bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence, Risk Factors, and Evolution of Proximal Junctional Kyphosis After Posterior Hemivertebra Resection and Short Fusion in Young Children With Congenital Scoliosis
Authors: Chen Xi , Xu Liang , Qiu Yong , Chen Zhong-hui , Zhu Ze-zhang , Li Song , Sun Xu 
Published: February 2018

Study Design.
A retrospective study.

Objective.
To investigate the incidence, risk factors, and evolution of proximal junctional kyphosis (PJK) in young children who underwent posterior hemivertebra resection and short fusion.

Summary of Background Data.
PJK is an undesired, but common complication following posterior spinal fusion. However, there is a paucity of data on PJK in young children after posterior hemivertebra resection and short fusion.

Methods.
This study included 189 children who had undergone posterior hemivertebra resection and short fusion (≤4 vertebra) from January 2008 and May 2015 at a single institution. Medical records were reviewed and radiographic assessments were made preoperatively and throughout the follow-up period. Risk factors for PJK were evaluated by correlation analysis and logistic regression analysis.

Results.
The mean age at surgery was 4.5 years (range, 3–10 yr) and the average follow-up was 48.4 months (range, 24–87 mo). Twenty-two (11.6%) patients experienced PJK. PJK was identified within 6 months after surgery in 21 cases (95%), and the most common type was ligamentous failure. In comparison with the non-PJK group, the PJK group had greater preoperative segmental kyphosis (26.9° vs. 16.7°, P < 0.01), longer fusion levels (3.4 vs. 2.5, P < 0.01), and larger postoperative sagittal vertical axis (SVA; 18.9 vs. 8.6 mm, P < 0.01). Preoperative segmental kyphosis >30°(odds ratio, 4.426), and postoperative SVA of more than 20 mm (odds ratio, 3.580) were identified as independent risk factors for PJK. In PJK group, the average proximal junctional angle increased from 4.9° to 18.5° at 6 months postoperatively, but significantly decreased to 14.8° at final follow-up. Eleven patient received brace treatment, and no patients required revision surgery.

Conclusion.
Despite the incidence of PJK in 11.6% of young children undergoing posterior hemivertebra resection and short fusion, no significant deterioration of proximal junctional angle were found till the last follow-up. Its risk factors include preoperative segmental kyphosis, a larger postoperative SVA and ligamentous failure. Early detection and active management may be helpful for minimizing the progression of PJK.

Level of Evidence: 3
Malpractice Litigation in Cornea and Refractive Surgery: A Review of the WestLaw Database
Authors: Engelhard Stephanie B. , Shah Christopher T. , Sim Austin J. , Reddy Ashvini K. 
Published: February 2018

Purpose:
To report and analyze the causes and outcomes of malpractice litigation in cornea and refractive surgery.

Methods:
The WestLaw database was reviewed for all malpractice litigation related to ophthalmology in the United States between 1930 and 2014. Search terms included ophthalmology or ophthalmologist and malpractice anywhere in the retrieved results. All cases involving cornea and refractive surgery were included in this analysis, and results were compared with ophthalmology as a whole.

Results:
One hundred fifty-nine cornea and refractive surgery cases between the years 1964 and 2014 were included. Ninety-three cases (58.5%) were resolved through a jury trial, 21.5% of which were associated with plaintiff verdicts with a median adjusted jury award of $588,896 (mean $1,518,686). Nineteen cases (11.9%) resulted in settlements with a median adjusted indemnity of $782,533 (mean $761,963). Commonly litigated scenarios included laser-assisted in situ keratomileusis (74.2%) and corneal transplantation (8.2%). Overall, 88.7% of cases involved surgical or procedural claims, 8.8% involved noninterventional claims, and 2.5% involved medical claims only.

