bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of Magnetic Resonance Imaging in Orthopaedic Trauma Patients With External Fixation: A Two-Center Case Series
Authors: Borgida Jacob S. , Wagner Robert Kaspar , Wong Alice W. , Yee Seonghwan , Husseini Jad , Aneja Arun , Harris Mitchel B. , Ly Thuan V. 
Published: May 2024

OBJECTIVES:
To report on adverse events during magnetic resonance imaging (MRI) in patients with external fixators.

METHODS:

Design:
Retrospective case series.

Setting:
Two Level 1 trauma centers.

Patient Selection Criteria:
Patients with external fixators on the appendicular skeleton or pelvis undergoing MRI between January 2005 and September 2023.

Outcome Measures and Comparisons:
Adverse events, defined as any undesirable event associated with the external fixator being inside or outside the MRI bore during imaging, including (subjective) heating, displacement or pullout of the external fixator, or early MRI termination for any reason.

RESULTS:
A total of 97 patients with 110 external fixators underwent at least one MRI scan with an external fixator inside or outside of the MRI bore. The median age was 51 years (interquartile range: 39–63) and 56 (58%) were male. The most common external fixator locations were the ankle (24%), knee (21%), femur (21%), and pelvis (19%). The median duration of the MRI was 40 minutes (interquartile range: 26–58), 86% was performed using 1.5-Tesla MRI, and 14% was performed using 3.0-Tesla MRI. Ninety-five percent of MRI was performed for the cervical spine/head. Two MRI scans (1.6%), one of the shoulder and one of the head and cervical spine, with the external fixator outside of the bore were terminated early because of patient discomfort. There were no documented events of displacement or pullout of the external fixator.

CONCLUSIONS:
These findings suggest that MRI scans of the (cervical) spine and head can be safely obtained in patients with external fixators on the appendicular skeleton or pelvis. Given the low numbers of MRI scans performed with the external fixator inside the bore, additional studies are necessitated to determine the safety of this procedure. The results from this study can aid orthopaedic surgeons, radiologists, and other stakeholders in developing local institutional guidelines on MRI scanning with external fixators in situ.

LEVEL OF EVIDENCE:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Immune checkpoint inhibition as a therapeutic strategy for HIV eradication: current insights and future directions
Authors: Lee Jina , Whitney James B. 
Published: May 2024

Purpose of review
HIV-1 infection contributes substantially to global morbidity and mortality, with no immediate promise of an effective prophylactic vaccine. Combination antiretroviral therapy (ART) suppresses HIV replication, but latent viral reservoirs allow the virus to persist and reignite active replication if ART is discontinued. Moreover, inflammation and immune disfunction persist despite ART-mediated suppression of HIV. Immune checkpoint molecules facilitate immune dysregulation and viral persistence. However, their therapeutic modulation may offer an avenue to enhance viral immune control for patients living with HIV-1 (PLWH).

Recent findings
The success of immune checkpoint inhibitor (ICI) therapy in oncology suggests that targeting these same immune pathways might be an effective therapeutic approach for treating PLWH. Several ICIs have been evaluated for their ability to reinvigorate exhausted T cells, and possibly reverse HIV latency, in both preclinical and clinical HIV-1 studies.

Summary
Although there are very encouraging findings showing enhanced CD8+ T-cell function with ICI therapy in HIV infection, it remains uncertain whether ICIs alone could demonstrably impact the HIV reservoir. Moreover, safety concerns and significant clinical adverse events present a hurdle to the development of ICI approaches. This review provides an update on the current knowledge regarding the development of ICIs for the remission of HIV-1 in PWH. We detail recent findings from simian immunodeficiency virus (SIV)-infected rhesus macaque models, clinical trials in PLWH, and the role of soluble immune checkpoint molecules in HIV pathogenesis.
Strip Harvesting Follicular Unit Transplantation Versus Follicular Unit Excision: Comparing the Number of Hairs and the Ratio of Hairs to Follicular Unit
Authors: Takata Pontes Luciana , Ruston Antonio , de Moraes Aparecida Machado 
Published: May 2024

BACKGROUND
There are 2 extraction techniques for follicular units (FUs) in hair transplantation: strip harvesting follicular unit transplantation (FUT) and follicular unit excision (FUE). Currently, no extant studies have demonstrated that one technique is superior in extraction and donor area optimization for a dense result.

