bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stereotactic radiosurgery as the primary management for patients with Koos grade IV vestibular schwannomas
Authors: Ogino Akiyoshi , Lunsford L. Dade , Long Hao , Johnson Stephen , Faramand Andrew , Niranjan Ajay , Flickinger John C. , Kano Hideyuki 
Published: February 2021

OBJECTIVEWhile extensive long-term outcome studies support the role of stereotactic radiosurgery (SRS) for smaller-volume vestibular schwannomas (VSs), its role in the management for larger-volume tumors remains controversial.METHODSBetween 1987 and 2017, the authors performed single-session SRS on 170 patients with previously untreated Koos grade IV VSs (volumes ranged from 5 to 20 cm3). The median tumor volume was 7.4 cm3. The median maximum extracanalicular tumor diameter was 27.5 mm. All tumors compressed the middle cerebellar peduncle and distorted the fourth ventricle. Ninety-three patients were male, 77 were female, and the median age was 61 years. Sixty-two patients had serviceable hearing (Gardner-Robertson [GR] grades I and II). The median margin dose was 12.5 Gy.RESULTSAt a median follow-up of 5.1 years, the progression-free survival rates of VSs treated with a margin dose ≥ 12.0 Gy were 98.4% at 3 years, 95.3% at 5 years, and 90.7% at 10 years. In contrast, the tumor control rate after delivery of a margin dose < 12.0 Gy was 76.9% at 3, 5, and 10 years. The hearing preservation rates in patients with serviceable hearing at the time of SRS were 58.1% at 3 years, 50.3% at 5 years, and 35.9% at 7 years. Younger age (< 60 years, p = 0.036) and initial GR grade I (p = 0.006) were associated with improved serviceable hearing preservation rate. Seven patients (4%) developed facial neuropathy during the follow-up interval. A smaller tumor volume (< 10 cm3, p = 0.002) and a lower margin dose (≤ 13.0 Gy, p < 0.001) were associated with preservation of facial nerve function. The probability of delayed facial neuropathy when the margin dose was ≤ 13.0 Gy was 1.1% at 10 years. Nine patients (5%) required a ventriculoperitoneal shunt because of delayed symptomatic hydrocephalus. Fifteen patients (9%) developed detectable trigeminal neuropathy. Delayed resection was performed in 4% of patients.CONCLUSIONSEven for larger-volume VSs, single-session SRS prevented the need for delayed resection in almost 90% at 10 years. For patients with minimal symptoms of tumor mass effect, SRS should be considered an effective alternative to surgery in most patients, especially those with advanced age or medical comorbidities.
Clinical Features of Apert Syndrome in Infancy: A rare case in Indonesia
Authors: Mapindra Muhammad Pradhika , Mahindra Muhammad Pradhiki 
Published: February 2021

Background: Apert syndrome is characterized by several malformations of cranial-facial and syndactyly. The incidence of Apert syndrome was reported at approximately 1 per 65,000 live births, globally. Fibroblast Growth Factor 2 (FGFR2) is believed to hold a key role in the syndrome.
Objectives: This case report is aiming to describe the information on a rare incidence of craniosynostosis syndromes on Indonesian infants.
Case Illustration: One month old female baby was admitted to the hospital due to the breastfeeding difficulty caused by cleft palate. The patient was known to experience defects of face-head features and syndactyly since birth. This patient was observed and controlled to undergo nasogastric feeding until meet the appropriate age for surgical therapy.
Discussion: Mutation of Ser252Trp and Pro253Arg was found in the patient. Based on this finding, this case report may strengthen the statement about the correlation between Ser252Trp and cleft palate whereas Pro253Arg is linked with syndactyly in individuals with the syndrome.
Conclusion:. This case may give beneficial information for clinicians when they receive a patient with the same clinical features. However, further investigation to know this syndrome still needs to be developed.
Keywords: Apert Syndrome, FGFR2, palate cleft, Pro253Arg, Ser252Trp

