bluuebunny/crossref_metadata_2025_split huggingface dataset:
An evidence-based approach to assess the accuracy of intravoxel incoherent motion imaging for the grading of brain tumors
Authors: Li Wen-fei , Niu Chen , Shakir Tahir Mehmood , Chen Tao , Zhang Ming , Wang Zhanqiu 
Published: November 2018

Abstract

Background:
Differentiation of high-grade gliomas (HGGs) and low-grade gliomas (LGGs) is an important clinical problem because treatment strategies vary greatly. This study was performed to investigate the potential diagnostic value of incoherent intravoxel motion imaging (IVIM) to distinguish HGG from LGG by meta-analysis.

Methods:
A computerized search of the literature was performed using the free-access PubMed database, Web of Science, and Chinese biomedical database, and relevant articles until September 18, 2018 that used IVIM to distinguish HGG from LGG were included. All analyses were performed using Review Manager 5.3 and Stata. Mean difference (MD) at 95% confidence interval (CI) of the apparent diffusion coefficient (ADC), diffusion coefficient value (D), perfusion fraction value (f), and perfusion coefficient value (D∗) were summarized.

Results:
Nine studies were used for general data pooling. In the tumor parenchyma (TP) regions, subgroup analysis revealed D∗ in HGG is higher than in LGG (MD = 1.19, P = .002), and D in HGG is lower than in LGG (MD = −1.06, P = .001). However, no significant difference in f (MD = 0.89, P = .056) was detected between HGG and LGG. In the white matter regions, HGG had higher D∗ (MD = 0.76, P = .04) compared with LGG, while no marked differences between the D value (P = .07) and f (P = .09) values.

Conclusion:
The present meta-analysis shows that the ADC, D, and D∗ values derived from IVIM may be useful in differentiating HGG from LGG. Considering the small sample of this study, we need to be cautious when interpreting the results of this study. Other prospective and large-sample randomized controlled trials were needed to establish the value of IVIM in differentiating HGG from LGG.
The clinical consequences of neutrophil priming
Authors: Vogt Katja L. , Summers Charlotte , Condliffe Alison M. 
Published: November 2018

Purpose of review
Neutrophils priming has been long studied in vitro. Recent studies describe it in vivo. In pathophysiological conditions, complex, heterogeneous characteristics of priming are described in the last few years.

Recent findings
Priming can occur systemically when insults such as sepsis or trauma result in an array of circulating mediators and circulating primed neutrophils seem to exert detrimental effects either directly, or indirectly by interacting with other cells, thereby contributing to the development of organ dysfunction. Local priming of neutrophils augments their ability to clear infection, but may also lead to local bystander tissue injury, for example, in the inflamed joint. The complexity, heterogeneity and dynamic nature of inflammatory responses and the accessibility of cells from local sites make neutrophil priming challenging to study in human disease; however, recent advances have made significant progress to this field.

Summary
Herein, we summarize the literature regarding neutrophil priming in selected conditions. In some diseases and in the setting of specific genetic influences, the priming repertoire seems to be restricted, with only some neutrophil functions upregulated. A greater understanding of the nature of neutrophil priming and its role in human disease is required before this process becomes tractable to therapeutic intervention.
Acculturation Into Nursing for Hispanic/Latino Prelicensure Nursing Students and New Graduates
Authors: Woodley Lisa K. , Lewallen Lynne P. 
Published: November 2018

Background
Increasing recruitment and retention of Hispanic/Latino nursing students is urgently needed to increase the diversity of the nursing profession and address persisting health disparities.

Purpose
This integrative review describes current knowledge of Hispanic/Latino prelicensure nursing student and new graduate experiences.

Methods
A comprehensive literature review was performed using several online databases.

Results
The Theory of Cultural Marginality provides structure for organizing and synthesizing the literature. Several concepts from the theory are prominent in the literature, including marginal living and across-culture conflict, easing cultural tension and adjustment responses, and contextual, independent, and personal influences.

