bluuebunny/crossref_metadata_2025_split huggingface dataset:
Botulinum Toxin for a Better Scar in Cleft Lip Surgery: A Prospective Randomized Control Trial
Authors: Sonane Jubin , Sharma Ramesh K. , John Jerry R. , Sharma Raman 
Published: July 2021

Introduction:An unsightly scar following cleft repair can undo the good work of even an experienced surgeon. A functioning orbicularis oris muscle beneath the lip scar maintains a zone of dynamic tension resulting in a stretched scar. Botulinum toxin type A (BTA) can be used to create a temporary paralysis of the orbicularis muscle during the healing phase. This may lead to better scar formation after a cleft lip repair.Method:The present prospective randomized control trial enrolled 28 infants with unilateral cleft lip undergoing primary lip repair. They were randomized to receive injection of either BTA (botox group) or normal saline (control group) intraoperatively into adjacent orbicularis oris muscle immediately after completion of cleft lip repair. Blinded experts reassessed the scar after 6 months. Objective assessment was undertaken employing Visual Analogue Scale (VAS), Vancouver Scar Scale (VSS), and photographic scar width measurements.Results:Twenty-two subjects were able to complete a follow-up duration of 6 months. Children in the BTA (Botox Group) had a statistically significantly better VAS score and lesser scar width compared to the control group. However, the difference in the VSS score between both groups was not statistically significant. On comparing patients with cleft lip alone with cleft lip and palate, no statistically significant difference was found in VAS, VSS, and scar width. There were no complications associated with the use of botulinum toxin A.Conclusions:Botulinum toxin type A injection is a safe and effective addition to improve scar appearance following cleft lip repair. There was improvement in appearance of the scar in terms of width, but no improvement was seen in the scar pigmentation. The scar outcome is independent of cleft lip classification.
Craniofacial Evolution: From Australopithecus to Modern Man
Authors: Sambataro Sergio , Fiorillo Luca , Bocchieri Salvatore , Stumpo Chiara , Cervino Gabriele , Herford Alan Scott , Cicciù Marco 
Published: July 2021

Abstract
Through the analysis and evaluation of the size and morphology of teeth and jaws, it is possible to differentiate animal species including man, allowing the theory of human evolution to be established. Hominin evolution is characterized by two main features, the transition to bipedality and the increase in brain size. This had an important impact on the structure and function of the hominine skull. The aim of this article is to retrace the evolutionary steps that led to Homo Sapiens, the direct ancestor of modern man. For the following paper, scientific articles from Medline (PubMed) and Google Scholar database were used from 1929 to 2018. Hominid evolution is characterized by 2 main features, the transition to bipedality and the increase in brain size. The fossils found show that both trends have had an important impact on the morphology and function of the skull of modern man. The basicranial flexion and growth have led to the facial modifications typical of modern man. The main changes concern the mandibular evolution with the appearance of the chin, the formation of the Spee curve due to mandibular arch growth, the formation of the temporomandibular joint as a hinge joint with a sliding socket as the condyle and a better function and maximum efficiency than its predecessors thanks to respect for the divine proportions of the face. Knowledge of ontogenesis allows us to know the factors underlying human form and function, analyze and evaluate them in the clinical context.
Reconstruction of Severe Neck Scar Contracture After Electrical Injury
Authors: Xiao Haitao , Liu Ruolin , Liu Xiaoxue , Wang Huaisheng , Cen Ying , Xu Xuewen 
Published: July 2021

Abstract
High-voltage (≥1000 V) electrical injury is always related to high mortality and poor prognosis. The incidence rates of the high-voltage electrical injuries of the neck are lower than those of the other parts of the body. This article reports a case of the reconstruction of severe neck scar contracture after electrical injury. Compared with cases of scar contractures caused by nonelectrical injuries, this case had the following remarkable characteristics: extremely severe difficult airway, contracture scars involving whole layers of tissue, muscle and nerve damage, mandibular retraction, and poor occlusal relationship. The chief complaints of the patient upon admission, including forced position and continuous salivation, were greatly relieved through several operations by using different kinds of flaps and offering support to the flap from the palmar tendon and relocated mandible. However, the problem of salivation was incompletely solved. This problem might be caused by damage to related nerves and masticatory muscle function caused by high-voltage electrical injury. The patient was satisfied with the recovery of his appearance and movement function.
Cancer care disparities in the LGBT community
Authors: Wakefield Donna 
Published: July 2021

Purpose of review
A review of the recent literature (2019–2021) around the current disparities in care for LGBT individuals with cancer.

