bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of neutral detergent fiber digestibility estimation method on calculated energy concentration of canola meals from twelve Canadian processing plants
Authors: Arce-Cordero J A , Paula E M , Daniel J L P , Silva L G , Broderick G A , Faciola A P
Published: October 2021

Our aim was to determine whether the method used to estimate truly digestible neutral detergent fiber (tdNDF) affects calculated concentrations of total digestible nutrients (TDN1x) and net energy of lactation (NEL3x) of canola meal (CM). Samples were collected from 12 CM processing plants in Canada over 4-years (2011-2014, n = 47) and analyzed for dry matter (DM), crude protein (CP), ether extract (EE), ash, neutral detergent fiber (NDF), acid detergent fiber (ADF), lignin (ADL) and neutral detergent insoluble CP (NDICP). Ruminal in situ incubation of CM samples was performed at 0, 24, 48, 96, and 288 h to determine NDF fractions (A, B and C), effective ruminal NDF digestibility (ERNDFD), and indigestible NDF (iNDF) of CM. Three tdNDF-estimation methods were evaluated: 1) NRC (National Research Council) = 0.75 × (NDF - NDICP - ADL) × {1- [ADL / (NDF - NDICP)] 0.667}; 2) iNDF = 0.75 × (NDF - NDICP – NDF remaining after 288 h in situ); and 3) ERNDFD estimated from in situ NDF digestion kinetics. Resulting tdNDF values were used for calculation of TDN1x and NEL3x according to NRC (2001) equations. Data were analyzed with MIXED procedure of SAS 9.4 to determine the effect of processing plant on chemical composition, NDF degradation kinetics and NEL3x of CM. Effect of tdNDF estimation method on calculated TDN1x and NEL3x of CM was also evaluated. Model for analysis of processing plant included the fixed effect of plant and the random effect of year (plant) as replication, while analysis of tdNDF methods included the fixed effect of tdNDF estimation method and the random effects of processing plant and of year(plant) as replication. There was an effect of processing plant on DM (P = 0.03), CP (P < 0.01), EE (P < 0.01), and NDF (P < 0.01) of CM. Processing plant also had an effect on NDF fractions A (P < 0.01) and B (P = 0.02) but did not affect fraction C and ERNDFD. The tdNDF estimation method had an effect on tdNDF (P < 0.01), TDN1x (P < 0.01) and NEL3x (P < 0.01) of CM, yielding average NEL3x values of 1.72, 1.87, and 2.07 Mcal/kg for NRC, iNDF, and ERNDFD, respectively. Our results indicate that calculated energy concentration of CM according to NRC (2001) equations varies depending on the method used for estimation of tdNDF. Further research will be needed to determine the most accurate estimation method.
High-Voltage Injuries by Contact With Overhead Lines: Case Reports of Two Young Girls
Authors: Günal Betül Y , Sokolovski Filipp , Neu Nikolaus , Schwabegger Anton Herbert , König Tatjana Tamara , Engel Veronika , Muensterer Oliver J
Published: October 2021

High-voltage burn injuries are rare in the pediatric age group, but can lead to devastating, severe sequelae. We present the cases of two young girls who suffered high-voltage burn injuries due to direct contact with overhead power lines. Both patients came from difficult psychosocial backgrounds. The injuries resulted in severe long-term consequences and functional deficits.
Stereolithography-assisted fabrication of 3D printed polymeric film for topical berberine delivery: in-vitro, ex-vivo and in-vivo investigations
Authors: Choudhury Dinesh , Sharma Peeyush Kumar , Suryanarayana Murty Upadhyayula , Banerjee Subham
Published: October 2021

Objectives

3D printed polymeric film intended for topical delivery of berberine (BBR) was developed using stereolithography (SLA) to enhance its local concentrations. PEGDMA was utilized as photopolymerizing resin, with PEG 400 as an inert component to facilitate BBR solubilization and permeation.

Methods

Three batches of topical films were printed by varying resin and PEG 400 compositions. In-vitro physicochemical characterizations of the 3D printed films were performed using several analytical techniques including ex-vivo drug permeation studies. In-vivo skin irritation studies were also conducted to assess the skin irritation potential.

Key findings

Films were 3D printed according to design specifications with minimal variations. Microscopic analysis confirmed 3D architecture, while thermal and X-ray diffraction studies revealed amorphous BBR entrapment. Drug permeation study showed effective ex-vivo diffusion up to 344.32 ± 61.20 µg/cm2 after 24.0 h possessing a higher ratio of PEG 400. In-vivo skin irritation studies have suggested the non-irritant nature of printed films.

Conclusions

Results indicated the suitability of SLA 3D printing for topical application in the treatment of skin diseases. The presence of PEG 400 in the printed 3D films facilitated BBR diffusion, resulting in an improved flux in ex-vivo model and non-irritant properties in vivo.
Bilateral primary testicular diffuse large B-cell lymphoma: a case report
Authors: Batista Baskara , Safriadi Ferry
Published: October 2021

Primary testicular lymphoma is a rare but aggressive form of extranodal lymphoma.

A 48-year-old man came with painless lump on both testicles since 10 months ago. Testicular tumour marker revealed increased LDH. Testicular USG revealed semi-solid spongiform mass in the right epididymis and bilateral testicles, suggesting malignancy and minimal bilateral hydroceles. Histopathologic examination revealed diffuse large B-cell type lymphoma.

