bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exclusion of left atrial appendage: effects beyond thromboembolic prevention
Authors: Bai Rong , Zawaneh Michael , Weiss Peter J. , Su Wilber W. 
Published: October 2021

Purpose of reviewThis review aims to summarize the nonthromboembolic prevention effects of left atrial appendage exclusion (LAAE).Recent findingsLeft atrial appendage (LAA) secretes multiple hormones; regulates blood volume and pressure; and generates trigger activities. Exclusion of the LAA by different techniques may lead to downstream effects including changes in blood pressure and cardiac performance, improvement of outcome of atrial fibrillation (AF) ablation, and alteration of metabolism.SummaryLAAE procedures not only prevent thromboembolic events in patients with AF, but rather may bring additional benefits or side-effect to patients undergoing LAAE.
Development of the Novel Pneumonia Risk Score to Predict Radiographic Pneumonia in Children
Authors: Lipsett Susan C. , Hirsch Alexander W. , Monuteaux Michael C. , Bachur Richard G. , Neuman Mark I. 
Published: October 2021

Background:
The diagnosis of pneumonia in children is challenging, given the wide overlap of many of the symptoms and physical examination findings with other common respiratory illnesses. We sought to derive and validate the novel Pneumonia Risk Score (PRS), a clinical tool utilizing signs and symptoms available to clinicians to determine a child’s risk of radiographic pneumonia.

Methods:
We prospectively enrolled children 3 months to 18 years in whom a chest radiograph (CXR) was obtained in the emergency department to evaluate for pneumonia. Before CXR, we collected information regarding symptoms, physical examination findings, and the physician-estimated probability of radiographic pneumonia. Logistic regression was used to predict the presence of radiographic pneumonia, and the PRS was validated in a distinct cohort of children with suspected pneumonia.

Results:
Among 1181 children included in the study, 206 (17%) had radiographic pneumonia. The PRS included age in years, triage oxygen saturation, presence of fever, presence of rales, and presence of wheeze. The area under the curve (AUC) of the PRS was 0.71 (95% confidence interval [CI]: 0.68–0.75), while the AUC of clinician judgment was 0.61 (95% CI: 0.56–0.66) (P < 0.001). Among 2132 children included in the validation cohort, the PRS demonstrated an AUC of 0.69 (95% CI: 0.65–0.73).

Conclusions:
In children with suspected pneumonia, the PRS is superior to clinician judgment in predicting the presence of radiographic pneumonia. Use of the PRS may help efforts to support the judicious use of antibiotics and chest radiography among children with suspected pneumonia.
Comparison of refractive and visual outcomes between image-guided system–assisted small-incision lenticule extraction and wavefront-optimized FS-LASIK in treatment of high astigmatism
Authors: Kose Bulent 
Published: October 2021

Purpose:
To compare the refractive and visual results of image-guided system–assisted small-incision lenticule extraction (IGA-SMILE) and wavefront-optimized femtosecond laser in situ keratomileusis (FS-LASIK) in the treatment of high astigmatism.

Settings:
Osmangazi Aritmi Hospital, Bursa, Turkey.

Design:
Retrospective.

Methods:
This retrospective case-matched study included 64 eyes that had undergone IGA-SMILE and 64 eyes that had undergone wavefront-optimized FS-LASIK. The mean preoperative myopia and astigmatism were −4.05 ± 1.98 diopter (D) and 3.11 ± 1.06 D in the IGA-SMILE group and −4.21 ± 2.23 D and −3.15 ± 0.62 D in the FS-LASIK group, respectively. One year later, visual and refractive results were compared in the groups. Vector analysis based on Alpins method was performed to evaluate astigmatic treatment.

