bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of sleep characteristics and night shift work with self-reported diagnosis of polycystic ovary syndrome: A questionnaire based cross-sectional study
Authors: Shao Shu-Yi , Zhao Huan-Qiang , Lu Zhi-Ying , Lei Xiao-Hong , Zhang Ying 
Published: February 2023

Objective:
To examine the association between sleep characteristics and night shift work and the risk of polycystic ovary syndrome (PCOS) in Chinese women and to investigate their relationship with infertility in PCOS.

Methods:
From March 21, 2021 to April 31, 2021, 3,927 Chinese women with or without PCOS were recruited online. All participants completed WeChat-based electronic questionnaires. Sleep characteristics were measured using the Pittsburgh sleep quality index.

Results:
A total of 2,871 women were included in the final analysis. Sleep duration (odds ratio [OR], 0.857; 95% confidence interval [CI], 0.763–0.963), sleep midpoint (OR, 1.142; 95% CI, 1.049–1.244), sleep disturbance (OR,1.320; 95% CI, 0.957–1.146), daytime dysfunction (OR, 1.136; 95% CI, 1.030–1.253), and night shift work (OR, 1.628; 95% CI, 1.264–2.097) were associated with a higher risk of PCOS. After adjusting for confounders, including age, body mass index, smoking status, and coffee and tea drinking status, sleep disturbance (OR, 1.314; 95% CI, 1.111–1.555), daytime dysfunction (OR, 1.143; 95% CI, 1.034–1.264), and night shift work (OR, 1.800; 95% CI, 1.388–2.333) remained associated. In addition, sleep disturbance (OR, 1.887; 95% CI, 1.400–2.542) and subjective sleep quality (OR, 1.299; 95% CI, 1.037–1.627) were associated with infertility in women with PCOS, and sleep disturbance (OR, 1.750; 95% CI, 1.281–2.390) remained significant after adjusting for confounders.

Conclusions:
Sleep disturbance, daytime dysfunction, and night shift work are significantly associated with PCOS. Screening for sleep disturbances and providing appropriate treatment could be potential strategies for managing PCOS and its long-term complications.
Contrast-Enhanced 3D Spin Echo T1-Weighted Sequence Outperforms 3D Gradient Echo T1-Weighted Sequence for the Detection of Multiple Sclerosis Lesions on 3.0 T Brain MRI
Authors: de Panafieu Ariane , Lecler Augustin , Goujon Adrien , Krystal Sidney , Gueguen Antoine , Sadik Jean-Claude , Savatovsky Julien , Duron Loïc 
Published: February 2023

Background
Using reliable contrast-enhanced T1 sequences is crucial to detect enhancing brain lesions for multiple sclerosis (MS) at the time of diagnosis and over follow-up. Contrast-enhanced 3D gradient-recalled echo (GRE) T1-weighted imaging (WI) and 3D turbo spin echo (TSE) T1-WI are both available for clinical practice and have never been compared within the context of this diagnosis.

Purpose
The aim of this study was to compare contrast-enhanced 3D GRE T1-WI and 3D TSE T1-WI for the detection of enhancing lesions in the brains of MS patients.

Methods
This single-center prospective study enrolled patients with MS who underwent a 3.0 T brain MRI from August 2017 to April 2021 for follow-up. Contrast-enhanced 3D GRE T1-WI and 3D TSE T1-WI were acquired in randomized order. Two independent radiologists blinded to all data reported all contrast-enhanced lesions in each sequence. Their readings were compared with a reference standard established by a third expert neuroradiologist. Interobserver agreement, contrast ratio, and contrast-to-noise ratio were calculated for both sequences.

Results
A total of 158 MS patients were included (mean age, 40 ± 11 years; 95 women). Significantly more patients had at least 1 contrast-enhanced lesion on 3D TSE T1-WI than on 3D GRE T1-WI for both readers (61/158 [38.6%] vs 48/158 [30.4%] and 60/158 [38.6%] vs 47/158 [29.7%], P < 0.001). Significantly more contrast-enhanced lesions per patient were detected on 3D TSE T1-WI (mean 2.47 vs 1.56 and 2.56 vs 1.39, respectively, P < 0.001). Interobserver agreement was excellent for both sequences, κ = 0.96 (confidence interval [CI], 0.91–1.00) for 3D TSE T1-WI and 0.92 (CI, 0.86–0.99) for 3D GRE T1-WI. Contrast ratio and contrast-to-noise ratio were significantly higher on 3D TSE T1-WI (0.84 vs 0.53, P < 0.001, and 87.9 vs 57.8, P = 0.03, respectively).

