bluuebunny/crossref_metadata_2025 huggingface dataset:
Managing Acute Seizures: New Rescue Delivery Option and Resources to Assist School Nurses
Authors: Dean Patricia , O’Hara Kathryn , Brooks Lai , Shinnar Ruth , Bougher Genei , Santilli Nancy
Published: June 2021

Approximately 470,000 children and adolescents in the United States have epilepsy, 30% of whom experience seizures despite antiseizure drug regimens. School nurses, teachers, caregivers, and parents play integral roles in implementing a care plan that avoids triggers, recognizes signs, and provides supportive care—ideally, guided by a patient-specific seizure action plan, which may include the use of rescue medication. Benzodiazepines are the mainstay of seizure rescue medication; for decades, rectally administered diazepam was the only approved rescue medication for seizure clusters outside the hospital setting. However, rectal administration has limitations that could delay treatment (e.g., social acceptability, removal of clothing, positioning). More recently, intranasal midazolam (for patients ≥12 years) and intranasal diazepam (for patients ≥6 years) were approved for this indication. Training and education regarding newer forms of rescue medication should improve confidence in the ability to treat seizures in school with the goal of increasing the safety of students with epilepsy.
Whole brain atlas-based diffusion kurtosis imaging parameters for evaluation of minimal hepatic encephalopathy
Authors: Gupta Prateek , Vyas Sameer , Salan Teddy , Jain Chirag , Taneja Sunil , Dhiman RK , Singh Paramjeet , Ahuja Chirag K , Ray Nirmalya , Govind Varan
Published: June 2021

Background and purposes

Minimal hepatic encephalopathy (MHE) has no recognizable clinical symptoms, but patients have cognitive and psychomotor deficits. Hyperammonemia along with neuroinflammation lead to microstructural changes in cerebral parenchyma. Changes at conventional imaging are detected usually at the overt clinical stage, but microstructural alterations by advanced magnetic resonance imaging techniques can be detected at an early stage.

Materials and methods

Whole brain diffusion kurtosis imaging (DKI) data acquired at 3T was analyzed to investigate microstructural parenchymal changes in 15 patients with MHE and compared with 15 age- and sex-matched controls. DKI parametric maps, namely kurtosis fractional anisotropy (kFA), mean kurtosis (MK), axial kurtosis (AK) and radial kurtosis (RK), were evaluated at 64 white matter (WM) and gray matter (GM) regions of interest (ROIs) in the whole brain and correlated with the psychometric hepatic encephalopathy score (PHES).

Results

The MHE group showed a decrease in kFA and AK across the whole brain, whereas MK and RK decreased in WM ROIs but increased in several cortical and deep GM ROIs. These alterations were consistent with brain regions involved in cognitive function. Significant moderate to strong correlations (–0.52 to –0.66; 0.56) between RK, MK and kFA kurtosis metrics and PHES were observed.

Conclusion

DKI parameters show extensive microstructural brain abnormalities in MHE with minor correlation between the severity of tissue damage and psychometric scores.
Delivering on the Binary Divide
Authors: Mangan David
Published: June 2021

Delivery companies have become a focal point of the ‘gig economy’, with Uber the most often identified entity. This commentary considers what recent cases involving delivery service companies suggest about labour law and the platform economy. Although these cases have focused on employment status, this commentary contends that the continuing lack of concerted engagement with the independent contractor status contributes to this spate of cases.

Cases:

Heller v Uber Technologies Inc. 2020 SCC 16. Uber Cass Soc, Appeal no. S 19-13.316. Uber v Aslam [2021] UKSC.
Extragonadal germ cell tumor, a report of two cases presenting in the gastrointestinal tract
Authors: Elkhaldi Mousa , Naser Ahamd Moayad , AlHalaseh Yazan , Al-Hussaini Maysa
Published: June 2021

Germ cell tumors are a heterogeneous group of tumors that can present primarily as gonadal tumors in either a localized or metastatic pattern. Rarely these tumors can initially present at extra-gonadal locations, including the gastrointestinal tract. We report two young male patients who presented with nonspecific gastrointestinal symptoms caused by a mass lesion involving the duodenum. Pathologically, both were confirmed to be germ cell tumors; an unfamiliar initial presentation of germ cell tumors. In both cases, evidence of pre-existing gonadal tumor in the form of a testicular mass and a burned-out tumor with microlithiasis, in the first and second cases, respectively was detected following the confirmed diagnosis of extra-gonadal germ cell tumor. Each patient’s clinical course and outcome emphasizes the importance of a high index of suspicion, timely diagnosis, and appropriate management.
A description of antipsychotic prescribing patterns based on race in the inpatient behavioral health setting
Authors: Maestri Thomas , Anderson David , Calderon-Abbo Jose , Waguespack Taylor , Echeverri Margarita
Published: June 2021

Background and aims:

A growing body of research shows that race contributes to disparities in mental health services utilization and influences the clinical diagnostic process. To our knowledge, no studies on current practice in the Unites States have documented whether these disparities impact the prescription of antipsychotic medications across individual patients based on race. Consequently, this study aims to describe the prescribing patterns of antipsychotic medications in the inpatient setting based on patients’ race, and to explore appropriateness of therapy based on Food and Drug Administration labeling and avoidance of inappropriate polypharmacy.

