bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prolonged Dysphagia After a COVID-19 Infection in a Patient With Parkinson Disease
Authors: Lee Min-Yong , Oh Byung-Mo , Seo Han Gil 
Published: June 2021

Abstract
Coronavirus disease 2019 might have an impact on patients with Parkinson disease because of the neuroinvasive potential. Herein, we report the case of a patient with Parkinson disease who developed severe and prolonged oropharyngeal dysphagia after a coronavirus disease 2019 infection. A 73-yr-old male patient with Parkinson disease was diagnosed with coronavirus disease 2019 and admitted to a tertiary care hospital. Before hospitalization, he was assessed at Hoehn and Yahr stage 4 and showed no symptoms of dysphagia. After admission, the patient gradually recovered; however, he was fed through a nasogastric tube. A videofluoroscopic swallowing study revealed a severe oropharyngeal dysphagia with a severely delayed oral phase. Therefore, he underwent percutaneous gastrostomy tube insertion. After discharge, although he received swallowing therapy for 4 mos, he still had severe dysphagia, which made him dependent on enteral feeding. We speculate that the impact of coronavirus disease 2019 on dopaminergic and nondopaminergic mechanisms could lead to the development of dysphagia in this patient. The present case suggests that clinicians must have a high index of suspicion without dismissing the possibility of dysphagia and subsequent aspiration pneumonia in coronavirus disease 2019 patients with Parkinson disease.
A qualitative study examining prosthesis use in everyday life in individuals with lower limb amputations
Authors: Roberts Evan , Burhani Lamya , Lankester Ryan , Mobbs Alexander , Tigert Carly , Vanvelzen Troy , Campbell Janet , Devlin Michael , Dilkas Steven , MacKay Crystal 
Published: June 2021

Background:
Lower limb amputation (LLA) is a life-changing event that affects functional mobility and participation in everyday life. Prostheses provide individuals with LLA the opportunity to improve mobility and quality of life; however, existing literature suggests that there is underuse of prostheses.

Objectives:
The purpose of this study is to describe how individuals with major LLA use their prosthesis in everyday life and describe barriers and facilitators that influence prosthesis use.

Study Design:
A qualitative descriptive methodology was used.

Methods:
Ten community dwelling adults (>18 years) with unilateral major LLAs (transtibial, transfemoral, and knee disarticulation) attending outpatient follow-up at a specialized rehabilitation center were recruited. Participants were purposively sampled for variation in prosthesis use and level of amputation. One-on-one semistructured in-depth interviews were conducted in person or by telephone. The interviews were audio recorded, transcribed verbatim, and analyzed inductively using thematic analysis.

Results:
The experiences of individuals with major LLA were organized into three overarching themes: everyday experiences using a prosthesis, extrinsic factors influencing prosthesis use, and intrinsic factors influencing prosthesis use. These themes, and their associated subthemes, highlight how individuals use their prosthesis and the various factors perceived to act as barriers and facilitators to prosthesis use in everyday life.

Conclusions:
These findings provide valuable insight into the everyday experiences of individuals with LLA and can be used to implement strategies to optimize prosthesis use.
Incidence of HIV-positive admission and inpatient mortality in Malawi (2012–2019)
Authors: Burke Rachael M. , Henrion Marc Y.R. , Mallewa Jane , Masamba Leo , Kalua Thokozani , Khundi McEwen , Gupta-Wright Ankur , Rylance Jamie , Gordon Stephen B. , Masesa Clemens , Corbett Elizabeth L. , Mwandumba Henry C. , Macpherson Peter 
Published: June 2021

Objective:
To investigate trends in population incidence of HIV-positive hospital admission and risk of in-hospital death among adults living with HIV between 2012 and 2019 in Blantyre, Malawi.

Design:
Population cohort study using an existing electronic health information system (‘SPINE’) at Queen Elizabeth Central Hospital and Blantyre census data.

Methods:
We used multiple imputation and negative binomial regression to estimate population age-specific and sex-specific admission rates over time. We used a log-binomial model to investigate trends in risk of in-hospital death.

Results:
Of 32 814 adult medical admissions during Q4 2012--Q3 2019, HIV status was recorded for 75.6%. HIV-positive admissions decreased substantially between 2012 and 2019. After imputation for missing data, HIV-positive admissions were highest in Q3 2013 (173 per 100 000 adult Blantyre residents) and lowest in Q3 2019 (53 per 100 000 residents). An estimated 10 818 fewer than expected people with HIV (PWH) [95% confidence interval (CI) 10 068–11 568] were admitted during 2012–2019 compared with the counterfactual situation where admission rates stayed the same throughout this period. Absolute reductions were greatest for women aged 25–34 years (2264 fewer HIV-positive admissions, 95% CI 2002–2526). In-hospital mortality for PWH was 23.5%, with no significant change over time in any age-sex group, and no association with antiretroviral therapy (ART) use at admission.