Results:
128 eyes of 128 patients were included in this study. At 1 year, the residual astigmatism was −0.21 ± 0.25 D in the IGA-SMILE group and −0.21 ± 0.24 D in the FS-LASIK group (P = .305). In the IGA-SMILE group, 57 eyes (89.1%) achieved uncorrected distance visual acuity of 20/20 or better, as did 56 eyes (85.9%) in the FS-LASIK group. Vector analysis results demonstrated that the difference vectors were 0.22 ± 0.24 D and 0.21 ± 0.22 D (P = .230), the correction indexes were 0.95 ± 0.08 and 0.95 ± 0.08 (P = .239), and the indices of success were 0.08 ± 0.09 and 0.08 ± 0.09 (P = .248) in the IGA-SMILE and the FS-LASIK groups, respectively.

Conclusions:
The combination of an image-guided system with SMILE resulted in high efficacy and safety indices that were comparable with FS-LASIK surgery.
Tale of Two Alopecias: Alopecia Areata and Central Centrifugal Cicatricial Alopecia Occurring in the Same Patient
Authors: See Sharlene Helene C. , Tan Timothy L. , Aderibigbe Oyinade , Yazdan Pedram 
Published: October 2021

Abstract

Introduction:
Scarring and non-scarring alopecias have rarely been described to occur together in the same patient. Distinguishing these two different types of alopecia is important as treatment and prognosis can be different.

Case presentation:
Here, we report the first case of simultaneous alopecia areata (AA) and central centrifugal cicatricial alopecia (CCCA) in a 35-year-old woman. New alopecic patches were noted on her frontal and vertex scalp. Biopsy of the frontal scalp revealed miniaturized hair follicles and dense lymphocytic infiltrate surrounding the hair bulbs, consistent with AA; while biopsy of the vertex scalp revealed decreased hair follicles, perifollicular fibroplasia with eccentric atrophy of the follicular epithelium, and premature desquamation of the inner root sheath at the level of the lower isthmus, consistent with CCCA.

Discussion:
Proposed mechanisms of these two alopecia types occurring together include loss of immune privilege, genetic predisposition, as well as unknown external factors that trigger an autoimmune lymphocytic response. Most recently, the peptidylarginine deiminase type III gene has been implicated in both diseases. Although treatment options can overlap between the two diseases, treatment response can differ and CCCA tends to have a worse prognosis.

Conclusion:
Awareness of this concomitant presentation of two alopecic types is important for appropriate treatment and prognostication.
Lichen Planus Pigmentosus Inversus: Two Case Reports
Authors: Lee Se Hoon , Cho Minah , Han Yu Jin , Woo Yu Ri , Cho Sang Hyun , Lee Jeong Deuk , Kim Hei Sung 
Published: October 2021

Abstract

Introduction:
Lichen planus pigmentosus inversus (LPPI) is a rare a rare variant of lichen planus characterized by hyperpigmented patches with predominating localization in intertriginous areas. Due to its rarity, only a few LPPI cases are reported.
We herein describe two rare cases of LPPI.

Case presentation:
The two patients were all with a brownish macular lesion on the intertriginous area. A diagnosis of LPPI was made based on their clinical manifestations, dermoscopic features, and histopathologic features, which revealed an interface change, lichenoid infiltration, and pigmentary incontinence.

Discussion:
LPPI is pruritic or asymptomatic, hyperpigmented macules and patches on the flexural folds. The axillae and flanks were the most commonly affected areas, followed by the groin and genitalia. About half of the female patients had inframammary fold lesions. LPPI shows higher female predominance than Lichen planus pigmentosus. There were fewer cases that lasted more than 3 years compared to LPP.

Conclusion:
LPPI is a rare variant of lichen planus, with a locational characteristic and female predominance. Therefore, in the case of a pigmented disease occurring in the flexural folds, it should be placed in the differential diagnosis.
Familial combined hyperlipidemia is a polygenic trait
Authors: Gill Praneet K. , Hegele Robert A. 
Published: October 2021

Purpose of review
: Familial combined hyperlipidemia (FCH), defined by concurrently elevated plasma triglyceride (TG) and low-density lipoprotein (LDL) cholesterol, has long been investigated to characterize its genetic basis. Despite almost half a century of searching, a single gene cause for the phenotype has not yet been identified.