OBJECTIVE
This study compares the FUT and FUE techniques by evaluating the percentage of FUs with 3 or more hairs and the hairs-to-follicular-unit ratio in patients who underwent both procedures at different times.

MATERIALS AND METHODS
The medical records of patients who underwent at least 1 FUT procedure and at least 1 FUE procedure (with this being the second surgical procedure) were reviewed. The surgeries were performed in the same clinic with the same surgeon and surgical team.

RESULTS
There was a higher percentage of FUs with 3 or more hairs and a higher hairs-to-follicular-unit ratio with the FUE technique than with the FUT technique.

CONCLUSION
In FUE, surgeons tend to choose better-looking FUs with thick, plentiful hairs. Even with these results, it is impossible to declare one procedure superior because the correct indication considers multiple factors.
Three-dimensional Simulation on Patient-reported Outcomes Following Oncoplastic and Reconstructive Surgery of the Breast: A Randomized Trial
Authors: Kuroda Flávia , Urban Cícero A. , Dória Maíra , Rabinovich Íris , Spautz Cleverton , Lima Rubens , Schunemann Eduardo , Furlan Karina Anselmi , Nissen Leonardo , Fornazari Alessandra C. , Soares Isabela , Sobreiro Bernardo , Lourenço Mateus , Loureiro Marcelo 
Published: May 2024

Background:
Three-dimensional (3D) imaging using computer simulations is an evolving technology. There is a lack of strong data on the use of this technology for oncoplastic (OP) and reconstructive surgery.

Methods:
A prospective, randomized, single-center trial including breast cancer patients undergoing OP or mastectomy with immediate breast reconstruction with implant (IBR) enrolled from November 2019 to October 2021 at the Hospital Nossa Senhora das Graças, Breast Unit in Curitiba, Brazil. Both patients undergoing OP and those in the IBR group were randomized to undergo 3D imaging and simulation of postoperative results (intervention group) or 3D imaging without simulation (control group). All patients were invited to complete a patient-reported outcome (BREAST-Q) expectations module and breast reconstruction or reduction/mastopexy module before and 6 months after surgery.

Results:
A total of 96 patients were enrolled. Sixty-nine patients (45 OP and 24 IBR) completed the pre- and postoperative questionnaires and were randomized for the simulation. Women in the OP group had higher expectations for breast appearance when clothed than those in the IBR implant group (93.4 ± 16.3 versus 82.9 ± 26.5; P = 0.03). The intervention group was more satisfied with information than the control group (P = 0.021). Both patients who underwent OP and IBR believed that the 3D simulation helped them understand the surgical process (86.6% and 75%, respectively).

Conclusions:
Preoperative 3D simulation significantly improved patient’s satisfaction with information and did not decrease postoperative satisfaction with the outcomes. The incorporation of preoperative 3D simulation may be a valuable tool in breast reconstruction.
Autologous Fat Grafting Air-valve Loading Technique
Authors: Garrett Harrison C. , Lam Thomas C. 
Published: May 2024

Summary:
Autologous fat transfer is fast becoming a common adjunct procedure in plastic surgical operations, especially in breast reconstruction. Postharvest fat processing can be performed actively or passively with various techniques. All techniques require the final step of loading the harvested fat into a syringe for injection. We describe here an innovative and elegant technique for safer and more efficient loading of the plunger back into the barrel of a fat-filled syringe before injection. This technique improves ease of loading, reduces loss of harvested fat, and eliminates the risk of bodily fluid splash.
Chinese text recognition and knowledge graph of Shen Nong Ben Cao Jing based on BERT pre-trained language models
Authors: Tong Lin , Tong Xu , Lei Lei , Zeng Ziling , Liu Sihong , Zhang Lei , Wang Cheng , Yang Hongjun , Zhang Huamin 
Published: May 2024

Background:
The research and utilization of ancient traditional Chinese medicine (TCM) books are relatively limited at present. With the rapid development of artificial intelligence (AI), knowledge graph related technology has brought light on this field.

Objective:
To construct the knowledge graph of Shen Nong Ben Cao Jing, analyze basic knowledge of materia medica, explore implicit knowledge, and conduct visualization display, as well to provide methodological references for the study of ancient TCM books.

