bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification and Characterization of Oral Injury in Suspected Child Abuse Cases
Authors: George Caroline L. S. , Theesfeld Samuel S. N. , Wang Qi , Hudson Mark J. , Harper Nancy S. 
Published: January 2019

Objectives
Accurately differentiating inflicted from accidental injury in infants and toddlers is critical. Many studies have documented characteristics of inflicted bruises, fractures, and head injuries facilitating the development of clinical tools. There are few studies characterizing inflicted oral injuries, and no clinical tools exist. This study identified characteristics that differentiated inflicted from accidental oral injuries in children younger than 24 months.

Methods
Retrospective review using International Classification of Diseases, Ninth Revision billing codes and an internal clinical database tool identified children younger than 24 months between 2004 and 2014. Two groups were created according to the presence or absence of a child abuse diagnosis resulting in an accidental injury and suspected child abuse (SCA) group. Statistical analyses were performed on patient demographics, history of trauma, oral injury characterization, bruises, and fractures.

Results
Billing codes were applied differently between the accidental injury and SCA groups, even when the same injury was described. Patients with SCA were younger and less mobile when compared with those with accidental injuries (P < 0.0001). Tongue injuries (P < 0.0001) and oropharynx bruising (P = 0.0018) were observed more and lacerations were observed less (P < 0.0001) in the SCA group. The SCA group was less likely to have a trauma history than those with accidental injury (P < 0.0001).

Conclusions
Several differences in patient characteristics, trauma history, injury type, and location were identified between the accidental versus SCA groups. A future clinical tool that incorporates age, history of trauma on presentation, tongue injury, and oropharynx bruising may assist medical providers in placing child physical abuse in the differential diagnosis.
Bone Fractures in Children With Cholestatic Liver Disease May Mimic Those Seen in Child Abuse
Authors: Goldner Dana , Vittorio Jennifer , Barrios Dulce M. , McGuire Jillian , Brodlie Susan , Brown Jocelyn , Lobritto Steven , Martinez Mercedes 
Published: January 2019

Abstract
Certain fractures in children are highly specific for child abuse. Metabolic bone disease frequently develops in patients with cholestatic liver disease (CLD); this can result in weakened bones and a predisposition to pathologic fractures. Fractures that occur in patients with rickets and osteopenia may mimic a bone response to inflicted injury, which in children raise the concern of child abuse. Here we report a series of 15 patients with CLD who developed pathologic fractures in the setting of metabolic bone disease. During initial evaluation, the caretakers of 5 of these 15 patients were reported to child protective services and investigated for child abuse. Pediatricians should be aware that children with CLD have an increased incidence of pathologic fractures, even after the cholestasis has resolved.
Instant Outcome Evaluation of Microwave Ablation With Subtraction CT in an In Vivo Porcine Model
Authors: Bressem Keno K. , Vahldiek Janis L. , Erxleben Christoph , Poch Franz , Hiebl Bernhard , Lehmann Kai , Hamm Bernd , Niehues Stefan M. 
Published: January 2019

Objectives
The aim of this study was to investigate whether the accuracy of multislice contrast-enhanced computed tomography (MS-CECT) may be improved by performing additional subtraction CT.

Materials and Methods
Thirty-five microwave ablations were performed under CT guidance in 12 healthy and anesthetized pigs. Preablation and postablation MS-CECT scans were obtained in arterial and venous contrast phases. These scans were reconstructed and subtracted from each other. Lesion size was measured in a region of interest drawn around the ablation area. Computed tomography measurements were compared with standardized macroscopic images of explanted liver tissue, obtained immediately after ablation. Paired correlation and Bland-Altman analyses were performed for assessing agreement between modalities and ratings.

Results
The correlation between lesion size measured in CT and histology was very strong for subtracted images (r = 0.91; 95% confidence interval [CI], 0.8–0.96) and strong for standard MS-CECT images (r = 0.85; 95% CI, 0.68–0.93). Interrater agreement for all measurements was excellent (intraclass correlation coefficient, 0.99; 95% CI, 0.98–0.99 for subtraction and intraclass correlation coefficient, 0.99; 95% CI, 0.98–1.00 for MS-CECT). All differences were statistically significant (P < 0.05).

