bluuebunny/crossref_metadata_2025 huggingface dataset:
Automated Reporting of Patient Outcomes in Hand Surgery: A Pilot Study
Authors: Franko Orrin I. , London Daniel A. , Kiefhaber Thomas R. , Stern Peter J.
Published: September 2021

Background

Obtaining patient-reported outcomes (PROs) is becoming a standard component of patient care. For nonacademic practices, this can be challenging. From this perspective, we designed a nearly autonomous patient outcomes reporting system. We then conducted a prospective, cohort pilot study to assess the efficacy of the system.

Methods

We created an automated system to gather PROs. All operative patients for 4 surgeons in an upper-extremity private practice were asked to participate. These patients completed the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaires preoperatively and received follow-up e-mails requesting patients to complete additional QuickDASH questionnaires at 3, 6, and 12 weeks postoperatively and to complete a 13-week postoperative satisfaction survey. Response rates and satisfaction levels are reported with descriptive statistics.

Results

Sixty-two percent of participants completed the 3-week assessment, 55% completed the 6-week assessment, and 43% completed the 12-week assessment. Overall, 35% of patients completed all questionnaires, and 73% completed at least 1 postoperative assessment. The collection of follow-up questionnaires required no additional time from the clinical staff, surgeon, or a research associate.

Conclusions

Automated e-mail assessments can collect reliable clinical data, with minimal surgeon or staff intervention required to administer and collect data, minimizing the financial cost. For nonacademic practices, without access to additional research resources, such a system is feasible. Further improvements in communication with patients could increase response rates.
Temperature dependency of the long-term thermal conductivity of spray polyurethane foam
Authors: Holcroft Neal
Published: September 2021

The thermal properties of closed-cell foam insulation display a more complex behaviour than other construction materials due to the properties of the blowing agent captured in their cellular structure. Over time, blowing agent diffuses out from and air into the cellular structure resulting in an increase in thermal conductivity, a process that is temperature dependent. Some blowing agents also condense at temperatures within the in-service range of the insulation, resulting in non-linear temperature dependent relationships. Moreover, diffusion of moisture into the cellular structure increases thermal conductivity.

Standards exist to quantify the effect of gas diffusion on thermal conductivity, however only at standard laboratory conditions. In this paper a new test procedure is described that includes calculation methods to determine Temperature Dependent Long-Term Thermal Conductivity (LTTC(T)) functions for closed-cell foam insulation using as a test material, a Medium-Density Spray Polyurethane Foam (MDSPF). Tests results are provided to show the validity of the method and to investigate the effects of both conditioning and mean test temperature on change in thermal conductivity. In addition, testing was conducted to produce a moisture dependent thermal conductivity function. The resulting functions were used in hygrothermal simulations to assess the effect of foam aging, in-service temperature and moisture content on the performance of a typical wall assembly incorporating MDSPF located in four Canadian climate zones. Results show that after 1 year, mean thermal conductivity increased 15%–16% and after 5 years 23%–24%, depending on climate zone. Furthermore, the use of the LTTC(T) function to calculate the wall assembly U-value improved accuracy between 3% and 5%.
Comparison of single-shot nebuliser protocol between dexmedetomidine and ketamine in children undergoing magnetic resonance imaging
Authors: Geetha K , Padhy Shibani , Karishma K
Published: September 2021

Background

Sedation for magnetic resonance imaging mandates deep sedation to ensure patient immobility. The nebulised route of drug delivery carries the advantage of good bioavailability and safety profile. We aimed to compare the efficacy and safety of nebulised dexmedetomidine and ketamine for sedation in children undergoing magnetic resonance imaging.

Methods

A total of 71 children, aged two to eight years scheduled for outpatient magnetic resonance imaging were randomly allocated to receive nebulised dexmedetomidine 2 μg/kg (group D) or nebulised ketamine 2 mg/kg (group K) 30min before magnetic resonance imaging.

Results

Nebulised dexmedetomidine (2 μg/kg) resulted in faster onset and significantly better sedation scores with rapid clear-headed recovery. Ketamine resulted in better venepuncture scores but was associated with more neuropsychological events at recovery.

Conclusion

Nebulised dexmedetomidine at 2 μg/kg provides rapid onset of satisfactory sedation, with good parental separation and a quicker and more clear-headed recovery, allowing for a smooth magnetic resonance imaging experience.
Functionalization and informalization in the design of an online fashion shop
Authors: van Leeuwen Theo , Boeriis Morten , Rytter Dakwar Julia
Published: September 2021

This paper presents a multimodal analysis of the design of an online fashion shop. Departing from systemic-functional genre theory, it analyses the functionality of the site, bringing out how it designs what sellers do to and for consumers and what the site does and does not enable consumers to do. Drawing on Joos’ analysis of (in)formality in language and Hall’s proxemics, the paper then analyses how the site conceals the power of its functional design by simulating informality and solidarity in a way that ultimately remains one-way and cannot be reciprocated. It finally argues that designs of consumer behaviour similar to that of the analysed site increasingly stand as a model for the digitization of other domains of practice, including education and research, so extending what Fairclough called the ‘marketization of discourse’ into these other domains.
The Chondrogenic Potential of First-Trimester and Term Placental Mesenchymal Stem/Stromal Cells
Authors: James Joanna L. , Umapathy Anandita , Srinivasan Sonia , Barker Claire N. , Brooks Anna , Hearn James , Chhana Ashika , Williams Eloise , Sheppard Hilary , McGlashan Sue R.
Published: September 2021

Objectives

Mesenchymal stem/stromal cells (MSCs) are a well-established cell source for cartilage engineering, but challenges remain as differentiation often results in chondrocyte hypertrophy. Chondrogenic potential also varies with MSC source and donor age. We assessed the chondrogenic potential of first-trimester and term placental MSCs and compared their response to commonly used bone marrow MSCs (BM-MSCs).

