bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for positive brain CT scan in children with traumatic brain injury and GCS = 15
Authors: Wang Junyou , Hu Yan , Wu Panxing 
Published: January 2021

Abstract
It is controversial whether it is necessary to carry out head computed tomography (CT) examination for children who had a traumatic brain injury (TBI) but are conscious (Glasgow Coma Scale (GCS) = 15). The present study explored the risk/predictive factors of positive CT results in children with mild closed head injury and GCS = 15.
This was a retrospective study of children (0–18 years of age) with TBI and GCS = 15 and treated at the First People's Hospital of Wenling between 06/2013 and 06/2018. The outcome was a positive head plain CT result. Univariable and multivariable logistic regression analyses were carried out to determine the factors independently associated with positive CT results.
A total of 279 children were included. The majority of the injured were boys (180/279, 64.5%). The top three causes of injury were traffic accidents (100/279, 35.8%), falling from height (92/279, 33.0%), and tumble (72/279, 25.8%). The top three clinical symptoms were headache (201/279, 72.0%), scalp hematoma (133/279, 47.7%), and nausea with or without vomiting (105/279, 37.6%). The multivariable analysis showed that scalp hematoma (OR = 3.040, 95%CI: 1.791–5.159, P < .0001), ear and nostril bleeding or periorbital soft tissue contusion (OR = 2.234, 95%CI: 1.087–4.590, P = .029), and nausea with or without vomiting (OR = 2.186, 95%CI: 1.255–3.810, P = .006) were independently associated with positive results of head CT.
For children with TBI and GCS = 15, the factors independently associated with positive CT results are scalp hematoma, ear and nostril bleeding or periorbital soft tissue contusion, and nausea with or without vomiting.
Uncertainty in the Time of Corona
Authors: Jiwani Zishan , Cadwell Olivia G. , Parnes McKenna , Brown Adam D. 
Published: January 2021

Abstract
The recent COVID-19 pandemic is having profound impacts on every sector of society, and New York City (NYC) emerged as an early epicenter of the disease. Given the novelty and scale of the disease, information surrounding COVID-19 has been marked by considerable uncertainty and confusion. Although various factors have been associated with COVID-19 distress, little is known about the relations between levels of intolerance of uncertainty (IU) and anxiety symptoms and behaviors. This cross-sectional study sought to examine potential correlates and pathways between anxiety and precautionary behaviors with the two levels of IU: prospective and inhibitory. Individuals from NYC (N = 99) completed an online survey through Amazon Mechanical Turk. Findings revealed that fear of COVID-19 accounts for associations between prospective IU and greater anxiety symptoms and behaviors, whereas precaution adherence accounts for associations between prospective IU and reduced anxiety symptoms and behaviors. In addition, precaution adherence accounts for associations between inhibitory IU and greater anxiety symptoms and behaviors. The results shed light on ways in which variations in IU may be associated with anxiety symptoms and behaviors in the context of COVID-19 and future pandemic scenarios.
Impacts of Changing Sexual Behavior on Chlamydia and Gonorrhea Burden Among US High School Students, 2007 to 2017
Authors: Goodreau Steven M. , Pollock Emily D. , Wang Li Yan , Aslam Maria V. , Barrios Lisa C. , Dunville Richard L. , Rosenthal Elizabeth M. , Hamilton Deven T. , Katz David A. , Rosenberg Eli S. 
Published: January 2021

Background
Rates of adolescent sexual activity have long been declining in the United States. We sought to estimate the number of cases of gonorrhea and chlamydia averted over 1 decade associated with these declines and associated costs saved.

Methods
We analyzed data from the Centers for Disease Control and Prevention's Youth Risk Behavior Survey of US high school students from 2007 to 2017 and combined it with epidemiological estimates drawn from the literature to parameterize a dynamic population transmission model. We compared transmissions from observed behavioral trends with a counterfactual scenario that assumed sexual behaviors from 2007 remained constant for 10 years. We calculated outcomes by age and for 3 racial/ethnic groups (Hispanic, non-Hispanic Black, and non-Hispanic White adolescents) who vary on underlying burden and amount of behavioral change.

Results
We estimated 1,118,483 cases of chlamydia and 214,762 cases of gonorrhea were averted (19.5% of burden across all ages). This yielded $474 million (2017 dollars) savings in medical costs over the decade. The largest number of averted cases (767,543) was among Black adolescents, but the largest proportion (28.7%) was among Hispanic adolescents.