Latar Belakang: Pasien dengan sindroma Apert memiliki fitur karakteristik berupa malformasi kepala dan wajah disertai syndactyly. Insidensi sindroma ini berkisar 1 per 65.000 kelahiran hidup secara global. Etiologi kelainan ini dikatikan dengna mutase pada Fibroblast Growth Factor 2 (FGFR2).
Tujuan: Laporan kasus ini bertujuan untuk mendeskripsikan kejadian langka dari sindroma craniosynostosis pada bayi Indonesia.
Ilustrasi Kasus: Bayi perempuan usia 1 bulan dibawa ke rumah sakit dengan masalah menyusui akibat palatoschizis. Pasien memiliki riwayat defek wajah dan kepala disertai syndactyly sejak lahir. Pasien ini kemudian diobservasi melalui diet per nasogastric tube sampai siap dilakukan terapi pembedahan.
Pembahasan: Mutasi pada Ser252Trp dan Pro253Arg ditemukan pada pasien ini. Sehingga, laporan kasus ini mungkin memperkuat temuan mengenai korelasi Ser252Trp dan palatoschizis sedangkan Pro253Arg dikaitkan dengan syndactyly.
Kesimpulan: Kasus ini mungkin dapat memberikan informasi tambahan sebagai referensi untuk klinisi ketika menerima pasien dengan gejala klinis serupa. Namun, studi terkait perlu diperdalam untuk mengetahui lebih jauh mengenai sindroma serupa.
Kata Kunci: FGFR2, palatoschizis, Pro253Arg, Ser252Trp, sindroma Apert
Estimation of Interleukin-6 for the Diagnosis of Septicemia in Children
Authors: Biswas Sanjoy Kanti , Husain Md Anwar , Akter Nasima , Sultan Md Tipu , Sultana Nahid , Ahmed Md Shakeel 
Published: February 2021

Septicemia is a common cause of morbidity and mortality among children in developing world. Clinicians are in need of better diagnostic markers to diagnose septicemia. This study was carried out to evaluate the usefulness of interleukin-6 (IL-6) as a marker for the diagnosis of septicemia in children. Blood samples from 202 clinically suspected cases of septicemia and 20 age and sex matched healthy children were studied. On the basis of clinical features, blood cultures and C-reactive protein (CRP) analysis results, study populations were categorized as culture proven septicemia 35(15.77%), probable septicemia 125(56.31%), non-septicemic febrile patient 42(18.92%) and healthy control 20(9.0%). Out of 35 culture positive cases, IL-6 estimation was done in 32 samples. In culture proven septicemia group, 28 (87.5%) had IL-6 levels above cut-of value (>137 pg/ml). In 20 probable septicemia and 10 non-septicemic febrile group, IL-6 level above cut-off value were found in 06 (30%) and 01(10%) cases respectively. None of the healthy control group showed the concentration of IL-6 above cut-off value. The sensitivity and specificity of IL-6 were 65.38% and 95% respectively. Measurement of IL-6 may be a good marker to diagnose septicemia in children but this needs further evaluation on larger population.
JCMCTA 2012; 23(1): 21-25
Desafios do processo ensino aprendizagem frente à pandemia do novo coronavírus
Authors: Lima Sonia Pantoja Nascimento , Santos Monyka Brito Lima dos , Costa Karla Simone da Silva , Passos Francisco Silva , Silva Beatriz Aguiar da , Santos Maria das Dores Medeiros de Almeida , Costa Annielson de Souza , Santos Barbara Maria Rodrigues dos , Cruz Adriano Nogueira da , Oliveira Luana de , Nascimento Silvania Maria Cunha do , Monte Layanne Lima , Costa Carla Adriana Ferreira , Costa Luís Domingos Ramos , Carvalho Caroline Mascarenhas Teixeira de 
Published: February 2021

