bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urine Lipoarabinomannan Testing for All HIV Patients Hospitalized in Medical Wards Identifies a Large Proportion of Patients With Tuberculosis at Risk of Death
Authors: Huerga Helena , Mathabire Rucker Sekai Chenai , Bastard Mathieu , Mpunga James , Amoros Quiles Isabel , Kabaghe Chimwemwe , Sannino Laura , Szumilin Elisabeth 
Published: December 2020

Abstract

Background
Diagnosing tuberculosis (TB), the leading cause of death in people with HIV, remains a challenge in resource-limited countries. We assessed TB diagnosis using a strategy that included systematic urine lipoarabinomannan (LAM) testing for all HIV patients hospitalized in medical wards and 6-month mortality according to LAM results.

Methods
This prospective, observational study included adult HIV patients hospitalized in the medical wards of a public district hospital in Malawi regardless of their TB symptoms or CD4 count. Each patient had a clinical examination, and Alere Determine TB-LAM, sputum microscopy, sputum GeneXpert MTB/RIF (Xpert), chest x-ray, and CD4 count were systematically requested.

Results
Among 387 inpatients, 54% had a CD4 &lt;200 cells/µL, 64% had presumptive TB, and 90% had ≥1 TB symptom recorded in their medical file. LAM results were available for 99.0% of patients, microscopy for 62.8%, and Xpert for 60.7%. In total, 26.1% (100/383) had LAM-positive results, 48% (48/100) of which were grades 2–4. Any TB laboratory test result was positive in 30.8% (119/387). Among patients with no Xpert result, 28.5% (43/151) were LAM-positive. Cumulative 6-month mortality was 40.1% (151/377): 50.5% (49/97) in LAM-positives and 36.2% (100/276) in LAM-negatives (P = .013). In multivariable regression analyses, LAM-positive patients had a higher risk of mortality than LAM-negatives (adjusted odds ratio, 2.5; 95% CI, 1.1–5.8; P = .037).

Conclusions
In resource-limited hospital medical wards with high TB prevalence, a diagnostic strategy including systematic urine LAM testing for all HIV patients is an easily implementable strategy that identifies a large proportion of patients with TB at risk of death.
When Selling Becomes Viral: Disruptions in Debt Markets in the COVID-19 Crisis and the Fed’s Response
Authors: Haddad Valentin , Moreira Alan , Muir Tyler 
Published: December 2020

AbstractWe document extreme disruption in debt markets during the COVID-19 crisis: a severe price crash accompanied by significant dislocations at the safer end of the credit spectrum. Investment-grade corporate bonds traded at a discount to credit default swaps; exchange-traded funds traded at a discount to net asset value, more so for safer bonds. The Federal Reserve’s announcement of corporate bond purchases caused these dislocations to disappear and prices to recover. These facts inform potential theories of the disruption. The best explanation is an acute liquidity need for specific bond investors, such as mutual funds, leading them to liquidate large positions.
Profiling severe acute respiratory syndrome coronavirus 2 and its relevance to otolaryngologic examinations during the coronavirus disease 2019 pandemic
Authors: Chan Catherine P.L. , Chan Jason Y.K. 
Published: December 2020

Purpose of review
The WHO announced the coronavirus disease 2019 (COVID-19) outbreak as a pandemic in February 2020 with over 15 million confirmed cases of COVID-19 globally to date. Otolaryngologists are at a high risk of contracting COVID-19 during this pandemic if there is inadequate and improper personal protective equipment provision, as we are dealing with diseases of the upper-aerodigestive tract and routinely engaged in aerosol-generating procedures.

Recent findings
This article discusses the background and transmission route for severe acute respiratory syndrome coronavirus 2, its viral load and temporal profile as well as precaution guidelines in outpatient and operative setting in otorhinolaryngology.

Summary
As it is evident that COVID-19 can be transmitted at presymptomatic or asymptomatic period of infections, it is essential to practice ear, nose, and throat surgery with high vigilance in a safe and up-to-standard protection level during the pandemic. This article provides a summary for guidelines and recommendations in otorhinolaryngology.
Impact of nodal involvement on survival outcomes in chondrosarcoma: retrospective cohort analysis of Surveillance, Epidemiology, and End Results (SEER) database (2004–2015)
Authors: Cranmer Lee D. , Chau Bonny , Thompson Matthew J. , Loggers Elizabeth T. , Pollack Seth M. , Wagner Michael J. , Kim Teresa S. , Kim Edward Y. , Kane Gabrielle M. , Pavey Gabriel J. 
Published: December 2020

Objectives:
Factors associated with nodal involvement in chondrosarcoma and outcomes based on treatment modality were analyzed using the Surveillance, Epidemiology, and End Results (SEER) database.

