bluuebunny/crossref_metadata_2025 huggingface dataset:
An enhanced cascade-based deep forest model for drug combination prediction
Authors: Lin Weiping , Wu Lianlian , Zhang Yixin , Wen Yuqi , Yan Bowei , Dai Chong , Liu Kunhong , He Song , Bo Xiaochen
Published: December 2021

Combination therapy has shown an obvious curative effect on complex diseases, whereas the search space of drug combinations is too large to be validated experimentally even with high-throughput screens. With the increase of the number of drugs, artificial intelligence techniques, especially machine learning methods, have become applicable for the discovery of synergistic drug combinations to significantly reduce the experimental workload. In this study, in order to predict novel synergistic drug combinations in various cancer cell lines, the cell line-specific drug-induced gene expression profile (GP) is added as a new feature type to capture the cellular response of drugs and reveal the biological mechanism of synergistic effect. Then, an enhanced cascade-based deep forest regressor (EC-DFR) is innovatively presented to apply the new small-scale drug combination dataset involving chemical, physical and biological (GP) properties of drugs and cells. Verified by the dataset, EC-DFR outperforms two state-of-the-art deep neural network-based methods and several advanced classical machine learning algorithms. Biological experimental validation performed subsequently on a set of previously untested drug combinations further confirms the performance of EC-DFR. What is more prominent is that EC-DFR can distinguish the most important features, making it more interpretable. By evaluating the contribution of each feature type, GP feature contributes 82.40%, showing the cellular responses of drugs may play crucial roles in synergism prediction. The analysis based on the top contributing genes in GP further demonstrates some potential relationships between the transcriptomic levels of key genes under drug regulation and the synergism of drug combinations.
Antibiotic prophylaxis for acute cholecystectomy: PEANUTS II multicentre randomized non-inferiority clinical trial
Authors: van Braak Willemieke G. , Ponten Jeroen E. H. , Loozen Charlotte S. , Schots Judith P. M. , van Geloven Anna A. W. , Donkervoort Sandra C. , Nieuwenhuijzen Grard A. P. , Besselink Marc G. , van Heek Tjarda N. T. , de Reuver Philip R. , Vlaminckx Bart , Kelder Johannes C. , Knibbe Catherijne A. J. , van Santvoort Hjalmar C. , Boerma Djamila
Published: December 2021

Background

Guidelines recommending antibiotic prophylaxis at emergency cholecystectomy for cholecystitis were based on low-quality evidence. The aim of this trial was to demonstrate that omitting antibiotics is not inferior to their prophylactic use.

Methods

This multicentre, randomized, open-label, non-inferiority clinical trial randomly assigned adults with mild-to-moderate acute calculous cholecystitis (immediate cholecystectomy indicated) to 2 g cefazolin administered before incision or no antibiotic prophylaxis. The primary endpoint was a composite of all postoperative infectious complications in the first 30 days after surgery. Secondary endpoints included all individual components of the primary endpoint, other morbidity, and duration of hospital stay.

Results

Sixteen of 226 patients (7.1 per cent) in the single-dose prophylaxis group and 29 of 231 (12.6 per cent) in the no-prophylaxis group developed postoperative infectious complications (absolute difference 5.5 (95 per cent c.i. −0.4 to 11.3) per cent). With a non-inferiority margin of 10 per cent, non-inferiority of no prophylaxis was not proven. The number of surgical-site infections was significantly higher in the no-prophylaxis group (5.3 versus 12.1 per cent; P = 0.010). No differences were observed in the number of other complications, or duration of hospital stay.

Conclusion

Omitting antibiotic prophylaxis is not recommended.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Delta Outbreak Among Fully Vaccinated Nursing Home Residents Likely Initiated by a Fully Vaccinated Staff Member – Connecticut, July–August 2021
Authors: Bart Stephen M , Harizaj Adora , Pearson Claire L , Conteh Tiara , Grogan Erin , Downing Randy , Kirking Hannah L , Tate Jacqueline E , Jernigan John A , Leung Vivian
Published: December 2021

During July–August 2021, a coronavirus disease 2019 (COVID-19) outbreak involving 21 residents (all fully vaccinated) and 10 staff (9 fully vaccinated) occurred in a Connecticut nursing home. The outbreak was likely initiated by a fully vaccinated staff member and propagated by fully vaccinated persons. Prior COVID-19 was protective among vaccinated residents.
Reassessing Ireland’s economic development through the lens of sustainable development
Authors: Mcgrath Luke , Hynes Stephen , Mchale John
Published: December 2021

After a century of Irish independence, this study constructs long run Genuine Savings estimates, a leading economic indicator of sustainable development, to reassess Irish economic history from the vantage of sustainable development. The main difference uncovered surrounds the post-1950 period where Ireland failed to achieve economic convergence and was considered an economic failure in growth terms. From a sustainability perspective, Ireland may have been an overachiever during a “great transition” of sustainable development driven by improved institutions and policies. The findings show the value of the sustainable development perspective in shedding new light on a country’s development experience.
The neglected members of the family: non-BRCAmutations in the Fanconi anemia/BRCA pathway and reproduction
Authors: Vanni Valeria Stella , Campo Giovanni , Cioffi Raffaella , Papaleo Enrico , Salonia Andrea , Viganò Paola , Lambertini Matteo , Candiani Massimo , Meirow Dror , Orvieto Raoul
Published: December 2021

BACKGROUND

BReast CAncer (BRCA) genes are extensively studied in the context of fertility and reproductive aging. BRCA proteins are part of the DNA repair Fanconi anemia (FA)/BRCA pathway, in which more than 20 proteins are implicated. According to which gene is mutated and which interactions are lost owing to the mutation, carriers and patients with monoallelic or biallelic FA/BRCA mutations exhibit very different phenotypes, from overt FA to cancer predisposition or no pathological implications. The effect of the so far neglected non-BRCA FA mutations on fertility also deserves consideration.

