bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Validation of a Natural Language Processing Algorithm to Extract Descriptors of Microbial Keratitis From the Electronic Health Record
Authors: Woodward Maria A. , Maganti Nenita , Niziol Leslie M. , Amin Sejal , Hou Andrew , Singh Karandeep 
Published: May 2021

Purpose:
The purpose of this article was to develop and validate a natural language processing (NLP) algorithm to extract qualitative descriptors of microbial keratitis (MK) from electronic health records.

Methods:
In this retrospective cohort study, patients with MK diagnoses from 2 academic centers were identified using electronic health records. An NLP algorithm was created to extract MK centrality, depth, and thinning. A random sample of patient with MK encounters were used to train the algorithm (400 encounters of 100 patients) and compared with expert chart review. The algorithm was evaluated in internal (n = 100) and external validation data sets (n = 59) in comparison with masked chart review. Outcomes were sensitivity and specificity of the NLP algorithm to extract qualitative MK features as compared with masked chart review performed by an ophthalmologist.

Results:
Across data sets, gold-standard chart review found centrality was documented in 64.0% to 79.3% of charts, depth in 15.0% to 20.3%, and thinning in 25.4% to 31.3%. Compared with chart review, the NLP algorithm had a sensitivity of 80.3%, 50.0%, and 66.7% for identifying central MK, 85.4%, 66.7%, and 100% for deep MK, and 100.0%, 95.2%, and 100% for thin MK, in the training, internal, and external validation samples, respectively. Specificity was 41.1%, 38.6%, and 46.2% for centrality, 100%, 83.3%, and 71.4% for depth, and 93.3%, 100%, and was not applicable (n = 0) to the external data for thinning, in the samples, respectively.

Conclusions:
MK features are not documented consistently showing a lack of standardization in recording MK examination elements. NLP shows promise but will be limited if the available clinical data are missing from the chart.
Keratoplasty Rejection After the BNT162b2 messenger RNA Vaccine
Authors: Wasser Lauren M. , Roditi Eduardo , Zadok David , Berkowitz Liron , Weill Yishay 
Published: May 2021

Purpose:
The aim of this report was to report 2 patients who presented with acute corneal graft rejection 2 weeks after receiving the BNT162b2 messenger RNA (mRNA) vaccine for severe acute respiratory syndrome coronavirus 2.

Methods:
Case report.

Results:
Two men, aged 73 and 56 years, with a history of penetrating keratoplasty due to keratoconus were noted to have acute corneal graft rejection 2 weeks after receiving a first dose of the BNT162b2 mRNA vaccine. Both patients were treated with hourly dexamethasone 0.1% and oral prednisone 60 mg per day with prompt resolution of keratoplasty rejection.

Conclusions:
The BNT162b2 mRNA vaccine may be have been associated with a low-risk corneal graft rejection that responded well to topical and systemic steroids. Treating physicians should be aware of this potential complication and patients should be advised to report any visual changes after vaccination.
Tendon repair with intercalated partial extensor carpi radialis longus tendon graft for chronic extensor pollicis longus tendon rupture
Authors: Lo I-Ning , Yin Cheng-Yu , Yu Jin-Huei , Huang Hui-Kuang , Huang Yi-Chao , Wang Jung-Pan 
Published: May 2021

Background:
The main treatment choices for chronic extensor pollicis longus (EPL) tendon rupture consists of tendon transfer and tendon repair with tendon graft. Tendon transfer with extensor indicis proprius (EIP) is currently considered the gold standard treatment which yields predictable and satisfactory results, but potentially compromises the strength of independent extension of the index finger. We propose our method of using a partial extensor carpi radialis longus (ECRL) tendon graft to repair chronic EPL tendon tears.

Methods:
The distal stump of the EPL was located through an incision at the basal joint level. The proximal stump was located through a curved incision at the dorsoradial wrist where the partial ECRL tendon graft was harvested. The tendon graft was subcutaneously transposed, sutured at both ends, and tensioned at full thumb extension with a neutral wrist position.