Methods:

Single-centered, retrospective, chart review of 398 psychiatric patients in the inpatient setting and who had a psychiatric diagnosis that warranted a prescription for an antipsychotic medication at the time of discharge. Frequencies were computed to describe differences in demographic variables (race, health insurance type, age, and gender), medical conditions (diagnosis, commodities, hospitalization status, antipsychotic medications, etc.), and screening tests (lipid panel, hemoglobin, urine and illicit drug use). Logistic regression, analysis of variance, and hypothesis tests were used to analyze the data.

Results:

Significant differences were not found in total chlorpromazine equivalent dose equivalencies by race or insurance. However, patients of involuntary admission status, past medication trials, a diagnosis of schizophrenia or bipolar disorder, and who lacked family support had higher total daily doses of antipsychotics upon discharge. Inappropriate therapy was significantly related to differences in increasing age and a diagnosis of insomnia.

Conclusion:

This single-centered study described patterns of antipsychotic prescribing based on race in an inpatient psychiatry facility. Future studies, using larger and more diverse sample populations, are recommended to elucidate the role that patients’ race, admission status, and family support play in the dose and appropriateness of antipsychotics prescribed for mental health care.
Genetic basis of pulmonary arterial hypertension: a prospective study from a highly inbred population
Authors: Aldalaan Abdullah M. , Ramzan Khushnooda , Saleemi Sarfraz A. , Weheba Ihab , Alquait Laila , Abdelsayed Abeer , Alzubi Fatima , Zaytoun Hamdeia , Alharbi Nadeen , Al‐Owain Mohammed , Imtiaz Faiqa
Published: June 2021

Pulmonary arterial hypertension (PAH), whether idiopathic PAH (IPAH), heritable PAH, or associated with other conditions, is a rare and potentially lethal disease characterized by progressive vascular changes. To date, there is limited data on the genetic basis of PAH in the Arab region, and none from Saudi Arabian patients. This study aims to identify genetic variations and to evaluate the frequency of risk genes associated to PAH, in Saudi Arabian patients. Adult PAH patients, diagnosed with IPAH and pulmonary veno‐occlusive disease, of Saudi Arabian origin, were enrolled in this study. Forty‐eight patients were subjected to whole‐exome sequencing, with screening of 26 genes suggested to be associated with the disease. The median age at diagnosis was 29.5 years of age, with females accounting for 89.5% of our cohort population. Overall, we identified variations in nine genes previously associated with PAH, in 16 patients. Fourteen of these variants have not been described before. Plausible deleterious variants in risk genes were identified in 33.3% (n = 16/48) of our entire cohort and 25% of these cases carried variants in BMPR2 (n = 4/16). Our results highlight the genetic etiology of PAH in Saudi Arabia patients and provides new insights for the genetic diagnosis of familial and IPAH as well as for the identification of the biological pathways of the disease. This will enable the development of new target therapeutic strategies, for a disease with a high rate of morbidity and mortality.
Ruptured infected popliteal artery aneurysm treated with endovascular therapy: A case report
Authors: Kojima Shunsuke , Nakama Tatsuya , Obunai Kotaro , Watanabe Hiroyuki
Published: June 2021

An 86-year-old woman was admitted for a ruptured popliteal artery aneurysm (rPAA, 26 × 28 mm). Due to the patient’s age and comorbidities, emergency endovascular repair was performed. After the failed antegrade guidewire crossing, a retrograde approach from the anterior tibial artery and snaring was performed for lesion crossing, and stentgraft (5 × 50 mm) was deployed from antegrade fashion. At the 14-month follow-up, computed tomography angiogram demonstrated stentgraft patency and reduced aneurysmal size. Although open surgery remains the first-line treatment for infected rPAA, our approach adds to the evidence and can be applied to emergency cases or high-risk surgical patients.
Determinants of first-line antiretroviral treatment failure among adult HIV patients at Nekemte Specialized Hospital, Western Ethiopia: Unmatched case-control study
Authors: Desalegn Mengistu , Seyoum Dejene , Tola Edosa Kifle , Tsegaye Gayesa Reta
Published: June 2021

Objective:

In Ethiopia, only a few studies were conducted to determine factors contributing to antiretroviral treatment failure, in general, and there are no published data in the study area, in particular. Thus, the aim of the study was to assess the determinants of first-line treatment failure among adult HIV patients on antiretroviral treatment at Nekemte Specialized Hospital, western Ethiopia.

Methods:

The hospital-based 1:2 unmatched case–control study was conducted in Nekemte Specialized Hospital from 1 August to 30 September, 2019, on 252 HIV-positive patients receiving antiretroviral treatment (86 cases and 166 controls). Cases were selected from patients who were switched to second-line antiretroviral treatment regimen after first-line antiretroviral treatment failure. Controls were from those who are on the first-line antiretroviral regimens for at least 6 months. Data were collected by two trained clinical nurses. Record review and an interviewer-administered questionnaire were used to collect data. Data were entered into Epi-Data, version 7.2.2, and then exported to SPSS, version 25, for analysis. The association between treatment failure and each covariate was assessed by bivariate analysis to identify candidate variables at p value < 0.25. All candidate variables were entered into multivariate analysis done in stepwise backward likelihood ratio to declare statistical significance association at p value < 0.05, 95% confidence interval.

