bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary closure of superior partial sternal cleft in a 2-month-old girl: case report
Authors: Tanriverdi Halil Ibrahim , Doğaneroğlu Fulya , Genç Abdülkadir , Yılmaz Ömer 
Published: October 2021

Abstract
Background
Sternal cleft is a quite rare malformation. It is seen 1 out of 100,000 live births and makes up less than 1% of all chest wall deformities, seen more often among females. The deformity can be partial or complete. Partial deformities can be superior or inferior. It is generally diagnosed at birth when paradoxical respiratory movements are seen. Patients are often asymptomatic when they are born and generally other abnormalities accompany. As sternal clefts can be repaired primarily at early ages, they are repaired using autologous or synthetic grafts in the following years. We present a 2-month-old girl with superior partial sternal cleft repaired primary and accompanying hemangiomas in this case report.

Case presentation
A girl who was born in another center and had a sternal cleft, who did not have any problems in the early period, was admitted to our hospital with respiratory distress at the age of 43 days. The patient was monitored with mechanical ventilator support, and there were hemangiomas around his left ear and lips. There were paradoxical respiratory movements in front of the heart, in the upper midline of the chest. Three-dimensional computed tomography showed that the upper part of the sternum did not develop, and there were hypoplasic sternal bars on both sides. It was evaluated as superior partial sternal cleft, and surgery was planned. In the operation, the sternal bars were released from the pericardium and pleura. The periosteum in the medial of both sternal bars was then released and connected in the midline, in front of the pericardium.

Conclusion
Although neonates with a sternal cleft are asymptomatic at birth, respiratory symptoms may develop in later periods. In addition, because the structures are more flexible in the neonatal period, the primary repair of the cleft is easier and the risk of cardiac compression is lower. In our case, sternal bars could be approached primary, and no chondral grafts, patches, or steel wires were required.
The role of ultrasound in evaluating salivary glands swellings
Authors: El-Rasheedy Abd El-latif Ibrahim , Abdalla Alaa Mohamed Abdel Rasoul , Hassanein Shaimaa Abdel-hamid , Hafez Tarek Abdel Rahman Abdel , Aboel-naga Heba Abdel-rehem 
Published: October 2021

Abstract
Background
Viral infection is the most common cause of salivary gland swelling as mumps which mainly affects the parotid glands. Sialolithiasis is another cause of obstruction of the salivary duct. A tumor is another cause of swelling. Around 70% of salivary gland tumors arise from the parotid glands. Benign lesions represent 57% of these tumors. Three to 5% of all tumors affecting the head and neck are represented in the salivary gland. Ultrasonography is considered a basic diagnostic tool in all salivary gland swellings. Our study is to evaluate the role of ultrasound in the evaluation of salivary glands swellings in comparison with a computed tomography scan.

Results
A total of 80 patients aged more than 1 year old with swellings affecting the salivary glands were collected from the out-patient clinic during the period from February 2020 to February 2021. All patients underwent ultrasonography and computed tomography examination of the neck. All submandibular gland lesions presented with sialolithiasis (40 cases) (100%), and 20 cases (50%) of parotid gland swellings presented as inflammation without stone (16 cases (40%) of acute inflammation and 4 cases (10%) with recurrent inflammation), while 4 patients only presented as sialolithiasis. Neoplastic lesions were diagnosed in 16 cases of the parotid gland group. Stones less than 3 mm were detected only by computed tomography in 5 patients (12.5%) of the submandibular group. Twenty-eight cases (70%) with stones ranged in size between 3 and 6 mm. Only 11 cases (27.5%) with stones ranged in size more than 6 mm. Of the 16 parotid swellings diagnosed with neoplastic lesions, 14 parotid cases (87%) showed well-defined margins by computed tomography and ultrasonography.

Conclusions
Sonography is the basic diagnostic tool in salivary glands swellings. Ultrasonography should be the initial imaging modality. Only in special cases, such as stones that could not be detected by ultrasonography or a neoplastic lesion in a deep location, or bone infiltration, computed tomography neck should be performed.
Comparative study between the effect of neural versus intra-articular dextrose prolotherapy on pain and disability in patients with knee osteoarthritis
Authors: Sallam Rehab A. , Abdelkhabir Aya A. , Shabana Adel A. 
Published: October 2021

Abstract
Background
Osteoarthritis (OA) is a degenerative disease which presents with joint pain and stiffness and reduced mobility. Knee OA is the commonest cause of disability in adults. Dextrose prolotherapy is a new option used to treat mild-to-moderate knee OA. Neural prolotherapy (NPT) is multiple small injections under the skin targeting painful areas with natural substances. The aim of work was to evaluate and compare neural prolotherapy versus intra-articular dextrose prolotherapy effect on relieving pain and improving disability of knee OA.