As adaptações do ensino por causa da pandemia estão afetando metade dos estudantes do mundo já que o ensino on-line e a distância tornaram-se uma nova rotina para alguns, porém, aponta obstáculos consideráveis, pois nem todos os alunos têm acesso. Como objetivo buscou-se descrever os impactos da pandemia do novo Coronavírus no processo acesso ensino aprendizagem. Estudo bibliográfico do tipo revisão integrativa, foram utilizadas as bases de dados Science Direct, Biblioteca Virtual em Saúde (BVS), Pub Med e Scientific Electronic Library Online (Scielo), os descritores utilizados foram: “Instituições de ensino”, “Educação a distância” e “Pandemia”. Os critérios de exclusão foram: trabalhos científicos com apenas resumos disponíveis, publicações duplicadas e aqueles que não se enquadravam dentro da proposta oferecida para o tema e/ou estavam fora do recorte temporal. Foram encontrados 1125 artigos, após a exclusão de achados duplicados e incompletos, restringiu-se a 383 obras, estas foram analisadas quanto a sua relação com o tema e ao final foram limitadas a 9 artigos, levando em consideração os quais possuíam os descritores inclusos no tema e/ou resumo. O COVID-19 trouxe consigo diversos transtornos a exemplo do fechamento total ou parcial de instituições de ensino por causa da pandemia está afetando 890 milhões de estudantes em 114 países. Os impactos gerados pela pandemia do novo Coronavírus na educação levaram a muitas mudanças repentinas na rotina de estudantes, estudantes trabalhadores, professores de sala de aula e instrutores de campo de prática.
Factors influencing the dental caries in pregnant women: a cross-sectional study
Authors: Bolsson Gabriela Bohrer , Knorst Jessica Klöckner , Maroneze Marília Cunha , Casarin Maísa , Dotto Patrícia Pasquali , Santos Bianca Zimmermann 
Published: February 2021

Objective: To assess factors associated with the average number of dental caries in pregnant women. Method: Basic research design: This cross-sectional study was performed between January 2017 and December 2018 in Santa Maria, Brazil. Clinical setting and participants: Multistage random sampling resulted in the recruitment of 256 pregnant women from public health centers across the city. Clinical exams and semi-structured questionnaires including demographic, socioeconomic and behavioral questions were performed by trained interviewers. Main outcome measure: The experience of dental caries was evaluated through the mean value of the Decay, Missing, and Filled Surface Index (DMFS) by 4 trained and calibrated examiners. Multilevel Poisson regression models were used to evaluate the influence of different variables on the average number of dental caries. Rate ratio (RR) and respective 95% confidence intervals were calculated (CI 95%). Results: The prevalence of untreated dental caries was 62.7% in the sample, while the mean DMFS index was 10.27 (± 10.92). Women who smoked during pregnancy had a higher mean DMFS (RR 1.41; 95% CI 1.25-1.57). Furthermore, pregnant women who had poor self-ratings of oral health had a higher average DMFS (RR 1.21; 95% CI 1.10-1.32). Conclusions: The results showed that older age, ethnicity, fewer years in education and the presence of dental plaque resulted in higher means of DMFS.
Delineation of Mitochondrial DNA Variants From Exome Sequencing Data and Association of Haplogroups With Obesity in Kuwait
Authors: Dashti Mohammed , Alsaleh Hussain , Eaaswarkhanth Muthukrishnan , John Sumi Elsa , Nizam Rasheeba , Melhem Motasem , Hebbar Prashantha , Sharma Prem , Al-Mulla Fahd , Thanaraj Thangavel Alphonse 
Published: February 2021

