bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Assessment of an Otolaryngology‐Specific Surgical Priority Scoring System
Authors: Sharma Arun , Matos Sophia , Ettema Sandra L. , Gregory Stacie R. , Javadi Pardis , Johnson Matthew D. , Stack Brendan C. , Crosby Dana L. 
Published: May 2021

ObjectiveTo develop and assess an otolaryngology‐specific surgical priority scoring system that incorporates varying levels of mucosal involvement.Study DesignRetrospective cohort.SettingAcademic medical center.MethodsA novel mucosal score was developed based on best available evidence. This mucosal score was incorporated into the Medically Necessary, Time‐Sensitive (MeNTS) score to generate a MeNTS‐Mucosal (MeNTS‐M) score. A retrospective cohort of patients was identified to assess the surgical priority scoring systems. Inclusion criteria included all scheduled surgical procedures between March 23, 2020, and April 17, 2020. Decisions about whether to proceed or cancel were made based on best clinical judgment by surgeons, without use of any surgical priority scores. The predictive value of the surgical priority scoring systems was assessed in this retrospective cohort.ResultsThe median MeNTS score was significantly lower in adult patients whose surgery proceeded compared to those for whom the surgery was cancelled (48 vs 56; P =. 004). Mucosal and MeNTS‐M scores were not statistically different based on whether surgery proceeded. Among adult patients, the highest area under the curve (AUC) was for the MeNTS scoring system (0.794); both the mucosal and MeNTS‐M systems had lower AUC values (which were significantly lower than the AUC for the MeNTS scoring system).ConclusionThis study represents development and assessment of the first otolaryngology‐specific surgical priority score and incorporates varying levels of mucosal disruption. The combined MeNTS‐M scoring system could be a valuable tool in appropriately triaging otolaryngology–head and neck surgery procedures.
Management of Large Subretinal Gas Bubble After Pneumatic Retinopexy With Head-Positioning Maneuver
Authors: Wang Jay C. , Tang William M. , Eliott Dean 
Published: May 2021

Purpose: This work reports on the management of a large subretinal gas bubble after pneumatic retinopexy. Methods: A case report is discussed. Results: We report a case of subretinal gas after pneumatic retinopexy for rhegmatogenous retinal detachment that was managed with a series of head-positioning maneuvers to allow the subretinal gas to migrate into the vitreous cavity through the retinal break. Despite the subretinal bubbles being larger than the retinal break, this approach eliminated the subretinal gas and averted surgical intervention. Conclusions: Subretinal gas after pneumatic retinopexy can be successfully managed by head-positioning maneuvers in some cases, even if the subretinal gas bubble is larger than the retinal break.
Rapid, Spontaneous Resolution of Prominent Subretinal Infiltrate in Vitreoretinal Lymphoma
Authors: Gong Dan , Aronow Mary E. , Eliott Dean 
Published: May 2021

Purpose: This case report describes a patient with vitreoretinal lymphoma who subacutely developed a large, peripapillary subretinal infiltrate that rapidly and spontaneously resolved. Methods: A case report is presented. Results: A 65-year-old Asian-American woman was referred for evaluation of a dense, peripapillary subretinal infiltrate in the left eye. A diagnostic vitrectomy revealed large, atypical lymphocytes with irregularly shaped nuclei, and mutational testing was positive for myeloid differentiation primary response 88 ( MYD88). Prior to surgery, the patient’s subretinal infiltrate had begun to resolve spontaneously, a process that continued after surgery without initiation of systemic or local ocular therapy. Conclusions: Patients with vitreoretinal lymphoma may present with transient, subretinal infiltrates that can resolve without treatment.
Medical device error and failure reporting: Learning from the car industry
Authors: Tase Arkeliana , Buckle Peter , Ni Melody Z , Hanna George B 
Published: May 2021

