bluuebunny/crossref_metadata_2025_split huggingface dataset:
Staged Management of Cervicothoracic Lordosis and Scoliosis in an Emery-Dreifuss VI Muscular Dystrophy Patient
Authors: Devkumar Devan , Sucato Daniel J. , Ramo Brandon A. 
Published: January 2021

Case:
We report the case of an 18-year-old man with extreme cervicothoracic lordosis and a progressive scoliosis secondary to Emery-Dreifuss Type VI muscular dystrophy. In a staged fashion, the patient underwent posterior cervical muscle release, halo-gravity traction, and posterior instrumented spinal fusion from C3-L4 with multiple posterior column osteotomies. The patient was followed over 2 years postoperatively with restoration of normal spinal alignment in both the coronal and sagittal profiles.

Conclusion:
This is the first reported case illustrating the gradual correction of severe lordoscoliosis in this patient population.
Injury to the Medial Superior Genicular Artery After Isolated Posterior Cruciate Ligament Reconstruction
Authors: Panagopoulos Andreas , Solou Konstantina , Kitrou Panagiotis M. , Kouzelis Antonis , Kokkalis Zinon T. , Triantafyllopoulos Ioannis K. 
Published: January 2021

Case:
A 19-year-old male patient with isolated posterior cruciate ligament (PCL) rupture underwent arthroscopic reconstruction using reinforced synthetic ligament (LARS system). Three weeks postoperatively, he presented with active bleeding from the medial side of his knee, near the proximal interference screw. An angiogram revealed extravasation from the medial superior genicular artery which was successfully embolized. One week later, he returned with active bleeding from the same area, located just under the initial coiling; a second embolization during superselective angiography was successful.

Conclusion:
Although rare, minor vascular injuries are a risk inherent to PCL surgery.
A protocol for exosome detection via the ultrafast-isolation system (EXODUS)
Authors: Chen Yuchao , Zhu Qingfu , Lee Luke P. , Liu Fei 
Published: January 2021

Abstract
Here we present a protocol for isolation and purification of exosomes using exosome detection via the ultrafast-isolation system (EXODUS). This protocol is associated with our Nature Methods paper: Exosome Detection via the Ultrafast-isolation System: EXODUS.
CaRBoKem: A Biofilter to Treat Heavy Metals by using the Household Waste Products
Authors: Sajeev Milan Maria , Krishnakumar Uma , John Merrin , Raj Amal , Thomas Hanna 
Published: January 2021

Abstract
Environmental toxic waste from heavy metals along with minerals within the waste matter is one of the most significant issues in an Asian country. The activities like industrial operations particularly mining, agricultural processes, and disposal of industrial waste materials; their concentration has redoubled to hazardous levels. Major metals in industrial sewage represent Cu, Cr3+and Pb, etc. So far, varieties of inexpensive strategies are reviewed for the removal of these metals. The various processes include chemical precipitation, reverse diffusion, electro qualitative analysis, nanofiltration, and floatation. But these strategies have many disadvantages like high chemical agent demand, unpredictable metal particle elimination, and production of unhealthful sludge. Surface absorption method being terribly straightforward, economical, effective, and versatile has become the most popular strategies for removal of unhealthful contaminants from waste matter. This paper gives a new idea for the utilization of natural materials as adsorbents for significant metal removal from industrial wastewater. The components used are mustard plant roots, human hair, and some common household waste products such as eggshells and coconut shells. Efficiently utilizing their adsorbent properties, it can be used to filter industrial heavy metals that cause pollution.
Exploration of Molecular Mechanism of Traditional Chinese Tuina Therapy for Insomnia by Proteomics Analysis
Authors: Zhou Jing , Cao Biwei , Wei Meng , Xiong Yuan , Liu Wan , Zhu Li , Zhao Yan 
Published: January 2021

