bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Computed Tomography in the Classification of Pediatric Pelvic Fractures—Revisited
Authors: Bent Melissa A. , Hennrikus William L. , Latorre Johan E. , Armstrong Douglas G. , Shaw Brian , Jones Kerwyn C. , Segal Lee S. 
Published: April 2017

Objectives:
To determine the need for computerized tomography (CT) scans in the assessment of pediatric pelvic fractures.

Design:
Retrospective Chart Review.

Setting:
Level-1 Pediatric Trauma Center.

Patients/Participants:
Thirty pediatric trauma patients with pelvic fractures who have obtained both a radiograph and CT scan.

Main Outcome Measurements:
Fleiss Kappa coefficient to compare interreliability.

Results:
The average age of the patients was 7 years (range 1–13 years). Seventeen were males and 13 were females. The Torode and Zieg classification included 3 type I, 6 type II, 13 type III, and 8 type IV. The Kappa value for interobserver agreement comparing radiographs was 0.453, and for CT was 0.42. Three patients (10%) were treated with a spica cast, and none required surgery for their pelvic fracture. Four patients (11%) demonstrated liver, spleen, or kidney injuries on CT. Out of those 4, 1 had indications for laparotomy and drain placement, 1 died secondary to shock, and 2 were treated conservatively.

Conclusions:
The results of this study demonstrated that plain radiographs alone can be used to classify and manage most pediatric fractures, confirming Silber previous findings. Furthermore, we recommend the specific instances of Schreck and Haasz et al in which CT scans should be used, sparing the general pediatric population unnecessary radiation. Such cases include patients with an abnormal abdominal or pelvic examination, complex fracture patterns, displacement greater than 1 cm, femur deformities, hematuria, Glasgow Coma Scale <13, hemodynamic instability, an aspartate aminotransferase > 200 U/L, an Hct < 30%, or an abnormal chest x-ray.
Pheochromocytoma Crisis in the ICU: A French Multicenter Cohort Study With Emphasis on Rescue Extracorporeal Membrane Oxygenation
Authors: Sauneuf Bertrand , Chudeau Nicolas , Champigneulle Benoit , Bouffard Claire , Antona Marion , Pichon Nicolas , Marrache David , Sonneville Romain , Marchalot Antoine , Welsch Camille , Kimmoun Antoine , Bouchet Bruno , Messai Elmi , Ricome Sylvie , Grimaldi David , Chelly Jonathan , Hanouz Jean-Luc , Mercat Alain , Terzi Nicolas 
Published: April 2017

Objectives:
To describe the characteristics, management, and outcome of patients admitted to ICUs for pheochromocytoma crisis.

Design:
A 16-year multicenter retrospective study.

Setting:
Fifteen university and nonuniversity ICUs in France.

Patients:
Patients admitted in ICU for pheochromocytoma crisis.

Interventions:
None.

Measurement and Main Results:
We included 34 patients with a median age of 46 years (40–54 yr); 65% were males. At admission, the median Sequential Organ Failure Assessment score was 8 (4–12) and median Simplified Acute Physiology Score II 49.5 (27–70). The left ventricular ejection fraction was consistently decreased with a median value of 30% (15–40%). Mechanical ventilation was required in 23 patients, mainly because of congestive heart failure. Vasoactive drugs were used in 23 patients (68%) and renal replacement therapy in eight patients (24%). Extracorporeal membrane oxygenation was used as a rescue therapy in 14 patients (41%). Pheochromocytoma was diagnosed by CT in 33 of 34 patients. When assayed, urinary metanephrine and catecholamine levels were consistently elevated. Five patients underwent urgent surgery, including two during extracorporeal membrane oxygenation. Overall ICU mortality was 24% (8/34), and overall 90-day mortality was 27% (9/34). Crude 90-day mortality was not significantly different between patients managed with versus without extracorporeal membrane oxygenation (22% vs 30%) (p = 0.7) despite higher severity scores at admission in the extracorporeal membrane oxygenation group.

Conclusions:
Mortality is high in pheochromocytoma crisis. Routinely considering this diagnosis and performing abdominal CT in patients with unexplained cardiogenic shock may allow an earlier diagnosis. Extracorporeal membrane oxygenation and adrenalectomy should be considered as a therapeutic in most severe cases.
Detection of Pulmonary Embolism During Cardiac Arrest—Ultrasonographic Findings Should Be Interpreted With Caution*
Authors: Aagaard Rasmus , Caap Philip , Hansson Nicolaj C. , Bøtker Morten T. , Granfeldt Asger , Løfgren Bo 
Published: April 2017

Objectives:
The aim of this study was to test the hypothesis that the right ventricle is more dilated during resuscitation from cardiac arrest caused by pulmonary embolism, compared with hypoxia and primary arrhythmia.

