bluuebunny/crossref_metadata_2025 huggingface dataset:
Cannabis use, sedentary behavior, and physical activity in a nationally representative sample of US adults
Authors: Ong Lydia Q. , Bellettiere John , Alvarado Citlali , Chavez Paul , Berardi Vincent
Published: April 2021

Background

Prior research examining the relationship between cannabis use, sedentary behavior, and physical activity has generated conflicting findings, potentially due to biases in the self-reported measures used to assess physical activity. This study aimed to more precisely explore the relationship between cannabis use and sedentary behavior/physical activity using objective measures.

Methods

Data were obtained from the 2005–2006 National Health and Nutrition Examination Survey. A total of 2,092 participants (ages 20–59; 48.8% female) had accelerometer-measured sedentary behavior, light physical activity, and moderate-to-vigorous physical activity. Participants were classified as light, moderate, frequent, or non-current cannabis users depending on how often they used cannabis in the previous 30 days. Multivariable linear regression estimated minutes in sedentary behavior/physical activity by cannabis use status. Logistic regression modeled self-reported moderate-to-vigorous physical activity in relation to current cannabis use.

Results

Fully adjusted regression models indicated that current cannabis users’ accelerometer-measured sedentary behavior did not significantly differ from non-current users. Frequent cannabis users engaged in more physical activity than non-current users. Light cannabis users had greater odds of self-reporting physical activity compared to non-current users.

Conclusions

This study is the first to evaluate the relationship between cannabis use and accelerometer-measured sedentary behavior and physical activity. Such objective measures should be used in other cohorts to replicate our findings that cannabis use is associated with greater physical activity and not associated with sedentary behavior in order to fully assess the potential public health impact of increases in cannabis use.
Colonoscopy in poorly prepped colons: a cost effectiveness analysis comparing standard of care to a new cleansing technology
Authors: Voigt Jeffrey , Mosier Michael , Gralnek Ian M.
Published: April 2021

Background

The objective of this Markov model lifetime cost-effectiveness analysis was to evaluate a new medical device technology which minimizes redo colonoscopies on the outcomes of cost, quality of life, and aversion of colorectal cancers (CRC).

Methods

A new technology (PureVu® System) which cleans inadequately prepped colons was evaluated using TreeAge 2019 software in patients who presented with inadequate prep in outpatient settings in the US. PureVu was compared to the standard of care (SOC). Peer reviewed literature was used to identify the CRC incidence cancers based on missing polyps. Costs for procedures were derived from 2019 Medicare and from estimated private payer reimbursements. Base case costs, sensitivity analysis and incremental cost effectiveness (ICE) were evaluated. The cost of PureVu was $750.

Results

Assuming a national average compliance rate of 60% for colonoscopy, the use of PureVu saved the healthcare system $833–$992/patient depending upon the insurer when compared to SOC. QALYs were also improved with PureVu mainly due to a lower incidence of CRCs. In sensitivity analysis, SOC becomes less expensive than PureVu when compliance to screening for CRC using colonoscopy is ≤ 28%. Also, in order for SOC to be less expensive than PureVu, the list price of PureVu would need to exceed $1753. In incremental cost effectiveness analysis, PureVu dominated SOC.

Conclusion

Using the PureVu System to improve bowel prep can save the healthcare system $3.1–$3.7 billion per year, while ensuring a similar quality of life and reducing the incidence of CRCs.
Changes in liver-related mortality by etiology and sequelae: underlying versus multiple causes of death
Authors: Sheu Ming-Jen , Liang Fu-Wen , Lin Ching-Yih , Lu Tsung-Hsueh
Published: April 2021

Background

The expanded definition of liver-related deaths includes a wide range of etiologies and sequelae. We compared the changes in liver-related mortality by etiology and sequelae for different age groups between 2008 and 2018 in the USA using both underlying and multiple cause of death (UCOD and MCOD) data.

Methods

We extracted mortality data from the CDC WONDER. Both the absolute (rate difference) and relative (rate ratio and 95% confidence intervals) changes were calculated to quantify the magnitude of change using the expanded definition of liver-related mortality.

Result

Using the expanded definition including secondary liver cancer and according to UCOD data, we identified 68,037 liver-related deaths among people aged 20 years and above in 2008 (29 per 100,000) and this increased to 90,635 in 2018 (33 per 100,000), a 13% increase from 2008 to 2018. However, according to MCOD data, the number of deaths was 113,219 (48 per 100,000) in 2008 and increased to 161,312 (58 per 100,000) in 2018, indicating a 20% increase. The increase according to MCOD was mainly due to increase in alcoholic liver disease and secondary liver cancer (liver metastasis) for each age group and hepatitis C virus (HCV) and primary liver cancer among decedents aged 65–74 years.

Conclusion

The direction of mortality change (increasing or decreasing) was similar in UCOD and MCOD data in most etiologies and sequelae, except secondary liver cancer. However, the extent of change differed between UCOD and MCOD data.
Breasts and the city: an urban ethnography of infant feeding in public spaces within Cardiff, United Kingdom
Authors: Grant Aimee
Published: April 2021

Background

Internationally, women report challenges breastfeeding in public spaces. This study aimed to investigate the social-spatial aspects of public spaces in one UK city, Cardiff, in order to suggest possible barriers and facilitators to breastfeeding in public spaces.