Results:
From March 2016 to June 2019, 23 patients (mean age: 59.7 years; mean follow-up: 29.6 months) were retrospectively reviewed. All the patients were followed for a minimum of 12 months. The final total active motion was 93.2% of the contralateral thumb. The mean Quick Disabilities of the Arm, Shoulder and Hand score was 6.0. There was one complication possibly due to poor EPL muscle quality, and the patient was subsequently treated with EIP tendon transfer.

Conclusion:
Our study showed that using a partial ECRL tendon graft to repair chronic EPL tendon rupture results in satisfactory functional outcomes. The advantages of this method include preservation of EIP function and using the same incision for graft harvesting and tendon repair. This method can be considered an alternative to EIP tendon transfer in patients with high demand for their index finger function.
Anesthesia services in Taiwan: A nationwide population-based study
Authors: Ho Shung-Tai , Chen Tzeng-Ji , Yeh Te-Chun , Kao Senyeong , Lin Tso-Chou , Wang Ju-O 
Published: May 2021

Background:
This study was conducted to provide an overview of anesthesia services in Taiwan from 2001 to 2010.

Methods:
A retrospective population-based analysis was performed using data from Taiwan’s National Health Insurance Research Database for the period 2001 to 2010. The results were stratified by patient sex, patient age, anesthesia type, and hospital setting. Categorical data are presented as totals and percentages. Linear regression was performed to analyze the anesthesia trends.

Results:
The annual use of anesthesia increased continually from 964,440 instances in 2001 to 1,073,160 in 2010, totaling 10,076,600 cases with a total cost of 25.4 billion USD. The overwhelming majority (83.9%) of anesthesia cases was for anesthesia in an inpatient setting; general anesthesia accounted for 73.8% of anesthesia cases, and female patients outnumbered male patients (52.4% vs 47.6%). The average number of anesthesia cases was 44.2 per thousand of the population annually, but this percentage was much higher in elderly people (100.9 cases per thousand people annually). The annual number of anesthesia cases per thousand of the population increased from 104.4 in 2001 to 113.0 in 2010 in the oldest group (>80 years). By contrast, a considerable decline in use of anesthesia was discovered over the study period among those aged younger than 18 years.

Conclusion:
The use of anesthesia services in Taiwan has increased over the years. The relationships of age with anesthesia volume and cost were found to follow an inverse U-shaped pattern. Elderly people used anesthesia services more frequently. The planning of geriatric anesthesia services deserves attention, especially in continually aging societies such as Taiwan.
The Correlation Between COVID-19 Activities and Climate Factors in Different Climate Types Areas
Authors: Liu Zhenchao , Zhu Lin , Wang Yue , Zhou Zhen , Guo Yunliang 
Published: May 2021

Objective:
To investigate the epidemiological characteristics of human infection with corona virus disease 2019 (COVID-19) in Moscow, Lima, Kuwait, and Singapore to analyze the effects of climate factors on the incidence of COVID-19.

Methods:
Collect the daily incidence of COVID-19 and related climate data in four areas, construct a negative binomial regression model, and analyze the correlation between the incidence of COVID-19 and meteorological factors.

Results:
AH was the climate factor affecting the incidence of COVID-19 in Moscow, Lima, and Singapore; Ta and RH were the climate factors affecting the incidence of COVID-19 in Kuwait.

Conclusions:
The incidence of COVID-19 in four areas were all associated with the humidity, and climate factors should be taken into consideration when epidemic prevention measures are taken, and environment humidification may be a feasible approach to decrease COVID-19 virus transmission.
Prevention, Medical Management, and Adjudication of Workplace Injuries
Authors: Bernacki Edward J. , Kalia Nimisha , Soistman Sharon , Minor Sebastian A. , Barry Jill , Lavin Robert A. , Tao Xuguang (Grant) 
Published: May 2021

Objective:
To describe the cost outcomes of an integrated workers’ compensation program.

Methods:
We studied a population that increased from 20K to 59K, incurring 8807 lost-time claims between 1988 and 2020.

Results:
Lost-time claims decreased from 22.15 to 4.32 per 1000 employees (1988 to 2020), and total closed lost-time claim costs per $100 payroll, decreased from $0.62 to $0.17 (1988 to 2017). The percent of claims resolved within 3 years of the accident increased from 10% to 89% (1988 to 2017). Adjusting for medical inflation and wage increases, total workers’ compensation benefits paid per claim decreased $124 per year, medical benefits decreased $45 per year and indemnity benefits decreased $79 per year.

