bluuebunny/crossref_metadata_2025 huggingface dataset:
Paediatric appendiceal neuroendocrine tumours: a review of 33 cases from a single center
Authors: Yalçın Bilgehan , Karnak İbrahim , Orhan Diclehan , Oğuz Berna , Aydın Burça , Kurucu Nilgün , Varan Ali , Kutluk Tezer
Published: October 2021

Background

Appendiceal neurendocrine tumours (NETs) are rare neoplasms and diagnosis is commonly incidental following appendectomy. We aimed to review our experience with appendiceal NETs.

Methods

Records of children with appendiceal NETs were reviewed and data concerning demographic characteristics, clinical findings, surgical procedures, histopathological findings, management and outcomes were recorded.

Results

Between 1985 and 2021, 33 cases with appendiceal NETs (median age 11.8 years, range 7.8–16; male/female = 10/23) were identified. All but one patients presented with abdominal pain, six had vomiting, four had fever and they underwent appendectomies with presumed diagnosis of acute appendicitis. Abscess drainage and appendectomy was performed in a 16‐year‐old girl for suspected right ovarian mass, and tumour was positive in the omentum. Histopathological diagnosis was classical carcinoid tumour (NET) in all cases. Median tumour size was 0.9 cm (n = 26, range, 0.1–3.5 cm); tumours were ≤1 cm in 19 cases, 2 cm in one, 3.5 cm in another case. Tumours were located in the tip (n = 11), body (n = 6) and base of appendix (n = 1) (in others data unavailable). In 28 patients with data, tumour extended to submucosa in five, to tunica muscularis in seven, to subserosa in six, to serosa in six, to mesoappendix in three, to periappendiceal fat in one. Three cases were lost to follow‐up, 31 cases were alive (median follow‐up 53 months).

Conclusions

Paediatric appendiceal NETs do not behave aggressively and appendectomy alone is sufficient for tumours ≤2 cm regardless of local invasion. The need for further extensive surgery in tumours >2 cm also remains controversial.
Eye colour and skin pigmentation as significant factors for refractive outcome and residual accommodation in hypermetropic children: a randomized clinical trial using cyclopentolate 1% and tropicamide 1%
Authors: van Minderhout Helena M. , Joosse Maurits V. , Grootendorst Diana C. , Schalij‐Delfos Nicoline E.
Published: October 2021

Purpose

To compare the refractive outcome and residual accommodation with respect to various degrees of iris and skin pigmentation in hypermetropic children using 2 drops of cyclopentolate 1% (C + C) or 1 drop of cyclopentolate 1% and 1 drop of tropicamide 1% (C + T).

Methods

Two hundred fifty‐one hypermetropic children were classified according to iris and skin pigmentation (light, medium, dark) and received randomized and double‐blind C + C or C + T. Refractive error (spherical equivalent, SEQ) was determined using the Retinomax‐K + 3. In 204 subjects, residual accommodation (RA) was determined using the PlusoptiX PowerRefractor.

Results

A linear mixed model with a light‐irided and light skin‐pigmented reference group receiving C + T (mean SEQ +3.10 ± 1.87D) indicated significant less hypermetropia in subjects with a dark iris having a medium‐ and dark‐pigmented skin in C + T, −1.02 ± 0.29 (−1.59/−0.45) and −1.53 ± 0.30 (−2.10/−0.95); and in subjects having a light‐, medium‐ and dark‐pigmented skin in C + C, −0.74 ± 0.34 (−1.41/−0.06), −1.26 ± 0.30 (−1.85/−0.66) and −1.84 ± 0.30 (−2.42/−1.26). Similar findings were present for RA. Our model with a light‐irided and light skin‐pigmented reference group receiving C + T (mean RA +0.84 ± 0.61D) indicated significantly higher RA in dark‐irided subjects with medium‐ and dark‐pigmented skin in C + T, +1.05 ± 0.19 (+0.67/+1.43) and +1.35 ± 0.20 (+0.9/+1.74), and in C + C, +1.13 ± 0.21 (+0.71/+1.55) and +1.90 ± 0.19 (+1.51/+2.28).

Conclusions

We found solid evidence that skin pigmentation rather than iris pigmentation is the decisive factor for effectiveness of cycloplegics. Awareness of the limitations of cycloplegic regimens in dark‐irided/pigmented children is needed. Our study showed that cyclopentolate 1% combined with tropicamide 1% provides more accurate refractive outcomes both statistically and clinically integrating the factor skin pigmentation for dark‐irided subjects.
Assessment of exposure to direct oral anticoagulants in elderly hospitalised patients
Authors: Kampouraki Emmanouela , Avery Peter , Biss Tina , Wynne Hilary , Kamali Farhad
Published: October 2021

