bluuebunny/crossref_metadata_2025 huggingface dataset:
Access to emergency paediatric surgery for testicular torsion or intestinal volvulus in New Zealand: A system perspective
Authors: Castle Cameron , Beasley Spencer W , Taghavi Kiarash
Published: August 2021

Aim

The risk of organ loss is increased in children with testicular torsion or intestinal volvulus if surgical management is not expedient. The current retrospective study aims to review the time‐course from first symptom to ‘knife to skin’ in these conditions, to determine where delays occur and facilitate a systems approach to better manage these children.

Methods

One hundred consecutive paediatric cases of scrotal exploration for presumed testicular torsion, and 100 neonatal cases presenting with possible malrotation/volvulus were analysed to evaluate the exact time‐course of events from admission to surgery.

Results

(i) Scrotal exploration: the median time from onset of symptoms to presentation was 12 h (interquartile range (IQR): 5–48 h). In children over 5 years of age, 36% (33/93) were transferred from an external district service area. (ii) Malrotation/volvulus: the median duration of symptoms prior to arrival/assessment was 12 h (IQR: 4–24 h). The median cumulative in‐hospital time was over 6 h (368 min, IQR: 247–634 min).

Conclusions

Time to presentation contributes significantly to testicular ischaemic time. This delay to timely surgical intervention is multi‐factorial, and must be addressed at a public health level. Support and training in the management of testicular torsion should be provided to all adult surgeons/trainees that may care for these children. In general, this condition is best managed at the presenting hospital whenever appropriate expertise is available. Novel pathways that streamline care may improve efficiency at an institutional level. Addressing issues of access to specialised neonatal surgery is more vexed on account of the tyranny of distance, and the pre‐requisite level of surgical expertise required.
Salt grains in hypervelocity impacts in the laboratory: Methods to sample plumes from the ice worlds Enceladus and Europa
Authors: Fisher C. R. , Price M. C. , Burchell M. J.
Published: August 2021

The plumes naturally erupting from the icy satellite Enceladus were sampled by the Cassini spacecraft in high‐speed fly‐bys, which gave evidence of salt. This raises the question of how salt behaves under high‐speed impact, and how it can best be sampled in future missions to such plumes. We present the results of 35 impacts onto aluminum targets by a variety of salts (NaCl, NaHCO3, MgSO4, and MgSO4·7H2O) at speeds from 0.26 to 7.3 km s−1. Using SEM‐EDX, identifiable projectile residue was found in craters at all speeds. It was possible to distinguish NaCl and NaHCO3 from each other, and from the magnesium sulfates, but not to separate the hydrous from anhydrous magnesium sulfates. Raman spectroscopy on the magnesium sulfates and NaHCO3 residues failed to find a signal at low impact speeds (<0.5 km s−1) where there was insufficient projectile material deposited at the impact sites. At intermediate speeds (0.5 to 2–3 km s−1), identifiable Raman spectra were found in the impact craters, but not at higher impact speeds, indicating a loss of structure during the high speed impacts. Thus, intact capture of identifiable salt residues on solid metal surfaces requires impact speeds between 0.75 and 2 km s−1.
Mapping culture with latent class analysis: A response to Eger and Hjerm
Authors: Bonikowski Bart , DiMaggio Paul
Published: August 2021

Eger and Hjerm's methodological critique of our 2016 study of Americans' sentiments towards the nation asserts that the latent class (LCA) models employed in our paper did not fit the data and that consequently, the paper fails to demonstrate the existence of multiple varieties of American nationalism. We challenge E&H's analyses and argue that their conclusions stem from erroneous assumptions, both about our models and about best practices for applied LCA‐based research. Based on a review of their results and additional analyses carried out with their preferred measures, we demonstrate that our model choices were justified and our 2016 findings are robust. In so doing, we offer a critique of unreflective adherence to inappropriate model fit criteria that ignores theory and concerns over the parsimony, interpretability, construct validity and external validity of model results.
“That Tesla of ours”: Modular nationalism and the cult of Nikola Tesla
Authors: Larson Ethan
Published: August 2021

This paper uses a comparative case study of Nikola Tesla's use as a symbol in interwar Yugoslavia and the contemporary United States to build upon Anderson's theory of modular nationalism. The modularity of national symbols, I argue, is driven by their utility in addressing similar social, political and economic transformations in different countries and may be transmissible through emigrant communities—albeit not without some changes in substance. Just as Yugoslavia used Tesla to bridge ethnic divisions, Yugoslav emigrants deployed Tesla to enhance their status in the United States. The cult of Tesla, moreover, is doubly modular, with its Yugoslav incarnation drawing inspiration from the American cult of Thomas Edison, just as Edison's current obsolescence as a symbol led to the cult of Tesla's adoption in the United States.
Phosphatic carapace of the waptiid arthropod Chuandianella ovata and biomineralization of ecdysozoans
Authors: Liu Cong , Fu Dongjing , Zhang Xingliang
Published: August 2021