Orchiectomy alone is not the definite treatment. Chemotherapy was given to increase survival rate. It is important to diagnose the disease with adequate diagnostic work up to achieve better prognosis and early treatment.
The Varsity Drag: Gender, Sexuality, and Cross-Dressing at the University of Cambridge, 1850–1950
Authors: Janes Dominic
Published: October 2021

The records of student societies show that cross-dressing was a very popular practice at Cambridge University from the second half of the nineteenth century not only in drama but at a wide range of social events. Male and female students were segregated from one another in single-sex colleges because of the perceived moral dangers of co-education. One result of this was that plays were acted entirely by men or by women. Men’s performances of female glamour were sexualized in ways that appeared to confirm cross-sex desire but also contained the potential for flirtation with same-sex eroticism. Some student male actors began to accentuate knowingly queer elements of cross-dressing during the 1920s at a time when homosexuality was becoming more widely discussed in association with gender inversion. The authorities, meanwhile, had become less worried about preventing romantic liaisons between members of the opposite sex than they were about the possibility of same-sex scandals. Drama societies that recruited from across the University began to debate the admission of women members as a way of preventing the student stage from becoming associated with homosexuality and effeminacy. Productions in which men and women only performed as their own sex restored an appearance of heterosexual normality. Cross-dressing had a long afterlife in burlesque reviews in which the audience could be led to understand that it was camp homosexuality that was being parodied.
Biomarkers of DNA damage response improve in vitro micronucleus assays by revealing genotoxic mode of action and reducing the occurrence of irrelevant positive results
Authors: Avlasevich Svetlana , Pellegrin Tina , Godse Manali , Bryce Steven , Bemis Jeffrey , Bajorski Peter , Dertinger Stephen
Published: October 2021

We have previously described two flow cytometry-based in vitro genotoxicity tests: micronucleus (MN) scoring (MicroFlow®) and a multiplexed DNA damage response biomarker assay (MultiFlow®). Here, we describe a strategy for combining the assays in order to efficiently supplement MN analyses with a panel of biomarkers that comment on cytotoxicity (i.e. relative nuclei count, relative increased nuclei count, cleaved PARP-positive chromatin and ethidium monoazide-positive chromatin) and genotoxic mode of action (MoA; i.e. γH2AX, phospho-histone H3, p53 activation and polyploidy). For these experiments, human TK6 cells were exposed to each of 32 well-studied reference chemicals in 96-well plates for 24 continuous hours. The test chemicals were evaluated over a range of concentrations in the presence and absence of a rat liver S9-based metabolic activation system. MultiFlow assay data were acquired at 4 and 24 h, and micronuclei were scored at 24 h. Testing 32 chemicals in two metabolic activation arms translated into 64 a priori calls: 42 genotoxicants and 22 non-genotoxicants. The MN assay showed high sensitivity and moderate specificity (90% and 68%, respectively). When a genotoxic call required significant MN and MultiFlow responses, specificity increased to 95% without adversely affecting sensitivity. The dose–response data were analysed with PROAST Benchmark Dose (BMD) software in order to calculate potency metrics for each endpoint, and ToxPi software was used to synthesise the resulting lower and upper bound 90% confidence intervals into visual profiles. The BMD/ToxPi combination was found to represent a powerful strategy for synthesising multiple BMD confidence intervals, as the software output provided MoA information as well as insights into genotoxic potency.
Louisa May Alcott
Authors: Phillips Anne K.
Published: October 2021

Louisa May Alcott (b. 1832–d. 1888) is among the most enduring of 19th-century American authors. Publishing in diverse genres, including fantasy, realism, gothic fiction, sketches, and poetry, she found favor with broad audiences. Her first notable success, Hospital Sketches (1863), reflected her experiences as a nurse during the Civil War. In the same period, she won a $100 prize from Frank Leslie’s Illustrated Newspaper for “Pauline’s Passion and Punishment,” one of the sensation stories featuring drug use, murder, and other illicit activities that she published anonymously or pseudonymously. Having also placed her work in respected literary magazines such as the Atlantic Monthly, Alcott built relationships with the leading editors of her era. In 1867, editor Thomas Niles of the Boston publishing firm Roberts Brothers invited Alcott to write a novel for girls that might compete with books for boys produced by authors such as Horatio Alger and “Oliver Optic” (William T. Adams). Alcott demurred for months until driven by her family’s chronic poverty to accept Niles’s offer. Volume 1 of Little Women (1868) introduces adolescent sisters Meg, Jo, Beth, and Amy March as well as Theodore “Laurie” Laurence, their wealthy, attractive neighbor. Encouraged by the girls’ wise, loving mother Marmee, they nurture artistic aspirations despite social, economic, and gender constraints. Readers immediately demanded a sequel. In the subsequent volume (1869), Alcott’s protagonists maintain to varying degrees their artistic ambitions and dreams while moving beyond the boundaries of family and home. Little Women spawned two sequels, Little Men (1871) and Jo’s Boys (1886), among other fiction. Although she later famously dismissed such work as “moral pap for the young,” Alcott nonetheless offered in it distinctive, lively representations of American youth and domestic life. Her work contrasts with other writings for young readers of the era, which was far more pious and lachrymose. The rediscovery of her lurid sensation stories in the 1940s and their republication in the 1970s provided scholars with new insights into Alcott’s life and writings, highlighting layers of anger, satire, and subversion in her work. Alcott advocated in her writings progressive causes such as educational reform, dress reform, temperance, suffrage, and racial equality. Among other works, An Old-Fashioned Girl (1869), Eight Cousins (1875), and Rose in Bloom (1876), as well as Alcott’s novels for adults Moods (1864) and Work: A Story of Experience (1873), continue to attract avid interest from scholars and enduring enthusiasm from fans.
Application of a global age-coding system (“WRP”), based on molts and plumages, for use in demographic and other studies of birds
Authors: Pyle Peter , Gahbauer Marcel , Johnson Erik I , Ryder Thomas B , Wolfe Jared D
Published: October 2021

