bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rituximab for eosinophilic granulomatosis with polyangiitis: a systematic review of observational studies
Authors: Menditto Vincenzo G , Rossetti Giulia , Olivari Diletta , Angeletti Alessia , Rocchi Marco , Gabrielli Armando , Pomponio Giovanni 
Published: January 2021

Abstract

Objective
To analyse the available evidence about the use of rituximab (RTX) and other biologic agents in eosinophilic granulomatosis with polyangiitis (EGPA) patients and to provide useful findings to inform the design of future, reliable clinical trials.

Methods
A systematic review was performed. A systematic search was conducted in PubMed/MEDLINE, Scopus, Web of Science and the Cochrane library databases on RTX, and an extensive literature search was conducted on other biologic agents.

Results
Forty-five papers pertinent to our questions were found: 16 retrospective cohort studies, 8 case series, 3 prospective cohort studies and 18 single case reports, for a total of 368 EGPA patients. More than 80% of evaluable patients achieved complete or partial remission with a tendency towards a higher rate of complete response in the pANCA-positive subgroup.

Conclusion
Although the majority of the evaluable EGPA patients treated with RTX appears to achieve complete remission, we strongly believe that a number of sources of heterogeneity impair a clear interpretation of results and limit their transferability in clinical practice. Differences in design, enrolment criteria, outcome definition and measurement make a comparison among data obtained from studies on RTX and other biologic agents unreliable.
NATURALLY OCCURRING RADIONUCLIDES IN SOIL SAMPLES OF BURETI SUB-COUNTY OF KERICHO COUNTY KENYA
Authors: Rotich C K , Hashim N O , Chege M W , Nyambura C 
Published: January 2021

Abstract
The activity concentration of soil samples of Bureti sub-county was measured using thallium-activated sodium iodide detector. To ascertain the level of radiation hazard to the public, gamma radiation dose rates were also estimated. The average activity concentration due to 40K, 226Ra and 232Th for soil samples are 1164 ± 70, 106 ± 8 and 79 ± 5 Bqkg−1, respectively. An average dose rate of 145 ± 10 nGyh−1 was recorded, which is about 2.5 times higher than the world average value of 60 nGyh−1(UNSCEAR). On the other hand, an average outdoor effective dose of 0.35 ± 0.02 mSvy−1 was measured, which is lower than the ICRP safety limit of 1 mSvy−1. This shows that the radiation hazards from naturally occurring terrestrial radionuclides in Bureti is low and therefore human radiation exposure is within the accepted limits.
MAPPING OF WORKPLACE RADIATION FIELDS IN DIAGNOSTIC RADIOLOGY FACILITIES USING PERSONNEL MONITORING TLD BADGES
Authors: Srivastava Kshama , Chakrabarty Shatabdi , Pai Rajeshri , Pradhan S M , Chaubey Ajay , Selvam T P , Sapra B K 
Published: January 2021

Abstract
The radiation protection programme is aimed at safe usage of radiation at workplace, ensuring minimum possible dose to radiation workers, patients and members of the public. Verification of the adequacy of protective measures in actual workplace is important, especially for diagnostic radiology facilities, as a substantial number of suspected overexposures are reported from these facilities. To address this issue, a study was conducted for mapping workplace radiation field at various locations in nine Diagnostic Radiology Facilities of two hospitals in India. The cumulative doses were measured for a period of 1–3 months, using personnel monitoring TLD badges. The dosemeters were placed at positions representative of two exposure situations: (1) probable locations of workers during procedures, leading to genuine exposure and (2) inappropriate storage locations of personal dosemeters at user end for probing claims of nongenuine exposures. The results indicate that the measured doses at locations (1) were just a fraction of the permissible dose, provided all safety practices are adhered to. However, the measured doses at certain locations (2) exceeded the investigation levels and indicate that any inadvertent storage of the dosemeters at such locations could lead to reporting of the overexposure from these radiology facilities. The outcome of the study will be useful for the investigation of such exposures and better understanding of the readout patterns of TLD badges in radiology workplaces.
Reported maternal childhood maltreatment experiences, amygdala activation and functional connectivity to infant cry
Authors: Olsavsky Aviva K , Stoddard Joel , Erhart Andrew , Tribble Rebekah , Kim Pilyoung 
Published: January 2021

