bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technical Pearls in Frontal and Periorbital Bone Contouring in Gender-Affirmation Surgery
Authors: Eisemann Bradley S. , Wilson Stelios C. , Ramly Elie P. , Kantar Rami S. , Alfonso Allyson R. , Frey Jordan D. , Bluebond-Langer Rachel , Rodriguez Eduardo D. 
Published: August 2020

Summary:
Changes made to the forehead and periorbital region can have dramatic effects in gender-affirmation surgery. Removal of frontal bossing and alteration of orbital shape can result in significant facial feminization. This elective surgical intervention must be safe, reliable, and aesthetically effective. The described technique of frontal and periorbital bone contouring allows for a safe and consistent surgical outcome in properly selected patients. Nuances in specific technical maneuvers in this operation can have profound effects on safety and aesthetic outcomes. In this article, specific points are detailed in text and video describing the senior author’s (E.D.R) surgical approach.
Economic Burden Among Gay, Bisexual, and Other Men Who Have Sex With Men Living With HIV or Living Without HIV in the Multicenter AIDS Cohort Study
Authors: Dean Lorraine T. , Nonyane Bareng Aletta Sanny , Ugoji Chinenye , Visvanathan Kala , Jacobson Lisa P. , Lau Bryan 
Published: August 2020

Background:
With HIV now considered a chronic disease, economic burden for people living with HIV (LWH) may threaten long-term disease outcomes. We studied associations between economic burden (employment, income, insurance, and financial difficulty) and HIV status for gay, bisexual, and other men who have sex with men (GBMSM) and how economic burden relates to disease progression.

Setting:
We analyzed data collected every 6 months through 2015 from GBMSM LWH and GBMSM living without HIV from 2 waves (2001–2003 cohort and 2010+ new recruit cohort) of the Multicenter AIDS Cohort Study.

Methods:
Using generalized estimating equations, we first assessed the association between HIV status (exposure) and economic burden indicators since the last study visit (outcomes) of employment (working/student/retired versus not currently working), personal annual income of ≥$10,000, insurance (public/private versus none), and financial difficulty meeting basic expenses. Then among people LWH, we assessed the relationships between economic burden indicators (exposures), risk of progressive immune suppression (CD4 ≤500 cells/uL), and progression to AIDS (CD4 ≤200; outcomes).

Results:
Of 1721 participants, 59.5% were LWH (n = 1024). GBMSM LWH were 12% less likely to be employed, 16% more likely to have health insurance, and 9% more likely to experience financial difficulty than GBMSM living without HIV. Among GBMSM LWH, employment was associated with a 6% and 32% lower likelihood of immune suppression or progression to AIDS, respectively, and the income was associated with a 15% lower likelihood of progression to AIDS.

Conclusions:
Interventions that stabilize employment, income, and offer insurance support may enrich GBMSM LWH's ability to prevent disease progression.
Diffuse Pulmonary Ossification on High-Resolution Computed Tomography in Idiopathic Pulmonary Fibrosis, Systemic Sclerosis-Related Interstitial Lung Disease, and Chronic Hypersensitivity Pneumonitis: A Comparative Study
Authors: Walkoff Lara , Dixit Anuj S. , Ryu Jay H. , Chung Jonathan H. , Cox Christian W. 
Published: August 2020

Objective
The aim of the study was to compare the prevalence of diffuse pulmonary ossification (DPO) in idiopathic pulmonary fibrosis (IPF), systemic sclerosis (SSc)-related interstitial lung disease (ILD), and chronic hypersensitivity pneumonitis (HP).

Methods
High-resolution computed tomography (HRCT) from 71 IPF, 67 SSc-ILD, and 75 HP cases were independently evaluated by 2 thoracic radiologists blinded to patient data. Studies were assessed for the presence of DPO, HRCT scanning pattern, stigmata of granulomatous infection, and honeycombing.

Results
The prevalence of DPO was significantly higher in cases of IPF and SSc compared with HP, although there was no significant difference in prevalence between the IPF and SSc groups, even when accounting for the presence of prior granulomatous infection. Interobserver agreement for the presence of DPO was substantial.