Design

MSCs were isolated from first-trimester and term placentae. BM-MSCs were commercially obtained. Chondrogenesis was induced by micromass culture in commercial chondrogenic media for 7, 14, or 21 days. Pellets were assessed for glycosaminoglycan (GAG) content, and types I, II, and X collagen. Gene expression was profiled using Qiagen RT2 human MSC arrays.

Results

At day 0, first-trimester and term MSCs expression levels of many chondrogenic genes to BM-MSC after 21 days of culture. Only first trimester MSCs showed significant changes in chondrogenic gene expression during induction compared to day 0 undifferentiated MSCs (greater BMP4, KAT2B, and reduced GDF6 expression). Additionally, first-trimester MSCs showed significantly greater expression of ABCB1 (at days 14 and 21) and BMP4 (at days 7, 14, 21) compared with term MSCs. Both first-trimester and term pellets showed increased GAG content over time and term MSCs had significantly GAG greater compared with BM-MSCs at days 7 and 14. Type II collagen was present in all pellets but unlike BM-MSCs, type I collagen was not observed in first-trimester or term MSC pellets.

Conclusions

These data highlight differences in BM-MSC and placental MSC chondrogenesis and demonstrate that placental MSCs may be an alternative cell source.
Metallic: A Bivalent Ambimodal Material Property?
Authors: Spence Charles , Carvalho Fabiana M. , Howes David
Published: September 2021

Many metallic visual stimuli, especially the so-called precious metals, have long had a rich symbolic meaning for humans. Intriguingly, however, while metallic is used to describe sensations associated with pretty much every sensory modality, the descriptor is normally positively valenced in the case of vision while typically being negatively valenced in the case of those metallic sensations that are elicited by the stimulation of the chemical senses. In fact, outside the visual modality, metallic would often appear to be used to describe those sensations that are unfamiliar and unpleasant as much as to refer to any identifiable perceptual quality (or attribute). In this review, we assess those sensory stimuli that people choose to refer to as metallic, summarising the multiple, often symbolic, meanings of (especially precious) metals. The evidence of positively valenced sensation transference from metallic serviceware (e.g., plates, cups, and cutlery) to the food and drink with which it comes into contact is also reviewed.
Excavating awareness and power in data science: A manifesto for trustworthy pervasive data research
Authors: Shilton Katie , Moss Emanuel , Gilbert Sarah A. , Bietz Matthew J. , Fiesler Casey , Metcalf Jacob , Vitak Jessica , Zimmer Michael
Published: September 2021

Frequent public uproar over forms of data science that rely on information about people demonstrates the challenges of defining and demonstrating trustworthy digital data research practices. This paper reviews problems of trustworthiness in what we term pervasive data research: scholarship that relies on the rich information generated about people through digital interaction. We highlight the entwined problems of participant unawareness of such research and the relationship of pervasive data research to corporate datafication and surveillance. We suggest a way forward by drawing from the history of a different methodological approach in which researchers have struggled with trustworthy practice: ethnography. To grapple with the colonial legacy of their methods, ethnographers have developed analytic lenses and researcher practices that foreground relations of awareness and power. These lenses are inspiring but also challenging for pervasive data research, given the flattening of contexts inherent in digital data collection. We propose ways that pervasive data researchers can incorporate reflection on awareness and power within their research to support the development of trustworthy data science.
Reexamining Asian American Masculinity and the Model Minority Myth Through a School-Based Counseling Group
Authors: Burt Isaac , Pham Andy V. , Hyun June H.
Published: September 2021

Adolescent Asian American males frequently encounter prejudice, discrimination, and emasculation, which result from and are exacerbated by the myth of the “model minority” group. This article provides school counselors with a group intervention, based on a collectivism and resiliency framework, for working with Asian American adolescent males. Recommendations regarding recruitment, screening, selection of participants, and group sessions underscore for school counselors the need to promote the well-being and resilience of Asian American males in school-based interventions.
“We Got to Do Better”: Interactions Between School Counselors and Black Male Student-Athletes
Authors: Harris Paul C. , Seward Miray D. , Mayes Renae D. , Elopre Liana , Wengert Ellie
Published: September 2021

