bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating Dual-Energy CT Post-Contrast Phases for Liver Iron Quantification: A Preliminary Study
Authors: Basso Luca , Baldi Dario , Mannelli Lorenzo , Cavaliere Carlo , Salvatore Marco , Brancato Valentina 
Published: June 2021

Background and Purpose: Quantification of hepatic virtual iron content (VIC) by using Multidetector Dual Energy Computed Tomography (DECT) has been recently investigated since this technique could offer a good compromise between accuracy and non-invasiveness for liver iron content quantification. The aim of our study is to investigate differences in VIC at different DECT time points (namely baseline and arterial, venous and tardive phases), identifying the most reliable and also exploring the underlying temporal trend of these values. Materials and Methods: Eleven patients who underwent DECT examination and were characterized by low liver fat content were included in this retrospective study. By using the Syngo.via Frontier–DE IronVNC tool, regions of interest (ROI) were placed on the VIC images at 3 hepatic levels, both in left and right liver lobes, at each DECT time point. Friedman’s test followed by Bonferroni-adjusted Wilcoxon signed-rank test for post-hoc analysis was performed to assess differences between DECT timepoints. Page’s L test was performed to test the temporal trend of VIC across the 4 examined timepoints. Results: For both liver lobes, Friedman’s test followed by Bonferroni-adjusted Wilcoxon signed-rank test revealed that VIC values differed significantly when extracted from ROIs placed at the 4 different timepoints. The Page’s L test for multiple comparison revealed a significant growing trend for VIC, from baseline acquisition to the fourth and last time point post-contrast agent injection. Conclusions: The extraction of hepatic VIC in healthy subjects was found to be significantly influenced by the DECT time point chosen for the extrapolation of the VIC values.
Imaging findings of trichilemmal cyst and proliferating trichilemmal tumour
Authors: Kawaguchi Masaya , Kato Hiroki , Suzui Natsuko , Miyazaki Tatsuhiko , Tomita Hiroyuki , Hara Akira , Matsuyama Kanako , Seishima Mariko , Matsuo Masayuki 
Published: June 2021

Purpose The purpose of this study was to evaluate computed tomography and magnetic resonance imaging of benign trichilemmal cysts and proliferating trichilemmal tumours. Methods Nineteen histologically confirmed cutaneous lesions with trichilemmal keratinisation (12 trichilemmal cysts and seven proliferating trichilemmal tumours) were enrolled. Among them, 10 lesions (six trichilemmal cysts and four proliferating trichilemmal tumours) were examined by computed tomography, while 13 lesions (eight trichilemmal cysts and five proliferating trichilemmal tumours) were examined by magnetic resonance imaging. Computed tomography and magnetic resonance imaging characteristics were retrospectively reviewed. RESULTS Sixteen lesions (84%, 10 trichilemmal cysts and six proliferating trichilemmal tumours) occurred on the scalp. Lobulated margins were observed in five lesions (26%, three trichilemmal cysts and two proliferating trichilemmal tumours). With respect to computed tomography attenuation, calcification (>200 Hounsfield units) was observed in seven lesions (70%, five trichilemmal cysts and two proliferating trichilemmal tumours), hyperdense areas (≥80 and ≤200 Hounsfield units) in six (60%, three trichilemmal cysts and three proliferating trichilemmal tumours), and soft tissue density areas (<80 Hounsfield units) in nine (90%, five trichilemmal cysts and four proliferating trichilemmal tumours). On T1-weighted images, intratumoral hyperintensity was only observed in eight trichilemmal cysts but no proliferating trichilemmal tumours (100% vs. 0%, P<0.01). On T2-weighted images, hypointense rim and intratumoral hypointensity was observed in all 13 lesions (100%, eight trichilemmal cysts and five proliferating trichilemmal tumours), and linear or reticular hypointensity was observed in 10 (77%, six trichilemmal cysts and four proliferating trichilemmal tumours). Conclusion Trichilemmal cysts and proliferating trichilemmal tumours predominantly occurred on the scalp with calcification, and usually exhibited linear or reticular T2 hypointensity. Intratumoral T1 hyperintensity may be a useful imaging feature for differentiating trichilemmal cysts from proliferating trichilemmal tumours.
An elevated serum creatinine in a patient receiving palbociclib
Authors: Bonilla Marco , Bashir Khawaja Arsalan , Jhaveri Kenar D 
Published: June 2021

