bluuebunny/crossref_metadata_2025_split huggingface dataset:
Value of the Petromeatal Angle in Predicting Outcome of Translabyrinthine Resection of Vestibular Schwannomas
Authors: Noureldine Mohammad Hassan A , Aum David , Piper Keaton , Zavadskiy Gleb , Peto Ivo , Bach Konrad , van Loveren Harry , Agazzi Siviero 
Published: April 2020

Abstract

BACKGROUND
Factors associated with extent of tumor resection (EOR) and facial nerve outcomes include tumor size, anterior extension of the tumor, patient age, and surgical approach.

OBJECTIVE
To check whether preoperative measurement of the petromeatal (PMA), petroclival (PCA), and petrous-petrous (PPA) angles can help in predicting EOR, facial nerve outcome, and cerebrospinal fluid (CSF) leak occurrence in patients undergoing vestibular schwannoma (VS) surgery via the translabyrinthine approach (TLA).

METHODS
A total of 75 patients were included in this retrospective study. Preoperative magnetic resonance imaging constructive interface in steady state and postcontrast T1-weighted sequences through the internal acoustic meatus were used to measure the PMA, PCA, and PPA.

RESULTS
There was a statistically significant association between tumor size and EOR; every additional cm in tumor size decreases the odds of gross-total (GTR)/near-total (NTR) resection by 524% (P = .0000355).
After controlling for tumor size, the logistic models revealed a significant effect of the angles on EOR. For example, in a patient with a 2-cm VS, every additional degree in PMA, PCA, and PPA increases the odds of GTR/NTR by 2.3% (P = .0000571), 4.05% (P = .0000397), and 0.37% (P = .0000438), respectively.
After adjusting for tumor size, sex, and age, the effect of PMA on the occurrence of an immediate postoperative facial nerve deficit and CSF leak indicated a trend towards significance (P = .0581 and P = .0568, respectively).

CONCLUSION
More obtuse petrous bone angles, namely PMA, PCA, and PPA, are good predictors of GTR or NTR in patients undergoing VS surgery via TLA and may be associated with better facial nerve outcomes and lower CSF leak occurrences.
Recycling resources: silica of diatom frustules as a source for spicule building in Antarctic siliceous demosponges
Authors: Riesgo Ana , Taboada Sergi , Kenny Nathan J , Santodomingo Nadia , Moles Juan , Leiva Carlos , Cox Eileen , Avila Conxita , Cardona Luis , Maldonado Manuel 
Published: April 2020

AbstractDissolved silicon (DSi) is biologically processed to produce siliceous skeletons by a variety of organisms including radiolarians, silicoflagellates, choanoflagellates, plants, diatoms and some animals. In the photic ocean, diatoms are dominant consumers over competing other silicifiers. In Antarctica, where DSi is not particularly limiting, diatoms and sponges coexist in high abundances. Interestingly, diatom ingestion by sponges is a regular feeding strategy there. Although it was known that the diatom organic nutrients are readily metabolized by the sponges, what happened to the inorganic diatom silica skeleton remained unexplored. Here, we have conducted a multi-analytical approach to investigate the processing of diatom silica and whether it is reconverted into sponge silica. We have documented widespread diatom consumption by several demosponges, identifying storage vesicles for the diatom-derived silica by electron microscopy and microanalysis. Diatom-consuming sponges showed upregulation of silicatein and silicase genes, which in addition to the δ 30Si values of their silica, supports that the sponges are converting the ingested diatom silica into sponge silica without much further Si fractionation. Our multidisciplinary approach suggests that the reutilization of diatom silica by sponges is a common feature among Antarctic sponges, which should be further investigated in other latitudes and in other silicifiers.
Incidence and Risk Factors of Anterior Longitudinal Ligament Rupture After Posterior Corrective Surgery Using Lateral Lumbar Interbody Fusion for Adult Spinal Deformity
Authors: Maruo Keishi , Arizumi Fumihiro , Kusuyama Kazuki , Kishima Kazuya , Tachibana Toshiya 
Published: April 2020

Study Design:
A retrospective single-center study.

Objective:
The objective of this study was to assess the incidence of anterior longitudinal ligament rupture (ALLR) and to identify the risk factors for ALLR in patients with adult spinal deformity (ASD).

Summary of Background Data:
Lateral lumbar interbody fusion (LIF) has been widely used for ASD surgery. However, ALLR has been occasionally identified after posterior spinal correction surgery.

