bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of COVID‐19 on Otolaryngology Community Practice in Massachusetts
Authors: Fan Timothy , Workman Alan D. , Miller Lauren E. , Sakats Mallory Mason , Rajasekaran Karthik , Brant Jason A. , Parasher Arjun K. , Huckins David , Aliphas Avner , Glicksman Robin , Eskander Antoine , Glicksman Jordan T. 
Published: February 2021

ObjectivesCoronavirus disease 2019 (COVID‐19) significantly affected many health care specialties, including otolaryngology. In response to governmental policy changes, many hospitals and private practices in Massachusetts canceled or postponed nonurgent office visits and elective surgeries. The objective of this study was to quantify the impact of COVID‐19 on the provision and practice trends of otolaryngology services for 10 private practices in Massachusetts.Study DesignRetrospective review.SettingMultipractice study for community practices in Massachusetts.MethodsElectronic billing records from 10 private otolaryngology practices in Massachusetts were obtained for the first 4 months of 2019 and 2020. Questionnaires from these otolaryngology practices were collected to assess financial and staffing impact of COVID‐19.ResultsThe local onset of the COVID‐19 pandemic had a significant decrease of 63% of visits in comparison to equivalent weeks in 2019. Virtual visits overtook in‐person visits over time. A greater decline in operating room (OR) procedures than for office procedures was recorded. Ninety percent of practices reduced working hours, and 80% furloughed personnel. Seventy percent of practices applied for the Paycheck Protection Program (PPP).ConclusionCOVID‐19 has had a multifaceted impact on private otolaryngology practices in Massachusetts. A significant decline in provision of otolaryngology services aligned with the Massachusetts government’s public health policy changes. The combination of limited personnel and personal protective equipment, as well as suspension of nonessential office visits and surgeries, led to decrease in total office visits and even higher decrease in OR procedures.
Lipoxin A4 promotes autophagy and inhibits overactivation of macrophage inflammasome activity induced by Pg LPS
Authors: Zhao Jie , Geng Wenjing , Wan Kefei , Guo Kailei , Xi Fengjun , Xu Xiangqun , Xiong Xiujuan , Huang Xu , Liu Jiayi , Kuang Xiaodong 
Published: February 2021

Objective To explore the role of lipoxin A4 (LXA4) on inflammasome and inflammatory activity in macrophages activated by Porphyromonas gingivalis lipopolysaccharide (PgLPS) one of the major causative agents of chronic periodontitis. Methods The mouse macrophage cell line RAW264.7 was used to produce an activated inflammation model. Markers of inflammasome and inflammatory activity and autophagy were assessed by ELISA, reverse transcription polymerase chain reaction (RT-PCR), and Western blot assay. Results Markers of inflammasome activity, inflammation and autophagy increased with Pg LPS concentration. They also increased with increasing exposure to Pg LPS up to 12h but decreased at 24h. However, markers of autophagy increased. Phosphorylated NF-κBp65 decreased with LXA4, which was similar to results obtained with the autophagy inducer, rapamycin. Conclusions LXA4 promoted autophagy and inhibited activation of inflammasomes and inflammation markers in macrophage inflammation induced by PgLPS and this action was linked to the phosphorylation of NF-κB.
Efficacy of rapid on-site cytological evaluation (ROSE) by a pulmonologist in determining specimen adequacy and diagnostic accuracy in interventional diagnosis of lung lesions
Authors: Yuan Mingli , Wang Yafei , Yin Wen , Xiao Yang , Hu Manman , Hu Yi 
Published: February 2021

