bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrent Syndrome of the Trephined in the Setting of Multiple Craniectomy and Cranioplasty
Authors: Kaura Arminder S. , Fahrenkopf Matthew P. , Kelpin John P. , Krebiehl Johanna R. 
Published: August 2020

Abstract
Decompressive craniectomy is an increasingly implemented intervention for relief of intracranial hypertension refractory to medical therapy. Despite its therapeutic benefit, a myriad of short and long-term complications may arise when the once fixed-volume cranial vault remains decompressed. The authors present a case of recurrent Syndrome of the Trephined in a patient undergoing repeated craniectomy and cranioplasty.
A 70-year old male with history significant for smoking and chronic obstructive pulmonary disease presented with frontoparietal subdural hematoma with midline shift following a ground level fall necessitating craniotomy and hematoma evacuation. Three months postoperatively, the patient developed an infection of his craniotomy bone flap necessitating craniectomy without cranioplasty. Six weeks post-craniectomy the patient began demonstrating right sided sensorimotor deficits with word finding difficulties. Alloplastic cranioplasty was performed following resolution of infection, with resolution of neurologic symptoms 6 weeks post cranioplasty. Due to recurrent cranioplasty infections, multiple alloplastic cranioplasties were performed, each with reliable re-demonstration of neurologic symptoms with craniectomy, and subsequent resolution following each cranioplasty. Final cranioplasty was successfully performed using a new alloplastic implant in combination with latissimus muscle flap, with subsequent return of neurologic function.
Decompressive craniectomy is a life-saving procedure, but carries many short- and long-term complications, including the Syndrome of the Trephined. Our case is the first published report, to our knowledge, to demonstrate recurrent Syndrome of the Trephined as a complication of craniectomy, with reliable resolution of the syndrome with restoration of the cranial vault.
Evaluation of Outcomes Related to Hearing and Tinnitus After Ossicular Chain Reconstruction
Authors: Erden Burak , Doblan Ahmet 
Published: August 2020

Objective:
The aim of this study was to evaluate both audiological and tinnitus related results in patients with tinnitus undergoing ossicular chain reconstruction (OCR) for ossicular chain injury.

Methods:
Between January 2015 and January 2019, patients who underwent OCR due to ossicular chain pathology and developed tinnitus symptoms were included in the study group. Middle ear pathologies were standardized using the middle ear risk index (MERI) scoring system and the tinnitus handicap inventory (THI) was used to determine the severity of tinnitus. The surgical methods used for reconstruction were partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP), depending on the patient's pathology.

Results:
The study group consisted of 43 patients aged between 34 and 65 years. Mean MERI score of the patients was 6.42 ± 2.52. When assessed categorically, 18.6% of the study group was identified in the ‘mild’, 46.5% were in the ‘moderate’, and 34.5% were in the ‘severe’ MERI category. Patients in the TORP group and those who were undergoing second session OCR had higher MERI and preop THI scores. Post-operative tinnitus levels were higher in patients who had OCR in the second session and were in the severe risk group. The ABG and tinnitus scores of patients were found to improve with OCR. In patients who underwent TORP, both ABG and tinnitus scores decreased significantly. Whereas, in patients who underwent PORP, only ABG values decreased significantly. After OCR, both ABG value and tinnitus scores significantly decreased compared to pre-operative results. ABG recovery rate was 100% in the study group.

Conclusion:
It can be said that OCR positively changes both audiological parameters and tinnitus levels in ossicular chain pathologies.
Pseudo Hemifacial Microsomia With Condylar-Coronoid Collapse: New Therapeutic Approach in Growing Patients
Authors: Perrotta Stefania , Bocchino Tecla , D’Antò Vincenzo , Michelotti Ambrosina , Valletta Rosa 
Published: August 2020