Abstract
Insomnia, one of the most common mental disorder, not only affects the quality of life, but also damages physical and mental health. Therefore, it is very necessary to explore the molecular mechanism of insomnia and find some suitable treatments. At present, methods of using drugs to treat insomnia is not satisfactory due to lack of evidences and side effects. Hence, development of non-drug treatments is particularly important. Tuina, a Chinese massage method, has achieved certain therapeutic effects on injuries, rheumatism, neurological diseases and other types of diseases. We have treated patient with insomnia by Tuina, and obtained therapeutic effects indeed. In the current study, we used iTRAQ (isobaric Tags for Relative and Absolute Quantitation) quantitative proteomics to analyze plasma samples taken from the healthy control (HC) group, insomnia patients group (before Tuina treatment, BTT) and insomnia-therapy group (after Tuina treatment, ATT) to identify the molecular correlation of insomnia. In BTT vs HC, we found that the expression of many immune-related and stress-related proteins were out of control, and it revealed that Tuina had the capacities to regulate expression of immune-related and stress-related proteins in ATT vs BTT, suggesting that Tuina may improve insomnia by regulating immune-related and stress-related proteins. The proteomics verification results had been verified by commercial ELISA(Enzyme linked immunosorbent assay. All in all,Our study not only found a good way to treat insomnia, but also provided a research foundation for improving insomnia.
Evolution of COVID-19 patients treated with ImmunoFormulation, a combination of nutraceuticals to reduce symptomatology and improve prognosis: a multi-centred, retrospective cohort study
Authors: Hernández Mariana , Urrea Jully , Bascoy Luciano 
Published: January 2021

Abstract
Background Although a vast knowledge has already been gathered on the pathophysiology of COVID-19, there are still limited, non-optimal treatment options. In this context, agents that can act on prophylaxis or as adjuvants to the therapies are of high value.Methods In this paper, we describe a multicentre, retrospective, observational study to describe the course of SARS-CoV-2 disease in patients treated with ImmunoFormulation (IF), an add-on therapy developed to decrease duration of clinical symptoms. In parallel, a group of patients that did not receive IF was used for comparison (using standard of care treatment). A total of 39 patients were evaluated for their recovery rate, general symptoms and their severity, and adverse reactions.Results Throughout the observational period, 90% of patients recovered in the IF cohort and 47.4% in the Control cohort (p=0.0057). From the symptoms with statistically significant differences, the duration of symptoms (i.e., the time to recover from it) was shorter in the IF cohort than in control cohort (in days, average), especially for fever (2.25 x 21.78), dry cough (4.38 x 24.00), dyspnoea (3.67 x 20.00), headache (2.00 x 26.50), diarrhoea (5.25 x 25.25), and weakness (1.92 x 23.30).Conclusions This demonstrates a potential promising role of IF as adjuvant therapy on the evolution of symptomatology to COVID-19 patients.
CMM-Net: Contextual Multi-Scale Multi-Level Network for Efficient Biomedical Image Segmentation
Authors: Al-masni Mohammed , Kim Dong-Hyun 
Published: January 2021

Abstract
Medical image segmentation of tissue abnormalities, key organs, or blood vascular system is of great significance for any computerized diagnostic system. However, automatic segmentation in medical image analysis is a challenging task since it requires sophisticated knowledge of the target organ anatomy. This paper develops an end-to-end deep learning segmentation method called Contextual Multi-Scale Multi-Level Network (CMM-Net). The main idea is to fuse the global contextual features of multiple spatial scales at every contracting convolutional network level in the U-Net. Also, we re-exploit the dilated convolution module that enables an expansion of the receptive field with different rates depending on the size of feature maps throughout the networks. In addition, an augmented testing scheme referred to as Inversion Recovery (IR) which uses logical “OR” and “AND” operators is developed. The proposed segmentation network is evaluated on three medical imaging datasets, namely ISIC 2017 for skin lesions segmentation from dermoscopy images, DRIVE for retinal blood vessels segmentation from fundus images, and BraTS 2018 for brain gliomas segmentation from MR scans. The experimental results showed superior state-of-the-art performance with overall dice similarity coefficients of 85.78%, 80.27%, and 88.96% on the segmentation of skin lesions, retinal blood vessels, and brain tumors, respectively. The proposed CMM-Net is inherently general and could be efficiently applied as a robust tool for various medical image segmentations.
Cadmium in Herbal Weight Loss Products as a Health Risk Factor for Consumers
Authors: Dziubanek Grzegorz , Dawid Konwant , Danuta Rogala , Joanna Domagalska 
Published: January 2021

