bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyperspectral imaging and evaluation of surgical margins: where do we stand?
Authors: Pertzborn David , Bali Ayman , Mühlig Anna , von Eggeling Ferdinand , Guntinas-Lichius Orlando 
Published: January 2024

Purpose of review
To highlight the recent literature on the use of hyperspectral imaging (HSI) for cancer margin evaluation ex vivo, for head and neck cancer pathology and in vivo during head and neck cancer surgery.

Recent findings
HSI can be used ex vivo on unstained and stained tissue sections to analyze head and neck tissue and tumor cells in combination with machine learning approaches to analyze head and neck cancer cell characteristics and to discriminate the tumor border from normal tissue. Data on in vivo applications during head and neck cancer surgery are preliminary and limited. Even now an accuracy of 80% for tumor versus nonneoplastic tissue classification can be achieved for certain tasks, within the current in vivo settings.

Summary
Significant progress has been made to introduce HSI for ex vivo head and neck cancer pathology evaluation and for an intraoperative use to define the tumor margins. To optimize the accuracy for in vivo use, larger HSI databases with annotations for head and neck cancer are needed.
Compartmental surgery for T4b oral squamous cell carcinoma involving the masticatory space
Authors: Mattavelli Davide , Montenegro Claudia , Piazza Cesare 
Published: January 2024

Purpose of review
This review aims to describe the oncological outcomes of T4b oral squamous cell carcinomas (OSCC) with masticatory space involvement as well as the surgical approaches that are able to achieve compartmental ‘en bloc’ resection of these lesions.

Recent findings
The masticatory space is subdivided into infra-notch and supra-notch spaces according to the axial plane passing through the mandibular notch between the coronoid process and the condyle neck. Compartmental resection for T4b OSCC with masticatory space invasion can be successfully achieved via purely external approaches or combining external and transnasal endoscopic routes. Infra-notch T4b OSCC showed survival outcomes comparable to T4a OSCC, thus prompting treatment with curative intent.

Summary
Compartmental resection of the masticatory space is technically feasible with comprehensive control of tumour margins. Use of a transnasal endoscopic anterior route within a multiportal approach may provide better control of margins at the level of the pterygo-maxillary fissure. Equivalent survival outcomes between T4a and infra-notch T4b OSCC are reported. Thus, a downstaging of the latter to T4a is advisable and compartmental surgery of such advanced lesions could be considered as a first-line treatment option in selected patients.
Magnetic Resonance Imaging–Based Assessment of Pancreatic Fat Strongly Correlates With Histology-Based Assessment of Pancreas Composition
Authors: Kiemen Ashley L. , Dbouk Mohamad , Diwan Elizabeth Abou , Forjaz André , Dequiedt Lucie , Baghdadi Azarakhsh , Madani Seyedeh Panid , Grahn Mia P. , Jones Craig , Vedula Swaroop , Wu PeiHsun , Wirtz Denis , Kern Scott , Goggins Michael , Hruban Ralph H. , Kamel Ihab R. , Canto Marcia Irene 
Published: January 2024

Objective
The aim of the study is to assess the relationship between magnetic resonance imaging (MRI)-based estimation of pancreatic fat and histology-based measurement of pancreatic composition.

Materials and Methods
In this retrospective study, MRI was used to noninvasively estimate pancreatic fat content in preoperative images from high-risk individuals and disease controls having normal pancreata. A deep learning algorithm was used to label 11 tissue components at micron resolution in subsequent pancreatectomy histology. A linear model was used to determine correlation between histologic tissue composition and MRI fat estimation.

Results
Twenty-seven patients (mean age 64.0 ± 12.0 years [standard deviation], 15 women) were evaluated. The fat content measured by MRI ranged from 0% to 36.9%. Intrapancreatic histologic tissue fat content ranged from 0.8% to 38.3%. MRI pancreatic fat estimation positively correlated with microanatomical composition of fat (r = 0.90, 0.83 to 0.95], P < 0.001); as well as with pancreatic cancer precursor (r = 0.65, P < 0.001); and collagen (r = 0.46, P < 0.001) content, and negatively correlated with pancreatic acinar (r = −0.85, P < 0.001) content.