Background: Serum Creatinine (SCr) is the most widely used parameter in clinical practice to estimate glomerular filtration rate (GFR). Various drugs have been reported to cause a reversible and transient elevation in SCr without a true reduction in overall kidney function Case Presentation: We describe a case of a 66-year-old-woman with right breast poorly differentiated invasive ductal carcinoma, hormone receptor positive and HER2 negative who received treatment with fulvestrant and palbociclib. The initial dose of Palbociclib was 125 mg orally a day, then reduce to 100 mg orally a day. She presented for evaluation of elevated serum creatinine with decreased eGFR. Upon evaluation an estimated glomerular filtration rate by cystatin C showed kidney function at her baseline for the past year. Conclusion: Palbocicib is a selective inhibitor of the cyclin-dependent kinases CDK4 and CDK6. Physicians should be aware that patients undergoing therapy with palbociclib require monitoring of kidney function and an increase in serum creatinine from baseline, might represent an inhibitory effect of the secretion of creatinine.
Nasopharyngeal Microbiota in SARS-CoV-2 Positive and Negative Patients
Authors: Engen Phillip A. , Naqib Ankur , Jennings Cheryl , Green Stefan J. , Landay Alan , Keshavarzian Ali , Voigt Robin M. 
Published: June 2021

AbstractWe investigated nasopharyngeal microbial community structure in COVID-19-positive and -negative patients. High-throughput 16S ribosomal RNA gene amplicon sequencing revealed significant microbial community structure differences between COVID-19-positive and -negative patients. This proof-of-concept study demonstrates that: (1) nasopharyngeal microbiome communities can be assessed using collection samples already collected for SARS-CoV-2 testing (viral transport media) and (2) SARS-CoV-2 infection is associated with altered dysbiotic microbial profiles which could be a biomarker for disease progression and prognosis in SARS-CoV-2.
Cephalad misplacement of a pulmonary artery catheter in a patient with a preexisting Hickman catheter
Authors: Choi Hoon , Jeon Joon Pyo , Huh Jaewon , Kim Youme , Hwang Wonjung 
Published: June 2021

Abstract
Background
Pulmonary artery catheter insertion is a routine practice in high-risk patients undergoing cardiac surgery. However, pulmonary artery catheter insertion is associated with numerous complications that can be devastating to the patient. Incorrect placement is an overlooked complication with few case reports to date.

Case presentation
An 18-year-old male patient underwent elective mitral valve replacement due to severe mitral valve regurgitation. The patient had a history of synovial sarcoma, and Hickman catheter had been inserted in the right internal jugular vein for systemic chemotherapy. We made multiple attempts to position the pulmonary artery catheter in the correct position but failed. A chest radiography revealed that the pulmonary artery catheter was bent and pointed in the cephalad direction. Removal of the pulmonary artery catheter was successful, and the patient was discharged 10 days after the surgery without complications.

Conclusions
To prevent misplacement of the PAC, clinicians should be aware of multiple risk factors in difficult PAC placement, and be prepared to utilize adjunctive methods, such as TEE and fluoroscopy.
Effect of hemoglobin content on cerebral oxygen saturation during surgery for scoliosis in pediatric patients
Authors: Liu Lin , Qiang Zhipeng , Zhang Jianmin , Ren Yi , Zhao Xin , Fu Wenya , Xin Zhong , Xu Zenghua , Wang Fang , Li Lijing , Zou Nan , Zhang Xuemei , Feng Lei , Ma Shuxuan 
Published: June 2021

Abstract
Background
Although regional cerebral oxygen saturation (rScO2) monitoring has been widely used in clinical practice, the relationship between hemoglobin (dHB) content and rScO2 is incompletely understood. The aim of this study was to analyze the effect of hemoglobin content on rScO2 in pediatric patients undergoing general anesthesia for correction of scoliosis.