Determination of a bird’s age or cohort is critical for studies on avian demography, occurrence patterns, behavior, and conservation management. Age designations have largely been developed in north-temperate regions and utilize calendar-based or seasonally based codes; however, in tropical regions and in the southern hemisphere, these coding systems have limited utility at best. To address these issues, we had previously devised the “WRP system,” based on the nomenclature of Humphrey and Parkes (H–P) and Howell et al., which defines molts in an evolutionary context applicable to birds globally. Here we refine and build upon core concepts and definitions of the WRP coding system, resolving key limitations that were identified during its first decade of use. The WRP system employs a three-letter alpha code in which each letter describes a different aspect of H–P terminology: the molt cycle (which informs a bird’s age) and molt and plumage status within the cycle (each of which can also inform age). Here we recommend the continued use of most of the original (“core”) WRP coding while augmenting the system with an optional adjunct-code entry for comprehensiveness, clarity, and flexibility, and we clarify a few additional codes to cover less common molting and plumage strategies. For most users, from 7 to 13 core and 1 adjunct WRP code will be sufficient to describe all plumages and provide molt status and ages for demographic studies or other purposes. The revised WRP system is flexible enough to be adapted to the specific goals of programs while also providing core codes that can facilitate the comparison of avian age, molt, and plumage status on a global basis. We anticipate that our revised and standardized version of the WRP system will be easily adopted and could eventually replace calendar-based and seasonally based coding.
Hydroclimatic drivers associated with an unusual bloom of Microcystis aeruginosa and increase of CyanoHABs in a deep oligotrophic lake
Authors: Fuentes Norka , Ríos-Henríquez Catalina , Díaz Patricio A
Published: October 2021

Hydroclimatic and anthropogenic factors in climate change scenarios contribute to ecological changes of harmful cyanobacterial algal blooms in lakes. This study describes the variability of the bathymetric and temporal distribution of cyanobacterial communities in a deep oligotrophic lake. An increase of two to nine in the detection of CyanoHABs potential was observed, likely linked to nitrogen contributions to Lake Rupanco during the last 36 years related to changes in land use and the cultivation of salmonids. We recorded an unusual bloom of Microcystis aeruginosa in winter, 2017 at 30 m during the total mixing period of the lake, associated with the highest N/P index (16.24), the increase of total nitrogen (75 μg/L) and climatic conditions that favored the availability of nitrogen of this cyanobacterium. This study provides information on the causes of increased cyanobacteria in a deep oligotrophic lake. Long-term information on the composition of cyanobacterial communities is very helpful in determining ecological changes.
Cardiopulmonary Phenotypes of Post Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2: A Narrative Review
Authors: Khan Muhammad H. , Becker Richard C.
Published: October 2021

The acute effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are well known; however, the long-term cardiopulmonary effects are less well characterized. The phenotypic expression of acute infection is heterogeneous, ranging from a complete absence of symptoms to shock, multisystem organ failure, and death. Patients with severe or critical coronavirus disease (COVID-19) who survive their initial illness can require a prolonged period of recovery lasting weeks to months. This specific patient group is part of a larger and even more heterogeneous group of patients who initially experience mild-to-moderate symptoms that fail to resolve over time. Collectively, patients recovering from severe or critical COVID-19 and those who continue to experience symptoms following a lower acuity infection are considered to havePost Acute Sequalae of SARS-CoV-2 infection(PASC). Using prognostic factors like myocardial infarction, myocarditis, pulmonary embolism, acute respiratory distress syndrome, need for mechanical ventilation or extracorporeal membrane oxygenation, and advanced pharmaceutical therapies that primarily occur or are instituted in the acute phase of illness one can begin to develop a taxonomy or corpus of PASC in its varied forms.
Emotional and Behavioral Problems in Youth with Autism: High Prevalence and Impact on Functioning
Authors: Fombonne Eric , Croen Lisa A. , Bulkley Joanna E. , Varga Alexandra M. , Daida Yihe G. , Hatch Brigit A. , Dickerson John F. , Lynch Frances L.
Published: October 2021

Objective:

Emotional and behavioral problems (EBPs) may co-occur with autism spectrum disorder (ASD) and impair children's functioning beyond autism symptomatology. We compared the prevalence of EBPs in youths with or without ASD and evaluated their unique contribution to impairment in ASD.

Methods:

We surveyed 1267 children (79.4% boys, mean age: 9.2 years, range: 3–17) recruited at 3 sites in Kaiser Permanente and OCHIN primary care clinical networks, with confirmed International Classification of Diseases-10th ed. diagnosis of ASD (N = 564), asthma (N = 468), or neither (N = 429). Children from the 2 comparison groups were age-matched and sex-matched to the ASD group. EBPs and impairment were measured by the Strengths and Difficulties Questionnaire and autism symptomatology by the Social Responsiveness Scale in the ASD group only.

Results:

EBPs and impairment mean scores were significantly (p < 0.001) higher in participants with ASD compared with children from the 2 comparison groups, across sexes and age groups, with no significant difference between the asthma and control groups. Among children with ASD, both EBPs and autistic symptoms were significantly correlated with impairment (r = 0.64 and r = 0.65, respectively) and explained a significant proportion of impairment variance (R
2 = 0.525; p < 0.001) in multiple linear regression. In the relative importance analysis, EBPs and autistic symptoms explained comparable proportions of impairment variance (46% and 52%, respectively) with no significant difference between their relative weights (mean difference: 0.03; 95% confidence interval: −0.049 to 0.114).

