bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stroke Due to Orthognathic Surgery: Case Report of a Rare Complication
Authors: Bulgarelli Luana Lima , Goldenberg Dov Charles , Loureiro Rafael Maffei , Gentil Andre Felix , Morgulis Roberto Franco , Ribas Eduardo Carvalhal 
Published: August 2022

Summary:
Le Fort I osteotomy is a frequent surgical procedure used in orthognathic surgeries to treat severe malocclusions and is associated with relatively rare surgical complications. Here, the authors report a case of thrombotic ischemic stroke as a result of this procedure, a complication still not described in the literature. A 19-year-old man with class II malocclusion and retrognathia underwent orthognathic surgery for aesthetic purposes. The surgery included a Le Fort I maxillary osteotomy with vertical impaction, bilateral sagittal split ramus osteotomy for mandibular advancement, and genioplasty. Postoperatively, the patient developed left eye blindness, headache, somnolence, aphasia, and right hemiplegia. Medical imaging showed the Le Fort I line of fracture extending from the maxillary osteotomy to the left optic canal and to the left carotid canal, with osseous fragments impinging the petrous segment of the internal carotid artery, left carotid artery occlusion and associated to an ischemic stroke at the left middle cerebral artery territory. Treatment required decompressive craniectomy and later focused on clinical stabilization, infection management, orthognathic care, neurorehabilitation, and cranioplasty. The hemiplegia and aphasia partially recovered during 12 months, and final dental occlusion was appropriate. Our report demonstrates that an unfavorable Le Fort I fracture trajectory can lead to ischemic stroke and severe neurological deficits.
PMMA-collagen Gel in Nonsurgical Rhinoplasty Defects: A Methodological Overview and 15-year Experience
Authors: Rivkin Alexander 
Published: August 2022

Background:
Nonsurgical rhinoplasty (NSR) is an alternative to surgical rhinoplasty for patients who desire correction of mild-to-moderate aesthetic nasal defects but do not wish to undergo surgery due to concern about risks, recovery time, or cost. Although not a surrogate, NSR can be a more accessible and more precise modality for achieving aesthetic goals. Furthermore, for certain types of defects, the precision possible with filler injection versus surgery can make NSR the preferred procedure. In these instances, polymethylmethacrylate (PMMA)-collagen gel is a valuable tool for appropriate candidates due to its permanence and its favorable safety profile when injected appropriately.

Methods:
Optimal use of PMMA-collagen gel for NSR is predicated on expert-level injector experience and careful patient selection and education. The author draws on over 15 years of experience treating more than 1000 NSR patients with PMMA-collagen gel to provide a discussion of relevant anatomy; methodological overview, including patient selection; and a video describing injection technique of NSR with PMMA-collagen gel.

Results:
To our knowledge, this is the first published guidance on NSR with permanent filler. In addition to the clinical experience provided, patient images with 10 years of follow-up are included to illustrate the durability of the results and the continued natural appearance of the correction as the treated patients continue to age.

Conclusion:
In patients with aesthetic nasal deficits treated with filler, where permanent correction is desired, the appropriate use of PMMA-collagen gel is an effective treatment option.
Periventricular rather than deep white matter hyperintensities mediate effects of hypertension on cognitive performance in the population-based 1000BRAINS study
Authors: Gronewold Janine , Jokisch Martha , Schramm Sara , Himpfen Heiko , Ginster Theresa , Tenhagen Isabell , Doeppner Thorsten R. , Jockwitz Christiane , Miller Tatiana , Lehmann Nils , Moebus Susanne , Jöckel Karl-Heinz , Erbel Raimund , Caspers Svenja , Hermann Dirk M. 
Published: August 2022

Objectives:
White matter hyperintensities (WMH) of presumed vascular origin are frequent in cerebral MRI of older people. They represent a sign of small vessel disease, are promoted by arterial hypertension, and relate to cognitive deficits. The interdependence of blood pressure and its treatment, WMH, and cognitive performance has not systematically been studied in population-based studies.

Methods:
Consequently, we analysed the interdependence of SBP, DBP, and antihypertensive medications, as well as BP/treatment category, with WMH and cognitive performance in 560 participants of the population-based 1000BRAINS study.

