bluuebunny/crossref_metadata_2025_split huggingface dataset:
Free superficial circumflex iliac artery perforator flap with a single-pedicle bilobed design for pediatric multi-digit defect reconstruction
Authors: Li Zhangcan , Zheng Dawei , Zheng Jian , Qi Weiya , Qi Qiang , Liu Yunyun 
Published: May 2020

Abstract
Objectives: This paper describes imaging and anatomical features, in order to assess the feasibility of superficial circumflex iliac artery perforator (SCIP) flap with a single-pedicle bilobed design for multi-digit skin and soft tissue reconstruction in pediatric patients.Methods: A total of 7 pediatric patients who were being treated with free single-pedicle bilobed SCIP flap reconstruction for multi-digit defects were included in this study. The details of the clinical features were collected, and the following were successively analyzed: the preoperative Computed Tomographic Angiography (CTA) and Color Doppler Sonography (CDS) examinations for flap design, the intraoperative anatomy for perforator vessel, defect reconstruction and interphalangeal range of motion (ROM) and tactile sense, pain sense and two-point discrimination recovery results.Results: CTA and CDS performed preoperatively could accurately and rapidly identify the position, location and course of the SCIP flap. All wounds healed by the first follow-up and no complications occurred at the follow-up visit. All flaps survived, the patients achieved proximal interphalangeal joint (PIP) ranges of motions (ROM) from 80 to 100 degree and distal interphalangeal joint (DIP) ROM from 65 to 80 degree. The tactile sense and pain sense recovered, and average of the two-point discrimination scores was 9.3mm (range 7-12mm). The donor area was primarily sutured with good scar concealment in the underwear region.Conclusion: CTA and CDS performed preoperatively are accurate and intuitive methods for assessing the location and course of SCIP. The SCIP flap is highly suitable for pediatric patients due to its small caliber, specific functional and aesthetic benefits. It can be designed in a lobulated fashion in order to repair two or more wounds during one surgery. We suggest that the free single-pedicle bilobed SCIP flap should be considered an optimal choice for multi-digit defect reconstruction in pediatric patients in the clinic.
The Association Between SAα2,3Gal Occurrence Frequency and Avian Influenza Viral Load in Mallards (Anas Platyrhynchos) and Blue-Winged Teals (Spatula discors)
Authors: Dolinski Amanda C , Jankowski Mark D , Fair Jeanne M , Owen Jennifer C 
Published: May 2020

Abstract
Background: Individual heterogeneity in pathogen load can affect disease transmission dynamics; therefore, identifying intrinsic factors responsible for variation in pathogen load is necessary for determining which individuals are prone to be most infectious. Because low pathogenic avian influenza viruses (LPAIV) preferentially bind to alpha-2,3 sialic acid receptors (SAα2,3Gal) in the intestines and bursa of Fabricius in wild ducks (Anas and Spatula spp.), we investigated juvenile mallards (Anas platyrhyncos) and blue-winged teals (Anas discors) orally inoculated with A/northern pintail/California/44221-761/2006 (H5N9) and the virus titer relationship to occurrence frequency of SAα2,3Gal in the intestines and bursa. To test the natural variation of free-ranging duck populations, birds were hatched and raised in captivity from eggs collected from nests of free-ranging birds in North Dakota, USA. Data generated from qPCR were used to quantify virus titers in cloacal swabs, ileum tissue, and bursa of Fabricius tissue, and lectin histochemistry was used to quantify the occurrence frequency of SAα2,3Gal. Linear mixed models were used to analyze infection status, species, and sex-based differences. Multiple linear regression was used to analyze the relationship between virus titer and SAα2,3Gal occurrence frequency. Results: In mallards, we found high individual variation in virus titers significantly related to high variation of SAα2,3Gal in the ileum. In contrast to mallards, individual variation in teals was minimal and significant relationships between virus titers and SAα2,3Gal were not determined. Collectively, teals had both higher virus titers and a higher occurrence frequency of SAα2,3Gal compared to mallards, which may indicate a positive association between viral load and SAα2,3Gal. Statistically significant differences were observed between infected and control birds indicating that LPAIV infection may influence the occurrence frequency of SAα2,3Gal, or vice versa, but only in specific tissues. Conclusions: The results of this study provide quantitative evidence that SAα2,3Gal abundance is related to LPAIV titers; thus, SAα2,3Gal should be considered a potential intrinsic factor influencing variation in LPAIV load.
The role of circulating microRNAs for the diagnosis of hepatitis B virus-associated hepatocellular carcinoma with low alpha-fetoprotein level: A systematic review and meta-analysis
Authors: Peng Cheng , Li Zhuonan , Xie Zishan , Wang Zhanpeng , Ye Yanshuo , Li Bo , Li Wei 
Published: May 2020