Arthropods other than trilobites or bradoriids constitute a major component of many Cambrian Burgess‐Shale‐type Lagerstätten. Owing to their scarcity in other less well‐preserved deposits, they are generally regarded as lightly sclerotized but non‐mineralized. Here we show that Chuandianella ovata, one of the typical lightly sclerotized arthropods from the Chengjiang biota, reinforced its carapace with phosphatic mineralization. Multiple methods reveal a pitted microstructure and organophosphatic composition of the carapace. Nanogranules of amorphous calcium phosphate (ACP) on the fossil carapace are comparable to those of recent crustacean microstructures, implying that arthropods may have a conserved mechanism of phosphatic mineralization since the Cambrian. The fossil record indicates that the mineralization of ecdysozoans, preceded by the mineralization of lophotrochozoans in the Terreneuvian (~541–521 Ma), appeared in Cambrian Stage 3 (~521–514 Ma) and surpassed the range of living counterparts in phylogenetic coverage. This phenomenon strengthens the view that biomineralization has evolved multiple times independently within the Metazoa. The sudden appearance of mineralized skeletons in the early history of metazoan evolution is frequently attributed to external environment drivers. However, this viewpoint cannot explain the minerology and appearance time of metazoan lineages with mineralized hard parts during the Cambrian explosion.
The Metaphysical Problem of Other Minds
Authors: Merlo Giovanni
Published: August 2021

This paper presents a distinctively metaphysical version of the problem of other minds. The main source of this version of the problem lies in the principle that, when it comes to consciousness, no distinction can sensibly be drawn between appearance and reality. I will argue that, unless we want to call that principle into question, we should seriously consider the possibility of accepting the conclusion that other minds are not like our own. This option is less problematic than it might seem at first if we are willing to reconceive facts of consciousness as subjective rather than objective in nature.
Evaluating the genetic effects of seed dormancy regulatory genes Qsd1 and Qsd2 in a global collection of cultivated barley (Hordeum vulgare ssp. vulgare) with functional kompetitive allele‐specific PCR markers
Authors: Yan Luxi , Jiang Congcong , Cai Yu , Pan Yuhan , Xu Rugen , Luan Haiye , Shen Huiquan , Ahmar Sunny , Zhang Jing , Yang Ping , Feng Zongyun
Published: August 2021

Seed dormancy is agronomically important trait that associates with plant survival and seed production. Wild species present long dormancy to protect their seeds from unfavourable climate conditions until the next growing season. In contrast, shortened dormancy extends crop adaptability and promotes crop rotation in agriculture. However, the shortened dormancy brought about the risk of preharvest sprouting (PHS) on cereal crops in temperate and subtropical regions. Recently, two major quantitative genetic loci Qsd1 and Qsd2 that control the seed dormancy in barley have been cloned. In this study, two kompetitive allele‐specific PCR (KASP) markers were developed and applied in a genotypic survey among 859 accessions of cultivated barley. Long‐dormancy‐associated alleles at both loci were over‐represented within East Asian accessions. Both Qsd1 and Qsd2 had significant genetic effects on seed dormancy variations in cultivated barley. Thus, the two KASP markers could be applied in selecting favourable alleles in breeding practice to optimize the seed dormancy duration.
A systematic review of romantic relationship initiation and maintenance factors in autism
Authors: Yew Rui Ying , Samuel Priscilla , Hooley Merrilyn , Mesibov Gary B. , Stokes Mark A.
Published: August 2021

Autistic individuals report similar levels of interest in romantic relationships to their nonautistic peers but experience greater challenges with the initiation and maintenance of these relationships. This systematic review synthesizes the factors that contribute to romantic relationship initiation and maintenance among autistic individuals to inform relationship support programs. Both successes (e.g., ability to initiate relationships and maintain a satisfying relationship) and challenges (e.g., relationship dissatisfaction) were investigated. Out of 1403 potentially relevant articles, 11 articles comprising 13 studies met the inclusion criteria (investigated factor[s] of romantic relationship success of challenges, involved participants with a formal autism diagnosis and/or their partners, presented quantitative results in relationship factors, and was available in an English‐language version). Social and communication challenges were studied to the greatest extent and were associated with difficulties in both relationship initiation and satisfaction. Several factors relating to the partner of the autistic individual were associated with successful relationships, including reciprocal liking, partner support, and the ability to meet the autistic partner's needs. Conclusions are limited by the small number of studies but provide initial indications that social and communicative factors, as well as the role of nonautistic partners, are important to the success of romantic relationships for autistic individuals. In keeping in line with the community's preference for identity‐first language (i.e., “autistic individual” rather than “individual with autism”), this language has been used throughout this review.
Quality and Private Label Encroachment Strategy
Authors: Li Xue , Cai Xiaoqiang , Chen Jian
Published: August 2021

We consider a supply chain consisting of an incumbent national brand manufacturer and a retailer, who wishes to determine the private label encroachment strategy. By investigating the cost–quality trade‐off between lower‐ and higher‐quality private labels, we characterize the retailer's optimal encroachment decisions. Intuitively, the retailer would choose to introduce a lower‐quality private label when the quality of the national brand is high. However, we find that a higher‐quality private label may better benefit the retailer under certain conditions. Moreover, we establish that introducing a higher‐quality private label can improve both channel profit and consumer welfare. Using the results we derive, we explain the market practices and provide useful guidelines for retailers’ private label encroachment decisions.
Uncommon Legislative Attitudes: Why a Theory of Legislative Intent Needs Nontrivial Aggregation
Authors: Tan David
Published: August 2021