Results:
BP, its treatment, and BP/treatment category were moderately associated with cognitive performance (e.g. unadjusted β = −0.10, 95%CI = −0.19 to −0.02 for the association of SBP (per standard deviation of 17.2 mmHg) with global cognition (per standard deviation of 0.5 z score)]. The harmful effect of BP on cognition was strongly mediated by periventricular hyperintensities (PVH), which were significantly associated with both SBP [β = 0.24, 95% CI = 0.14–0.34 (per 1-point-increase in Fazekas score)] and global cognition (β = −0.22, 95%CI =  −0.32 to −0.13). Thus, PVH mediated as much as 52% of the effects of SBP on cognitive performance. Mediation was less strong for deep white matter hyperintensities (DWMH, 16%), which showed less association with SBP (β = 0.14, 95% CI = 0.05–0.24) and global cognition (β = −0.12, 95%CI = −0.21 to −0.03). Regarding different cognitive domains, PVH most strongly mediated effects of SBP on nonverbal memory (94%) and executive function (81%).

Conclusion:
Our results indicate that PVH may predispose to cognitive impairment associated with hypertension, especially in the domains of nonverbal memory and executive function.
A qualitative exploration of dentists' opioid prescribing decisions within U.S. veterans affairs facilities
Authors: Sharp Lisa K. , Solanki Pooja , Boyer Taylor , Vivo Amanda , Kale Ibuola , Hughes Ashley M. , Gibson Gretchen , Jurasic M. Marianne , Evans Charlesnika T. , Suda Katie J. 
Published: August 2022

Abstract
The U.S. Department of Veterans Affairs (VA) is the largest integrated healthcare system in the United States and provides dental care to approximately one-half million veterans annually. In response to the opioid crisis, the VA released several opioid risk mitigation strategies. Although opioid prescribing by VA dentists has decreased on the whole, the implementation experiences at the level of dentists remains unclear. Our objective was to explore the barriers and facilitators that affect opioid decision making for management of acute dental pain among VA dentists. Dentists practicing in the VA facilities with the highest and lowest volume of opioid prescriptions were recruited. Standardized qualitative interviews by telephone followed a semistructured guide designed around the Capability (C), Opportunity (O), Motivation (M), and Behaviour (B) model. Audio recordings were transcribed and independently double-coded using NVivo to identify potential targets for future guideline-based opioid interventions. Of 395 eligible general and specialty dentists, 90 (24.8%) completed an interview representing 33 VA facilities. Opportunities for prescribing opioids included 1) completion of dental procedures associated with acute dental pain, 2) caring for patients who presented with existing dental pain, and 3) responding to patient opioid requests. Capabilities included using resources (eg, electronic medical records), clinical judgement (eg, evaluation of medical history including medication use), communication skills, and ability to screen for opioid misuse. Motivation themes focused on alleviating patients' acute dental pain. Barriers and facilitators of opioid prescribing varied across facilities. The results can offer intervention targets for continued opioid risk mitigation efforts.
Lower brachial artery flow-mediated dilation is associated with a worse prognosis and more lung parenchymal involvement in Covid-19: Prospective observational study
Authors: Güz Göksel , Demirgan Serdar 
Published: August 2022

Severe acute respiratory syndrome coronavirus-2 is a highly infectious pathogenic coronavirus, which has appeared toward the end of 2019. The virus seen all over the world caused a pandemic of an acute respiratory disease named coronavirus disease 2019 (Covid-19). It has been shown that the virus that uses angiotensin-converting enzyme 2 receptors is causing endothelial dysfunction resulting in vascular inflammation and coagulopathy. It is possible to assess endothelial dysfunction by the flow-mediated dilatation (FMD) technique. Our study aimed to demonstrate the effect of endothelial dysfunction assessed using the FMD on prognosis and mortality in the patients hospitalized with the diagnosis of Covid-19.
In this prospective observational study, endothelial functions of 94 patients hospitalized due to the Covid-19 in the ward or intensive care unit (ICU) were evaluated by FMD. The relationship among endothelial dysfunction and prognosis of disease, biochemical parameters, lung involvement, and mortality was investigated.
We found that the FMD% values of the Covid-19 ICU patients compared to those followed up in the ward (2.66 ± 0.62 vs. 5.23 ± 1.46/P < .001) and those who died due to Covid-19 compared to those who were discharged alive (2.57 ± 0.22 vs. 4.66 ± 1.7/P < .001) were significantly lower. There were moderate negative correlation between FMD% and peak values of D-dimer (r = −0.52, P < .001), troponin (r = −0.45, P < .001), ferritin (r = −0.47, P < .001), lactate dehydrogenase (r = −0.49, P < .001), and white blood cells count (r = −0.23, P = .024). Lower FMD% was associated with higher lung parenchymal involvement (P < .001). The optimum cutoff point of FMD in predicting mortality was found to be 3.135% (sensitivity: 1, selectivity: 0.70).
According to our results, lower FMD% was associated with higher lung parenchyma involvement, ICU admission, and mortality rate in Covid-19 patients. The best cutoff point for predicting mortality of FMD was 3.135%. Nevertheless, largescale, multicenter studies are needed to evaluate lower FMD values as a risk factor for mortality in Covid-19.
Effect of circuit training with low-carbohydrate diet on body composition, cardiometabolic indices, and exercise capacity in adults with mild to moderate obesity in Saudi Arabia: A randomized control trial
Authors: Seyam Mohamed K. , Alqahtani Mazen , Sirajudeen Mohamed Sherif , Muthusamy Hariraja , Kashoo Faizan Z. , Salah Mukhtar M. 
Published: August 2022

