bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safe surgery for every child, implementation of paediatric anaesthesia training in Nigeria
Authors: Desalu Ibironke , Osazuwa Maryrose O. 
Published: June 2022

Purpose of review
Nigeria is the most populous country in Africa and 43.5% of its population is under 15 years. Most of these children do not have access to specialized paediatric anaesthesia care when needed, as there are only few paediatric anaesthetists in the country. We highlight the barriers to safe anaesthesia in children, present training opportunities in paediatric anaesthesia and the need for additional, more extensive training in Nigeria.

Recent findings
The Nigerian paediatric anaesthesia workforce is minimal with a dismal paediatric anaesthetist to child density of 0.028 per 100 000 children <15 years old. Training opportunities in paediatric anaesthesia exist during residency, diploma and master's programmes. Short paediatric anaesthesia-related courses are also provided, sometimes by partnering with nongovernmental organizations. There is at present, no Fellowship training programme in Nigeria, to train specialists and leaders in paediatric anaesthesia.

Summary
To solve the urgent problem of acute shortage of paediatric anaesthetists in Nigeria, general anaesthetists should be empowered through short courses to provide safe anaesthesia for children. A comprehensive Fellowship programme is urgently needed to train specialists in paediatric anaesthesia. Equipment upgrade, creation of children's hospitals and empowerment for research are important end points that require governmental support.
Dementia in a Hearing-impaired Population According to Hearing Aid Use: A Nationwide Population-based Study in Korea
Authors: Byun Hayoung , Chung Jae Ho , Lee Seung Hwan , Kim Eun Mi , Kim Inah 
Published: June 2022

Background:
Hearing loss is considered a potentially modifiable risk factor for dementia. However, the effect of use of a hearing aid on the development of dementia has not been clearly established. We aimed to assess the incidence of dementia in hearing-impaired individuals according to hearing aid use in a nationwide population-based cohort study with matched controls.

Methods:
This was a retrospective, longitudinal, cohort study of South Korean national claims data for individuals newly registered with hearing disabilities (better ear ≥40 dBHL with worse ear ≥80 dBHL, or better ear ≥60 dBHL) between 2004 and 2008. The hearing aid cohort comprised individuals who received hearing aid subsidies from the National Health Insurance within a year from disability registration. The comparison cohort comprised individuals without a record of a hearing aid claim during the study period after 1:1 matching for audiologic and sociodemographic factors with the hearing aid cohort. The occurrence of dementia was followed up until 2018.

Results:
Each cohort comprised 8780 individuals. Overall incidence of dementia in the hearing aid and comparison cohorts were 156.0 and 184.5 per 10,000 person-years, respectively (incidence rate ratio = 0.85, 95% confidence interval 0.79–0.91). In a multivariable analysis of the whole study populations, hearing aid use (hazard ratio = 0.75, 95% confidence interval 0.70–0.81) attenuated the risk of dementia.

Conclusions:
Dementia incidence in individuals with hearing disabilities was lower in hearing aid users than that in nonusers. Hearing rehabilitation with hearing aids should be encouraged for individuals with hearing loss.
Systemic treatment of recurrent and/or metastatic squamous cell carcinomas of the head and neck: what is the best therapeutic sequence?
Authors: Saada-Bouzid Esma , Peyrade Frederic , Guigay Joël 
Published: June 2022

Purpose of review
The treatment of recurrent and/or metastatic head and neck squamous cell carcinoma patients is revolutionized by the advent of anti-PD1 checkpoint inhibitors.

Recent findings
Indeed, Pembrolizumab is approved as monotherapy or used in combination with platin and fluorouracil for first-line patients with tumors expressing PD-L1. Nivolumab and Pembrolizumab are also approved in second line of recurrent/metastatic head and neck squamous cell carcinoma. Moreover, the substitution of fluorouracil for a taxane in the TPEx regimen has shown improvement in safety profile when compared with EXTREME regimen.

