bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delayed Periorbital Reconstruction After War Injuries
Authors: Abu-Sitta Ghassan S. , Ma’luf Riad , Dabbous Helene , Hakim Christopher , Chalhoub Rawad 
Published: April 2020

Introduction:
Syrian patients injured in the war frequently undergo rudimentary primary wound closure in combat zones. These patients are later transferred to Lebanon where their wounds need to be secondarily managed. This often leads to the creation of unorthodox approaches for reconstruction of orbital injuries.

Case presentation:
The authors of this manuscript demonstrate a few cases of peri-ocular trauma with a delayed presentation, in which adaptations of conventional reconstructive methods had to be implemented had to be undertaken for optimal results.

Conclusion:
Modified techniques for reconstruction of peri-ocular injuries with delayed presentation are discussed in this paper. The patients are cases of trauma secondary to war in the region of Lebanon and Syria. The unique presentations of these patients have led to the use of “opportunity flaps” surrounding highly fibrotic and scarred tissue, in an attempt to allow for delayed reconstruction.
Timing of Ossification of the Anterior Skull Base in Syndromic Synostosis
Authors: Nassar Amer H. , Mercan Ezgi , Massenburg Benjamin B. , Lee Amy , Brown Jevon , Skladman Rachel , Guo Yifan , Hopper Richard A. 
Published: April 2020

Abstract
The anterior skull base undergoes a progressive ossification after birth. This has implications on the epidural dissection of early trans-craniofacial osteotomy procedures such as monobloc advancements. Our purpose was to determine the rate of ossification in syndromic synostosis patients relative to a normal cohort to establish when maturation of the anterior skull base is complete. The authors analyzed CT scans from 35 patients with Crouzon, Apert or Pfeiffer syndrome, and 84 patients without any craniofacial anomaly between the ages of 0 and 6 years. The non-ossified anterior skull base area was measured using 3D Slicer. The authors compared the sizes of the defects at different ages between the three syndromes and with the control group using Mann-Whitney test. Significance was set at P < 0.05. All patients less than 12 months of age had a measurable defect anterior to the cribriform whereas patients greater than five years of age had full ossification of the anterior skull base with no evidence of defect. The relationship of defect size and age at scan was non-linear, with most defects closing rapidly in the first six months. The temporal closure pattern of the defect was similar between the three syndromes and the control group with no significant difference. Our findings indicate that syndromic children undergo skull base maturation at the same rate as non-syndromic cases, with the majority ossified by three years of age. Anterior skull base surgeries performed before three years should optimize visualization of this area during dissection.
The Use of A Solitary Multi-Planer Herbert Cannulated Bone Screw Osteosynthesis for The Treatment of Mandibular Angle Fracture
Authors: El-Mahallawy Yehia , Al-Mahalawy Haytham 
Published: April 2020

Abstract
This study aimed to evaluate the clinical and radiographic performance of a single Herbert bone screw in the treatment of mandibular angle fractures. A prospective case series clinical trial enrolling a sample of patients with unilateral isolated mandibular angle fractures was implemented in this study. The primary outcome variable was the fracture healing with postoperative stability. The secondary outcome was the incidence of postoperative complications. All of the recorded data were documented, tabulated, computed, and analyzed. Statistical significance was set at 5% level. Twenty patients were selected. Neither major nor minor clinical complication was reported. Only one case showed slight interfragmentary mobility in the first follow-up period, which improved spontaneously in the sixth postoperative week. A statistically significant gain in the mean bone density across the fracture line was calculated. These favorable clinical and radiographic outcomes may conclude that the utilization of a solitary Herbert cannulated bone screw osteosynthesis provides a successful, economic, minimally invasive and predictable treatment modality for the treatment of mandibular angle fractures.
Orbital Trapdoor Facture in Child: More Predictable Outcomes and Less Consequences
Authors: Guerra Raphael Capelli , Pulino Bianca F. Borim , Mendes Bruno Coelho , Pereira Rodrigo dos Santos , Pinheiro Flávia Lima , Hochuli-Vieira Eduardo 
Published: April 2020

