bluuebunny/crossref_metadata_2025_split huggingface dataset:
SARS-CoV-2 Infections and Serologic Responses Among Military Personnel Deployed on the USNS COMFORT to New York City During the COVID-19 Pandemic
Authors: Lalani Tahaniyat , Lee Tida K , Laing Eric D , Ritter Andrew , Cooper Elizabeth , Lee Melissa , Baker Matthew , Baldino Tyler , Mcadoo Terrance , Phogat Shreshta , Samuels Emily , Nguyen Huy , Broder Christopher C , Epsi Nusrat , Richard Stephanie A , Warkentien Tyler E , Millar Eugene V , Burgess Timothy , Kronmann Karl C 
Published: January 2021

Abstract

Background
Coronavirus disease 2019 (COVID-19) presents a unique challenge to United States Navy hospital ships. The aim of this study was to determine the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among US Navy personnel deployed on the USNS COMFORT to augment the inpatient health care capacity in New York City.

Methods
This was a cross-sectional study conducted on USNS COMFORT crewmembers returning to Norfolk, Virginia, following deployment. Participants completed an electronic questionnaire and provided a serum sample at Day 14 post-deployment. Polymerase chain reaction (PCR) results from testing of symptomatic crewmembers during deployment and Day 0 and Day 14 post-deployment screening swabs conducted on all crewmembers, per military order, were abstracted. SARS-CoV-2 infection was defined as a positive SARS-CoV-2 spike glycoprotein immunoglobulin G antibody or PCR result.

Results
Of the ship’s total complement of 1200 crewmembers, 450 were enrolled: 432 (96.0%) completed the questionnaire and provided a serum sample. The median age of participants (interquartile range) was 30 (24–39) years, 50.8% were female, 58.6% were White, and 14.0% were Black; 80.1% had a clinical role during deployment. The cumulative prevalence of SARS-CoV-2 infection was 3.01% (13/432; 95% CI, 1.61%–5.09%). Twelve of 13 infections occurred in health care providers, and 8 of 13 were asymptomatic. The antibody profile of infected crewmembers varied by suspected timing of infection.

Conclusions
We observed a low prevalence of SARS-CoV-2 infection among USNS COMFORT crewmembers despite the inherent risk of a shipboard deployment to an area with high rates of community transmission. Our findings suggest that early infection control measures mitigated the spread of SARS-CoV-2 among crewmembers.
Technical Note: Extreme Lateral Supracerebellar Approach for Resection of Superior Cerebellar Peduncle Arteriovenous Malformations
Authors: Klironomos Georgios , Chiluwal Amrit K , Dehdashti Amir R 
Published: January 2021

Abstract

BACKGROUND
The surgical approaches to the region of the cerebello-mesencephalic sulcus and superior cerebellar peduncle (SCP) remain a neurosurgical challenge.

OBJECTIVE
To present the use of the extreme lateral supracerebellar infratentorial (SC-IT) approach to treat arteriovenous malformations (AVMs) of the SCP, which is a different entity compared to brainstem AVMs

METHODS
We treated 4 patients with SCP AVMs in the last 5 yr at our institution. The mean age was 49.7 yr. The average nidus size was 2.12 cm. Of those, 3 patients presented with hemorrhage and 1 with headache and tinnitus. Extreme lateral SC-IT approach was used in all cases.

RESULTS
Complete resection was achieved in all cases as verified with postoperative angiogram. In 1 case, intraoperative rupture with intraventricular hemorrhage was encountered, and the patient required temporary external ventricular drainage. There was no permanent complication or neurological deficit. The modified Rankin Scale (at discharge or follow-up) was less than 2 in all cases.

