bluuebunny/crossref_metadata_2025_split huggingface dataset:
HBV-related acute-on-chronic liver failure with underlying chronic hepatitis has superior survival compared to cirrhosis
Authors: Liu Xiaohui , Zhang Jing , Wei Xinhuan , Duan Zhongping , Liu Hongqun , Chen Yu , Liu Yali , Lee Samuel S. 
Published: June 2021

Background
Acute-on-chronic liver failure (ACLF) is divided into three types according to the underlying liver disease: non-cirrhosis (type A), compensated cirrhosis (type B) and decompensated cirrhosis (type C). However, whether the underlying chronic liver diseases impact the ACLF prognosis is not clear. The present study aimed to compare the characteristics and outcomes of type A and type B hepatitis B virus (HBV)-ACLF patients.

Methods
According to the European Association for the Study of Liver-Chronic Liver Failure (EASL-CLIF) diagnostic criteria, 86 type A HBV-ACLF and 71 type B HBV-ACLF were prospectively enrolled. The demography and laboratory data, organ failures, ACLF grades and prognosis were evaluated. Univariate and multivariate Cox regression analyses were performed to analyze the prognostic factors.

Results
The 28-day and 90-day mortality rates of type A and type B ACLF were 20.9 vs. 60.6% and 34.9 vs. 73.2%, respectively (both P < 0.001). Patients with type A ACLF were younger, had higher viral load and higher levels of alanine aminotransferase and aspartate aminotransferase, platelet count, serum albumin and sodium, international normalized ratio and alpha-fetoprotein, lower rate of ascites, lower Child-Pugh scores and CLIF sequential organ failure assessment scores, higher rate of coagulation failure. Type B ACLF had more renal and cerebral failure. Cirrhosis was one of the independent prognostic factors [hazard ratio, 2.4 (95% CI, 1.451–3.818) P < 0.001].

Conclusion
ACLF developing on noncirrhotic chronic hepatitis B had more serious liver inflammation but fewer extrahepatic organ failures and better outcome than ACLF developing from compensated HBV cirrhosis.
A Case of Combined Central and Peripheral Demyelination Associated With Antineurofascin 155 Antibodies and Paternal History of Multiple Sclerosis
Authors: Lambrianides Sakis , Kinnis Evgenios , Cleanthous Michele , Myrianthopoulou Panayiota , Leonidou Eleni , Kyriakides Theodoros 
Published: June 2021

Introduction:
Combined central and peripheral demyelination (CCPD) is a term used to describe a rare condition involving demyelinating lesions of both the central and the peripheral nervous system. Its etiology remains unclear, and a pathogenic role of cell-mediated and/or humoral immunity has been proposed. A number of patients with CCPD are positive to antineurofascin (anti-NF), antigalactocerebroside, and antilactosylseramide antibodies. The relation between CCPD and multiple sclerosis (MS) is unclear.

Case Report:
We report the case of a 30-year-old man who was referred for evaluation after having episodes of numbness and gait impairment worsened by intravenous Methylprednisolone and was found to have demyelination in both central and peripheral nervous system. The patient was eventually diagnosed with anti-NF 155 CCPD and received multiple courses of intravenous immunoglobulin without significant improvement, while he remained stable under Rituximab. Interestingly, the patient’s father suffered from a mild form of relapsing remitting MS.

Conclusion:
Our case emphasizes that clinicians need to keep in mind the possibility of a coexisting demyelination in both central and peripheral nervous system, even in patients with a family history of MS. The need for a timely diagnosis is imperative since several drugs used in the management of MS can worsen the patient’s symptoms in CCPD. This is, to our knowledge, the first reported case of a patient with anti-NF 155 positive CCPD and a family history of MS.
Parkinsonism-hyperpyrexia Syndrome After Amantadine Withdrawal
Authors: dos Santos Daniel T. , Imthon Alexandre K. , Strelow Matheus Z. , Pille Arthur , Schumacher-Schuh Artur F. 
Published: June 2021

Introduction:
Parkinsonism-hyperpyrexia syndrome (PHS) is a rare and potentially fatal complication of Parkinson disease (PD) characterized by a neuroleptic malignant-like syndrome due to abrupt discontinuation of antiparkinsonian medications.