Recent findings
: Recent studies using next-generation genetic analytic methods confirm that FCH has a polygenic basis, with a clear large contribution from the accumulation of small-to-moderate effect common single nucleotide polymorphisms (SNPs) throughout the genome that is associated with raising TG, and probably also those raising LDL cholesterol. On the other hand, rare monogenic variants, such as those causing familial hypercholesterolemia, play a negligible role, if any. Genetic profiling suggests that patients with FCH and hypertriglyceridemia share a strong polygenic basis and show a similar profile of multiple TG-raising common SNPs.

Summary
: Recent progress in genomics has shown that most if not all of the genetic susceptibility to FCH is polygenic in nature. Future research should include larger cohort studies, with wider ancestral diversity, ancestry-specific polygenic scores, and investigation of epigenetic and lifestyle factors to help further elucidate the causative agents at play in cases where the genetic etiology remains to be defined.
Severe Burnout and Poor Mental Health Among Healthcare Workers 6 Months After COVID-19 Pandemic Declaration
Authors: Kim Son Chae , Sloan Christine , Chechel Laura , Redila Matt , Ferguson Jennifer 
Published: October 2021

OBJECTIVES
The aim of this study was to examine the predictors associated with severe burnout and poor mental health among healthcare workers during the COVID-19 pandemic as a learning opportunity for future emergent situations.

BACKGROUND
Modifiable predictors of mental health need to be further examined and quantified to prioritize human resource support in organizations as healthcare workers confront stressful situations.

METHODS
A cross-sectional survey was conducted among 271 healthcare workers from September 8 to October 10, 2020.

RESULTS
Approximately one-third reported severe burnout, as well as moderate/severe anxiety and depression. Feeling protected working with COVID-19 patients, high family functioning, and spirituality were associated with 2- to 4-fold lower odds of severe burnout. Satisfaction with the organization's communications predicted 2-fold lower odds of anxiety, whereas high resilience was associated with almost 4-fold lower odds of stress and depression.

CONCLUSIONS
Healthcare organizations may consider adopting programs to foster resilience, family and spiritual support, and effective communication strategies to reduce burnout and poor mental health among healthcare workers during pandemics and other situations of high stress.
Antiretroviral therapy for HIV and intrahepatic hepatitis C virus replication
Authors: Quinn Jeffrey R. , Goyal Ashish , Ribeiro Ruy M. , Massaccesi Guido , Bailey Justin R. , Thomas David L. , Balagopal Ashwin 
Published: October 2021

Objective:
HIV alters host responses to hepatitis C virus (HCV). However, the impact of antiretroviral therapy (ART) on HCV is rarely understood in relevant tissues and never before within individual hepatocytes.

Design:
HIV and HCV kinetics were studied before and after ART initiation among 19 HIV/HCV co-infected persons. From five persons with the largest decline in plasma HCV RNA, liver tissues collected before and during ART, when plasma HIV RNA was undetectable, were studied.

Methods:
We used single-cell laser capture microdissection and quantitative PCR to assess intrahepatic HCV. Immunohistochemistry was performed to characterize intrahepatic immune cell populations.

Results:
Plasma HCV RNA declined by 0.81 (0.52–1.60) log10 IU/ml from a median (range) 7.26 (6.05–7.29) log10 IU/ml and correlated with proportions of HCV-infected hepatocytes (r = 0.89, P = 2 × 10−5), which declined from median (range) of 37% (6–49%) to 23% (0.5–52%) after plasma HIV clearance. Median (range) HCV RNA abundance within cells was unchanged in four of five participants. Liver T-cell abundance unexpectedly decreased, whereas natural killer (NK) and NK T-cell infiltration increased, correlating with changes in proportions of HCV-infected hepatocytes (r = −0.82 and r = −0.73, respectively). Hepatocyte expression of HLA-E, an NK cell restriction marker, correlated with proportions of HCV-infected hepatocytes (r = 0.79).

