bluuebunny/crossref_metadata_2025_split huggingface dataset:
Host transcriptional signatures as predictive markers of infection in children
Authors: Mejias Asuncion , Cohen Shira , Glowinski Rebecca , Ramilo Octavio 
Published: July 2021

Purpose of review
Analyses of the host transcriptional response to infection has proved to be an alternative diagnostic strategy to standard direct pathogen detection. This review summarizes the value of applying blood and mucosal transcriptome analyses for the diagnosis and management of children with viral and bacterial infections.

Recent findings
Over the years, studies have validated the concept that RNA transcriptional profiles derived from children with infectious diseases carry a pathogen-specific biosignature that can be qualitatively and quantitively measured. These biosignatures can be translated into a biologically meaningful context to improve patient diagnosis, as seen in children with tuberculosis, rhinovirus infections, febrile infants and children with pneumonia; understand disease pathogenesis (i.e. congenital CMV) and objectively classify patients according to clinical severity (i.e. respiratory syncytial virus).

Summary
The global assessment of host RNA transcriptional immune responses has improved our understanding of the host-pathogen interactions in the clinical setting. It has shown the potential to be used in clinical situations wherein our current diagnostic tools are inadequate, guiding the diagnosis and classification of children with infectious diseases.
Systematic Undercoding of Diagnostic Procedures in National Inpatient Sample (NIS): A Threat to Validity Due to Surveillance Bias
Authors: Owodunni Oluwafemi P. , Lau Brandyn D. , Florecki Katherine L. , Webster Kristen L. W. , Shaffer Dauryne L. , Hobson Deborah B. , Kraus Peggy S. , Holzmueller Christine G. , Canner Joseph K. , Streiff Michael B. , Haut Elliott R. 
Published: July 2021

Background and Objectives:
Health services research often relies on readily available data, originally collected for administrative purposes and used for public reporting and pay-for-performance initiatives. We examined the prevalence of underreporting of diagnostic procedures for acute myocardial infarction (AMI), deep venous thrombosis (DVT), and pulmonary embolism (PE), used for public reporting and pay-for-performance initiatives.

Method:
We retrospectively identified procedures for AMI, DVT, and PE in the National Inpatient Sample (NIS) database between 2012 and 2016. From January 1, 2012, through September 30, 2015, the NIS used the International Classification of Diseases, Ninth Revision (ICD-9) coding scheme. From October 1, 2015, through December 31, 2016, the NIS used the International Classification of Diseases, Tenth Revision (ICD-10) coding scheme. We grouped the data by ICD code definitions (ICD-9 or ICD-10) to reflect these code changes and to prevent any confounding or misclassification. In addition, we used survey weighting to examine the utilization of venous duplex ultrasound scan for DVT, electrocardiogram (ECG) for AMI, and chest computed tomography (CT) scan, pulmonary angiography, echocardiography, and nuclear medicine ventilation/perfusion (

) scan for PE.

Results:
In the ICD-9 period, by primary diagnosis, only 0.26% (n = 5930) of patients with reported AMI had an ECG. Just 2.13% (n = 7455) of patients with reported DVT had a peripheral vascular ultrasound scan. For patients with PE diagnosis, 1.92% (n = 12 885) had pulmonary angiography, 3.92% (n = 26 325) had CT scan, 5.31% (n = 35 645) had cardiac ultrasound scan, and 0.45% (n = 3025) had

scan. In the ICD-10 period, by primary diagnosis, 0.04% (n = 345) of reported AMI events had an ECG and 0.91% (n = 920) of DVT events had a peripheral vascular ultrasound scan. For patients with PE diagnosis, 2.08% (n = 4805) had pulmonary angiography, 0.63% (n = 1460) had CT scan, 1.68% (n = 3890) had cardiac ultrasound scan, and 0.06% (n = 140) had

scan. Small proportions of diagnostic procedures were observed for any diagnoses of AMI, DVT, or PE.