This qualitative study explores the perspectives and experiences of Black male student-athletes with particular focus on their interactions with school counselors. It draws on nine participants selected through purposive and snowball sampling techniques. The Black male participants were current or former student-athletes at the high school and Division I levels. We developed and analyzed the semistructured interview questions through the lens of critical race theory. Using deductive data analysis techniques, we identified key factors that appear to shape interactions between Black male student-athletes and school counselors, including the perception of the school counselor role, a village of support, and prior experiences with school counselors. The results of this study have implications for school counselor practice, policy, and research.
Introduction to the Special Issue: Males of Color and School Counseling
Authors: Moore James L. , Hines Erik M. , Harris Paul C.
Published: September 2021

The sense of urgency for addressing the concerns of males of color cannot be overstated. The reality of racial discrimination and trauma is present for males of color in urban, suburban, and rural settings and regardless of their socioeconomic status. Such oppressive conditions in education, criminal justice, health, and employment, for example, wreak havoc on their overall well-being and advancement in society. Until the systems constraining the progress of males of color are addressed through substantive policy and practice, the social, economic, and educational struggles will persist. This special issue presents 19 theoretical, qualitative, and quantitative articles focusing specifically on the experiences of males of color in educational settings and the importance of school counselors in helping them to thrive.
A Case of S-Variant Hepatitis B Virus: An Immune System Escape Artist
Authors: Shah Amar S. , Civelli Valerie F. , Bali Varun , Johnson Royce H. , Heidari Arash
Published: September 2021

Genomic variants of the hepatitis B virus (HBV) preS/S protein are well-known to occur. Typically, immunity is gained through recovered HBV infection or by immunization. Very rarely, there are certain mutations that may enable HBV escape from the immune detection. PreS/S mutants may present with unpredictable pathobiologic, clinical, and transmittable implications. Standard laboratory testing for genomic HBV variants is not routinely performed by reference guidelines. s-variant HBV management remains challenging. Herein is a case of s-variant chronic HBV infection in a 55-year-old man. Diagnosis and treatment are described.
Athletes With Anterior Shoulder Instability: A Prospective Study on Player Perceptions of Injury and Treatment
Authors: Fink Barnes Leslie A. , Jobin Charles M. , Popkin Charles A. , Ahmad Christopher S.
Published: September 2021

Background:

Many in-season athletes choose to delay or avoid surgery in order to continue playing and avoid downtime such as missed games or seasons.

Purpose:

To learn about the attitudes toward the injury and treatment of in-season shoulder instability in competitive athletes who have suffered a shoulder dislocation.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A study-specific questionnaire about athletes’ perceptions of injury and treatment was administered to injured players. Secondary outcomes included the American Shoulder and Elbow Surgeons (ASES) score and the Western Ontario Shoulder Instability Index (WOSI). Mean scores and standard deviations were calculated, and between-group analyses with t tests were performed to compare the ASES and WOSI scores. The Mann-Whitney U test was used for analyses performed on the following groups: early operative versus nonoperative management; age <18 versus ≥18 years; first-time dislocators versus recurrent dislocators; self-reducing subluxations versus dislocations requiring assistance; and dominant arm affected versus nondominant arm.

Results:

There were 45 patients included in this study (33 male, 12 female) with a mean age of 18 ± 2.8 years. Several sports were represented, with the most common being football, baseball, soccer, and rugby. In this study of in-season athletes with shoulder instability, 13 (28.9%) chose early surgery, 4 (8.9%) chose surgery at season’s end, while 28 (62.2%) chose physical therapy followed by a wait-and-see approach, with 13 (46.4%) of these patients ultimately requiring surgery. Athletes who chose nonoperative treatment were statistically more likely to believe that their shoulder would heal on its own ( P < .001) or with physical therapy ( P < .025); they were also more likely to agree that they would rather stop sports than undergo surgery ( P < .04). Athletes with worse ASES and WOSI scores at injury were more likely to choose surgery ( P < .03 and P < .05, respectively). Athletes with >1 dislocation were less likely to believe that the shoulder would heal without surgery ( P < .025). Most athletes agreed that seasonal timing and recruitment prospects were an important factor in their decision in favor of surgery ( P < .038), and most agreed that their doctor influenced their ultimate treatment decision ( P < .006). Most athletes also agreed that a repeat dislocation would cause further injury to the shoulder.

Conclusion:

Treatment decisions were most strongly related to the athletes’ perceptions of injury severity and the influence of the treating surgeon.
Business Incubation Centres in Universities and Their Role in Developing Entrepreneurial Ecosystem
Authors: Vardhan Julie , Mahato Madhuri
Published: September 2021

Given the potential of start-ups in wealth creation in an economy, universities can play a leading role in the entrepreneurial ecosystem. Our article focuses on the need to provide a strong impetus for establishing business incubation centres at universities for progressive creation of innovation start-ups. The study reviews the current status of business incubators affiliated with universities in India. It also explores the variables such as location, affiliation and ease of doing business which help facilitate innovation and entrepreneurship. An ontological perspective of objectivism whereby universities are seen to play a role in not just generation of knowledge but also in the development of an ecosystem where the knowledge is transferred to initiate new ventures is considered for the study. Based on the entire population of universities in India; 937 universities were considered for the study through the websites, and an analysis of the coherent and incoherent activities of these incubation centres was performed to check for the presence of entrepreneurship-related activities. Also, the ease of doing business rankings were mapped to assess whether they played a role in stimulating the setup of incubators.
Singer and the Pareto distribution: A note
Authors: Parr John B
Published: September 2021

