bluuebunny/crossref_metadata_2025_split huggingface dataset:
Odontogenic keratocyst: An incidental finding during an orthodontic examination
Authors: Hameed Othman , Gwilliam Jamie , Whaites Eric 
Published: June 2020

For all orthodontic patients, a detailed clinical examination is essential to obtain the correct diagnosis before the formulation of an orthodontic treatment plan. Additional information may be required from radiographs in order to supplement this clinical examination. While orthodontists principally prescribe dental panoramic tomographs for orthodontic patients to confirm the presence, position and morphology of unerupted teeth, the absence or presence of disease within the supporting structures may be overlooked. This case report presents one such instance where the pre-orthodontic radiographic examination of a young male patient revealed the presence of an asymptomatic odontogenic keratocyst in the right posterior body of the mandible. This case report discusses how this incidental finding was diagnosed, managed and how its surgical treatment subsequently affected the orthodontic management of the patient. Furthermore, this case highlights the importance of undertaking a thorough and systematic approach when analysing any prescribed radiographs, in order to reduce the risk of overlooking any evidence of underlying disease.
Protective effect of exogenous hydrogen sulfide on diaphragm muscle fibrosis in streptozotocin-induced diabetic rats
Authors: Yang Rui , Jia Qiang , Li Yan , Mehmood Shomaila 
Published: June 2020

Diabetes mellitus has been shown to impair respiratory function. The diaphragm is an important skeletal muscle involved in respiration. Hydrogen sulfide (H2S) is one of the three endogenous gas messengers in mammals, which exhibits anti-fibrotic activity in some types of diabetes-related complications. However, whether and how H2S exerts its anti-fibrotic activity on the diabetic diaphragmatic muscle remains unclear. In this study, we explored the anti-fibrotic activity of exogenous H2S on the diaphragm using a streptozotocin (STZ)-induced diabetic rat model. The results showed that diaphragmatic biomechanical parameters were decreased, whereas the levels of inflammatory cytokines, collagen, and nucleotide-binding oligomerization domain-like receptor protein (NLRP) 3 inflammasome-related protein expression were increased in diabetic diaphragms. This implies that diabetes causes fibrosis of the diaphragm muscle through activation of NLRP3 inflammasome. After supplementation with exogenous H2S, the diaphragmatic biomechanical and pathological alterations were ameliorated and activation of NLRP3 inflammasome was inhibited, followed by a decline in diaphragm muscle inflammation and fibrosis. These results demonstrate for the first time that exogenous H2S effectively attenuates STZ-induced diabetic diaphragm muscle fibrosis, and that the underlying mechanism may be associated with suppression of the NLRP3 inflammasome-mediated inflammatory reaction. Impact statement Diabetes mellitus is a group of chronic metabolic disorders, which causes serious damage to a variety of organs, such as the retina, heart, and skeletal muscle. The diaphragm is an important skeletal muscle involved in respiration in mammals. Fibrosis of the diaphragm muscle affects its contractility, which in turn impairs respiratory function. Accumulating evidence suggests that exogenous hydrogen sulfide (H2S) exhibits anti-fibrotic activity in diabetes mellitus, but whether and how H2S exerts this anti-fibrotic effect in the diabetic diaphragm remains unclear. The current work for the first time reveals that exogenous H2S attenuates hyperglycemia-induced fibrosis of the diaphragm muscle and strengthens diaphragmatic biomechanical properties in diabetes mellitus, and the mechanism may involve the alleviation of collagen deposition by suppression of the nucleotide-binding oligomerization domain-like receptor protein (NLRP) 3 inflammasome-mediated inflammatory reaction. Therefore, H2S supplementation could be used as an efficient targeted therapy against the NLRP3 inflammasome in the diabetic diaphragm.
New Preoperative Spinal Cord Ischemia Risk Stratification Model for Patients Undergoing Thoracic Endovascular Aortic Repair
Authors: Mousa Albeir Y. , Morcos Ramez , Broce Mike , Bates Mark C. , AbuRahma Ali F. 
Published: June 2020

