bluuebunny/crossref_metadata_2025 huggingface dataset:
¿Los índices biológicos de calidad son universalmente útiles? Límites de los índices basados en bentos en una subcuenca salobre y árida de Argentina
Authors: Alvarez Dalinger Florencia Soledad , Lozano Verónica Laura , Moraña Liliana , Borja Claudia Nidia , Salusso Mónica
Published: April 2023

Se evaluó la calidad del agua de los ríos de una subcuenca árida del norte de Argentina en un gradiente longitudinal, durante el período de sequía máxima de 2017. Se estudió la composición y estructura del fitobentos mediante índices bióticos. Se determinaron 126 spp. en total, con predominio de diatomeas y cianobacterias. La mayoría de las especies de diatomeas encontradas eran de meso a polihalobas y tolerantes a la contaminación orgánica. A pesar de que los ríos de la cuenca atraviesan zonas con usos de la tierra muy diferentes, no se registraron diferencias en las abundancias de fitobentos entre los sitios. Según el Índice de Saprobiedad de Pantle & Buck, la subcuenca se clasificó en el rango de α‐mesosaprobiedad, y el Índice de Eutrofización/Contaminación por Diatomeas asigna una calidad baja a la mayoría de los sitios. La salinidad debe inducir una homogeneización de la ficoflora que limita la sensibilidad de los índices bióticos a los impactos antropogénicos.
Clinical and dermoscopic features of nail unit melanoma in an Australian nail clinic cohort
Authors: Arasu Alexis , Howard Anne , Tan Chin‐Guan , Prakash Saurabh , Kern Johannes S.
Published: April 2023

Nail unit melanoma carries diagnostic challenges conferring with its poor prognosis. This audit aims to characterise both clinical and dermoscopic features of nail unit malignant lesions and compare them with biopsied benign lesions. It focuses on informing future practice by aiding in the stratification and recognition of malignant diagnostic patterns in the Australian context.
The simultaneous occurrence of livedoid vasculopathy and lymphocytic thrombophilic arteritis in six cases
Authors: Kelly Robert , Gan Christian , Ting Sarajane , Manuelpallai Nicholas , Wee Edmund
Published: April 2023

Lymphocytic thrombophilic arteritis and livedoid vasculopathy may both present with livedo racemosa and ulceration. We present 6 cases with features of both conditions, raising the possibility that they are either closely linked or are part of a spectrum of the same condition.
Ethnonationalist Gender Norms: How Parties Shape Voter Attitudes toward Female Candidates in India
Authors: Thomas Anjali , Banerjee Sayan , Hankla Charles , Banerjee Arindam
Published: April 2023

How do parties in multiethnic societies shape voter attitudes toward female candidates? We address this question, focusing on parties with ideologies that contain ethnonationalist gender norms—patriarchal norms applied to women from an ethnonationalist party's core ethnic constituency. We argue that, while these norms appeal to an ethnonationalist party's base, they also provide informational cues to the party's “non‐core” voters that undermine their support for the party's “core” female candidates. Evidence from an original conjoint survey experiment in the Indian state of Bihar supports our argument; upper‐caste female candidates suffer a support penalty when they are affiliated with the national ruling party, whose ideology prescribes ethnonationalist gender norms targeting its core Hindu upper‐caste constituency. This penalty, we show, is driven by the party's non‐core voters. Our results, which we further bolster using real‐world electoral data, illuminate when and how ethnonationalist gender norms disadvantage elite female candidates.
Emotional involvement matters, too: Associations among parental involvement, time management and academic engagement vary with Youth's developmental phase
Authors: Liu Sihan , Wang Xinyi , Ying Jiefeng , Shi Jialin , Wu Xinchun
Published: April 2023

Background

Prior studies have emphasized the importance of parents' educational involvement (a type of cognitive involvement) to academic engagement, although little is known about emotional involvement.

Aims

This study investigated whether and how different facets of involvement (cognitive vs. emotional, paternal vs. maternal) are differentially related to academic engagement and whether and how the associations among parental involvement, time management and academic engagement vary by adolescents' developmental phases.

Samples

The participants of this large national survey were students in elementary, middle and high school across different regions of mainland China. A total of 2687 adolescents (52.7% females, Mage = 14.07 ± 2.47) participated in this study.

Methods

Structural equation models and multigroup analysis were conducted.

Results

We found that the total effect of paternal and maternal emotional involvement on academic engagement was positive in elementary‐, middle‐ and high school students, and an indirect effect of time management underlying the above paths was found in all three groups. In contrast, the positive effect of maternal cognitive involvement on academic engagement as well as the indirect effects underlying the above pathways was established only in high school students.

