bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public Health and Epidemiology Informatics: Recent Research Trends Moving toward Public Health Data Science
Authors: Cossin Sébastien , Thiébaut Rodolphe ,   Section Editors for the IMIA Yearbook Section on Public Health and Epidemiology Informatics
Published: August 2020

Objectives: To introduce and summarize current research in the field of Public Health and Epidemiology Informatics.
Methods: PubMed searches of 2019 literature concerning public health and epidemiology informatics were conducted and the returned references were reviewed by the two section editors to select 14 candidate best papers. These papers were then peer-reviewed by external reviewers to allow the Editorial Committee a curated selection of the best papers.
Results: Among the 835 references retrieved from PubMed, two were finally selected as best papers. The first best paper leverages satellite images and deep learning to identify remote rural communities in low-income countries; the second paper describes the development of a worldwide human disease surveillance system based on near real-time news data from the GDELT project. Internet data and electronic health records are still widely used to detect and monitor disease activity. Identifying and targeting specific audiences for public health interventions is a growing subject of interest.
Conclusions: The ever-increasing amount of data available offers endless opportunities to develop methods and tools that could assist public health surveillance and intervention belonging to the growing field of public health Data Science. The transition from proofs of concept to real world applications and adoption by health authorities remains a difficult leap to make.
A Study to Ascertain the Expression of Aquaporin 4 and Neuropeptide Y in the Jejunal Mucosa Secondary to Traumatic Brain Injury in Humans
Authors: Patil Parag Parshuram , Subramanian Arulselvi , Aggarwal Garima , Lalwani Sanjeev , Agrawal Deepak 
Published: August 2020

Abstract
Introduction Gastrointestinal (GI) dysfunction is a common complication in patients with traumatic brain injury (TBI). Studies in rats have shown alterations in intestinal mucosa to correlate with severity and duration of TBI. There is lack of such evidence in humans. So we intended to find correlation between histopathological changes and expression of aquaporin 4 (AQ4) and neuropeptide Y (NPY) in jejunal mucosa in post TBI patients.
Materials and Methods Autopsy specimens of jejunum were obtained from patients who had died due to TBI (n = 20), patients dying due to traumatic injury other than TBI, and patients who were brought dead (diseased controls n = 20). Abdominal trauma was the exclusion criterion for both. Jejunal specimens were grossly examined and then analyzed histopathologically and graded immunohistochemically for AQ4 and NPY. Unpaired t-test was used to compare results.
Results After exclusion, 19 cases and 17 controls were studied. No significant difference was observed in the microscopic findings between cases and controls (p-value = 0.70). The expression of AQ4 was more in cases (p-value = 0.04). NPY expression was not significantly different (p-value = 0.93).
Conclusion AQ4 can hence be used as a marker of GI injury post TBI. Histopathological examination cannot distinguish between these changes.
Sinonasal Malignancy and Orbital Exenteration Sparing Cancer Surgery
Authors: Reyes Camilo , Patel Mihir , Solares C. Arturo 
Published: August 2020

AbstractThis article reviews the most common locations and natural history of sinonasal carcinomas. It also reviews surgical indications and current evidence regarding adjuvant and neoadjuvant therapies. In the past, orbital clearance was generally done for ethmoid and maxillary cancers, even without a marked neoplastic infiltration; however, such indications have changed in the recent years due to advances in our understanding of the disease, as well as new chemotherapeutic and radiotherapy protocols. Surgical resection of tumors close to the orbit exhibits the challenging task of balancing treatment goals and patient's desires.
Siblings with Infantile Neuroaxonal Dystrophy
Authors: Agarwal Pulkit , Goswami Jyotindra Narayan 
Published: August 2020