Conclusion:
On both a population (per employee) and on a per claim basis, workers’ compensation costs decreased substantially, which is attributable to improvements in accident prevention and decreases in claim duration.
Ten-Word List Performance in Healthy Athletes and Athletes at 3-to-5 Days Following Concussion
Authors: Hutchison Michael G. , Di Battista Alex P. , Pyndiura Kyla L. , Corallo Danielle N. , Lawrence David W. , Richards Doug 
Published: May 2021

Objective:
Although the word recall component of the Sport Concussion Assessment Tool (SCAT) was updated from 5-to-10 words, its clinical utility across athletic populations remains unknown. The purpose of this study was to provide normative data on the SCAT-5 10-word test and examine its discriminative ability between healthy university level athletes and those with sport-related concussion (SRC).

Design:
Cross-sectional.

Setting:
University.

Participants:
Three hundred sixty-three (363, M = 220, F = 153) healthy athletes and 49 (M = 30, F = 19) athletes following SRC.

Independent Variable:
Healthy athletes measured preseason were compared with athletes following an SRC (median = 4.0 days postinjury).

Main Outcome Measure:
Ten-word list performance from the SCAT-5.

Results:
There were no significant differences in either immediate (P = 0.228, Cohen's D = 0.18) or delayed (P = 0.908, Cohen's D = 0.02) recall tests between athletes with SRC and healthy athletes; the null findings extended to both the male and female subset comparisons. Among healthy athletes, females outperformed males on both immediate (mean difference = 1.0, P < 0.001) and delayed (mean difference = 0.5, P = 0.006) recall tasks.

Conclusion:
Concussion does not seem to impact immediate or delayed recall of the 10-word list in the subacute period following injury. Practitioners should be mindful of sex differences and the time point of administration following injury.
Kidney lymphatics: new insights in development and disease
Authors: Donnan Michael D. 
Published: May 2021

Purpose of review
This review will highlight recent advances in our understanding of the kidney lymphatics regarding their development, physiologic function, and their potential role in the progression of kidney disease.

Recent findings
Although sparse in comparison to the blood vasculature, lymphatic vessels within the healthy kidney perform an important role in maintaining homeostasis. Additionally, in response to kidney injury, lymphatic vessels undergo substantial expansion, termed lymphangiogenesis, which shows a direct correlation to the extent of tubulointerstitial fibrosis. Kidney lymphatics expand through both the proliferation of lymphatic endothelial cells from existing lymphatic vessels, as well as from direct contribution by other cell types of nonvenous origin. The primary driver of lymphatic growth is vascular endothelial growth factor C, both in development and in response to injury. The clinical implications of lymphangiogenesis in the setting of kidney diseases remains debated, however growing evidence suggests lymphatic vessels may perform a protective role in clearing away accumulating interstitial fluid, inflammatory cytokines, and cellular infiltrates that occur with injury.

Summary
There is increasing evidence the kidney lymphatics perform an active role in the response to kidney injury and the development of fibrosis. Recent advances in our understanding of these vessels raise the possibility of targeting kidney lymphatics for the treatment of kidney disease.
Scaling an Enhanced Recovery Program to an Institution-Wide Initiative: It Takes a Village
Authors: Kruse Brittany , Recinos Iris , Eska Jarrod , Amaku Ruth , Aloia Thomas , Luciano Margaret , Gottumukkala Vijaya 
Published: May 2021

Background and Objective:
With the inclusion of Enhanced Recovery Programs (ERPs) into routine clinical practice, scaling programs across an institution is important to drive sustainable change in a patient-centric care delivery paradigm. A review of ERP implementation within a large institution was performed to understand key components that hinder or facilitate success of scaling an ERP.

Methods:
From January 2018 to March 2018, a needs assessment was completed to review implementation of enhanced recovery across the institution. Implementation progress was categorized into one of 5 phases including Define, Implement, Measure, Analyze, and Optimize.