Summary
Here we carry out a review of the main results of pivotal trials and discuss the pros and cons of the three possible scenarios when considering the therapeutic sequence (first and second line).
A Case of Clinically Atypical Gelatinous Drop-like Corneal Dystrophy With Unilateral Recurrent Amyloid Depositions
Authors: Maeno Sayo , Soma Takeshi , Nishida Kohji 
Published: June 2022

Purpose:
The purpose of this article was to describe the successful diagnosis and management of clinically atypical, unilateral, gelatinous drop-like corneal dystrophy (GDLD) in a pediatric patient.

Methods:
This study was a case report.

Results:
A 7-year-old Japanese girl was referred to our clinic with right corneal opacity for over 3 years. Slitlamp examination revealed a white, protruding, paracentral corneal opacity with an irregular surface and tiny stromal lattice figures with subepithelial opacities. No trichiasis or epiblepharon was observed, and the patient's right corrected distance visual acuity (CDVA) was 18/20. The contralateral cornea was intact but demonstrated fluorescein uptake. After 8 months, the right CDVA worsened from 18/20 to 6/20, and corneal epithelial scraping was performed. Histopathological analysis revealed amyloid nodules in the subepithelial layer and in the anterior corneal stroma stained with Congo red, which reoccurred 2 months after the procedure, and corneal dystrophy was suspected. Isolation and sequencing of the genomic DNA revealed a homozygous p.Gln118Ter. mutation in TACSTD2 in the patient and heterozygous p.Gln118Ter. mutations in both parents. GDLD was diagnosed; bilateral use of therapeutic soft contact lenses was prescribed after the first corneal scraping. No additional surgical intervention was required for the right eye for 4.5 years. CDVA of the contralateral left eye has been successfully maintained at 30/20 over this period, without emergence of nodular lesions or corneal opacities.

Conclusions:
We encountered a patient with early, atypical GDLD, who was definitively diagnosed using genomic DNA sequencing. GDLD should be a part of the differential diagnosis in patients presenting with unilateral, recurrent amyloid deposition.
Femtosecond LASIK Retreatments After Primary Myopic Photorefractive Keratectomy
Authors: Leccisotti Antonio , Fields Stefania V. , De Bartolo Giuseppe 
Published: June 2022

Purpose:
The purpose of the study was to evaluate the results and complications of laser-assisted in situ keratomileusis (LASIK) using a femtosecond laser as a retreatment modality of myopia and myopic astigmatism after previous myopic photorefractive keratectomy (PRK).

Methods:
In this retrospective, consecutive, noncomparative case series study, 69 eyes of 41 patients receiving femtosecond LASIK after previous myopic PRK were evaluated. The mean age was 43.0 ± 8.9 years. The preoperative mean SE was −1.82 ± 1.01 diopter (D), range −0.62 to −6.25. The mean central epithelial thickness was 65 ± 5 μm. A flap was created using a low-energy femtosecond laser (Ziemer LDV Z8), with a programmed thickness calculated by adding 40 μm to the epithelial thickness. Refractive ablation was performed using a Technolas Teneo 317 laser (Bausch and Lomb).

Results:
Twelve months after LASIK, the mean SE was −0.03 ± 0.17 D, with all eyes ≤0.50 D of SE. The mean DE was 0.30 ± 0.25, with 62 eyes (89.9%) ≤0.50 D and all eyes ≤1 D. The mean corrected distance visual acuity (CDVA) was 0.04 ± 0.10 logMAR; no eye lost more than 1 line of CDVA. The mean uncorrected distance visual acuity was 0.07 ± 0.13 logMAR, being 20/25 or better in all eyes. The safety index (postoperative CDVA/preoperative CDVA) was 1.05. The efficacy index (postoperative uncorrected distance visual acuity/preoperative CDVA) was 0.98. No significant complications occurred.

Conclusions:
Myopic retreatments by femtosecond LASIK after primary PRK yielded excellent refractive results without relevant complications. The flap thickness must be tailored to the epithelial thickening after PRK.
The Challenges of Upper Extremity Intramuscular Hemangioma: A Case Study and Systematic Review
Authors: Abu-Ghname Amjed , Luu Bryan C. , Trost Jeffrey , Raj Sarth , Truong Lauren , Davis Matthew J. , Desai Sudhen B. , Pederson William C. , Maricevich Marco , Maricevich Renata S. 
Published: June 2022

Background:
Intramuscular hemangiomas are rare, benign vascular tumors, constituting 0.8 percent of all hemangiomas. Upper extremity intramuscular hemangiomas pose diagnostic and therapeutic challenges because of their rarity, invasive nature, and potential for neurovascular involvement. The authors report a comprehensive systematic review of upper extremity intramuscular hemangioma management and a challenging case report.