Singer was the first to draw attention to the fact that the Pareto Law (originally employed to describe income inequality) could also be applied to the size distribution of urban centres. His argument was illustrated with evidence from seven nations at various points in time. As part of his study, Singer attempted to demonstrate two propositions relating to the Pareto distribution of centre size. One was that the populations of larger centres could be described by the Pareto distribution, while the other was that the populations of the smaller (non-urban) centres would also conform to this distribution. It is argued that neither proposition can be regarded as valid.
Bradyarrhythmic Cardiac Arrest—A Rare Manifestation of Fexofenadine Cardiotoxicity
Authors: Ghose Tapan , Kachru Ranjan , Dey Jaideep
Published: September 2021

A 66-year-old diabetic, hypertensive, and hypothyroid female presented in the emergency department with cardiac arrest, for which cardiopulmonary resuscitation was immediately initiated. She had been on oral fexofenadine for 36 h prior to the event. Post successful resuscitation, her cardiac rhythm showed high-grade atrioventricular block. Patient was treated with mechanical ventilatory support and temporary transvenous pacing. No treatable cause could be identified, and she recovered completely following fexofenadine discontinuation, without need for a permanent pacemaker. She has remained asymptomatic during 1 year of follow-up with no documented arrhythmias. An electrophysiological study at 6 months revealed prolonged HV interval (70 ms) with 1:1 AV conduction and no inducible arrhythmias. This is probably the first reported case of fexofenadine-induced cardiac arrest in a patient without previous history of heart disease.
Outcomes of acute lymphoblastic leukemia with KMT2A (MLL) rearrangement: the MD Anderson experience
Authors: Richard-Carpentier Guillaume , Kantarjian Hagop M. , Tang Guilin , Yin C. Cameron , Khoury Joseph D. , Issa Ghayas C. , Haddad Fadi , Jain Nitin , Ravandi Farhad , Short Nicholas J. , DiNardo Courtney D. , Takahashi Koichi , Konopleva Marina Y. , Daver Naval G. , Kadia Tapan , Garcia-Manero Guillermo , Garris Rebecca , O’Brien Susan , Jabbour Elias
Published: September 2021

Acute lymphoblastic leukemia (ALL) with t(4;11)(q21;q23)-KMT2A-AFF1 is associated with a poor prognosis. The impact of KMT2A rearrangements other than t(4;11) is uncertain, and the benefit of allogeneic stem cell transplantation (HSCT) is unclear. We reviewed adult patients with ALL treated at our institution from 1984 to 2019 and identified 50 out of 1102 (5%) with KMT2A rearrangement, including 42 (84%) with t(4;11)/KMT2A-AFF1 and 8 (16%) with other gene partners. The median age was 45 years (range, 18-78 years); median white blood cell count was 109.0 3 109/L (range, 0.5-1573.0). The complete remission (CR) rate was 88%, and the rate of measurable residual disease negativity by flow cytometry at CR was 41% (76% overall during follow-up). At the last follow-up, 14 patients were alive. The 5-year overall survival (OS) rate was 18% (95% confidence interval [CI], 9% to 35%), with no difference between t(4;11) and other KMT2A rearrangements (P 5 .87). In a 4-month landmark analysis, the 5-year OS rate was 32% (95% CI, 14% to 70%) in patients who underwent HSCT vs 11% (95% CI, 3-39) in others (P 5 .10). Our study confirms the poor prognosis of ALL with any KMT2A rearrangement and the role of HSCT in these patients.
Juvenile myelomonocytic leukemia in the molecular era: a clinician’s guide to diagnosis, risk stratification, and treatment
Authors: Wintering Astrid , Dvorak Christopher C. , Stieglitz Elliot , Loh Mignon L.
Published: September 2021

Juvenile myelomonocytic leukemia is an overlapping myeloproliferative and myelodysplastic disorder of early childhood . It is associated with a spectrum of diverse outcomes ranging from spontaneous resolution in rare patients to transformation to acute myeloid leukemia in others that is generally fatal. This unpredictable clinical course, along with initially descriptive diagnostic criteria, led to decades of productive international research. Next-generation sequencing now permits more accurate molecular diagnoses in nearly all patients. However, curative treatment is still reliant on allogeneic hematopoietic cell transplantation for most patients, and additional advances will be required to improve risk stratification algorithms that distinguish those that can be observed expectantly from others who require swift hematopoietic cell transplantation.
The cystic fibrosis lung microenvironment alters antibiotic activity: causes and effects
Authors: Van den Bossche Sara , De Broe Emma , Coenye Tom , Van Braeckel Eva , Crabbé Aurélie
Published: September 2021