Methods
Ninety-two pediatric patients aged 3 to 14 years undergoing scoliosis correction surgery were enrolled. Continuous monitoring of bilateral regional cerebral oxygen saturation by near-infrared spectroscopy (NIRS, CASMED, USA) was performed after entering the operation room. rScO2 was recorded when the patients entered the operating room (T0, baseline), after anesthesia induced intubation (T1), and after radial artery puncture (T2). The lowest value of rScO2 during surgery was also recorded. The arterial blood pressure (ABP), heart rate (HR), pulse oxygen saturation (SpO2), end tidal carbon dioxide partial pressure (PetCO2) were continuously recorded. Patients were classified as low rScO2 or high rScO2 group according to whether the lowest intraoperative rScO2 was 15% lower than the baseline value. An analysis and comparison of differences in hemoglobin content in these two groups was carried out.

Results
The preoperative hemoglobin-postoperative hemoglobin of patients in the high rScO2 group was significantly lower than that in the low rScO2 group (t = − 7.86, p < 0.01), the amount of bleeding during the operation was also less than that in the low rScO2 group (t = − 6.05, p < 0.01), and the systolic pressure of patients was higher than that in the low rScO2 group (t = 4.27, p < 0.01).

Conclusions
The decrease in hemoglobin level which occurs during surgery leads to a decrease in cerebral oxygen saturation. In order to ensure patient safety during surgery, it is necessary to carry out volume management and appropriate transfusion and fluid replacement in a timely manner.

Trial registration
Chinese Clinical Trial Registry, ChiCTR1800016359. Registered 28 May 2018.
A method for assessing robustness of the results of a star-shaped network meta-analysis under the unidentifiable consistency assumption
Authors: Yoon Jeong-Hwa , Dias Sofia , Hahn Seokyung 
Published: June 2021

Abstract
Background
In a star-shaped network, pairwise comparisons link treatments with a reference treatment (often placebo or standard care), but not with each other. Thus, comparisons between non-reference treatments rely on indirect evidence, and are based on the unidentifiable consistency assumption, limiting the reliability of the results. We suggest a method of performing a sensitivity analysis through data imputation to assess the robustness of results with an unknown degree of inconsistency.

Methods
The method involves imputation of data for randomized controlled trials comparing non-reference treatments, to produce a complete network. The imputed data simulate a situation that would allow mixed treatment comparison, with a statistically acceptable extent of inconsistency. By comparing the agreement between the results obtained from the original star-shaped network meta-analysis and the results after incorporating the imputed data, the robustness of the results of the original star-shaped network meta-analysis can be quantified and assessed. To illustrate this method, we applied it to two real datasets and some simulated datasets.

Results
Applying the method to the star-shaped network formed by discarding all comparisons between non-reference treatments from a real complete network, 33% of the results from the analysis incorporating imputed data under acceptable inconsistency indicated that the treatment ranking would be different from the ranking obtained from the star-shaped network. Through a simulation study, we demonstrated the sensitivity of the results after data imputation for a star-shaped network with different levels of within- and between-study variability. An extended usability of the method was also demonstrated by another example where some head-to-head comparisons were incorporated.

Conclusions
Our method will serve as a practical technique to assess the reliability of results from a star-shaped network meta-analysis under the unverifiable consistency assumption.
Factors associated with latent tuberculosis among international migrants in Brazil: a cross-sectional study (2020)
Authors: de Jezus Sonia Vivian , do Prado Thiago Nascimento , Arcêncio Ricardo Alexandre , Mascarello Keila Cristina , Sales Carolina Maia Martins , Fauth Maysa Mabel , de Faria Marcos Terena Nahari , Amorim Raphael Florindo , Araujo Vania Maria Silva , Aragón Miguel Angel López , Maciel Ethel Leonor Noia 
Published: June 2021

Abstract
Background
Migrants are a high priority group for TB control measures due to their high exposure to risk factors such as poverty and social vulnerability. The study aimed to identify factors associated with latent TB among international migrants living in four Brazilian state capitals.