Abstract
Background: Alpha-fetoprotein (AFP) has been widely used for many years as a serum marker for hepatocellular carcinoma (HCC). However, AFP has been recognized as having poor sensitivity. More and more studies have concluded that circulating microRNAs (miRNAs) might be a promising biomarker that could complement AFP. However, the diagnostic ability of circulating miRNAs has varied among the studies. Therefore, we performed the present meta-analysis to appraise the diagnostic performance of circulating miRNAs as a biomarker for hepatitis B virus-associated HCC (HBV-HCC) patients with low AFP levels. Methods: We performed a systematic review and meta-analysis of the published literature to assess the diagnostic accuracy of circulating miRNAs in differentiating HBV-HCC patients with low AFP levels from non-HCC controls. Results: Circulating miRNAs showed promising potential in the diagnosis of HBV-HCC patients with low AFP levels. In the low-AFP HBV-HCC patients, the area under the curve (AUC) was 0.88 (95% confidence interval [CI]: 0.84–0.90). The pooled sensitivity and specificity were 0.84 (95% CI: 0.78–0.88) and 0.76 (95% CI: 0.69–0.83), respectively. Conclusions: The detection of circulating miRNAs provides a valuable method for the diagnosis of HBV-HCC in patients with low AFP levels.
Feasibility Study and Process Evaluation of MRI Plus Physiotherapy vs. Physiotherapy alone in Non-Specific Chronic Low Back Pain Among Patients in Saudi Arabia
Authors: alhowimel AHMED , Alotaibi Mazyad , Coulson Neil , Radford Kate 
Published: May 2020

Abstract
Aim To determine the feasibility of conducting a definitive randomized control trial (RCT) to answer the question of whether an MRI diagnosis can negatively influence psychosocial and disability outcomes in patients with chronic low back pain (CLBP) treated by physiotherapy in Saudi Arabia.Methods In a feasibility RCT in Riyadh City from 01/03/2018 until 29/07/2018, CLBP patients presenting to spine clinics were randomized to receive an MRI (intervention) plus physiotherapy rehabilitation or physiotherapy alone (control group). The acceptability of randomization to the control group (non-MRI) was tested during the recruitment by qualitatively interviewing study participants and referring physicians. Moreover, interviews with study participants exploring the broader social, political, economic, and environmental (context) aspects that may influence trial delivery and intervention implementation.Results The recruitment target was not met: 16/24 (66%) participants were recruited in 4 months (12.4% of those screened); 33% declined. The process evaluation identified numerous factors that may affect the success of a definitive RCT in Saudi Arabia. These were research resources, the lack of research infrastructure to support recruitment to trials; limited research capacity in terms of knowledge and skills of the healthcare team; and limited funding. Conclusion A definitive RCT to test the influence of MRI diagnosis on the psychosocial and disability outcomes in people with CLBP treated with physiotherapy in Saudi Arabia is feasible. However, the lack of research infrastructure, research capacity, the impact of MRI on patient outcomes, and a lack of clinical equipoise in the treatment and management of CLBP in Saudi Arabia pose major barriers to clinical trials.
Comparison of diagnostic sensitivity of 18F-fluoroestradiol and 18F-fluorodeoxyglucose positron emission tomography/computed tomography for breast cancer recurrence in patients with a history of estrogen receptor-positive primary breast cancer
Authors: Chae Sun Young , Son Hye Joo , Lee Dong Yun , Shin Eonwoo , Oh Jungsu S. , Seo Seung Yeon , Baek Sora , Kim Ji Young , Na Sae Jung , Moon Dae Hyuk 
Published: May 2020