It is unclear whether elderly patients established on direct oral anticoagulants (DOACs) have greater exposure to these drugs, which could subsequently increase their risk of bleeding. We assessed DOAC exposure and factors affecting it in a real‐world elderly cohort of patients. For this, 151 medically stable hospital inpatients (76 established on apixaban, 61 on rivaroxaban, 14 on dabigatran) with a median [interquartile range (IQR)] age of 84 (78–89) years were recruited. Patients provided blood samples for measurement of peak and trough plasma DOAC concentrations. There was up to 48‐fold and 13‐fold variation in trough and peak plasma drug concentrations respectively. A significantly greater proportion of patients on apixaban had peak plasma drug concentrations within the reported ranges compared to those on either rivaroxaban or dabigatran (82·9% vs. 44·3% vs. 64·3% respectively; P < 0·001). A third of the variability in DOAC plasma concentrations was attributed to the influences of DOAC dosage, renal function and gender. To what extent the observed increases in DOAC exposure in the older patients is the cause of their increased risk of bleeding, which could potentially be ameliorated by dosing titration, requires further investigation.
Research on professional organizations: A review of theoretical traditions, themes, methods and locations
Authors: Brock David M.
Published: October 2021

This research note presents an overview of the contemporary “professional organization” research area. We begin with the historical roots and evolution of research into professionals and the organizations in which they work, identifying five theoretical traditions—namely sociology of organization, sociology of the professions, professional organization, professional service firms, and public professionalism. Reviewing recent research in these areas allows us to identify important research phenomena—such as hybridity, institutional work, internationalization, and professional identity—and to understand how the institutional view within the “sociology of the professions” tradition has become a dominant paradigm for this research. This review also reveals the extent to which various occupations, methodological approaches, and academic fields, and locations have assumed positions of importance in recent years. Finally, future directions relevant to sociology researchers are discussed.
Imperatorin inhibits mitogen‐activated protein kinase and nuclear factor kappa‐B signaling pathways and alleviates neuroinflammation in ischemic stroke
Authors: Ge Jian‐wei , Deng Shi‐ji , Xue Zhi‐wei , Liu Pin‐yi , Yu Lin‐jie , Li Jiang‐nan , Xia Sheng‐nan , Gu Yue , Bao Xin‐yu , Lan Zhen , Xu Yun , Zhu Xiao‐lei
Published: October 2021

Aims

Microglia‐mediated neuroinflammation plays an important role in the pathological process of ischemic stroke, and the effect of imperatorin on post‐stroke neuroinflammation is not fully understood.

Methods

Primary microglia were treated with imperatorin for 2 h followed by LPS (100 ng/ml) for 24 h. The expression of inflammatory cytokines was detected by RT‐PCR, ELISA, and Western blot. The activation of MAPK and NF‐κB signaling pathways were analyzed by Western blot. The ischemic insult was determined using a transient middle cerebral artery occlusion (tMCAO) model in C57BL/6J mice. Behavior tests were used to assess the neurological deficits of MCAO mice. TTC staining was applied to measure infract volume.

Results

Imperatorin suppressed LPS‐induced activation of microglia and pro‐inflammatory cytokines release and attenuated ischemic injury in MCAO mice. The results of transcriptome sequencing and Western blot revealed that downregulation of MAPK and NF‐κB pathways might contribute to the protective effects of imperatorin.

Conclusions

Imperatorin downregulated MAPK and NF‐κB signaling pathways and exerted anti‐inflammatory effects in ischemic stroke, which indicated that imperatorin might be a potential compound for the treatment of stroke.
Why do animal groups matter for conservation and management?
Authors: Maldonado‐Chaparro Adriana A. , Chaverri Gloriana
Published: October 2021

The internationally recognized levels of conservation, namely ecosystems, species, and genes, have thus far served as important guidelines to determine how national and international laws should protect nature. However, a far ignored aspect of a species' life history in the legislation is its tendency to form social groups. Group members greatly depend on each other for survival and reproduction, and when the persistence of groups is threatened, so may the population as a whole. Humans affect groups through indirect activities, such as tourism, or directly by removing individuals through poaching, for example. These activities disturb groups in both predictable and unpredictable ways: destabilizing dominance hierarchies, changing the strength of social relationships, modifying cooperative interactions, reducing alloparental care, and altering social skills, among others. We propose that greater efforts must be undertaken first, to more thoroughly understand how our actions are affecting group dynamics in as many species as possible, and second, to adapt policies to reduce the negative effects of direct and indirect anthropogenic activities on group and population persistence.
Status quo and perspectives of dermatology hospitals in Germany: spectra of health care and staff situation
Authors: Augustin Matthias , Girbig Gefion , Hertl Michael , Elsner Peter , Welzel Julia , Honak Laura , Hischke Sandra , Biedermann Tilo
Published: October 2021

Background

Inpatient care in Germany has been subject to change since the introduction of the DRG‐based payment system. There have been no publications on important differentiating factors such as the spectrum of care and the staffing situation in dermatology.

Methods

Health care analysis of 115 dermatology hospitals in October 2019 using a structured survey questionnaire.

Results

On average, the spectrum of care included 31.0 % general dermatology, 33.6 % surgical dermatology, 15.6 % oncology, and 10.1 % allergology. The clinics had an average of 14 full‐time positions and 3 part‐time positions (university clinics: 23/5, non‐university clinics: 9/2). The mean nationwide proportion of women in the physician teams showed the following distribution: postgraduate physicians 73.3 %, senior physicians 53.0 %, directors 20.0 %. The applicant situation of senior physicians and specialists was assessed as predominantly poor, that of residents as predominantly good. Worse applicant situations were present in non‐university hospitals and in rural areas. The satisfaction of the medical directors with the current conditions of inpatient care showed a variable assessment independent of university hospital and non‐university hospital status. However, the threat to inpatient care was predominantly assessed as low (71.6 %).

