bluuebunny/crossref_metadata_2025_split huggingface dataset:
Scalp Staples Placed in a Pediatric Emergency Department
Authors: Quinn Bruce J. , Mancinelli Andrea , Rooney-Otero Kathleen , Martin Michelle , Ghavi Lila N. , Wojewoda Eva M. , Rogers Brent D. 
Published: August 2020

Objectives
Scalp lacerations are a common occurrence in the pediatric population. A preferred method of closure in a busy pediatric emergency department (PED) is skin staples, because of their ease of use and rapid application. However, using skin staples also demands that the child have a follow-up visit for their removal. This study examines whether caregivers can be taught how to safely remove their child's skin staples at home, obviating the need for a return clinic visit and its associated costs.

Methods
This is a prospective, convenience study of 30 children older than 4 years presenting with a scalp laceration that the attending physician chose to close with skin staples. Caregivers of enrolled children completed an initial survey and received training in skin staple removal in the PED. Upon discharge, caregivers were given the staple removal device and specific instructions indicating the date for staple removal and how to access an online video reviewing proper staple removal technique. Caregivers were contacted after anticipated staple removal for completion of a follow-up survey. We recorded caregiver success rate at staple removal and measured potential benefits with regard to lost wages, transportation costs, and missed school time. Data were analyzed using descriptive statistics.

Results
Twenty-eight (93%) of 30 enrolled caregivers were successful in completely removing their child's staples; one caregiver did not attempt removal and another was lost to follow-up. Twenty-five caregivers (83%) completed follow-up surveys. All caregivers reported that if given a future choice, they would prefer to remove their child's staples at home rather than return to a clinic and all said that they would be “very comfortable” if they needed to remove staples again in the future. Sixty-four percent of caregivers estimated that it would have taken greater than 2 hours to attend a clinic for staple removal. Thirty-two percent of caregivers would have lost greater than US $100 in wages. Eighty-eight percent of children would have missed school time, with 46% having to miss an entire school day.

Conclusions
Caregivers who were taught how to remove their child's scalp staples in the PED before discharge were highly successful at home. Ninety-three percent of enrolled patients had their staples completely removed and no complications were reported. Benefits included avoiding lost wages, lost time attending a follow-up clinic, and lost time from school. Staple removal is a simple technique that can easily be taught to caregivers in a matter of minutes and lead to greater patient and parent satisfaction.
Defining the Histologic Support Structures of the Nasal Ala and Soft Triangle: Toward Understanding the Cause of Iatrogenic Alar Retraction
Authors: Dowlatshahi A. Samandar , Constantian Mark B. , Deng April , Fudem Gary 
Published: August 2020

Background:
As rhinoplasty techniques have evolved to more extensive dissections, the incidence of iatrogenic deformities, such as alar rim retraction, has risen. Its mechanism is presently unknown. This study examined the microscopic anatomy of the nasal ala to define architectural support elements at the histologic level to determine why rhinoplasty dissection creates such deformities.

Methods:
Eight cadaveric noses were harvested and sectioned through the soft triangle and ala. Various tissue stains were performed. Slides were examined using light microscopy. Anatomical features pertaining to cartilage, skin, mucosa, elastic fibers, and muscle were documented.

Results:
Four male and four female noses were sectioned. The median cadaver age was 64 years (range, 47 to 83 years). On Elastica van Gieson stain, distinct elastic fibers span from the vestibular lining to the caudal margin of the lower lateral cartilage, and from the caudal edge of the lower lateral cartilage to the external alar skin. In the nasal ala midsection, trichrome stains reveal that skeletal muscle is located far beyond the lower lateral cartilage, close to the free alar margin. The soft triangle shows a distinct microanatomical structure, with heavy longitudinal condensations of elastin. These histologic findings have not been previously reported.