Conclusion:

Among youth with ASD, high levels of EBPs impair daily functioning as much as autistic symptoms. Systematic detection and management of EBPs may improve functioning and outcomes in youth with ASD.
The impact of socioeconomic status and race on the outcomes of congenital heart disease
Authors: Nashed Lydia M. , O’Neil Jennifer
Published: October 2021

Purpose of review

Studying the outcomes of congenital heart disease and their associations allows paediatric cardiologists and intensivists to improve the care and health equity of their patients. This review presents the most recent literature discussing the socioeconomic and racial disparities that pervade the outcomes of patients with congenital heart disease in every facet of treatment. The outcomes of congenital heart disease discussed are prenatal detection, maintenance of care, quality of life, neurodevelopment and mortality.

Recent findings

Historically, it has been documented that patients with congenital heart disease who are of racial and ethnic minorities disproportionately experience poor outcomes. Recently, the association between racial minorities and mortality has been traced to underlying socioeconomic disparities emphasizing that race and ethnicity are not independent determinants of health.

The effect of socioeconomic status on the outcomes of congenital heart disease is profound and reaches beyond the association with racial and ethnic minorities. Changes to address these disparities in outcomes must be made at the individual, institutional, community and system levels.
An Analysis of HPV Infection and Distribution in Cervical and Genital Samples With Condyloma Acuminatum: A Retrospective Study
Authors: Hu Wen , Shi Yan , Guan Meng-Meng , Zhang Xiang-Yue , Zhang Jing-Zhan , Wang Peng , Liu Xin-Mei , Kang Xiao-Jing
Published: October 2021

Objective:

Human papillomavirus (HPV) causes condyloma acuminata, which is one of the most widespread sexually transmitted diseases. This study was aimed to evaluate the prevalence of HPV infection and HPV genotype distribution in patients with condyloma acuminatum in Urumqi, China.

Methods:

A total of 835 cervical and genital samples were collected from outpatients treated for condyloma acuminatum between December 2016 and December 2018. HPV genotyping was performed with the HPV Genotyping Real-time PCR Kit for 23 different HPV types. Statistcal analysis was conducted using the chi-square test.

Results:

The total prevalence of HPV infection was 80.72% (674/835) in patients with condyloma acuminatum in Urumqi. The HPV genotypes were HPV-6 (372/835, 44.55%), HPV-11 (180/835,21.56%), HPV-16 (91/835,10.90%), HPV-43 (65/835, 7.78%), HPV-42 (56/835, 6.71%), and HPV-58 (53/835, 6.35%). Among HPV-infected individuals, 49.11% (331/674) were infected by a single HPV subtype, while 50.89% (343/674) were infected by multiple HPV subtypes. The prevalence of HPV infection was higher in females (82.14%, 276/336) than in males (79.76%, 398/499) (χ
2 = 0.73, P=0.39), and higher in other ethnicities (86.36%, 133/154) than in people of Han ethnicity (79.76%, 541/ 681) (χ
2 = 3.866, P=0.049). The peak prevalence of HPV infection was observed in the age groups of 20–29 years and 30–39 years.

Conclusion:

HPV infection was detected in most patients with condyloma acuminatum in Urumqi with prevalence of 80.72%, and the most common HPV types were HPV-6, -11, -16, -43, -42, and -58. The detection of HPV genotypes is very important to monitor HPV infection so that effective treatment is administered to patients with condyloma acuminatum.
Chronic obstructive pulmonary disease and COVID-19: interrelationships
Authors: Singh Dave , Mathioudakis Alexander G. , Higham Andrew
Published: October 2021

Purpose of review

Chronic obstructive pulmonary disease (COPD) and COVID-19 have many potentially negative interrelationships, which may influence the course of infection and clinical outcomes. The aim of this review is to provide clinicians with an up-to-date perspective of the complex interactions between COPD and COVID-19.

Recent findings

We consider mechanisms that could increase SARS-CoV-2 infection susceptibility in COPD, including increased ACE2 expression, reduced antiviral defence and dysfunctional immunity. We review evidence that COPD is associated with worse clinical outcomes from COVID-19 in analyses that have adjusted for confounding factors, and describe the mechanisms responsible. We discuss the use of inhaled corticosteroids in the context of susceptibility to COVID-19, and consider the impact of COVID-19 on the usual care of COPD patients.

The current review highlights the evidence that COPD patients have worse outcomes from COVID-19, and the multiple mechanisms responsible.
Longitudinal Development of Health‐related Quality of Life and Fatigue in Children on Home Parenteral Nutrition
Authors: Nagelkerke Sjoerd C.J. , van Oers Hedy A. , Haverman Lotte , Vlug Lotte E. , de Koning Barbara A.E. , Benninga Marc A. , Tabbers Merit M.
Published: October 2021

Objectives:

The aim of the study was to describe the longitudinal development of health‐related quality of life (HRQOL) and fatigue in children with chronic intestinal failure (CIF) on home parenteral nutrition (PN) and compare these children to the general population.

Methods:

Prospective, observational study conducted over 7 years in patients suffering from CIF receiving home PN from 2 tertiary hospitals in the Netherlands. Every 6 months, parents (if child <8 years old) or patients (if child ≥8 years old) completed 2 questionnaires: Pediatric Quality of Life Inventory 4.0 (PedsQL) Generic and Fatigue on the KLIK (kwaliteit van leven in kaart [Dutch Acronym for Quality of Life in Clinical Practice]) Patient Reported Outcome Measures portal, which were compared with the general population. Linear mixed models (LMMs) were constructed to investigate the course of HRQOL over time.

