bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ideal Nasal Radix Position in Fluctuating Facial Asymmetry
Authors: Hsu Fang-Yu , Yen Cheng-I , Chang Chun-Shin , Hsiao Yen-Chang 
Published: March 2021

Background:
Augmentation rhinoplasty had become increasingly popular among Asians. Failure to recognize nasal deviation before surgery may engender unsatisfactory outcomes because the deviation becomes prominently visible after surgery due to the central position of the nose. Ideal nasal radix positioning has yet to be addressed. The head position affects facial asymmetry judgements; however, its effect on rhinoplasty has never been studied. This study determined the ideal nasal radix position in facial fluctuating asymmetry and investigated the effects of the natural head position (NHP) on nasal deviation perceptions.

Methods:
A survey was conducted to compare different head and nasal radix horizontal positions using images of patients who underwent augmentation rhinoplasty. Images were retouched using editing software to adjust the head and nasal radix positions. The survey was performed using questionnaires involving 3 plastic surgeons and 3 laypersons, who were asked to determine the presence of nasal deviation and select the ideal nasal radix position among the retouched images.

Results:
Twenty patients who underwent primary rhinoplasty were included in this study. The recognition of nasal deviation was significantly higher in the NHP than in the compensatory head position. The surgeons and the laypersons considered the midsagittal line the most appropriate position of the nasal radix.

Conclusions:
Facial analysis for augmentation rhinoplasty should be performed with the patient's head in the NHP to prevent nasal deviation masking. The preferred nasal radix position in facial fluctuating asymmetry is the midsagittal line.
Level of Evidence: Level V, descriptive study.
An Integrated Approach to the Management of Meningoencephalocoeles
Authors: Roumeliotis Grayson , Wiberg Akira , Thomas Gregory , Magdum Shailendra , Jayamohan Jayaratnam , Wall Steven , Johnson David 
Published: March 2021

Abstract
Meningoencephalocoeles are congenital herniations of meningeal and cerebral tissues through a cranial defect. They occur most commonly in South-East Asia, and are relatively rare amongst European ancestry populations, with an estimated prevalence of 1/40,000 live births. The treatment of congenital meningoencephalocoeles is primarily surgical and are best managed by dedicated multi-disciplinary craniofacial teams. The authors performed a retrospective case review of all primary meningoencephalocoeles managed in the Oxford University Hospitals NHS Foundation Trust between 1986 and 2012. Twenty-nine cases (13 frontal, 9 occipital, 2 parietal, and 5 basal) were included in this study. The median age at presentation was 11 months (range 0–60 years). Twenty-five cases presented with an external mass; 3 with recurrent meningitis and 1 with otorrhoea. Twenty-six cases underwent surgery, and 17 of these were managed by an integrated approach between 2 or more surgical specialties. Twenty out of 26 operations were performed via a transcranial approach. The authors describe a particularly complex case in order to highlight the challenges associated with management of meningoencephalocoeles, the surgical technique employed, and the importance of a multidisciplinary surgical approach. This is the largest reported case series of meningoencephalocoeles managed in a single hospital in the United Kingdom. Designated craniofacial units with access to multidisciplinary surgical specialties provide a safe and optimal setting for the management of meningoencephalocoeles.
Application of Proximal Splenic Vein Embolization to Interrupt Complicated Large Splenorenal Shunts in Adult Living Donor Liver Transplantation
Authors: Kang Woo-Hyoung , Moon Deok-Bog , Ko Gi-Young , Gwon Dong-Il , Yoon Young-In , Cho Hwui-Dong , Lee Sung-Gyu 
Published: March 2021

Objective:
The aim of the present study is to evaluate efficacy and safety of proximal splenic vein embolization (PSVE) for liver transplant recipients having complicated large splenorenal shunts (SRS).

Background:
In adult living donor liver transplantation for a patient who has large splenorenal shunts (SRS), their interruption is utmost important to maintain adequate portal flow by avoidance of portal flow steal through the preexisting SRS. We effectively managed most of the recipients with surgical ligation and/or additional radiologic embolization using by intraoperative cine-portogram. However, when complete interruption is not achieved in a few recipients having complicated large SRS, it may leave a chance of lethal portal flow steal in the recipient afterward.