Abstract
Maternal childhood maltreatment experiences (CMEs) may influence responses to infants and affect child outcomes. We examined associations between CME and mothers’ neural responses and functional connectivity to infant distress. We hypothesized that mothers with greater CME would exhibit higher amygdala reactivity and amygdala–supplementary motor area (SMA) functional connectivity to own infant’s cries. Postpartum mothers (N = 57) assessed for CME completed an functional magnetic resonance imaging task with cry and white-noise stimuli. Amygdala region-of-interest and psychophysiological interaction analyses were performed. Our models tested associations of CME with activation and connectivity during task conditions (own/other and cry/noise). Exploratory analyses with parenting behaviors were performed. Mothers with higher CME exhibited higher amygdala activation to own baby’s cries vs other stimuli (F1,392 = 6.9, P &lt; 0.01, N = 57) and higher differential connectivity to cry vs noise between amygdala and SMA (F1,165 = 22.3, P &lt; 0.001). Exploratory analyses revealed positive associations between both amygdala activation and connectivity and maternal non-intrusiveness (Ps &lt; 0.05). Increased amygdala activation to own infant’s cry and higher amygdala–SMA functional connectivity suggest motor responses to baby’s distress. These findings were associated with less intrusive maternal behaviors. Follow-up studies might replicate these findings, add more granular parenting assessments and explore how cue processing leads to a motivated maternal approach in clinical populations.
Personalized Estimates of Brain Structural Variability in Individuals With Early Psychosis
Authors: Antoniades Mathilde , Haas Shalaila S , Modabbernia Amirhossein , Bykowsky Oleg , Frangou Sophia , Borgwardt Stefan , Schmidt André 
Published: January 2021

Abstract

Background
Early psychosis in first-episode psychosis (FEP) and clinical high-risk (CHR) individuals has been associated with alterations in mean regional measures of brain morphology. Examination of variability in brain morphology could assist in quantifying the degree of brain structural heterogeneity in clinical relative to healthy control (HC) samples.

Methods
Structural magnetic resonance imaging data were obtained from CHR (n = 71), FEP (n = 72), and HC individuals (n = 55). Regional brain variability in cortical thickness (CT), surface area (SA), and subcortical volume (SV) was assessed with the coefficient of variation (CV). Furthermore, the person-based similarity index (PBSI) was employed to quantify the similarity of CT, SA, and SV profile of each individual to others within the same diagnostic group. Normative modeling of the PBSI-CT, PBSI-SA, and PBSI-SV was used to identify CHR and FEP individuals whose scores deviated markedly from those of the healthy individuals.

Results
There was no effect of diagnosis on the CV for any regional measure (P &gt; .38). CHR and FEP individuals differed significantly from the HC group in terms of PBSI-CT (P &lt; .0001), PBSI-SA (P &lt; .0001), and PBSI-SV (P = .01). In the clinical groups, normative modeling identified 32 (22%) individuals with deviant PBSI-CT, 12 (8.4%) with deviant PBSI-SA, and 21 (15%) with deviant PBSI-SV; differences of small effect size indicated that individuals with deviant PBSI scores had lower IQ and higher psychopathology.

Conclusions
Examination of brain structural variability in early psychosis indicated heterogeneity at the level of individual profiles and encourages further large-scale examination to identify individuals that deviate markedly from normative reference data.
Integrative Computational Approaches to Inform Relative Bioaccumulation Potential of Per- and Polyfluoroalkyl Substances Across Species
Authors: Cheng Weixiao , Doering Jon A , LaLone Carlie , Ng Carla 
Published: January 2021

