bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wide-awake Surgery for Congenital Thumb Flexion Anomaly in a Child
Authors: Zukawa Mineyuki , Osada Ryusuke , Inagaki Miku , Hirokawa Tatsurou , Kwaguchi Yoshiharu 
Published: April 2021

Summary:
We report a rare case of absent thumb IP joint flexion in bilateral thumbs due to anomalous tendon slips of the flexor pollicis longus. Cutting the anomalous insertions failed to improve active flexion of the IP joints. Successful treatment was achieved by evaluating the musculotendinous units of the original flexor pollicis longus and the anomalous flexor pollicis longus tendon during a wide-awake surgery.
Application of FACE-Q and NOSE in Nasal Reconstruction with Paramedian Frontal Flap after Skin Cancer Resection
Authors: Pagotto Vitor Penteado Figueiredo , Tutihashi Rafael Mamoru Carneiro , Ribeiro Renan Diego Americo , Takahashi Giulia Godoy , Camargo Cristina Pires , Busnardo Fábio de Freitas , Gemperli Rolf 
Published: April 2021

Introduction:
Nonmelanoma skin cancer (NMSC) is responsible for high morbidity and mortality, resulting in a high cost to the health system. The nose is the leading region affected by this type of tumor and may need reconstruction by tissue transfer. The paramedian forehead flap (PFF) is one of the main options used, and the factors that influence the result should be studied. The FACE-Q questionnaire allows the assessment of appearance, quality of life, and side effects related to the procedure, whereas the Nasal Obstruction Symptom Evaluation questionnaire enables the nose function evaluation.

Methods:
This study evaluates nasal reconstruction with a PFF after resection of NMSC with the FACE-Q questionnaire and Nasal Obstruction Symptom Evaluation. Spearman Rank correlation coefficient tests between the questionnaire results and patients' characteristics were performed.

Results:
The questionnaires were completely answered by 49 patients who underwent this reconstruction between 2011 and 2019 in a cancer center. The patients’ evaluations demonstrate high satisfaction with appearance, quality of life, side effects, and function. Completing reconstruction under 6 months was associated with a higher quality of life among patients (P = 0.002). Reconstruction of lining or scaffold, moment of flap division, complications, and number of operations did not show an association.

Conclusion:
This study suggests that the PFF is a reliable option for nasal reconstruction. Identifying the total reconstruction time as an impact factor on patients’ quality of life should be considered when planning treatment.
Increasing Walking Speed to Achieve a Pre-training Endurance Shuttle Walk Time of 5-10 min May Improve Test Responsiveness in People With Chronic Obstructive Pulmonary Disease
Authors: Hill Kylie , Chao Yan Ling , Cavalheri Vinicius , Ng L. W. Cindy , Wootton Sally L. , McKeough Zoe J. , Jenkins Sue C. , Eastwood Peter R. , Hillman David R. , Jenkins Christine , Cecins Nola , Spencer Lissa M. , Alison Jennifer A. 
Published: April 2021

Purpose:
The endurance shuttle walk test (ESWT) was used to evaluate ground-based walking training in chronic obstructive pulmonary disease. During pre-training testing, those who walked 5-10 min on the first ESWT with minimal symptoms performed additional ESWTs at increasing speeds until they were at least moderately symptomatic and terminated the test between 5 and 10 min. This report compares participant characteristics and test responsiveness with participants grouped according to whether or not faster walking speeds were selected for the ESWT during pre-training testing.

Methods:
We conducted a retrospective analysis of data collected in the intervention group during a randomized controlled trial. The intervention was supervised ground-based walking training, performed two to three times/wk, for 8-10 wk. Prior to and immediately following completion of training, participants completed the 6-min walk test (6MWT), incremental shuttle walk test (ISWT), and ESWT.

Results:
Data were available on 77 participants (70 ± 9 yr, forced expiratory volume in the first second of expiration [FEV1] 43 ± 15 % predicted). For those whom a faster speed was selected during the pre-training ESWTs were characterized by milder dyspnea and leg fatigue on completion of the baseline 6MWT and ISWT (P < .05 for all). On training completion, the change in ESWT was greater in those for whom a faster speed was selected (376 ± 344 sec vs 176 ± 274 sec; P = .017).