Conclusions

The overall situation of inpatient dermatological care can be classified as predominantly good. In addition, the majority of dermatology clinics provide a wide range of care with regard to the variety of indications. The general conditions, which in some cases are rated as inadequate, require further measures.
Morbus Darier und Morbus Hailey‐Hailey: Stand 2021
Authors: Rogner Danielle Franziska , Lammer Judith , Zink Alexander , Hamm Henning
Published: October 2021

Die autosomal‐dominanten Genodermatosen Morbus Darier und Morbus Hailey‐Hailey stellen Dermatologen vor besondere Herausforderungen. Trotz ähnlicher Pathogenese, die in einer verminderten Adhäsion suprabasaler Keratinozyten aufgrund defekter ATPasen in epidermalen Calciumkanälen besteht, unterscheiden sich die beiden Erkrankungen in klinischem Bild und Therapiemöglichkeiten erheblich. Der Morbus Darier ist gekennzeichnet durch bräunlich‐erythematöse, keratotische Papeln in seborrhoischen und intertriginösen Arealen, welche zu großflächigen Läsionen konfluieren können. Betroffene mit Morbus Hailey‐Hailey entwickeln vornehmlich intertriginös Papulovesikel und Bläschen, aus denen oft erythematöse Plaques mit Erosionen und schmerzhaften Fissuren entstehen. Die Lebensqualität ist aufgrund von Beschwerden (Juckreiz, Brennen, Schmerzen), Körpergeruch und des chronischen Verlaufs deutlich eingeschränkt. Die Therapieoptionen sind immer noch limitiert. Antiseptika und topische Glukokortikoide bilden eine wichtige Säule der Therapie, bei Superinfektionen ist oft eine systemische antiinfektiöse Therapie erforderlich. Ablative Maßnahmen wie Dermabrasion und CO2‐Laser‐Therapie können bei intertriginösem Morbus Hailey‐Hailey zu langfristiger Erscheinungsfreiheit führen, temporäre Besserungen wurden auch durch intraläsionale Botulinumtoxin‐Injektionen erzielt. Unter den Systemtherapeutika liegt beim Morbus Darier die beste Evidenz für das hierfür zugelassene Acitretin vor. Die Wirksamkeit von Immunsuppressiva und ‐modulatoren ist uneinheitlich. Niedrig dosiertes Naltrexon zeigt bei Morbus Hailey‐Hailey zufriedenstellendere Ergebnisse als bei Morbus Darier. Der vorliegende CME‐Artikel fasst das aktuelle Wissen über die beiden Dermatosen unter Berücksichtigung neuer Entwicklungen zusammen.
Design considerations for rapid biodiversity reconnaissance surveys and long‐term monitoring to assess the impact of wildfire
Authors: Southwell Darren , Legge Sarah , Woinarski John , Lindenmayer David , Lavery Tyrone , Wintle Brendan
Published: October 2021

Aims

Reconnaissance surveys followed by monitoring are needed to assess the impact and response of biodiversity to wildfire. However, post‐wildfire survey and monitoring design are challenging due to the infrequency and unpredictability of wildfire, an urgency to initiate surveys and uncertainty about how species respond. In this article, we discuss key design considerations and quantitative tools available to aid post‐wildfire survey design. Our motivation was to inform the design of rapid surveys for threatened species heavily impacted by the 2019–2020 fires in Australia.

Location

Global.

Methods

We discuss a set of best practice design considerations for post‐wildfire reconnaissance surveys across a range of survey objectives. We provide examples that illustrate key design considerations from post‐fire reconnaissance surveys and monitoring programmes from around the world.

Results

We highlight how the objective of post‐fire surveys drastically influences design decisions (e.g. survey location and timing). We discuss how the unpredictability of wildfire and uncertainty in the response of biodiversity complicate survey design decisions.

Main conclusions

Surveys should be conducted immediately following wildfire to assess the impact on biodiversity, to ground truth fire severity mapping and to provide a benchmark from which to assess recovery. Where possible, surveys should be conducted at burnt and unburnt sites in regions with historical data so that state variables of interest can be compared with baseline estimates (i.e. BACI design). This highlights the need to have long‐term monitoring programmes already in place and be prepared to modify their design when wildfires occur. There is opportunity to adopt tools from statistics (i.e. power analysis) and conservation planning (i.e. spatial prioritization) to improve survey design. We must anticipate wildfires rather than respond to them reactively as they will occur more frequently due to climate change.
Firm‐specific forecast errors and asymmetric investment propensity
Authors: Buchholz Manuel , Tonzer Lena , Berner Julian
Published: October 2021

This paper analyzes how firm‐specific forecast errors derived from survey data of German manufacturing firms over 2007–2011 relate to firms' investment propensity. Our findings reveal that asymmetries arise depending on the size and direction of the forecast error. The investment propensity declines if the realized situation is worse than expected. However, firms do not adjust investment if the realized situation is better than expected suggesting that the uncertainty component of the forecast error counteracts good surprises of unexpectedly favorable business conditions. This asymmetric mechanism can be one explanation behind slow recovery following crises.
The influence of financial and economic literacy on policy preferences in Italy
Authors: Magistro Beatrice
Published: October 2021