Conclusions
Although prevalence DPO on HRCT varies between some forms of ILD, the use of DPO to influence characterization of ILD should be considered with caution.
Computed Tomography Thermography for Ablation Zone Prediction in Microwave Ablation and Cryoablation: Advantages and Challenges in an Ex Vivo Porcine Liver Model
Authors: Pohlan Julian , Kress Wiebke , Hermann Kay-Geert , Mews Jürgen , Kroes Maarten , Hamm Bernd , Diekhoff Torsten 
Published: August 2020

Purpose
The aim of this study was to investigate the diagnostic accuracy of computed tomography (CT) for the prediction of ablation zones from microwave ablation (MWA) and cryoablation (CA) in an ex vivo porcine liver model.

Methods
Sequential (30 seconds) CT scans were acquired during and after MWA and CA in an ex vivo porcine liver model. We generated 120-kVp equivalent reconstructions of generic dual-energy CT data sets, and comprehensive region-of-interest measurements were statistically correlated with invasive temperature monitoring using Pearson correlation coefficient. Binary logistic regression was performed for prediction of successful ablation.

Results
With the use of pooled data from 6 lesions in 2 separate experiments, correlation analysis of attenuation in Hounsfield units (HU) and temperature yielded r = −0.79 [confidence interval (CI), −0.85 to −0.71] for MWA and r = 0.62 (CI, 0.55 to 0.67) for CA.
For MWA, there was a linear association between attenuation and temperature up to 75°C; thus, linear regression yielded a slope of −2.00 HU/°C (95% CI, −1.58 to −2.41). For CA, a linear association between attenuation and temperature was observed in the cooling phase with a slope of 2.11 HU/°C (95% CI, 1.79 to 2.58). In MWA treatment, binary logistic regression separated less than 70°C and greater than 70°C with 89.2% accuracy. Within the ice ball, temperatures above and below −20°C were distinguished with 65.3% accuracy.

Conclusions
Our experiments reveal several difficulties in predicting ablation zone temperature from CT attenuation. Microwave ablation leads to gas production in the tissue, which degrades the accuracy of noninvasive temperature measurement, especially at higher temperatures. In CA, CT thermometry is limited by ice ball formation, which leads to homogeneous attenuation, nearly independent of temperature. Further research is needed to define the role of CT thermography in ablation zone monitoring in liver malignancies.
The Role of Multiparametric Magnetic Resonance Imaging in the Study of Primary Tumor and Pelvic Lymph Node Metastasis in Stage IB1–IIA1 Cervical Cancer
Authors: Zhang Xiaomiao , Dong Yue , Song Qingling , Zhu Yanmei , Pang Huiting , Luo Yahong , Yu Tao , Liu Fan , Guo Yan 
Published: August 2020

Objective
The aim of this study was to investigate the value of multiparametric magnetic resonance imaging (MRI) in demonstrating the metastatic potential of primary tumor and differentiating metastatic lymph nodes (MLNs) from nonmetastatic lymph nodes (non-MLNs) in stage IB1–IIA1 cervical cancer.

Methods
Fifty-seven stage IB1–IIA1 subjects were included. The apparent diffusion coefficient (ADC) values and dynamic contrast-enhanced MRI (DCE-MRI) parameters of primary tumors and lymph nodes and the conventional imaging features of the lymph nodes were measured and analyzed. Mann-Whitney test and χ2 test were used to analyze statistically significant parameters, logistic regression was used for multivariate analysis, and receiver operating characteristic analysis was used to compare the diagnostic performance of the MLNs.

