bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atypical Clinical and Neuroradiological Findings in a Child With Bifacial Weakness With Paresthesias
Authors: Rubino Alfonso , della Corte Marida , Bruno Giorgia , Tucci Celeste , Fasolino Alessandra , de Liso Maria , Varone Antonio 
Published: November 2021

Abstract

Background:
Guillain–Barré syndrome (GBS) is the broad term used to describe a number of related acute autoimmune neuropathies, which together form a continuous spectrum of variable and overlapping syndromes. Bifacial weakness with paresthesias (BFP) is a rare variant of GBS, characterized by isolated facial diplegia in the absence of ophthalmoplegia, ataxia, or limb weakness, and it is usually associated with distal limb paresthesias.

Case Description:
An 8-year-old boy was brought to our attention; because 5 days before coming to the hospital, he noticed he could no longer smile. Bilateral facial droop and inability to close both eyes were evident along with slight paresthesias at the hands and feet and gait disturbances. He progressively developed hypophonia, dysarthria, dysphagia associated with dysmetria, and limb ataxia. Nerve conduction studies showed a demyelinating polyneuropathy. Brain and spine magnetic resonance imaging (MRI) revealed contrast enhancement of both facial nerves and cauda equina nerve roots along with a hyperintense signal of the periaqueductal gray matter, superior cerebellar peduncles, and pontine tegmentum. Because BFP is not typically associated with other cranial neuropathies or ataxia, these clinical features along with peculiar MRI findings supported the diagnosis of “BFP plus.” Finally, it can be speculated that this case configures a rare overlap between BFP and the other GBS variants, such as Bickerstaff encephalitis.

Conclusions:
This atypical case underlines the potential role of MRI in contributing to refining the nosological classification of GBS spectrum and optimizing individual treatment, especially in children where unusual manifestations are not infrequent and neurological examination is more challenging.
LncRNA NEAT1 Accelerates the Proliferation, Oxidative Stress, Inflammation, and Fibrosis and Suppresses the Apoptosis Through the miR-423-5p/GLIPR2 Axis in Diabetic Nephropathy
Authors: Wu Xu , Fan Deyong , Chen Bo 
Published: November 2021

Abstract:
Diabetic nephropathy (DN) is a serious microvascular complication of diabetes. The aim of our study was to investigate the potential mechanism in DN progression. SV40 mesangial cells (MES)13 cells were exposed to high concentration of glucose (HG: 30 mmol/L) for 48 hours to establish a DN cell model in vitro. Bioinformatic software StarBase was adopted to establish the long noncoding RNA (lncRNA)-microRNA–messenger RNA axis. Dual-luciferase reporter assay, RNA immunoprecipitation assay, and RNA pull-down assay were performed to verify intermolecular interaction. LncRNA nuclear paraspeckle assembly transcript 1 (NEAT1) was overexpressed in the serum of patients with DN. HG time-dependently upregulated NEAT1 levels, and HG promotes cell proliferation, oxidative stress, inflammation, and fibrosis and suppressed cell apoptosis in SV40 MES13 cells partly through upregulating NEAT1. NEAT1 functioned as a molecular sponge of miR-423-5p, and NEAT1 silencing-mediated effects were partly overturned by miR-423-5p interference in HG-induced SV40 MES13 cells. Glioma pathogenesis related-2 (GLIPR2) was a target of miR-423-5p. GLIPR2 overexpression in normal concentration of glucose (NG)-induced SV40 MES13 cells partly simulated HG-induced effects. GLIPR2 overexpression partly reversed NEAT1 interference–induced effects in HG-induced SV40 MES13 cells. LncRNA NEAT1 contributed to HG-induced DN progression through the miR-423-5p/GLIPR2 axis in vitro. NEAT1/miR-423-5p/GLIPR2 axis might be a potential target for DN treatment.
Bridging Care Transition After Hospitalization for Atrial Fibrillation and Coronary Interventions
Authors: Hijazi Yosef , Karkabi Basheer , Feldman Marina , Malca Bruria , Lavi Idit , Jaffe Ronen , Schliamser Jorge E. , Shiran Avinoam , Flugelman Moshe Y. 
Published: November 2021