Abstract

Herbal weight loss remedies are produced on the basis of various plant species which could accumulate heavy metals from the environment. The consumption of contaminated herbal preparations could be a source of consumer exposure to toxic metals. The aim of the study was to evaluate the content of cadmium in selected herbal weight loss products available on the Polish market in terms of exposure of consumers to the heavy metal included in herbal infusions prepared from the studied products and the related health risk. The study included 29 herbal weight loss products available on the Polish market. The content of cadmium in the analyzed dried herbs and herbal infusions was analyzed. On the basis of the obtained results, the exposure of consumers to cadmium and related health risk were estimated. Cadmium concentration in dried herbs did not exceed the maximum allowable concentration. The exposure of consumers of the most contaminated herbal infusions to cadmium could be even equal to half of the reference dose, which is an acceptable exposure threshold. The total health risk of consumers resulting from the dietary exposure to cadmium could be high because the analyzed herbal products are not the essential part of the total diet.
Asymptomatic Bacteriuria&nbsp;Bacterial Profile and Antibiotic Susceptibility Pattern Among Pregnant Women Attending Antenatal Care (Anc) Clinic of Assosa General Hospital, Benishangul Gumuz Region, Western Ethiopia
Authors: Tusuna Duresa Abu 
Published: January 2021

Abstract
Background: ASB is a common problem in pregnant women. About 40% of women with untreated asymptomatic bacteriuria during pregnancy develop pyelonephritis, this has the possibility of leading to low birth weight, preterm, premature rupture of membranes and preterm labour. This study is aimed to assess the prevalence of asymptomatic bacteriuria and antimicrobial susceptibility pattern isolating among pregnant women attending the antenatal clinical care of Assosa General Hospital in western Ethiopia.Methods: A facility-based cross-sectional study was conducted from January to February 2019. Well-mixed and uncentrifuged urine specimens obtained from the pregnant women were directly inoculated on cystine lactose electrolyte deficient agar (CLED) (Oxoid, Ltd, England) media by streak plate method. Bacterial isolates were identified as per the standard bacteriological procedure using colony characteristics, gram-staining, and series of biochemical tests. Antimicrobial susceptibility test was carried out by Kirby- Bauer disk diffusion technique on Muller-Hinton agar medium and the diameter of zone of inhibition was interpreted according to Clinical Laboratory Standard Institute (CLSI) guidelinesResult: The overall prevalence of ASB among pregnant women in this study was 14.85%. E-coli was the most predominant isolate (50 %,) followed by K. pneumoniae (16.7%,), S. aureus (14.3%), coagulase-negative staphylococci (CONS) (11.9%), and group B streptococci (GBS) (7.1%). Gram-negative bacteria were highly resistant for tetracycline (96.4%), ampicillin. Gram-positive bacteria were 100% sensitive for ceftazidime. Conclusion: Significant bacteriuria was observed in asymptomatic pregnant women. Therefore, routine laboratory diagnosis of ASB in pregnant women in addition to providing appropriate treatment should be needed to reduce its complications.
Mediation Analysis in Sibling Designs: An Application to the Effect of Prenatal Antidepressant Exposure on Toddler Depression Mediated by Gestational Age at Birth
Authors: Wood Mollie , Eilertsen Espen , Ystrom Eivind , Nordeng Hedvig , Hernandez-Diaz Sonia 
Published: January 2021

Abstract
Background: Mediation analysis requires strong assumptions of no unmeasured confounding. Sibling designs offer a method for controlling confounding shared within families, but no previous research has done mediation analysis using sibling models. Methods: We demonstrate the validity of the sibling mediation approach using simulation, and show its application using the example of prenatal antidepressant exposure and toddler anxiety and depression, with gestational age at birth as a mediator. We used data from the Norwegian Mother and Child Cohort Study, a cohort comprising 41% of births in Norway between 1999 and 2008 to identify 91,333 pregnancies, of which 25,776 were part of sibling groups. Results: In simulations, sibling models were less biased than cohort models in cases where non-shared confounding was weaker than shared confounding, and when stronger non-shared confounding was controlled, but more biased otherwise. In the full cohort, the estimated mean difference in depression/anxiety scale z-scores for natural direct effects (NDE) were 0.31 (95% confidence interval 0.23 to 0.39) and 0.14 (95% CI 0.03 to 0.24), without and with adjustment for non-shared confounders, respectively. The natural indirect effect was 0.01 (95% CI 0.00 to 0.02) after adjustment. Adjustment for shared and non-shared confounding showed similar point estimates with wider confidence intervals (NDE 0.18, 95% CI -0.21 to 0.47; NIE -0.01, 95% CI -0.06 to 0.06).Conclusions: Findings suggest that the modest association between prenatal antidepressant exposure and anxiety/depression is not mediated by gestational age and is likely explained by both shared confounders and non-shared confounders, and chance.
Chest Wall Resection and Reconstruction for Locally Recurrent Breast Cancer :&nbsp;An Experience Over a 5-Year Period
Authors: Sun Qiang , Wang Yu-xin , Jin Shi-feng , Wang Chen-chao , Zhou You , Guo Shu 
Published: January 2021

