bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic sub-mucosal resection of gastric antrum stromal tumour
Authors: Roy Susmit Prosun , Benjamin Aditya Thomas , Talbot Michael 
Published: September 2021

Abstract

Rationale:
Gastrointestinal stromal tumour (GIST) is the most common mesenchymal tumour of the gastrointestinal tract with 10% to 30% being malignant. Resection of GIST lesions require wide local excision to achieve negative margins.

Patient concerns:
A 68-year-old woman presented with acute on chronic dyspeptic symptoms, including abdominal pain, postprandial nausea, bloating, and early satiety. She did not have any history of previous malignancy or gastro-intestinal haemorrhage. The patient had no other significant past medical history.

Diagnoses:
Endoscopy revealed a 2 cm nodular lesion in the gastric antrum which was confirmed to be GIST on endoscopic ultrasound and computed tomography.

Intervention:
The 2 cm GIST was successfully resected (RO) endoscopically.

Outcomes:
The patient was discharged from the hospital the next day, and follow-up suggested no disease recurrence.

Lessons:
To the best of our knowledge, this is the first reported case of endoscopic submucosal dissection for a 2 cm GIST. The current gold standard for the majority of GISTs is laparoscopic resection, with open resection sometimes needed for larger malignant tumours with multi-visceral involvement. Endoscopic or combined endoscopic/laparoscopic techniques are evolving and may become the preferred choice for smaller lesions and for lesions in areas that are more difficult to approach surgically, such as around the esophagogastric junction and the pre-pyloric antrum.
Management of Complicated Monochorionic Twin Gestations: An Evidence-Based Protocol
Authors: Narang Kavita , Novoa Victoria A. N. , Alrahmani Layan , Parikh Pavan , Codsi Elisabeth , Rose Carl H. , Davies Norman P. , Trinidad Mari Charisse , Favre Romain , Szymanski Linda M. , Ruano Rodrigo 
Published: September 2021

Importance
Monochorionic (MC) twins are hemodynamically connected by vascular anastomoses within the single shared placenta. The transfer of fluid or blood from one fetus to the other may result in development of pathologic complications, such as twin-twin transfusion syndrome, twin anemia polycythemia sequence, selective intrauterine growth restriction, and twin reversed arterial perfusion sequence. Monoamniotic gestations, which comprise a small fraction of MC pregnancies, can also present with unique challenges, particularly antepartum umbilical cord entanglement. All these complications carry a high risk of fetal morbidity and mortality if not recognized and managed in a timely fashion.

Objective
The purpose of this article is to review evidence-based management of complicated MC twin gestations and propose a standardized approach to surveillance.

Evidence Acquisition
Monochorionic gestations account for the majority of complications that occur in twin pregnancies; however, there is unclear evidence on the appropriate surveillance for and management of specific complications associated with these pregnancies.

Results
This article summarizes management for each specific type of MC complication in a structured and clear manner.

Conclusions
Early pregnancy ultrasound, ideally between 10 and 13 weeks' gestation, is critical for the diagnosis and characterization of twin pregnancies. To improve outcomes for MC twins, appropriate fetal surveillance should be initiated at 16 weeks' gestation and continued until delivery.

Relevance
Improve perinatal outcomes in MC twin pregnancies.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
After completing this activity, the learner should be better able to describe the sonographic findings used to establish the diagnosis of MC twin pregnancies; identify complications unique to MC twins pregnancies, including twin-twin transfusion syndrome, twin reversed arterial perfusion sequence, twin anemia polycythemia syndrome, co-twin demise, cord entanglement, and conjoined twins; and explain the management of complications associated with MC twin pregnancies.
Spontaneous Renal Rupture During Pregnancy: A Contemporary Literature Review and Guide to Management
Authors: Cardenas Raquel T. , Doiron Tucker E. , Ramseyer Abigail M. , Pates Jason A. , Po William D. , Magann Everett F. 
Published: September 2021

Importance
Spontaneous renal rupture is a rare pregnancy complication, which requires a high index of suspicion for a timely diagnosis to prevent a poor maternal or fetal outcome.

Objective
This review highlights risk factors, pathophysiology, symptoms, diagnosis, management, and complications of spontaneous renal rupture in pregnancy.