Abstract:
Treatment fragmentation between hospitals and the community can result in catastrophic outcomes; uninterrupted treatment with anticoagulant and platelet aggregation inhibitors is particularly important. We assessed the proportion and characteristics of patients who did not visit their primary community-based physician within 1 week of discharge from our department of cardiovascular medicine and the proportion that failed to procure essential drugs at the community pharmacy. We prospectively studied 423 patients who were discharged from our department. They were provided detailed explanations, tablets for 7 days, prescriptions, and a printed drug plan. We traced the time from discharge until a visit with a primary community-based physician, and the time until the procurement of medications, using our computerized community–hospital–integrated system. Complete data were available for 313 patients, of whom 220 were treated with anticoagulants or platelet aggregation inhibitors. For 175 patients, these drugs were initiated during index hospitalizations. Only 1 patient did not receive platelet aggregation inhibitors despite recommendations. Seventy-nine patients (25%) first visited their primary care physicians more than 1 week after discharge. Predictors for delayed visits were living alone (hazard ratio 1.91) and having an in-house caregiver (hazard ratio 2.01). In conclusion, all but 1 patient continued drug therapy after discharge from the hospital. The simple predischarge steps included patient education and provision of a 1-week supply of tablets and prescriptions. Treatment continuation was independent of visits to the community-based primary physician. Patients living alone or with an in-house caregiver more often delayed visits to primary physicians yet continued relevant drug therapy.
A Myocutaneous Latissimus Dorsi Propeller Flap Based on a Single Dorsal Intercostal Perforator
Authors: Geierlehner Alexander , Ludolph Ingo , Arkudas Andreas , Horch Raymund E. 
Published: November 2021

Summary:
This study presents a novel surgical technique for the reconstruction of highly challenging large lower back defects. In this case, a 72-year-old man initially diagnosed with renal cell carcinoma received nephrectomy followed by the dissection of an iliac crest metastasis and repeated high-dose irradiation therapy. Several years later, an osteocutaneous fistula at the right caudal posterior trunk made the reconstruction of the lower back defect necessary. High-dose irradiation of the lower back and poor vascular conditions at the pelvic region disqualified the patient for previously published local or free flap options. The initial strategy of an arteriovenous loop anastomosed to the femoral vessels and a free latissimus dorsi flap transfer had to be withdrawn due to repeated intraoperative loop thrombosis. For that reason, the entire latissimus dorsi muscle was used as a myocutaneous propeller flap receiving its blood supply solely through a single dorsal intercostal artery perforator. The flap survived completely and no fistulous formation occurred postoperatively. The time to complete wound healing was 4 months. This new technique is considered a valuable addition for the reconstruction of challenging posterior caudal trunk defects.
Simultaneous Central Slip and Volar Plate Injuries at PIP Joint: A Novel Therapeutic Approach
Authors: Alotaibi Ahmed S. , AlMarshad Felwa A. , Alzahrani Abdullah M. , Hossein Mohanad O. , Ijaz Attiya , Ifthikar Zainab , Jarman Abdulaziz T. 
Published: November 2021

Background:
Central slip and volar plate injuries rarely occur in the same finger, with only two cases previously reported in published literature. In these two patients, both teenagers, two highly distinct protocols were used. Here, we report a third case involving a 51-year-old gentleman who closed a door on his left third finger.

Methods:
Because the fractures were noncomminuted and only minimally displaced, he was treated nonsurgically using a multi-step process of splinting to prevent impairment of either proximal interphalangeal joint extension or flexion, combined with active range of motion exercises. This included five weeks of splinting in neutral, 24-hour daily use of a proximal interphalangeal dorsal block, followed by active range of motion exercises combined with nocturnal splinting using a PIP volar block over the next 7 weeks, with relative motion and Joint Jack splints added over the final 4 of these 7 weeks.

