bluuebunny/crossref_metadata_2025 huggingface dataset:
Results of a study of remote reporting over virtual applications and using visually calibrated monitors
Authors: Lai Yusheng Keefe , Kuo Benjamin Jyhhan , Lim Kheng Choon , Lim Chee Yeong , Low Albert Su Chong , Png Meng Ai
Published: December 2021

Background and Objectives

The purpose of this study is to examine differences in image quality, discrepancy rates, productivity and user experience between remote reporting over Virtual Application (VA) using visually calibrated monitors, and reporting using diagnostic grade workstations in hospital premises.

Methods

Three specialist accredited radiologists examined and provisionally reported outpatient CT and MR studies over PACS delivered as a VA, using visually calibrated monitors from their homes. They then proceeded to view the same studies within hospital premises and issue a final report. Surveys were filled out for each imaging study. Discrepancies were reviewed and assigned RADPEER scores.

Results

A total of 51 outpatient CT and MRIs were read. Relative to hospital premise reporting, on a Likert scale of 5 (the higher the better), average image quality was 3.9, speed of loading and image manipulation was 4.4 and productivity was 4.1. Remote reporting user experience did not differ significantly between CT versus MRI studies. Complete concordance rate was 80.4% (41/51) and only one of the studies had a significant discrepancy, which may have been due to extra time given to interpretation. All three radiologists reported factors influencing image display and quality as the top factor impacting remote reporting throughput.

Conclusions

Remote reporting over VA with visually calibrated monitors for CT and MR can be useful in periods of staffing difficulty to augment on-site radiologists, though attention must be paid to its limitations and policies defined by local leadership with reference to relevant national position
The Return of the “Lurker”: A Longitudinal Study of Citizens’ Use of Social Media in Danish Elections 2011, 2015, and 2019
Authors: Jensen Jakob Linaa , Schwartz Sander Andreas
Published: December 2021

In this case study on Denmark, we particularly focus on trajectories of participation, the question of increasing mobilization, and the perceived outcomes in terms of efficacy. Contrary to other studies, we seek to establish a coherent perspective including the “silent majority.” By combining studies of participation, mobilization, and efficacy, we wish to provide not only a rigorous documentation of mobilization and efficacy of social media during election campaigns, but also a historic documentation of the participatory use and perception of social media as a democratic and political tool during three national election campaigns from 2011 to 2019.
Acupressure: An Effective and Feasible Alternative Treatment for Anxiety During the COVID-19 Pandemic
Authors: Yang Juan , Do Alex , Mallory Molly J , Wahner-Roedler Dietlind L , Chon Tony Y , Bauer Brent A
Published: December 2021

Anxiety is highly reported during the COVID-19 pandemic. The use of acupressure for anxiety is a common practice in integrative medicine, and previous literature has shown that acupressure can be an effective and feasible alternative treatment for decreasing anxiety. Given the social distancing requirements during the COVID-19 pandemic, it appears reasonable to assume that acupressure may be especially suited to treat anxiety under these circumstances. However, there has been relatively little reported use of acupressure for anxiety during the pandemic. This viewpoint aims to highlight the possible role of acupressure as a self-administered therapeutic approach for anxiety amidst the COVID-19 pandemic and to outline key areas for future research.
How the Emotional Environment Shapes the Emotional Life of the Child
Authors: LoBue Vanessa , Ogren Marissa
Published: December 2021

Emotion understanding facilitates the development of healthy social interactions. To develop emotion knowledge, infants and young children must learn to make inferences about people's dynamically changing facial and vocal expressions in the context of their everyday lives. Given that emotional information varies so widely, the emotional input that children receive might particularly shape their emotion understanding over time. This review explores how variation in children's received emotional input shapes their emotion understanding and their emotional behavior over the course of development. Variation in emotional input from caregivers shapes individual differences in infants’ emotion perception and understanding, as well as older children's emotional behavior. Finally, this work can inform policy and focus interventions designed to help infants and young children with social-emotional development.
Seeing the Forest for the Trees: A Medical Education Focused on Concepts
Authors: Agusala Kartik
Published: December 2021

A pedagogical shift in medical education that emphasizes concepts and skills over memorization and recall will strengthen the broad-based foundation of knowledge unique to physicians and free up time for students to engage important new areas that need physician leaders.
Prevalence and Factors Associated With Oral Cavity and Pharyngeal Cancer Screening in a Rural Population
Authors: Matos Sophia , Boakye Eric Adjei , Crosby Dana , Sharma Arun
Published: December 2021

Objective

(1) To quantify the prevalence of provider recommendation and receipt of oral cavity and pharyngeal cancer (OCPC) screening and (2) to examine the factors associated with OCPC screening recommendation and receipt among adults.

Study Design

Cross‐sectional.

Setting

Rural counties in central Illinois.

Methods

This study among adults (N = 145) was conducted between January 1 and June 30, 2017. The outcomes of interest were provider recommendation and receipt of OCPC screening. Multivariable logistic regression models were used to examine the association between (1) sociodemographic, health care access and utilization, and OCPC risk factors and (2) provider recommendation and receipt of OCPC screening.