Conclusions
At 3.0 T, contrast-enhanced 3D TSE-T1-WI supports the detection of significantly more enhancing lesions than 3D GRE T1-WI and should therefore be used for MS patients requiring contrast-enhanced examination.
Accurate Diagnosis of Cortical and Infratentorial Lesions in Multiple Sclerosis Using Accelerated Fluid and White Matter Suppression Imaging
Authors: Martin Anna , Emorine Thibaut , Megdiche Imen , Créange Alain , Kober Tobias , Massire Aurélien , Bapst Blanche 
Published: February 2023

ObjectivesThe precise location of multiple sclerosis (MS) cortical lesions can be very challenging at 3 T, yet distinguishing them from subcortical lesions is essential for the diagnosis and prognosis of the disease. Compressed sensing–accelerated fluid and white matter suppression imaging (CS-FLAWS) is a new magnetic resonance imaging sequence derived from magnetization-prepared 2 rapid acquisition gradient echo with promising features for the detection and classification of MS lesions. The objective of this study was to compare the diagnostic performances of CS-FLAWS (evaluated imaging) and phase sensitive inversion recovery (PSIR; reference imaging) for classification of cortical lesions (primary objective) and infratentorial lesions (secondary objective) in MS, in combination with 3-dimensional (3D) double inversion recovery (DIR).Materials and MethodsProspective 3 T scans (MS first diagnosis or follow-up) acquired between March and August 2021 were retrospectively analyzed. All underwent 3D CS-FLAWS, axial 2D PSIR, and 3D DIR. Double-blinded reading sessions exclusively in axial plane and final consensual reading were performed to assess the number of cortical and infratentorial lesions. Wilcoxon test was used to compare the 2 imaging datasets (FLAWS + DIR and PSIR + DIR), and intraobserver and interobserver agreement was assessed using the intraclass correlation coefficient.ResultsForty-two patients were analyzed (38 with relapsing-remitting MS, 29 women, 42.7 ± 12.6 years old). Compressed sensing–accelerated FLAWS allowed the identification of 263 cortical lesions versus 251 with PSIR (P= 0.74) and 123 infratentorial lesions versus 109 with PSIR (P= 0.63), corresponding to a nonsignificant difference between the 2 sequences. Compressed sensing–accelerated FLAWS exhibited fewer false-negative findings than PSIR either for cortical lesions (1 vs 13;P< 0.01) or infratentorial lesions (1 vs 15;P< 0.01). No false-positive findings were found with any of the 2 sequences. Diagnostic confidence was high for each contrast.ConclusionThree-dimensional CS-FLAWS is as accurate as 2D PSIR imaging for classification of cortical and infratentorial MS lesions, with fewer false-negative findings, opening the way to a reliable full brain MS exploration in a clinically acceptable duration (5 minutes 15 seconds).
A Randomized Trial of Intra-articular Injection Therapy for Knee Osteoarthritis
Authors: Tschopp Marcel , Pfirrmann Christian W.A. , Fucentese Sandro F. , Brunner Florian , Catanzaro Sabrina , Kühne Nathalie , Zwyssig Iwan , Sutter Reto , Götschi Tobias , Tanadini Matteo , Rosskopf Andrea B. 
Published: February 2023

Background
Intra-articular injections are widely used for conservative treatment of knee osteoarthritis (OA). However, rigorous data are lacking regarding the comparative therapeutic effectiveness of these injections.

Purpose
The aim of this study was to compare clinical outcomes after intra-articular injections of glucocorticoid, hyaluronic acid, platelet-rich plasma (PRP), or placebo in patients with mild or moderate OA of the knee.

Materials and Methods
In a double-blinded, placebo-controlled, single-center trial, we randomly assigned knees with early- to middle-stage knee OA (Kellgren-Lawrence grade 1–3) to an intra-articular injection with one of these substances: glucocorticoid, hyaluronic acid, PRP, or placebo. Primary outcome was pain reduction within 6 months after the injection, assessed with the numeric rating scale (NRS; range, 0–100). Secondary outcome parameters included WOMAC scores, Tegner Activity Scale, knee mobility, and adverse events. Finally, a linear mixed-effects model was calculated and corrected for possible patient and covariate effects.