Conclusion:
Rates of admission for adult PWH decreased substantially, likely because of large increases in community provision of HIV diagnosis, treatment and care. However, HIV-positive in-hospital deaths remain unacceptably high, despite improvements in ART coverage. A concerted research and implementation agenda is urgently needed to reduce inpatient deaths among PWH.
Estimated time from HIV infection to diagnosis and diagnosis to first viral suppression during 2014–2018
Authors: Crepaz Nicole , Song Ruiguang , Lyss Sheryl B. , Hall H. Irene 
Published: June 2021

Objective:
To examine changes in the lengths of time from HIV infection to diagnosis (Infx-to-Dx) and from diagnosis to first viral suppression (Dx-to-VS), two periods during which HIV can be transmitted.

Design:
Data from the National HIV Surveillance System (NHSS) for persons who were aged at least 13 years at the time of HIV diagnosis during 2014–2018 and resided in one of 33 United States jurisdictions with complete laboratory reporting.

Methods:
The date of HIV infection was estimated based on a CD4+-depletion model. Date of HIV diagnosis, and dates and results of first CD4+ test and first viral suppression (<200 copies/ml) after diagnosis were reported to NHSS through December 2019. Trends for Infx-to-Dx and Dx-to-VS intervals were examined using estimated annual percentage change.

Results:
During 2014–2018, among persons aged at least 13 years, 133 413 HIV diagnoses occurred. The median length of infx-to-Dx interval shortened from 43 months (2014) to 40 months (2018), a 1.5% annual decrease (7% relative change over the 5-year period). The median length of Dx-to-VS interval shortened from 7 months (2014) to 4 months (2018), an 11.4% annual decrease (42.9% relative change over the 5-year period). Infx-to-Dx intervals shortened in only some subgroups, whereas Dx-to-VS intervals shortened in all groups by sex, transmission category, race/ethnicity, age, and CD4+ count at diagnosis.

Conclusion:
The shortened Infx-to-Dx and Dx-to-VS intervals suggest progress in promoting HIV testing and earlier treatment; however, diagnosis delays continue to be substantial. Further shortening both intervals and eliminating disparities are needed to achieve Ending the HIV Epidemic goals.
Adverse Event Trends Within a Large-Scale, Routine, Voluntary Medical Male Circumcision Program in Zimbabwe, 2014–2019
Authors: Victor Omollo , Phiona Marongwe , Vernon Murenje , Thoko Madoda , Paidamoyo Gonouya , Farai Gwenzi , Joseph Hove , Munyaradzi Tinashe , Olbarn Rutsito , Pesanai Chatikobo , Mufuta Tshimanga , Vuyelwa Sidile-Chitimbire , Sinokuthemba Xaba , Batsirai Makunike-Chikwinya , Marrianne Holec , Scott Barnhart , Feldacker Caryl 
Published: June 2021

Background:
Between 2008 and 2020, over 22.6 million male circumcisions (MCs) were performed among men ≥10 years in 15 priority countries of East and Southern Africa. Few studies from routine MC programs operating at scale describe trends of adverse events (AEs) or AE rates over time.

Setting:
Routine program data from a large MC program in Zimbabwe.

Methods:
χ2 compared characteristics of patients with AEs. Univariable and multivariable logistic models examined factors associated with AE severity. Cochran–Armitage trend tests compared AE rate trends by year (2014–2019), age, and MC method (2017–2019).

Results:
From 2014 to 2019, 469,000 men were circumcised; of the total men circumcised, 38%, 27%, and 35% were conducted among individuals aged 10–14; 15–19; and ≥20 years, respectively. Most MCs (95%) used surgical (dorsal slit or forceps-guided) methods; 5% were device based (PrePex). AEs were reported among 632 (0.13%) MCs; 0.05% were severe. From 2015 to 2019, overall AE rates declined from 34/10,000 to 5/10,000 (P-value <0.001). Severe AE rates also decreased over this period from 12/10,000 to 2/10,000 (P-value <0.001). AE rates among younger clients, aged 10–14 (18/10,000) were higher than among older age men (9/10,000) aged ≥20 years (P < 0.001); however, there was no significant association between age and AE severity.