Since the publication of Ekins’sThe Nature of Legislative Intent, significant attention has been paid to common attitude models of legislative intention, that is, models that require unanimity among its group members. A common interpretation of Ekins is that these common attitudes are to be preferred over aggregated attitudes. I argue that any feasible theory of legislative attitudes will require nontrivial aggregation (i.e., not based on unanimity rules alone). Two arguments are put forward in this regard: first, that nontrivial aggregation better explains uncooperative legislative behaviour and, second, that mathematical problems with aggregation apply to common attitudes as well, since they involve trivial aggregation. These arguments generalise to theories of common attitudes other than Ekins’s.
Attending to science concepts during planning: Exploring and supporting the process
Authors: Nixon Ryan S. , Campbell Benjamin K.
Published: August 2021

Teachers make many important decisions about instruction during the process of planning. While educational researchers have extensively explored teacher planning, this research has largely neglected the ways teachers attend to subject matter while planning. We first explore ways a sample of 13 experienced secondary biology teachers attend to science concepts in planning. Teachers in this study reported attending to science ideas in order to decide what was important to teach and to enhance their own knowledge of science concepts. We next introduced teachers to a tool, called the concept model, that is designed to support teachers in attending to science concepts while planning. After completing a concept model, participants reported that the tool influenced them to focus on important aspects of the concept, recognize the range of complexity in the topic, consider aspects students find difficult, evaluate their own understanding, and identify connected concepts. These findings extend our understanding of how teachers attend to subject matter during planning and suggest the potential of a tool like the concept model for supporting that process.
Characterization of the novel HLA‐DQA1*01:02:11 allele by sequencing‐based typing
Authors: Cargou Marine , Andreani Marco , Battarra Mariarosa , Wojciechowski Elodie , Visentin Jonathan
Published: August 2021

HLA‐DQA1*01:02:11 differs from HLA‐DQA1*01:02:01:10 by one nucleotide substitution in codon 201 in exon 4.
Characterization of the novel HLA‐C*07:01:101 allele by sequencing‐based typing
Authors: Cargou Marine , Elsermans Vincent , Top Isabelle , Wojciechowski Elodie , Visentin Jonathan
Published: August 2021

HLA‐C*07:01:101 differs from HLA‐C*07:01:01:15 by one nucleotide substitution in codon 332 in exon 7.
Character Constellations
Authors: Smeets Roel
Published: August 2021

Fiction has a major social impact, not least because it co-shapes the image that society has of various social groups. Drawing on a collection of 170 contemporary Dutch-language novels, Character Constellations presents a range of data-driven, statistical models to study depictions of characters in terms of gender, race, ethnicity, class, age, sexuality, and other identity categories. Incorporating the tools of network analysis, each chapter highlights an aspect of fictional social networks that affects the representation of social groups: their centrality, their communities, and their conflicts. While reading individual novels in light of emerging statistical patterns, combining the formal methods of social network analysis with the interpretive tools of narratology, this study shows how central societal themes such as (in)equality and emancipation, integration and segregation, and social mobility and class struggle are foregrounded, replicated, or distorted in the Dutch novel. Showcasing what character-based critiques of literary representation gain by integrating data-driven methods into the practice of critical close reading, Character Constellations contributes to societal debates on cultural representation and identity and the role fiction and art have in those debates.
High-Performance Computing Probabilistic Fracture Mechanics Implementation for Gas Turbine Rotor Disks on Distributed Architectures Including Graphics Processing Units
Authors: Gajjar1 Mrugesh , Amann Christian , Kadau Kai
Published: August 2021

We present an efficient Monte Carlo-based probabilistic fracture mechanics simulation implementation for heterogeneous high-performance computing (HPC) architectures including central processing units (CPUs) and graphics processing units (GPUs). The specific application focuses on large heavy-duty gas turbine rotor components for the energy sector. A reliable probabilistic risk quantification requires the simulation of millions to billions of Monte Carlo (MC) samples. We apply a modified Runge–Kutta algorithm in order to solve numerically the fatigue crack growth for this large number of cracks for varying initial crack sizes, locations, material, and service conditions. This compute intensive simulation has already been demonstrated to perform efficiently and scalable on parallel and distributed HPC architectures including hundreds of CPUs utilizing the message passing interface (MPI) paradigm. In this work, we go a step further and include GPUs in our parallelization strategy. We develop a load distribution scheme to share one or more GPUs on compute nodes distributed over a network. We detail technical challenges and solution strategies in performing the simulations on GPUs efficiently. We show that the key computation of the modified Runge–Kutta integration step speeds up over two orders of magnitude on a typical GPU compared to a single threaded CPU. This is supported by our use of GPU textures for efficient interpolation of multidimensional tables utilized in the implementation. We demonstrate weak and strong scaling of our GPU implementation, i.e., that we can efficiently utilize a large number of GPUs/CPUs in order to solve for more MC samples, or reduce the computational turn-around time, respectively. On seven different GPUs spanning four generations, the presented probabilistic fracture mechanics simulation tool ProbFM achieves a speed-up ranging from 16.4× to 47.4× compared to single threaded CPU implementation.
Ultra-High Temperature Thermal Conductivity Measurements of a Reactive Magnesium Manganese Oxide Porous Bed Using a Transient Hot Wire Method
Authors: Hayes Michael , Masoomi Faezeh , Schimmels Philipp , Randhir Kelvin , Klausner James , Petrasch Joerg
Published: August 2021