As populist and protectionist sentiments across the world increase, this paper explores the role that financial and economic literacy plays in shaping individual economic policy preferences. Analyzing original survey data collected in Italy, this study shows that financially and economically literate individuals, regardless of their economic self‐interest, are more likely to prefer remaining in the Eurozone, to favor free trade, EU immigration, non‐EU immigration, and the Fornero pension reform. The author provides preliminary evidence that the lack of differential effects between financially and economically literate winners and losers from globalization and pension reform is driven by longer time horizons. Finally, the author examines different ways to measure financial and economic literacy and finds that there is no evidence of a similar effect when looking at general education, suggesting that financial and economic literacy has distinctive features that more closely capture an individual's ability to evaluate policies.
Monitoring techniques for equine anaesthesia
Authors: Dagnall C. , Khenissi L. , Love E.
Published: October 2021

The anaesthetist aims to preserve normal physiology of the horse notwithstanding the use of general anaesthetic drugs and pre‐existing pathological changes. Provision of analgesia and maintaining an adequate plane of anaesthesia are important alongside monitoring cardiorespiratory performance, response to noxious stimuli and temperature. There are a variety of techniques that subjectively or objectively assess physiological variables, and the results should be interpreted in the context of the anaesthetic protocol. Basic ‘hands‐on’ monitoring of anaesthesia requires no equipment and is a core skill for every anaesthetist. However, as technology advances, many more electronic monitoring options have become available. This review describes how to use specific monitoring techniques, discusses the evidence underpinning them and evaluates their place in clinical practice. Where appropriate, normal and abnormal values are highlighted, although evaluation of trends may be more important in some cases. Regular documentation of variables enables trends to be identified and is key to appropriate early intervention. All basic monitoring techniques that require no equipment, such as ocular and mucous membrane assessment and pulse palpation, are recommended for every general anaesthetic procedure. The use of capnography, pulse oximetry, electrocardiography and blood pressure monitoring devices is recommended where indicated (Martinez et al., 2008), recognising that anaesthesia in horses is performed in a variety of places with different facilities and using various drug combinations.
Heritable variation in locomotion, reward sensitivity and impulsive behaviors in a genetically diverse inbred mouse panel
Authors: Bailey Lauren S. , Bagley Jared R. , Dodd Rainy , Olson Ashley , Bolduc Mikayla , Philip Vivek M. , Reinholdt Laura G. , Sukoff Rizzo Stacey J. , Tarantino Lisa , Gagnon Leona , Chesler Elissa J. , Jentsch James David
Published: October 2021

Drugs of abuse, including alcohol and stimulants like cocaine, produce effects that are subject to individual variability, and genetic variation accounts for at least a portion of those differences. Notably, research in both animal models and human subjects point toward reward sensitivity and impulsivity as being trait characteristics that predict relatively greater positive subjective responses to stimulant drugs. Here we describe use of the eight collaborative cross (CC) founder strains and 38 (reversal learning) or 10 (all other tests) CC strains to examine the heritability of reward sensitivity and impulsivity traits, as well as genetic correlations between these measures and existing addiction‐related phenotypes. Strains were all tested for activity in an open field and reward sensitivity (intake of chocolate BOOST®). Mice were then divided into two counterbalanced groups and underwent reversal learning (impulsive action and waiting impulsivity) or delay discounting (impulsive choice). CC and founder mice show significant heritability for impulsive action, impulsive choice, waiting impulsivity, locomotor activity, and reward sensitivity, with each impulsive phenotype determined to be non‐correlating, independent traits. This research was conducted within the broader, inter‐laboratory effort of the Center for Systems Neurogenetics of Addiction (CSNA) to characterize CC and DO mice for multiple, cocaine abuse related traits. These data will facilitate the discovery of genetic correlations between predictive traits, which will then guide discovery of genes and genetic variants that contribute to addictive behaviors.
Balancing cropland gain and desert vegetation loss: The key to rural revitalization in Xinjiang, China
Authors: Chen Weijia , Lu Yongquan , Liu Guilin
Published: October 2021

In arid zones, ecological barriers can affect the agricultural development and sustainable development of oases. Therefore, balancing cropland and desert vegetation is the key to realizing ecological and rural revitalization. Then, we proposed a theoretical framework from the perspective of rural revitalization to analyze the key drivers that affect the balance of cropland and desert vegetation during 1990–2020. The results showed that cropland area in Xinjiang decreased by 881 km2 during 1990–1995, while it continually increased by 34,086 km2 during 1995–2020. However, grassland and woodland increased by 8,086 km2 during 2015–2020, indicating that the balance between cropland gain and desert vegetation loss began to improve. Most cropland expansions were reclaimed from woodland/grassland and unused land. During 1990–2005, changes between cropland and unused land in Xinjiang were mainly affected by gross domestic product (GDP). GDP and population most significantly affected the conversion (17,939 km2) of woodland/grassland to cropland during 1995–2015. Although population and economic growth led to an increase in cropland, the implementation of simultaneous and consistent policies on ecological conservation offset the reduction in desert vegetation. The findings can provide suggestions for smart cropland management and rural revitalization in Xinjiang, Central Asian countries and other countries with similar backgrounds worldwide.
If I knew then what I know now
Authors: O’Shea Saoirse Caitlin
Published: October 2021