Conclusions:
Participants who report modest symptoms on completion of the pre-training 6MWT or ISWT may achieve a long pre-training ESWT time. In this situation, repeating the pre-training ESWT at a faster walking speed to achieve an exercise time between 5 and 10 min with moderate symptoms may be advantageous.
Protective strategy of parathyroid glands during thyroid lobectomy
Authors: Xing Zhichao , Qiu Yuxuan , Fei Yuan , Xia Baoying , Abuduwaili Munire , Zhu Jingqiang , Su Anping 
Published: April 2021

Abstract
Parathyroid protection during thyroid lobectomy was not illustrated previously. Aim of this study was to find out the influence of parathyroid glands in situ preservation and autotransplantation on postoperative parathyroid function in thyroid lobectomy.
Consecutive patients who underwent primary thyroid lobectomy with unilateral central neck dissection for papillary thyroid carcinoma in our center were included retrospectively. Postoperative hypoparathyroidism was defined as low parathyroid hormone (PTH) levels (<1.6 pmol/L) and keeping over 6 months was defined as permanent. Patients were divided into 3 groups: all identified parathyroid glands preserved in situ (preservation group); at least one parathyroid gland autotransplanted without accidental resection (autotransplantation group); at least one parathyroid gland accidental resected (resection group).
A total of 425 patients were included. No permanent hypoparathyroidism was reported, and the rates of transient hypoparathyroidism were similar among all groups. Significantly lower serum PTH levels were found in autotransplantation group versus preservation group at postoperative 1-day (3.77 ± 1.61 vs 4.72 ± 2.31, P < .001). Transient hypoparathyroidism was significantly associated with reduced intraoperative carbon nanoparticles utilization (57.1% vs 77.4%, P = .039).
Thyroid lobectomy was a safe surgical method for parathyroid protection no matter the practice to ipsilateral parathyroid glands. However, preservation of all parathyroid glands was still recommended considering relatively stable PTH levels.
The effect of insulin pump combined with ulinastatin on the levels of PCT, TG, PTX-3, and CX3CL1 in patients with diabetic ketoacidosis and pancreatitis
Authors: Wei Dongmei , Yin Chao , Lu Songtao , Xiong Juwen , Zhu Lishuang , Yan Shaoru , Meng Rui 
Published: April 2021

Abstract
The aim of this research is to observe the effect of insulin pump combined with Ulinastatin on the levels of procalcitonin (PCT), triglycerides (TG), pentraxin-3(PTX-3), and C-X3-C motif chemokine ligand 1 (CX3CL1) in patients with diabetic ketoacidosis and pancreatitis.
A total of 72 patients with diabetic ketoacidosis and pancreatitis who were admitted to our hospital from February 2016 to February 2020 were selected as the research subjects. They were divided into study groups (36 cases, given insulin pump combined Ulinastatin treatment) and control group (36 cases, given insulin pump treatment). Statistics of changes in blood amylase (AMS), blood glucose, blood ketones, glycosylated hemoglobin (HbA1c), PCT, TG, PTX-3, and chemokine CX3CL in pancreatic tissue before and after treatment.
After treatment, the clinical efficacy of the study group was significantly higher than that of the control group (94.44% vs 75.00%), the difference was significant (P < .05). After treatment, the clinical symptoms (abdominal distension, abdominal pain, body temperature, blood sugar, HbA1c and blood amylase) in the study group were significantly less time-to-normal than in the control group, and the difference was significant (P < .05). After treatment, the AMS, blood sugar, HbA1c, and blood ketones of the 2 groups were all lower than before treatment, and the study group's AMS, blood sugar, HbA1c, and blood ketones were all lower In the control group, the difference was significant (P < .05). After treatment, the 2 groups of PCT, TG, PTX-3, and CX3CL were all lower than before treatment, among which the study group PCT, TG, PTX-3, and CX3CL1 were lower than the control group, the difference was significant (P < .05). After treatment, the total adverse reaction rate of the 2 groups was not significantly different (P > .05), but the total adverse reaction rate of the study group was lower than that of the control group.
The combination of insulin pump and ulinastatin in the treatment of patients with diabetic ketoacidosis complicated with acute pancreatitis has a effect, which can shorten the recovery time of clinical symptoms, reduce the levels of PCT, TG, PTX-3, and CX3CL1, and has fewer adverse reactions. It is worthy of clinical application.
MicroRNA-496 inhibits triple negative breast cancer cell proliferation by targeting Del-1
Authors: Lee Soo Jung , Jeong Jae-Hwan , Lee Jeeyeon , Park Ho Yong , Jung Jin Hyang , Kang Jieun , Kim Eun Ae , Park Nora Jee-Young , Park Ji-Young , Lee In Hee , Chae Yee Soo 
Published: April 2021