Abstract
Orbital trapdoor fractures are characterized by tissue entrapment between the fractured bone fragment and the remnant of the orbital floor. This entrapment can result in immediate local and systemic complications and poor outcomes when approached late. This article presents the case of an orbital floor fracture in a child with dystopia, pain, edema and entrapment of the inferior rectus muscle and consequent limitation of ocular motility. The strategy proposed in the early approach to orbital floor reconstruction and release of incarcerated tissue allowed the patient to achieve satisfactory results without morbidity, as compared to the outcomes of corrective sequel surgery.
Prophylactic Topical Tranexamic Acid Versus Placebo in Surgical Patients
Authors: Teoh Wan Yi , Tan Tun Giap , Ng Ka Ting , Ong Ke Xin , Chan Xue Lin , Hung Tsan Samuel Ern , Wang Chew Yin 
Published: April 2020

Objectives:
Perioperative bleeding remains a major concern to all clinicians caring for perioperative patients. Due to the theoretical risk of thromboembolic events associated with tranexamic acid (TXA) when administered intravenously, topical route of TXA has been extensively studied, but its safety and efficacy profile remain unclear in the literature. The primary aim of this review was to assess the effect of topical TXA on incidence of blood transfusion and mortality in adults undergoing surgery.

Data sources:
EMBASE, MEDLINE, CENTRAL, and ISI Web of Science were systematically searched from their inception until May 31, 2019.

Review methods:
Parallel-arm randomized controlled trials were included.

Results:
Seventy-one trials (7539 participants: orthopedics 5450 vs nonorthopedics 1909) were included for quantitative meta-analysis. In comparison to placebo, topical TXA significantly reduced intraoperative blood loss [mean difference (MD) −36.83 mL, 95% confidence interval (CI) −54.77 to −18.88, P < 0.001], total blood loss (MD −319.55 mL, 95% CI −387.42 to −251.69, P < 0.001), and incidence of blood transfusion [odds ratio (OR) 0.30, 95% CI 0.26–0.34, P < 0.001]. Patients who received topical TXA were associated with a shorter length of hospital stay (MD −0.28 days, 95% CI −0.47 to −0.08, P = 0.006). No adverse events associated with the use of topical TXA were observed, namely mortality (OR 0.78, 95% CI 0.45–1.36, P = 0.39), pulmonary embolism (OR 0.73, 95% CI 0.27–1.93, P = 0.52), deep vein thrombosis (OR 1.07, 95% CI 0.65–1.77, P = 0.79), myocardial infarction (OR 0.79, 95% CI 0.21–2.99, P = 0.73), and stroke (OR 0.85, 95% CI 0.28–2.57, P = 0.77). Of all included studies, the risk of bias assessment was “low” for 20 studies, “unclear” for 26 studies and “high” for 25 studies.

Conclusions:
In the meta-analysis of 71 trials (7539 patients), topical TXA reduced the incidence of blood transfusion without any notable adverse events associated with TXA in adults undergoing surgery.

PROSPERO:
CRD 42018111762.
Optic Nerve Regeneration: How Will We Get There?
Authors: Gokoffski Kimberly K. , Lam Phillip , Alas Basheer F. , Peng Micalla G. , Ansorge Heidi R. R. 
Published: April 2020

Background:
Restoration of vision in patients blinded by advanced optic neuropathies requires technologies that can either 1) salvage damaged and prevent further degeneration of retinal ganglion cells (RGCs), or 2) replace lost RGCs.

Evidence Acquisition:
Review of scientific literature.

Results:
In this article, we discuss the different barriers to cell-replacement based strategies for optic nerve regeneration and provide an update regarding what progress that has been made to overcome them. We also provide an update on current stem cell-based therapies for optic nerve regeneration.

Conclusions:
As neuro-regenerative and cell-transplantation based strategies for optic nerve regeneration continue to be refined, researchers and clinicians will need to work together to determine who will be a good candidate for such therapies.
Vitamin D recommendations in nutritional guidelines: Protocol for a systematic review, quality evaluation using AGREE-2 and analysis of potential predictors
Authors: Fraile-Navarro D , López-García-Franco A , Niño de Guzmán E , Pardo-Hernandez H , Canelo-Aybar C , Kuindersma J , Gich-Saladich I , Alonso-Coello P. 
Published: April 2020