Chronic airway colonisation byPseudomonas aeruginosa, a hallmark of cystic fibrosis (CF) lung disease, is associated with increased morbidity and mortality and despite aggressive antibiotic treatment,P. aeruginosais able to persist in CF airways.In vitroantibiotic susceptibility assays are poor predictors of antibiotic efficacy to treat respiratory tract infections in the CF patient population and the selection of the antibiotic(s) is often made on an empirical base. In the current review, we discuss the factors that are responsible for the discrepancies between antibiotic activityin vitroand clinical efficacyin vivo. We describe how the CF lung microenvironment, shaped by host factors (such as iron, mucus, immune mediators and oxygen availability) and the microbiota, influences antibiotic activity and varies widely between patients. A better understanding of the CF microenvironment and population diversity may thus help improvein vitroantibiotic susceptibility testing and clinical decision making, in turn increasing the success rate of antibiotic treatment.
Impairment of hypoxic pulmonary vasoconstriction in acute respiratory distress syndrome
Authors: Gierhardt Mareike , Pak Oleg , Walmrath Dieter , Seeger Werner , Grimminger Friedrich , Ghofrani Hossein A. , Weissmann Norbert , Hecker Matthias , Sommer Natascha
Published: September 2021

Acute respiratory distress syndrome (ARDS) is a serious complication of severe systemic or local pulmonary inflammation, such as caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. ARDS is characterised by diffuse alveolar damage that leads to protein-rich pulmonary oedema, local alveolar hypoventilation and atelectasis. Inadequate perfusion of these areas is the main cause of hypoxaemia in ARDS. High perfusion in relation to ventilation (V/Q<1) and shunting (V/Q=0) is not only caused by impaired hypoxic pulmonary vasoconstriction but also redistribution of perfusion from obstructed lung vessels. Rebalancing the pulmonary vascular tone is a therapeutic challenge. Previous clinical trials on inhaled vasodilators (nitric oxide and prostacyclin) to enhance perfusion to high V/Q areas showed beneficial effects on hypoxaemia but not on mortality. However, specific patient populations with pulmonary hypertension may profit from treatment with inhaled vasodilators. Novel treatment targets to decrease perfusion in low V/Q areas include epoxyeicosatrienoic acids and specific leukotriene receptors. Still, lung protective ventilation and prone positioning are the best available standard of care. This review focuses on disturbed perfusion in ARDS and aims to provide basic scientists and clinicians with an overview of the vascular alterations and mechanisms of V/Q mismatch, current therapeutic strategies, and experimental approaches.
Exertional ventilation/carbon dioxide output relationship in COPD: from physiological mechanisms to clinical applications
Authors: Neder J. Alberto , Berton Danilo C. , Phillips Devin B. , O'Donnell Denis E.
Published: September 2021

There is well established evidence that the minute ventilation (V′E)/carbon dioxide output (V′CO2) relationship is relevant to a number of patient-related outcomes in COPD. In most circumstances, an increasedV′E/V′CO2reflects an enlarged physiological dead space (“wasted” ventilation), although alveolar hyperventilation (largely due to increased chemosensitivity) may play an adjunct role, particularly in patients with coexistent cardiovascular disease. TheV′E/V′CO2nadir, in particular, has been found to be an important predictor of dyspnoea and poor exercise tolerance, even in patients with largely preserved forced expiratory volume in 1 s. As the disease progresses, a high nadir might help to unravel the cause of disproportionate breathlessness. When analysed in association with measurements of dynamic inspiratory constraints, a highV′E/V′CO2is valuable to ascertain a role for the “lungs” in limiting dyspnoeic patients. Regardless of disease severity, cardiocirculatory (heart failure and pulmonary hypertension) and respiratory (lung fibrosis) comorbidities can further increaseV′E/V′CO2. A highV′E/V′CO2is a predictor of poor outcome in lung resection surgery, adding value to resting lung hyperinflation in predicting all-cause and respiratory mortality across the spectrum of disease severity. Considering its potential usefulness, theV′E/V′CO2should be valued in the clinical management of patients with COPD.
A higher bacterial inward BCAA transport driven by Faecalibacterium prausnitzii is associated with lower serum levels of BCAA in early adolescents
Authors: Moran-Ramos Sofia , Macias-Kauffer Luis , López-Contreras Blanca E. , Villamil-Ramírez Hugo , Ocampo-Medina Elvira , León-Mimila Paola , del Rio-Navarro Blanca E. , Granados-Portillo Omar , Ibarra-Gonzalez Isabel , Vela-Amieva Marcela , Tovar Armando R. , Torres Nimbe , Gomez-Perez Francisco J. , Aguilar-Salinas Carlos , Canizales-Quinteros Samuel
Published: September 2021

Background

Elevations of circulating branched-chain amino acids (BCAA) are observed in humans with obesity and metabolic comorbidities, such as insulin resistance. Although it has been described that microbial metabolism contributes to the circulating pool of these amino acids, studies are still scarce, particularly in pediatric populations. Thus, we aimed to explore whether in early adolescents, gut microbiome was associated to circulating BCAA and in this way to insulin resistance.

Methods

Shotgun sequencing was performed in DNA from fecal samples of 23 early adolescents (10–12 years old) and amino acid targeted metabolomics analysis was performed by LC–MS/MS in serum samples. By using the HUMAnN2 algorithm we explored microbiome functional profiles to identify whether bacterial metabolism contributed to serum BCAA levels and insulin resistance markers.