AbstractPredictive toxicology is increasingly reliant on innovative computational methods to address pressing questions in chemicals assessment. Of importance is the evaluation of contaminant impact differences across species to inform ecosystem protection and identify appropriate model species for human toxicity studies. Here we evaluated 2 complementary tools to predict cross-species differences in binding affinity between per- and polyfluoroalkyl substances (PFAS) and the liver fatty acid-binding protein (LFABP): the Sequence Alignment to Predict Across Species Susceptibility (SeqAPASS) tool and molecular dynamics (MD). SeqAPASS determined that the structure of human LFABP, a key determinant of PFAS bioaccumulation, was conserved in the majority of vertebrate species, indicating these species would have similar PFAS bioaccumulation potentials. Level 3 SeqAPASS evaluation identified several potentially destabilizing amino acid differences across species, which were generally supported by DUET stability change predictions. Nine single-residue mutations and 7 whole species sequences were selected for MD evaluation. One mutation (F50V for PFNA) showed a statistically significant difference with stronger affinity than wild-type human LFABP. Predicted binding affinities for 9 different PFAS across 7 species showed human, rat, chicken, and rainbow trout had similar binding affinities to one another for each PFAS, whereas Japanese medaka and fathead minnow had significantly weaker LFABP-binding affinity for some PFAS. Based on these analyses, the combined use of SeqAPASS and MD provides rapid screening for potential species differences with deeper structural insight. This approach can be easily extended to other important biological receptors and potential ligands.
Rapid ethical appraisal of stakeholder views on research prior to undertaking immunopathogenesis studies on podoconiosis in northeast Ethiopia during a period of social instability
Authors: Negash Mikias , Chanyalew Menberework , T Gebresilase Tewodros , Sintayehu Bizunesh , Anteye Temesgen , Aseffa Abraham , Newport Melanie J 
Published: January 2021

Abstract

Background
Undertaking research and attaining informed consent can be challenging when there is political unrest and community mistrust. Rapid ethical appraisal (REA) is a tool that uses qualitative methods to explore sociocultural issues that may affect the ethical conduct of research.

Methods
We used REA in northeast Ethiopia shortly following a period of unrest, during which violence against researchers occurred, to assess stakeholder perceptions of research, researchers and the informed consent process. We held 32 in-depth interviews and 2 focus group discussions.

Results
Most community members had little awareness about podoconiosis or healthcare research. Convincing the community to donate blood for research is challenging due to association with HIV testing. The attack on researchers was mainly motivated by the community's mistrust of their intentions against the background of a volatile political situation. Social media contributed to the spread of misinformation. Lack of community engagement was also a key contributing factor.

Conclusions
Using REA, we identified potential barriers to the informed consent process, participant recruitment for data and specimen collection and the smooth conduct of research. Researchers should assess existing conditions in the study area and engage with the community to increase awareness prior to commencing their research activities.
Delays in lymphatic filariasis elimination programmes due to COVID-19, and possible mitigation strategies
Authors: Prada Joaquín M , Stolk Wilma A , Davis Emma L , Touloupou Panayiota , Sharma Swarnali , Muñoz Johanna , Caja Rivera Rocio M , Reimer Lisa J , Michael Edwin , de Vlas Sake J , Hollingsworth T Déirdre 
Published: January 2021

Abstract

Background
In view of the current global coronavirus disease 2019 pandemic, mass drug administration interventions for neglected tropical diseases, including lymphatic filariasis (LF), have been halted. We used mathematical modelling to estimate the impact of delaying or cancelling treatment rounds and explore possible mitigation strategies.

Methods
We used three established LF transmission models to simulate infection trends in settings with annual treatment rounds and programme delays in 2020 of 6, 12, 18 or 24 months. We then evaluated the impact of various mitigation strategies upon resuming activities.

Results
The delay in achieving the elimination goals is on average similar to the number of years the treatment rounds are missed. Enhanced interventions implemented for as little as 1 y can allow catch-up on the progress lost and, if maintained throughout the programme, can lead to acceleration of up to 3 y.

Conclusions
In general, a short delay in the programme does not cause a major delay in achieving the goals. Impact is strongest in high-endemicity areas. Mitigation strategies such as biannual treatment or increased coverage are key to minimizing the impact of the disruption once the programme resumes and lead to potential acceleration should these enhanced strategies be maintained.
Preconditioning with Foam-mediated External Suction on Flap Microvasculature and Perfusion in a Rodent Model
Authors: Mohan Anita T. , Zhu Lin , Michalak Gregory J. , Laungani Alexis T. , Vercnocke Andrew J. , Moran Steven L. , Saint-Cyr Michel 
Published: January 2021

Background:
Foam-mediated external suction (FMES) has previously shown to improve tissue microcirculation. We hypothesized that preconditioning fasciocutaneous perforator flaps with FMES would augment perfusion and demonstrate greater capillary recruitment.

