bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isolated intracranial hypertension associated with COVID-19
Authors: Silva Marcus Tulius T , Lima Marco A , Torezani Guilherme , Soares Cristiane N , Dantas Claudia , Brandão Carlos Otávio , Espíndola Otávio , Siqueira Marilda M , Araujo Abelardo QC 
Published: November 2020

Background Headache is a frequent complaint in COVID-19 patients. However, no detailed information on headache characteristics is provided in these reports. Our objective is to describe the characteristics of headache and the cerebrospinal fluid (CSF) profile in COVID-19 patients, highlighting the cases of isolated intracranial hypertension. Methods In this cross-sectional study, we selected COVID-19 patients who underwent lumbar puncture due to neurological complaints from April to May 2020. We reviewed clinical, imaging, and laboratory data of patients with refractory headache in the absence of other encephalitic or meningitic features. CSF opening pressures higher than 250 mmH2O were considered elevated, and from 200 to 250 mmH2O equivocal. Results Fifty-six COVID-19 patients underwent lumbar puncture for different neurological conditions. A new, persistent headache that prompted a CSF analysis was diagnosed in 13 (23.2%). The pain was throbbing, holocranial or bilateral in the majority of patients. All patients had normal CSF analysis and RT-qPCR for SARS-CoV-2 was negative in all samples. Opening pressure >200 mmH2O was present in 11 patients and, in six of these, > 250 mmH2O. 6/13 patients had complete improvement of the pain, five had partial improvement, and two were left with a daily persistent headache. Conclusions In a significant proportion of COVID-19 patients, headache was associated to intracranial hypertension in the absence of meningitic or encephalitic features. Coagulopathy associated with COVID-19 could be an explanation, but further studies including post-mortem analysis of areas of production and CSF absorption (choroid plexuses and arachnoid granulations) are necessary to clarify this issue.
Food Insecurity in Tribal High Migration Communities in Rajasthan, India
Authors: Saxena Anupriya , Amin Arpita , Mohan Sanjana Brahmawar , Mohan Pavitra 
Published: November 2020

Background: The COVID pandemic and subsequent lockdown has disrupted food supplies across large parts of India, where even prior to the pandemic, food insecurity and malnutrition were widely prevalent. Tribal populations in southern Rajasthan, India, live in extreme scarcity, rely mainly on outward migration for sustenance, and have been significantly affected by the pandemic. In this study, we assess the availability of foodstuffs at the household level and community experiences about satiety and hunger during lockdown. Methodology: We conducted a rapid assessment of food security in rural southern Rajasthan, India, using a structured questionnaire. Trained interviewers conducted telephonic interviews using KoBoToolbox, an open-source tool. A total of 211 respondents including community volunteers, family members of tuberculosis patients and malnourished children, pregnant women, and influential members in the villages participated in the study. Results: A cereal was reported to be present by 97% of the respondents, two-thirds had pulses, and nearly half had milk. The amount of cereals available was adequate for about 5 months and that of pulses, oil/ ghee, and sugar for about 1 to 2 weeks. Two-thirds of the respondents reported that food in their households was sometimes not sufficient for the amount they wanted to eat, and 97% of these mentioned not having money to buy food as the reason for not having sufficient food. Conclusion: This study highlights widespread food insecurity among tribal communities in southern Rajasthan, and the scenario is likely to be similar in other tribal migration dependent areas of the country.
Evaluation of Lefort I Osteotomy Line and Pterygomaxillary Junction Region in Patients With Cleft Lip and Palate
Authors: Sancar Bahadır , Duman Şuayip Burak 
Published: November 2020