Conclusions:
A distinct anatomical alar wall endoskeleton has been identified. It is obligatorily disrupted by specific rhinoplasty maneuvers when dissection is carried out over the lateral crura and into areas without cartilaginous support. This microanatomy may explain factors that contribute to postoperative alar wall retraction. Leaving this area undisturbed or performing adjunctive measures with rhinoplasty can provide structural support to the external valves, thus minimizing the risk of deformity.
The Impact of Markers of HIV Infection on Change in Liver Stiffness in People With HIV and Hepatitis C Virus Co-infection After Treatment and Cure of Hepatitis C
Authors: van Santen Daniela K. , Agius Paul A. , Sasadeusz Joseph , Fairley Christopher K. , Sievert William , Gane Edward , Iser David , O'Reilly Mark , Medland Nicholas A. , Moore Richard , Hellard Margaret E. , Hoy Jennifer F. , Doyle Joseph S. ,   on behalf of the Co-EC Study Group
Published: August 2020

Background:
Markers of HIV disease severity are associated with increased liver fibrosis in HIV/Hepatitis C virus (HCV) co-infected individuals. HCV treatment may reverse liver fibrosis, but evidence among HIV/HCV-co-infected populations and the impact of HIV parameters on fibrosis regression is limited. We aimed to assess the influence of surrogate markers of HIV-infection and other determinants of liver stiffness before HCV treatment and changes after HCV cure in people living with HIV.

Methods:
We used data from an HCV treatment implementation study aiming for HCV micro-elimination among gay and bisexual men with HIV in Melbourne, Australia (co-EC Study). We obtained liver stiffness measurements (LSM) before and after direct-acting antiviral treatment using transient elastography (FibroScan). Linear mixed models were used to evaluate determinants of pretreatment LSM and changes in LSM following cure with duration in years between pre- and post-LSM assessment as main exposure variable.

Results:
At least one LSM was available in 173 participants, and 98 participants had 2 LSMs. Median pre- and post-treatment LSMs were 5.7 and 5.1 kPa, respectively. Median time between transient elastography measurements was 1.3 years (interquartile range = 0.9–2.1). In multivariable analysis, longer duration of known HIV infection, a lower CD4 and CD8 T-cell count and hazardous alcohol consumption were associated with higher LSM values before treatment initiation. Successfully treated patients had a 6% (95% confidence interval = −10% to −2%) annual decrease (0.34 kPa predicted decrease) in LSM following cure. Changes in LSM values did not depend on any of the pretreatment HIV markers or other factors.

Conclusion:
Low levels of liver stiffness were observed before treatment initiation and a small decrease (6%) in LSM following HCV cure in people living with HIV. No clear predictors affecting change in LSM following cure were found in this study, including markers of HIV infection. However, markers of advanced HIV immunodeficiency and hazardous alcohol consumption remained associated with higher LSM values even after HCV cure.
Texture Analysis as a Radiomic Marker for Differentiating Benign From Malignant Adrenal Tumors
Authors: Yu HeiShun , Parakh Anushri , Blake Michael , McDermott Shaunagh 
Published: August 2020

ObjectiveThe aim of this study was to evaluate the use of texture analysis for differentiation between benign from malignant adrenal lesions on contrast-enhanced abdominal computed tomography (CT).MethodsAfter institutional review board approval, a retrospective analysis was performed, including an electronic search of pathology records for all biopsied adrenal lesions. Patients were included if they also had a contrast-enhanced abdominal CT in the portal venous phase. Computed tomographic images were manually segmented, and texture analysis of the segmented tumors was performed. Texture analysis results of benign and malignant tumors were compared, and areas under the curve (AUCs) were calculated.ResultsOne hundred twenty-five patients were included in the analysis. Excellent discriminators of benign from malignant lesions were identified, including entropy and standard deviation. These texture features demonstrated lower values for benign lesions compared with malignant lesions. Entropy values of benign lesions averaged 3.95 using a spatial scaling factor of 4 compared with an average of 5.08 for malignant lesions (P< .0001). Standard deviation values of benign lesions averaged 19.94 on the unfiltered image compared with an average of 34.32 for malignant lesions (P< .0001). Entropy demonstrated AUCs ranging from 0.95 to 0.97 for discriminating tumors, with sensitivities and specificities ranging from 81% to 95% and 88% to 100%, respectively. Standard deviation demonstrated AUCs ranging from 0.91 to 0.94 for discriminating tumors, with sensitivities and specificities ranging from 73% to 93% and 86% to 95%, respectively.ConclusionTexture analysis offers a noninvasive tool for differentiating benign from malignant adrenal tumors on contrast-enhanced CT images. These results support the further development of texture analysis as a quantitative biomarker for characterizing adrenal tumors.
Head Ultrasound Resistive Indices Are Associated With Brain Injury on Diffusion Tensor Imaging Magnetic Resonance Imaging in Neonates With Hypoxic-Ischemic Encephalopathy
Authors: Snyder Elizabeth J. , Perin Jamie , Chavez-Valdez Raul , Northington Frances J. , Lee Jennifer K. , Tekes Aylin 
Published: August 2020