Methods:
Gluteal perforator flaps were designed on sixteen 400 g rats. Continuous FMES at −125 mm Hg was applied on one side (intervention) to precondition tissue for 5 days, with the contralateral side as a paired control. In group A, we assessed changes following pretreatment, after surgery, and 7 days postprocedure, and in group B, we evaluated changes during preconditioning alone. In group A (N = 8), control and intervention flaps were assessed using laser-assisted indocyanine green fluorescence angiography. In group B, flap regions were assessed using 4-dimensional computed tomographic angiography. All flaps were analyzed for microvessel density using micro–computed tomography and histological assessment using hematoxylin and eosin and CD3 immunohistochemistry.

Results:
Thirty-two flaps were included in this study (N = 16 intervention and matched controls). Four-dimensional computed tomographic angiography demonstrated 17% greater tissue perfusion in preconditioned flaps (mean, 78.7 HU; SD, 8.8) versus controls (mean, 67.3 HU; SD, 15.7; P < 0.01). Laser-assisted indocyanine green fluorescence angiography showed a 30% higher mean absolute intensity in preconditioned flaps versus controls (P < 0.01). Postsurgery mean absolute intensity in preconditioned flaps remained 21% higher than in controls (P = 0.03). Preconditioned flaps demonstrated a 2-fold increase in mean vessel volume of 9.1 mm3 (SD, 7) versus 4.5 mm3 (SD, 3) in controls (P = 0.04); there was a 33% higher mean area fraction of CD31 in preconditioned flaps, 3.9% (SD, 3) versus 2.9% (SD, 3) in controls (P = 0.03).

Conclusion:
FMES preconditioning has the potential to augment vascularity of tissue for flap harvest; however, further experimental studies are required to optimize strategies and evaluate long-term effects for clinical applications.
Combined Horizontal Split Gluteus Maximus Muscle and Fasciocutaneous Limberg Flaps for Reconstruction of Recurrent Sacrococcygeal Pilonidal Sinus
Authors: Ahmad Mahfouz S. I. , Eltayeb Hazem 
Published: January 2021

Background:
Pilonidal sinus is a chronic recurrent medical disease. The exact etiology of the disease is still unknown, but the most accepted theory is an acquired condition characterized by infected sinus in the natal cleft area containing a lifeless hair tuft. Multiple techniques were prescribed for its treatment; however, the ideal method is not yet defined.

Methods:
The study population includes 58 male patients who underwent excision of their recurrent pilonidal sinus, and the resulting defects were reconstructed using combined horizontal split gluteus maximus flaps and rhomboid flaps. Outcomes were revised from patient case files and followed up in our outpatient clinic and via questionnaires.

Results:
The mean hospital stay was 3 days. The mean time to return to work was 16 days. Partial wound dehiscences occurred in 2 patients. Distal end flap necrosis occurred in 1 patient. There were no flap losses, no recurrences, no infections, no loss of function, and no seromas during a mean follow-up period of 24 months. All patients were satisfied with the results.

Conclusions:
This technique has an operative time and hospital stays comparable to those of other techniques. It has minimal and acceptable complication rates and no recurrences. We can conclude that this procedure of combined split gluteus maximus muscle flap and rhomboid flap provides an excellent, effective, easy, and feasible method of choice for reconstructing defects of recurrent pilonidal sinus disease.
Reconstruction with Free Flaps of Head and Neck Cancer Defects: A National Cohort Study
Authors: Buitrago Giancarlo , Caballero Felipe , Montealegre Giovanni E. 
Published: January 2021

Background:
The purpose of this study was to determine the perioperative mortality rate, reintervention rate, and total healthcare costs for head and neck cancer patients who underwent free tissue transfer (FTT) in Colombia. The prognostic factors associated with those results were estimated.