Purpose: Our objective was to determine significant predictors of spinal cord ischemia (SCI) following Thoracic Endovascular Aortic Repair (TEVAR) and to further develop a simple and clinically orientated risk score model. Methods: A retrospective review of data from the Society of Vascular Surgery/Vascular Quality Initiative national data set was performed for all patients undergoing TEVAR from January, 2014 to June 2018. Preoperative demographics, procedure-related variables, and clinical details related to SCI were examined. A SCI risk score was developed utilizing a multivariable logistic regression model. Results: For the 7889 patients in the final analysis who underwent TEVAR during the study period, the mean age was 67.6 ± 13.9, range 18 to 90 years, and the majority was male (65%). Postoperative outcomes included stroke (3.0%), myocardial infarction (2.9%), inhospital mortality (5.4%), transient SCI (1.5%), and permanent SCI (2.1%). Nearly half of the overall cases were performed in high volume centers. Predictors of increased risk for SCI included age by decade (odds ratio [OR]: 1.2), celiac coverage (OR: 1.5), current smoker (OR: 1.6), dialysis (OR: 1.9), 3 or more aortic implanted devices (OR: 1.7), emergent or urgent surgery (OR: 1.5), adjunct aorta-related procedure (OR: 2.5), adjunct not related (OR: 2.6), total estimated length of aortic device (19-31 cm, OR: 1.9 and ≥32 cm, OR: 3.0), ASA class 4 or 5 (OR: 1.6), and procedure time ≥154 minutes (OR: 1.8). Two predictors decreased the risk of SCI, cases from high-volume centers (OR: 0.6) and eGFR ≥ 60 (OR: 0.6). To evaluate the risk score model, probabilities of SCI from the original regression, raw score, and raw score categories resulted in area under the curve statistics of 0.792, 0.786, and 0.738, respectively. Conclusions: Spinal cord ischemia remains one of the most feared complications of TEVAR. Incidence of SCI in this large series of patients with TEVAR was 3.6% with nearly 60% being permanent. The proposed model provides an assessment tool to guide clinical decisions, patient consent process, risk-assessment, and procedural strategy.
Physical activity in working mothers: Running low impacts quality of life
Authors: Limbers Christine A , McCollum Christina , Ylitalo Kelly R , Hebl Mikki 
Published: June 2020

Objectives: The transition to motherhood is associated with declines in physical activity in women. Working mothers may be particularly at-risk for low levels of physical activity, since they have to balance the competing interests of work and family life, and exercise often takes a backseat to more seemingly pressing concerns. The potential benefits working mothers can experience from physical activity are numerous. The objectives of this study were to evaluate the percentage of working mothers from the United States who met the World Health Organization’s and the American College of Sports Medicine’s recommended guidelines for weekly physical activity and investigate the associations between physical activity, quality of life, and self-rated work productivity in this sample of working mothers. Methods: Participants were 334 working mothers from the United States (mean age = 35.00 years; standard deviation (SD) = 5.85; 77.8% White) recruited from a Qualtrics research panel. To be eligible to participate in the study, a woman had to be 18 years or older with at least one child aged 5 years or younger, work at least 30 h per week at a job, live with her child(ren) at least 50% of the time, and have a minimum of a bachelor’s degree. Participants completed the Godin leisure time exercise questionnaire, the World Health Organization—five well-being index, a single-item indicator of self-rated work productivity, and a demographic questionnaire. Results: Of the working mothers in the sample, 45.5% met the recommended guidelines of at least 150 min of moderate exercise in the past week. Approximately 39% of working mothers reported engaging in no 30-min bouts of strenuous exercise in the past week. Non-white working mothers, working mothers with a higher singular annual income, and working mothers who obtained a higher educational level were more likely to meet the recommended guidelines for physical activity in the past week. Meeting the recommended physical activity guidelines in the past week was associated with better quality of life ( r = 0.39; p < 0.001) and self-rated work productivity ( r = 0.13; p < 0.05). Only the association between physical activity and quality of life remained significant in a multivariate analysis (standardized beta coefficient = 0.33; p < 0.001) after controlling for race/ethnicity, maternal singular annual income, and maternal highest level of education. Conclusion: Our findings highlight that working mothers in the United States are a group at risk for low levels of physical activity. Given the great benefits that these women do experience as a function of getting exercise, it is critically important we pay more attention to how individual, organizational, and societal-level interventions might assist them in attaining target levels of physical activity.
A randomized controlled trial of dorsal web space versus palmar midline injection of steroid in the treatment of trigger digits
Authors: Jiménez Isidro , Garcés Gerardo L. , Marcos-García Alberto , Medina José 
Published: June 2020

