bluuebunny/crossref_metadata_2025_split huggingface dataset:
Airway Obstruction from a Tracheal Mass in a 5-Year-Old
Authors: Eitel Kelsey , Mitchell Ryan M. , Lefort Roxanna 
Published: May 2021

Abstract
Stridor is a common presenting symptom for children in emergency departments (EDs) and usually represents an infectious process, such as croup, or aspiration of a foreign body. We present the case of an otherwise healthy 5-year-old girl with episodic increased work of breathing for several months that was initially diagnosed as asthma by her primary care physician. She subsequently presented to the ED with acutely worsening noisy breathing and dyspnea. Patient and parent denied any recent foreign body ingestions or choking episodes. We gave multiple doses of racemic epinephrine in the ED without symptom improvement. A lateral neck x-ray showed an occlusive subglottic airway mass. Otolaryngology (ENT) evaluation demonstrated an 85% airway occlusion. The mass was partially resected, resolving all of her respiratory symptoms. Although primary airway tumors in children are rare, they must be considered on the differential diagnosis of new noisy breathing or respiratory distress. Failure to diagnose these tumors in a timely manner can be life-threatening.
The 10-Year Experience with Volume Distribution Mastopexy: A Novel, Safe, and Efficient Method for Breast Rejuvenation
Authors: Hamdi Moustapha , Chahine Fadl , Alharami Sara , De Baerdemaeker Randy , Hendrickx Benoit , Zeltzer Assaf 
Published: May 2021

Background:
Recurrent ptosis may occur after mastopexy procedures over time. The volume distribution mastopexy technique provides breast lifting with projection enhancement and maintains breast suspension.

Method:
Since 2010, 50 patients underwent volume distribution mastopexy procedures. The technique consists of a superior or superomedial pedicle, dissection of a Würinger-septum–based chest wall flap, suspension of the flap to the pectoralis major muscle using a prosthetic mesh, gland suture to the mesh, and fat grafting if required. A prospective study was conducted. Nipple position and length of the lower pole distance of the breast were noted. Patient satisfaction and results evaluation were reported using a Likert scale.

Results:
A Vicryl mesh was used in the first 23 patients and a mixed polyester/Vicryl mesh was used in the following 27 patients. Wound dehiscence occurred in one patient. At an average follow-up of 3 years, nipple position remained stable in position, but lower pole distance elongation was observed in five patients (20 percent) and in one patient (3 percent) who had Vicryl mesh and mixed mesh respectively (p < 0.05). Only four breasts (4.7 percent) demonstrated significant lower pole elongation over time (>15 percent), all in the Vicryl mesh group. Worth noting, both the patients and the independent evaluators provided high ratings of the result of 4.7 and 4.6, respectively, on a Likert scale.

Conclusions:
The volume distribution mastopexy technique repositions the ptotic gland with a mesh to suspend the breast gland and to maintain the lifting effect. However, the synthetic mixed mesh proved to be significantly more effective in achieving this goal.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Practice Diversity and Burn Center Growth
Authors: Lineaweaver William C. , Mullins R. Fred 
Published: May 2021

Background
Growth and sustainability of burn practices can be impaired by irregular patterns of patient presentations, resulting in uneven utilization of facilities and staff. Burn care itself may not engage the full capacities of members of burn care teams. To address these problems, we organized a burn and reconstruction center to provide statewide acute care as Mississippi's only burn unit, to fully integrate reconstructive surgery into management of burn patients, and to diversify practice based on plastic surgery scope of practice. The first 10 years of this unit were reviewed to evaluate the performance of this scheme.

Methods
Burn admissions to and surgical procedures at this unit between July 2009 and June 2019 were analyzed to quantify acute burn care, secondary reconstructive burn care, and categories of practice growth.

Results
The unit admitted 5469 acute burn patients with a mortality rate of 1.49%. Comparing year 10 to year 1 of practice, acute burn admissions increased 58%. Total operations increased 276%. Acute burn procedures increased 176%. Secondary burn procedures increased 405%. Nonburn procedures increased 352%, with the subset of nonburn hand surgery increasing 1062%.

Conclusion
Acute burn admissions and procedures increased over this period, but greater growth was seen in secondary burn procedures and nonburn procedures, especially hand cases. Expansion of practice into areas within the overall skill sets of burn team members was an effective growth strategy.
Involuntary “Voluntary” Nystagmus
Authors: Rosenberg Michael L. 
Published: May 2021

Background:
Voluntary nystagmus is a common phenomenon in the general population and is believed to be under voluntary control. Some patients have an eye movement disorder indistinguishable from voluntary nystagmus and yet have no control over these movements.