Abstract
Del-1 has been linked to the pathogenesis of various cancers, including breast cancer. However, the regulation of Del-1 expression remains unclear. We previously reported the interaction between microRNA-137 (miR-137) and the Del-1 gene. In this study, we investigated miR-496 and miR-137 as regulators of Del-1 expression in triple negative breast cancer (TNBC). Del-1 mRNA and miR-496 were measured by quantitative PCR in breast cancer cells (MDA-MB-231, MCF7, SK-BR3, and T-47D) and tissues from 30 patients with TNBC. The effects of miR-496 on cell proliferation, migration, and invasion were determined with MTT, wound healing, and Matrigel transwell assays, respectively. In MDA-MB-231 cells, miR-496 levels were remarkably low and Del-1 mRNA levels were higher than in other breast cancer cell lines. Luciferase reporter assays revealed that miR-496 binds the 3′-UTR of Del-1 and Del-1 expression is downregulated by miR-496 mimics. Furthermore, miR-496 inhibited the proliferation, migration, and invasion of MDA-MB-231 cells. The effects of miR-496 on cell proliferation were additive with those of miR-137, another miRNA that regulates Del-1 expression. Moreover, in the 30 TNBC specimens, miR-496 was downregulated (P < .005) and the levels of Del-1 in the plasma were significantly elevated as compared with in normal controls (P = .0142). The Cancer Genome Atlas (TCGA) data showed the correlation of miR-496 expression with better overall survival in patients with early TNBC. In in silico and in vitro analyses, we showed that Del-1 is a target of miR-496 in TNBC and thereby affects cancer progression. Our findings suggest that miR-496 and miR-137 additively target Del-1 and act as modulating factors in TNBC. They are potentially new biomarkers for patients with TNBC.
Randomized clinical trial of preoperative skin preparation with 2% chlorhexidine versus conventional hair shaving in percutaneous coronary intervention
Authors: Tsai Hsueh-Ya , Liao Wen-Chun , Wang Meilin , Ueng Kwo-Chang , Huang Cheng-Yi , Tseng Ying-Chen 
Published: April 2021

Abstract

Background:
Preoperative skin preparation is associated with surgical site infection (SSI). Traditional preoperative shaving fails to reduce the risk of SSI. The efficacy of 2% chlorhexidine for preoperative skin preparation in percutaneous coronary intervention (PCI) is sketchy. The aim of this trial was to evaluate whether preoperative skin preparation performed with chlorhexidine was not inferior to a conventional hair removal method.

Methods:
Seventy-eight patients undergoing PCI were randomized into 2 groups of 39 patients, receiving either single sterilization with 2% chlorhexidine or hair shaving respectively between July 2016 and October 2016. The primary endpoints were wound infection rate and bacterial counts. Secondary endpoints were rate of SSI and adverse effects of 2% chlorhexidine.

Results:
The results showed that 2% chlorhexidine significantly reduced the colonization of Staphylococcus aureus (P = .032), S epidermidis (P = .000), and miscellaneous bacteria (P = .244) in comparison with hair shaving, respectively. Redness in 24 hours after surgery was observed in 6 patients in the control group (15.4%) and 5 patients (12.8%) in 2% chlorhexidine group. There was no statistically significant difference in SSI rate between 2 skin preparations.

Conclusion:
In PCI, preoperative skin preparation with 2% chlorhexidine was not inferior to conventional hair shaving in terms of the wound infection rate and SSI rate.
Ovarian dysgerminoma in pregnancy
Authors: Sas Ioan , Şerban Denis Mihai , Tomescu Larisa - Cristina , Nicolae Nicoleta 
Published: April 2021

Abstract

Rationale:
Although dysgerminomas are relatively uncommon among all ovarian neoplasms, representing for only about 2%, they account for 32.8 percent of malignant ovarian germ cell tumors. Their association with pregnancy is extremely rare; due to the low frequency of occurrence, there are few recommendations regarding pregnancy management; therefore, it is important to discuss and summarize the treatment strategy.

Patient concerns:
We present the case of a 25 years patient, gestation 1, para 1, who was hospitalized in the clinic at 38/39 weeks of gestation at the beginning of labor. Following the ultrasound examination, a hypoechogenic lesion on the uterine fundus was found, suggestive of subterranean fibroid. After caesarean section, right adnexectomy was performed; the histopathological examination revealed, unexpectedly, the diagnosis of dysgerminoma.

Diagnoses:
Dysgerminoma as associated with pregnancy.

Interventions:
Birth by Caesarean section and right adnexectomy. No other medical complications occurred.