Results

The prevalence of provider recommendation and receipt of OCPC screening was 12.4% and 28.3%, respectively. Approximately 15% of current smokers, 13% of participants who consume alcohol, and 10% of participants with ≥5 lifetime sexual partners had received an OCPC screening recommendation. OCPC screening rates were 19% for current smokers, 30% for those who consume alcohol, and 32% for those with ≥5 lifetime sexual partners. In the adjusted analyses, respondents with ≥5 partners (adjusted odds ratio, 3.10 [95% CI, 1.25‐7.66]) had a higher odds of receiving OCPC screening than those with <5. There were no significant associations between other OCPC risk factors and provider recommendation and receipt of OCPC screening.

Conclusion

OCPC screening recommendation and receipt were low; only number of lifetime sexual partners was associated with OCPC screening receipt. Our findings suggest that rural populations may be vulnerable to late‐stage diagnosis of OCPC, and interventions to help improve screening rates are warranted.
Lobsters, Whales, and Traps: The Politics of Endangerment in the Gulf of Maine
Authors: Besky Sarah
Published: December 2021

In 2019, a debate arose among Maine lobster fishers and environmental groups over the role of lobster traps in killing North Atlantic right whales, the world's most endangered whale species. Maine fishers denied that their gear was killing whales. To do so, they leveraged longstanding representations by regional natural and social scientists of lobster fishing as part of a unique and ecologically sustainable “heritage” economy—one that was itself “endangered” by over-regulation. Setting this debate in the context of a global climate crisis that is irrevocably changing Atlantic coastal environments, this article shows how ecological fragility and white working-class fragility become yoked together. Efforts to understand what lobster traps do, and how they might do it differently, perpetuated a key feature of settler colonialism, namely, the tendency to seek harmony between resource extraction and conservation.
Providing diabetes education to patients with chronic kidney disease: A survey of diabetes educators in Ontario, Canada
Authors: Clemens Kristin K , Ouédraogo Alexandra M , Liu Selina L , Bleah Paulina , Mikalachki Amanda , Spaic Tamara
Published: December 2021

Background

Patients with diabetes and chronic kidney disease (CKD) have complex diabetes care needs. Diabetes educators can play an important role in their clinical care.

Aim

To understand diabetes educators’ experience providing diabetes support to patients with CKD and elicit their view on the additional care needs of this population.

Methods

We conducted a quantitative online survey of diabetes educators between May 2019 and May 2020. We surveyed English-speaking educators actively practicing in Ontario, Canada for at least 1 year. We recruited them through provincial Diabetes Education Programs and Diabetes Education Section Chairs of Diabetes Canada.

Results

We made email contact with 219/233 (94%) Diabetes Education Programs and 11/12 (92%) provincial Diabetes Canada Section Chairs. 122 unique diabetes educators submitted complete surveys (survey participation rate ∼79%). Most worked in community education programs (91%). Almost half were registered nurses (48%), and 39% had practiced for more than 15 years. Respondents noted difficulty helping patients balance complex medical conditions (19%), faced socioeconomic barriers (17%), and struggled to provide dietary advice (16%). One-third were uncertain of how to support those receiving dialysis. Eighty-five percent felt they needed more training and education to care for this high-risk group. When asked about the care needs of patients with CKD, almost all (90%) felt that patients needed more diabetes support in general. Improvement in care coordination was most commonly suggested (38%).

Conclusions

In this study of the diabetes educators’ experience treating patients with diabetes and CKD, respondents noted numerous challenges. There may be opportunities to better support both diabetes care professionals, and patients who live with multiple medical comorbidities.
Celiac Disease Presenting as Hemolytic Anemia Mimic: A Case Report
Authors: Siddiqui Anjum , Khan Ruhi
Published: December 2021

Celiac disease, an immune-mediated enteropathy, results from gluten ingestion in the form of wheat, rye, and barley in genetically susceptible individuals. It is a systemic disorder characterized by a variable combination of gluten-related signs and symptoms, and disease-specific antibodies in addition to enteropathy. The clinical presentation of celiac disease is extremely variable: a small proportion of patients presenting with severe gastrointestinal symptoms and malabsorption, and extraintestinal symptoms, and a large proportion having no symptoms at all. Owing to the varied clinical presentation, diagnosing celiac disease remains a challenge. We present a case of celiac disease presenting with severe anemia and clinical features suggestive of hemolytic anemia, making diagnosis even more difficult.
The influence of microscale lithological layering and fluid availability on the metamorphic development of garnet and zircon: insights into dissolution–reprecipitation processes
Authors: McElhinney Tara R. , Dempster Tim J. , Chung Peter
Published: December 2021

The response of garnet and zircon to prograde amphibolite-facies metamorphism in late Proterozoic mica schists from the Scottish Highlands has been investigated. Spatial analysis of zircon populations using scanning electron microscopy was undertaken in Dalradian Schists that have undergone a sequence of prograde garnet growth and localised breakdown reactions involving coupled dissolution–reprecipitation. Fluid availability and matrix permeability strongly control this metamorphic response and different generations of garnet contain radically different populations of metamorphic micro-zircon and associated changes in the detrital zircon population. Micro-zircon abundance increases during garnet growth, whereas that of detrital zircon decreases. The mineralogy of the matrix influences zircon abundance in porphyroblast phases, where garnet overgrows a micaceous matrix zircon-rich garnet forms and where it overgrows a quartzofeldspathic matrix the result is zircon-poor garnet. Following garnet growth, micro-zircon abundance decreases at each stage of the prograde reaction history, with sillimanite-zone schists containing the lowest abundance, suggesting micro-zircons are texturally less stable at staurolite- and sillimanite-grade metamorphism. Micro-zircons are distributed evenly across host minerals in the matrix, with the exception of retrograde chlorite where micro-zircons are absent due to fluids removing Zr before new zircon can precipitate. There is an overall decrease in the mode of zircon at each stage of the reaction history, indicating that zircon is a highly reactive phase during amphibolite-facies metamorphism and is very sensitive to individual prograde and retrograde reactions.
Red-baiting in tooth and claw
Authors: Branch Glenn
Published: December 2021