Conclusions:
Cornea and refractive surgery is a high-risk subspecialty of ophthalmology. Laser-assisted in situ keratomileusis and corneal transplant claims were the most commonly litigated entities in this series. Many cases focus on failure to achieve patients' desired expectations after elective refractive procedures or the negligent performance of refractive surgery on patients with contraindications to surgery, both highlighting the importance of detailed informed consent discussions, realistic goal setting with patients, and thorough examinations and preoperative evaluation.
Evaluation of different treatment and management options for chondrosarcoma; the prognostic factors determining the outcome of the disease
Authors: Abbas Kiran , Siddiqui Amber T. 
Published: February 2018

Importance:
This review provides an in-depth discussion of the different treatment and management strategies adopted for chondrosarcoma, the various outcomes and the prognostic factors of the disease. Chondrosarcoma is the third most common malignant bone tumor after myeloma and osteosarcoma. It is characterized by the production of a cartilaginous matrix by malignant cells. It can be classified according to the source of its origin, histopathologic grade, site of occurrence, and rarity. Chondrosarcomas that are de novo in nature are classified as primary chondrosarcomas, while those derived from pre-existing enchondromas or osteochondromas are regarded as secondary chondrosarcomas. Other rare forms of chondrosarcoma include dedifferentiated, mesenchymal, and clear cell chondrosarcomas.

Observations/Findings:
Early diagnosis, accurate interpretation of histopathology, precise grading, and careful localization are crucial in the management of chondrosarcoma. Surgery is the treatment of choice. Three forms of surgical interventions are present; curettage, radical resection, and amputation. The choice of procedure depends on the size and site of the lesion and degree of malignancy. Radical procedures give the most promising outcomes with wider margins yielding better prognosis. Recurrence is usually seen with delayed surgery, high histopathologic grading, inadequate surgical procedures, marginal excision or curettage, tumor present in inaccessible sites such as sacrum and metastasis.

Conclusion:
Chondrosarcoma is responsible for placing a significant burden on pediatric as well as adult orthopedic oncology. Optimum diagnosis, accurate interpretation of histopathology, precise grading, careful localization, and timely as well as adequate management is crucial to successfully manage and prevent recurrence of the disease. Surgery is the most effective form of treatment. The main goal of treatment and management is to keep well ahead of the growth of the neoplasm and to prevent recurrences.
Functional imaging in microfluidic chambers reveals sensory neuron sensitivity is differentially regulated between neuronal regions
Authors: Clark Alex J. , Menendez Guillermo , AlQatari Mona , Patel Niral , Arstad Erik , Schiavo Giampietro , Koltzenburg Martin 
Published: February 2018

Abstract
Primary afferent sensory neurons are incredibly long cells, often traversing distances of over 1 m in humans. Cutaneous sensory stimuli are transduced in the periphery by specialised end organs or free nerve endings, which code the stimulus into electrical action potentials that propagate towards the central nervous system. Despite significant advances in our knowledge of sensory neuron physiology and ion channel expression, many commonly used techniques fail to accurately model the primary afferent neuron in its entirety. In vitro experiments often focus on the cell somata and neglect the fundamental processes of peripheral stimulus transduction and action potential propagation. Despite this, these experiments are commonly used as a model for cellular investigations of the receptive terminals. We demonstrate that ratiometric calcium imaging performed in compartmentalised sensory neuron cultures can be used to directly and accurately compare the sensitivity and functional protein expression of isolated neuronal regions in vitro. Using microfluidic chambers, we demonstrate that the nerve terminals of cultured dorsal root ganglion neurons can be depolarised to induce action potential propagation, which has both tetrodotoxin-resistant and tetrodotoxin-sensitive components. Furthermore, we show that there is a differential regulation of proton sensitivity between the sensory terminals and somata in cultured sensory neurons. We also demonstrate that capsaicin sensitivity is highly dependent on embryonic dissection age. This approach enables a comprehensive method to study the excitability and regional sensitivity of cultured sensory neurons on a single-cell level. Examination of the sensory terminals is crucial to further understand the properties and diversity of dorsal root ganglion sensory neurons.
Psychological factors predict an unfavorable pain trajectory after hysterectomy: a prospective cohort study on chronic postsurgical pain
Authors: Pinto Patrícia R. , McIntyre Teresa , Araújo-Soares Vera , Almeida Armando , Costa Patrício 
Published: February 2018