Evidence Acquisition
A literature search was carried out by research librarians using the PubMed and Web of Science search engines at 2 universities. Fifty cases of spontaneous renal rupture in pregnancy were identified and are the basis of this review.

Results
The first case of spontaneous renal rupture in pregnancy was reported in 1947. Rupture occurs more commonly on the right side and during the third trimester. Pain was a reported symptom in every case reviewed. Treatment usually consists of stent or nephrostomy tube placement. Conservative management has been reported.

Conclusions
When diagnosed early and managed appropriately, maternal and fetal outcomes are favorable. Preterm delivery is the most common complication.

Relevance
Our aim is to increase the awareness of spontaneous renal rupture in pregnancy and its associated complications in order to improve an accurate diagnosis and maternal and fetal outcomes.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
After completing this activity, the learner should be better able to identify the risk factors of spontaneous renal rupture in pregnancy; outline the presenting signs and symptoms of renal system rupture during pregnancy; explain the preferred diagnostic tools and imaging modalities for diagnosing renal system rupture in pregnancy, including the risks and benefits to the fetus; and describe the management and potential complications of pregnant patients presenting with renal system rupture.
Olaparib Tablets as Maintenance Therapy in Patients With Platinum-Sensitive Relapsed Ovarian Cancer and a BRCA1/2 Mutation (SOLO2/ENGOT-Ov21): A Final Analysis of a Double-Blind, Randomised, Placebo-Controlled, Phase 3 Trial
Authors: Poveda Andrés , Floquet Anne , Ledermann Jonathan A. , Asher Rebecca , Penson Richard T. , Oza Amit M. , Korach Jacob , Huzarski Tomasz , Pignata Sandro , Friedlander Michael , Baldoni Alessandra , Park-Simon Tjoung-Won , Tamura Kenji , Sonke Gabe S. , Lisyanskaya Alla , Kim Jae-Hoon , Filho Elias Abdo , Milenkova Tsveta , Lowe Elizabeth S. , Rowe Phil , Vergote Ignace , Pujade-Lauraine Eric ,   The SOLO2/ENGOT-Ov21 Investigators
Published: September 2021

(Abstracted from Lancet Oncol 2021;22:620–631)
The poly (ADP-ribose) polymerase (PARP) inhibitor olaparib is approved as maintenance therapy in newly diagnosed ovarian cancer or in patients with platinum-sensitive, relapsed ovarian cancer regardless of BRCA1/2 mutation status. The primary analysis of the SOLO2/ENGOT-Ov21 phase 3 trial found a significant improvement in median progression-free survival associated with olaparib treatment compared with placebo in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA1/2 mutation.
Clobetasol Compared With Fractionated Carbon Dioxide Laser for Lichen Sclerosus: A Randomized Controlled Trial
Authors: Burkett Linda S. , Siddique Moiuri , Zeymo Alexander , Brunn Elizabeth A. , Gutman Robert E. , Park Amy J. , Iglesia Cheryl B. 
Published: September 2021

(Abstracted from Obstet Gynecol 2021;137:968–978)
Vulvar lichen sclerosus (LS) is a dermatologic condition characterized by labial atrophy, hypopigmentation, and synechiae leading to pruritis and vulvar pain. Lichen sclerosus also is associated with a 3% to 9% incidence of vulvar squamous cell carcinoma that may be mitigated by adequate treatment.
Video Virtual Clinical Encounters Versus Office Visits for Postoperative Care After Pelvic Organ Prolapse Surgery: A Randomized Clinical Trial
Authors: Lee Daniel D. , Arya Lily A. , Andy Uduak U. , Harvie Heidi S. 
Published: September 2021

(Abstracted from Female Pelvic Med Reconstr Surg 2021;27:432–438)
Nowadays, patients expect to have telehealth options when accessing care. Besides the expanded access to care, benefits of telehealth include increased efficiency and improved patient engagement and adherence to care plans.
Long-Term Patency and Fluid Dynamics of Recipient Artery after End-to-Side Anastomosis for Free Tissue Transfer
Authors: Treiser Matthew D. , Miles Megan R. , Albino Frank P. , Giladi Aviram M. , Katz Ryan D. , Higgins James P. 
Published: September 2021

Background:
End-to-end microvascular anastomoses sacrifice downstream inline perfusion of the recipient vessels. End-to-side anastomoses, in theory, maintain distal inline flow of the recipient vessel. The proposed benefit of the end-to-side technique depends on patency of the distal vessels and subsequent flow parameters, but maintenance of distal perfusion has not been conclusively demonstrated.