Methods:
Four patients with involuntary eye movements consisting of spontaneous or induced bursts of saccadic eye movements with no intersaccadic interval are described. All eye movements were typical of “voluntary nystagmus,” yet they denied any control over the movements. In none of the patients was there any evidence of psychopathology or secondary gain.

Results:
Two types of patients with involuntary eye movements that were indistinguishable from voluntary nystagmus are presented. One group of 2 patients had clear neurological disease, whereas another 2 had no evidence of any neurological pathology.

Conclusions:
The patterns seen in these patients suggest that there is a spectrum of oculomotor saccadic instabilities that includes voluntary nystagmus on one extreme and ocular flutter on the other. In between these 2 are both normal and abnormal patients with eye movements indistinguishable from ocular flutter/voluntary nystagmus that may or may not be induced by convergence. It is suggested that involuntary “voluntary nystagmus” is a real condition and that psychopathology should be ruled in rather than simply assumed.
Mild Bilateral Internuclear Ophthalmoplegia: The Diagnostic Role of the Vertical Posterior Canal Vestibulo-Ocular Reflex in Acute Brainstem Demyelination, a Clinical–Radiologic Correlation
Authors: Manrique Luis G. , Zhang Xiajoun , Kathryn Laurel , Marie Catherine , Kattah Jorge C. 
Published: May 2021

Background:
The ocular signs of internuclear ophthalmoplegia (INO) with slow, restricted adduction of one eye and abduction nystagmus of the contralateral eye are easily recognized and have a high localizing/lateralizing value. However, subtle INO is difficult to diagnose. Recent reports identified novel vestibular abnormalities in unilateral and bilateral INO. Frequent findings include decreased horizontal and posterior canal gains, and generally relative sparing of both anterior canals. We studied one patient with a subtle bilateral INO, performed serial quantitative saccade (QS) and video head impulse test (vHIT), and correlated clinical–radiological findings caused by acute demyelination.

Methods:
Single case study of a 30-year-old man presented with 1 week of painless, binocular, horizontal diplopia in left gaze. We performed 3 serial neurological examination, QS, vHIT, and clinical–MRI correlation (1 pretreatment and 2 post steroid treatment).

Results:
We found bilateral slow adducting, clinically positive posterior canal HITs, and borderline abducting saccade velocity, without abducting nystagmus. The videonystagmography with fixation block showed bilateral horizontal gaze evoked nystagmus, and vHIT testing confirmed decreased right horizontal and bilateral posterior canal gains. The abnormalities resolved after steroid treatment. MRI showed acute bilateral medial longitudinal fascicle demyelinating lesions.

Conclusions:
A bilaterally positive, posterior, canal HIT and slow adduction saccades are localizing findings in bilateral INO, even in the absence of abduction nystagmus. Quantitative confirmation of these findings suggest most frequently an ischemic or demyelinating disorder and are a compelling indication for MRI. This case shows value to testing multiaxial head impulses and performing QS and vHIT in brainstem lesions.
Vitreoretinal Findings in Nonarteritic Ischemic Optic Neuropathy
Authors: Molaie Amir M. , Pramil Varsha , Hedges Thomas R. , Tomb Landon C. , Vuong Laurel N. 
Published: May 2021

Background:
Although nonarteritic anterior ischemic optic neuropathy (NAION) is considered a disorder that primarily affects the optic nerve head, optical coherence tomography (OCT) shows peripapillary and foveal subretinal fluid associated with optic disc swelling from NAION. We sought to further evaluate retinal and vitreous changes in patients with NAION.

Methods:
Patients diagnosed with NAION at the New England Eye Center between 2013 and 2017 were evaluated using OCT. The presence and distribution of subretinal fluid was analyzed. Evidence of other vitreoretinal changes, including vitreopapillary traction (VPT) and the presence of hyperreflective dots (HRD), were also determined.

Results:
Twenty-five eyes from 20 patients who presented within 4 weeks of symptom onset were assessed. Peripapillary subretinal fluid was seen in 16 eyes (64%). Of those eyes, the subretinal fluid extended into the macula in 4 eyes (16%). Visual acuity improved in 2 of 4 eyes after subfoveal fluid resolution. Intraretinal cysts located in the peripapillary region were seen in 8 eyes (32%), HRD were noted in 11 (44.0%). There was no evidence of VPT.