Conclusions
Subtraction CT was superior to nonsubtracted MS-CECT in measurement of liver lesion size after microwave ablation in a porcine model, achieving a very strong correlation with pathologic measurement and a significantly lower overestimation of lesion size compared with MS-CECT.
SPECT/CT Findings in Scapular Notching After Reverse Shoulder Arthroplasty
Authors: Cieciera Matthaeus , Schoeniger Ralf , Bhure Ujwal , Strobel Klaus 
Published: January 2019

Abstract
Scapular notching (SN) is a unique complication in reverse shoulder arthroplasty, caused by repetitive impingement of the humeral polyethylene liner against the inferior scapular neck. It occurs in up to 96% of cases, with bone loss beneath the glenoid baseplate and polyethylene wear. SN can be associated with pain, decreased range of motion, and might result in glenoid implant failure. Modification of glenosphere design and humeral neck angle showed substantially less SN. SPECT/CT is a promising tool providing combined morphologic and metabolic information in symptomatic SN. We present SPECT/CT findings in 7 cases of symptomatic SN in reverse shoulder arthroplasty patients.
Asymptomatic Isolated Vulvar Metastasis in Old Treated Case of Carcinoma Rectum—Diagnosis and Treatment Response Evaluation by 18F-FDG PET/CT Scan
Authors: Elumalai Ram Kumar , Verma Ritu , Malik Dharmender , Belho Ethel Shangne 
Published: January 2019

Abstract
We report a clinically asymptomatic, old treated case of carcinoma rectum, presenting with raised serum carcinoembryonic antigen level, referred for 18F-FDG PET/CT scan for restaging. Whole-body PET/CT scan revealed an isolated FDG-avid lesion in the left labia majora region, which on histopathology was found to be metastasis from carcinoma rectum. Subsequent 18F-FDG PET/CT done after 4 cycles of chemotherapy revealed favorable response to therapy. 18F-FDG PET/CT facilitates the detection of unusual site of metastasis and its subsequent response evaluation in the index case.
Diffuse Intense Intestinal FDG Activity in a Patient With Familial Adenomatous Polyposis
Authors: Cai Liang , Shao Fuqiang , Zhang Jie , Chen Yue 
Published: January 2019

Abstract
Familial adenomatous polyposis is a rare autosomal dominant intestinal syndrome with a high rate of malignant transformation. Here, we report a 20-year-old woman with a diagnosis of familial adenomatous polyposis by pathologic examination after colonoscopy biopsy, who underwent an 18F-FDG PET/CT to assess the extent of this disease. The images showed diffuse elevated FDG uptake along the entire colorectum. Additionally, focal enlarged lymph nodes with increased FDG uptake were noted. These findings promoted proctocolectomy and lymphadenectomy.
Case of Solitary Peritoneal Metastasis From Atypical Bronchopulmonary Carcinoid on 18F-FDG PET/CT
Authors: Gawde Sachin , Singhal Ashok , Kasat Amrita , Parekh Siddharth , Ramaswamy Veena 
Published: January 2019

Abstract
Atypical lung carcinoids frequently metastasize to mediastinal nodes, liver, bone, lungs, and brain and rarely to ovaries, pancreas, subcutaneous, and skin. Solitary peritoneal metastasis is extremely rare and unreported previously. We present a case of a 36-year-old woman with cough, hemoptysis, dyspnea with detection of lung mass, and incidental detection of pelvic mass. Fine needle aspiration cytology failed to reveal the true nature of both the lesions. FDG PET/CT showed intensely avid mediastinal nodes, left lung, and rectouterine masses. Core biopsy from lung mass revealed atypical carcinoid without appreciable uptake on 68Ga-DOTANOC scan. Subsequent postchemotherapy CT scan shows significant regression in lung and peritoneal masses.
Colon Visualization on Bone Scan Due to Recto-abscess Fistula From Urinoma
Authors: Chao Kang-Hung , Yen Tsung-Hsien , Huang Cheng-Kai , Changlai Sheng-Pin 
Published: January 2019

Abstract
The accumulation of the bone-seeking agent in the bowel during a bone scan is rare. A 68-year-old man with colon cancer underwent bone scintigraphy for staging. Whole-body images revealed an abnormal accumulation of hot radioactivity in the abdominal cavity and the colon. Abdominal CT showed a recto-abscess fistula between the rectum and the urinoma. Incidental visualization of colonic radioactivity suggested the presence of a fistula between the bowel and the urinoma, explaining the peculiar finding of the bone-seeking agent in the bowel.
18F-FDG-Labeled Autologous Leukocyte PET-CT in a Patient With Aortic Valve-Tube Graft Infection After Bentall Procedure
Authors: Sood Apurva , Bhattacharya Anish , Aggarwal Pankaj , Basher Rajender Kumar , Mittal Bhagwant Rai 
Published: January 2019