Methods:
Fifteen patients who underwent a successful extremity free flap procedure via end-to-side anastomoses to a noncritical vessel between 2003 and 2017 were enrolled. Recipient artery patency distal to the anastomosis was assessed using pulse volume recordings and duplex ultrasound imaging. Resistance indices, flow velocities, vessel diameters, volumetric flow, and turbulent flow dimensionless number (Reynolds number) were measured. Comparisons were made to the ipsilateral collateral vessel as well as to the vessels on the nonoperative contralateral limb using paired t tests.

Results:
Downstream flow was identified in 14 of 15 patients (93 percent patency). There was no statistical difference in resistive indices comparing the anastomotic vessel (0.859 ± 0.300) and the collateral vessel (0.853 ± 0.179) of the ipsilateral extremity. Ultrasound flows were similar; the anastomotic vessel demonstrated downstream volumetric flows of 139 ± 92.0 cm3/min versus 137 ± 41.6 cm3/min within the same vessel of the nonoperative contralateral limb. The anastomotic vessel had Reynolds numbers well below the turbulent threshold (448 ± 202 and 493 ± 127 for the anastomotic and nonoperative contralateral limb, respectively).

Conclusion:
End-to-side anastomosis to noncritical vessels resulted in a 93 percent long-term recipient vessel patency rate, with no statistically significant changes in volumetric flows, resistive indices, or fluid dynamics in the vessels that remained patent.
Evaluation of Social Media Utilization by Academic Plastic Surgery Programs during the COVID-19 Pandemic
Authors: Shiah Eric , Laikhter Elizabeth , Manstein Samuel M. , Comer Carly D. , Shen Abra H. , Lin Samuel J. 
Published: September 2021

Background:
In response to the cancellation of away rotations and the shift to virtual interviews due to the coronavirus disease of 2019 (COVID-19) pandemic, residency programs have pursued other methods of sharing program details, most notably with the use of social media. This study aimed to evaluate the extent of social media utilization in the setting of the COVID-19 pandemic by plastic surgery residency programs.

Methods:
Instagram, Twitter, and Facebook accounts of plastic surgery programs, program directors, and chiefs were identified. Number of followers, total posts, and posts since March 1, 2020, were extracted. Account content was categorized as informational, social, operative, research, self-promotional, guest lecture, education, or other. Spearman’s coefficient was used to determine correlations among account data. Differences among regions and program pathways were evaluated using the Kruskal-Wallis test.

Results:
Since March 1, 2020, 17 Instagram, five Twitter, and three Facebook accounts have been created. Instagram was most widely used and followed (1720 posts, 1235.7 ± 735.9 followers) compared with Twitter (722 tweets, 325.6 ± 451.0 followers) and Facebook (430 posts, 338.3 ± 363.3 followers). Although the majority of content was informational (45.1 percent), Instagram contained more social content (21 percent), Twitter contained more research (21 percent), and Facebook contained more self-promotional content (25 percent). Integrated-only programs on average posted more on Instagram (21.5 ± 15.1 posts) than did independent-only programs (9.4 ± 8.5 posts), and post volume moderately correlated with number of followers. There were no statistically significant differences among regional means.

Conclusion:
Plastic surgery residency programs have incorporated social media into their recruitment strategies and will likely continue to increase and diversify their posts to effectively engage with future applicants.
Neurotoxicity with high-dose disulfiram and vorinostat used for HIV latency reversal
Authors: McMahon James H. , Evans Vanessa A. , Lau Jillian S.Y. , Symons Jori , Zerbato Jennifer M. , Chang Judy , Solomon Ajantha , Tennakoon Surekha , Dantanarayana Ashanti , Hagenauer Michelle , Lee Sulggi , Palmer Sarah , Fisher Katie , Bumpus Namandje , Heck Carley J.S. , Burger David , Wu Guoxin , Zuck Paul , Howell Bonnie J. , Zetterberg Henrik H. , Blennow Kaj , Gisslen Magnus , Rasmussen Thomas A. , Lewin Sharon R. 
Published: September 2021

Objective:
The aim of this study was to examine whether administering both vorinostat and disulfiram to people with HIV (PWH) on antiretroviral therapy (ART) is well tolerated and can enhance HIV latency reversal.