Results
One hundred twenty knees (30 knees per treatment group) in 95 patients (41 female) were included in the final analysis. The median age of patients was 60 years (interquartile range, 54.0–68.0). There was no evidence that the drug effects of primary and secondary outcome parameters differed over time. The median pain at baseline was 32.5 (interquartile range, 15.00–50.00) on NRS. The changes in pain level during the first 6 months compared with baseline were small (within ±5 points on NRS), whereas the intrapatient variability was large between −20 and +20 points. Secondary outcome parameters did not differ significantly among the groups. Kellgren-Lawrence grade did not have a statistically significant effect on pain reduction (P = 0.61).

Conclusions
There is no evidence that knee injections with glucocorticoid, PRP, or hyaluronic acid have superior short- or long-term effects in patients with low pain level at baseline and early- to middle-stage knee OA when compared with placebo.
Hypermetabolic Broad Ligament Leiomyoma in Postmenopausal Women Mimicking Ovarian Tumors on 18F-FDG PET/CT
Authors: Liu Meixi , Wang Peipei , Huo Li , Cheng Wuying 
Published: February 2023

Abstract
Extrauterine leiomyomas are rare and often occur in broad ligament or fallopian tube. Diagnosis of broad ligament leiomyoma is challenging for its solid nature and special location. Leiomyomas typically exhibit mild FDG uptake, especially in postmenopausal woman. We here reported a 57-year-old postmenopausal woman with intense FDG-avid broad ligament leiomyoma on 18F-FDG PET/CT, which might be misdiagnosed as ovarian tumor.
Nuclear Medicine—A Name for Now and the Future
Authors: Bashir Humayun , Gul Muhammad R. , Younis Muhammad N. , Tulchinsky Mark , Li Yaming , Fanti Stefano , Alavi Abass 
Published: February 2023

Abstract
Our article addresses the prevailing trend of new terminology introduced alongside the progress being made in nuclear medicine. Our article provides a historic, current, and future perspective.
PET/CT Manifestations of a Case of Penicilliosis Marneffei Misdiagnosed as Lung Cancer
Authors: Cheng You , Li Wen-min , Wang Shu-xia , Shao Dan 
Published: February 2023

AbstractPenicilliosismarneffeiis an extremely rare fungal infectious disease and is especially rare in people with normal immunity. Penicilliosismarneffeirestricted to the lung and involving the formation of a pulmonary tumor is difficult to distinguish from peripheral lung cancer. This kind of case has rarely been reported. We report the case of a 53-year-old man with penicilliosismarneffeimisdiagnosed as lung cancer by18F-FDG PET/CT.
18F-THK5351 PET Can Evaluate Tumor Extension in Intravascular Large B-Cell Lymphoma
Authors: Hatano Keiko , Ishibashi Kenji , Kondo Soichiro , Ishii Kenji , Iwata Atsushi 
Published: February 2023

Abstract
A 79-year-old man presenting with gait disturbance and cognitive decline was diagnosed with intravascular large B-cell lymphoma (IVLBCL) by random skin biopsy. Some IVLBCL lesions were identified by PET examinations using 11C-methionine, 18F-FDG, and 18F-THK5351. 11C-methionine and 18F-FDG uptake, which likely reflects the presence of the lymphoma cells themselves, increased clearly in the left putamen but weakly in the left deep white matter. 18F-THK5351 uptake increased in all lesions, likely reflecting perivascular astrogliosis caused by IVLBCL. Hence, 18F-THK5351 PET can evaluate tumor extension in IVLBCL lesions where 11C-methionine and 18F-FDG PET may fail in its visualization.
Is 18F-FDG/18F-Choline Dual-Tracer PET Behavior a Surrogate of Tumor Differentiation in Hepatocellular Carcinoma
Authors: Sivapathasundaram Abarnaa , Golse Nicolas , Pascale Alina , Durand Emmanuel , Sebagh Mylène , Besson Florent L. 
Published: February 2023

Background
In hepatocellular carcinoma (HCC) setting, 18F-FDG and 18F-choline PET/CT radiotracers are classically considered surrogates of the degree of differentiation, a strong predictor of disease recurrence after curative treatment. Because the corresponding level of evidence has never been assessed as primary end point, the aim of this retrospective study was to specifically assess the relevance of 18F-FDG combined to 18F-choline PET imaging as a surrogate of tumor differentiation in HCC.