Objective: This study aimed to evaluate the Le Fort I osteotomy line and pterygomaxillary junction via cone-beam computed tomography in individuals with cleft lip and palate (CLP). Design: Retrospective study. Patients and Methods: The study included individuals older than 16 years with CLP, who were scheduled for repositioning of the maxilla by Le Fort I osteotomy, and those with class III malocclusion with maxillary hypoplasia, who were scheduled for Le Fort I osteotomy. The measurements made in the area of the cleft of individuals with CLP were compared with both the side with no cleft and those with class III malocclusion with maxillary hypoplasia. A total of 11 measurements were made on the axial section parallel to the Frankfurt Horizontal plane, corresponding to the lower 1/5 of the distance between the infraorbital foramen and the anterior nasal spine. Results: There were significant differences both in the comparisons made between the individuals with CLP and those without CLP in terms of the canal-anterior alveolar crest (G) and sinus-anterior alveolar crest (L) measurements ( P < .05). The mean measurement values showed that the measurement results were higher in individuals with CLP in general. Conclusion: In conclusion, we believe that there might be difficulties both in osteotomy and down fracture stages during Le Fort I osteotomies performed in individuals with CLP.
Osilodrostat: A Novel Steroidogenesis Inhibitor to Treat Cushing’s Disease
Authors: Dougherty John A. , Desai Divya Sanjaykumar , Herrera Javier Barrios 
Published: November 2020

Objective: To review data on efficacy and safety of osilodrostat (Isturisa), a novel oral steroidogenesis inhibitor for treatment of Cushing’s disease (CD), a life-threatening endocrine disorder. Data Sources: A PubMed/CINAHL search from inception to September 25, 2020, was performed using the following keywords: osilodrostat, 11-beta hydroxylase, pituitary, ACTH hypersecretion, and Cushing’s disease. Study Selection and Data Extraction: Phase 2 and 3 clinical trials and supplementary documents investigating osilodrostat were obtained from a primary literature search, the manufacturer’s website, and the Food and Drug Administration website. These articles evaluated the clinical pharmacology, efficacy, safety, adverse events, warnings, and precautions for osilodrostat. Data Synthesis: Osilodrostat was efficacious and safe in the treatment of CD in mostly middle-aged Caucasian women. A pivotal phase 3 study revealed a significant difference in 24-hour mean urinary free cortisol (primary end point) between osilodrostat and placebo (86% vs 29%; P < 0.001). Relevance to Patient Care and Clinical Practice: Osilodrostat provides a potent and consistent effect in reducing life-threatening supraphysiological levels of cortisol in patients with CD. Hypocortisolism adverse effects can be mitigated by slowly increasing osilodrostat’s dose at ≥2-week intervals. QT interval prolongation was noted; therefore, the QT interval must be monitored by the electrocardiogram. Increased levels of cortisol precursors during treatment with osilodrostat may increase the risk of hypokalemia, edema, and hypertension. Conclusions: Osilodrostat was efficacious in decreasing cortisol levels and safe in treating patients who have failed or are ineligible for pituitary surgery. Although risks exist, a pivotal clinical trial revealed efficacy in 86% of participants.
First Metatarsophalangeal Arthrodesis After Failed Distal Chevron Osteotomy for Hallux Valgus
Authors: Garcia-Ortiz Maria Tiscar , Talavera-Gosalbez Jose Juan , Moril-Peñalver Lorena , Fernandez-Ruiz Maria Dolores , Alonso-Montero Carolina , Lizaur-Utrilla Alejandro 
Published: November 2020

Background: The purpose of this study was to compare the clinical outcomes after first metatarsophalangeal (MTP) joint arthrodesis for hallux rigidus between patients who underwent primary arthrodesis and those who had had a prior surgery for hallux valgus. Methods: Our design was a retrospective cohort study comparing 29 patients who underwent primary arthrodesis (primary group) and 34 patients with hallux rigidus after hallux valgus surgery (secondary group). The clinical assessment included the American Orthopaedic Foot & Ankle Society (AOFAS) score and a visual analog scale (VAS) for pain. Radiological evaluation was also performed. Overall, the mean postoperative follow-up was 3.4 (range, 2-5) years. Results: At final follow-up, AOFAS and VAS pain scores significantly improved in both groups ( P = .001). However, the mean AOFAS ( P = .001) and VAS pain ( P = .008) scores were significantly better in the primary group than in the secondary group. Radiologically, there were no significant differences between the groups in any angle after arthrodesis. Revision surgeries were not required in the primary group. In the secondary group, there was 1 revision due to deep infection, and 3 other patients required dorsal plate removal. Excluding plate removal, the Kaplan-Meier survival at 3 years was not significantly different between groups ( P = .775). Conclusion: Although arthrodesis of the first MTP joint was an effective procedure for hallux rigidus, the clinical outcomes in patients who had prior hallux valgus surgery were worse than those for patients who underwent primary surgery for hallux rigidus. Level of Evidence: Level III, retrospective cohort study.
Utilization of an Innovative Psychoeducational Group for Veterans With Severe Mental Illness: A Program Evaluation of a Quality Improvement Initiative
Authors: Koonce Morse Wendi L. , Mankowski Sasha , Harrold S. Akeya 
Published: November 2020