One hundred and sixty patients were enrolled in a prospective randomized controlled trial to assess whether a steroid injection through the dorsal web space was less painful than the palmar midline technique in the treatment of trigger digits and whether they were equally effective. There were 116 women and 44 men with a mean age of 60 years. The mean visual analogue score for pain during the injection was 3.6 in the dorsal web space group and 5.4 in the palmar midline group on a scale of 0–10. The overall success of treatment in the dorsal group was 67%, whereas it was 56% in the palmar group. No complications were noted. We concluded from this study that the dorsal web space technique is less painful and at least as effective as the palmar midline technique. Level of evidence: I
Risk factors for rupture of extensor tendons in the rheumatoid wrist
Authors: Asano Kenichi , Shinohara Takaaki , Iwatsuki Katsuyuki , Yamamoto Michiro , Tatebe Masahiro , Hirata Hitoshi 
Published: June 2020

This study assessed the risk factors for spontaneous extensor tendon rupture in the rheumatoid wrist. The rupture group consisted of 25 wrists that had rupture of the extensor tendons and later received tendon reconstruction. The non-rupture group included 77 rheumatoid wrists without extensor tendon rupture. We assessed patients' pain at the distal radioulnar joint and swelling in the extensor tendon compartments clinically, matrix metalloproteinase-3 level in blood samples, and radiographic findings. We found that swelling in the extensor tendon compartments, the scallop sign, and severe dorsal subluxation are significantly associated with spontaneous extensor tendon rupture, but serum matrix metalloproteinase-3 level is not. Level of evidence: IV
High and Varied Anterior Condyle of the Distal Femur Is Associated with Limited Flexion in Varus Knee Osteoarthritis
Authors: Nishitani Kohei , Ito Takayuki , Hatada Ryosuke , Kuriyama Shinichi , Nakamura Shinichiro , Ito Hiromu , Matsuda Shuicih 
Published: June 2020

Objective This study aimed to evaluate variations in anterior condylar height (ACH) of the distal femur in varus knee osteoarthritis and evaluate the association between ACH and knee flexion. Design Computed tomography (CT) images of 171 knees (143 patients; age 73.7 ± 8.3 years; 132 females, 39 males) with symptomatic primary knee osteoarthritis and varus alignment undergoing primary total knee arthroplasty, unilateral knee arthroplasty, or high tibial osteotomy were evaluated. Several other anatomic parameters were measured on CT or radiography. The ACH and knee flexion correlation was analyzed, and factors contributing to knee flexion were determined using multivariable regression analysis. Results Medial ACH (mean, 8.1 mm; range, −2.8 to 19.9 mm) was smaller ( P < 0.001) but more variable ( F = 1.8, P < 0.001) than lateral ACH (mean, 10.7 mm; range, 3.6-18.3 mm). Medial ACH was moderately correlated with flexion ( r = −0.44, 95% confidence interval [CI], −0.55 to −0.32), whereas lateral ACH was weakly correlated ( r = −0.38; 95% CI, −0.50 to −0.25). On multivariable linear regression analysis of knee flexion, body mass index ( B [partial regression coefficient] = −1.1), patellofemoral Kellgren-Lawrence grade ( B = −4.3), medial ACH ( B = −1.2), medial posterior condylar offset ( B = 1.2), age ( B = −0.4), and varus alignment ( B = −0.6) remained significant independent variables (adjusted R2 = 0.35). Conclusions Wide variation and anteriorization of the anterior condyle of the distal femur was observed in advanced osteoarthritis, as an independent determinant of limited knee flexion.
The course of COVID‐19 in a 55‐year‐old patient diagnosed with severe idiopathic pulmonary arterial hypertension
Authors: Mandler Diana , Lichtblau Mona , Ulrich Silvia 
Published: June 2020