Conclusions
Pancreatic fat content, measurable by MRI, correlates to acinar content, stromal content (fibrosis), and presence of neoplastic precursors of cancer.
Health Beliefs, Protective Behaviors, and Information-Seeking
Authors: Liu Yen-Wen , Tang Chia-Chun 
Published: January 2024

Abstract

Background
The outbreak of coronavirus disease 2019 (COVID-19) caused severe damage to public health globally and served as a stark reminder of the potential for future pandemics. Promoting protective behaviors to prevent the spread of any contagious disease thus remains a priority. While research has shown that health beliefs can affect protective behaviors, few studies have examined the role of information-seeking in this relationship.

Objective
Based on the health belief model, this research focused on whether health beliefs affect personal protective behaviors through health information-seeking behaviors.

Methods
This cross-sectional study with a causal–comparative design used an online questionnaire to investigate the Taiwanese public’s health beliefs, protective behaviors, and information-seeking behaviors during the COVID-19 pandemic. Data were analyzed using descriptive statistics and multiple regression analysis.

Results
Between September 2021 and January 2022, 322 valid questionnaires were collected. The results revealed that the effects of two health beliefs—self-efficacy and perceived benefits—on handwashing, social distancing, practicing good cough etiquette, and keeping one’s environment clean and well-ventilated were partially mediated by the frequency of official information-seeking.

Discussion
Results of this study support the regular and timely promotion of pandemic prevention measures through official sites. Promoting official information-seeking can help enhance protective behaviors.
Association of Designated Pediatric Trauma Center and Outcomes of Severely Injured Children Who Were Mechanically Ventilated and Underwent Tracheostomy: A Propensity-Matched Analysis
Authors: Ahmed Nasim , Kuo Yen-Hong 
Published: January 2024

Objectives
The purpose of the study is to examine the outcomes of care delivered at the pediatric trauma center (PTC) in severely injured children who were intubated, mechanically ventilated, and underwent tracheostomy.

Methods
The study data were obtained from the Trauma Quality Improvement Program database for the calendar years 2017 to 2019. All children aged ≤17 years who sustained severe injury, required intubation and mechanical ventilation for more than 96 hours, and underwent tracheostomy were included in the study. Patients' characteristics, injury severity, and outcomes were compared between the care provided at the PTCs (level I or level II) and nonpediatric trauma centers (NPTCs). The propensity score matching methodology was used to perform the analysis. All P values are 2-sided, and a P value of <0.0.5 is considered statistically significant.

Results
Of 2164 patients who were qualified for the study, 1288 (59%) of the patients were treated at PTCs, and 876 (40.5%) of the patients were treated at NPTCs. Propensity matching created 876 pairs of patients. There were no significant differences found between the 2 groups on patients' characteristics except for age. Patients who were treated at PTCs had a median age of 14 (10–16) versus 15 (11–17) years (P < 0.001) when compared with care provided at NPTCs. A longer hospital stay was found in the PTC group when compared with the NPTC group (24 [23, 25] vs 22 [21, 24], P = 0.008). Patients who were treated at PTC were found to have significantly less sepsis occurrence (0.9% vs 2.2%), and a higher proportion of patients were discharged home without needing additional support (26.2% vs 18.5%).

Conclusions
Care at the PTC was associated with a lower occurrence of sepsis complications. A higher number of patients were discharged home without additional services when the care was provided at PTC.
Minimally Invasive Corneal Neurotization: 10-Year Update in Technique Including Novel Donor Transfer of the Great Auricular Nerve
Authors: Gross Jeffrey N. , Bhagat Neel , Tran Khoa , Liu Shaohui , Boente Charline S. , Ali Asim , Borschel Gregory H. 
Published: January 2024

Summary:
Corneal anesthesia, caused by lack of corneal innervation, is a rare but devastating condition that can lead to neurotrophic keratopathy, corneal ulceration, scarring, and blindness. Minimally invasive corneal neurotization enables transfer of regional donor sensory nerves to the cornea to provide sensation and ocular protection. The authors provide an update on technical advances and modifications that have refined the surgery over the past 10 years, as well as step-by-step intraoperative videos of corneal neurotization, noting its critical steps, pitfalls, and caveats. The videos illustrate the novel technique of using the greater auricular nerve with a sural nerve graft extension as the donor nerve for the procedure. The steps and considerations depicted will allow surgeons to carry out corneal neurotization efficiently, safely, and effectively.
From Data to Decisions: How Artificial Intelligence Is Revolutionizing Clinical Prediction Models in Plastic Surgery
Authors: Kooi Kevin , Talavera Estefania , Freundt Liliane , Oflazoglu Kamilcan , Ritt Marco J. P. F. , Eberlin Kyle R. , Selles Ruud W. , Clemens Mark W. , Rakhorst Hinne A. 
Published: January 2024