Results
Nineteen subjects had lymph node metastasis. A total of 94 lymph nodes were evaluated, including 30 MLNs and 64 non-MLNs. There were no significant difference in ADC and DCE-MRI parameters between metastatic and nonmetastatic primary tumors. The heterogeneous signal was more commonly seen in MLNs than in non-MLNs (P = 0.001). The values of ADCmean, ADCmin, and ADCmax of MLNs were lower than those of non-MLNs (P < 0.001). The values of short-axis diameter, K
trans, K
ep, and V
e of MLNs were higher than those of non-MLNs (P < 0.05). Compared with individual MRI parameters, the combined evaluation of short-axis diameter, ADCmean, and K
trans showed the highest area under the curve of 0.930.

Conclusions
Diffusion-weighted imaging and DCE-MRI could not demonstrate the metastatic potential of primary tumor in stage IB1–IIA1 cervical cancer. Compared with individual MRI parameters, the combination of multiparametric MRI could improve the diagnostic performance of lymph node metastasis.
Two-Stage “On-Top Plasty” for Thumb Polydactyly With a Floating Ulnar Thumb
Authors: Zhong Wenyao , Tian Wen , Sun Liying , Yin Yuehan , Zhang Nan 
Published: August 2020

Abstract
We present 3 cases of thumb polydactyly treated with a 2-stage “on-top plasty” technique. For all the 3 cases, the ulnar thumbs floated in the first web with a skin pedicle, and the radial thumbs presented hypoplasia of different degree. We designed a 2-stage “on-top plasty” technique. The first operation included transplantation of the ulnar floating thumb and construction of skin tube containing the neurovascular bundle. When followed up after the first operation, there was no vascular compromise, and all union was achieved. At the time of the second operation, the skin tube was opened up, the neurovascular bundle was transposed to the reconstructed thumb, and the first web plasty was performed. At the final follow-up, 3 cases showed acceptable results both cosmetically and functionally.
A 22-gene transcriptomic model indicating individual therapy durations in multidrug-resistant tuberculosis
Authors: Heyckendorf Jan , Marwitz Sebastian , Reimann Maja , Avsar Korkut , DiNardo Andrew , Günther Gunar , Hoelscher Michael , Ibraim Elmira , Kalsdorf Barbara , Kaufmann Stefan H.E. , Kontsevaya Irina , Leth Frank van , Mandalakas Anna Maria , Maurer Florian , Müller Marius , Nitschkowski Dörte , Olaru Ioana D. , Popa Cristina , Rachow Andrea , Rolling Thierry , Rybniker Jan , Salzer Helmut J. F. , Sanchez-Carballo Patricia , Schuhmann Maren , Schaub Dagmar , Spinu Victor , Suárez Isabelle , Terhalle Elena , Unnewehr Markus , Weiner January , Goldmann Torsten , Lange Christoph 
Published: August 2020

AbstractEmerging multidrug-resistant tuberculosis is a major global health challenge. The World Health Organization currently recommends treatment durations of 9–18 months or more for patients with multidrug-resistant tuberculosis. We identified and validated a host-RNA signature to serve as a biomarker for individualized therapy durations for patients with multidrug-resistant tuberculosis. Adult patients with pulmonary tuberculosis were prospectively enrolled into 5 independent cohorts in Germany and Romania. Clinical and microbiological data, and whole-blood for RNA transcriptomic analysis were collected at pre-defined timepoints throughout therapy. Treatment outcomes were ascertained one year after end-of-therapy. A whole-blood RNA therapy end model was developed in a multi-step process involving a machine-learning algorithm to identify hypothetical individual end-of-treatment timepoints. Fifty patients with drug-susceptible tuberculosis and 30 patients with multidrug-resistant tuberculosis were recruited in the German identification cohorts (DS- and MDR-GIC), 28 patients with drug-susceptible tuberculosis and 32 patients with multidrug-resistant tuberculosis in the German validation cohorts (DS- and MDR-GVC), and 52 patients with multidrug-resistant tuberculosis in the Romanian validation cohort (MDR-RVC). A 22-gene RNA model that defined cure-associated end-of-therapy timepoints was derived from the DS- and MDR-GIC data. The model accurately predicted clinical outcomes for patients in the DS-GVC (AUC=0.937 [95%CI:0.899–0.976]) and suggested that cure may be achieved with shorter treatment durations for tuberculosis patients in the MDR-GIC (mean reduction 218.0 days, 34.2%, p<0.001), the MDR-GVC (mean reduction 211.0 days, 32.9%, p<0.001), and the MDR-RVC (mean reduction of 161.0 days, 23.4%, p=0.001). Biomarker-guided management may substantially shorten the duration of therapy for many patients with multidrug-resistant tuberculosis.One Sentence SummaryWe identified and validated a transcriptome model based on a 22-gene signature to predict individual treatment durations for patients with multidrug-resistant tuberculosis.
Role of interfering substances in the survival of coronaviruses on surfaces and their impact on the efficiency of hand and surface disinfection
Authors: Szpiro L , Pizzorno A , Durimel L , Julien T , Traversier A , Bouchami D , Marie Y , Rosa-Calatrava M , Terrier O , Moules V 
Published: August 2020