Pelletized magnesium manganese oxide shows promise for high temperature thermochemical energy storage. It can be thermally reduced in the temperature range between 1250 °C and 1500 °C and re-oxidized with air at typical gas-turbine inlet pressures (1–25 bar) in the temperature range between 600 °C and 1500 °C. The combined thermal and chemical volumetric energy density is approximately 2300 MJ/m3. The rate at which a thermochemical storage module can be charged is limited by heat transfer inside the solid packed bed. Hence, the effective thermal conductivity of packed beds of magnesium-manganese oxide pellets is a crucial parameter for engineering Mg-Mn-O redox storage devices. We have measured the effective thermal conductivity of a packed bed of 3.66 ± 0.516 mm sized magnesium manganese oxide (Mn to Mg molar ratio of 1:1) pellets in the temperature range of 300–1400 °C. Since the material is electrically conductive at temperatures above 600 °C, the sheathed transient hot wire method is used for measurements. Raw data is analyzed using the Blackwell solution to extract the bed thermal conductivity. The effective thermal conductivity standard deviation is less than 10% for a minimum of three repeat measurements at each temperature. Experimental results show an increase in the effective thermal conductivity with temperature from 0.50 W/m °C around 300 °C to 1.81 W/m °C close to 1400 °C. We propose a dual porosity model to express the effective thermal conductivity as a function of temperature. This model also considers the effect of radiation within the bed, as this is the dominant heat transfer mode at high temperatures. The proposed model accounts for microscale pellet porosity, macroscale bed porosity, pellet size, solid thermal conductivity (phonon transport), and radiation (photon transport). The coefficient of determination between the proposed model and the experimental results is greater than 0.90.
Improved Motor Proficiency and Quality of Life in Youth With Prader–Willi Syndrome and Obesity 6 Months After Completing a Parent-Led, Game-Based Intervention
Authors: Rubin Daniela A. , Wilson Kathleen S. , Tucker Jared M. , Castner Diobel M. , Dumont-Driscoll Marilyn C. , Rose Debra J.
Published: August 2021

Purpose: To determine changes and potential differences in physical activity (PA), gross motor proficiency (MP), and health parameters after a 6-month follow-up (FU) period following participation in a parent-led PA intervention in youth with or without Prader–Willi syndrome (PWS). Methods: About 42 youth with PWS and 65 youth without PWS but with obesity (body fat percentage >95th percentile for age and sex), aged 8–16 years, participated. The intervention included preplanned PA sessions containing playground and console-based video games scheduled 4 days per week for 24 weeks. Families received training and curriculum materials. PA (accelerometry), MP (Bruininks–Oseretsky Test of MP), and health-related quality of life were obtained before (PRE), after completing the intervention (POST), and at FU. Results: There were no significant changes in PA at any time point. At FU and POST, participants showed higher bilateral coordination (PRE = 9.3 [0.4], POST = 11.7 [0.5], and FU = 11.1 [0.6]); speed and agility (PRE = 9.2 [0.4], POST = 10.8 [0.4], and FU = 11.5 [0.5]); and strength (PRE = 8.0 [0.3], POST = 9.2 [0.3], and FU = 9.2 [0.3]) than at PRE. At FU (80.3 [2.1]) and POST (79.8 [1.7]), youth without PWS showed higher health-related quality of life than PRE (75.0 [1.8]). Conclusion: The improvements in MP and health-related quality of life at FU suggest long-term durability of intervention outcomes.
Clarion call from climate panel
Authors: Sherwood Steven , Hoskins Brian
Published: August 2021

Unprecedented flooding, searing temperatures, and raging fires across Europe, Asia, and North America this summer have created a stark backdrop for this week's release of the sixth physical science assessment report (AR6) of the Intergovernmental Panel on Climate Change (IPCC). These reports, initiated in 1990, arrive about every 7 years at the request of the countries of the United Nations Framework Convention on Climate Change. They form the basis for UN discussions and have become a crucial means to take stock of the latest scientific developments. The reports' future projections about climate change have remained fairly stable over the years and have, sadly, proven quite accurate. So, what does the new report add?
Integrated longitudinal immunophenotypic, transcriptional, and repertoire analyses delineate immune responses in patients with COVID-19
Authors: Notarbartolo Samuele , Ranzani Valeria , Bandera Alessandra , Gruarin Paola , Bevilacqua Valeria , Putignano Anna Rita , Gobbini Andrea , Galeota Eugenia , Manara Cristina , Bombaci Mauro , Pesce Elisa , Zagato Elena , Favalli Andrea , Sarnicola Maria Lucia , Curti Serena , Crosti Mariacristina , Martinovic Martina , Fabbris Tanya , Marini Federico , Donnici Lorena , Lorenzo Mariangela , Mancino Marilena , Ungaro Riccardo , Lombardi Andrea , Mangioni Davide , Muscatello Antonio , Aliberti Stefano , Blasi Francesco , De Feo Tullia , Prati Daniele , Manganaro Lara , Granucci Francesca , Lanzavecchia Antonio , Francesco Raffaele De , Gori Andrea , Grifantini Renata , Abrignani Sergio
Published: August 2021

Characterization of the immune responses to SARS-CoV-2 reveals a CD8
+
T cell subset that likely establishes the memory to the virus.
Endophytic
Streptomyces hygroscopicus
OsiSh-2-Mediated Balancing between Growth and Disease Resistance in Host Rice
Authors: Gao Yan , Ning Qing , Yang Yuanzhu , Liu Ying , Niu Shuqi , Hu Xiaochun , Pan Huairong , Bu Zhigang , Chen Ning , Guo Jinyou , Yu Jinlan , Cao Lidan , Qin Peng , Xing Junjie , Liu Bin , Liu Xuanming , Zhu Yonghua
Published: August 2021