Recent findings
Recent studies highlight that there continue to be multiple barriers to LGBT individuals with cancer receiving equity of care. These include healthcare professionals (HCPs) lack of knowledge of LGBT-specific issues and an under appreciation of the importance of sexuality and gender in order to provide holistic, person-centred care. Suggestions are made of how embedding training, updating guidelines, and improving communication skills could help to address this care disparity.

Summary
Lesbian, gay, bisexual and/or trans (LGBT) individuals have an increased risk of certain illnesses, including certain types of cancer. They belong to a minority group, who may be subjected to discrimination and so are less likely to present for screening or engage with healthcare professionals. This review of recent studies highlights that LGBT individuals still fear discrimination from HCPs, and that many HCPs themselves admit to poor knowledge of LGBT specific issues and the importance of sexuality and gender identity when providing cancer care. Advances in education programmes, including enhanced communication skills and creating LGBT safe spaces are all vital in reducing the disparity in LGBT cancer care.
Atypical chronic inflammatory demyelinating polyradiculoneuropathy: recent advances on classification, diagnosis, and pathogenesis
Authors: Doneddu Pietro Emiliano , Dentoni Marta , Nobile-Orazio Eduardo 
Published: July 2021

Purpose of review
In recent years, there has been an intense debate in literature regarding the definition of the individual variants of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), their possible pathogenetic mechanisms, and impact in the diagnosis of CIDP.

Recent findings
The 2021 European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) guidelines revised the definition of the individual CIDP variants and implemented their diagnostic criteria. Diagnosis of atypical CIDP is challenging and misdiagnosis is frequent, leading to diagnostic delay and consequent greater accumulation of disability and treatment dependency. Recent studies suggest that patients with typical CIDP have an antibody-mediated mechanism of neuropathy whereas in those with Lewis--Sumner syndrome (LSS) neuropathy is preferentially mediated by macrophages and T cells.

Summary
Although the validity of the 2021 EFNS/PNS diagnostic criteria for atypical CIDP is unknown, they will hopefully lead to greater uniformity in the selection of patients to be enrolled in future studies and to a greater diagnostic accuracy. New data are emerging on the possible pathological mechanisms of individual variants and this could result in the discovery of specific diagnostic biomarkers and new therapies.
Evaluation of lymphocyte subtypes in COVID-19 patients
Authors: Rezaei Mitra , Marjani Majid , Tabarsi Payam , Moniri Afshin , purabdollah Mihan , Abtahian Zahra , Dizaji Mehdi Kazempour , Roofchayee Neda Dalil , Dezfuli Neda K. , Mansouri Davood , Hossein-Khannazer Nikoo , Varahram Mohamad , Mortaz Esmaeil , Velayati Ali Akbar 
Published: July 2021

AbstractBackgroundAlthough the many aspects of COVID-19 have not been yet recognized, it seems that the dysregulation of the immune system has a very important role in the progression of the disease. In this study the lymphocyte subsets were evaluated in COVID-19 patients with different severity.MethodsIn this prospective study, the levels of peripheral lymphocyte subsets (CD3+, CD4+, CD8+T cells; CD19+and CD20+B cells; CD16+/CD56+NK cells, and CD4+/CD25+/FOXP3+regulatory T cells) were measured in 67 confirmed patients with COVID-19 on the first day of admission.ResultsThe mean age of cases was 51.3 ± 14.8 years. Thirty-two patients (47.8%) were classified as severe cases and 11 (16.4%) patients were categorized as critical. The frequency of blood lymphocytes, CD3+cells, CD25+FOXP3+T cells; and absolute count of CD3+T cells, CD25+FOXP3+T cells, CD4+T cells, CD8+T cells, CD16+56+lymphocytes were lower in more severe cases in comparison to milder cases. Percentages of lymphocytes, T cells, and NK cells were significantly lower inthe patients who died (p= 0.002 and P= 0.042, p=0.006, respectively).ConclusionFindings of this cohort study suggests that the frequency of CD4+, CD8+, CD25+FOXP3+T cells, and NK cells were difference in the severe COVID-19 patients. Moreover, lower frequency of, T cells, and NK cells are predictors of mortality of these patients.
EVALUATION OF THE PANBIO SARS-COV-2 RAPID ANTIGEN DETECTION TEST IN THE BAHAMAS
Authors: Johnson Christoph , Ferguson Kirvina , Smith Tavion , Wallace Dashaunette , McConnell Keith , Conserve Donaldson , Martin Indira 
Published: July 2021