Conclusions

The findings highlight the necessity of parents' emotional involvement and the consideration of adolescent developmental characteristics in the design of interventions.
Circular RNA circARHGEF28 inhibited the progression of prostate cancer via the miR‐671‐5p/LGALS3BP/NF‐κB axis
Authors: Guo Kaixuan , Shi Juanyi , Tang Zhuang , Lai Cong , Liu Cheng , Li Kuiqing , Li Zhuohang , Xu Kewei
Published: April 2023

Circular RNAs (circRNAs) play crucial roles in various biological processes, including prostate cancer (PCa). However, the precise roles and mechanism of circRNAs are complicated. Hence, we studied the function of a circRNA that might be involved in the progression of PCa. In this study, we found that circARHGEF28 was frequently downregulated in PCa tissues and cell lines. Furthermore, gain‐ and loss‐of function experiments in vitro showed that circARHGEF28 inhibited proliferation, migration, and invasion of PCa. Additionally, circARHGEF28 suppressed PCa progression in vivo. Bioinformatics analysis and RNA pull‐down and capture assay found that circARHGEF28 sponged miR‐671‐5p in PCa cells. Importantly, qRT‐PCR and dual luciferase assays found that Lectin galactoside‐binding soluble 3 binding protein (LGALS3BP) was downstream of miR‐671‐5p, and western blot analysis further confirmed that LGALS3BP negatively regulated the nuclear factor kappa‐B (NF‐κB) pathway. These results demonstrated that circARHGEF28 abolished the degradation of LGALS3BP by sponging miR‐671‐5p, thus blocking the activation of the NF‐κB pathway. Our findings revealed that circARHGEF28/miR‐671‐5p/LGALS3BP/NF‐κB may be an important axis that regulates PCa progression.
A synonymous codon variant altering splicing of RBCK1 expands the phenotype and genotype spectra of polyglucosan body myopathy 1
Authors: Wen Qi , Zhu Wenjia , Wen Xinmei , Zhang Shu , Sun Yanan , Li Yun , Wang Jingsi , Wang Yaye , Duo Jianying , Huang Yue , Lu Yan , Di Li , Xu Min , Wang Min , Chen Hai , Da Yuwei
Published: April 2023

Polyglucosan body myopathy type 1 (PGBM1, OMIM #615895.) is a rare autosomal recessive disorder caused by RBCK1 mutations. The patients displayed polyglucosan accumulation in skeletal and cardiac muscles, giving rise to loss of ambulation and heart failure with or without immune system dysregulation. So far, only 24 patients have been reported, all of whom exhibited symptoms before adulthood. Here, we reported the first case of an adult‐onset PGBM1 patient with a novel compound heterozygous RBCK1 gene mutation consisting of a nonsense and synonymous variant affecting splicing.
‘They are always in the top of our mind’: Designated Teachers' views on supporting care experienced children in England
Authors: De La Fosse Lynn , Parsons Sarah , Kovshoff Hanna
Published: April 2023

Care experienced children are at substantial risk for poor educational outcomes, so it is vital to understand where the challenges and opportunities may lie in providing improved support for them. Designated Teachers have statutory responsibilities within maintained schools in England to promote the educational achievement of care experienced children, but very little research has examined their views and experiences. Following purposive sampling, in‐depth, online, semi‐structured interviews were conducted with five Designated Teachers during the COVID‐19 pandemic to explore their experiences of the facilitators and barriers to supporting care experienced children. Four themes were developed through reflexive thematic analysis. Designated Teachers enacted change through both systemic working, and the provision of targeted support to address individual child needs. Various facilitators and barriers to role fulfilment were identified, including multi‐agency working and the impact of competing roles and responsibilities. Implications for professionals are discussed and suggestions for future research are made.
Constitutional instability and foreign direct investment in Africa
Authors: Youssouf Nvuh‐Njoya , Joseph Keneck‐Massil , Thierry Yogo Urbain
Published: April 2023

This paper assesses the impact of constitutional changes on foreign direct investment (FDI) in 49 African countries during the period 1980–2020. The paper uses a dummy variable related to the year of the constitutional change and the number of changes during the study period to capture the frequency of constitutional changes. The results reveal that an increase in the frequency of constitutional changes negatively affects FDI. The negative relationship between constitutional change and FDI is consistent across different measures of constitutional change and FDI and is robust to alternative empirical approaches. These results suggest that frequent constitutional changes may create uncertainty and instability in the investment climate, which may discourage foreign investors from investing in these African countries. The study provides evidence for policymakers that a stable constitutional framework may attract FDI in African countries.
Automated, machine learning–based alerts increase epilepsy surgery referrals: A randomized controlled trial
Authors: Wissel Benjamin D. , Greiner Hansel M. , Glauser Tracy A. , Mangano Francesco T. , Holland‐Bouley Katherine D. , Zhang Nanhua , Szczesniak Rhonda D. , Santel Daniel , Pestian John P. , Dexheimer Judith W.
Published: April 2023

Objective

To determine whether automated, electronic alerts increased referrals for epilepsy surgery.

Methods

We conducted a prospective, randomized controlled trial of a natural language processing–based clinical decision support system embedded in the electronic health record (EHR) at 14 pediatric neurology outpatient clinic sites. Children with epilepsy and at least two prior neurology visits were screened by the system prior to their scheduled visit. Patients classified as a potential surgical candidate were randomized 2:1 for their provider to receive an alert or standard of care (no alert). The primary outcome was referral for a neurosurgical evaluation. The likelihood of referral was estimated using a Cox proportional hazards regression model.

Results

Between April 2017 and April 2019, at total of 4858 children were screened by the system, and 284 (5.8%) were identified as potential surgical candidates. Two hundred four patients received an alert, and 96 patients received standard care. Median follow‐up time was 24 months (range: 12–36 months). Compared to the control group, patients whose provider received an alert were more likely to be referred for a presurgical evaluation (3.1% vs 9.8%; adjusted hazard ratio [HR] = 3.21, 95% confidence interval [CI]: 0.95–10.8; one‐sidedp = .03). Nine patients (4.4%) in the alert group underwent epilepsy surgery, compared to none (0%) in the control group (one‐sidedp = .03).