Conclusion:
These are the first data to show that ART control of HIV reduces the intrahepatic burden of HCV. Furthermore, our data suggest that HIV affects the pathogenesis of HCV infection by an NK/NK T-cell-mediated mechanism that may involve HLA-E and can be rescued, at least in part, by ART.
Randomized, Blinded, Placebo-Controlled Trial of De Simone Formulation Probiotic During HIV-Associated Suboptimal CD4+ T Cell Recovery
Authors: Rousseau Rodney K. , Walmsley Sharon L. , Lee Terry , Rosenes Ron , Reinhard Robert J. , Malazogu Fat , Benko Erika , Huibner Sanja , Kovacs Colin M. , Singer Joel , Kim Connie J. , Kaul Rupert 
Published: October 2021

Objective:
To assess whether probiotic supplementation may reduce disease-linked systemic immune activation in people living with HIV with the immunologic nonresponder phenotype.

Design:
Phase 2b, randomized, double-blind, placebo-controlled pilot trial.

Methods:
HIV-positive individuals with blood CD4+ T-cell counts <350/mm3 despite viral suppression were randomized to 2:1 to receive De Simone Formulation Probiotic (DSFP; “Visbiome” commercially) or placebo for 48 weeks; target enrollment was 36 patients. The primary endpoint was the change in blood CD8+ T-cell coexpression of human leukocyte antigen-DR isotype and CD38 (“CD8 activation”). Secondary endpoints included biomarkers of inflammation, immune reconstitution, bacterial translocation, and gut permeability. Adjusted linear regression and linear mixed regression methods evaluated the differences between study arms from baseline to week 48. Study monitoring was performed by the CIHR Canadian HIV Trials Network Data Safety Monitoring Committee.

Results:
Nineteen patients received DSFP, whereas 10 received placebo. One probiotic arm patient withdrew early. Blood CD8 activation increased 0.82 percentage points (pp) in the probiotic arm (95% confidence interval: −1.23 to 2.87;) and decreased by 2.06 pp in the placebo arm (−4.81 to 0.70; between arms P = 0.097). CD4+ T-cell activation (%HLA-DR+) decreased in the placebo arm [−3.79 pp (−7.32 to −0.26)] but increased in the probiotic arm [1.64 (−0.98 to 4.26); between arms P = 0.018]. No differences were observed in plasma or urine biomarkers of inflammation or microbial translocation.

Conclusions:
Blood immune activation markers in immunologic nonresponder individuals on effective antiretroviral treatment were not reduced by supplementation with DSFP; CD4+ T-cell activation may have been increased.
Prostate-Specific Membrane Antigen Radioguided Surgery for Salvage Pelvic Lymph Node Dissection in a Man With Prostate Cancer
Authors: Erfani Soheila , Sadeghi Ramin , Aghaee Atena , Ghorbani HamidReza , Roshanravan Vahid 
Published: October 2021

Abstract
A 75-year-old man with evidence of recurrent prostate cancer on 68Ga–prostate-specific membrane antigen (PSMA) PET/CT after radical prostatectomy was referred to our department for 99mTc-PSMA radioguided surgery. Intraoperatively, lymph nodes with high count rates were localized using a handheld gamma probe. High-count specimens were resected from the exact locations as reported by 68Ga-PSMA PET/CT. The total prostate-specific antigen value decreased 6 weeks after surgery. Our case shows the feasibility of radioguided surgery with 99mTc-PSMA for salvage lymphadenectomy in prostate cancer.
Treatment of Syndromic Craniosynostosis by Anterior and Posterior Vault Distraction Osteogenesis (A-PVDO)
Authors: Shen Weimin , Cui Jie , Chen Jianbing , Yi Ji , Kong Liangliang , Sun Buhao 
Published: October 2021

Objective:
To explore the feasibility and therapeutic effect of anterior and posterior vault distraction osteogenesis (A-PVDO) in the treatment of infantile syndromic craniosynostosis.