AbstractContaminated environmental surfaces are considered to represent a significant vector for hospital-acquired viral infections. In this study, we have evaluated the impact of interfering substances on SARS-CoV-2 surface stability and virucidal efficiency of hand sanitizers and surface disinfectant. To this end, surface stability of SARS-CoV-2 was measured on stainless steel in different experimental conditions, with or without an artificial mucus/saliva mixture and compared against that of human coronavirus HCoV-229E and feline coronavirus FCoV. The impact of the mucus/saliva mixture on the virucidal efficiency of 3 commercial alcohol hand sanitizers and 1 surface chemical disinfectant against SARS-CoV-2, HCoV-229E and FCoV was then measured. Our results indicate that mucus/saliva mixture did not demonstrate a beneficial effect on the surface survival of tested viruses, with temperature being an important parameter. In addition, we demonstrated that interfering substances may play an important role in the virucidal efficacy of hand sanitizers and disinfectants, highlighting the need for adapted testing protocols that better reflect current “real life” conditions of use.HighlightsContaminated environmental surfaces are a significant vector for viral infections.We studied the impact of interfering substances on SARS-CoV-2 surface stability and virucidal efficiency.Mucus/saliva did not demonstrate a beneficial effect on viral surface stability, with temperature being an important parameter.Interfering substances are important for virucidal surface activity of disinfectants.
Combined Use of Stress Echocardiography and Cardiopulmonary Exercise Testing to Assess Exercise Intolerance after Acute Myocardial Infarction
Authors: Smarz Krzysztof , Jaxa-Chamiec Tomasz , Zaborska Beata , Tysarowski Maciej , Budaj Andrzej 
Published: August 2020

AbstractBackgroundExercise capacity (EC) after acute myocardial infarction (AMI) influences prognosis, but the causes of its reduction are complex and not sufficiently studied.MethodsWe prospectively enrolled consecutive patients who underwent percutaneous coronary intervention for their first AMI with left ventricular ejection fraction (LV EF) >40% at least 4 weeks after AMI. We performed combined stress echocardiography and cardiopulmonary exercise testing (CPET-SE) using a semi-supine cycle ergometer to determine predictors of EC (peak oxygen uptake [VO2]).ResultsAmong 81 patients (70% male, mean age 58 ± 11 years), 40% had AMI with ST-segment elevation, and 60% non ST-segment elevation, LV EF was 57 ± 7%; wall motion score index, 1.18 (IQR 1.06 – 1.31); peak VO2, 19.5 ± 5.4 mL/kg/min. Multivariate analysis revealed that parameters at peak exercise: heart rate (β = 0.17, p < 0.001), stroke volume (β = 0.09, p < 0.001), and arteriovenous oxygen difference (A-VO2Diff, β = 93.51, p < 0.001) were independently positively correlated with peak VO2, with A-VO2Diff being its strongest contributor.ConclusionsIn patients treated for AMI with normal/mildly reduced LV EF, EC is associated with peak peripheral oxygen extraction as well as peak heart rate and peak stroke volume. CPET-SE is a useful tool to evaluate decreased fitness in this group.
Promoter methylation and gene expression of Pin1 is associated to the risk on Alzheimer’s disease in Southern Chinese
Authors: Ma Suk Ling , Tang Nelson Leung Sang , Wa Lam Linda Chiu 
Published: August 2020