Significance

Machine learning–based automated alerts may improve the utilization of referrals for epilepsy surgery evaluations.
THE MANAGEMENT OF THE SECOND STAGE OF LABOUR IN PRIMIPARAE WITH EPIDURAL ANALGESIA
Authors: Gleeson N C , Griffith A P
Published: April 2023

One hundred and ninety‐four primiparae with lumbar epidural analgesia established during the first stage of labour were discouraged from pushing until the fetal head was visible at the perineum or until three hours had elapsed since full dilation of the cervix. The outcome in this group was compared with a similar group in whom pushing was commenced as soon as the second stage was diagnosed. The observed increase in spontaneous deliveries did not reach statistical significance. There was a reduction in non‐rotational forceps (p<0.05), but no change occurred in the incidence of rotational forceps deliveries. The high rates of oxytocin augmentation in these primiparous labours may account for the failure of delayed pushing to increase the spontaneous delivery rate in our population.
AN EVALUATION OF CLINICAL ASPECTS OF POST‐OPERATIVE AUTOTRANSFUSION, EITHER ALONE OR IN CONJUNCTION WITH PRE‐OPERATIVE ASPIRIN, IN CARDIAC SURGERY
Authors: Shirvani R
Published: April 2023

Two groups of 21 otherwise healthy patients undergoing coronary artery bypass grafting (CABG) for the first time were studied in order to evaluate the advantages and disadvantages of post‐operative autotransfusion using a red cell ‘salvage’ method. Group 1 patients (control group) were transfused using donor blood only. Group 2 patients were transfused with their own (autologous) blood, salvaged post‐operatively, although donor blood was also available to them if needed. The two groups were further subdivided according to whether the patients received aspirin pre‐operatively or not.

The four subgroups thus formed were comparable pre‐ as well as intra‐operatively with respect to all available clinical and laboratory criteria. The post‐operative data, however, showed that the combination of pre‐operative aspirin and autotransfusion leads to excessive post‐operative bleeding, together with increased donor blood requirement. It was also shown that autotransfusion without aspirin does reduce the need for donor blood transfusion without any increase in post‐operative bleeding. Although aspirin alone did not increase post‐operative bleeding or donor blood requirement, its combination with autotransfusion should be avoided.
HLA AND DISEASE
Authors: Hpowis S , Trowsdale J
Published: April 2023

It is nearly 20 years since the first reports appeared linking genes within the human major histocompatibility complex, the HLA region, with disease.1–5 The literature now contains many hundreds of papers confirming an increased frequency of different HLA antigens in a diverse spectrum of conditions, ranging from narcolepsy to diabetes. Over the years many different hypotheses have been proposed to explain this association, but none has been proven. Nevertheless, our knowledge of the HLA region and the function of its many genes is expanding rapidly and the pathogenesis of many HLA‐linked diseases may soon become apparent. In this review we aim to provide clinicians with a broad understanding of the basis for the association between HLA and disease. We will describe the genes of the HLA region before discussing the diseases with which they are linked. Finally, we will explore mechanisms through which HLA genes might influence disease.
PORTAL HYPERTENSION DUE TO HEPATOSPLENIC SCHISTOSOMIASIS: A CASE REPORT AND REVIEW OF THE LITERATURE
Authors: Eyres K S , Kantharia B , Magides A D , Ali H H , MacDonald R C
Published: April 2023

Although hepatosplenic schistosomiasis is the commonest cause of liver disease worldwide, the diagnosis is not often considered in European countries.

A case of Schistosomiasis mansoni complicated by portal hypertension is reported to demonstrate how diseases endemic to an immigrant's homeland can present many years later in non‐endemic countries.
TRAUMATIC CARDIAC TAMPONADE: A HEARTBREAKING TALE
Authors: Scott A D N
Published: April 2023

Penetrating cardiac injuries following civil violence are less common in Britain than in other parts of the world,1 but, in the light of recent evidence,2,3 the incidence of the problem is likely to increase.4,5 The patient described in this report demonstrates the pitfalls in the management of traumatic cardiac tamponade and highlights the need for a change in the management of the seriously injured patient.
CROHN'S DISEASE OF THE VULVA IN CHILDHOOD
Authors: Tuffnell D , Buchan P C
Published: April 2023

A case of vulval Crohn's disease in childhood is presented. The presentation of this disease as a vulval lesion is well recognised, either as the initial complaint,1or as a metastatic lesion.2–4Crohn's disease in childhood is well recognised and up to 49% of sufferers may have perianal disease.5Vulval Crohn's disease in children, however, is uncommon, especially when it is the presenting symptom.
AN AUDIT OF TRAUMA DEATHS IN NEWCASTLE UPON TYNE
Authors: Sen B , Maitra A
Published: April 2023

The TRISS methodology was applied to identify unexpected trauma deaths during a one‐year period. Out of a total of 104 deaths, 50 were hospital deaths (M = 0.6837). Twelve (27%) of these deaths were judged to be unexpected, ie, had a probability of survival (Ps) ≥0.50 (Z = +4.80). Those deaths deemed to be unexpected were subject to further analysis. The implications of these findings are discussed.
A SURVEY OF HEAD INJURIES IN A GENERAL HOSPITAL
Authors: Wilson PB
Published: April 2023

