bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disseminated nocardiosis involving the central nervous system in the context of newly diagnosed HIV infection: A case report
Authors: Liu Yuan , Hu Zhiliang , Wei Hongxia , Chen Yaling , Cheng Cong , Chi Yun 
Published: June 2021

Background: A newly diagnosed HIV patient with tuberculosis-like symptoms was confirmed with disseminated nocardiosis involving the central nervous system (CNS). This case report provides novel insights into the diagnosis and treatment of nocardiosis. Case presentation: A 44-year-old male newly diagnosed HIV patient presented on March 20, 2017, with the major symptoms of fever and headache. Computed tomography (CT) of the chest showed a mass in the lower lobe of the right lung. Brain magnetic resonance imaging (MRI) revealed multiple abnormal signals and ring enhancement. Blood culture suggested the presence of mycobacteria and positive acid-fast staining, and the strain was identified as Nocardia. He was administered an anti-infective therapeutic regimen consisting of cefotaxime sodium and sulbactam sodium (2.25 g, qid, iv), linezolid (0.6 g, bid, iv), moxifloxacin (0.4 g, qd, iv), sulfamethoxazole (1.44 g, qid, per os), and amikacin (0.4 g, qd, iv). After treatment, fever and skin nodules resolved, and reexamination by chest CT and brain MRI suggested improvement compared with the pretreatment situation. Conclusions: At present, there are few reports of disseminated Nocardia infection involving the CNS in HIV patients in China. This case report will help to enhance the understanding of disseminated Nocardia infection. In the process of clinical diagnosis and treatment, Nocardia may be initially misdiagnosed as disseminated TB. In the present case, tuberculosis-like symptoms actually corresponded to disseminated nocardiosis involving the CNS.
Sight Beyond Sight: A Conceptual Exploration of the ‘Gaze’ in Facilitating Simulations
Authors: Naweed Anjum , Leigh Elyssebeth 
Published: June 2021

Background: This article connects disparate components in simulation. The central component is that facilitators manage simulations as learning contexts. The second concerns a perception of simulations as safe containers, implying the existence of impermeable barriers between simulation and dangers of reality. However, when stepping into the facilitation space, facilitators encounter a third component—the gaze. A concept from critical theory and psychoanalysis, this refers to acts of seeing and being seen, of/by themselves and others, and can engender heightened awareness as facilitators see themselves from the focal point of multiple lens, and within a container that may not be so impermeable. Aim: To increase understanding of simulation skills and development options for facilitators, we explore these components using: a) novice to expert progression; b) power relationships; and c) the body memory as key factors which may influence the intensity and direction of awareness. Method: A narrative-based analysis of literature examines instances where awareness of self, and/or others influences how facilitators operate within simulations. Results: Aware that simulations create uncertainties, facilitators may experience greater anxiety than those managing non-facilitation settings. They must navigate participants through emergent conditions wherein the unexpected can conspire to render safe containers permeable, and alter participants’ expectations. Increased understanding of the impact of gaze may enable facilitators to respond flexibly to unanticipated developments. Conclusions: Understanding the impacts of the gaze within and beyond a simulation may enable facilitators to prepare internally—and perform externally. A conceptual framework is developed to assist facilitators reflect and identify applications.
Identification of key genes and pathways involved in abdominal aortic aneurysm initiation and progression
Authors: Su Zhixiang , Gu Yongquan 
Published: June 2021

