bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of baloxavir marboxil on household transmission of influenza infection
Authors: Umemura Takumi , Mutoh Yoshikazu , Kawamura Takato , Saito Masayuki , Mizuno Takahito , Ota Aiko , Kozaki Koji , Yamada Tetsuya , Ikeda Yoshiaki , Ichihara Toshihiko 
Published: September 2020

Abstract
Background
Baloxavir marboxil (baloxavir) is a new anti-influenza virus agent that is comparable to oseltamivir phosphate (oseltamivir). Since the efficacy of baloxavir in preventing household transmission of influenza is not well established, we compared the secondary household influenza virus transmission rates between patients on baloxavir vs oseltamivir.

Methods
Between October 2018 and March 2019, we enrolled index patients (diagnosed with influenza and treated with baloxavir or oseltamivir) and household members. The secondary attack rate of household members was compared between index patients treated with baloxavir vs oseltamivir. Risk factors of household transmission were determined using multivariate logistic analyses.

Results
In total, 169 index patients with influenza type A were enrolled. The median age was 27.0 (interquartile range; 11–57) years. The number of index patients treated with baloxavir and oseltamivir was 49 and 120, respectively. The secondary attack rate was 9.0% (95% confidence interval [CI]: 4.6–15.6) in the baloxavir group and 13.5% (95% CI: 9.8–17.9) in the oseltamivir group. In the multivariate analysis, independent risk factors were 0–6 years of age (odds ratio [OR] 2.78, 95% CI: 1.33–5.82, p < 0.01) and not being on baloxavir treatment. (OR: 0.63, 95% CI: 0.30–1.32, p = 0.22).

Conclusion
The household secondary attack rate of influenza was comparable in patients treated with baloxavir vs oseltamivir. Therefore, baloxavir can be used as an alternative therapy to oseltamivir in reducing household transmission of influenza.

Trial registration
Patients in this study were retrospectively registered. https://www.tosei.or.jp/clinical/pdf/2_influenza.pdf.
Laparoscopic cholecystectomy for a cholelithiasis patient with an aberrant biliary duct of B5: a case report
Authors: Suzuki Takuto , Asahi Yoh , Sawada Akifumi , Umemoto Kohei , Kina Masaya , Shinohara Masahiro , Yokoyama Kazunori , Masuko Hiroyuki 
Published: September 2020

Abstract
Background
An aberrant biliary duct of segment 5 (B5) is a rare anomaly of the biliary tract. All anatomical anomalies of the biliary tract are risk factors for bile duct injury during surgery. We report a case of cholelithiasis with an aberrant B5 that was detected during a detailed preoperative imaging examination and treated with laparoscopic cholecystectomy.

Case presentation
A 69-year-old woman was admitted to the emergency room of our hospital with abdominal pain. She was diagnosed with cholelithiasis, and an aberrant B5 branching off the hepatic duct was suggested during preoperative imaging. Laparoscopic cholecystectomy was performed at our surgical department. There were no intra- or postoperative complications, and the patient was discharged on the fourth day after surgery.

Conclusions
Laparoscopic cholecystectomy can be safely performed without intra- or postoperative complications in patients with cholelithiasis and an aberrant B5 if it is accurately diagnosed preoperatively.
Surgical resection of a middle mediastinal paraganglioma that caused diabetes
Authors: Miura Kentaro , Kobayashi Nobutaka , Satomi Hidetoshi 
Published: September 2020

Abstract
Background
Paragangliomas are rare neuroendocrine tumors originating from chromaffin cells of extra-adrenal origin. Ninety percent of adrenergic tumors originate in the adrenal medulla and are known as pheochromocytomas; the remaining 10% are extra-adrenal and are called paragangliomas. Mediastinum paragangliomas is rare and commonly originate from the posterior mediastinum, while those originating from the middle posterior are quite rare. Some paragangliomas secrete catecholamines, leading to symptoms such as hypertension, tachycardia, and diabetes.