Background:
Circuit training that combines aerobic and resisted training is reported to reduce body fat, weight, and improve exercise capacity than performing either type of exercise independently. There is no study evaluating the combined effect of circuit training exercise (CTE) and dietary intervention (low-carbohydrate [LC] diet) among young males with obesity.

Methods:
A randomized control trial was conducted to explore the effects of a combined program of CTE and a LC diet for adults with mild or moderate obesity. Seventy adults with obesity were allocated randomly into 2 groups. The experimental group (group 1) received circuit training with LC diet intervention, whereas the control (group 2) received only circuit training. The study variables such as exercise capacity, body composition, and cardiometabolic indices were measured at the baseline and the end of 60 days of intervention.

Results:
The participants of group 1 showed significant improvements in body composition (body weight, body mass index, waist circumference, waist hip circumference, and body fat percentage), exercise capacity (maximal oxygen consumption), and cardiometabolic indices (high-density lipoprotein, low-density lipoprotein, triglycerides, and total cholesterol) with a P < .05 for all the variables, when compared with group 2.

Conclusions:
The combined structured CTE with controlled LC diet intervention in obese adults caused significant reduction in body composition and cardiometabolic indices variables and an increase in exercise capacity.
Exceptional response of skin symptoms to secukinumab treatment in a patient with SAPHO syndrome: Case report and literature review
Authors: Ji Qiang , Wang Qing , Pan Wenping , Hou Yanfeng , Wang Xiuhua , Bian Lin , Wang Zhankui 
Published: August 2022

Rationale:
SAPHO syndrome is a rare clinical entity characterized by a wide range of dermatological and musculoskeletal manifestations. Treatment strategies are not standardized. Palmoplantar pustulosis (PPP) is the most common rash in patients with SAPHO syndrome.

Patient concerns:
A 24-year-old Chinese woman with no relevant medical or familial history had a 1-year history of cutaneous lesions with PPP and pain in the sternoclavicular joint.

Diagnosis:
Based on the diagnostic criteria for SAPHO syndrome proposed by Nguyen et al in 2012, we diagnosed SAPHO syndrome with severe PPP as the predominant manifestation.

Interventions:
Due to the limited therapeutic efficacy of methotrexate and cyclosporin, we started therapy with subcutaneous secukinumab 150 mg weekly for the first month, then 150 mg monthly thereafter.

Outcomes:
After 4 weeks of secukinumab administration, the patient showed significant remission of pustular skin lesions, with almost no joint pain and no adverse reaction. Complete remission of skin symptoms was achieved after 3 months. Joint pain and adverse events have not reoccurred in follow-up thus far.

Conclusions:
In patients with SAPHO syndrome, we recommend personalized treatment, which may have excellent therapeutic efficacy in those with PPP or severe skin symptoms. Although data related to the use of IL-17 blockers for SAPHO syndrome are very limited, secukinumab provides a novel therapeutic option, especially for patients with PPP and severe skin lesions. Further prospective studies are needed to support our findings.
Influencing a Culture of Quality and Safety Through Huddles
Authors: McCain Natalia , Ferguson Tysa , Barry Hultquist Teresa , Wahl Carol , Struwe Leeza 
Published: August 2022

Background:
Literature shows that interdisciplinary huddles help promote clear communication and proactive reporting of potential errors.

Local Problem:
High reliability organization (HRO) and just culture models were implemented, yet fragmented team communication about patient safety remained. Huddles were implemented to identify and address patient safety issues.

