bluuebunny/crossref_metadata_2025_split huggingface dataset:
Local Pterional Advancement Flap: A Minimally Invasive Option to Reconstruct Spheno-Temporal Extracranial Soft Tissues Dehiscences in Fragile Patients
Authors: Gagliardi Filippo , Giordano Leone , Bussi Mario , Mortini Pietro 
Published: August 2021

Background:
Late-onset, extracranial soft tissues dehiscence in the spheno-temporal region after major neurosurgical procedures might represent a potentially life-threatening complication.
Due to surgery-related galeal/pericranial and myofascial temporal atrophy, classical regional flaps are often unavailable, enforcing potential indication for free vascularized flaps.
Nevertheless, in elderly multioperated patients, who are not eligible for major surgery, it becomes mandatory to consider less invasive options for reconstruction.
Authors describe the application of a reconstructive option for late-onset, pterional soft tissues dehiscence in fragile patients, using a local pterional advancement flap.

Methods:
Technique is stepwise described and illustrated in its clinical application.

Results:
Local pterional advancement flap provides an excellent coverage, being extremely pliable, and flexible in contents and design. Vascular pedicle is independent from distal branches of the superficial temporal artery and provides adequate blood flow. Pedicle length enables a good arc of rotation, which facilitates its transposition. Flap preparation is very easy and minimally time consuming, due to its immediate regional availability and the easy harvesting technique.

Conclusions:
Local pterional advancement flap represents an effective option as regional flap for the reconstruction of late-onset, pterional soft tissues dehiscence in fragile patients.
A Digital Approach to Evaluating Tooth Root Position Without Repeated Cone-beam Computed Tomography Scans
Authors: Lee Kyungmin Clara 
Published: August 2021

Abstract
The purpose of this report is to introduce a digital approach to evaluating three-dimensional root position without radiation using virtual tooth model which is composed of intraoral-scanned crown and cone-beam computed tomography (CBCT)-scanned root. Successful treatment depends not only on the formulation of a proper initial diagnosis, but also on an accurate assessment of treatment progress, which should include the monitoring and evaluation of tooth and root movements. Although CBCT allows the visualization of the true root position and angulation in three-dimensions, the obtaining of serial CBCT scans for this purpose is associated with concerns regarding radiation exposure. This report introduces a method for monitoring three-dimensional root position following tooth movement during treatment that does not require repeated CBCT scans. This method uses an individual virtual tooth model composed of intraoral-scanned crowns and CBCT-scanned roots. When an evaluation of root positions is needed during treatment, only additional intraoral scan is needed and is integrated into the tooth model; this allows root positions to be estimated without the need for another CBCT scan. The use of a virtual tooth model can potentially allow clinicians to accurately monitor tooth position in routine clinical practice, without the hazards of increased radiation exposure.
Diverting Enterostomy Improves Overall Survival of Patients With Severe Steroid-refractory Gastrointestinal Acute Graft-Versus-Host Disease
Authors: Khodr Justine , Zerbib Philippe , Rogosnitzky Moshe , Magro Leonardo , Truant Stéphanie , Yakoub-Agha Ibrahim , Duhamel Alain , Seguy David 
Published: August 2021

Objective:
The aim of this study was to evaluate the benefit of diverting enterostomy (DE) in patients with severe steroid-refractory (SR) gastrointestinal acute graft-versus-host-disease (GI-aGVHD) following allogeneic hematopoietic stem-cell transplantation (ASCT).

Summary and Background Data:
Severe GI-aGVHD refractory to the first-line steroid therapy is a rare but dramatic life-threatening complication. Second lines of immunosuppressors have limited effects and increase the risk of sepsis. Data suggest that limiting GI bacterial translocation by DE could restrain severe GI-aGVHD.

Methods:
From 2004 to 2018, we retrospectively reviewed all consecutive patients undergoing ASCT for hematologic malignancies who developed severe SR GI-aGVHD. We compared patients in whom a proximal DE was performed (Enterostomy group) with those not subjected to DE (Medical group). The primary endpoint was the 1-year overall survival (OS) measured from the onset of GI-aGVHD. Secondary endpoints were the 2-year OS and causes of death.