Conclusions
Whatever its origins, changing sexual behavior among adolescents results in large estimated reductions in STI burden and medical costs relative to previous cohorts. Although diagnoses among adolescents have not declined at this rate, multiple explanations could make these apparently divergent trends consistent. Efforts to continue supporting effective sex education in and out of school along with STI screening for adolescents should reinforce these gains.
Syphilitic Spinal Disease: An Old Nemesis Revisited. A Case Series and Review of Literature
Authors: Koh Pei Xuan , Neo Shermyn Xiumin , Chiew Hui Jin , Singh Dinesh Rambachan , Saini Monica , Chen Zhiyong 
Published: January 2021

Abstract
Syphilitic spinal disease is a rare condition caused by the spirochete Treponema pallidum, either from direct spirochete involvement of the cord or as a consequence of indirect spirochete involvement of the meninges, blood vessels, or the vertebral column. After the introduction of penicillin therapy in the 1940s, it has become an increasingly rare condition. We report 3 challenging cases of syphilitic spinal disease presenting as myelopathy—1 with an extra-axial gumma of tertiary syphilis causing cord compression and 2 with tabes dorsalis complicated by tabetic spinal neuroarthropathy—each presenting a diagnostic dilemma to their treating physicians. We also review the literature for updates on modern investigative modalities and discuss pitfalls physicians need to avoid to arrive at the diagnosis.
Rapid Absolute Neutrophil Count Testing Guides Targeted Antimicrobial Therapy in Febrile Pediatric Oncology Patients
Authors: Gerber Nicole , Vella Adam , Racine-Brzostek Sabrina , Platt Shari L. 
Published: January 2021

Objectives
It is well established that early antibiotic administration leads to improved outcomes in febrile neutropenic patients. To achieve this, many institutions administer empiric antibiotics to all febrile oncology patients in the emergency setting, before knowing their neutropenic status. This study evaluates the role of rapid absolute neutrophil count (ANC) testing in the targeted antimicrobial management of nonneutropenic febrile oncology patients.

Methods
We conducted a retrospective review of patients 19 years or younger presenting to the pediatric emergency service with an oncologic process and fever or history of fever. We examined the administration of antibiotics and outcomes in nonneutropenic patients.

Results
We included 101 patient encounters, representing 62 distinct patients. The rapid ANC test influenced antibiotic management in 94% (95/101) of patient encounters and resulted in no antibiotics or targeted antibiotic therapy in 88% (60/68) of nonneutropenic patients. Use of the rapid ANC test to guide treatment would have spared antibiotic administration in 68% (46/68) of well-appearing nonneutropenic patients with no alternate indication. No well-appearing, nonneutropenic patient had a positive blood culture, and only 1 required hospital admission on a repeat visit.

Conclusions
The rapid ANC is a useful tool to balance the goal of early antibiotic administration in febrile neutropenic oncology patients while promoting antibiotic stewardship in this vulnerable population.
Positron Emission Tomography Imaging of Programmed Death 1 Expression in Cancer Patients Using 124I-Labeled Toripalimab
Authors: Wang Shujing , Zhu Hua , Ding Jin , Wang Feng , Meng Xiangxi , Ding Lixin , Zhang Yan , Li Nan , Yao Sheng , Sheng Xinan , Yang Zhi 
Published: January 2021

Purpose
Although anti–programmed cell death molecule-1 (PD-1)/PD-1 ligand therapy has achieved remarkable success in oncology field, the low response rate and lack of accurate prognostic biomarker identifying benefiting patients remain unresolved challenges. This study developed a PD-1 targeting radiotracer 124I-labeled toripalimab (124I-JS001) for clinical PET imaging and evaluated its biodistribution, safety, and dosimetry in human.

Methods
Patients with melanoma or urologic cancer confirmed by pathology were enrolled. 124I-JS001 PET/CT and PET/MR were performed with or without coinjection of 5 mg unlabeled JS001, and 18F-FDG PET was undertaken within 1 week.