Background Improving the design of technology relies in part, on the reporting of performance failures in existing devices. Healthcare has low levels of formal reporting of performance and failure of medical equipment. This paper examines methods of reporting in the car industry and healthcare and aims to understand differences and identify opportunities for improvement within healthcare. Methods A literature search was carried out in Pubmed, Medline, Embase, Engineering Village, Scopus. NHS England and MHRA publications and guidelines were also reviewed. Focus was placed on the current system of reporting in both industries, known degree of patient harm, initiating factors, barriers, quality and methods of incident investigation and their validity. The findings were used to compare error reporting system in the two industries. Results Derivation of healthcare incident data from different sources means the full extent of patient harm is not known. For example, in 2012 there were 13,549 and 38,395 incidents reported by MHRA and NRLS (National Reporting and Learning System) respectively leading to uncertainties on the extent of the problem. The car industry emphasises the role of reporting source in ensuring data quality. Utilising some aspects of this approach might benefit healthcare reporting. These include a specific reporting system that stresses the importance of organisational learning in improving safety and recognises the limitations of root cause analysis. Conclusions Learning from reporting systems within the car industry may help the healthcare sector improve its own reporting, aiding healthcare performance.
How do foster children placed in long-term family foster care experience school?
Authors: Van Holen Frank , Van Hove Lisa , Clé Ann , Verheyden Camille , Vanderfaeillie Johan 
Published: May 2021

Background: Foster children often experience school problems and perform less well than average. This may result in failed school careers and compromised future career paths. Nonetheless, few studies have focused on the perspective of foster children regarding education. Method: Semi-structured interviews were conducted with 27 foster children (M = 14 years, range = 12–18 years) placed in long-term family foster care about their experiences regarding “school.” Results: A thematic analysis distinguished four main themes: (1) the importance of school for foster children; (2) the impact of the foster care placement on the school performance (3) support foster children receive with regard to their functioning and performance at school; and (4) the fear of stigmatization. Discussion: Foster children attach a great importance to school and receive support from different persons. Yet, many foster children are confronted with school difficulties, such as bullying, hindered concentration, and negative reactions to being placed in foster care. Interventions should be developed to support this group and improve their performances. Furthermore, actors who get in touch with foster children should be better acquainted with foster care.
Graft Preparation for Combined ACL and ALL Reconstruction With a Single Femoral Tunnel
Authors: Helito Camilo Partezani , Guimarães Tales Mollica , Sobrado Marcel Faraco 
Published: May 2021

Background: Combined reconstruction of the anterolateral ligament (ALL) and anterior cruciate ligament (ACL) has shown excellent results. It could potentially reduce graft failure and improve outcomes in high-risk patients. There are several surgical techniques described. Hamstrings are the most frequently used graft for ALL reconstruction. The distal portion of the iliotibial band is used for the modified Lemaire procedure. Indications: Anterior cruciate ligament reconstructions associated with the following risk factors: pivoting sports, high-demand athletes, high-grade pivot-shift, chronic ACL injury, lateral femoral condyle notch, Segond fractures, young patients (<20 years), ACL revision, generalized hyperlaxity, and Lachman >7 mm. Technique Description: Semitendinosus and gracilis tendons are harvested and their extremities are prepared with continuous suture. The semitendinosus graft is folded in 3 parts leaving the ends of the graft internalized. The triple semitendinosus will be the main component of the ACL and the single gracilis will be used for both ACL and ALL. Anterolateral ligament anatomical landmarks are proximal and posterior to the lateral epicondyle in the femur, and in the mid distance from the fibular head and the Gerdy tubercle in the tibia. The ALL is fixed in knee extension with interference screws. This video also includes a brief demonstration of graft preparation for the modified Lemaire procedure. Results: Results from our group using this technique have shown excellent clinical outcomes, minimal complications, and low failure rates in high-risk populations. This graft preparation shows excellent diameter and length for combined ACL and ALL reconstruction. Conclusion: This technique is easy to perform, with minimal complications, and should be considered in high-risk patients undergoing ACL reconstruction.
The CAT-SIR is out of the bag: tumors prefer host rather than dietary nutrients
Authors: Abbott Keene L. , Vander Heiden Matthew G. 
Published: May 2021

AbstractThe extent to which tumors acquire nutrients from dietary sources as opposed to from the breakdown of host tissues is not known. In this issue of BMC Biology, Holland et al. report an approach where food sources with different isotope labeled carbon ratios can be used to answer this question, and find that tumors arising in Drosophila melanogaster procure most of their nutrients from the host.
DIA proteomics analysis through serum profiles reveals the significant proteins as candidate biomarkers in women with PCOS
Authors: Yu Ying , Tan Panli , Zhuang Zhenchao , Wang Zhejiong , Zhu Linchao , Qiu Ruyi , Xu Huaxi 
Published: May 2021

Abstract
Background
The aim of this study was to apply proteomic methodology for the analysis of proteome changes in women with polycystic ovary syndrome (PCOS).