Under disease stress, activation of defense response in plants often comes with the cost of a reduction in growth and yield, which is referred as the growth-defense trade-off. The microorganisms which can be recruited by plants to mitigate the growth-defense trade-off are of great value in crop breeding.
Bacterial Outer Membrane Vesicles as a Versatile Tool in Vaccine Research and the Fight against Antimicrobial Resistance
Authors: Zhu Zhuang , Antenucci Fabio , Villumsen Kasper Rømer , Bojesen Anders Miki
Published: August 2021

Gram-negative bacteria include a number of pathogens that cause disease in humans and animals. Although antibiotics are still effective in treating a considerable range of infections caused by Gram-negative bacteria, the alarming increase of antimicrobial resistance (AMR) induced by excessive use of antibiotics has raised global concerns.
Meta-analysis of Clinical Microbiome Studies in Urolithiasis Reveal Age, Stone Composition, and Study Location as the Predominant Factors in Urolithiasis-Associated Microbiome Composition
Authors: Kachroo Naveen , Lange Dirk , Penniston Kristina L. , Stern Joshua , Tasian Gregory , Bajic Petar , Wolfe Alan J. , Suryavanshi Mangesh , Ticinesi Andrea , Meschi Tiziana , Monga Manoj , Miller Aaron W.
Published: August 2021

Studies focused on the microbiome broadly support the hypothesis that the microbiome influences the onset of chronic diseases such as urinary stone disease. However, it is unclear what environmental factors shape the microbiome in ways that increase the risk for chronic disease.
The Resistome and Mobilome of Multidrug-Resistant Staphylococcus sciuri C2865 Unveil a Transferable Trimethoprim Resistance Gene, Designated
dfrE
, Spread Unnoticed
Authors: Gómez-Sanz Elena , Haro-Moreno Jose Manuel , Jensen Slade O. , Roda-García Juan J. , López-Pérez Mario
Published: August 2021

The discovery and surveillance of antimicrobial resistance genes (AMRG) and their mobilization platforms are critical to understand the evolution of bacterial resistance and to restrain further expansion. Limited genomic data are available on
Staphylococcus sciuri
; regardless, it is considered a reservoir for critical AMRG and mobile elements.
Rapid, Large-Scale Wastewater Surveillance and Automated Reporting System Enable Early Detection of Nearly 85% of COVID-19 Cases on a University Campus
Authors: Karthikeyan Smruthi , Nguyen Andrew , McDonald Daniel , Zong Yijian , Ronquillo Nancy , Ren Junting , Zou Jingjing , Farmer Sawyer , Humphrey Greg , Henderson Diana , Javidi Tara , Messer Karen , Anderson Cheryl , Schooley Robert , Martin Natasha K. , Knight Rob
Published: August 2021

Wastewater-based epidemiology can be particularly valuable at university campuses where high-resolution spatial sampling in a well-controlled context could not only provide insight into what affects campus community as well as how those inferences can be extended to a broader city/county context. In the present study, a large-scale wastewater surveillance was successfully implemented on a large university campus enabling early detection of 85% of COVID-19 cases thereby averting potential outbreaks.
High-Selectivity Polysiloxane Membranes for Gases and Liquids Separation (A Review)
Authors: Grushevenko E. A. , Borisov I. L. , Volkov A. V.
Published: August 2021

The most promising approaches to making polysiloxane-based membranes more selective are considered. These approaches can be subdivided into three groups: (1) development of new membrane materials by copolymerization, (2) modification of the polysiloxane chain (in the backbone and pendant chains), and (3) development of mixed matrix membranes. All the three approaches are subjected to a critical analysis, and conclusions are made on the prospects for the development of high-selectivity materials and high-performance membranes based on them. The data are presented from the viewpoint of applied aspects of polysiloxane-based membranes.
Youssef syndrome with a summary of management options
Authors: Bahadur Anupama , Ravi Anoosha K , Ajmani Megha , Mundhra Rajlaxmi
Published: August 2021

Vesicouterine fistula is one of the rare varieties of urogenital fistula. Type I urogenital fistula or Youssef syndrome is characterised by menouria, amenorrhoea and urinary continence and it mostly follows lower segment caesarean delivery. There are only scattered case reports to help guide diagnostic and therapeutic options for this condition. These patients mostly need a combination of diagnostic modalities to confirm the diagnosis. Here, we present one such case of para 4 live 4 with classical symptoms of Youssef syndrome following a laparotomy for uterine rupture repair. CT urography confirmed the diagnosis and cystoscopy helped localise the exact location. Transabdominal fistula excision and repair was done. The paper also presents a summary of diagnostic and therapeutic options for this condition as reported in previous case reports for easy reference for practising gynaecologists and urologists.
Feasibility and acceptability of a community pharmacy referral service for suspected lung cancer symptoms
Authors: Holland-Hart Daniella , McCutchan Grace M , Quinn-Scoggins Harriet Dorothy , Brain Kate , Hill Lucy , Shanbag Savita , Abel Michael , White Kelly , Evans Angela , Rees Sarah , Bowen Sarah , Gemine Rachel , Collier Gareth
Published: August 2021

Background

Lung cancer survival rates in the UK are among the lowest in Europe, principally due to late-stage diagnosis. Alternative routes to earlier diagnosis of lung cancer are needed in socioeconomically deprived communities that are disproportionately affected by poor lung cancer outcomes. We assessed the feasibility and acceptability of a community-based pharmacy referral service to encourage earlier symptomatic referral for chest X-rays.