Outcomes:
The histopathological and immunohistochemical examinations were consistent with the pure dysgerminoma. Oncology was staged AI, with the monitoring of markers and abdominal and pelvic magnetic resonance imaging at 3, 6, 9, and 12 months.

Lessons:
Dysgerminoma is the most common ovarian malignancy associated with pregnancy with a good fetal maternal outcome. If these tumors are discovered accidentally during caesarean section, tumor markers and magnetic resonance imaging scanning should be done postoperatively to plan optimal treatment.
Roseola Infantum During the COVID-19 Pandemic
Authors: Aktürk Hacer , Bağci Mihrimah S. , Yiğit Murat H. , Khalilova Fidan , Ünlügedik Özlem , Asarcikli Fikret 
Published: April 2021

Introduction:
Roseola infantum is always considered to be among the differential diagnosis of young patients with fever and leukopenia whom to be strictly isolated with the preliminary diagnosis of COVID-19 until otherwise proven during the pandemic.

Results:
Human herpes virus-6 (HHV-6) polymerase chain reaction (PCR) blood test was performed in 4 of 7 patients with a clinical diagnosis of roseola infantum and all found to be HHV-6 PCR positive. The most striking laboratory finding in all patients was leukopenia. HHV-6 PCR tests were found to be positive. Severe acute respiratory syndrome coronavirus-2 testing were found to be negative in all patients.

Conclusion:
During the peak of the pandemic, children continued to present with fever because of viral infections other than COVID-19.
Analysis of the Peripapillary Choroidal Vascular Characteristics in Papilledema Associated with Pseudotumor Cerebri
Authors: Kesim Cem , Solmaz Banu , Pasaoglu Isil , Karslioglu Melisa Zisan , Tatar Ipek , Yildiz-Tas Ayse , Zabun Burak , Sahin Afsun , Gedik Sansal 
Published: April 2021

SIGNIFICANCE
Choroidal vascularity index measured by image binarization method from peripapillary optical coherence tomography sections has been found significantly lower in papilledema patients than healthy controls.

PURPOSE
The purpose of this study was to compare peripapillary choroidal parameters in papilledema patients with control subjects.

METHODS
Peripapillary spectral domain optical coherence tomography scans of 34 patients with papilledema and 34 healthy controls are acquired for the study. Images are binarized with the ImageJ software (National Institutes of Health, Bethesda, MD) to calculate total choroidal area, stromal area, luminal area, and choroidal vascularity index.

RESULTS
Total choroidal area, luminal area, and choroidal vascularity were significantly lower in papilledema patients compared with healthy controls on right (1.343 ± 0.286 vs. 1.694 ± 0.344, P < .001; 0.880 ± 0.209 vs. 1.167 ± 0.255, P < .001; 65.28 ± 2.99% vs. 68.68 ± 2.81%, P < .001, respectively) and left eyes (1.376 ± 0.308 vs. 1.647 ± 0.339, P < .001; 0.899 ± 0.231 vs. 1.134 ± 0.237, P < .001; 64.92 ± 3.44 vs. 68.84 ± 3.23, P < .001, respectively). No difference was found between active and remitted stages of papilledema in terms of choroidal parameters.

CONCLUSIONS
Peripapillary total choroidal area, luminal area, and choroidal vascularity index are significantly reduced in patients with papilledema. These parameters might be beneficial tools for evaluating choroidal vascularity in papilledema quantitatively and differential diagnosis for optic disc edema.
MRI Dynamic Contrast Imaging of Oral Cavity and Oropharyngeal Tumors
Authors: Sideras Panagiotis , Singh Gagandeep 
Published: April 2021

Abstract
In the past decade, dynamic contrast-enhanced magnetic resonance imaging has had an increasing role in assessing the microvascular characteristics of various tumors, including head and neck cancer. Dynamic contrast-enhanced magnetic resonance imaging allows noninvasive assessment of permeability and blood flow, both important parametric features of tumor hypoxia, which is in turn a marker for treatment resistance for head and neck cancer.
In this article we will provide a comprehensive review technique in evaluating tumor proliferation and application of its parameters in differentiating between various tumor types of the oral cavity and how its parameters can correlate between epidermal growth factor receptor and human papillomavirus which can have an implication in patient's overall survival rates.
We will also review how the parameters of this method can predict local tumor control after treatment and compare its efficacy with other imaging modalities. Lastly, we will review how its parameters can be used prospectively to identify early complications from treatment.
Increased vulnerability to SARS-CoV-2 infection among indigenous peoples living in the urban area of Manaus
Authors: Pontes Gemilson Soares , de Melo Silva Jean , Pinheiro-Silva Renato , Barbosa Anderson Nogueira , Santos Luciano Cardenes , de Pádua Quirino Ramalho Antônio , de Castro Alves Carlos Eduardo , da Silva Danielle Furtado , de Oliveira Leonardo Calheiros , da Costa Allyson Guimarães , Bruno Ana Carla 
Published: April 2021