Objective The study aimed to assess the gene expression profile of biopsies obtained from the neck of human abdominal aortic aneurysm (AAA) and the main site of AAA dilatation and to investigate the molecular mechanism underlying the development of AAA. Methods The microarray profile of GSE47472 and GSE57691 were obtained from the Gene Expression Omnibus (GEO) database. The GSE47472 was a microarray dataset of tissues from the aortic neck of AAA patients versus normal controls. The GSE57691 was a microarray dataset including the tissues from main site of AAA dilatation versus normal controls. Differentially expressed genes (DEGs) were chosen using the R package and annotated by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomics (KEGG). The hub genes were identified in the protein–protein interaction (PPI) network. Results 342 upregulated DEGs and 949 downregulated DEGs were obtained from GSE47472. The upregulated DEGs were mainly enriched in biological regulation (ontology: BP), the membrane (ontology: CC), and protein binding (ontology: MF), and the downregulated genes were mainly enriched in biological regulation (ontology: BP), the membrane (ontology: CC), and protein blinding (ontology: MF). In the KEGG enrichment analysis, the DEGs mainly involved glycosaminoglycan degradation, vasopressin-regulated water reabsorption, and pyruvate metabolism. The hub genes in GSE47472 mainly include VAMP8, PTPRC, DYNLL1, RPL38, RPS4X, HNRNPA1, PRMT1, TGOLN2, PA2G4, and CUL2. From GSE57691, 248 upregulated DEGs and 1120 downregulated DEGs were selected. The upregulated DEGs of GSE57691 were mainly enriched in biological regulation (ontology: BP), the membrane (ontology: CC), and protein binding (ontology: MF), and the downregulated genes were mainly enriched in metabolic process (ontology: BP), the membrane (ontology: CC), and protein blinding (ontology: MF). In the KEGG enrichment analysis, the DEGs mainly involved the mitochondrial respiratory, respiratory chain complex, and respiratory chain. RPS15A, RPS5, RPL23, RPL27A, RPS24, RPL35A, RPS4X, RPL7, RPS25, and RPL21 were identified as the hub genes . Conclusion At the early stage of AAA, the current study indicated the importance of glycosaminoglycan degradation and anaerobic metabolism. We also identified several hub genes closely related to AAA ( VAMP8, PTPRC, DYNLL1, etc. ). At the progression of the AAA, the dysfunctional mitochondria played a critical role in AAA formation and the RPS15A, RPS5, RPL23, etc., were identified as the hub genes.
Up to five-week delay in primary repair of Zone 2 flexor tendon injuries: outcomes and complications
Authors: Munz Giovanni , Poggetti Andrea , Cenci Luca , Rizzo Anna Rosa , Biondi Marco , Pfanner Sandra 
Published: June 2021

We report the outcomes of delayed primary repair of flexor tendons in Zone 2 in 31 fingers and thumb (28 patients) averaging 15 days (range 4–37) after injury in 2020. The delay was longer than usual due to the COVID-19 pandemic. The tendons were repaired with a 6-strand core suture (M-Tang method) or a double Tsuge suture and a peripheral suture. This was followed by an early, partial-range, active flexion exercise programme. Adhesions in four digits required tenolysis. These patients were not with longest delay. Outcomes of two improved after tenolysis. The other two patients declined further surgery. One finger flexor tendon ruptured in early active motion. This was re-repaired, and final outcome was good. Overall excellent and good results using the Tang criteria were in 27 out of 31 fingers and thumbs (87%). The time elapsed between the injury and surgery is not an important risk factor for a good outcome, rather it depends on proper surgical methods, the surgeon's experience and early mobilization, properly applied. Adhesions may occur, but they can be managed with tenolysis. Level of evidence: IV
Open Treatment of Osteochondral Lesions of the Talus With Bone Grafting and Particulated Juvenile Cartilage Allografting
Authors: Dasari Suhas P. , Langer Thomas M. , Parshall Derek , Law Brian 
Published: June 2021

Background: Large cystic osteochondral lesions of the talus (OLT) are challenging pathological conditions to treat, but particulated juvenile cartilage allografts (PJCAs) supplemented with bone grafts are a promising therapeutic option. The purpose of this project was to further elucidate the role of PJCA with concomitant bone autografts for treating large cystic OLTs with extensive subchondral bone involvement (greater than 150 mm2 in area and/or deeper than 5 mm). Methods: We identified 6 patients with a mean OLT area of 307.2 ± 252.4 mm2 and a mean lesion depth of 10.85 ± 6.10 mm who underwent DeNovo PJCA with bone autografting between 2013 and 2017. Postoperative outcomes were assessed with radiographs, Foot and Ankle Outcome Scores (FAOS), and visual pain scale scores. Results: At final follow-up (27.0 ± 12.59 weeks), all patients had symptomatic improvement and incorporation of the graft on radiographs. At an average of 62 ± 20.88 months postoperatively, no patients required a revision surgery. All patients contacted by phone in 2018 and 2020 reported they would do the procedure again in retrospect and reported an improvement in their symptoms relative to their preoperative state, especially with pain and in the FAOS activities of daily living subsection (91.93 ± 9.04 in 2018, 74.63 ± 26.86 in 2020). Conclusion: PJCA with concomitant bone autograft is a viable treatment option for patients with large cystic OLTs. Levels of Evidence: Level IV
Early Results of a Novel Intramedullary Fixation Device for Proximal Fifth Metatarsal Fractures
Authors: Umbel Benjamin D. , Sharpe B. Dale , Hockman Taylor , Philbin Terrence M. 
Published: June 2021