Results

We identified that abundance of genes encoding bacterial BCAA inward transporters were negatively correlated with circulating BCAA and HOMA-IR (P < 0.01). Interestingly,Faecalibacterium prausnitziicontributed to approximately ~ 70%of bacterial BCAA transporters gene count.Moreover,Faecalibacterium prausnitziiabundance was also negatively correlated with circulating BCAA (P = 0.001) and with HOMA-IR (P = 0.018), after adjusting for age, sex and body adiposity. Finally, the association betweenFaecalibacteriumgenus and BCAA levels was replicated over an extended data set (N = 124).

Conclusions

We provide evidence that gut bacterial BCAA transport genes, mainly encoded byFaecalibacterium prausnitzii, are associated with lower circulating BCAA and lower insulin resistance. Based on the later, we propose that the relationship betweenFaecalibacterium prausnitziiand insulin resistance, could be through modulation of BCAA.
The gut-microbiota-brain axis in autism: what Drosophila models can offer?
Authors: Salim Safa , Banu Ayesha , Alwa Amira , Gowda Swetha B. M. , Mohammad Farhan
Published: September 2021

The idea that alterations in gut-microbiome-brain axis (GUMBA)-mediated communication play a crucial role in human brain disorders like autism remains a topic of intensive research in various labs. Gastrointestinal issues are a common comorbidity in patients with autism spectrum disorder (ASD). Although gut microbiome and microbial metabolites have been implicated in the etiology of ASD, the underlying molecular mechanism remains largely unknown. In this review, we have summarized recent findings in human and animal models highlighting the role of the gut-brain axis in ASD. We have discussed genetic and neurobehavioral characteristics ofDrosophilaas an animal model to study the role of GUMBA in ASD. The utility ofDrosophilafruit flies as an amenable genetic tool, combined with axenic and gnotobiotic approaches, and availability of transgenic flies may reveal mechanistic insight into gut-microbiota-brain interactions and the impact of its alteration on behaviors relevant to neurological disorders like ASD.
Predicting progress in word learning for children with autism and minimal verbal skills
Authors: Brady Nancy C. , Kosirog Christine , Fleming Kandace , Williams Lindsay
Published: September 2021

Background

Approximately 30% of children diagnosed with autism remain minimally verbal past age 5. Interventions are often effective in increasing spoken communication for some of these children. Clinical and research decisions would be facilitated by identifying early indicators of progress in interventions. The purpose of this study was to investigate the relationship between speech sound measures obtained from the early phases of treatment and later treatment outcomes in children with autism and minimal verbal skills.

Methods

Twenty-three children (18 boys) between 5 and 9 years of age participated. We compared scores reflecting the phonemic features of word attempts produced during probes, and the number of correct words after 4 weeks of intervention to later word learning outcomes.

Results

Correlational and hierarchical regression analyses showed that both predictors were positively correlated with outcomes, but the phonemic scores were more strongly related than number of correct words.

Conclusion

We conclude that phonemic scoring may be a useful measure to determine proximal gains in a spoken word learning intervention. Proximal measures are particularly helpful when trying to decide if the current course of intervention should be maintained or altered.

Trial registration

https://register.clinicaltrials.gov/prs/app/action/LoginUser?ts=2&cx=-jg9qo3.
Utilization of telemedicine to support caregivers of young children with ASD and their Part C service providers: a comparison of intervention outcomes across three models of service delivery
Authors: Corona Laura L. , Stainbrook J. Alacia , Simcoe Kathleen , Wagner Liliana , Fowler Bethena , Weitlauf Amy S. , Juárez A. Pablo , Warren Zachary
Published: September 2021

Background

Families of young children with autism spectrum disorder (ASD) frequently experience barriers to accessing evidence-based early intervention services. Telemedicine presents an opportunity to increase access to these services, particularly for families in rural and under-resourced areas. The present article describes a brief behavioral intervention and support model for families of young children with concerns for ASD. In the context of the COVID-19 pandemic, this service model shifted to telemedicine-only service delivery, resulting in an opportunity to analyze intervention outcomes from services delivered either via traditional in-person visits, telemedicine-only sessions, or a hybrid model including both in-person and telemedicine sessions.

Methods

Data are presented for 115 families with toddlers 16-33 months of age who participated in a six-session behavioral intervention and support service model either in-person, through telemedicine, or through a hybrid service model. This intervention was available for families referred for ASD evaluation through the state Part C early intervention program. Intervention feasibility, fidelity of implementation, child outcomes, and stakeholder satisfaction are compared across service delivery models.

Results

Caregivers, behavioral consultants, and Part C early intervention providers reported satisfaction with services, regardless of service delivery model. Caregivers and consultants also reported positive child outcomes. Statistically significant differences emerged for caregiver- and consultant-reported child outcomes in some domains, with stakeholders in the telemedicine-only group reporting slightly less improvement, compared to stakeholders in the in-person-only group. Caregivers and consultants in the telemedicine-only group also provided qualitative feedback on benefits and challenges related to telemedicine services.