Results:
Twelve weeks after initial splinting, the patient’s finger was pain free, with swelling largely resolved, normal extension (−10 degrees) and near-normal flexion (95 degrees) achieved, and full function restored. The patient was very satisfied with the result.

Conclusions:
Ours is just the third case of concomitant central slip and volar plate injuries reported in the literature. Other surgeons are strongly encouraged to publish similar cases, approaches, and results, as clinical wisdom can sometimes be gleaned from even a small number of well-documented clinical cases.
Artifacts on Magnetic Resonance Imaging from Electronic Identification Enablement in Silicone Gel Implants Are Not Negligible
Authors: Kurz Kathinka D. , Kallevåg Øystein , Austrått Kenneth , Styr Bodil , Leiknes Jon Bjarne , Krøger Pål 
Published: November 2021

Summary:
Breast implants filled with silicone gel are used worldwide for cosmetic reasons, or breast reconstruction following risk-reducing or therapeutic mastectomy. The importance of identifiable implants is undeniable. A recent development has been the labeling of the implants with a radio-frequency device micro responder chip (RFID). We examined a patient with silicone implants containing RFID chips with magnetic resonance imaging and were surprised by the artifacts caused by the RFID chip. We raise the question if the benefits of RFID-labeled silicone implants outweigh the drawbacks of magnetic resonance artifacts caused by the RFID chip itself.
Simultaneous Breast and Nipple–Areolar Reconstruction Using Musculo-derma-glandular, Axio-perforator, Bipedicled Flap
Authors: Kalender Vagif , Guliyeva Gunel , Güven Erdem , Galandarova Aysune 
Published: November 2021

Summary:
Although breast reconstruction has been performed for centuries, there is a constant search for new approaches to achieve an aesthetically pleasing appearance while causing minimal patient morbidity. In our previous article, we have described our experience with the bipedicled musculo-derma-glandular, axio-perforator flap. The main advantage of this well-vascularized flap is the ability to restore the shape after mastectomy while removing the excess tissue from the hypertrophic and ptotic healthy breast. Based on our promising results with this technique in the previous two patients, we combined the breast reconstruction using bipedicled musculo-derma-glandular, axio-perforator flap with simultaneous nipple–areolar complex reconstruction. The surgery was successful, and the patient did not experience any complications. We believe this technique can be applied for patients with breast hypertrophy and ptosis to achieve reliable and aesthetically acceptable results in a one-stage operation.
RADIATION MACULOPATHY IS ANTICIPATED BY OCT HYPERREFLECTIVE RETINAL FOCI
Authors: Parrozzani Raffaele , Midena Giulia , Frizziero Luisa , Marchione Giulia , Midena Edoardo 
Published: November 2021

Purpose:
To investigate, by means of spectral domain optical coherence tomography, retinal reflectivity changes as an early biomarker anticipating radiation-induced macular edema (ME) in patients treated by iodine-125 (I-125) brachytherapy.

Methods:
Thirty patients planned for I-125 brachytherapy because of uveal melanoma were prospectively included and followed every 4 months for five years. Reflectivity alterations, namely hyperreflective retinal foci, were characterized and counted by two independent masked examiners by means of spectral domain optical coherence tomography imaging. Hyperreflective retinal foci were defined as discrete intraretinal reflectivity changes ≤30 µm, with reflectivity similar to nerve fiber layer and without back shadowing.

Results:
Macular edema occurred in 17 patients (24.2 ±15.1 months) (group 1) after irradiation. Thirteen patients showed no signs of ME at the 5-year follow-up (group 2). The number of hyperreflective retinal foci was statistically higher in sequential visits until the evidence of ME in group 1 vs group 2 (P < 0.0001). In group 1, hyperreflective retinal foci at the follow-up before the evidence of ME were significantly related to the OCT central subfield thickness at ME appearance (P = 0.0002, r2=0.6129). The intergrader agreement was almost perfect (intraclass correlation coefficient = 0.80).