In this essay, I present an autoethnographic account of my gender affirmation surgery and subsequent recovery. Surgery is considered as the benchmark for people like me but remains little discussed. In the organizational literature the focus is on those who may transition and those who have transitioned, not on the surgery itself. It is glossed over in popular accounts to leave the impression that one goes to sleep one day and wakes fully formed the next. These accounts pay little heed to the somatic, embodied nature of surgery and issues of body dysphoria, euphoria, transition, potential detransition, and retransition. Such accounts affirm a binarized gender narrative where surgery normalizes bodies to meet the expectations of a cis‐normative society. Moreover such accounts do little justice as to what happens next since surgery is seen as the outcome of transition rather than part of the process.
Subjective sensory sensitivity and its relationship with anxiety in people with probable migraine
Authors: Price Alice , Sumner Petroc , Powell Georgina
Published: October 2021

Objective

To better characterize differences in interictal sensory experience in adults with migraine and more comprehensively describe the relevance of anxiety to these experiences.

Background

Evidence suggests that sensitivity to sensory input may not be limited to migraine attacks but continues between them. However, there is a need to better understand whether this is the case across senses, and to clearly distinguish sensory experience from measured sensory threshold, which are not straightforwardly related. Previous literature also indicates a co‐occurrence between sensory sensitivity, migraine, and anxiety, but this relationship remains to be fully elucidated.

Methods

The present cross‐sectional study used online questionnaires to investigate how self‐reported sensory experiences relate to migraine in a large community sample including 117 individuals with probable migraine and 827 without. Mediation analyses were also used to determine whether any relationship between migraine and sensory sensitivity was mediated by anxiety.

Results

Significant increases in subjective reports of sensory sensitivity (d = 0.80) and sensory avoidance (d = 0.71) were found in participants with migraine. Anxiety symptoms partially mediated the relationship between subjective sensory sensitivity and migraine. Finally, visual, movement, and auditory subscales were found to provide unique explanatory variance in analyses predicting the incidence of migraine (area under the curve = 0.73, 0.69, 0.62 respectively).

Conclusion

Subjective sensory sensitivities are present between attacks and across senses in individuals with migraine. Anxiety symptoms are relevant to this relationship; however, sensory sensitivities appear to exist independent of this affective influence. The implications of interictal sensitivities for the daily lives of those with migraine should, therefore, be considered in clinical management wherever appropriate.
Plant seeds as source of nutrients and phytochemicals for the Indian population
Authors: Cervera‐Mata Ana , Sahu Pravin Kumar , Chakradhari Suryakant , Sahu Yaman Kumar , Patel Khageshwar Singh , Singh Samarendra , Towett Erick K. , Martín‐Ramos Pablo , Quesada‐Granados José Javier , Rufián‐Henares José A.
Published: October 2021

Plant seeds are major sources of nutrients and bioactive compounds for human beings and vary across different locations. In addition, they are under used foods that could be a good complement for the daily nutrition of people. Therefore, the aim of this study was the analysis of different physical parameters, nutrients and bioactive compounds of 60 plant seeds belonging to 48 species and 9 families. The seeds were collected in 2016–2017 in the Raipur area, India (21.25°N 81.63°E), from three different locations. Fat, protein, starch, total polyphenols and mineral contents ranged from 0.7 to 44.2, 1.6 to 68.5, 11.3 to 84.0, 0.01 to 3.85 and 0.67 to 4.91 g/100 g (dry weight) respectively. Regarding physical properties, the heavier seeds were covered with thick testa over the range of 3.0 to 40% of the seed mass. Higher moisture and ash fractions for the starchy (cereal and pulses) and weed seeds were also found. The most abundant mineral elements in the seeds were P, S, K, Mg, Ca, Fe and Zn. Finally, it was calculated the contribution of the consumption of seeds to the daily macronutrients and micronutrients intake for Indian population, reaching up to 38, 13 and 25% for proteins, fat and carbohydrates respectively.
Vaccine‐induced immune thrombosis and thrombocytopenia syndrome following adenovirus‐vectored severe acute respiratory syndrome coronavirus 2 vaccination: a novel hypothesis regarding mechanisms and implications for future vaccine development
Authors: Monagle Paul , Ng Ashley P , Linden Matthew , Ignjatovic Vera , Farley Alison , Taoudi Samir , Pasricha Sant Rayn , Torresi Joseph
Published: October 2021

We hypothesize that thrombosis with thrombocytopenia syndrome recently described after administration of adenovirus‐vectored vaccines for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) occurs as a result of the unique properties of the adenovirus vectors, which can have widespread biodistribution throughout the body. The antigen is delivered to megakaryocyte cells, which act as part of the primary immune system and distribute the antigen within progeny platelets, also a key component of the immune system. The interaction of the antigen induces preformed antiplatelet factor 4 (PF4) antibodies to bind to PF4–heparan sulfate complexes in the absence of exogenous heparin, at sites where the heparan sulfate concentration in the vascular glycocalyx is optimal for complex formation, causing thrombosis and thrombocytopenia as observed clinically. This hypothesis is testable in cell culture and animal models, and potentially in vivo, and if proven correct has significant implications for vaccine development and our understanding of the links between the coagulation and immune systems.
In situ 4D tomography image analysis framework to follow sintering within 3D‐printed glass scaffolds
Authors: Kondarage Achintha I. , Poologasundarampillai Gowsihan , Nommeots‐Nomm Amy , Lee Peter D. , Lalitharatne Thilina D. , Nanayakkara Nuwan D. , Jones Julian R. , Karunaratne Angelo
Published: October 2021