Results
VAS and WOMAC scores improved significantly immediately and at 3 and at 6 months, respectively, in group I compared with group II (P < 0.001). The decrease in VAS scores and all the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in group I along the follow-up period in comparison with the baseline scores was statistically significant (P < 0.001). In group II, only WOMAC pain and stiffness scores improved significantly. ROM showed insignificant increase in both groups at 3 and 6 months assessment. On follow-up, range of motion increased in both groups and reached significance in group I (P = .002).

Conclusion
Dextrose prolotherapy both intra-articular and periarticular (neural) is a very effective and cheap therapy for knee OA with good patient selection. Neural prolotherapy significantly relieves pain and improves function in patients with knee osteoarthritis when compared with intra-articular prolotherapy thus avoiding hazards of intra-articular knee injections.
Born-Infeld generalization: Axion and Kalb-Ramond from dynamical torsion fields
Authors: Cirilo-Lombardo Diego Julio 
Published: October 2021

Abstract
We show that in theories of gravitation based on affine geometries the torsion field, that takes a dynamical character, not only the chiral magnetic effect (CME) intervenes in the wash up of the chiral anomaly but also the chiral vortical effect (CVE) and the coupled chiral effect (CCE) coming from the hypermagnetic field interaction with the primordial plasma are crucial in a realistic physical scenario, as in the case of the early universe. We also show that the equation governing the wash up takes the form given in this paper, supplemented with the dynamical equation for the torsion vector

containing the helicities and other axial couplings. The role played by the neutrinos in the interaction with the axion field in this theoretical framework is briefly discussed.
Three-dimensional optical manipulation of trapped light-absorbing particles based on a hollow beam
Authors: Zhang Wending , Cheng Xuemei , Wang Xing , Niu Chen , Chen Haowei , Bai Jintao 
Published: October 2021

Abstract
We report a method for optical trapping and three-dimensional manipulation of light-absorbing particles in air based on a hollow beam. The particles can be stably trapped for hours in the focused hollow beam with either horizontal or vertical trapping configuration. Particle revolution in the lateral plane (x-y plane) is achieved by employing a wedge prism to deviate and rotate the optical traps. And the particle movement along the laser propagating direction (z-direction) is realized by changing the size of the hollow trapping beam. The mechanism of particle trapping and manipulation in air is analyzed based on the characteristics of photophoretic force. As high trapping power is avoided, this method is meaningful for the particles of low damage threshold and provides a useful tool for in situ analysis of the single aerosol particle in a non-destructive and non-contact manner.
Oxygen Saturation and Postoperative Mortality in Patients With Acute Ischemic Stroke Treated by Endovascular Thrombectomy
Authors: Farag Ehab , Liang Chen , Mascha Edward J. , Toth Gabor , Argalious Maged , Manlapaz Mariel , Gomes Joao , Ebrahim Zeyd , Hussain Muhammad Shazam 
Published: October 2021

BACKGROUND:
Monitored anesthesia care (MAC) and general anesthesia (GA) with endotracheal intubation are the 2 most used techniques for patients with acute ischemic stroke (AIS) undergoing endovascular thrombectomy. We aimed to test the hypothesis that increased arterial oxygen concentration during reperfusion period is a mechanism underlying the association between use of GA (versus MAC) and increased risk of in-hospital mortality.

METHODS:
In this retrospective cohort study, data were collected at the Cleveland Clinic between 2013 and 2018. To assess the potential mediation effect of time-weighted average oxygen saturation (Spo
2) in first postoperative 48 hours between the association between GA versus MAC and in-hospital mortality, we assessed the association between anesthesia type and post-operative Spo
2 tertiles (exposure–mediator relationship) through a cumulative logistic regression model and assessed the association between Spo
2 and in-hospital mortality (mediator–outcome relationship) using logistic regression models. Confounding factors were adjusted for using propensity score methods. Both significant exposure–mediator and significant mediator–outcome relationships are needed to suggest potential mediation effect.