Summary:
The impact of clinical prediction models within artificial intelligence (AI) and machine learning is significant. With its ability to analyze vast amounts of data and identify complex patterns, machine learning has the potential to improve and implement evidence-based plastic, reconstructive, and hand surgery. In addition, it is capable of predicting the diagnosis, prognosis, and outcomes of individual patients. This modeling aids daily clinical decision-making, most commonly at the moment, as decision support. The purpose of this article is to provide a practice guideline to plastic surgeons implementing AI in clinical decision-making or setting up AI research to develop clinical prediction models using the 7-step approach and the ABCD validation steps of Steyerberg and Vergouwe. The authors also describe 2 important protocols that are in the development stage for AI research: (1) the transparent reporting of a multivariable prediction model for Individual Prognosis or Diagnosis checklist, and (2) the Prediction Model Risk of Bias Assessment Tool checklist to access potential biases.
7 T Lesion-Attenuated Magnetization-Prepared Gradient Echo Acquisition for Detection of Posterior Fossa Demyelinating Lesions in Multiple Sclerosis
Authors: Middlebrooks Erik H. , Patel Vishal , Zhou Xiangzhi , Straub Sina , Murray John V. , Agarwal Amit K. , Okromelidze Lela , Singh Rahul B. , Lopez Chiriboga Alfonso S. , Westerhold Erin M. , Gupta Vivek , Sandhu Sukhwinder Johnny Singh , Marin Collazo Iris V. , Tao Shengzhen 
Published: January 2024

Objectives
Detection of infratentorial demyelinating lesions in multiple sclerosis (MS) presents a challenge in magnetic resonance imaging (MRI), a difficulty that is further heightened in 7 T MRI. This study aimed to assess the efficacy of a novel MRI approach, lesion-attenuated magnetization-prepared gradient echo acquisition (LAMA), for detecting demyelinating lesions within the posterior fossa and upper cervical spine on 7 T MRI and contrast its performance with conventional double-inversion recovery (DIR) and T2-weighted turbo spin echo sequences.

Materials and Methods
We conducted a retrospective cross-sectional study in 42 patients with a confirmed diagnosis of MS. All patients had 7 T MRI that incorporated LAMA, 3D DIR, and 2D T2-weighted turbo spin echo sequences. Three readers assessed lesion count in the brainstem, cerebellum, and upper cervical spinal cord using both DIR and T2-weighted images in one session. In a separate session, LAMA was analyzed alone. Contrast-to-noise ratio was also compared between LAMA and the conventional sequences. Lesion counts between methods were assessed using nonparametric Wilcoxon signed rank test. Interrater agreement in lesion detection was estimated by intraclass correlation coefficients.

Results
LAMA identified a significantly greater number of lesions than DIR + T2 (mean 6.4 vs 3.0; P < 0.001). LAMA also exhibited better interrater agreement (intraclass correlation coefficient [95% confidence interval], 0.75 [0.41–0.88] vs 0.61 [0.35–0.78]). The contrast-to-noise ratio for LAMA (3.7 ± 0.9) significantly exceeded that of DIR (1.94 ± 0.7) and T2 (1.2 ± 0.7) (all P's < 0.001). In cases with no lesions detected using DIR + T2, at least 1 lesion was identified in 83.3% with LAMA. Across all analyzed brain regions, LAMA consistently detected more lesions than DIR + T2.

Conclusions
LAMA significantly improves the detection of infratentorial demyelinating lesions in MS patients compared with traditional methods. Integrating LAMA with standard magnetization-prepared 2 rapid acquisition gradient echo acquisition provides a valuable tool for accurately characterizing the extent of MS disease.
Marked Decreased Tracer Binding in 123I-FP-CIT SPECT Scans From Lisdexafetamine Dismesylate Interaction: A Case Report
Authors: Miyagawa Toji , Vernon Cynthia , Przybelski Scott A. , Min Hoon-Ki , Fields Julie A. , Kantarci Kejal , Lowe Val , Boeve Bradley F. 
Published: January 2024

Objectives
The objective of this case study is to raise awareness of potential 123I-FP-CIT SPECT interference by lisdexafetamine dimesylate, a prodrug of d-amphetamine.