INTRODUCTION Cognitive impairments—episodes of mania or psychosis, paranoia, and substance use—are common effects of serious mental illness, which can lead to stigmatization, social isolation, and a decrease in interaction with health care providers. These consequences can obstruct a person with serious mental illness ability to comprehend diagnosed mental disorders and to fully participate in treatment. Consistent with the Substance Abuse and Mental Health Services Administration Recovery Model for Disease Management, nurse practitioner residents in a mental health nurse practitioner residency program developed an interactive psychoeducation series to improve veteran health self-efficacy and self-management. AIM The overall purpose of this sequential quality improvement initiative was to develop and deliver a psychoeducational series, which is both veteran centric and recovery oriented. METHODS Series I of the project produced psychoeducational sessions based on collaborative interactions among veterans and members of the treatment team, with a focus on neurobiology, pharmacology, and evidence-based treatment recommendations. Through an innovative and interactive framework, Plan–Do–Study–Act cycles were utilized to bring about foundational themes and inherent changes in the psychoeducation delivery. With veterans’ feedback and collaboration, Series II of the project was developed within the continuous improvement evaluations from Series I. RESULTS Treatment collaboration between veterans and providers was fostered as veterans experienced learning, symptom recognition, and empowerment. CONCLUSION This project is unique in that it is the first known review of a quality improvement initiative to incorporate concurrent changes in psychoeducational session delivery, involving veterans and their providers to foster collaboration.
Mathematical modeling of thin layer microwave drying of Jaya fish (Aspidoparia jaya)
Authors: Ghimire Arjun , Basnet Sabina , Poudel Ranjana , Ghimire Arjun 
Published: November 2020

The effect of microwave power levels on the drying attributes of Jaya fish ( Aspidoparia jaya) in a microwave dryer was investigated in this study. Microwave power levels of 100, 180, 300, and 450 W were used to dry 50 g of fish samples, and the drying kinetics were evaluated. Higher microwave power levels resulted in faster drying when increased from 100 to 450 W. The moisture ratio of fish during drying was calculated, and the data obtained were applied to 5 well known thin-layer mathematical models of drying, namely Approximate diffusion, Modified Henderson and Pabis, Two-Term, Logarithmic, and Midilli et al. model. Model constants and coefficients were calculated by nonlinear regression techniques. All the models were validated using statistical parameters namely; Coefficient of determination (R2), Root Mean Square Error (RMSE), Chi-square (χ2), and Standard Sum of Error (SSE). The Midilli et al. model gave an excellent fit to the experimental data of all the models evaluated. The effective diffusivity was calculated using Fick’s diffusion equation, and the value varied from 1.40 × 10−9 to 1.08 × 10−8 m2/s. The activation energy and the diffusivity constant were found to be 4.656W/g and 1.22 × 10−8 m2/s, respectively.
Quantitative deep vascular complex analysis of different AMD stages on optical coherence tomography angiography
Authors: Colantuono Donato , Souied Eric H , Borrelli Enrico , Capuano Vittorio , Amoroso Francesca , Sacconi Riccardo , Jung Camille , Querques Giuseppe , Miere Alexandra 
Published: November 2020