Material and methods
All the participators including 31 PCOS patients and 31 healthy female as controls were recruited, the clinical characteristics data was recorded at the time of recruitment, the laboratory biochemical data was detected. Then, a data-independent acquisition (DIA)-based proteomics method was performed to compare the serum protein changes between PCOS patients and controls. In addition, Western blotting was used to validate the expression of identified proteomic biomarkers.

Results
There were 80 proteins differentially expressed between PCOS patients and controls significantly, including 54 downregulated and 26 upregulated proteins. Gene ontology and Kyoto Encyclopedia of Genes and Genomes analysis showed that downregulated proteins were enriched in platelet degranulation, cell adhesion, cell activation, blood coagulation, hemostasis, defense response and inflammatory response terms; upregulated proteins were enriched in cofactor catabolic process, hydrogen peroxide catabolic process, antioxidant activity, cellular oxidant detoxification, cellular detoxification, antibiotic catabolic process and hydrogen peroxide metabolic process. Receiver operating characteristic curves analysis showed that the area under curve of Histone H4 (H4), Histone H2A (H2A), Trem-like transcript 1 protein (TLT-1) were all over than 0.9, indicated promising diagnosis values of these proteins. Western blotting results proved that the detected significant proteins, including H4, H2A, TLT-1, Peroxiredoxin-1, Band 3 anion transport protein were all differently expressed in PCOS and control groups significantly.

Conclusion
These proteomic biomarkers provided the potentiality to help us understand PCOS better, but future studies comparing systemic expression and exact role of these candidate biomarkers in PCOS are essential for confirmation of this hypothesis.
HDAC4 degradation during senescence unleashes an epigenetic program driven by AP-1/p300 at selected enhancers and super-enhancers
Authors: Di Giorgio Eros , Paluvai Harikrishnareddy , Dalla Emiliano , Ranzino Liliana , Renzini Alessandra , Moresi Viviana , Minisini Martina , Picco Raffaella , Brancolini Claudio 
Published: May 2021

AbstractBackgroundCellular senescence is a permanent state of replicative arrest defined by a specific pattern of gene expression. The epigenome in senescent cells is sculptured in order to sustain the new transcriptional requirements, particularly at enhancers and super-enhancers. How these distal regulatory elements are dynamically modulated is not completely defined.ResultsEnhancer regions are defined by the presence of H3K27 acetylation marks, which can be modulated by class IIa HDACs, as part of multi-protein complexes. Here, we explore the regulation of class IIa HDACs in different models of senescence. We find that HDAC4 is polyubiquitylated and degraded during all types of senescence and it selectively binds and monitors H3K27ac levels at specific enhancers and super-enhancers that supervise the senescent transcriptome. Frequently, these HDAC4-modulated elements are also monitored by AP-1/p300. The deletion of HDAC4 in transformed cells which have bypassed oncogene-induced senescence is coupled to the re-appearance of senescence and the execution of the AP-1/p300 epigenetic program.ConclusionsOverall, our manuscript highlights a role of HDAC4 as an epigenetic reader and controller of enhancers and super-enhancers that supervise the senescence program. More generally, we unveil an epigenetic checkpoint that has important consequences in aging and cancer.
Alpha-1 antitrypsin deficiency in the elderly: a case report
Authors: Annunziata Anna , Lanza Maurizia , Coppola Antonietta , Fiorentino Giuseppe 
Published: May 2021

Abstract
Background
Generally, alpha-1 antitrypsin deficiency (AATD) is suspected in young patients with pulmonary emphysema or chronic obstructive pulmonary disease (COPD). Patients often suffer from diagnostic gaps and are misdiagnosed with chronic obstructive pulmonary disease (COPD), asthma, and airway hyperresponsiveness (AHR), as AATD may present with nonspecific respiratory symptoms. It is never too late to suspect AATD, especially in a patient with an unusual medical history. In recent years, evidence is beginning to emerge that there may be value in identifying and treating patients who do not already have deterioration of functional parameters.