Objective To evaluate the efficacy of rapid on-site cytological evaluation (ROSE) in determining specimen adequacy and diagnostic accuracy in the interventional diagnosis of lung lesions. Methods This retrospective study included 127 consecutive cases of lung lesions, which were sampled by bronchoscopy or transthoracic fine needle aspiration, and diagnosed on ROSE followed by histopathology. ROSE was performed by a trained pulmonologist and the diagnosis of ROSE was compared with the final diagnosis. Results The sensitivity of ROSE in determining adequacy of specimens was 97.5% and specificity in determining inadequacy was 85.7%. The diagnostic efficacy of ROSE for assessing malignancy (sensitivity of 94.5% and specificity of 100%) and non-malignancy (sensitivity of 97.8% and specificity of 100%) was excellent. The sensitivity of ROSE for diagnosing small cell carcinoma (100%) was highest, followed by adenocarcinoma (89.2%) and squamous cell carcinoma (75.0%). Performance of ROSE by a trained pulmonologist also determined tuberculosis with a high diagnostic sensitivity (83.3%) and specificity (100%). Conclusions A trained pulmonologist can reliably carry out ROSE to ensure the adequacy of the sample, distinguish between malignancy and non-malignancy, and make a preliminary diagnosis in a large number of cases.
Lessons Learned from Countries That Have Introduced Palliative Care Services into Their National Health System: A Narrative Review
Authors: Abu-Odah Hammoda , Molassiotis Alex , Liu Justina 
Published: February 2021

Objective: This review aims at gaining a broad overview of national approaches about Palliative care (PC) implementation into health care systems in countries that have PC identified within their national policies and strategies. Methods: Paper searching was conducted using both peer-reviewed databases and gray literature sources covering governmental reports with PC strategies from 2000 onward. Articles published in English that cited at least 1 category of the WHO’s public health PC model were included. Qualitative content analysis was used for data analysis and synthesis of findings. Results: Thirteen reports met the inclusion criteria. Education and appropriate policies were the most frequent strategies covered by all countries included. Under education; information about training health care providers was needed for the effective introduction of a PC program. Reviewing standards of care required to deliver PC effectively, and financial support for PC service development were considered the central policies needed. Furthermore, partnerships and collaborations across the health systems as well as providing care based on patients’ needs were required for the provision of a PC program. Conclusion: It is of the essence to learn from countries demonstrating enhanced PC practices before the implementation of a new PC program in a given country. Such practices could be used as a guide and to address barriers that may hinder the development of PC at a national level. Best practices can be achieved by focusing on educational and policy-based strategies through identifying patients’ needs, assessing general public awareness, health care providers’ knowledge and training as well as incorporating stakeholders’ perspectives.
Proactive Evaluation: The Program Stress Test
Authors: Chen Huey T. , Morosanu Liliana , Bellury Lanell M. , Teleaga Jessica , Hardin Abigail E. 
Published: February 2021

Intervention programs are open systems that must withstand the disturbances of the environments in which they are implemented if they are to thrive. Stakeholders can benefit from proactive insights related to potential program malfunction or failure. Evaluators have not developed approaches to serve this preventive function. This study proposes the program stress test as a holistic, preventive approach to program evaluation, aiming to identify vulnerable areas at risk of failure, and to suggest preventive strategies. The stress test can be used in the planning stage of a program (called ex-ante stress test), or during the implementation stage (called ex-post stress test). This study illustrates an ex-post test. The authors introduce its concept, methodology, research steps, and application to a student retention program, including findings of structural and functional issues, as well as solutions proposed by participants. The authors call the evaluators’ attention to the need to expand the traditional scope of evaluation, to include future-focused assessments.
The association of aldosterone with papillophlebitis and retinal artery occlusion: A case report
Authors: Kuo Che-Yuan , Lin Po-Kang 
Published: February 2021

Purpose: To explore the association between elevated blood aldosterone levels and papillophlebitis and retinal artery occlusion in a young, healthy woman. Case description: A 19-year-old woman with an unremarkable medical history presented with sudden-onset visual loss in the right eye, which lasted for 10 hours. Fundus examination revealed retinal whitening, splinter hemorrhages, disc swelling, and tortuous vessels in the right eye. Optical coherence tomography revealed inner retinal thickening. Fluorescein angiography demonstrated a delayed arteriovenous transit time and delayed filling of the cilioretinal artery circulation. Further workup showed a high aldosterone level and aldosterone-to-renin ratio. The patient was treated with steroid pulse therapy and combined intravitreal injection of dexamethasone implant and aflibercept. Visual acuity was recovered from count finger at initial presentation to 6/15 on the fifth day. For over 2 months, the fundal manifestations gradually subsided. Three months after the episode, her visual acuity further improved to 6/6.7. Conclusion: This report emphasizes the potential role aldosterone plays in the complex disease mechanism of retinal vasculopathy. In addition, steroid pulse therapy is more effective when applied in conjunction with combined intravitreal injection therapy for rescuing impaired vision caused by retinal vascular occlusion.
The impact of telemedicine on patients with uncontrolled type 2 diabetes mellitus during the COVID-19 pandemic in Saudi Arabia: Findings and implications
Authors: M Tourkmani Ayla , J ALHarbi Turki , Rsheed Abdulaziz M Bin , Alrasheedy Alian A , ALMadani Wedad , ALJuraisi Fahad , AlOtaibi Azzam Fahad , AlHarbi Mohammed , AlAbood Abood F , Alshaikh Abdulaziz A Ibn 
Published: February 2021