Methods:
Chondrosarcomas involving axial and appendicular parts of the body diagnosed from 2004 to 2015 were identified in SEER. Clinical, pathologic, and treatment parameters were compared with respect to nodal status at initial diagnosis by Fisher’s exact or Student’s t-test. Disease-specific survival (DSS) and overall survival (OS) were evaluated by Kaplan-Meier analyses, and by Cox regression models.

Results:
Synchronous regional nodal metastases were present in 1.3% of chondrosarcoma patients. Lymph node involvement was associated with primary tumor location in extraskeletal tissue and the pelvis, and with distant metastasis and larger primary tumor size at diagnosis. Patients with nodal involvement had 5-year DSS of 48% [95% confidence interval (CI): 28%–65%], versus 82% (95% CI: 80%–84%) for those without (log-rank P<0.001). 5-year OS with and without nodal involvement were 38% (95% CI: 21%–55%) and 73% (95% CI: 71%–75%), respectively (log-rank P<0.001). Surgical excision of nodes was associated with improved DSS and OS. Radiation and chemotherapy were not associated with improved DSS/OS.

Conclusions:
The nodal disease is uncommon at presentation in chondrosarcoma. Greater clinical vigilance for regional nodal metastases may be warranted for those with specific risk factors, including extraskeletal or pelvic primary sites, myxoid, mesenchymal, or dedifferentiated histologies, and large size. Surgical excision of regional nodes is associated with improved DSS/OS. This analysis suggests a therapeutic effect of surgical treatment, rather than selection for favorable underlying biological factors.
Analysis of disease progression and prognosis in differentiated thyroid cancer with pulmonary metastases: a retrospective study
Authors: Iwasaki Hiroyuki , Toda Soji , Murayama Daisuke , Matsui Ai 
Published: December 2020

Introduction:
Pulmonary metastasis originating from differentiated thyroid cancer is rare. Pulmonary metastasis generally progresses slowly and results in a relatively long prognosis when treated with radioactive iodine therapy and thyroid-stimulating hormone suppression therapy. However, some cases still result in death. Since 2015, lenvatinib administration for pulmonary metastases with disease progression has yielded satisfactory results.

Materials and methods:
Among the 798 patients with differentiated thyroid cancer treated at Kanagawa Cancer Center, Japan, between April 2015 and March 2020, 194 had distant metastasis. Of these 194 patients, 118 diagnosed with pulmonary metastasis had lesions that influence the prognosis. We retrospectively investigated the transition of the maximum diameter of pulmonary metastases, serum thyroglobulin, follow-up, and survival time.

Results:
We included 83 follow-up cases and 35 patients treated with lenvatinib. Considering that the disease progressed, 35 patients were treated with lenvatinib, and 4 died from cancer-specific disease. Treatment results were evaluated as progressive disease, stable disease, and partial response in 2, 11, and 22 patients, respectively.

Conclusions:
Among pulmonary metastases, no death occurred because of relatively slow disease progression up to a maximum diameter of 10 mm. However, when the size exceeded 15 mm, radioactive iodine treatment and thyroid-stimulating hormone suppression therapy did not work, and disease progression accelerated. As long as the lenvatinib treatment could be continued, the disease could be controlled satisfactorily. The patients who discontinued lenvatinib died from disease progression.
Evaluating reliability and validity of the modified radiographic union scale for tibia (mRUST) among North American and Tanzanian surgeons
Authors: Coburn Alexander , Shearer David , Albright Patrick , Ali Syed , Roberts Heather J. , Haonga Billy , Eliezer Edmund , Chu Kevin , Morshed Saam 
Published: December 2020

Abstract

Objectives:
To determine the international reliability and validity of the modified Radiographic Union Scale for Tibial fracture (mRUST) scoring method for open tibial shaft fractures based on ratings of radiographs by separate groups of North American and Tanzanian surgeons.