Case presentation
We describe a case of a 69-year-old Caucasian female patient, late diagnosis of AATD, with both severe bronchial hyperreactivity and numerous exacerbations due to the peculiar clinical history and the presence of a rare mutation; although not presenting forced expiratory volume in 1 second (FEV1) between 30 and 65%, the patient was treated with alpha-1 antitrypsin (AAT) augmentation therapy and achieved clinical and functional improvement.

Conclusion
AATD should always be suspected. The Alpha-1 Foundation recommendations for the diagnosis and management of AATD in adult patients indicate that treatment should be provided for patients with FEV1 between 30 and 65%. It may be useful to evaluate and treat patients based on clinical symptoms, even outside the established parameters, in particular cases.
The association between somatotype and nutritional status: a cross-sectional study among the adult Sabar males of Purulia, West Bengal, India
Authors: Das Kaustav , Mukherjee Koel , Ganguli Sayak , Pal Somosree , Bagchi Subrata Sankar 
Published: May 2021

AbstractSomatotype is the parameter used to determine the body composition, which is influenced by several factors and nutrition is the crucial one. This study aimed to determine somatotype and nutritional status as well as investigate the somatotype variations in relation to the age and nutritional status among the adult males of Sabar community living in Purulia district of West Bengal, India. The present cross-sectional study included 334 Sabar males aged between 18 to 60 years. Anthropometric measurements including height, weight, 2 breadths, 2 circumferences and 4 skinfolds were taken following standard protocol. Somatotype was determined following the Heath-Carter method and Body Mass Index (BMI) was used to access the level of nutrition. Descriptive statistics, Kruskal-Wallis H test, Pearson correlation, Spearman correlation and Chi-square test were performed to find out variation, correlation and association of the somatype components with age and nutritional categories. Prior ethical clearance had been obtained. As a result, the trend of undernutrition was gradually increasing with age and found highest among aged people (50–60 years) with an overall prevalence of 49.7%. Eleven different somatotype subgroups were identified. The mean somatotype of the participants was 2.3–3.6-3.9 which indicates mesomorph-ectomorph body type. Kruskal-Wallis H test revealed significant differences among somatotype components in different nutritional categories. Undernutrition was found highest among the mesomorphic ectomorph (62.7%) type. Chi-square test stated significant association between somatotype categories and nutritional statuses (Chi-square = 283.160,p < 0.01). This is the first reporting on the somatotype study among the Sabar community, where the dominant body type was found mesomorph-ectomorph. A highly significant correlation was found between somatotype and BMI. At the same time, this study expressed the need for immediate nutritional intervention.
18F-FDG PETCT and 68Ga-DOTA PETCT mismatch with in vivo histopathological characterization of low-grade neuroendocrine pancreatic tumor
Authors: Queiroz Marcello Moro , Lopes Carlos Diego Holanda , Salgues Alessandra Corte Real , Barbosa Felipe de Galiza , Abe Emerson Shigueaki , Silveira Thales Parenti , Machado Marcel Cerqueira Cesar , Capareli Fernanda Cunha 
Published: May 2021

Abstract
Background
Pancreatic neuroendocrine tumor (PNET) is a subgroup of neuroendocrine tumor (NET) that has unique biology and natural history. The histological classification has a major role in the management of this pathology, but in recent years Gallium 68 dotatate (68Ga-DOTA) scanning is at the center of a discussion about how these imaging technologies can modify clinical management of neuroendocrine tumors and how their results are correlated to Ki67 index.

Method
We hereby describe a case of a patient that investigated an unspecific stable pancreatic nodule suspected of high-grade NET after evaluation with 68Ga-DOTATOC positron emission tomography—computed tomography (PETCT) and 18F-Fluorodeoxyglucose (18F-FDG) PETCT.

Results
The images corroborate the hypothesis of high-grade NET based on the standard uptake value (SUV) described in both image exams (16.4 in 18FDG PETCT and 9.2 in 68Ga-DOTATOC PETCT). After surgery, the histopathological analyses revealed a localized grade 2 well-differentiated NET, Ki-67 of 4.7, glucose transport proteins 1 (GLUT1) negative by immunohistochemistry, evidencing a rare case of mismatch between the functional image and the in vivo characterization of the neoplasm.