Conclusions:
Our findings question the validity of using NIS and other administrative databases for health services and outcomes research that rely on certain diagnostic procedures. Unfortunately, the NIS does not provide granular data that can control for differences in diagnostic procedure use, which can lead to surveillance bias. Researchers and policy makers must understand and acknowledge the limitations inherent in these databases, when used for pay-for-performance initiatives and hospital benchmarking.
Evaluation of Patients for Percutaneous Edge-to-edge Mitral Valve Repair
Authors: Renker Matthias , Fischer-Rasokat Ulrich , Walther Claudia , Kim Won-Keun , Rixe Johannes , Dörr Oliver , Nef Holger , Rolf Andreas , Möllmann Helge , Hamm Christian W. 
Published: July 2021

Purpose:
We sought to compare parameters derived from cardiac computed tomography angiography (CCTA) with those from transesophageal echocardiography (TEE) for the evaluation of patients with severe mitral regurgitation (MR) before percutaneous edge-to-edge mitral valve repair (PE2E). TEE is the mainstay for PE2E, although it has specific limitations. CCTA enables measurements in any arbitrary plane with high spatial resolution and offers good calcium visibility.

Materials and Methods:
Patients who underwent TEE and CCTA before scheduled PE2E at 2 medical centers were included in this retrospective analysis. Quantitative parameters relevant for PE2E were obtained from TEE and CCTA in a blinded manner and the intrareviewer variability was assessed.

Results:
All 30 patients (15 female, 76±10 y) had secondary MR attributable to ischemic (60%) or nonischemic cardiomyopathy (40%). On comparing parameters from TEE and CCTA, left ventricular end-diastolic diameter was 60±11 versus 64±11 mm (r=0.90), intercommissural mitral annulus was 35±5 versus 35±5 mm (r=0.88), long-axis annulus was 33±5 versus 33±5 mm (r=0.74), the distance between the fossa ovalis and the leaflet coaptation was 42±5 versus 41±5 mm (r=0.81), the anterior mitral leaflet was 21±6 versus 20±7 mm (r=0.81), the posterior mitral leaflet was 13±2 versus 13±2 mm (r=0.91), and the median mitral calcification was 1 (interquartile range: 0 to 2) versus 0 (interquartile range: 0 to 1; r=0.53), respectively. Intrareviewer agreement was good and excellent for continuous and categorical variables, respectively.

Conclusions:
Our data suggest that evaluation of the mitral valve apparatus with CCTA in patients considered for PE2E is feasible, correlates well with TEE, and offers improved calcium visibility. In selected cases, additional information from CCTA may be helpful for achieving optimal interventional results.
Factors Affecting Outcomes of Craniofacial Clinical Trials
Authors: Halepas Steven , Lee Kevin C. , Nwokeji Paul , Castiglione Charles , Ferneini Elie M. 
Published: July 2021

Purpose:
This study aims to provide a cross-sectional view of craniofacial trials and to identify factors associated with completion, publication, and trial longevity.

Materials and Methods:
This is a cross-sectional study of cleft and craniofacial clinical trials registered with ClinicalTrials.gov between September 1999 and April 2020. Predictor variables included funding source, trial design, trial location, number of recruitment sites, and investigator specialty.
Study outcomes were completion status, publication status, and trial duration. Univariate comparisons and multivariate regression models were calculated for each outcome.

Results:
The final sample included 179 clinical trials pertaining to craniofacial care. Nearly all trials were single-center (86.5%), and roughly half of trials were interventional (57.0%) or conducted in the United States (40.5%). No single specialty predominated, although plastic surgery (13.4%) was the most common investigator specialty. The completion rate was 82.7%, the publication rate was 40.8%, and the mean trial duration was 39.1 months. Interventional design (odds ratio = 0.30, P = 0.02) and United States location (odds ratio = 0.15, P < 0.01) were each independently associated with lower odds of trial completion. Trial longevity was independently associated with the National Institute of Health-funding (P < 0.01) and multicenter design (P < 0.01).

Conclusions:
Craniofacial trials are multidisciplinary and have a high rate of completion. Although most existing trials were conducted at only a single-center, multicenter efforts significantly increased trial longevity without compromising completion and publication rates. Given the diverse array of conditions and lines of inquiry that compose craniofacial care, it is reassuring that collaboration did not negatively affect trial outcomes.
Patient First: Surgery First and More
Authors: Azzuni Camillo , Moro Alessandro , Saponaro Gianmarco , Gasparini Giulio , Soverina Davide , Barbera Giorgio , Pelo Sandro 
Published: July 2021