Background
Neonatal hypoxic-ischemic encephalopathy (HIE) is associated with dysfunctional cerebral autoregulation. Resistive index (RI) measured in the anterior cerebral artery on transfontanellar head ultrasound is a noninvasive measure of blood flow and may indicate autoregulation dysfunction. We tested whether RI was associated with brain injury on diffusion tensor imaging magnetic resonance imaging (MRI).

Materials and Methods
Seventy-five neonates who underwent therapeutic hypothermia for HIE were enrolled. Resistive index values were obtained from head ultrasound performed at the end of therapeutic hypothermia. Apparent diffusion coefficient scalars were measured on MRIs performed before day of life 10.

Results
Lower RI was associated with lower apparent diffusion coefficient in the centrum semiovale, basal ganglia, thalamus, and posterior limb of the internal capsule. Combining RI and Apgar scores improved the ability to distinguish injury severity on MRI relative to either metric alone.

Conclusions
Low RI correlated with worse brain injury on diffusion tensor imaging and may serve as an early marker of brain injury in cooled HIE neonates.
Covid-19: Correlation of Early Chest Computed Tomography Findings With the Course of Disease
Authors: Erturk Sukru Mehmet , Durak Gorkem , Ayyildiz Hakan , Comert Rana Gunoz , Medetalibeyoglu Alpay , Senkal Naci , Uysal Emre , Tunaci Atadan 
Published: August 2020

Objective
To investigate the role of chest computed tomography (CT) examinations acquired early after initial onset of symptoms in predicting disease course in coronavirus disease 2019.

Methods
Two hundred sixty-two patients were categorized according to intensive care unit (ICU) admission, survival, length of hospital stay, and reverse transcriptase-polymerase chain reaction positivity. Mean time interval between the onset of symptoms and CT scan was 5.2 ± 2.3 days. Groups were compared using Student t test, Mann-Whitney U, and Fisher exact tests.

Results
In the ICU (+) and died groups, crazy paving (64% and 57.1%), bronchus distortion (68% and 66.7%), bronchiectasis-bronchiolectasis (80% and 76.2%), air trapping (52% and 52.4%) and mediastinal-hilar lymph node enlargement (52% and 52.4%) were significantly more encountered (P < 0,05). These findings were correlated with longer hospital stays (P < 0.05). There were no differences between reverse transcriptase-polymerase chain reaction-positive and -negative patients except bronchiectasis-bronchiolectasis.

Conclusion
Computed tomography examinations performed early after the onset of symptoms may help in predicting disease course and planning of resources, such as ICU beds.
Superficial Peroneal Neurocutaneous Flap for Coverage of Donor Site Defect After the Combined Transfer of Toe and Dorsal Foot Flap
Authors: Wang Chunyang , Yang Weichao , Zhang Feng , Lineaweaver William C. , Wen Gen , Chai Yimin 
Published: August 2020

Background
Reconstruction of digital loss with soft tissue defects remains a tough challenge. Although a combined flap of toe and dorsal foot skin provides a good option for “like-for-like” hand reconstruction, the disappointed donor site morbidity prevents it from popularity. In this study, we presented experiences of the superficial peroneal neurocutaneous (SPNC) flap for donor site closure after the combined toe and dorsal foot flap transfer.

Methods
Superficial peroneal neurocutaneous flaps were used to cover foot donor site defects in 9 patients. The flaps harvested from feet including 3 cases of wrap-around flap with dorsal foot flap, 4 cases of 2nd toe flap with dorsal foot flap, 2 cases of 2nd and 3rd toe flap with dorsal foot flap. The flap size, operation time, and complications were documented, and the donor sites were evaluated by the subjective outcome measure, the foot evaluation questionnaire, and the Vancouver Scar Scale.