Methods

The study observation location guide prioritised places that had been reported as hostile to breastfeeding or breastfeeding friendly in the existing literature. Data were collected between April and September 2018 at various times of day, in several areas of the city, and included transport (n = 4), transport hubs (n = 3), high streets (n = 4), cafes (n = 2), a large city centre shopping complex, comprising of three joined shopping malls and a large city centre department store containing a third café. Low inference field notes were written on an encrypted smart phone and expanded soon after. Data were analysed thematically using deductive codes based on the observation schedule. Additional inductive codes relating to places were added.

Results

Overall, public transport and the city centre were inhospitable environments for those who might need to breastfeed, and even more so for those who need to express breastmilk. The core barriers and facilitators across locations were the availability of appropriate seating coupled with either high privacy or politely unimposing strangers (civil inattention). The one variation to this model arose from the department store café, where civil inattention was not performed and there was low privacy, but breastfeeding occurred anyway.

Conclusions

This research highlights the physical and social barriers to breastfeeding within one urban city centre in the UK and its associated transport links. It is clear that there is an urgent need for change in urban city centres and public transport if countries are to meet their aims in relation to increasing breastfeeding rates. Interventions will need to be multifaceted, accounting for social norms relating to infant feeding as well as changes to the physical environment, policy and potentially legal change. Further research should be undertaken in other countries to examine the extent to which hostile environments exist, and if correcting these could facilitate breastfeeding and reduce gender-based violence.
Maize-IAS: a maize image analysis software using deep learning for high-throughput plant phenotyping
Authors: Zhou Shuo , Chai Xiujuan , Yang Zixuan , Wang Hongwu , Yang Chenxue , Sun Tan
Published: April 2021

Background

Maize (Zea mays L.) is one of the most important food sources in the world and has been one of the main targets of plant genetics and phenotypic research for centuries. Observation and analysis of various morphological phenotypic traits during maize growth are essential for genetic and breeding study. The generally huge number of samples produce an enormous amount of high-resolution image data. While high throughput plant phenotyping platforms are increasingly used in maize breeding trials, there is a reasonable need for software tools that can automatically identify visual phenotypic features of maize plants and implement batch processing on image datasets.

Results

On the boundary between computer vision and plant science, we utilize advanced deep learning methods based on convolutional neural networks to empower the workflow of maize phenotyping analysis. This paper presents Maize-IAS (Maize Image Analysis Software), an integrated application supporting one-click analysis of maize phenotype, embedding multiple functions: (I) Projection, (II) Color Analysis, (III) Internode length, (IV) Height, (V) Stem Diameter and (VI) Leaves Counting. Taking the RGB image of maize as input, the software provides a user-friendly graphical interaction interface and rapid calculation of multiple important phenotypic characteristics, including leaf sheath points detection and leaves segmentation. In function Leaves Counting, the mean and standard deviation of difference between prediction and ground truth are 1.60 and 1.625.

Conclusion

The Maize-IAS is easy-to-use and demands neither professional knowledge of computer vision nor deep learning. All functions for batch processing are incorporated, enabling automated and labor-reduced tasks of recording, measurement and quantitative analysis of maize growth traits on a large dataset. We prove the efficiency and potential capability of our techniques and software to image-based plant research, which also demonstrates the feasibility and capability of AI technology implemented in agriculture and plant science.
Postoperative bisphosphonate do not significantly alter the fusion rate after lumbar spinal fusion: a meta-analysis
Authors: Mei Jun , Song Xiaoxu , Guan Xiaoming , Wu Dou , Wang Junjie , Liu Qiang
Published: April 2021

Background

To evaluate the effect of postoperative BP treatment on improving the fusion rate after lumbar spinal fusion surgery by performing a meta-analysis of randomized controlled trials (RCTs) and other comparative cohort studies.

Methods

A comprehensive search of PubMed, EMBASE, the Web of Science, and the Cochrane Central Register of Controlled Trials was performed for RCTs and other comparative cohort studies on the effect of BP treatment on improving the fusion rate after lumbar spinal fusion surgery. The primary outcome measures were the number of patients with bone formation grades A, B, and C at 12 months of follow-up; fusion rates at 12 and 24 months of follow-up; vertebral compression fracture (VCF) at 12 and 24 months of follow-up; pedicle screw loosening at 24 months of follow-up; and cage subsidence, the Oswestry disability index (ODI), and the visual analogue score (VAS) at 12 months of follow-up. The final search was performed in July 2020.

Results

Seven studies with 401 patients were included. Compared with the placebo, BP treatment did not significantly alter the number of patients with bone formation grades A, B, and C, or the VAS at the 12-month follow-up or the fusion rates at the 12- and 24-month follow-ups. In addition, compared with the placebo, BPs significantly reduced the risks of VCF at the 12- and 24-month follow-ups, pedicle screw loosening at the 24-month follow-up, and cage subsidence and the ODI at the 12-month follow-up.