Case Report:
A 79-year-old woman with late-stage PD presented at the hospital with neuropsychiatric and uncontrolled parkinsonian motor symptoms. Soon after the abrupt discontinuation of amantadine, the patient suddenly presented with global rigidity, global unresponsiveness, diaphoresis, tachycardia, recurrent hyperpyrexia, and a mildly elevated creatine kinase, which lead to the diagnosis of PHS. Amantadine was then reinitiated and her symptoms resolved within 10 days.

Conclusions:
Amantadine is an antiparkinsonian medication scarcely associated with PHS. The few reported cases are further summarized and discussed in this article. This case highlights the importance of early recognition of PHS, which may be caused by changes in other antiparkinson agents such as amantadine, and the need to slowly titrate such agents.
Wall-Eyed Bilateral Internuclear Ophthalmoplegia (WEBINO) in a Patient With a Unilateral Midbrain Infarction
Authors: Jo Yoon-Sik , Hong Jun Yeong , Kim Si Yeon , Na Sang-Jun 
Published: June 2021

Introduction:
Wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) is a rare variation of internuclear ophthalmoplegia associated with bilateral lesions of the medial longitudinal fasciculus.

Case Report:
In this case, the edematous lesions of the ipsilateral midbrain infarction appeared to compress the contralateral medial longitudinal fasciculus, resulting in WEBINO. Treatment of focal cerebral edema caused by ischemic stroke is still under debate. However, in this case, antiedema treatment was implemented to prevent the sequelae of the edematous lesion caused by a midbrain infarction, and a relatively rapid improvement of ocular symptoms was observed.

Conclusion:
Herein, we report a rare case of WEBINO caused by a unilateral midbrain infarction in which the patient experienced edema-related neurological deficits. This case provides evidence that early antiedema therapy may benefit patients with similar presentations.
Effects of Case Management on Risky Sexual Behaviors and Syphilis Among HIV-Infected Men Who Have Sex With Men in China: A Randomized Controlled Study
Authors: Xie Nianhua , Hu Xuejiao , Yan Han , Ruan Lianguo , Liu Cong , Hu Rong , Ma Hongfei , Luo Yanhe , Liu Li , Wang Xia 
Published: June 2021

Background
The prevalence of syphilis is very high in human immunodeficiency virus (HIV)–positive men who have sex with men (MSM), and effective interventions are needed to educate HIV-positive individuals about behavioral and biological risk factors. Therefore, we developed a standard case management process and conducted a randomized controlled study to investigate the impact on risky sexual behaviors and syphilis in HIV-positive MSM.

Methods
Men who have sex with men (n = 220) were enrolled and randomized to the case management intervention group and the control group between May 2016 and January 2017. The control group received routine HIV-related care. In addition to routine HIV-related care, those in the intervention group regularly received extended services from a well-trained case manager. Epidemiological information was collected during the baseline face-to-face interviews by a trained investigator. Serological tests for syphilis and assessments of risky sexual behaviors were performed at baseline and 6 and 12 months after the initiation of treatment.

Results
The syphilis incidence rates in the intervention and control groups were 11.3 per 100 person-years and 20.6 per 100 person-years, respectively. The multivariable-adjusted hazard ratio (95% confidence inter) for syphilis in case management group was 0.34 (0.14–0.87). The percentages of participants who resumed risky sexual behaviors in both groups were significantly reduced (P < 0.05) but did not significantly differ between the 2 groups.

Conclusions
A case management intervention reduced the incidence of syphilis in HIV-positive MSM. We should further increase the content of case management on the basis of providing routine HIV-related care to those people.
The Application of the Divine Proportion for the Construction of the Visualized Treatment Objective in Craniofacial Surgery
Authors: Sambataro Sergio , Cicciù Marco , Nocini Riccardo , Crimi Salvatore , Bianchi Alberto , Ciancio Francesco , Stumpo Chiara , Bocchieri Salvatore , Fiorillo Luca , Caprioglio Alberto 
Published: June 2021