RESULTS:
Among 358 patients included in the study, 104 (29%) patients received GA and 254 (71%) received MAC, with respective hospital mortality rate of 19% and 5% (unadjusted P value <.001). GA patients were 1.6 (1.2, 2.1) (P < .001) times more likely to have a higher Spo
2 tertile as compared to MAC patients. Patients with higher Spo
2 tertile had 3.8 (2.1, 6.9) times higher odds of mortality than patients with middle Spo
2 tertile, while patients in the lower Spo
2 tertile did not have significant higher odds compared to the middle tertile odds ratio (OR) (1.8 [0.9, 3.4]; overall P < .001). The significant exposure–mediator and mediator–outcome relationships suggest that Spo
2 may be a mediator of the relationship between anesthetic method and mortality. However, the estimated direct effect of GA versus MAC on mortality (ie, after adjusting for Spo
2; OR [95% confidence interval {CI}] of 2.1 [0.9–4.9]) was close to the estimated association ignoring Spo
2 (OR [95% CI] of 2.2 [1.0–5.1]), neither statistically significant, suggesting that Spo
2 had at most a modest mediator role.

CONCLUSIONS:
GA was associated with a higher Spo
2 compared to MAC among those treated by endovascular thrombectomy for AIS. Spo
2 values that were higher than the middle tertile were associated with higher odds of mortality. However, GA was not significantly associated with higher odds of death. Spo
2 at most constituted a modest mediator role in explaining the relationship between GA versus MAC and mortality.
Control of Chemical Structure and Lithium-ion Conductivity of Amorphous Lithium Phosphate Thin Film Deposited by Pulsed Laser Deposition
Authors: Yamamoto Takayuki , Takeuchi Ayumi , Ohnishi Junji , Yasuno Satoshi , Motoyama Munekazu , Iriyama Yasutoshi 
Published: October 2021

Abstract
Effects of target-substrate (TS) distance during pulsed laser deposition process on the chemical structure and lithium-ion conductivity of amorphous lithium phosphate (LPO) thin films are investigated. The shorter TS distance results in lower Li concentration, longer phosphate chain, and higher ionic conductivity. The ionic conductivity of 2.7 × 10−7 S/cm is obtained at 25 °C in the LPO thin film with short TS distance.
Imaging findings in a patient with suspected vaccine induced immune thrombotic thrombocytopenia
Authors: Kadam Nikhil , Ramavathu Kumar VM , Kamath Namita , Min Kaung Kyaw 
Published: October 2021

Covid-19 vaccine was developed in response to the SARS Cov2 pandemic. Despite the effectiveness of the vaccine, various complications have been reported after vaccination. We present the case of a 55-year-old patient with post-vaccination complication. The patient was vaccinated with ChAdOx1 nCov-19 Vaccine and 2 weeks later presented with headache, confusion and abdominal pain for 1 week duration. Clinical examination demonstrated reduced Glasgow Coma Scale (GCS), reduced muscle power bilaterally and dysphasia. Blood test showed thrombocytopenia, high titres of D-Dimer and mildly raised INR. The CT scan of the head showed a fairly large left temporoparietal intracranial hemorrhage with midline shift and subsequent CT venogram demonstratedthrombosis of the left transverse and sigmoid dural venous sinuses. CT scan of the abdomen and pelvis showed thrombosis of the portal and hepatic veins and multiple infarcts of the liver, left kidney and lingular segment of the partially imaged lungs (Figure 2). Patient tested positive for antibodies directed against platelet factor-4 and was treated for vaccine induced thrombotic thrombocytopenia. Treatment included Intravenous immunoglobulin, Fresh Frozen Plasma, non-heparin based anticoagulant and required care in tertiary center. Incidence of vaccine-induced immune thrombotic thrombocytopenia is unknown and strongly mimics autoimmune heparin-induced thrombocytopenia with typical clinical features of thrombocytopenia and thrombosis. Of the reported cases, the common imaging finding is thrombosis in various sites such as cerebral venous thrombosis, portal vein thrombosis, pulmonary embolism and ischemic stroke.
Louisiana Medicaid access for treatment and care for hepatitis C virus (LA-MATCH) project: A cross-sectional study protocol
Authors: Afaneh Hasheemah , Straif-Bourgeois Susanne , Oral Evrim , Wennerstrom Ashley , Sugarman Olivia , Robinson William T. , Whittington Angel , Trapido Edward 
Published: October 2021