OBJECTIVE AND RATIONALE

As improved treatments allow a longer life expectancy in patients with biallelic FA mutations and overt FA, infertility is emerging as a predominant feature. We thus reviewed the mechanisms for such a manifestation, as well as whether they also occur in monoallelic carriers of FA non-BRCA mutations.

SEARCH METHODS

Electronic databases PUBMED, EMBASE and CENTRAL were searched using the following term: ‘fanconi’ OR ‘FANC’ OR ‘AND’ ‘fertility’ OR ‘pregnancy’ OR ‘ovarian reserve’ OR ‘spermatogenesis’ OR ‘hypogonadism’. All pertinent reports in the English-language literature were retrieved until May 2021 and the reference lists were systematically searched in order to identify any potential additional studies.

OUTCOMES

Biallelic FA mutations causing overt FA disease are associated with premature ovarian insufficiency (POI) occurring in the fourth decade in women and with primary non-obstructive azoospermia (NOA) in men. Hypogonadism in FA patients seems mainly associated with a defect in primordial germ cell proliferation in fetal life. In recent small, exploratory whole-exome sequencing studies, biallelic clinically occult mutations in the FA complementation group A (Fanca) and M (Fancm) genes were found in otherwise healthy patients with isolated NOA or POI, and also monoallelic carrier status for a loss-of-function mutation in Fanca has been implicated as a possible cause for POI. In those patients with known monoallelic FA mutations undergoing pre-implantation genetic testing, poor assisted reproduction outcomes are reported. However, the mechanisms underlying the repeated failures and the high miscarriage rates observed are not fully known.

WIDER IMPLICATIONS

The so far ‘neglected’ members of the FA/BRCA family will likely emerge as a relevant focus of investigation in the genetics of reproduction. Several (rather than a single) non-BRCA genes might be implicated. State-of-the-art methods, such as whole-genome/exome sequencing, and further exploratory studies are required to understand the prevalence and mechanisms for occult FA mutations in infertility and recurrent miscarriage.
Analysis of local qualitative cancer patient experience alongside the 2019 results of the UK National Cancer Patient Experience Survey
Authors: Dalby Melanie , Hill Alison , Nabhani-Gebara Shereen
Published: December 2021

Objectives

This study analyses data from local qualitative interviewing about what matters most to patients with information from the National Cancer Patient Experience Survey (NCPES) to formulate an accurate improvement plan. This study seeks to provide a deeper analysis of the results of the 2019 NCPES.

Methods

Qualitative data were collected through a focus group, telephone and virtual interviews from patients in North East London. Ten questions from the NCPES were asked. Interviews were recorded, transcribed verbatim and analysed using an NVivo framework matrix. The results were analysed considering the 2019 National Cancer Patient Experience report.

Key findings

In total, 17 patients and 4 carers participated. The interview answers provided a more in-depth response when compared with the NCPES results, allowing for a deeper understanding of patient experience. This provided an insightful understanding of what matters most to our patients.

Conclusions

The NCPES results are not always reflective of the patient population. Limitations of the survey make it hard for healthcare providers to develop accurate improvement plans. It is important to use other data sources such as qualitative interviewing alongside the NCPES. The data collated during this study have been used to identify themes and deliverables for achievable and sustainable improvements to be made.
The Effect of Covid-19 Pandemic on Current and Future Endoscopic Personal Protective Equipment Practices: A National Survey of 77 Endoscopists
Authors: Sun Warren Y L , Verhoeff Kevin , El Hafid Melanie , Mocanu Valentin , Dang Jerry T , Lutzak Gregory , Sultanian Richard , Karmali Shahzeer , Wong Clarence K
Published: December 2021

Introduction

The COVID-19 pandemic has raised awareness about the importance of personal protective equipment (PPE). We aimed to study and compare PPE practices among Canadian endoscopists before and after the COVID-19 pandemic.

Methods

A 74-item questionnaire was emailed from June 2020 to September 2020 to practicing endoscopists in Canada. Survey questions collected basic demographics and differences between PPE practices pre- and post-COVID-19. PPE practices were categorized into four endoscopic procedure types including upper or lower endoscopy and diagnostic or interventional. Outcomes for specific procedures were reported as rates, with ranges shown when evaluating all procedure types together.

Results

A total of 77 respondents completed the survey with the majority of respondents aged 40 to 49 (44%) and identifying as Gastroenterologists (70%). Gender was evenly split (49% females versus 51% males). In the pre-pandemic era, the majority of endoscopists wore gowns (91 to 94%) and all endoscopists wore gloves (100%). However, the majority of endoscopists did not wear surgical masks (21 to 31%), face shields (13 to 34%), eye protection (13 to 21%), hair protection (11 to 13%), or N95 respirators (2 to 3%). In the post-pandemic era, more surgeons plan on wearing face shields (33 to 47%, P = 0.001 to 0.045), goggles (38.5 to 58.7%, P < 0.001), hair protection (33 to 36%, P = 0.011 to 0.024), and a trend suggests more surgeons will wear surgical masks (51 to 61%, P = 0.163 to 0.333). More endoscopists also plan on wearing N95 respirators during lower endoscopy (6 to 7%, P < 0.005).