Methods:
Seven North American and 9 Tanzanian surgeons viewed 100 pairs of AP and lateral radiographs of open tibial shaft fractures obtained in Dar Es Salaam, Tanzania. The radiographs showed 25 patients’ fractures at 4 time points postfracture after treatment with either external fixation or intramedullary nailing. Surgeons evaluated each fracture using the mRUST scoring method and indicated their confidence that the fracture was healed on a scale from 1 to 10. Reliability of mRUST was determined using inter-rater agreement among North American and Tanzanian surgeons. Validity was determined via analysis of correlation between mRUST scores and EQ-5D-3L index scores at each time point postfracture.

Results:
mRUST scores demonstrated strong reliability overall (ICC = 0.64) as well as within each group of North American (ICC = 0.72) and Tanzanian (ICC = 0.69) surgeons. Reliability was stronger for external fixation than for intramedullary nailing cases. mRUST scores were significantly correlated with overall healing confidence at all time points and with quality of life at 6 months and 1 year postfracture. mRUST scores also correlated significantly with patients’ quality of life scores (EQ-5D index) at 6 months and 1 year postfracture.

Conclusion:
North American and Tanzanian surgeons exhibited strong agreement in rating open tibial shaft fractures. Using mRUST scores is a valid means of assessing radiographic healing of tibial fractures in austere environments like Tanzania.
Advancing the Evidence Base of Pediatric Physical Therapy: “Sincerely, From the Heart”
Authors: Bartlett Doreen J. 
Published: December 2020

Purpose:
To share reflections on themes that have become important to me as a developing pediatric physical therapy researcher contributing to knowledge generation in our field.

Key Points:
The themes are: select strong mentors, assemble a research team with diverse perspectives and strengths, be family-centered, be rigorous in approaches to study design to match the research question, mentor the next generation, and engage in knowledge translation and exchange.

Conclusions:
I encourage everyone to reflect on who has been or could be your mentors or mentees, and on how you can be a part of an effective, family-centered research team, by encouraging a breadth of research designs to answer the many research questions that remain and by assisting in the implementation of knowledge to practice.

Clinical Relevance:
Outcomes for children and families receiving pediatric physical therapy services are enhanced through the use of evidence-based knowledge.
Dermal Shift Umbilical Reconstruction: An Innovative and Simple Technique
Authors: Yousif N. John , Venditto Chelsea , Matloub Hani S. 
Published: December 2020

Summary:
Umbilical reconstruction is a procedure with widespread indications in the setting of congenital or postsurgical loss. Reconstruction of the umbilicus when no remnant of the natural umbilicus is present is also called neoumbilicoplasty. Numerous neoumbilicoplasty techniques have been published, including cartilage grafts, full-thickness skin grafts, and multiflap reconstruction. No consensus has been reached regarding an optimal technique, and many procedures involve complicated designs with small flaps that are difficult to reproduce or explain. The authors divide patients into three types depending on the thickness of the adipose layer of the abdomen. With appropriate patient selection and minor variations depending on patient type, the technique can be applied to all patients. The umbilicus is marked in the appropriate position. Local anesthesia is infiltrated, and the area beneath the skin is defatted. The dermis is then applied to the underlying fascia with a superior shift. The authors describe the technique and its variations and present one illustrative case with additional supplemental digital content. The authors have gone through a progression of techniques to find a simple surgical method yielding consistently reproducible results with minimal complexity, limited morbidity, and an aesthetic final outcome. The authors believe that the technique described here achieves those goals. It can be performed under local anesthetic and with a simple occlusive dressing so that the patient can go on with most of his or her daily activities. There is no scar to suggest a surgical procedure, and patients are extremely happy with the aesthetic outcomes.
Anticholestatic Effect of Bardoxolone Methyl on Hepatic Ischemia-reperfusion Injury in Rats
Authors: Kim Joohyun , Hagen Catherine E. , Kumar Suresh N. , Park Jong-In , Zimmerman Michael A. , Hong Johnny C. 
Published: December 2020

Background.
Cholestasis is a sign of hepatic ischemia-reperfusion injury (IRI), which is caused by the dysfunction of hepatocyte membrane transporters (HMTs). As transcriptional regulation of HMTs during oxidative stress is mediated by nuclear factor erythroid 2-related factor 2, we hypothesized that bardoxolone methyl (BARD), a nuclear factor erythroid 2-related factor 2 activator, can mitigate cholestasis associated with hepatic IRI.