Methods:
PSVE was performed in 13 patients between April 2014 and November 2017. We performed a retrospective analysis of preoperative images, postoperative graft and recipient outcomes, and presence of isolated portal hypertension.

Results:
Ten patients underwent PSVE as an additional secondary method because of portal steal syndrome through the remaining SRS after surgical interruption and/or embolization, and 3 patients underwent PSVE only as a primary method of SRS interruption. In all 13 patients, portal steal on the final intraoperative cine-portogram completely disappeared after PSVE. All patients recovered with satisfactory regeneration of the partial liver graft without the reappearance of portosystemic collaterals, and there were no procedure-related complications.

Conclusions:
PSVE is an effective and safe procedure to secure adequate portal flow without portal steal for patients with complicated large SRS arising from multiple sites of the splenic vein or escaping to multiple terminal ends.
Genetic Variants Associated With Alzheimer Disease in the 22 Arab Countries
Authors: Al-Thani Hissa F. , Ahmad Muneera N. , Younes Salma , Zayed Hatem 
Published: March 2021

Background and Aims:
Alzheimer disease (AD) is a progressive and complex neurodegenerative disease. Approximately 70% of AD risk is attributed to genetic risk factors, including variants in amyloid precursor protein (APP), presenilin 1 (PSEN1), and presenilin 2 (PSEN2) genes. Several studies have revealed a considerable number of candidate loci and genes for AD among different ethnic populations. However, the outcomes of these studies have been inconsistent. In this study, we aimed to investigate the spectrum of variants that are associated with the onset and development of AD among 22 Arab countries.

Methodology:
We systematically searched 4 literature databases (Science Direct, Scopus, PubMed, and Web of Science) from the date of inception until July 2020 using various search terms to obtain all the reported genetic data on Arab AD cases.

Results:
In total, 18 studies were included, comprising a total of 2173 individuals, of whom 888 were clinically diagnosed AD patients and were genetically tested for genes and variants associated with AD. A total of 27 variants in 8 genes were found to be associated with AD. Of these variants, 17 were unique to the Arab population and 10 were shared with other ethnic groups.

Conclusions:
There is a dearth of studies on the genetics of AD in the Arab world. There seems to be distinctive genetic and clinical susceptibility profiles for Arab patients with AD.
Factors Affecting Ophthalmology Resident Choice to Pursue Neuro-Ophthalmology Fellowship Training
Authors: Solomon Alexander M. , Patel Vivek R. , Francis Courtney E. 
Published: March 2021

Background:
The number of ophthalmology-trained residents applying to neuro-ophthalmology fellowships has not increased despite a trend toward seeking fellowship training after residency. This study sought to identify factors affecting the choice to pursue or not pursue neuro-ophthalmology fellowship training by graduating ophthalmology residents and recently graduated neuro-ophthalmology fellows.

Methods:
An anonymous survey was sent to Association of University Professors of Ophthalmology residency directors to distribute to post-graduate Year 4 (PGY4) ophthalmology residents graduating in either 2018 or 2019. A second anonymous survey was distributed via the North American Neuro-Ophthalmology Society (NANOS) Young Neuro-Ophthalmologists listserv to ophthalmology-trained neuro-ophthalmology fellows. A total of 147 respondents, including 96 PGY4 ophthalmology residents not going into neuro-ophthalmology and 51 practicing neuro-ophthalmologists are included.

Results:
The most common reasons for residents to choose to not pursue further training in neuro-ophthalmology included a stronger interest in other fields, types of patients seen, no intraocular surgery, and the assumption that it is a nonsurgical discipline. The leading factors influencing graduated, ophthalmology-trained fellows to choose neuro-ophthalmology included interest in the clinical diseases treated, interaction with other specialty fields, and a supportive NANOS culture. Interestingly, despite perceptions of graduating residents, two-thirds of the neuro-ophthalmologists surveyed perform surgery. There were no differences between the 2 groups with respect to the degree of exposure to neuro-ophthalmology in medical school, presence of a dedicated neuro-ophthalmology rotation in residency, or timing of the rotation.