Results:
Only 25% of service line ERPs reached the optimization phase within 5 years. One hundred percent of respondents reported more strengths (n = 41) and opportunities (n = 41) than weaknesses or threats (n = 25 and 14, respectively). Commonly identified strengths included established enhanced recovery pathways, functional team databases, and effective provider education. Weaknesses identified were inconsistencies in data quality/collection and a lack of key personnel participation including buy-in and time availability. Respondents perceived the need for data standardization to be an opportunity, while personnel factors were viewed as key threats.

Conclusion:
Identification of strengths, weaknesses, opportunities, and threats could prove beneficial in helping scale an ERP across an institution. Successful optimization and expansion of ERPs require robust data management for continuous quality improvement efforts among clinicians, administrators, executives, and patients.
Dysbiosis and Gut Microbiota Modulation in Systemic Sclerosis
Authors: Lemos Maria Paula Calil , Zucoloto Talita Graminha , Oliveira Maria Carolina , de Oliveira Gislane Lelis Vilela 
Published: May 2021

Abstract
Gastrointestinal (GI) involvement is an early manifestation in systemic sclerosis (SSc), affecting more than 90% of patients, and severe GI disease is a marker of poor prognosis and mortality. Recent studies have hypothesized that alterations of the intestinal microbiota, known as dysbiosis, may represent 1 of the possible environmental factors influencing SSc disease status. In addition, specific microorganisms may be associated with SSc pathogenesis, progression, and GI manifestations. Therapeutic approaches aiming to modulate the intestinal microbiota have emerged, as alternatives to treat GI symptoms, and dietary interventions, probiotic administration, and fecal microbiota transplantation are potential therapies for SSc patients. However, given the complexity and variability of pathogenesis and clinical manifestations in SSc, these therapies need to be combined with additional interventions that target other disease components. Here, we summarize studies addressing intestinal dysbiosis in SSc and discuss the potential of microbiota modulators to treat SSc-related GI disorders.
Diagnosis of Ectopic Pancreas in Small Intestine With 18F-DOPA PET/CT
Authors: Jacquet-Francillon Nicolas , Passot Guillaume , Galan Alexandre , Tordo Jérémie , Dhomps Anthony 
Published: May 2021

Abstract
A 77-year-old man was referred for a PET/CT 18F-FDG after incidental discovery of a lobulated jejunal lesion during surgery for an abdominal aortic aneurysm. The lesion was not removed due to the risk of digestive perforation. PET/CT 18F-FDG did not show pathologic hypermetabolism. Subsequently, we decided to perform PET/CT 18F-DOPA to better characterize this incidentaloma. A moderate uptake was showed, less than the pancreas. After multidisciplinary discussion, taking into account macroscopic and imaging aspects, the hypothesis of an ectopic pancreas was retained, allowing the exclusion of surgical excision.
Response to Oral Erlotinib Monotherapy in a Patient With EGFR-Negative Status in Histology and Progressive Disease on Conventional Chemotherapy
Authors: Sharma Anshul , Kumar Rakesh 
Published: May 2021

Abstract
An 80-year-old woman, presenting with weight loss and dyspnea for 8 months, showed bilateral lung consolidation in baseline 18F-FDG PET/CT and adenocarcinoma in bronchoscopy-guided biopsy. Epidermal growth factor receptor mutational status was negative in immunohistochemistry analysis, as well as in repeat liquid biopsy. When she developed progression on conventional chemotherapy, a trial of T. Erlotinib was given (since patient was a nonsmoker woman). Within a month, patient reported significant improvement in the dyspnea and did not require nebulization. 18F-FDG PET/CT was repeated after ~6 months, which showed significant response to the oral erlotinib monotherapy. Patient was doing well at 1-year follow-up, with only dermatological adverse effects (rashes).
68Ga-FAPI PET/CT Versus 18F-FDG PET/CT for the Evaluation of Disease Activity in Takayasu Arteritis
Authors: Wu Simin , Pang Yizhen , Zhao Liang , Zhao Long , Chen Haojun 
Published: May 2021