Design:
Twenty-four pigs were anesthetized and cardiac arrest was induced using three different methods. Pigs were resuscitated after 7 minutes of untreated cardiac arrest. Ultrasonographic images were obtained and the right ventricular diameter was measured.

Setting:
University hospital animal laboratory.

Subjects:
Female crossbred Landrace/Yorkshire/Duroc pigs (27–32 kg).

Interventions:
Pigs were randomly assigned to cardiac arrest induced by pulmonary embolism, hypoxia, or primary arrhythmia.

Measurements and Main Results:
There was no difference at baseline. During induction of cardiac arrest, the right ventricle dilated in all groups (p < 0.01 for all). The primary endpoint was right ventricle diameter at the third rhythm analysis: 32 mm (95% CI, 29–36) for pulmonary embolism which was significantly larger than both hypoxia: 23 mm (95% CI, 20–27) and primary arrhythmia: 25 mm (95% CI, 22–28)—the absolute difference was 7–9 mm. Physicians with basic training in focused cardiac ultrasonography were able to detect a difference in right ventricle diameter of approximately 10 mm with a sensitivity of 79% (95% CI, 64–94) and a specificity of 68% (95% CI, 56–80).

Conclusions:
The right ventricle was more dilated during resuscitation when cardiac arrest was caused by pulmonary embolism compared with hypoxia and primary arrhythmia. However, the right ventricle was dilated, irrespective of the cause of arrest, and diagnostic accuracy by physicians with basic training in focused cardiac ultrasonography was modest. These findings challenge the paradigm that right ventricular dilatation on ultrasound during cardiopulmonary resuscitation is particularly associated with pulmonary embolism.
Plaque-Like Myofibroblastic Tumor: Report of 4 Cases
Authors: Moulonguet Isabelle , Biaggi Annonciade , Eschard Catherine , Durlach Anne , Stock Nathalie , Delanoé Philippe , Coussirat-Voreaux Marie-France , Fraitag Sylvie 
Published: April 2017

Abstract:
Plaque-like myofibroblastic tumor of infancy was first characterized in 2007 by Clarke et al. In the first 2 cases described, large plaque-like tumors presented in the first 3 months of life exhibited microscopic features consistent with dermatofibroma but with immunohistochemical features of myofibroblastic lineage. In 2013, Marqueling et al reported 3 additional cases, 2 of which presented in early childhood, prompting the authors to recommend that the name of this condition be shortened to plaque-like myofibroblastic tumor. We present here 4 additional cases to better characterize clinical and histopathological features of this newly recognized entity. This benign lesion is of myofibroblastic lineage and demonstrates features consistent with multiple clustered dermatofibroma.
CLINICAL PRESENTATION, MICROBIOLOGIC PROFILE AND FACTORS PREDICTING OUTCOMES IN BACILLUS ENDOPHTHALMITIS
Authors: Dave Vivek P. , Pathengay Avinash , Budhiraja Ina , Sharma Savitri , Pappuru Rajeev R. , Tyagi Mudit , Narayanan Raja , Jalali Subhadra , Chhablani Jay , Das Taraprasad 
Published: April 2017

Purpose:
To describe the clinical presentation, microbiologic profile, and factors predicting outcomes in Bacillus endophthalmitis.

Methods:
Retrospective interventional case series. Eighty-six patients with culture-proven Bacillus endophthalmitis, from January 2001 to December 2015, underwent vitrectomy/vitreous biopsy and intravitreal antibiotic with or without steroid as appropriate. The undiluted vitreous biopsy was subjected to microbiologic evaluation. The duration of symptoms, presenting visual acuity, organisms isolated, influence of intravitreal dexamethasone with intravitreal antibiotics, and type of initial intervention were examined for any clinical and statistical correlation in terms of odds ratio with the final visual outcome.

Results:
Trauma was the commonest etiology (n = 75; 87.2%). Mixed infection with other bacteria was seen in 11 patients. All Bacillus species were sensitive to gentamicin followed by ciprofloxacin (n = 85; 98.83%) and vancomycin (n = 81; 94.18%). Odds in favor of a favorable visual outcome were seen with clinical treatment within 48 hours of the symptoms (OR 25.47, 95% CI 2.45–254.16, P = 0.006), better presenting vision (OR 31.21, 95% CI 2.96–323.64, P = 0.004), and absence of polymicrobial infection (OR 18.03, 95% CI 0.9–344.4, P = 0.05). Only 20% of all treated patients regained ambulatory vision, and one fifth of all of them developed phthisis.