Background Proximal fifth metatarsal fractures are commonly treated surgically due to their poor healing capacity. While intramedullary screws may be the most popular operative treatment choice, newer fixation methods continue to develop. We present a case series utilizing a novel intramedullary fixation device for proximal fifth metatarsal fractures. To our knowledge, no other study in the literature has assessed the safety and efficacy of this fixation method. Methods A retrospective analysis was performed for 16 patients with proximal fifth metatarsal fractures who underwent fixation with the same novel intramedullary device. Patient charts were reviewed for fracture union, plantar fracture gapping, time to weight-bearing, refracture, perioperative complications, and secondary surgeries. Results Sixteen patients with an average age of 43.3 years underwent fixation with this novel device from 2015 to 2020. Mean follow-up was 32.4 weeks. Fifteen of the 16 patients achieved radiographic union at a mean of 8.9 weeks. One patient suffered a nonunion. Mean time to full weight-bearing in, and out of, a walking boot was 6.4 and 9.8 weeks, respectively, for healed fractures. Mean plantar fracture gap improved from 1.22 mm to 0.88 mm following surgery. There were zero infections, refractures, or hardware complications. Three patients suffered iatrogenic fracture during implant insertion. Conclusion To our knowledge, this is the first report of early results for this novel intramedullary device. Excellent union rates, acceptable time to weight-bearing, and a low complication profile can be achieved. Based on our findings, we propose a safe and effective treatment option for proximal fifth metatarsal fractures. Levels of Evidence Level IV: Clinical case series
Conservative Treatment of the Fifth Metatarsal Bone Fractures in Professional Football Players Using Platelet-Rich Plasma
Authors: Bezuglov Eduard , Zholinsky Andrey , Chernov Gleb , Khaitin Vladimir , Goncharov Evgeniy , Waśkiewicz Zbigniew , Barskova Ekaterina , Lazarev Artemii 
Published: June 2021

Injuries of the metatarsal bones in football are relatively rare and in most cases are localized in the fifth metatarsal. The gold standard of the diagnosis of fractures in this area can be X-rays, which in most cases allows verifying the diagnosis. The treatment tactics depend on the localization of the fracture according to Lawrence and Botte’s classification: 3 zones of localization are distinguished. Fractures located in zones 2 and 3 belong to a high-risk group due to delayed consolidation and nonunion and therefore athletes are most often treated with osteosynthesis using intramedullary screws. The minimal recovery time for this type of treatment is at least 8 weeks. This report describes 7 cases of the fifth metatarsal bone fractures, located in zones 2 and 3 in professional football players who were treated with an immobilization boot, cryotherapy, nutritional supplements of calcium and vitamin D, and local injections of platelet-rich plasma, which contains numerous growth factors. The deadline for returning to regular training activities was 43 to 50 days, and there was no relapse of damage within 6 months of follow-up. Levels of Evidence: Level of evidence 4: case report study
The Impact of an Educational Program on Medical Students’ Knowledge and Awareness of Elder Abuse
Authors: West Abbie , Cawley Cara , Crow Elizabeth , Stoner Alexis M. , Fadel Natalie M. , Ford-Scales Kristi , Cheng Ning 
Published: June 2021

