bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Cetuximab on the Development of Epidural Fibrosis Based on CD105 and Osteopontin Immunohistochemical Staining
Authors: Tanriverdi Osman , Yilmaz İlhan , Adilay Huseyin Utku , Gunaldi Omur , Erdogan Uzay , Gungor Abuzer , Kilic Mustafa , Tanik Canan 
Published: July 2018

Study Design.
The effect of cetuximab on the development of epidural fibrosis (EF) was assessed using immunohistochemical methods as well as antibodies for CD105 and osteopontin (OPN).

Objective.
The goal of this study was to assess of EGFR inhibition for the postoperative treatment of fibrosis.

Summary of Background Data.
EF is one of most common causes of failed back surgery syndrome, which occurs after laminectomy. Numerous causes and mechanisms have been proposed to explain its development after laminectomy. Many agents have been tested to prevent the development of EF. EGFR, a multi-functional transmembrane glycoprotein, causes cell growth, proliferation, and EF by interacting with epidermal growth factor and TGF-β1. The inhibition of postoperative fibrosis using cetuximab, an epidermal growth factor receptor blocker, is theoretically possible. However, this has not been tested to date.

Methods.
Sixteen Wistar-Albino rats were divided into two groups, namely, control and cetuximab groups. L1-2 laminectomy alone was performed in both groups, and topical cetuximab was applied to the treatment group. After 6 weeks, rats were sacrificed and examined histopathologically and immunohistochemically; EF tissue was also graded. Statistical significance was accepted at P < 0.05.

Results.
Fibroblast counts and fibrosis density, determined by histopathologic examination, and EF, according to immunohistochemical assessment based on CD105, were found to be higher in the treatment group than in the control group, and this was statistically significant (P < 0.001). Based on OPN staining, the results were consistent with classical methods, and no significant difference was detected among the groups (P = 0.358).

Conclusion.
Our study revealed that cetuximab inhibits the development of EF and that CD105, and not OPN, is a reliable marker for grading EF. In addition, cetuximab did not result in toxic, systemic side effects in surrounding tissues.

Level of Evidence: N/A
Can C2-6 Cobb Angle Replace C2-7 Cobb Angle?
Authors: Zhang Jiandang , Buser Zorica , Abedi Aidin , Dong Xiangyu , Wang Jeffrey C. 
Published: July 2018

Study Design.
Retrospective study of consecutive 113 cervical kinetic magnetic resonance images (kMRIs) and 57 radiographs.

Objective.
To elucidate the relationship between C2-6 or C2-7 Cobb angle and cervical sagittal alignment parameters using kMRI, and evaluate the visibility of C6 and C7 inferior endplates on cervical radiographs.

Summary of Background Data.
Several studies have used C2-6 Cobb angle instead of C2-7 Cobb angle as C7 inferior endplate is not always visible because of overlying shadows. However, the relationship between C2-6 or C2-7 Cobb angle and cervical sagittal alignment parameters remains unclear. Moreover, visibility of C6 inferior endplate remains unknown.

Methods.
C2-6 Cobb angle, C2-7 Cobb angle, occiput-C2 angle, Atlas-dens interval (ADI), narrowest oropharyngeal airway space (nPAS), cervical sagittal vertical axis (cSVA), cervical tilt, cranial tilt, neck tilt, thoracic inlet angle (TIA), and T1 slope were measured using kMRI, and analyzed for their relationship with C2-6 or C2-7 Cobb angle. Visibility rates of C6 or C7 inferior endplates were evaluated using cervical radiographs.

Results.
Linear regression analysis showed high association between C2-6 and C2-7 Cobb angle (R2 = 0.696, P < 0.01). C2-6 Cobb angle was significantly correlated with occiput-C2 angle, TIA, T1 slope, neck tilt, cSVA, and cervical tilt; but not with nPAS, ADI, and cranial tilt. C2-7 Cobb angle resembled C2-6 Cobb angle regarding the relationships with other parameters. In our study, 94.7% C6 and 50.9% C7 inferior endplate were clearly visible; 1.8% C6 and 24.6% C7 inferior endplate were invisible. Chi-square test and residual analysis showed significant difference between the two groups (P < 0.01).

Conclusion.
C2-6 Cobb angle highly resembled C2-7 Cobb angle regarding its relationships with parameters of craniovertebral, cervical and thoracic inlet alignment. C2-6 Cobb angle could be an alternative to C2-7 Cobb angle because of its significantly higher visibility rate.