Throughout the twentieth century, Carl Weinberg explains inRed Dynamite: Creationism, Culture Wars, and Anticommunism in America, American antievolutionists regularly attempted to vilify evolution through its supposed association with communism. His book is a splendid chronicle of the deployment and development of their claims.
The prognostic and clinical significance of IFI44L aberrant downregulation in patients with oral squamous cell carcinoma
Authors: Ou Deming , Wu Ying
Published: December 2021

Background

It is a basic task in high-throughput gene expression profiling studies to identify differentially expressed genes (DEGs) between two phenotypes. RankComp, an algorithm, could analyze the highly stable within-sample relative expression orderings (REOs) of gene pairs in a particular type of human normal tissue that are widely reversed in the cancer condition, thereby detecting DEGs for individual disease samples measured by a particular platform.

Methods

In the present study, Gene Expression Omnibus (GEO) Series (GSE) GSE75540, GSE138206 were downloaded from GEO, by analyzing DEGs in oral squamous cell carcinoma based on online datasets using the RankComp algorithm, using the Kaplan-Meier survival analysis and Cox regression analysis to survival analysis, Gene Set Enrichment Analysis (GSEA) to explore the potential molecular mechanisms underlying.

Results

We identified 6 reverse gene pairs with stable REOs. All the 12 genes in these 6 reverse gene pairs have been reported to be associated with cancers. Notably, lower Interferon Induced Protein 44 Like (IFI44L) expression was associated with poorer overall survival (OS) and Disease-free survival (DFS) in oral squamous cell carcinoma patients, and IFI44L expression showed satisfactory predictive efficiency by receiver operating characteristic (ROC) curve. Moreover, low IFI44L expression was identified as risk factors for oral squamous cell carcinoma patients’ OS. IFI44L downregulation would lead to the activation of the FRS-mediated FGFR1, FGFR3, and downstream signaling pathways, and might play a role in the PI3K-FGFR cascades.

Conclusions

Collectively, we identified 6 reverse gene pairs with stable REOs in oral squamous cell carcinoma, which might serve as gene signatures playing a role in the diagnosis in oral squamous cell carcinoma. Moreover, high expression of IFI44L, one of the DEGs in the 6 reverse gene pairs, might be associated with favorable prognosis in oral squamous cell carcinoma patients and serve as a tumor suppressor by acting on the FRS-mediated FGFR signaling.
Factors influencing online orthopedic doctor–patient consultations
Authors: Lei Ping , Zheng Jianjun , Li Yun , Li Zhongjiang , Gao Fei , Li Xuesong
Published: December 2021

Background

Online doctor–patient consultation is a new option for orthopedic patients in China to obtain a diagnosis and treatment advice. This study explores the factors associated with online consultation to formulate operational guidelines for managing online consultations in an online medical community (OMC).

Methods

An empirical model was developed to identify the factors that influence online orthopedic doctor–patient consultations in an OMC while focusing on the perceived value of and perceived trust in online consultations. The moderating effects of different risk categories of orthopedic diseases were also considered. Data from 339 feedback surveys from orthopedic patients who used online consultation services and Stata software version 14.0 were used to estimate the model parameters and test the robustness of the empirical model.

Results

Of those who completed the feedback surveys, 53.42% were female patients, 82.27% were between 18 and 60 years old, and 61.98% sought consultations online more than 2 times per year. Model analysis demonstrated that the regression coefficients of the perceived value of and perceived trust in online consultations are 0.489 (p < 0.01) and 0.505 (p < 0.01), respectively. The interaction coefficient between disease risk and perceived value is 0.336 (p < 0.01), and the interaction coefficient between disease risk and perceived trust is − 0.389 (p < 0.01).

Conclusions

Orthopedic patients’ perceived value of and perceived trust in online consultations in an OMC can significantly influence their intention to seek online disease diagnosis and treatment consultations. The effects of perceived value and perceived trust on patients' intention to consult vary significantly across different disease risk categories. Therefore, enhancing the perceived value and perceived trust of orthopedic patients is an important component of OMC operation and management.
A comprehensive gene-centric pleiotropic association analysis for 14 psychiatric disorders with GWAS summary statistics
Authors: Lu Haojie , Qiao Jiahao , Shao Zhonghe , Wang Ting , Huang Shuiping , Zeng Ping
Published: December 2021

Background

Recent genome-wide association studies (GWASs) have revealed the polygenic nature of psychiatric disorders and discovered a few of single-nucleotide polymorphisms (SNPs) associated with multiple psychiatric disorders. However, the extent and pattern of pleiotropy among distinct psychiatric disorders remain not completely clear.