Abstract
BackgroundExpanded local resection is suitable for recurrent breast cancer patients who have isolated local lesion and have not metastasized. The extend of chest wall resection must be overall radical resection of the tumors diagnosed by pathology. However, surgery often leads to huge defects, even full-thickness defects, and these defects are difficult to repair. MethodsChest wall resection was performed in 5 patients with locally recurrent breast cancer, followed by chest wall reconstruction with a pedicled rectus abdominis musculocutaneous flap or a pedicled latissimus dorsi musculocutaneous flap and, if necessary, a piece of titanium mesh. ResultsChest wall resection and reconstruction were successfully achieved in all 5 patients. No complication and recurrence were observed, except one patient died of late lymphatic metastasis. Other patients reported good quality of life.ConclusionsFor locally recurrent breast cancer, complete tumor resection is complete tumor resection is essential and ensures no recurrence. Appropriate material and the blood-rich flap or myocutaneous flap should be used to reconstruct the chest wall defect as an effective treatment for surgical procedure.
Evolution of core archetypal phenotypes in progressive high grade serous ovarian cancer
Authors: Nath Aritro , Cosgrove Patrick A. , Copeland Benjamin , Mirsafian Hoda , Christie Elizabeth L. , Pflieger Lance , Majumdar Sumana , Cristea Mihaela C. , Han Ernest S. , Lee Stephen J. , Wang Edward W. , Fereday Sian , Traficante Nadia , Salgia Ravi , Werner Theresa , Cohen Adam L. , Moos Philip , Chang Jeffrey T. , Bowtell David D. L. , Bild Andrea H. 
Published: January 2021

Abstract
The evolution of resistance in high-grade serous ovarian cancer (HGSOC) cells following chemotherapy is only partially understood. To uncover phenotypic changes associated with chemotherapy resistance, we profiled single-cell RNA-sequencing (scRNA-seq) transcriptomes of HGSOC tumors collected longitudinally during patient treatment. Analysis of scRNA-seq data from two independent patient cohorts revealed that HGSOC is driven by three core archetypal phenotypes, defined as oncogenic tasks that describe the majority of the transcriptome variation. A multi-task learning approach to identify the biological tasks of each archetype identified metabolism and proliferation, cellular defense response, and DNA repair signaling. The metabolism and proliferation archetype evolved during treatment and was enriched in cancer cells from patients that received multiple-lines of treatment and had elevated tumor burden indicated by CA-125 levels. The emergence of archetypes was not consistently associated with specific whole-genome driver mutations. However, archetypes were closely associated with subclonal populations at the single-cell level, indicating that subclones within a tumor often specialize in unique biological tasks. Our study reveals the core archetypes found in progressive HGSOC and shows consistent enrichment of subclones with the metabolism archetype as resistance is acquired to multiple lines of therapy.
Paraneoplastic Focal Segmental Glomerulosclerosis Associated With Gastrointestinal Stromal Tumors With Cutaneous Metastasis: a Case Report
Authors: Zhou Jun , Yang Zhen , Yang Cuishun , Lin Hua , Yuan Wanqiong 
Published: January 2021

Abstract
Background: Gastrointestinal stromal tumor (GIST) is one of most common mesenchymal neoplasms occurring in different areas of the gastrointestinal tract. GISTs with cutaneous metastasis is very rare and its rarity cutaneous GISTs have not been well characterized. Focal segmental glomerulosclerosis (FSGS) is also rare among paraneoplastic nephritic syndromes (PNS).Case presentation: In this case report, we described a 64-year-old patient with cutaneous metastasis GIST accompanied by nephrotic syndrome as PNS, in whom symptomatic treatment was ineffective, but clinical remission was achieved after surgery. Moreover, the patient has a missense mutation of NPHP4. NPHP4 served as a negative regulator of the Hippo pathway. Hippo signaling pathway is involved in the development and progression of FSGS. NPHP4 is also indeed a driving force for proliferation in tumor cells. Therefore, the mutation of NPHP4 in this patient could explain the occurrence of GIST and FSGS and this was therefore not a random association.Conclusions: This is the first reported case of a GIST with cutaneous metastasis accompanied by nephrotic syndrome as PNS.
Management and Outcome of Patients With Femoral Head Fractures: Injuries and Associated Prognostic Factors
Authors: Shakya Sujan , Chen Jialei , Sun JiaChen , Xiang Zhou 
Published: January 2021

