bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evolution of Cleft Lip and Palate Surgical Training in the UK: A Qualitative Study
Authors: Butterworth Sophie , Hodgkinson Emma L. , Stock Nicola M. , Sainsbury David C. G. , Hodgkinson Peter D. 
Published: November 2021

Background Although the United Kingdom (UK) cleft surgeons follow a similar training pathway, and cleft centers adhere to similar protocols regarding the timing of palate surgery and surgical technique, speech outcomes still vary between centers. Objective To explore the training experiences of consultant cleft lip and palate (CL/P) surgeons, performing a Sommerlad radical intravelar veloplasty (IVVP) and their approach to teaching others. Design An exploratory, qualitative approach was adopted to understand the views of UK cleft surgeons performing a Sommerlad radical IVVP and discuss what was important during training and upon qualifying as a consultant. Method A semi-structured interview schedule was designed, interviews were conducted in-person or via videoconferencing, depending on preference and availability, with interested surgeons. The interviews were recorded, transcribed, and checked for accuracy. Analysis involved inductive thematic analysis. Results Fourteen cleft consultants from the UK participated (3F:11M). Seven of the consultants were trained in plastic surgery and four in maxillofacial surgery. Seven themes were identified from the thematic analysis. Three themes, namely Learning to perform palate repair, Teaching others to perform palate repair, and Ongoing learning as a consultant are discussed. Conclusions Cleft palate repair is clearly a technically challenging procedure to learn and teach with the potential to cause harm if performed incorrectly. Positive changes have been made to improve exposure to palate surgery, encourage practice away from the patient, and increase supervised practical experience. The role of colleagues in providing mentorship and support appears invaluable. We provide some simple recommendations that may improve the training experience and ensure parity for all trainees.
Is There a Relationship Between ADHD and COVID-19 Prevalence and Mortality Indices? An Analysis of Data From 156 Countries
Authors: Rajkumar Ravi Philip 
Published: November 2021

Objective: To examine the relationship between nation-level prevalence of ADHD and COVID-19 prevalence and mortality indices. Method: Associations between nation-wise estimated prevalence, crude mortality rates and case-fatality ratios for COVID-19 and estimated prevalence rates for ADHD were examined, controlling for medical conditions known to be associated with COVID-19 outcome, as well as demographic, climate-related, and economic variables. Results: Prevalence of ADHD was positively correlated with COVID-19 prevalence and crude mortality rates on bivariate analyses, though the strength of this association was low. On multivariate regression, prevalence of ADHD was negatively associated with COVID-19 prevalence and crude mortality rates, though only the former finding was statistically significant. Conclusion: The association between ADHD and COVID-19 prevalence and mortality at a national level is inconsistent, modest, and may be largely due to confounding factors such as age, lifestyle factors, and medical comorbidities.
Spontaneous regression and quiescence of choroidal neovascularization secondary to traumatic choroidal rupture depicted on OCT angiography
Authors: Adhi Mehreen , Reinoso Maria 
Published: November 2021

Introduction Choroidal rupture is a tear/break within the Bruch's membrane, retinal pigment epithelium and choroid following blunt trauma. Choroidal neovascularization is a well-known complication of traumatic choroidal rupture that is typically treated with intravitreal injections of Bevacizumab. This case describes an early detection of choroidal neovascular complex secondary to traumatic choroidal rupture and its spontaneous regression and quiescence without treatment followed using optical coherence tomography (OCT) angiography. Case Description A healthy 19 year old female presented with decreased vision in her left eye following a blunt non-penetrating closed globe injury two weeks prior. A complete ophthalmic examination with ancillary testing was consistent with sub-foveal choroidal neovascularization secondary to traumatic choroidal rupture. Five weeks later, there was spontaneous regression of the choroidal neovascular complex as depicted on OCT angiography and complete resolution of subretinal fluid/exudation on structural OCT. A conservative approach without intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections was chosen for management. Conclusion To the authors’ knowledge this is a first case describing a unique evolution with spontaneous regression and quiescence of choroidal neovascularization secondary to traumatic choroidal rupture without treatment followed using OCT angiography. Expectant management may be a viable treatment option for this condition.
Fluoroscopy, CT, and MR imaging characteristics of a novel primarily bioresorbable flow-diverting stent for aneurysms
Authors: Morrish Rosalie , Corcoran Ronan , Cooke Jillian , Eesa Muneer , Wong John H , Mitha Alim P 
Published: November 2021