Abstract
Aesthetics and function of maxillofacial district are closely related and could interfere with patient psychological conditions. The aim of this paper is to describe and to analyze the procedures necessary for a proper surgical visualized treatment objective (VTO) realization through the use of the tracing on lateral head film, applying the divine proportion (or golden ratio) in certain steps. The method described is easy to realize, cheap and help both orthodontist and maxillo-facial surgeon to communicate each other and to the patients.
For the following article, digital research and handheld research on surgical VTO planning for patients with skeletal or dentoalveolar severe deformities managed by surgeons and orthodontics were used. The research included articles in English published on dental and maxillofacial surgery journals.
The surgical VTO consists of a “previsualization” of the objectives in order to make the desired changes for the individual patient. The result can thus be visualized and pre-evaluated rather than just imagined by the mind's eye. To simplify the procedure, the surgical VTO has been divided into 11 steps. The accurate model of the surgical result is fundamental in the treatment of dentofacial deformities. These predictions are intended to guide the treatment towards the desired result, to give the patient a reasonable preview of the outcome, and to ensure communication between the orthodontist and the surgeon.
This technique proves to be effective in planning surgical treatment and it allows the clinician to view changes before, during, and after orthognathic surgery. The skeletal, dental, and aesthetic complete cephalometric evaluation is the key point to the long-term success of the results.
Morphometric Analysis of the Glenoid Fossa in the Skull Base
Authors: Karayol Kudret Cem , Karayol Sunay Sibel 
Published: June 2021

Objective:
The aim of this study was to investigate the possible relationship between disc displacement and the presence of reduction by comparing condyle anteroposterior (AP) diameter, condyle height, mandibular fossa AP diameter, and mandibular fossa depth.

Methods:
A total of 588 joints of 294 patients were included in the study for evaluation. Disc displacement and the presence of reduction, condyle AP diameter, condyle height, mandibular fossa AP diameter, and mandibular fossa depth were evaluated.

Results:
Of the 588 temporomandibular joint examined in the study, there was disc displacement in 141 (24%) and no disc displacement in 447 (76%). Of the joints with disc displacement, reduction was observed in 53 (9%) and not in 88 (15%).
A statistically significant correlation was determined between condyle AP diameter and disc displacement (P = 0.00); in the cases with disc displacement, the condyle AP diameter was measured smaller. A statistically significant correlation was determined with condyle height, mandibular fossa AP diameter, and fossa depth. In the patients with disc displacement, the condyle height value was lower and the measured values of the mandibular fossa AP diameter and mandibular fossa depth were higher (P = 0.00). A statistically significant relationship was determined between the presence of reduction and age, condyle AP diameter, condyle height, and articular eminence depth.

Conclusions:
In conclusion, a deep and wide mandibular fossa, and a short and small condyle lay the ground for disc displacement in the temporomandibular joint.
ASSESSMENT OF POTENTIAL SARS-CoV-2 VIRUS N GENE INTEGRATION INTO HUMAN GENOME REVEALS NO SIGNIFICANT IMPACT ON RT-qPCR COVID-19 DIAGNOSTIC TESTING
Authors: Briggs Erica , Ward William , Rey Sol , Law Dylan , Nelson Katharine , Bois Michael , Ostrov Nili , Lee Henry H. , Laurent Jon M. , Mita Paolo 
Published: June 2021