Results
All flaps but one survived completely without complications. Marginal necrosis occurred in the distal part of the flap in one case, which was treated by daily dressings. The skin grafts on the lower leg healed uneventfully. The average operation time of flap transfer was 40 minutes. Follow-up ranged from 9 to 16 months, and patients were content with the results of the foot donor site according to the outcome measures. All the patients were able to wear normal shoes walking and running with a normal gait, and none sustained complications of skin erosion or ulceration. Protective sensibility was obtained in all the flaps. Two patients complained of cold intolerance and 2 could not wear a thong sandal. The donor site scars on the lower leg were measured 3.2 on average on the Vancouver Scar Scale.

Conclusions
The SPNC flap is a practical procedure for donor site closure on the foot, especially when extra dorsal foot skin is elevated with a toe flap for hand reconstruction.
Considerations for Continuing Simulation Training During Infectious Outbreaks
Authors: Ong Say Yang , Ashokka Balakrishnan , Khoo Deborah , Kelly Michelle A. 
Published: August 2020

Summary Statement
Healthcare simulation training can be significantly disrupted by infectious disease outbreaks, yet it is a key component in several important medical education activities, such as resuscitation refresher training and high-stakes prelicensure healthcare examinations. This article details the strategic and tactical considerations for continuing simulation training during infectious disease outbreaks. A framework of graded responses, titrated to outbreak severity, is provided from the perspective of an academic medical center managing simulation training during the early stage of the now global coronavirus disease 2019 outbreak.
Distinct cortical systems reinstate the content and context of episodic memories
Authors: Kragel James E. , Ezzyat Youssef , Lega Bradley C. , Sperling Michael R. , Worrell Gregory A. , Gross Robert E. , Jobst Barbara C. , Sheth Sameer A. , Zaghloul Kareem A. , Stein Joel M. , Kahana Michael J. 
Published: August 2020

AbstractEpisodic recall depends upon the reinstatement of cortical activity present during the formation of a memory. We identified dissociable cortical networks via functional connectivity that uniquely reinstated semantic content and temporal context of previously studied stimuli during free recall. Network-specific reinstatement predicted the temporal and semantic organization of recall sequences, demonstrating how specialized cortical systems enable the human brain to target specific memories.
IMPACT OF COVID-19 PANDEMIC LED LOCKDOWN ON THE LIFESTYLE OF ADOLESCENTS AND YOUNG ADULTS
Authors: Roy Shubhajeet , Tiwari Sunita , Kanchan Shweta , Bajpai Prashant 
Published: August 2020

AbstractOBJECTIVEThis study was designed to study affect of COVID 19 pandemic on lifestyle of young adults and adolescent.METHODOnline survey, was conducted in about 1000 respondents in the age group of 13–25 years.RESULTSQuestionnaire based survey showed mean sleeping duration changing from 6.85hours to 8.17hours, average screen time becoming 5.12hours from 3.5hours, 51.9% subjects experiencing increased stress levels, 76.4% subjects experiencing increased food intake and 38.6% subjects had decreased levels of physical activity as per self-monitoring.CONCLUSIONThese changes might have long lasting effect on their physical, mental and social health and need counteractive measures to help young people lead a healthy lifestyle during the epidemic and beyond.
Impact of bariatric surgery on multiple health outcomes: a protocol for umbrella review of systematic review and meta-analysis
Authors: Seo Kim Min , Yeob Kim Jong , Park Sungsoo 
Published: August 2020

ABSTRACTThe number of bariatric surgery rises as the prevalence of obesity and metabolic comorbidities consistently increases[1]. Although bariatric surgery was originally developed for glycemic control and weight reduction, increasing evidence suggested extra-metabolic health outcomes are followed by bariatric surgery; incidences on diverse types of cancer[2], perinatal outcomes[3], sexual function[4], and even degree of physical activity[5] are known to be altered after bariatric surgery. We aim to conduct umbrella review for metabolic and other multiple health outcomes following bariatric surgery, and systematically appraise the context and quality of the relevant evidence.Contactminseolike@naver.com; crossing96@yonsei.ac.kr
ELAVL1 Primarily Couples mRNA Stability with the 3’UTRs of Interferon Stimulated Genes
Authors: Rothamel Katherine , Arcos Sarah , Kim Byungil , Reasoner Clara , Mukherjee Neelanjan , Ascano Manuel 
Published: August 2020