Methods:
The types of knowledge entities and relationships between entities in Shen Nong Ben Cao Jing were analyzed. A training corpus dataset was produced by using the BIO sequence labeling method; a self-developed CNLP text labeling system was used for text labeling; the BERT model was used to recognize named entities; the relationships between entities were set based on rules and semantic associations; the data into the Neo4j-community 4.4.9 graph database was imported by using Cypher language for storage and visualization display after knowledge fusion; finally, a knowledge graph was constructed.

Results:
The knowledge graph of Shen Nong Ben Cao Jing included 5, 273 nodes and 11, 064 relationships. The schema layer contained 14 entity types and 15 relationship types. Through the query, knowledge can be visualized from the aspects of classification, property, and seven mutual relationships of herbal combination.

Conclusion:
The knowledge graph constructed in this study directly reflects the knowledge recorded in Shen Nong Ben Cao Jing and the relationship between them, which is suitable for knowledge mining and intuitive multi-dimensional display of ancient TCM books.
Costs of Forced Retirement
Authors: Voss Maren Wright , Hung Man , Li Wei , Richards Lorie Gage , Price Pollie , Terrill Alexandra , Barrett Tyson 
Published: May 2024

Objective
Unemployment is a known health stressor that also increases early retirements. This study addresses mixed literature on retiree health and underreporting of forced retirement to better identify potential health impacts of lost work opportunity.

Methods
A Lost-work Opportunity Score (LOS) was created using variables from the Health and Retirement Study assessing unemployment, forced retirement, and earlier-than-planned retirement for 2576 respondents. Reliability and unidimensionality of the score with multivariate regression analyses examined health impacts controlling for demographics and prior health status.

Results
The LOS possessed unidimensionality with a Cronbach’s alpha of a = 0.76 while predicting self-reported health declines (LOS = 2; β = 0.381, OR = 1.464, P < 0.05) and depression increase (LOS = 2; β = 0.417, OR = 1.517, P < 0.05).

Conclusions
LOS predicts 46% increased odds of negative self-reported health change after retirement associated with two LOS events, with implications to support aging workers.
Endobronchial Phenylephrine in Airway Bleeding During Bronchoscopy Does not Cause Hypertension
Authors: Kim Jeremy , Phan Chinh , Adams Jason , Cortes-Puch Irene , Stocking Jacqueline C. , Liu Anna , Ren Yunyi , Taylor Sandra , Yoneda Ken Y. 
Published: May 2024

Background:
Bleeding is a known complication during bronchoscopy, with increased incidence in patients undergoing a more invasive procedure. Phenylephrine is a potent vasoconstrictor that can control airway bleeding when applied topically and has been used as an alternative to epinephrine. The clinical effects of endobronchial phenylephrine on systemic vasoconstriction have not been clearly evaluated. Here, we compared the effects of endobronchial phenylephrine versus cold saline on systemic blood pressure.

Methods:
In all, 160 patients who underwent bronchoscopy and received either endobronchial phenylephrine or cold saline from July 1, 2017 to June 30, 2022 were included in this retrospective observational study. Intra-procedural blood pressure absolute and percent changes were measured and compared between the 2 groups.

Results:
There were no observed statistical differences in blood pressure changes between groups. The median absolute change between the median and the maximum intra-procedural systolic blood pressure in the cold saline group was 29 mm Hg (IQR 19 to 41) compared with 31.8 mm Hg (IQR 18 to 45.5) in the phenylephrine group. The corresponding median percent changes in SBP were 33.6 % (IQR 18.8 to 39.4) and 28% (IQR 16.8 to 43.5) for the cold saline and phenylephrine groups, respectively. Similarly, there were no statistically significant differences in diastolic and mean arterial blood pressure changes between both groups.

