall, 131 eyes of 131 patients were studied: 87 in group A, 28 in group B, and 16 in group C. Significant differences and wide variations were noted in corneal pachymetry and anterior chamber parameters in all 3 groups. The highest magnitude and range of difference was observed in pachymetry at the pupil center (17 ± 53.5 μm) and in anterior chamber volume (26.7 ± 69.8 mm3). Corneal shape measurements of anterior and posterior corneal surfaces were not significantly affected by either fluorescein or mydriatics. Pupillary dilation also affected the ability of the Pentacam to accurately trace the pupil margin in 19.5% of cases.

Conclusions:
For consistent and accurate measurements, it is important that Scheimpflug imaging be performed before other tests which may need the instillation of fluorescein or mydriatics.
Safety and importance of colonoscopy in nonagenarians
Authors: Sung Kuan-I , Wang Yen-Po , Chang Tien-En , Wang Huann-Sheng , Jiang Jeng-Kai , Luo Jiing-Chyuan , Lee Fa-Yauh , Hou Ming-Chih , Lu Ching-Liang 
Published: November 2021

Background:
With the growth of the aging population, the need for colonoscopies in nonagenarians is rising. However, few data on colonoscopies in extremely elderly individuals are available. To better acknowledge the role of colonoscopies in this specific group of patients, we conducted this study to evaluate the safety and clinical impact of colonoscopy in nonagenarian patients.

Methods:
We performed a retrospective cohort study comparing nonagenarians who received colonoscopy in a tertiary medical center in Taiwan in 2016 with 76- to 80-year-old patients (relatively elderly patients) who were 1:1 propensity score matched by sex as the control subjects. The postcolonoscopy 30-day adverse events, mortality, and long-term survival were recorded.

Results:
A total of 137 nonagenarians and 137 relatively elderly patients were included. The nonagenarians receiving colonoscopy were more likely to be hospitalized (40.1% vs 19.7%, p < 0.001), and the adjusted colonoscopy completion rates were comparable in both groups (92.0% vs 97.1%, p = 0.063). The overall adverse event rate and postcolonoscopy 30-day mortality rates were low in both groups (2.9% vs 1.5%, p = 0.409 and 2.2% vs 1.5%, p = 0.652, respectively). A total of 18.2% of the nonagenarians were diagnosed with advanced neoplasia. Among the nonagenarians diagnosed with colorectal cancer, the patients receiving surgery had a significantly lower risk of death than the patients receiving conservative management (hazards ratio 0.1044, 0.01275–0.8529, p = 0.0352).

Conclusion:
Colonoscopy in patients older than 90 years is generally safe. Colonoscopy findings that led to surgery in nonagenarians diagnosed with colorectal cancer were associated with survival benefits.
Third-Generation Dual-Source Computed Tomography for Coronary Angiography With Individually Tailored Scan Protocols Can Achieve a Low Radiation Dose With Good Image Quality in Unselected Patients
Authors: Basar Yeliz , Akbas Tugana , Alis Deniz , Ulus Sila , Topel Cagdas , Tekcan Sanli Deniz Esin , Karaarslan Ercan 
Published: November 2021

Objective
To explore the image quality and radiation exposure associated with coronary angiography obtained with a third-generation dual-source computed tomography, using body mass index (BMI)– and heart rate (HR)–adapted protocols in real-world patients.

Methods
Three scan protocols were implemented with regard to HR: prospective turbo high-pitch spiral, sequential, and retrospective spiral modes. We adapted the reference kilovoltage value according to BMI. Image quality was evaluated using a 4-point scale, and effective dose estimates were calculated using the dose-length product.

Results
Among the 896 patients, 417 (46.54%), 433 (48.32%), and 45 (5.02%) were imaged using prospective turbo high-pitch spiral, sequential, and retrospective spiral modes, respectively. The median BMI was 27.3 (25–30.4) kg/m2, and the effective dose was 0.65 mSv (interquartile range, 0.33–1.56 mSv). Only 32 of 896 examinations (3.5%) had poor image quality.

Conclusions
Computed tomography angiography with BMI- and HR-tailored protocols offers good image quality with low radiation dose in unselected patients.
Impact of Sublingual Nitroglycerin on the Assessment of Computed Tomography–derived Fractional Flow Reserve: An Intraindividual Comparison Study
Authors: Gao Yifeng , Wang Wenjing , Wang Hongwei , Zhou Zhen , Xu Pengpeng , Jiang Mengdi , Yang Lin , Wang Hui , Wen Hui , Sun Zhonghua , Leipsic Jonathon A. , Zhang Longjiang , Xu Lei 
Published: November 2021

Objective
The aim of this study was to investigate the impact of nitroglycerin (NTG) on the assessment of computed tomography–derived fractional flow reserve (CT-FFR).