Methods:
A pre/postintervention design was used. Near-miss and actual event safety metrics, patient satisfaction, and employee satisfaction/work group perceptions were measured at 3 time points over 1 year.

Interventions:
Daily interdisciplinary huddles were implemented to improve communication, reduce errors, and improve patient and employee satisfaction.

Results:
Near-miss reporting increased across time points. Patient satisfaction with how the staff worked together to provide care significantly increased over time. Employee satisfaction and perception of work group communication, collaboration, and psychological safety scores improved, however, were not statistically significant.

Conclusion:
Implementing huddles demonstrated improved outcomes in patient safety, patient satisfaction, and employee satisfaction/work group perceptions.
Typhoid fever control in the 21st century: where are we now?
Authors: Carey Megan E. , McCann Naina S. , Gibani Malick M. 
Published: August 2022

Purpose of review
Momentum for achieving widespread control of typhoid fever has been growing over the past decade. Typhoid conjugate vaccines represent a potentially effective tool to reduce the burden of disease in the foreseeable future and new data have recently emerged to better frame their use-case.

Recent findings
We describe how antibiotic resistance continues to pose a major challenge in the treatment of typhoid fever, as exemplified by the emergence of azithromycin resistance and the spread of Salmonella Typhi strains resistant to third-generation cephalosporins. We review efficacy and effectiveness data for TCVs, which have been shown to have high-level efficacy (≥80%) against typhoid fever in diverse field settings. Data from randomized controlled trials and observational studies of TCVs are reviewed herein. Finally, we review data from multicountry blood culture surveillance studies that have provided granular insights into typhoid fever epidemiology. These data are becoming increasingly important as countries decide how best to introduce TCVs into routine immunization schedules and determine the optimal delivery strategy.

Summary
Continued advocacy is needed to address the ongoing challenge of typhoid fever to improve child health and tackle the rising challenge of antimicrobial resistance.
Analysis of the High Submandibular Approach: A Critical Reapprasail of a Transfacial Access to the Mandibular Skeleton
Authors: Laganà Francesco , Arcuri Francesco , Spinzia Alessia , Bianchi Bernardo 
Published: August 2022

Aim:
In 2006 following the development of dedicated osteosynthesis plates, Meyer and colleagues reported a successful clinical study of condylar fractures treated by a modified submandibular approach; it was called high submandibular approach or “Strasbourg approach.” The aim of this study is to describe the high submandibular approach step by step.

Case Series:
Between January 2010 and December 2015 at the Maxillofacial Unit of the Hospital “Policlinico San Martino” 13 patients affected by subcondylar fracture underwent open reduction and internal with high submandibular approach. Surgery was uneventful in all patients; no infections occurred in any of the cases; the mean procedure duration was 89 minutes, ranging from 66 to 125 minutes. The mean hospital stay was 2.9 days, ranging from 2 to 6 days. At the 1-year follow-up, all patients had stable occlusion with a natural, well-balanced morphology of the face and adequate dynamic excursion of the mandible.

Conclusions:
The morbidity is negligible in terms of damage to the facial nerve, vascular injuries, and aesthetic deformity. The authors think that further prospective clinical trials are necessary to assess and eventually develop this approach.
MECHANISM OF MIR-25-3P CARRIED BY EXTRACELLULAR VESICLES DERIVED FROM PLATELET-RICH PLASMA IN IL-1β–INDUCED NUCLEUS PULPOSUS CELL DEGENERATION VIA THE SOX4/CXCR7 AXIS
Authors: Hu Baoshan , Wang Lianxin , Sun Naikun , Lin Shengrong , Rui Gang 
Published: August 2022