Conclusions:
We found no significant differences in median intra-procedural systemic blood pressure changes comparing patients who received endobronchial cold saline to those receiving phenylephrine. Overall, this argues for the vascular and systemic safety of phenylephrine for airway bleeding as a reasonable alternative to epinephrine.
Different extramedullary disease shown in chemokine receptor 4 targeted PET/CT with [68Ga]Ga-pentixafor in patients with Waldenström macroglobulinemia and smoldering disease
Authors: Pan Qingqing , Cao Xinxin , Li Jian , Li Fang , Luo Yaping 
Published: May 2024

Introduction
It is important to distinguish Waldenström macroglobulinemia from smoldering Waldenström macroglobulinemia (sWM), because only patients with Waldenström macroglobulinemia require treatment, however the distinction can be clinically complex. The aim of this study is to investigate whether [68Ga]Ga-pentixafor PET/CT shows different characteristics in sWM and Waldenström macroglobulinemia patients and therefore can help to differentiate Waldenström macroglobulinemia and sWM.

Results
Thirty-seven patients with newly diagnosed Waldenström macroglobulinemia and 11 sWM patients were analyzed [35 men and 13 women; 64.3 ± 10.7 (range, 29–87) years old]. The SUVmax of bone marrow disease, lymph nodes, and other extramedullary diseases on [68Ga]Ga-pentixafor were significantly higher than those on 2-[18F]FDG PET/CT (P < 0.05). On [68Ga]Ga-pentixafor PET/CT, patients with Waldenström macroglobulinemia had more lymph node regions involved, significantly higher incidence of involvement in more than three lymph node regions, larger nodal disease, and higher incidence of other extramedullary disease when compared with sWM patients (P < 0.05). Waldenström macroglobulinemia patients showed significantly higher total lesions uptake, total lesion volume, and SUVmax of extramedullary disease than sWM patients did (P < 0.05). None of the visual or semiquantitative indexes in 2-[18F]FDG PET/CT showed significant difference between Waldenström macroglobulinemia and sWM patients.

Conclusion
[68Ga]Ga-pentixafor PET/CT had better diagnostic performance than 2-[18F]FDG PET/CT in Waldenström macroglobulinemia. Patients with Waldenström macroglobulinemia presented with more extensive extramedullary disease shown in [68Ga]Ga-pentixafor PET/CT than sWM patients did.
Unruptured tubal ectopic pregnancy concurrent with trophoblastic tissue spread to the rectum: a case report
Authors: Zabad Kareem , Tarakji Massa , Arafat Raghad , Al-Douni Yeser , Nakhleh Merry , Kurdi Bashar 
Published: May 2024

Introduction and importance:
Ectopic pregnancy is a term used to describe pregnancies outside of the uterus. If ruptured, persistent trophoblastic tissue can be present at the site of an ectopic pregnancy, which is an unusual complication. In rare cases, the patients may present with primary implants.

Case presentation:
A 23-year-old woman who was pregnant for the first time complained of abdominal pain and was diagnosed with a 10-week tubal ectopic pregnancy. During laparotomy, trophoblastic implants were discovered in the rectum; however, the pregnancy did not rupture.

Clinical discussion:
The presented case report highlights a rare and late diagnosis of ectopic pregnancy in a 23-year-old primigravida woman with no known risk factors. The patient experienced sudden abdominal pain in the tenth week of gestation, leading to the surgical approach of salpingectomy. Notably, trophoblastic tissue was found in the rectum, indicating local invasion. It was then treated with methotrexate therapy. However, the low-resource setting in Syria limited the use of laparoscopy and resulted in the use of laparotomy.

Conclusion:
This case emphasizes the importance of considering trophoblastic implantation in the management plan for ectopic pregnancies, even in cases in which the pregnancy has not ruptured. It is crucial to evaluate all possible complications of this disease to ensure proper treatment and care of the patient.
Characteristics of Intracranial Injuries in Pediatric Patients Following Blunt Head Trauma
Authors: Akie Thomas E. , Gupta Malkeet , Rodriguez Robert M. , Hendey Gregory W. , Wilson Jake L. , Quinones Alexandra K. , Mower William R. 
Published: May 2024

Objectives
Pediatric head trauma is a frequent reason for presentation to the emergency department. Despite this, there are few reports on specific characteristics and injury patterns in head injured children. The goal of this study was to evaluate head injury patterns in children with blunt head injury and their prevalence by age group.

Methods
This is a planned secondary analysis of the NEXUS II Head CT validation study. Consecutive patients with blunt head trauma were enrolled between 2006 and 2015. Demographics and criteria from 2 clinical decision instruments (NEXUS and Canadian Head CT rules) were gathered at the time of enrollment. We abstracted and cataloged injuries for pediatric patients based on radiologist report. Frequencies of injuries and severity were analyzed by developmental age group.