Conclusion:
AE rates each year and over time were lower than the World Health Organization acceptable maximum (2% AEs). ZAZIC quality assurance activities ensured guideline adherence, mentored clinicians to MC competency, promoted quality client education and counseling, and improved AE reporting over time. Decreases in AE rates are likely attributed to safety gains and increasing provider experience.
Chemokine Receptor 4–Targeted 68Ga-Pentixafor PET/CT in Response Assessment of Waldenström Macroglobulinemia/Lymphoplasmacytic Lymphoma
Authors: Pan Qingqing , Cao Xinxin , Luo Yaping , Li Jian , Li Fang 
Published: June 2021

Purpose

68Ga-pentixafor PET/CT was reported to have a high sensitivity in detecting tumor involvement of Waldenström macroglobulinemia/lymphoplasmacytic lymphoma (WM/LPL) in our previous study. We aimed to further investigate its value in response assessment in WM/LPL.

Patients and Methods
Fifteen patients with WM/LPL were recruited in a prospective cohort study and underwent both 68Ga-pentixafor and 18F-FDG PET/CT at baseline and posttreatment. PET/CT-based responses were analyzed with visual assessments and compared with clinical response.

Results
At baseline, all of the 15 patients had a positive 68Ga-pentixafor PET/CT scan, whereas 18F-FDG PET/CT was positive in 11/15 patients. After chemotherapy, the overall response rate was 86.7% (13/15), and 68Ga-pentixafor PET/CT showed different degree of tumor response from baseline in these patients. In the 2 patients with progressive disease, 68Ga-pentixafor PET/CT detected new lesions or remarkable increase of 68Ga-pentixafor uptake in tumor involvements. However, 18F-FDG PET/CT failed to detect the improvement of disease in 6/13 patients and missed disease progression in 1 of the 2 patients.

Conclusions

68Ga-pentixafor PET/CT outperformed 18F-FDG PET/CT in response assessment of WM/LPL.
The Role of Imaging Studies in Favor of Possible Cerebellar Multiple System Atrophy
Authors: Utrera-Costero Ana , Martinez-Sanchis Begoña , Sopena-Novales Pablo , Bello-Arques Pilar 
Published: June 2021

Abstract
We report a 64-year-old woman whose history started with urinary incontinence and neurological symptoms (cognitive impairment, dysarthria, and gait difficulties). The 18F-FDG PET/CT showed hypometabolism of the whole cerebellum. Then 6 months later, she developed tremor, postural instability, and ataxia, so she was hospitalized to complete study. Blood tests (antibodies, vitamin B12, copper, genetic test of spinocerebellar ataxia) did not have alterations, but imaging studies, along with clinical symptoms, provide the diagnosis of possible multiple system atrophy.
Increased 68Ga-FAPI Uptake in Intramuscular Gluteal Hematoma in a Patient With Hemophagocytic Syndrome
Authors: Yang Xiao , Liu Huipan , You Zhouxiang , Gong Weidong , Chen Yue 
Published: June 2021

Abstract
A 39-year-old man was diagnosed clinically with hemophagocytic syndrome, which was suspected to be secondary to a malignancy. Therefore, the patient underwent a 68Ga-FAPI PET/CT scan as part of an ongoing clinical trial (ChiCTR2100044131). Increased tracer uptake was noted the gluteal region. Medical history revealed recent iliac bone marrow aspiration on the same side. On further examination, the lesion was confirmed to be a hematoma. The present case highlights that puncture operations may result in intramuscular hematomas, which might potentially malignancy on a 68Ga-FAPI PET/CT.
Prognostic Impact of Metabolic Heterogeneity in Patients With Newly Diagnosed Multiple Myeloma Using 18F-FDG PET/CT
Authors: Terao Toshiki , Machida Youichi , Hirata Kenji , Kuzume Ayumi , Tabata Rikako , Tsushima Takafumi , Miura Daisuke , Narita Kentaro , Takeuchi Masami , Tateishi Ukihide , Matsue Kosei 
Published: June 2021

Purpose
This study aimed to investigate the prognostic impact of metabolic heterogeneity (MH) in patients with multiple myeloma (MM).

Patients and Methods
We retrospectively analyzed MH with 18F-FDG PET/CT in 203 patients with newly diagnosed MM. Metabolic heterogeneity was estimated using the area under the curve of the cumulative SUV volume histogram. To evaluate MH, we selected 2 lesions: “MH-SUVmax,” a lesion with SUVmax, and “MH–metabolic tumor volume (MTV),” a lesion with the largest MTV.