AbstractA 2 years 3 months male toddler with motor delay and his female sibling with history of marked global developmental regression following an intercurrent febrile illness were both noted to have phospholipase A2G6 (PLA2G6) mutation, confirming the diagnosis of infantile neuroaxonal dystrophy (INAD). This case report attempts to familiarize readers with the pleomorphic presentation of INAD and the role of early clinical identification, examination, and prompt genetic testing in establishing a diagnosis.
Clinical Outcomes of May–Thurner Syndrome in Pediatric Patients: A Single Institutional Experience
Authors: Warad Deepti M. , Rao Amulya Nageswara , Bjarnason Haraldur , Rodriguez Vilmarie 
Published: August 2020

Abstract
Introduction May–Thurner syndrome (MTS) is a vascular anatomic variant resulting in compression of the left common iliac vein by the right common iliac artery, affecting approximately 22% of the population. In adults, following acute deep vein thrombosis (DVT) of the iliofemoral veins, the incidence of postthrombotic syndrome (PTS) and recurrent DVT are high if treated with anticoagulation alone, warranting adjunctive treatment with thrombolysis and stent placement. However, there is paucity of literature documenting the course of treatment and associated outcomes in pediatric patients with MTS.
Methods A retrospective chart review of pediatric patients (≤ 18 years of age) with radiologic confirmation of MTS with or without DVT evaluated and/or treated at our institution from January 1, 2005 through December 31, 2015 was conducted.
Results Seventeen patients (4 male; 13 female) were identified. Median age was 15.4 years (range 8.8–17.1 years) with a median follow-up of 1.2 years (range 0.4–7.5 years). Thirteen (76.5%) patients presented with left lower extremity DVT. Management included catheter-directed thrombolysis (n = 5), systemic thrombolysis (n = 1), and mechanical thrombectomy (n = 1). Fifteen patients were treated with anticoagulation including two patients with endovascular stents without DVT. Median duration of anticoagulation was 6.3 months (range 3.2–18.7 months). Ten patients (59%) underwent stent placements.Complete and partial thrombus resolution was noted in six patients each and no resolution in one patient. Four patients had recurrence/progression of thrombus (n = 3 with stents) at a median time of 29 days (range 12–495 days). No bleeding complications were observed. Clinically documented or self-reported PTS was noted in 8 patients (62%).
Conclusion There are no clear guidelines for MTS management in children and adolescents. In our cohort, thrombolysis, anticoagulation, or stent placements were not associated with bleeding risks, with recurrence/progression of DVT and signs and symptoms of PTS noted in 30 and 62%, respectively. Further studies are needed to determine a standardized treatment approach of the pediatric patient with MTS with or without thrombosis.
Lurking Infantile Pertussis: Experience from a Tertiary Care Center in Northern India
Authors: Bhattacharya Deepanjan , Dash Nabaneeta , Kavitha Thondi Kkandy , Sharma Megha , Gautam Vikas , Verma Sanjay 
Published: August 2020

Abstract
Objectives The aim is to study the clinical laboratory profile and outcome of infants with laboratory confirmed pertussis.
Methods In this retrospective study, records of 30 infants with laboratory confirmed pertussis, admitted to the pediatric department of a tertiary care hospital, were reviewed. Clinical features, laboratory parameters, and outcomes were noted.
Results Median (interquartile range age was 10 (7–24.5) weeks, with a male preponderance. Large majority (60%) of enrolled infants were less than 16 weeks of age and nine (30%) developed pertussis even before 8 weeks of age. Cough was universal (100%), followed by rapid breathing (73%), fever (70%), and apnea (10%). Bubble continuous positive airway pressure (CPAP), nasal prongs oxygen, and invasive ventilation were required in 15 (54%), 11 (39%), and 2 (7%) infants, respectively; 12 (40%) needed to be admitted to the pediatric intensive care unit. Anemia was observed in 28 (93%) and leukemoid reaction in 15 (50%). All except one were discharged successfully. None of the mothers had received tetanus, diphtheria, and pertussis or Tdap vaccination during pregnancy.
Conclusion Our study reports the continued occurrence of infantile pertussis in the community, suggesting reconsideration of our vaccination policy, including maternal immunization.
Role of Toll-Like Receptors 2 and 4 Genes Polymorphisms in Neonatal Sepsis in a Developing Country: A Pilot Study
Authors: Khaled Bedewy M. , Noha Abou Seada M. , Manal Antonios A. M. , Engy Saleh M. 
Published: August 2020