Objective: Approximately 1 in 6 adults 60 and older have experienced a form of abuse in the past year. Many cases remain under-reported due to lack of knowledge and awareness. This study created an educational program on elder abuse for medical students to determine if participation would increase knowledge and awareness of elder abuse. Methods: This study used a pre and post survey methodology to evaluate students’ knowledge and awareness of elder abuse before and after participating in this educational program. Sixty first and second year osteopathic medical students at the Edward Via College of Osteopathic Medicine, Carolinas Campus participated in this study. Students were emailed a pre-survey to evaluate their pre-existing knowledge and awareness. The survey was, previously created by the Student Training on Preventing Domestic Violence (STOP-DV) team using validated measures. Participants then attended educational events about various forms of elder abuse and recognizing its associated signs, and afterward completed the post-survey. The results were compared using t-tests to determine if there was a significant difference. Results: First and second year students differed significantly in pre-survey results of knowledge but not post-survey results. The results showed a significant difference in overall mean knowledge ( P-value < .001) and awareness scores ( P-value < .001) in all students. Conclusion: These results suggest education on elder abuse can enable future physicians to better recognize, understand, and support older adults regarding elder maltreatment.
Oxfordshire Community Stroke Project Classification: A proposed automated algorithm
Authors: Andrade Joao Brainer Clares de , Mohr Jay P , Timbó Felipe Brito , Nepomuceno Camila Rodrigues , Moreira João Vitor da Silva , Timbó Isabelle da Costa Goes , Lima Fabricio Oliveira , Silva Gisele Sampaio , Bamford John 
Published: June 2021

Introduction The Oxfordshire Community Stroke Project (OCSP) proposed a clinical classification for Stroke patients. This classification has proved helpful to predict the risk of neurological complications. However, the OCSP was initially based on findings on the neurological assesment, which can pose difficulties for classifying patients. We aimed to describe the development and the validation step of a computer-based algorithm based on the OCSP classification. Materials and methods A flow-chart was created which was reviewed by five board-certified vascular neurologists from which a computer-based algorithm (COMPACT) was developed. Neurology residents from 12 centers were invited to participate in a randomized trial to assess the effect of using COMPACT. They answered a 20-item questionnaire for classifying the vignettes according to the OCSP classification. Each correct answer has been attributed to 1-point for calculating the final score. Results Six-two participants agreed to participate and answered the questionnaire. Thirty-two were randomly allocated to use our algorithm, and thirty were allocated to adopt a list of symptoms alone. The group who adopted our algorithm had a median score of correct answers of 16.5[14.5, 17]/20 versus 15[13, 16]/20 points, p = 0.014. The use of our algorithm was associated with the overall rate of correct scores (p = 0.03). Discussion Our algorithm seemed a useful tool for any postgraduate year Neurology resident. A computer-based algorithm may save time and improve the accuracy to classify these patients. Conclusion An easy-to-use computer-based algorithm improved the accuracy of the OCSP classification, with the possible benefit of further improvement of the prediction of neurological complications and prognostication.
Rapid, simplified whole blood-based multiparameter assay to quantify and phenotype SARS-CoV-2-specific T-cells
Authors: Riou Catherine , Schäfer Georgia , du Bruyn Elsa , Goliath Rene T. , Stek Cari , Mou Huihui , Hung Deli , Wilkinson Katalin A. , Wilkinson Robert J. 
Published: June 2021

BackgroundRapid tests to evaluate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific T-cell responses are urgently needed to decipher protective immunity and aid monitoring vaccine-induced immunity.MethodsUsing a rapid whole blood assay requiring a minimal amount of blood, we measured qualitatively and quantitatively SARS-CoV-2-specific CD4 T-cell responses in 31 healthcare workers using flow cytometry.Results100% of COVID-19 convalescent participants displayed a detectable SARS-CoV-2-specific CD4 T-cell response. SARS-CoV-2-responding cells were also detected in 40.9% of participants with no COVID-19-associated symptoms or who tested PCR-negative. Phenotypic assessment indicated that, in COVID-19 convalescent participants, SARS-CoV-2 CD4 responses displayed an early differentiated memory phenotype with limited capacity to produce interferon (IFN)-γ. Conversely, in participants with no reported symptoms, SARS-CoV-2 CD4 responses were enriched in late differentiated cells, coexpressing IFN-γ and tumour necrosis factor-α and also Granzyme B.ConclusionsThis proof-of-concept study presents a scalable alternative to peripheral blood mononuclear cell-based assays to enumerate and phenotype SARS-CoV-2-responding T-cells, thus representing a practical tool to monitor adaptive immunity due to natural infection or vaccine trials.
Within-session variability as quality control for oscillometry in health and disease
Authors: Harkness Louise M. , Patel Kieran , Sanai Farid , Rutting Sandra , Cottee Alice M. , Farah Claude S. , Schoeffel Robin E. , King Gregory G. , Thamrin Cindy 
Published: June 2021