Conclusions
The process that Hispanic/Latino prelicensure nursing students and new graduates experience as they acculturate into the profession of nursing is complex. Understanding this process is paramount for nurse educators and should be the foundation on which to design, measure, and evaluate educational strategies aimed at fostering student success.
Derivation and Validation of an Objective Effort of Breathing Score in Critically Ill Children
Authors: Shein Steven L. , Hotz Justin , Khemani Robinder G. 
Published: November 2018

Objectives:
To derive and validate a score that correlates with an objective measurement of a child’s effort of breathing.

Design:
Secondary analysis of a previously conducted observational study.

Setting:
The pediatric and cardiothoracic ICUs of a quaternary-care children’s hospital.

Patients:
Patients more than 37 weeks gestational age to age 18 years who were undergoing extubation.

Interventions:
Effort of breathing was measured in patients following extubation using esophageal manometry to calculate pressure rate product. Simultaneously, members of a multidisciplinary team (nurse, physician, and respiratory therapist) assessed respiratory function using a previously validated tool. Elements of the tool that were significantly associated with pressure rate product in univariate analysis were identified and included in a multivariate model. An Effort of Breathing score was derived from the results of the model using data from half of the subjects (derivation cohort) and then validated using data from the remaining subjects (validation cohort) by calculating the area under the receiver operator characteristic curve for pressure rate product greater than 90th percentile and for the need for reintubation.

Measurements and Main Results:
Among 409 subjects, the median age was 5 months, and nearly half were cardiac surgery patients (49.1%). Retractions, stridor, and pulsus paradoxus were included in the Simple Score. Area under the receiver operator characteristic curve for pressure rate product greater than 90th percentile was 0.8359 (95% CI, 0.7996–0.8722) in the derivation cohort and 0.7930 (0.7524–0.8337) in the validation cohort. Area under the receiver operator characteristic curve for reintubation was 0.7280 (0.6807–0.7752) when all scores were analyzed individually and was 0.7548 (0.6644–0.8452) if scores from three clinicians from different disciplines were summated. Results were similar regardless of provider discipline or training.

Conclusions:
A scoring system was derived and validated, performed acceptably to predict increased effort of breathing or need for advanced respiratory support and may function best when used by a team.
Patterns of Use of Heated Humidified High-Flow Nasal Cannula Therapy in PICUs in the United Kingdom and Republic of Ireland*
Authors: Morris Jenny V. , Kapetanstrataki Melpo , Parslow Roger C. , Davis Peter J. , Ramnarayan Padmanabhan 
Published: November 2018

Objectives:
To 1) describe patterns of use of high-flow nasal cannula therapy, 2) examine differences between patients started on high-flow nasal cannula and those started on noninvasive ventilation, and 3) explore whether patients who failed high-flow nasal cannula therapy were different from those who did not.

Design:
Retrospective analysis of data collected prospectively by the Paediatric Intensive Care Audit Network.

Setting:
All PICUs in the United Kingdom and Republic of Ireland (n = 34).

Patients:
Admissions to study PICUs (2015–2016) receiving any form of respiratory support at any time during PICU stay.

Interventions:
None.

Measurements and Main Results:
Eligible admissions were classified into nine groups based on the combination of the first-line and second-line respiratory support modes. Uni- and multivariate analyses were performed to test the association between PICU and patient characteristics and two outcomes: 1) use of high-flow nasal cannula versus noninvasive ventilation as first-line mode and 2) high-flow nasal cannula failure, requiring escalation to noninvasive ventilation and/or invasive ventilation. We analyzed data from 26,423 admissions; high-flow nasal cannula was used in 5,951 (22.5%) at some point during the PICU stay. High-flow nasal cannula was used for first-line support in 2,080 (7.9%) and postextubation support in 978 admissions (4.5% of patients extubated after first-line invasive ventilation). High-flow nasal cannula failure occurred in 559 of 2,080 admissions (26.9%) when used for first-line support. Uni- and multivariate analyses showed that PICU characteristics as well as patient age, primary diagnostic group, and admission type had a significant influence on the choice of first-line mode (high-flow nasal cannula or noninvasive ventilation). Younger age, unplanned admission, and higher admission severity of illness were independent predictors of high-flow nasal cannula failure.