Methods:
Between January 2017 and December 2019, 7 children with syndromic craniosynostosis underwent osteotomy with Piezo-surgery at our hospital. The first step was to harvest the frontal bone flap and the orbitofrontal bone flap. The second step was to separate the scalp and expose the posterior occipital. Osteotomy was performed on the occipital tubercle. Thereafter, 2 distractors were horizontally installed on the upper edge of the anterior cranial orbit, 2 distractors of 3 cm were installed on the posterior cranial bone. Meanwhile, lambdoidal sutures were fixed by titanium plates. Bone distraction was initiated on postoperative day 5 at the rate of 0.4 to 0.6 mm/day, twice per-day, for a total of 10 to 15 days. After 6 months, the distractors and the titanium plates were removed by secondary surgery.

Results:
The intracranial volume and posterior cranial morphology were recorded during the follow-up of 6 to 14 months (average = 12 months). The posterior craniums of 7 cases with lambdoidal sutures fixation were completely extended. The anterior cranial morphology was normal. All the cranial deformities were significantly improved. There were no severe complications, such as death, cranial necrosis, and intracranial infection.

Conclusions:
A-PVDO is an ideal method for the treatment of severe syndromic craniosynostosis, which can achieve more natural appearance than anterior vault distraction osteogenesis or posterior vault distraction osteogenesis. Moreover, A-PVDO causes no severe complications and is suitable for the treatment of severe syndromic craniosynostosis.
Midface Growth Potential in Unoperated Clefts: A Systematic Review and Meta-Analysis
Authors: Wlodarczyk Jordan R. , Munabi Naikhoba C.O. , Wolfswinkel Erik , Nagengast Eric , Higuch Emma C. , Turk Marvee , Urata Mark M. , Hammoudeh Jeffrey A. , Yao Caroline , Magee William 
Published: October 2021

Abstract
Competing hypotheses for the development of midface hypoplasia in patients with cleft lip and palate include both theories of an intrinsic restricted growth potential of the midface and extrinsic surgical disruption of maxillary growth centers and scar growth restriction secondary to palatoplasty. The following meta-analysis aims to better understand the intrinsic growth potential of the midface in a patient with cleft lip and palate unaffected by surgical correction. A systematic review of studies reporting cephalometric measurements in patients with unoperated and operated unilateral cleft lip and palate (UCLP), bilateral cleft lip and palate (BCLP), and isolated cleft palate (iCP) abstracted SNA and ANB angles, age at cephalometric analysis, syndromic diagnosis, and patient demographics. Age and Region-matched controls without cleft palate were used for comparison. SNA angle for unoperated UCLP (84.5 ± 4.0°), BCLP (85.3 ± 2.8°), and ICP (79.2 ± 4.2°) were statistically different than controls (82.4 ± 3.5°), (all P ≤ 0.001). SNA angles for operated UCLP (76.2 ± 4.2°), BCLP (79.8 ± 3.6°), and ICP (79.0 ± 4.3°) groups were statistically smaller than controls (all P ≤ 0.001). SNA angle in unoperated ICP (n = 143) was equivalent to operated ICP patients (79.2 ± 4.2° versus 79.0 ± 4.3° P = 0.78). No unoperated group mean SNA met criteria for midface hypoplasia (SNA < 80). Unoperated UCLP/BLCP exhibit a more robust growth potential of the maxilla, whereas operated patients demonstrate stunted growth compared to normal phenotype. Unoperated ICP demonstrates restricted growth in both operated and unoperated patients. As such, patients with UCLP/BCLP differ from patients with ICP and the factors affecting midface growth may differ.
Level of Evidence: IV
Massive Exophytic Brown's Tumor of the Bilateral Maxilla with Mandibular Involvement
Authors: Pham Matthew , Bhatt Poolak , Purvey Timothy A. 
Published: October 2021