Results
Eight melanoma and 3 urologic cancer patients were enrolled. No adverse events were noticed during the whole examination after the injection of 124I-JS001 and an acceptable dosimetry of 0.236 mSv/MBq was found. 124I-JS001 PET/CT showed high uptake in spleen and liver and slight uptake in bone marrow and lung. All primary and metastatic tumor lesions in 11 patients demonstrated different levels of uptake of 124I-JS001 with SUVmax ranging from 0.2 to 4.7. With coinjection of unlabeled JS001, the uptake in spleen was reduced significantly (P < 0.05), whereas tumor uptake and tumor background ratio increased significantly (P < 0.05). Four patients undertook regional 124I-JS001 PET/MR. All tumor lesions were detected effectively with abnormal MR signal on PET/MR, whereas PET/MR detected liver lesions more sensitively than PET/CT.

Conclusions
The first-in-human study demonstrated 124I-JS001 was a safe tracer for PET with acceptable dosimetry, and the PET/CT results showed a favorable biodistribution. PET/MR could detect liver lesions more sensitively than PET/CT.
Advancing the Specialty of Plastic Surgery While Helping and Supporting Other Surgical Services at an Academic Medical Center
Authors: Pu Lee L.Q. , Song Ping 
Published: January 2021

Abstract
While helping and supporting other surgical services at our academic medical center, we noticed that many clinical problems presented to our plastic surgery team are truly unique and challenging. Many of the necessary reconstructive procedures, performed by the senior author, had never been published in plastic surgery textbooks or the literature before. Because of the plastic surgeon's creative problem-solving ability, we use reconstructive treatment plans that also innovate and advance the field of plastic surgery. In this case series, we share our experience with creative solutions for the management of novel and challenging clinical problems faced by our plastic surgery service. The resultant and effective solutions for each challenging case have all been published in reputable plastic surgery journals by the senior author. Once published, our inventive reconstructive solutions can be harnessed by other plastic surgeons and trainees and new standardized techniques or solutions for these unique and challenging clinical problems can be established. Ultimately, plastic surgeons can evolve their specialty through helping and supporting other surgical services at an academic medical center by establishing innovative solutions for ever arising challenging clinical problems. Once again, the plastic surgery team in a tertiary hospital supports many surgical services so that more complex surgical procedures can be performed safely and complications from other surgical services can be managed successfully. Therefore, adequate support for a plastic surgery service, by the hospital or department, is critical in developing a strong plastic surgery program at an academic medical center.
Repair of Small-Size Wound With Achilles Tendon Exposure With Proximal Pedicled Cutaneous Neurovascular Flap
Authors: Yang Yun-fa , Gao Xiao-sheng , Liu Zai-li , Huang Jian-wen , Wang Jian-wei , Xu Zhong-he 
Published: January 2021

Objective
To investigate the clinical outcomes associated with repairing of small-sized wounds of Achilles tendon exposure with proximal pedicled cutaneous neurovascular flap in the dorsolateral foot.

Methods
After thorough debridement, 16 cases with small-sized wounds of Achilles tendon exposure were repaired by proximal pedicled cutaneous neurovascular flap of the dorsolateral foot, and their clinical outcomes were observed.

Results
All the flaps in the 16 cases survived completely, excluding the marginal part necrosis in 1 case, and all the wounds were healed. The 2-point discrimination of the flaps was 14.53 ± 1.55 mm (range, 12–17 mm) in patients without sural nerve injury after 3 to 18 months follow-up. No discomfort was felt in wearing normal shoes by all the 16 patients.

Conclusions
It is reasonable to repair the small-sized wounds of Achilles tendon exposure with proximal pedicled cutaneous neurovascular flap of dorsolateral foot due to its effective repair of the wound, relatively uncomplicated surgery, and had satisfactory healing recovery.
Implementation of Distance-Based Simulation Training Programs for Healthcare Professionals
Authors: Vera Magdalena , Kattan Eduardo , Cerda Tomas , Niklitshek Jessie , Montaña Rodrigo , Varas Julian , Corvetto Marcia A. 
Published: January 2021