Methods

We analyzed 14 psychiatric disorders using summary statistics available from the largest GWASs by far. We first applied the cross-trait linkage disequilibrium score regression (LDSC) to estimate genetic correlation between disorders. Then, we performed a gene-based pleiotropy analysis by first aggregating a set of SNP-level associations into a single gene-level association signal using MAGMA. From a methodological perspective, we viewed the identification of pleiotropic associations across the entire genome as a high-dimensional problem of composite null hypothesis testing and utilized a novel method called PLACO for pleiotropy mapping. We ultimately implemented functional analysis for identified pleiotropic genes and used Mendelian randomization for detecting causal association between these disorders.

Results

We confirmed extensive genetic correlation among psychiatric disorders, based on which these disorders can be grouped into three diverse categories. We detected a large number of pleiotropic genes including 5884 associations and 2424 unique genes and found that differentially expressed pleiotropic genes were significantly enriched in pancreas, liver, heart, and brain, and that the biological process of these genes was remarkably enriched in regulating neurodevelopment, neurogenesis, and neuron differentiation, offering substantial evidence supporting the validity of identified pleiotropic loci. We further demonstrated that among all the identified pleiotropic genes there were 342 unique ones linked with 6353 drugs with drug-gene interaction which can be classified into distinct types including inhibitor, agonist, blocker, antagonist, and modulator. We also revealed causal associations among psychiatric disorders, indicating that genetic overlap and causality commonly drove the observed co-existence of these disorders.

Conclusions

Our study is among the first large-scale effort to characterize gene-level pleiotropy among a greatly expanded set of psychiatric disorders and provides important insight into shared genetic etiology underlying these disorders. The findings would inform psychiatric nosology, identify potential neurobiological mechanisms predisposing to specific clinical presentations, and pave the way to effective drug targets for clinical treatment.
Biodegradable reduce expenditure bioreactor for augmented sonodynamic therapy via regulating tumor hypoxia and inducing pro-death autophagy
Authors: Zou Weijuan , Hao Junnian , Wu Jianrong , Cai Xiaojun , Hu Bing , Wang Zhigang , Zheng Yuanyi
Published: December 2021

Backgrounds

Sonodynamic therapy (SDT) as an emerging reactive oxygen species (ROS)-mediated antitumor strategy is challenged by the rapid depletion of oxygen, as well as the hypoxic tumor microenvironment. Instead of the presently available coping strategies that amplify the endogenous O2 level, we have proposed a biodegradable O2 economizer to reduce expenditure for augmenting SDT efficacy in the present study.

Results

We successfully fabricated the O2 economizer (HMME@HMONs-3BP-PEG, HHBP) via conjugation of respiration inhibitor 3-bromopyruvate (3BP) with hollow mesoporous organosilica nanoparticles (HMONs), followed by the loading of organic sonosensitizers (hematoporphyrin monomethyl ether; HMME) and further surface modification of poly(ethylene glycol) (PEG). The engineered HHBP features controllable pH/GSH/US-sensitive drug release. The exposed 3BP could effectively inhibit cell respiration for restraining the oxygen consumption, which could alleviate the tumor hypoxia conditions. More interestingly, it could exorbitantly elevate the autophagy level, which in turn induced excessive activation of autophagy for promoting the therapeutic efficacy. As a result, when accompanied with suppressing O2-consumption and triggering pro-death autophagy strategy, the HHBP could achieve the remarkable antitumor activity, which was systematically validated both in vivo and in vitro assays.

Conclusions

This work not only provides a reduce expenditure means for enduring SDT, but also represents an inquisitive strategy for tumor treatments by inducing pro-death autophagy.

Graphical Abstract
Circulating tumor cells in patients undergoing androgen deprivation therapy with versus without cryosurgery for metastatic prostate cancer: a retrospective analysis
Authors: Sheng Mingxiong , Guo Shanming , Liu Chunxiao
Published: December 2021

Background

The study aimed to assess the value of circulating tumor cells (CTCs) as a prognostic and treatment response marker in patients undergoing androgen deprivation therapy (ADT) plus cryosurgery vs. ADT alone for metastatic prostate cancer (mPCA).

Methods

This retrospective analysis included 43 patients with mPCA: 23 receiving ADT alone (control) and 20 receiving additional cryosurgery (cryosurgery group). CTCs and progression-free survival (PFS) were compared between the two groups. Cox proportional hazards regression was conducted to identify variables associated with PFS.

Results

Median PFS was 35 months (IQR, 33‑37) in the cryosurgery group vs. 30 months (IQR, 27‑32) in the control (p < 0.001). CTCs count was significantly lower in the cryosurgery group at both 3 months (z = 2.170, p = 0.030) and 12 months (z = 2.481; p = 0.013). In comparison to the baseline, the number of CTCs at both 3 and 12 months was lower in the cryosurgery group (p = 0.004 and p < 0.001, respectively), but not in the ADT alone group. In multivariate Cox regression, shorter PFS was associated with baseline PSA ≧100 ng/ml (HR 6.584, 95% CI, 5.309‑8.166), biopsy Gleason score ≧ 8 (HR 2.064, 95% CI, 1.608‑2.650), clinic T stage>T2b (HR 5.021, 95% CI, 3.925‑6.421), number of bone metastases>3 (HR 3.421, 95% CI, 2.786‑4.202), positive CTCs at 3 months post-treatment (HR 6.833, 95% CI, 5.176‑9.022), positive CTCs 1 year post-treatment (HR 6.051, 95% CI, 4.347‑8.424). Prostate cryosurgery was associated with longer PFS (HR 0.062, 95% CI, 0.048‑.080).