Materials and Methods
Seventy-seven patients with suspected coronary artery disease were recruited, and they underwent computed tomography angiography (CCTA) before and after NTG administration. The CT-FFRs were compared at 2 CCTAs. The difference was compared using the Wilcoxon signed rank test. Patients were divided into normal and stenosis groups according to CCTA results. Vessels in the stenosis group were further divided into different groups based on coronary artery calcium score (CACS) and stenosis degree. The poststenotic CT-FFR differences before and after NTG (DCT-FFR) were calculated to evaluate the impact of stenosis degree and CACS. Terminal CT-FFRs derived from CCTAs before and after NTG in total and vessel-specific levels were compared in the normal group.

Results
Of 47 patients in the stenosis group, poststenotic CT-FFR was significantly increased after NTG at per-vessel level. By taking CT-FFR of 0.75 or lower as the threshold, 5 and 4 patients showed abnormal CT-FFR before and after NTG, respectively. No significant differences were noted among the various stenosis degree and CACS groups regarding DCT-FFR. Of 30 patients in the normal group, terminal CT-FFR was significantly increased after NTG in total level and vessel-specific level of left anterior descending and right coronary artery, but not in the left circumflex.

Conclusions
Both post lesion and distal vessel CT-FFR significantly improved after the administration of GTN with the degree of change not affected by stenosis severity or CACS.
Spindle Cell Carcinoma of the Breast: Investigation of Magnetic Resonance Imaging Features of 26 Cases
Authors: Tokuda Yukiko , Ko Eun Sook , Yanagawa Masahiro , Honma Keiichiro , Shimazu Kenzo , Tomiyama Noriyuki 
Published: November 2021

Objective
The aim of the study was to retrospectively investigate the fat-saturated T2-weighted sequences (FST2WI) and 3-dimensional dynamic contrast-enhanced sequence (DCE) of magnetic resonance imaging (MRI) findings of breast spindle cell carcinoma (SpCC).

Methods
Twenty-six women with surgically confirmed breast SpCC, who underwent breast MRI in 2 institutions, were enrolled in this study (mean age, 54 years; range, 27–81 years). Two breast radiologists determined the MRI findings by consensus after independent interpretations. Each MRI finding was analyzed.

Results
Most lesions of SpCC showed a solitary mass (92.2%). Most masses were round/oval (76.0%), had an irregular margin (88.0%), rim enhancement (72.0%), washout kinetic analysis (96.0%), hyperintensity on FST2WI (84%), hyperintensity on FST2WI and fast enhancing component on DCE (56%), and hypointense rim on FST2WI (72.0%).

Conclusions
Most breast SpCC showed a solitary mass, round/oval shape, irregular margin, rim enhancement, washout kinetics, and intratumoral hyperintensity on FST2WI; a hypointense rim on FST2WI; and hyperintensity on FST2WI and fast enhancing component on DCE.
Comparison of 100-Kilovoltage Tin Filtration With Advanced Modeled Iterative Reconstruction Protocol to an Automated Kilovoltage Selection With Filtered Back Projection Protocol on Radiation Dose and Image Quality in Pediatric Noncontrast-Enhanced Chest Computed Tomography
Authors: Siegel Marilyn J. , Raptis Demetrios , Bhalla Sanjeev , Ramirez-Giraldo Juan Carlos 
Published: November 2021

Objective
The aim of the study was to compare effects of a 100-kilovoltage (kVp) tin filtration (Sn100kVp) with Advanced Modeled Iterative Reconstruction (ADMIRE) protocol to an automated kVp selection and filtered back projection (FBP) protocol on radiation dose and image quality of in noncontrast-enhanced pediatric chest computed tomography (CT).

Methods
This retrospective study included 55 children (12 ± 6 years) undergoing baseline imaging using automated kVp selection with FBP on a second-generation dual-source CT scanner and follow-up CT using Sn100kVp with ADMIRE on a third-generation dual-source CT scanner. The volume CT dose index, dose length product, size-specific dose estimate, and milliamperage were compared. Image quality was calculated using signal-to-noise ratio and subjectively evaluated by 2 radiologists.

Results
Mean volume CT dose index, dose length product, and size-specific dose estimate were lower for the Sn100kVp protocol with ADMIRE (0.83 ± 0.18 mGy, 21.9 ± 7.5 mGy × cm, 1.28 ± 0.24 mGy) compared with the automated kVp protocol with FBP (2.17 ± 1.10 mGy, 65.1 ± 41.1 mGy × cm, 3.25 ± 1.44 mGy, P < 0.001), whereas milliamperage was and subjective image quality were higher for Sn100kVp (P < 0.001).

Conclusions
A Sn100kVp protocol with ADMIRE lowers dose while maintaining image quality in noncontrast-enhanced pediatric chest CT.
Virtual Noncontrast Images Derived From Contrast-Enhanced Dual-Layer Spectral Abdominal Computed Tomography: A Pilot Study Between Pediatric and Adult Scans
Authors: Azuma Minako , Nakada Hiroshi , Khant Zaw Aung , Kimura Aya , Hirai Toshinori 
Published: November 2021

Objective
We aimed to compare the accuracy of virtual noncontrast (VNC) images obtained from contrast-enhanced dual-layer spectral computed tomography (DLSCT) scans of the abdomen between pediatric and adult patients.