Background/ObjectivesWhole-exome sequencing is a valuable tool to determine genetic variations that are associated with rare and common health conditions. A limited number of studies demonstrated that mitochondrial DNA can be captured using whole-exome sequencing. Previous studies have suggested that mitochondrial DNA variants and haplogroup lineages are associated with obesity. Therefore, we investigated the role of mitochondrial variants and haplogroups contributing to the risk of obesity in Arabs in Kuwait using exome sequencing data.Subjects/MethodsIndirect mitochondrial genomes were extracted from exome sequencing data from 288 unrelated native Arab individuals from Kuwait. The cohort was divided into obese [body mass index (BMI) ≥ 30 kg/m2] and non-obese (BMI &lt; 30 kg/m2) groups. Mitochondrial variants were identified, and haplogroups were classified and compared with other sequencing technologies. Statistical analysis was performed to determine associations and identify mitochondrial variants and haplogroups affecting obesity.ResultsHaplogroup R showed a protective effect on obesity [odds ratio (OR) = 0.311; P = 0.006], whereas haplogroup L individuals were at high risk of obesity (OR = 2.285; P = 0.046). Significant differences in mitochondrial variants between the obese and non-obese groups were mainly haplogroup-defining mutations and were involved in processes in energy generation. The majority of mitochondrial variants and haplogroups extracted from exome were in agreement with technical replica from Sanger and whole-genome sequencing.ConclusionsThis is the first to utilize whole-exome data to extract entire mitochondrial haplogroups to study its association with obesity in an Arab population.
Identifying Client Targets for Improved Mobilization and Uptake of Integrated Family Planning and Reproductive Health in Environmental Programs in Kenya
Authors: Obat Edmon , Schaefer Krista , Opiyo Mumma , Otieno George , Windindi Henrietta , Omuodo Derick , Mehta Supriya D. 
Published: February 2021

Background: We conducted a population health environment program in Lake Victoria Basin (LVB) and assessed incorporation and integration of family planning with environmental conservation.Methods: Routine program data were collected from clients by community-based distributors from four environmental community-based organizations. Multivariable regressions identified factors associated with distribution of: (1) oral contraceptive pills to women, (2) male condoms, and (3) integrated family planning and environmental messaging.Results: April 2015 through May 2016, 10,239 client encounters were completed, with 56% made by men. We distributed contraceptive pills at 28% of client encounters. Multivariable modeling showed this was more likely for women &lt;40 years old (p &lt; 0.001) and was less likely for women attending household (30%) and group sessions (46%) compared to individual sessions (p &lt; 0.001). Male condoms were distributed at 73% of client encounters; (p &lt; 0.01, all) women were half as likely to receive condoms than men, and single and widowed clients were more likely than married clients to receive condoms. Integrated messaging occurred at 89% of client encounters, and was 85% more likely for women, increased with client age, and was less likely for single and widowed persons. Exit interviews with 87 clients (42% male, 58% female) confirmed program data by report of commodities received: 27% contraceptive pills, 75% male condoms, 91% integrated messaging.Conclusions: Partnership with environmental conservation organizations effectively expanded family planning and reproductive health to non-traditional audiences and men among rural communities surrounding LVB-Kenya. Specific client subgroups can be targeted for improved mobilization and uptake of services.
Impact of National Lockdown on the Hyperacute Stroke Care and Rapid Transient Ischaemic Attack Outpatient Service in a Comprehensive Tertiary Stroke Centre During the COVID-19 Pandemic
Authors: D'Anna Lucio , Brown Maddison , Oishi Sikdar , Ellis Natalya , Brown Zoe , Bentley Paul , Drumm Brian , Halse Omid , Jamil Sohaa , Jenkins Harri , Malik Abid , Kalladka Dheeraj , Venter Marius , Kwan Joseph , Banerjee Soma 
Published: February 2021