This paper reports the incidence of head injuries as patients attended a general hospital Accident & Emergency Department. The survey was carried out over a twelve‐month period. The Accident & Emergency Department of Luton & Dunstable Hospital sees approximately 60,000 new patients every year. It is situated in close proximity to the M1 motorway and other major road systems. Facilities are available on site for computerised tomography from Monday to Friday between 9.00 am and 5.00 pm. At other times, if it is considered necessary after consultations with our neurosurgical colleagues, they are referred to the Royal Free Hospital, 30 miles away.
BETA BLOCKERS AND QUALITY OF LIFE
Authors: Cruikshank J M , McAinsh J
Published: April 2023

Hypertension is an asymptomatic condition which can be life threatening. It is thus important that hypertensive patients maintain compliance with their therapy. This can be put at risk if the patient experiences adverse affects or if the patient's lifestyle is significantly altered in some way. The ability to perform daily activities and derive satisfaction is referred to as quality of life. With this in mind the published literature is reviewed here with regard to comparative studies involving beta‐blockers.

The balance of the evidence reviewed indicates that there are differences in quality of life between ACE inhibitors and the non‐selective, lipophilic beta blocker, propranolol, favouring the former. However, this is clearly not a class difference as atenolol, which is beta1 selective and hydrophilic, results in a similar quality of life profile to that with either captopril or enalapril. This difference between atenolol and propranolol probably arises out of their differing pharmacology, as opposed to any fundamental difference in their blood pressure lowering ability.

There are probably too few studies to compare beta blockers and either calcium antagonists or diuretics definitively with regard to quality of life. What little evidence there is suggests a difference between propranolol and verapamil, with the latter giving the better quality of life. However, no difference was observed between verapamil SR and atenolol. Although data are very limited it appears that atenolol impacts more favourably than thiazide diuretics.
SPONTANEOUS RUPTURE OF NORMAL SPLEEN: AN ENIGMA RECALLED
Authors: Kumar S , Gupta A , Shrivastava UK , Mathur SB
Published: April 2023

That a normal spleen can rupture spontaneously has long been a point of debate. A definitive case is reported here in an attempt to resolve the issue in its favour. Spleen involved in tropical diseases like malaria, infectious mononucleosis and typhoid fever is prone to rupture spontaneously as well as in cases follow minor trauma.1 In contrast, normal spleen ruptures almost always following severe trauma, such as road accidents or fall from significant heights. Though cases of spontaneous rupture of normal spleens have appeared off and on in the past, doubt has always surrounded the very existence of such an entity. We are reporting a definitive case of spontaneous rupture of normal spleen. This is only the second case of its kind since 1958 and the first ever from the Indian subcontinent.
BABINGTON'S SYNDROME — SETTING THE RECORD STRAIGHT
Authors: Joiner C L
Published: April 2023

Mrs FM walked slowly to Guys Hospital on 5th July 1945. She had to walk slowly, for she had been increasingly breathless with exertion of late. She was to attend Ear, Nose and Throat Outpatients, and after some initial delays she was ushered in to see the consultant, Mr TB Layton. He had been appointed to the staff of Guys Hospital in 1912. He then served in the Great War, was twice mentioned in despatches, and won the DSO. He claimed to be the first British officer to enter Jerusalem when it was taken by Allenby's forces. In a word he was a character; and much loved (Figure 1).
PARANEOPLASTIC PARALYSIS IN A PATIENT WITH MALIGNANT FIBROUS HISTIOCYTOMA
Authors: Reinecke L , Thornley A L
Published: April 2023

A patient presented with lower limb paralysis and a large malignant fibrous histiocytoma (MFH) on her back. Metastatic disease to the spine was excluded and the diagnosis of paraneoplastic paralysis was made. This may be the first described case of a neuromyopathic paraneoplastic syndrome in malignant fibrous histiocytoma. Tissue culture and electron microscopy assisted in establishing the diagnosis of the tumour. A hitherto unrecognised endocrine factor may account for the hypokalaemia which was a feature in this patient.
THE VALUE OF SEROLOGICAL TESTS FOR SYPHILIS IN ATYPICAL GENITAL ULCER DISEASE
Authors: Fernando J J R , Wanas T M
Published: April 2023

A 45‐year‐old heterosexual man presented with phimosis three weeks after arriving in this country from India. Examination under anaesthesia and circumcision revealed a large ulcer on the ventral aspect of the penis around the fraenum. Histopathological examination of a biopsy taken from the ulcer revealed granulation tissue with inflammatory cell infiltrate. Specific and non‐specific serological tests for syphilis carried out four weeks after the initial presentation showed high titres. The importance of serological tests for syphilis in genital ulcer disease, especially in atypical presentations, is discussed.
UNSUSPECTED FACTORS IN ‘SELF‐LIMITING’ AILMENTS
Authors: Bennett J D C , McFarlane H W
Published: April 2023

An unsuspected subtotally perforated eardrum treated with wax softening drops shows how clinical findings do not always correlate with symptoms or history. Attention is drawn to the dilemma posed by delegating matters such as diagnosis and prescribing which have been considered to be purely in the medical sphere.
THE AETIOLOGY AND PATHOGENESIS OF VAGINAL CANDIDOSIS: AN UPDATE
Authors: Granger S E
Published: April 2023

The aetiology and pathogenesis of the condition of vaginal candidosis is discussed in brief. The causative organism, the incidence and source of infection and various host and pathogen factors related to the disease state are dealt with. An update of current work relating to the cause of the recurrent condition is presented.
THE TREATMENT OF ACUTE AND CHRONIC VAGINAL CANDIDOSIS
Authors: SCUDAMORE J A , Tooley P J H , Allcorn R J
Published: April 2023

INTRODUCTION

Vaginal candidosis is one of the most common infections of the vagina and the first accredited record of the disease appeared in 1849. Over the years the terms ‘candidiasis’ and ‘candidosis’ have been used, but it is generally accepted now that the terms are synonymous, and the term most commonly in use today is ‘candidosis’. Mainly caused by the yeastCandida albicans, the condition is characterised by intense inflammation of the vaginal mucosa and a curdy, off‐white discharge; it is often associated with severe vulval itching and possibly burning pain.