Results:

Data from a total of 252 (86 cases and 166 controls) patients were extracted at a response rate of 98.4%. Statistically higher odds of first-line treatment failure were observed among those who started treatment at an advanced stage (Baseline World Health Organization stage 3 o r4 (adjusted odds ratio = 3.12, 95% confidence interval: 1.55–6.26), lower Baseline CD4 count < 100 cells (adjusted odds ratio = 3.06, 95 % confidence interval: 1.45–6.50), lack of participation in a support group (adjusted odds ratio = 4.03, 95% confidence interval: 1.98–8.21), history of antiretroviral treatment discontinuation for greater than 1 month (adjusted odds ratio = 2.36, 95% confidence interval: 1.17–4.78) and poor adherence to antiretroviral treatment (adjusted odds ratio = 3.09, 95% confidence interval: 1.54–6.19).

Conclusion:

Antiretroviral treatment initiation at an advanced stage, lower CD4 count, no participation in a support group, and poor adherence were determinants of treatment first-line antiretroviral treatment failure. Therefore, health care providers and program developers should give special attention to; early diagnosis and start of treatment, encouraging patients to participate in a support group, trace patients early, and attentively follow patients to improve their adherence to antiretroviral treatment.
A case of cutaneous necrosis due to intra-articular hyaluronic acid and treated with hyaluronidase
Authors: Aaron Michelle , Qing Huang Yu , Bouffard Danielle , Costa Jean-Pascal , Côté Benoît
Published: June 2021

A 66-year-old woman presented to the hospital with cutaneous necrosis of her right ankle and foot. Her symptoms began immediately after an intra-articular injection of hyaluronic acid for ankle osteoarthritis, which was performed 6 days before. Histopathology showed an intra-vascular hyaluronic acid embolus. The initial treatment approach was conservative, but the patient’s clinical state degraded. She was thus treated with sub-cutaneous hyaluronidase, the enzyme that degrades hyaluronic acid, which yielded a moderate improvement even though it was administered 22 days after the initial hyaluronic acid injection. Although hyaluronic acid embolism and subsequent cutaneous necrosis are well-known complications of dermal fillers, there are few reported cases of embolism following intra-articular injection. To our knowledge, this is the first time hyaluronidase has been used in this setting.
Rehabilitation approach in oropharyngeal cancer: Case report
Authors: Lawati Zainab Al , Smith Riley
Published: June 2021

Introduction:

Cancer rehabilitation can be preventive, restorative, supportive, and palliative. The rehabilitation goals change as the cancer pathway alters. Following any treatment for head and neck cancer, a physiatrist plays an essential role in preventing various complications and helping patients to mitigate impairments and restore function, optimizing their quality of life.

Case description:

This is a case study of a 56-year-old man with squamous cell cancer of the tongue managed with glossectomy, chemotherapy, and radiotherapy. He also has a remote history of acute myeloid leukemia involving the central nervous system, presenting with seizure and infective endocarditis. He underwent a sternotomy and an aortic valve replacement. His postoperative course was complicated by sternal infection, bradycardia with agonal breathing, and a weak pulse, for which the patient underwent cardiopulmonary resuscitation and achieved return of spontaneous circulation and was intubated and managed with antibiotics. He had a tracheostomy and underwent aggressive pulmonary toileting and suctioning in acute care. As the patient stabilized, he was transferred to in-patient rehabilitation.

Interventions:

While the patient was in the in-patient rehabilitation unit, cancer rehabilitation issues were addressed, including swallowing, pulmonary rehabilitation, management of upper-extremity deep venous thrombosis and infection, bowel and bladder issues, skin care, and evaluation of mental status. The patient’s cancer prognosis and future were discussed in collaboration with his oncologist. He was discharged with a palliative care plan.

Conclusion:

This report illustrates the significance of physical medicine and rehabilitation in management of cancer patients, as most cancer patients experience some deconditioning that results in physical challenges. As the prognosis for most types of cancers improves, it becomes more important to ensure that all cancer patients regain maximum function in the broadest sense to maximize their independence.
Dashboard stories: How narratives told by predictive analytics reconfigure roles, risk and sociality in education
Authors: Jarke Juliane , Macgilchrist Felicitas
Published: June 2021

In this paper, we explore how the development and affordances of predictive analytics may impact how teachers and other educational actors think about and teach students and, more broadly, how society understands education. Our particular focus is on the data dashboards of learning support systems which are based on Machine Learning (ML). While previous research has focused on how these systems produce credible knowledge, we explore here how they also produce compelling, persuasive and convincing narratives. Our main argument is that particular kinds of stories are written by predictive analytics and written into their data dashboards. Based on a case study of a leading predictive analytics system, we explore how data dashboards imply causality between the ‘facts’ they are visualising. To do so, we analyse the stories they tell according to their spatial and temporal dimensions, characters and events, sequentiality as well as tellability. In the stories we identify, teachers are managers, students are at greater or lesser risk, and students’ sociality is reduced to machine-readable interactions. Overall, only data marked as individual behaviours becomes relevant to the system, rendering structural inequalities invisible. Reflecting on the implications of these systems, we suggest ways in which the uptake of these systems can interrupt such stories and reshape them in other directions.
Racial formation, coloniality, and climate finance organizations: Implications for emergent data projects in the Pacific
Authors: Anantharajah Kirsty
Published: June 2021