Conclusion
Functional imaging of neuroendocrine tumors with different modalities of PETCT is a well-described strategy for evaluating PNET and can dictate conducts in some cases. However, histopathological analysis is crucial to confirm the grade and prognosis related to this disease.
Inadvertent internal carotid artery (ICA) injury during transsphenoidal surgery: review of literature
Authors: Al-Shami Hieder , Alnemare Ahmad K. 
Published: May 2021

Abstract
Background
Internal carotid artery (ICA) injury is a hazardous catastrophe for the skull base surgery team. We aimed to illustrate the vital joints in this hazardous event during endoscopic surgery.

Main text
The condition is rare (1.1%) but fatal per se. Working in the field of endoscopic surgery is not free of charges. It demands a thorough knowledge of anatomy, variations, and pathoanatomy to expect what can be seen thereafter. Once the injury occurs, one must have a quite clear plan to proceed. Marvelous bleeding is confusing not only in the field but also in the mind process.

Conclusion
Endoscope teams when expose to this event should think in a stepwise manner. In our review, we explained the pathoanatomy of the field after an injury, pre-conditions of injury, and how to avoid certain drawbacks during management.
Treatment of progressive multiple sclerosis with high-dose all-trans retinoic acid – no clear evidence of positive disease modifying effects
Authors: Ruschil Christoph , Dubois Evelyn , Stefanou Maria-Ioanna , Kowarik Markus Christian , Ziemann Ulf , Schittenhelm Marcus , Krumbholz Markus , Bischof Felix 
Published: May 2021

Abstract
Background
All-trans retinoic acid (ATRA) is an acid derivative of vitamin A which is discussed as a promising candidate to ameliorate the disease course of multiple sclerosis (MS) by immunomodulation or even by promoting regeneration in progressive MS. Here we report a patient who significantly improved for MS related disability following administration of chemotherapy including ATRA for mitoxantrone-related acute promyelocytic leukemia and assess the effect of high-dose ATRA in three additional patients with progressive MS.

Methods
Patients with progressive MS who had failed previous therapies were treated with high-dose ATRA. Patients underwent clinical and routine laboratory monitoring. Additionally, PBMCs were analyzed by flow cytometry for lymphocyte subsets.

Results
ATRA was well tolerated and no pathological laboratory abnormalities were observed. After initial mild (not statistically significant) improvement of EDSS and mean MSFC z-score, ongoing disease progression was observed. One patient subacutely experienced severe cognitive and motor worsening. Cerebral MRI revealed persistent gadolinium-enhancing lesions. Flow cytometric alterations of peripheral blood naïve, central memory and effector memory CD4 and CD8 T cells, B lymphocytes, plasma cells, memory B cells, plasmablasts and natural killer (NK) cells did not reach statistical significance.

Conclusions
Stand-alone therapy with ATRA did not ameliorate progressive MS in our limited cohort and we did not observe consistent alterations of T and B cell subsets. Intriguingly, application of ATRA may have caused marked disease exacerbation in one patient.
Autistic traits in offspring of schizophrenic patients in comparison to those of normal population: a case-control study
Authors: Amin Shimaa Ibrahim , Salah EL-Deen Ghada Mohamed 
Published: May 2021

Abstract
Background
Autism is not a discreet condition and those families members with autistic propend are more likely to display autistic symptoms with a wide range of severity, even below the threshold for diagnosis of autism spectrum disorders. Even with a parental history of schizophrenia, the likelihood of autistic spectrum disorder was found to be 3-fold greater. The aim of this study is to assess autistic traits among offspring of schizophrenic patients in the age group from 4 to 11 years and compare it in the offspring of normal individuals, and its association with the sociodemographic data. To determine whether schizophrenic parents are a risk factor to autistic traits in their children.

Results
There was a statistically significant (P < 0.05*) increase in Autism Quotient Child scores of the case group where 47.2% had a score equal or more than the cutoff point (76), while only 17 19.4% of the control group had the same score with odds = 3.71 indicating that children of schizophrenic parents 18 were three times likely to have Autism Quotient-Child score greater than or equal to the cutoff point (76) than 19 children of healthy parents. No statistically significant association (P ≥ 0.05) was found between all 20 sociodemographic characteristics and Autism Quotient-Child scores among the case group except for family 21 income and social class where there was a statistically significant association (P < 0.05) between insufficient income 22 and low social class and higher Autism Quotient-Child score (≥ 76).

Conclusions
Children of schizophrenic parents are at high risk to have autistic traits than children of normal parents.