Abstract
The purpose of this study is to describe the management of 2 dimorphic patients affected by Hemimandibular Hypoplasia with Condylar-Coronoid Collapse (HH-CCC), also called Pseudo Hemifacial Microsomia, where the orthopedic treatment gave an excellent long-term follow-up. The patients were a 7-year-old female and a 6-year-old male with a HH-CCC on the left side, an asymmetrical face with chin deviation, class II dental malocclusion and canting of the occlusal plane. An X-ray evaluation and clinical observation confirmed the unilateral mandibular deficiency and the collapse of the condyle on the coronoid process on the affected side. The treatment plan consisted of the use of an asymmetrical functional appliance with a vertical screw. The appliance was gradually activated on the vertical plane on one side by a screw incorporated on an acrylic plate. It was used for 22 hours/day, including sleep time but not during meals. This treatment improved the patient’ s facial appearance. HH-CCC showed a positive response to functional therapy.
Clinical Management of Nasal Skin Necrosis Caused by Hyaluronic Acid Filler
Authors: Vieira Marcelo Germani , Machado-Filho Daniel Augusto , Alcantara Allan Rafael , Mendonça Adriana , Kim Jun Ho , Gonzalez Cortes Arthur Rodriguez 
Published: August 2020

Abstract
Nose augmentation with Hyaluronic acid (HA) fillers has been considered the preferred technique for minimally invasive cosmetic procedures. Despite severe complications related to HA injection are rare, none of the existing treatment protocols has been established as standard. The aim of this report is to present an alternative approach to treat nasal skin necrosis related to HA injection. A high dose of hyaluronidase – 6000 IU was applied in the nose, for the purpose of reversing a necrotic process. The present findings suggest that a high dose of hyaluronidase could be a promising approach to treat severe nasal skin necrosis caused by HA filler.
The Shapes and Normal Dimensions of the Sella Turcica
Authors: Çullu Neşat , Yeniçeri Ibrahim Önder , Kilinç Rabia Mihriban , Güney Bünyamin , Elibol Funda Dinç 
Published: August 2020

Objective:
The aim of this study was to evaluate the normal dimensions and shape of the sella turcica (ST) in the Turkish population using multidetector computed tomography.

Methods:
This single-center, retrospective study included 188 patients who met the study criteria and had paranasal multidetector computed tomography taken between January 2019 and December 2019. The patients included in the study comprised 77 females and 111 males. The whole patient group was separated into 3 age groups of 18 to 25 years (group 1), 25 to 40 years (group 2), and 40 years and over (group 3). They were also separated according to gender.

Results:
The mean length of the ST was determined as 8.52 ± 1.42 mm (min-max 4.61–12.73 mm), mean height as 7.00 ± 1.31 mm (min-max 3.00–10.51 mm), mean aperture as 6.50 ± 2.00 mm (min-max 2.24–12.51 mm), and mean width as 11.01 ± 1.50 mm (min-max 7.78–14.94 mm). No statistically significant difference was determined between the length, height, width, and aperture size values of the ST according to gender and age groups.

Conclusion:
The results of this study demonstrated no significant difference in ST dimensions according to gender or age groups. It can be considered that the shape and dimensions of the ST can be more accurately evaluated with computed tomography and classification can be more robustly applied.
Differences in Early Immunosuppressive Therapy Among Liver Retransplantation Recipients in a National Cohort
Authors: Mezochow Alyssa K. , Abt Peter L. , Bittermann Therese 
Published: August 2020

Background.
There is no unified consensus as to the preferred immunosuppression (IS) strategy following liver retransplantation (reLT).

Methods.
This was a retrospective cohort study using the United Network for Organ Sharing database. Recipient, donor, and center characteristics associated with induction use and early maintenance IS regimen were described. Multivariable Cox proportional hazards analysis evaluated induction receipt as a predictor of post-reLT survival.

Results.
There were 3483 adult reLT recipients from 2002 to 2018 at 116 centers with 95.6% being performed at the same center as the initial liver transplant. Timing of reLT was associated with induction IS use and the discharge regimen (P < 0.001 for both) but not with regimens at 6- and 12-month post-reLT (P = 0.1 for both). Among late reLTs (>365 d), initial liver disease cause was a more important determinant of maintenance regimen than graft failure cause. Low-reLT volume centers used induction more often for late reLTs (41.1% versus 22.6% high volume; P = 0.002) yet were less likely to wean to calcineurin inhibitors alone in the first year (19.1% versus 38.7% high volume; P = 0.002). Accounting for recipient and donor factors, depleting induction marginally improved post-reLT mortality (adjusted hazard ratio, 0.77; 95% CI, 0.61-0.99; P = 0.08), whereas nondepleting induction had no significant effect.

