bluuebunny/crossref_metadata_2025_split huggingface dataset:
Schwannoma in the External Auditory Canal
Authors: Jeong Junhui , Oh Jangwon , Choi Hyun Seung 
Published: March 2021

Abstract
Schwannoma is a slow-growing, benign tumor originating from the Schwann cells of peripheral nerve sheaths. Schwannoma in the external auditory canal is rare but should be included in the possible diagnosis of a cystic mass. If schwannoma is suspected, computed tomography or magnetic resonance imaging should be performed to explore tumor size, location, possible extension, and origin before excision. The authors here present a large schwannoma that almost completely occluded the external auditory canal and was completely excised using a transcanal approach.
Fully Endoscope-Controlled Clipping Ruptured Intrameatal Anterior Inferior Cerebellar Artery Aneurysm: Report of 2 Cases
Authors: Gao Wenbo , Liu Pengfei , Deng Guozhi , Li Zefu 
Published: March 2021

Abstract
Aneurysms of the anterior inferior cerebellar artery (AICA) are a rare entity. Purely intrameatal aneurysms are even rarer. The author reported 2 ruptured intrameatal aneurysms that were treated by fully endoscope-controlled clipping. Retrosigmoid craniotomy was performed and the aneurysm was clipped definitely intraoperative without postoperative deficits except hearing loss and slight facial nerve paresis. Follow-up angiography demonstrated exclusion of the aneurysm, confirming preservation of the distal aneurysms of the anterior inferior cerebellar artery. Endoscopic enhancement of the visual field provided by the endoscope may be a safe and effective application to increase the quality of treatment for intrameatal aneurysm, especially for deep aneurysm.
The Effect of Bimaxillary Orthognathic Surgery on Voice Characteristics in Skeletal Class 3 Deformity Patients: An Evaluation Using Acoustic Analysis
Authors: Emrani Erfan , Ghaemi Hamide , Labafchi Ali , Samieirad Sahand 
Published: March 2021

Abstract
The aim of this study was to analyze the effects of bimaxillary orthognathic surgery on the acoustic voice characteristics of skeletal class 3 patients. All healthy nonsyndromic patients with Class 3 deformity who were eligible for bimaxillary orthognathic surgery, were included in this before and after quasi-experimental study. This experiment's main intervention was mandibular setback surgery by bilateral sagittal split osteotomy plus maxillary advancement using LeFort 1 osteotomy. Age, sex, and intraoperative jaw movements were recorded. Acoustic analysis of voice samples (vowels /a/ and /i/) was performed with Praat software as outcome variables. The formant frequencies (F0, F1, F2, and F3) of these vowels were extracted 1 week preoperatively (T0), 1 and 6 months (T1, T2) postoperatively by a speech therapist. The significance level was set at 0.05 using SPSS 19. The study sample comprised 20 patients including 11 women (55%) and 9 men (45%) with a mean age of 31.95 ± 4.72 years. The average mandibular setback and maxillary advancement were 3.30 ± 0.86 and 2.85 ± 0.74 mm, respectively. The fundamental frequency (F0) and the first, second, and third formants (F1, F2, F3) of vowels /i/ and /a/ were significantly decreased over time intervals, postoperatively (P < 0.05). The finding revealed that bimaxillary orthognathic surgery (maxillary advancement and mandibular setback with bilateral sagittal split osteotomy) might reduce the acoustic formant parameters of voice to the normal frequency ranges, in patients with class 3 skeletal deformities. More clinical trials with greater sample sizes and long-term follow-ups are suggested in the future.
Kick Start to an Epidemiological Report of Soccer-Related Craniofacial Trauma Analysis
Authors: Nahas John V. , Choi Melinda J. , Wolfe Erin M. , Pierrot Randall G. , Slavin Benjamin R. , Plotsker Ethan L. , Mathew Prakash J. , Thaller Seth R. 
Published: March 2021

Introduction:
Soccer is a global sport played by millions annually with an increasing popularity in the United States. Game is played by a wide range of participants from all ages and levels of competition. This scenario leads to a potential disparity in the injury profile based on quantifiable demographics. As the game continues to grow, injury detection and side-line assessment must change as well.

