bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association between cardiac risk factors and the probability of acute myocardial infarction in the emergency department: analysis from a multicentre prospective observational study in the high sensitivity troponin era
Authors: Bali Trishan , Boda Shivani , Reynard Charles , Body Richard 
Published: March 2021

Background and objective
Hypertension, hyperlipidaemia, diabetes mellitus, smoking and family history are established risk factors for coronary artery disease. This study sought to determine the diagnostic value these factors have in patients presenting to an emergency department (ED) with suspected acute myocardial infarction (AMI).

Design, settings and analysis
This secondary analysis of a prospective diagnostic test accuracy study took place across 14 hospitals in England. A total of 1273 patients, presenting with suspected cardiac chest pain, were included for analysis - 179 (14.1%) had an adjudicated diagnosis of AMI.

Outcome measure and analysis
AMI diagnosis was adjudicated with serial troponin testing conducted on arrival and 3–12 hours later. The presence of any risk factors was documented at the time of initial presentation.

Results
The post-test probability of AMI in the absence of risk factors (9.7%) shifts to only 23.5% when 4–5 factors are present. Associations of risk factors with AMI diagnosis were found as follows; hypertension [odds ratio (OR) 1.47, confidence interval (CI) 1.07–2.02], hyperlipidaemia (OR 1.57, CI 1.14–2.16), diabetes mellitus (OR 1.51, CI 1.04–2.20), smoking (OR 1.51, CI 1.05–2.17) and family history (OR 0.98, CI 0.71–1.37). The area under the receiver operating characteristic curve was 0.58.

Conclusion
Traditional cardiac risk factors have limited association with AMI in the ED, but an increasing risk factor burden is associated with increasing prevalence of AMI. These findings suggest that future work to refine existing decision aids used in this patient group may be of value.
Ultra Diced Cartilage Graft in Rhinoplasty: A Fine Tool
Authors: Taş Süleyman 
Published: March 2021

Background:
Free diced cartilage smaller than 0.2 mm in diameter to smoothen the nasal dorsum is a well-known procedure. However, creating smaller diced cartilage takes a really long time. In contrast, the free diced cartilage technique has some visibility problems, especially in thin-skin patients, although a fine job is done to chop the cartilage. The author aimed to present the “ultra diced cartilage graft” and the way to achieve it, to eliminate the problems of diced cartilage during rhinoplasty, and compare it with free diced cartilage grafting technique.

Methods:
Between April of 2015 and December of 2018, the ultra diced cartilage graft technique in 104 patients and the free diced cartilage graft technique in 113 patients were used to smoothen the dorsum or augment the radix/dorsum. Operation records, rhinoplasty outcome evaluation questionnaire, palpation test, and evaluation of the immediate postoperative photographs on the table with postoperative 1-year postoperative photographs by two independent blinded plastic surgeons were analyzed.

Results:
Ultra diced cartilage seemed superior to free diced cartilage grafting with regard to graft visibility and resorption.

Conclusions:
Ultra diced cartilage graft is an effective and easily reproducible technique in rhinoplasty. There is no extra cost, and it is the easiest and fastest way to have this perfectly pliable cartilage have no dead space. The ultra diced cartilage grafting technique should be known by all plastic surgeons to achieve fineness in rhinoplasty.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Syndemics and preexposure prophylaxis are independently associated with rectal immune dysregulation in sexual minority men
Authors: Tapia Gregory R. , Glynn Tiffany R. , Miller Charlene , Manuzak Jennifer A. , Broedlow Courtney A. , Mcgaugh Angela , Cherenack Emily M. , Bauermeister José A. , Grov Christian , Dilworth Samantha E. , Parisi Robert , Martinez Darling , Klatt Nichole R. , Carrico Adam W. 
Published: March 2021

Objective:
Syndemic conditions have been linked to engagement in receptive condomless anal sex (CAS) and HIV seroconversion. However, little is known about the biological pathways whereby syndemics could amplify vulnerability to HIV and other sexually transmitted infections (STIs).

Design:
HIV-negative sexual minority men (i.e. gay, bisexual and other MSM) were recruited from four STI clinics in South Florida for a cross-sectional study.