This commentary explores the potential consequence of latent racial formation in emergent climate finance data projects and draws from ethnographic research on climate finance governance conducted in Fiji. Climate finance data projects emerging in the Pacific aim to ease the flow of finance from the Global North to the South. These emergent data projects, such as renewable energy resource availability and investment mapping, are imbedded in the climate finance organizations that fund, develop, and use them. Thus, the commentary explores climate finance organizations through the lens of Ray’s (2019) theory of racial organizations, highlighting the ways in which important climate-related resources are mediated through racial and colonial schemas. The racial mediation of two key resources are spotlighted in this discussion: the finance itself and knowledge. Given that the Pacific region is at the coalface of climate change’s existential effects, the just allocation of resources is imperative. In interrogating the ways in which emergent data projects may deny these resources based on hidden racial schemas, the paper cautions against new and old forms of colonization that may be mobilized through even well-meaning techno-benevolent fixes ( Benjamin, 2019 ).
Sensationalist social media usage by doctors and dentists during Covid-19
Authors: Law Richard WM , Kanagasingam Shalini , Choong Kartina A
Published: June 2021

Introduction

Many doctors and dentists took to social media to raise alarm and/or express professional opinion, dissatisfaction, anger and/or incredulity associated with the Covid-19 pandemic. Although most of these social media posts involved practitioners from abroad, this article explores whether they would attract fitness to practise investigations had they been posted by UK-based medical and dental practitioners. In particular, it asks whether such conduct comes into conflict with the existing professional standards issued by the General Medical Council (GMC) and the General Dental Council (GDC). It questions also whether those guidelines should be updated and/or further clarified in view of the extraordinary circumstances posed by the pandemic.

Method

An exploratory study was conducted using sensationalist pandemic-related social media posts by doctors and dentists discovered during the first half of 2020 (n = 11). The contents were analysed qualitatively using documentary analysis using coding terms based on the professional standards on social media published by both the GMC and the GDC. The codes generated common and recurring themes that were used to structure discussion.

Findings

This study provides a partial insight as to the likely motivations of doctors and dentists to use social media in a manner that may not necessarily lend well to the professional standards expected. In a majority of instances, doctors and dentists who posted social media material with a sensationalist outlook tended to focus on single-issue campaigns pertaining to specific aspects of the Covid-19 pandemic. These issues included controversial commentary on acute shortages of personal protective equipment and attendant occupational risks to clinical staff to Covid-19 infection; criticisms directed towards regulatory bodies in the handling of the pandemic; and professional advice to the general public which was later found to be inaccurate.

Conclusions

Social media offer opportunities for healthcare professionals to play a constructive role in raising awareness, disseminating information, and promoting solidarity in the management of the Covid-19 pandemic. However, doctors and dentists must carefully consider the ethical and professional pitfalls involved in sensationalist social media posts. The GMC and the GDC should, at the same time, regularly update and clarify their social media guidance in response to major global events like a pandemic as well as advances in social media technology.
Adopting standard variable labels solves many of the problems with sharing and reusing data
Authors: Buttliere Brett
Published: June 2021

Datasets and analysis scripts are becoming more available online, but most datasets are still unclear and difficult to use due to poor meta-data. Adopting standard variable label solves most of these problems and is easily implemented if we set the labels at the time of publication, that is, for authors to also establish standard variable labels when they establish for example, question wording. This simple step involves little effort but facilitates the sharing of datasets and analysis scripts enormously. Current initiatives to improve meta-data rely on users spending much time creating new meta-data for each variable, which is time consuming, unenjoyable, and hinders adoption. Some suggestions are made on how brief, unique, and clear variable labels can be developed, especially using the last two digits of the year the scale was published in. Standards for dataset and analysis script etiquette are the future, and the final section of the manuscript examines other easy places simple standards can save time and frustration for (re)users.
Edutocracy: A Model of the New West Indian Plantocracy in Barbados
Authors: Denny Stacy L.
Published: June 2021

This work draws on a combination of three theories, dependency (economics theory), the inner plantation as a socio-psychological construct, and plantation pedagogy (education theory) to develop its own educational theory called edutocracy, as a partial explanation of the failure of the West Indian education system in Barbados. It employs document analysis as its primary method of data collection and analysis and culminates in the construction of a model of edutocracy. Edutocracy reveals how the current West Indian debate surrounding educational reform of the Secondary School Entrance Exam in Barbados and neighboring islands will, like most previous reforms, net little meaningful change if legislators and educators continue to negate the impact of the socio-historical context on education in this region, specifically the deleterious colonial ideologies which continue to shape education for the Afro-West Indian/Barbadian with the interests of the Euro-American metropole as paramount.
Masculinities, Media and the Rugby Mind: An Analysis of Stakeholder Views on the Relationship Between Rugby Union, the Media, Masculine-Influenced Views on Injury, and Concussion
Authors: Parry Keith , White Adam J. , Cleland Jamie , Hardwicke Jack , Batten John , Piggin Joe , Howarth Nathan
Published: June 2021