Conclusion

The COVID-19 pandemic has changed the attitudes of many endoscopists regarding future PPE use in routine endoscopy. Ongoing studies are needed to inform new post-pandemic PPE consensus guidelines.
Parsec-scale properties of the peculiar gigahertz-peaked spectrum quasar 0858−279
Authors: Kosogorov N A , Kovalev Y Y , Perucho M , Kovalev Yu A
Published: December 2021

We performed multifrequency studies on the gigahertz-peaked spectrum high-redshift quasar 0858−279. Initially, the source presented itself in the early VLBI images as a very peculiar resolved blob. We observed the quasar with the VLBA at 1.4–24 GHz in a dual-polarization mode. The high spatial resolution and the spectral index maps enabled us to resolve the core-jet structure and locate a weak and compact core by its inverted spectrum. The dominant jet component 20 parsecs away from the core was optically thin above 10 GHz and opaque below it. We also estimated an uncommonly strong magnetic field in the bright jet feature, which turned out to be around 1 G. The Faraday rotation measure maps revealed high RM values over 6000 rad m−2. Additionally, these maps allowed us to follow the magnetic field direction in the bright jet feature being perpendicular to the propagation direction of the jet. All the results strongly indicated the formation of a shock wave in the dominant component arising from an interaction with the surrounding matter. Using the proposed hypothesis and the core shift approach, we discovered that the magnetic field in the core region is of the order of 0.1 G.
The synchrony of production and escape: half the bright Lyα emitters at z ≈ 2 have Lyman continuum escape fractions ≈50
Authors: Naidu Rohan P , Matthee Jorryt , Oesch Pascal A , Conroy Charlie , Sobral David , Pezzulli Gabriele , Hayes Matthew , Erb Dawn , Amorín Ricardo , Gronke Max , Schaerer Daniel , Tacchella Sandro , Kerutt Josephine , Paulino-Afonso Ana , Calhau João , Llerena Mario , Röttgering Huub
Published: December 2021

The ionizing photon escape fraction [Lyman continuum (LyC) fesc] of star-forming galaxies is the single greatest unknown in the reionization budget. Stochastic sightline effects prohibit the direct separation of LyC leakers from non-leakers at significant redshifts. Here we circumvent this uncertainty by inferring fesc using resolved (R > 4000) Lyman α (Lyα) profiles from the X-SHOOTER Lyα survey at z = 2 (XLS-z2). With empirically motivated criteria, we use Lyα profiles to select leakers ($f_{\mathrm{ esc}} > 20{{\ \rm per\ cent}}$) and non-leakers ($f_{\mathrm{ esc}} < 5{{\ \rm per\ cent}}$) from a representative sample of >0.2L* Lyman α emitters (LAEs). We use median stacked spectra of these subsets over λrest ≈ 1000–8000 Å to investigate the conditions for LyC fesc. Our stacks show similar mass, metallicity, MUV, and βUV. We find the following differences between leakers versus non-leakers: (i) strong nebular C iv and He ii emission versus non-detections; (ii) [O iii]/[O ii] ≈ 8.5 versus ≈3; (iii) Hα/Hβ indicating no dust versus E(B − V) ≈ 0.3; (iv) Mg ii emission close to the systemic velocity versus redshifted, optically thick Mg ii; and (v) Lyα fesc of ${\approx} 50{{\ \rm per\ cent}}$ versus ${\approx} 10{{\ \rm per\ cent}}$. The extreme equivalent widths (EWs) in leakers ([O iii]+$\mathrm{ H}\beta \approx 1100$ Å rest frame) constrain the characteristic time-scale of LyC escape to ≈3–10 Myr bursts when short-lived stars with the hardest ionizing spectra shine. The defining traits of leakers – extremely ionizing stellar populations, low column densities, a dust-free, high-ionization state interstellar medium (ISM) – occur simultaneously in the $f_{\rm esc} > 20{{\ \rm per\ cent}}$ stack, suggesting they are causally connected, and motivating why indicators like [O iii]/[O ii] may suffice to constrain fesc at z > 6 with the James Webb Space Telescope (JWST). The leakers comprise half of our sample, have a median LyC$f_{\rm esc} \approx 50{{\ \rm per\ cent}}$ (conservative range: $20\!-\!55{{\ \rm per\ cent}}$), and an ionizing production efficiency $\log ({\xi _{\rm {ion}}/\rm {Hz\ erg^{-1}}})\approx 25.9$ (conservative range: 25.7–25.9). These results show LAEs – the type of galaxies rare at z ≈ 2, but that become the norm at higher redshift – are highly efficient ionizers, with extreme ξion and prolific fesc occurring in sync.
FRB 190520B – An FRB in a young supernova remnant?
Authors: Katz J I
Published: December 2021

FRB 190520B, a repeating FRB near-twin of FRB 121102, has a dispersion measure excess over the intergalactic and Galactic contributions of about 900 pc cm−3, attributable to its host galaxy or near-source environment. This excess varies on a time-scale of $\sim30$ yr and might be explained by a supernova remnant no more than a few decades old. A magnetic field in equipartition with the remnant’s expansion would be $\sim1\, \rm{G}$. I suggest the use of baseband data to measure very large rotation measures.
Single-cell RNA sequencing reveals abnormal fluctuations in human eight-cell embryos associated with blastocyst formation failure
Authors: He Qi-Long , Yuan Peng , Yang Lu , Yan Zhi-Qiang , Chen Wei , Chen Yi-Dong , Kong Si-Ming , Tang Fu-Chou , Qiao Jie , Yan Li-Ying
Published: December 2021