Summary Statement
The sudden rise of critically ill patients secondary to the SARS-CoV-2 pandemic has triggered a surge in healthcare response. This project's goal was to provide essential cognitive and technical skills to healthcare professionals returning to the workforce or reassigned to critical care clinical duties during the COVID-19 pandemic. The plan included the implementation of 4 distance-based simulation training programs, with asynchronous personalized feedback. The courses allowed the acquisition of skills for the complete critical care patient management chain: use of personal protection equipment, use of a high-flow nasal cannula, endotracheal intubation, and prone positioning. Participants logged into the platform, reviewed material, practiced while recording the session, and uploaded the video through the training platform. The expert tutor remotely delivered asynchronous feedback. Participants trained remotely until achieving course approval. Remote-based simulation seems a feasible and attractive alternative to provide adequate educational solutions, especially for remote and rural areas.
Predicting Cognitive Impairment in Cerebrovascular Disease Using Spoken Discourse Production
Authors: Roberts Angela , Aveni Katharine , Basque Shalane , Orange Joseph B. , McLaughlin Paula , Ramirez Joel , Troyer Angela K. , Gutierrez Stephanie , Chen Angie , Bartha Robert , Binns Malcolm A. , Black Sandra E. , Casaubon Leanne K. , Dowlatshahi Dar , Hassan Ayman , Kwan Donna , Levine Brian , Mandzia Jennifer , Sahlas Demetrios J. , Scott Christopher J. M. , Strother Stephen , Sunderland Kelly M. , Symons Sean , Swartz Richard 
Published: January 2021

Purpose:
Dementia due to cerebrovascular disease (CVD) is common. Detecting early cognitive decline in CVD is critical because addressing risk factors may slow or prevent dementia. This study used a multidomain discourse analysis approach to determine the spoken language signature of CVD-related cognitive impairment.

Method:
Spoken language and neuropsychological assessment data were collected prospectively from 157 participants with CVD as part of the Ontario Neurodegenerative Disease Research Initiative, a longitudinal, observational study of neurodegenerative disease. Participants were categorized as impaired (n = 92) or cognitively normal for age (n = 65) based on neuropsychology criteria. Spoken language samples were transcribed orthographically and annotated for 13 discourse features, across five domains. Discriminant function analyses were used to determine a minimum set of discourse variables, and their estimated weights, for maximizing diagnostic group separation.

Results:
The optimal discriminant function that included 10 of 13 discourse measures correctly classified 78.3% of original cases (69.4% cross-validated cases) with a sensitivity of 77.2% and specificity of 80.0%.

Conclusion:
Spoken discourse appears to be a sensitive measure for detecting cognitive impairment in CVD with measures of productivity, information content, and information efficiency heavily weighted in the final algorithm.
Association between COVID-19 mortality and population level health and socioeconomic indicators
Authors: Kandula Sasikiran , Shaman Jeffrey 
Published: January 2021

AbstractWith the availability of multiple COVID-19 vaccines and the predicted shortages in supply for the near future, it is necessary to allocate vaccines in a manner that minimizes severe outcomes. To date, vaccination strategies in the US have focused on individual characteristics such as age and occupation. In this study, we assess the utility of population-level health and socioeconomic indicators as additional criteria for geographical allocation of vaccines. Using spatial autoregressive models, we demonstrate that 43% of the variability in COVID-19 mortality in US counties can be explained by health/socioeconomic factors, adjusting for case rates. Of the indicators considered, prevalence of chronic kidney disease and proportion of population living in nursing homes were found to have the strongest association. In the context of vaccine rollout globally, our findings indicate that national and subnational estimates of burden of disease could be useful for minimizing COVID-19 mortality.
SNAI2-mediated direct repression ofBIMprotects rhabdomyosarcoma from ionizing radiation
Authors: Wang Long , Hensch Nicole R. , Bondra Kathryn , Sreenivas Prethish , Zhao Xiang Ru , Chen Jiangfei , Baxi Kunal , Campos Rodrigo Moreno , Gryder Berkley , Pomella Silvia , Rota Rossella , Chen Eleanor Y. , Khan Javed , Houghton Peter J. , Ignatius Myron S. 
Published: January 2021