CONCLUSION
The AVMs located primarily in the SCP are distinct compared to brainstem AVMs, and their management should be different. Extreme lateral SC-IT approach should be considered as a viable alternative surgical approach for resection of these AVMs, and excellent surgical results can be achieved.
Safety and Efficacy of Perioperative Intravenous Meloxicam for Moderate-to-Severe Pain Management in Total Knee Arthroplasty: A Randomized Clinical Trial
Authors: Berkowitz Richard D , Steinfeld Richard , Sah Alexander P , Mack Randall J , McCallum Stewart W , Du Wei , Black Libby K , Freyer Alex , Coyle Erin 
Published: January 2021

AbstractObjectiveTo evaluate the effect of perioperative meloxicam IV 30 mg on opioid consumption in primary total knee arthroplasty (TKA).DesignMulticenter, randomized, double-blind, placebo-controlled trial.SubjectsIn total, 181 adults undergoing elective primary TKA.MethodsSubjects received meloxicam 30 mg or placebo via an IV bolus every 24 hours, the first dose administered prior to surgery as part of a multimodal pain management protocol. The primary efficacy parameter was total opioid use from end of surgery through 24 hours.ResultsMeloxicam IV was associated with less opioid use versus placebo during the 24 hours after surgery (18.9 ± 1.32 vs 27.7 ± 1.37 mg IV morphine equivalent dose; P &lt; 0.001) and was superior to placebo on secondary endpoints, including summed pain intensity (first dose to 24 hours postdosing, first dose to first assisted ambulation, and first dose to discharge) and opioid use (48–72 hrs., 0–48 hrs., 0–72 hrs., hour 0 to end of treatment, and the first 24 hours after discharge). Adverse events (AEs) were reported for 69.9% and 92.0% of the meloxicam IV and placebo groups, respectively; the most common AEs were nausea (40% vs. 59%), vomiting (16% vs 22%), hypotension (14% vs 15%), pruritus (15% vs 11%), and constipation (11% vs 13%).ConclusionsPerioperative meloxicam IV 30 mg as part of a multimodal analgesic regimen for elective primary TKA reduced opioid consumption in the 24-hour period after surgery versus placebo and was associated with a lower incidence of AEs typically associated with opioid use.
COVID-19 and shielding: experiences of UK patients with lupus and related diseases
Authors: Sloan Melanie , Gordon Caroline , Lever Elliott , Harwood Rupert , Bosley Michael A , Pilling Mark , Brimicombe James , Naughton Felix , Blane Moira , Walia Chanpreet , D’Cruz David 
Published: January 2021

Abstract

Objective
The shielding guidance in the UK for the clinically extremely vulnerable (CEV) commenced on 23 March 2020 in response to the coronavirus disease 2019 (COVID-19) pandemic. The purpose of this study was to explore the impact of the pandemic and shielding on patients with lupus and related systemic autoimmune rheumatic diseases (SARDs).

Methods
This was a mixed-methods cohort study (n = 111) including pre-lockdown baseline surveys (March 2020), follow-up surveys (June 2020) and in-depth interviews during July 2020 (n = 25).

Results
Most participants had a high level of anxiety regarding their mortality risk from COVID-19 and supported the concept of shielding. Shielding allocations and communications were perceived as inconsistently applied and delivered. More than half of those not classified as CEV reported feeling abandoned, at increased risk and with no support. Shielding communications increased feelings of being ‘cared about’, but also increased fear, and the ‘vulnerable’ labelling was perceived by some to damage social and self-identity. More than 80% of those classified as CEV stated that the classification and subsequent communications had changed their social-mixing behaviour. Despite many negative impacts of COVID-19 and shielding/lockdown being identified, including isolation, fear and reduced medical care, the quantitative data during the pandemic showed increases in most measures of wellbeing (which was low at both time points) from pre-lockdown, including reductions in the impact of fatigue and pain (P-values &lt; 0.001).

Conclusion
Shielding classifications and communications were, in general, viewed positively, although they were perceived as inconsistently delivered and anxiety-provoking by some participants. More frequent positively framed communication and wellbeing support could benefit all SARD patients. Slower-paced lockdown lifestyles might confer health/wellbeing benefits for some people with chronic diseases.
Use of the Subfascial Plane for Gender-affirming Breast Augmentation: A Case Series
Authors: Mehra Geetika , Kaufman-Goldberg Tal , Meshulam-Derazon Sagit , Boskey Elizabeth R. , Ganor Oren 
Published: January 2021

Background:
Transgender women seeking gender-affirming breast augmentation often present with differences in preoperative chest measurements and contours in comparison with cisgender women. These include a more robust pectoralis muscle and limited glandular tissue, raising important considerations in determining the optimal anatomical plane for implantation. Abundant literature has described advantages and drawbacks of the available planes for breast augmentation in cisgender women. Certain drawbacks may be more pronounced for transgender women, given their distinct anatomy. The subfascial plane offers lower complication rates than the subglandular plane when using smooth implants, and avoids implant animation and displacement associated with the subpectoral plane. To our knowledge, existing studies have not yet addressed this discussion in the transfeminine population. The goal of this article is to highlight potential benefits of the subfascial plane for gender-affirming breast augmentation, utilizing a case series of 3 transfeminine patients, and to review the literature on surgical techniques and outcomes in this population.