ABSTRACTThe SARS Coronavirus 2 (SARS-CoV-2) pandemic presents new scientific and scale-up challenges for diagnostic capabilities worldwide. The gold standard diagnostic for SARS-CoV-2 infection is a reverse transcription/quantitative PCR (RT-qPCR) which targets the viral genome, an assay that has now been performed on millions of patient specimens worldwide regardless of symptomatic status. Recently Zhang et al. suggested the possibility that the SARS-CoV-2 N gene could integrate into host cell DNA through the action of the LINE-1 retrotransposon, a mobile element that is potentially active in human somatic cells, thereby calling into question the veracity of N-gene based RT-qPCR for detection of SARS-CoV-2 infection. Accordingly, we assessed the potential impact of these purported integration events on nasal swab specimens tested at our clinical laboratory. Using an N-gene based RT-qPCR assay, we tested 768 arbitrarily selected specimens and identified 2 samples which resulted in a positive detection of viral sequence in the absence of reverse transcriptase, a necessary but not sufficient signal consistent with possible integration of the SARS-CoV-2 N gene into the host genome. Regardless of possible viral N gene integration into the genome, in this small subset of samples, all patients were still positive for SARS-CoV-2 infection, as indicated by a much lower Ct value for reactions performed in the presence of reverse transcriptase (RT) versus reactions performed without RT. Moreover, one of the two positives observed in the absence of RT also tested positive when using primers targeting ORF1ab, a gene closer to the 5’ end of the genome. These data are inconsistent with the N gene integration hypothesis suggested by the studies by Zhang et al., and importantly, our results suggest little to no practical impact of possible SARS-CoV-2 genome integration events on RT-qPCR testing.COMPETING INTEREST STATEMENTThe authors of this study are employees of the Pandemic Response Lab (PRL)/ReOpen Diagnostics, a private company performing SARS-CoV-2 RT-qPCR based testing, an area of interest of this study.
Carriage of ESBL-producing Enterobacterales in wastewater treatment plant workers and surrounding residents - The AWARE Study
Authors: Rodríguez-Molina Daloha , Berglund Fanny , Blaak Hetty , Popa Marcela , Flach Carl-Fredrik , Kemper Merel , Marutescu Luminita , Pircalabioru Gratiela , Spießberger Beate , Weinmann Tobias , Wengenroth Laura , Chifiriuc Mariana Carmen , Larsson D. G. Joakim , Radon Katja , Nowak Dennis , Wieser Andreas , de Roda Husman Ana Maria , Schmitt Heike 
Published: June 2021

AbstractPurposeTo investigate whether wastewater treatment plant (WWTP) workers and residents living in close proximity to a WWTP have elevated carriage rates of ESBL-producing Enterobacterales, as compared to the general population.MethodsFrom 2018 to 2020, we carried out a cross-sectional study in Germany, the Netherlands, and Romania among WWTP workers (N=344), nearby residents (living ≤ 300 meters away from WWTPs; N=431) and distant residents (living ≥ 1000 meters away = reference group; N=1165). We collected information on potential confounders via questionnaire. Culture of participants’ stool samples was performed with ChromID®-ESBL agar plates and species identification with MALDI-TOF-MS. We used logistic regression to estimate the odds ratio (OR) for carrying ESBL-producingE. coli(ESBL-EC). Sensitivity analyses included stratification by country and interaction models using country as secondary exposure.ResultsPrevalence of ESBL-EC was 11% (workers), 29% (nearby residents), and 7% (distant residents), and higher in Romania (28%) than in Germany (7%) and the Netherlands (6%). Models stratified by country showed that within the Romanian population, WWTP workers are about twice as likely (aOR = 2.34, 95% CI: 1.22-4.5) and nearby residents about three times as likely (aOR = 3.17, 95% CI: 1.8-5.59) to be ESBL-EC carriers, when compared with distant residents.ConclusionsIn stratified analyses by country, we found an increased risk for carriage of ESBL-EC in Romanian workers and nearby residents. This effect was higher for nearby residents than for workers, which suggests that, for nearby residents, factors other than the local WWTP could contribute to the increased carriage.
Microbiome profiles are associated with cognitive functioning in 45-month-old children
Authors: Streit Fabian , Prandovszky Emese , Send Tabea , Zillich Lea , Frank Josef , Sabunciyan Sarven , Foo Jerome , Sirignano Lea , Lange Bettina , Bardtke Svenja , Hatfield Glen , Witt Stephanie H , Gilles Maria , Rietschel Marcella , Deuschle Michael , Yolken Robert 
Published: June 2021