Design:
Vorinostat and disulfiram can increase HIV transcription in PWH on ART. Together, these agents may lead to significant HIV latency reversal.

Methods:
Virologically suppressed PWH on ART received disulfiram 2000 mg daily for 28 days and vorinostat 400 mg daily on days 8–10 and 22–24. The primary endpoint was plasma HIV RNA on day 11 relative to baseline using a single copy assay. Assessments included cell-associated unspliced RNA as a marker of latency reversal, HIV DNA in CD4+ T-cells, plasma HIV RNA, and plasma concentrations of ART, vorinostat, and disulfiram.

Results:
The first two participants (P1 and P2) experienced grade 3 neurotoxicity leading to trial suspension. After 24 days, P1 presented with confusion, lethargy, and ataxia having stopped disulfiram and ART. Symptoms resolved by day 29. After 11 days, P2 presented with paranoia, emotional lability, lethargy, ataxia, and study drugs were ceased. Symptoms resolved by day 23. CA-US RNA increased by 1.4-fold and 1.3-fold for P1 and P2 respectively. Plasma HIV RNA was detectable from day 8 to 37 (peak 81 copies ml−1) for P2 but was not increased in P1 Antiretroviral levels were therapeutic and neuronal injury markers were elevated in P1.

Conclusion:
The combination of prolonged high-dose disulfiram and vorinostat was not safe in PWH on ART and should not be pursued despite evidence of latency reversal.
Role of Solvent Compatibility in the Phase Behavior of Binary Solutions of Weakly Associating Multivalent Polymers
Authors: Michels Jasper J. , Brzezinski Mateusz , Scheidt Tom , Lemke Edward A. , Parekh Sapun H. 
Published: September 2021

AbstractCondensate formation of biopolymer solutions, prominently those of various intrinsically disordered proteins (IDPs), is determined by “sticky” interactions between associating residues, multivalently present along the polymer backbone. Using a ternary mean field “stickers-and-spacers” model, we demonstrate that if sticker association is of the order of a few times the thermal energy, a delicate balance between specific binding and non-specific polymer-solvent interactions gives rise to a particularly rich ternary phase behavior under physiological circumstances. For a generic system represented by a solution comprising multi-associative scaffold and client polymers, the difference in solvent compatibility between the polymers modulates the nature of isothermal liquid-liquid phase separation (LLPS) between associative and segregative. The calculations reveal regimes of dualistic phase behavior, where both types of LLPS occur within the same phase diagram, either associated with the presence of multiple miscibility gaps, or a flip in the slope of the tie-lines belonging to a single coexistence region.
Detecting a History of Repetitive Head Impacts from a Short Voice Recording
Authors: Tauro Michael G. , Ravanelli Mirco , Droppelmann Cristian A. 
Published: September 2021

ABSTRACTRepetitive head impacts (RHI) are associated with an increased risk of developing various neurodegenerative disorders, such as Alzheimer’s disease (AD), Parkinson’s disease (PD), and most notably, chronic traumatic encephalopathy (CTE). While the clinical presentation of AD and PD is well established, CTE can only be diagnosed post-mortem. Therefore, a distinction can be made between the pathologically defined CTE and RHI-related functional or structural brain changes (RHI-BC) which may result in CTE. Unfortunately, there are currently no accepted biomarkers of CTE nor RHI-BC, a major hurdle to achieving clinical diagnoses. Interestingly, speech has shown promise as a potential biomarker of both AD and PD, being used to accurately classify individuals with AD and PD from those without. Given the overlapping symptoms between CTE, RHI-BC, PD and AD, we aimed to determine if speech could be used to identify individuals with a history of RHI from those without. We therefore created the Verus dataset, consisting of 13 second voice recordings from 605 professional fighters (RHI group) and 605 professional athletes in non-contact sports (control group) for a total of 1210 recordings. Using a deep learning approach, we achieved 85% accuracy in detecting individuals with a history of RHI from those without. We then used our model trained on the Verus dataset to fine-tune on publicly available AD and PD speech datasets and achieved new state-of-the-art accuracies of 84.99% on the AD dataset and 89% on the PD dataset. Finding a biomarker of CTE and RHI-BC that presents early in disease progression is critical to improve risk management and patient outcome. Our study is the first we are aware of to investigate speech as such a candidate biomarker of RHI-BC.
Towards Understanding Comprehensive Morphometric Changes and Its Correlation with Cognition and Exposure to Fighting in Active Professional Boxers
Authors: Mishra Virendra R. , Zhuang Xiaowei , Sreenivasan Karthik R. , Cordes Dietmar , Ritter Aaron , Banks Sarah J. , Bernick Charles 
Published: September 2021