Conclusions

CTC was a prognostic and treatment response marker for mPCA. ADT plus cryosurgery could reduce CTCs and prolong PFS vs. ADT alone in mPCA patients with low metastatic volume.
Loss of epidermal MCPIP1 is associated with aggressive squamous cell carcinoma
Authors: Szukala Weronika , Lichawska-Cieslar Agata , Pietrzycka Roza , Kulecka Maria , Rumienczyk Izabela , Mikula Michal , Chlebicka Iwona , Konieczny Piotr , Dziedzic Katarzyna , Szepietowski Jacek C , Fontemaggi Giulia , Rys Janusz , Jura Jolanta
Published: December 2021

Background

Squamous cell carcinoma (SCC) of the skin is a common form of nonmelanoma skin cancer. Monocyte chemotactic protein 1-induced protein 1 (MCPIP1), also called Regnase-1, is an RNase with anti-inflammatory properties. In normal human skin, its expression is predominantly restricted to the suprabasal epidermis. The main aim of this study was to investigate whether MCPIP1 is involved in the pathogenesis of SCC.

Methods

We analyzed the distribution of MCPIP1 in skin biopsies of patients with actinic keratoses (AKs) and SCCs. To explore the mechanisms by which MCPIP1 may modulate tumorigenesisin vivo, we established a mouse model of chemically induced carcinogenesis.

Results

Skin expression of MCPIP1 changed during the transformation of precancerous lesions into cutaneous SCC. MCPIP1 immunoreactivity was high in the thickened area of the AK epidermis but was predominantly restricted to keratin pearls in fully developed SCC lesions. Accelerated development of chemically induced skin tumors was observed in mice with loss of epidermal MCPIP1 (Mcpip1eKO). Papillomas that developed in Mcpip1eKOmouse skin were larger and characterized by elevated expression of markers typical of keratinocyte proliferation and tumor angiogenesis. This phenotype was correlated with enhanced expression of IL-6, IL-33 and transforming growth factor-beta (TGF-β). Moreover, our results demonstrated that in keratinocytes, the RNase MCPIP1 is essential for the negative regulation of genes encoding SCC antigens and matrix metallopeptidase 9.

Conclusions

Overall, our results provide a mechanistic understanding of how MCPIP1 contributes to the development of epidermoid carcinoma.
Characterizing telemedicine use in clinical immunology and allergy in Canada before the COVID-19 pandemic
Authors: Lee Erika Yue , Song Christine , Vadas Peter , Morgan Matthew , Betschel Stephen
Published: December 2021

Rationale

There exists a geographic barrier to access CIA care for patients who live in rural communities; telemedicine may bridge this gap in care. Herein we characterized the use of telemedicine in CIA at a population-based level and single centre.

Methods

Before the COVID-19 pandemic, telemedicine care was provided via the Ontario Telemedicine Network (OTN) in Ontario, Canada. Descriptive data were collected from the OTN administrative database and from electronic medical records at a single academic centre during 2014 to 2019. The potential distance travelled and time saved by telemedicine visits were calculated using postal codes.

Results

A total of 1298 telemedicine visits was conducted over OTN, with an average of 216 visits per year. Only 11% of the allergists/immunologists used telemedicine to provide care before the COVID-19 pandemic. In the single centre that provided the majority of the telemedicine care, 66% patients were female and the overall mean age was 46. The most common diagnosis was immunodeficiency (40%), followed by asthma (13%) and urticaria (11%). Most patients required at least one follow-up via telemedicine. The average potential two-way distance travelled per visit was 718 km and the average potential time travelled in total was 6.6 h.

Conclusion

Telemedicine was not widely used by allergists/immunologists in Ontario, Canada before the COVID-19 pandemic. It could offer a unique opportunity to connect patients who live in remote communities and allergists/immunologists who practice in urban centres in Canada. Independent of the current pandemic, our study further highlights the need for more physicians to adopt and continue telemedicine use as well as for healthcare agencies to support its use as a strategic priority once the pandemic is over.
Free gracilis end-to-side microanastomosis to a peronea arteria magna: a case report
Authors: Dargan Dallan , Lakshminarayan Raghuram , Chuo Cher Bing
Published: December 2021

Background

Complex orthoplastic lower limb trauma in individuals with multiple injuries requires considerable resources and interdisciplinary collaboration for good outcomes. We present the first reported end-to-side free flap microanastomosis for lower limb trauma reconstruction involving a peronea arteria magna without radiographic collaterals.

Case presentation

A 55-year-old Caucasian gentleman involved in road traffic collision sustained an open tibial fracture on the anteromedial distal third of the left lower leg with local degloving and a subtotal right foot and ankle degloving. Both injuries were reconstructed with free tissue transfer. A left lower limb peronea arteria magna successfully received a free gracilis muscle flap by end-to-side microanastomosis and perfusion of the foot was preserved. This rare anatomical variant and its anatomy is reviewed, as well as a description of the suggested preoperative planning and technique for reconstruction.

Conclusions

Successful free flap reconstruction may be performed to a lower limb with a peronea arteria magna recipient as the lone vessel supplying the foot in trauma, although preoperative counseling of the risks, benefits, and options are essential.