Case presentation
A 76-year-old woman visited our hospital for the treatment and further evaluation of diabetes. Her hemoglobin A1c levels had risen to 11.0%. To investigate the cause of her diabetes, a contrast-enhanced chest computed tomography scan was performed, revealing a ring-enhancing tumor (30 × 30 mm) in the middle mediastinum. The surgical resection was performed via video-assisted thoracic surgery. Surgery was performed using a vessel-sealing device; however, bleeding was persistent from the surrounding tissue. Total bleeding was 400 g. Blood pressure fluctuations and arrhythmia did not occur during the operation. The patient’s uncontrolled diabetes was cured after the surgery, and the tumor was diagnosed as a functional paraganglioma.

Conclusions
We encountered a rare case of functional paraganglioma located in the middle mediastinum. Functional paragangliomas should be considered as a potential cause of uncontrolled diabetes, and a whole-body CT scan should be performed to investigate this possible cause.
Narrow band imaging for thoracic endometriosis
Authors: Yamamoto Takehiro , Fujikawa Ryo , Arai Yoshifumi , Nakamura Toru 
Published: September 2020

Abstract
Background
The thoracic cavity is the most frequent site of extrapelvic endometriosis. It exhibits a wide variety of clinical manifestations, such as chest pain, cough, and respiratory distress, and is frequently associated with pelvic endometriosis. Although histological confirmation is the gold standard for a definitive diagnosis, endoscopic identification of the affected area is often difficult. Narrow band imaging (NBI) is an imaging technique that emphasizes vascular structures and is reported to be useful in the diagnosis of pelvic endometriosis.

Case presentations
A 31-year-old woman and 39-year-old woman developed a recurrent right pneumothorax during their menstruation cycles. They both had no medical history suggesting pelvic endometriosis. We planned an elective video-assisted thoracoscopic surgery for the suspicion of thoracic endometriosis. In addition to white light alone, an NBI observation enhanced the microvasculature of the suspected lesions and allowed us to identify the affected area more clearly. Partial resections of the diaphragm were performed. Histopathological and immunohistochemical studies of each specimen confirmed the diagnosis of extrapelvic endometriosis.

Conclusions
NBI may improve the diagnostic accuracy for thoracic endometriosis, especially in clinically suspected patients but without a history of pelvic endometriosis.
Vestibular rehabilitation for persons with stroke and concomitant dizziness—a pilot study
Authors: Ekvall Hansson Eva , Pessah-Rasmussen Hélène , Bring Annika , Vahlberg Birgit , Persson Liselott 
Published: September 2020

Abstract
Background
Dizziness is common among patients with first time stroke. It affects self-perceived health and is a risk factor for falls. Vestibular rehabilitation (VR) is effective for treating dizziness among various conditions, but the effect of dizziness with origin in the central nervous system is poorly studied.
This pilot study of a randomized controlled trial aimed at investigating a vestibular rehabilitation programme among patients with first time stroke and concomitant dizziness. A second aim was to study the feasibility of performing the randomized controlled trial.

Methods
The participants were computer generated randomized to either an intervention or a control group. The intervention comprised of four different vestibular rehabilitation exercises, adapted for each patient and usual rehabilitation. The control group received usual rehabilitation without the vestibular rehabilitation exercises. Outcome measures used were The Activities-specific Balance Confidence Scale, the Berg Balance Scale, the Functional Gait Assessment Scale and the EuroQol-5D. Feasibility was studied in terms of recruitment, adherence and retention rates, also as the ability to collect primary and secondary outcomes as well as to find indications of treatment differences.

Results
Self-rated health improved for all participants. No other differences between baseline and follow-up were detected neither within nor between groups. Recruitment rate was 23%, adherence to the intervention 90%, retention rate 69% and ability to collect outcome measures 90%. No adverse events occurred.

Conclusion
Both the intervention and the control groups improved in self-perceived health. The measures of feasibility were satisfactory in this study, apart from a low recruitment rate.
How does an individual’s default behavior on an online peer-to-peer lending platform influence an observer’s default intention?
Authors: Tang Mingfeng , Mei Mei , Li Cuiwen , Lv Xingyang , Li Xushuang , Wang Lihao 
Published: September 2020