Methods.
BARD (2 mg/kg) or the vehicle was intravenously administered into rats immediately before sham surgery, 60 min of ischemia (IR60), or 90 min of ischemia (IR90); tissue and blood samples were collected after 24 h to determine the effect on key surrogate markers of bile metabolism and expression of HMT genes (Mrp (multidrug resistance-associated protein) 2, bile salt export pump, Mrp3, sodium-taurocholate cotransporter, and organic anion-transporting polypeptide 1).

Results.
Significantly decreased serum bile acids were detected upon BARD administration in the IR60 group but not in the IR90 group. Hepatic tissue analyses revealed that BARD administration increased mRNA levels of Mrp2 and Mrp3 in the IR60 group, and it decreased those of bile salt export pump in the IR90 group. Protein levels of multidrug resistance–associated protein 2, multidrug resistance–associated protein 3, and sodium-taurocholate cotransporter were higher in the IR90 group relative to those in the sham or IR60 groups, wherein the difference was notable only when BARD was administered. Immunohistochemical and morphometric analyses showed that the area of expression for multidrug resistance–associated protein 2 and for sodium-taurocholate cotransporter was larger in the viable tissues than in the necrotic area, and the area for multidrug resistance–associated protein 3 was smaller; these differences were notable upon BARD administration.

Conclusions.
BARD may have the potential to change HMT regulation to mitigate cholestasis in hepatic IRI.
SARS-CoV-2 neutralizing antibodies; longevity, breadth, and evasion by emerging viral variants
Authors: Tea Fiona , Stella Alberto Ospina , Aggarwal Anupriya , Darley David Ross , Pilli Deepti , Vitale Daniele , Merheb Vera , Lee Fiona X. Z. , Cunningham Philip , Walker Gregory J. , Brown David A. , Rawlinson William D. , Isaacs Sonia R. , Mathivanan Vennila , Hoffman Markus , Pöhlmann Stefan , Dwyer Dominic E. , Rockett Rebeca , Sintchenko Vitali , Hoad Veronica C. , Irving David O. , Dore Gregory J. , Gosbell Iain B. , Kelleher Anthony D. , Matthews Gail V. , Brilot Fabienne , Turville Stuart G 
Published: December 2020

AbstractThe SARS-CoV-2 antibody neutralization response and its evasion by emerging viral variants are unknown. Antibody immunoreactivity against SARS-CoV-2 antigens and Spike variants, inhibition of Spike-driven virus-cell fusion, and infectious SARS-CoV-2 neutralization were characterized in 807 serial samples from 233 RT-PCR-confirmed COVID-19 individuals with detailed demographics and followed up to seven months. A broad and sustained polyantigenic immunoreactivity against SARS-CoV-2 Spike, Membrane, and Nucleocapsid proteins, along with high viral neutralization were associated with COVID-19 severity. A subgroup of ‘high responders’ maintained high neutralizing responses over time, representing ideal convalescent plasma therapy donors. Antibodies generated against SARS-CoV-2 during the first COVID-19 wave had reduced immunoreactivity and neutralization potency to emerging Spike variants. Accurate monitoring of SARS-CoV-2 antibody responses would be essential for selection of optimal plasma donors and vaccine monitoring and design.One Sentence SummaryNeutralizing antibody responses to SARS-CoV-2 are sustained, associated with COVID19 severity, and evaded by emerging viral variants
The auditory Mismatch Negativity reflects accelerated aging in adults with Down’s Syndrome
Authors: Avancini Chiara , Jennings Sally , Chennu Srivas , Noreika Valdas , Le April , Bekinschtein Tristan , Walpert Madeleine , Clare Isabel , Holland Anthony , Zaman Shahid , Ring Howard 
Published: December 2020

AbstractDown’s Syndrome (DS) is associated with premature and accelerated ageing and a propensity for early-onset Alzheimer’s disease (AD). The early symptoms of dementia in people with DS may reflect frontal lobe vulnerability to amyloid deposition. The Mismatch Negativity (MMN) is a frontocentral component elicited by auditory violations of expected sensory input and it reflects sensory memory and automatic attention switching. In the typically developing (TD) population, the MMN response has been found to decrease with age. In the cross-sectional phase of this study the MMN was used to investigate the premature neurological ageing hypothesis of DS. In the longitudinal phase, we evaluated the MMN as a potential predictor of cognitive decline. The study found that age predicted MMN amplitude in DS but not in those who are TD, showing that the MMN reflects accelerated ageing in DS. However, a follow-up of 34 adults with DS found that neither amplitude nor latency of the MMN predicted cognitive decline one year later.
Time use and social mixing during and around festive periods: Potential changes in the age distribution of COVID-19 cases from increased intergenerational interactions
Authors: van Leeuwen Edwin , Sandmann Frank G. , Eggo Rosalind M. ,   PHE Joint modelling group, White Peter J. 
Published: December 2020