Methods:
Participants completed assessments for four syndemic conditions: depression, posttraumatic stress disorder, hazardous alcohol use and any stimulant use (i.e. any self-reported use or reactive urine toxicology results). Cytokine and chemokine levels were measured using LEGENDplex from the rectal swabs of 92 participants reporting receptive CAS and no antibiotic use in the past three months.

Results:
After controlling for age, race/ethnicity, preexposure prophylaxis (PrEP) use and number of receptive CAS partners, a greater number of syndemic conditions was associated with higher levels of rectal cytokines/chemokines relevant to immune activation, inflammation and the expansion and maintenance of T-helper 17 target cells, including rectal interferon-gamma (β = 0.22; P = 0.047), CXCL-8 (β = 0.24; P = 0.025) and interleukin-23 (β = 0.22; P = 0.049). Elevations in rectal cytokine or chemokine levels were most pronounced among participants experiencing two or more syndemic conditions compared with those experiencing no syndemic conditions. PrEP use was independently associated with elevations in multiple rectal cytokines/chemokines.

Conclusion:
Syndemic conditions could increase biological vulnerability to HIV and other STIs in sexual minority men by potentiating rectal immune dysregulation.
Distraction Osteogenesis in Craniofacial Surgery: Past, Present, and Future
Authors: Konofaos Petros , Wallace Robert D. 
Published: March 2021

Abstract
Distraction osteogenesis (DO) is considered one of the treatments of choice for the surgical correction of malformations of the craniofacial skeleton. This is due to its ability to generate bone at the distraction site along with the accompanying soft tissue changes, the possibility to combine DO with traditional orthognathic procedures and the successful reported long-term outcomes following its application to various craniofacial deformities. The aim of this review is to present an overview of the literature on the evolution of DO applications in craniofacial surgery through the last 35 years.
A Review on Variability in Treatment Protocols With Posterior Cranial Vault Distraction
Authors: Sanati-Mehrizy Paymon , Graziano Francis , Sayegh Farah , Taub Dylan M. , Morgenstern Peter , Ghatan Saadi , Taub Peter J. 
Published: March 2021

Background:
Prior studies have confirmed the ability of posterior cranial vault distraction osteogenesis (PVDO) to expand the intracranial volume in patients with craniosynostosis. To date, there is scant literature on the optimal distraction protocol for PVDO. The authors sought to review the literature and define a common protocol for posterior cranial vault distraction.

Methods:
The authors performed a systematic review for published PVDO protocols. The data collected from these studies included age at the time of PVDO, number of distraction devices placed, time for latency, rate and rhythm of distraction, distraction length, time for consolidation, and surgical outcomes.

Results:
A total of 286 patients were identified within 24 studies from 2011 to 2019. The mean age of patients identified was 25.34 months. After application of distractors, latency period ranged between 1 and 7 days, with most patients undergoing 5 to 7 days of latency. Once distraction was begun, the majority of patients (77.4%) underwent 1 mm of distraction daily. Total lengths of distraction ranged between 13 and 35 mm, with the largest cohort of patients undergoing 26 to 30 mm of total distraction. A total of 60 complications were reported for a total of 212 patients, yielding an overall complication rate of 28.3%.

Conclusions:
Although there is variability in reported PVDO protocols, the majority are similar to distraction osteogenesis protocols described for long bone sites. Increased patient age correlates with selection of a greater latency period and total distraction length, while frequency of complications is also increased.
Vaccinations in multiple sclerosis patients receiving disease-modifying drugs
Authors: Otero-Romero Susana , Ascherio Alberto , Lebrun-Frénay Christine 
Published: March 2021

Purpose of review
This review focuses on new evidence supporting the global immunization strategy for multiple sclerosis (MS) patients receiving disease-modifying drugs (DMDs), including the recently available vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Recent findings
New data strengthen the evidence against a causal link between MS and vaccination. Recent consensus statements agree on the need to start vaccination early. Timings for vaccine administration should be adjusted to ensure safety and optimize vaccine responses, given the potential interference of DMDs. Patients treated with Ocrelizumab (and potentially other B-cell depleting therapies) are at risk of diminished immunogenicity to vaccines. This has relevant implications for the upcoming vaccination against SARS-CoV-2.