Methods:
A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases were used to identify articles describing upper extremity intramuscular hemangiomas through 2019. Patient demographics, clinical presentation, management, complications, and outcomes were reviewed. Based on operative timing, cases were categorized as either “primary” (excision performed at initial diagnosis) or “secondary” (excision performed after failure of conservative treatment).

Results:
Eighteen articles encompassing 25 patients were included in the authors’ systematic review. Of those, 18 underwent primary excision and seven underwent secondary excision. The majority involved the forearm or antecubital region. Complete excision, evaluated by gross examination or pathology, was reported in all primary cases and 71 percent of secondary cases. Primary excisions demonstrated smaller size of mass (19.4 cm2 versus 165.3 cm2) and superior reported functional outcomes (100 percent versus 33 percent). Complications were reported in 5 percent of the primary excisions compared to 71 percent of the secondary excisions, where one complication was a fatal hematoma.

Conclusions:
The literature concerning upper extremity intramuscular hemangioma is limited to mostly case reports and several case series with the potential risk of bias. With careful dissection and microsurgical technique, wide local excision followed by complete reconstruction can be successfully performed at initial diagnosis for upper extremity intramuscular hemangiomas. At early stages, smaller lesion size significantly reduces the risk of functional impairment and complications.
Evolution of Anomaly-Specific Techniques in Infant Ear Molding: A 10-Year Retrospective Study
Authors: Charipova Karina , Rogers Ashley , Barra Christina , Baker Stephen B. 
Published: June 2022

Background:
Congenital ear anomalies occur in at least one-third of the population, and less than one-third of cases self-correct. Ear molding is an alternative to surgery that spares operative morbidity and allows for significantly earlier intervention. In this retrospective study, the senior author (S.B.B.) developed a tailored approach to each specific type of ear deformity. The use of modifications to adapt standard ear molding techniques for each unique ear are described.

Methods:
The authors conducted a retrospective, institutional review board–approved study of 246 patients who underwent ear molding performed by a single surgeon. The procedure reports for each case were reviewed to develop stepwise customization protocols for existing EarWell and InfantEar systems.

Results:
This review included 385 ears in 246 patients. Patient age at presentation ranged from less than 1 week to 22 weeks. Presenting ear deformities were subclassified into mixed (37.4 percent), helical rim (28.5 percent), prominent (10.6 percent), lidding/lop (9.3 percent), Stahl ear (3.6 percent), conchal crus (3.3 percent), and cupping (2.8 percent). Two patients (0.8 percent) had cryptotia. Deformity subclass could not be obtained for 11 patients (4.5 percent). Recommended modifications to existing ear correction systems are deformity-specific: cotton-tip applicator/setting material (Stahl ear), custom dental compound mold (lidding/lop and cupping), scaphal wire (helical rim), cotton-tip applicator/protrusion excision (prominent), and custom dental compound stent (conchal crus).

Conclusions:
Presentation of ear anomalies is heterogenous. This 10-year experience demonstrates that the approach to ear molding should be dynamic and customized, using techniques beyond those listed in system manuals to complement each ear and to improve outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
A single-subject comparison of functional outcomes between lower limb salvage vs. transtibial amputation through sequential participation in a fall-prevention program
Authors: Acasio Julian C. , Tullos Meghan L. , Mahon Caitlin E. , Khatri Binni R. , Kaufman Kenton R. , Dearth Christopher L. , Hendershot Brad D. 
Published: June 2022

Purpose:
Prior research has noted similar functional and subjective outcomes between individuals with delayed amputation vs. limb salvage; however, these reports are generally retrospective in nature. Here, we prospectively compare functional and subjective outcomes from an individual with limb salvage to a delayed transtibial amputation using a single-subject design with sequential participation in a fall-prevention program.