AbstractBackgroundThe COVID-19 pandemic threatens indigenous peoples living in suburban areas of large Brazilian cities and has thus far intensified their pre-existing socio-economic inequalities. This study evaluated the epidemiological situation of SARS-CoV-2 infection among residents of the biggest urban multiethnic indigenous community of the Amazonas state, Brazil.MethodsBlood samples of 280 indigenous people who live in the urban community known as Parque das Tribos, which is located in the surrounding area of Manaus, were tested for the presence of anti- SARS-CoV-2 IgA or IgG antibodies using an enzyme-linked immunosorbent assay. An epidemiological standardized interviewer-administered questionnaire was applied to assess the risk factors and sociodemographic information of the study population.ResultsWe found a total positivity rate of 64.64% (95% CI 59.01-70.28) for SARS-CoV-2 infection. IgA and IgG were detected in 55.71% (95% CI 49.89-61.54) and 60.71% (95% CI 54.98-66.45) of the individuals tested, respectively. From the total number (n=280), 80.11% of positive individuals (95%; CI 74.24-85.98) were positive for both IgA and IgG Abs. All individuals with COVID-19-related symptoms on the day of blood collection (n=11) were positive for IgG, while IgA was detected in 84.61% (n=55) of individuals who had presented symptoms several weeks before the blood collection. Individuals aged 30-39 were more susceptible to SARS-CoV-2 infection (prevalence ratio [PR] 0.77; 95% CI 0.58-1.03; p=0.033). People whose main source of information on COVID-19 was religious leaders or friends showed higher susceptibility to infection (PR 1.22; 95% CI 1.00-1.49; p=0.040). In addition, individuals who left home more frequently were at higher risk of infection (PR 1.22; 95% CI 1.00-1.49; p=0.048). Five or more individuals per household increased almost 5-fold the risk of virus transmission (Odds ratio [OR] 2.56; 95% CI; 1.09-6.01; p=0.019). Over 95% of the study population had no access to clean water and/or sanitation.ConclusionsThe disproportionate dissemination of SARS-CoV-2 infection observed in the Parque das Tribos urban indigenous community might be driven by typical cultural behavior and socioeconomic inequalities. Despite the pandemic threat, this population is not being targeted by public policies and appears to be chronically invisible to the Brazilian authorities.
Making sense of non-randomized comparative treatment studies in times of Covid-19: A case study of tocilizumab
Authors: Owen Ruth , Qizilbash Nawab , Díaz Sara Velázquez , Vázquez José María Castellano , Pocock Stuart 
Published: April 2021

ABSTRACTBACKGROUNDTocilizumab (TCZ) is an interleukin-6 inhibitor and the second established effective drug for the treatment of hospitalized patients with Covid-19. In this study, we sought to validate the recent positive findings from the randomised clinical trial RECOVERY and to evaluate the challenges in the analysis and interpretation of non-randomized comparative effectiveness studies in Covid-19.METHODSWe performed a retrospective cohort study using an openly available database of hospitalised Covid-19 patients in Spain. The primary outcome was all-cause in-hospital mortality at 28 days. We used multivariable Fine and Gray competing risk models which adjusted for both fixed and time-variant confounders to investigate the effect of TCZ on the primary outcome.RESULTSWe analysed 2547 patients hospitalised with Covid-19 between 1st January and 28th June 2020. Patients in the TCZ group tended to have more severe Covid-19 at admission, as measured by biomarkers of disease severity including CRP, D-dimer and LDH. At 28 days, 91 out of 440 TCZ patients had died compared to 267 out of 2107 patients in the control group. In multivariable analysis, there was no evidence of an association between TCZ and the primary outcome (adjusted hazard ratio 1.20, 95% CI 0.86 to 1.64, P=0.26).CONCLUSIONSOur observational study failed to find a benefit of TCZ on all-cause in-hospital mortality in Covid-19 patients compared with randomized trials, highlighting the impact that unmeasured confounding and other sources of bias can have in a retrospective observational setting. For future observational studies, we recommend prospective data collection to ensure all variables have the necessary quality, completeness and timing for reliable treatment evaluation.