bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antipsychotic Medication in Sub-Saharan Africa
Authors: Kumar Sanjana , Sudhakar Shwetha , Sajatovic Martha , Levin Jennifer B. 
Published: October 2020

Abstract

Purpose
There is limited evidence on the use of antipsychotic medications to treat people with schizophrenia in Sub-Saharan Africa (SSA). This systematic literature review identified original research on use of antipsychotic drugs for primary psychotic disorders in SSA, assessed the methodological quality of studies, summarized intervention strategies, and examined patient-level outcomes.

Methods
PubMed, PsychInfo, Cochrane Collaboration, African Journals Online, and CINAHL databases were searched for studies in SSA that focused on antipsychotic treatment for primary psychotic disorders and that investigated at least one patient-level outcome. Articles in English and published before April 2019 were included. Epidemiological studies, drug discontinuation studies, studies with drugs other than antipsychotics, and multicenter studies that did not specify SSA results were excluded. An adapted standardized instrument assessed methodological quality.

Results
Twenty-six articles were reviewed. Three levels of evidence were found: single-group reports, quasi-experimental studies, and randomized controlled trials. Study outcomes included change in psychiatric symptoms, adverse effects, remission rates, or change in functional status. Nine studies reported improvements in psychiatric symptoms with antipsychotic medication. Seven studies investigating adverse effects of antipsychotics found that they were associated with an increase in metabolic syndrome. Two studies reported that remission was achieved in most subjects, and one study reported improvements in functional status.

Conclusions
Despite adverse effects, treatment with antipsychotic medications may be beneficial for individuals with primary psychotic disorders in SSA. Apart from South Africa, there is a scarcity of research on antipsychotics from countries in SSA, and there are numerous important gaps in the literature.
The integration of artificial intelligence models to augment imaging modalities in pancreatic cancer
Authors: Wang Xianze , Chung Wen Yuan , Correa Elon , Zhu Yi , Issa Eyad , Dennison Ashley R. 
Published: October 2020

Abstract
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with a limited number of effective treatments. Using emerging technologies such as artificial intelligence (AI) to facilitate the earlier diagnosis and decision-making process represents one of the most promising areas for investigation. The integration of AI models to augment imaging modalities in PDAC has made great progression in the past 5 years, especially in organ segmentation, AI-aided diagnosis, and radiomics based individualized medicine. In this article, we review the developments of AI in the field of PDAC and the present clinical position. We also examine the barriers to future development and more widespread application which will require increased familiarity of the underlying technology among clinicians to promote the necessary enthusiasm and collaboration with computer professionals.
Treatment for eosinophilic esophagitis
Authors: Syverson Erin Phillips , Hait Elizabeth J. 
Published: October 2020

Purpose of review
To summarize current dietary and pharmacologic approaches in the treatment of eosinophilic esophagitis (EoE).

Recent findings
Studies comparing dietary approaches in EoE treatment support empiric elimination diets as the preferred approach to dietary EoE treatment, with no data to support use of currently available allergy tests to guide specific food elimination diets. Swallowed topical corticosteroid therapy is the current standard of care in pharmacologic EoE treatment, with similar effectiveness of fluticasone and budesonide, but their discontinuation results in return of both EoE symptoms and disease. A number of nonsteroid-based therapies are currently under investigation for the treatment of EoE, which are focused on targeting disease at a cellular level.

Summary
EoE can be treated with diet or medications. Empiric elimination is presently the preferred dietary approach. Swallowed steroids is the standard of care to treat EoE with medication; however, there are several promising drugs currently undergoing clinical trials.
Magnetic Resonance Imaging of the Triangular Fibrocartilage Complex
Authors: Daun Mitchell , Rudd Adam , Cheng Karen , Rezai Farzad 
Published: October 2020