Methods
We retrospectively studied 10 pediatric and 40 adult patients who underwent unenhanced and contrast-enhanced DLSCT for nontraumatic acute abdomen or a follow-up of tumor or aneurysm. On true noncontrast (TNC) and VNC images, we placed a region-of-interest on 7 abdominal structures. The mean attenuation difference between VNC and TNC images was compared between these structures and between pediatric and adult scans. Data were analyzed by using the Wilcoxon signed-rank test, 1-way analysis of variance, Scheffe's test and independent t test. A P value less than 0.05 was considered statistically significant.

Results
In mean attenuation difference between VNC and TNC images, there was a significant interstructure difference in adult scans (P < 0.05), but not in pediatric scans. Mean attenuation difference between VNC and TNC images of the kidney was significantly higher on adult than pediatric scans (P = 0.0046).

Conclusions
The VNC images obtained from contrast-enhanced DLSCT data may be more accurate on pediatric than adult scans. Patient age can be a factor influencing the accuracy of the VNC images.
A prototype vaccination model for endemic Covid-19 under waning immunity and imperfect vaccine take-up
Authors: Dagpunar John , Wu Chenchen 
Published: November 2021

AbstractIn this paper, for an infectious disease such as Covid-19, we present a SIR model which examines the impact of waning immunity, vaccination rates, vaccine efficacy, and the proportion of the susceptible population who aspire to be vaccinated. Under an assumed constant control reproduction number, we provide simple conditions for the disease to be eliminated, and conversely for it to exhibit the more likely endemic behaviour. With regard to Covid-19, it is shown that if the control reproduction number is set to the basic reproduction number (say 6) of the dominant delta (B1.617.2) variant, vaccination alone, even under the most optimistic of assumptions about vaccine efficacy and high vaccine coverage, is very unlikely to lead to elimination of the disease. The model is not intended to be predictive but more an aid to understanding the relative importance of various biological and control parameters. For example, from a long-term perspective, it may be found that in the UK, through changes in societal behaviour (such as mask use, ventilation, and level of homeworking), without formal government interventions such as on-off lockdowns, the control reproduction number can still be maintained at a level significantly below the basic reproduction number. Even so, our simulations show that endemic behaviour ensues. The model obtains equilibrium values of the state variables such as the infection prevalence and mortality rate under various scenarios.
High-resolution ultrasonography of gingival biomarkers for periodontal diagnosis in healthy and diseased subjects
Authors: Moore Colman , Law Jane , Pham Christopher , Joe Chang Kai Chiao , Chen Casey , Jokerst Jesse V. 
Published: November 2021

ABSTRACTPeriodontal disease affects nearly 50% of Americans but diagnostic methods have remained the same for decades. Periodontal examination via physical probing provides critical metrics such as pocket depth, clinical attachment level, and gingival recession; however, this practice is time consuming, variable, and often painful. In this study, we investigated high-frequency ultrasound (40 MHz) for the image-based measurement of periodontal metrics. Imaging was performed at midbuccal sites for a set of periodontally healthy (n = 10) and diseased (n = 6) subjects and image-based measurements were compared to gold-standard physical probing measurements. Human operators identified relevant markers (e.g., cementoenamel junction, gingival margin, alveolar bone crest) in B-mode ultrasound images from 66 teeth to calculate gingival height and alveolar bone level. These metrics were correlated to clinical measurements of probing pocket depth and clinical attachment level for disease staging (1.57-mm bias and 0.25-mm bias, respectively). Interoperator bias was negligible (<0.1 mm) for gingival height measurements and 0.45 mm for alveolar bone level measurements. The ultrasonographic measurements of gingival height and alveolar bone level served as effective diagnostic surrogates for clinical probing measurements while offering more detailed anatomical information and painless operation.
Tropical forest dynamics correspond to fair games in economic theory of financial markets
Authors: Lin Yue , Rosindell James , Berger Uta , Bruelheide Helge , Kattge Jens , Grimm Volker 
Published: November 2021

ABSTRACTEcological and economic systems both comprise of autonomous adaptive agents. It is thus possible that similar mechanisms determine the organization of both these complex systems. Indeed several economic theories have already been successfully applied in an ecological context. Here we show that ‘efficient market theory’ in economics, where future earnings are distributed between competitors by a ‘fair game’, corresponds to fitness-equalizing mechanisms of coexistence in ecology. In contrast to stabilizing mechanisms, which promote coexistence by giving each species an equilibrium abundance that is resilient to perturbations, equalizing mechanisms promote coexistence without such resilience by minimizing the net fitness differences between species. However, identifying stabilizing and equalizing mechanisms from the short time-series data that are typically available in ecology is challenging. We used techniques from economics that are applied to collections of short time-series from a system. We found that observed species abundance dynamics in a neotropical forest are generally in agreement with efficient market theory implying a dominant role of equalizing mechanisms, which finding quantifies and supports what was generally believed about that specific forest system. Our study highlights that complex systems from ecology and economics share common features suggesting the possibility of further synergy between ecology and economics in future.