Results
A total of 1018 pediatric patients were enrolled, 128 (12.6%) of whom had an injury on computed tomography scan. Median age was 11.9 (Interquartile range 4.5–15.5) for all patients and 12 (4.8–15.5) for injured patients. Of injured patients, 49 (38.3%) had a significant injury, and 27 (21.1%) received an intervention. Teenagers had the highest rate of significant injury (50%) and intervention (30%). Injuries were most frequently noted in the temporal (46.1%), frontal (45.3%), and parietal (45.3%) regions. Subarachnoid hemorrhage (29.7%) and subdural hematoma (28.9%) were the most common injuries observed.
Intraparenchymal hemorrhage and cerebral edema were more prevalent in older age groups. The most common injury mechanism overall was fall from height (24.7%). Motor vehicle accidents and nonmotorized wheeled vehicle accidents were more common in older patients.

Conclusions
Serious injuries requiring intervention were rarely encountered in pediatric patients experiencing blunt head trauma. Mechanisms of injury, type of injury, and rates of intervention varied between developmental age groups.
Implementation Barriers Encountered During a Universal Suicide Screening Program in Pediatric Emergency Departments
Authors: Seag Dana E. M. , Cervantes Paige E. , Narcisse Iriane , Wiener Ethan , Tay Ee Tein , Knapp Katrina , Horwitz Sarah McCue 
Published: May 2024

Objective
Because understanding barriers to universal suicide risk screening in pediatric emergency departments (PEDs) may improve both identification and management of suicidal behaviors and ideation, this study assessed barriers to a quality improvement initiative examining the use of a novel computerized adaptive test (CAT), the Kiddie-CAT, in 2 PEDs.

Methods
Research assistants (RAs) trained in Rapid Assessment Procedures-Informed Clinical Ethnography methods documented barriers related to the environment, individuals, and workflow as encountered during screening shifts, categorizing the barriers' impacts as either general to a screening shift or related to screening an individual youth/caregiver dyad. Using thematic content analysis, investigators further categorized barriers based on type (eg, workflow, language/comprehension, clinician attitudes/behaviors) and relationship to the limited integration of this initiative into clinical protocols. Reasons for refusal and descriptive data on barriers are also reported.

Results
Individual screen barriers were most often related to workflow (22.9%) and youth/caregiver language/comprehension challenges (28%). Similarly, workflow issues accounted for 48.2% of all general shift barriers. However, many of these barriers were related to the limited integration of the initiative, as RAs rather than clinical staff conducted the screening.

Conclusions
Although this study was limited by a lack of complete integration into clinical protocols and was complicated by the COVID-19 pandemic impacts on PEDs, the findings suggest that considerable attention needs to be directed both to physician education and to workflow issues that could impede universal screening efforts.
Viral infections and inborn errors of immunity
Authors: Ewing Anne , Madan Rebecca Pellett 
Published: May 2024

Purpose of review
The purpose of this focused review is to discuss unusual presentations of viral infections in the context of specific inborn errors of immunity. We will discuss hyper immunoglobulin E (IgE) syndromes, epidermodysplasia verruciformis, and X-linked agammaglobulinemia as examples of inborn errors of immunity associated with specific presentations of viral infection and disease.

Recent findings
Advances in both genetic and viral diagnostics have broadened our understanding of viral pathogenesis in the setting of immune dysfunction and the variable phenotype of inborn errors of immunity. Dedicator of cytokinesis 8 (DOCK8) deficiency is now recognized as an inborn error of immunity within the hyper IgE syndrome phenotype and is associated with unusually aggressive cutaneous disease caused by herpes simplex and other viruses. Studies of patients with epidermodysplasia verruciformis have proven that rarely detected human papillomavirus subtypes may cause malignancy in the absence of adequate host defenses. Finally, patients with X-linked agammaglobulinemia may remain at risk for severe and chronic viral infections, even as immune globulin supplementation reduces the risk of bacterial infection.

Summary
Susceptibility to viral infections in patients with inborn errors of immunity is conferred by specific, molecular defects. Recurrent, severe, or otherwise unusual presentations of viral disease should prompt investigation for an underlying genetic defect.