AbstractPrenatal, perinatal, and postnatal factors have been shown to shape neurobiological functioning and alter the risk for mental disorders later in life. The gut microbiome is established early in life, and interacts with the brain via the brain-immune-gut axis. However, little is known about how the microbiome relates to early-life cognitive functioning in children. The present study, where the fecal microbiome of 380 children was characterized using 16s rDNA and metagenomic sequencing aimed to investigate the association between the microbiota and cognitive functioning of children at the age of 45 months measured with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III).Overall the microbiome profile showed a significant association with cognitive functioning. A strong correlation was found between cognitive functioning and the relative abundance of an unidentified genus of the family Enterobacteriaceae. Follow-up mediation analyses revealed significant mediation effects of the level of this genus on the association of maternal smoking during pregnancy and current cigarette smoking with cognitive function. Metagenomic sequencing of a subset of these samples indicated that the identified genus was most closely related to Enterobacter asburiae. Analysis of metabolic potential showed a nominally significant association of cognitive functioning with the microbial norspermidine biosynthesis pathway.Our results indicate that alteration of the gut microflora is associated with cognitive functioning in childhood. Furthermore, they suggest that the altered microflora might interact with other environmental factors such as maternal cigarette smoking. Interventions directed at altering the microbiome should be explored in terms of improving cognitive functioning in young children.
In vivo kinetics of SARS-CoV-2 infection and its relationship with a person’s infectiousness
Authors: Ke Ruian , Zitzmann Carolin , Ho David D. , Ribeiro Ruy M. , Perelson Alan S. 
Published: June 2021

AbstractThe within-host viral kinetics of SARS-CoV-2 infection and how they relate to a person’s infectiousness are not well understood. This limits our ability to quantify the impact of interventions on viral transmission. Here, we develop data-driven viral dynamic models of SARS-CoV-2 infection and estimate key within-host parameters such as the infected cell half-life and the within-host reproductive number. We then develop a model linking VL to infectiousness, showing that a person’s infectiousness increases sub-linearly with VL. We show that the logarithm of the VL in the upper respiratory tract (URT) is a better surrogate of infectiousness than the VL itself. Using data on VL and the predicted infectiousness, we further incorporated data on antigen and reverse transcription polymerase chain reaction (RT-PCR) tests and compared their usefulness in detecting infection and preventing transmission. We found that RT-PCR tests perform better than antigen tests assuming equal testing frequency; however, more frequent antigen testing may perform equally well with RT-PCR tests at a lower cost, but with many more false-negative tests. Overall, our models provide a quantitative framework for inferring the impact of therapeutics and vaccines that lower VL on the infectiousness of individuals and for evaluating rapid testing strategies.SignificanceQuantifying the kinetics of SARS-CoV-2 infection and individual infectiousness is key to quantitatively understanding SARS-CoV-2 transmission and evaluating intervention strategies. Here we developed data-driven within-host models of SARS-CoV-2 infection and by fitting them to clinical data we estimated key within-host viral dynamic parameters. We also developed a mechanistic model for viral transmission and show that the logarithm of the viral load in the upper respiratory tract serves an appropriate surrogate for a person’s infectiousness. Using data on how viral load changes during infection, we further evaluated the effectiveness of PCR and antigen-based testing strategies for averting transmission and identifying infected individuals.
Age reporting in the Brazilian COVID-19 vaccination database: What can we learn from it?
Authors: Turra Cássio M , Fernandes Fernando , Calazans Julia , Nepomuceno Marília R. 
Published: June 2021

AbstractAge is a key variable for sciences and public planning. The demographic consequences of not measuring age correctly are manifold, including errors in mortality rates and population estimates, particularly at older ages. It also affects public programs because target populations depend on reliable population age distributions. In Brazil, the start of the vaccination campaign against COVID-19 marked the collection of new administrative data. Every citizen must be registered and need to show an identity document to get vaccinated. The requirement of proof-of-age documentation provides a unique opportunity for measuring the elderly population using a different database. This article examines the reliability of age distributions of men and women 80 years and older. We calculate various demographic indicators using data from the vaccination registration system and compare them to those from the target population estimates of the National Vaccination Plan, censuses, and population projections for Brazil and countries with high-quality population data. We show that requiring proof-of-age, such as in the vaccination records, increases data quality, mainly through the reduction of age heaping and age exaggeration. However, I.D. cards cannot fully solve wrong birth dates that result from weak historical registration systems. Thus, one should be careful when using estimates of the old age population living in some of the Brazilian regions, particularly the North, Northeast, and Center-West. Also, our analysis reveals a mismatch between the projected population by age, sex, and region, which guided the vaccination plan, and the number of vaccinated at ages 80 and older. The methodology developed to adjust the mortality rates used in the demographic projections is probably the main factor behind the disparities found.