Level of Evidence: 3
Lateral Inframammary Approach for Asian Augmentation Mammaplasty
Authors: Zelken Jonathan , Tobbia Dalia , Lin Yi-Ling , Cheng Ming-Huei 
Published: July 2018

Background:
The inframammary fold (IMF) approach for augmentation mammaplasty is less popular in Asia. The incision was modified to lateral IMF(L-IMF) for easy access and better outcome. The aim of this study was to evaluate if L-IMF approach is feasible in Asian women.

Methods:
Between 2002 and 2016, 53 patients with 96 augmentation mammaplasties were performed using lateral (L-IMF, 31 cases, 56 breasts) and traditional IMF approaches (T-IMF, 22 cases, 40 breasts). Surgical outcome was compared between L-IMF and T-IMF groups. Scar was assessed using photographic images by 4 assessors with a modified Manchester Scar Score, and telephone surveys available in L-IMF group.

Results:
The average age was 41 ± 10.7 years (range, 20–73 years). There were no statistical differences in demographics in both groups besides of implant type (P < 0.01). At a follow-up of 80.1 months (range, 20–173 months), the capsular contracture rate and overall complication rate were statistically lower in L-IMF group, 3.6%, and 3.6%, than in T-IMF group, 15%, and 20% (P = 0.05, and P < 0.01, respectively). The modified Manchester Scar for L-IMF scars was 8.47 ± 2.4. The average score of 24 of 31 patients with L-IMF incision was 3.8 ± 0.96/5 points with patient-reported questionnaire. Nineteen patients (79.2%) would recommend or strongly recommend the procedure to friends.

Conclusions:
The scar of L-IMF group healed satisfactorily with lower capsular contracture and overall complication rates than T-IMF group. Patients were satisfied with the outcome of breast augmentation and scar appearance using L-IMF approach.
PEDIATRIC RETINAL DETACHMENT IN AN ASIAN POPULATION WITH HIGH PREVALENCE OF MYOPIA
Authors: Tsai Andrew S. H. , Wong Chee Wai , Lim Laurence , Yeo Ian , Wong Doric , Wong Edmund , Ang Chong Lye , Ong Sze Guan , Lee Shu Yen , Tan Gavin 
Published: July 2018

Purpose:
To evaluate the clinical characteristics and surgical outcomes of pediatric retinal detachments (RDs) in an Asian population.

Methods:
Retrospective review of 171 eyes of 152 pediatric patients with rhegmatogenous RD over a 20-year period.

Results:
Myopia was the most common risk factor in our population. At 6 months, primary anatomical success was 60.7%, and overall anatomical success was 86.7%. A total of 46.8% had best-corrected visual acuity of 20/40 or better, and 81.6% had best-corrected visual acuity of 20/200 or better. In primary RDs, high myopia (≤−6D) patients had a lower primary anatomical success compared to patients with moderate myopia (≤−2D) (59.3 vs. 100% P = 0.03). Increasing age and absence of proliferative vitreoretinopathy were associated with anatomical and visual success. Pars plana vitrectomy as the primary procedure was associated with decreased odds of anatomical success. A longer duration of symptoms, cataract, and a larger RD extent were associated with poorer functional outcome.

Conclusion:
Myopia was the commonest risk factor for pediatric RD in our population. Good anatomical and functional outcome can be achieved with surgery. Increasing age at presentation and absence of proliferative vitreoretinopathy was associated with anatomical and functional success. High myopia was associated with poorer anatomical and functional outcome.
INTRAOPERATIVE OCULAR MANOMETRY IN SILICONE OIL–FILLED EYES WITH A BOSTON TYPE 1 KERATOPROSTHESIS
Authors: Toygar Okan , Mestanoglu Mert , Riemann Christopher D. 
Published: July 2018

Purpose:
To demonstrate a novel technique to measure the intraocular pressure in silicone oil (SO)-filled eyes with Boston Type 1 keratoprosthesis (KPro) during intraocular surgery.

Methods:
In this retrospective case series, an ocular manometer that is predicated on a continuous fluid column between a pressure sensor and interior of the eye was designed and used to directly measure intraocular pressure during intraocular surgery in SO-filled eyes with KPro.

Results:
Six eyes of six patients were included in the study. The indications for SO injection with ocular manometry were hypotony in five patients, and endophthalmitis and complex retinal detachment with proliferative vitreoretinopathy in one patient. All patients had a successful reinflation of their globes without any evidence of SO underfill, without evidence of SO overfill, and without progression of glaucomatous optic neuropathy. Visual acuity increased in five eyes and was maintained in one eye.