Methods:
A retrospective cohort study was performed using administrative data from patients of all ages diagnosed with head and neck cancer who underwent FTT between 2013 and 2016 in Colombia’s contributory health system. Postoperative mortality rates were estimated at 30, 90, and 180 days, as well as reintervention rates at 30 and 90 days. Total healthcare costs were calculated. Generalized linear models were generated to determine prognostic factors associated with outcomes.

Results:
A total of 485 patients were included, 215 (44.33%) of which were women. Mean age was 61.4 years. Mortality rate was 3.09 at 30 days, 9.28 at 90 days, and 15.26 at 180 days, per 100 surgeries. Reintervention rate was 5.77 at 30 days and 8.25 at 90 days, per 100 surgeries. The 30-day reintervention rate was lower for 40- to 59-year-old group and for a Charlson Index ≤ 3. The median total healthcare cost of an episode was USD 12,403.68 (interquartile range, 5754–16,736). The bivariate and multivariate models determined that age, the Charlson Index, and geographic region were associated with outcomes.

Conclusion:
For patients undergoing FTT in Colombia, differences in reintervention and total costs incurred by the national health system exist, and these differences are associated with age, the Charlson Index, and the geographic region.
Pediatric Malignancies in Plastic Surgery: Case Report of Facial Leukemia Cutis
Authors: Gargya Vipul , Hoogendoorn Joris , Kahn Alissa R. , Bascone Corey , Podda Silvio 
Published: January 2021

Summary:
Skin and soft tissue lesion removal contributes significantly to both academic and private plastic surgery practices. When encountering various types of dermatologic diseases, it is crucial for a plastic surgeon to exercise caution and consider further medical evaluation before proceeding with local excision of any abnormal skin growth, especially those that involve the face in the pediatric or adolescent population. In this case report, we discuss the case of a child who presented with a primary cutaneous skin lesion involving the left nasal ala, which was ultimately diagnosed as B-cell acute lymphoblastic leukemia. This case is reported to highlight B-cell acute lymphoblastic leukemia for plastic and reconstructive surgeons so that it can be included in the differential when encountering fast growing cutaneous lesions of the face in children.
Late Bleed after Deep Inferior Epigastric Perforator Flap Breast Reconstruction
Authors: Pferdehirt Rachel E. , Nahabedian Maurice Y. 
Published: January 2021

Summary:
Late bleed following deep inferior epigastric perforator (DIEP) flap breast reconstruction is an uncommon event. In this case report, the authors describe a case of late bleed 7 months following the index operation. This occurred in the setting of strenuous exercise. No specific etiology was determined and the condition resolved without treatment.
Surgical Reconstruction following Wide Local Excision of Malignant Melanoma of the Scalp
Authors: Baldelli Ilaria , Mangialardi Maria Lucia , Salgarello Marzia , Raposio Edoardo 
Published: January 2021

Background:
Scalp reconstruction in cases of melanoma excision can be challenging due to specific functional and aesthetic outcome requirements. Reconstructive techniques reported in the literature were reviewed to establish whether a surgical algorithm for the management of melanoma of the scalp may be deduced.

Methods:
A literature search was conducted to evaluate reconstructive strategies after melanoma wide local excision of the scalp according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Inclusion criteria were English language, diagnosis of melanoma of the scalp, and the presence of the following data: characteristics of the residual defect (width and depth), type of reconstruction, follow-up, and surgical outcome.

Results:
Six hundred twenty-five records were identified after excluding the duplicates; 48 full-text articles were assessed for eligibility, and 17 records were selected for inclusion. A total of 39 patients were included in the review. The majority of patients (n = 20) underwent skin grafting subsequent to dermal regeneration template positioning. Local flaps (n = 10), free flaps (n = 7), skin grafting alone (n = 1), and dermal regeneration template positioning alone (n = 1) were less frequent.

Conclusions:
Numerous reconstructive strategies for the scalp are described in the literature. Melanoma patients present a greater variability in terms of general health conditions and social needs that must be taken into account while choosing the most suitable procedure.