Rugby union, alongside other collision and contact sports, faces ever mounting pressure from increased recognition of concussive injuries and the risks they present to athletes, both in the short-term and long-term. Here, the media is a central component of increasing pressure for cultural change. This research analysed data from 524 self-selected survey respondents to examine rugby union fans’ and stakeholders’ perceptions of media portrayal of concussion and how it might influence their own perceptions. We found evidence of a complex and heterogenous relationship between perceptions of masculinity, views and attitudes toward mass media, and degree of involvement in rugby union. Specifically, partisans of the sport generally saw mass media as hostile, with coverage biased against rugby, allowing them to manufacture doubt regarding risk information, as well as maintaining involvement in the sport. We conclude that critical commentaries from the media have the ability to challenge masculinities around concussion.
A Natural Language Processing Approach to Measuring Treatment Adherence and Consistency Using Semantic Similarity
Authors: Anglin Kylie L. , Wong Vivian C. , Boguslav Arielle
Published: June 2021

Though there is widespread recognition of the importance of implementation research, evaluators often face intense logistical, budgetary, and methodological challenges in their efforts to assess intervention implementation in the field. This article proposes a set of natural language processing techniques called semantic similarity as an innovative and scalable method of measuring implementation constructs. Semantic similarity methods are an automated approach to quantifying the similarity between texts. By applying semantic similarity to transcripts of intervention sessions, researchers can use the method to determine whether an intervention was delivered with adherence to a structured protocol, and the extent to which an intervention was replicated with consistency across sessions, sites, and studies. This article provides an overview of semantic similarity methods, describes their application within the context of educational evaluations, and provides a proof of concept using an experimental study of the impact of a standardized teacher coaching intervention.
Patients’ Experience of Attending a Binge Eating Group Program – Qualitative Evaluation of a Pilot Study
Authors: Rørtveit Kristine , Furnes, PhD Bodil , Dysvik, PhD Elin , Ueland, PhD Venke
Published: June 2021

Introduction

We developed a group program for patients with binge eating disorders (BED), comprising cognitive therapy, affect consciousness, and therapeutic writing. We wished to investigate how therapeutic writing and affect consciousness were experienced by the patients when integrated in a cognitive behavioral therapy (CBT) program. To our knowledge, such an intervention has not been tried in patients with BED. Aim: To explore patients’ experience of attending a binge eating group program comprising therapeutic writing, affect consciousness, and CBT. Research question: How do patients evaluate their experience of attending an integrative binge eating group program? Method: A qualitative design using an evaluative focus group interview with participants (four women and two men) who had completed the pilot program. Results: Three themes emerged: Enhanced self-awareness about the meaning of feelings; A more generous attitude towards oneself; and On the path to a better grip on the eating difficulties. Discussion: We interpreted the three themes in light of transition processes. The program was described as an essential part of the healing process and seems valuable for enabling new approaches leading to therapeutic changes when suffering from BED.
The Persistence of Caste: Part I—The Impossible Simultaneity of Religion and Social Revolution in Ambedkar’s Last Essay: Buddha or Karl Marx
Authors: Sampath Rajesh
Published: June 2021

This study will explore the problem of the persistence of caste in South Asia, particularly in India but not excluding the global diaspora of peoples of South Asian descent. Within Ambedkar’s massive, far-reaching corpus of writings we will explore his last great work Buddha or Karl Marx, written shortly before his death in 1956 but published posthumously. By examining this inexplicable constancy of caste, we will argue why it is a moral imperative to continue the legacy of Ambedkar by offering new philosophical reasons for its ultimate destruction.
Mycophenolate in scleroderma-associated interstitial lung disease: Real-world data from rheumatology and pulmonology clinics in South Asia
Authors: Janardana Ramya , Irodi Aparna , Chebbi Pramod P , Goel Ruchika , Vimala Leena R , Padiyar Shivraj , Peediyakal Anoof , Mathew John , Nair Aswin , Christopher Devasahayam J , Danda Debashish
Published: June 2021

Introduction:

There is a paucity of real-world data on mycophenolate mofetil/mycophenolate sodium in systemic sclerosis-related interstitial lung disease.

Aim:

To study the efficacy of mycophenolate mofetil/ mycophenolate sodium in systemic sclerosis-related interstitial lung disease.

Methods:

In this single-centre study, clinical, laboratory and imaging details of consecutive patients with systemic sclerosis-related interstitial lung disease receiving mycophenolate mofetil/mycophenolate sodium from rheumatology and pulmonology clinics between January 2008 and March 2017 were retrospectively retrieved. The change in percentage of predicted normal forced vital capacity at last follow-up visit as compared with baseline was studied. In addition, high-resolution computed tomography scans at baseline and 2-year follow-up visit were scored as either stable/improved or worsened by experienced thoracic radiologists blinded to the clinical details of patients.