We describe a 55‐year‐old woman with severe idiopathic pulmonary arterial hypertension (mean pulmonary artery pressure 71 mmHg, pulmonary vascular resistance 30 WU at diagnosis five months ago), who was diagnosed with SARS‐CoV‐2 infection (COVID‐19) and experienced a relatively mild course with symptoms resembling a common cold. To date, information about the clinical course of COVID‐19 in pre‐existing pulmonary arterial hypertension is lacking, and it is thus unknown whether pulmonary arterial hypertension belongs to the risk factors of severe COVID‐19 disease.
Management of Primary Necrotizing Fasciitis of the Breast: A Systematic Review
Authors: Konik Ryan D. , Huang Gregory S. 
Published: June 2020

Purpose: Necrotizing fasciitis (NF) is a life-threatening infection that involves spreading necrosis of the subcutaneous tissue and fascia that affects the extremities, abdominal wall, and perineum. Primary infection of the breast is a rare occurrence. Shah et al described the first case of primary breast NF and recommended radical “pseudotumor” excision and delayed skin closure months after resolution. Numerous other cases reported were successfully managed with different strategies. We aimed to summarize management options for primary breast NF through a systematic review of the literature. Methods: A systematic review of English literature was performed using PubMed. A total of 58 abstracts were reviewed. Data were abstracted from 25 cases that met inclusion criteria. Results: A total of 25 cases of primary NF of the breast without an inciting event were found within the literature. Common initial operations included total mastectomy (36.0%), excisional debridement (32.0%), and partial mastectomy (12.0%). A total or radical mastectomy was completed for definitive source control in 13 (52.0%) cases. A total of 18 cases underwent reconstruction. Split-thickness skin grafts (44.4%) and delayed primary closures (33.3%) were the most common methods of reconstruction. Conclusion: Majority of cases with primary breast NF are managed with a total mastectomy to gain source control. Reconstruction using split-thickness skin grafts was most common. Other options included delayed primary closure, full thickness skin grafts, local tissue rearrangement, and pedicle flap reconstruction. Reconstruction should be patient dependent, but the whole arsenal of the reconstructive ladder may be used.
Using Telemedicine and Infographics for Physician‐Guided Home Drain Removal
Authors: Go Beatrice C. , Brewster Ryan , Patel Risha , Rajasekaran Karthik 
Published: June 2020

ObjectiveMeasures to decrease hospital length of stay and outpatient visits are crucial during the coronavirus disease 2019 (COVID‐19) pandemic. Physician‐guided home drain removal presents a potential opportunity for mitigating viral spread and transmission.MethodsA prospective case series on patients undergoing major head and neck surgery with Jackson‐Pratt drain placement was conducted. Patients were shown an infographic detailing drain care and removal at preoperative assessment and prior to discharge. At a 1‐week follow‐up telemedicine visit, patients were instructed to remove the drain under physician guidance. Patients were assessed 7 days after to determine complication rate and satisfaction.ResultsTwenty‐five patients were enrolled with 100% patients undergoing successful drain removal at home with caregiver support. There were no complications reported at the 7‐day postdrain removal time point, and overall patient satisfaction was high.DiscussionInfographics and telemedicine are 2 synergistic strategies to guide safe and effective home drain removal.Implications for PracticeThis study demonstrates how telemedicine and an infographic can be effectively used in physician‐guided home drain removal. During a time like the COVID‐19 pandemic, innovative measures are necessary to curb transmission and infection rates. We propose a unique and replicable yet safe solution to limit unnecessary exposure and encourage other surgical providers to adopt a similar strategy.
Innate lymphoid cells in isocyanate-induced asthma: role of microRNA-155
Authors: Blomme Evy E. , Provoost Sharen , Bazzan Erica , Van Eeckhoutte Hannelore P. , Roffel Mirjam P. , Pollaris Lore , Bontinck Annelies , Bonato Matteo , Vandenbroucke Louise , Verhamme Fien , Joos Guy F. , Cosio Manuel G. , Vanoirbeek Jeroen A. J. , Brusselle Guy G. , Saetta Marina , Maes Tania 
Published: June 2020