Results:

Thirty‐five patients were included (40% girls). At time of last KLIK contact, patients received HPN for a median of 5.3 years (interquartile range [IQR]: 2.9–9.7). In total, 272 questionnaires were completed. PedsQL generic total score for ages 5 to 7 and 8 to 12 years was significantly lower than the general population (P < 0.01 for both age groups) with effect sizes of 0.73 and 0.71, respectively. PedsQL fatigue total score for ages 5 to 7 years was also significantly lower (P = 0.01; effect size 0.70). LMMs for PedsQL Generic and Fatigue total score 2 to 7 and 8 to 18 years showed no significant coefficient for duration of home PN.

Conclusions:

Children suffering from CIF receiving home PN ages 5 to 12 years report lower HRQOL scores than the general population. HRQOL and fatigue do not change during long‐term treatment with home PN in these children.
Clinical Features and Outcomes of Paediatric Patients With Isolated Colonic Crohn Disease
Authors: Berger Tal David , Lee Huey Miin , Padmanaban Lavenya Ramasamy , Wine Eytan , Yerushalmy‐Feler Anat , Hojsak Iva , Kazeka Denis , Serban Daniela Elena , Yogev Dotan , Ledder Oren , Lionetti Paolo , Scarallo Luca , Gasparetto Marco , Croft Nicholas M. , Miele Erasmo , Staiano Annamaria , Meredith Joseph , Aloi Marina , Alvisi Patrizia , Urlep Darja , Weiss Batia , Malham Mikkel , Matar Manar , Navas‐López Víctor Manuel , Romano Claudio , Dipasquale Valeria , Norsa Lorenzo , Kolho Kaija‐Leena , Shamir Raanan , Shouval Dror S. ,   Paediatric IBD Porto Group of ESPGHAN
Published: October 2021

Objectives:

Adult studies suggest that patients with isolated colonic Crohn disease (L2 CD) exhibit unique characteristics differentiating them from patients with ileo‐caecal (L1) CD and ulcerative colitis (UC). We aimed to characterize clinical features and outcomes of paediatric patients with L2.

Methods:

Retrospective data was collected through the Porto Inflammatory Bowel Disease group of the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) on Paediatric patients with L2, L1 or UC at different time‐points. Outcome measures included time to first flare, hospital admissions, initiation of anti‐tumor necrosis factor‐alpha (TNFα) drug, stricture and surgery.

Results:

Three hundred patients were included: 102 L1, 94 L2 and 104 UC. Rates of hematochezia at presentation were 14.7%, 44.7% and 95.2%, while rates of fever were 12.7%, 26.6% and 2.9%, for patients with L1, L2 and UC, respectively (P < 0.001 for all comparisons). Skip lesions were identified in 65% of patients with L2, and granulomas in 36%, similar to L1 patients. Rates of anti‐Saccharomyces cerevisiae antibodies (ASCA) and perinuclear antineutrophil cytoplasmic (pANCA) positivity significantly differed between the three groups: 25.4% and 16.7% for patients with L2, compared with 55.2% and 2.3%, and 1.8% and 52.9% for patients with L1 and UC, respectively. Response rates to exclusive enteral nutrition were comparable between L1 and L2 (78.3–82.4%), as was the response to oral steroids (70.4–76.5%) in the three groups. While times to first flare and admission were similar between groups, patients with L1 were commenced on anti‐TNFα earlier. Moreover, stricturing phenotype and need for colectomy were very rare in patients with L2.

Conclusions:

Significant differences are observed in the clinical presentation and outcomes of Paediatric patients with L2, compared to patients with L1 and UC.
Perceived Stigma and Its Association With Stress, Anxiety, and Depression Among Patients With Epilepsy
Authors: Ranjan Lokesh Kumar , Gupta Pramad R. , Srivastava Mayank
Published: October 2021

The present study focuses on exploring the prevalence and relationship of stigma, stress, anxiety, and depression among patients with epilepsy. This hospital-based study consisted of 200 patients diagnosed with epilepsy using a purposive sampling selected from the outpatient department of the Central Indian Institute of Mental Health and Neuro Sciences, Dewada, Chhattisgarh, India. Patients were assessed through a sociodemographic datasheet, Stigma Scale of Epilepsy, and Depression Anxiety Stress Scales. The result of the study reveals that patient with epilepsy perceived 25% of high stigma 61.0% of stress, 55.0% of anxiety, and 47.5% of the extremely severe level depression. In regression analysis, overall perceived stigma strongly contributes 32.9% to the variance on stress, anxiety, and depression in epileptic patients. The present study helps mental health professionals to understand the problems faced by patients with epilepsy and to create awareness about the same in society so that patients diagnosed with epilepsy are not ostracized.
Predicting Emergence of Primary and Secondary Syphilis Among Women of Reproductive Age in US Counties
Authors: Kimball Anne A. , Torrone Elizabeth A. , Bernstein Kyle T. , Grey Jeremy A. , Bowen Virginia B. , Rickless David S. , Learner Emily R.
Published: October 2021

Background

Syphilis, a sexually transmitted infection that can cause severe congenital disease when not treated during pregnancy, is on the rise in the United States. Our objective was to identify US counties with elevated risk for emergence of primary and secondary (P&S) syphilis among women of reproductive age.

Methods

Using syphilis case reports, we identified counties with no cases of P&S syphilis among women of reproductive age in 2017 and 1 case or more in 2018. Using county-level syphilis and sociodemographic data, we developed a model to predict counties with emergence of P&S syphilis among women and a risk score to identify counties at elevated risk.

Results

Of 2451 counties with no cases of P&S syphilis among women of reproductive age in 2017, 345 counties (14.1%) had documented emergence of syphilis in 2018. Emergence was predicted by the county's P&S syphilis rate among men; violent crime rate; proportions of Black, White, Asian, and Hawaiian/Pacific Islander persons; urbanicity; presence of a metropolitan area; population size; and having a neighboring county with P&S syphilis among women. A risk score of 20 or more identified 75% of counties with emergence.