Conclusion:
Intraoperative ocular manometry is a safe and effective technique in determining intraocular pressure in SO-filled eyes with KPro.
Risk Factors and Main Indications for Palivizumab Prophylaxis in a Second Season Population
Authors: Simon Arne , Gehrmann Susanne , Wagenpfeil Gudrun , Wagenpfeil Stefan 
Published: July 2018

Background:
After national recommendations, palivizumab is administered in Germany to high-risk infants to prevent hospitalizations related to respiratory syncytial virus (RSV) infection. Limited data are available to characterize those children who receive palivizumab in 2 consecutive RSV seasons.

Methods:
This was a comparative analysis of data from a postmarketing observational study (German SYNAGIS Registry, AbbVie Germany GmbH & Co.KG, Wiesbaden) detailing RSV-related risk factors and main indications for palivizumab in 920 children who received at ≥1 palivizumab injection in a second season between 2010 and 2016 [second season population (SSP)].

Results:
Median birth weight and gestational age at birth as well as the proportion of children with hemodynamically significant congenital heart disease, with any form of chronic lung disease of prematurity or with any form of neuromuscular impairment, were significantly higher in the SSP. Accordingly, hemodynamically significant congenital heart disease, chronic lung disease and other reasons (including neuromuscular impairment) and not prematurity were the main indications for palivizumab in the SSP. The RSV-related hospitalization rate confirmed by viral testing in the SSP (receiving palivizumab prophylaxis) was 0.9%. No deaths due to RSV were reported.

Conclusions:
Second season recipients of palivizumab differ from one season recipients of palivizumab in terms of risk factors and main indications for prophylaxis. Keeping in mind the limitations of an uncontrolled prospective observational study, these results support the effectiveness of palivizumab (concerning the RSV rehospitalization rate) and do not reveal new safety alerts in a large SSP.
Effects of Exercise on Sport Concussion Assessment Tool-Third Edition Performance in Women
Authors: Chung Pin Yong Jean-Paul , Lee Jin H. , Howell David R. , Meehan William P. , Iverson Grant L. , Gardner Andrew J. 
Published: July 2018

Objective:
The purpose of this study was to examine the influence of a brief exercise protocol on Sport Concussion Assessment Tool-Third Edition (SCAT3) performance in amateur women athletes.

Design:
Cross-over repeated-measures design. Setting: Off-season, uninjured community amateur athletes. Participants: We examined 87 amateur women athlete volunteers (age = 29.9, SD = 6.9 years).

Independent Variables:
Participants were assessed using the SCAT3 under 2 conditions: at rest and after a 5-minute physical exertion protocol, completed in a counterbalanced order.

Main Outcome Measures:
Participants' performance on the various components of the SCAT3 under the 2 conditions: at rest and after a 5-minute physical exertion protocol.

Results:
No significant differences were detected between at-rest and postexercise conditions for the balance, orientation, or cognitive components of the SCAT3. There were no significant differences in the proportion of participants who endorsed specific symptoms at rest compared with the postexercise condition (P > 0.05). However, women athletes who rated their exertion after exercise as “hard” or greater (Borg scale rating 13-20) reported significantly greater blurred vision (M = 0.25, SD = 0.62 vs M = 0.00, SD = 0.00; P = 0.006) and fatigue/low energy (M = 1.38, SD = 1.17 vs M = 0.66, SD = 0.91; P = 0.002) symptoms after exercise than those who rated their exertion as “light” or lower (Borg scale rating 6-12).

Conclusions:
In this study of women athletes, a brief bout of exercise did not seem to adversely affect SCAT3 performance and had only small effects on self-reported symptoms. There were differences in symptom reporting, however, in the subgroup of women who rated their exertion levels as “hard” or greater; they reported more blurred vision and fatigue/low energy.
Analysis of Different Approaches for Clinical Cochlear Coverage Evaluation After Cochlear Implantation
Authors: Schurzig Daniel , Timm Max Eike , Batsoulis Cornelia , John Samuel , Lenarz Thomas 
Published: July 2018

Hypothesis:
Methods for cochlear coverage determination vary in their accuracy and are hence not equally reliable.

Background:
The audiological outcome after cochlear implantation is known to depend on several factors. One factor shown to positively correlate with speech perception is the insertion angle. This parameter is one of the ways to describe the fraction of the cochlea spiral exposed to electric stimulation after implantation, also known as cochlear coverage, which itself is dependent on the length and type of electrode array as well as the size and shape of the implanted cochlea. While the assessment of cochlear coverage as the insertion angle is quick and uncomplicated, the accuracy of representing the relative fraction of the cochlea exposed to electric stimulation by this single measurement value remains unknown.