Results:

Altogether, 88 patients (85.2% females) with mean age (SD) of 33.8 years (± 11.3) and median (interquartile range) duration of disease since non-Raynaud’s symptoms of 36 months (13.5–60) were studied. Diffuse systemic sclerosis comprised 85.2% of them. The mean baseline forced vital capacity was 61.2 ± 17.9% and median scores for ground glass opacities and fibrosis in high-resolution computed tomography were 0.5 (0–1.3) and 1 (0–1.3), respectively. At a median follow-up duration of 30 months (interquartile range = 16.5–49), the percentage of forced vital capacity improved by 1.8% (–3.82 to 9.07) as compared with baseline visit ( p = 0.02). In the 2-year follow-up, the ground glass opacity and fibrosis scores in high-resolution computed tomography improved in 17.3% and 7.7% of patients and stabilized in 63.5% and 78.8% patients, respectively.

Conclusion:

Mycophenolate mofetil/mycophenolate sodium was efficacious in improving /stabilizing forced vital capacity irrespective of the baseline high-resolution computed tomography lung scores in our patients with systemic sclerosis-related interstitial lung disease during the ⩾ 2-year follow-up period.
Integrating conformance and performance for the evaluation of urban planning implementation from a goal-oriented perspective
Authors: Li Jianwei , Li Guo'ao , Li Jingang , Liu Aoran
Published: June 2021

Urban planning implementation evaluation (UPIE) is an important tool for the supervision and inspection of the outcomes, processes and effectiveness of planning implementation. Conformance-based evaluation refers to the exploration of the degree of coincidence between actual situations and planning contents. Decision-centred performance evaluation focuses on exploring the role and purpose of plans in the implementation process. Although consensus has been reached on conformance and decision-centred performance evaluation, goal-oriented performance evaluation needs further development. Therefore, the integrated theoretical framework of UPIE, which emphasizes social effectiveness, has been constructed with goal-oriented performance in mind. It is suggested that performance-based evaluation that focuses on social effectiveness reveals the gap between actual situations and planning goals and can be established by the degree of realization of planning goals. Meanwhile, it has put forward a service-capabilities-based evaluation methodology which relies on the spatial matching between service supply and user group demands. Taking the Urban Master Plan of Xi’an (2008–2020) as an example, the results of UPIE show that this blueprint needs further revisions and adjustments. Through a goal-oriented methodology, the integrated theoretical framework can attract more attention to social effectiveness.
Examine the association between key determinants identified by the chronic disease indicator framework and multimorbidity by rural and urban settings
Authors: Moin John S. , Glazier Richard H. , Kuluski Kerry , Kiss Alex , Upshur Ross E.G.
Published: June 2021

Background:

Multimorbidity, often defined as having two or more chronic conditions is a global phenomenon. This study examined the association between key determinants identified by the chronic disease indicator framework and multimorbidity by rural and urban settings. The prevalence of individual diseases was also investigated by age and sex.

Methods:

The Canada Community Health Survey and linked health administrative databases were used to examine the association between multimorbidity, sociodemographic, behavioral, and other risk factors in the province of Ontario. A multivariable logistic regression model was used to conduct the main analysis.

Results:

Analyses were stratified by age (20–64 and 65–95) and area of residence (rural and urban). A total sample of n = 174,938 residents between the ages of 20–95 were examined in the Ontario province, of which 18.2% (n = 31,896) were multimorbid with 2 chronic conditions, and 23.4% (n = 40,883) with 3+ chronic conditions. Females had a higher prevalence of 2 conditions (17.9% versus 14.6%) and 3+ conditions (19.7% vs. 15.6%) relative to males. Out of all examined variables, poor self-perception of health, age, Body Mass Index, and income were most significantly associated with multimorbidity. Smoking was a significant risk factor in urban settings but not rural, while drinking was significant in rural and not urban settings. Income inequality was associated with multimorbidity with greater magnitude in rural areas. Prevalence of multimorbidity and having three or more chronic conditions were highest among low-income populations.

Conclusion:

Interventions targeting population weight, age/sex specific disease burdens, and additional focus on stable income are encouraged.
Effect of phosphate treatment on interfacial properties of poplar fiber/high-density polyethylene composites
Authors: Caiping Liang
Published: June 2021

Poplar fiber was treated with phosphate solution as a modifier and then wood fiber/high-density polyethylene (HDPE) degradable composite was prepared by melt blending with HDPE. The effects of phosphate solution concentration on tensile strength and flexural strength of composites were investigated. The surface morphology of phosphate-treated poplar fibers was observed by scanning electron microscopy. The results show that the phosphate treatment increases the surface roughness of the poplar fiber, increases the strength of the single fiber, and effectively improves the mechanical adhesion to the HDPE matrix. However, when the phosphate concentration is too large, the density of the cellulose molecular chains is lowered, and the mechanical properties of the whole fiber are lowered. When the concentration of phosphate solution is 3%, the treatment time is 4 h, and the treatment temperature is 60°C, the tensile properties, bending properties, and water resistance of poplar fiber/HDPE composites are the best.
All-metal terahertz metamaterial biosensor for protein detection
Authors: Wang Gangqi , Zhu Fengjie , Lang Tingting , Liu Jianjun , Hong Zhi , Qin Jianyuan
Published: June 2021