AbstractChronic postsurgical pain (CPSP) is a well-recognized potential complication with negative personal, social, and health care consequences. However, limited data exist on CPSP and on the course of pain over time after hysterectomy. Using data from a prospective cohort study on a consecutive sample assessed at 4 time points, presurgery (T1), 48 hours (T2), 4 months (T3), and 5 years postsurgery (T4), we sought to examine women's PSP trajectories using assessments of pain at T3 and T4. In addition, this study aimed to investigate presurgical and postsurgical risk factors associated with an unfavourable pain trajectory (PT). Based on pain data collected at T3 and T4, 3 distinct trajectories of PSP emerged: no CPSP (PT1; n = 88), prolonged PSP (PT2; n = 53), and CPSP (PT3; n = 29). Moreover, reported CPSP prevalence at 5 years was 17.1%. Multinomial logistic regression models controlling for age, presurgical pain, and type of hysterectomy tested for baseline and acute postsurgical predictive variables. Membership in PT2 and PT3 was predicted by presurgical anxiety (odds ratio [OR] = 1.131,P= 0.015; OR = 1.175,P= 0.009, respectively), emotional representation of the surgical disease (OR = 1.155,P= 0.034; OR = 1.213,P= 0.020, respectively), and pain catastrophizing (OR = 1.079,P= 0.043; OR = 1.143,P= 0.001, respectively). Furthermore, acute PSP intensity and frequency determined membership of women in PT3 (OR = 1.211,P= 0.033; OR = 3.000,P= 0.029, respectively), and postsurgical anxiety (OR = 1.182,P= 0.026) also played a key predictive role. This study identified factors that can be easily screened before and after surgery and are amenable to change through carefully designed timely and tailored interventions for women at risk of an unfavorable PSP trajectory posthysterectomy.
Chemotherapy-induced pain is promoted by enhanced spinal adenosine kinase levels through astrocyte-dependent mechanisms
Authors: Wahlman Carrie , Doyle Timothy M. , Little Joshua W. , Luongo Livio , Janes Kali , Chen Zhoumou , Esposito Emanuela , Tosh Dilip K. , Cuzzocrea Salvatore , Jacobson Kenneth A. , Salvemini Daniela 
Published: February 2018

Abstract
Development of chemotherapy-induced neuropathic pain (CINP) compromises the use of chemotherapy and greatly impacts thousands of lives. Unfortunately, there are no Food and Drug Administration–approved drugs to prevent or treat CINP. Neuropathological changes within CNS, including neuroinflammation and increased neuronal excitability, are driven by alterations in neuro-glia communication; but, the molecular signaling pathways remain largely unexplored. Adenosine is a potent neuroprotective purine nucleoside released to counteract the consequences of these neuropathological changes. Adenosine signaling at its adenosine receptors (ARs) is dictated by adenosine kinase (ADK) in astrocytes, which provides a cellular sink for the removal of extracellular adenosine. We now demonstrate that chemotherapy (oxaliplatin) in rodents caused ADK overexpression in reactive astrocytes and reduced adenosine signaling at the A3AR subtype (A3AR) within the spinal cord. Dysregulation of ADK and A3AR signaling was associated with increased proinflammatory and neuroexcitatory interleukin-1β expression and activation of nucleotide-binding oligomerization domain-like receptor protein 3 inflammasome, but not putative oxaliplatin-associated GSK3β transcriptional regulation. Intrathecal administration of the highly selective A3AR agonist MRS5698 attenuated IL-1β production and increased the expression of potent anti-inflammatory and neuroprotective IL-10. The effects of MRS5698 were blocked by attenuating IL-10 signaling in rats with intrathecal neutralizing IL-10 antibody and in IL-10−/− knockout mice. These findings provide new molecular insights implicating astrocyte-based ADK-adenosine axis and nucleotide-binding oligomerization domain-like receptor protein 3 in the development of CINP and IL-10 in the mechanism of action of A3AR agonists. These findings strengthen the pharmacological rationale for clinical evaluation of A3AR agonists already in advanced clinical trials as anticancer agents as an adjunct to chemotherapy.
Ceftaroline for Suspected or Confirmed Invasive Methicillin-Resistant Staphylococcus aureus: A Pharmacokinetic Case Series
Authors: Cies Jeffrey J. , Moore Wayne S. , Enache Adela , Chopra Arun 
Published: February 2018

Objectives:
To describe the ceftaroline pharmacokinetics in critically ill children treated for suspected or confirmed methicillin-resistant Staphylococcus aureus infections, including blood stream infection and describe the microbiological and clinical outcomes.

Design:
Retrospective electronic medical record review.

Settings:
Free-standing tertiary/quaternary pediatric children’s hospital.

Patients:
Critically ill children receiving ceftaroline monotherapy or combination therapy for suspected or confirmed methicillin-resistant S. aureus infections in the PICU.