Conclusions

Both caregivers and behavioral consultants reported positive outcomes following a brief behavioral intervention and support model targeted at families of young children with concern for ASD. Stakeholders reported improvement in child behavior and satisfaction with services across in-person, telemedicine-only, and hybrid models of service delivery. These results suggest that telemedicine presents a promising opportunity for increasing service access. Additional research is needed to continue optimizing the experience of telemedicine-based service delivery for both families and intervention providers.
Neural correlates of schema-dependent episodic memory and association with behavioral flexibility in autism spectrum disorders and typical development
Authors: Cook Kevin M. , You Xiaozhen , Cherry Joseph Bradley , Merchant Junaid S. , Skapek Mary , Powers Meredith D. , Pugliese Cara E. , Kenworthy Lauren , Vaidya Chandan J.
Published: September 2021

Background

Conceptual knowledge frameworks termed schemas facilitate memory formation and are posited to support flexible behavior. In adults, the medial temporal lobe (MTL) and medial prefrontal cortex (mPFC) trade-off in supporting schema-based memory formation, such that encoding of subsequently remembered schema-congruent information relies on mPFC, whereas schema-incongruent information relies on MTL. Whether this is true in the immature brain and relates to behavioral flexibility is unknown. In this preliminary investigation, we aimed to replicate the adult findings in typically developing (TD) children and to investigate the relevance to behavioral flexibility by examining a disorder with pathognomonic behavioral rigidity, autism spectrum disorder (ASD).

Methods

Children completed an associative subsequent memory paradigm, encoding object-scene pairs in an MRI scanner and subsequently completing a recognition test outside the scanner after a delay. Recognition performance was back sorted to construct remembered vs forgotten contrasts. One-way ANOVAS were conducted in MTL and mPFC masks for schema-congruency, followed by congruency by flexibility scores. Exploratory analyses were then conducted within the whole brain.

Results

As reported in adults, episodic memory was strongest for schema-congruent object-scene pairs, followed by intermediate pairs, and lowest for schema-incongruent pairs in both TD and ASD groups. However, the trade-off between mPFC and MTL in TD children differed from adult reports such that mPFC supported memory for intermediate schema-congruency and left anterior MTL supported memory for schema-congruent pairs. In ASD, mPFC engagement interacted with flexibility such that activation supporting memory for intermediate schema-congruency varied with parent-reported flexibility and was higher in those with more flexible behavior. A similar interaction was also observed in both the left dorsolateral and rostrolateral PFC in whole-brain analysis.

Conclusion

Our findings provide the first preliminary evidence for the association of schema-based episodic memory formation and behavioral flexibility, an executive function impaired in multiple developmental disorders. Upon replication, this line of research holds promise for memory-based interventions addressing executive problems of behavioral rigidity.
Combined endophthalmitis and orbital cellulitis in patients with corona virus disease (COVID-19)
Authors: Abdelkader Mohamed Farouk Sayed Othman , Elshafei Ahmed Mohamed Kamal , Nassar Mahmoud Mamdouh , Abu Elela Mostafa A. , Abdallah Raafat Mohyeldeen Abdelrahman
Published: September 2021

Purpose

To document the presentation of unilateral combined endophthalmitis and orbital cellulitis in patients with COVID-19 infection and study their prognosis.

Patients and methods

This interventional case series study included 9 patients referred to the Ophthalmology Department, Minia University Hospital with unilateral combined endophthalmitis and orbital cellulitis between April 2020 and March 2021. In addition to the COVID-19 work-up, all patients were subjected to full ophthalmological evaluation and managed according to their ophthalmic and systemic disease.

Results

The patients were 5 females and 4 males. They had clinical, laboratory and imaging findings that confirmed COVID-19 infection. All patients had unilateral endophthalmitis with orbital cellulitis and profound visual loss in the affected eye. Three patients died due to respiratory failure, while 6 patients recovered systemically. The survived patients developed atrophia bulbi in 4 patients and in 2 patients, the globe retained normal size but with complete visual loss.

Conclusion

Combined endophthalmitis and orbital cellulitis can be one of the early presentations of patients with COVID-19 infection with poor visual prognosis.

Trial registration

Clinical registration: clinicaltrials.gov identifier: NCT04456556.
Acute posterior multifocal placoid pigment epitheliopathy (APMPPE)
Authors: Testi Ilaria , Vermeirsch Sandra , Pavesio Carlos
Published: September 2021

Background

Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is a rare inflammatory eye disease, affecting the inner choroid and the outer retina. Recent advances in multimodal imaging have been important in the understanding of the pathophysiology of the disease, allowing a better characterization of the morphology of this condition.

Methods

Narrative review.

Results

In this review, a comprehensive overview of clinical features, imaging findings, treatment management, and long-term outcomes of patients with APMPPE will be provided.

Conclusions

Although APMPPE was originally believed to be a self-limited condition with a good prognosis, the disease can be recurrent and result in significant loss of vision function. Fundus imaging plays an important role in the diagnosis and management of the disease, allowing to evaluate response to treatment and onset of complications.
Male cancer patient sperm cryopreservation for fertility preservation: 10-year monocentric experience
Authors: Liu Xiao , Liu Bo , Liu Shasha , Xian Yang , Zhao Wenrui , Zhou Bin , Xiao Xiao , Wang Li , Zhu Xiaofang , Shu Bizhen , Jiang Min , Li Fuping
Published: September 2021

Background

Sperm cryopreservation, an effective method for preserving male fertility, is very advantageous for men suffering from cancer. Unfortunately, as both physicians and cancer patients are unaware of the possibilities for sperm cryopreservation, the data on evaluation of semen parameters and disposition of cryopreserved samples among Chinese cancer patients are scarce.