Patients and Methods
A total of 49 histologically proven HCCs (46 patients treated by surgery or liver transplantation) with available baseline 18F-FDG and 18F-choline PET/CT, dedicated liver contrast-enhanced CT scan, and histological key features were retrospectively reviewed. Hepatocellular carcinoma tumors with well, moderately, and poorly differentiation (grades I, II, and III of the World Health Organization classification) were compared on their PET findings (double-blinded visual analysis and 8 usual semiquantitative metrics) by using nonparametric Kruskal-Wallis analyses of variance. In the case of statistical significance, pairwise post hoc tests with family-wise error rate adjustment were performed.

Results
No statistical difference between the grades was observed for any of the patients’ or lesions’ characteristics (P > 0.05), except for the macrovascular invasion between the grades I and II (adjusted P = 0.03). None of the PET findings showed statistical difference between the grades, except the tumor-to-background ratio of 18F-FDG, higher for the grade III compared with grades I (adjusted P = 0.02) and II (adjusted P = 0.01). For less than one third of cases (14 lesions; 28.5%), the regional uptake was judged visually heterogeneous, but none of the related semiquantitative PET metrics were statistically discriminant (P > 0.05).

Conclusions
Contrary to a common belief, 18F-FDG/18F-choline dual-tracer PET behavior is not a relevant surrogate of tumor differentiation in HCC. Future multitracer PET studies are mandatory to refine our knowledges of their deep biological meaning in this field.
Updates on Diagnosis and Treatment of PIK3CA-Related Overgrowth Spectrum
Authors: Chen Hongrui , Gao Wei , Liu Hongyuan , Sun Bin , Hua Chen , Lin Xiaoxi 
Published: February 2023

Abstract
Hyperactivation of the PI3K/AKT/mTOR signaling pathway caused by PIK3CA mutations is associated with a category of overgrowth syndromes that are defined as PIK3CA-related overgrowth spectrum (PROS). The clinical features of PROS are highly heterogeneous and usually present as vascular malformations, bone and soft tissue overgrowth, and neurological and visceral abnormalities. Detection of PIK3CA variants is necessary for diagnosis and provides the basis for targeted therapy for PROS. Drugs that inhibit the PI3K pathway offer alternatives to conventional therapies. This article reviews the current knowledge of PROS and summarizes the latest progress in precise treatment, providing new insights into future therapies and research goals.
Patient Safety and Quality Improvement Initiatives in Cleft Lip and Palate Surgery: A Systematic Review
Authors: Grue Brendan , McGuire Connor , Hong Paul , Bezuhly Michael 
Published: February 2023

Background:
Cleft lip and/or palate repair techniques require continued reevaluation of best practice through high-quality evidence. The objective of this systematic review was to highlight the existing evidence for patient safety and quality improvement (QI) initiatives in cleft lip and palate surgery.

Methods:
A systematic review of published literature evaluating patient safety and QI in patients with cleft lip and/or palate was conducted from database inception to June 9, 2022, using Preferred Reporting Items for Systematic Reviews guidelines. Quality appraisal of included studies was conducted using Methodological Index for Non-Randomized Studies, Cochrane, or a Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 instruments, according to study type.

Results:
Sixty-one studies met inclusion criteria, with most published between 2010 and 2020 (63.9%). Randomized controlled trials represented the most common study design (37.7%). Half of all included studies were related to the topic of pain and analgesia, with many supporting the use of infraorbital nerve block using 0.25% bupivacaine. The second most common intervention examined was use of perioperative antibiotics in reducing fistula and infection (11.5%). Other studies examined optimal age and closure material for cleft lip repair, early recovery after surgery protocols, interventions to reduce blood loss, and safety of outpatient surgery.

Conclusions:
Patient safety and QI studies in cleft surgery were of moderate quality overall and covered a wide range of interventions. To further enhance PS in cleft repair, more high-quality research in the areas of perioperative pharmaceutical usage, appropriate wound closure materials, and optimal surgical timing are needed.
Alternative Path for Optic Nerve Decompression in Pseudotumor Cerebri With Full Endoscopic Lateral Transorbital Approach
Authors: Ozdogan Sibel , Beton Suha , Gungor Yigit , Comert Ayhan , Bakir Abdurrahman , Kahilogullari Gokmen 
Published: February 2023