Conclusion:
Patients diagnosed with Bacillus endophthalmitis merit aggressive vitreous intervention guided by the culture-sensitivity report. Despite early and appropriate treat ment, the outcomes are generally poor.
SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN MACULA-INVOLVING CYTOMEGALOVIRUS RETINITIS
Authors: Gupta Mrinali P. , Patel Sarju , Orlin Anton , Marlow Elizabeth , Chee Ru-Ik , Nadelmann Jennifer , Chan R.V.Paul , D'Amico Donald J. , Kiss Szilard 
Published: April 2017

Purpose:
To evaluate the microstructural features of cytomegalovirus (CMV) retinitis by spectral domain optical coherence tomography (OCT).

Methods:
Subjects were patients with macula-involving CMV retinitis with OCT imaging. The leading edge of retinitis in the macula was identified based on fundus imaging, and OCT findings were longitudinally evaluated in three areas: within the area of active retinitis, at the leading edge of retinitis, and just beyond the leading edge of retinitis.

Results:
Optical coherence tomography imaging of macular CMV retinitis identified vitreous cells in 10 eyes (100%), posterior vitreous detachment in four eyes (40%), broad-based vitreomacular traction in one eye (10%), epiretinal membrane in eight eyes (80%), and lamellar hole–associated epiretinal proliferation associated with an atrophic hole in one eye (10%). Retinal architectural disruption, disruption of inner retinal layers, disruption of the external limiting membrane, and ellipsoid zone abnormalities were noted within the area of retinitis in all eyes and decreased in frequency and severity at and beyond the leading edge of retinitis, although all 10 eyes (100%) exhibited one of these abnormalities, especially outer retinal microabnormalities, beyond the leading edge of retinitis.

Conclusion:
Microstructural abnormalities were frequently noted on OCT of CMV retinitis, including within the retina beyond the leading edge of retinitis identified by corresponding fundus imaging. Outer retinal abnormalities were noted more frequently than inner retinal abnormalities beyond the leading edge of retinitis. These findings provide insight into the effects of CMV retinitis on retinal microstructure and potentially on vision and highlight the potential utility of OCT for monitoring microprogression of macula-involving CMV retinitis.
Disparities in Standard of Care Treatment and Associated Survival Decrement in Patients With Locally Advanced Cervical Cancer
Authors: Robin Tyler P. , Amini Arya , Schefter Tracey E. , Behbakht Kian , Fisher Christine M. 
Published: April 2017

(Abstracted from Gynecol Oncol 2016;143:319–325)
Brachytherapy has been shown to increase survival in patients with cervical cancer when added to external beam radiation. Standard of care (SOC) treatment for locally advanced cervical cancer includes concurrent chemotherapy with external beam radiation therapy (EBRT) plus brachytherapy.
Association Between the Birth of an Infant With Major Congenital Anomalies and Subsequent Risk of Mortality in Their Mothers
Authors: Cohen Eyal , Horváth-Puhó Erzsébet , Ray Joel G. , Pedersen Lars , Adler Nancy , Ording Anne Gulbech , Wise Paul H. , Milstein Arnold , Sørensen Henrik Toft 
Published: April 2017

(Abstracted from JAMA 2016;316(23):2515–2524)
Medical science is advancing. Consequently, the survival rate of children born with genetic congenital anomalies has improved.
Neonatal Abstinence Syndrome
Authors: McQueen Karen , Murphy-Oikonen Jodie 
Published: April 2017

(Abstracted from N Engl J Med 2016;375:2468–2479)
Neonatal abstinence syndrome (NAS) is a postnatal opioid withdrawal syndrome occurring in 55% to 94% of newborns whose mothers were addicted to or treated with opioids while pregnant. A lack of clarity and consistency regarding the definition, measurement, and management of the syndrome still exists.
New Human Immunodeficiency Virus Diagnosis Independently Associated With Rectal Gonorrhea and Chlamydia in Men Who Have Sex With Men
Authors: Barbee Lindley A. , Khosropour Christine M. , Dombrowksi Julia C. , Golden Matthew R. 
Published: April 2017

Background
Rectal sexually transmitted infections (STI) have been associated with human immunodeficiency virus (HIV) diagnosis, but inferring a causal association requires disentangling them from receptive anal intercourse (RAI).