Methods:
A retrospective chart review of patients presenting to a single surgeon for gender-affirming breast augmentation in 2019 was performed. A narrative literature review on surgical techniques and outcomes for gender-affirming breast augmentation was conducted.

Results:
Three cases of gender-affirming breast augmentation using subfascial implant placement are described. From the literature search, 12 articles inclusive of 802 transfeminine patients were identified.

Conclusions:
The subfascial plane represents an option for implant placement in gender-affirming breast augmentation that merits further investigation. There is a need for more research comparing surgical techniques and outcomes in the transfeminine population.
Combined Phialemonium curvatum and Acanthamoeba Keratitis: The Importance of Early Diagnosis and Specific Therapy
Authors: Roszkowska Anna M. , Severo Alice A. , Biondo Carmelo , Postorino Elisa I. , Inferrera Leandro , Aragona Pasquale 
Published: January 2021

Purpose:
To report the clinical and confocal findings of a unique case of combined Phialemonium curvatum and Acanthamoeba keratitis and to highlight the role of the prompt diagnosis and specific medical treatment in preserving visual function.

Methods:
A case report and literature review.

Results:
A 54-year-old woman presented with a 3-day history of visual impairment, photophobia, and ocular pain in her right eye. Her best corrected visual acuity was 0.4 Logarithm of the Minimum Angle of Resolution scale, and the slit-lamp examination showed whitish corneal stromal infiltrate with satellite lesions. In vivo confocal microscopy evidenced Acanthamoeba cysts and fungal hyphae that resulted P. curvatum in the culture examination. The intensive medical treatment was started with topical 0.02% polyhexamethylene biguanide, voriconazole 1%, and moxifloxacin hydrochloride 0.5%. Progressive improvement of clinical and confocal pictures was registered with a complete recovery of visual function after 1 month.

Conclusions:
This is the first case report of combined P. curvatum and Acanthamoeba keratitis. The fast diagnosis with in vivo confocal microscopy allowed early and intensive specific treatment with recovery of corneal infection.
Anticancer effects of dietary administration of secoisolariciresinol diglucoside in a patient of gastrointestinal stromal tumor: a case report
Authors: Wu Hao , Wang Yao , Chen Jia-Tao , Wang Li-Ping , Liu Gui-Rong , Liu Shu-Lin 
Published: January 2021

Introduction:
Gastrointestinal stromal tumor (GIST) is among the leading malignancies of the digestive system. GIST is not susceptible to chemotherapies and is prone to recurrence or metastasis after surgical operation. Secoisolariciresinol diglucoside (SDG) was suggested to have potential anticancer effects, but no clinical evidence had been available. Here we report successful treatment of a postoperative GIST case with dietary SDG.

Presentation of Case:
The patient was a 58-year-old man. He had GIST and received resection of small intestinal lesions 1 year before. He was diagnosed with postoperation of GIST and presented with high level of serum carbohydrate antigen 72-4 (CA72-4). The patient was then treated with dietary administration of SDG with his voluntary acceptance for 5 months, and underwent 2 serum CA72-4 measurements during this period. CA72-4 level of the patient was restored to normal range after treatment with dietary SDG for 1 month. There was no aberrant CA72-4 level, recurrence or metastasis after the treatment with dietary SDG.

Discussion:
This is to our knowledge the first report on application of dietary SDG on a postoperative GIST patient with aberrant level of serum CA72-4. SDG can be transformed into active substances with antitumor effects by human gut bacteria. Dietary SDG might inhibit tumorigenicity and malignant behavior of GIST cells.