Conclusions:
A substantial number of patients with NAION have subretinal fluid on OCT, consistent with prior reports. Resolution of subfoveal fluid may result in some recovery of visual acuity. Other retinal changes, such as intraretinal cysts and HRD, are present but have unclear implications. We did not find evidence of a primary role of VPT in the pathophysiology of NAION.
Binocular Visual Field and Vision-Related Quality of Life in Patients With Hemianopia
Authors: Burgos-Blasco Barbara , Perez-Garcia Pilar , Fernandez-Vigo Jose I. , Benito-Pascual Blanca , Hernandez-Garcia Elena , Saenz-Frances Federico , Santos-Bueso Enrique 
Published: May 2021

Background:
Hemianopias can have a severe impact on functional ability and quality of life (QoL). Binocular visual field (VF) analysis is clinically more relevant to visual function than monocular VF. The aim is to analyze the binocular VF of patients with hemianopias and its association with the monocular VF and to assess the QoL of these patients through questionnaires specifically related to vision compared with healthy controls.

Methods:
The case–control study included patients with hemianopias and controls. Sex, age, general history, etiology, location of the lesion, and time since the lesion appeared were recorded. Monocular VF and Esterman binocular VF were performed. VF defect, mean defect (MD), and Esterman scores were recorded. Visual Activities Questionnaire (VAQ-33) and Visual Function Questionnaire (VFQ-25) questionnaires were administered.

Results:
Twenty patients with hemianopia and 22 healthy controls were included. The Esterman score in homonymous hemianopia patients (n = 17) correlated with best eye MD (r = −0.62, P = 0.01), worst eye MD (r = −0.70, P = 0.002), and average MD (r = −0.68, P = 0.003). Compared with healthy control subjects, patients with homonymous hemianopia had significantly lower VFQ-25 score and in 10/12 subscales (all P < 0.001). VAQ-33 scores revealed lower overall and subscales scores with the exception of light/dark adaptation (P = 0.08). Correlations were found between monocular and binocular VF scores and general vision (r = −0.55), peripheral vision (on both questionnaires, r-range −0.75 to 0.47), VFQ-25 and VAQ-33 overall scores (r = −0.59, −0.49 and 0.50), and glare disability (r = 0.53 and 0.67).

Conclusions:
Hemianopic VF defects involve a major alteration in the patients' vision-related QoL.
Who complies with coronavirus disease 2019 precautions and who does not?
Authors: Urbán Róbert , Király Orsolya , Demetrovics Zsolt 
Published: May 2021

Purpose of review
Severe acute respiratory syndrome (SARS)–coronavirus disease 2019 (COVID-19) virus imposes a higher risk of complications and mortality among people with mental disorders. Until widely available vaccines, adherence to preventive behaviours remains the most crucial tool to prevent SARS/COVID-19 virus transmission. Our review focuses on the determinants of adherence behaviours.

Recent findings
Adherence behaviours include the use of a face mask and protective gloves, personal hygienic behaviours (handwashing or using hand sanitiser), and keeping physical distance and avoiding social gatherings. In almost all studies, males and younger people show less adherence. Risk perception and health beliefs (especially perceived severity of COVID-19 related conditions) can explain the sex and age differences in adherence. Studies covering the impact of mental disorders on adherence are surprisingly missing, with the exception of smoking.

Summary
Engaging men and young people in adopting preventive behaviours is crucial in protecting the whole community and specific vulnerable populations. There is a lack of studies investigating preventive behaviours among people living with mental disorders and addiction problems. Furthermore, descriptive and intervention studies are needed to understand and improve the adherence of this population to preventive behaviours.
Transferability and interpretability of the sepsis prediction models in the intensive care unit
Authors: Chen Qiyu , Li Ranran , Lin ChihChe , Lai Chiming , Chen Dechang , Qu Hongping , Huang Yaling , Lu Wenlian , Tang Yaoqing , Li Lei 
Published: May 2021