Conclusions

Jurisdictions can identify counties at elevated risk for emergence of syphilis in women and tailor prevention efforts. Prevention of syphilis requires multidisciplinary collaboration to address underlying social factors.
Treatment of Syphilis With Doxycycline in a Pregnant Woman Unable to Be Desensitized to Penicillin
Authors: Tillery Kory A. , Smiley Sarah G. , Thomas Elaine
Published: October 2021

A pregnant woman with a non–IgE-mediated penicillin allergy was treated for syphilis with doxycycline with resolution of infection and no evidence of adverse outcome for mother or infant.
Rehabilitation outcomes after major lower limb amputation in the oldest old: a systematic review
Authors: Frengopoulos Courtney , Fuller Katherine , Payne Michael W.C. , Viana Ricardo , Hunter Susan W.
Published: October 2021

Background:

Because the population grows older and the burden of chronic disease increases, many individuals will undergo major lower limb amputation (LLA) at advanced ages. There is a scarcity of literature focusing on the outcomes of rehabilitation for people who acquire LLA at 80 years of age and older.

Objectives:

To determine the scope of empirical evidence regarding prosthetic rehabilitation for newly acquired LLA in the oldest old (≥80 years of age).

Study design:

Systematic Review.

Methods:

The databases CINAHL, EMBASE, MEDLINE, and Scopus were searched from inception through June 6, 2020 (PROSPERO: #CRD 42020188623). Two authors independently reviewed all titles and abstracts for inclusion. Inclusion criteria, LLA of any etiology at the transtibial level or above, those who were ≥80 years of age at the time of amputation, and had rehabilitation outcomes reported.

Results:

Of 11,738 articles identified from databases, 117 underwent full-text review and 10 met inclusion criteria. Multiple rehabilitation outcomes were assessed by the selected studies, including general outcomes, prosthetic-related outcomes, and functional abilities. Individuals ≥80 years of age were able to successfully use a prosthesis, discharged home, and performed activities independently or with support. However, increased age was negatively associated with prosthesis fitting and rehabilitation success was not uniform in some participants.

Conclusions:

The oldest old with major LLA can be successful in prosthetic rehabilitation. Age alone should not disqualify individuals from assessment or participation in an amputee rehabilitation program. More research is needed to better understand the rehabilitation outcomes in this population of people with LLA.
Risk of Upstaging Due to Oncofertility Treatment Mimicking Pelvic Lymphoma on 18F-FDG PET/CT
Authors: Schierz Jan-Henning , Ali Farzana , McLeod Anke
Published: October 2021

A 23-year-old woman with primary mediastinal large B-cell lymphoma was referred to 18F-FDG PET/CT for staging. Besides the large mediastinal FDG-avid tumor, another FDG-avid lesion with an SUV higher than expected in corpus luteum cysts was found in the pelvis, raising suspicion for tumor. However, gynecologic ultrasound and review of patient chart revealed history of oncofertility treatment with GNRH analog. This prior treatment was responsible for the intense 18F-FDG uptake within the left ovary, way above the SUV levels commonly associated with menstrual cycle. In this case, the disease was downgraded to stage II, resulting in a less aggressive treatment.
Thyroid Incidentaloma on 68Ga-PSMA-11 PET/CT Leading to Detection of Thyroid Metastasis in Metastatic Prostate Carcinoma
Authors: Parghane Rahul V. , Basu Sandip
Published: October 2021

68Ga-labeled prostate-specific membrane antigen (PSMA)-11 PET/CT has evolved as the noninvasive imaging modality of choice in prostatic adenocarcinoma to detect overexpression of PSMA on prostate cancer cells. Metastasis to the thyroid gland is rarely observed in clinical practice of prostatic adenocarcinoma. Herein, we report the first and rare case of metastatic castration-resistant prostatic adenocarcinoma with thyroid metastasis. The patient demonstrated intensely PSMA-expressing primary prostatic lesion, metastatic lymph nodes, and skeletal lesions, and also mild uptake in thyroid nodule, which on further investigations was established as thyroid metastasis from prostate adenocarcinoma.
The Supraorbital Approach via an Eyebrow Incision: Analysis of Cosmetic Outcomes Using the Scar Cosmesis Assessment Rating Scale
Authors: Ziai Kasra , Shah Sejal , Daggubati Lekhaj C. , Zacharia Brad E. , Lighthall Jessyka G.
Published: October 2021

The supraorbital craniotomy through an eyebrow incision, referred to as the suprabrow approach, may be used to access intracranial lesions. Though offering good surgical exposure for anterior base cranial lesions, the suprabrow approach has a paucity of studies on its cosmetic outcomes. In this study, we aimed to assess the cosmetic outcomes of suprabrow approach using validated Scar Cosmesis Assessment Rating (SCAR) scale for the first time. Three patients underwent a suprabrow approach for resection of a suprasellar or frontal mass. Their postoperative courses were followed, with specific attention to the cosmetic outcome of their procedures. The SCAR scale was used to determine the cosmetic success of the approach. We found that all 3 patients scored ≤ 5 on the SCAR scale. All 3 resections were successful with no major postoperative complications. The only minor complication was transient hypoesthesia of the ipsilateral forehead that was noted in all 3 patients.