Conclusions.
Although several recipient attributes inform early IS decision-making, this does not occur in a uniform manner and center factors also play a role. Further studies are needed to assess the effect of early IS on post-reLT outcomes.
The Prognostic Value of Quantitative EEG in Patients Undergoing Mechanical Thrombectomy for Acute Ischemic Stroke
Authors: Dickey Adam S. , Mitsias Panayiotis D. , Olango Weredeselam M. , Agan Matthew C. , Roche William P. , Thomas Julien R. , Rodrigues Gabriel M. , Frankel Michael R. , Ratcliff Jonathan J. , Nogueira Raul G. , Haussen Diogo C. , Karakis Ioannis 
Published: August 2020

Purpose:
Previous work has shown that quantitative EEG measures correlate with the severity of ischemic stroke. This has not been systematically validated in patients with acute ischemic stroke who have undergone mechanical thrombectomy.

Methods:
Data were collected from 73 patients who underwent mechanical thrombectomy and had a standard head set EEG performed during their hospital admission. For each patient, the global delta-alpha ratio (DAR) and its difference between the two hemispheres were calculated. Associations between the global and interhemispheric DAR difference with the patients' National Institutes of Health Stroke and Modified Rankin Scale scores at discharge and 3 months after thrombectomy were assessed.

Results:
The interhemispheric DAR difference correlated with the National Institutes of Health Stroke scores at discharge (Spearman R = 0.41, P = 0.0008), National Institutes of Health Stroke scores at 3 months (Spearman R = 0.60, P = 0.02) and Modified Rankin Scale scores at 3 months (Spearman R = 0.27, P = 0.01). In contrast, the global DAR did not correlate significantly with any of these clinical outcomes when evaluated as continuous variables. In a multivariate logistic regression model, both the interhemispheric DAR difference (β = 0.25, P = 0.03) and the infarct volume (β = 0.02, P = 0.03) were independently predictive of good versus poor functional outcome (Modified Rankin Scale score ≤2 vs. >2) at 3 months.

Conclusions:
The quantitative EEG measure of interhemispheric slow relative to fast frequencies power asymmetry correlated with the discharge and 3-month National Institutes of Health Stroke and Modified Rankin Scale scores and provided added value to infarct volume in predicting functional outcome at 3 months. These data support the prognostic value of quantitative EEG in ischemic stroke patients who have undergone mechanical thrombectomy.
Recent attempts to change the periodic table
Authors: Scerri Eric 
Published: August 2020

The article concerns various proposals that have been made with the aim of improving the currently standard 18-column periodic table. We begin with a review of 8-, 18- and 32-column formats of the periodic table. This is followed by an examination of a possible, although rather impractical, 50-column table and how it could be used to consider the changes to the periodic table that have been predicted by Pyykkö in the domain of superheavy elements. Other topics reviewed include attempts to derive the Madelung rule as well as an analysis of what this rule actually provides. Finally, the notion of an ‘optimal’ periodic table is discussed in the context of recent work by philosophers of science who have examined the nature of classifications in general, as well as the notion of natural kinds. The article takes an unapologetically philosophical approach rather than focusing on specific data concerning the elements. Nevertheless, some pragmatic issues and educational aspects of the periodic table are also examined.
This article is part of the theme issue ‘Mendeleev and the periodic table’.
The tree and the table: Darwin, Mendeleev and the meaning of ‘theory’
Authors: Reznick David 
Published: August 2020