Methods
This was a cross-sectional study conducted in September and October 2020 in a sample of 903 international migrants living in four Brazilian state capitals: Boa Vista/RR (458), Manaus/AM (136), São Paulo/SP (257), and Curitiba/PR (52). Data were collected with a questionnaire consisting of open and closed questions on personal characteristics, information on TB, and use of preventive measures. Tuberculin skin test (TST) was performed, with reading after 72 h by trained nurses and using 5 mm induration as the positive cutoff. Chi-square test (X2) and Fisher's exact test, both two-tailed, were used to compare statistically significant levels of association between the migrants´ sociodemographic characteristics, vulnerability, and latent TB infection (LTBI). Binary logistic regression was applied to calculate odds ratios and respective 95% confidence intervals. For all the tests, type I error of 5% was defined as statistically significant (p < 0.05).

Results
Prevalence of LTBI among migrants was 46.1% in Manaus/AM, 33.3% in São Paulo/SP, 28.1% in Curitiba/PR, and 23.5% in Boa Vista/RR. Factors associated with latent infection were age, male gender, and brown or indigenous race.

Conclusions
The study showed high prevalence of latent TB among international migrants.
Discontinuation of tuberculosis treatment among children in the Kampala Capital City Authority health facilities: a mixed-methods study
Authors: Kibirige Leonard , Izudi Jonathan , Okoboi Stephen 
Published: June 2021

Abstract
Introduction
Discontinuation of tuberculosis treatment (DTT) among children in sub-Saharan Africa is a major obstacle to effective tuberculosis (TB) control and has the potential to worsen the emergence of multi-drug resistant TB and death. DTT in children is understudied in Uganda. We examined the level and factors associated with DTT among children at four large health facilities in Kampala Capital City Authority and documented the reasons for DTT from treatment supporters and healthcare provider perspectives.

Methods
We conducted a retrospective analysis of records for children < 15 years diagnosed and treated for TB between January 2018 and December 2019. We held focus group discussions with treatment supporters and key informant interviews with healthcare providers. We defined DTT as the stoppage of TB treatment for 30 or more consecutive days. We used a stepwise generalized linear model to assess factors independently associated with DTT and content analysis for the qualitative data reported using sub-themes.

Results
Of 312 participants enrolled, 35 (11.2%) had discontinued TB treatment. The reasons for DTT included lack of privacy at healthcare facilities for children with TB and their treatment supporters, the disappearance of TB symptoms following treatment initiation, poor implementation of the community-based directly observed therapy short-course (CB-DOTS) strategy, insufficient funding to the TB program, and frequent stock-outs of TB drugs. DTT was more likely during the continuation phase of TB treatment compared to the intensive phase (Adjusted odds ratio (aOR), 5.22; 95% Confidence Interval (CI), 1.76–17.52) and when the treatment supporter was employed compared to when the treatment supporter was unemployed (aOR, 3.60; 95% CI, 1.34–11.38).

Conclusion
Many children with TB discontinue TB treatment and this might exacerbate TB morbidity and mortality. To mitigate DTT, healthcare providers should ensure children with TB and their treatment supporters are accorded privacy during service provision and provide more information about TB symptom resolution and treatment duration versus the need to complete treatment. The district and national TB control programs should address gaps in funding to TB care, the supply of TB drugs, and the implementation of the CB-DOTS strategy.
Rac inhibition as a novel therapeutic strategy for EGFR/HER2 targeted therapy resistant breast cancer
Authors: Borrero-García Luis D. , del Mar Maldonado Maria , Medina-Velázquez Julia , Troche-Torres Angel L. , Velazquez Luis , Grafals-Ruiz Nilmary , Dharmawardhane Suranganie 
Published: June 2021

Abstract
Background
Even though targeted therapies are available for cancers expressing oncogenic epidermal growth receptor (EGFR) and (or) human EGFR2 (HER2), acquired or intrinsic resistance often confounds therapy success. Common mechanisms of therapy resistance involve activating receptor point mutations and (or) upregulation of signaling downstream of EGFR/HER2 to Akt and (or) mitogen activated protein kinase (MAPK) pathways. However, additional pathways of resistance may exist thus, confounding successful therapy.