Intervention:
None.

Measurements and Main Results:
Seven patients, three females (43%), and four males (57%), accounted for 33 ceftaroline samples for therapeutic drug management. A median of four samples for therapeutic drug management was collected per patient (range, 2–9 samples). The median age was 7 years (range, 1–13 yr) with a median weight of 25.5 kg (range, 12.6–40.1 kg). Six of seven patients (86%) demonstrated an increase in volume of distribution, five of seven patients (71%) demonstrated an increase in clearance, and 100% of patients demonstrated a shorter half-life estimate as compared with the package insert estimate. Six of seven patients (85.7%) had documented methicillin-resistant S. aureus growth from a normally sterile site with five of six (83.3%) having documented BSI, allowing six total patients to be evaluated for the secondary objective of microbiological and clinical response. All six patients achieved a positive microbiological and clinical response for a response rate of 100%.

Conclusions:
These data suggest the pharmacokinetics of ceftaroline in PICU patients is different than healthy pediatric and adult patients, most notably a faster clearance and larger volume of distribution. A higher mg/kg dose and a more frequent dosing interval for ceftaroline may be needed in PICU patients to provide appropriate pharmacodynamic exposures. Larger pharmacokinetic, pharmacodynamic, and interventional treatment trials in the PICU population are warranted.
Brief Report: HIV Postexposure Prophylaxis-in-Pocket (“PIP”) for Individuals With Low-Frequency, High-Risk HIV Exposures
Authors: Tumarkin Ethan , Heendeniya Amila , Murphy Pauline , Placido Tania , Tan Darrell H. S. , Bogoch Isaac I. 
Published: February 2018

Background:
On-demand preexposure prophylaxis may reduce one's risk of HIV acquisition; however, it is unclear if individuals with a very low frequency of HIV exposures are conferred adequate protection. We evaluated a novel approach dubbed HIV postexposure prophylaxis-in-pocket (“PIP”), for individuals with a low frequency of high-risk HIV exposures.

Setting:
Two HIV clinics in Toronto, Canada, managing HIV prevention cases.

Methods:
A retrospective evaluation of patients referred to HIV clinics for preexposure prophylaxis between January 1, 2013, and September 30, 2017, inclusive. After counseling and education, selected patients were initiated on PIP if they were having very infrequent HIV exposures.

Results:
Thirty patients were prescribed PIP. Four patients (13.3%) used PIP during this study. There were no HIV seroconversions in 21.8 cumulative patient-years of PIP.

Conclusions:
PIP may be a useful HIV prevention modality for individuals with a very low frequency of HIV exposures.
Orbital Schwannoma With Atypical Presentation
Authors: Young Stephanie M. , Kim Yoon-Duck , Hwang Sung Soon , Woo Kyung In 
Published: February 2018

Abstract
Orbital schwannomas are characteristically slow-growing benign tumors arising from peripheral sensory nerves. However, the authors’ case illustrates the atypical presentation of such a tumor.
A 71-year-old male presented with proptosis, visual loss, and periorbital inflammation. Sequential imaging showed continuous and rapid growth of an intraconal mass arising from the medial rectus. Excision of the mass was performed and it was histopathologically proven to be an orbital schwannoma.
This patient demonstrates the atypical presentation of an orbital schwannoma, arising from an extraocular muscle with rapid progressive growth and inflammation, indicating it should be considered a differential diagnosis in orbital masses presenting as such.
Evaluation of the Characteristics and Association Between Schneiderian Membrane Thickness and Nasal Septum Deviation
Authors: Bayrak Seval , Ustaoğlu Gülbahar , Demiralp Kemal Özgür , Kurşun Çakmak Emine Şebnem 
Published: February 2018

Objective:
Nasal septum deviation (NSD) is an anomaly that disturbs normal mucus drainage in sinuses, leading to recurrent sinusitis. Sinusitis, infections, and mucosal irritations are the potential causes of Schneiderian membrane thickening (SMT). The aim of this study was to evaluate the characteristics and association between NSD and SMT along with factors such as age, gender, and tooth groups using cone-beam computed tomography (CBCT) imaging.

Methods:
The maxillary sinus and nasal cavity of 249 patients (136 females and 113 males) were examined retrospectively using CBCT. The statistical analysis was performed to determine the association between SMT, NSD, gender, and age.