Conclusions

Postoperative BPs do not clearly improve bone formation and the fusion rate, but they reduce VCF, cage subsidence, and loosening of pedicle screws after lumbar fusion surgery compared with the control treatment.
Protective genes and pathways in Alzheimer’s disease: moving towards precision interventions
Authors: Seto Mabel , Weiner Rebecca L. , Dumitrescu Logan , Hohman Timothy J.
Published: April 2021

Alzheimer’s disease (AD) is a progressive, neurodegenerative disorder that is characterized by neurodegeneration, cognitive impairment, and an eventual inability to perform daily tasks. The etiology of Alzheimer’s is complex, with numerous environmental and genetic factors contributing to the disease. Late-onset AD is highly heritable (60 to 80%), and over 40 risk loci for AD have been identified via large genome-wide association studies, most of which are common variants with small effect sizes. Although these discoveries have provided novel insight on biological contributors to AD, disease-modifying treatments remain elusive. Recently, the concepts of resistance to pathology and resilience against the downstream consequences of pathology have been of particular interest in the Alzheimer’s field as studies continue to identify individuals who evade the pathology of the disease even into late life and individuals who have all of the neuropathological features of AD but evade downstream neurodegeneration and cognitive impairment. It has been hypothesized that a shift in focus from Alzheimer’s risk to resilience presents an opportunity to uncover novel biological mechanisms of AD and to identify promising therapeutic targets for the disease. This review will highlight a selection of genes and variants that have been reported to confer protection from AD within the literature and will also discuss evidence for the biological underpinnings behind their protective effect with a focus on genes involved in lipid metabolism, cellular trafficking, endosomal and lysosomal function, synaptic function, and inflammation. Finally, we offer some recommendations in areas where the field can rapidly advance towards precision interventions that leverage the ideas of protection and resilience for the development of novel therapeutic strategies.
Ethical considerations and patient safety concerns for cancelling non-urgent surgeries during the COVID-19 pandemic: a review
Authors: Brown Nolan J. , Wilson Bayard , Szabadi Stephen , Quon Cameron , Ong Vera , Himstead Alexander , Shlobin Nathan A. , Yang Chen Yi , Lien Brian V. , Shahrestani Shane , Tran Katelynn , Tafreshi Ali R. , Birkenbeuel Jack , Ransom Seth C. , Choi Elliot H. , Sahyouni Ronald , Chan Alvin Y. , Kheriaty Aaron , Yang Isaac
Published: April 2021

At the time of writing of this article, there have been over 110 million cases and 2.4 million deaths worldwide since the start of the Coronavirus Disease 2019 (COVID-19) pandemic, postponing millions of non-urgent surgeries. Existing literature explores the complexities of rationing medical care. However, implications of non-urgent surgery postponement during the COVID-19 pandemic have not yet been analyzed within the context of the four pillars of medical ethics. The objective of this review is to discuss the ethics of elective surgery cancellation during the COVID-19 pandemic in relation to beneficence, non-maleficence, justice, and autonomy. This review hypothesizes that a more equitable decision-making algorithm can be formulated by analyzing the ethical dilemmas of elective surgical care during the pandemic through the lens of these four pillars. This paper’s analysis shows that non-urgent surgeries treat conditions that can become urgent if left untreated. Postponement of these surgeries can cause cumulative harm downstream. An improved algorithm can address these issues of beneficence by weighing local pandemic stressors within predictive algorithms to appropriately increase surgeries. Additionally, the potential harms of performing non-urgent surgeries extend beyond the patient. Non-maleficence is maintained through using enhanced screening protocols and modifying surgical techniques to reduce risks to patients and clinicians. This model proposes a system to transfer patients from areas of high to low burden, addressing the challenge of justice by considering facility burden rather than value judgments concerning the nature of a particular surgery, such as cosmetic surgeries. Autonomy can be respected by giving patients the option to cancel or postpone non-urgent surgeries. However, in the context of limited resources in a global pandemic, autonomy is not absolute. Non-urgent surgeries can ethically be postponed in opposition to the patient’s preference. The proposed algorithm attempts to uphold the four principles of medical ethics in rationing non-urgent surgical care by building upon existing decision models, using additional measures of resource burden and surgical safety to increase health care access and decrease long-term harm as much as possible. The next global health crisis will undoubtedly present its own unique challenges. This model may serve as a comprehensive starting point in determining future guidelines for non-urgent surgical care.
Crosstalk between microRNA expression and DNA methylation drives the hormone-dependent phenotype of breast cancer
Authors:   OSBREAC, Aure Miriam Ragle , Fleischer Thomas , Bjørklund Sunniva , Ankill Jørgen , Castro-Mondragon Jaime A. , Børresen-Dale Anne-Lise , Tost Jörg , Sahlberg Kristine K. , Mathelier Anthony , Tekpli Xavier , Kristensen Vessela N.
Published: April 2021

Background

Abnormal DNA methylation is observed as an early event in breast carcinogenesis. However, how such alterations arise is still poorly understood. microRNAs (miRNAs) regulate gene expression at the post-transcriptional level and play key roles in various biological processes. Here, we integrate miRNA expression and DNA methylation at CpGs to study how miRNAs may affect the breast cancer methylome and how DNA methylation may regulate miRNA expression.