AbstractPrevious studies indicate that individuals’ default behaviors on online peer-to-peer (P2P) lending platforms greatly influence other borrowers’ default intentions. However, the mechanism of this impact is not clear. Moreover, there is scarce research in regard to which factors influence the relationship between an individual’s default behavior and an observer’s default intention. These important questions are yet to be resolved; hence, we conducted two experiments using the scenario-based research method, focusing on Chinese online P2P lending platforms. Our results indicate that an individual’s default behavior can trigger an observer’s default intention as a result of the imperfect punitive measures as they currently exist on Chinese online P2P lending platforms. Both the observer’s moral disengagement level and pragmatic self-activation level serve as mediating variables. In situations where an observer knows an individual’s default behavior, the level of intimacy between the defaulter and observer positively affects the relationship between their default behavior and intention. The intimacy level also positively influences the relationship between the individual’s default behavior and the two mediator variables. Based on the findings, we provide management suggestions in the context of online P2P lending. Our study sets a foundation for future research to utilize other methods to extend the present research findings to other regions and domains.
3D printing in critical care: a narrative review
Authors: Boshra Mina , Godbout Justin , Perry Jeffrey J. , Pan Andy 
Published: September 2020

Abstract
Background
3D printing (3DP) has gained interest in many fields of medicine including cardiology, plastic surgery, and urology due to its versatility, convenience, and low cost. However, critical care medicine, which is abundant with high acuity yet infrequent procedures, has not embraced 3DP as much as others. The discrepancy between the possible training or therapeutic uses of 3DP in critical care and what is currently utilized in other fields needs to be addressed.

Objective
This narrative literature review describes the uses of 3DP in critical care that have been documented. It also discusses possible future directions based on recent technological advances.

Methods
A literature search on PubMed was performed using keywords and Mesh terms for 3DP, critical care, and critical care skills.

Results
Our search found that 3DP use in critical care fell under the major categories of medical education (23 papers), patient care (4 papers) and clinical equipment modification (4 papers). Medical education showed the use of 3DP in bronchoscopy, congenital heart disease, cricothyroidotomy, and medical imaging. On the other hand, patient care papers discussed 3DP use in wound care, personalized splints, and patient monitoring. Clinical equipment modification papers reported the use of 3DP to modify stethoscopes and laryngoscopes to improve their performance. Notably, we found that only 13 of the 31 papers were directly produced or studied by critical care physicians.

Conclusion
The papers discussed provide examples of the possible utilities of 3DP in critical care. The relative scarcity of papers produced by critical care physicians may indicate barriers to 3DP implementation. However, technological advances such as point-of-care 3DP tools and the increased demand for 3DP during the recent COVID-19 pandemic may change 3DP implementation across the critical care field.
Serum protein biomarkers for juvenile dermatomyositis: a pilot study
Authors: Tawalbeh Shefa M. , Marin Wilfredo , Morgan Gabrielle A. , Dang Utkarsh J. , Hathout Yetrib , Pachman Lauren M. 
Published: September 2020

AbstractBackgroundBlood accessible biomarkers to assess disease activity and their response to therapies in Juvenile Dermatomyositis (JDM) are urgently needed. This pilot study aims to identify serum protein biomarkers associated with clinical disease activity in untreated JDM and their response to medical therapy.MethodsSomaScan® technology screened JDM patients for 1305 proteins at three points: 1) before start of treatment, 2) while on therapy, and 3) after treatment tapering when patients were clinically inactive. To define disease associated biomarkers, SomaScan® data from untreated JDM patients (n = 8) were compared to SomaScan® data from an independent age-matched healthy control group (n = 12). Longitudinal analysis defined treatment responsive proteins at three time points: untreated (7 samples), treated (7 samples), and clinically inactive (6 samples). To confirm the SomaScan® data, a subset of nine candidate proteins (CXCL11, IL-17B, IL-17D, IL-22, CXCL10, MCP-1, ANGPT2, MIF, IL-23) weretested by ELISA after adding 2 JDM (one untreated, one clinically inactive) serum samples to the same group of JDM girls (8 untreated, 7 treated; 7 clinically inactive) as well as with 17 age, gender, matched healthy controls.ResultsComparison of untreated JDM versus healthy controls identified 202 elevated and 49 decreased serum proteins in JDM patients with an adjustedp-value < 0.001. Only 82 out of 251 identified biomarker candidates responded to treatment while 12 out of these 82 proteins returned to their original untreated disease levels upon therapy tapering. The ELISA testing of the untreated samples for nine candidate proteins confirmed previously known biomarkers (CXCL10 or IP-10, CXCL11 or I-TAC and MCP-1) and identified novel biomarkers including IL-22, Angiopoetin-2, and IL-17B in a cross-sectional analysis comparing 8 untreated JDM and 17 age/gender matched controls. The subsequent longitudinal data by ELISA were not concordant for some biomarkers (IL-22 and IL-17B), but the other biomarkers either normalized or rebounded concordantly.ConclusionsBlood accessible protein biomarkers reflecting JDM pathophysiology were identified; some of them rebounded after therapy was tapered. Further studies bridging these biomarkers to specific clinical features of JDM are required to confirm the clinical utility of these serum protein biomarkers.
Low-grade oncocytic tumour of kidney (CD117-negative, cytokeratin 7-positive)
Authors: de Andrade Melo Cláudio Galeno Ramalho , Xavier Marcus Vinicius Nunes , Pimenta Isabela Soares , Athanazio Daniel Abensur 
Published: September 2020