Aims: To investigate alterations in deep retinal vascular complex (DVC) in patients with non-neovascular intermediate AMD (iAMD), treatment-naïve quiescent macular neovascularization (qMNV), exudative AMD (eAMD) by means of OCT angiography (OCTA). Methods: Patients with iAMD, qMNV, eAMD and healthy controls presenting in the Department of Ophthalmology of the Centre Hospitalier Intercommunal de Créteil between January 2016 and January 2018, were retrospectively included. 3 × 3-mm OCTA (AngioVue RTVue XR Avanti) perfusion density (PD) of DVC was computed in all groups at baseline and follow up (12.0 ± 1.1 months). Results: A total of 46 eyes of 45 patients were enrolled: 11/46 iAMD, 10/46 qMNV, 13/46 eAMD, 12/46 control eyes. PD showed a significant decrease during follow-up in qMNV ( p = 0.0059) and iAMD ( p = 0.0076) eyes. PD in eAMD and healthy controls didn’t show significant changes. Conclusion: PD decreases at the level of DVC in eyes with qMNV and iAMD, while in eAMD eyes, PD is stable throughout follow up, suggesting that repeated anti-vascular endothelial growth factor (VEGF) injections do not impact on the DVC PD.
Infective endocarditis in hemodialysis patients: A 10-year observational single center study
Authors: Bentata Y , Haloui I , Haddiya I , Benzirar A , El Mahi O , Ismailli N , Elouafi N 
Published: November 2020

Background: The incidence of infective endocarditis (IE) in chronic hemodialysis (CHD) patients remains high, despite the preventive measures implemented by nephrologists, especially the rigorous respect of hygiene, the use of antibiotic locks for catheters and the use of tunneled catheters instead of non-tunneled. Objective: The objective of this study was to determine the clinical, biological, and echocardiographic characteristics, and the prognosis of IE in CHD. Patients and methods: It was a retrospective study, conducted from December 2010 to March 2020, at the Nephrology and Cardiology units of University Hospital in Oujda, Morocco. Results: We compiled a series of 31 CHD patients having developed IE. Eleven cases (35.4%) were collected between 2010 and 2015, and 20 cases (64.6%) between 2016 and 2020. The mean age was 47 ± 19 years, 58% were male, and 25.8% of patients had diabetes. Vascular access for hemodialysis was by arteriovenous fistula, non-tunneled catheter, and tunneled catheter in 22.5%, 32.2%, and 45.2%, of the cases, respectively. About 25.8% of patients had benefited from more than two catheters (tunneled or non-tunneled) during the 3 months preceding the occurrence of IE. The mitral, tricuspid, and aortic valves were the site of IE in 41.9%, 41.9%, and 13% of the cases, respectively. Right heart IE and left heart IE were observed in 42% (13 cases) and 58% (18 cases) of cases, respectively. Blood cultures were negative in 58.1% of the cases at the time of diagnosis of IE. Staphylococcus aureus was identified in 69.2% of the cases. Mortality occurred in 54.8% of the cases. Conclusion: IE remains a severe condition in CHD patients with an increasing incidence. Rigorous prevention and screening strategies should be implemented at the hemodialysis centers.
[11C]Methionine and [11C]PBR28 as PET Imaging Tracers to Differentiate Metastatic Tumor Recurrence or Radiation Necrosis
Authors: Tran Thuy T. , Gallezot Jean-Dominique , Jilaveanu Lucia B. , Zito Christopher , Turcu Gabriela , Lim Keunpoong , Nabulsi Nabeel , Huang Henry , Huttner Anita , Kluger Harriet M. , Chiang Veronica L. , Carson Richard 
Published: November 2020

Purpose: As stereotactic radiosurgery (SRS) and immunotherapy are increasingly used to treat brain metastases, incidence of radiation necrosis (RN) is consequently rising. Differentiating tumor regrowth (TR) from RN is vital in management but difficult to assess using MRI. We hypothesized that tumor methionine levels would be elevated given increased metabolism and high amino acid uptake, whereas RN would increase inflammation marked by upregulated translocator protein (PBR-TSPO), which can be quantified with specific PET tracers. Procedures: We performed a feasibility study to prospectively evaluate [11C]methionine and [11C]PBR28 using PET in 5 patients with 7 previously SRS-treated brain metastases demonstrating regrowth to differentiate TR from RN. Results: Sequential imaging with dual tracers was well-tolerated. [11C]methionine was accurate for detecting pathologically confirmed TR in 7/7 lesions, whereas [11C]PBR28 was only accurate in 3/7 lesions. Tumor PBR-TSPO expression was elevated in both melanoma and lung cancer cells, contributing to lack of specificity of [11C]PBR28-PET. Conclusion: Sequential use of PET tracers is safe and effective. [11C]Methionine was a reliable TR marker, but [11C]PBR28 was not a reliable marker of RN. Studies are needed to determine the causes of post-radiation inflammation and identify specific markers of RN to improve diagnostic imaging.
Systematic review with meta-analysis: age-related malignancy detection rates at upper gastrointestinal endoscopy
Authors: de Jong Judith J. , Lantinga Marten A. , Thijs Ina M. E. , de Reuver Philip R. , Drenth Joost P. H. 
Published: November 2020