Methods

miRNA expression and DNA methylation data from two breast cancer cohorts, Oslo2 (n = 297) and The Cancer Genome Atlas (n = 439), were integrated through a correlation approach that we term miRNA-methylation Quantitative Trait Loci (mimQTL) analysis. Hierarchical clustering was used to identify clusters of miRNAs and CpGs that were further characterized through analysis of mRNA/protein expression, clinicopathological features, in silico deconvolution, chromatin state and accessibility, transcription factor binding, and long-range interaction data.

Results

Clustering of the significant mimQTLs identified distinct groups of miRNAs and CpGs that reflect important biological processes associated with breast cancer pathogenesis. Notably, two major miRNA clusters were related to immune or fibroblast infiltration, hence identifying miRNAs associated with cells of the tumor microenvironment, while another large cluster was related to estrogen receptor (ER) signaling. Studying the chromatin landscape surrounding CpGs associated with the estrogen signaling cluster, we found that miRNAs from this cluster are likely to be regulated through DNA methylation of enhancers bound by FOXA1, GATA2, and ER-alpha. Further, at the hub of the estrogen cluster, we identified hsa-miR-29c-5p as negatively correlated with the mRNA and protein expression of DNA methyltransferase DNMT3A, a key enzyme regulating DNA methylation. We found deregulation of hsa-miR-29c-5p already present in pre-invasive breast lesions and postulate that hsa-miR-29c-5p may trigger early event abnormal DNA methylation in ER-positive breast cancer.

Conclusions

We describe how miRNA expression and DNA methylation interact and associate with distinct breast cancer phenotypes.
Elevated APOBEC mutational signatures implicate chronic injury in etiology of an aggressive head-and-neck squamous cell carcinoma: a case report
Authors: Patel Jena , den Breems Nicoline Y. , Tuluc Madalina , Johnson Jennifer , Curry Joseph M , South Andrew P. , Cho Raymond J.
Published: April 2021

Background

Aggressive squamous cell carcinomas (SCCs) present frequently in the context of chronic skin injury occurring in patients with the congenital blistering disease recessive dystrophic epidermolysis bullosa. Recently, these cancers were shown to harbor mutation signatures associated with endogenous deaminases of the active polynucleotide cytosine deaminase family, collectively termed APOBEC, and clock-like COSMIC [Catalogue of Somatic Mutations in Cancer] signatures, which are associated with normal aging and might result from cumulative DNA replication errors. We present a case of a nasal septal SCC arising in the context of recurrent injury, but also modest past tobacco use. Our genetic analysis of this tumor reveals unusually high APOBEC and clock-like but low tobacco-related COSMIC signatures, suggesting that chronic injury may have played a primary role in somatic mutation. This case report demonstrates how signature-based analyses may implicate key roles for certain mutagenic forces in individual malignancies such as head-and-neck SCC, with multiple etiological origins.

Case presentation

We report the case of a 43-year-old male former smoker who presented with congestion and swelling following a traumatic nasal fracture. During surgery, the mucosa surrounding the right nasal valve appeared abnormal, and biopsies revealed invasive keratinizing SCC. Frozen section biopsies revealed multiple areas to be positive for SCC. Gene sequencing showed loss of PTEN (exons 2–8), CDKN2A/B and TP53 (exons 8–9), MYC amplification, and BLM S338*. Exome sequencing data also revealed that 36% of mutations matched an APOBEC mutational signature (COSMIC signatures 2 and 13) and 53% of mutations matched the clock-like mutation signature (COSMIC signature 5). These proportions place this tumor in the 90th percentile bearing each signature, independently, in a reference data set combining cutaneous and The Cancer Genome Atlas (TCGA) head and neck SCC data. In contrast, few mutations harbored a tobacco-related COSMIC signature 4, representing about the 10th percentile in our reference SCC data set. The patient was treated with partial rhinectomy with local flap reconstruction, bilateral neck dissection, and adjuvant radiation therapy; the patient remains disease-free to date.

Conclusion

Based on comparative mutational signature analysis, we propose that the history of tobacco use and traumatic injury may have collaborated in activating APOBEC enzymes and the clock-like mutational process, ultimately leading to cancer formation. Clinical awareness of the relationship between epithelial injury and tumorigenesis should enhance earlier detection of this particularly aggressive type of cancer.
A modified proximal point algorithm involving nearly asymptotically quasi-nonexpansive mappings
Authors: Khatoon Sabiya , Cholamjiak Watcharaporn , Uddin Izhar
Published: April 2021

In this paper, we propose a modified proximal point algorithm based on the Thakur iteration process to approximate the common element of the set of solutions of convex minimization problems and the fixed points of two nearly asymptotically quasi-nonexpansive mappings in the framework of$\operatorname{CAT}(0)$CAT(0)spaces. We also prove the Δ-convergence of the proposed algorithm. We also provide an application and numerical result based on our proposed algorithm as well as the computational result by comparing our modified iteration with previously known Sahu’s modified iteration.
A new generalization of some quantum integral inequalities for quantum differentiable convex functions
Authors: Li Yi-Xia , Ali Muhammad Aamir , Budak Hüseyin , Abbas Mujahid , Chu Yu-Ming
Published: April 2021