Conclusions:
The use of high-flow nasal cannula is common in PICUs in the United Kingdom and Republic of Ireland. Variation in the choice of first-line respiratory support mode (high-flow nasal cannula or noninvasive ventilation) between PICUs reflects the need for clinical trial evidence to guide future practice.
Pediatric Injuries Treated at a Level 1 Trauma Center After an F5 Tornado
Authors: Watts Jennifer 
Published: November 2018

Background
On May 22, 2011, an F5 tornado ripped through the city of Joplin, Mo, resulting in over 150 fatalities and over 750 injuries. Pediatric trauma centers in the region needed to be prepared to receive patients. Little data exist on the types of patients who are received at pediatric trauma centers after disasters such as tornados.

Objective
The purpose of this study is to describe the patients received at the nearest level 1 pediatric trauma center after the tornado.

Methods
Cases were identified through the trauma registry. Data regarding patient demographics, past medical history, characteristics of injury, treatment received, and outcomes were obtained retrospectively from medical records.

Results
A total of 10 patients were received at the pediatric trauma center. Traumatic brain injury was the most common diagnosis followed by orthopedic and maxillofacial injuries. Seven patients required surgical procedures in the operating room, but only 1 patient required surgery within the first 24 hours of arrival. Eight patients were intubated and were in the pediatric intensive care unit. The average length of stay in the hospital was 19.4 days with a range of 14 hours to 94 days.

Conclusions
Immediately after a significant tornado in the referral region, pediatric trauma centers need to prepare to receive patients. Head injuries will likely be common, and pediatric trauma centers will likely receive multiple intubated patients. Knowledge of injuries received and resources needed can better prepare these trauma centers for future devastating tornadoes.
An Update on Pediatric Stroke Protocol
Authors: McKinney Shane M. , Magruder Jessica T. , Abramo Thomas J. 
Published: November 2018

Abstract
Pediatric stroke is relatively rare, with approximately 1000 childhood strokes in the United States per year. However, the occurrence of stroke in children leads to significant morbidity and mortality, warranting the development proven screening tools, protocols, and treatment options. Because significant delays in seeking medical attention can occur, time to recognition of pediatric stroke in the emergency department is uniquely challenging and critical. Once recognized, a trained multidisciplinary team with a multifaceted approach is needed to provide the best possible outcome for the patient. Key elements of the pediatric stroke protocol should include recognition tools, stroke alert mechanism, stroke order sets, timely imaging, laboratory evaluation, and treatment options. Substantial advancements have been made in the field of pediatric stroke protocols mainly due to formation of international consortiums and clinical trial. Despite significant progress, treatment options remain controversial.
Management of Primary Lymph Nodal Gastrinoma With Liver Metastases Resulting in Zollinger-Ellison Syndrome
Authors: Singh Deepa , Lal Sadhna B. , Sood Ashwani , Gupta Rajesh , Kumar Rajender , Vashishta Rakesh K. , Mittal Bhagwant Rai 
Published: November 2018

Abstract
Primary lymph node gastrinoma has been defined as gastrin-producing tumor present in lymph nodes and predominantly found in well-defined anatomical region known as gastrinoma triangle. They are usually localized preoperatively with imaging, and their surgical resection results in long-term relief. The authors report a case of unresectable primary lymph nodal gastrinoma with liver metastases in a 14-year-old adolescent boy with proven histopathology detected on 68Ga-DOTANOC whole-body PET/CT scan followed by preoperative multiple 177Lu-DOTATATE cycles for cytoreduction. Subsequent surgical resection of residual mass resulted in complete response with a follow-up of around 4 years in this unusual case of Zollinger-Ellison syndrome.
18F-FDG PET/CT Imaging in an Adolescent Patient With Primary Prostatic Stromal Sarcoma
Authors: Lai Ruihe , Ding Chongyang 
Published: November 2018