Introduction
This article presents the Louisiana Hepatitis C Elimination Program’s evaluation protocol underway at the Louisiana State University Health Sciences Center–New Orleans. With the availability of direct-acting antiviral (DAA) agents, the elimination of Hepatitis C (HCV) has become a possibility. The HCV Elimination Program was initiated by the Louisiana Department of Health (LDH) Office of Public Health (OPH), LDH Bureau of Health Services Financing (Medicaid), and the Louisiana Department of Public Safety and Corrections (DPSC) to provide HCV treatment through an innovative pricing arrangement with Asegua Therapeutics, whereby a fixed cost is set for a supply of treatment over five years.

Materials and methods
A cross-sectional study design will be used. Data will be gathered from two sources: 1) an online survey administered via REDCap to a sample of Medicaid members who are receiving HCV treatment, and 2) a de-identified data set that includes both Medicaid claims data and OPH surveillance data procured via a Data Use Agreement between LSUHSC-NO and Louisiana Medicaid.

Discussion
The evaluation will contribute to an understanding of the scope and reach of this innovative treatment model, and as a result, an understanding of areas for improvement. Further, this evaluation may provide insight for other states considering similar contracting mechanisms and programs.
Barriers and strategies for cervical cancer screening: What do female university students know and want?
Authors: Shin Hye Young , Song Soo Yeon , Jun Jae Kwan , Kim Ka Young , Kang Purum 
Published: October 2021

Objective
This study aimed to identify the distinct barriers and knowledge level of cervical cancer screening among female university students and establish intervention strategies to overcome these barriers.

Methods
This study used a mixed-methods design with 26 female university students aged 20–29 years. We first conducted a quantitative online survey for the same study participants, divided them into three groups, and conducted focus group interviews (FGIs). Group A: participants who had sexual experience and had undergone cervical cancer screening; Group B: participants who had sexual experience and had not undergone cervical cancer screening; Group C: participants who did not have sexual experience and had not undergone cervical cancer screening.

Results
The participants’ ages were 21.92 ± 1.26 years. The knowledge levels for cervical cancer and screening were low to moderate. The four main themes that emerged as barriers to cervical cancer screening through the FGIs were: 1) socio-cultural barrier: conservative social perception of unmarried women’s sexual life, 2) knowledge barrier: lack of knowledge and information, 3) psychological barrier: discomfort, and 4) practical barrier: time-consuming. The three themes identified for strategies were: 1) socio-cultural intervention: changing social perceptions and ensuring confidentiality, 2) educational intervention: improvement of knowledge and accessibility, and 3) alternative screening intervention: comfortable screening methods.

Conclusions
While university students’ sexual experience rapidly increased, the socio-cultural perceptions of sexual health remained closed, and they had a reasonably low level of knowledge about cervical cancer screening. Therefore, various strategies sensitive to female university students’ culture should be implemented to increase the knowledge level, and social efforts should be made to change the socio-cultural perception of unmarried young women’s sexual health.
Evaluation of albumin use in a community hospital setting: A retrospective study looking at appropriate use and prescribing patterns
Authors: Coyle Timothy , John Samuel M. 
Published: October 2021

Purpose
Albumin has been shown to be safe and effective in clinical practice for a wide variety of indications. The purpose of this medication use evaluation is to quantify the use of albumin in the community hospital setting based on indication and prescribing department.

Methods
This study is a retrospective, single-center, chart review over a 6-month period of 186 patients aged 18 and older who were treated with IV human albumin 5% or 25% at a single 202-bed community hospital setting from February 1, 2020, to August 1, 2020. A chart review was completed for each patient and the data collected included date of albumin administration, the ordering provider, the specialty of the provider, the indication for albumin as stated in the order, patient notes, crystalloid therapy use prior to albumin, albumin strength, the presence of acute or chronic renal, hepatic or respiratory disorders, and lab values denoting renal and hepatic function. Appropriate albumin use was determined utilizing criteria which included FDA labeled indications, the Surviving Sepsis Campaign, and existing literature.