In this paper, a terahertz (THz) biosensor based on all-metal metamaterial is theoretically investigated and experimentally verified. This THz metamaterial biosensor uses stainless steel materials that are manufactured via laser-drilling technology. The simulation results show that the maximum refractive index sensitivity and the figure of merit of this metamaterial sensor are 294.95 GHz/RIU and 4.03, respectively. Then, bovine serum albumin was chosen as the detection substance to assess this biosensor’s effectiveness. The experiment results show that the detection sensitivity is 72.81 GHz/(ng/mm2) and the limit of detection is 0.035 mg/mL. This THz metamaterial biosensor is simple, cost-effective, easy to fabricate, and has great potential in various biosensing applications.
Laparoscopic Resection of Renal Capsular Endometriosis in a Woman with Menstrual-Related Flank Pain: Case Report
Authors: Basiri Abbas , Ghanaat Iman , Gilani Hamidreza Akbari
Published: June 2021

Background

Although involvement of the urinary system is not uncommon, endometriosis in the kidneys is rare. To date, laparoscopic partial nephrectomy has been the preferred approach for managing renal endometriosis. Here, we report for the first time the results of laparoscopic removal of a renal capsular endometriosis in a malrotated kidney in an attempt to save the whole kidney parenchyma, in terms of feasibility and safety.

Case presentation

A 37-year-old female presented with periodic right flank pain associated with her menstrual cycle. On imaging, a malrotated right kidney and a hypodense irregular-shaped lesion measuring 30 * 20 * 15 mm were seen in the superior portion of the right perinephric space. Histologic evaluation of the ultrasound-guided biopsy was consistent with renal capsular endometriosis. The patient underwent laparoscopic surgery to remove the capsular mass while preserving the normal renal parenchyma. Pathological examination of the biopsy obtained during surgery was in favor of renal endometriosis. At 6-month follow-up, the patient’s pain had completely disappeared and no complications had occurred. In addition, imaging did not show any remarkable recurrence.

Conclusion

Renal endometriosis should be strongly considered as a differential diagnosis in female patients with a renal capsular mass and exacerbation of flank pain during menstruation. Based on our experience, with preoperative needle biopsy and clearing the pathology, laparoscopic removal of the mass in spite of renal anatomic abnormality is feasible and safe and thus could be considered as a possible treatment option.
Isolated renal mucormycosis presenting with bilateral renal artery thrombosis: a case report
Authors: Saneesh P. S. , Yelamanchi Raghav , Pilllai Shalini
Published: June 2021

Background

Mucormycosis is a rare infection caused by the fungus belonging to the order Mucorales. Mucormycosis predominantly affects immunocompromised individuals such as people with acquired immunodeficiency syndrome, blood malignancies, organ transplant, etc. Involvement of the kidneys usually occurs as a result of disseminated mucormycosis. We report a very rare case of isolated renal mucormycosis in an immunocompetant individual without any prior comorbidities who had an unusual presentation of mucormycosis.

Case presentation

A 17-year-old male student had presented to our emergency department with complaints of bilateral loin pain and fever for 10 days. There was no urine output for 2 days. Patient was in sepsis with acute kidney injury. A Doppler ultrasound of the abdomen revealed bilateral enlarged kidneys with absent blood flow in the renal vasculature. Dialysis was done, and patient was started on intravenous antibiotics. Patient was investigated for thrombophilia, the test results of which were normal. Sickle cell test was negative. Immunodeficiency screening was negative. Contrast-enhanced computed tomography revealed bilateral enlarged kidneys with bilateral renal artery thrombosis and mild ascitis. CT-guided renal biopsy was performed in the same sitting which revealed fungal hyphae in the background of necrotic glomeruli. Patient was started on liposomal amphotericin B with renal replacement therapy. However, patient deteriorated and succumbed to sepsis on the 4th day of admission.

Conclusion

Isolated renal mucormycosis with bilateral renal artery thrombosis is a very rare clinical scenario with high mortality. One must have a high degree of suspicion to diagnose renal mucormycosis at an early stage.
The olfactory bulb modulates entorhinal cortex oscillations during spatial working memory
Authors: Salimi Morteza , Tabasi Farhad , Nazari Milad , Ghazvineh Sepideh , Salimi Alireza , Jamaati Hamidreza , Raoufy Mohammad Reza
Published: June 2021