Level of evidence

Level V, case report
Extensive bilateral diffuse infiltrates and deterioration of lung following infection with severe acute respiratory syndrome coronavirus 2 in a pregnant woman: a case report
Authors: Moeindarbary Somayeh , Dadgar Salmeh , Layegh Parvaneh , Shahriari Zahra , Fayyaz Faezeh , Danesteh Sina , Rafiee Mahdi , Bahrami Milad
Published: December 2021

Introduction

Severe acute respiratory syndrome coronavirus 2 is the third member of the coronavirus family to cause global concern in the twenty-first century. Pregnant women are particularly at higher risk of developing severe viral pneumonia, possibly because of a partial immune suppression during their pregnancy. Under such critical and rapidly evolving circumstances, these poor findings might be helpful for the treatment of infected pregnant women with the 2019 novel coronavirus.

Case presentation

In this study, we report the case of a 33-year-old Asian pregnant woman at 25 gestational weeks with coronavirus disease 2019 who developed severe complications, including hypoxemia, acute respiratory distress syndrome, pulmonary infiltration, and bilateral pleural effusion. She died 1 month after admission to the hospital.

Conclusion

Pregnant populations are especially at higher risk of viral pneumonia development caused by severe acute respiratory syndrome coronavirus 2. Further research on the prevention and treatment of the new coronavirus is necessary.
A full-term pregnant woman with secondary Evans syndrome caused by severe coronavirus disease 2019: a case report
Authors: Santosa Damai , Sofro Muchlis A. U. , Farida  , Nindita Nurvita , Pangarsa Eko A. , Setiawan Budi , Rizky Daniel , Suharti Catharina
Published: December 2021

Background

In this report, we describe a very challenging case of a patient with secondary Evans syndrome caused by severe coronavirus disease 2019 infection in a pregnant full-term woman.

Case presentation

A 29-year-old full-term pregnant Indonesian woman presented with gross hematuria, dry cough, fever, dyspnea, nausea, anosmia, and fatigue 5 days after confirmation of coronavirus disease 2019 infection. Laboratory examinations showed very severe thrombocytopenia, increased indirect bilirubin, and a positive direct Coombs’ test. From peripheral blood, there was an increased number of spherocytes, which indicated an autoimmune hemolytic process. Antinuclear antibody and anti-double-stranded DNA test results were negative, and her virology serological markers are also negative for human immunodeficiency virus, cytomegalovirus, and hepatitis B and C. Despite aggressive treatment with platelet transfusion, high-dose steroid, and thrombopoietin receptor agonists, the platelet count did not recover, and a speculative cesarean delivery had to be done with a very low platelet count.
Gestational hemostasis: a natural model for hemostasis resuscitation of major periprocedural blood loss
Authors: Babik Barna , Kupcsulik Szilvia , Fazakas János
Published: December 2021

Early goal-directed treatment is an evidence-based approach to guide hemostatic therapy during major periprocedural bleeding. If viscoelastic coagulation tests are not available, an algorithm, termed the pyramid of hemostatic interventions, can help manage severe bleeding. Pregnant women accumulate huge reserves of prothrombotic and antifibrinolytic hemostatic elements to avoid peripartum blood loss. We provide comparison of therapeutic hemostatic approaches and natural gestational process and identified remarkable analogy between early goal-directed management of bleeding and hemostatic adaptation of pregnant woman. Therefore, gestational hemostasis serves as a natural model for goal-directed hemostasis resuscitation and can foster understanding of hemostatic management of periprocedural bleeding.
Correction to: Estimating thigh skeletal muscle volume using multi-frequency segmental-bioelectrical impedance analysis
Authors: Taniguchi Masashi , Yamada Yosuke , Yagi Masahide , Nakai Ryusuke , Tateuchi Hiroshige , Ichihashi Noriaki
Published: December 2021

An amendment to this paper has been published and can be accessed via the original article.
Biobanking and risk assessment: a comprehensive typology of risks for an adaptive risk governance
Authors: Akyüz Kaya , Chassang Gauthier , Goisauf Melanie , Kozera Łukasz , Mezinska Signe , Tzortzatou Olga , Mayrhofer Michaela Th.
Published: December 2021

Biobanks act as the custodians for the access to and  responsible use of human biological samples and related data that have been generously donated by individuals to serve the public interest and scientific advances in the health research realm. Risk assessment has become a daily practice for biobanks and has been discussed from different perspectives. This paper aims to provide a literature review on risk assessment in order to put together a comprehensive typology of diverse risks biobanks could potentially face. Methodologically set as a typology, the conceptual approach used in this paper is based on the interdisciplinary analysis of scientific literature, the relevant ethical and legal instruments and practices in biobanking to identify how risks are assessed, considered and mitigated. Through an interdisciplinary mapping exercise, we have produced a typology of potential risks in biobanking, taking into consideration the perspectives of different stakeholders, such as institutional actors and publics, including participants and representative organizations. With this approach, we have identified the following risk types: economic, infrastructural, institutional, research community risks and participant’s risks. The paper concludes by highlighting the necessity of an adaptive risk governance as an integral part of good governance in biobanking. In this regard, it contributes to sustainability in biobanking by assisting in the design of relevant risk management practices, where they are not already in place or require an update. The typology is intended to be useful from the early stages of establishing such a complex and multileveled biomedical infrastructure as well as to provide a catalogue of risks for improving the risk management practices already in place.
MEGANE investigations of Phobos and the Small Body Mapping Tool
Authors: Chabot Nancy L. , Peplowski Patrick N. , Ernst Carolyn M. , Nair Hari , Lucks Michael , Steele R. Josh , Lawrence David J.
Published: December 2021