In this paper, we offer a new quantum integral identity, the result is then used to obtain some new estimates of Hermite–Hadamard inequalities for quantum integrals. The results presented in this paper are generalizations of the comparable results in the literature on Hermite–Hadamard inequalities. Several inequalities, such as the midpoint-like integral inequality, the Simpson-like integral inequality, the averaged midpoint–trapezoid-like integral inequality, and the trapezoid-like integral inequality, are obtained as special cases of our main results.
Daratumumab therapy for post-HSCT immune-mediated cytopenia: experiences from two pediatric cases and review of literature
Authors: Driouk Lina , Schmitt Robert , Peters Anke , Heine Sabine , Girschick Hermann Josef , Strahm Brigitte , Niemeyer Charlotte M. , Speckmann Carsten
Published: April 2021

Background

Immune-mediated cytopenias (AIC) are challenging complications following allogeneic hematopoietic stem cell transplantation (HSCT). While broad-acting immunosuppressive agents like corticosteroids are often standard of care, several novel therapies which target specific immunological pathways have recently been developed and provide hope for patients with steroid-refractory courses and may limit long-term toxicity. The successful off-label use of the plasma cell depleting anti-CD38 antibody daratumumab was published in several case reports, suggesting efficacy, i.e., in patients with antibody-mediated AIC refractory to previous B cell depletion. We want to share our experience with two children, whom we treated with daratumumab, including one fatal course with uncontrolled disease. Given the absence of substantial data from HSCT registries or prospective trials, we furthermore provide a critical review of the literature on daratumumab treatment of AIC.

Case presentations

Patient 1 (P1), an 11-year-old girl with lipopolysaccharide-responsive and beige-like anchor protein (LRBA) deficiency who developed immune-mediated thrombocytopenia (AIT) from day +58 after HSCT, showed a complete response to daratumumab after the fourth of six total daratumumab doses. She remains transfusion independent for over a year of follow-up. Previously, her thrombocytopenia was refractory to corticosteroids, rituximab, intravenous immunoglobulins (IVIG), eltrombopag, cyclosporine A, and sirolimus. Patient 2 (P2), a 6-year-old boy with CD40 ligand (CD40L) deficiency, developed both AIT and hemolytic anemia (AIHA) after HSCT on days +58 and +83, respectively, and was also treated with daratumumab after being previously refractory to prednisolone, rituximab, and IVIG. Yet, he did neither respond to daratumumab nor the concomitantly administered methyprednisolone pulse, plasmapheresis, and eculizumab and succumbed due to refractory disease.

Conclusion

Reviewing the literature on the use of daratumumab for refractory AIC post-HSCT, we consider daratumumab a promising agent for this life-threatening disorder: ten of the twelve patients reached transfusion independency in the literature. However, treatment failures are likely to be underreported. Thus, controlled trials are needed to explore the safety and efficacy of daratumumab in this rare post-HSCT complication.
Leveraging fine-grained mobile data for churn detection through Essence Random Forest
Authors: Colot Christian , Baecke Philippe , Linden Isabelle
Published: April 2021

The rise of unstructured data leads to unprecedented opportunities for marketing applications along with new methodological challenges to leverage such data. In particular, redundancy among the features extracted from this data deserves special attention as it might prevent current methods to benefit from it. In this study, we propose to investigate the value of multiple fine-grained data sources i.e. websurfing, use of applications and geospatial mobility for churn detection within telephone companies. This value is analysed both in substitution and in complement to the value of the well-known communication network. What is more, we also suggest an adaptation of the Random Forest algorithm called Essence Random Forest designed to better address redundancy among extracted features. Analysing fine-grained data of a telephone company, we first find that geo-spatial mobility data might be a good long term alternative to the classical communication network that might become obsolete due to the competition with digital communications. Then, we show that, on the short term, these alternative fine-grained data might complement the communication network for an improved churn detection. In addition, compared to Random Forest and Extremely Randomized Trees, Essence Random Forest better leverages the value of unstructured data by offering an enhanced churn detection regardless of the addressed perspective i.e. substitution or complement. Finally, Essence Random Forest converges faster to stable results which is a salient property in a resource constrained environment.
Comparison of implant placement accuracy in two different preoperative digital workflows: navigated vs. pilot-drill-guided surgery
Authors: Spille Johannes , Jin Feilu , Behrens Eleonore , Açil Yahya , Lichtenstein Jürgen , Naujokat Hendrik , Gülses Aydin , Flörke Christian , Wiltfang Jörg
Published: April 2021

Background

The aim of the study is to evaluate the accuracy of a new implant navigation system on two different digital workflows.