Results:
Of the 1295 patients who underwent ASCT, 51 patients with severe SR GI-aGVHD were analyzed (13 in Enterostomy group and 38 in Medical group). Characteristics of patients, transplantation modalities, and aGVHD severity were similar in both groups. The 1-year OS was better after DE (54% vs 5%, P = 0.0004). The 2-year OS was also better in “Enterostomy group” (31% vs 2.5%; P = 0.0015), with a trend to lower death by sepsis (30.8% vs 57.9%; P = 0.091).

Conclusion:
DE should be considered for severe GI-aGVHD as soon as resistance to the corticosteroid is identified.
Survey of Clinical Neurophysiology and Epilepsy Fellowship Programs in the United States During COVID-19
Authors: Nakhleh Lauren , Gavvala Jay R. , Haneef Zulfi 
Published: August 2021

Purpose:
The COVID-19 pandemic impacted clinical practice, education, and research in Neurophysiology/Epilepsy. Although there is published literature on clinical impact, its educational impact is not well described. A national survey of Clinical Neurophysiology (CNP) and Epilepsy fellowship programs was conducted to assess the impact of COVID-19 on fellowship education.

Methods:
A list of accredited Clinical Neurophysiology and Epilepsy fellowship programs was obtained from the Accreditation Council for Graduate Medical Education. Program directors at individual locations were contacted to complete a brief survey about the program and impact of COVID-19. Fellows from responding programs were subsequently invited to share their perceptions about the impact of the pandemic on their training.

Results:
From 176 programs, 40 PDs responded (22.7%). From these 40 programs, fellows from 26 completed surveys (65.0% response). There was a reduction in EEG and epilepsy monitoring unit volumes post-COVID-19, with a trend of change for EMG, whereas continuous EEG volumes were mostly unchanged. The impact of the pandemic on training was rated as moderate to severe (≥50%) by 30.0% of PDs and 49.0% of trainees. In remarkable agreement, 20.0% of PDs and 20.4% of fellows believed that additional fellowship training was needed before graduation. Lack of fellow satisfaction was correlated with the perceived impact of the pandemic on education (p = 0.008).

Conclusions:
This survey revealed a considerable impact on EEG/EMG clinical volume because of COVID-19, although continuous EEG was not as impacted. More fellows than PDs believed that training was considerably impacted by COVID-19, but a similar number thought that additional training was needed. It was unclear from this study whether the fellows' perception of educational impact was solely because of the pandemic or in addition to preexisting training deficiencies in the training programs.
Explore the role of CR1 genetic variants in late-onset Alzheimer’s disease susceptibility
Authors: Lu Liu , Yao Qing-yu , Ruan Sha-Sha , Hu Jia-Wei , Long Wen-jun , Dai Wen-Zhuo , Ma Tao , Zhu Xi-Chen 
Published: August 2021

Background
Complement component (3b/4b) receptor 1 (CR1) is an interesting candidate gene which has a close connection with Alzheimer’s disease, and its polymorphisms have been reported to link to the late-onset Alzheimer’s disease (LOAD) susceptibility. However, the findings of these related studies are inconsistent. Objective To explore the effect of CR1 genetic variants in LOAD susceptibility. MethodsWe searched relevant studies for the period up to 1 November 2020. And odds ratios (ORs) and their 95% confidence intervals (CIs) were utilized to assess the strength of the association. In addition, we carried out a case-control association study to assess their genetic association.

Results
Finally, a total of 30 articles with 30108 LOAD cases and 37895 controls were included. Significant allele frequency between LOAD patients and controls was observed in rs3818361 and rs6656401 (rs3818361, T vs. C: OR,1.18; 95% CI, 1.13–1.23; rs6656401, A vs. G: OR, 1.23; 95% CI, 1.10–1.36). Moreover, these results remain significant in subgroup of rs3818361 in Asia or America (OR,1.26; 95% CI,1.06–1.45; OR, 1.18; 95% CI, 1.13–1.24, respectively) and rs6656401 in Europe (OR = 1.26; 95% CI, 1.09–1.42). In addition, the two single nucleotide polymorphisms were proved to significantly increase LOAD risk in the overall population under the dominant model (OR = 1.12; 95% CI, 1.02–1.21; OR = 1.18, 95% CI, 1.15–1.22, respectively). Our case–control study showed that the distribution of rs6656401 genotype was significant (P = 0.000; OR, 6.889; 95% CI, 2.709–17.520), suggesting the A allele of rs6656401 is the risk allele.