Background Five to ten percent of the global population have unruptured intracranial aneurysms, and ruptured brain aneurysms cause approximately 500,000 deaths a year. Flow-diverting stent treatment is a less invasive intracranial aneurysm treatment that induces aneurysm thrombosis. The imaging characteristics of a novel primarily bioresorbable flow-diverting stent (BFDS) are assessed in comparison to the leading metal stent using fluoroscopy, CT, and MRI. Methods X-ray/fluoroscopic images of stents were taken using a human cadaveric skull model. CT and MRI were acquired using silicone flow models of residual aneurysms. Images were analyzed with Likert scales in anonymous surveys by neurointerventionalists. Quantitative measurements of radiographic density (CT) and artifact boundary size (CT & MRI) were also obtained. Results Visibility of the BFDS on X-ray was less than the metal stent but deemed adequate for deployment and intraprocedural assessment. The metal stent was more radiopaque than the BFDS on CT, but qualitative assessment was not significantly different for the two stents. MRI imaging was significantly better using the BFDS in terms of overall artifact and intraluminal assessment. Conclusions The BFDS has adequate visualization on X-ray/fluoroscopy and should be clinically acceptable for fluoroscopic deployment. On MRI, there is less quantitative artifact as well as overall improved qualitative assessment that will allow for more detailed non-invasive imaging follow-up of treated aneurysms, potentially reducing the need for digital subtraction catheter angiography.
Idiopathic purpura fulminans associated with anti-protein S antibodies in children: a multicenter case series and systematic review
Authors: Theron Alexandre , Dautremay Olivier , Boissier Elodie , Zerroukhi Amel , Baleine Julien , Moulis Lionel , Rodière Michel , Schved Jean-François , Duraes Martha , Kanouni Tarik , Cau-Diaz Isabelle , Jeziorski Eric , Biron-Andreani Christine 
Published: November 2021

Abstract
Idiopathic purpura fulminans (IPF) is a rare but severe prothrombotic coagulation disorder that can occur after chickenpox or human herpesvirus 6 (HHV-6) infection. IPF leads to an autoantibody-mediated decrease in the plasma concentration of protein S. We conducted a retrospective multicenter study involving patients with IPF from 13 French pediatric centers and a systematic review of cases in published literature. Eighteen patients were included in our case series, and 34 patients were included as literature review cases. The median age was 4.9 years, and the diagnostic delay after the first signs of viral infection was 7 days. The lower limbs were involved in 49 patients (94%) with typical lesions. In all, 41 patients (78%) had a recent history of varicella-zoster virus infection, and 7 patients (14%) had been infected by HHV-6. Most of the patients received heparin (n = 51; 98%) and fresh frozen plasma transfusions (n = 41; 79%); other treatment options were immunoglobulin infusion, platelet transfusion, corticosteroid therapy, plasmapheresis, and coagulation regulator concentrate infusion. The antithrombin level and platelet count at diagnosis seemed to be associated with severe complications. Given the rarity of this disease, the creation of a prospective international registry is required to consolidate these findings.
Optimal fludarabine lymphodepletion is associated with improved outcomes after CAR T-cell therapy
Authors: Fabrizio Vanessa A. , Boelens Jaap Jan , Mauguen Audrey , Baggott Christina , Prabhu Snehit , Egeler Emily , Mavroukakis Sharon , Pacenta Holly , Phillips Christine L. , Rossoff Jenna , Stefanski Heather E. , Talano Julie-An , Moskop Amy , Margossian Steven P. , Verneris Michael R. , Myers Gary Douglas , Karras Nicole A. , Brown Patrick A. , Qayed Muna , Hermiston Michelle , Satwani Prakash , Krupski Christa , Keating Amy K. , Wilcox Rachel , Rabik Cara A. , Chinnabhandar Vasant , Kunicki Michael , Goksenin A. Yasemin , Mackall Crystal L. , Laetsch Theodore W. , Schultz Liora M. , Curran Kevin J. 
Published: November 2021