Infertility has become a global health issue, with the number of people suffering from the disease increasing year by year, and ART offering great promise for infertility treatment. However, the regulation of early embryonic development is complicated and a series of processes takes place, including the maternal-to-zygotic transition. In addition, developmental arrest is frequently observed during human early embryonic development. In this study, we performed single-cell RNA sequencing on a biopsied blastomere from human eight-cell embryos and tracked the developmental potential of the remaining cells. To compare the sequencing results between different eight-cell embryos, we have combined the research data of this project with the data previously shared in the database and found that cells from the same embryo showed a higher correlation. Additionally, the transcriptome of embryos with blastocyst formation failure was significantly different from developed embryos, and the gene expression as well as cell signaling pathways related to embryonic development were also altered. In particular, the expression of some maternal and zygotic genes in the failed blastocyst formation group was significantly altered: the overall expression level of maternal genes was significantly higher in the failed blastocyst than the developed blastocyst group. In general, these findings provide clues for the causes of human embryonic arrest after the eight-cell stage, and they also provide new ideas for improving the success rate of ART in clinical practice.
Condensin extrudes DNA loops in steps up to hundreds of base pairs that are generated by ATP binding events
Authors: Ryu Je-Kyung , Rah Sang-Hyun , Janissen Richard , Kerssemakers Jacob W J , Bonato Andrea , Michieletto Davide , Dekker Cees
Published: December 2021

The condensin SMC protein complex organizes chromosomal structure by extruding loops of DNA. Its ATP-dependent motor mechanism remains unclear but likely involves steps associated with large conformational changes within the ∼50 nm protein complex. Here, using high-resolution magnetic tweezers, we resolve single steps in the loop extrusion process by individual yeast condensins. The measured median step sizes range between 20–40 nm at forces of 1.0–0.2 pN, respectively, comparable with the holocomplex size. These large steps show that, strikingly, condensin typically reels in DNA in very sizeable amounts with ∼200 bp on average per single extrusion step at low force, and occasionally even much larger, exceeding 500 bp per step. Using Molecular Dynamics simulations, we demonstrate that this is due to the structural flexibility of the DNA polymer at these low forces. Using ATP-binding-impaired and ATP-hydrolysis-deficient mutants, we find that ATP binding is the primary step-generating stage underlying DNA loop extrusion. We discuss our findings in terms of a scrunching model where a stepwise DNA loop extrusion is generated by an ATP-binding-induced engagement of the hinge and the globular domain of the SMC complex.
Neural representation of the parent–child attachment from infancy to adulthood
Authors: Ulmer-Yaniv Adi , Waidergoren Shani , Shaked Ariel , Salomon Roy , Feldman Ruth
Published: December 2021

Attachment theory is built on the assumption of consistency; the mother–infant bond is thought to underpin the life-long representations individuals construct of attachment relationships. Still, consistency in the individual’s neural response to attachment-related stimuli representing his or her entire relational history has not been investigated. Mothers and children were followed across two decades and videotaped in infancy (3–6 months), childhood (9–12 years) and young adulthood (18–24 years). In adulthood, participants underwent functional magnetic resonance imaging while exposed to videos of own mother–child interactions (Self) vs unfamiliar interactions (Other). Self-stimuli elicited greater activations across preregistered nodes of the human attachment network, including thalamus-to-brainstem, amygdala, hippocampus, anterior cingulate cortex (ACC), insula and temporal cortex. Critically, self-stimuli were age-invariant in most regions of interest despite large variability in social behavior, and Bayesian analysis showed strong evidence for lack of age-related differences. Psycho–physiological interaction analysis indicated that self-stimuli elicited tighter connectivity between ACC and anterior insula, consolidating an interface associating information from exteroceptive and interceptive sources to sustain attachment representations. Child social engagement behavior was individually stable from infancy to adulthood and linked with greater ACC and insula response to self-stimuli. Findings demonstrate overlap in circuits sustaining parental and child attachment and accord with perspectives on the continuity of attachment across human development.
Monitoring Benzimidazole Resistance in Phyllosticta citricarpa Using a Molecular Assay Targeting Mutations in Codons 198 and 200 of the β-Tubulin Gene
Authors: Moyo Providence , Cook Glynnis , Basson Elaine , Steyn Chanel , Bester Rachelle , Olivier Charmaine , Fourie Paul H.
Published: December 2021