Abstract
Objective Toll-like receptors (TLR) are one of the key molecules that alert the immune system to the presence of microbial infections. This study attempts to elucidate the role of TLR2 and TLR4 polymorphisms in neonatal sepsis.
Methods A case–control study including 30 neonates with confirmed sepsis compared with 20 neonates in a control group. TLR2 and TLR24 gene polymorphisms were confirmed by polymerase chain reaction.
Results The majority of infections were attributed to gram-negative organisms (72.5%) namely Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. Results also revealed that incidence of TLR polymorphism was significantly different between the sepsis and control groups (p = 0.016). The most common polymorphism was TLR2; Arg 753 Gln (16.7%). Presence of TLR polymorphism was also associated with a longer duration of therapy (a median of 10 days for cases with positive polymorphism compared with 6.5 days for negative cases; p = 0.001).
Conclusion This pilot study suggests that any polymorphisms in TLR2 and TLR4 might have a role that interferes with the innate immune response of newborn.
Radial Shortening Osteotomy for Symptomatic Kienböck's Disease: Complications and Long-Term Patient-Reported Outcome
Authors: van Leeuwen Wouter F. , Pong Taylor M. , Gottlieb Rachel W. , Deml Christian , Chen Neal , van der Heijden Brigitte E.P.A. 
Published: August 2020

AbstractObjective To determine the rate of salvage procedures and any other unplanned reoperations in patients with symptomatic Kienböck's disease who were treated with radial shortening osteotomy. In addition, we studied patient-reported outcome in the long term using Patient-Reported Outcome Measure Information System (PROMIS) instruments.Patients and Methods We performed a retrospective review of all patients who underwent radial shortening osteotomy for stage 2 and 3A Kienböck's disease. Patients who had concomitant revascularization were grouped separately. We collected demographic data, data regarding type of surgery and reoperations, and radiographic data. Patient-reported outcome measures were the PROMIS Upper Extremity Computer Adaptive Testing (CAT) and Pain Interference instruments, the abbreviated Disabilities of Arm, Shoulder, and Hand (QuickDASH), and the 0 to 10 numeric rating scale for pain and satisfaction.Results We included 48 patients who had radial shortening osteotomy alone, and 17 patients who had a combined procedure of radial shortening and direct revascularization. The rate of unplanned reoperations was 33% (16 of 48) in those who had radial shortening osteotomy and 24% (4 of 17) in those who had a combined procedure. Six (13%) of 48 patients underwent proximal row carpectomy due to failed radial shortening osteotomy. No salvage procedures were performed after combined radial shortening/revascularization. Median PROMIS Physical Function CAT scores were 56 (interquartile range [IQR]: 44–56) and 56 (IQR: 41–56), respectively. Median PROMIS Pain Interference scores were 39 (IQR: 39–52) and 39 (IQR: 39–49), respectively. Median QuickDASH scores were 2.3 (IQR: 0–23) and 4.5 (IQR: 2.3–14), respectively.Conclusion Radial shortening osteotomy for symptomatic Kienböck's disease yields reasonable long-term function. We observed that approximately one in eight patients underwent salvage surgery after radial shortening, and this should be taken into account when making the initial decision to treat Kienböck's disease surgically. There appeared to be no benefit of direct revascularization in addition to radial shortening in terms of patient-reported outcome in the long term.Level of Evidence This is a Level IV, therapeutic study.
Impact of Excess Weight Gain on Risk of Postpartum Infection in Class III Obesity
Authors: Mitchell Courtney J. , Adkins LaMani , Tucker Ann , Brown Haywood , Siegel Anne , Dotter-Katz Sarah 
Published: August 2020