Abstract
The imaging evaluation and interpretation of the triangular fibrocartilage complex (TFCC) is both challenging and rewarding for the radiologist and surgeon alike. The TFCC comprises a complicated group of fibrocartilaginous and ligamentous structures at the ulnar aspect of the wrist that plays an important role in wrist biomechanics. It is the main stabilizer of the distal radioulnar and ulnocarpal joints and functions to distribute compressive forces at the ulnocarpal joint during axial loading. Derangement of the TFCC is the most common source of ulnar-sided wrist pain. Imaging plays an important role in the diagnosis and management of these lesions. The TFCC can anatomically be divided into proximal and distal parts to emphasize the role that the proximal TFCC has in stabilizing the distal radioulnar joint. Tears can be divided into traumatic and degenerative categories using the Palmer classification. Further subclassification based on the location for traumatic tears and the degree of derangement in degenerative tears guides clinical management. The vascular anatomy is important in determining management options for various lesions. A detailed understanding of the normal anatomy of the TFCC, imaging limitations and pitfalls, the Palmer classification system, and current treatment options is critical to the accurate and clinically useful interpretation of radiologic examinations of the TFCC.
Multimodality Pitfalls of Wrist Imaging With a Focus on Magnetic Resonance Imaging
Authors: Hansford Barry G. 
Published: October 2020

Abstract
Numerous pitfalls are frequently encountered at multimodality imaging of the wrist, which may mimic various tendinous, osseous, capsuloligamentous, muscular, and neurovascular pathologic conditions. These pitfalls may be secondary to variant anatomy, artifactual due to magnetic resonance imaging or sonographic technique, or represent varying ranges of structure-specific normal including a spectrum of findings associated with aging in asymptomatic subjects. When an imaging finding of questionable significance is encountered, it is critical that the interpreting radiologist make every attempt to review any relevant clinical information in an effort to determine whether the imaging findings in question may account for the patient's presenting symptomology. In order to accurately diagnose true pathology at wrist imaging, it is imperative that the radiologist be familiar with the pitfalls discussed throughout this manuscript that may mimic disease. This familiarity will allow the radiologist to provide a more useful report for referring providers focusing on true pathology while eliminating potentially confusing or misleading findings which are inconsistent with the patient's clinical presentation.
Course Review
Authors: Johal Kavan S. , Din Asmat H. 
Published: October 2020

Abstract
The combined Norfolk and Norwich & St. Andrew's (Chelmsford) FRCS (Plast) revision course is aimed at preparing candidates for Part 2 of the FRCS examination. It aims to closely replicate the actual examination and is delivered in the same format over 2 days. It differs from other FRCS courses in offering each candidate a significant number of real patient examination scenarios. This review evaluates the course.
A Special Thank You to the Plastic and Reconstructive Surgery Medical Education Community During the COVID-19 Pandemic
Authors: Nnamani Silva Ogonna N. 
Published: October 2020

Abstract
In light of the most competitive match in history, the plastic and reconstructive surgery application process is in the midst of unprecedented times due to the COVID-19 pandemic. In-person visiting subinternships and interview processes have transitioned to online formats. The American Council of Academic Plastic Surgeons, program directors, coordinators, faculty, and residents have demonstrated an outstanding commitment to providing meaningful experiences for prospective applicants. The passion of the field of plastic and reconstructive surgery is palpable, and the innovative virtual experiences have resulted in the formation of a community despite the lack of in-person experiences.
Equity on the frontlines of trauma surgery: An #EAST4ALL roundtable
Authors: Tung Lily , Long Andrea M. , Bonne Stephanie , Tseng Esther S. , Bruns Brandon , Joseph Bellal , Williams Brian H. , Stein Deborah , Freischlag Julie A. , Goulet Nicole , Khandelwal Cathleen , Kiselak Elizabeth , Hoofnagle Mark , Gelbard Rondi , Rattan Rishi , Joseph D’Andrea , Bernard Andrew , Zakrison Tanya L. ,   the Equity, Quality, and Inclusion in Trauma Surgery Practice Ad Hoc Task Force of the Eastern Association for the Surgery of Trauma
Published: October 2020

BACKGROUND
Inequity exists in surgical training and the workplace. The Eastern Association for the Surgery of Trauma (EAST) Equity, Quality, and Inclusion in Trauma Surgery Ad Hoc Task Force (EAST4ALL) sought to raise awareness and provide resources to combat these inequities.

METHODS
A study was conducted of EAST members to ascertain areas of inequity and lack of inclusion. Specific problems and barriers were identified that hindered inclusion. Toolkits were developed as resources for individuals and institutions to address and overcome these barriers.