AbstractBackgroundPin1 is a propyl cis-trans isomerase and it has been associated with age-at-onset of Alzheimer’s disease (AD) and other pathological characteristic of AD. DNA methylation is one of the gene regulation and it might affect the gene expression.ObjectivesThis study was aimed to examine the correlation between DNA methylation and gene expression of Pin1 and its effect on the risk of AD in a Chinese population.Methods80 AD patients and 180 normal controls were recruited in this study and their cognitive function were assessed. Pin1 gene expression and methylation were quantified by real-time RT-PCR and Melting Curve Analysis-Methylation assay (MCA-Meth) respectively.ResultsOur finding revealed a positive correlation between methylation and gene expression of Pin1 (p=0.001) and increased Pin1 methylation was predisposed to the risk of AD (p<0.001). CG genotype of Pin1 SNP rs2287839 was associated with higher gene expression of Pin1 (p=0.036) and the effect was only prominent in normal controls as AD patients were already methylated at Pin1 promoter. Furthermore, methylation of Pin1 was associated with better performance in cognition (p=0.018).ConclusionsOur result further supported the involvement of Pin1 in AD and the increased level of Pin1 might be a protective factor for AD.
Asthma inflammatory phenotypes on four continents: most asthma cases are non-eosinophilic
Authors: Pembrey Lucy , Brooks Collin , Mpairwe Harriet , Figueiredo Camila A , Oviedo Aida Y. , Chico Martha , Nambuya Irene , Tumwesige Pius , Robertson Steven , Ring Susan , Barreto Mauricio L. , Cooper Philip J. , Henderson John , Cruz Alvaro A. , Douwes Jeroen , Pearce Neil ,   the WASP Study Group
Published: August 2020

AbstractThe World Asthma Phenotypes (WASP) study is being conducted in five centres in Brazil, Ecuador, Uganda, New Zealand and the United Kingdom, with a range of prevalence levels and exposures, and a likely range of phenotype distributions. Here we present the main findings with regards to asthma inflammatory phenotypes. We recruited 998 cases and 356 controls: 204/40 in Brazil, 176/67 in Ecuador, 207/50 in Uganda, 235/132 in New Zealand, and 176/67 in the United Kingdom. All centres studied children and adolescents (age-range 8–20 years), with the exception of the UK centre which involved 26–27 year olds. The proportion of participants who produced sputum samples was 87%, with a range from 74% (Brazil) to 91% (Ecuador), and of these 62% were countable with regards to the inflammatory cell types.The proportions of asthma cases who were classified as eosinophilic or mixed granulocytic asthma (the two inflammatory phenotypes which involve eosinophilia) was 39% overall: 35% in Brazil, 32% in Ecuador, 33% in Uganda, 50% in New Zealand, and 28% in the United Kingdom. The non-eosinophilic asthmatics (NEA) had similar chronic severity (e.g. in terms of attacks in the previous year) to the eosinophilic asthmatics (EA). Of the 61% of cases with NEA, 50% showed no signs of inflammation (paucigranulocytic), with 11% having neutrophilic inflammation. This is the first time that sputum induction has been used in a standardised manner to compare asthma inflammatory phenotypes in high income countries (HICs) and low-and-middle-income countries (LMICs). It confirms that most cases are non-eosinophilic, with the proportions ranging from 50% to 72%, across these varied environments; most of these non-eosinophilic cases were paucigranulocytic, with no sign of airways inflammation.
COVID-19 is associated with relative ADAMTS13 deficiency and VWF multimer formation resembling TTP
Authors: Doevelaar Adrian , Bachmann Martin , Hölzer Bodo , Seibert Felix S. , Rohn Benjamin S. , Bauer Frederic , Witzke Oliver , Dittmer Ulf , Bachmann Michael , Yilmaz Serap , Dittmer Rita , Schneppenheim Sonja , Babel Nina , Budde Ulrich , Westhoff Timm H. 
Published: August 2020