Introduction Routine diabetes care changed during the COVID-19 pandemic due to precautionary measures such as lockdowns, cancellation of in-person visits, and patients’ fear of being infected when attending clinics. Because of the pandemic, virtual clinics were implemented to provide diabetes care. Therefore, we conducted this study to assess the impact of these virtual clinics on glycaemic control among high-risk patients with type 2 diabetes mellitus (DM). Methods A prospective single-cohort pre-/post telemedicine care intervention study was conducted on 130 patients with type 2 DM attending a virtual integrated care clinic at a chronic Illness center in a family and community medicine department in Riyadh, Saudi Arabia during the COVID-19 pandemic. Results The mean age of the participants was 57 years (standard deviation (SD) = 12) and the mean (SD) duration of diabetes was 14 (7) years. Over a period of 4 months, the HbA1c decreased significantly from 9.98 ± 1.33 pre-intervention to 8.32 ± 1.31 post-intervention (mean difference 1.66 ± 1.29; CI = 1.43–1.88; P <0.001). In addition, most in-person care visits were successfully replaced, as most patients (64%) needed only one or two in-person visits during the 4-month period, compared with typically one visit every 1–2 weeks in the integrated care programme before the pandemic for this group of high-risk patients. Discussion The current study found a significant positive impact of telemedicine care on glycaemic control among high-risk patients with DM during the COVID-19 pandemic. Moreover, it showed that telemedicine could be integrated into diabetic care to successfully replace many of the usual in-person care visits. Consequently, health policy makers need to consider developing comprehensive guidelines in Saudi Arabia for telemedicine care to, ensure the quality of care and address issues such as financial reimbursement and patient information privacy.
Feasibility of Atlas Pedicle Screw Fixation Perpendicular to the Coronal Plane—A 3D Anatomic Analysis
Authors: Wu Chao , Deng Jiayan , Wang Qing , Pan Jian , Hu Haigang , Li Guangzhou , Tan Lun , Wei Qin 
Published: February 2021

Study Design: An anatomic analysis. Objective: To investigate the feasibility of the ideal atlas pedicle screw trajectory perpendicular to the coronal plane via atlas digital 3D reconstruction. Methods: One hundred adult atlases were evaluated in this study. The projection of the corridor for atlas pedicle screw fixation perpendicular to the coronal plane was quickly obtained using the perspective model of 3D reconstruction, and the area, long axis, short axis and width of the pedicle corridor were measured. The inner trajectory was near the lateral wall of the pedicle, and the center of the corridor was point A. The lateral trajectory was near the lateral wall of the transverse foramen, and the center of the trajectory was point C. The midpoint of A and C was B. The length of the inner, middle and lateral trajectorys were measured. The distances from points A, B and C to the posterior tubercle of the atlas and safety swing angle were measured. Results: From the dorsal view, the pedicle corridor was fitted into an ellipse with an average long axis of 13.6 mm, an average short axis of 5.2 mm, and an average area of 56.3 mm2. From the axial view, the pedicle corridor had an average width of 9.4 mm. The average lengths of the inner trajectory, middle trajectory and lateral trajectory were 31.7 mm, 28.7 mm and 25.1 mm, respectively; The average distances from the posterior tubercle to points A, B and C were 17.1 mm, 20.8 mm and 24.5 mm, respectively. The average swing angles from points A, B and C were 16.1°, 25.5°, and 28.1°, respectively. Conclusion: Atlas pedicle screw fixation perpendicular to the coronal plane is feasible for almost all the volunteers. Pedicle screws close to the pedicle lateral wall of the atlas posterior arch perpendicular to the coronal plane is an advanced technique that is easy to master.
Effect of Cooling Irrigating Saline in Tongue Base Ablation in Obstructive Sleep Apnea
Authors: Bahgat Ahmed Yassin 
Published: February 2021