Methods:
Both the cochlea spiral and implanted electrode array of N = 10 cochlear implant patients were traced within clinical imaging data and processed to derive the respective cochlear coverage values. These values were compared to ones derived with alternative measures like the insertion angle as well as other methods to yield the accuracy and reliability of these approaches.

Results:
The insertion angle as well as two novel approaches were found to be superior to all other analyzed assessment options and well suited for clinical cochlear coverage evaluations.

Conclusion:
Insertion angle measurements are well suited for cochlear coverage determination, especially regarding retrospective analyses. Prospective studies independent of anatomical irregularities should be performed with the newly proposed approaches.
The Novel Peptide Vaccine GV1001 Protects Hearing in a Kanamycin-induced Ototoxicity Mouse Model
Authors: Kim So Young , Jung Gaon , Shim Ye Ji , Koo Ja-Won 
Published: July 2018

Hypothesis:
We tested whether GV1001 has any ototoxic side effects at different doses and whether it protects hearing in an aminoglycoside-induced ototoxicity mouse model.

Background:
GV1001, a novel peptide vaccine currently being examined in a Phase 3 clinical trial to treat pancreatic cancer, also has anti-inflammatory and antioxidant effects.

Methods:
In the first experiment, C57/BL6 mice were injected with GV1001 preparations at concentrations of 0.1 to 100 mg/kg for 7 days to evaluate the toxicity of GV1001 on the inner ear and kidneys. In the second experiment, the protective effect of GV1001 was tested in an ototoxicity mouse model that was generated by injecting 800 mg/kg kanamycin (KM) for 2 weeks. The hearing threshold and hair cell loss were compared between the KM + GV1001 group (treated with 10 mg/kg GV1001 for 2 wk) and the KM + saline group. The hearing threshold was measured before, and 7, 14, and 21 days after the initial treatment. The blood urea nitrogen level was measured.

Results:
No ototoxicity or renal toxicity was found following treatment with different doses of GV1001 (0.1–100 mg/kg). The KM + saline group showed impaired auditory function and markedly disoriented and missing cochlear hair cells, while the KM + GV1001 group showed significant hearing and hair cell preservation in comparison (p < 0.05).

Conclusion:
GV1001 itself did not have any detrimental effects on the inner ear or kidney. In the KM induced ototoxicity model, concomitant administration of GV1001 protected against cochlear hair cell damage and preserve hearing.
Flipping the Classroom in Health Care Higher Education
Authors: Evans Leda , Vanden Bosch Melodee L. , Harrington Susan , Schoofs Nancy , Coviak Cynthia 
Published: July 2018

Background
The flipped classroom is an approach to teaching with independent and asynchronous study of content by students and active learning during scheduled class times.

Purpose
The purpose of this review was to systematically examine research on the use of the flipped classroom approach in health professions education.

Methods
Eleven electronic databases were searched for peer-reviewed literature from 2005 through September 2017. Inclusion criteria for studies addressed health professions students and quantitative outcomes (quizzes, examinations, course grades).

Results
Of the 49 articles identified, 24 met the inclusion criteria. The majority of studies (n = 17) noted a significant improvement in at least 1 student academic outcome using the flipped classroom compared with the traditional lecture.

Conclusions
This systematic review of the effects of the flipped classroom approach for the education of health professions students did not reveal compelling evidence for the effectiveness of the method in improving academic outcomes above that of traditional classroom approaches.
Prognostic Factors of Children Admitted to a Pediatric Intensive Care Unit After an Episode of Drowning
Authors: Salas Ballestín Alberto , de Carlos Vicente Juan Carlos , Frontera Juan Guillem , Sharluyan Petrosyan Artur , Reina Ferragut Cristina M. , González Calvar Amelia , Clavero Rubio Maria del Carmen , Fernández de la Ballina Andrea 
Published: July 2018

Objective
The aim of this study was to evaluate the prognostic factors of patients admitted to a pediatric intensive care unit (PICU) after drowning.

Methods
Retrospective observational study from January 1992 to December 2004 and prospective study from January 2005 to December 2015 were conducted in a tertiary children's hospital PICU. The data analyzed refer to the patient, event, type of resuscitation performed, and clinical situation after resuscitation and at arrival to the PICU; results of additional tests; and clinical evolution and neurological status at discharge from the PICU (categorized as death, severe encephalopathy, or normal). The considered potential prognostic factors were whether drowning was witnessed, the type of initial resuscitation, Glasgow Coma Scale score at admission, pupil status and reactivity, and pH.