Methods:
Utilizing a national injury database, a retrospective cohort study was conducted using 10 years of data collected from randomly selected emergency departments across the United States. Patient demographics, injury sites, and diagnosis were recorded. Diagnoses examined included concussion, contusion or abrasion, dental injury, fracture, hematoma, hemorrhage, internal injury, and laceration.

Results:
Highest percentage of craniofacial injuries was observed in soccer players between the ages of 12 and 18. In ages 6 to 11 the most common injuries were contusions and dental injuries, with a significantly low number of fractures. Within the age group of 12 to 18 the highest percentage of injuries was concussions. Finally, the highest percentage of injury in the ages of 19 to 34 were fractures and lacerations.

Discussion:
There is a shift in injury profile as the age of soccer players increases and the level of play becomes faster-paced. In youth players, there is a higher percentage of soft tissue injury. Older players are more likely to suffer a higher degree of injury including fractures, concussions, and lacerations. This suggests a great utility for a layperson-friendly educational intervention initiative applicable to all demographics for the sport of soccer.
Complement Blockade in Recipients Prevents Delayed Graft Function and Delays Antibody-mediated Rejection in a Nonhuman Primate Model of Kidney Transplantation
Authors: Eerhart Michael J. , Reyes Jose A. , Blanton Casi L. , Danobeitia Juan S. , Chlebeck Peter J. , Zitur Laura J. , Springer Megan , Polyak Erzsebet , Coonen Jennifer , Capuano Saverio , D’Alessandro Anthony M. , Torrealba Jose , van Amersfoort Edwin , Ponstein Yolanda , van Kooten Cees , Burlingham William , Sullivan Jeremy , Pozniak Myron , Zhong Weixiong , Yankol Yucel , Fernandez Luis A. 
Published: March 2021

Background.
Complement activation in kidney transplantation is implicated in the pathogenesis of delayed graft function (DGF). This study evaluated the therapeutic efficacy of high-dose recombinant human C1 esterase inhibitor (rhC1INH) to prevent DGF in a nonhuman primate model of kidney transplantation after brain death and prolonged cold ischemia.

Methods.
Brain death donors underwent 20 h of conventional management. Procured kidneys were stored on ice for 44–48 h, then transplanted into ABO-compatible major histocompatibility complex-mismatched recipients. Recipients were treated with vehicle (n = 5) or rhC1INH 500 U/kg plus heparin 40 U/kg (n = 8) before reperfusion, 12 h, and 24 h posttransplant. Recipients were followed up for 120 d.

Results.
Of vehicle-treated recipients, 80% (4 of 5) developed DGF versus 12.5% (1 of 8) rhC1INH-treated recipients (P = 0.015). rhC1INH-treated recipients had faster creatinine recovery, superior urinary output, and reduced urinary neutrophil gelatinase-associated lipocalin and tissue inhibitor of metalloproteinases 2-insulin-like growth factor-binding protein 7 throughout the first week, indicating reduced allograft injury. Treated recipients presented lower postreperfusion plasma interleukin (IL)-6, IL-8, tumor necrosis factor-alpha, and IL-18, lower day 4 monocyte chemoattractant protein 1, and trended toward lower C5. Treated recipients exhibited less C3b/C5b-9 deposition on day 7 biopsies. rhC1INH-treated animals also trended toward prolonged mediated rejection-free survival.

Conclusions.
Our results recommend high-dose C1INH complement blockade in transplant recipients as an effective strategy to reduce kidney injury and inflammation, prevent DGF, delay antibody-mediated rejection development, and improve transplant outcomes.
Kidney Allograft and Recipient Survival After Heart Transplantation by Induction Type in the United States
Authors: Riad Samy , Alexy Tamas , Jackson Scott , Goswami Umesh , Martin Cindy 
Published: March 2021

Background.
Induction choices for kidney-after-heart transplant recipients are variable. We examined the impact of kidney induction types on kidney graft and patient survival in heart transplant recipients.

Methods.
We analyzed the Scientific Registry of Transplant Recipient database from inception through the end of 2018 to study kidney and patient outcomes in the United States after heart transplantation. We only included recipients who were discharged on tacrolimus and mycophenolate maintenance. We grouped recipients by induction type into 3 groups: depletional (N = 307), nondepletional (n = 253), and no-induction (steroid only) (n = 57). We studied patients and kidney survival using Cox PH regression, with transplant centers included as a random effect. We adjusted the models for heart induction, recipient and donor age, gender, time between heart and kidney transplant, heart transplant indication, HLA mismatches, payor, live-donor kidney, transplant year, dialysis status, and diabetes mellitus at the time of kidney transplant.