Abstract
Infection of aortic valve-tube graft, although rare, is associated with high morbidity and mortality. Early identification of site and extent of infection is not only challenging but also crucial for adequate patient management and prognostication of disease. Combined clinical, laboratory investigation and imaging modalities assist in the identification of aortic valve graft infection. Molecular imaging techniques like PET/CT using 18F-FDG and 18F-FDG-labeled autologous leukocytes (LALs) have improved the sensitivity for detection of infection, resulting in better outcome for these patients. 18F-FDG-labeled autologous leukocyte PET/CT in our patient after Bentall procedure accurately localized the site and extent of infection.
Focal 123I-MIBG Uptake in the Medial Segment of the Normal Liver
Authors: Matsusaka Yohji , Nakahara Tadaki , Iwabuchi Yu , Minami Yasuhiro , Jinzaki Masahiro 
Published: January 2019

Abstract
An 84-year-old man with parkinsonism was referred for 123I-MIBG scintigraphy. Abnormal uptake in the right upper abdomen was incidentally seen in planar image, and SPECT revealed focal uptake in the medial segment (S4) of the liver. Subsequent triple-phase contrast-enhanced CT showed no evidence of hepatic tumors, although in the arterial phase, there were an enhanced region corresponding to the uptake area and the enhanced vein of Sappey that flowed into S4. In this case, the focal 123I-MIBG uptake would be attributable to hemodynamic change in the liver.
Diffuse Bone Metastases in Pancreatic Neuroendocrine Tumor Shown on Octreoscan
Authors: Adkins Jake , Lu Yang 
Published: January 2019

Abstract
A 32-year-old man with a pancreatic neuroendocrine tumor and known liver metastasis presented with diffuse back pain. Workup octreoscan showed newly developed diffuse bone metastases, in addition to the persistent liver metastases. The bone metastases were later confirmed on MRI spine images.
How Well Do the Popular Ultrasonic Techniques Estimate Amniotic Fluid Volume and Diagnose Oligohydramnios, in Fact?
Authors: Madendag Yusuf , Madendag Ilknur Col , Sahin Erdem , Aydin Emine , Sahin Mefkure Eraslan , Acmaz Gokhan 
Published: January 2019

Abstract
The aims of the study were to compare the different estimation methods for the diagnosis of oligohydramnios and to determine concordance between estimated amniotic fluid volume (AFV) measured by ultrasonography and actual AFV measured directly. Another purpose was to investigate the effect of oligohydramnios on neonatal outcome. This study was done at a tertiary care center. The participants were scheduled between 37 and 40 weeks for cesarean delivery. Estimated AFV was ultrasonographically assessed, and then actual AFV was directly measured during the cesarean delivery to compare the subjective method (SM), amniotic fluid index (AFI), single deepest pocket (SDP), and 2-diameter pocket. Totally, 138 patients were included in the present study. Of 35 (34%), 24 (21%), 12 (9.5%), and 10 (7.8%) were defined as oligohydramnios by the SM, AFI, SDP, and 2-diameter pocket, respectively. The number of patients with actual oligohydramnios was 35 (34%). Most authors suggest as a method use of the SDP more than the AFI, because of overmanagement through the AFI. However, this study, which was conducted using both nonprejudiced and criterion-standard methods, showed that the SM and AFI technique were more successful to estimate oligohydramnios than other methods. Also, adverse pregnancy outcome was not closely associated with isolated oligohydramnios.
A Low-Cost Highly Configurable Phantom for Simulation of Imaging-Guided Endocavitary Procedures
Authors: Li Qian , Yang Long , Duan Yu , Xiang Feixiang , McCarthy Colin J. , Thabet Ashraf , Cai Wenli , Grajo Joseph R. , Baikpour Masoud , McConnell Roland , White Phillip J. , Samir Anthony E. 
Published: January 2019