Conclusion:
The excellent effects suggest dietary SDG to be a potential therapy for GIST, especially against recurrence or metastasis.
Ultraviolet Induced Skin Inflammation
Authors: Zhao Hai-Chao , Xiao Ta , Chen Yu-Jie 
Published: January 2021

Abstract
Ultraviolet (UV) induced skin inflammation (UISI) is associated with many skin disorders. However, the mechanism by which UV causes skin inflammation remains unclear. Studies evaluating UISI in vivo have mainly been conducted using mouse models. Current investigations indicate that the classic inflammatory pathways involving nuclear factor kappa B and Toll-like receptor contribute to the regulation of UISI. However, more novel signaling factors have been identified as being involved in this process, including interleukin 22 receptor-α, cluster of differentiation 28 and cluster of differentiation 1d, serum amyloid A1, estrogen, melatonin, peroxisome proliferator activated receptors β/δ, isocitrate dehydrogenase 2, and transglutaminase 2. In addition, the gene mutation of fermitin family member 1 and selenium deficiency are reported to affect the phenotype of UISI. Although the actual roles of UISI in UV-related skin diseases need to be clarified, recent studies have reported the potent contribution of UISI to photocarcinogesis. To clarify the process and modulation of UISI, the special profiles of cytokines and inflammatory mediators and the core regulatory pathways should be identified clearly. These investigations would be promoted rapidly, accompanied by the conduction of high-quality clinical research on patients with UV-related skin disease and the construction of precise animal models of UISI.
Muscle Damage and Overreaching During Wildland Firefighter Critical Training
Authors: Christison Katherine S. , Gurney Shae C. , Sol Joseph A. , Williamson-Reisdorph Cassie M. , Quindry Tiffany S. , Quindry John C. , Dumke Charles L. 
Published: January 2021

Objective:
To document the effects of wildland firefighter (WLFF) critical training (CT) on physiologic markers of muscle damage and acute overreaching.

Methods:
Eighteen male and three female WLFFs were studied during an 11-day CT. Upper-body (US), lower-body (LS) muscle soreness and body weight (BW) were collected daily. Blood was collected on days 1, 4, 8, and 11 to measure creatine kinase (CK), lactate dehydrogenase (LDH), cortisol, and testosterone. Skinfolds were taken on days 1 and 11 to estimate body fat (BF) and lean body weight (LBW).

Results:
CT resulted in a significant depression in BF and elevation in LBW, while main effects of time were seen in US, LS, CK, LDH, cortisol, and testosterone/cortisol ratio (P < 0.05).

Conclusion:
These data suggest WLFFs undergo significant physiological stressors resulting in muscle soreness, damage, and possible overreaching during CT.
Temporal Trends and Regionalization of Acute Mastoiditis Management in the United States
Authors: Fujiwara Rance J.T. , Alonso Jose E. , Ishiyama Akira 
Published: January 2021

Objective:
To describe demographics and to analyze temporal trends in the inpatient management of acute mastoiditis admissions.

Study Design:
Cross-sectional analysis.

Setting:
National Inpatient Sample, 2002–2014.

Patients:
26,072 nonelective inpatient admissions with primary diagnosis of acute mastoiditis

Intervention:
Myringotomy, mastoidectomy, or no procedure.

Main Outcome Measures:
We described the patient- and hospital-level demographics of acute mastoiditis admissions and the frequency of complications. We evaluated the percentage of patients requiring surgical management. Binary logistic regression was performed to determine whether there was a significant increase in the percentage of patients treated at academic institutions.

Results:
The majority of patients were ≤40 years old (64.9%) and Elixhauser comorbidity index ≥4 (57.4%); 23.3% (SE 0.8%) presented with complications associated with acute mastoiditis, the most common of which was a subperiosteal abscess (11.5%, SE 0.7%). Among all admissions, 30.9% (SE 1.1%) underwent myringotomy, 13.8% (SE 0.8%) required both myringotomy and mastoidectomy. On multivariate analysis, there was a statistically significant increase in the percentage of mastoiditis admissions to teaching hospitals for all admissions (OR 1.55 [CI 1.22–1.97], p < 0.001) and even more evident for cases with associated complications (OR 1.85 [CI 1.21–2.83], p = 0.004).