Methods

A total of 18 phantom jaws consisting of hard and non-warping plastic and resembling edentulous jaws were used to stimulate a clinical circumstance. A conventional pilot-drill guide was conducted by a technician, and a master model was set by using this laboratory-produced guide. After cone beam computed tomography (CBCT) and 3D scanning of the master models, two different digital workflows (marker tray in CBCT and 3D-printed tray) were performed based on the Digital Imaging Communication in Medicine files and standard tessellation language files. Eight Straumann implants (4.1 mm × 10 mm) were placed in each model, six models for each group, resulting in 144 implant placements in total. Postoperative CBCT were taken, and deviations at the entry point and apex as well as angular deviations were measured compared to the master model.

Results

The mean total deviations at the implant entry point for MTC (marker tray in CBCT), 3dPT (3d-printed tray), and PDG (pilot-drill guide) were 1.024 ± 0.446 mm, 1.027 ± 0.455 mm, and 1.009 ± 0.415 mm, respectively, and the mean total deviations at the implant apex were 1.026 ± 0.383 mm, 1.116 ± 0.530 mm, and 1.068 ± 0.384 mm. The angular deviation for the MTC group was 2.22 ± 1.54°. The 3dPT group revealed an angular deviation of 1.95 ± 1.35°, whereas the PDG group showed a mean angular deviation of 2.67 ± 1.58°. Although there were no significant differences among the three groups (P > 0.05), the navigation groups showed lesser angular deviations compared to the pilot-drill-guide (PDG) group. Implants in the 3D-printed tray navigation group showed higher deviations at both entry point and apex.

Conclusions

The accuracy of the evaluated navigation system was similar with the accuracy of a pilot-drill guide. Accuracy of both preoperative workflows (marker tray in CBCT or 3D-printed tray) was reliable for clinical use.
Genome-wide gene expression changes of Pseudomonas veronii 1YdBTEX2 during bioaugmentation in polluted soils
Authors: Morales Marian , Sentchilo Vladimir , Hadadi Noushin , van der Meer Jan Roelof
Published: April 2021

Background

Bioaugmentation aims to use the capacities of specific bacterial strains inoculated into sites to enhance pollutant biodegradation. Bioaugmentation results have been mixed, which has been attributed to poor inoculant growth and survival in the field, and, consequently, moderate catalytic performance. However, our understanding of biodegradation activity mostly comes from experiments conducted under laboratory conditions, and the processes occurring during adaptation and invasion of inoculants into complex environmental microbiomes remain poorly known. The main aim of this work was thus to study the specific and different cellular reactions of an inoculant for bioaugmentation during adaptation, growth and survival in natural clean and contaminated non-sterile soils, in order to better understand factors limiting bioaugmentation.

Results

As inoculant we focused on the monoaromatic compound-degrading bacterium Pseudomonas veronii 1YdBTEX2. The strain proliferated in all but one soil types in presence and in absence of exogenously added toluene. RNAseq and differential genome-wide gene expression analysis illustrated both a range of common soil responses such as increased nutrient scavenging and recycling, expression of defense mechanisms, as well as environment-specific reactions, notably osmoprotection and metal homeostasis. The core metabolism of P. veronii remained remarkably constant during exponential growth irrespective of the environment, with slight changes in cofactor regeneration pathways, possibly needed for balancing defense reactions.

Conclusions

P. veronii displayed a versatile global program, enabling it to adapt to a variety of soil environments in the presence and even in absence of its target pollutant toluene. Our results thus challenge the widely perceived dogma of poor survival and growth of exogenous inoculants in complex microbial ecosystems such as soil and provide a further basis to developing successful bioaugmentation strategies.
Transient maintenance of tracheal patency upon the insertion of a flexible bronchoscope in a patient with an anterior mediastinal mass: a case report
Authors: Hasegawa Takayuki , Obara Shinju , Oishi Rieko , Shirota Satsuki , Honda Jun , Kurosawa Shin
Published: April 2021

Background

Patients with an anterior mediastinal mass are at risk of perioperative respiratory collapse.

Case presentation

A 74-year-old woman with a large anterior mediastinal mass that led to partial tracheal collapse (shortest diameter, 1.3 mm) was scheduled for tracheobronchial balloon dilation and stent placement under general anesthesia. Although veno-venous extracorporeal membrane oxygenation (V-V ECMO) had been established, maximum flow was limited to 1.6 L/min, and general anesthesia induction was followed by hypoxia probably due to inadequate ventilation. A flexible bronchoscope was inserted through the tracheal lumen that was being compressed by the anterior mass; this not only increased tracheal patency but also enabled positive pressure ventilation and resulted in recovery from hypoxia. Scheduled procedures were successfully performed without complications.