The severity of symptoms seems to vary greatly from patient to patient and the reason for this is unclear. It is suggested that in some patients there may be an element of hypersensitivity. Vaginal candidosis may occur in children but is most common in adults and only sometimes affects the elderly. The majority of women will suffer at least one attack of vaginal candidosis during their lifetime, and there are several predisposing factors such as diabetes, pregnancy and antibiotics. Some authorities consider the condition more frequent in those taking oral contraceptives or other hormones.
INFARCTION OF THE TONGUE IN WEGENER'S GRANULOMATOSIS
Authors: Rodgers H , Quirke P , Lipkin G W , John A M Brown
Published: April 2023

Wegener's granulomatosis is a form of systemic vasculitis. Untreated, it has a 90% two year mortality,1 but complete remission can be obtained in 93% of patients following treatment with cyclophosphamide (usually in combination with steroids).2 There is early and major involvement of the respiratory tract.3 Renal involvement adversely affects prognosis.2
WOLFF‐PARKINSON‐WHITE SYNDROME MIMICKING MYOCARDIAL INFARCTION ON ECG — EXPLOITATION BY A HEROIN ADDICT
Authors: Wheeldon N M
Published: April 2023

Wolff‐Parkinson‐White (WPW) syndrome produces several electrocardiographic features, including mimicking the changes of myocardial infarction.

A case is described of an astonishingly well‐informed heroin addict, who himself had WPW syndrome and who exploited his condition attempting to obtain opiates from hospital.
COVERT TOXOCARIASIS – A CAUSE OF RECURRENT ABDOMINAL PAIN IN CHILDHOOD
Authors: Nathwani D , Laing R B S , Currie P F
Published: April 2023

Toxocariasis, usually caused by Toxocara canis, is a zoonosis acquired by ingestion of worms which inhabit the gut of young canines. Domestic pets, such as dogs, become infected from soil in public parks and playgrounds which are often heavily contaminated.1 Although toxocariasis is often regarded as having two principal, though uncommon, manifestations — visceral larva migrans (VLM) and ocular toxocariasis (OT) — recent studies have suggested otherwise.2,3 A third, more common, condition, termed ‘covert toxocariasis’, describes patients in whom positive toxocara serology is associated with a number of systemic and localised symptoms and signs (notably abdominal pain) but not VLM or OT. A quarter of patients with covert toxocariasis have no eosinophilia and, although symptoms regress after treatment, they may persist for months or years. We report a 13‐year‐old girl with recurrent abdominal pain who, despite positive toxocara serology, was extensively investigated for other abdominal pathology.
FOLLOW‐UP OF CHILDREN BORN TO HYPERTENSIVE MOTHERS
Authors: Wilson D C , Harper A , McClure G , Halliday H L , Reid M McC
Published: April 2023

Maternal hypertension has significant adverse effects on perinatal outcome. We aimed to assess whether there are long‐term effects on growth and neurodevelopment in childhood. Thirty‐seven children were reviewed at a median age of 56 months. Although maternal hypertension had had a significant impact on perinatal outcome of these children, most had normal growth and development in childhood. The severity of maternal hypertension was influential on perinatal outcome, but not on long‐term outcome.
HISTOPATHOLOGY: ITS ROLE IN THE DIAGNOSIS OF A CHILD WITH INTUSSUSCEPTION
Authors: Rashid A‐M H , Williams R Menai , Strang C
Published: April 2023

Spontaneous expulsion of a small portion of the intestinal mucosa per rectum, in an infant, associated with ileocolic intussusception is an extremely rare condition. This appears to be the first report of such a clinical presentation. The initial diagnosis was raised by the histopathologist following examination of the eliminated piece of tissue. Subsequent barium enema and laparotomy confirmed the diagnosis and the ileocolic intussusception was successfully reduced.

This unusual presentation, together with a review of the pertinent literature, is discussed. Our findings indicate that both the clinicians and histopathologists should be aware of this phenomenon and stress the importance of the histological examination of any unusual faecal matter. This may prove to be a simple, quick and cheap method of investigation of this condition.
ENDOMETRIOSIS – THE PROBLEMS OF INTESTINAL OBSTRUCTION
Authors: Hunt T M , Kelly M J
Published: April 2023

Endometriosis is a relatively common condition in women of child‐bearing age, and coincidental intestinal serosal involvement is frequently recognised. However, intestinal obstruction, although reported, is rare. We report what we believe is the first case with synchronous ileo‐caecal and rectosigmoid obstructing endometriomas. Endometriosis as a cause of bowel obstruction is discussed and in particular the differential diagnosis from Crohn's disease and malignancy.
PERICARDIAL EFFUSION — AN UNCOMMON COMPLICATION OF SALMONELLA ENTERITIS
Authors: Doig J C , Ferner R E , ReiD D S
Published: April 2023