ObjectivePlasma is formed by creating a high‐density energy field within an electrically conductive fluid such as saline. Sometimes ablated bits of tissue get stuck between the electrodes of the wand, obstructing the suction channel. The purpose of this study is to investigate the effect of cooling the irrigating saline during ablation of the hypertrophied tongue base in patients with obstructive sleep apnea.Study DesignProspective randomized controlled trial.SettingAn otorhinolaryngology department in Main University hospitals.MethodsSixty adult patients with obstructive sleep apnea and tongue base hypertrophy underwent tongue base ablation surgery. Patients were randomly divided into 2 groups of 30 patients each: cooled saline and room temperature saline. The Coblation wand used was the EVac 70 Xtra HP (Smith & Nephew).ResultsIn this study, a significant difference in operative time (mean ± SD) was seen between groups: 21.2 ± 5.5 minutes in the cold group and 47 ± 9.5 minutes in the control group (P =. 001). The wands in the cold group did not obstruct, while all the wands in the control group were obstructed by tissue clogs with variable degrees, hence wasting more time to clean the wands’ tips.ConclusionCooling the irrigating saline overcame the problem of wand clogs, and the wand tip did not occlude at all during the procedures, thus saving time lost in wand cleaning and demonstrating a faster and safer surgical procedure. Further studies are needed to identify the hemostatic effect of the cooled saline over the regular one.
Genomic landscape of cutaneous follicular lymphomas reveals 2 subgroups with clinically predictive molecular features
Authors: Zhou Xiaolong Alan , Yang Jingyi , Ringbloom Kimberly G. , Martinez-Escala Maria Estela , Stevenson Kristen E. , Wenzel Alexander T. , Fantini Damiano , Martin Haley K. , Moy Andrea P. , Morgan Elizabeth A. , Harkins Shannon , Paxton Christian N. , Hong Bo , Andersen Erica F. , Guitart Joan , Weinstock David M. , Cerroni Lorenzo , Choi Jaehyuk , Louissaint Abner 
Published: February 2021

Abstract
Primary cutaneous follicle center lymphomas (PCFCLs) are indolent B-cell lymphomas that predominantly remain skin restricted and manageable with skin-directed therapy. Conversely, secondary cutaneous involvement by usual systemic follicular lymphoma (secondary cutaneous follicular lymphoma [SCFL]) has a worse prognosis and often necessitates systemic therapy. Unfortunately, no histopathologic or genetic features reliably differentiate PCFCL from SCFL at diagnosis. Imaging may miss low-burden internal disease in some cases of SCFLs, leading to misclassification as PCFCL. Whereas usual systemic FL is well characterized genetically, the genomic landscapes of PCFCL and SCFL are unknown. Herein, we analyzed clinicopathologic and immunophenotypic data from 30 cases of PCFCL and 10 of SCFL and performed whole-exome sequencing on 18 specimens of PCFCL and 6 of SCFL. During a median follow-up of 7 years, 26 (87%) of the PCFCLs remained skin restricted. In the remaining 4 cases, systemic disease developed within 3 years of diagnosis. Although the SCFLs universally expressed BCL2 and had BCL2 rearrangements, 73% of the PCFCLs lacked BCL2 expression, and only 8% of skin-restricted PCFCLs had BCL2 rearrangements. SCFLs showed low proliferation fractions, whereas 75% of PCFCLs had proliferation fractions &gt;30%. Of the SCFLs, 67% had characteristic loss-of-function CREBBP or KMT2D mutations vs none in skin-restricted PCFCL. Both SCFL and skin-restricted PCFCL showed frequent TNFRSF14 loss-of-function mutations and copy number loss at chromosome 1p36. These data together establish PCFCL as a unique entity with biological features distinct from usual systemic FL and SCFL. We propose 3 criteria based on BCL2 rearrangement, chromatin-modifying gene mutations (CREBBP, KMT2D, EZH2, and EP300), and proliferation index to classify cutaneous FL specimens based on the likelihood of concurrent or future systemic spread.
Adenylate kinase 2 expression and addiction in T-ALL
Authors: Maslah Nabih , Latiri Mehdi , Asnafi Vahid , Féroul Mélanie , Bedjaoui Nawel , Steimlé Thomas , Six Emmanuelle , Verhoyen Els , Macintyre Elizabeth , Lagresle-Peyrou Chantal , Lhermitte Ludovic , Andrieu Guillaume P. 
Published: February 2021