ABSTRACTIdentification and isolation of persons infected with SARS-COV-2 are key mitigation strategies in the current pandemic, and rapid antigen detection tests (RADTs) offer the promise of decreased turnaround time to diagnosis when compared with gold standard RT-PCR testing. We evaluated the analytical performance of the Abbott® Panbio™ RADT on nasopharyngeal samples stored at the Ministry of Health National Reference Lab in Nassau, Bahamas. The Panbio™ demonstrated a test sensitivity of 94% and a specificity of 100% on 50 PCR negative samples and 50 samples presumed to be infectious based on having PCR cycle threshold values below 30. Additionally, in our examination of operator results there was low interpersonal variation (1%) among three blind operators and significant correlation between sample Ct value and perceived signal strength on the RADT device. However, three PCR positive samples below Ct 30 were misdiagnosed by RADT, including one sample with Ct value less than 20. These results support the use of the Panbio™ in symptomatic persons to detect active SARS-COV-2 infections, with the caveat that RADT-negative samples should be confirmed by RT-PCR.
Clinical outcomes in vaccinated individuals hospitalized with Delta variant of SARS-CoV-2
Authors: Jagadeesh Kumar V , Sowpati Divya Tej , Munigela Apoorva , Banu Sofia , Siva Archana Bharadwaj , Sasikala M , Nutalapati Chandrasekhar , Kulkarni Anand , Mukherjee Payel , Zaveri Lamuk ,   CCMB COVID-19 Team,   AIG Hospitals COVID-19 Vaccine study Team, Tallapaka Karthik Bharadwaj , Reddy D Nageshwar 
Published: July 2021

AbstractEmerging variants of SARS-CoV-2 with increased transmissibility or immune escape have been causing large outbreaks of COVID-19 infections across the world. As most of the vaccines currently in use have been derived from viral strains circulating in the early part of the pandemic, it becomes imperative to constantly assess the efficacy of these vaccines against emerging variants. In this hospital-based cohort study, we analysed clinical profiles and outcomes of 1161 COVID-19 hospitalized patients (vaccinated with COVISHIELD (ChAdOx1) or COVAXIN (BBV-152), n = 495 and unvaccinated n = 666) in Hyderabad, India between April 24th and May 31st 2021. Viral genome sequencing revealed that >90% of patients in both groups were harbouring the Delta variant (Pango lineage B.1.617.2) of SARS-CoV-2. Vaccinated individuals showed higher neutralizing antibodies (545±1256 AU/ml Vs 51.1±296 AU/ml; p<0.001) and significantly decreased Ferritin (392.26 ± 448.4 ng/mL Vs 544.82 ± 641.41 ng/mL; p<0.001) and LDH (559.45 ± 324.05 U/L Vs 644.99 ± 294.03 U/L; p<0.001), when compared to the unvaccinated group. Severity of the disease (3.2% Vs 7.2%; p=0.0039) and requirement of ventilatory support (2.8% Vs 5.9%; p=0.0154) were significantly low in the vaccinated group despite the fact that these individuals had significantly higher age and risk factors. The rate of mortality was about 50% lower (2/132=1.51%) in the completely vaccinated breakthrough infections although mortality in individuals who had received a single dose was similar to the unvaccinated group (9/269=3.35% vs 23/666= 3.45%). Our results demonstrate that both COVISHIELD and COVAXIN are effective in preventing disease severity and mortality against the Delta variant in completely vaccinated hospitalized patients.
The age-stratified analytical model for the spread of the COVID-19 epidemic
Authors: Mairanowski F. , Below  
Published: July 2021