Abstract
Background To compare the diagnostic sensitivity of [ 18 F]fluoroestradiol ([ 18 F]FES) and [ 18 F]fluorodeoxyglucose ([ 18 F]FDG) positron emission tomography/computed tomography (PET/CT) for breast cancer recurrence in patients with estrogen receptor (ER)-positive primary breast cancer. Methods Our database of consecutive patients enrolled in a previous prospective cohort study to assess [ 18 F]FES PET/CT was reviewed to identify eligible patients who had ER-positive primary breast cancer with suspected first recurrence at presentation and who underwent [ 18 F]FDG PET/CT. The sensitivity of qualitative [ 18 F]FES and [ 18 F]FDG PET/CT interpretations was assessed, comparing them with histological diagnoses. Results Of the 46 enrolled patients, 45 were confirmed as having recurrent breast cancer, while one was diagnosed with chronic granulomatous inflammation. Forty (89%) patients were ER-positive, four (9%) were ER-negative, and one (2%) patient did not undergo an ER assay. The sensitivity of [ 18 F]FES PET/CT was 71.1% (32/45, 95% CI: 55.7–83.6), while that of [ 18 F]FDG PET/CT was 80.0% (36/45, 95% CI: 65.4–90.4) with a threshold of positive interpretation, and 93.3% (42/45, 95% CI: 81.7–98.6) when a threshold of equivocal was used. There was no significant difference in sensitivity between [ 18 F]FES and [ 18 F]FDG PET/CT ( P =0.48) with a threshold of positive [ 18 F]FDG uptake, but the sensitivity of [ 18 F]FDG was significantly higher than [ 18 F]FES ( P =0.013) with a threshold of equivocal [ 18 F]FDG uptake. One patient with a benign lesion showed negative [ 18 F]FES but positive [ 18 F]FDG uptake. Conclusions The restaging of patients who had ER-positive primary breast cancer and present with recurrent disease may include [ 18 F]FES PET/CT as an initial test when standard imaging studies are equivocal or suspicious.
Estimating the serial interval of the novel coronavirus disease (COVID-19): A statistical analysis using the public data in Hong Kong from January 16 to February 15, 2020
Authors: Zhao Shi , Gao Daozhou , Zhuang Zian , Chong Marc KC , Cai Yongli , Ran Jinjun , Cao Peihua , Wang Kai , Lou Yijun , Wang Weiming , Yang Lin , He Daihai , Wang Maggie H 
Published: May 2020

Abstract
Background : The emerging virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a large outbreak of novel coronavirus disease (COVID-19) in Wuhan, China since December 2019. As of February 15, there were 56 COVID-19 cases confirmed in Hong Kong since the first case with symptom onset on January 23, 2020. Methods : Based on the publicly available surveillance data, we identified 21 transmission events, which occurred in Hong Kong, and had primary cases known, as of February 15, 2020. An interval censored likelihood framework is adopted to fit three different distributions, Gamma, Weibull and lognormal, that govern the SI of COVID-19. We selection the distribution according to the Akaike information criterion corrected for small sample size (AICc). Findings : We found the Lognormal distribution performed lightly better than the other two distributions in terms of the AICc. Assuming a Lognormal distributed model, we estimated the mean of SI at 3.9 days (95%CI: 2.7−7.3) and SD of SI at 3.1 days (95%CI: 1.7−10.1) by using the information of all 21 transmission events in Hong Kong. Conclusion : The SI of COVID-19 may be shorter than the preliminary estimates in previous works. Given the likelihood that SI could be shorter than the incubation period, pre-symptomatic transmission may occur, and extra efforts on timely contact tracing and quarantine are crucially needed in combating the COVID-19 outbreak.
Randomized clinical trials in ANCA-associated vasculitis: a systematic analysis of the WHO - International Clinical Trials Registry Platform.
Authors: IUDICI Michele , Puéchal Xavier , Brigante Alejandro , Atal Ignacio , Gabay Cem 
Published: May 2020