The MEGANE instrument onboard the MMX mission will acquire gamma-ray and neutron spectroscopy data of Phobos to determine the elemental composition of the martian moon and provide key constraints on its origin. To produce accurate compositional results, the irregular shape of Phobos and its proximity to Mars must be taken into account during the analysis of MEGANE data. The MEGANE team is adapting the Small Body Mapping Tool (SBMT) to handle gamma-ray and neutron spectroscopy investigations, building on the demonstrated record of success of the SBMT being applied to scientific investigations on other spacecraft missions of irregularly shaped bodies. This is the first application of the SBMT to a gamma-ray and neutron spectroscopy dataset, and the native, three-dimensional foundation of the SBMT is well suited to MEGANE’s needs. In addition, the SBMT will enable comparisons between the MEGANE datasets and other datasets of the martian moons, including data from previous spacecraft missions and MMX’s multi-instrument suite.
Effect of assistive devices on the precision of digital impressions for implants placed in edentulous maxilla: an in vitro study
Authors: Masu Rena , Tanaka Shinpei , Sanda Minoru , Miyoshi Keita , Baba Kazuyoshi
Published: December 2021

Purpose

To examine the effect of assistive devices on the precision of digital impression for multiple implants placed in the edentulous maxilla.

Methods

A reference model representing an edentulous maxilla with four implants was developed. The digital impression group included three settings: Type 0, without an assistive device; Type 1, with an assistive device connecting only neighboring implants; and Type 2, with an assistive device connecting not only neighboring implants but also the two posterior implants, with perpendicular branches from this bar towards the anterior implants. Digital impressions were made five times for each type using three intraoral scanners (IOSs). For conventional method, silicone impressions and verification jigs were prepared; fabricated plaster models were scanned using a laboratory scanner/industrial 3D scanner. In analysis 1, two-way ANOVA analyzed the effect of IOSs and assistive devices on the precision of digital impressions. In analysis 2, one-way ANOVA compared the silicone impressions, the verification jigs, and the most precise group of digital impressions from analysis 1.

Results

In analysis 1, the IOS and assistive device type (F = 25.22, p < .0001) effects and the interaction between these two factors (F = 5.64, p = .0005) were statistically significant. In analysis 2, CON, VJ, and digital impression with Type 2 devices (most precise devices in analysis 1) were compared; better precision was obtained by digital impression with Type 2 device than by CON and VJ (F = 30.08, p < .0001).

Conclusions

For implants placed in an edentulous maxilla, digital impressions with assistive devices can provide better precision compared to silicone impressions and verification jigs.
Utilization and reproductive performance of gilts in large-scale pig farming system with different production levels in China: a descriptive study
Authors: Guan Ran , Gao Wenchao , Li Peng , Qiao Xuwei , Ren Jing , Song Jian , Li Xiaowen
Published: December 2021

Background

This study was to investigate the utilization and reproductive performance of gilts in large-scale pig farms. Data of this descriptive study included 169,013 gilts of 1540 gilts’ batches on 105 large-scale pig farms from April 2020 to March 2021. According to the upper and lower 25th percentiles of piglets weaned per sow per year (PSY) during the research stage, pig farms were divided into three productivity groups: high-performing (HP), intermediate-performing (IP) and low-performing (LP) farms. On the basis of breeds, LP (LP-Total) farms was further divided into LP-breeding pig (LP-BP) and LP-commercial pig (LP-CP) groups. Average utilization, estrus and first mating data was collected from a total of 1540 gilts’ batches. The age-related factors (introduction age, age at first estrus and age at first mating) and litter production (total number of piglets, number of piglets born alive and number of weaned piglets, as well as their proportion distribution) among HP and LP groups were compared. The litter production in different age groups were also analyzed.

Results

The introduction age, mortality and culling rate of HP farms were lower compared with LP farms. Total number of piglets per litter, number of piglets born alive per litter and number of weaned piglets per litter in HP farms were significantly more than those of LP groups, respectively. The proportion distribution peaks of litter production in HP farms were shifted about two more than those in LP groups, respectively; and the proportion of low litter production (eight per litter or less) was lower than that in LP groups. The results of different age groups showed that total number of piglets per litter and number of piglets born alive per litter in 220–279 d were the most, while that of 370 d was the least.

Conclusions

The overall utilization and reproductive performance of gilts in HP farms was better than those of LP farms. The difference in utilization was reflected in introduction source, culling rate and mortality. While the age at first estrus and first mating, breeds and litter production were the main differences for reproductive performance.
A LC-MS/MS method with electrospray ionization and atmospheric pressure chemical ionization source for analysis of pesticides in hemp
Authors: Dalmia Avinash , Cudjoe Erasmus , Jalali Jacob , Qin Feng
Published: December 2021

Background

Pesticide testing for hemp has traditionally focused on techniques like QuEChERS with dSPE and SPE which demand time-consuming sample preparation, typically resulting in poor recovery rates for some pesticides, and requires the use of both LC-MS/MS and GC-MS/MS based instruments to cover the analysis for all regulated pesticides. In this study, we describe a streamlined approach for working with LC-MS/MS featuring a dual electrospray ionization (ESI) and atmospheric pressure chemical ionization (APCI) sources using solvent extraction for faster and easier sample preparation and with 80–120% recovery for the analysis of all of 66 pesticides (regulated by California state in cannabis) with low detection limits in hemp.