AbstractThe previously developed ASILV model for calculating epidemic spread under conditions of lockdown and mass vaccination was modified to analyse the intensity of COVID-19 infection growth in the allocated age groups.Comparison of the results of calculations of the epidemic spread, as well as the values of the seven-day incidence values with the corresponding observation data, shows their good correspondence for each of the selected age groups.The greatest influence on the overall spread of the epidemic is in the 20-40 age groups. The relatively low level of vaccination and the high intensity of contact in these age groups contributes to the emergence of new waves of the epidemic, which is especially active when the virus mutates and the lockdown conditions are relaxed.The intensity of the epidemic in the 90+ age group has some peculiarities compared to other groups, which may be explained by differences in contact patterns among individuals in this age group compared to others.Approximate ratios for estimating mortality as a function of the intensity of infection for individual age groups are provided.The proposed stratified ASILV model by age group will allow more detailed and accurate prediction of the spread of the COVID-19 epidemic, including when new, more transmissible versions of the virus mutate and emerge.
Estimating the basic reproduction number at the beginning of an outbreak under incomplete data
Authors: Boonpatcharanon Sawitree , Heffernan Jane , Jankowski Hanna 
Published: July 2021

AbstractWe compare different methods of estimating the basic reproduction number,R0, focusing on the early stages of an epidemic, and considering weekly reports of new infecteds. We study three standard epidemiological models: SIR, SEIR, and SEAIR and examine the sensitivity of the estimators to the model structure. As some methods are developed assuming specific epidemiological models, our work adds a study of their performance in both the well- and miss-specified settings. We focus on parameters matching various types of respiratory viruses, although the general approach is easily extendable to other scenarios.
Hemodilution in High Risk Cardiac Surgery: Laboratory Values, Physiological Parameters and Outcomes
Authors: Mladinov Domagoj , Padilla Luz A , Leahy Benjamin , Norman Joseph B , Enslin Jacob , Camp Riley S , Eudailey Kyle W , Tanaka Kenichi , Davies James E 
Published: July 2021

ABSTRACTBackgroundAcute normovolemic hemodilution (ANH) is a blood conservation strategy in cardiac surgery, predominantly used in coronary artery bypass graft (CABG) and/or valve procedures. Although higher complexity cardiac procedures may benefit from ANH, concerns for hemodynamic instability and organ injury during hemodilution hinder its wider acceptance. Laboratory and physiological parameters during hemodilution in complex cardiac surgeries have not been described.Study Design and MethodsThis observational cohort (2019-2021) study included 169 patients who underwent thoracic aortic repair, multiple valve procedure, concomitant CABG with the aforementioned procedure, and/or redo sternotomies. Patients who received allogeneic blood were excluded. Statistical comparisons were performed between ANH (N=66) and non ANH controls (N=103). ANH consisted of removal of blood at the beginning of surgery and its return after cardiopulmonary bypass (CPB).ResultsIntraoperatively, the ANH group received more albumin (p=0.04) and vasopressor medications (p=0.01); while urine output was no different between ANH and controls. Bilateral cerebral oximetry (rSO2) values were similar before and after hemodilution. During bypass rSO2were discretely lower in the ANH vs. control group (right rSO2p=0.03, left rSO2(p=0.05). No differences in lactic acid values were detected across the procedural continuum. Postoperatively, no differences in extubation times, ICU length of stay, kidney injury, stroke or infection were demonstrated.DiscussionThis study suggests hemodilution to be a safe and comparable blood conservation technique, even without accounting for potential benefits of reduced allogenic blood administration. The study may contribute to better understanding and wider acceptance of ANH protocols in high risk cardiac surgeries.
Upper airway gene expression reveals a more robust innate and adaptive immune response to SARS-CoV-2 in children compared with older adults
Authors: Mick Eran , Tsitsiklis Alexandra , Spottiswoode Natasha , Caldera Saharai , Serpa Paula Hayakawa , Detweiler Angela M. , Neff Norma , Pisco Angela Oliveira , Li Lucy M. , Retallack Hanna , Ratnasiri Kalani , Williamson Kayla M. , Soesanto Victoria , Simões Eric A. F. , Kistler Amy , Wagner Brandie D. , DeRisi Joseph L. , Ambroggio Lilliam , Mourani Peter M. , Langelier Charles R. 
Published: July 2021