RESULTS
Four key areas were identified: (1) harassment and discrimination, (2) gender pay gap or parity, (3) implicit bias and microaggressions, and (4) call-out culture. A diverse panel of seven surgeons with experience in overcoming these barriers either on a personal level or as a chief or chair of surgery was formed. Four scenarios based on these key areas were proposed to the panelists, who then modeled responses as allies.

CONCLUSION
Despite perceived progress in addressing discrimination and inequity, residents and faculty continue to encounter barriers at the workplace at levels today similar to those decades ago. Action is needed to address inequities and lack of inclusion in acute care surgery. The EAST is working on fostering a culture that minimizes bias and recognizes and addresses systemic inequities, and has provided toolkits to support these goals. Together, we can create a better future for all of us.
Assessment of the interaction effect between injury regions in multiple injuries: A nationwide cohort study in Japan
Authors: Tachino Jotaro , Katayama Yusuke , Kitamura Tetsuhisa , Kiyohara Kosuke , Nakao Shunichiro , Umemura Yutaka , Ishida Kenichiro , Hirose Tomoya , Nakagawa Yuko , Shimazu Takeshi 
Published: October 2020

BACKGROUND
There have been no clinical studies to sufficiently reveal the interaction effect generated by combinations of injury regions of multiple injuries. We hypothesized that certain combinations of trauma regions might lead to increased risk of traumatic death and aimed to verify this hypothesis using a nationwide trauma registry in Japan.

MATERIALS AND METHODS
This was a retrospective study of trauma patients registered in the Japan Trauma Data Bank between 2004 and 2017. We included patients who suffered blunt trauma with an Injury Severity Score of 16 or more. The trauma was classified into four regions (head, chest, abdomen, and extremities), and a multivariable logistic regression analysis was performed that included interaction terms derived from the combination of two regions as covariates.

RESULTS
We included 78,280 trauma patients in this study. Among them, 16,100 (20.6%) patients were discharged to death. Multivariable logistic regression showed the odds ratio (OR) of in-hospital death compared with patients without injury of an Abbreviated Injury Scale score of 3 or more in each injured region as follows: head score, 2.31 (95% confidence interval [CI], 2.13–2.51); chest score, 2.28 (95% CI, 2.17–2.39); abdomen score, 1.68 (95% CI, 1.56–1.82); and extremities score, 1.84 (95% CI, 1.76–1.93), respectively. In addition, the ORs of the statistically significant interaction terms were as follows: head-chest 1.29 (95% CI, 1.13–1.48), chest-abdomen 0.77 (95% CI, 0.67–0.88), chest-extremities 1.95 (95% CI, 1.77–2.14), and abdomen-extremities 0.70 (95% CI, 0.62–0.79), respectively.

CONCLUSION
In this population, among patients with multiple injuries, a combination of head-chest trauma and chest-extremities trauma was shown to increase the risk of traumatic death.

LEVEL OF EVIDENCE
Prognostic, Level III.
Severe pediatric war trauma: A military-civilian collaboration from retrieval to repatriation
Authors: Samuel Nir , Epstein Danny , Oren Asaf , Shapira Shachar , Hoffmann Yoav , Friedman Nir , Shavit Itai 
Published: October 2020

BACKGROUND
Modern conflicts take a disproportionate and increasing toll on civilians and children. Since 2013, hundreds of Syrian children have fled to the Israeli border. Severely injured children were triaged for military airborne transport and brought to civilian trauma centers in Israel. After recovery, these patients returned to their homes in Syria.
We sought to describe a unique model of a coordinated military-civilian response for the stabilization, transport, and in-hospital management of severe pediatric warzone trauma.

METHODS
Prehospital and in-hospital data of all severe pediatric trauma casualties transported by military helicopters from the Syrian border were extracted. Data were abstracted from the electronic medical records of military and civilian medical centers’ trauma registries.

RESULTS
Sixteen critically injured children with a median age of 9.5 years (interquartile range [IQR], 6.5–11.5) were transported from the Syrian border to Level I and Level II trauma centers within Israel. All patients were admitted to intensive care units. Eight patients underwent lifesaving procedures during flight, 7 required airway management, and 5 required thoracostomy. The median injury severity score was 35 (IQR, 13–49). Seven laparotomies, 5 craniotomies, 3 orthopedic surgeries, and 1 skin graft surgery were performed. The median intensive care unit and hospital length of stay were 6 days (IQR, 3–16) and 34 days (IQR, 14–46), respectively. Fifteen patients survived to hospital discharge and returned to their families.