Conclusion

We describe a case wherein tracheal patency was transiently maintained by inserting a flexible bronchoscope in a patient with an anterior mediastinal mass.
New insights on CRISPR/Cas9-based therapy for breast Cancer
Authors: Sabit Hussein , Abdel-Ghany Shaimaa , Tombuloglu Huseyin , Cevik Emre , Alqosaibi Amany , Almulhim Fatma , Al-Muhanaa Afnan
Published: April 2021

CRISPR/Cas9 has revolutionized genome-editing techniques in various biological fields including human cancer research. Cancer is a multi-step process that encompasses the accumulation of mutations that result in the hallmark of the malignant state. The goal of cancer research is to identify these mutations and correlate them with the underlying tumorigenic process. Using CRISPR/Cas9 tool, specific mutations responsible for cancer initiation and/or progression could be corrected at least in animal models as a first step towards translational applications. In the present article, we review various novel strategies that employed CRISPR/Cas9 to treat breast cancer in both in vitro and in vivo systems.
Multi-color and Multi-Material 3D Printing of Knee Joint models
Authors: Ruiz Oliver Grimaldo , Dhaher Yasin
Published: April 2021

Objective

This study reports on a new method for the development of multi-color and multi-material realistic Knee Joint anatomical models with unique features. In particular, the design of a fibers matrix structure that mimics the soft tissue anatomy.

Methods

Various Computer-Aided Design (CAD) systems and the PolyJet 3D printing were used in the fabrication of three anatomical models wherein fibers matrix structure is mimicked: (i) Anterior cruciate ligament reconstruction (ACL-R) model used in the previous study. (ii) ACL-R model, incorporating orientations, directions, locations, and dimensions of the tunnels, as well as a custom-made surgical guide (SG) for avoiding graft tunnel length mismatch. (iii) Total knee arthroplasty (TKA) model, including custom-made implants. Before models 3D printing, uni-axial tensile tests were conducted to obtain the mechanical behaviors for individual No. 1 (A60-A50), No. 2 (A50-A50), No. 3 (A50-A40), and No. 4 (A70-A60) soft tissue-mimicking polymers. Each material combination represents different shore-hardness values between fiber and matrix respectively.

Results

We correlated the pattern of stress-strain curves in the elastic region, stiffness, and elastic modulus of proposed combinations with published literature. Accordingly, material combinations No. 1 and No. 4 with elastic modules of 0.76-1.82 MPa were chosen for the soft tissues 3D printing. Finally, 3D printing Knee Joint models were tested manually simulating 50 flexo-extension cycles without presenting ruptures.

Conclusion

The proposed anatomical models offer a diverse range of applications. These may be considered as an alternative to replacing cadaver specimens for medical training, pre-operative planning, research and education purposes, and predictive models validation. The soft tissue anatomy-mimicking materials are strong enough to withstand the stretching during the flexo-extension. The methodology reported for the design of the fiber-matrix structure might be considered as a start to develop new patterns and typologies that may mimic soft tissues.
Examining resource availability and usefulness in a National Health Service Research Interprofessional Postdoctoral Fellowship Program
Authors: Bryan Jennifer L. , Gregory Megan E. , Brown Charnetta R. , Walder Annette , Hamer Joshua D. , Mills Whitney L. , Naik Aanand D. , Godwin Kyler M. , Hysong Sylvia J.
Published: April 2021

Postdoctoral fellowships are costly: institutions incur substantial monetary costs, and fellows suffer the opportunity cost of delaying entry into their professional careers. Nevertheless, fellowship training is a beneficial academic investment; the right resources can attract high-quality candidates and maximize return on investment for all parties. This study examined the availability and perceived utility of training resources in a national, multisite interprofessional health services research fellowship program and examined differences in resource perception between alumni and directors as well as M.D. and Ph.D. alumni. One-hundred thirty-one alumni and 15 directors from a multisite interprofessional postdoctoral fellowship completed surveys regarding fellowship resources. Results from the fellowship sample as a whole revealed that mentoring and seminars were the most commonly available resources in fellowships and alumni from the same site often disagreed about resource availability. When we compared alumni and directors’ responses from the same site, we found they often disagreed about resource availability, with directors often being more likely to respond that the resource is available than the alumni. Finally, M.D. alumni reported availability of more resources and found resources to be more useful overall than Ph.D. alumni. Mentoring and seminars are important and commonly provided resources for trainees in fellowship programs; however, M.D.s and Ph.D.s vary in perceived usefulness of other resources, suggesting that one resource does not fit all. Given the gap, postdoctoral fellows may benefit from direct communication of available resources. Moreover, as Ph.D. fellows reported less resource availability and usefulness, attention should be given to meeting their unmet needs. Taken together, this will optimize their fellowship experience, thus better preparing them for their career and, ultimately, their impact on health care.
Pulmonary benign metastasising leiomyoma: a single-institution case series
Authors: Chandarana Karishma , Caruana Edward J. , Richards Cathy J. , Rathinam Sridhar , Nakas Apostolos
Published: April 2021

Background

Benign metastasising leiomyoma (BML) is a rare and often asymptomatic presentation of smooth muscle tumour of uterine origin, occurring outside the uterus. We present the first case series of pulmonary BML in a contemporary UK population.

Patients were identified from prospective histopathological databases spanning from 2003 to 2019. Data was collected retrospectively from physical and electronic data sources.