Results
A total of 186 patients received albumin 5% or 25% IV solution at least once during the study period. The study population was 52.2% female, and the average age was 68 years. Of the patients selected for the study, 23 (11.6%) had chronic hepatic disease, and 37 (18.7%) had chronic renal disease. The top indications for which albumin was administered were sepsis or septic shock (25.3%), hypotension or hypovolemia (19.4%), intra-dialytic hypotension (13.4%), fluid support in surgery (10.8%), and nephrosis or nephropathy (10.8%). The departments with highest albumin use during this study period were critical care (41%), nephrology (28%), and surgery (17%). Overall, albumin was used for an appropriate indication in 126 out of 186 patients (67.7%).

Conclusion
We found that albumin was most utilized for sepsis and septic shock, hypovolemia and hypotension, and intradialytic hypotension in our community hospital setting and it was most frequently ordered by critical care, nephrology, and surgical departments. Further research could determine if this trend is seen in other community hospital settings.
Electromagnetic energy (670 nm) stimulates vasodilation through activation of the large conductance potassium channel (BKCa)
Authors: Gebremendhin Debebe , Lindemer Brian , Weihrauch Dorothee , Harder David R. , Lohr Nicole L. 
Published: October 2021

Introduction
Peripheral artery disease (PAD) is a highly morbid condition in which impaired blood flow to the limbs leads to pain and tissue loss. Previously we identified 670 nm electromagnetic energy (R/NIR) to increase nitric oxide levels in cells and tissue. NO elicits relaxation of smooth muscle (SMC) by stimulating potassium efflux and membrane hyperpolarization. The actions of energy on ion channel activity have yet to be explored. Here we hypothesized R/NIR stimulates vasodilation through activation of potassium channels in SMC.

Methods
Femoral arteries or facial arteries from C57Bl/6 and Slo1-/- mice were isolated, pressurized to 60 mmHg, pre-constricted with U46619, and irradiated twice with energy R/NIR (10 mW/cm2 for 5 min) with a 10 min dark period between irradiations. Single-channel K+ currents were recorded at room temperature from cell-attached and excised inside-out membrane patches of freshly isolated mouse femoral arterial muscle cells using the patch-clamp technique.

Results
R/NIR stimulated vasodilation requires functional activation of the large conductance potassium channels. There is a voltage dependent outward current in SMC with light stimulation, which is due to increases in the open state probability of channel opening. R/NIR modulation of channel opening is eliminated pharmacologically (paxilline) and genetically (BKca α subunit knockout). There is no direct action of light to modulate channel activity as excised patches did not increase the open state probability of channel opening.

Conclusion
R/NIR vasodilation requires indirect activation of the BKca channel.
Altered mental status is a predictor of poor outcomes in COVID-19 patients: A cohort study
Authors: Attia Abdallah S. , Hussein Mohammad , Aboueisha Mohamed A. , Omar Mahmoud , Youssef Mohanad R. , Mankowski Nicholas , Miller Michael , Munshi Ruhul , Swinford Aubrey , Kline Adam , Nguyen Therese , Toraih Eman , Duchesne Juan , Kandil Emad 
Published: October 2021

Introduction
Several studies have described typical clinical manifestations, including fever, cough, diarrhea, and fatigue with COVID-19 infection. However, there are limited data on the association between the presence of neurological manifestations on hospital admission, disease severity, and outcomes. We sought to investigate this correlation to help understand the disease burden.

Methods
We delivered a multi-center retrospective study of positive laboratory-confirmed COVID-19 patients. Clinical presentation, laboratory values, complications, and outcomes data were reported. Our findings of interest were Intensive Care Unit (ICU) admission, intubation, mechanical ventilation, and in-hospital mortality.

Results
A total of 502 patients with a mean age of 60.83 ± 15.5 years, of them 71 patients (14.14%) presented with altered mental status, these patients showed higher odds of ICU admission (OR = 2.06, 95%CI = 1.18 to 3.59, p = 0.01), mechanical ventilation (OR = 3.28, 95%CI = 1.86 to 5.78, p < 0.001), prolonged (>4 days) mechanical ventilation (OR = 4.35, 95%CI = 1.89 to 10, p = 0.001), acute kidney injury (OR = 2.18, 95%CI = 1.28 to 3.74, p = 0.004), and mortality (HR = 2.82, 95%CI = 1.49 to 5.29, p = 0.01).

Conclusion
This cohort study found that neurological presentations are associated with higher odds of adverse events. When examining patients with neurological manifestations, clinicians should suspect COVID-19 to avoid delayed diagnosis or misdiagnosis and lose the chance to treat and prevent further transmission.