Results.
The 1-y kidney rejection rates and creatinine levels were similar in all groups. The 1-y rehospitalization rate was higher in the depletional group (51.7%) and nondepletional group (50.7%) than in the no-induction group (39.1%) although this was not statistically significant. There were no differences in recipient or kidney survival by kidney induction type. Live-donor kidney was associated with improved patient (hazard ratio, 0.74; 95% confidence interval, 0.54-1.0; P = 0.05) and kidney survival (hazard ratio, 0.45; 95% confidence interval, 0.24-0.84; P = 0.012].

Conclusions.
Type of kidney induction did not influence patient or kidney graft survival in heart transplant recipients. No-induction may be the preferred choice due to the lack of clinical benefits associated with induction use.
Successful use of the sodium-glucose co-transporter-2 inhibitor dapagliflozin in patients with renal transplant and diabetes: a case series and literature review
Authors: Gul Wajiha , Naem Emad , Elawad Safa , Elhadd Tarik 
Published: March 2021

Background
Management of patients with diabetes and renal transplant could be challenging. Transplant patients use multiple immune suppressants that can worsen or even trigger hyperglycemia. There are no data about the use of the new class of sodium-glucose co-transporter-2 (SGLT-2) inhibitor dapagliflozin in patients with renal transplant and diabetes.

Case series
Four patients, with diabetes, who are attending the diabetes clinic at our institution, are presented here. They were all counseled to be started on dapagliflozin 10 mg to improve diabetes control as they were on multiple agents and not achieving targets. All four patients showed significant improvement in hemoglobin A1c, with no adverse effects on renal parameters and had favorable effect on weight and blood pressure (BP).

Conclusion
Use of the SGLT-2 inhibitor dapagliflozin in the standard dose of 10 mg helped to achieve satisfactory control with favorable effects on BP and weight with no adverse effects on renal function.
COVID-19 IN IRAQ, THE RURAL INITIATION (AL-MUTHANNA PROVINCE AS AN EXAMPLE)
Authors: Thwiny Hazim Talib , Jaber Safa Ibrahim , Ateya Hekmat Kadhum , Al-Yasari Ali Mosa Rashid , Alsalih Nawar Jasim , AL- Saadawe Moyed A. , Jasim Emad Salih , Alsaadawi Mohenned A. 
Published: March 2021

ABSTRACTA sustained pneumonia outbreak associated with a novel coronavirus named acute respiratory coronavirus 2 syndrome (SARS-CoV-2) was identified in Wuhan, Hubei Province, China in December 2019 which was later called COVID-19. The first confirmed case of COVID-19 was reported in Najaf/ Iraq on 24th February. This paper provided some information on COVID-19 infection in the Province of Al-Muthanna / South Iraq, which was then statistically analyzed and concluded. Confirmed cases of COVID-19 infections were reported by the Iraqi Ministry of Health in the Province of Al-Muthanna. The first foci started and the first dead infected individual was from Hilal which refers mainly to the role or rural places in starting and transmission of COVID-19 in Iraq. Many of the infections resulted in non-traveling persons because they were contaminated by contact (96%). Therefore, contact is perceived to be the best-recognized form of transmission. It was also reported that infections in Soweir District of Samawah City were the highest (45%) compared to other areas of the region. They should also be observed, however, that the steps to enforce and monitor the curfew are directly related to the direction of the City Centre, because the more they drive away from the city centers, the less stringent the procedures. Infections were focused between the ages of 20 and 50 years old, as that is the expected result, because these ranges are at the core of active age groups including social and sports events.Graphical abstract
Targeted Hybridization Capture of SARS-CoV-2 and Metagenomics Enables Genetic Variant Discovery and Nasal Microbiome Insights
Authors: Nagy-Szakal Dorottya , Couto-Rodriguez Mara , Wells Heather L. , Barrows Joseph , Debieu Marilyne , Butcher Kristin , Chen Siyuan , Berki Agnes , Hager Courteny , Boorstein Robert J. , Taylor Mariah K. , Jonsson Colleen B. , Mason Christopher E. , O’Hara Niamh B. 
Published: March 2021