Results

Male tumours were classified into six major types, germ cell tumours (26 %), haematological neoplasms (28 %), head and neck cancers (19 %), thoracic tumours (4 %), abdominal tumours (10 %), and others (13 %). Haematological neoplasm was the most prevalent cancer among our cohort of patients who opted for sperm banking, followed by germ cell tumours. Patients with germ cell tumours had the lowest pre-thaw and post-thaw seminal sperm concentrations. We separately compared patients with testicular tumours, lymphoma, and leukaemia, and found that leukaemia patients had the lowest pre-thaw sperm concentrations. Most cancer patients (58 %) chose to keep their specimens stored, while 31 % chose to discard the specimens. Over the years, only 13 patients (4 %) returned to use their spermatozoa by assisted reproductive technology. Of the stored samples, patients with germ cell tumours constituted the highest proportion (29.3 %). Moreover, the percentage of haematological neoplasm patients who had no spermatozoa frozen was the highest (46.2 %).

Conclusions

The present data confirm the deleterious impact of various cancers on semen quality. Leukaemia was associated with the worst semen quality and the highest number of semen samples that could not be frozen. We suggest that sperm quality may have decreased even before anti-neoplastic treatment and that sperm banking before treatment should be strongly recommended for cancer patients. A sperm banking programme before gonadotoxic therapy requires close cooperation between assisted reproduction centres and cancer clinics.
Spinal versus general anesthesia for patients undergoing outpatient total knee arthroplasty: a national propensity matched analysis of early postoperative outcomes
Authors: Kendall Mark C. , Cohen Alexander D. , Principe-Marrero Stephanie , Sidhom Peter , Apruzzese Patricia , De Oliveira Gildasio
Published: September 2021

Background

A comparison of different anesthetic techniques to evaluate short term outcomes has yet to be performed for patients undergoing outpatient knee replacements. The aim of this investigation was to compare short term outcomes of spinal (SA) versus general anesthesia (GA) in patients undergoing outpatient total knee replacements.

Methods

The ACS NSQIP datasets were queried to extract patients who underwent primary, elective, unilateral total knee arthroplasty (TKA) between 2005 and 2018 performed as an outpatient procedure. The primary outcome was a composite score of serious adverse events (SAE). The primary independent variable was the type of anesthesia (e.g., general vs. spinal).

Results

A total of 353,970 patients who underwent TKA procedures were identified comprising of 6,339 primary, elective outpatient TKA procedures. Of these, 2,034 patients received GA and 3,540 received SA. A cohort of 1,962 patients who underwent outpatient TKA under GA were propensity matched for covariates with patients who underwent outpatient TKA under SA. SAE rates at 72 h after surgery were not greater in patients receiving GA compared to SA (0.92%, 0.66%, P = 0.369). In contrast, minor adverse events were greater in the GA group compared to SA (2.09%, 0.51%), P < 0.001. The rate of postoperative transfusion was greater in the patients receiving GA.

Conclusions

The type of anesthetic technique, general or spinal anesthesia does not alter short term SAEs, readmissions and failure to rescue in patients undergoing outpatient TKR surgery. Recognizing the benefits of SA tailored to the anesthetic management may maximize the clinical benefits in this patient population.
A cross-sectional analysis of health literacy: patient- versus family doctor-reported and associations with self-efficacy and chronic disease
Authors: Stock Stephanie , Altin Sibel , Nawabi Farah , Civello Daniele , Shukri Arim , Redaèlli Marcus , Alayli Adrienne
Published: September 2021

Background

Adequate health literacy (HL) levels contribute to good health outcomes and successful disease self-management in patients with chronic disease. Hence, it is essential that family doctors recognize patients with inadequate HL in need of additional support. This study had two aims: (1) to assess and compare patient self-reported versus family doctor-rated HL estimates, and (2) to explore associations between patient-reported HL, self-efficacy and chronic diseases.

Methods

Participants in this cross-sectional survey were recruited through general practices in North Rhine-Westphalia, Germany. Patient self-reported HL was measured using the European Health Literacy Survey-16. Family doctor-rated HL was measured with an adapted version of this instrument. Using crosstabulations patient-reported and family doctor-rated HL estimates were compared for 346 patient-family doctor pairs. Associations between HL, self-efficacy and chronic disease were investigated using regression analyses.

Results

Patient-reported and family doctor-rated HL estimates were concordant in 38% of all cases. On average family doctors rated their patients’ HL lower than patients rated their own HL. The lower average family doctor ratings were more pronounced when patients were older, male and had more than one chronic disease. Female family doctors rated HL of male patients lower than their male colleagues. Patient reported HL had a significant positive association with self-efficacy. Mediation analysis provided support that self-efficacy acts as mediator between HL and the number of chronic diseases.

Conclusions

Our study findings indicate a significant discrepancy between patients’ self-reported HL and externally rated HL by family doctors. A more systematic utilization of HL screeners might help reduce this discrepancy. At the same time, consideration should be given to enhancing communication training for family doctors and addressing critical HL skills in patient education.