Materials and Methods:
The study included 43 consecutive patients (8 male and 35 female patients) who underwent posterior corrective surgery involving LIF (128 levels) for ASD between 2014 and 2018. The mean age was 72±7 years (range: 62–81 y), and the minimum follow-up period was 1 year [mean: 34±15 mo (range: 12–58 mo)]. Posterior correction and fusion surgery using the cantilever technique was performed following LIF. Oblique LIF was performed in 27 patients, and extreme lateral interbody fusion (XLIF) was performed in 16 patients. The mean number of spinal fused levels was 8.9±1.8 levels (range: 8–15), and the mean number of LIF levels was 3±0.6 levels (range: 2–4). ALLR was considered if a LIF cage showed no contact with the vertebral endplates. The radiographic parameters were thoracic kyphosis, lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt, and sagittal vertical axis.

Results:
ALLR occurred in 10 patients (22%) and at 11 levels (8.6%). XLIF and preexisting osteoporotic vertebral fracture were identified as independent risk factors for ALLR. The change in LL was ∼10 degrees greater in the ALLR group than in the non-ALLR group (P=0.017), and overcorrection was observed in the ALLR group (PI-LL: −7.9±7 degrees). The change in the segmental lordotic angle at the ALLR level was much larger than after LIF and correction surgery. ALLR-related reoperation was performed in 2 cases (decompression surgery owing to posterior impingement and rod breakage).

Conclusions:
ALLR occurred in 10 patients (22%). XLIF and preexisting osteoporotic vertebral fracture were independent risk factors for ALLR. Overcorrection was observed in patients with ALLR.
BMI Does Not Affect Complications or Patient Reported Outcomes After Lumbar Decompression Surgery
Authors: Divi Srikanth N. , Goyal Dhruv K.C. , Stull Justin D. , Kothari Parth , Padua Fortunato G. , Patel Parthik D. , Bowles Daniel R. , Reyes Ariana A. , Galetta Matthew S. , Kaye Ian D. , Kurd Mark F. , Woods Barrett I. , Radcliff Kris E. , Rihn Jeffrey A. , Anderson David G. , Hilibrand Alan S. , Kepler Christopher K. , Vaccaro Alexander R. , Schroeder Gregory D. 
Published: April 2020

Study Design:
This is a retrospective comparative review.

Objective:
The objective of this study was to identify the influence of body mass index (BMI) on postsurgical complications and patient reported outcomes measures (PROMs) following lumbar decompression surgery.

Summary of Background Data:
Current literature does not accurately identify the impact of BMI on postsurgical complications or outcomes.

Materials and Methods:
Records from a single-center, academic hospital were used to identify patients undergoing 1 to 3-level lumbar decompression surgery. Patients under 18 years of age, those undergoing surgery for infection, trauma, tumor, or revision, and those with <1-year follow-up were excluded. Patients were split into groups based on preoperative BMI: class I: BMI <25.0 kg/m2; class II: BMI 25.0–29.9 kg/m2; class III: BMI 30.0–34.9 kg/m2; and class IV: BMI >35.0 kg/m2. Absolute PROM scores, the recovery ratio and the percent of patients achieving minimum clinically important difference between groups were compared and a multiple linear regression analysis was performed.

Results:
A total of 195 patients were included with 34 (17.4%) patients in group I, 80 (41.0%) in group II, 49 (25.1%) in group III, and 32 (16.5%) in group IV. Average age was 60.0 (58.0, 62.0) years and average follow-up was 13.0 (12.6, 13.4) months. All patients improved significantly within each group, except for class III and class IV patients, who did not demonstrate significant improvements in terms of Mental Component Score (MCS-12) scores (P=0.546 and 0.702, respectively). There were no significant differences between BMI groups for baseline or postoperative PROM values, recovery ratio, or the percent of patients reaching minimum clinically important difference. Multiple linear regression analysis revealed that BMI was not a significant predictor for change in outcomes for any measure. The 30-day readmission rate was 6.2% and overall revision rate at final follow-up was 5.1%, with no significant differences between groups.

Conclusion:
This study’s results suggest that BMI may not significantly affect complications or patient outcomes at 1-year in those undergoing lumbar decompression surgery.