Abstract
We developed a method to create customizable phantoms suitable for endocavitary imaging and interventional research, based on the fabrication of an acrylic phantom mold, and development of a phantom matrix composed of gelatin, agar, graphite particles, and propanol. Our phantom was mechanically stable, easily fabricated, and highly adjustable, and its ultrasound (US) and magnetic resonance imaging (MRI) scans showed the qualification for the procedure guidance compared with the human prostate image using the same US system. To test the feasibility of the phantom for the research, the seeds placement guided by MRI/US fusion was performed, and the overall test error (distance from the seed center to the virtual lesion center in olives) was 2.59 ± 0.59 mm. We have created a simple, low-cost, configurable, gelatin-based phantom and tested its feasibility for simulating endorectal interventional US procedures. The design of the phantom mold and matrix is likely to be useful to the broader medical training community, and the preliminary data from the experiment of MRI/US-guided seeds placement showed its potential to test the clinical hypothesis in US research.
The Value of Superb Microvascular Imaging in Detecting Hepatic Artery Occlusion in Liver Transplantation
Authors: Güven Fadime , Karaca Leyla , Ogul Hayri , Sade Recep , Öztürk Gürkan , Kantarci Mecit 
Published: January 2019

Abstract
Superb microvascular imaging (SMI) is an innovative color Doppler technique that is used to evaluate low-velocity blood flow in particular. Our purpose in this study was to examine the sensitivity and specificity of SMI for assessing occlusion of the hepatic artery after liver transplantation. Ninety-five prospective patients who underwent liver transplantation were included in our study between April 2014 and February 2018. The patients were assessed with color power Doppler sonography and SMI method examinations in this study. Those who were suspected of having hepatic artery occlusion were assessed with computed tomography angiography. Computed tomography angiography was used in all the patients who were suspected of having occlusion of the hepatic artery on power Doppler and SMI method. The hepatic artery was considered to be patent and have normal flow on color Doppler examination in 72 (75.7%) of the total 95 patients. The hepatic artery was not observed in 23 (24.2%) of the patients with color Doppler sonography. In 3 of those 23 patients, arterial flow was detected with power Doppler sonography (31%). The sensitivity of SMI for the detection of hepatic artery occlusion was 100%, the specificity was 97.87%, the positive predictive value was 33.33%, and the negative predictive value was 100%. Thus, SMI is a noninvasive technique that is easy to use and has high sensitivity in patients who have undergone liver transplantation. In patients who are suspected of having hepatic artery occlusion with Doppler ultrasound, SMI can detect hepatic artery occlusion without the need for invasive techniques.
Tip Reinforcement Flap
Authors: Irmak Fatih , Serin Merdan , Sirvan Selami Serhat , Kurt Yazar Sevgi , Kuran Ismail , Sevim Kamuran Zeynep , Karsidag Semra 
Published: January 2019

Background
Middle crura support deficiency and short middle crura can usually cause insufficient definition and projection of the tip and can sometimes result in a flat tip. The aim of this study was to investigate the effectiveness of a new technique involving a tip reinforcement flap to strengthen the middle crura and to achieve a well-projected and defined tip.

Methods
Twenty-nine patients who underwent primary open-approach rhinoplasty that included the use of tip reinforcement flaps were included in the study. Cartilage flaps that had been created from the excess cephalic portion of the lateral crura were prepared as medial crura-based cartilaginous flaps.

Results
There were 29 patients (17 women, 12 men) aged 18 to 44 years (mean age, 31 years). Follow-up time ranged between 3 and 25 months (mean, 21 months). Preoperative and postoperative average of nasal tip length was 10.84 (±1.07) mm and 14.32 (±2.34) mm, respectively (P = 0.0214). Preoperative and postoperative average of nasolabial angle was 97.42° (±9.84°) and 107.99° (±12.16°), respectively (P = 0.0344). Preoperative and postoperative average of nasal projection ratio was 0.53 (±0.04) and 0.57 (±0.03), respectively (P = 0.4347). The tip reinforcement flap technique provided strengthening and extra support for the middle crura and increased definition, projection, and stability to the domal area.

Conclusions
The tip reinforcement flap technique offers advantages for tip plasty in those cases with middle crural deficiency, short middle crura, and middle crural weakness. The technique also provides an additional projection, stabilization, and definition to the nasal tip while reducing lateral crural cephalic excess. This technique improves nostril-lobular disproportion and has the advantage of hiding extra support grafted into the folded flap. Complications such as graft visibility, malposition, and asymmetry, which may occur with the use of classic tip grafts, can be eliminated with the tip reinforcement flap technique.
Unique Considerations for Females Undergoing Esophagectomy
Authors: Nobel Tamar B. , Livschitz Jennifer , Eljalby Mahmoud , Janjigian Yelena Y. , Bains Manjit S. , Adusumilli Prasad S. , Jones David R. , Molena Daniela 
Published: January 2019

Objective:
To improve understanding of sex differences in clinicopathologic characteristics, treatment and outcomes between male and female patients undergoing esophagectomy for esophageal cancer.