Endonasal endoscopic approaches are the most preferred surgical methods in patients with pseudotumor cerebri because of easy access to the optic nerve, but the choice of this technique may not apply to all endoscopic endonasal cases. Moreover, there may be difficulties in practice in some cases, including the coronavirus disease 2019 pandemic. This study aimed to suggest an alternative endoscopic approach by lateral orbitotomy for optic nerve decompression in patients with pseudotumor cerebri. The study was performed using 5 fresh-frozen cadaver heads (bilaterally, total of 10 sides) injected intravenously with colored silicone preserved in the cold chain. An average of 2.5 cm skin incision was made to fit the lateral orbitotomy. The lengths of the recurrent meningeal artery (mm), the meningo-orbital band (mm), and the optic nerve (mm) to the orbital margin were measured. After these morphometric measurements, optic nerve decompression was performed endoscopically, and the length of the decompression was measured (mm). The average length (mm) between the orbital rim and meningeal recurrent artery (or meningolacrimal branch) was 16.2 mm, between the orbital rim and the meningo-orbital band was 18.5 mm, and between the orbital rim and optic nerve was 44.1 mm. The average optic nerve decompression length was 4.4 mm. The endoscopic lateral orbitotomy approach provides easy access to the optic nerve by anatomically following the recurrent meningeal artery and the meningo-orbital band. It can be a safe second-line approach after endonasal approaches for optic nerve decompression in pseudotumor cerebri.
How do Plastic Surgeons use the Metaverse: A Systematic Review
Authors: Sun Pengfei , Zhao Shanbaga , Yang Yang , Liu Chao , Pan Bo 
Published: February 2023

Objective:
In 2021, metaverse became a buzzword. The metaverse is a digital virtual world in which people can live as a digital virtual identity. In the metaverse, people can participate in making rules and create their own worlds. As plastic surgeons in the new era, we have been thinking about the application of the metaverse in plastic surgery. Therefore, we carried out this study to systematically review the current published articles on the application of metaverse in medicine, so as to provide a reference for the rational and effective application of metaverse by plastic surgeons in the future.

Methods:
The researchers searched the Wanfang, Weipu, China National Knowledge Infrastructure (CNKI), PubMed, the Cochrane Library, and the Embase database. The retrieval time was set from the database establishment to April 2022. All studies on the use of the metaverse in medicine were included in our study.

Results:
A total of 4 studies were included in this study. According to our study, the metaverse is mostly used for skill training for residents and medical students. The metaverse was used for the first time to train doctors in lung cancer surgery at Seoul National University Bundang Hospital, Korea. Augmented reality in the metaverse has also been used to aid surgery and to address a variety of medical and mental health problems for patients.

Conclusion:
At present, the application of metaverse is still in the preliminary stage of exploration, and the practical effect of metaverse on plastic surgery needs to be observed and evaluated. Although there are still many problems in the metaverse, the new medical model of plastic surgery supported by the metaverse is worth looking forward to.
Prefabrication—a Vascularized Skin Flap Using an Arteriovenous LoopPrefabricated Flap With Arteriovenous Loop
Authors: Liu Pingping , Wang Weixin , Ma Ning , Li Yangqun , Yang Zhe , Tang Yong 
Published: February 2023

Background:
Arteriovenous loops have a high potency to induce angiogenesis and are promising to solve the problem of scarce implanted pedicle sources and insufficient neovascularization in flap prefabrication. But there is a lack of large animal experiments to support their clinical application. Therefore, we aimed to explore the feasibility of prefabricating large flaps based on arteriovenous loops in pigs.

Methods:
Five minipigs were used. In the experimental group, a 10-cm-long ear vein graft was microanastomosed with the saphenous artery and vein to form an arteriovenous loop and implanted under the medial thigh flap. A month later, a 10×10 cm prefabricated flap pedicled with the arteriovenous loop was elevated and sutured in situ. In the control group, a 10×10 cm flap with no vascular pedicle was elevated completely and sutured in situ in the same position. The patency of the arteriovenous loop was evaluated by angiography 30 days after implantation, and the viability of flaps was assessed by macroscopic analysis 10 days after elevation. Three animals received arteriovenous loop flaps unilaterally and no-pedicle flaps unilaterally. Two animals received arteriovenous loop flaps bilaterally.

Results:
In the experimental group, no thrombi were exhibited in any arteriovenous loop. All 7 prefabricated flaps survived uneventfully. In the control group, 3 flaps were completely necrotic.

Conclusion:
The arteriovenous loops with long interpositional venous grafts can be used as vascular pedicles to prefabricated large area and well-vascularized flaps. This approach can greatly expand the application of flap prefabrication.