Methods
We conducted a stratified case-control study by frequency matching 4 controls to each case within year using clinical data from men who have sex with men (MSM) attending the Seattle STD Clinic 2001 to 2014. Cases were MSM with a new HIV diagnosis and negative HIV test at 12 months or less. Controls were HIV-negative MSM. All included men had rectal STI testing, tested negative for syphilis, and had complete sexual behavior data. We categorized men by RAI: (1) none; (2) condoms for all RAI; (3) condomless RAI only with HIV-negative partners; and (4) condomless RAI with HIV-positive or unknown-status partners. We created 3 logistic regression models: (1) 3 univariate models of concurrent rectal gonorrhea, rectal chlamydia, and rectal STI in 12 months or less with new HIV diagnosis; (2) those 3 infections, plus age, race, year, number of sexual partners in 2 months or less, and methamphetamine use; and (3) model 2 with RAI categories. We calculated the population attributable risk of rectal STI on HIV diagnoses.

Results
Among 176 cases and 704 controls, rectal gonorrhea, chlamydia and rectal STI in 12 months or less were associated with HIV diagnosis. The magnitude of these associations attenuated in the second model, but persisted in model 3 (gonorrhea: adjusted odds ratio [aOR], 2.3; 95% confidence interval [CI], 1.3–3.8; chlamydia: aOR, 2.5; 95% CI, 1.5–4.3; prior STI: aOR, 3.0; 95% CI, 1.5–6.2). One in 7 HIV diagnoses can be attributed to rectal STI.

Conclusions
Rectal STI are independently associated with HIV acquisition. These findings support the hypothesis that rectal STI play a biologically mediated causal role in HIV acquisition and support screening/treatment of STI for HIV prevention.
Biological and Behavioral Factors Associated With Positive Chlamydia Retests
Authors: Smith Kirsty S. , Guy Rebecca , Danielewski Jennifer , Tabrizi Sepehr N. , Fairley Christopher K. , McNulty Anna M. , Rawlinson William , Saville Marion , Garland Suzanne M. , Donovan Basil , Kaldor John M. , Hocking Jane S. 
Published: April 2017

Background
Repeat chlamydia detection after treatment is common, and there is concern that treatment failure may be a cause.

Methods
Within a randomized trial, we established a prospective cohort of 600 participants with anogenital chlamydia diagnoses (200 each of women, heterosexual men, and men who have sex with men [MSM]). Participants were invited for repeat testing at 3 months and to complete a behavioral survey at 4 months. Positive samples were analyzed for organism DNA load and genovar. We estimated repeat chlamydia positivity, reinfection and treatment failure rates, and investigated the biological and behavioral factors associated with a repeat positive test.

Results
A total of 290 participants (100 women, 89 heterosexual men, 101 MSM) were retested at 1 to 4 months, with 43 repeat positives, including 26 classed as reinfection and 9 as treatment failures. Comparing MSM with heterosexual men and women combined, repeat positivity was higher (20.8% vs 11.6%, P = 0.04), and treatment failure was higher (6.9% vs 1.1%, P = 0.01), but there was no difference in reinfection rates (11.9% vs 7.4%, P = 0.21). Among MSM, the odds of repeat positivity increased by 90% with each additional log organism load in the original specimen (baseline) (adjusted odds ratio, 1.9; 95% confidence interval, 1.1–3.2). Among heterosexuals, the odds of repeat positivity decreased by 10% with each additional week delay in being retested for chlamydia (adjusted odds ratio, 0.9; 95% confidence interval, 0.8–0.9).

Conclusions
Positive retests were more common among MSM than heterosexuals. Treatment failure was more common in MSM with rectal chlamydia, reinforcing concerns about azithromycin treatment failure.
Urinary Meatal Swabbing Detects More Men Infected With Mycoplasma genitalium and Four Other Sexually Transmitted Infections Than First Catch Urine
Authors: Chernesky Max , Jang Dan , Smieja Marek , Arias Manuel , Martin Irene , Weinbaum Barbara , Getman Damon 
Published: April 2017

Abstract
Urinary meatal swabs compared with urine showed higher infection rates for Mycoplasma genitalium (15.3% vs 12.6%, P = 0.035), Chlamydia trachomatis (11.3% vs 9.3%, P = 0.039), Neisseria gonorrhoeae (1.4% vs 1.1%, P = 1.00), Trichomonas vaginalis (8.0% vs 1.7%, P < 0.001), and high-risk human papillomavirus (5.9% vs 3.4%, P = 0.078) respectively.
Characteristics of Submacular Hemorrhages in Age-Related Macular Degeneration
Authors: Kim Jae Hui , Chang Young Suk , Kim Jong Woo , Kim Chul Gu 
Published: April 2017

ABSTRACT

Purpose
The aims of this research are to report the incidence and characteristics of submacular hemorrhage secondary to neovascular age-related macular degeneration (AMD) and to compare the detailed morphologic features of hemorrhages between typical neovascular AMD and polypoidal choroidal vasculopathy (PCV).