AbstractRationaleAmid the ongoing coronavirus disease 2019 (COVID-19) pandemic in which many countries have adopted physical distancing measures, tiered restrictions, and episodic “lockdowns,” the impact of potentially increased social mixing during festive holidays on the age distribution of new COVID-19 cases remains unclear.ObjectiveWe aimed to gain insights into possible changes in the age distribution of COVID-19 cases in the UK after temporarily increased intergenerational interactions in late December 2020.MethodWe modelled changes in time use and social mixing based on age-stratified contact rates using historical nationally-representative surveys and up-to-date Google mobility data from four weeks before and after the festive period. We explored changes in the effective reproduction number and the age distribution of cases, in four scenarios: (1) “normal”: time use and contact patterns as observed historically, (2) “pre-lockdown”: patterns as seen before the lockdown in November 2020, (3) “lockdown”: patterns restricted as in November 2020, and (4) “festive break”: similar to 3 but with social visits over the holiday period as in 1.ResultsAcross ages, the estimated Reff decreases during the festive break in scenarios 1-3 and returns to pre-holiday levels in scenarios 2-3, while remaining relatively stable in scenario 4. Relative incidence is likely to decrease in children aged 0-15 but increase in other ages. Changes in age distribution were large during the holidays, and are likely to start before the holidays for individuals aged 16-24 years in scenarios 1-3.ConclusionsOur modelling findings suggest that increased contacts during the festive period may shift the age distribution of COVID-19 cases from children towards adults. Given that COVID-19-related hospitalisations and deaths rise by age, more intergenerational mixing risks an increased burden in the period following the holidays.HighlightsHome visits are associated with increased intergenerational mixing.The effective reproduction number is likely to remain stable or even reduce slightly due to a reduction in contacts at work and school.Relative incidence is likely to become lower in children, but higher in theolder (more vulnerable) age groups around the holiday period, which could lead to increased health care burden.
Emergence and rapid spread of a new severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) lineage with multiple spike mutations in South Africa
Authors: Tegally Houriiyah , Wilkinson Eduan , Giovanetti Marta , Iranzadeh Arash , Fonseca Vagner , Giandhari Jennifer , Doolabh Deelan , Pillay Sureshnee , San Emmanuel James , Msomi Nokukhanya , Mlisana Koleka , von Gottberg Anne , Walaza Sibongile , Allam Mushal , Ismail Arshad , Mohale Thabo , Glass Allison J , Engelbrecht Susan , Van Zyl Gert , Preiser Wolfgang , Petruccione Francesco , Sigal Alex , Hardie Diana , Marais Gert , Hsiao Marvin , Korsman Stephen , Davies Mary-Ann , Tyers Lynn , Mudau Innocent , York Denis , Maslo Caroline , Goedhals Dominique , Abrahams Shareef , Laguda-Akingba Oluwakemi , Alisoltani-Dehkordi Arghavan , Godzik Adam , Wibmer Constantinos Kurt , Sewell Bryan Trevor , Lourenço José , Alcantara Luiz Carlos Junior , Pond Sergei L Kosakovsky , Weaver Steven , Martin Darren , Lessells Richard J , Bhiman Jinal N , Williamson Carolyn , de Oliveira Tulio 
Published: December 2020

SummaryContinued uncontrolled transmission of the severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) in many parts of the world is creating the conditions for significant virus evolution. Here, we describe a new SARS-CoV-2 lineage (501Y.V2) characterised by eight lineage-defining mutations in the spike protein, including three at important residues in the receptor-binding domain (K417N, E484K and N501Y) that may have functional significance. This lineage emerged in South Africa after the first epidemic wave in a severely affected metropolitan area, Nelson Mandela Bay, located on the coast of the Eastern Cape Province. This lineage spread rapidly, becoming within weeks the dominant lineage in the Eastern Cape and Western Cape Provinces. Whilst the full significance of the mutations is yet to be determined, the genomic data, showing the rapid displacement of other lineages, suggest that this lineage may be associated with increased transmissibility.