Abstract
Chimeric antigen receptor (CAR) T cells provide a therapeutic option in hematologic malignancies. However, treatment failure after initial response approaches 50%. In allogeneic hematopoietic cell transplantation, optimal fludarabine exposure improves immune reconstitution, resulting in lower nonrelapse mortality and increased survival. We hypothesized that optimal fludarabine exposure in lymphodepleting chemotherapy before CAR T-cell therapy would improve outcomes. In a retrospective analysis of patients with relapsed/refractory B-cell acute lymphoblastic leukemia undergoing CAR T-cell (tisagenlecleucel) infusion after cyclophosphamide/fludarabine lymphodepleting chemotherapy, we estimated fludarabine exposure as area under the curve (AUC; mg × h/L) using a validated population pharmacokinetic (PK) model. Fludarabine exposure was related to overall survival (OS), cumulative incidence of relapse (CIR), and a composite end point (loss of B-cell aplasia [BCA] or relapse). Eligible patients (n = 152) had a median age of 12.5 years (range, &lt;1 to 26), response rate of 86% (n = 131 of 152), 12-month OS of 75.1% (95% confidence interval [CI], 67.6% to 82.6%), and 12-month CIR of 36.4% (95% CI, 27.5% to 45.2%). Optimal fludarabine exposure was determined as AUC ≥13.8 mg × h/L. In multivariable analyses, patients with AUC &lt;13.8 mg × h/L had a 2.5-fold higher CIR (hazard ratio [HR], 2.45; 95% CI, 1.34-4.48; P = .005) and twofold higher risk of relapse or loss of BCA (HR, 1.96; 95% CI, 1.19-3.23; P = .01) compared with those with optimal fludarabine exposure. High preinfusion disease burden was also associated with increased risk of relapse (HR, 2.66; 95% CI, 1.45-4.87; P = .001) and death (HR, 4.77; 95% CI, 2.10-10.9; P &lt; .001). Personalized PK-directed dosing to achieve optimal fludarabine exposure should be tested in prospective trials and, based on this analysis, may reduce disease relapse after CAR T-cell therapy.
Effects of different exercise interventions on heart rate variability and cardiovascular health factors in older adults: a systematic review
Authors: Grässler Bernhard , Thielmann Beatrice , Böckelmann Irina , Hökelmann Anita 
Published: November 2021

Abstract
Background
Aging impairs physiological processes in the autonomic nervous, endocrine, and cardiovascular systems which are associated with increased risk of cardiovascular disease. Heart rate variability (HRV), the beat-to-beat variations of successive heartbeats, is an indicator of cardiac autonomic control and cardiovascular health. Physical activity has beneficial effects on cardiovascular health. However, no review has been conducted to summarize the effects of different exercise modalities on HRV in older adults. Therefore, the aim of this systematic review was to summarize the effects of endurance, resistance, coordinative, and multimodal exercise interventions on resting HRV and secondary health factors in healthy older adults aged 60 years in average and over.

Methods
Five databases (PubMed, Scopus, SPORTDiscus, Ovid, and Cochrane Library) were searched for eligible studies published between 2005 and September 8th, 2020. Two reviewers independently assessed the studies for potential inclusion. Outcome measures were changes in resting HRV indices, baroreflex sensitivity, blood pressure, body fat, body mass, body mass index, cardiac output, distance in the six-minute walking test, stroke volume, total peripheral resistance, and VO2 max or VO2 peak from pre to post intervention. The methodological quality of the final data set was assessed using two scales (TESTEX and STARDHRV). This review was registered in PROSPERO: CRD42020206606.