Background: The COVID-19 pandemic is having major implications for stroke services worldwide. We aimed to study the impact of the national lockdown period during the COVID-19 outbreak on stroke and transient ischemic attack (TIA) care in London, UK.Methods: We retrospectively analyzed data from a quality improvement registry of consecutive patients presenting with acute ischemic stroke and TIA to the Stroke Department, Imperial College Health Care Trust London during the national lockdown period (between March 23rd and 30th June 2020). As controls, we evaluated the clinical reports and stroke quality metrics of patients presenting with stroke or TIA in the same period of 2019.Results: Between March 23rd and 30th June 2020, we documented a fall in the number of stroke admissions by 31.33% and of TIA outpatient referrals by 24.44% compared to the same period in 2019. During the lockdown, we observed a significant increase in symptom onset-to-door time in patients presenting with stroke (median = 240 vs. 160 min, p = 0.020) and TIA (median = 3 vs. 0 days, p = 0.002) and a significant reduction in the total number of patients thrombolysed [27 (11.49%) vs. 46 (16.25%, p = 0.030)]. Patients in the 2020 cohort presented with a lower median pre-stroke mRS (p = 0.015), but an increased NIHSS (p = 0.002). We registered a marked decrease in mimic diagnoses compared to the same period of 2019. Statistically significant differences were found between the COVID and pre-COVID cohorts in the time from onset to door (median 99 vs. 88 min, p = 0.026) and from onset to needle (median 148 vs. 126 min, p = 0.036) for thrombolysis whilst we did not observe any significant delay to reperfusion therapies (door-to-needle and door-to-groin puncture time).Conclusions: National lockdown in the UK due to the COVID-19 pandemic was associated with a significant decrease in acute stroke admission and TIA evaluations at our stroke center. Moreover, a lower proportion of acute stroke patients in the pandemic cohort benefited from reperfusion therapy. Further research is needed to evaluate the long-term effects of the pandemic on stroke care.
Safety and Efficacy of Tirofiban for Acute Ischemic Stroke Patients With Large Artery Atherosclerosis Stroke Etiology Undergoing Endovascular Therapy
Authors: Huo Xiaochuan , Raynald  , Wang Anxin , Mo Dapeng , Gao Feng , Ma Ning , Wang Yilong , Wang Yongjun , Miao Zhongrong 
Published: February 2021

Objective: To investigate the safety and efficacy of tirofiban in acute ischemic stroke (AIS) patients with large artery atherosclerosis (LAA) stroke etiology receiving endovascular therapy (EVT).Methods: In this multi-center prospective study, patients who were considered to have an indication received a low dose intra-arterial bolus (0.25–1 mg) of tirofiban. The safety and efficacy outcomes at 90-day follow-ups included symptomatic intracranial hemorrhage (sICH), recanalization rate, functional outcome, and mortality.Results: Among the 649 AIS patients with LAA, those in the tirofiban group (n = 244) showed higher systolic blood pressure (BP) and NIHSS score on admission, puncture-to-recanalization time, lower frequency of intravenous thrombolysis and intra-arterial thrombolysis, higher frequency of antiplatelet, heparinization, mechanical stent retrieval, aspiration, balloon angioplasty, and more retrieval times compared with those in the non-tirofiban group (n = 405) (all P &lt; 0.05). Tirofiban was found to be associated with superior clinical outcomes in anterior circulation stroke and major stroke patients [adjusted odds ratio (OR) = 2.163, 95% confidence interval (CI) = 1.130–4.140, P = 0.02 and adjusted OR = 2.361, 95% CI = 1.326–4.202, P = 0.004, respectively] and a lower risk of mortality at 90-day follow-ups (adjusted OR = 0.159, 95% CI = 0.042–0.599, P = 0.007 and adjusted OR = 0.252, 95% CI = 0.103–0.621, P = 0.003, respectively). There was no significant difference in sICH between the two groups.Conclusions: Tirofiban in AIS patients with LAA undergoing EVT is safe and may benefit the functional outcomes in anterior circulation and major stroke patients and showed a trend for reduced mortality.
Therapeutic Hypothermia Inhibits the Classical Complement Pathway in a Rat Model of Neonatal Hypoxic-Ischemic Encephalopathy
Authors: Shah Tushar A. , Pallera Haree K. , Kaszowski Cortney L. , Bass William Thomas , Lattanzio Frank A. 
Published: February 2021