Results:
No statistically significant relation was detected between NSD and SMT. The NSD was found in 50.6% of patients without gender predilection. Age was not associated with the presence of NSD. The mean thickness of the membrane was least in the third molar region and highest in the first molar region. The average SMT was found to be higher in males for all the examined tooth areas (P ≤ 0.05).

Conclusion:
A retrospective evaluation of CBCT images emphasized the concept that NSD was not a factor that affected the thickening of maxillary sinus mucosa. The CBCT imaging could be used for evaluating the maxillary sinuses and nasal septum.
Extended Release Liposomal Bupivacaine Injection (Exparel) for Early Postoperative Pain Control Following Pharyngoplasty
Authors: Day Kristopher M. , Nair Narayanan M. , Griner Devan , Sargent Larry A. 
Published: February 2018

Background:
Liposomal bupivacaine (LB, Exparel) is a long-acting local anesthetic reported to decrease postoperative. The authors demonstrate the first safe use of LB in pediatric patients with improved pain control following pharyngoplasty.

Methods:
Retrospective case-control of all the patients who underwent pharyngoplasty at a tertiary craniofacial center from March 2010 to June 2016. Treatment group (TG) administered 1.3% LB and 0.5% bupivacaine and 1:200,000 epinephrine. Control group (CG) administered 0.5% lidocaine with 1:200,000 epinephrine. Pain scores, oral intake, opioids administered, and duration of hospitalization were measured.

Results:
Sixty patients (30 males, 30 females; average age 6.2 ± 2.4 years, weight 20.9 ± 6.8 kg) were evenly divided into a TG that received 3.5 ± 2.1 mL (2.6 ± 1.9 mg/kg) LB and 2.0 ± 2.3 mL 0.5% bupivacaine and a CG that received 2.7 ± 3.2 mL lidocaine. Treatment group patients had lower initial face, legs, activity, cry, consolability pain scale scores (0.1 ± 0.55/10, P = 0.0049; CG 4.5 ± 1.1/10, P = 0.00061) and no significant inpatient pain score difference 0 to 36 hours postoperative (P = 0.32–0.53). Oral intake was tolerated 0.21 ± 0.12 days (P < 0.0001) earlier by the TG and with greater first 24-hour average volume (377.6 ± 351.9 cc, P < 0.0001). Treatment group patients were discharged 1.8 ± 0.87 days (P = 0.00023) earlier and required lower average opioids (15.1 ± 11.2 mg hydrocodone-equivalents) than CG (27.5 ± 19.1 mg hydrocodone-equivalents; P = 0.0017).

Conclusions:
Liposomal bupivacaine is safe in pediatric patients, associated with less opioids, increased and earlier oral intake, and shorter hospital stay.
Investigating the moderating role of Export Promotion Programmes using evidence from North-Africa
Authors: Haddoud Mohamed Yacine , Onjewu Adah-Kole , Jones Paul , Newbery Robert 
Published: February 2018

PurposeBased on an institutional approach to explaining firms’ internationalisation, this paper aims to empirically investigate the role of Export Promotion Programmes (EPPs) in moderating the influence of export barriers perceptions on small and medium enterprises’ (SMEs) propensity to export.Design/methodology/approachThe study uses evidence from Algeria, the largest North-African country. The data were collected using an online questionnaire, targeting SMEs operating in the manufacturing sector. The study considers the influence of procedural, informational, environmental and functional barriers on export propensity, to uncover the moderating role of trade missions, trade shows and export seminars and workshops on such relationships. To examine these links, five main hypotheses are proposed and tested through a non-linear partial least squares structural equation modelling on a sample of 128 Algerian SMEs.FindingsThe results show that while internal barriers decrease firms’ export propensity, EPPs including trade fairs and shows may independently pose either a positive or negative influence on such relationships.Research limitations/implicationsThe study confirms the applicability of the institutional perspective to explaining firms’ internationalisation. More importantly, the present study highlights the role of EPPs in moderating the influence of export barriers perceptions on SMEs’ international market entry, a role neglected by the extant empirical literature.Practical implicationsThe current findings hold important implications to export promotion organisations operating in African countries. Notably, the results reveal that some programmes could have a negative influence if they are not delivered appropriately.Originality/valueThis study offers a rare focus on the moderating role of EPPs in the relationship between export barriers and export propensity, within the setting of a North-African country.