Results
Metabolic heterogeneity from an MH-SUVmax lesion showed more prognostic relevance than that from a lesion with the largest MTV. The progression-free survival (PFS) and overall survival (OS) rates were significantly lower in the high-MH-SUVmax group than in the low-MH-SUVmax group (median PFS: 25.2 vs 33.9 months; median OS: 41.6 vs 112.0 months; P = 0.004 and 0.046, respectively), whereas high MH-SUVmax retained independent prognostic power on multivariate analysis. Even among patients with high whole-body MTV, those with high MH-SUVmax tended to show poorer prognosis than those without (median PFS, 23.8 vs 30.2 months; P = 0.085). Moreover, patients with high MH-SUVmax and high-risk cytogenetic abnormalities showed dismal outcomes even with standard treatment (median PFS and OS, 10.0 and 33.3 months, respectively).

Conclusions
Our results suggested that high MH-SUVmax based on pretreatment with 18F-FDG PET/CT is a novel prognostic factor for cases of MM.
FDG PET/CT in a Case of Lynch Syndrome With Synchronous Inverted Urothelial Papilloma of the Bladder, Urothelial Carcinoma of the Ureter, and Jejunal Adenocarcinoma
Authors: Zhao Qian , Dong Aisheng , Wang Yang 
Published: June 2021

Abstract
A 64-year-old man was referred because of the right ureteral obstruction. CT urography showed an intraluminal enhancing mass in the right midureter and an enhancing nodule in the bladder wall. FDG PET/CT showed increased FDG uptake of the ureteral mass and an unexpected hypermetabolic lesion in the jejunum. The patient underwent transurethral resection of the bladder tumor, right laparoscopic nephroureterectomy, and partial enterectomy. Inverted urothelial papilloma of the bladder, high-grade urothelial carcinoma of the right ureter, and jejunal adenocarcinoma were confirmed by histopathology. Genetic testing of the jejunal adenocarcinoma revealed MSH2 germline mutation, confirming the diagnosis of Lynch syndrome.
Three-Dimensional Osteosynthesis Plates for the Surgical Treatment of Mandibular Fractures
Authors: Khalil Sherin , Khamis Hamza , Kauke Martin , Iizuka Tateyuki , Safi Ali-Farid 
Published: June 2021

Objectives:
Mandible fractures can be treated with different plate systems, that is, miniplates or three-dimensional (3D) plates. This systematic review describes the effectiveness and clinical outcomes of 3D plates used in fractures of the mandible and aims to critically evaluate its risks and benefits.

Materials and Methods:
A comprehensive electronic search was conducted without date but with restriction to articles written in English. Studies in humans, including randomized or quasi-randomized controlled trials and retrospective studies, were included. The outcome parameters measured were number of patients, fracture classification, results, follow-up period, postoperative complications, and mean age of patients. Major complications were defined as those needing additional surgical intervention, for example, malocclusion, infection or plate fracture. Accordingly, complications not needing additional surgical intervention were defined as minor (ie, dehiscence, trismus).

Results:
Guided by the PRISMA statement and the Cochrane Handbook for Systematic Reviews of Interventions, the authors identified 44 publications with a total of 1790 patients. Among the articles selected for the final review, there were 32 reported prospective studies, 12 reported retrospective studies. Regarding the evaluation of quality, 8 studies showed a low value of the risk of bias, 17 a moderate risk, and 19 a high risk. There were statistically significant advantages for 3D plates in mandibular fractures in terms of postoperative complications, for example, wound dehiscences or plate fracture.

Conclusions:
The 3D plate is an effective treatment modality for mandibular fractures, with low incidence of major complications, decreased length of operation time, and increased stability of osteosynthesis.
Quality of Life After Class III Repair Orthognathic Surgery: Five-Year Retrospective Study
Authors: Joachim Michael V. , Richter Din Emm , Mohana Aladdin , Labeeb Musa , Abdelraziq Murad , Abu El-Naaj Imad 
Published: June 2021

Objective:
To evaluate the effect of orthognathic surgery on the long-term quality of life of patients with presurgical skeletal Class III and to identify its strongest effect—whether esthetic, social, or functional.

Materials and Methods:
In this retrospective cohort study, the subjects were patients after orthognathic surgery for repairing skeletal Class III. Fifty-five patients who had undergone orthognathic surgery from 2013 to 2018 in the oral and maxillofacial surgery department participated in this study. Each participant completed a modified questionnaire used to assess the patient's esthetic, social, and functional abilities after orthognathic surgery.