Citrus black spot (CBS), caused by Phyllosticta citricarpa, is an economically important disease, which is effectively controlled by repeated fungicide applications to protect fruit from infection. Systemic fungicides such as benzimidazoles are widely used for controlling CBS in South Africa, but the molecular mechanisms of benzimidazole resistance in P. citricarpa had not been investigated. Analysis of the nucleotide sequence of the β-tubulin gene in P. citricarpa revealed mutations inducing three amino acid replacements in benzimidazole-resistant isolates when compared with those of sensitive strains. Amino acid replacements in benzimidazole-resistant isolates included the change of glutamic acid to either alanine or lysine at codon 198 of the β-tubulin gene and the change from phenylalanine to tyrosine at codon 200. All three mutations were previously implicated in benzimidazole resistance in several fungal pathogens. A PCR assay was designed to amplify a portion of the β-tubulin gene, which is subsequently sequenced to identify benzimidazole resistance in P. citricarpa. This PCR and sequence assay was found to be a more rapid and reliable method for detecting resistance compared with the fungicide-amended plate tests and is valuable for monitoring the occurrence of benzimidazole-resistant P. citricarpa and for assessment of the need for alternative CBS management practices.
FUSARIUM-ID v.3.0: An Updated, Downloadable Resource for Fusarium Species Identification
Authors: Torres-Cruz Terry J. , Whitaker Briana K. , Proctor Robert H. , Broders Kirk , Laraba Imane , Kim Hye-Seon , Brown Daren W. , O’Donnell Kerry , Estrada-Rodríguez Tania L. , Lee Yong-Hwan , Cheong Kyeongchae , Wallace Emma C. , McGee Chyanna T. , Kang Seogchan , Geiser David M.
Published: December 2021

Species within Fusarium are of global agricultural, medical, and food/feed safety concern and have been extensively characterized. However, accurate identification of species is challenging and usually requires DNA sequence data. FUSARIUM-ID ( http://isolate.fusariumdb.org/blast.php ) is a publicly available database designed to support the identification of Fusarium species using sequences of multiple phylogenetically informative loci, especially the highly informative ∼680-bp 5′ portion of the translation elongation factor 1-alpha (TEF1) gene that has been adopted as the primary barcoding locus in the genus. However, FUSARIUM-ID v.1.0 and 2.0 had several limitations, including inconsistent metadata annotation for the archived sequences and poor representation of some species complexes and marker loci. Here, we present FUSARIUM-ID v.3.0, which provides the following improvements: (i) additional and updated annotation of metadata for isolates associated with each sequence, (ii) expanded taxon representation in the TEF1 sequence database, (iii) availability of the sequence database as a downloadable file to enable local BLAST queries, and (iv) a tutorial file for users to perform local BLAST searches using either freely available software, such as SequenceServer, BLAST+ executable in the command line, and Galaxy, or the proprietary Geneious software. FUSARIUM-ID will be updated on a regular basis by archiving sequences of TEF1 and other loci from newly identified species and greater in-depth sampling of currently recognized species.
Population Structure of Moniliophthora perniciosa in the Main Cacao Producing Departments of Colombia
Authors: Jaimes Yeirme , Gonzalez Carolina , Rojas Jairo , Rivera Jessica Johana , Cilas Christian , Argout Xavier
Published: December 2021

The witches’ broom (Moniliophthora perniciosa) is considered as one of the main threats for cacao production and, consequently, for chocolate production worldwide. In this work, the genetic diversity and population structure of M. perniciosa were analyzed for 59 isolates collected in five departments of Colombia and using 10 microsatellite markers. Analyses revealed 35 multilocus genotypes and clonal populations structure according to linkage disequilibrium analysis. One of the objectives of this study was to determine whether populations were differentiated by geographic origin or Theobroma cacao host genotype. Analysis of molecular variance, discriminant analysis of principal components, and Bruvo genetic distance suggested that the genetic structure was driven by geographic origin and not by T. cacao genotype. The results of this study were consistent with previous findings obtained in other cocoa-producing countries. Important insights were discussed regarding the dispersal patterns of the pathogen in Colombia and the genetic change of its populations because of different environmental conditions.
CE: Diagnosing and Managing Migraine
Authors: Goetz Allene , McCormick Samantha , Phillips Rosemary , Friedman Deborah
Published: December 2021

Roughly 90% of the U.S. population will develop a headache within their lifetime, and headache disorders account for more disability-adjusted life-years than all other neurologic disorders combined. Among primary headache disorders, the two most common are tension-type headache and migraine, with migraine identified as the most disabling. Here, the authors describe the importance of differentiating primary and secondary headache disorders and discuss the pathophysiology; clinical assessment; and outpatient management of the debilitating migraine headache, summarizing both acute and prophylactic treatment strategies that can substantially reduce associated disability.
Perceptions Regarding the SARS-CoV-2 Pandemic’s Impact on Neurocritical Care Delivery: Results From a Global Survey
Authors: Lele Abhijit V. , Wahlster Sarah , Alunpipachathai Bhunyawee , Awraris Gebrewold Meron , Chou Sherry H.-Y. , Crabtree Gretchen , English Shane , Der-Nigoghossian Caroline , Gagnon David J. , Kim-Tenser May , Karanjia Navaz , Kirkman Matthew A. , Lamperti Massimo , Livesay Sarah L. , Mejia-Mantilla Jorge , Melmed Kara , Prabhakar Hemanshu , Tumino Leandro , Venkatasubba Rao Chethan P. , Udy Andrew A. , Videtta Walter , Moheet Asma M. ,   the NCC-COVID Study Collaborators
Published: December 2021

Background:

The SARS-CoV-2 (COVID-19) pandemic has impacted many facets of critical care delivery.

Methods:

An electronic survey was distributed to explore the pandemic’s perceived impact on neurocritical care delivery between June 2020 and March 2021. Variables were stratified by World Bank country income level, presence of a dedicated neurocritical care unit (NCCU) and experiencing a COVID-19 patient surge.