Level of Evidence:
Level III.
Utility of Blood Cultures and Empiric Antibiotics in Febrile Pediatric Hemophilia Patients With Central Venous Access Devices
Authors: Al-Samkari Hanny , Ozonoff Al , Landschaft Assaf , Kimia Rotem , Harper Marvin B. , Croteau Stacy E. , Kimia Amir A. 
Published: April 2020

Background
Children with hemophilia frequently require long-term central venous access devices (CVADs) for regular infusion of factor products. Hemophilia patients are not immunocompromised, but the presence and use of CVADs are associated with infections including bacteremia. Currently, the utility of blood cultures in evaluation of the febrile hemophilia patient with an indwelling CVAD is unknown, nor is optimal empiric antibiotic use.

Methods
We performed a retrospective cross-sectional study of febrile immunocompetent hemophilia patients with CVADs presenting to a large academic urban pediatric emergency department from 1995 to 2017. We used a natural language processing electronic search, followed by manual chart review to construct the cohort. We analyzed rate of pathogen recovery from cultures of blood in subgroups of hemophilia patients, the pathogen profile, and the reported pathogen susceptibilities to ceftriaxone.

Results
Natural language processing electronic search identified 181 visits for fever among hemophilia patients with indwelling CVADs of which 147 cases from 44 unique patients met study criteria. Cultures of blood were positive in 56 (38%) of 147 patients (95% confidence interval, 30%–47%). Seventeen different organisms were isolated (10 pathogens and 7 possible pathogens) with Staphylococcus aureus and coagulase-negative Staphylococcus species as the most common. Thirty-four percent of isolates were reported as susceptible to ceftriaxone. Positive blood cultures were more common in cases involving patients with inhibitors (n = 71) versus those without (n = 76), odds ratio, 7.4 (95% confidence interval, 3.5–15.9). This was observed irrespective of hemophilia type.

Conclusions
Febrile immunocompetent hemophilia patients with indwelling CVADs have high rates of bacteremia. Empiric antimicrobial therapy should be targeted to anticipated pathogens and take into consideration local susceptibility patterns for Staphylococcus aureus.
A Human-Derived, Collagen-Rich Hydrogel Augments Wound Healing in a Diabetic Animal Model
Authors: Williams Tokoya , Sotelo Leon Daniel , Kaizawa Yukitoshi , Wang Zhen , Leyden Jacinta , Chang James , Fox Paige M. 
Published: April 2020

Background
Application of collagen products to wounds has been shown to improve wound healing. Using a collagen-based hydrogel (cHG) capable of cellular support previously developed by our laboratory, we hypothesize that our hydrogel will increase the speed of wound healing by providing a 3-dimensional framework for cellular support, increasing angiogenesis and cell-proliferation at the wound bed.

Methods
Two, 10-mm excisional wounds were created over the dorsum of 12 male, genetically modified Zucker diabetic rats. Wounds were splinted open to limit healing by wound contracture. One wound was treated with an occlusive dressing (OD), whereas the adjacent wound was treated with an OD plus cHG. Occlusive dressings were changed every other day. Hydrogel was applied on day 2 and every 4 days after until complete wound closure. Rate of wound closure was monitored with digital photography every other day. Wounds were harvested at days 10 and 16 for histological and immunohistochemical analysis.

Results
Wound closure was significantly faster in cHG-treated wounds compared with OD-treated wounds. By day 10, cHG-treated wounds achieved 63% wound closure, compared with 55% wound closure in OD-treated wounds (P < 0.05). By day 16, cHG-treated wounds achieved 84% wound closure, compared with 68% wound closure in OD-treated wounds (P < 0.05).
Histologically, wound depth was not different between the cHG and OD groups on days 10 and 16. However, wound length was significantly less in the cHG group compared with the OD group (P < 0.05) consistent with digital photographic analysis. Immunohistochemical analysis for RECA-1 demonstrated that blood vessel density in the wound bed was 2.3 times higher in the cHG group compared with the OD group (P = 0.01) on day 16. Cell proliferation was 3.8 times higher in the cHG group versus the OD group (P < 0.05) on day 10.