Abstract
Background. The analysis of the main features of randomized controlled trials (RCTs) on ANCA-associated vasculitis (AAV) can inform future study design.Methods. We searched within the International Clinical Trials Registry Platform all registered RCTs on AAV from October 2008 to December 2018. Two reviewers selected studies according to pre-specified eligibility criteria. We retrieved information including countries, funding, design, sample sizes, eligibility criteria, primary outcomes (POs), and treatments.Results. Among the 40 RCTs identified, 22 (38%) were conducted in Europe, 29 (72%) in a single country, 14 (35%) were industry-funded. The median number of patients planned to enrol was 68 (IQR 36-138). Only 28% of RCTs targeted a single vasculitis and ANCA negative patients were not included in 40% of studies. Interventions investigated were mainly drugs given to induce (40%) or maintain (32%) remission. Eighty-five percent of POs were considered being ‘patient-important’, but discrepancies in definition of disease states such as remission or relapse were observed. Glucocorticoids use was part of the PO in <25% of studies. The number of trials targeting a single disease, non-industry funded, incorporating glucocorticoids in PO, as well as the planned sample size increased over time.Conclusion. Despite the important achievements in the field, the design of RCTs on AAV could be further improved.
The Changes of Gut Microbiota in Drug-Naïve First-Episode MDD Patients Under Treatment by SSRIs
Authors: Shen Yang , Yang Xiao , Li Gaofei , Xing Xiaoxi , Li Zhiyong , Huang Yichen , Gao Jiayu , Ying Liang 
Published: May 2020

Abstract
Background Recently, gut microbiota has been found to play an important role during the development of MDD in mice models. Meanwhile, the antidepressant treatment with SSRIs could correct the abnormal performance in mice, and played a dual role of antibiotics. Therefore, this study aims to further explore whether the gut microbiota of MDD patients can be reshaped after receiving SSRI drugs.Methods Thirty patients with drug-naive first-episode MDD and thirty healthy controls were recruited and their samples were collected to complete 16S rRNA sequencing. All patients received standardized treatment with ecitalopram. When the reduction rate of HAMD scale score ≥ 50%, their fecal samples were collected again to sequence as follows group. Bioinformatics analysis was used to understand the changes of gut microbiota before and after treatment.Results A significant difference in gut microbiota abundance was found after treatment with escitalopram. The Firmicutes/Bacteroides ratio decreased significantly in the follows group. After treatment, the differences in the classification and metabolic pathways of gut microbiota still existed between follows group and controls. The mainly difference were found as follows: Transport and catabolism, Nervous system, Glycan biosynthesis and metabolism, etc.Conclusions The study found that the gut microbiota of patients with first-episode MDD was similar, but was significantly different from controls. Under escitalopram treatment, the gut microbiota diversity of MDD patients tended to transform to normal. However, there were still some differences of structures and metabolic pathways in microbes between patients and controls, which might be related to the relapse of MDD.
Clonazepam Versus Lorazepam in the Treatment of Methamphetamine-Poisoned Children: A Pilot Clinical Trial
Authors: Farnaghi Fariba , Rahmani Razieh , Hassanian-Moghaddam Hossein , Zamani Nasim , McDonald Rebecca , Gholami Narges , Gachkar Latif 
Published: May 2020

Abstract
Background: To evaluate the efficacy of oral clonazepam versus oral lorazepam following initial parenteral benzodiazepine administration to control methamphetamine-induced agitation in children.Methods: In a single-center clinical trial, intravenous diazepam (0.2 mg/Kg) was initially administered to all methamphetamine-poisoned pediatric patients to control their agitation, followed by a single dose of oral clonazepam (0.05 mg/Kg; n = 15) or oral lorazepam (0.05 mg/Kg; n = 15) to prevent relapse of toxicity.Results: The median age [IQR] (range) was 15 [10, 36] (6-144) months. The source of poisoning was methamphetamine exposure from oral ingestion in 23 (76.7%) and passive inhalation in 7 (23.3%) patients. The most common symptoms/signs were agitation (23; 96.7%), mydriatic pupils (26; 86.7%), and tachycardia (20; 66.6%). Four patients (13.3%) needed re-administration of IV diazepam due to persistent agitation. There was no report of benzodiazepine complications in either group.Conclusions: Although both benzodiazepines were effective, considering the similar administered doses of oral clonazepam and lorazepam as well as the higher potency of clonazepam, it seems that lorazepam is a better suited oral benzodiazepine for the maintenance treatment of methamphetamine-induced agitation in children and can be used with minimal complications.Trial registration: IRCT20180610040036N2, April 18th 2020. Retrospectively registered
Computed Tomography Radiomics for the Preoperative Prediction of Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma: Development and External Validation
Authors: Han Zhi-Jiang , Wei Peiying , Ding Zhongxiang , Luo Dingcun , Qian Liping , Zhou Jian , Wang Haibin , Cai Wenli , Zhang Ming 
Published: May 2020