Results:

Respondents from 253 hospitals (78.3% response rate) from 47 countries (45.5% low/middle income countries; 54.5% with a dedicated NCCU; 78.6% experienced a first surge) participated in the study. Independent of country income level, NCCU and surge status, participants reported reductions in NCCU admissions (67%), critical care drug shortages (69%), reduction in ancillary services (43%) and routine diagnostic testing (61%), and temporary cancellation of didactic teaching (44%) and clinical/basic science research (70%). Respondents from low/middle income countries were more likely to report lack of surge preparedness (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.8-5.8) and struggling to return to prepandemic standards of care (OR, 12.2; 95% CI, 4.4-34) compared with respondents from high-income countries. Respondents experiencing a surge were more likely to report conversion of NCCUs and general-mixed intensive care units (ICUs) to a COVID-ICU (OR 3.7; 95% CI, 1.9-7.3), conversion of non-ICU beds to ICU beds (OR, 3.4; 95% CI, 1.8-6.5), and deviations in critical care and pharmaceutical practices (OR, 4.2; 95% CI 2.1-8.2). Respondents from hospitals with a dedicated NCCU were less likely to report conversion to a COVID-ICU (OR, 0.5; 95% CI, 0.3-0.9) or conversion of non-ICU to ICU beds (OR, 0.5; 95% CI, 0.3-0.9).

Conclusion:

This study reports the perceived impact of the COVID-19 pandemic on global neurocritical care delivery, and highlights shortcomings of health care infrastructures and the importance of pandemic preparedness.
Evaluating the Anatomic Spread of Selective Nerve Scalp Blocks Using Methylene Blue: A Cadaveric Analysis
Authors: Harbell Monica W. , Bolton Patrick B. , Koyyalamudi Veerandra , Seamans David P. , Langley Natalie R.
Published: December 2021

Background:

The modern scalp block consists of local anesthesia injections that target the supraorbital, supratrochlear, zygomaticotemporal, auriculotemporal, and greater and lesser occipital nerves. Limited data exist on the local anesthetic spread that occurs with this technique. This study examines the extent of the spread of a scalp block using methylene blue in a cadaveric model.

Methods:

A traditional landmark-based scalp block was performed on 6 unembalmed human cadavers using 25-G, 1.5-inch needles to inject 1 to 2 mL of methylene blue 0.1% at each nerve bilaterally; a total volume of 20 mL was injected. The cadavers were then dissected, and the spread of injectate was measured and recorded.

Results:

All the nerves required for analgesic coverage were appropriately stained by the injections, except for in 2 specimens where the lesser occipital nerve could not be identified. The zygomatic (stained in 2 of 8 specimens) and temporal (stained in 5 of 8 specimens) branches of the facial nerve were stained as a result of the zygomaticotemporal and/or auriculotemporal injections. Tracking from the zygomatic injection site was noted as far inferior as the temporalis muscle attachments on the mandible.

Conclusions:

This cadaveric study confirms that the landmark-based technique for scalp blocks consistently stained all 6 nerves involved in scalp innervation. There was significant unintentional spread to the branches of the facial nerve when using the landmark technique.
Use of Mobile Application as an Auxiliary Tool in the Preoperative Marking of Nipple-areola Complex Positioning in Mammoplasty
Authors: Saliba Gustavo Augusto Matos , Alves José Carlos Ribeiro Resende
Published: December 2021

Background:

Smartphones have the ability to benefit plastic surgeons in many ways. The aim of the study is to demonstrate that the use of a mobile application is a useful auxiliary tool for checking and eventual correction/adjustment of preoperative markings by plastic surgeons in mammoplasty.

Methods:

The retrospective study was performed in a consecutive series of cases from July 2016 to October 2019. After preoperative marking, photographs were taken using the laser-level application (inclinometer, a leveling instrument), produced by Examobile, with an objective of verifying alignment deviations in preoperative marking. Some marking asymmetry related to the vertical height of the areolas was immediately corrected and a new photograph using the application was made for alignment checking.

Results:

Ninety-three patients were included in the study. Comparatively, there was an increase in symmetry index around 28.6% of patients. The application of the Fisher and Chi-square tests evidenced statistical significance between the groups demonstrating the application as an auxiliary preoperative marking tool in relation to the symmetrical vertical positioning of the areolas.

Conclusions:

The use of technology has become an important component of the way plastic surgeons train and practice. Today, there is a big gap between the desire for digital resources and awareness of the resources that are already available. By aggregating and evaluating current mobile applications available, surgeons, residents, and medical students will have more efficient ways to connect to the information that drives education and tactical surgery development.
Real-world effectiveness and safety of golimumab in rheumatoid arthritis treatment: A two-center study in Taiwan
Authors: Wang Chun-Chun , Tseng Kuo-Sen , Tsao Yen-Po , Chen Wei-Sheng , Lai Chien-Chih , Sun Yi-Syuan , Liao Hsien-Tzung , Chen Ming-Han , Tsai Chang-Youh
Published: December 2021

Background:

The real-world outcomes of golimumab (GLM) use have been rarely studied in Asian patients with rheumatoid arthritis (RA). This study assessed the real-world effectiveness and safety of GLM in a Taiwanese cohort.

Methods:

One hundred and eight GLM-treated RA patients were enrolled. Predictors of a good European League Against Rheumatism (EULAR) response at 24 months and drug retention were identified through multivariate analyses.