Abstract
Background
The term low-grade oncocytic tumour of kidney is an emerging entity describing CD117-negative and cytokeratin 7-positive indolent tumors with overlapping morphological features between oncocytic tumors.

Case presentation
We present herein the case of a 77-year-old female with a 3.2-cm nodule in mid pole of the left kidney. The tumor was uniformly oncocytic with solid, compact nested and trabecular growth patterns. There was common areas of transition to central zones of stromal edema with marked tumor hypocellularity and growth in cords. Some of these areas had adjacent fresh hemorrhage. Immunohistochemistry showed strong and diffuse expression of cytokeratin 7 and negativity for cKIT/CD117.

Conclusion
The proper use of this new diagnostic category avoids labeling such tumors as unclassified renal cell carcinoma – a broad category with different morphologic features and heterogenous prognosis.
Barriers and facilitators in implementing a pilot, pragmatic, telemedicine-delivered healthy lifestyle program for obesity management in a rural, academic obesity clinic
Authors: Batsis John A. , McClure Auden C. , Weintraub Aaron B. , Sette Diane , Rotenberg Sivan , Stevens Courtney J. , Gilbert-Diamond Diane , Kotz David F. , Bartels Stephen J. , Cook Summer B. , Rothstein Richard I. 
Published: September 2020

Abstract
Purpose
Few evidence-based strategies are specifically tailored for disparity populations such as rural adults. Two-way video-conferencing using telemedicine can potentially surmount geographic barriers that impede participation in high-intensity treatment programs offering frequent visits to clinic facilities. We aimed to understand barriers and facilitators of implementing a telemedicine-delivered tertiary-care, rural academic weight-loss program for the management of obesity.

Methods
A single-arm study of a 16-week, weight-loss pilot evaluated barriers and facilitators to program participation and exploratory measures of program adoption and staff confidence in implementation and intervention delivery. A program was delivered using video-conferencing within an existing clinical infrastructure. Elements of Consolidated Framework for Implementation Research (CFIR) provided a basis for assessing intervention characteristics, inner and outer settings, and individual characteristics using surveys and semi-structured interviews. We evaluated elements of the RE-AIM model (reach, adoption) to assess staff barriers to success for future scalability.

Findings
There were 27 patients and 8 staff completing measures. Using CFIR, the intervention was valuable from a patient participant standpoint; staff equally had positive feelings about using telemedicine as useful for patient care. The RE-AIM framework demonstrated limited reach but willingness to adopt was above average. A significant barrier limiting sustainability was physical space for intervention delivery and privacy and dedicated resources for staff. Scheduling stressors were also a challenge in its implementation.

Conclusions
The need to engage staff, enhance organizational culture, and increase reach are major factors for rural health obesity clinics to enhance sustainability of using telemedicine for the management of obesity.