AbstractIonizing radiation (IR) and chemotherapy are the mainstays of treatment for patients with rhabdomyosarcoma (RMS). Yet, the molecular mechanisms that underlie the success or failure of radiotherapy remain unclear. The transcriptional repressor SNAI2 was previously identified as a key regulator of IR sensitivity in normal and malignant stem cells through its repression of the proapoptotic BH3-only genePUMA.Here, we demonstrate a clear correlation between SNAI2 expression levels and radiosensitivity across multiple RMS cell lines. Moreover, modulatingSNAI2levels in RMS cells through its overexpression or knockdown can alter radiosensitivityin vitroandin vivo.SNAI2 expression reliably promotes overall cell growth and inhibits mitochondrial apoptosis following exposure to IR, with either variable or minimal effects on differentiation and senescence, respectively. Importantly,SNAI2knockdown results in a striking increase in expression of the proapoptotic BH3-only geneBIM,and ChIP-seq experiments establish that SNAI2 is a direct repressor ofBIM.Since the P53 pathway is nonfunctional in the RMS cells used in this study, we have identified a new, P53-independent SNAI2/BIM axis that could potentially predict clinical responses to IR treatment and be exploited to improve RMS therapy.HighlightsSNAI2 expression levels are directly correlated with protection from radiation in rhabdomyosarcoma.Loss of SNAI2 primes rhabdomyosarcomas for IR-induced apoptosis.SNAI2 directly represses the expression of the proapoptotic BH3-only geneBIM.
Stringency of the containment measures in response to COVID-19 inversely correlates with the overall disease occurrence over the epidemic wave
Authors: Mezencev R. , Klement C. 
Published: January 2021

AbstractNon-pharmaceutical interventions (NPIs) were the only viable choice to mitigate or suppress transmission of COVID-19 in the absence of efficient and safe vaccines. Moreover, the importance of some NPIs is likely to remain in the future, at least in specific settings, in which the limited vaccination coverage and the high rate of contacts would enable further disease transmission. Nonetheless, the benefits of NPIs have been questioned with respect to their effectiveness and societal costs. In this study of 28 European countries during the first wave of epidemic we demonstrate a significant inverse correlation between the stringency of adopted containment measures and cumulative incidences of the confirmed COVID-19 cases. Our results indicate that early implementation of the stringent containment measures prior to detection of the first confirmed case, and rapid ramp-up of containment stringency after the first case was diagnosed, were instrumental for lowering the number of COVID-19 cases during the epidemic wave. The impact of delayed adoption of containment measures could not be fully attenuated by later adoption of even more stringent community containment.
Lumipulse G SARS-CoV-2 Ag Assay Evaluation for SARS-CoV-2 Antigen Detection Using 594 Nasopharyngeal Swab Samples from Different Testing Groups
Authors: Menchinelli Giulia , Bordi Licia , Liotti Flora Marzia , Palucci Ivana , Capobianchi Maria Rosaria , Sberna Giuseppe , Lalle Eleonora , Romano Lucio , Angelis Giulia De , Marchetti Simona , Sanguinetti Maurizio , Cattani Paola , Posteraro Brunella 
Published: January 2021

ABSTRACTCompared to RT-PCR, lower performance of antigen detection assays, including the Lumipulse G SARS-CoV-2 Ag assay, may depend on specific testing scenarios. We tested 594 nasopharyngeal swab samples from individuals with COVID-19 (RT-PCR cycle threshold [Ct] values ≤40) or non-COVID-19 (Ct values ≤40) diagnoses. RT-PCR positive samples were assigned to diagnostic, screening, or monitoring groups of testing. With a limit of detection of 1.2 × 104 SARS-CoV-2 RNA copies/ml, Lumipulse showed positive percent agreement (PPA) of 79.9% (155/194) and negative percent agreement of 99.3% (397/400), whereas PPAs were 100% for samples with Ct values of <18 or 18–<25 and 92.5% for samples with Ct values of 25–<30. By three groups, Lumipulse showed PPA of 87.0% (60/69), 81.1% (43/53), or 72.2% (52/72), respectively, whereas PPA was 100% for samples with Ct values of <18 or 18–<25, and was 94.4%, 80.0%, or 100% for samples with Ct values of 25–<30, respectively. RT-PCR positive samples were also tested for SARS-CoV-2 subgenomic RNA and, by three groups, testing showed that PPA was 63.8% (44/69), 62.3% (33/53), or 33.3% (24/72), respectively. PPAs dropped to 55.6%, 20.0%, or 41.7% for samples with Ct values of 25–<30, respectively. All 101 samples with a subgenomic RNA positive result had a Lumipulse assay’s antigen positive result, whereas only 54 (58.1%) of remaining 93 samples had a Lumipulse assay’s antigen positive result. In conclusion, Lumipulse assay was highly sensitive in samples with low RT-PCR Ct values, implying repeated testing to reduce consequences of false-negative results.