A 62‐year‐old lady who was receiving corticosteroids for rheumatoid arthritis was admitted suffering from dehydration due to salmonella enteritis. Despite rehydration and appropriate chemotherapy she remained unwell and developed hypotension and elevation of her jugular venous pressure. Echocardiography and subsequent aspiration demonstrated a purulent pericardial effusion from which S typhimurium was cultured. Following aspiration and a change of antibiotic therapy, her condition improved dramatically.
THE NEUROLEPTIC MALIGNANT SYNDROME: A MISSED DIAGNOSIS?
Authors: Saunders B P , Trewby P N
Published: April 2023

The neuroleptic malignant syndrome (NMS) is an idiosyncratic reaction to major tranquilliser drugs characterised by hyperpyrexia, extrapyramidal disorders and altered consciousness. First described in 1968 by Delay and Deniker, early case reports suggested a mortality of between 20 and 30%.1–3

Though the syndrome is now more widely recognised, the diversity of its clinical features may not always be appreciated and may lead to diagnostic confusion with other, more common, disorders. We report on two severe cases of NMS: in the first the diagnosis was initially thought to be sepsis from a urinary tract infection, and in the second the primary clinical diagnosis was of a mid brain infarction.
A Note on Latent Traits Estimates under IRT Models with Missingness
Authors: Guo Jinxin , Xu Xin , Xin Tao
Published: April 2023

Missingness due to not‐reached items and omitted items has received much attention in the recent psychometric literature. Such missingness, if not handled properly, would lead to biased parameter estimation, as well as inaccurate inference of examinees, and further erode the validity of the test. This paper reviews some commonly used IRT based models allowing missingness, followed by three popular examinee scoring methods, including maximum likelihood estimation, maximum a posteriori, and expected a posteriori. Simulation studies were conducted to compare these examinee scoring methods across these commonly used models in the presence of missingness. Results showed that all the methods could infer examinees' ability accurately when the missingness is ignorable. If the missingness is nonignorable, incorporating those missing responses would improve the precision in estimating abilities for examinees with missingness, especially when the test length is short. In terms of examinee scoring methods, expected a posteriori method performed better for evaluating latent traits under models allowing missingness. An empirical study based on the PISA 2015 Science Test was further performed.
The relationships among metacognitive functions, sleep‐related thought‐control strategies and sleep quality: A mediation analysis
Authors: Socci Valentina , Pino Maria Chiara , Carcione Antonino , D'Aurizio Giulia , Ferrara Michele , Tempesta Daniela
Published: April 2023

In the context of sleep disturbances, increasing evidence suggests a critical role of sleep‐related dysfunctional metacognitive activity, including metacognitive control of intrusive thoughts in the pre‐sleep period. Although the relationship between sleep‐related thought‐control strategies and poor sleep quality is well recognized, the possible contribution of general metacognitive functioning within this relation is still unclear. In this study, we performed a mediation analysis to examine the role of thought‐control strategies on the relationship between metacognitive abilities and sleep quality in individuals with different self‐reported sleep characteristics. Two‐hundred and forty‐five individuals participated in the study. Participants completed the Pittsburgh Sleep Quality Index, the Thought Control Questionnaire Insomnia‐Revised, and the Metacognition Self‐Assessment Scale to evaluate sleep quality, thought‐control strategies and metacognitive functions, respectively. The results showed that worry strategy in the pre‐sleep period mediates the relationship between metacognitive functions and sleep quality. Particularly, the ability to understand one's mental states and mastery functions could be the two metacognitive domains primarily involved in the dysfunctional metacognitive thought‐control activity responsible for reduced sleep quality. The observed effect suggests that inadequate metacognitive functioning is associated with poor sleep quality in healthy subjects via the mediation of dysfunctional worry strategy. These findings suggest the potential relevance of clinical interventions to enhance specific metacognitive abilities, with the aim to promote more functional strategies for managing cognitive and emotional processes during the pre‐sleep period.
A deep natural language processing‐based method for ontology learning of project‐specific properties from building information models
Authors: Yin Mengtian , Tang Llewellyn , Webster Chris , Yi Xiaoyue , Ying Huaquan , Wen Ya
Published: April 2023

Element property is a crucial aspect of building information modeling (BIM) for almost all BIM‐based engineering tasks. Since there are limited properties predefined in Industry Foundation Classes (IFC) specifications, a vast number of property concepts were customized and stored in BIM models, which lack labor‐intensive data modeling and alignment for effective information management and reuse. To tackle the challenge, this study presents a natural language understanding (NLU)‐based method for the automatic ontological knowledge modeling of project‐specific property concepts from BIM models. A soft pattern matching model was used to acquire contextual definitions of concepts from a domain corpus before applying deep NLU models to transform the concept names and definitions into dense vector representations. These outputs were then fed into two stacking ensemble learning models to carry out two tasks: (a) classifying whether an unseen concept overlaps with the IFC ontology, and (b) aligning the repetitive concepts with the most relevant concepts in the ontology. Finally, all fresh properties were appended to an IFC ontology, either as new objects or new synonyms. The performance was evaluated based on 327 property concepts from real‐life BIM models. The results show that the proposed approach incorporating reading comprehension of definitions outperforms the existing name similarity‐based methods. Finally, a case study on a renovation project demonstrates the effectiveness of this study in automatic ontology modeling of property concepts.
Knockdown of Anopheles dirus far upstream element‐binding protein gene lower oocyst numbers of Plasmodium vivax
Authors: Kubera Anchanee , Putanyawiwat Piriya , Bantuchai Sirasate , Kumpitak Chalermpon , Duangmanee Apisak , Sattabongkot Jetsumon
Published: April 2023