Trial registration
Clinicaltrials.gov NCT03309787. Registered on 16 October 2017.
The posterior urethral valves revisited: embryological correlation, clinical classification, and risk stratification of the spectrum
Authors: Sarma Vivek Parameswara 
Published: September 2020

Abstract
Background
The diagnosis of posterior urethral valves (PUV) encompasses a vast spectrum of disease with variable severity and clinical features. It is vital to understand the extent of developmental insult and to define the different distinct entities grouped together under the diagnostic umbrella of PUV. This would help to determine the severity of the disease, enable better prognostication, and optimize therapy. The objective of this study is to analyze the variable features of PUV and correlate the different manifestations with the embryological development of the urinary system. The possible developmental basis of anomalies in PUV is analyzed, as recognition of the underlying defect would help to determine the severity of the disease. A clinical classification and a risk stratification approach encompassing the spectrum of PUV is proposed, to help define diagnosis and guide prognosis. A combined retrospective and prospective analysis of cases diagnosed as PUV at the tertiary teaching institute over a 5-year period from July 2014 to July 2019 was done. The outcome of selected cases was analyzed, based on the risk group stratification.

Results
The incidence of major complications during follow-up in each risk group was assessed individually and found to be highest in the high-risk group (92%), which was significantly higher than the other groups. The intermediate risk group was found to have a complication rate of 38%, while the low-risk group had only 12.5% complication rate. The three key concepts addressed in this study pertain to the embryological basis of PUV, the necessity of a clinical subdivision of patients, and the possibility of risk stratification based on clinical criteria. The limited review of institutional series is added to highlight the method of risk stratification and its probable utility.

Conclusions
The most critical factors to be accounted for in the diagnosis and management of PUV are the definition of disease severity, recognition of systemic complications, and identification of children at risk of progression to ESRD. The proposed developmental defect analysis, description of PUV sequence, clinical classification, and risk stratification approach are only the means to this end of segregating patient groups within the diagnostic spectrum.
Five-Year Outcomes With Nivolumab in Patients With Wild-Type BRAF Advanced Melanoma
Authors: Robert Caroline , Long Georgina V. , Brady Benjamin , Dutriaux Caroline , Di Giacomo Anna Maria , Mortier Laurent , Rutkowski Piotr , Hassel Jessica C. , McNeil Catriona M. , Kalinka Ewa Anna , Lebbé Céleste , Charles Julie , Hernberg Micaela M. , Savage Kerry J. , Chiarion-Sileni Vanna , Mihalcioiu Catalin , Mauch Cornelia , Arance Ana , Cognetti Francesco , Ny Lars , Schmidt Henrik , Schadendorf Dirk , Gogas Helen , Zoco Jesús , Re Sandra , Ascierto Paolo A. , Atkinson Victoria 
Published: September 2020

PURPOSE The CheckMate 066 trial investigated nivolumab monotherapy as first-line treatment for patients with previously untreated BRAF wild-type advanced melanoma. Five-year results are presented herein. PATIENTS AND METHODS In this multicenter, double-blind, phase III study, 418 patients with previously untreated, unresectable, stage III/IV, wild-type BRAF melanoma were randomly assigned 1:1 to receive nivolumab 3 mg/kg every 2 weeks or dacarbazine 1,000 mg/m2 every 3 weeks. The primary end point was overall survival (OS), and secondary end points included progression-free survival (PFS), objective response rate (ORR), and safety. RESULTS Patients were followed for a minimum of 60 months from the last patient randomly assigned (median follow-up, 32.0 months for nivolumab and 10.9 months for dacarbazine). Five-year OS rates were 39% with nivolumab and 17% with dacarbazine; PFS rates were 28% and 3%, respectively. Five-year OS was 38% in patients randomly assigned to dacarbazine who had subsequent therapy, including nivolumab (n = 37). ORR was 42% with nivolumab and 14% with dacarbazine; among patients alive at 5 years, ORR was 81% and 39%, respectively. Of 42 patients treated with nivolumab who had a complete response (20%), 88% (37 of 42) were alive as of the 5-year analysis. Among 75 nivolumab-treated patients alive and evaluable at the 5-year analysis, 83% had not received subsequent therapy; 23% were still on study treatment, and 60% were treatment free. Safety analyses were similar to the 3-year report. CONCLUSION Results from this 5-year analysis confirm the significant benefit of nivolumab over dacarbazine for all end points and add to the growing body of evidence supporting long-term survival with nivolumab mono-therapy. Survival is strongly associated with achieving a durable response, which can be maintained after treatment discontinuation, even without subsequent systemic therapies.