Cognitive functions such as working memory require integrated activity among different brain regions. Notably, entorhinal cortex (EC) activity is associated with the successful working memory task. Olfactory bulb (OB) oscillations are known as rhythms that modulate rhythmic activity in widespread brain regions during cognitive tasks. Since the OB is structurally connected to the EC, we hypothesized that OB could modulate EC activity during working memory performance. Herein, we explored OB–EC functional connectivity during spatial working memory performance by simultaneous recording local field potentials when rats performed a Y-maze task. Our results showed that the coherence of delta, theta, and gamma-band oscillations between OB and EC was increased during correct trials compared to wrong trials. Cross-frequency coupling analyses revealed that the modulatory effect of OBs low-frequency phase on EC gamma power and phase was enhanced when animals correctly performed working memory task. The influx of information from OB to EC was also increased at delta and gamma bands within correct trials. These findings indicated that the modulatory influence of OB rhythms on EC oscillations might be necessary for successful working memory performance.
Integration of a single-step genome-wide association study with a multi-tissue transcriptome analysis provides novel insights into the genetic basis of wool and weight traits in sheep
Authors: Zhao Bingru , Luo Hanpeng , Huang Xixia , Wei Chen , Di Jiang , Tian Yuezhen , Fu Xuefeng , Li Bingjie , Liu George E. , Fang Lingzhao , Zhang Shengli , Tian Kechuan
Published: June 2021

Background

Genetic improvement of wool and growth traits is a major goal in the sheep industry, but their underlying genetic architecture remains elusive. To improve our understanding of these mechanisms, we conducted a weighted single-step genome-wide association study (WssGWAS) and then integrated the results with large-scale transcriptome data for five wool traits and one growth trait in Merino sheep: mean fibre diameter (MFD), coefficient of variation of the fibre diameter (CVFD), crimp number (CN), mean staple length (MSL), greasy fleece weight (GFW), and live weight (LW).

Results

Our dataset comprised 7135 individuals with phenotype data, among which 1217 had high-density (HD) genotype data (n = 372,534). The genotypes of 707 of these animals were imputed from the Illumina Ovine single nucleotide polymorphism (SNP) 54 BeadChip to the HD Array. The heritability of these traits ranged from 0.05 (CVFD) to 0.36 (MFD), and between-trait genetic correlations ranged from − 0.44 (CN vs. LW) to 0.77 (GFW vs. LW). By integrating the GWAS signals with RNA-seq data from 500 samples (representing 87 tissue types from 16 animals), we detected tissues that were relevant to each of the six traits, e.g. liver, muscle and the gastrointestinal (GI) tract were the most relevant tissues for LW, and leukocytes and macrophages were the most relevant cells for CN. For the six traits, 54 quantitative trait loci (QTL) were identified covering 81 candidate genes on 21 ovine autosomes. Multiple candidate genes showed strong tissue-specific expression, e.g. BNC1 (associated with MFD) and CHRNB1 (LW) were specifically expressed in skin and muscle, respectively. By conducting phenome-wide association studies (PheWAS) in humans, we found that orthologues of several of these candidate genes were significantly (FDR < 0.05) associated with similar traits in humans, e.g. BNC1 was significantly associated with MFD in sheep and with hair colour in humans, and CHRNB1 was significantly associated with LW in sheep and with body mass index in humans.

Conclusions

Our findings provide novel insights into the biological and genetic mechanisms underlying wool and growth traits, and thus will contribute to the genetic improvement and gene mapping of complex traits in sheep.
Embryonic thermal manipulation impacts the postnatal transcriptome response of heat-challenged Japanese quails
Authors: Vitorino Carvalho Anaïs , Hennequet-Antier Christelle , Brionne Aurélien , Crochet Sabine , Jimenez Justine , Couroussé Nathalie , Collin Anne , Coustham Vincent
Published: June 2021

Background

The thermal-manipulation (TM) during egg incubation is a cyclic exposure to hot or cold temperatures during embryogenesis that is associated to long-lasting effects on growth performance, physiology, metabolism and temperature tolerance in birds. An increase of the incubation temperature of Japanese quail eggs affected the embryonic and post-hatch survival, growth, surface temperatures and blood characteristics potentially related to thermoregulation capacities. To gain new insights in the molecular basis of TM in quails, we investigated by RNA-seq the hypothalamus transcriptome of 35 days-old male and female quails that were treated by TM or not (C, control) during embryogenesis and that were exposed (HC) or not (RT) to a 36 °C heat challenge for 7 h before sampling.

Results

For males, 76, 27, 47 and 0 genes were differentially expressed in the CHC vs. CRT, CRT vs. TMRT, TMHC vs. TMRT and CHC vs. TMHC comparisons, respectively. For females, 17, 0, 342 and 1 genes were differentially expressed within the same respective comparisons. Inter-individual variability of gene expression response was observed particularly when comparing RT and HC female animals. The differential expression of several genes was corroborated by RT-qPCR analysis. Gene Ontology functional analysis of the differentially expressed genes showed a prevalent enrichment of terms related to cellular responses to stimuli and gene expression regulation in both sexes. Gene Ontology terms related to the membrane transport, the endoplasmic reticulum and mitochondrial functions as well as DNA metabolism and repair were also identified in specific comparisons and sexes.

Conclusions

TM had little to no effect on the regulation of gene expression in the hypothalamus of 35 days-old Japanese quails. However, the consequences of TM on gene expression were revealed by the HC, with sex-specific and common functions altered. The effects of the HC on gene expression were most prominent in TM females with a ~ 20-fold increase of the number of differentially expressed genes, suggesting that TM may enhance the gene response during challenging conditions in female quail hypothalamus. TM may also promote new cellular strategies in females to help coping to the adverse conditions as illustrated by the identification of differentially expressed genes related to the mitochondrial and heat-response functions.