We propose a novel image analysis framework to automate analysis of X‐ray microtomography images of sintering ceramics and glasses, using open‐source toolkits and machine learning. Additive manufacturing (AM) of glasses and ceramics usually requires sintering of green bodies. Sintering causes shrinkage, which presents a challenge for controlling the metrology of the final architecture. Therefore, being able to monitor sintering in 3D over time (termed 4D) is important when developing new porous ceramics or glasses. Synchrotron X‐ray tomographic imaging allows in situ, real‐time capture of the sintering process at both micro and macro scales using a furnace rig, facilitating 4D quantitative analysis of the process. The proposed image analysis framework is capable of tracking and quantifying the densification of glass or ceramic particles within multiple volumes of interest (VOIs) along with structural changes over time using 4D image data. The framework is demonstrated by 4D quantitative analysis of bioactive glass ICIE16 within a 3D‐printed scaffold. Here, densification of glass particles within 3 VOIs were tracked and quantified along with diameter change of struts and interstrut pore size over the 3D image series, delivering new insights on the sintering mechanism of ICIE16 bioactive glass particles in both micro and macro scales.
Integrative computational immunogenomic profiling of cortisol‐secreting adrenocortical carcinoma
Authors: Baechle Jordan J. , Hanna David N. , Sekhar Konjeti R. , Rathmell Jeffrey C. , Rathmell W. Kimryn , Baregamian Naira
Published: October 2021

Adrenocortical carcinoma (ACC) is a rare but highly aggressive malignancy. Nearly half of ACC tumours overproduce and secrete adrenal steroids. Excess cortisol secretion, in particular, has been associated with poor prognosis among ACC patients. Furthermore, recent immunotherapy clinical trials have demonstrated significant immunoresistance among cortisol‐secreting ACC (CS‐ACC) patients when compared to their non‐cortisol‐secreting (nonCS‐ACC) counterparts. The immunosuppressive role of excess glucocorticoid therapies and hypersecretion is known; however, the impact of the cortisol hypersecretion on ACC tumour microenvironment (TME), immune expression profiles and immune cell responses remain largely undefined. In this study, we characterized the TME of ACC patients and compared the immunogenomic profiles of nonCS‐ACC and CS‐ACC tumours to assess the impact of differentially expressed genes (DEGs) by utilizing The Cancer Genome Atlas (TCGA) database. Immunogenomic comparison (CS‐ vs. nonCS‐ACC tumour TMEs) demonstrated an immunosuppressive expression profile with a direct impact on patient survival. We identified several primary prognostic indicators and potential targets within ACC tumour immune landscape. Differentially expressed immune genes with prognostic significance provide additional insight into the understanding of potential contributory mechanisms underlying failure of initial immunotherapeutic trials and poor prognosis of patients with CS‐ACC.
Infrared drying of pear slices: Drying kinetics, energy, and exergy analysis
Authors: de Araujo Marcos Eduardo Viana , Barbosa Eloiny Guimarães , Lopes Roberto Precci , Corrêa Paulo Cesar , Barbosa Elisa Guimarães
Published: October 2021

Over the last few decades, the drying process has proven to be a fundamental operation within the food industry, as it prolongs the shelf life and reduces the levels of deterioration of the product. Infrared drying has gained great attention in recent years as it promotes more uniform and energy‐efficient drying. Given the above, this study aimed to perform infrared drying of pear slices at different temperatures, evaluating the drying kinetics, and the thermodynamic analysis. The pear slices 3‐mm thick were dried in an infrared dryer at temperatures between 50 and 100°C until constant mass. Different mathematical models were fitted to the experimental data to represent drying as a function of time. Energy and exergy analysis were performed by applying the first and second laws of thermodynamics. The Henderson and Pabis modified model satisfactorily represented the drying of pear slices. The effective diffusion coefficient increased linearly with increasing temperature, ranging from 1.15 × 10−9 and 5.08 × 10−9 m2/s. From Arrhenius's relations, the activation energy of the drying process of pear slices was 29.87 kJ/mol. The lowest specific energy consumption (10.28 kWh/kg) was observed for higher drying temperature. The drying temperature positively influenced the energy and exergy efficiencies of the process. The efficiency of the first law of thermodynamics varied between 40 and 99%. The increase in the energy required in the dryer, overcomes the destruction of exergy in the equipment.

Practical Applications

Infrared radiation drying is a promising high‐efficiency technology. One of the main advantages of this method is the significant reduction in drying time compared with convective drying. For a complete evaluation of the drying system, analysis of the first and second laws of thermodynamics must be applied. Few studies on energy and exergy analysis of infrared dryers are found. A detailed literature review showed that there is no information on energy and exergy analysis of the infrared drying process of pear slices. It is believed that this study will contribute to the pear food industry by providing results from the best drying process in terms of kinetics, energy, and exergy.
Life expectancy with and without dementia in persons with mild cognitive impairment in the community
Authors: Mooldijk Sanne S. , Yaqub Amber , Wolters Frank J. , Licher Silvan , Koudstaal Peter J. , Ikram M. Kamran , Ikram M. Arfan
Published: October 2021

Background

Various clinical studies have provided estimates of life expectancy of patients with mild cognitive impairment (MCI) from outpatient clinics, but whether these apply to community‐dwelling individuals at home or in primary care is uncertain.