AbstractBackgroundThrombotic microangiopathy (TMA) has been repeatedly described in COVID-19 and may contribute to SARS-CoV-2 associated hypercoagulability. The underlying mechanisms remain elusive. We hypothesized that endothelial damage may lead to substantially increased concentrations of Von Willebrand Factor (VWF) with subsequent relative deficiency of ADAMTS13.MethodsA prospective controlled trial was performed on 75 patients with COVID-19 of mild to critical severity and 10 healthy controls. VWF antigen (VWF:Ag), ADAMTS13 and VWF multimer formation were analyzed in a German hemostaseologic laboratory.ResultsVWF:Ag was 4.8 times higher in COVID-19 patients compared to healthy controls (p< 0.0001), whereas ADAMTS13 activities were not significantly different (p = 0.24). The ADAMTS13/VWF:Ag ratio was significantly lower in COVID-19 than in the control group (24.4±20.5 vs. 79.7±33.2, p< 0.0001). Fourteen patients (18.7%) undercut a critical ratio of 10 as described in thrombotic thrombocytopenic purpura (TTP). Gel analysis of multimers resembled the TTP constellation with loss of the largest multimers in 75% and a smeary triplet pattern in 39% of the patients. The ADAMTS13/VWF:Ag ratio decreased continuously from mild to critical disease (ANOVA p = 0.026). Moreover, it differed significantly between surviving patients and those who died from COVID-19 (p = 0.001) yielding an AUC of 0.232 in ROC curve analysis.ConclusionCOVID-19 is associated with a substantial increase in VWF levels, which can exceed the ADAMTS13 processing capacity resulting in the formation of large VWF multimers identical to TTP. The ADAMTS13/VWF:Ag ratio is an independent predictor of severity of disease and mortality. These findings render further support to perform studies on the use of plasma exchange in COVID-19 and to include VWF and ADAMTS13 in the diagnostic workup.
Deep learning-based Helicobacter pylori detection for histopathology: A diagnostic study
Authors: Zhou Sharon , Marklund Henrik , Blaha Ondrej , Desai Manisha , Martin Brock , Bingham David , Berry Gerald J. , Gomulia Ellen , Ng Andrew Y. , Shen Jeanne 
Published: August 2020

AbstractAimsDeep learning (DL), a sub-area of artificial intelligence, has demonstrated great promise at automating diagnostic tasks in pathology, yet its translation into clinical settings has been slow. Few studies have examined its impact on pathologist performance, when embedded into clinical workflows. The identification of H. pylori on H&E stain is a tedious, imprecise task which might benefit from DL assistance. Here, we developed a DL assistant for diagnosing H. pylori in gastric biopsies and tested its impact on pathologist diagnostic accuracy and turnaround time.Methods and resultsH&E-stained whole-slide images (WSI) of 303 gastric biopsies with ground truth confirmation by immunohistochemistry formed the study dataset; 47 and 126 WSI were respectively used to train and optimize our DL assistant to detect H. pylori, and 130 were used in a clinical experiment in which 3 experienced GI pathologists reviewed the same test set with and without assistance. On the test set, the assistant achieved high performance, with a WSI-level area-under-the-receiver-operating-characteristic curve (AUROC) of 0.965 (95% CI 0.934–0.987). On H. pylori-positive cases, assisted diagnoses were faster (, the fixed effect size for assistance = –0.557, p = 0.003) and much more accurate (OR = 13.37, p< 0.001) than unassisted diagnoses. However, assistance increased diagnostic uncertainty on H. pylori- negative cases, resulting in an overall decrease in assisted accuracy (OR = 0.435, p = 0.016) and negligible impact on overall turnaround time ( for assistance = 0.010, p = 0.860).ConclusionsDL can assist pathologists with H. pylori diagnosis, but its integration into clinical workflows requires optimization to mitigate diagnostic uncertainty as a potential consequence of assistance.