Conclusion
These available data indicate that rs6656401 in CR1 is significant to increase LOAD risk.
Diverse clinical manifestations of X-linked adrenoleukodystrophy in a Chinese family with identical multisite variants of ABCD1 gene
Authors: Zhang Lin , Zhao Su Li , Wang Zhi Hong 
Published: August 2021

Objective
This study summarized the clinical characteristics of X-linked adrenoleukodystrophy (X-ALD) patients in this family, and two different manifestations of the same variants in a Chinese family were reported in this article. That conducted a follow-up study to further clarify the characteristics of this disease.

Basic methods
Clinical data and test results were analyzed, and the exon region of ALD-related gene ABCD1 was sequenced by Sanger sequencing.

Main results
Gene analysis showed that there were three ABCD1 variants in the proband, c.1047C>A, c.1415-1416delAG and c.1548G>A. The elder brother of the proband had the same three variants as the proband, but showed different clinical symptoms. The mother was the carrier of three variants. Multisite variants were uncovered in this family, which caused two different manifestations of adult-onset childhood cerebral ALD and adrenomyeloneuropathy.

Principal conclusion
These findings further increase our knowledge about ABCD1 mutations and the associated phenotypes, which is beneficial for the genetic counseling of patients with X-ALD.
Combined Metabolic Activators Improve Cognitive Functions without Altering Motor Scores in Parkinson’s Disease
Authors: Yulug Burak , Altay Ozlem , Li Xiangyu , Hanoglu Lutfu , Cankaya Seyda , Lam Simon , Yang Hong , Coskun Ebru , İdil Ezgi , Nogaylar Rahim , Hacımuftuoglu Ahmet , Arif Muhammad , Shoaie Saeed , Zhang Cheng , Nielsen Jens , Turkez Hasan , Borén Jan , Uhlén Mathias , Mardinoglu Adil 
Published: August 2021

ABSTRACTThe neuropathologic hallmarks of Parkinson’s disease (PD) are associated with mitochondrial dysfunction and metabolic abnormalities. We have reported that the Combined Metabolic Activators (CMA), consisting of L-serine, nicotinamide riboside, N-acetyl-L-cysteine, and L-carnitine tartrate can be used in treating metabolic abnormalities. These metabolic activators are the precursors of nicotinamide adenine dinucleotide (NAD+) and glutathione (GSH) and used in activation of mitochondrial and global metabolism. We have performed a placebo-controlled, phase-2 study in Alzheimer’s disease (AD) patients and reported that the cognitive functions in AD patients is significantly improved 29% in the CMA group whereas it is improved only 14% in the placebo group after 84 days of CMA administration. Here, we designed a randomized, double-blinded, placebo-controlled, phase-2 study in PD patients with CMA administration. We found that the cognitive functions in PD patients is significantly improved 21% in the CMA group, whereas it is improved only 11% in the placebo group after 84 days of CMA administration. We also found that the administration of CMA did not affect motor functions in PD patients. We performed a comprehensive multi-omics analysis of plasma proteins and metabolites, and revealed the molecular mechanism associated with the treatment of the patients. In conclusion, our results show that treating PD patients with CMAs leads to enhanced cognitive function, as recently reported in AD patients.
Multi-trait genome-wide association study identifies novel endometrial cancer risk loci that are associated with obesity or female testosterone levels
Authors: Wang Xuemin , Kho Pik Fang , Ramachandran Dhanya , Bafligil Cemsel , Amant Frederic , Goode Ellen L. , Scott Rodney J. , Tomlinson Ian , Evans D. Gareth ,   Endometrial Cancer Association Consortium, Crosbie Emma J. , Dörk Thilo , Spurdle Amanda B. , Glubb Dylan M. , O’Mara Tracy A. 
Published: August 2021