CONCLUSION
The findings of this small cohort suggest the benefits of a coordinated military-civilian retrieval of severe pediatric warzone trauma.

LEVEL OF EVIDENCE
Therapeutic, Level V.
An Initial Empirical Operationalization of the Earliest Stages of the Alzheimer’s Continuum
Authors: Kiselica Andrew M. , Kaser Alyssa N. , Benge Jared F. 
Published: October 2020

Purpose:
The Alzheimer’s Continuum (AC) includes 2 preclinical stages defined by subjective cognitive complaints, transitional cognitive declines, and neurobehavioral symptoms. Operationalization of these stages is necessary for them to be applied in research.

Methods:
Cognitively normal individuals with known amyloid biomarker status were selected from the National Alzheimer’s Coordinating Center Uniform Data Set. Participants and their caregivers provided information on subjective cognitive complaints, neurobehavioral features, and objective cognitive functioning.

Patients:
The sample included 101 amyloid positive (A+) and 447 amyloid negative (A−) individuals.

Results:
Rates of subjective cognitive complaints (A+: 34.90%, A−: 29.90%) and neurobehavioral symptoms (A+: 22.40%, A−: 22.40%) did not significantly differ between A+/− individuals. However, the frequency of transitional cognitive decline was significantly higher among A+ (38.00%) than A− participants (24.90%). We explored various empirical definitions for defining the early stages of the AC among A+ participants. Rates of classification into AC stage 1 versus AC stage 2 varied depending on the number of symptoms required: 57.40% versus 42.60% (1 symptom), 28.70% versus 71.30% (2 symptoms), and 6.90% versus 93.10% (all 3 symptoms).

Conclusion:
The presence of 2 of the proposed symptom classes to separate AC stage 2 from stage 1 seems to provide a good empirical balance.
Current Practices of Electroconvulsive Therapy in Mental Disorders
Authors: Landry Marilyne , Moreno Alexander , Patry Simon , Potvin Stephane , Lemasson Morgane 
Published: October 2020

Abstract
Electroconvulsive therapy (ECT) remains one of the most effective treatments for major depressive disorder, but uncertainties persist regarding the cognitive tests to include in ECT follow-up. The current study is a systematic review and meta-analysis of the most frequent cognitive side effects after ECT. We also discuss the most common cognitive tests in ECT follow-up. We searched studies published from 2000 to 2017 in English and French language in Pubmed, EBM Reviews, EMBASE, and PsycINFO. Standardized cognitive tests were separated into 11 cognitive domains. Comparisons between cognitive measures included pre-ECT baseline with post-ECT measures at 3 times: PO1, immediately post-ECT (within 24 hours after last ECT); PO2, short term (1–28 days); and PO3, long term (more than 1 month). A total of 91 studies were included, with an aggregated sample of 3762 individuals. We found no significant changes in global cognition with Mini-Mental State Examination at PO1. Hedges g revealed small to medium effect sizes at PO2, with individuals presenting a decrease in autobiographical memory, verbal fluency, and verbal memory. Verbal fluency problems showed an inverse correlation with age, with younger adults showing greater deficits. At PO3, there is an improvement on almost all cognitive domains, including verbal fluency and verbal memory. There is a lack of standardization in the choice of cognitive tests and optimal cognitive timing. The Mini-Mental State Examination is the most common screening test used in ECT, but its clinical utility is extremely limited to track post-ECT cognitive changes. Cognitive assessment for ECT purposes should include autobiographical memory, verbal fluency, and verbal memory.
Pathogenesis-based pre-exposure prophylaxis associated with low risk of SARS-CoV-2 infection in healthcare workers at a designated Covid-19 hospital
Authors: Dubina Michael V. , Gomonova Veronika V. , Taraskina Anastasia E. , Vasilyeva Natalia V. , Sayganov Sergey A. 
Published: October 2020