Conclusions:
There are a variety of factors influencing decisions regarding pursuing neuro-ophthalmology fellowship among ophthalmology residents. The perceived lack of surgical opportunities in neuro-ophthalmology is a deterrent for many. However, a significant number of neuro-ophthalmologists continue to perform surgery, including intraocular surgery. Repeated exposure later in residency may provide an opportunity to reconsider the field and to re-emphasize opportunities to remain surgically involved as a neuro-ophthalmologist. Exposure to the practice patterns of recently graduated neuro-ophthalmologists offers residents in training excellent exposure to the contemporary practice of neuro-ophthalmology. Hence, ensuring trainees receive a balanced exposure to practicing neuro-ophthalmologists across the spectrum of seniority and scope of practice may promote greater interest among ophthalmology residents to pursue a career in neuro-ophthalmology.
Healthy diets, lifestyle changes and wellbeing during and after lockdown: Longitudinal evidence from the West Midlands
Authors: van Rens Thijs , Hanson Petra , Oyebode Oyinlola , Walasek Lukasz , Barber Thomas M. , Mujcic Redzo , Al-Khudairy Lena 
Published: March 2021

ABSTRACTBackground‘Lockdowns’ to control the spread of COVID-19 in the UK have affected many aspects of life, with concerns that they may have adversely affected diets. We aimed to examine (i) the effect of living in lockdown on fruit and vegetable consumption; (ii) whether any population subgroup was particularly adversely affected; (iii) the barriers and facilitators to a healthy diet in lockdown; and (iv) the effect of lockdown on secondary outcomes such as weight and mental wellbeing.MethodsWe conducted a mixed-method longitudinal study, involving an online survey of 1003 adults in the West Midlands, UK, 494 of whom were surveyed at two different points in time. Our first time point (T0: May 2020) was during stringent COVID-19 lockdown and the second (T1: September 2020) during a period of more relaxed restrictions. The survey included detailed quantitative questions about fruit and vegetable consumption; questions on physical activity, socio-demographic characteristics, BMI and wellbeing; and qualitative data collection about the reasons behind reported changes.ResultsWe find no evidence for respondents decreasing their fruit and vegetable consumption during lockdown compared to afterwards. If anything, consumption of fruit and vegetables increased by about half a portion daily among women, particularly among those who normally have a long commute. These findings combined with a significant increase in physical activity, suggest that behaviours were healthier during lockdown, consistent with higher self-reported health compared with afterwards. However, there was a marked deterioration in wellbeing during lockdown, and on average participants self-reported being heavier during this period as well. Our qualitative data suggested that an abundance of resources supported higher fruit and vegetable consumption during lockdown, for instance, participants had more time, while access issues were one barrier to consumption.ConclusionsOur results are reassuring for those concerned that lockdowns may have adversely affect diets. They may point to the impact of commuting on diet, particularly for women, and intervening to reduce commuting times may be one way to improve population diets. Our study adds longitudinal evidence to a growing body of literature on the adverse effect of lockdown on mental health.
Simultaneous evaluation of antibodies that inhibit SARS-CoV-2 RBD variants with a novel competitive multiplex assay
Authors: Lopez Ester , Haycroft Ebene R. , Adair Amy , Mordant Francesca L. , O’Neill Matthew T. , Pymm Phillip , Redmond Samuel , Gherardin Nicholas A. , Wheatley Adam K. , Juno Jennifer. A. , Selva Kevin J. , Davis Samantha , Harty Leigh , Purcell Damian F.J. , Subbarao Kanta , Godfrey Dale I. , Kent Stephen J. , Tham Wai-Hong , Chung Amy W. 
Published: March 2021

ABSTRACTThe SARS-CoV-2 Receptor Binding Domain (RBD) is both the principal target of neutralizing antibodies, and one of the most rapidly evolving domains, which can result in the emergence of immune escape mutations limiting the effectiveness of vaccines and antibody therapeutics. To facilitate surveillance, we developed a rapid, high-throughput, multiplex assay able to assess the inhibitory response of antibodies to 24 RBD natural variants simultaneously. We demonstrate that immune escape can occur through two mechanisms, antibodies that fail to recognize mutations, along with antibodies that have reduced inhibitory capacity due to enhanced variant RBD-ACE2 affinity. A competitive approach where antibodies simultaneously compete with ACE2 for binding to the RBD may therefore more accurately reflect the physiological dynamics of infection. We describe the enhanced affinity of RBD variants N439K, S477N, Q493L, S494P and N501Y to the ACE2 receptor, and demonstrate the ability of this assay to bridge a major gap for SARS-CoV-2 research; informing selection of complementary monoclonal antibody candidates and the rapid identification of immune escape to emerging RBD variants following vaccination or natural infection.
The 501Y.V2 SARS-CoV-2 variant has an intermediate viral load between the 501Y.V1 and the historical variants in nasopharyngeal samples from newly diagnosed COVID-19 patients
Authors: Teyssou Elisa , Soulie Cathia , Visseaux Benoit , Lambert-Niclot Sidonie , Ferre Valentine , Marot Stéphane , Jary Aude , Sayon Sophie , Zafilaza Karen , Leducq Valentin , Schnuriger Aurélie , Abdi Basma , Wirden Marc , Houhou-Fidouh Nadhira , Charpentier Charlotte , Morand-Joubert Laurence , Burrel Sonia , Descamps Diane , Calvez Vincent , Geneviève Marcelin Anne 
Published: March 2021