Abstract
Objective To assess the impact of gestational weight gain >20 pounds (more than Institute of Medicine [IOM] recommendations) on postpartum infectious morbidity in women with class III obesity.
Methods This is a retrospective cohort of term, nonanomalous singleton pregnancies with body mass index ≥40 at a single institution from 2013 to 2017. Pregnancies with multiple gestation, late entry to care, and missing weight gain data are excluded. Primary outcome is a composite of postpartum infection (endometritis, urinary tract, respiratory, and wound infection). Secondary outcomes include components of composite, wound complication, readmission, and blood transfusion. Bivariate statistics compared demographics, pregnancy complications, and delivery characteristics of women exceeding IOM guidelines (GT20) with those who did not (LT20). Regression models were used to estimate adjusted odds of outcomes.
Results Of 374 women, 144 (39%) gained GT20 and 230 (62%) gained LT20. Primiparous, nonsmokers more likely gained GT20 (p < 0.05). No significant difference in other demographics. Among women who gained GT20, 10.4% had postpartum infectious morbidity compared with 3.0% in LT20 (p < 0.01). Wound infection is more common in the GT20 group (7.6 vs. 2%, p = 0.02). After adjustment, women who gained GT20 had threefold higher odds of postpartum infectious morbidity (adjusted odds ratio: 3.17, 95% confidence interval: 1.17, 8.60).
Conclusion Women with class III obesity who gain more than the IOM recommends are at increased risk for postpartum infectious morbidity.
Coronavirus Disease 2019 in a Premature Infant: Vertical Transmission and Antibody Response or Lack Thereof
Authors: Rivera-Hernandez Pedro , Nair Jayasree , Islam Shamim , Davidson Lauren , Chang Arthur , Elberson Valerie 
Published: August 2020

AbstractWith the global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, several reports highlight its effects on pregnant women. Based on scant available data, vertical transmission is considered unlikely. We present here a preterm neonate born to a critically ill mother with SARV-CoV-2 with early evidence of infection with a positive reverse transcription polymerase chain reaction on day 1. Lack of parental contact prior to testing and strict adherence to recommended airborne precautions perinatally suggest vertical transmission of infection. Critical maternal illness and medications may have contributed to the need for extensive resuscitation at birth and highlight the importance of close fetal monitoring. Infant lacked immunoglobulin G antibody response by 3 weeks, presumably secondary to mild clinical course and prematurity. Effects of SARS-CoV-2 in preterm infants, their antibody response and potential for asymptomatic carriage remain uncertain.
The Spectrum of Disease Severity in Cirrhosis and Its Implications for Hemostasis
Authors: Stotts Matthew J. , Lisman Ton , Intagliata Nicolas M. 
Published: August 2020

AbstractBleeding and thrombosis are both common complications that patients with advanced liver disease experience. While hemostatic pathways remain largely intact with cirrhosis, this balance can quickly shift in the direction of bleeding or clotting in an unpredictable manner. A growing body of literature is attempting to shed light on difficult scenarios that clinicians often face, ranging from predicting and mitigating bleeding risk in those who need invasive procedures to determining the best strategies to manage both bleeding and thrombotic complications when they occur. Studies examining hemostasis in those with advanced liver disease, however, often include heterogeneous cohorts with varied methodology. While these studies often select a cohort of all types and degrees of cirrhosis, emerging evidence suggests significant differences in underlying systemic inflammation and hemostatic abnormalities among specific phenotypes of liver disease, ranging from compensated cirrhosis to decompensated cirrhosis and acute-on-chronic liver failure. It is paramount that future studies account for these differing disease severities if we hope to address the many critical knowledge gaps in this field.
Lost in Transition: The Long and Winding Road Toward Epilepsy Surgery—An Analysis of Obstacles Prior to Surgery and Call for Orchestrated Health Care Efforts in Epilepsy
Authors: Graf Wolfgang , Kasper Burkhard S. , Sharma Sunjay , Kasper Ekkehard M. 
Published: August 2020