Methods

Seventeen community pharmacies located in a deprived area of Wales participated between March 2019 and March 2020. Stakeholder interviews were conducted with four patients, seven pharmacy professionals and one general practitioner. Four focus groups were conducted, including one with healthcare professionals (n=6) and three with members of the public who were current and former smokers (n=13). Quantitative data regarding patient characteristics and clinical outcomes were collected from hospital records and patient referral questionnaires completed by pharmacists and analysed using descriptive statistics. Qualitative data sets were analysed thematically and triangulated.

Results

Twelve patients used the pharmacy referral service, all of whom were male. Average length of the pharmacy consultation was 13 min, with a mean 3 days to accessing chest X-rays in secondary care. Patients experienced a mean 46-day wait for results, with no lung cancer detected. Participants found the service to be acceptable and considered the pharmacy element to be broadly feasible. Perceived barriers included low awareness of the service and concerns about the role and capacity of pharmacists to deliver the service. Facilitators included perceived approachability and accessibility of pharmacists. A well-publicised, multifaceted awareness campaign was recommended.

Conclusions

A community pharmacy referral service for lung symptoms was considered an acceptable alternative pathway to symptomatic diagnosis of lung cancer in deprived communities. Wider implementation of the service would require workforce capacity and training to be addressed to ensure optimum utilisation and promotion of the service.
Dental implications of some commonly prescribed medicines
Authors: Sohal Gursahib , Dave Manas , Patel Neil
Published: August 2021

Several medicines can have an impact on oral health or have implications for dental treatment. It is important that general dental practitioners review the medicines that their patients are taking and consider their potential impact. In this article we highlight some of the medicines or groups of medicines that can affect dental treatment and oral health.
Risk factors and outcomes of unrecognised endobronchial intubation in major trauma patients
Authors: Heyne Guido , Ewens Sebastian , Kirsten Holger , Fakler Johannes Karl Maria , Özkurtul Orkun , Hempel Gunther , Krämer Sebastian , Struck Manuel Florian
Published: August 2021

Background

Emergency tracheal intubation during major trauma resuscitation may be associated with unrecognised endobronchial intubation. The risk factors and outcomes associated with this issue have not previously been fully defined.

Methods

We retrospectively analysed adult patients admitted directly from the scene to the ED of a single level 1 trauma centre, who received either prehospital or ED tracheal intubation prior to initial whole-body CT from January 2008 to December 2019. Our objectives were to describe tube-to-carina distances (TCDs) via CT and to assess the risk factors and outcomes (mortality, length of intensive care unit stay and mechanical ventilation) of patients with endobronchial intubation (TCD <0 cm) using a multivariable model.

Results

We included 616 patients and discovered 26 (4.2%) cases of endobronchial intubation identified on CT. Factors associated with an increased risk of endobronchial intubations were short body height (OR per 1 cm increase 0.89; 95% CI 0.84 to 0.94; p≤0.001), a high body mass index (OR 1.14; 95% CI 1.04 to 1.25; p=0.005) and ED intubation (OR 3.62; 95% CI 1.39 to 8.90; p=0.006). Eight of 26 cases underwent tube thoracostomy, four of whom had no evidence of underlying chest injury on CT. There was no statistically significant difference in mortality or length of stay although the absolute number of endobronchial intubations was small.

Conclusions

Short body height and high body mass index were associated with endobronchial intubation. Before considering tube thoracostomy in intubated major trauma patients suspected of pneumothorax, the possibility of unrecognised endobronchial intubation should be considered.
Application of Lyon Consensus criteria for GORD diagnosis: evaluation of conventional and new impedance-pH parameters
Authors: Frazzoni Leonardo , Frazzoni Marzio , De Bortoli Nicola , Ribolsi Mentore , Tolone Salvatore , Russo Salvatore , Conigliaro Rita Luisa , Penagini Roberto , Fuccio Lorenzo , Zagari Rocco Maurizio , Savarino Edoardo
Published: August 2021

Objective

To validate Lyon Consensus criteria for diagnosing gastro-oesophageal reflux disease (GORD) by reflux monitoring.

Design

Manual review of impedance-pH tracings from patients with proton pump inhibitor (PPI)-dependent heartburn, evaluated off PPI. Acid exposure time (AET) thresholds defined by the Lyon Consensus and impedance parameters were investigated, namely, total refluxes (TRs), postreflux swallow-induced peristaltic wave (PSPW) index and mean nocturnal baseline impedance (MNBI).

Results

The study included 488 patients, 178 (36%) with normal (<4%) AET, 89 (18%) with inconclusive (4%–6%) AET and 221 (45%) with abnormal (>6%) AET, alongside with 70 healthy controls. At receiver operating characteristic analysis, area under curve was 0.89, 0.95 and 0.89 for TRs, PSPW index and MNBI, respectively, and threshold values were 40, 50% and 2000 Ω; the 4% physiological AET threshold defined by the Lyon Consensus showed 100% specificity but 63% sensitivity. The thresholds defined for impedance parameters were validated against AET by means of ordered logistic regression, being in concordance with the 4% AET threshold (OR 2.5 for TRs, 18.9 for PSPW index and 5.7 for MNBI). TRs positivity and concordant PSPW index/MNBI positivity were found in 80%–90% of patients in the abnormal AET group, in 73%–74% of cases in the inconclusive AET group and in 28%–40% of cases in the group with normal AET.