ObjectiveComplement activation is instrumental in the pathogenesis of Hypoxic-ischemic encephalopathy (HIE), a significant cause of neonatal mortality and disability worldwide. Therapeutic hypothermia (HT), the only available treatment for HIE, only modestly improves outcomes. Complement modulation as a therapeutic adjunct to HT has been considered, but is challenging due to the wide-ranging role of the complement system in neuroinflammation, homeostasis and neurogenesis in the developing brain. We sought to identify potential therapeutic targets by measuring the impact of treatment with HT on complement effector expression in neurons and glia in neonatal HIE, with particular emphasis on the interactions between microglia and C1q.MethodsThe Vannucci model was used to induce HIE in term-equivalent rat pups. At P10-12, pups were randomly assigned to three different treatment groups: Sham (control), normothermia (NT), and hypothermia (HT) treatment. Local and systemic complement expression and neuronal apoptosis were measured by ELISA, TUNEL and immunofluorescence labeling, and differences compared between groups.ResultsTreatment with HT is associated with decreased systemic and microglial expression of C1q, decreased systemic C5a levels, and decreased microglial and neuronal deposition of C3 and C9. The effect of HT on cytokines was variable with decreased expression of pro and anti-inflammatory effectors. HT treatment was associated with decreased C1q binding on cells undergoing apoptosis.ConclusionOur data demonstrate the extreme complexity of the immune response in neonatal HIE. We propose modulation of downstream effectors C3a and C5a as a therapeutic adjunct to HT to enhance neuroprotection in the developing brain.
La incertidumbre en tiempos de pandemia
Authors: Caila Mercedes , Gómez Silvia 
Published: February 2021

El planeta afronta una pandemia en el marco de una coyuntura difícil que, en algunas latitudes, ha profundizado una crisis en términos socioeconómicos. Creemos necesario resaltar que la delicada situación ambiental a la que nos enfrentamos se encuentra ausente en la mayor parte de los discursos políticos, a pesar de que ser consecuencia directa de las prácticas productivas y depredadoras del capitalismo, que ha generado desequilibrios en los sistemas sociales y naturales. Esta situación ha puesto a individuos y Estados nacionales en escenarios adversos, donde la complejidad del problema dificulta las respuestas eficientes. Uno de los aspectos que la comunidad en general comenzó a entender es la necesidad de mejorar la relación con el ambiente. Los sectores que han interpretado la problemática desde esta perspectiva consideran esta oportunidad como un momento histórico para modificar las formas de vincularnos con la producción y con el consumo de modalidades sustentables, para generar pautas culturales que respeten la biodiversidad y disminuyan el impacto antrópico.
El trabajo territorial. Nuevas configuraciones para un programa en tiempos de pandemia
Authors: Vigoni Luciano , Tobin Patricia 
Published: February 2021

La irrupción del Covid-19 impacta en las perspectivas de la continuidad de una propuesta que requiere reconfigurar las acciones de trabajo en los espacios barriales, en una construcción que integre la población juvenil, las organizaciones sociales y el Estado local en este contexto de pandemia que moviliza tramas organizacionales y vinculares de manera diversa.Sin desconocer el acumulado en las relaciones territoriales, y considerando la importancia de continuar con la presencia de los equipos del Estado municipal en los entramados barriales, desde el Programa “Nueva Oportunidad” se diseña un trazado de acciones que aporten a pensar estrategias sanitarias para la vida cotidiana con las grupalidades juveniles y sus referentes.En este trabajo, se parte de la explicitación de la esencia del “Nueva Oportunidad”, el cual consiste en un programa de intervención social con jóvenes que no estudian ni trabajan y que habitan barriadas con condiciones socio-económicas y habitacionales deprimidas, hoy denominadas “barrios populares”, para dar mayor contenido y sentido a las acciones de intervención planificadas.