Methods

Within the population‐based Rotterdam Study, we studied life expectancy with and without dementia in 648 community‐dwelling persons with MCI and 6410 without MCI. Participants aged 60 years and older were assessed for MCI at baseline (2002–2014) and subsequently followed for the onset of dementia and death. We used multistate life tables to determine age‐specific life expectancy with and without dementia by sex, educational attainment, and MCI subtype.

Results

Total life expectancy for MCI ranged from 21.4 years (95% CI: 19.0–23.6) at age 60 to 2.6 years (1.6–3.6) at age 95. With advancing age, an increasing proportion of these years was lived with dementia (2.9 years [1.8–4.0] at age 60; 1.2 [0.2–2.2] at age 95). Women and higher educated individuals lived longer and lived more years with dementia. No differences in total life expectancy were observed by MCI subtype, although individuals with amnestic MCI lived a larger proportion of those years with dementia.

Conclusions

Prognosis of MCI, in terms of life years lived with and without dementia, is more favorable in the general population than described in prior clinical observations, due likely to a substantial proportion of individuals with MCI in the clinic not seeking medical attention in an earlier stage.
Differentiation of frontal fibrosing alopecia and Lichen planopilaris on trichoscopy: A comprehensive review
Authors: Rajan Aswath , Rudnicka Lidia , Szepietowski Jacek C. , Lallas Aimilios , Rokni Ghasem Rahmatpour , Grabbe Stephan , Goldust Mohamad
Published: October 2021

Trichoscopy in dermatology has opened up the new concept in overcoming the optical challenge faced clinically. It reveals the diagnostic details to the depth of superficial dermis, and thereby increasing the clinician's diagnostic accuracy and the level of confidence. The importance of trichoscopy in cicatricial alopecia is very evident in the current scenario for its precise diagnosis. The clinical picture in delineating lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) from each other and also from other close mimickers such as androgenetic alopecia, alopecia areata, female patterned hair loss, and other cicatricial alopecia is bewildered due to its varied presentation and co‐existence with the above disease. The indecisive comparative findings on histopathology make the situation even more perplexed. In this article, we have reviewed the characteristic trichoscopy patterns that can differentiate LPP and FFA and from their close mimickers.
The use of light in the treatment of acne vulgaris—a review
Authors: Zdrada Julita , Stolecka‐Warzecha Anna , Odrzywołek Wiktoria , Deda Anna , Błońska‐Fajfrowska Barbara , Wilczyński Sławomir
Published: October 2021

Topical and oral antibiotic therapy is also a popular method of treatment. The effectiveness of this method is limited by the increasing resistance of bacteria to antibiotics. Over the decades since the introduction of antibiotics to treat acne, the resistance levels of bacteria have changed. This defense mechanism is developed evolutionarily. Modifications of antibiotic receptor sites, alteration of drug influx/efflux, or enzymatic degradation are common mechanisms used by bacteria to initiate and strengthen internal antibiotic resistance. The basic chromophores used in light therapy are hemoglobin, melanin, water bound to proteins, and porphyrins. Hemoglobin absorbs light mainly at 580 nm, while melanin absorbs the entire visible spectral range (400–750 nm). Porphyrins are aromatic compounds, classified as photosensitizing substances, intensively absorbing blue light, and to a lesser extent in long visible bands, such as orange and red light. Using IPL makes it possible to cover the maximum light absorption of porphyrins and hemoglobin, therefore it can be an effective tool in the treatment of inflammatory lesions in acne vulgaris. In view of the effectiveness of light therapy and its effect even on antibiotic‐resistant bacteria, it is worth considering the possibility of using light therapy instead of antibiotic therapy. Due to the increasing resistance of bacteria to antimicrobials, they should be used with caution and as a last resort. The high‐energy light treatment act only locally (unlike with antibiotics taken orally) and on a chromophore, such as melanin, hemoglobin, or porphyrins.
Effect of modified levonorgestrel‐releasing intrauterine system in human adenomyosis with heavy menstrual bleeding
Authors: Yang Hong , Wang Shengtan , Fu Xiaoyan , Lan Ruihong , Gong Humin
Published: October 2021

Aim

The levonorgestrel‐releasing intrauterine (LNG‐IUS) system is an effective primary treatment for adenomyosis; however, it has high expulsion rates. We aimed to modify the system—allowing affixion to the myometrium—and evaluate the expulsion rate, effectiveness, and side effects in patients with adenomyosis and heavy menstrual bleeding.

Methods

This study included patients with adenomyosis and heavy menstrual bleeding who underwent implantation of: a modified LNG‐IUS (experimental group, n = 47); and the original system after gonadotropin‐releasing hormone agonist treatment (control group, n = 47), between January 2014 and April 2016.

Results

In the experimental group, two device expulsions occurred 12–18 months postimplantation. In the remaining 45 patients, the system was safely removed after the 60‐month validity period, and no extrauterine device movement or infection occurred. In the control group, downward displacement and expulsion of the device occurred in eight (17%) patients within 60 months. The 5‐year total expulsion rates were 4.3% and 17.0% in the experimental and control groups, respectively (p = 0.045). There were significant changes in the pretreatment severity of dysmenorrhea, menstrual volume, uterine volume (cm3), and hemoglobin level in each group compared with after 1 year (p < 0.01 in all groups). The severity of dysmenorrhea, menstrual volume, uterine volume, and hemoglobin level after 1 year were similar between the two groups (p > 0.05 in all groups).