AbstractBackgroundVitamin D has been widely promoted for bone health through supplementation and fortification of the general population. However, there is growing evidence that does not support these strategies. Our aim is to review the quality and recommendations on vitamin D nutritional and clinical practice guidelines and explore predictive factors for their direction and strength.Methods and analysisWe searched PubMed, EMBASE and CINAHL databases for vitamin D guidelines for the last 10 years. We aim to perform descriptive analysis, a quality appraisal using AGREE II scores (Appraisal of Guidelines Research and Evaluation) and a bivariate analysis evaluating the association recommendations and AGREE II domains’ scores and pre-specified characteristics.Ethics and disseminationThis is a systematic review protocol and therefore formal ethical approval is not required, as no primary, identifiable, personal data will be collected. Patients or the public were not involved in the design of our research. However, the findings from this review will be shared with key stakeholders, including patient groups, clinicians and guideline developers. We intend to publish our results in a suitable, peer-reviewed journal.
The aging transcriptome and cellular landscape of the human lung in relation to SARS-CoV-2
Authors: Chow Ryan D. , Chen Sidi 
Published: April 2020

AbstractSince the emergence of SARS-CoV-2 in December 2019, Coronavirus Disease-2019 (COVID-19) has rapidly spread across the globe. Epidemiologic studies have demonstrated that age is one of the strongest risk factors influencing the morbidity and mortality of COVID-19. Here, we interrogate the transcriptional features and cellular landscapes of the aging human lung through integrative analysis of bulk and single-cell transcriptomics. By intersecting these age-associated changes with experimental data on host interactions between SARS-CoV-2 or its relative SARS-CoV, we identify several age-associated factors that may contribute to the heightened severity of COVID-19 in older populations. We observed that age-associated gene expression and cell populations are significantly linked to the heightened severity of COVID-19 in older populations. The aging lung is characterized by increased vascular smooth muscle contraction, reduced mitochondrial activity, and decreased lipid metabolism. Lung epithelial cells, macrophages, and Th1 cells decrease in abundance with age, whereas fibroblasts, pericytes and CD4+ Tcm cells increase in abundance with age. Several age-associated genes have functional effects on SARS-CoV replication, and directly interact with the SARS-CoV-2 proteome. Interestingly, age-associated genes are heavily enriched among those induced or suppressed by SARS-CoV-2 infection. These analyses illuminate potential avenues for further studies on the relationship between the aging lung and COVID-19 pathogenesis, which may inform strategies to more effectively treat this disease.
Rapid Point-Of-Care Breath Test Predicts Breast Cancer And Abnormal Mammograms in Symptomatic Women
Authors: Phillips Michael , Bevers Therese B , Larsen Linda Hovanessian , Pappas Nadine , Pathak Sonali 
Published: April 2020

ABSTRACTBackgroundPrevious studies have reported volatile organic compounds (VOCs) in the breath as biomarkers of breast cancer. These biomarkers may be derived from cancer-associated fibroblasts, in which oxidative stress degrades polyunsaturated fatty acids to volatile alkanes and methylated alkane derivatives that are excreted in the breath. We evaluated a rapid point-of-care test for breath VOC biomarkers as predictors of breast cancer and abnormal mammograms.MethodsWe studied 593 women aged ≥ 18 yr referred to three sites for mammography for a symptomatic breast-related concern (e.g. breast mass, nipple discharge). A rapid point-of-care breath testing system collected and concentrated alveolar breath VOCs on a sorbent trap and analyzed them with gas chromatography and surface acoustic wave detection in < 6 min. Breath VOC chromatograms were randomly assigned to a training set or to a validation set. Monte Carlo analysis identified significant breath VOC biomarkers of breast cancer and abnormal mammograms in the training set, and these biomarkers were incorporated into a multivariate algorithm to predict disease in the validation set.ResultsPrediction of breast cancer: 50 women had biopsy-proven breast cancer (invasive cancer 41, ductal non-invasive cancer 9) Unsplit data set: Breath VOCs identified breast cancer with 83% accuracy (area under curve of receiver operating characteristic), 82% sensitivity and 77.1% specificity. Split data sets: Training set breath VOCs identified breast cancer with 80.3% accuracy, 84% sensitivity and 74.3% specificity. Corresponding values in the validation set were 68%% accuracy, 72.4% sensitivity and 61.5% specificity.Prediction of BIRADS 4 and 5 mammograms (versus BIRADS 1, 2 and 3): Unsplit data set: Breath VOCs identified abnormal mammograms with 76.2% accuracy. Split data sets: Breath VOCs identified abnormal mammograms with 74.2% accuracy, 73.3% sensitivity and 60% specificity. Corresponding values in the validation set were 60.5% accuracy, 64.2% sensitivity and 51% specificity.ConclusionsA rapid point-of-care test for breath VOC biomarkers accurately predicted risk of breast cancer and abnormal mammograms in women with breast-related symptoms.
Textile Masks and Surface Covers – A ‘Universal Droplet Reduction Model’ Against Respiratory Pandemics
Authors: Rodriguez-Palacios Alex , Cominelli Fabio , Basson Abigail R. , Pizarro Theresa T. , Ilic Sanja 
Published: April 2020