Methods

A simple solvent extraction with acetonitrile was used to extract pesticides from hemp. A LC-MS/MS system with dual ESI and APCI source was used to determine sensitivity for the analysis of 66 pesticides in hemp matrix, 62 pesticides were analyzed using an 18-min LC-MS/MS method with an ESI source and the other 4 pesticides were measured using a 6-min LC-MS/MS method with an APCI source.

Results

The limit of quantitation (LOQ) of all 66 pesticides in hemp was in the range of 0.0025–0.1 μg/g which was well below the California state action limits of these analytes in cannabis products. A simple, fast, and cost-effective solvent extraction method was used for sample preparation to get good recovery in the range of 80–120% with RSD less than 20%. The unique ionization mechanism of chlorinated pesticides such as pentachloronitrobenzene using the LC-MS/MS system with an APCI source was elucidated. The proficiency test report generated with the LC-MS/MS method showed acceptable results for all of 66 pesticides in hemp with all of th z scores less than 2 with no false positives and negatives. The stability data collected over 5 days showed RSD less than 20% for 66 pesticides in hemp, and this demonstrated the robustness of the LC-MS/MS system used in this work.

Conclusions

A LC-MS/MS method with dual ESI and APCI sources was developed for the analysis of 66 pesticides in hemp. The recovery of all pesticides from a hemp matrix was in the acceptable range of 80–120% with RSD less than 20%.
Modified Seldinger technique for internal jugular open central venous line insertion in neonates: merging two different manoeuvers
Authors: Shalaby Mohamed Mahmoud , Salama Rami Mohammed , Mansour Mohammed Awad
Published: December 2021

Background

Central venous line insertion in neonates is an important and lifesaving procedure. It can carry significant risks and complications, including death, at the time of insertion or later. We aimed to retrospectively assess the modified Seldinger technique for open placement of a central venous catheter in neonates, regarding its safety, feasibility, operative time, and preservation of the patency of the internal jugular vein. This study was conducted on 120 neonates from March 2018 to March 2020. We closely monitored the pulse for the detection of arrhythmia or bradycardia, which might be caused during the insertion of the guide wire or the tip of the catheter. Post-operative X-ray was done immediately after the end of the procedure for all cases, to determine the site of the central venous catheter and to detect the presence of pneumothorax.

Results

Arrhythmia was observed in 9 cases (7.5%), and blood oozing in 5 cases (4.1%). There were 3 cases of pneumothorax (2.5%), 2 cases of neck hematoma in two cases (1.6%), 6 cases of internal jugular vein thrombosis (5%), and dislodging of the catheter in 3 cases (2.5%). There were no cases of arterial puncture, failure of cannulation, or haemothorax in our study.

Conclusions

The modified Seldinger technique insertion for open central venous line in neonates is a safe, accessible, and feasible method, especially in centers that lack the experience of ultrasound-guided insertion in neonates.
Risks of all-cause death and completed suicide in patients with schizophrenia/schizoaffective disorder treated with long-acting injectable or oral antipsychotics: A population-based retrospective cohort study in Taiwan
Authors: Tang Chao-Hsiun , Shen Shih-Pei , Huang Min-Wei , Qiu Hong , Watanabe Sayuri , Goh Choo Hua , Liu Yanfang
Published: December 2021

Background

Long-acting injectable (LAI) antipsychotics improve medication adherence in patients with schizophrenia and extend the duration of therapeutic drug levels but with administration of an increased dose. Real-world mortality data in patients prescribed LAIs are lacking. We conducted a population-based cohort study to estimate and compare the incidence rates of all-cause death and completed suicide in patients with schizophrenia/schizoaffective disorder exposed to LAIs and oral antipsychotics.

Methods

Patients with a diagnosis of schizophrenia/schizoaffective disorder between January 1, 2015 and November 30, 2019 were enrolled from the Taiwan National Health Insurance Research Database and linked to Death Registry records. Eligible patients were new antipsychotic users. Relative risks of death for each antipsychotic compared with oral paliperidone were evaluated using a Cox proportional hazard model adjusted for age, sex, Charlson Comorbidity Index, index year, bipolar or major depressive or other mood disorders, mental disorders due to drug use, and baseline hospitalization frequency.

Results

There were 228,791.08 person-years of follow-up (mean 2.48 years). The incidence rates of all-cause death in users of LAI paliperidone administered monthly (PP1M) and every 3 months (PP3M) were 7.40/1,000 person-years (95% confidence interval 5.94–9.11) and 9.93 (5.88–15.79), respectively. The incidences of completed suicide were 2.03/1,000 person-years (1.32–2.99) and 3.10 (1.14–6.88), respectively. No significant associations were observed between PP1M and PP3M compared to oral paliperidone in incidences of all-cause death or for completed suicide.

Discussion

No increased risk of all-cause death or completed suicide was observed in users of antipsychotic LAIs, including PP1M and PP3M.