Introduction:
The success of surgery first approach has been defined by the number of advantages offered and is definitively determined by the satisfaction of the patients themselves. The strength of this protocol resides in its philosophy that puts the patient at the center of the whole diagnostic-therapeutic process. The compliance of the patient, its happiness and comfort are the best guarantee of a good final results. While pursuing this philosophy we have wondered whether there was way to increase the comfort of surgery first approach even more and to make it even more appealing for the patients. For these reasons, we have decided to work on a preliminary protocol in order to reduce or even eliminate the use of orthodontic braces and wires during perioperative stages. Materials and Methods: No orthodontic braces or wires are bonded on the teeth before surgery. Intraoperatory intermaxillary fixation (IMF) is carried out with the use of IMF screws which are positioned at the beginning of the operation on the edge between keratinized and nonkeratinized gingiva. Once the osteotomies are performed IMF with IMF screws is carried out on the planned occlusion with the use of surgical splints.
Discussion and Conclusions: In selected cases the postsurgical orthodontic treatment can be carried out with the use of clear aligners, completely eliminating the need of braces and wires with an additional level of comfort.
Oral-Ocular Synkinesis in a 21-Year Old Female Head Trauma Patient Following Facial Nerve Decompression Surgery
Authors: Abbas Kirellos Said , Dong Vinh , Ha Nam Xuan , Ragheb Marina Samy , Brown Ashlyn , AL-Manaseer Balqees , Shehata Joseph , Raut Akshay , Minh Le Huu Nhat , Biala Marwa , Huy Nguyen Tien 
Published: July 2021

Abstract
Facial synkinesis can happen as a negative event following the recovery of facial nerve paralysis. In this case report, five months after right facial nerve decompression surgery following right sided head trauma, a 21-year-old female patient developed oral-ocular synkinesis. During her attempt to voluntarily smile, she experienced uncontrolled winking of her right eye. Exercise therapy was used as a treatment modality which largely improved her facial nerve function and decreased her synkinesis. As a treatment modality, exercise therapy was used which saw a great improvement in both her facial nerve function and decreased her synkinesis.
Accessory Nostril Associated With Choanal Atresia
Authors: Shanmuganathan Pragaash , Chong David K. 
Published: July 2021

Abstract
Accessory nostril or supernumerary nostril is one of the rare congenital deformities of the nose. The first case was reported by Lindsay B (1906),
1
since then 42 cases have been reported in the literature. There is no uniform surgical approach to treat this anomaly. The authors present a child with left side accessory nostril with bilateral choanal atresia and describe our surgical approach.
Intracranial Infiltration of a Scalp Neoplasm After Hair Dyeing 10 Years Ago
Authors: Xiao Jin , Ye Lei , Cheng Hong-Wei 
Published: July 2021

Abstract
Cosmetics with unknown chemical components may cause unexpected cancers. Here, we report a rare case of hair dye-induced intracranial communicating scalp sebaceous carcinoma in a young female who dyed her hair 10 years ago. The histological origin of the intracranial communicating neoplasm was of priority for subsequent therapeutic decisions, therefore, requiring comprehensive diagnostic strategy. In conclusion, this case report emphasizes careful evaluation of the long-term risks for unlabeled cosmetics.
Comparative Study on the Treatment of Ankyloglossia by Using Er:YAG Laser or Traditional Scalpel
Authors: Shang Jiang , Han Maoqiang , Sun Jing , Xu Dapeng , Qu Weidong 
Published: July 2021

Abstract
The aim of this study was to compare, respectively, postoperative pain, wound healing, and patient satisfaction following lingual frenum extension treated with the Erbium Yttrium aluminum garnet. (Er:YAG) laser or the conventional scalpel. Twenty-eight patients receiving lingual frenectomy were randomly assigned to the Er:YAG laser group (n = 15) or the traditional scalpel group (n = 13). The surgical parameters were set to 3W or 4W basing on types of the lingual frenum when the Er:YAG laser was working. The same procedure was applied to the traditional scalpel group with transverse incision and longitudinal suture. The postoperative pain, wound healing and patient satisfaction were evaluated at 3 hours, 3, 7, and 30 days after operation. The visual analog scale score of postoperative pain in Er:YAG laser group was lower than that in traditional scalpel group at each time point. The wound healing score of the laser group were significantly lower than that of the traditional scalpel group at 3 and 7 days after surgery. There was no significant difference in mental, diet, and language satisfaction between the 2 groups at different time points after operation. In conclusion, Er:YAG laser was superior to the scalpel regarding minor soft-tissue surgery, and it could relieve the pain and discomfort of patients in the early stage of wound.
The Educational Reliability and Viewer Interest of YouTube Videos Presenting Otoplasty Procedures
Authors: Avci Hakan , Boldaz Eren 
Published: July 2021

Introduction:
Otoplasty procedures consist of around 30% of facial plastics surgeries in the adult population. In this study, we aimed to assess the reliability of YouTube otoplasty videos based on technical video analysis, usefulness scores, and recommended surgical steps.