ABSTRACTThe main form of COVID-19 transmission is via ‘oral-respiratory droplet contamination’ (droplet; very small drop of liquid) produced when individuals talk, sneeze or cough. In hospitals, health-care workers wear facemasks as a minimum medical ‘droplet precaution’ to protect themselves. Due to the shortage of masks during the pandemic, priority is given to hospitals for their distribution. As a result, the availability/use of medical masks is discouraged for the public. However, given that asymptomatic individuals, not wearing masks within the public, can be highly contagious for COVID-19, prevention of ‘environmental droplet contamination’ (EnDC) from coughing/sneezing/speech is fundamental to reducing transmission. As an immediate solution to promote ‘public droplet safety’, we assessed household textiles to quantify their potential as effective environmental droplet barriers (EDBs). The synchronized implementation of a universal ‘community droplet reduction solution’ is discussed as a model against COVID-19. Using a bacterial-suspension spray simulation model of droplet ejection (mimicking a sneeze), we quantified the extent by which widely available clothing fabrics reduce the dispersion of droplets onto surfaces within 1.8m, the minimum distance recommended for COVID-19 ‘social distancing’. All textiles reduced the number of droplets reaching surfaces, restricting their dispersion to <30cm, when used as single layers. When used as double-layers, textiles were as effective as medical mask/surgical-cloth materials, reducing droplet dispersion to <10cm, and the area of circumferential contamination to ∼0.3%. The synchronized implementation of EDBs as a ‘community droplet reduction solution’ (i.e., face covers/scarfs/masks & surface covers) could reduce EnDC and the risk of transmitting or acquiring infectious respiratory pathogens, including COVID-19.
Variation in False Negative Rate of RT-PCR Based SARS-CoV-2 Tests by Time Since Exposure
Authors: Kucirka Lauren M , Lauer Stephen A , Laeyendecker Oliver , Boon Denali , Lessler Justin 
Published: April 2020

ABSTRACTSARS-CoV-2 RT-PCR based tests are being used to “rule out” infection among high-risk individuals such as exposed inpatients and healthcare workers. It is critical to understand how the predictive value of the test varies with time from exposure and symptom onset in order to avoid being falsely reassured by negative tests. As such, the goal of our study was to estimate the false negative rate by day since infection. We used previously published data on RT-PCR sensitivity on samples derived from nasal swabs by day since symptom onset (n=633) and fit a cubic polynomial spline to calculate the false negative rate by day since exposure and symptom onset. Over the four days of infection prior to the typical time of symptom onset (day 5) the probability of a false negative test in an infected individual falls from 100% on day one (95% CI 69-100%) to 61% on day four (95% CI 18-98%), though there is considerable uncertainty in these numbers. On the day of symptom onset, the median false negative rate was 39% (95% CI 16-77%). This decreased to 26% (95% CI 18-34%) on day 8 (3 days after symptom onset), then began to rise again, from 27% (95% CI 20-34%) on day 9 to 61% (95% CI 54-67%) on day 21. Care must be taken when interpreting RT-PCR tests for SARS-CoV-2 infection, particularly if performed early in the course of infection, when using these results as a basis for removing precautions intended to prevent onward transmission. If there is high clinical suspicion, patients should not be ruled out on the basis of RT-PCR alone, and the clinical and epidemiologic situation should be carefully considered.
Spatial Correlation of Particulate Matter Pollution and Death Rate of COVID-19
Authors: Yao Ye , Pan Jinhua , Wang Weidong , Liu Zhixi , Kan Haidong , Meng Xia , Wang Weibing 
Published: April 2020