Conclusions

Use of the modified LNG‐IUS is a safe, cost‐effective, and simple method for reducing the downward movement and expulsion rate in patients with adenomyosis and heavy menstrual bleeding.
Temporal relationship between sleep‐time masseter muscle activity and apnea–hypopnea events: A pilot study
Authors: Colonna Anna , Cerritelli Luca , Lombardo Luca , Vicini Claudio , Marchese‐Ragona Rosario , Guarda‐Nardini Luca , Manfredini Daniele
Published: October 2021

Background

Obstructive sleep apnea (OSA) is the most common sleep disorder due mainly to peripheral causes, characterized by repeated episodes of obstruction of the upper airways, associated with arousals and snoring. Sleep bruxism (SB) is a masticatory muscle activity during sleep that is characterized as rhythmic (phasic) or nonrhythmic (tonic) and is not a movement disorder or a sleep disorder in otherwise healthy individuals. Given the potentially severe consequences and complications of apnea, the concurrent high prevalence of SB in daily dental practice, getting deeper into the correlation between these phenomena is worthy of interest..

Study Objectives

The aim of this study was to investigate the correlation between SB‐related masseter muscle activity (MMA) and apnea–hypopnea events as well as to assess their temporal sequence.

Methods

Thirty (N = 30) patients with sleep respiratory disorders and clinical suspicion of sleep bruxism (SB) were recruited. Ambulatory polygraphic recording was performed to detect apnea–hypopnea events (AHEs) and sleep bruxism episodes (SBEs). Pearson test was used to assess the correlation between apnea–hypopnea index (AHI) and SB index (SBI). A 5‐s time window with respect to the respiratory events was considered to describe the temporal distribution of SBEs. Furthermore, SBI was compared between groups of patients with different AHI severity (i.e., mild, moderate and severe) using ANOVA.

Results

On average, AHI was 27.1 ± 21.8 and SBI 9.1 ± 7.5. No correlation was shown between AHI and SBI. Most of SBEs (66.8%) occurred without a temporal relationship with respiratory events. Considering OSA, 65.7% of SBEs occurred within 5 s after AHEs, while in the case of central apnea (CA) 83.8% of SBEs occurred before the respiratory event. The participants with severe apnea (N = 9) show a tendency to have higher bruxism indexes when compared to patients with mild (N = 11) and moderate apnea (N = 10).

Conclusions

Findings suggest that: 1. At the study population level, there is no correlation between AHI and SBI, as well as any temporal relationship between SBEs and respiratory events. 2. Specific patterns of temporal relationship might be identified with future studies focusing on the different types of apnea–hypopnea events and bruxism activities.
Predicting the number of physical therapy visits and patient satisfaction in individuals with temporomandibular disorder: A cohort study
Authors: Prodoehl Janey , Kraus Steven , Buros Stein Amy
Published: October 2021

Background

Temporomandibular disorders (TMD) can be challenging to manage for clinicians and patients alike. It is unclear which factors are associated with prolonging conservative care and patient dissatisfaction with treatment outcomes.

Objectives

To examine factors collected during a physical therapy (PT) evaluation in a cohort of individuals with TMD to determine factors associated with an increased number of PT visits and reduced patient satisfaction.

Methods

Records of 511 patients referred to PT over 18 months were reviewed to extract 27 variables to develop a predictive model. Outcomes were patient satisfaction following PT and number of PT visits. Linear and zero inflated negative binomial regressions were used, and a multivariate regression model was built for both outcomes.

Results

Two factors were associated with both lower patient satisfaction and an increased number of PT visits: higher patient rated functional neck disability and a greater number of healthcare professionals seen. Other factors associated with patient satisfaction were duration of symptoms, subluxation, and referral from an oral surgeon. Only patient rated functional neck disability score was a significant predictive factor in the multivariate model. Factors associated with number of PT visits were gender, educational level, time between initial visit and discharge, number of pain areas, bruxism, biopsychosocial factors, dizziness, pain rating, and presence of neck pain. In the multivariate model, gender, number of healthcare professionals seen, and resting pain rating were significant predictors of number of PT visits.

Conclusion

Considering key factors on initial evaluation, specifically functional neck disability and the number of prior healthcare professionals seen before starting PT, can help to predict a higher number of PT visits and reduced patient satisfaction with outcomes.
Vaccine apartheid: This is not the way to end the pandemic
Authors: Lanziotti Vanessa S , Bulut Yonca , Buonsenso Danilo , Gonzalez‐Dambrauskas Sebastian
Published: October 2021

There are many reasons why the international community as a whole should advocate for COVID‐19 vaccine equity: global economic recession, uncontrolled outbreaks with higher risk of virus variants and persistent unsafe travelling in an era of now vaccine‐preventable cause of death. This inequity is an avoidable threat to global health. Funding agencies, policy makers, drug companies and NGOs among others have the moral duty to end this vaccine apartheid and to make vaccine equity a reality. In this viewpoint, we discuss how inequalities in vaccination access affect a proper control of the pandemic, highlighting specific consequences on child health.