Results:

After 24 months of GLM treatment, the mean Disease Activity Score using 28 joint counts with the erythrocyte sedimentation rate (DAS28-ESR) decreased from 6.7 to 3.1 (p < 0.001). Up to 58.9% of patients achieved a good EULAR response at 24 months. Multivariate logistic regression analysis revealed that after adjustment for other variables, a higher baseline C-reactive protein was an independent negative predictor of good EULAR responses (odds ratio, 0.82; 95% confidence interval [CI], 0.67-0.99; p = 0.043). During the mean follow-up period of 38.3 months, 15 (13.9%) patients discontinued GLM due to treatment failure. In multivariate analysis, high baseline ESR level, high DAS28-ESR, and the experience of biologic therapy were independent risk factors for GLM discontinuation (adjusted hazard ratio [HR], 1.03; 95% CI, 1.01-1.05; p = 0.003; adjusted HR, 2.93; 95% CI, 1.42-6.08; p = 0.004; and adjusted HR, 5.00; 95% CI, 1.75-14.26; p = 0.003, respectively). In receiver operator characteristic curve analysis, the optimal cutoff values of baseline ESR and DAS28-ESR for predicting drug survival were 52 mm/h (sensitivity: 60.0% and specificity: 77.4%) and 7.7 (sensitivity: 46.7% and specificity: 94.3%), respectively. During the follow-up period, 22 patients (20.4%) developed adverse events. The safety profile of GLM in this study was comparable with that in previous clinical trials.

Conclusion:

GLM was effective and safe for the real-life management of Taiwanese RA patients and showed a high retention rate in biologic-naive patients compared with biologic-experienced patients.
Percutaneous direct puncture and embolization of vascularly inaccessible abdominal visceral pseudoaneurysms: A single-center experience and literature review
Authors: Tsai Yin-Chen , Tseng Hsiou-Shan , Lee Edward W. , Lee Rheun-Chuan , Chiu Nai-Chi , Hwang Hsuen-En , Liu Chien-An
Published: December 2021

Background:

To evaluate the techniques, efficacy, and safety for treating vascularly inaccessible abdominal visceral pseudoaneurysms by direct puncture and embolization.

Methods:

A retrospective study of 5 consecutive patients who underwent percutaneous direct puncture embolization for intra-abdominal pseudoaneurysms in our institution between January 2009 and December 2016. Technical aspects, success, clinical outcome, and complications were discussed.

Results:

Four patients (80%) were men, and the mean age of all five patients was 57.2 years (range, 47–72 years). The mean diameter of the pseudoaneurysms was 2.5 cm (range, 1.9–3.4 cm). All the pseudoaneurysms were punctured under the imaging guidance of fluoroscopy, ultrasound, or computed tomography. Coils and glue were used in four of the patients, the remaining one with coil only. The mean injected glue volume was 1.5 (range, 0.8–2) mL. The overall technical and clinical success rate was 100% without major complications or mortality.

Conclusion:

Our single-center experience and the literature review demonstrate that percutaneous direct puncture embolization is feasible and effective to serve as an alternative for treating abdominal vascular pseudoaneurysms when the traditional endovascular embolization fails. In this approach, fluoroscopy is the most needed guidance technique.
Zero-Calibrating External Ventricular Drains: Exploring Practice
Authors: Pratt Karen A. , Peacock Sarah H. , Yost Kaylie D. , Freeman William David , Collins Christina I. , McLaughlin Diane C.
Published: December 2021

BACKGROUND: Guidelines call for the removal of the nonvented cap (NVC) on the flushless transducer applied to the external ventricular drain (EVD) to zero the device to atmospheric pressure. Some hospitals have abandoned this practice to prevent opening the system to air. No data exist to determine the safest, most effective method of EVD zero-calibration. METHODS: A multidisciplinary team was assembled to use reflective practice to evaluate current zero-calibration of EVD practice. RESULTS: Clinical Nursing Focus showed recommendations largely out of date without detailed rationale or a high level of evidence. Manufacturer recommendations were fragmented and did not address rationale for technique. Bedside trial showed equivalence when comparing intracranial pressure (ICP) tidal, ICP after EVD zero with NVC removal, and ICP after EVD zero without NVC removal. CONCLUSION: Institutional guidelines were changed to reflect zero-calibration of EVD without NVC removal in systems that are amendable to this procedure. Further study is needed to determine best practice.
Effects of Shenmai injection combined with platinum-containing first-line chemotherapy on quality of life, immune function and prognosis of patients with nonsmall cell lung cancer
Authors: Chen Yanqiong , Zhang Chao , Pan Cheng , Yang Yunkui , Liu Jin , Lv Jialing , Pan Guilin
Published: December 2021

Background:

Lung cancer is the leading cause of death among cancer patients worldwide. Close to 85% of lung cancer pathology types are nonsmall cell lung cancer (NSCLC). With advances in medicine, the survival rate of early-stage NSCLC has improved. Nevertheless, about 70% of patients are diagnosed at an advanced stage, and chemotherapy is the primary treatment option. Chemotherapy causes toxic side effects such as bone marrow suppression, gastrointestinal reactions, and damage to vital organs, which are difficult for patients to tolerate. Many published literatures have reported that Shenmai injection (SMI) combined with platinum-containing first-line chemotherapy regimen for NSCLC can improve the recent efficacy, reduce toxic side effects and improve the quality of life. However, most of the studies were small samples and lacked persuasive power, while controversies existed among individual studies. Therefore, this study used meta-analysis to further evaluate the effects of SMI combined with platinum-containing first-line chemotherapy on the quality of life, immune function and prognosis of patients with NSCLC.