Results

Six post-menopausal females were identified with an average age of 44±8 years (mean±SD). Fifty percent of our cohort was asymptomatic with an incidental finding of pulmonary nodules, whilst the others complained of non-specific respiratory symptoms. Five patients (88%) had multiple lesions (median 9, range 2 to 12)—with bilateral distribution, measuring an average of 11 mm (range 7 to 27) in size on cross-sectional imaging. All patients underwent diagnostic surgical pulmonary wedge resection, with no perioperative morbidity.

Immunohistochemistry confirmed the presence of ‘spindle cells’, staining positive for smooth muscle actin, desmin and progesterone receptors for all patients (100%), and oestrogen receptors in five patients (87%). Four patients (67%) underwent a hysterectomy prior to diagnosis of BML and one (17%) due to the diagnosis itself. Four patients (67%) underwent oophorectomy, whilst one patient required hormonal suppression therapy. Survival was 100% at a median follow-up of 59.5 months (range 29 to 166).

Conclusions

BML is a rare clinical entity accounting for a small proportion of patients presenting with pulmonary nodules. Following successful tissue diagnosis, outcomes with conservative or medical management are excellent.
Implementation of a Flipped Active-Learning Approach in a Community College General Biology Course Improves Student Performance in Subsequent Biology Courses and Increases Graduation Rate
Authors: Riedl Ann , Yeung Fan , Burke Tina
Published: April 2021

A large-scale study on the efficacy of active learning in a community college biology class showed that students in active-learning sections earned higher exam scores, performed better in subsequent biology courses, and graduated at a higher rate compared with students from traditional sections.
Physical activity as an intervention in severe mental illness
Authors: Kandola Aaron A. , Osborn David P. J.
Published: April 2021

Physical activity is a modifiable risk factor for several physical and mental health conditions. It is well established that people with severe mental illness have increased risk of physical health complications, particularly cardiovascular disease. They are also more likely to be physically inactive, contributing to the elevated cardiovascular and metabolic risks, which are further compounded by antipsychotic medication use. Interventions involving physical activity are a relatively low risk and accessible way of reducing physical health problems and weight in people with severe mental illness. They also have wider benefits for mental health symptoms and quality of life. However, many barriers still exist to the widespread implementation of physical activity interventions in the treatment of severe mental illness. A more concerted effort is needed to facilitate their translation into routine practice and to increase adherence to activity interventions.
Routine clozapine assay monitoring to improve the management of treatment-resistant schizophrenia
Authors: Kitchen David , Till Alex , Xavier Panchu
Published: April 2021

Aims and method

Routine therapeutic drug monitoring in clozapine therapy has previously not been considered justifiable. Using observational data, the clinical utility of annual clozapine assay monitoring is explored within a large mental health trust.

Results

After the introduction of routine monitoring, the rate of clozapine assays rose to 2.3 per patient per year, with a consistent reduction in high-risk clozapine assays (<0.1 mg/L or >1.0 mg/L or any result more than 24 months old). High-risk assays are associated with a mortality rate of 31.6 deaths per 1000 patients, more than twice that of those within the target range (0.35–0.60 mg/L and conducted within the past 12 months) (P = 0.048).

Clinical implications

Routine clozapine assay monitoring has significant clinical utility. Our simple but targeted approach can be readily implemented to reduce the number of patients with high-risk clozapine assay levels, potentially reduce all-cause mortality and provide optimal treatment for those with treatment-resistant schizophrenia.
Quasi-two-dimensional magnetism in spin-

square lattice compound Cu[C6H2(COO)4][H3N-(CH2)2-NH3] · 3H2O
Authors: Guchhait S. , Baby S. , Padmanabhan M. , Medhi A. , Nath R.
Published: April 2021

We report the crystal growth and structural and magnetic properties of quasi-two-dimensional

quantum magnet Cu[C6H2(COO)4][H3N-(CH2)2-NH3]

3H2O. It is found to crystallize in a monoclinic structure with space group

. The CuO4 plaquettes are connected into a two-dimensional framework in the ab-plane through the anions of [C6H2(COO)4]4− (pyromellitic acid). The [H3N-(CH2)2-NH3]

3H2O groups are located between the layers and provide a weak interlayer connection via hydrogen (H...O) bonds. The temperature-dependent magnetic susceptibility is well described by

frustrated square lattice

model with nearest-neighbor interaction

and next-nearest-neighbor interaction

. Our analysis using frustrated rectangular lattice

model also confirms almost isotropic nearest-neighbour interactions (

and

) in the ab-plane and

. Further, the isothermal magnetization at

is also well described by a non-frustrated square lattice model with

. Based on the

ratio, the compound can be placed in the Néel antiferromagnetic state of the

phase diagram. No signature of magnetic long-range order is detected down to 2 K.
The Jurisgenerativity of a Liquid Praxis
Authors: Raengo Alessandra
Published: April 2021

liquid blackness founder Alessandra Raengo talks with filmmaker and installation artist John Akomfrah about the emergence of the trope of liquidity in his work, in the context of the reversibility between aesthetics, practice, and praxis exhibited since his output with the Black Audio Film Collective, and about the intellectual errantry of his practice ever since. Together they explore liquidity as a feature of double consciousness, a way to comprehend the dispersion of the polyrhythmic, and a key to approach the aesthetic philosophy of collective praxis.