AbstractWe have performed genetic correlation and Mendelian randomization analyses using publicly available genome-wide association study (GWAS) data to identify endometrial cancer risk factors. These and previously established risk factors of endometrial cancer were then included in a multi-trait Bayesian GWAS analysis to detect endometrial cancer susceptibility variants, identifying three novel loci (7q22.1, 8q24.3 and 16q12.2); two of which were replicated in an independent endometrial cancer GWAS dataset. These loci are hypothesized to affect endometrial cancer risk through altered sex-hormone levels or through effects on obesity. Consistent with this hypothesis, several genes with established roles in these pathways (CYP11B1, CYP3A7, IRX3 and IRX5) were prioritized as candidate endometrial cancer risk genes by interrogation of quantitative trait loci data and chromatin capture assays in endometrial cell lines. The findings of this study identify additional opportunities for hormone treatment and further support weight loss to reduce the risk of developing endometrial cancer.Statement of SignificanceThis study prioritizes four genes related to testosterone and obesity as candidate endometrial cancer risk genes, as well as identifies additional opportunities for hormone treatment and further supports weight loss to reduce endometrial cancer risk.
Initial Antidepressant Choice by Non-Psychiatrists: Learning from Large-scale Electronic Health Records
Authors: Sheu Yi-han , Magdamo Colin , Miller Matthew , Smoller Jordan W. , Blacker Deborah 
Published: August 2021

AbstractIntroductionPharmacological treatment of depression mostly occurs in non-psychiatric settings, but factors that determine the initial choice of antidepressant treatment in these settings are not well-understood. This study models how non-psychiatrists choose among four antidepressant classes at first prescription (selective serotonin reuptake inhibitors [SSRI], bupropion, mirtazapine, or serotonin-norepinephrine reuptake inhibitors [SNRI]), by analyzing electronic health record (EHR) data.MethodsEHR data were from the Mass General Brigham Healthcare System (Boston, Massachusetts, USA) for the period from 1990 to 2018. From a literature search and expert consultation, we selected 64 variables that may be associated with antidepressant choice. Patients who participated in the study were aged 18 to 65 at the time of first antidepressant prescription with a co-occurring International Classification of Diseases (ICD) code for a depressive disorder. Multinomial logistic regression with main effect terms for all 64 variables was used to model the choice of antidepressant. Using SSRI as the reference class, odds ratios, 95% confidence intervals (CI), and likelihood ratio-based p-values for each variable were reported. We used a false discovery rate (FDR) with the Benjamini–Hochberg procedure to correct for multiple comparisons.FindingsA total of 47,107 patients were included after application of inclusion/exclusion criteria. We observed significant associations for 36 of 64 variables after multiple comparison corrections. Many of these associations suggested that antidepressants’ known pharmacological properties/actions guided choice. For example, there was a decreased likelihood of bupropion prescription among patients with epilepsy (adjusted OR 0.41, 95% CI: 0.33–0.51, p < 0.001), an increased likelihood of mirtazapine prescription among patients with insomnia (adjusted OR 1.58, 95% CI: 1.39–1.80, p < 0.001), and an increased likelihood of SNRI prescription among patients with pain (adjusted OR 1.22, 95% CI: 1.11–1.34, p = 0.001).InterpretationNon-psychiatrists’ selection of antidepressant class appears to be guided by clinically relevant pharmacological properties, indications, and contraindications, suggesting that broadly speaking they choose antidepressants based on meaningful differences among medication classes.
Liposomal Dexamethasone Reduces A/H1N1 Influenza-Associated Morbidity in Mice
Authors: Kwon Jung Won , Quan Hailian , Song Juha , Chung Hyewon , Jung Daun , Hong Jung Joo , Na Yi Rang , Seok Seung Hyeok 
Published: August 2021