Conclusions

Our results show the overall validity of the Lyon Consensus approach to GORD diagnosis. Adding evaluation of impedance parameters, namely, TRs, PSPW index and MNBI to AET appraisal, substantially improves the diagnostic yield of reflux monitoring.
Malignant pleural mesothelioma with heterologous elements
Authors: Kawai Toshiaki , Seki Reishi , Miyajima Kuniharu , Nakashima Hiroshi , Takeda Takayuki , Murakami Tomoyuki , Aoe Keisuke , Okabe Kazunori , Homma Keiichi , Tsukamoto Yoshitane , Sunada Koichi , Terasaki Yasuhiro , Iida Maki , Orikasa Hideki , Hiroshima Kenzo
Published: August 2021

Aims

Malignant pleural mesothelioma with heterologous elements (such as osseous, cartilaginous or rhabdomyoblastic differentiation) is very rare. We tried to differentiate such mesothelioma cases from extraskeletal pleural osteosarcoma, which is very challenging.

Methods

We compared 10 malignant pleural mesotheliomas (three biphasic and seven sarcomatoid types) with two pleural osteosarcomas using clinicopathological and immunohistochemical methods, and also fluorescence in situ hybridisation (FISH) to examine for homozygous deletion of p16.

Results

The median age was 72 years for mesotheliomas, and 69 years for osteosarcoma. For mesothelioma, eight cases were male and two were female. Growth was diffuse in all mesothelioma cases except case 10, where it was localised, as it was for the two osteosarcomas. Among mesothelioma cases, 80% displayed osteosarcomatous and 60% chondromatous elements, while 10% exhibited rhabdomyoblastic ones. Immunohistochemical labelling for calretinin and AE1/AE3 was present in 8/10 and 7/10 mesotheliomas, respectively, but in only one osteosarcoma. Loss of methylthioadenosine phosphorylase was seen in 5/7 mesotheliomas. FISH analysis revealed homozygous deletion of p16 in 5/8 mesothelioma and 2/2 osteosarcoma. Median survival was 6.5 months after biopsy or surgical operation in mesothelioma, and 12 months after operation in osteosarcoma.

Conclusions

Although median survival was longer for osteosarcoma than for malignant mesothelioma, we could not differentiate mesothelioma from pleural osteosarcoma on the combined basis of clinicopathological and immunohistochemical data, and FISH analysis. However, diffuse growth was more frequent in mesothelioma than in osteosarcoma.
High-risk human papillomavirus (HPV) detection in formalin-fixed paraffin-embedded cervical tissues: performances of Aptima HPV assay and Beckton Dickinson (BD) Onclarity assay
Authors: Kir Gozde , Gunel Humeyra , Olgun Zeynep Cagla , McCluggage W Glenn
Published: August 2021

Aim

There are many scenarios where high-risk human papillomavirus (HPV) detection in formalin-fixed paraffin-embedded (FFPE) specimens is important. However, there is no Food and Drug Administration (FDA)-approved and clinically validated technique for detecting high-risk HPV in FFPE tissues. In this study, we evaluated two commercially available HPV assays which are FDA-approved for use on cytology specimens, the Aptima HPV assay and the Beckton Dickinson (BD) Onclarity assay, to detect high-risk HPV in FFPE tissues of cervical high-grade squamous intraepithelial lesion (HSIL) and squamous cell carcinoma (SCC).

Methods

A total of 189 cases (46 SCC, 107 HSIL and 36 benign/normal) were tested for high-risk HPV with the Aptima HPV assay and a subset of cases (n=97) with the BD Onclarity assay.

Results

The sensitivities of the Aptima and BD Onclarity HPV assays were 99.4% (95% CI 96.46% to 99.98%) and 75.9% (95% CI 65.27% to 84.62%), respectively; the specificity and positive predictive value (PPV) of the two assays were 100%. Negative predictive values of the Aptima and BD Onclarity HPV assays were 97.3% (95% CI 83.61% to 99.61%) and 67.7% (95% CI 58.91% to 75.47%), respectively. The kappa value (0.96) for comparison of the distribution of high-risk HPV types between the two assays was high. HPV 16 was the most common high-risk HPV type for HSIL and SCC cases. However, SCC cases had higher percentages of HPV 16 and HPV 18/45 and lower percentages of other high-risk HPV types compared with HSIL cases.

Conclusion

Both assays are reliable methods for high-risk HPV detection and genotype determination in FFPE specimens, with high PPV and specificity. The Aptima HPV assay has the advantage of higher sensitivity. As far as we are aware, this is the first study comparing the Aptima HPV assay and the BD Onclarity assay in FFPE tissues. Our study results should be tested and confirmed in larger cohorts.
Associations between GDF15 Levels and Pre-Diabetes in Non-Obese Subjects
Authors: Hung Hao-Chang , Wu Hung-Tsung , Lin Ching-Han , Chou Hsuan-Wen , Ou Horng-Yih , Chang Chih-Jen
Published: August 2021