Methods
A 69-year-old man with Rapid Eye Movement sleep behavior disorder and mild cognitive impairment had been treated with lisdexafetamine dimesylate for attention-deficit/hyperactivity disorder. The patient had annual or biennial 123I-FP-CIT SPECT evaluations after their baseline visit at 69 years old. Nigrostriatal dopamine transporter uptake was semiquantitatively evaluated with 123I-FP-CIT SPECT using DaTQUANT 2.0 software. Lisdexafetamine dimesylate was discontinued 3 months before the sixth-year visit (76 years old) by his primary care provider.

Results
The patient had 4 123I-FP-CIT SPECT scans with lisdexafetamine dimesylate and 2 scans after the discontinuation of lisdexafetamine dimesylate. The DaTQUANT z-scores of the putamen declined from −1.36 at the baseline visit to −3.02 at the fifth-year visit. After the discontinuation of lisdexafetamine dimesylate, DaTQUANT z-scores of the putamen increased to −0.63 at the sixth-year visit and remained in the normal range of −0.71 at the seventh-year visit.

Conclusions
This case suggests that lisdexafetamine dimesylate may have a strong interference with 123I-FP-CIT SPECT, decreasing the tracer binding to the dopamine transporter and presenting false positive results.
Corticothalamic Responsive Neurostimulation for Focal Epilepsy: A Single-Center Experience
Authors: Burdette David , Patra Sanjay , Johnson Lise 
Published: January 2024

Purpose:
Owing to its extensive, reciprocal connectivity with the cortex and other subcortical structures, the thalamus is considered an important target for neuromodulation in drug-resistant focal epilepsy. Using corticothalamic stimulation, it is possible to modulate both the thalamus and the cortical seizure onset zone. Limited published clinical experience describes corticothalamic stimulation with depth leads targeting one of the anterior (ANT), centromedian (centromedian nucleus), or pulvinar (PUL) thalamic nuclei. However, it is not clear which of these nuclei is the “best” therapeutic target.

Methods:
This study comprised a single-center experience with corticothalamic responsive neurostimulation using the RNS System to target these three thalamic nuclei. Presented here are the methods for target selection and device programming as well as clinical outcomes and a comparison of ictal and nonictal electrophysiological features.

Results:
In this small retrospective study (N = 19), responsive corticothalamic neurostimulation was an effective therapy for 79% of patients (≥50% reduction in disabling seizure frequency), regardless of whether the thalamic lead was implanted in the ANT (N = 2), PUL (N = 6), or centromedian nucleus (N = 11). Twenty-six percent of patients reported a reduction in disabling seizure frequency ≥90%. Both high frequency (≥100 Hz) and low (≤20 Hz) frequency were used to stimulate the thalamus depending on the patient's response and ability to tolerate higher charge densities. In all patients, a longer burst duration (2000–5000 ms) was ultimately implemented on the thalamic leads. Across patients, peaks in the intracranial EEG were observed at theta, beta, gamma, and sleep spindle frequencies. Changes in frequency content and distribution were observed over time in all three nuclei.

Conclusions:
These results indicate that both high frequency and low frequency corticothalamic responsive neurostimulation can potentially be an effective adjunctive therapy in drug-resistant focal epilepsy. These data can also contribute to a broader understanding of thalamic electrophysiology in the context of focal epilepsy.
Transcranial Magnetic Stimulation in the Diagnosis of Compressive Myelopathy at the Thoracolumbar Junction
Authors: Fujimoto Kazuhiro , Funaba Masahiro , Suzuki Hidenori , Nishida Norihiro , Ikeda Hiroaki , Ichihara Yusuke , Imajo Yasuaki , Sakai Takashi 
Published: January 2024

Purpose:
The disc level in the thoracolumbar junction at which measurement of the central motor conduction time in the lower limbs (CMCT-LL) is useful for a diagnosis remains unclear. Therefore, this study investigated the spinal vertebral level at which compressive myelopathy due to ossification of the ligamentum flavum in the thoracolumbar junction is detectable using CMCT-LL.

Methods:
We preoperatively measured CMCT-LL in 57 patients (42 men, 15 women; aged 35–85 years) with a single ossification of the ligamentum flavum from the T10-11 to T12-L1 disc levels and in 53 healthy controls. Motor evoked potentials after transcranial magnetic stimulation, compound muscle action potentials, and F waves were recorded from the abductor hallucis. Central motor conduction time in the lower limbs was calculated as follows: Motor evoked potential latency − (compound muscle action potential latency + F latency − 1)/2 (ms). Central motor conduction time in the lower limbs was compared between patients and controls.