AbstractEvaluation of disease activity in Takayasu arteritis (TA) is challenging because clinical, biological, and imaging data do not always correlate. In this case, a 19-year-old woman with TA underwent18F-FDG PET/CT for evaluating disease activity. However, no abnormal18F-FDG uptake was observed in the large arteries. Follow-up with68Ga-FAPI PET/CT showed intense activity in the mildly thickened walls of bilateral carotid, subclavian arteries, and thoracic and abdominal aorta. This case presented an example where68Ga-FAPI outperformed18F-FDG for detecting active inflammation of TA. Therefore,68Ga-FAPI PET/CT may allow monitoring of disease activity and facilitate selecting the optimal therapy for TA patients.
Bone Marrow Activation After Chemotherapy Presenting as Diffuse Skeletal Uptake on 18F-Fluorocholine PET/CT
Authors: Taralli Silvia , Cocciolillo Fabrizio , Alitto Anna Rita , Caldarella Carmelo 
Published: May 2021

Abstract
Diffuse 18F-FDG skeletal uptake due to chemotherapy-induced bone marrow activation is well documented, whereas it has never been reported with 18F-fluorocholine. We described a patient with pelvic recurrence of prostate cancer at 18F-fluorocholine PET/CT. A second PET/CT after docetaxel showed minimal residual activity in pelvis, but it revealed diffuse, intense 18F-fluorocholine skeletal uptake. Considering biochemical and metabolic response and absence of morphologically suspected bone lesions, skeletal hyperactivity was interpreted as chemotherapy-related bone marrow rebound rather than diffuse metastatic involvement, as confirmed by its resolution after treatment ended. The occurrence of such 18F-fluorocholine pattern should be considered to avoid imaging misinterpretation.
Petrous Apex Cholesterol Granuloma Showing 68Ga-DOTATATE Uptake
Authors: Filizoglu Nuh , Soydemir Efe , Ones Tunc , Ozguven Salih , Sen Feyza 
Published: May 2021

Abstract
The importance of 68Ga-DOTATATE PET/CT in the evaluation of neuroendocrine tumors is well established. However, false-positive results can occur due to inflammatory pathologies. We report a 47-year-old man who was diagnosed with a neuroendocrine tumor of the stomach. Initial 68Ga-DOTATATE PET/CT showed intense 68Ga-DOTATATE uptake in the petrous apex. Histopathological confirmation could not be obtained, thus the asymptomatic patient was followed with periodic clinical/radiologic examinations for more than 2.5 years. Therefore, this lesion was diagnosed as a cholesterol granuloma of the temporal bone. These results suggested that an initial wait-and-scan approach is a feasible management strategy for similar presentations.
Comparing 99mTc-PSMA to 99mTc-MDP in Prostate Cancer Staging of the Skeletal System
Authors: Kabunda Joseph , Gabela Lerato , Kalinda Chester , Aldous Colleen , Pillay Venesen , Nyakale Nozipho 
Published: May 2021

Purpose
This prospective study was aimed at assessing the ability of 99mTc-PSMA scan to detect bone metastases in prostate cancer (PCa) against 99mTc-MDP scan as a standard and assess the correlation of these modalities in PCa staging of bone involvement.

Patients and Methods
Forty-one patients (41) with histologically confirmed PCa were scanned using both methods. Planar imaging was performed with additional regional SPECT/CT 3 to 4 hours posttracer injection. Scans were reported as positive, negative, or equivocal. In the case of positive scans, lesions were quantified by each of the 3 reporters separately. Planar and SPECT/CT images were reported together to obtain the final report on each scan.

Results
Our preliminary results showed no significant difference in the detection of bone metastases between the 2 scans. 99mTc-PSMA detected 52 of the 55 bone lesions detected on 99mTc-MDP. However, 99mTc-PSMA provided extra information by reporting lymph nodal metastases in 7 patients and residual disease in the prostate in 2 patients with biochemical progression after radical therapy. In 1 patient, the PSMA scan resulted in change in management with patient now on 177Lu-PSMA radioligand therapy. Equivocal findings were reported in 4 patients on 99mTc-MDP and none on 99mTc-PSMA.

Conclusions

99mTc-PSMA was comparable to 99mTc-MDP in detection of bone metastases and demonstrated an additional benefit of providing information on visceral disease. 99mTc-PSMA may be a better alternative to 99mTc-MDP in staging, restaging, and assessment of patients with biochemical progression after radical therapy of PCa in a resource-limited setup like ours while also assisting to detect patients eligible for PSMA-labeled radioligand therapy.