Methods
To determine novel mechanisms of EGFR/HER2 therapy resistance in breast cancer, gefitinib or lapatinib resistant variants were created from SKBR3 breast cancer cells. Syngenic therapy sensitive and resistant SKBR3 variants were characterized for mechanisms of resistance by mammosphere assays, viability assays, and western blotting for total and phospho proteins.

Results
Gefitinib and lapatinib treatments reduced mammosphere formation in the sensitive cells, but not in the therapy resistant variants, indicating enhanced mesenchymal and cancer stem cell-like characteristics in therapy resistant cells. The therapy resistant variants did not show significant changes in known therapy resistant pathways of AKT and MAPK activities downstream of EGFR/HER2. However, these cells exhibited elevated expression and activation of the small GTPase Rac, which is a pivotal intermediate of GFR signaling in EMT and metastasis. Therefore, the potential of the Rac inhibitors EHop-016 and MBQ-167 to overcome therapy resistance was tested, and found to inhibit viability and induce apoptosis of therapy resistant cells.

Conclusions
Rac inhibition may represent a viable strategy for treatment of EGFR/HER2 targeted therapy resistant breast cancer.
The Great Gut Mimicker: A case report of MIS-C and appendicitis clinical presentation overlap in a teenage patient
Authors: Hwang Michelle , Wilson Kelsey , Wendt Lisa , Pohlman Joshua , Densmore Emily , Kaeppler Caitlin , Van Arendonk Kyle , Yale Sarah 
Published: June 2021

Abstract
Background
Abdominal pain and other gastrointestinal symptoms are common presenting features of multisystem inflammatory syndrome in children (MIS-C) and can overlap with infectious or inflammatory abdominal conditions, making accurate diagnosis challenging.

Case Presentation
We describe the case of a 16-year-old female who presented with clinical symptoms suggestive of appendicitis and an abdominal computed tomography (CT) that revealed features concerning for appendicitis. After laparoscopic appendectomy, histopathology of the appendix demonstrated only mild serosal inflammation and was not consistent with acute appendicitis. Her overall clinical presentation was felt to be consistent with MIS-C and she subsequently improved with immunomodulatory and steroid treatment.

Conclusions
We note that MIS-C can mimic acute appendicitis. This case highlights MIS-C as a cause of abdominal imaging with features concerning for appendicitis, and MIS-C should be considered in the differential for a patient with appendicitis-like symptoms and a positive COVID-19 IgG. Lab criteria, specifically low-normal white blood cell count and thrombocytopenia, appears to be of high relevance in differing MIS-C from acute appendicitis, even when appendix radiologically is dilated.
Adult ADHD and emerging models of maladaptive personality: a meta-analytic review
Authors: Jacobsson Peter , Hopwood Christopher J. , Söderpalm Bo , Nilsson Thomas 
Published: June 2021

Abstract
Background
ADHD is a highly consequential disorder that is estimated to affect 2.5% of the adult population. Emerging models of psychopathology posit that disorders like ADHD can be usefully situated within general models of individual differences in personality, such as those recently implemented in the DSM and ICD for the diagnosis of personality disorder. Previous research and systematic reviews have linked adult ADHD to the personality traits Conscientious Inhibition and Negative Emotionality. However, there have been some inconsistencies in the literature and research embedding ADHD-personality connections in the DSM-5 and ICD-11 personality disorder models has been limited. The goal of this paper was to systematically review associations between adult ADHD and personality traits, organized within a maladaptive five factor framework.

Method
A comprehensive literature search yielded 13 papers whose effects were meta-analyzed.

Results
Results supported associations between ADHD and low Conscientious Inhibition and high Negative Emotionality. However, interesting patterns of variability were observed, potentially related to issues such as instrumentation and facet variation.

Conclusion
Results support the clinical application of personality assessment for suggesting risk for ADHD symptoms, and point to important directions for further research.