AbstractDifficult-to-treat epilepsy is defined as ongoing seizures despite adequate pharmacological treatment. This condition is affecting a significant percentage of epilepsy patients and is estimated to be as high as one-third of all patients. Epilepsy surgery, targeting the removal of the key parts of cerebral convolutions responsible for seizure generation and often including a structural lesion, can be a very successful approach. However, this necessitates careful patient selection by comprehensive investigations, proving the localization of the epileptogenic zone as well as measures to make such surgeries safe. With careful selection as a prerequisite, the percentage of patients achieving seizure freedom by neurosurgical intervention is high, approximating two-thirds of all epilepsy surgeries performed. In contrast, the average duration of a patient's pharmacoresistant focal epilepsy prior to surgery anywhere around the globe is around 20 years. Given that typical patients are ∼30 to 40 years of age at the time of surgery, many patients have been living with chronic seizures since childhood or adolescence. This means that most of these patients have been going through several stages of medical care for years or even decades, both as children and adults, without ever being fully investigated and/or selected for surgery which is concerning. Yet, there is no set standard for a timeline leading toward successful surgery in epilepsy. It is obvious that the average transit period from the moment of first seizure manifestation until the day of successful surgery takes much too long. This is the reason why we see these patients lost in transition.
Safety of Coupled Arterial Anastomosis in Autologous Breast Reconstruction
Authors: McLaughlin Mariel , Porter Brooke E. , Cohen-Shohet Rachel , Leyngold Mark M. 
Published: August 2020

Abstract
Background This study compares the outcomes of coupled versus hand-sewn arterial anastomosis in microvascular breast reconstruction.
Methods Retrospective chart review of breast reconstruction free flaps performed between 2013 and 2018 was conducted. Primary end points included flap loss, intraoperative arterial anastomosis revision, and operating room takeback. The decision to couple the arterial anastomosis was based on patient's age, surgeon's preference, history of radiation, and vessel quality. All anastomoses were performed under ×3.5 loupe magnification to internal mammary or thoracodorsal vessels.
Results Authors reviewed 104 free flaps; two were lost in hand-sewn group; no flaps were lost in coupled group. There was no significant difference in anastomotic revision rate between coupled and hand-sewn arterial anastomosis (p = 0.186) or return to operating room (OR) between coupled and hand-sewn flaps (p = 1.000). Reasons for takeback included venous congestion and hematoma.
Conclusion This study reflects that coupled arterial anastomosis in breast reconstruction may be safely performed without increased risk in anastomotic revision, takeback, or flap loss. Decision to couple should be based on surgeon skill, patient age and history, and assessment of flap and recipient site vasculature.
Choledochal Cysts Resected during Childhood Show No Mutations of KRAS and BRAF as Early Markers of Malignancy in Cholangiocytes
Authors: Uecker Marie , Lehmann Ulrich , Braubach Peter , Schukfeh Nagoud , Madadi-Sanjani Omid , Ure Benno M. , Petersen Claus , Kuebler Joachim F. 
Published: August 2020

Abstract
Introduction In patients with choledochal cysts (CDC), a hyperplasia-dysplasia-carcinoma sequence can lead to biliary tract malignancy. The limited data available suggest that the risk decreases considerably after excision in childhood. We analyzed samples of resected CDC from pediatric patients histologically and performed mutational analysis of the proto-oncogenes KRAS and BRAF as early markers of malignant alteration in cholangiocytes.
Materials and Methods After institutional review board approval, patients undergoing resection for CDC in our center from 2011 to 2019 were retrospectively identified. Histopathological reports were searched for inflammation and endothelial alteration. Cases with sufficient tissue specimen were tested for KRAS codon 12/13 and BRAF codon 600 mutations by pyrosequencing.
Results In total, 42 patients underwent resection for choledochal cyst in the study period. Median age at surgery was 2.4 years (range = 18 days–18 years). Histopathological analysis showed no malignancy, but various degrees of inflammation or fibrosis in approximately 50% of the patients and in all age groups. Sufficient tissue for mutation analysis was available for 22 cases, all of which tested negative for KRAS or BRAF mutation.
Conclusion In our series, chronic inflammatory changes were frequently present in CDC of infants and children. However, the lack of KRAS and BRAF mutations suggests that no malignant changes have been initiated in this group of European patients undergoing early resection.