ABSTRACTProfessional athletes exposed to repetitive head impacts are at increased risk for developing a progressive neurological syndrome known as traumatic encephalopathy syndrome and neuropathology seen on autopsy called chronic traumatic encephalopathy (CTE). The early identification of individuals at increased risk for CTE is important and the search for biomarkers is underway. In this study, we utilized data from a large cohort study to compare differences in regional brain volumes, cortical thickness, voxel-based morphometric (VBM)-derived measures, and graph-theoretical measures derived from large-scale topographical maps in active professional boxers. We compared the above morphometric measures between active professional boxers with low cognitive scores (impaired boxers) and active professional boxers with intact cognitive scores (nonimpaired boxers). The cognitive scores were evaluated through neuropsychological evaluation. As an exploratory analysis, we also examined the power of various machine-learning algorithms to identify impaired and nonimpaired boxers using both group-level regression-driven analysis and previously identified hypothesis-driven cortical thickness and volumetric measures. We found significant group-level differences between impaired and nonimpaired boxers in cortical thickness in a single brain region (right precuneus), differences in VBM-derived gray matter density encompassing the caudate, putamen, and thalamus; and white matter density encompassing the right paracentral lobule, but no differences in any graph-theoretical network properties. Additionally, we found that a priori hypothesis-driven T1-derived cortical thickness and volumetric analysis performed better than traditional regression-based analysis. Overall, this study suggests that neuroanatomical differences exist between impaired and nonimpaired active professional boxers, and that hypothesis-driven techniques are likely necessary to become reliable biomarkers.
Methods for Estimation of SARS-CoV-2 Seroprevalence and Reported COVID-19 Cases in U.S. Children, August 2020—May 2021
Authors: Couture Alexia , Lyons Casey , Mehrotra Megha L. , Sosa Lynn , Ezike Ngozi , Brown Catherine M. , Yendell Stephanie , Azzam Ihsan A. , Katić Božena J , Cope Anna , Dickerson Kristen , Dunn John , Traxler L. Brannon , Davis Lora B. , Ahmed Farah S. , Stone Jolianne , Reed Carrie , Clarke Kristie E. N. , Flannery Brendan , Charles Myrna D. 
Published: September 2021

AbstractBackground and ObjectivesCase-based surveillance of pediatric COVID-19 cases underestimates the prevalence of SARS-CoV-2 infections among children and adolescents. Our objectives were to: 1) estimate monthly SARS-CoV-2 antibody seroprevalence among children aged 0-17 years and 2) calculate ratios of SARS-CoV-2 infections to reported COVID-19 cases among children and adolescents in 14 U.S. states.MethodsUsing data from commercial laboratory seroprevalence surveys, we estimated monthly SARS-CoV-2 antibody seroprevalence among children aged 0-17 years from August 2020 through May 2021. Seroprevalence estimates were based on SARS-CoV-2 anti-nucleocapsid immunoassays from February to May 2021. We compared estimated numbers of children infected with SARS-CoV-2 by May 2021 to cumulative incidence of confirmed and probable COVID-19 cases from case-based surveillance, and calculated infection: case ratios by state and type of anti-SARS-CoV-2 nucleocapsid immunoassay used for seroprevalence testing.ResultsAnalyses included 67,321 serum specimens tested for SARS-CoV-2 antibodies among children in 14 U.S. states. Estimated ratios of SARS-CoV-2 infections to reported confirmed and probable COVID-19 cases among children and adolescents varied by state and type of immunoassay, ranging from 0.8-13.3 in May 2021.ConclusionsThrough May 2021, the majority of children in selected states did not have detectable SARS-CoV-2 nucleocapsid antibodies. Case-based surveillance underestimated the number of children infected with SARS-CoV-2, however the predicted extent of the underestimate varied by state, immunoassay, and over time. Continued monitoring of pediatric SARS-CoV-2 antibody seroprevalence should inform prevention and vaccination strategies.