Results:
Compressive lesions were located at the T10 to 11 level in 27 patients, the T11 to 12 level in 28, and the T12-L1 level in 2. Central motor conduction time values in the lower limbs at the T10 to 11 level (19.9 ± 4.7 ms) and T11 to 12 level (18.1 ± 3.4 ms) were significantly longer than control values (11.8 ± 1.1 ms; P < 0.01). Central motor conduction time in the lower limbs was not calculated at the T12-L1 level because motor evoked potentials were not recorded in any patient.

Conclusions:
We confirmed that CMCT-LL was significantly longer in patients with ossification of the ligamentum flavum at the T10 to 11 and T11 to 12 levels because the S2 segment of the spinal cord is caudal at the T12 vertebral body level. Therefore, CMCT-LL is useful for diagnosing thoracolumbar junction disorders proximal to the T12 vertebral body level.
Lateralized Rhythmic Delta Activity and Lateralized Periodic Discharges in Critically Ill Pediatric Patients
Authors: Gupta Siddharth , Ritzl Eva K. , Husari Khalil S. 
Published: January 2024

Purpose:
To evaluate the clinical and electrographic characteristics of critically ill pediatric patients with lateralized rhythmic delta activity (LRDA) and compare them with patients with lateralized periodic discharges (LPDs).

Methods:
This was a retrospective study examining consecutive critically ill pediatric patients (1 month–18 years) with LRDA or LPDs monitored on continuous electroencephalography. Clinical, radiologic, and electrographic characteristics; disease severity; and acute sequelae were compared between the two groups.

Results:
Of 668 pediatric patients monitored on continuous electroencephalography during the study period, 12 (1.79%) patients had LRDA and 15 (2.24%) had LPDs. The underlying etiologies were heterogeneous with no difference in the acuity of brain MRI changes between both groups. Lateralized rhythmic delta activity and LPDs were concordant with the side of MRI abnormality in most patients [85.7% (LRDA) and 83.3% (LPD)]. There was no difference in the measures of disease severity between both groups. Seizures were frequent in both groups (42% in the LRDA group and 73% in the LPD group). Patients in the LPD group had a trend toward requiring a greater number of antiseizure medications for seizure control (median of 4 vs. 2 in the LRDA group, p = 0.09), particularly those patients with LPDs qualifying as ictal–interictal continuum compared with those without ictal–interictal continuum (p = 0.02).

Conclusions:
Lateralized rhythmic delta activity and LPDs are uncommon EEG findings in the pediatric population. Seizures occur commonly in patients with these patterns. Seizures in patients with LPDs, especially those qualifying as ictal–interictal continuum, showed a trend toward being more refractory. Larger studies are needed in the future to further evaluate these findings.
The Electrographic Effects of Ketamine on Patients With Refractory Status Epilepticus After Cardiac Arrest: A Single-Center Retrospective Cohort
Authors: Qing Kurt , Alkhachroum Ayham , Claassen Jan , Forgacs Peter , Schiff Nicholas 
Published: January 2024

Purpose:
To investigate the effects of ketamine on patients with refractory status epilepticus after cardiac arrest.

Methods:
In this retrospective cohort, selected EEG segments from patients after cardiac arrest were classified into different EEG patterns (based on background continuity and burden of epileptiform discharges) and spectral profiles (based on the presence of frequency components). For patients who received ketamine, EEG data were compared before, during, and after ketamine infusion; for the no-ketamine group, EEG data were compared at three separated time points during recording. Ketamine usage was determined by clinical providers. Electrographic improvement in epileptiform activity was scored, and the odds ratio was calculated using the Fisher exact test. Functional outcome measures at time of discharge were also examined.

Results:
Of a total of 38 patients with postcardiac arrest refractory status epilepticus, 13 received ketamine and 25 did not. All patients were on ≥2 antiseizure medications including at least one sedative infusion (midazolam). For the ketamine group, eight patients had electrographic improvement, compared with only two patients in the no-ketamine group, with an odds ratio of 7.19 (95% confidence interval 1.16–44.65, P value of 0.0341) for ketamine versus no ketamine. Most of the patients who received ketamine had myoclonic status epilepticus, and overall neurologic outcomes were poor with no patients having a favorable outcome.

Conclusions:
For postarrest refractory status epilepticus, ketamine use was associated with electrographic improvement, but with the available data, it is unclear whether ketamine use or EEG improvement can be linked to better functional recovery.