Results
The literature search retrieved 3991 articles, of which 13 were included in the review. Five studies used multimodal, three studies endurance, two studies resistance, two studies coordinative, and one study used an endurance and a resistance training intervention. The majority of the studies revealed significant positive effects on cardiac autonomic control, except for the resistance training interventions. All exercise modalities improved secondary health factors. The methodological quality assessment revealed a few criteria to improve the quality of and comparability between studies.

Conclusion
This systematic review revealed beneficial effects on cardiac autonomic control in healthy older adults through endurance, coordinative, and multimodal training but not through resistance training. Secondary health factors improved after all types of physical interventions. Future investigations should more thoroughly adhere to methodological standards of exercise interventions and ECG recording for the assessment of autonomic regulation.
Brain is modulated by neuronal plasticity during postnatal development
Authors: Kourosh-Arami Masoumeh , Hosseini Nasrin , Komaki Alireza 
Published: November 2021

AbstractNeuroplasticity is referred to the ability of the nervous system to change its structure or functions as a result of former stimuli. It is a plausible mechanism underlying a dynamic brain through adaptation processes of neural structure and activity patterns. Nevertheless, it is still unclear how the plastic neural systems achieve and maintain their equilibrium. Additionally, the alterations of balanced brain dynamics under different plasticity rules have not been explored either. Therefore, the present article primarily aims to review recent research studies regarding homosynaptic and heterosynaptic neuroplasticity characterized by the manipulation of excitatory and inhibitory synaptic inputs. Moreover, it attempts to understand different mechanisms related to the main forms of synaptic plasticity at the excitatory and inhibitory synapses during the brain development processes. Hence, this study comprised surveying those articles published since 1988 and available through PubMed, Google Scholar and science direct databases on a keyword-based search paradigm. All in all, the study results presented extensive and corroborative pieces of evidence for the main types of plasticity, including the long-term potentiation (LTP) and long-term depression (LTD) of the excitatory and inhibitory postsynaptic potentials (EPSPs and IPSPs).
SCYN: single cell CNV profiling method using dynamic programming
Authors: Feng Xikang , Chen Lingxi , Qing Yuhao , Li Ruikang , Li Chaohui , Li Shuai Cheng 
Published: November 2021

Abstract
Background
Copy number variation is crucial in deciphering the mechanism and cure of complex disorders and cancers. The recent advancement of scDNA sequencing technology sheds light upon addressing intratumor heterogeneity, detecting rare subclones, and reconstructing tumor evolution lineages at single-cell resolution. Nevertheless, the current circular binary segmentation based approach proves to fail to efficiently and effectively identify copy number shifts on some exceptional trails.

Results
Here, we propose SCYN, a CNV segmentation method powered with dynamic programming. SCYN resolves the precise segmentation on in silico dataset. Then we verified SCYN manifested accurate copy number inferring on triple negative breast cancer scDNA data, with array comparative genomic hybridization results of purified bulk samples as ground truth validation. We tested SCYN on two datasets of the newly emerged 10x Genomics CNV solution. SCYN successfully recognizes gastric cancer cells from 1% and 10% spike-ins 10x datasets. Moreover, SCYN is about 150 times faster than state of the art tool when dealing with the datasets of approximately 2000 cells.