AbstractRe-emerging viral threats have continued to challenge the medical and public health systems. It has become clear that a significant number of severe viral infection cases are due to an overreaction of the immune system, which leads to hyperinflammation. In this study, we aimed to demonstrate the therapeutic efficacy of the dexamethasone nanomedicine in controlling the symptoms of influenza infection. We found that the A/Wisconsin/WSLH34939/2009 (H1N1) infection induced severe pneumonia in mice with a death rate of 80%, accompanied by significant epithelial cell damage, infiltration of immune cells, and accumulation of pro-inflammatory cytokines in the airway space. Moreover, the intranasal delivery of liposomal dexamethasone during disease progression reduced the death rate by 20%. It also significantly reduced the protein level of tumor necrosis factor-alpha (TNFα), interleukin1β (IL-1β), IL-6, and the C-X-C motif chemokine ligand 2 (CXCL2) as well as the number of infiltrated immune cells in the bronchoalveolar lavage fluids as compared to the free drug. It was found that the liposomal dexamethasone was mainly distributed into the monocyte/macrophages in the lungs, suggesting its mode of action via the specific delivery of the drug into myeloid cells as a major cell population for inducing the cytokine storm. Taken together, the intranasal delivery of liposomal dexamethasone may serve as a novel promising therapeutic strategy for the treatment of influenza A-induced pneumonia.ImportanceInfluenza A virus causes annual epidemics and sporadic pandemics of respiratory diseases. An excessive immune response, called a cytokine storm, caused by the influenza virus is the most common complication of influenza infection that is associated with high levels of morbidity and mortality. Here, we report that the liposomal dexamethasone targeting the monocytes/macrophages during disease progression reduced the death rate as well as the protein level of inflammatory cytokines and the number of immune cells. Therefore, the findings of this study may be applied to address the limitations of the current strategies for the treatment of influenza.
Influential social marketing interventions in physical activity promotion
Authors: Ebrahimipour Hajar , Mokhtari Dinani Maryam , Pandari Abbas Rezaei 
Published: August 2021

PurposeThe purpose of this paper is to identify and rank the influential social marketing factors for physical activity promotion.Design/methodology/approachA descriptive-survey approach is used in this study. First, the influential social marketing factors for physical activity promotion were determined through the review of theoretical foundations and literature. The factors with a >0.7 content validity index (CVI) value, based on the experts' opinion, were selected. A total of 23 individuals participated in the study, including sports marketing experts and members of physical activity committees of Iranian sports federations, and they were selected purposively. The study data were collected using a pairwise comparison questionnaire and analyzed using the DEMATEL-based analytic network process (DANP) method.FindingsIn this study, a total of 17 influential social marketing factors were identified and categorized in 5 dimensions: product, price, place, promotion and partnership. Based on DEMATEL-based analytic network process (DANP) results, the “promotion” with the weight of 0.212 was the most important dimension and “providing inexpensive sports services” with the weight of 0.096 was the most important social marketing factor influencing the promotion of the physical activity.Originality/valueThe results highlight the importance of sport for all services expenses and costs in promoting physical activity. Thus, the results can be the basis for policies regarding social marketing to promote physical activity.
MHD stagnation point flow on a shrinking surface with hybrid nanoparticles and melting phenomenon effects
Authors: Pop Ioan , Waini Iskandar , Ishak Anuar 
Published: August 2021

Purpose
This study aims to explore the stagnation flow over a shrinking surface in a hybrid nanofluid consists of Al2O3 and Cu nanoparticles. Here, the flow is subjected to the magnetohydrodynamic (MHD) and the melting phenomenon effects.

Design/methodology/approach
The similarity variables are used to gain the similarity equations. These equations are solved via the bvp4c solver. The effects of several physical parameters on the flow and the thermal characteristics of the hybrid nanofluid are analysed and discussed. Later, the temporal stability analysis is used to determine the stability of the dual solutions obtained as time evolves.

Findings
Results show that two solutions are found for the limited range of the stretching/shrinking parameter

λ, and then these solutions are terminated at

λ=λc. The rise of the melting parameter

Me from 0 to 2 contributes to enhance 109.63% of the local Nusselt number

Rex-1/2Nux and 3.30% of the skin friction coefficient

Rex1/2Cf. Contrarily, the values of

Rex-1/2Nux and

Rex1/2Cf decline by 25.04% and 5.58%, respectively, as the magnetic parameter

Mg increases from 0 to 0.3. Additionally, Al2O3-Cu/water has the highest values of

Rex1/2Cf and the lowest values of

Rex-1/2Nux. Lastly, it is found that the first solution is physically stable as time evolves.

Originality/value
This paper considers the MHD stagnation point flow of a hybrid nanofluid over a shrinking surface with the melting phenomenon effects. Most importantly, it is shown that there exist dual solutions within a specific range of the physical parameters. Besides, the temporal stability of the solutions is also reported in this study. The finding can contribute to foresee the flow and thermal behaviours in industrial applications. Also, the suitable values of parameters can be determined to avoid misjudgement in flow and heat transfer analysis.