The modulation of gene expression levels of Anopheles dirus on Plasmodium vivax infection at the ookinete and oocyst stages was previously reported. In the present study, several upregulated An. dirus genes were selected based on their high expression levels and subcellular locations to examine their roles in P. vivax infection. Five An. dirus genes—carboxylesterase, cuticular protein RR‐2 family, far upstream element‐binding protein, kraken, and peptidase212—were knocked down by dsRNA feeding using dsRNA‐lacZ as a control. The dsRNA‐fed mosquitoes were later challenged by P. vivax–infected blood, and the oocyst numbers were determined. The expression of these five genes was examined in many organs of both male and female mosquitoes. The results showed that the decreased expression level of the far upstream element‐binding protein gene could lower the oocyst numbers, whereas the others showed no effect on P. vivax infection. The expression levels of these genes in ovaries were found, and in many organs, they were similar between male and female mosquitoes. The reduction of these five gene expressions did not affect the lifespan of the mosquitoes. In addition, the malaria box compound, MMV000634, demonstrated the lowest binding energy to the far upstream element‐binding protein using virtual screening. This protein might be a target to block malaria transmission.
A new stoloniferous species of Begonia Begoniaceae from Yunnan, China
Authors: Ding Hong‐Bo , Quan Dong‐Li , Zeng Xiao‐Dong , Zhao Jin‐Chao , Tan Yun‐Hong
Published: April 2023

Begonia cangyuanensis, a new species of Begonia sect. Stolonifera Begoniaceae from Yunnan, China, is described and illustrated. Morphologically, it is similar to B. dioica in its tuberous habit with red stolons between tubers. However, it significantly differs in having two bracteoles under the ovary and four tepals of the female flower. A detailed description, photographs, and a comparison with allied species are provided.
A tribute to whom defend the forest: Hyptidendron dorothyanum (Lamiaceae: Hyptidinae), a new species from the Amazonian domain
Authors: Antar Guilherme Medeiros , Mervyn Harley Raymond , Floriano Barêa Pastore José , Sano Paulo Takeo
Published: April 2023

Amazonia, despite being famous as the most prominent tropical forest, is currently suffering high rates of degradation, with recurrent fires and deforestation, which could shortly lead it to be classified as a biodiversity hotspot for conservation. Although the known flora of the domain displays exceptional richness, its diversity is far from being well known, with several new species being described each year and lots of areas still poorly collected. During the preparation of a revision of Hyptidendron (Lamiaceae, subtribe Hyptidinae), a small genus with 21 species, unidentified and unmatched specimens from the Amazonian domain were uncovered. Here we describe and illustrate these specimens as Hyptidendron dorothyanum sp. nov., named in honor of Sister Dorothy Stang, murdered for her support for the biodiversity of the Amazon and her defence of the rights of local people. The new species, currently known from just two gatherings from Amazonas and Pará States is compared with its most closely related species, Hyptidendron canum, H. arboreum, H. asperrimum and H. leucophyllum. We also provide a distribution map, a preliminary conservation assessment, as well as comments on the phenology and ecology of the new species. This paper calls attention to the importance of the conservation of Amazonia and its rich but still not completely known diversity.
Desiccation‐tolerant vascular plants from Western Ghats, India: review, updated checklist, future prospects and new insights
Authors: Smrithy Vijayan , Kulkarni Aboli , Shigwan Bhushan K. , Porembski Stefan , Datar Mandar N.
Published: April 2023

Desiccation‐tolerant vascular (DT) plants are predominant occupants of rock outcrops in tropical regions. Though rock outcrops are common landscapes in the Western Ghats (WG), a biodiversity hotspot in India, knowledge of DT plants in the region is poor. This study provides an overview of Indian DT vascular plants, emphasizing the WG, and includes an inventory of species with their habitat preferences. Outcrop species were scrutinized for their DT properties by seasonal field observations, followed by relative water content estimation protocols. The inventory revealed 62 DT species, many more than the earlier known nine species. Nine genera of DT plants are reported as new also in a global perspective, and Tripogon capillatus represent the first record of an epiphytic DT angiosperm. We also provide the first field observation‐based proof of DT properties of the gesneriad Corallodiscus lanuginosus. Of the 62 species, 16 are Indian endemic, and 12 are exclusive to Western Ghat outcrops, highlighting WG's importance as a global DT hotspot. In addition to rock outcrops, partially shaded sites in forests are crucial habitats for DT species. This pioneering inventory addresses India's need for more knowledge on DT plants and opens new research avenues.
Invited review: Bovine abortion—Incidence, risk factors and causes
Authors: Mee John F.
Published: April 2023