AbstractObjectiveWe aimed to develop an early warning system for real-time sepsis prediction in the ICU by equipping with interpretation analysis and transfer learning tools to improve the feasibility to deploy the sepsis prediction system, particularly to target cohorts.DesignRetrospective and observational study.SettingMedical Information Mart for Intensive Care (MIMIC) dataset, the private Historical Database of local Ruijin Hospital (HDRJH), and data collected from Ruijin real-world study.Patients6891 patients from MIMIC dataset and 453 patients from HDRJH for model development and 67 cases from Ruijin real-world data for model evaluation.InterventionsNone.Measurements and Main ResultsLight Gradient Boosting Machine (LightGBM) and multilayer perceptron (MLP) were trained on MIMIC dataset and then finetuned on HDRJH using transfer learning technique. Ultimately, the performance of the sepsis prediction system was further evaluated in the real-world study in the ICU of the target Ruijin Hospital. The area under the receiver operating characteristic curves (AUCs) for LightGBM and MLP models derived from MIMIC were 0.98–0.98 and 0.95–0.96 respectively on MIMIC dataset, and, in comparison, 0.82–0.86 and 0.84–0.87 respectively on HDRJH, from 1–5h preceding. After transfer learning and ensemble learning, the AUCs of the final ensemble model were enhanced to 0.94–0.94 on HDRJH and to 0.86–0.9 in the real-world study in the ICU of the target Ruijin Hospital. In addition, the Shapley additive explanation (SHAP) analysis illustrated the importance of age, antibiotics, net balance, and ventilation for sepsis prediction, making the model interpretable.ConclusionsOur machine learning model allows accurate real-time prediction of sepsis within 5-h preceding. Transfer learning can effectively improve the feasibility to deploy the prediction model in the target cohort, effectively ameliorating the model performance for external validation. SHAP analysis may illuminate the importance of optimizing antibiotic use and restricting fluid management.Trial registrationNCT05088850 (retrospectively registered).Key PointsQuestionWe aimed to develop an early warning system for real-time sepsis prediction in the ICU and to improve the feasibility to deploy the system to target cohorts.FindingsTransfer learning technique effectively enhanced the AUCs for LightGBM and MLP models on the target cohort, HDRJH, from 0.82–0.86 and 0.84–0.87 to 0.93-0.94 and 0.92-0.93 for 1-5 hour preceding. Additionally, SHAP analysis illuminated the importance of optimizing antibiotic use and restricting fluid management.MeaningTransfer learning can improve the feasibility to deploy the prediction model to the target cohort, and SHAP analysis made the prediction model interpretable.
Drug Repositioning by Merging Active Subnetworks Validated in Cancer and COVID-19
Authors: Lucchetta M. , Pellegrini M. 
Published: May 2021

AbstractComputational Drug Repositioning aims at ranking and selecting existing drugs for use in novel diseases or existing diseases for which these drugs were not originally designed. Using vast amounts of available omic data in digital form within anin silicoscreening has the potential for speeding up considerably the shortlisting of promising candidates in response to outbreaks of diseases such as COVID-19 for which no satisfactory cure has yet been found. We describe DrugMerge as a methodology for preclinical computational drug repositioning based on merging multiple drug rankings obtained with an ensemble of Disease Active Subnetwork construction algorithms. DrugMerge uses differential transcriptomic data from cell lines/tissues of patients affected by the disease and differential transcriptomic data from drug perturbation assays, in the context of a large gene co-expression network. Experiments with four benchmark diseases (Asthma, Rheumatoid Arthritis, Prostate Cancer, and Colorectal Cancer) demonstrate that our method detects in first position drugs in clinical use for the specified disease, in all four cases. Our method is competitive with the state-of-the-art tools such as CMAP (Connectivity Map). Application of DrugMerge to COVID-19 data found rankings with many drugs currently in clinical trials for COVID-19 in top positions, thus showing that DrugMerge is able to mimic human expert judgment.
Distinct Mucoinflammatory Phenotype and the Immunomodulatory Long Noncoding Transcripts Associated with SARS-CoV-2 Airway Infection
Authors: Devadoss Dinesh , Acharya Arpan , Manevski Marko , Pandey Kabita , Borchert Glen M. , Nair Madhavan , Mirsaeidi Mehdi , Byrareddy Siddappa N. , Chand Hitendra S. 
Published: May 2021