Abstract
Brown's tumor is a benign bone lesion that occurs in the setting of hyperparathyroidism and can affect the facial skeleton. It often presents as a single lesion and is usually less than 3 centimeters. To our knowledge, no cases have been reported to have bilateral involvement of the maxilla and mandible with the largest dimension measuring over 7 centimeters. This report describes such a case and provides a review of the literature.
An atlas of associations between polygenic risk scores from across the human phenome and circulating metabolic biomarkers
Authors: Fang Si , Holmes Michael V , Gaunt Tom R , Smith George Davey , Richardson Tom G 
Published: October 2021

AbstractPolygenic risk scores (PRS) are becoming an increasingly popular approach to predict complex disease risk, although they also hold the potential to develop insight into the molecular profiles of patients with an elevated genetic predisposition to disease. In this study, we have constructed an atlas of associations between 129 different PRS and 249 circulating metabolites in up to 83,004 participants from the UK Biobank study. As an exemplar to demonstrate the value of this atlas we conducted a hypothesis-free evaluation of all associations with glycoprotein acetyls (GlycA), an inflammatory biomarker. Using bi-directional Mendelian randomization, we find that the associations highlighted likely reflect the effect of risk factors, such as body mass index (Beta=0.16 per standard deviation change in GlycA, 95% CI=0.11 to 0.21, P=9.9×10−10) or liability towards smoking cigarettes (Beta=0.28, 95% CI=0.20 to 0.35, P=2.4×10−14), on systemic inflammation as opposed to the converse direction of effect. Furthermore, we repeated all analyses in our atlas within age strata to investigate potential sources of collider bias, such as medication usage. This was exemplified by comparing associations between lipoprotein lipid profiles and the coronary artery disease PRS in the youngest and oldest age strata, which had differing proportions of individuals undergoing statin therapy. All results can be visualised athttp://mrcieu.mrsoftware.org/metabolites_PRS_atlas.
Safety and Effectiveness of COVID-19 SPUTNIK V Vaccine in Dialysis Patients
Authors: Rosa-Diez Guillermo , Papaginovic Leiva María Marina , Lombi Fernando , Crucelegui María Soledad , Martínez Ricardo Dulio , Trimarchi Hernán , Schiavelli Rubén , Grizzo Mercedes , Raño Miguel , Heguilén Ricardo M. , Jones Rocío Anahí , Paganti Luciana Gonzalez , Ferrrari Matías , Zingoni Dra. Paula , Kjohede Victoria , Geffner Jorge Raúl , Ferrante Daniel , de Quirós Fernán González Bernaldo , Pagotto Vanina 
Published: October 2021

AbstractGiven the vulnerability of people with chronic kidney disease to COVID-19, nephrology societies have issued statements calling for prioritization of these patients for vaccination. It is not yet known whether COVID-19 vaccines confer the same high level of protection in patients with kidney disease. The aims of this study were to evaluate the safety measured by the events supposedly attributed to vaccines and the effectiveness evaluated by the presence of antibodies in dialysis patients immunized with the COVID-19 Sputnik V vaccine.Methodsmulticenter, observational and analytical study of a prospective cohort of hemodialysis patients in the Autonomous City of Buenos Aires with a vaccination plan. Patients older than 18 years on dialysis who received both components of the COVID-19 vaccine were included.Results491 patients included in the safety analysis. ESAVI with either the first or second component was detected in 186 (37.9% 95% CI 33.6%-42.34%). The effectiveness analysis measures of antibodies against SARS-Cov-2 were performed in 102 patients, 98% had positive IgG against SARS-Cov-2 antibodies 21 days after the second component .In patients with COVID-19 prior to vaccination, antibodies at day 21 after the first component reached almost the highest levels compared to those patients who did not have COVID-19, and the rise between the last measures was lower than patients without COVID-19.ConclusionDialysis patients constitute a vulnerable population for SARS-Cov-2 infection, beyond the recommendations that were implemented by dialysis units, full vaccination is a priority and necessary. The Sputnik V vaccine has been shown to be safe and effective in this patient population.