Methods:
The present study evaluated 356 videos after a search on YouTube with the keywords “otoplasty, prominent ear, cosmetic otoplasty, and aesthetic ear surgery” during the period from October 2008 to June 2020. The viewer interest parameters such as the total number of views, comments, subscribers, likes, dislikes, source of videos, and video upload date were assessed. Besides, usefulness scores and recommended surgical steps were also analyzed.

Results:
Among the 356 videos that were compatible with the keywords of the study, only 122 (34%) of them were in agreement with the inclusion criteria. Group 1 (not useful and slightly useful) comprised 69 (57%) videos, and Group 2 (useful and very useful) consisted of 53 (43%) videos. The mean numbers of views, subscribers, and likes were 20544.65 ± 55235.41, 6718.37 ± 20213.54, and 44.34 ± 121.48, respectively, in Group 1, and 82905.22 ± 292819.49, 18603.57 ± 58007.94, and 1089.09 ± 6991.91, respectively, in Group 2. All 3 parameters were significantly higher in Group 2 than Group 1 (P: 0.02, P: 0.005, P: 0.01, respectively).

Conclusions:
Overall, only 43% of YouTube videos presenting otoplasty procedures were defined as useful or very useful. The interest rates of the viewers are compatible with the usefulness rate of the otoplasty videos.
Decreasing Incidence of Palatoplasty in the United States
Authors: ElHawary Hassan , Czuzoj-Shulman Nicholas , Abenhaim Haim A. , Gilardino Mirko S. 
Published: July 2021

Introduction:
Cleft palate is amongst the most common birth defect across the world. Although its etiology is multifactorial, including genetic and environmental contributors, the investigators were interested in exploring whether its incidence was changing over time.

Methods:
The Nationwide Inpatient Sample database, the largest publically available healthcare database in the United States, was used to identify all primary palatoplasties performed under 2 years of age and births which occurred over a 17-year period from 1999 to 2015. The change in rate of palatoplasties and overall maternal demographics were assessed longitudinally using the chi-squared test. Significance level was set at P < 0.001.

Results:
A total of 13,808,795 pregnancies were reviewed during the time period, from 1999 to 2015, inclusively. A total of 10,567 primary palatoplasties were performed in that period of time reflecting an overall rate of 7.7 palatoplasties per 10,000 deliveries. Palatoplasty rates decreased across the study period from 9.5 per 10,000 in 1999 to 7.1 per 10,000 died/delivered pregnancies in 2015 which corresponds to an average compounded year-to-year decrease of 1.76%, P < 0.001.

Conclusions:
The rate of primary palatoplasties, as a proxy for the rate of cleft palate prevalence, has been significantly decreasing over the last 2 decades and may represent improvements in early diagnosis in pregnancy, changing genetic or racial demographics, and/or environmental factors such as decreased maternal smoking in the US population. Future research may be directed at better understanding the definitive etiology of this decreasing prevalence of children undergoing primary cleft palate repairs in the United States.
Virtual Navigation Endoscopically Integrated Into Orbital Trauma
Authors: González Luis Vicente , López Juan Pablo , Valencia-Muñoz Carolina , Arango Alejandro 
Published: July 2021

Abstract
Orbital reconstruction has traditionally been accomplished utilizing different techniques developed for this purpose and has been modified and improved throughout the years. However, there is a high rate of complications associated with eye globe positioning and/or migration of implants, which has created the need to continue to improve these techniques to decrease the frequency of complications. On the other hand, techniques that involve an endoscopic approach and technologies that use virtual surgical planning and three-dimensional model impressions are being used more often to decrease complication rates and seek better surgical outcomes. Combining these 2 methods results in endoscopically integrated virtual surgical navigation. When used for orbital reconstruction, it can be a great alternative and can be useful to decrease the risk of complications associated with this procedure. Therefore, this technical note aims to describe the integration of these 2 techniques into the same instrument to demonstrate the synergy of their benefits when used together.
Transmission networks of SARS-CoV-2 in coastal Kenya during the first two waves: a retrospective genomic study
Authors: Agoti Charles N. , Ochola-Oyier Lynette Isabella , Mohammed Khadija Said , Lambisia Arnold W. , de Laurent Zaydah R. , Morobe John M. , Mburu Maureen W. , Omuoyo Donwilliams O. , Ongera Edidah M. , Ndwiga Leonard , Maitha Eric , Kitole Benson , Suleiman Thani , Mwakinangu Mohamed , Nyambu John , Otieno John , Salim Barke , Musyoki Jennifer , Murunga Nickson , Otieno Edward , Kiiru John , Kasera Kadondi , Amoth Patrick , Mwangangi Mercy , Aman Rashid , Kinyanjui Samson , Warimwe George , Phan My , Agweyu Ambrose , Cotten Matthew , Barasa Edwine , Tsofa Benjamin , Nokes D. James , Bejon Philip , Githinji George 
Published: July 2021