SUMMARYUpon detection of a pathogen, the innate immune system triggers signaling events leading to the transcription of mRNAs that encode for pro-inflammatory and anti-microbial effectors. RNA-binding proteins (RBPs) interact with these functionally critical mRNAs and temporally regulate their fates at the post-transcriptional level. One such RBP is ELAVL1, which is known to bind to introns and 3’UTRs. While significant progress has been made in understanding how ELAVL1 regulates mRNAs, how its target repertoire and binding affinity changes within an immunological context remains poorly understood. Here, we overlap four distinct high-throughput approaches to define its cell-type and context-dependent targets and determine its regulatory impact during immune activation. ELAVL1 overwhelmingly binds to intronic sites in a naïve state, but during an innate immune response, ELAVL1 targets the 3’UTR - binding both previously and newly expressed mRNAs. We find that ELAVL1 mediates the RNA stability of genes that regulate the pathways involved in pathogen sensing and cytokine production. Our findings reveal the importance of examining RBP regulatory impact under dynamic transcriptomic events to best understand their post-transcriptional regulatory roles within specific biological circuitries.
TOLLIP resolves lipid-induced EIF2 signaling in alveolar macrophages for durableMycobacterium tuberculosisprotection
Authors: Venkatasubramanian Sambasivan , Plumlee Courtney , Dill-McFarland Kim , Pearson Gemma L. , Cohen Sara B. , Lietzke Anne , Pacheco Amanda , Hinderstein Sarah A. , Emery Robyn , Soleimanpour Scott A. , Altman Matthew , Urdahl Kevin B. , Shah Javeed A. 
Published: August 2020

AbstractRelative deficiency of TOLLIP expression in monocytes is associated with increased tuberculosis (TB) susceptibility in genetic studies, despite antagonizing host innate immune pathways that controlMycobacterium tuberculosis(Mtb) infection. In this study, we investigated the mechanisms by which TOLLIP influences Mtb immunity.Tollip-/-mice developed worsened disease, consistent with prior genetic observations, and developed large numbers of foam cells. Selective TOLLIP deletion in alveolar macrophages (AM) was sufficient to induce lipid accumulation and increased Mtb persistence 28 days after infection, despite increased antimicrobial responses. We analyzed sorted, Mtb-infectedTollip-/-AM from mixed bone marrow chimeric mice to measure global gene expression 28 days post-infection. We found transcriptional profiles consistent with increased EIF2 signaling. Selective lipid administration toTollip-/-macrophages induced lipid accumulation, and Mtb infection of lipid laden,Tollip-/-macrophages induced cellular stress and impaired Mtb control. EIF2 activation induced increased Mtb replication within macrophages, irrespective of TOLLIP expression, and EIF2 kinases were enriched in human caseous granulomas. Our findings define a critical checkpoint for TOLLIP to prevent lipid-induced EIF2 activation and demonstrate an important mechanism for EIF2 signaling to permit Mtb replication within macrophages.
State-dependent changes in perception and coding in the mouse somatosensory cortex
Authors: Lee Conrad CY , Kheradpezhouh Ehsan , Diamond Mathew E. , Arabzadeh Ehsan 
Published: August 2020

SUMMARYAn animal’s behavioral state is reflected in the dynamics of cortical population activity and its capacity to process sensory information. To better understand the relationship between behavioral states and information processing, mice are trained to detect varying amplitudes of whisker-deflection under two-photon calcium imaging. Layer 2/3 neurons (n=1436) in the vibrissal primary somatosensory cortex are imaged across different behavioral states, defined based on detection performance (low to high-state) and pupil diameter. The neurometric curve in each behavioral state mirrors the corresponding psychometric performance, with calcium signals predictive of the animal’s choice outcome. High behavioral states are associated with lower network synchrony, extending over shorter cortical distances. The decrease of correlations in variability across neurons in the high state results in enhanced information transmission capacity at the population level. The observed state-dependent changes suggest that the coding regime within the first stage of cortical processing may underlie adaptive routing of relevant information through the sensorimotor system.HighlightsNetwork synchrony and pupil diameter are coupled to changes in behavioral state.High behavioral state results in enhanced information transmission capacity at the population level, with neurometric curve in each behavioral state mirroring the corresponding psychometric performanceBehavioral state and calcium signal in primary somatosensory cortex predict choice outcome.eTOCIn BriefLee et al. investigates the relationship between behavioral states and information processing in the primary somatosensory cortex. They demonstrate increases in behavioral state results in decrease cortical variability, enhanced information transmission capacity and stimulus encoding at the population level.