Conclusion:
Hyperreflective retinal foci may be considered as an early in vivo imaging biomarker of retinal inflammatory response to ocular irradiation, anticipating the development of radiation maculopathy.
Technical Note on Three- and Four-Wall Orbital Reconstructions With Patient-Specific Implants
Authors: Sabelis Juliana F. , Youssef Stephen A.L.Y. , Hoefnagels Friso W.A. , Becking Alfred G. , Schreurs Ruud , Dubois Leander 
Published: November 2021

Abstract
Orbital reconstruction is one of the most complex procedures in maxillofacial surgery. It becomes even more complex when all references to the original anatomy are lost. The purpose of this article is to provide an overview of techniques for complex three- and four-wall orbital reconstructions. Preoperative virtual surgical planning is essential when considering different reconstruction possibilities. The considerations that may lead to different approaches are described, and the advantages and drawbacks of each technique are evaluated. It is recommended to reconstruct solitary three-wall or four-wall orbital defects with multiple patientspecific implants. Optimizations of this treatment protocol are suggested, and their effects on predictability are demonstrated in a case presentation of a four-wall defect reconstruction with multiple patient-specific implants.
Assessment of the Pelvic Floor and Associated Musculoskeletal System: Guide for Medical Practitioners
Authors: Harm-Ernandes Ingrid , Boyle Valerie , Hartmann Dee , Fitzgerald Colleen M. , Lowder Jerry L. , Kotarinos Rhonda , Whitcomb Emily 
Published: November 2021

Objectives
This study aimed to assist practitioners in performing an accurate assessment of the external and internal pelvic musculoskeletal (MSK) systems to improve appropriate diagnosis and referral of patients with pelvic floor disorders or pelvic pain and to improve understanding of physical therapy (PT) treatment principles, thereby improving communication between practitioners and encouraging a multidisciplinary approach.

Methods
A referenced review of the anatomy of the pelvic floor muscles, pelvis, and surrounding structures, followed by a detailed assessment of anatomy, posture, and gait, is presented. A thorough description of PT assessment and treatment is included with clinical relevance.

Results
When proper assessments are routinely performed, MSK conditions can be recognized, allowing for prompt and appropriate referrals to PT. Assessment and treatment by qualified physical therapists are integral to pelvic health care. After efficient medical assessment, MSK dysfunction can be addressed expeditiously, thereby avoiding further decline. Left unaddressed, pelvic dysfunction may become chronic.

Conclusions
We propose a guide for MSK assessment of the pelvis and associated structures that can be used for both clinical and research purposes. This guide is designed for health care providers caring for women with pelvic floor disorders, including physicians, advanced practice providers, and nurses. This guide serves to improve communication among multidisciplinary practitioners to refine MSK assessment and treatment approaches and thereby advance clinical care and research.
Increase in Pediatric Pseudotumor Cerebri Syndrome Emergency Department Visits, Inpatient Admissions, and Surgeries During the COVID-19 Pandemic
Authors: Chang Melinda Y. , Yim Cindi K. , Borchert Mark S. 
Published: November 2021

Background:
Pediatric pseudotumor cerebri syndrome (PTCS) is a vision-threatening condition that is associated with female sex and obesity in pubertal and postpubertal children. It is unknown whether the increase in childhood obesity during the COVID-19 pandemic has affected the rates and characteristics of pediatric PTCS.

Methods:
We conducted a retrospective study of children evaluated for PTCS (inpatient or emergency department) at our children's hospital before (March 19, 2015 to March 19, 2020) and during (March 20, 2020 to February 20, 2021) the pandemic. We compared the monthly number of inpatient and emergency department encounters for pediatric PTCS before and during the pandemic. In addition, anthropometric and ophthalmologic characteristics of children evaluated for pediatric PTCS before and during the pandemic were compared.

Results:
A total of 36 encounters in the 5 years before the pandemic and 26 encounters in the 11 months during the pandemic were identified. The median monthly number of encounters for pediatric PTCS was significantly higher during the pandemic compared with the 5 years before the pandemic (2 vs 0, P = 0.0021). Compared with prepandemic patients, children evaluated during the pandemic were older (median age 16 vs 14 years, P = 0.02), with higher rates of obesity (85% vs 66%, P = 0.05) and lower likelihood of reporting Caucasian race (4% vs 31%, P = 0.02). Pandemic patients had worse presenting visual acuity (median logMAR 0.14 vs 0.05, P = 0.05) and were more likely to have fulminant presentation (23% vs 6%, P = 0.04) and require surgical intervention (23% vs 6%, P = 0.04).