AbstractUnlike other respiratory viruses, SARS-CoV-2 disproportionately causes severe disease in older adults and only rarely in children. To investigate whether differences in the upper airway immune response could contribute to this disparity, we compared nasopharyngeal gene expression in 83 children (<19-years-old; 38 with SARS-CoV-2, 11 with other respiratory viruses, 34 with no virus) and 154 adults (>40-years-old; 45 with SARS-CoV-2, 28 with other respiratory viruses, 81 with no virus). Expression of interferon-stimulated genes (ISGs) was robustly activated in both children and adults with SARS-CoV-2 compared to the respective non-viral groups, with only relatively subtle distinctions. Children, however, demonstrated markedly greater upregulation of pathways related to B cell and T cell activation and proinflammatory cytokine signaling, including TNF, IFNγ, IL-2 and IL-4 production. Cell type deconvolution confirmed greater recruitment of B cells, and to a lesser degree macrophages, to the upper airway of children. Only children exhibited a decrease in proportions of ciliated cells, the primary target of SARS-CoV-2, upon infection with the virus. These findings demonstrate that children elicit a more robust innate and adaptive immune response to SARS-CoV-2 infection in the upper airway that likely contributes to their protection from severe disease in the lower airway.
Elderly acceptance of telemedicine use in Hong Kong during and after the COVID-19 pandemic: a cross-sectional cohort survey
Authors: Yin Choi Maxwell Chun , Chu Shing Him , Siu Lok Lam , Tse Anakin Gajy , Yuen Wu Justin Che , Fung Hong , Fai Chiu Billy Chi , Tong Mok Vincent Chung 
Published: July 2021

AbstractBackgroundTelemedicine services worldwide have experienced an unprecedented boom since the beginning of the COVID-19 pandemic. Multiple studies have noted telemedicine as an effective alternative to traditional face-to-face management of patients. This study provides insight into public perception and impression of telemedicine in Hong Kong, specifically among the elderly who are the most vulnerable to COVID-19.MethodsFace-to-face surveys were conducted on elderly relatives of current medical students at the Chinese University of Hong Kong who were aged ≥ 60 years. The survey included socio-demographic details; past medical history; and concerns towards telemedicine use. Univariate and multivariable regression analyses were conducted to examine statistically significant associations. The primary outcomes are consideration of telemedicine use during: (1) a severe outbreak; and (2) after the COVID-19 pandemic.Results109 surveys were conducted. Multivariable regression analyses revealed that expectation of government subsidies for telemedicine services was the strongest common driver, and also the only positive independent predictors of telemedicine use for both during a severe outbreak, as well as after the COVID-19 pandemic. No negative independent predictors of telemedicine use during severe outbreak were found. Negative independent predictors of telemedicine use after the COVID-19 pandemic included old age, and living in the New Territories.ConclusionsGovernment support such as telemedicine-specific subsidies will be crucial in promoting telemedicine use in Hong Kong both during a severe outbreak and after the current COVID-19 pandemic. Robust dissemination of information regarding the pros and cons of telemedicine towards the public, especially towards the elderly population, is warranted.
“If somebody had told me I’d feel like I do now, I wouldn’t have believed them…” Older adults’ experiences of the BELL trial: a qualitative study
Authors: Meigh Neil J. , Davidson Alexandra R. , Keogh Justin W.L. , Hing Wayne 
Published: July 2021

ABSTRACTObjectivesThis study examined older adults’ experiences of participating in the BELL trial, involving 12-weeks of group-based hardstyle kettlebell training.MethodsIn the BELL trial, 28 insufficiently active older adults (15 women, 13 men, 59-79 years) completed 6 weeks of face-to-face group training, and 6 weeks of home-based training. In-depth semi-structured interviews were audio recorded and transcribed, inductively coded, with themes constructed thematically from patterns of shared meaning.ResultsFour higher-order themes were developed that reflect older adults’ experiences participating in a group-exercise program of hardstyle kettlebell training. These included: (1) “It’s one of the best things we’ve done” - enjoying the physical and psychosocial benefits, (2) “It’s improved it tremendously!” - change in a long-term health condition, (3) “It put me on a better course” - overcoming challenges, (4) “I wasn’t just a number” - feeling part of a group/community.DiscussionFindings highlight the perceived physical and psychological benefits of participating in hardstyle group kettlebell training, the value attributed to being part of an age-matched community of like-minded people engaged in group-exercise, as well as the challenges participants faced, and the sense of achievement in overcoming them. Implications for program design and delivery, and future research are discussed.