ABSTRACTThe emergence of novel SARS-CoV-2 genetic variants that may alter viral fitness highlights the urgency of widespread next-generation sequencing (NGS) surveillance. To profile genetic variants, we developed and clinically validated a hybridization capture SARS-CoV-2 NGS assay, integrating novel methods for panel design using dsDNA biotin-labeled probes, and built accompanying software. The positive and negative percent agreement were defined in comparison to an orthogonal RT-PCR assay (PPA and NPA: both 96.7%). The limit of detection was established to be 800 copies/ml with an average fold-enrichment of 46,791x. We identified novel 107 mutations, including 24 in the functionally-important spike protein. Further, we profiled the full nasopharyngeal microbiome using metagenomics and found overrepresentation of 7 taxa and macrolide resistance in SARS-CoV-2-positive patients. This hybrid capture NGS assay, coupled with optimized software, is a powerful approach to detect and comprehensively map SARS-CoV-2 genetic variants for tracking viral evolution and guiding vaccine updates.TEASERThis is the first target hybridization capture-based NGS assay to detect SARS-CoV-2 genetic variants for tracking viral evolution.
Adapting French COVID-19 vaccination campaign duration to variant dissemination
Authors: Pageaud Simon , Ponthus Nicolas , Gauchon Romain , Pothier Catherine , Rigotti Christophe , Eyraud-Loisel Anne , Bertoglio Jean-Pierre , Bienvenüe Alexis , Gueyffier François , Vanhems Philippe , Leboisne Nicolas , Iwaz Jean , Loisel Stéphane , Roy Pascal 
Published: March 2021

AbstractBackgroundThe outbreak of SARS-CoV-2 virus has caused a major international health crisis with serious consequences in terms of public health and economy. In France, two lockdown periods were decided in 2020 to avoid the saturation of intensive care units (ICU) and an increase in mortality. The rapid dissemination of variant SARS-CoV-2 VOC 202012/01 has strongly influenced the course of the epidemic. Vaccines have been rapidly developed. Their efficacy against the severe forms of the disease has been established, and their efficacy against disease transmission is under evaluation. The aim of this paper is to compare the efficacy of several vaccination strategies in the presence of variants in controlling the COVID-19 epidemic through population immunity.MethodsAn agent-based model was designed to simulate with different scenarios the evolution of COVID-19 pandemic in France over 2021 and 2022. The simulations were carried out ignoring the occurrence of variants then taking into account their diffusion over time. The expected effects of three Non-Pharmaceutical Interventions (Relaxed-NPI, Intensive-NPI, and Extended-NPI) to limit the epidemic extension were compared. The expected efficacy of vaccines were the values recently estimated in preventing severe forms of the disease (75% and 94%) for the current used vaccines in France (Pfizer-BioNTech and Moderna since January 11, 2021, and AstraZeneca since February 2, 2021). All vaccination campaigns reproduced an advanced age-based priority advised by the Haute Autorité de Santé. Putative reductions of virus transmission were fixed at 0, 50, 75 and 90%. The effects of four vaccination campaign durations (6-month, 12-month, 18-month and 24-month) were compared.ResultsIn the absence of vaccination, the presence of variants led to reject the Relaxed-NPI because of a high expected number of deaths (170 to 210 thousands) and the significant overload of ICUs from which 35 thousand patients would be deprived. In comparison with the situation without vaccination, the number of deaths was divided by 7 without ICU saturation with a 6-month vaccination campaign. A 12-month campaign would divide the number of death by 3 with Intensive-NPI and by 6 with Extended-NPI (the latter being necessary to avoid ICU saturation). With 18-month and 24-month vaccination campaigns without Extended-NPI, the number of deaths and ICU admissions would explode.ConclusionAmong the four compared strategies the 6-month vaccination campaign seems to be the best response to changes in the dynamics of the epidemic due to the variants. The race against the COVID-19 epidemic is a race of vaccination strategy. Any further vaccination delay would increase the need of strengthened measures such as Extended-NPI to limit the number of deaths and avoid ICU saturation.
Modelling addition and replacement mechanisms of plasmid-based beta-lactam resistant E. coli infections
Authors: Godijk Noortje G. , Bootsma Martin C.J. , van Werkhoven Henri C. , Schweitzer Valentijn A. , de Greeff Sabine C. , Schoffelen Annelot F. , Bonten Marc J.M. 
Published: March 2021