Background: Age is an important and objective risk factor for upper gastrointestinal (GI) malignancy. The accuracy of various age limits to detect upper GI malignancy is unclear. Determination of this accuracy may aid in the decision to refer symptomatic patients for upper GI endoscopy. The aim of this analysis was to synthesize data on upper GI malignancy detection rates for various age limits worldwide through meta-analysis. Methods: We searched MEDLINE, EMBASE, and Web of Science in November 2018. Selection criteria included studies addressing malignant findings at upper GI endoscopy in a symptomatic population reporting age at time of diagnosis. Meta-analyses were conducted to derive continent-specific cancer detection rates. Results: A total of 33 studies including 346,641 patients across 21 countries fulfilled the inclusion criteria. To detect >80% of malignant cases all symptomatic patients over 40 years of age should be investigated in Africa, over 50 years of age in South America and Asia, and over 55 years of age in North America and Europe. Conclusion: This systematic review and meta-analysis provides data on intercontinental variation in age at time of upper GI malignancy diagnosis in symptomatic patients referred for upper GI endoscopy. Guideline recommendations for age-based selection should be tailored to local age-related detection rates.
Current Role of Radiotherapy in the Management of Oral Cavity Squamous Cell Carcinoma
Authors: Mendenhall William M. , Holtzman Adam L. , Dagan Roi , Bryant Curtis M. , Hitchcock Kathryn E. , Amdur Robert J. , Fernandes Rui P. 
Published: November 2020

Study Design: Literature review. Objective: To review the current role of radiotherapy (RT) in the management of oral cavity squamous cell carcinoma (SCC). Methods: Review of selected literature. Results: T1-T2N0 SCCs may be treated with either RT alone or surgery with a high likelihood of cure. The pendulum swung toward surgery with postoperative RT (PORT) added depending on the pathological findings in the mid 1980s. Patients with positive margins, extranodal extension (ENE), and/or 4 or more positive nodes receive concomitant chemotherapy (POCRT). Patients with T3-T4 and/or positive regional nodes are treated with surgery and PORT alone or POCRT. The likelihood of cure is moderate to low depending on extent of disease. The likelihood of major complications ranges from 10% to 30% depending on the method of reconstruction and the aggressiveness of postoperative PORT/POCRT. Patients with very advanced disease are treated with palliative RT, chemotherapy, or supportive care. Conclusions: The role of RT in the management of oral cavity SCC is primarily in the postoperative setting with palliative RT being reserved for those with very advanced disease where the likelihood of cure is remote.
Using social media for vaccination promotion: Practices and challenges
Authors: Steffens Maryke S , Dunn Adam G , Leask Julie , Wiley Kerrie E 
Published: November 2020

Objective Vaccination misinformation is widespread on social media. Vaccine-promoting organisations are working to curb its influence, but face obstacles. We aimed to analyse their social media strategies and the challenges they encounter. Methods In this qualitative study, we purposively sampled 21 participants responsible for social media from vaccine-promoting organisations. We used Framework Analysis to explore the data. Results Vaccine-promoting organisations faced obstacles using social media, including fast-paced change, limited resources, and insufficient organisational buy-in. They experienced difficulties reaching audiences, exploiting social media listening, and measuring impact. Consequently, they may miss opportunities to counter misinformation, connect with groups low in vaccine confidence, and determine diverse audience responses. They lack strong evidence linking social media strategies with behaviour change, and have difficulty understanding silent audiences. Conclusions Vaccine-promoting organisations have an opportunity to embrace the participatory nature of social media. They could share listening insights with like-minded groups, and conduct research exploring associations between social media strategies and community attitude/behaviour change. Social media platforms could assist by renewing vaccine-promoting organisations' organic reach, supporting the development of tailored listening and credibility tools, and strengthening collaborations to promote credible content.