This study quantified the positive cosmetic outcomes of a minimally invasive suprabrow approach. The suprabrow approach provides acceptable surgical exposure and access in an appropriately selected patient with anterior cranial base lesions and results in favorable cosmesis. Although transient hypoesthesia in the distribution of the ophthalmic branch of the trigeminal nerve occurs, the overall benefits of the approach and desirable cosmetic outcomes make the suprabrow approach a good technique to access intracranial lesions in appropriate cases.
Facial Nerve Reconstruction Using Acellular Nerve Allograft
Authors: Robinson Jordan , Fisher David
Published: October 2021

When repaired with interposition nerve grafts, segmental facial nerve defects are traditionally treated with nerve autograft. The authors present a patient who presented after partial resection of a basal cell carcinoma over the left zygomatic region with positive deep and peripheral margins and complete loss of frontal and zygomatic facial nerve function. She was subsequently treated with wide resection, superficial parotidectomy, and cervicofacial flap. The parotidectomy was performed for deep margin control and the facial nerve was dissected distally demonstrating the prior resection of a segment of frontal and zygomatic branches consistent with clinical exam. For acute segmental facial nerve defects, nerve autograft has been the gold standard. in our patient, segmental repair using processed nerve allograft demonstrated rapid and complete recovery. This is a viable option for facial nerve reconstruction with various benefits of avoiding donor site morbidity, ease of allograft nerve handling and decreased operative time.
Valid publication of the names of forty-two phyla of prokaryotes
Authors: Oren Aharon , Garrity George M.
Published: October 2021

After the International Committee on Systematics of Prokaryotes (ICSP) had voted to include the rank of phylum in the rules of the International Code of Nomenclature of Prokaryotes (ICNP), and following publication of the decision in the IJSEM, we here present names and formal descriptions of 42 phyla to effect valid publication of their names, based on genera as the nomenclatural types.
The antiviral drug efavirenz reduces biofilm formation and hemolysis by Staphylococcus aureus
Authors: Wang Hongyan , Shi Yiyi , Chen Junwen , Wang Yu , Wang Zhanwen , Yu Zhijian , Zheng Jinxin , Shang Yongpeng
Published: October 2021

Introduction. Biofilm formation and hemolysis are closely related to the pathogenicity of

Staphylococcus aureus

.

Hypothesis/Gap Statement. Strategies that reduce the mortality of

S. aureus

infections may involve novel antimicrobials and/or drugs that decrease

S. aureus

virulence, such as biofilm formation. The antiviral drug efavirenz is a non-nucleoside reverse transcriptase inhibitor, which also has shown antibacterial effect on

Bacillus subtilis

and

Escherichia coli

. Its effect on pathogen virulence has not yet been explored.

Aim. This study investigates the antimicrobial and anti-virulence effect of efavirenz on

S. aureus

.

Methodology. Biofilm biomasses were detected by crystal violet staining. Hemolysis activities of

S. aureus

were determined by rabbit erythrocytes lysis assay. RNA levels of transcriptional regulatory genes, biofilm-related genes, and virulence-related genes of

S. aureus

were determined by RT-qPCR.

Results. Efavirenz showed an inhibitory effect on the growth of

S. aureus

,

Enterococcus faecalis

and

Streptococcus agalactiae

at 50 µM. Efavirenz significantly inhibited biofilm formation of both methicillin-sensitive

S. aureus

(MSSA) and methicillin-resistant

S. aureus

(MRSA) at 25 µM, but did not affect the growth of planktonic

S. aureus

cells. Moreover, hemolysis by

S. aureus

was inhibited by efavirenz at 25 µM. The expression levels of RNA transcriptional regulatory genes (agrA, agrC, sigB, saeR and saeS), biofilm-related genes (cidA, clfA, clfB, fnbA, fnbB), and virulence-related genes (hla, hld, staphopain B, alpha-3 PSM, beta PSM, delta PSM) of

S. aureus

decreased significantly at 25 µM efavirenz.

Conclusion. Efavirenz inhibits

S. aureus

biofilm formation and virulence in vitro.
High seroprevalence of anti-DENV IgM in blood donors in an early outbreak in the Federal District of Brazil, 2019
Authors: Cilião-Alves Daiani Cristina , Barcelos Stefhani Martins de , Bezerra Ariádine Loraine Oliveira , Almeida Isabella Santana , Silveira João Vitor Martins , Alencar Jessica Pereira de , Pimentel Bárbara Maciel Sidou , Araújo Wildo Navegantes de , Haddad Rodrigo
Published: October 2021

Dengue is endemic in Brazil, and several Brazilian cities are affected by frequent seasonal outbreaks of the disease. During the outbreaks the possibility of transfusion-transmitted dengue (TTD) is increased, mainly by the presence of asymptomatic or oligosymptomatic infections in eligible blood donors. The retrospective assessment of anti-DENV IgM and NS1 seroprevalence during a given time interval may indicate the need for measures for the previous screening of DENV infection in blood donors. In this context, we performed retrospective screening for anti-DENV IgM and NS1 in blood donors from the Federal District of Brazil during the early outbreak that occurred in 2019, the largest outbreak in recent years. In total, 450 blood donations were screened for anti-DENV IgM and DENV NS1 using commercial enzyme-linked immunosorbent assay kits (Panbio Dengue IgM Capture ELISA and Platelia Dengue NS1 Ag, respectively). Among the tested plasma samples, 16 % (72/450) presented anti-DENV IgM; no samples presented DENV NS1. Despite the apparent absence of antigenaemia in tested blood donations, the high prevalence of anti-DENV IgM highlights the importance of DENV screening in blood donors, principally during outbreak periods.
Comparative Effectiveness of BNT162b2 versus Ad26.COV2.S for the Prevention of COVID-19 among Dialysis Patients
Authors: Brunelli Steven M. , Sibbel Scott , Karpinski Steph , Marlowe Gilbert , Walker Adam G. , Giullian Jeffrey , Van Wyck David , Kelley Tara , Lazar Rachael , Zywno Meredith L. , Connaire Jeffrey J. , Young Amy , Tentori Francesca
Published: October 2021

Background

mRNA-based SARS-CoV-2 vaccines have been shown to be highly effective among dialysis patients. Because individual vaccines may be differentially available or acceptable to patients, it is important to understand comparative effectiveness of other vaccines, such those based on adeno-virus technologies.