Oscillometry is increasingly adopted in respiratory clinics, but many recommendations regarding measurement settings and quality control remain subjective. The aim of this study was to investigate the optimal number of measurements and acceptable within-session coefficient of variation (CoV) in health, asthma and COPD.15 healthy, 15 asthma and 15 COPD adult participants were recruited. Eight consecutive 30-s measurements were made using an oscillometry device, from which resistance at 5 Hz (Rrs5) was examined. The effect of progressively including a greater number of measurements onRrs5and its within-session CoV was investigated. Data were analysed using one-way repeated-measures ANOVA with Bonferronipost hoctest.The CoV(Rrs5) of the first three measurements was 6.7±4.7%, 9.7±5.7% and 12.6±11.2% in healthy, asthma and COPD participants, respectively. Both meanRrs5and CoV(Rrs5) were not statistically different when progressively including four to eight measurements. Selecting the three closestRrs5values over an increasing number of measurements progressively decreased the CoV(Rrs5). In order for ≥95% of participants to fall within a target CoV(Rrs5) of 10%, four or more, five and six measurements were needed in health, asthma and COPD, respectively.Within-session variability of oscillometry is increased in disease. Furthermore, the higher number of measurements required to achieve a set target for asthma and COPD patients may not be practical in a clinical setting. Provided technical acceptability of measurements is established,i.e.by removing artefacts and outliers, then a CoV of 10% is a marker of quality in most patients, but we suggest higher CoVs up to 15–20% should still be reportable.
AXL receptor tyrosine kinase: a possible therapeutic target in acute promyelocytic leukemia
Authors: Fatima Mariam , Kakar Salik Javed , Adnan Fazal , Khan Khalid , Mian Afsar Ali , Khan Dilawar 
Published: June 2021

Abstract
Background
Acute promyelocytic leukemia (APL) is a subset of acute myeloid leukemia (AML) which is characterized by the fusion of promyelocytic leukemia PML and retinoic acid receptor- alpha (RAR-alpha) genes. All-trans retinoic acid (ATRA) and/or arsenic trioxide (ATO) have resulted in durable cytogenetic and molecular remissions in most APL patients and have altered the natural history of the disease. Most APL patients treated with ATRA and/or ATO are now anticipated to have a nearly normal life expectancy. Unfortunately, relapse and resistance to the current treatment occur in APL patients and the outcome remains dismal in these refractory patients.
AXL receptor tyrosine kinase (AXL-RTK) has been shown to increase tumour burden, provide resistance to therapy and is critical to maintain cancer stem cells (CSCs) in chronic myeloid leukemia (CML) by stabilizing β-catenin in the Wnt/β-catenin signalling pathway. However, the role of AXL-RTK has not been explored in PML/RARα-positive APL. This study aimed to explore the role of AXL-RTK receptor in PML/RARα-positive APL.

Methods and results
By using biochemical and pharmacological approaches, here we report that targeting of AXL-RTK is related to the down-regulation of β-catenin target genes including c-myc (p < 0.001), AXIN2 (p < 0.001), and HIF1α (p < 0.01) and induction of apoptosis in PML/RARα-positive APL cell line. Resistance to all-trans retinoic acid (ATRA) was also overcomed by targeting AXL-RTK with R428 in APL (p < 0.05).

Conclusion
Our results provide clear evidence of the involvement of AXL-RTK in leukemogenic potential of PML/RARα-positive APL and suggest targeting of AXL-RTK in the treatment of therapy resistant APL patients.