Summary
An early assessment and immunization of MS patients allows optimizing vaccine responses and avoiding potential interference with treatment plans. Vaccinations are safe and effective but some specific considerations should be followed when vaccinating before, during, and after receiving immunotherapy. A time-window for vaccination taking into account the kinetics of B cell repopulation could potentially improve vaccine responses. Further understanding of SARS-CoV-2 vaccine response dynamics in MS patients under specific therapies will be key for defining the best vaccination strategy.
Demonstrate, observe, assist perform (DOAP) versus structured educational video (SEV) in imparting standard skill in male urinary bladder catheterisation
Authors: Balakrishnan Santosh , Paul Lijo , Rajan Minu N , Arthungal Sherin A 
Published: March 2021

AbstractIntroductionConventional teaching and learning methods have been seen to fail to assure achievement of competencies in male bladder catherization in the Indian Medical Graduate (IMG) with wide variation noted in competencies. This could be remedied by introduction of Structured training methods.Aims and ObjectiveThe study aimed to investigate DOAP method of training in a Skill Lab against training through a Structured Educational Video (SEV) with the objective of comparing their efficacy in training Final MBBS Students in the psychomotor skill of performing male bladder catheterisation.Material & MethodsFinal MBBS students fulfilling selection criteria were randomly allocated into two comparable groups. One group underwent Skill lab training using DOAP method while the other group underwent training using a SEV by the same instructor. CRRI interns, regularly performing MBC at work by virtue of conventional training, with 6-8 months experience formed a control group. All participants underwent assessment of skill in MBC by skill lab OSCE evaluation, by assessors who were blinded to the participant’s method of training. Data was recorded and analysed using standard statistical software. Trial evaluation from the trial groups was obtained using Survey monkey tool.ObservationThere was no statistically significant difference in the ability of DOAP group or SEV group in being able to safely perform MBC though a higher level of confidence was expressed with their training by DOAP group. Both trial groups statistically outperformed the control group.ConclusionStructured training assures competence. Video-assisted Training produces comparable results though DOAP method is preferred by students. A combination of the techniques may facilitate optimal training.
Impact of previous COVID-19 on immune response after a single dose of BNT162b2 SARS-CoV-2 vaccine
Authors: Velasco María , Galán Ma Isabel , Casas Ma Luisa , Pérez-Fernández Elia , Martínez-Ponce Diana , González-Piñeiro Beatriz , Castilla Virgilio , Guijarro Carlos ,   Working Group Alcorcón COVID-19
Published: March 2021

AbstractImmune response after a single-dose of BNT162b2 vaccine is markedly increased in subjects with previous SARS-CoV-2 infection, reaching similar IgG titers to those elicited by the full two-doses in naïve cases, and increased modestly after the second dose. These data may inform the priority of the boosting dose.
Agreement between commercially available ELISA and in-house Luminex SARS-CoV-2 antibody immunoassays
Authors: Santano Rebeca , Barrios Diana , Crispi Fàtima , Crovetto Francesca , Vidal Marta , Chi Jordi , Izquierdo Luis , Gratacós Eduard , Moncunill Gemma , Dobaño Carlota 
Published: March 2021