Abstract
Primary prostatic stromal sarcoma is an extremely rare disease that predominantly occurs in adults, accounting for only 0.1% of all prostate cancers. Prostatic stromal sarcoma is quite aggressive and can spread to lung, liver, bone, and other organs. Metastasis is one of the most important predictors for prognosis. Here, we reported a case of a 17-year-old adolescent boy diagnosed with primary prostatic stromal sarcoma through prostate biopsy, and stage was confirmed by 18F-FDG PET/CT.
Dental Implants With a Platform-Switched Morse Taper Connection and an Osteo Growth Induction Surface
Authors: Ghensi Paolo , Tonetto Gianmarco , Soldini Costanza , Bettio Elia , Mortellaro Carmen , Soldini Claudio 
Published: November 2018

Aim:
The aim of this study was to analyze the clinical outcomes after using an innovative implant system characterized by a modern platform-switched Morse taper connection and an osteo growth induction titanium surface (a particular type of SLA surface). Peri-implant bone loss (PBL) and implant success rate were examined after a 1- to 3-year follow-up.

Methods:
The study was conducted as a cross-sectional analysis on all patients treated from January 2011 to December 2014 using CLC CONIC implants. Implants were divided into 3 main groups, based on the duration of the follow-up (1 year, 2 years, and 3 years), then subgrouped by diameter, length, and type of prosthetic rehabilitation to compare differences in PBL. X-rays were taken at the time of surgery, at prosthetic loading, at 1 year, and then annually thereafter. Previously-established success criteria were used to assess the implants. Frequency analyses and comparisons between the means (with 95% CI) were conducted for the statistical analysis of the data collected.

Results:
One hundred twenty patients met inclusion and exclusion criteria, and completed the follow-up, and were thus eligible for the study, with a total of 261 CLC CONIC implants. The mean follow-up was 22.45 months. No implants failed, giving an overall success rate of 100%. The average PBL at 1-year follow-up was 0.047 mm, at 2 years it was 0.128 mm, and at 3 years it was 0.236 mm.

Conclusions:
The CLC CONIC implant system had a high success rate after 1 to 3 years of follow-up, in line with previous reports in the scientific literature. Combining platform switching with the Morse taper connection enabled stable bone levels to be achieved in the short to medium term.
Preliminary Study to Evaluate Marginal Bone Loss in Cases of 2- and 3-Implant-Supported Fixed Partial Prostheses of the Posterior Mandible
Authors: Segal Pnina , Makhoul Areej , Eger Michal , Lucchina Alberta Greco , Winocur Ephraim , Mijiritsky Eitan 
Published: November 2018

Purpose:
The purpose of this study was to evaluate, by radiographic examinations, the marginal bone resorption around implants in cases of 2 and 3 implant-supported fixed partial prostheses (FPPs) at the posterior mandible.

Methods:
A retrospective study of 41 patients (23 males, 18 females) of an average age of 67 years (range, 53–85), with 2 and 3 implants-supported FPPs in the posterior mandible that were treated during 2006 to 2015. The mean follow-up time was 6.32 years (range, 2–10). Twenty-four patients had FPPs on 2 implants (a total of 48 implants). Seventeen patients had FPPs on 3 implants (a total of 51 implants). Clinical and radiographic follow-up examinations were performed. All radiographs were analyzed for changes in marginal bone height surrounding the implants.

Results:
The mean marginal bone loss around the most mesial implant was slightly higher in the 2-implant group (0.833 mm) compared with the 3-implant group (0.431 mm). The correlation between the mean marginal bone loss around the most mesial implant and the number of implants was of borderline value (P = 0.055).

Conclusions:
Considering the limitations of this preliminary study, the authors found that the mesial implant in the 2-implant group is more susceptible to marginal bone loss.
Multisuture Craniosynostosis and Papilledema in Pycnodysostosis: A Paradox?
Authors: Thomas Gregory P. L. , Magdum Shailendra A. , Saeed Nad R. , Johnson David 
Published: November 2018