Abstract
Objective: Femoral head fractures are rare injuries that are often associated with poor functional outcome and complications. Fracture management and surgical methods for these fractures are variable. The purpose of this study was to evaluate the incidence, treatment methods and approaches, complications and functional outcomes of femoral head fractures.Methods: We conducted a retrospective review of fifty patients who sustained femoral head fractures from January 2011- December 2018. There were thirty-seven males and thirteen females with median age of 40 years. A surgical approach and fixation method were recorded. Patients were classified according to the Pipkin Classification system. Clinical results were evaluated for patients with two years or greater follow-up using the Modified Harris Hip Score (MHHS). Results: Eight patients (16%) were managed successfully with closed reduction without surgery and thirty-seven (74%) patients required operative reduction and internal fixation (ORIF) of the femoral head and acetabulum, 5 (10%) patients required immediate Total Hip Replacement (THR). Six (12%) developed AVN, four (8%) requiring secondary total hip replacement (THR). Sixteen patients (33%) developed PTA, eight (16%) developed HO and six patients (12 %) had sciatic nerve injury, none requiring operative treatment. Overall functional results, according to modified Harris hip score were excellent in two (4%) patients, good in sixteen (32%) patients, fair in twenty-two (44%) patients, and poor in ten (20%) patients. A statistically significant difference in outcome was observed among four pipkin subtypes. Conclusion: Femoral head fracture are a rare injury that are often associated with poor outcome. In this study we report the functional outcomes and complications of all treatment approaches for femoral head fracture based on Pipkin classification. This study, adds to the growing literature on femoral head fractures and provide reference for the clinical treatment to guide patient management.
Operating on a Stretcher is a Safe Alternative to An Operating Room Table
Authors: Garrett Christopher , Neal James Eric , Lewellyn Brett 
Published: January 2021

Abstract
Purpose:The primary purpose of this study was to compare intraoperative and post-operative complication rates for upper extremity surgical cases performed on a standard operating room (OR) table with similar cases done on a typical hospital stretcher. Secondary measures reviewed included surgical time, turnover time, total OR time, blood loss, tourniquet time, and postoperative complications.Methods:Using our institution’s electronic medical record system, we reviewed 100 consecutive upper extremity cases performed on a stretcher as well as 100 consecutive upper extremity cases done on a standard OR table. All cases were performed by the same board certified, fellowship trained orthopaedic surgeon. The cases were performed between February of 2014 and May of 2016 at a level one trauma center and its associated outpatient surgical center. Basic univariate statistical analyses were performed, and the two groups were compared for primary and secondary outcome measures.Results:The data showed no significant increase in intraoperative complication rateswhen operating on a standard hospital stretcher compared to operating on an OR table. There were a total of 6 postoperative complications in the stretcher group and a total of 11 complications in the OR table group. The most common postoperative complication seen in both cohorts was infection. There was one intraoperative complication in the OR table group and none in the stretcher group. With regard to total operating room time, surgical time, and delta time (overall OR room time minus surgical time which was used to calculate the turnover time), we found that the OR table group had shorter times in each category. The total OR time for the OR table group was a mean time of 105 minutes compared to 146 minutes seen in the stretcher group (p= 0.0002). Similarly, there was a shorter mean surgical time for surgeries done on an OR table (73 minutes) when compared to surgeries done on a stretcher (104 minutes) (p = 0.0026). Finally, the average turnover time (delta time) for the OR table group was 32 minutes while the average turnover time for the stretcher group was 42 minutes (p= 0.0002). The average tourniquet time for the OR table group was 36 minutes as compared to 41 in the stretcher group (p=0.467).Conclusion:Operating on a typical hospital stretcher is a safe alternative to operating on a standard operating room table as there was no increased complication rate seen with surgeries performed on a stretcher compared to an OR table.Level of Evidence: Level 3 evidence