Modular custom prosthetic reconstruction of proximal tibia giant cell tumor: a case report and review of literature

Giant cell tumors (GCTs) of bone are primary bone tumors that are benign in nature. They are biologically aggressive and have metastatic potential after malignant transformation. They occur in skeletally mature individual mainly in 3rd decade of life. Here, we present a case of a 29-year-old female diagnosed with right proximal tibia GCT, managed with en bloc excision and custom mega prosthesis arthroplasty

Large osteochondroma excision from distal radius

Osteochondroma is a common benign bone tumor, originating within the periosteum as a small cartilaginous nodule. The distal femur, the proximal tibia, and the proximal humerus are the most common locations and the majority of these lesions cause no symptoms and are discovered incidentally. We present a rare solitary large (approx. 11 cm long) osteochondroma originating from the ventral aspect of the distal end of the radius with mechanical restriction of movement of the wrist joint in an 8-year-old female patient. The biopsy is suggestive of benign chondro-osseous neoplasm favoring the diagnosis of osteochondroma. Surgical intervention with the excision of the osteochondroma of the distal radius was performed and thereby the symptoms showed a complete resolution.

Corpus for Automatic Structuring of Legal Documents

In populous countries, pending legal cases have been growing exponentially. There is a need for developing techniques for processing and organizing legal documents. In this paper, we introduce a new corpus for structuring legal documents. In particular, we introduce a corpus of legal judgment documents in English that are segmented into topical and coherent parts. Each of these parts is annotated with a label coming from a list of pre-defined Rhetorical Roles. We develop baseline models for automatically predicting rhetorical roles in a legal document based on the annotated corpus. Further, we show the application of rhetorical roles to improve performance on the tasks of summarization and legal judgment prediction. We release the corpus and baseline model code along with the paper.Comment: Accepted at LREC 2022, 10 Pages (8 page main paper + 2 page references

SemEval 2023 Task 6: LegalEval -- Understanding Legal Texts

In populous countries, pending legal cases have been growing exponentially. There is a need for developing NLP-based techniques for processing and automatically understanding legal documents. To promote research in the area of Legal NLP we organized the shared task LegalEval - Understanding Legal Texts at SemEval 2023. LegalEval task has three sub-tasks: Task-A (Rhetorical Roles Labeling) is about automatically structuring legal documents into semantically coherent units, Task-B (Legal Named Entity Recognition) deals with identifying relevant entities in a legal document and Task-C (Court Judgement Prediction with Explanation) explores the possibility of automatically predicting the outcome of a legal case along with providing an explanation for the prediction. In total 26 teams (approx. 100 participants spread across the world) submitted systems paper. In each of the sub-tasks, the proposed systems outperformed the baselines; however, there is a lot of scope for improvement. This paper describes the tasks, and analyzes techniques proposed by various teams.Comment: 13 Pages (9 Pages + References), Accepted at SemEval 202

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

1633. Improving the diagnosis of extra-pulmonary tuberculosis (EPTB): experience from north India

Abstract Background Rapid and accurate diagnosis of extra-pulmonary tuberculosis (EPTB) is imperative for early treatment and better patient outcome. Loop-mediated Isothermal Amplification (LAMP) is a promising nucleic-acid amplification assay. LAMP assay could be carried out in simple water bath under isothermal conditions in 60 minutes, and can be performed in any laboratory even in rural setting in resource poor endemic countries. We evaluated LAMP assay using two different target regions LAMP primers specific for Mycobacterium tuberculosis complex for the diagnosis of EPTB. Methods LAMP assay using 6 primers (each for IS6110 and IS1081) specific for Mycobacterium tuberculosis complex were performed on patients suspected of EPTB on various EPTB samples(CSF, Synovial fluid, Lymaphnode and tissue biopsies and various other samples) of 150 patients (50 confirmed, 100 suspected) Clinically suspected of EPTB and 100 non-TB control subjects. Results Overall LAMP test (using any of the two targets) had sensitivity and specificity of 96% and 100% for confirmed (50 culture positive) EPTB cases. In 100 clinically suspected but unconfirmed EPTB cases, LAMP was positive in 87 out of 100 cases (87%). Sensitivity of IS6110 LAMP, 1S1081 LAMP and IS6110 PCR for clinically suspected cases was 78 (78%), 84 (84%) and 70 (70%), respectively. In total 150 EPTB patients, the overall sensitivity of microscopy, culture, IS6110 PCR, IS6110 LAMP, 1081 LAMP and the LAMP test (if any of the two targets were used) were 4%, 33.3%, 74.6%, 82.66%, 87% and 92%, respectively. Specificity of all the tests was 100%. There were 8 cases which were missed by IS6110 LAMP and 2 cases by 1081 LAMP. Conclusion LAMP assay using two targets is a promising technique for rapid diagnosis of EPTB in 60 minutes especially in a resource poor setting who are still battling with this deadly disease. Disclosures All Authors: No reported disclosures </jats:sec