Materials and Methods:
The subject participated in a fall-prevention rehabilitation training program, once before undergoing a delayed transtibial amputation and again after. As part of the fall-prevention program, the participant completed pretraining and post-training assessments which quantified trunk control by 1) trunk flexion and flexion velocity after trip-inducing perturbations on a treadmill and 2) trunk sway parameters during unstable sitting. In addition, the four square step test was administered, and patient-reported outcomes, including pain, prosthetic/orthotic comfort, and walking/running endurance, were collected.

Results:
In general, the participant demonstrated improved trunk control after amputation, as evidenced by decreases in trunk flexion and flexion velocity after perturbation and sway parameters during unstable sitting. In addition, four square step test times were shorter with amputation vs. limb salvage; the participant also reported reduced pain and greater comfort with amputation (vs. limb salvage).

Conclusions:
Although just a single participant, within-subject comparisons provide quantitative evidence that, for some individuals, delayed/late (transtibial) amputation after prolonged limb salvage may be beneficial in reducing pain and restoring function.
Effect of different undergarment designs on the compliance and acceptance of the patients with adolescent idiopathic scoliosis under orthotic treatment
Authors: Wong Man Sang , Beygi Babak Hassan , Wong Kim Wai , Sin Sai Wing , Kwok Wing Kwan , Wu Hui Dong 
Published: June 2022

Background:
Patient's acceptance and compliance to spinal orthosis could influence the outcome of orthotic treatment in adolescent idiopathic scoliosis. Two innovative undergarments (thin and thick designs) were designed to improve the patient's orthosis wearing experience and acceptance.

Objective:
This study aimed to evaluate the effects of patients' self-provided undergarment and 2 newly designed undergarments with respect to the orthosis wearing compliance and quality of life (QoL) measures.

Methods:
A prospective randomized-controlled study was conducted to compare the effect of three types of undergarments. Thirty-eight subjects with adolescent idiopathic scoliosis were randomly assigned to one of the three groups: self-provided, thin-design, or thick-design undergarment. Wearing compliance logbook, Scoliosis Research Society questionnaire, and Brace Questionnaire were used to document the orthosis wearing period and quantify the health-related and orthosis-related QoL measures. Kruskal-Wallis one-way analysis of variance (ANOVA) and Friedman two-way ANOVA by ranks tests were conducted for intergroup and intragroup comparisons, respectively.

Results:
The compliance and QoL domains of the subjects in the thin-design undergarment group were significantly higher than those of the other two undergarment groups (P < .05). The intragroup compliance and QoL scores varied significantly in the 4 visits throughout the study period (P < .05).

Conclusions:
It was observed that an adaptation period toward the prescribed spinal orthosis is required to help patients gradually achieve a more stable acceptance. The thin-design undergarment was ranked higher than the other two tested undergarments in compliance and QoL measures.
Evaluation of NG-Test CARBA 5 for the detection of carbapenemase-producing Gram-negative bacilli
Authors: Saito Kai , Mizuno Sayaka , Nakano Ryuichi , Tanouchi Ayako , Mizuno Tomoki , Nakano Akiyo , Suzuki Yuki , Kakuta Naoki , Yano Hisakazu 
Published: June 2022

Carbapenemase-producing

Enterobacterales

(CPE) pose one of the most serious antimicrobial resistance threats to public health worldwide. The outcome of CPE infection differs depending on the resistance mechanism. Therefore, rapid detection of CPE infection is essential for optimizing patient management. The carbapenem inactivation method (CIM) and modified CIM (mCIM) are standard methods for detecting CPE, but they usually require 24 h to generate results.
Recently, an immunochromatographic assay, NG-Test CARBA 5, has become commercially available. It detects the five most common carbapenemase producers (KPC, IMP, NDM, VIM, and OXA-48) rapidly and accurately.
We aimed to evaluate the diagnostic accuracy of NG-Test CARBA 5 for detecting carbapenemase-producing Gram-negative bacilli (CPGNB).
We used 116 carbapenemase-producing strains and 48 non-carbapenemase-producing strains. Of the 116 carbapenemase-producing strains, 107 harboured genes for at least one of the five most common carbapenemases, KPC, IMP, NDM, VIM, and OXA-48-like. Forty-eight non-carbapenemase-producing strains, including carbapenem-resistant