Methods

This retrospective study compared the clinical effectiveness of Ad26.COV2.S (Janssen/Johnson and Johnson) to BNT162b2 among dialysis patients. Patients initiating BNT162b2 (Pfizer/BioNTech) were matched 1:1 to Ad26.COV2.S recipients based on age, race, US state of residence, calendar week of first vaccine receipt, and history of COVID-19. The primary outcome was the comparative rate of COVID-19 considered over 3 follow-up intervals: weeks 1-3, 4-6, and ≥ 7 post-vaccination. In a subset of consented Ad26.COV2.S patients, blood samples were collected ≥28 days after vaccination and anti-SARS-Cov-2 immunoglobulin G antibodies were measured.

Results

There were 2659 matched pairs of patients who received a first dose of each vaccine. During weeks 1-3, incidence rates were 1.13 vs 1.39 per 1000 patient-weeks (pt-wks) for BNT162b2 and Ad26.COV2.S recipients, respectively (incident rate difference [IRD]: 0.25; 95% CI: -0.90, 1.36). During weeks 4-6, incidence rates were 0.78 vs 0.39 per 1000 pt-wks for BNT162b2 and Ad26.COV2.S recipients, respectively (IRD: -0.39; 95% CI: -1.16, 0.38). After week 7, incidence rates were 1.29 vs 1.39 per 1000 pt-wks for BNT162b2 and Ad26.COV2.S recipients, respectively (IRD: 0.10; 95% CI: -0.35, 0.55). Results were similar when considering only patients without a history of COVID-19 and among matched pairs in which BNT162b2 recipients completed the 2-dose regimen. SARS-CoV-2 antibodies were detected in 59.4% (95% CI: 53.0%-65.5%) of Ad26.COV2.S patients.

Conclusion

In a large real-world cohort of dialysis patients, no difference was detected in the clinical effectiveness of BNT162b2 and Ad26.COV2.S, despite an inconsistent antibody response to the latter. These data support the use of either agent in ongoing vaccination efforts in this population.
The Contribution of Pharmacogenetic Drug Interactions to 90-Day Hospital Readmissions: Preliminary Results from a Real-World Healthcare System
Authors: David Sean P. , Singh Lavisha , Pruitt Jaclyn , Hensing Andrew , Hulick Peter J. , Meltzer David O. , O’Donnell Peter H. , Dunnenberger H. Mark
Published: October 2021

Clinical Pharmacogenomics Implementation Consortium (CPIC) guidelines exist for many medications commonly prescribed prior to hospital discharge, yet there is limited data regarding the contribution of gene-x-drug interactions to hospital readmissions. The present study evaluated the relationship between prescription of CPIC medications prescribed within 30 days of hospital admission and 90-day hospital readmission from 2010-2020 in a study population (N=10,104) who underwent sequencing with a 14-gene pharmacogenetic panel. The presence of at least one pharmacogenetic indicator for a medication prescribed within 30 days of hospital admission was considered a gene-x-drug interaction. Multivariable logistic regression analyzed the association between one or more gene-x-drug interactions with 90-day readmission. There were 2,211/2,354 (93.9%) admitted patients who were prescribed at least one CPIC medication. Univariate analyses indicated that the presence of at least one identified gene-x-drug interaction increased risk of 90-day readmission by more than 40% (OR=1.42, 95% confidence interval (CI) 1.09-1.84)(p=0.01). A multivariable model adjusting for age, race, sex, employment status, body mass index, and medical conditions, slightly attenuated the effect (OR=1.33, 95% CI 1.02-1.75)(p=0.04). Our results suggest that the presence of one or more CPIC gene-x-drug interactions increases the risk of 90-day hospital readmission, even after adjustment for demographic and clinical risk factors.
Effects of Confounding Bias in COVID-19 and Influenza Vaccine Effectiveness Test-Negative Designs Due to Correlated Influenza and COVID-19 Vaccination Behaviors
Authors: Doll Margaret K. , Pettigrew Stacy M. , Ma Julia , Verma Aman
Published: October 2021

Background

The test-negative design is commonly used to estimate influenza and COVID-19 vaccine effectiveness (VE). In these studies, correlated COVID-19 and influenza vaccine behaviors may introduce a confounding bias where controls are included with the other vaccine-preventable acute respiratory illness (ARI). We quantified the impact of this bias on VE estimates in studies where this bias is not addressed.

Methods

We simulated study populations under varying vaccination probabilities, COVID-19 VE, influenza VE, and proportions of controls included with the other vaccine-preventable ARI. Mean bias was calculated as the difference between true and estimated VE. Absolute mean bias in VE estimates was classified as low (<10%), moderate (10% to <20%), and high (≥20%).

Results

Where vaccination probabilities are positively correlated, COVID-19 and influenza VE test-negative studies with influenza and SARS-CoV-2 ARI controls, respectively, underestimate VE. For COVID-19 VE studies, mean bias was low for all scenarios where influenza represented ≤50% of controls. For influenza VE studies, mean bias was low for all scenarios where SARS-CoV-2 represented ≤10% of controls. Although bias was driven by the conditional probability of vaccination, low VE of the vaccine of interest and high VE of the confounding vaccine increase its magnitude.

Conclusions

Where a low percentage of controls are included with the other vaccine-preventable ARI, bias in COVID-19 and influenza VE estimates is low. However, influenza VE estimates are likely more susceptible to bias. Researchers should consider potential bias and its implications in their respective study settings to make informed methodological decisions in test-negative VE studies.