Methods:

Wanfang, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, the Chongqing VIP Chinese Science and Technology Periodical Database, PubMed, Embase, and Web of Science databases were searched. The search was scheduled from the establishment of the database to September 2021. All randomized controlled trials comparing SMI in combination with platinum-containing first-line chemotherapy to platinum-containing first-line chemotherapy alone for the treatment of NSCLC were searched and evaluated for inclusion. Two investigators independently performed study selection, data extraction and synthesis. The Cochrane Risk of Bias tool was used to assess the risk of bias in the randomized controlled trials. Stata 16.0 software was used for meta-analysis.

Results:

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:

This study comprehensively evaluated the effects of SMI combined with platinum-containing first-line chemotherapy on quality of life, immune function and prognosis in patients with NSCLC to provide an evidence-based basis for clinical practice.

Ethics and dissemination:

The private information from individuals will not be published. This systematic review should also not damage participants’ rights. Ethical approval was not available. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF Registration number: DOI 10.17605/OSF.IO/AMKDC
Quadrantanopia as the only symptom of post-COVID stroke in the occipital pole
Authors: Baltaziak Katarzyna , Szpringer Agata , Czarnek-Chudzik Aleksandra , Onyszkiewicz Maksymilian , Toro Mario Damiano , Pankowska Anna , Pietura Radoslaw , Rejdak Robert , Nowomiejska Katarzyna
Published: December 2021

Rationale:

This is a case report describing delayed complications of COVID-19 pneumonia, which evolved into the vascular-ischemic complications leading to quadrantanopia and MRI findings consistent with recent ischemic event in the occipital pole of the brain.

Patient concerns:

We report a case of a 46-year-old woman with quadrantanopia due to stroke confirmed with brain MRI, secondary to COVID-19 infection with chronically elevated D-dimers and treated with anticoagulation/antithrombotic modalities. Quadrantanopia was the only symptom recognized by the patient of a stroke localized in the occipital pole of the brain.

Diagnosis:

The patient was diagnosed with quadrantanopia due to stroke confirmed with brain MRI, secondary to COVID-19 infection.

Intervention:

Patient underwent ophthalmological examination and MRI.

Outcomes:

A thrombotic or ischemic risks in the chronic recovery from COVID-19 should be considered in patients with elevated D-dimers.

Lessons:

An MRI should be considered as a long term follow up for post-COVID-19 patients reporting ophthalmic or neurologic complains.
Using 18F-FDG PET/CT to rule out Richter transformation as cause of deterioration in a patient with chronic lymphatic leukemia and severe COVID-19
Authors: Fjordside Lasse , Mens Helene , Asmar Ali
Published: December 2021

Rationale:

This case report demonstrates the use of flourine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) to rule out Richter transformation (RT) as the cause of clinical deterioration in a patient with chronic lymphatic leukemia (CLL) and severe COVID-19. 18F-FDG PET/CT can be used to establish the diagnosis of RT in patients with CLL, but the use of 18F-FDG PET/CT to exclude RT as the cause of clinical deterioration in patients with CLL and severe COVID-19 has not previously been described.

Patient concerns:

A 61-year-old male with CLL and COVID-19 developed increased dyspnea, malaise and fever during hospitalization for treatment of severe and prolonged COVID-19.

Diagnoses:

18F-FDG PET/CT ruled out RT and revealed progression of opacities in both lungs consistent with exacerbation of severe acute respiratory syndrome coronavirus 2 pneumonia.

Interventions:

18F-FDG PET/CT imaging.

Outcomes:

The patient was discharged at day 52 without the need of supplemental oxygen, with normalized infection marks and continued care for CLL with venetoclax.

Lessons:

18F-FDG PET/CT ruled out RT as the cause of deteriorations in a patient with CLL and severe COVID-19, enabling directed care of exacerbation of severe acute respiratory syndrome coronavirus 2 pneumonia.
Impact of early postoperative activities on postoperative recovery in patients undergoing abdominal surgery
Authors: Fang Aohua , Ding Wei , Zeng Wei , Zhou Jinman , Zhu Hongfang , Yan Jiaohua , Wang Na
Published: December 2021

Introduction:

A refined nursing process is utilized to formulate a detailed early postsurgical activity plan. The postsurgical activity aims to conduct focused and planned interventions to address the early postoperative activities of patients, enhance the awareness and compliance of the patients through the early postsurgical activities. Currently, in traditional clinical practice, there is no clear evidence showing the effect of initial postsurgical actions related to the rehabilitation of inpatients undertaking abdominal operations. The present study will systematically evaluate how initial postsurgical actions impact the rehabilitation of patients undertaking abdominal operation through the analysis of relevant domestic and foreign literature.

Objective:

Analyze the how initial postsurgical actions impact the rehabilitation of abdominal surgery inpatients.

Methods and analysis:

The present systematic study will retrieve randomized controlled trials and case-control studies from online databases. The retrieved studies will describe the initial postsurgical activities in inpatients undergoing abdominal surgery. Accordingly, the following databases are searched for the aforementioned types of studies: Cochrane library, China National of Knowledge Infrastructure, Web of Science, PubMed database, WanFang database, and Embase database. Studies from inception to August 19, 2021 will be searched. The quality evaluation and data extraction for the studies that will satisfy the inclusion criteria will be conducted by 2 independent researchers. A meta-analysis on the postoperative indicators will be performed using RevMan 5.3.5 software.