AbstractThe 501Y.V2 and the 501Y.V1 SARS-CoV-2 variants emerged and spread rapidly into the world. We analysed the viral load of 643 nasopharyngeal samples of COVID-19 patients at diagnosis and found that the 501Y.V1 and the 501Y.V2 variants presented a viral load three to ten times and two times higher than the historical variants, respectively.HighlightsViral load in COVID-19 patient nasopharyngeal samples was different between variants.The 501Y.V2 variant had a viral load 2 times higher than the historical variantsThe 501Y.V2 variant had a viral load slightly lower than the 501Y.V1The 501Y.V1 variant had a viral load 3-10 times higher than the historical variants
Hyperglycemia in Acute COVID-19 is Characterized by Adipose Tissue Dysfunction and Insulin Resistance
Authors: Reiterer Moritz , Rajan Mangala , Gómez-Banoy Nicolás , Lau Jennifer D. , Gomez-Escobar Luis G. , Gilani Ankit , Alvarez-Mulett Sergio , Sholle Evan T. , Chandar Vasuretha , Bram Yaron , Hoffman Katherine , Rubio-Navarro Alfonso , Uhl Skyler , Shukla Alpana P. , Goyal Parag , tenOever Benjamin R. , Alonso Laura C. , Schwartz Robert E. , Schenck Edward J. , Safford Monika M. , Lo James C. 
Published: March 2021

AbstractCOVID-19 has proven to be a metabolic disease resulting in adverse outcomes in individuals with diabetes or obesity. Patients infected with SARS-CoV-2 and hyperglycemia suffer from longer hospital stays, higher risk of developing acute respiratory distress syndrome (ARDS), and increased mortality compared to those who do not develop hyperglycemia. Nevertheless, the pathophysiological mechanism(s) of hyperglycemia in COVID-19 remains poorly characterized. Here we show that insulin resistance rather than pancreatic beta cell failure is the prevalent cause of hyperglycemia in COVID-19 patients with ARDS, independent of glucocorticoid treatment. A screen of protein hormones that regulate glucose homeostasis reveals that the insulin sensitizing adipokine adiponectin is reduced in hyperglycemic COVID-19 patients. Hamsters infected with SARS-CoV-2 also have diminished expression of adiponectin. Together these data suggest that adipose tissue dysfunction may be a driver of insulin resistance and adverse outcomes in acute COVID-19.
Genomic profiling defines variable clonal relatedness between invasive breast cancer and primary ductal carcinoma in situ
Authors: Lips Esther H. , Kumar Tapsi , Megalios Anargyros , Visser Lindy L. , Sheinman Michael , Fortunato Angelo , Shah Vandna , Hoogstraat Marlous , Sei Emi , Mallo Diego , Roman-Escorza Maria , Ahmed Ahmed A. , Xu Mingchu , Brugman Wim , Clements Karen , Davies Helen R. , Fu Liping , Grigoriadis Anita , Hardman Timothy M. , King Lorraine M. , Krete Marielle , Kristel Petra , Maaker Michiel de , Maley Carlo C. , Marks Jeffrey R. , Menegaz Brian , Mulder Lennart , Nieboer Frank , Nowinski Salpie , Pinder Sarah , Quist Jelmar , Salinas-Souza Carolina , Schaapveld Michael , Schmidt Marjanka K. , Shaaban Abeer M. , Shami Rana , Sridharan Mathini , Zhang John , Stobart Hilary , Collyar Deborah , Nik-Zainal Serena , Wessels Lodewyk F.A. , Hwang E. Shelley , Navin Nicholas N. , Futreal Andrew , Thompson Alastair , Wesseling Jelle , Sawyer Elinor J. 
Published: March 2021