AbstractThe Coronavirus (COVID-19) epidemic, which was first reported in December 2019 in Wuhan, China, has caused 3,314 death as of March 31, 2020 in China. This study aimed to investigate the spatial associations of daily particulate matter (PM) concentrations with death rate of COVID-19 in China. We conducted a cross-sectional analysis to examine the spatial associations of daily PM2.5 and PM10 concentrations with death rate of COVID-19 in China through multiple linear regression method. We found that COVID-19 held higher death rates with increasing concentration of PM2.5 and PM10 levels in the spatial scale, which may affect the process of patients developed from mild to severe and finally influence the prognosis of COVID-19 patients.
COVID-19 UK Lockdown Forecasts and R0
Authors: Dropkin Greg 
Published: April 2020

AbstractIntroductionThe first reported UK case of COVID-19 occurred on 31 January 2020, and a lockdown of unknown duration began on 24 March. One model to forecast disease spread depends on clinical parameters and transmission rates. Output includes the basic reproduction number R0 and the log growth rate r in the exponential phase.MethodsUK data on reported deaths is used to estimate r. A likelihood for the transmission parameters is defined from a gaussian density for r using the mean and standard error of the estimate. Parameter samples from the Metropolis-Hastings algorithm lead to an estimate and credible interval for R0 and forecasts for severe and critical cases, and deaths during a lockdown.ResultsIn the exponential phase, the UK growth rate for log(deaths) is r = 0.224 with s.e. 0.005. R0 = 5.81 with 90% CI (5.08, 6.98). In a 12 week lockdown from 24 March with transmission parameters reduced to 20% of their previous values, around 63,000 severely ill patients will need hospitalisation by mid June, 37,000 critically ill will need intensive care, whilst over 81,000 are expected to die. Had the lockdown begun on 17 March around 16,500 severe, 9,250 critical cases and 18,500 deaths would be expected by early June. With 10% transmission, severe and critical cases peak in April.DiscussionThe R0 estimate is around twice the value quoted by the UK government. The NHS faces extreme pressures, even if transmission is reduced ten-fold. An earlier lockdown could have saved many lives.
Routine deworming during antenatal care decreases risk of neonatal mortality and low birthweight: a retrospective cohort of survey data
Authors: Walia Bhavneet , Kmush Brittany L. , Lane Sandra D. , Endy Timothy , Montresor Antonio , Larsen David A. 
Published: April 2020

AbstractBackgroundSoil transmitted helminths (STH) are a common infection among pregnant women in areas with poor access to sanitation. Deworming medications are cheap and safe; however, the health benefit of deworming during pregnancy is not clear.Methods / Principal FindingsWe created a retrospective cohort of more than 800,000 births from 95 Demographic and Health Survey datasets to estimate the impact of deworming medicine during routine antenatal care (ANC) on neonatal mortality and low birthweight. We first matched births on the probability of receiving deworming during ANC. We then modeled the birth outcomes with the matched group as a random intercept to estimate the effect of deworming during antenatal care after accounting for various risk factors. We also tested for effect modification of soil transmitted helminth prevalence on the impact of deworming during ANC. Receipt of deworming medication during ANC was associated with a 15% reduction in the risk of neonatal mortality (95% confidence interval = 11-18%, n = 797,772 births), with no difference between high and low transmission countries. In low transmission countries, we found an 11% reduction in the odds of low birth weight (95% confidence interval = 8-13%) for women receiving deworming medicine and in high transmission we found a 3% reduction in the odds of low birthweight (95% confidence interval = 1-5%).Conclusions / SignificanceThese results suggest a substantial health benefit for deworming during ANC that may be even greater in countries with low STH transmission.
Air Pollution Increases Influenza Hospitalizations
Authors: Singer Gregor , Zivin Joshua Graff , Neidell Matthew , Sanders Nicholas 
Published: April 2020

AbstractSeasonal influenza is a recurring health burden shared widely across the globe. We study whether air quality affects the occurrence of severe influenza cases that require inpatient hospitalization. Using longitudinal information on local air quality and hospital admissions across the United States, we find that poor air quality increases the incidence of significant influenza hospital admissions. Effects diminish in years with greater influenza vaccine effectiveness. Apart from increasing vaccination rates, improving air quality may help reduce the spread and severity of influenza.