Conclusions
SCYN robustly and efficiently detects segmentations and infers copy number profiles on single cell DNA sequencing data. It serves to reveal the tumor intra-heterogeneity. The source code of SCYN can be accessed in https://github.com/xikanfeng2/SCYN.
Performance of rapid rk39 tests for the diagnosis of visceral leishmaniasis in Ethiopia: a systematic review and meta-analysis
Authors: Hagos Dawit Gebreegziabiher , Schallig Henk D. F. H. , Kiros Yazezew K. , Abdulkadir Mahmud , Wolday Dawit 
Published: November 2021

Abstract
Background
Visceral Leishmaniasis (VL) is a severely neglected disease affecting millions of people with high mortality if left untreated. In Ethiopia, the primary laboratory diagnosis of VL is by using an antigen from a 39-amino acid sequence repeat of a kinesin-related (rK39) of leishmania donovani complex (L. donovani), rapid diagnostic tests (RDT). Different rk39 RDT brands are available with very variable performance and studies from Ethiopia showed a very wide range of sensitivity and specificity. Therefore, a systematic review and meta-analysis were conducted to determine the pooled sensitivity and specificity of rk39 RDT in Ethiopia.

Method
PUBMED, EMBASE, and other sources were searched using predefined search terms to retrieve all relevant articles from 2007 to 2020. Heterogeneity was assessed by visually inspecting summary receiver operating curves (SROC), Spearman correlation coefficient (rs), Cochran Q test statistics, inconsistency square (I2) and subgroup analysis. The presence and statistical significance of publication bias were assessed by Egger's test at p < 0.05, and all the measurements showed the presence of considerable heterogeneity. Quality assessment of diagnostic accuracy studies (QUADAS-2) checklists was used to check the qualities of the study.

Results
A total of 664 articles were retrieved, and of this 12 articles were included in the meta-analysis. Overall pooled sensitivity and specificity of the rk39 RDT to diagnose VL in Ethiopia were 88.0% (95% CI 86.0% to 89.0%) and 84.0% (95% CI 82.0% to 86.0%), respectively. The sensitivity and specificity of the rk39 RDT commercial test kits were DiaMed: 86.9% (95% CI 84.3% to 89.1%) and 82.2% (95% CI 79.3% to 85.0%), and InBios: 80.0% (95% CI 77.0% to 82.8%) and 97.4% (95% CI 95.0% to 98.8%), respectively.

Conclusion
Referring to our result, rk39 RDT considered an essential rapid diagnostic test for VL diagnosis. Besides to the diagnostic accuracy, the features such as easy to perform, quick (10–20 min), cheap, equipment-free, electric and cold chain free, and result reproducibility, rk39 RDT is advisable to remains in practice as a diagnostic test at least in the remote VL endemic localities till a better test will come.
The “anti-vax” movement: a quantitative report on vaccine beliefs and knowledge across social media
Authors: Benoit Staci L , Mauldin Rachel F. 
Published: November 2021

Abstract
Background
Social media use has become a mainstay of communication and with that comes the exchange of factual and non-factual information. Social media has given many people the opportunity to speak their opinions without repercussions and create coalitionS of like-minded people. This also has led to the development of a community know as anti-vaxxers or vaccine deniers. This research explores the extent to which vaccine knowledge has reached on social media.

Methods
This cross sectional research explored the relationship between the spread of information regarding vaccines in relation to social media use. A sample of 2515 people over the age of 18 around the world completed the survey via a link distributed on Twitter, Facebook and Instagram. A series of questions on vaccine knowledge and beliefs were compounded to create an individual’s “knowledge score” and a “belief score”. Knowledge scores were ranked from low knowledge to high knowledge with increasing scores. Belief scores were ranked from belief in myths to disbelief in myths with higher scores. This score was then analysed, using a Welch test and post hoc testing when applicable, across demographics and questions relating to social media use.

Results
Significant relations were found in both the knowledge and belief categories, many of which were similar findings between the two. North Americans had significantly lower knowledge and belief scores compared to all other continents. While the majority of people primarily use Facebook, Twitter users were significantly more knowledgeable. It was also found that higher education was correlated with higher knowledge and belief scores.

Conclusions
Overall, these correlations are important in determining ways to intervene into the anti-vax movement through the use of social media. Cross demographics were not analysed in this study but could be in future studies. To better understand the social media exposures related to vaccine information a follow up structured interview research study would be beneficial. Note that due to the cross sectional nature of this study, causal relationships could not be made.