Darwin and Mendeleev revolutionized their respective disciplines by organizing diverse facts into simple, pictorial representations—a tree and a table. Each representation provides a foundation for a scientific theory for two reasons. First, a successful theory unites diverse phenomena under a single explanatory framework. Second, it does so in a way that defines paths for future inquiry that extends its reach and tests its limits. For Mendeleev, this meant creating a table that accommodated the current understanding of the elements but also contained blanks that predicted the discovery of previously unknown elements. More importantly, the structure of the table helped shape future research to define the structure of matter. For Darwin, envisioning life as a tree meant defining the rules that govern the origin of adaptations, species and shape the constantly shifting diversity of life. At the same time, his theory inspired research into the laws of inheritance and created diverse new areas of research, like behaviour, sexual selection and biogeography. The shared property of Darwin and Mendeleev's contributions was to provide a unifying rational explanation for natural phenomena.This article is part of the theme issue ‘Mendeleev and the periodic table’.
Effect of covid-19 lockdown on child protection medical assessments: a retrospective observational study in Birmingham, UK
Authors: Garstang Joanna , Debelle Geoff , Anand Indu , Armstrong Jane , Botcher Emily , Chaplin Helen , Hallett Nutmeg , Morgans Clare , Price Malcolm , Tan Ern Ern Henna , Tudor Emily , Taylor Julie 
Published: August 2020

AbstractObjectivesTo determine any change in referral patterns and outcomes in children (0-18) referred for child protection medical examination (CPME) during the covid-19 pandemic compared to previous years.DesignRetrospective observational study, analysing routinely collected clinical data from CPME reports in a rapid response to the pandemic lockdown.SettingBirmingham Community Healthcare NHS Trust, which provides all routine CPME for Birmingham, England, population 1.1 million including 288,000 children.ParticipantsChildren aged under 18 years attending CPME during an 18 week period from late February to late June during the years 2018, 2019, and 2020.Main Outcome MeasuresNumbers of referrals, source of disclosure and outcomes from CPMEResultsThere were 78 CPME referrals in 2018, 75 in 2019 and 47 in 2020, this was a 39.7% (95%CI 12.4-59.0) reduction in referrals from 2018 to 2020, and a 37.3% (95%CI 8.6-57.4) reduction from 2019 to 2020. There were fewer CPME referrals initiated by school staff in 2020, 12(26%) compared to 36 (47%) and 38 (52%) in 2018 and 2019 respectively. In all years 75.9% of children were known to social care prior to CPME, and 94% of CPME concluded that there were significant safeguarding concerns.ConclusionsSchool closure due to covid-19 may have harmed children as child abuse has remained hidden. There needs to be either mandatory attendance at schools in future or viable alternatives found. There may be a significant increase in safeguarding referrals when schools fully re-open as children disclose the abuse they have experienced at home.Article summary: Strengths and Limitations of the StudyThis is a highly robust study: we obtained CPME reports for 97% of CPME referrals during the study period.We ensured consistency of data extraction by double reviewing every report, with further consensus discussions for the few cases that raised uncertainties.The team extracting the data comprised highly experienced paediatricians with expertise in child abuse.One weakness is that we only considered minor injuries from outpatient CPME, excluding those admitted to hospital, so our findings do not include those with more serious NAI, however they would be taken to hospital for treatment due to the severity of their injuries.
Investigation of pooling strategies using clinical COVID-19 samples for more efficient diagnostic testing
Authors: Adikari Samantha H. , Alipio Lyon Emily Z. , Hollander Attelia D. , Deshpande Alina , Hong-Geller Elizabeth 
Published: August 2020

AbstractWhen testing large numbers of clinical COVID-19 samples for diagnostic purposes, pooling samples together for processing can offer significant reductions in the materials, reagents, time, and labor needed. We have evaluated two different strategies for pooling independent nasopharyngeal swab samples prior to testing with an EUA-approved SARS-CoV-2 RT-qPCR diagnostic assay. First, in the Dilution Study, we assessed the assay's ability to detect a single positive clinical sample diluted in multiple negative samples before the viral RNA extraction stage. We observed that positive samples with Ct values at ~30 can be reliably detected in pools of up to 30 independent samples, and positive samples with Ct values at ~35 can be detected in pools of 5 samples. Second, in the Reloading Study, we assessed the efficacy of reloading QIAamp viral RNA extraction columns numerous times using a single positive sample and multiple negative samples. We determined that one RNA extraction column can be reloaded with up to 20 clinical samples (1 positive and 19 negatives) sequentially without any loss of signal in the diagnostic assay. Furthermore, we found there was no significant difference in assay readout whether the positive sample was loaded first or last in a series of 20 samples. These results demonstrate that different pooling strategies can lead to increased process efficiencies for COVID-19 clinical diagnostic testing.
Distinct microRNA signature in human serum and germline after childhood trauma
Authors: Jawaid Ali , Kunzi Marina , Mansoor Mahgul , Khan Zain Yar , Abid Anooshay , Taha Muhammad , Rigotti Serena , Thumfart Kristina , Faisal Saba , Chughtai Omar , Mansuy Isabelle M 
Published: August 2020