Abstract
Background Cervical lymph node (LN) status is a critical factor related to the treatment and prognosis of papillary thyroid carcinoma (PTC). The aim of this study was to investigate the preoperative predictions of cervical LN metastasis in PTC using computed tomography (CT) radiomics.Methods A total of 134 PTC patients who underwent CT examinations were enrolled in the study at two institutes between January 2018 and January 2020. Of these patients, 289 cervical LNs (institute 1: 206 LNs from 88 patients; institute 2: 83 LNs from 46 patents) were selected. All the cases had been confirmed by surgery and pathology. Each LN was segmented and 1408 radiomic features were calculated radiomic features in noncontrast and contrast-enhanced CT images. Features were selected using the Boruta algorithm followed by an iterative culling-out algorithm. We compared four machine learning classifiers, including random forest (RF), support vector machine (SVM), neural network (NN), and naïve bayes (NB) for the classification of LN metastasis. The models were first trained and validated by 10-fold cross-validation using data from institute 1 and then tested using independent data from institute 2. The performance of the models was compared using the area under the receiver operating characteristic curves (AUC).Results Seven radiomic features were selected for building the models − 3 histogram statistical textures, 1 gray level co-occurrence matrix texture, and 3 gray level zone size matrix textures. The AUCs of the radiomic models with 10-fold cross-validation were 0.941 (95% confidence interval [CI]: 0.93–0.95), 0.943 (95% CI: 0.93–0.95), 0.914 (95% CI: 0.90–0.95), and 0.905 (95% CI: 0.88–0.91) for RF, SVM, NN, and NB, respectively. The AUCs for the testing data were 0.926 (95% CI: 0.86–0.98), 0.932 (95% CI: 0.88–0.98), 0.925 (95% CI: 0.86–0.97), and 0.912 (95% CI: 0.83–0.98) for RF, SVM, NN, and NB, respectively.Conclusions CT radiomic model demonstrated robustness in preoperative classification of LN metastases for patients with PTC, which may provide significant support for clinical decision making and prognosis evaluation.
A data-driven analysis of fiber type architecture over the entire muscle
Authors: Bindellini Davide , Voortman Lenard M. , Olie Cyriel S. , Putten Maaike van , Akker Erik van den , Raz Vered 
Published: May 2020

Abstract
Background

Skeletal muscle function is inferred from the spatial arrangement of muscle fibers architecture, which corresponds to myofiber molecular and metabolic features. Myofiber types can be distinguished by the expression of myosin heavy chain (MyHC) isoforms, representing contraction properties. In most studies, myofiber typing is determined from a local sampling, typically obtained from the muscle median region. This median region is assumed to represent the entire muscle. However, it remains largely unknown to what extent this local sampling represents the entire muscle.
Methods

We present here a pipeline to study the architecture of muscle fiber type over the entire muscle, from sectioning, staining, imaging to image quantification and data-driven analysis.
Results

We reconstructed muscle architecture from consecutive cross-sections stained for laminin and MyHC isoforms. Examining the entire muscle using consecutive cross-sections is extremely laborious, we provide consideration to reduce dataset and yet to cover the entire muscle. Analyses of over 15,000 myofibers, showed spatial variations in myofiber geometric features, myofiber type and the distribution of neuromuscular junctions along the entire muscle.
Conclusions

We suggest that asymmetric spatial distribution of myofiber types, geometric features of myofibers and the neuromuscular junctions along the muscle could affect muscle function. Therefore, instead of a single sampling from a median region, representative regions covering the entire muscle should be investigated in future studies.