AbstractIt is unknown whether antibiotic-resistant bacterial infections occur in addition to antibiotic-susceptible bacterial infections, thereby increasing the infection incidence, or whether they replace such infections, leaving total incidence unaffected. Observational longitudinal studies cannot separate both mechanisms. Using plasmid-based beta-lactam resistant E. coli as example, we applied a mathematical neutral null model to investigate whether biological mechanisms implying either a fitness cost or a benefit due to resistance lead to replacement or addition. Fitness costs cause resistant strains to die out if other strain characteristics are maintained equal. Under the assumptions tested, only increased virulence increases the total number of infections, while other of resistance lead to replacement without changing the total number of infections. As there is no biological evidence that plasmid-based beta-lactam resistance increases virulence, these findings suggest that the burden of disease is determined by attributable effects of resistance rather than by an increase in infections.
Investigation of the ventilation situation in a lecture room of building 033 at the Universität der Bundeswehr München
Authors: Kähler Christian J. , Fuchs Thomas , Hain Rainer 
Published: March 2021

AbstractThe SARS-CoV-2 pandemic is limiting both the private and public lives of many people around the world. It is now considered certain that SARS-CoV-2 is transmitted via droplets, smear infection, and aerosol particles. While simple masks, spacing, and hand hygiene significantly reduce the risk of infection via the first two routes mentioned, the risk from aerosol particles remains. These small particles move with the air in the room and spread unhindered throughout it. To reduce the risk of infection from viruses present in aerosol particles, the following options exist. First, good respiratory masks can be worn to reduce the viral load in the inhaled air. Another option is to make the viruses harmless (e.g., by UV light). A third option is to reduce the viral load in the room by bringing in virus-free air and moving contaminated air out or cleaning the air in the room. To investigate how well virus load reduction via ventilation works in a real lecture room, measurements were carried out at the Universität der Bundeswehr München (University of the Federal Armed Forces Munich). The lecture room holds a maximum of approx. 90 people and has a ventilation system as well as 2 windows that can be opened. In the absence of a ventilation system in a comparable room, the effectiveness of a room air cleaner was also investigated.
Impact of the COVID-19 pandemic on surgical procedures in Brazil: a descriptive study
Authors: Luizeti Bárbara Okabaiasse , Perli Victor Augusto Santos , da Costa Gabriel Gonçalves , Eckert Igor da Conceição , Roma Aluisio Marino , da Costa Karina Miura 
Published: March 2021

AbstractBackgroundThe COVID-19 pandemic has deeply affected medical practice, and changes in healthcare activities were needed to minimize the overload and avoid healthcare systems collapse. The aim of this study was to evaluate the impact of the pandemic on surgical procedures in Brazil.Materials and MethodsWe conducted a descriptive study of the number of hospitalizations for surgical procedures in Brazil from 2016 to 2020. Data were collected from the Brazilian Department of Informatics of the Unified Health System (DATASUS). Analyzes were performed according to the type of procedure, geographical region, subgroups of surgical procedures, and the number of surgeries from 2020 were compared with the average from 2016 to 2019.ResultsThere were 4,009,116 hospitalizations for surgical procedures in the Brazilian Public Health System in 2020. When comparing it to the average of hospitalizations from 2016-2019, there was a decrease of 14.88% [95%IC (14.82-14.93)]. Decrease rates were 34.82% [95%IC (34.73-34.90)] for elective procedures and 1.11% [95%IC (1.07-1.13)] for urgent procedures. Decrease rates were similar in all the five regions of the country (average 14.17%). Surgical procedure subgroups with the highest decrease rates were endocrine gland surgery (48.03%), breast surgery (40.68%), oral and maxillofacial surgery (37.03%), surgery of the upper airways, face, head and neck (36.06%), and minor surgeries and surgeries of skin, subcutaneous tissue and mucosa (33.16%). Conclusion: The overload of healthcare facilities has demanded a reduction of non-urgent activities to prevent a collapse of healthcare systems, resulting in a decrease in elective surgeries. Recommendations about the performance of surgical procedures were made, and continuous refinements of these recommendations are encouraged.