Results:
The rate of esthetic improvement in orthognathic surgery patients was 88%. More than four-fifths (81.8%) of the patients reported improvement in their personal and social self-esteem and confidence. Finally, 40.7% of the patients reported functional improvement. No significant differences between male and female patients were found. All but one of the patients recommended orthognathic surgery for patients with similar problems. One in six (17.3%) patients was dissatisfied with the nasal appearance after the surgical procedure, while almost a quarter (21.8%) reported worsening of their mouth opening, and 25.4% reported worsening of TMJ (Temporo-Mandibular Joint) symptoms. Analysis of the results revealed no statistically significant pattern connecting preoperative overjet or overbite measures with satisfaction rates.

Conclusions:
In this study, patient satisfaction with the orthognathic surgical procedure was mostly a result of improvements in facial esthetics, followed by psychological well-being and functional abilities. Most dissatisfaction after the orthognathic surgical procedure was related to nasal appearance, mouth opening, and TMJ complaints.
Extensive Convexity Flattening of a Synthetic Skull Implant the Overcome Major Scalp Deficiency After Multiple Craniotomies
Authors: Andereggen Lukas , Marbacher Serge , Dolp Armando , Gruber Philipp , Remonda Luca , Meuli-Simmen Claudia , Eyer David 
Published: June 2021

AbstractMultiple craniofacial surgeries and postoperative recalcitrant infections frequently can lead to secondary scalp tissue scarring and skin retraction. Although there are different methods of reducing and optimizing scalp skin tension, the authors describe a last resort treatment method of cranioplastic procedure, which despite of its unfavorable cosmetic outcome, relieves the skin tension through extensive flattening of the polyetheretherketone curvature. Thereby, a custom-made cranioplastic bone flap was extensively flattened in the curvature of the fronto-parietal area with consideration of the related brain hemisphere extension. The extent of bone curvature flatting reduced the skin tension significantly and allowed for plain and simple tension-free wound closure in a chronic smoker patient with poor skin quality and brain atrophy. Although brain extension was sufficient, the cosmetic outcome was unfavorable with regard to skull symmetry, but well accepted and satisfactory for the patient due to preoperative discussion outcome expectation from surgery. Thus, extensive polyetheretherketone curvature flattening is a straightforward and simple last resort treatment option for tension-free skin closure in high-risk patients with extensive skin scarring and retraction and previous reconstructive plastic skin relief procedures. However, this method is limited in patients with normal brain hemisphere extension.
Transcriptomic Changes Within Human Bone Marrow After Severe Trauma
Authors: Kelly Lauren S. , Apple Camille G. , Darden Dijoia B. , Kannan Kolenkode B. , Pons Erick E. , Fenner Brittany P. , Parvataneni Hari K. , Hagen Jennifer E. , Brakenridge Scott C. , Efron Philip A. , Mohr Alicia M. 
Published: June 2021

ABSTRACT

Background:
Severe trauma is associated with severe systemic inflammation and neuroendocrine activation that is associated with erythroid progenitor growth suppression and refractory anemia. Although distinct transcriptional profiles have been detected in numerous tissue types after trauma, no study has yet characterized this within the bone marrow. This study sought to identify a unique bone marrow transcriptomic response following trauma.

Methods:
In a prospective observational cohort study, bone marrow was obtained from severely injured trauma patients with a hip or femur fracture (n = 52), elective hip replacement patients (n = 33), and healthy controls (n = 11). RNA was isolated from bone marrow using a Purelink RNA mini kit. Direct quantification of mRNA copies was performed by NanoString Technologies on a custom gene panel.

Results:
Trauma patients displayed an upregulation of genes encoding receptors known to have inhibitory downstream effects on erythropoiesis, including ferroportin, interleukin-6 (IL-6) receptor, transforming growth factor-beta (TGF-β) receptor, and IL-10, as well as genes involved in innate immunity including toll-like receptor 4 (TLR4)-mediated signaling factors. In contrast, hip replacement patients had downregulated transcription of IL-1β, IL-6, TGF-β, tumor necrosis factor alpha, and the HAMP gene with no change in TLR4-mediated signaling factors.

Conclusions:
A unique transcriptomic response within the bone marrow was identified following severe trauma compared to elective hip replacement. These transcriptomic differences were related to the innate immune response as well as known inhibitors of erythropoiesis. Although confined to just one time point, this differential transcriptional response may be linked to refractory anemia and inflammation after injury.