AbstractSerological diagnostic of the severe respiratory distress syndrome coronavirus 2 (SARS-CoV-2) is a valuable tool for the determination of immunity and surveillance of exposure to the virus. In the context of an ongoing pandemic, it is essential to externally validate widely used tests to assure correct diagnostics and epidemiological estimations. We evaluated the performance of the COVID-19 ELISA IgG and IgM/A (Vircell, S.L.) against a highly specific and sensitive in-house Luminex immunoassay in a set of samples from pregnant women and cord blood. The agreement between both assays was moderate to high for IgG but low for IgM/A. Considering seropositivity by either IgG and/or IgM/A, the technical performance of the ELISA was highly imbalanced, with 96% sensitivity at the expense of 22% specificity. As for the clinical performance, the negative predictive value reached 87% while the positive predictive value was 51%. Our results stress the need for highly specific and sensitive assays and external validation of diagnostic tests with different sets of samples to avoid the clinical, epidemiological and personal disturbances derived from serological misdiagnosis.
Rapid Screening for SARS-CoV-2 Variants of Concern in Clinical and Environmental Samples Using Nested RT-PCR Assays Targeting Key Mutations of the Spike Protein
Authors: La Rosa G. , Mancini P. , Bonanno Ferraro G. , Veneri C. , Iaconelli M. , Lucentini L. , Bonadonna L. , Brusaferro S. , Brandtner D. , Fasanella A. , Pace L. , Parisi A. , Galante D. , Suffredini E. 
Published: March 2021

SUMMARYNew SARS-CoV-2 mutations are constantly emerging, raising concerns of increased transmissibility, virulence or escape from host immune response.We describe a nested RT-PCR assay (∼1500 bps) to detect multiple key spike protein mutations distinctive of the major known circulating SARS-CoV-2 variants, including the three Variants of Concern (VOCs) 20I/501Y.V1 (United Kingdom), 20H/501Y.V2 (South Africa), and 20J/501Y.V3 (Brazil), as well as the 20E.EU1 variant (Spain), the CAL.20C recently identified in California, and the mink-associated variant (GR, lineage B.1.1.298). Prior to application to field samples, the discriminatory potential of this PCR assay was explored using GISAID and Nextclade. To extend variant detection to challenging matrices such as sewage, where the amplification of long fragments is problematic, two short nested RT-PCR assays (∼300 bps) were also designed, targeting portions of the region spanned by the long nested assay.The three newly-designed assays were then tested on field samples, including 7 fully-sequenced viral isolates from swab samples and 34 urban wastewater samples, some of which collected in areas where circulation of VOCs had been reported.The long assay successfully amplified all the previously characterized viral isolates, allowing the correct identification of variants 20I/501Y.V1 and 20E.EU1 present in the panel. The sequences obtained using the short assays were consistent with those obtained with the long assay. Mutations characteristic of VOCs (UK and Brazilian variant) and of other variant (Spanish) were detected in sewage samples. To our knowledge, this is the first evidence of the presence of sequences harboring key mutations of 20I/501Y.V1 and 20J/501Y.V3 in urban wastewaters, highlighting the potential contribution of wastewater surveillance to explore SARS-CoV-2 diversity.The developed nested RT-PCR assays can be used as an initial rapid screening test to select clinical samples containing mutations of interest. This can speed up diagnosis and optimize resources since it allows full genome sequencing to be done only on clinically relevant specimens. The assays can be also employed for a rapid and cost-effective detection of VOCs or other variants in sewage for the purposes of wastewater-based epidemiology. The approach proposed here can be used to better understand SARS-CoV-2 variant diversity, geographic distribution and impact worldwide.
Prediction of COVID-19 mortality among hospitalized patients in Sudan
Authors: Abd El-Raheem Ghada Omer Hamad , Awad Yousif Maysoun Ahmed , Ibrahim Mohamed Doaa Salih 
Published: March 2021