AbstractTraumatic experiences during childhood can persistently alter mental and physical health in humans and have been implicated in transmission of symptoms to the progeny in animal models. Molecular evidence from these models implicates epigenetic/non-genetic factors, such as microRNAs (miRNAs), in the expression of trauma-induced symptoms and their transmission to the offspring. To confirm these findings in humans, we assembled three cohorts of subjects exposed to childhood trauma and examined selected miRNAs linked to psychological and pathophysiological manifestations of childhood trauma. Children aged 7-12 years (n = 72, control n = 30) exposed to paternal loss and maternal separation (PLMS) exhibited increase in two miRNAs, miR-16 and miR-375 in serum and reduced level of high-density lipoproteins (HDL) compared to control children. Comparable miRNA changes were observed in serum of adult men aged 18-25 years (n = 13, control n = 17) who had been exposed to PLMS at a young age. Finally, the same miRNAs were altered in sperm of adult men aged 21-50 years (n = 23, control n = 35) exposed to two or more significant traumatic events in childhood, assessed retrospectively using the standardized childhood trauma questionnaire (CTQ). In vitro experiments show that regulation of these miRNA involves the HDL receptor SRB-1, suggesting a link between trauma-associated miRNAs and metabolic alterations.
Challenges and proposed solutions in making clinical research on COVID-19 ethical. A status quo analysis across German research ethics committees
Authors: Faust Alice , Sierawska Anna , Krüger Katharina , Wisgalla Anne , Hasford Joerg , Strech Daniel 
Published: August 2020

AbstractBackgroundIn the course of the COVID-19 pandemic, the biomedical research community’s attempt to focus the attention on fighting COVID-19, led to several challenges within the field of research ethics. However, we know little about the practical relevance of these challenges for Research Ethics Committees (RECs).MethodsWe conducted a qualitative survey across all 52 German RECs on the challenges and potential solutions with reviewing proposals for COVID-19 studies. We de-identified the answers and applied thematic text analysis for the extraction and synthesis of challenges and potential solutions that we grouped under established principles for clinical research ethics.ResultsWe received an overall response rate of 42%. The 22 responding RECs reported that they had assessed a total of 441 study proposals on COVID-19 until 21 April 2020. For the review of these proposals the RECs indicated a broad spectrum of challenges regarding i) social value (e.g. lack of coordination), ii) scientific validity (e.g. provisional study planning), iii) favourable risk-benefit ratio (e.g. difficult benefit assessment), iv) informed consent (e.g. strict isolation measures), v) independent review (e.g. lack of time), vi) fair selection of trial participants (e.g. inclusion of vulnerable groups), and vii) respect for study participants (e.g. data security). Mentioned solutions ranged from improved local/national coordination, over guidance on modified consent procedures, to priority setting across clinical studies.ConclusionsRECs are facing a broad spectrum of pressing challenges in reviewing COVID-19 studies. Some challenges for consent procedures are well known from research in intensive care settings but are further aggravated by infection measures. Other challenges such as reviewing several clinical studies at the same time that potentially compete for the recruitment of in-house COVID-19 patients are unique to the current situation. For some of the challenges the proposed solutions in our survey could relatively easy be translated into practice. Others need further conceptual and empirical research. Our findings together with the increasing body of literature on COVID-19 research ethics, and further stakeholder engagement should inform the development of hands-on guidance for researchers, funders, RECs, and further oversight bodies.