ABSTRACTBackgroundThe transmission networks of SARS-CoV-2 in sub-Saharan Africa remain poorly understood.MethodsWe undertook phylogenetic analysis of 747 SARS-CoV-2 positive samples collected across six counties in coastal Kenya during the first two waves (March 2020 - February 2021). Viral imports and exports from the region were inferred using ancestral state reconstruction (ASR) approach.ResultsThe genomes were classified into 35 Pango lineages, six of which accounted for 79% of the sequenced infections: B.1 (49%), B.1.535 (11%), B.1.530 (6%), B.1.549 (4%), B.1.333 (4%) and B.1.1 (4%). Four identified lineages were Kenya specific. In a contemporaneous global subsample, 990 lineages were documented, 261 for Africa and 97 for Eastern Africa. ASR analysis identified >300 virus location transition events during the period, these comprising: 69 viral imports into Coastal Kenya; 93 viral exports from coastal Kenya; and 191 inter-county import/export events. Most international viral imports (58%) and exports (92%) occurred through Mombasa City, a key touristic and commercial Coastal Kenya center; and many occurred prior to June 2020, when stringent local COVID-19 restriction measures were enforced. After this period, local virus transmission dominated, and distinct local phylogenies were seen.ConclusionsOur analysis supports moving control strategies from a focus on international travel to local transmission.FundingThis work was funded by Wellcome (grant#: 220985) and the National Institute for Health Research (NIHR), project references: 17/63/and 16/136/33 using UK aid from the UK Government to support global health research, The UK Foreign, Commonwealth and Development Office.
Germline rare deleterious variant load alters cancer risk, age of onset and tumor characteristics
Authors: Selvan Myvizhi Esai , Onel Kenan , Gnjatic Sacha , Klein Robert J. , Gümüş Zeynep H. 
Published: July 2021

AbstractBackgroundInherited genetic variants play an important role in cancer susceptibility. Recent studies show that rare, deleterious variants (RDVs) in a few genes are critical determinants of heritable cancer risk. Better understanding of germline RDVs will contribute to improved precision prevention, screening and treatment.MethodsWe have performed the largest to date jointly processed germline pan-cancer case-control association study from whole-exome sequencing (WES) data of 20,789 participants, split into discovery and validation cohorts. We focused on high-penetrance RDVs based on ClinVar database. To increase the statistical power, we pursued a collapsing approach and compared the cumulative RDV burden at gene and gene-set levels using penalized logistic regression. Next, we investigated how the accumulation of RDVs in an individual (RDV load) is associated with cancer risk. Finally, we studied how personal RDV load in specific gene-sets affected i) age of diagnosis; ii) tumor immune microenvironment; and iii) tumor mutational burden using Mann-Whitney U test and Kruskal-Wallis test.ResultsOur results confirm known associations between cancer risk and germline RDVs in BRCA1/2 genes, and show associations with risk for RDVs in Fanconi Anemia (FA), DNA damage repair (DDR), cancer predisposition (CPD) and somatic cancer driver gene-sets in two independent cohorts. Furthermore, increased personal germline RDV load in these gene-sets increased cancer risk, and once cancer developed, tumor characteristics. Notably, we show that the personal RDV load of an individual in FA, DDR or CPD genes is a potential marker for younger age of onset, M1 macrophage fraction in tumor microenvironment, and, in specific cancers, increased tumor mutation burden.ConclusionsOur findings will help better stratification of individuals at high cancer risk, as well as the characterization of the influence of their personal germline RDV load on age of diagnosis, tumor microenvironment and mutational burden. These high-risk individuals may benefit from increased surveillance, earlier screening and prevention efforts, and treatments that exploit their tumor characteristics, improving prognosis.