Summary Background Data:
Esophageal cancer is a male predominant disease, and sex has not been considered in previous studies as an important factor in diagnosis or management. Sex differences in demographics, clinicopathologic characteristics, and postoperative outcomes remain largely undefined.

Methods:
Retrospective review of 1958 patients (21% female) with esophageal cancer who underwent esophagectomy at a single institution between 1995 and 2017.

Results:
Most patients had adenocarcinoma (83%); however, the rate of squamous cell carcinoma was significantly higher in females (35% vs 11%, respectively; P < .0001). Females had a lower rate of smoking (62 vs 73%) and heavy alcohol use (12 vs 19%) but a higher rate of previous mediastinal radiation (8.4 vs 1.8%) (P < 0.001). Postoperative mortality and overall survival (OS) were similar between sexes. However, subanalysis of patients with locoregional disease (clinical stage II/III) demonstrated that females received neoadjuvant therapy less frequently than males and had worse OS (median OS 2.56 yrs vs 2.08; P = 0.034). This difference remained significant on adjusted analysis (HR 1.24, 95% CI 1.06–1.46).

Conclusions:
Female patients had higher incidence of squamous cell carcinoma despite lower prevalence of behavioral risk factors. Among patients with locoregional disease, undertreatment in females may reflect treatment bias and history of previous mediastinal radiation. Esophageal cancer in females should be considered a unique entity as compared with the presentation and treatment of males.
MultiFRAGing: Rapid and Simultaneous Genotyping of Multiple Alleles in a Single Reaction
Authors: Petree Cassidy , Varshney Gaurav K 
Published: January 2019

AbstractThe powerful and simple RNA-guided CRISPR/Cas9 technology is a versatile genome editing tool that has revolutionized targeted mutagenesis. CRISPR-based genome editing has enabled large-scale functional genetic studies through the generation of gene knockouts in a variety of model organisms including zebrafish. CRISPR/Cas9 can also be used to target multiple genes simultaneously. One of the challenges associated with applying this technique to zebrafish in a high-throughput manner is the absence of a cost-effective method by which to identify mutants. To address this, we optimized the high-throughput, high-resolution fluorescent PCR-based fragment analysis method to develop MultiFRAGing, a robust and cost-effective method for genotyping of multiple targets in a single reaction. Our approach can identify indels in 4 targets from a single reaction, which represents a four-fold increase in genotyping throughput. This method can be used by any laboratory with access to capillary electrophoresis based sequencing equipment.
Real-time assembly of an artificial virus elucidated at the single-particle level
Authors: Marchetti Margherita , Kamsma Douwe , Vargas Ernesto Cazares , García Armando Hernandez , der Schoot Paul van , Vries Renko de , Wuite Gijs J.L. , Roos Wouter H. 
Published: January 2019

AbstractWhile the structure of a variety of viruses has been resolved at atomistic detail, their assembly pathways remain largely elusive. Key unresolved issues in assembly are the nature of the critical nucleus starting particle growth, the subsequent self-assembly reaction and the manner in which the viral genome is compacted. These issues are difficult to address in bulk approaches and are effectively only accessible by tracking the dynamics of assembly of individual particles in real time, as we show here. With a combination of single-molecule techniques we study the assembly into rod-shaped virus-like particles (VLPs) of artificial capsid polypeptides, de-novo designed previously. Using fluorescence optical tweezers we establish that oligomers that have pre-assembled in solution bind to our DNA template. If the oligomer is smaller than a pentamer, it performs one-dimensional diffusion along the DNA, but pentamers and larger oligomers are essentially immobile and nucleate VLP growth. Next, using real-time multiplexed acoustic force spectroscopy, we show that DNA is compacted in regular steps during VLP growth. These steps, of ∼30 nm of DNA contour length, fit with a DNA packaging mechanism based on helical wrapping of the DNA around the central protein core of the VLP. By revealing how real-time, single particle tracking of VLP assembly lays bare nucleation and growth principles, our work opens the doors to a new fundamental understanding of the complex assembly pathways of natural virus particles.