BackgroundOccupational asthma, induced by workplace exposures to low molecular weight agents such as toluene 2,4-diisocyanate (TDI), causes a significant burden to patients and society. Little is known about innate lymphoid cells (ILCs) in TDI-induced asthma. A critical regulator of ILC function is microRNA-155, a microRNA associated with asthma.ObjectiveTo determine whether TDI exposure modifies the number of ILCs in the lung and whether microRNA-155 contributes to TDI-induced airway inflammation and hyperresponsiveness.MethodsC57BL/6 wild-type and microRNA-155 knockout mice were sensitised and challenged with TDI or vehicle. Intracellular cytokine expression in ILCs and T-cells was evaluated in bronchoalveolar lavage (BAL) fluid using flow cytometry. Peribronchial eosinophilia and goblet cells were evaluated on lung tissue, and airway hyperresponsiveness was measured using the forced oscillation technique. Putative type 2 ILCs (ILC2) were identified in bronchial biopsies of subjects with TDI-induced occupational asthma using immunohistochemistry. Human bronchial epithelial cells were exposed to TDI or vehicle.ResultsTDI-exposed mice had higher numbers of airway goblet cells, BAL eosinophils, CD4+T-cells and ILCs, with a predominant type 2 response, and tended to have airway hyperresponsiveness. In TDI-exposed microRNA-155 knockout mice, inflammation and airway hyperresponsiveness were attenuated. TDI exposure induced IL-33 expression in human bronchial epithelial cells and in murine lungs, which was microRNA-155 dependent in mice. GATA3+CD3−cells, presumably ILC2, were present in bronchial biopsies.ConclusionTDI exposure is associated with increased numbers of ILCs. The proinflammatory microRNA-155 is crucial in a murine model of TDI asthma, suggesting its involvement in the pathogenesis of occupational asthma due to low molecular weight agents.
Minimal clinically important difference for asthma endpoints: an expert consensus report
Authors: Bonini Matteo , Di Paolo Marcello , Bagnasco Diego , Baiardini Ilaria , Braido Fulvio , Caminati Marco , Carpagnano Elisiana , Contoli Marco , Corsico Angelo , Del Giacco Stefano , Heffler Enrico , Lombardi Carlo , Menichini Ilaria , Milanese Manlio , Scichilone Nicola , Senna Gianenrico , Canonica Giorgio W. 
Published: June 2020

Minimal clinically important difference (MCID) can be defined as the smallest change or difference in an outcome measure that is perceived as beneficial and would lead to a change in the patient's medical management.The aim of the current expert consensus report is to provide a “state-of-the-art” review of the currently available literature evidence about MCID for end-points to monitor asthma control, in order to facilitate optimal disease management and identify unmet needs in the field to guide future research.A series of MCID cut-offs are currently available in literature and validated among populations of asthmatic patients, with most of the evidence focusing on outcomes as patient reported outcomes, lung function and exercise tolerance. On the contrary, only scant and partial data are available for inflammatory biomarkers. These clearly represent the most interesting target for future development in diagnosis and clinical management of asthma, particularly in view of the several biologic drugs in the pipeline, for which regulatory agencies will soon require personalised proof of efficacy and treatment response predictors.