AbstractPure ductal carcinoma in situ (DCIS) is being diagnosed more frequently through breast screening programmes and is associated with an increased risk of developing invasive breast cancer. We assessed the clonal relatedness of 143 cases of pure DCIS and their subsequent events using a combination of whole exome, targeted and copy number sequencing, supplemented by single cell analysis. Unexpectedly, 18% of all invasive events after DCIS were clonally unrelated to the primary DCIS. Single cell sequencing of selected pairs confirmed our findings. In contrast, synchronous DCIS and invasive disease (n=44) were almost always (93%) clonally related. This challenges the dogma that almost all invasive events after DCIS represent invasive transformation of the initial DCIS and suggests that DCIS could be an independent risk factor for developing invasive disease as well as a precursor lesion. Our findings support a paradigm shift that confirms a more complex role for DCIS than previously recognized, and that the future management of DCIS should take into account both the precursor and risk factor implications of this diagnosis.
Acute Brain Ischemia, Infarction and Hemorrhage in Subjects Dying with or Without Autopsy-Proven Acute Pneumonia
Authors: Beach Thomas G. , Sue Lucia I. , Intorcia Anthony J. , Glass Michael J. , Walker Jessica E. , Arce Richard , Nelson Courtney M. , Serrano Geidy E. 
Published: March 2021

AbstractStroke is one of the most serious complications of Covid-19 disease but it is still unclear whether stroke is more common with Covid-19 pneumonia as compared to non-Covid-19 pneumonia. We investigated the concurrence rate of autopsy-confirmed acute brain ischemia, acute brain infarction and acute brain hemorrhage with autopsy-proven acute non-Covid pneumonia in consecutive autopsies in the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND), a longitudinal clinicopathological study of normal aging and neurodegenerative diseases. Of 691 subjects with a mean age of 83.4 years, acute pneumonia was histopathologically diagnosed in 343 (49.6%); the concurrence rates for histopathologically-confirmed acute ischemia, acute infarction or subacute infarction was 14% and did not differ between pneumonia and non-pneumonia groups while the rates of acute brain hemorrhage were 1.4% and 2.0% of those with or without acute pneumonia, respectively. In comparison, in reviews of Covid-19 publications, reported clinically-determined rates of acute brain infarction range from 0.5% to 20% while rates of acute brain hemorrhage range from 0.13% to 2%. In reviews of Covid-19 autopsy studies, concurrence rates for both acute brain infarction and acute brain hemorrhage average about 10%. Covid-19 pneumonia and non-Covid-19 pneumonia may have similar risks tor concurrent acute brain infarction and acute brain hemorrhage when pneumonia is severe enough to cause death. Additionally, acute brain ischemia, infarction or hemorrhage may not be more common in subjects dying of acute pneumonia than in subjects dying without acute pneumonia.
Endogenous interferon-beta but not interferon-alpha or interferon-lambda levels in nasal mucosa predict clinical outcome in critical COVID-19 patients independent of viral load
Authors: Menezes Soraya Maria , Braz Marcos , Llorens-Rico Veronica , Wauters Joost , Van Weyenbergh Johan 
Published: March 2021

AbstractAlthough the subject of intensive preclinical and clinical research, controversy on the protective vs. deleterious effect of interferon (IFN) in COVID-19 remains. Some apparently conflicting results are likely due to the intricacy of IFN subtypes (type I: IFN-alpha/beta, type III: IFN-lambda), timing and mode of administration (nebulized/subcutaneous) and clinical groups targeted (asymptomatic/mild, moderate, severe/critical COVID-19). Within the COntAGIouS (COvid-19 Advanced Genetic and Immunologic Sampling) clinical trial, we investigated endogenous type I and type III IFNs in nasal mucosa as possible predictors of clinical outcome in critical patients, as well as their correlation to SARS-CoV-2 viral load, using nCounter technology. We found that endogenous IFN-beta expression in the nasal mucosa predicts clinical outcome, independent of viral replication or Apache II score, and should be considered as a prognostic tool in a precision medicine approach of IFN therapy in COVID-19 clinical management.