Results
One hundred thirty-one patients were registered. Mortality was 16.7%, and 8.3% had significant neurological sequelae. The clearest factor associated with poor outcome was the type of initial resuscitation performed. All patients who did not require cardiopulmonary resuscitation (CPR), or only basic CPR, had good outcomes; 96.3% of those who required advanced CPR with epinephrine administration had poor outcomes. Patients who needed advanced resuscitation with administration of epinephrine had lower temperature, Glasgow Coma Scale score, pH, and bicarbonate at admission and higher level of glucose. In this group, there was also a higher incidence of seizures, acute respiratory distress syndrome, hemodynamic compromise, and acute renal failure.

Conclusions
The need for advanced CPR with epinephrine administration on the scene predicts poor neurological outcome (severe encephalopathy or death) in drowned children.
Measuring Anxiety in the Pediatric Emergency Department
Authors: Rochat Cosette Pharisa , Gaucher Nathalie , Bailey Benoit 
Published: July 2018

Objectives
The objective of this study was to evaluate the agreement between the State Trait Anxiety Inventory (STAI) and other anxiety scales to determine whether these shorter to administer scales could replace the STAI.

Methods
This was a prospective cohort study on a convenience sample of children, aged 9 to 17 years, presenting to a pediatric emergency department. Patients were divided into 2 groups: preteens (PT) (aged 9–12 years) completed the pediatric STAI and teens (T) (aged 13–17 years) completed the adult STAI. Participants also completed a visual analog scale (0–100 mm), a Likert scale (1–5), and a short version of the STAI. Intraclass correlation (2-way mixed model, average measures) was used to evaluate agreement between the STAI and the other scales. A sample size of 100 patients per group was estimated as sufficient.

Results
The median (interquartile range) STAI state anxiety scores were 33 (28.25–36.75) and 37.5 (32–44), in the PT (n = 100) and T (n = 100) groups, respectively. The median (interquartile range) STAI trait anxiety scores were 33.5 (28–38.75) and 36 (31–44), in the PT and T groups, respectively. Agreements between the STAI and the other scales were poor for all scales. At best, the intraclass correlation was 0.71 for the agreement between the STAI and the short version of the STAI.

Conclusions
There appears to be poor agreement between the STAI and the other scales designed to measure anxiety in children 9 to 17 years presenting to the pediatric emergency department.
Differentiation of Glioblastoma and Solitary Brain Metastasis by Gradient of Relative Cerebral Blood Volume in the Peritumoral Brain Zone Derived from Dynamic Susceptibility Contrast Perfusion Magnetic Resonance Imaging
Authors: She Dejun , Xing Zhen , Cao Dairong 
Published: July 2018

Objective
The purpose of our study was to evaluate the efficacy of the relative cerebral blood volume (rCBV) gradient in the peritumoral brain zone (PBZ)—the difference in the rCBV values from the area closest to the enhancing lesion to the area closest to the healthy white matter—in differentiating glioblastoma (GB) from solitary brain metastasis (MET).

Methods
A 3.0-T magnetic resonance imaging (MRI) machine was used to perform dynamic susceptibility contrast perfusion MRI (DSC-MRI) on 43 patients with a solitary brain tumor (24 GB, 19 MET). The rCBV ratios were acquired by DSC-MRI data in 3 regions of the PBZ (near the enhancing tumor, G1; intermediate distance from the enhancing tumor, G2; far from the enhancing tumor, G3). The maximum rCBV ratios in the PBZ (rCBVp) and the enhancing tumor were also calculated, respectively. The perfusion parameters were evaluated using the nonparametric Mann-Whitney test. The sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve were identified.

Results
The rCBVp ratios and rCBV gradient in the PBZ were significantly higher in GB compared with MET (P < 0.05 for both rCBVp ratios and rCBV gradient). The threshold values of 0.50 or greater for rCBVp ratios provide sensitivity and specificity of 57.69% and 79.17%, respectively, for differentiation of GB from MET. Compared with rCBVp ratios, rCBV gradient had higher sensitivity (94.44%) and specificity (91.67%) using the threshold value of greater than 0.06.

Conclusions
The parameter of rCBV gradient derived from DSC-MRI in the PBZ seems to be the most efficient parameter to differentiate GB from METs.