AbstractAt present, no agents are known to be effective in preventing Covid-19. Based on current knowledge of the pathogenesis of this disease, we suggest that SARS-CoV-2 infection might be attenuated by directly maintaining innate pulmonary redox, metabolic and dilation functions using well-tolerated medications that are known to serve these functions, specifically, using a low dose aerosolized combination of glutathione, inosine and potassium. From June 1 to July 10, 2020, we conducted a low-intervention open-label single-centre study to evaluate safety and efficacy of pre-exposure prophylaxis (PrEP) with the aerosolized combination medications (ACM) on SARS-CoV-2 incidence in 99 healthcare workers (HCWs) at a hospital that was designated to treat Covid-19 patients. We also retrospectively compared SARS-CoV-2 incidence in the ACM users to that in 268 untreated HCWs at the same hospital. Eligible participants received an aerosolized combination of 21.3 mg/ml glutathione, 8.7 mg/ml inosine in 107 mM potassium solution for 14 days. The main outcome was the frequency of laboratory confirmed SARS-CoV-2 cases, defined as individuals with positive genetic or immunological tests within 28 days of the study period. During the PrEP period, solicited adverse events occurred in five participants; all were mild and transient reactions. SARS-CoV-2 was detected in 2 ACM users (2%, 95% CI: 0.3% to 7.1%), which was significantly less than the incidence in 24 nonusers (9%, 95% CI: 5.8% to 13.0%; P = 0.02). Our findings might be used either to prevent SARS-CoV-2 infection, or to support ongoing and new research into more effective treatments for Covid-19. The study was registered with rosrid.ru, AAAA-A20-120061690058-2, and isrctn.com, ISRCTN34160010.
Benchmarking COVID-19 Mortality in the United States
Authors: Etzioni Ruth , Markowitz Elan , Douglas Ivor S. 
Published: October 2020

AbstractOn September 22nd the US officially recorded 200,000 COVID-19 deaths. It is unclear how many deaths might have been expected in the case of an early and effective response to the pandemic. We aim to provide a best-case estimate of COVID-19 deaths in the US by September 22nd using the experience of Germany as a benchmark. Our methods accommodate the differences in demographics between Germany and the US. We match cumulative incidence of COVID-19 deaths by age group in Germany to non-Hispanic whites in the US and project the implied number of deaths in this population and among the black and Hispanic populations under observed racial/ethnic disparities in cumulative COVID-19 mortality in the US. We estimate that if the US had been as successful as Germany in managing the pandemic we would have expected 22% of the deaths actually recorded. The number of deaths would have been lower by a further one-third if we could have eliminated racial/ethnic disparites in COVID-19 outcomes. We conclude that almost 80 percent of the COVID-19 deaths in the US by September 22nd could have been avoided with an early and effective response producing similar age-specific death rates among non-Hispanic whites as in Germany.
Geographical based variations in white truffleTuber magnatumtruffle aroma is explained by quantitative differences in key volatile compounds
Authors: Niimi Jun , Deveau Aurélie , Splivallo Richard 
Published: October 2020

SummaryThe factors that vary the aroma ofTuber magnatumfruiting bodies are poorly understood. The study determined the headspace aroma composition, sensory aroma profiles, maturity, and microbiome composition fromT. magnatumoriginating from Italy, Croatia, Hungary, and Serbia, and tested if truffle aroma is dependent on provenance and if fruiting body volatiles are explained by maturity and/or microbiome composition.Headspace volatile profiles were determined by gas chromatography-mass spectrometry-olfactometry (GC-MS-O) and aroma of fruiting body extracts were sensorially assessed. Fruiting body maturity were estimated through spore melanisation. Bacterial community was determined using 16S rRNA amplicon sequencing.Main odour active compounds were present in all truffles but varied in concentration. Aroma of truffle extracts were sensorially discriminated by sites. However, volatile profiles of individual fruiting bodies varied more within sites than across geographic area, while maturity level did not play a role. Microbiome composition varied highly and was partially explained by provenance. A few rare bacterial operational taxonomical units associated with select few non-odour active volatile compounds.Specificities of the aroma ofT. magnatumtruffles are more likely linked to individual properties than provenance. Some constituents of the microbiome may provide biomarkers of provenance and be linked to non-odour active volatiles.