Conclusions:
At our children's hospital, the rate of inpatient admissions and emergency department visits for pediatric PTCS increased during the pandemic. The severity of disease and frequency of surgical treatment also increased. Racial and ethnic minorities seem to be disproportionately affected. These changes may be related to increasing rates of childhood obesity during the pandemic.
Behavioural response to heterogeneous severity of COVID-19 explains temporal variation of cases among different age groups
Authors: Steinegger Benjamin , Arola-Fernández Lluís , Granell Clara , Gómez-Gardeñes Jesús , Arenas Alex 
Published: November 2021

Together with seasonal effects inducing outdoor or indoor activities, the gradual easing of prophylaxis caused second and third waves of SARS-CoV-2 to emerge in various countries. Interestingly, data indicate that the proportion of infections belonging to the elderly is particularly small during periods of low prevalence and continuously increases as case numbers increase. This effect leads to additional stress on the health care system during periods of high prevalence. Furthermore, infections peak with a slight delay of about a week among the elderly compared to the younger age groups. Here, we provide a mechanistic explanation for this phenomenology attributable to a heterogeneous prophylaxis induced by the age-specific severity of the disease. We model the dynamical adoption of prophylaxis through a two-strategy game and couple it with an SIR spreading model. Our results also indicate that the mixing of contacts among the age groups strongly determines the delay between their peaks in prevalence and the temporal variation in the distribution of cases.
This article is part of the theme issue ‘Data science approaches to infectious disease surveillance’.
Calibrating COVID-19 susceptible-exposed-infected-removed models with time-varying effective contact rates
Authors: Gleeson James P. , Brendan Murphy Thomas , O’Brien Joseph D. , Friel Nial , Bargary Norma , O'Sullivan David J. P. 
Published: November 2021

We describe the population-based susceptible-exposed-infected-removed (SEIR) model developed by the Irish Epidemiological Modelling Advisory Group (IEMAG), which advises the Irish government on COVID-19 responses. The model assumes a time-varying effective contact rate (equivalently, a time-varying reproduction number) to model the effect of non-pharmaceutical interventions. A crucial technical challenge in applying such models is their accurate calibration to observed data, e.g. to the daily number of confirmed new cases, as the history of the disease strongly affects predictions of future scenarios. We demonstrate an approach based on inversion of the SEIR equations in conjunction with statistical modelling and spline-fitting of the data to produce a robust methodology for calibration of a wide class of models of this type.
This article is part of the theme issue ‘Data science approaches to infectious disease surveillance’.
Unequal impact and spatial aggregation distort COVID-19 growth rates
Authors: Burghardt Keith , Guo Siyi , Lerman Kristina 
Published: November 2021

The COVID-19 pandemic has posed unprecedented challenges to public health world-wide. To make decisions about mitigation strategies and to understand the disease dynamics, policy makers and epidemiologists must know how the disease is spreading in their communities. Here we analyse confirmed infections and deaths over multiple geographic scales to show that COVID-19’s impact is highly unequal: many regions have nearly zero infections, while others are hot spots. We attribute the effect to a Reed–Hughes-like mechanism in which the disease arrives to regions at different times and grows exponentially at different rates. Faster growing regions correspond to hot spots that dominate spatially aggregated statistics, thereby skewing growth rates at larger spatial scales. Finally, we use these analyses to show that, across multiple spatial scales, the growth rate of COVID-19 has slowed down with each surge. These results demonstrate a trade-off when estimating growth rates: while spatial aggregation lowers noise, it can increase bias. Public policy and epidemic modelling should be aware of, and aim to address, this distortion.
This article is part of the theme issue ‘Data science approaches to infectious disease surveillance’.