AbstractBackgroundCOVID-19 was primarily reported in China. The mortality rate across countries had ranged from 1% up to more than 10% and it is underestimated in some countries. Advanced age is the most frequently reported factor associated to mortality. Other factors were the presence of comorbidities such as diabetes mellitus, hypertension and obesity. Several models for mortality prediction had been developed to assist in improving the prognosis. The aim of our study was to assess the factors related to mortality among COVID-19 patients and develop a prediction model based on these factors.MethodsA retrospective cohort study assessed the factors related to the mortality among COVID-19 patients who attended Imperial Hospital isolation centre on November-December, 2020, Khartoum, Sudan. Statistical tests performed were chi-square test, odds ratio and regression to develop the prediction model. Tests were considered statistically significant whenp< 0.05.Results105 patients were studied. 29% of the patients were deceased, while, 71% were discharged alive. A statistically significant association was found between the age and severity with regards to mortality rate (p=0.034, 0.018 respectively). The model equation for mortality prediction: Mortality = −14.724+ (1.387* Age) + (−0.323* Gender) + (1.814* Admission) + (0.193* Ischemic Heart Disease) + (−0.369* Fever) + (1.595* Cough) + (1.953* Complications) + (0.149* Duration of hospitalization) + (0.999* Enoxaparin dose).ConclusionsAge, admission ward, cough and enoxaparin dose were statistically significant predictors for COVID-19 mortality (p= 0.014, 0.011, 0.015, 0.006 respectively).
Detection of SARS-CoV-2 lineage P.1 in patients from a region with exponentially increasing hospitalization rates in February 2021, Rio Grande do Sul, Southern Brazil
Authors: Martins Andreza Francisco , Zavascki Alexandre Prehn , Wink Priscila Lamb , Volpato Fabiana Caroline Zempulski , Monteiro Francielle Liz , Rosset Clévia , De-Paris Fernanda , Ramos Álvaro Krüger , Luís Barth Afonso 
Published: March 2021

AbstractThe emergence SARS-CoV-2 P.1 lineage has been coincidental with a rapid growth in hospitalization in the northern region of Brazil. An exponential growth of severe COVID-19 occurred in Rio Grande do Sul state, Southern Brazil in February-2021. Whole-genome sequencing revealed that the previously undetected P.1 lineage accounted for 88.9% of specimens collected from patients at a referral COVID-19 hospital. These findings raise concerns regarding a possible association between lineage P.1 and rapid growth in cases and hospitalizations.
Topaz1, an essential gene for murine spermatogenesis, down-regulates the expression of numerous testis-specific long non-coding RNAs
Authors: Chadourne Manon , Poumerol Elodie , Jouneau Luc , Passet Bruno , Castille Johan , Sellem Eli , Pailhoux Eric , Mandon-Pépin Béatrice 
Published: March 2021

AbstractSpermatogenesis involves coordinated processes, including meiosis, to produce functional gametes. We previously reportedTopaz1as a germ cell-specific gene highly conserved in vertebrates.Topaz1knockout males are sterile with testes that lack haploid germ cells because of meiotic arrest after prophase I. To better characterizeTopaz1−/−testes, we used RNA-sequencing analyses at two different developmental stages (P16 and P18). The absence of TOPAZ1 disturbed the expression of genes involved in microtubule and/or cilium mobility, which was consistent with testicular histology showing the disruption of microtubules and centrosomes. Moreover, a quarter of P18 dysregulated genes are long non-coding RNAs (lncRNAs), and three of them are testis-specific and located in spermatocytes, their expression starting between P11 and P15. The suppression of one of them,4939463O16Rik, did not alter fertility although sperm parameters were disturbed and sperm concentration fell. The transcriptome of P18-4939463O16Rik−/−testes was altered and the molecular pathways affected included microtubule-based processes, the regulation of cilium movement and spermatogenesis. The absence of TOPAZ1 protein or4930463O16Rikproduced the same enrichment clusters in mutant testes despite a contrasted phenotype on male fertility. In conclusion, TOPAZ1 appeared to stabilize the expression of numerous lncRNAs. Its suppression is not essential for fertility but required during the terminal differentiation of male gametes.Author SummaryTheTopaz1gene was initially characterized during the initiation of meiosis in the sheep fetal ovary. In order to determine its function, a KO of the murine gene was performed. In this species, only males were sterile and spermatogenesis was blocked before the first meiotic division. Here, we show that cytoskeletal elements are markedly disturbed in mutant testes, indicating that these elements play an important function in spermatogenesis. While the mitotic spindle of spermatogonia was normal, the meiotic spindle of spermatocytes was hemi-spindle-shaped and the homologous chromosome pairs could position themselves on the equatorial plate. In addition, lncRNAs account for 25% of genes whose expression in testes varies significantly in the absence ofTopaz1. This suggests a key role for these factors in spermatogenesis. Largely testis-specific, they may be involved in spermatogenesis and play a more or less critical role in mouse fertility, which probably also depends on their redundancies.