Conclusions and Relevance:
A sizeable percentage of patients with acute mastoiditis present with complications which may require surgical intervention. From 2002 to 2014, inpatient care of acute mastoiditis became increasingly regionalized to teaching hospitals, suggestive of increased specialization within certain facilities. This trend may have significant impacts on the cost and subsequent quality of care provided to these patients.
Imaging and surgical predictive factors for postoperative hemorrhage after partial nephrectomy and clinical results of trans-arterial embolization
Authors: Qin Caipeng , Zhi Xin , Wang Fei , Li Qing , Gao Jian , Liu Shijun , Xu Tao 
Published: January 2021

Abstract
Partial nephrectomy (PN) has been established as the standard treatment for T1 renal tumors, and postoperative hemorrhage due to vascular complications is a rare but potentially life-threatening complication reported after PN. Thus, this study evaluated the imaging and surgical factors associated with postoperative hemorrhage after PN and the clinical results of trans-arterial embolization. A retrospective review of the institutional PN database was performed from May 2012 to January 2019, revealing that we performed 810 PN procedures at our institution. In total, 12 patients were referred to the interventional radiology department for vascular complications after the procedure. Patients with and without transarterial embolization (TAE) were age- and sex-matched with 56 patients. Preoperative imaging characteristics and operative details were considered. Univariable and multivariable analyses were used to test their eventual association with the occurrence of hemorrhage. Furthermore, renal functions at diagnosis, after operation or embolization for TAE cases, and at the last follow-up were recorded. A diagnosis of hemorrhage was made at a median of 4 (range, 0–25) days after surgery. The majority of patients (50%) presented with gross hematuria. T test revealed higher renal tumor-parenchyma contact area (TPA) (P = .0407), Length-A (P = .0136), Length-P (P = .0267), operation time (P = .0214) and estimated blood loss (P = .0043) in patients with hemorrhage than in controls. Binary logistic regression analysis identified TPA (P = .048) and estimated blood loss (P = .042) as independent predictors for postoperative hemorrhage with an area under the ROC curve of 0.705 (64% sensitivity and 79% specificity). In conclusion, the occurrence of hemorrhage after PN was associated with a larger TPA and more estimated blood loss during the procedure. In patients who underwent selective TAE, renal function remained comparable with that of controls.
Efficacy and safety of Bacillus coagulans LBSC in irritable bowel syndrome
Authors: Gupta Anil Kumar , Maity Chiranjit 
Published: January 2021

Abstract

Goals:
To evaluate safety and efficacy of Bacillus coagulans LBSC [DSM17654] in irritable bowel syndrome (IBS) through a prospective, interventional, randomized, double-blind, and placebo-controlled, CONSORT compliant clinical trial.

Background:
Bacteriotherapy shows promising impact on alleviating clinical conditions of IBS and associated functional gastrointestinal disorders. B coagulans LBSC is a genetically and phenotypically safe probiotic strain used in this study to study its impact on ameliorating IBS symptoms and improving quality of life.

Methods:
In this interventional, randomized, double-blind, placebo-controlled clinical study, total 40 subjects (18–65 years) were screened through Rome IV criteria and randomized into 2 groups, that is, interventional and placebo arm (n = 20/arm). Similar dosages were received by both the arm, that is, placebo (vehicle) and interventional arm (B coagulans LBSC, 6 billion/d) for a period of 80 days. Study completed with per protocol subjects (n = 38) and results were considered to evaluate the primary and secondary endpoints.

Results:
Assessment through Digestive Symptom Frequency Questionnaire 5 point Likert scale showed significant improvement in interventional arm compared to placebo on symptoms such as bloating/cramping, abdominal pain, diarrhea, constipation, stomach rumbling, nausea, vomiting, headache, and anxiety. Maximum of “no symptoms” cases and mild to moderate gastrointestinal symptoms along with improved stool consistency were from interventional arm tested following IBS severity scoring system and Bristol stool form scale. Upper gastrointestinal endoscopy revealed no clinical difference of gastrointestinal mucosa between both the arms. B coagulans LBSC was well tolerated with no serious adverse events.

Conclusions:

B coagulans LBSC was safe for human consumption and efficacious in alleviating overall pathophysiological symptoms of IBS and thereby improving inclusive quality of life evaluated.