Abstract
Pycnodysostosis (PYCD) is a rare autosomal-recessive skeletal disorder that typically presents with osteosclerosis of the majority of the postcranial skeleton and osteolysis of the calvarium, manifesting as persistent open cranial fontanelles and widely spaced cranial sutures. Craniosynsostosis in PYCD is a somewhat paradoxical feature, and has only been rarely reported. The authors present a unique case of a 6-year-old girl with PYCD, multisuture craniosynostosis involving the coronal and sagittal sutures, severe obstructive sleep apnoea, and raised intracranial pressure presenting as papilledema. She underwent a frontofacial monobloc distraction advancement which successfully corrected her papilledema and obstructive sleep apnoea.
Pycnodysostosis is caused by a loss of function mutation in the CTSK gene that codes for the lysosomal cysteine protease, cathepsin K (CTSK). Loss of CTSK impairs the ability of osteoclasts to degrade bone extracellular matrix. Differences in osteoclast phenotype and extracellular matrix composition between membranous and cartilaginous bone may explain the clinical features of PYCD. Animal model studies suggest that craniosynostosis may arise due to variations in patient genetic background.
Full-Thickness Skin Grafting for Local Defect Coverage Following Scalp Adjacent Tissue Transfer in the Setting of Cranioplasty
Authors: Wolff Amir Y. , Santiago Gabriel F. , Belzberg Micah , Manson Paul N. , Huang Judy , Brem Henry , Gordon Chad R. 
Published: November 2018

Introduction:Numerous techniques have been described to overcome scalp deficiency and high-tension closure at time of cranioplasty. However, there is an existing controversy, over when and if a free flap is needed during complex skull reconstruction (ie, cranioplasty). As such the authors present here our experience using full-thickness skin grafts (FTSGs) to cover local defects following scalp adjacent tissue transfer in the setting of cranioplasty.Methods:By way of an institutional review board-approved database, the authors identified patients treated over a 3-year period spanning January 2015 to December 2017, who underwent scalp reconstruction using the technique presented here. Patient demographics, clinical characteristics, technical details, outcomes, and long-term follow up were statistically analyzed for the purpose of this study.Results:Thirty-three patients, who underwent combined cranioplasty and scalp reconstruction using an FTSG for local donor site coverage, were identified. Twenty-five (75%) patients were considered to have “high complexity” scalp defects prior to reconstruction. Of them, 12 patients (36%) were large-sized and 20 (60%) medium-sized; 21 (64%) grafts were inset over vascularized muscle or pericranium while the remaining grafts were placed over bare calvarial bone. In total, the authors found 94% (31/33) success for all FTSGs in this cohort. Two of the skin grafts failed due to unsuccessful take. Owing to the high rate of success in this series, none of the patient's risk factors were found to correlate with graft failure. In addition, the success rate did not differ whether the graft was placed over bone verses over vascularized muscle/pericranium.Conclusion:In contrary to previous studies that have reported inconsistent success with full-thickness skin grafting in this setting, the authors present a simple technique with consistent results—as compared to other more complex reconstructive methods—even in the setting of highly complex scalp reconstruction and simultaneous cranioplasty.
The External Jugular Vein Used as Recipient Vessel in Head and Neck Free Flap Reconstruction: Outcomes Compared to the Internal Jugular Vein
Authors: Ibrahim Amir E. , Adelman David M , Parham Christopher , Hong Zhang , Villa Mark , Chahine Fadel M. , Ghieh Fadi M. 
Published: November 2018

Background:
Contradictory data exists on the success rates of employing the external jugular (EJ) vein as a recipient vessel for venous outflow in free flap head and neck reconstruction compared with the internal jugular (IJ) vein. The authors hereby present a retrospective study of prospectively collected data over a 14-year period.

Methods:
Five hundred seventy-eight patients underwent 639 free flap head and neck over 14 years. Two hundred seventy-eight free flaps employed the EJ vein as the recipient vessel while 326 free flaps employed the IJ vein. Rates of acute and late complications were compared.

Results:
There were no differences in rates of complications: flap loss, venous thrombosis, arterial thrombosis, bleeding, hematoma, or infection between the EJ and IJ vein groups.

Conclusion:
The external jugular vein as a recipient vessel for venous outflow in head and neck free flap reconstruction of postoncologic resection defects is a valid option for both primary reconstructions and secondary surgeries.