Conclusions
Collagen-based hydrogel–treated wounds demonstrated significantly improved healing compared with control. The thermoresponsive feature of collagen hydrogel and its structural stability at body temperature demonstrate promising clinical potential as a vehicle for the delivery of therapeutic cells to the wound bed.
COVID-19 containment policies through time may cost more lives at metapopulation level
Authors: Wells Konstans , Lurgi Miguel 
Published: April 2020

AbstractThe rapid and pandemic spread of COVID-19 has led to unprecedented containment policies in response to overloaded health care systems. Disease mitigation strategies require informed decision-making to ensure a balance between the protection of the vulnerable from disease and the maintenance of global economies. We show that temporally restricted containment efforts, that have the potential to flatten epidemic curves, can result in wider disease spread and larger epidemic sizes in metapopulations. Longer-term rewiring of metapopulation networks or the enforcement of feasible long-term measures that decrease disease transmissions appear to be more efficient than temporarily restricted intensive mitigation strategies (e.g. short-term mass quarantine). Our results may inform balanced containment strategies for short-term disease spread mitigation in response to overloaded health care systems and longer-term epidemiological sizes.
The closer to the Europe Union headquarters, the higher risk of COVID-19? Cautions regarding ecological studies of COVID-19
Authors: Li Shuai , Hua Xinyang 
Published: April 2020

AbstractSeveral ecological studies of the coronavirus disease 2019 (COVID-19) have reported correlations between group-level aggregated exposures and COVID-19 outcomes. While some studies might be helpful in generating new hypotheses related to COVID-19, results of such type of studies should be interpreted with cautions. To illustrate how ecological studies and results could be biased, we conducted an ecological study of COVID-19 outcomes and the distance to Brussels using European country-level data. We found that, the distance was negatively correlated with COVID-19 outcomes; every 100 km away from Brussels was associated with approximately 6% to 17% reductions (all P<0.01) in COVID-19 cases and deaths in Europe. Without cautions, such results could be interpreted as the closer to the Europe Union headquarters, the higher risk of COVID-19 in Europe. However, these results are more likely to reflect the differences in the timing of and the responding to the outbreak, etc. between European countries, rather than the ‘effect’ of the distance to Brussels itself. Associations observed at the group level have limitations to reflect individual-level associations – the so-called ecological fallacy. Given the public concern over COVID-19, ecological studies should be conducted and interpreted with great cautions, in case the results would be mistakenly understood.
Experimental human pneumococcal colonisation in older adults is feasible and safe, not immunogenic
Authors: Adler Hugh , German Esther L , Mitsi Elena , Nikolaou Elissavet , Pojar Sherin , Hales Caz , Robinson Rachel , Connor Victoria , Hill Helen , Hyder-Wright Angela D , Lazarova Lepa , Lowe Catherine , Smith Emma L , Wheeler India , Zaidi Seher R , Jochems Simon P , Loukov Dessi , Reiné Jesús , Solórzano-Gonzalez Carla , d’Argoeuves Polly de Gorguette , Jones Tessa , Goldblatt David , Chen Tao , Aston Stephen J , French Neil , Collins Andrea M , Gordon Stephen B , Ferreira Daniela M , Rylance Jamie 
Published: April 2020

AbstractRationalePneumococcal colonisation is key to the pathogenesis of invasive disease, but is also immunogenic in young adults, protecting against re-colonisation. Colonisation is rarely detected in older adults, despite high rates of pneumococcal disease.ObjectivesTo establish experimental human pneumococcal colonisation in healthy adults aged 50—84 years, to measure the immune response to pneumococcal challenge, and to assess the protective effect of prior colonisation against autologous strain rechallenge.MethodsSixty-four participants were inoculated with Streptococcus pneumoniae (serotype 6B, 80,000CFU in each nostril). Colonisation was determined by bacterial culture of nasal wash, serum anti-6B capsular IgG responses by ELISA, and anti-protein immune responses by multiplex electrochemiluminescence.Measurements and Main ResultsExperimental colonisation was established in 39% of participants (25/64) with no adverse events. Colonisation occurred in 47% (9/19) of participants aged 50—59 compared with 21% (3/14) in those aged ≥70 years. Previous pneumococcal polysaccharide vaccination did not protect against colonisation. Colonisation did not confer serotype-specific immune boosting: GMT (95% CI) 2.7μg/mL (1.9—3.8) pre-challenge versus 3.0 (1.9—4.7) four weeks post-colonisation (p = 0.53). Furthermore, pneumococcal challenge without colonisation led to a drop in specific antibody levels from 2.8μg/mL (2.0—3.9) to 2.2μg/mL (1.6—3.0) post-challenge (p = 0.006). Anti-protein antibody levels increased following successful colonisation. Rechallenge with the same strain after a median of 8.5 months (IQR 6.7—10.1) led to recolonisation in 5/16 (31%).ConclusionsIn older adults, experimental pneumococcal colonisation is feasible and safe, but demonstrates different immunological outcomes compared with younger adults in previous studies.
Significantly Improved COVID-19 Outcomes in Countries with Higher BCG Vaccination Coverage: A Multivariable Analysis
Authors: Klinger Danielle , Blass Ido , Rappoport Nadav , Linial Michal 
Published: April 2020