Enterobacterales

, harboured genes for extended-spectrum β-lactamases (CTX-M groups [n=25] and SHV groups [n=2]) or plasmid-mediated AmpC β-lactamases (DHA [n=3], CMY-2 [n=2], and CFE-1 [n=1]). Antimicrobial susceptibility was tested using the agar dilution method, according to the Clinical and Laboratory Standards Institute guidelines.
Of the 116 carbapenemase-producing strains, 79 were resistant to at least meropenem or imipenem. The sensitivity and specificity of the NG-Test CARBA 5 for the strains were 99.1 % (106 strains positive for 107 strains of the five most common carbapenemase producers) and 100 % (60 strains negative for other types of CPGNB [n=10] and non-CPGNB strains [n=48]), respectively. The carbapenemase-producing strain with a false-negative result produced IMP-66.
The NG-Test CARBA 5 had high sensitivity and specificity for detecting carbapenemase-producing strains.
Emergent visual creativity in frontotemporal dementia is associated with dorsomedial visual cortex enhancement
Authors: Friedberg Adit , Pasquini Lorenzo , Diggs Ryan , Glaubitz Erika A. , Lopez Lucia , Illán-Gala Ignacio , Iaccarino Leonardo , La Joie Renaud , Mundada Nidhi , Brown Jesse , Allen Isabel Elaine , Rankin Katherine P. , Bonham Luke W. , Yokoyama Jennifer S. , Ramos Eliana M. , Geschwind Daniel H. , Spina Salvatore , Grinberg Lea T. , Miller Zachary A. , Kramer Joel H. , Rosen Howard , Gorno-Tempini Maria Luisa , Rabinovici Gil , Seeley William W. , Miller Bruce L. 
Published: June 2022

ABSTRACTIMPORTANCEThe neurological substrates of visual creativity are unknown. We demonstrate the role of dorsomedial visual cortex in emergence of visual artistic creativity (VAC) in the setting of dementia. Our findings illuminate neural substrates of human creativity and suggest that hyperactivation of specific brain areas may manifest as enhanced cognitive or behavioral capacities.OBJECTIVETo determine the anatomical and physiological underpinnings of VAC in dementia.DESIGN, SETTING, AND PARTICIPANTSAs part of a prospective, longitudinal cohort study focused on frontotemporal dementia (FTD), 734 patients met research criteria for an FTD spectrum disorder between 2002 and 2019. Of these, seventeen showed emergence of visual artistic creativity (VAC-FTD). Two control groups (n = 51 each) were matched to VAC-FTD based on demographic and clinical parameters: (1) Not Visually Artistic FTD (NVA-FTD) and (2) Healthy Controls (HC).MAIN OUTCOMES AND MEASURESClinical, neuropsychological, genetic and neuroimaging data were analyzed to characterize VAC-FTD and compare VAC-FTD to control groups.RESULTSEmergence of VAC occurred around the time of onset of symptoms, and was disproportionately seen in patients with temporal lobe predominant degeneration (n = 8/17). Atrophy network mapping identified a dorsomedial occipital region whose activity inversely correlated, in healthy brains, with activity in the patient-specific atrophy patterns in VAC-FTD (n = 17/17) and NVA-FTD (n = 45/51). Structural covariance analysis revealed that volume of this dorsal occipital region was strongly correlated, in VAC-FTD, but not in NVA-FTD or HC, with a volume in the primary motor cortex corresponding to the right hand representation. One patient, who underwent fluorodeoxyglucose positron emission tomography before and after VAC onset, showed increasing glucose metabolism in the dorsal occipital region over the interval when creativity emerged.CONCLUSIONS AND RELEVANCEFTD lesion-induced intensification of dorsal visual association cortex structure and function predisposes to emergence of VAC in certain environmental or genetic conditions. Paradoxical gains of function are early manifestations of neurodegenerative disease, and this study delineates a specific brain region associated with the emergence of VAC.