The true incidence of bovine abortion (42–260 days of gestation) is unknown because of under‐reporting. This is particularly true of the first half of gestation when most abortions occur. From research studies, it is estimated that the animal‐level incidence of abortion between day 45 and term is approximately 10%, being lower in suckler than in dairy cows. While wide variation exists in herd‐level incidence, up to 30%, it is estimated that less than 5% of farmers report high (>5%) observed abortion rates. Given these figures, veterinary practitioners and farmers tend to use investigation thresholds close to these values, ≥5 and ≥3%, respectively. Most of the risk factors for abortion are animal‐level factors (e.g. parity), but there are also herd‐level factors (e.g. enterprise type). Of the many risk factors for bovine abortion, only a small number are modifiable. While the causes of bovine abortion are often classified as noninfectious or infectious, in reality, this means diagnosis not reached (DNR) or infectious. Approximately 40% of abortions are diagnosed as infectious and the remaining 60% as DNR; DNR includes both infectious and noninfectious causes not diagnosed. Increasingly, genetic causes are being diagnosed and changes to current national genetic selection indices may be warranted. Of the infectious causes, Neospora caninum is now the most commonly diagnosed abortifacient internationally, followed by Trueperella pyogenes, BVDv and fungi. Both national eradication programmes and effective vaccination programmes can reduce the burden of some infectious abortifacients, but the control of sporadic, noninfectious and Neospora‐associated abortions remains challenging.
The role of bone marrow microenvironment on CAR‐T efficacy in haematologic malignancies
Authors: Gao Dandan , Hong Fei , He Aili
Published: April 2023

In recent years, chimeric antigen receptor‐T (CAR‐T) cell therapy has emerged as a novel immunotherapy method. It has shown significant therapeutic efficacy in the treatment of haematological B cell malignancies. In particular, the CAR‐T therapy targeting CD19 has yielded unprecedented efficacy for acute B‐lymphocytic leukaemia (B‐ALL) and non‐Hodgkin's lymphoma (NHL). In haematologic malignancies, tumour stem cells are more prone to stay in the regulatory bone marrow (BM) microenvironment (called niches), which provides a protective environment against immune attack. However, how the BM microenvironment affects the anti‐tumour efficacy of CAR‐T cells and its underlying mechanism is worthy of attention. In this review, we discuss the role of the BM microenvironment on the efficacy of CAR‐T in haematological malignancies and propose corresponding strategies to enhance the anti‐tumour activity of CAR‐T therapy.
Design and implementation of two medical escape rooms: An educational case study
Authors: Percival Katie , Snow Sarah , Isles Chris
Published: April 2023

Background

Escape rooms (ERs) have become increasingly popular as an interactive educational experience, especially in medical education. We present an educational case study covering the design, implementation and evaluation of two medical ERs.

Approach

We created ERs for senior medical students from Glasgow University on rotation at Dumfries and Galloway Royal Infirmary. Students assessed and managed a patient presenting with either stroke or sepsis. The information gained during students' assessment ‘unlocked’ padlocks or generated codes providing further information or equipment. The ERs were evaluated following analysis of video recordings, debriefings and student and faculty feedback.

Evaluation

Evaluation was focused on students' perceptions of the teaching experience, with changes made to the scenario design following student feedback and faculty reflection. Feedback was positive; students enjoyed the ‘fun’ nature of the learning experience. They felt they gained knowledge covering the subject areas and that the ERs also highlighted the importance of non‐technical skills. We discuss the aspects of ER design and implementation that we learnt during the evaluation process.

Implications

We have shown that medical ERs provide an immersive and engaging learning experience for students. We recognise a need for a more objective review of knowledge gained. We hope that by sharing our design and assessment of two medical ERs, we may inform and inspire other educators to consider ERs as an innovative learning experience.
Signs and symptoms of human T‐lymphotropic virus 1 and 2 infections in paediatric patients
Authors: Rojas Cerón Christian Andrés , Galvis Arias Deigober , García‐Perdomo Herney Andrés
Published: April 2023

Objective

To determine the prevalence of signs and symptoms of HTLV‐1 and 2 infection in paediatric patients.

Methods

We included cohort, case‐control and descriptive observational studies that reported the prevalence of signs and symptoms of HTLV‐1 and 2 infections in paediatric patients. Searches were performed in MEDLINE® (Ovid), EMBASE and LILACS from inception to the present, and we saturated information with other sources of published and unpublished literature. We decided not to perform meta‐analysis according to heterogeneity.

Results

A total of eight studies met the inclusion criteria for qualitative analysis. No studies of HTLV‐2 were found. Females predominated and there was vertical transmission in nearly 100% of cases. Infective dermatitis was a common manifestation of HTLV in paediatric patients. In addition, persistent hyperreflexia, clonus and the Babinski sign were early neurological alterations observed in patients carrying the virus.

Conclusion

HTLV screening is recommended in patients presenting infective dermatitis, persistent hyperreflexia, walking disturbances and in those who come from endemic zones.
Fatal exposure to quaternary ammonium disinfectant in 2 dogs
Authors: Wipond Marley , Prittie Jennifer , Mastrocco Alicia , Donovan Taryn A.
Published: April 2023

Objective

To describe the clinical course and necropsy findings of 2 dogs after exposure to quaternary ammonium disinfectants.

Case Series Summary

Two dogs were treated after accidental exposure to quaternary ammonium disinfectants in kennel settings. Both dogs developed ulcerative upper gastrointestinal lesions, severe pulmonary disease, and skin lesions. In the second case, the skin lesions were severe and became necrotizing. Both patients were ultimately euthanized due to severity of illness and lack of response to therapy.

New or Unique Information Provided

Quaternary ammonium compounds are commonly used as disinfectants in veterinary hospitals and boarding facilities. This is the first report detailing presentation, clinical picture, case management, and necropsy findings in dogs exposed to these chemicals. Awareness of the severity of these poisonings and the potential for fatal outcome is imperative.