AbstractCOVID-19 has spread to 210 countries within 3 months. We tested the hypothesis that the vaccination with BCG correlates with a better outcome for COVID-19 patients. Our analysis covers 55 countries, complying with predetermined thresholds on population size and deaths per million (DPM). We found a strong negative correlation between the years of BCG administration and a lower DPM along with the pandemic progression in time. The results from multivariable regression tests with 22 economical, demographic, and health-related quantitative properties for each country substantiate the dominant contribution of BCG administration years to the COVID-19 outcomes. Analyzing countries according to an age-group partition reveals that the strongest correlation is attributed to the coverage in BCG vaccination of the young population and mostly to recent years immunization. We propose that BCG immunization coverage, especially among the most recently vaccinated contributes to attenuation of the spread and severity of the COVID-19 pandemic.One Sentence SummaryBCG vaccination regimes and COVID-19 outcomes
Towards the next phase: evaluation of serological assays for diagnostics and exposure assessment
Authors: GeurtsvanKessel Corine H. , Okba Nisreen M.A. , Igloi Zsofia , Embregts Carmen W.E. , Laksono Brigitta M. , Leijten Lonneke , Rahamat-Langendoen Janette , van den Akker Johannes P.C. , van Kampen Jeroen J.A. , van der Eijk Annemiek A. , van Binnendijk Rob S. , Haagmans Bart , Koopmans Marion 
Published: April 2020

AbstractThe world is entering a new era of the COVID-19 pandemic in which there is an increasing call for reliable antibody testing. To support decision making on the deployment of serology for either population screening or diagnostics, we present a comprehensive comparison of serological COVID-19 assays. We show that the assay detecting total immunoglobulins against the receptor binding domain of SARS CoV-2, had optimal characteristics for antibody detection in different stages of disease.
Detection and isolation of asymptomatic individuals can make the difference in COVID-19 epidemic management
Authors: Mayorga Lía , García Samartino Clara , Flores Gabriel , Masuelli Sofía , Sanchez María Victoria , Mayorga Luis S. , Sánchez Cristián G. 
Published: April 2020

AbstractMathematical modeling of infectious diseases is a powerful tool for the design of management policies and a fundamental part of the arsenal currently deployed to deal with the COVID-19 pandemic. Here we present a compartmental model for the disease that can provide healthcare burden parameters allowing to infer possible containment and suppression strategies, explicitly including asymptomatic individuals. The main conclusion of our work is that efficient and timely detection and isolation of these asymptomatic individuals can have dramatic effects on the effective reproduction number and healthcare burden parameters. This intervention can provide a valuable tool complementary to other non-pharmaceutical interventions to contain the epidemic.
Enacting national social distancing policies corresponds with dramatic reduction in COVID19 infection rates
Authors: McGrail Daniel J. , Dai Jianli , McAndrews Kathleen M. , Kalluri Raghu 
Published: April 2020

ABSTRACTThe outbreak the SARS-CoV-2 (CoV-2) virus has resulted in over 2.5 million cases of COVID19, greatly stressing global healthcare infrastructure. Lacking medical prophylactic measures to combat disease spread, many nations have adopted social distancing policies in order to mitigate transmission of CoV-2. While mathematical models have suggested the efficacy of social distancing to curb the spread of CoV-2, there is a lack of systematic studies to quantify the real-world efficacy of these approaches. Here, we quantify the spread rate of COVID19 before and after national social distancing measures were implemented in 26 nations and compare this to the changes in COVID19 spread rate over equivalent time periods in 27 nations that did not enact social distancing policies. We find that social distancing policies significantly reduced the COVID19 spread rate. Using mixed linear regression models we estimate that social distancing policies reduced the spread of COVID19 by 66%. These data suggest that social distancing policies may be a powerful tool to prevent spread of COVID19 in real-world scenarios.