Growth differentiation factor 15 (GDF15) is a stress-response cytokine which belongs to the transforming growth factor β superfamily. Although GDF15 was initially found to have a role in metabolic diseases, the association between GDF15 and dysglycemic status remains inconclusive. Thus, the aim of this study was to examine the relationships between GDF15 and different glycemic statuses in non-obese subjects. We enrolled 502 non-obese subjects, among individuals who had normal glucose tolerance (NGT; n=125), isolated impaired fasting glucose (IFG; n=116), isolated impaired glucose tolerance (IGT; n=106), IFG plus IGT (n=27), and newly diagnosed diabetes (NDD; n=128). A multivariate linear regression analysis of GDF15 levels was used to find independent predictors. The median (IQR) GDF15 levels were 1641.0 (1187.0–1985.5) pg/mL, 1656.1 (1226.8–2379.7) pg/mL, 1487.8 (1145.9–1987.2) pg/mL, 1722.2 (1172.9–1939.0) pg/mL, and 2204.5 (1767.4–2919.1) pg/mL in NGT, IFG, IGT, IFG plus IGT, and NDD groups, respectively. The NDD group had significantly higher GDF15 levels than those with NGT, IFG, IGT, and IFG plus IGT. The IFG group had a significantly higher GDF15 value than the NGT group. In multivariate linear regression analysis, IFG (beta=0.145, 95% CI 192.487 to 740.937, p=0.001), NDD (beta=0.227, 95% CI 390.459 to 888.145, p<0.001), and high-sensitivity C reactive protein (beta=0.105, 95% CI 3.276 to 27.768, p=0.013) were independently associated with GDF15 levels. Non-obese subjects with isolated IFG and NDD had significantly higher GDF15 levels than those with NGT. In addition, A1C was independently associated with GDF15 levels. IFG and NDD, but not isolated IGT or IFG plus IGT, were positively associated with GDF15 levels.
Tobacco industry pricing strategies in response to excise tax policies: a systematic review
Authors: Sheikh Zaineb Danish , Branston J Robert , Gilmore Anna B
Published: August 2021

Objective

To explore what is known about the tobacco industry’s (TI) price-based responses to tobacco excise tax policies and whether these vary by country income group using a systematic review.

Data sources

Studies assessing TI pricing tactics were identified via searches of five online databases using a combination of search keywords.

Study selection

Inclusion criteria were applied by two reviewers independently who screened all search results (titles and abstracts) for possible inclusion. They identified 37 publications that reported TI pricing tactics.

Data extraction

Study details were tabulated, and information was extracted on the country income group, population characteristics, excise tax structure, and pricing strategies.

Data synthesis

Of the 37 publications identified, 22 were conducted in high-income countries, while 15 covered low-income and middle-income countries (LMICs). Major pricing strategies employed were: differentially shifting taxes between products (35 studies); launching new brands/products as pathways for downtrading (six studies), product promotions and different prices for the same products for different customers (six studies); price smoothing (two studies); and changing product attributes such as length/size of cigarettes or production processes (three studies).

Conclusions

While there is limited evidence to fully ascertain industry responses to tax increases, this review suggests that the TI widely uses a multitude of sophisticated pricing strategies across different settings around the world with the intention of undermining tax policies, thereby increasing tobacco consumption and maximising their profits. There is a need for further research in this area especially in LMICs so that effective policy responses can be developed.
Evaluation of mapped-plot variance estimators across a range of partial nonresponse in a post-stratified national forest inventory
Authors: Westfall James A. , Lister Andrew J. , Scott Charles T.
Published: August 2021

When conducting a forest inventory, sometimes portions of plots cannot be measured due to inaccessibility. Two primary methods have been presented to account for partial nonresponse in the estimation phase: (i) use a ratio-to-size estimator or (ii) apply an adjustment factor to all plot observations in proportion to the missing area. Both approaches provide identical estimates of the population mean, but the estimates of variance differ when partial nonresponse is present. The performance of variance estimators was examined for a range of population forest area and partial nonresponse proportions in the sample. The ratio-to-size variance estimator performed unbiasedly with respect to simulation results, but the adjustment factor variance estimates were biased, with magnitude and direction dependent upon the forest area proportion and amount of partial nonresponse. The bias is relatively small when the partial nonresponse is small, which is often the case; however, the ratio-to-size method is preferred to ensure accurate variance estimation for a wide range of circumstances.
Liquid intrusion in and extrusion from non-wettable nanopores for technological applications
Authors: Giacomello Alberto , Casciola Carlo Massimo , Grosu Yaroslav , Meloni Simone
Published: August 2021

In this article, we review some recent theoretical results about intrusion and extrusion of non-wetting liquids in and out of cavities of nanotextured surfaces and nanoporous materials. Nanoscale confinement allows these processes to happen at conditions which significantly differ from bulk phase coexistence. In particular, the pressure at which a liquid penetrates in and exits from cavities is of interest for many technological applications such as energy storage, dissipation, and conversion, materials with negative compressibility, ion channels, liquid chromatography, and more. Notwithstanding its technological interest, intrusion/extrusion processes are difficult to understand and control solely via experiments: the missing step is often a simple theory capable of providing a microscopic interpretation of the results, e.g., of liquid porosimetry or other techniques used in the field, especially in the case of complex nanoporous media. In this context, simulations can help shedding light on the relation between the morphology of pores, the chemical composition of the solids and liquids, and the thermodynamics and kinetics of intrusion and extrusion. Indeed, the intrusion/extrusion kinetics is determined by the presence of free energy barriers and special approaches, the so-called rare event techniques, must be used to study these processes. Usually, rare event techniques are employed to investigate processes occurring in relatively simple molecular systems, while intrusion/extrusion concerns the collective dynamics of hundreds to thousands of degrees of freedom, the molecules of a liquid entering in or exiting from a cavity, which, from the methodological point of view, is itself a challenge.