ABSTRACTRespiratory epithelial cells are the primary target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We investigated the 3D human airway tissue model to evaluate innate epithelial cell responses to SARS-CoV-2 infection. A SARS-CoV-2 clinical isolate productively infected the 3D-airway model with a time-dependent increase in viral load (VL) and concurrent upregulation of airway immunomodulatory factors (IL-6, ICAM-1, andSCGB1A1) and respiratory mucins (MUC5AC, MUC5B, MUC2, andMUC4), and differential modulation of select long noncoding RNAs (lncRNAs i.e.,LASI, TOSL, NEAT1, andMALAT1). Next, we examined these immunomodulators in the COVID-19 patient nasopharyngeal swab samples collected from subjects with high- or low-VLs (∼100-fold difference). As compared to low-VL, high-VL patients had prominent mucoinflammatory signature with elevated expression ofIL-6, ICAM-1, SCGB1A1, SPDEF, MUC5AC, MUC5B, andMUC4. Interestingly,LASI, TOSL, andNEAT1lncRNA expressions were also markedly elevated in high-VL patients with no change inMALAT1expression. In addition, dual-staining ofLASIand SARS-CoV-2 nucleocapsidN1RNA showed predominantly nuclear/perinuclear localization at 24 hpi in 3D-airway model as well as in high-VL COVID-19 patient nasopharyngeal cells, which exhibited high MUC5AC immunopositivity. Collectively, these findings suggest SARS-CoV-2 induced lncRNAs may play a role in acute mucoinflammatory response observed in symptomatic COVID-19 patients.
A Time Series Analysis and Predictive Modeling of COVID-19 Impacts in the African American Community
Authors: Oladunni Timothy , Tossou Sourou , Denis Max , Ososanya Esther , Adesina Joseph 
Published: May 2021

ABSTRACTBackgroundSometimes in 2019, there was an outbreak of coronavirus pandemic. Data shows that the virus has infected millions of people and claimed thousands of lives. Vaccination and other non-pharmacological interventions have brought a relief; however, COVID-19 left some indelible marks. This work focuses on a time series analysis and prediction of COVID-19 fatality rates in the Black community. Decision makers will find the work useful in building a robust architecture for a resilient pandemic preparedness and responsiveness against the next pandemic. Method: Our analysis of COVID-19 cases and deaths spans March 2020 to December 2020. Assuming there was no vaccine and other factors remained the same, we hypothesized that COVID-19 disproportionality would have continued. To test our hypothesis, COVID-19 forecasting cases and deaths models were built for the total population as well as the Black population. Holt and Holt-Winters exponential smoothing forecast methodologies were used for the forecast modeling. Forecasting accuracy was based on Mean Absolute Percentage Error (MAPE). Furthermore, we designed, developed, and evaluated a fatality rate predictive model for a Black county. Considering the number of ethnic groups in the USA, a Black county was defined as any county in the USA that at least 45% of its population are Blacks. Five learning algorithms were trained and evaluated. Dataset was a merger of datasets obtained from John Hopkins COVID-19 repository, US Census Bureau and US Center for Disease Control and Prevention.Results and ConclusionTime series analysis shows that there exists a strong evidence of COVID-19 disproportionate impacts in the states investigated. Using 9 different criteria for performance comparison, our predictive modeling showed that decision tree model has a slight edge over other models. Our experiment suggests that Blacks and senior citizens with pre-existing condition living in Georgia State are the most vulnerable to COVID-19.
NEOage clocks - Epigenetic clocks to estimate post-menstrual and postnatal age in preterm infants
Authors: Graw Stefan , Camerota Marie , Carter Brian S. , Helderman Jennifer , Hofheimer Julie A. , McGowan Elisabeth C. , Neal Charles R. , Pastyrnak Steven L. , Smith Lynne M. , DellaGrotta Sheri A. , Dansereau Lynne M. , Padbury James F. , O’Shea T. Michael , Lester Barry M. , Marsit Carmen J. , Everson Todd M. 
Published: May 2021

AbstractEpigenetic clocks based on DNA methylation (DNAm) can to accurately predict chronological age and are thought to capture biological aging. A variety of epigenetic clocks have been developed for different tissue types and age ranges, but none has focused on age prediction for preterm infants. Epigenetic estimators of biological age might be especially informative in epidemiologic studies of neonates, particularly those born preterm, since this is a key developmental window. Neonatal DNAm is dynamic and preterm infants are at heightened risk of developmental impairments. We aimed to fill this gap by developing epigenetic clocks for neonatal aging in preterm infants.As part of the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) study, buccal cells were collected at NICU discharge to profile DNAm levels in 542 very preterm infants. We applied elastic net regression to identify four epigenetic clocks (NEOage) predictive of post-menstrual and postnatal age, compatible with the Illumina EPIC and 450K arrays. We observed high correlations between predicted and reported ages (0.93 – 0.94) with root mean squared errors (1.28 - 1.63 weeks).Epigenetic estimators of neonatal aging in preterm infants can be useful tools to evaluate biological maturity and associations with neonatal and long-term morbidities.