ABSTRACT

Objectives: Nucleus pulposus (NP) cell degeneration promotes the progression of intervertebral disc (IVD) degeneration. MicroRNAs (miRs) are associated with IVD degeneration. This study expounded the mechanism of microRNA (miR)-25-3p carried by extracellular vesicles (EVs) derived from platelet-rich plasma (PRP) in interleukin (IL)-1β–induced NP cell degeneration. Methods: Platelet-rich plasma from mouse blood was obtained, and EVs were isolated from PRP (EVs derived from PRP [PRP-EVs]) and identified. Nucleus pulposus cells were isolated from the mouse lumbar IVD and treated with IL-1β to induce NP cell degeneration. Extracellular vesicles derived from PRP were added into NP cell culture medium. Afterward, intracellular miR-25-3p, sex determining region Y-related high-mobility-group box 4 (SOX4), and CXC chemokine receptor 7 (CXCR7) levels were examined. Nucleus pulposus cell viability, apoptosis, and inflammation were detected. Extracellular vesicles derived from PRP were labeled by PKH67 to obverse the uptake of EVs by NP cells. The binding relations between SOX4 and miR-25-3p and CXCR7 were predicted and examined. Functional rescue experiments were performed to investigate the roles of miR-25-3p, SOX4, and CXCR7 in NP cell degeneration. Results: miR-25-3p was downregulated, whereas SOX4 and CXCR7 were upregulated in IL-1β–induced NP cells. Extracellular vesicles derived from PRP increased the cell viability, and decreased apoptosis and inflammation. miR-25-3p carried by PRP-EVs into NP cells alleviated NP cell degeneration. miR-25-3p inhibited SOX4 expression and limited CXCR7 transcription. Silencing miR-25-3p or overexpressing SOX4 or CXCR7 reversed the alleviating role of PRP-EVs in NP cell degeneration. Conclusion: miR-25-3p carried by PRP-EVs into NP cells elevated intracellular miR-25-3p expression, which suppressed SOX4 expression and further limited CXCR7 transcription, thus alleviating IL-1β–induced NP cell degeneration. Extracellular vesicles derived from PRP containing miR-25-3p may be a new method for IVD treatment.
ACUTE AND SUSTAINED ALTERATIONS TO THE BONE MARROW IMMUNE MICROENVIRONMENT FOLLOWING POLYMICROBIAL INFECTION
Authors: Cho Dong Seong , Schmitt Rebecca E. , Dasgupta Aneesha , Ducharme Alexandra M. , Doles Jason D. 
Published: August 2022

ABSTRACT
Sepsis is a highly prevalent cause of death in intensive care units. Characterized by severe immune cell derangements, sepsis is often associated with multiorgan dysfunction. For many sepsis survivors, these deficits can persist long after clinical resolution of the underlying infection. Although many studies report on the impact of sepsis on individual immune cell subtypes, a comprehensive analysis of sepsis-induced alterations within and across the immune cell landscape is lacking. In this study, we used single-cell RNA sequencing to assess sepsis-associated transcriptional changes in immune cells isolated from bone marrow at single-cell resolution. We used a high-survival fecal-induced peritonitis sepsis model using Friend leukemia virus B mice. Single-cell RNA sequencing classified 3402 single cells from control subjects into 14 clusters representing long-term hematopoietic stem cell (HSC), short-term HSC, basophil, dendritic cell, eosinophil, erythroblast, erythrocyte, macrophage, neutrophil, natural killer cell, plasma cell, plasmacytoid dendritic cell, pre-B cell, and T memory cell lineages. One day following experimentally induced sepsis, cell type compositions shifted significantly and included notable decreases in HSC and myeloid cell abundance. In addition to proportional cell composition changes, acute sepsis induced significant transcriptional alterations in most immune cell types analyzed—changes that failed to completely resolve 1 month after sepsis. Taken together, we report widespread and persistent transcriptional changes in diverse immune cells in response to polymicrobial infection. This study will serve as a valuable resource for future work investigating acute and/or long-term sepsis-associated immune cell derangements.
Accurate support vector machine identification of limb-onset amyotrophic lateral sclerosis using resting-state activity of regions within executive control network
Authors: Meroiti James 
Published: August 2022

AbstractAmyotrophic lateral sclerosis (ALS) is a motor neuron degenerative disorder facing diagnostic challenges due to its highly variable presentation and symptom overlap. In other neurodegenerative disorders, support vector machine (SVM) classifiers have utilized neuroimaging to address these challenges. Given functional alterations may be the earliest detectable in ALS, we aimed to uncover resting-state functional MRI (rs-fMRI) biomarkers for SVM classification. Resting-state networks derived from independent component analysis were compared between limb-onset ALS patients (n = 14) and controls (n = 12). A cluster within the executive control network (EXN) localizing predominantly to the anterior cingulate gyrus (ACG) was significantly decreased in limb-onset ALS. Activity of this cluster was able to develop a SVM with 86% sensitivity and 87% specificity on the validation dataset. These findings suggest the ACG and EXN may be important in classifying limb-onset ALS patients and could be incorporated into multi-modal SVM classifiers.