Abstract
T-cell acute lymphoblastic leukemia (T-ALL) represents the malignant expansion of immature T cells blocked in their differentiation. T-ALL is still associated with a poor prognosis, mainly related to occurrence of relapse or refractory disease. A critical medical need therefore exists for new therapies to improve the disease prognosis. Adenylate kinase 2 (AK2) is a mitochondrial kinase involved in adenine nucleotide homeostasis recently reported as essential in normal T-cell development, as defective AK2 signaling pathway results in a severe combined immunodeficiency with a complete absence of T-cell differentiation. In this study, we show that AK2 is constitutively expressed in T-ALL to varying levels, irrespective of the stage of maturation arrest or the underlying oncogenetic features. T-ALL cell lines and patient T-ALL–derived xenografts present addiction to AK2, whereas B-cell precursor ALL cells do not. Indeed, AK2 knockdown leads to early and massive apoptosis of T-ALL cells that could not be rescued by the cytosolic isoform AK1. Mechanistically, AK2 depletion results in mitochondrial dysfunction marked by early mitochondrial depolarization and reactive oxygen species production, together with the depletion of antiapoptotic molecules (BCL-2 and BCL-XL). Finally, T-ALL exposure to a BCL-2 inhibitor (ABT-199 [venetoclax]) significantly enhances the cytotoxic effects of AK2 depletion. We also show that AK2 depletion disrupts the oxidative phosphorylation pathway. Combined with pharmaceutical inhibition of glycolysis, AK2 silencing prevents T-ALL metabolic adaptation, resulting in dramatic apoptosis. Altogether, we pinpoint AK2 as a genuine and promising therapeutic target in T-ALL.
Search for SINE repeats in the rice genome using correlation-based position weight matrices
Authors: Suvorova Yulia M. , Kamionskaya Anastasia M. , Korotkov Eugene V. 
Published: February 2021

AbstractBackgroundTransposable elements (TEs) constitute a significant part of eukaryotic genomes. Short interspersed nuclear elements (SINEs) are non-autonomous TEs, which are widely represented in mammalian genomes and also found in plants. After insertion in a new position in the genome, TEs quickly accumulate mutations, which complicate their identification and annotation by modern bioinformatics methods. In this study, we searched for highly divergent SINE copies in the genome of rice (Oryza sativasubsp.japonica) using the Highly Divergent Repeat Search Method (HDRSM).ResultsThe HDRSM considers correlations of neighboring symbols to construct position weight matrix (PWM) for a SINE family, which is then used to perform a search for new copies. In order to evaluate the accuracy of the method and compare it with the RepeatMasker program, we generated a set of SINE copies containing nucleotide substitutions and indels and inserted them into an artificial chromosome for analysis. The HDRSM showed better results both in terms of the number of identified inserted repeats and the accuracy of determining their boundaries. A search for the copies of 39 SINE families in the rice genome produced 14,030 hits; among them, 5704 were not detected by RepeatMasker.ConclusionsThe HDRSM could find divergent SINE copies, correctly determine their boundaries, and offer a high level of statistical significance. We also found that RepeatMasker is able to find relatively short copies of the SINE families with a higher level of similarity, while HDRSM is able to find more diverged copies. To obtain a comprehensive profile of SINE distribution in the genome, combined application of the HDRSM and RepeatMasker is recommended.