Methods
This retrospective observational study included 791 eyes of 791 patients who had newly diagnosed neovascular AMD at a single institution. The incidence and extent of submacular hemorrhage of one disc area or greater were estimated and compared between typical neovascular AMD and PCV. In addition, submacular hemorrhages were classified into groups according to location (location of fovea at the center of the hemorrhage versus at the periphery of the hemorrhage) and morphology (circular versus irregular margin). The proportion of each subtype of neovascular AMD was evaluated according to the aforementioned classification.

Results
Among those included, 129 (16.3%) eyes exhibited submacular hemorrhage at initial presentation. Among the 627 eyes with available indocyanine green angiography findings, the incidence of submacular hemorrhage was greater in PCV (23.6%, 78 of 330 eyes) than in typical neovascular AMD (9.4%, 28 of 297 eyes; χ2 test, P < .001). When divided into four groups according to hemorrhage shape and location (central and circular, central and irregular, peripheral and circular, and peripheral irregular), the proportion of eyes in these groups was significantly different between the two disease groups (χ2 test, P = .018).

Conclusions
The incidence of submacular hemorrhage was greater in PCV than in typical neovascular AMD. The morphology and location of submacular hemorrhage may provide useful clues to differentiate PCV from typical neovascular AMD.
Failure mechanism of hollow tree trunks due to cross-sectional flattening
Authors: Huang Yan-San , Hsu Fu-Lan , Lee Chin-Mei , Juang Jia-Yang 
Published: April 2017

Failure of hollow trees in urban areas is a worldwide concern, and it can be caused by different mechanisms, i.e. bending stresses or flattening-related failures. Here we derive a new analytical expression for predicting the bending moment for tangential cracking, and compare the breaking moment of various failure modes, including Brazier buckling, tangential cracking, shear failure and conventional bending failure, as a function of
t
/
R
ratio, where
t
and
R
are the trunk wall thickness and trunk radius, respectively, of a hollow tree. We use Taiwan red cypress as an example and show that its failure modes and the corresponding
t
/
R
ratios are: Brazier buckling (Mode I), tangential cracking followed by longitudinal splitting (Mode II) and conventional bending failure (Mode III) for 0 <
t
/
R
< 0.06, 0.06 <
t
/
R
< 0.27 and 0.27 <
t
/
R
< 1, respectively. The exact values of those ratios may vary within and among species, but the variation is much smaller than individual mechanical properties. Also, shear failure, another type of cracking due to maximum shear stress near the neutral axis of the tree trunk, is unlikely to occur since it requires much larger bending moments. Hence, we conclude that tangential cracking due to cross-sectional flattening, followed by longitudinal splitting, is dominant for hollow trunks. Our equations are applicable to analyse straight hollow tree trunks and plant stems, but are not applicable to those with side openings or those with only heart decay. Our findings provide insights for those managing trees in urban situations and those managing for conservation of hollow-dependent fauna in both urban and rural settings.
Chance long-distance or human-mediated dispersal? HowAcacia s.l. farnesianaattained its pan-tropical distribution
Authors: Bell Karen L. , Rangan Haripriya , Fernandes Manuel M. , Kull Christian A. , Murphy Daniel J. 
Published: April 2017

Acacia s.l. farnesiana, which originates from Mesoamerica, is the most widely distributedAcacia s.l.species across the tropics. It is assumed that the plant was transferred across the Atlantic to southern Europe by Spanish explorers, and then spread across the Old World tropics through a combination of chance long-distance and human-mediated dispersal. Our study uses genetic analysis and information from historical sources to test the relative roles of chance and human-mediated dispersal in its distribution. The results confirm the Mesoamerican origins of the plant and show three patterns of human-mediated dispersal. Samples from Spain showed greater genetic diversity than those from other Old World tropics, suggesting more instances of transatlantic introductions from the Americas to that country than to other parts of Africa and Asia. Individuals from the Philippines matched a population from South Central Mexico and were likely to have been direct, trans-Pacific introductions. Australian samples were genetically unique, indicating that the arrival of the species in the continent was independent of these European colonial activities. This suggests the possibility of pre-European human-mediated dispersal across the Pacific Ocean. These significant findings raise new questions for biogeographic studies that assume chance or transoceanic dispersal for disjunct plant distributions.