bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of a Congested Fixture Period on Speed and Power Performance of Elite Young Soccer Players
Authors: Freitas Tomás T. , Pereira Lucas A. , Reis Valter P. , Fernandes Victor , Alcaraz Pedro E. , Azevedo Paulo H.S.M. , Loturco Irineu
Published: March 2021

Purpose: To investigate the effects of a match-congested period on straight and curve sprint performance, change of direction (COD) speed and deficit, vertical jumping ability, and half-squat (HS) mean propulsive power (MPP) output in young soccer players. Methods: A total of 15 under-20 elite male soccer players participated in 14 matches over 8 weeks. The following assessments were performed before and after the congested fixture period: squat and countermovement jumps, 17-m linear sprint, curve sprint test for the “good” (CSGS) and “weak” (CSWS) sides, modified 17-m Zigzag test, and HS MPP. Magnitude-based inferences and a paired t test were used to analyze pre–post changes in the assessed variables. Results: Very likely (P < .05) decreases were noticed in 17-m sprint velocity (effect size [ES] [90% confidence limit; CL], −0.56 [−0.32 to −0.81]) and CSGS (ES [90% CL], −0.72 [−0.40 to 1.03]) after the 8-week period. A possible but nonsignificant impairment was revealed in CSWS (ES [90% CL], −0.18 [0.03 to −0.39]), and countermovement jump (ES [90% CL], −0.21 [−0.54 to 0.12]). Zigzag velocity (ES [90% CL], −2.90 [−2.45 to −3.36]) and COD deficit (ES [90% CL], 0.86 [0.52 to 1.20]) were almost certainly and significantly (P < .05) reduced and increased, respectively, after the match-congested period. An almost certain and significant (P < .05) reduction was found in HS MPP (ES [90% CL], −1.18 [−0.76 to −1.61]). Conclusions: Straight and curve sprint velocity, COD speed and deficit, and HS MPP were impaired after the match-congested period. Vertical jump height was possibly decreased. Seasonal phases comprising high volumes of soccer-specific training and competition seem to be detrimental to speed–power qualities in under-20 elite soccer players.
Acute Effects of 2 Consecutive Simulated Badminton Matches on the Shoulder Range of Motion and Isometric Strength of Elite Youth Players
Authors: Fernandez-Fernandez Jaime , Lopez-Valenciano Alejandro , Garcia-Tormo Jose Vicente , Cabello-Manrique David , García-López Juan
Published: March 2021

Purpose: To analyze the influence of playing 2 consecutive prolonged badminton matches on the shoulder strength and range of motion (ROM) of young players. Methods: Sixteen elite junior badminton players (12 males and 4 females; mean (SD): age 16.2 [0.8] years, body mass 63.5 [6.6] kg, height 173.2 [6.3] cm) participated in a cross-sectional study. Shoulder internal (IR)/external rotation (ER) ROM and IR/ER strength measures were conducted before and after 2 consecutive prolonged (ie, 35 min) matches and 12 hours after the second match. Results: After consecutive matches, IR strength of the dominant side and ER strength of the dominant and nondominant sides (effect size [ES] = 0.20–0.57) were reduced. Shoulder total ROM of the dominant side was decreased (ES = 0.80), while on the nondominant side, IR (ES = 0.66) was also decreased. After 12 hours, results showed decreased values in the IR/ER strength of the dominant side (ES = 0.36–1.00), as well as ER of both dominant and nondominant sides (ES = 0.30–0.59). IR ROM of the nondominant side (ES = 0.69) was also decreased. Conclusion: Present results showed that 2 consecutive matches on the same day with brief rest periods led to significant impairments in shoulder strength and ROM levels. These data can potentially elucidate the need for shoulder-specific training and recovery strategies prior to or during competitions.
“As Many as Possible for as Long as Possible”—A Case Study of a Soccer Team That Fosters Multiple Outcomes
Authors: Erikstad Martin K. , Tore Johansen Bjørn , Johnsen Marius , Haugen Tommy , Côté Jean
Published: March 2021

The personal assets framework suggests that dynamic elements of (a) personal engagement in activities, (b) quality social dynamics, and (c) appropriate settings will influence an athlete’s long-term outcomes of performance, personal development, and continued participation in sport. The aim of the present study was to conduct a case study of a Norwegian age-restricted team that was successful in promoting participation, performance, and positive development for individual participants and to investigate how the dynamic elements of activities, social dynamics, and settings have led to these long-term outcomes. The results indicated that the case is a best-practice example of successful attainment of personal development and long-term participation and performance through appropriate structure and application of the dynamic elements within the personal assets framework, including enjoyable peer-led play activities and quality practice, quality relationships with teammates and coaches, and access to facilities.
Enhanced mechanical energy conversion with selectively decayed wood
Authors: Sun Jianguo , Guo Huizhang , Schädli Gian Nutal , Tu Kunkun , Schär Styfen , Schwarze Francis W.M.R. , Panzarasa Guido , Ribera Javier , Burgert Ingo
Published: March 2021

Fungi decay helps wood produce efficient electricity under mechanical stimuli, boosting energy efficiency of future buildings.
Modular immune-homeostatic microparticles promote immune tolerance in mouse autoimmune models
Authors: Chen Xin , Yang Xiaoshan , Yuan Pingyun , Jin Ronghua , Bao Lili , Qiu Xinyu , Liu Siying , Liu Tao , Gooding John Justin , Chen WanJun , Liu Guozhen , Bai Yongkang , Liu Shiyu , Jin Yan
Published: March 2021

Modular microparticles induce antigen-specific immune tolerance by inducing apoptosis and promoting T
reg
differentiation.
Cranberry-Derived Proanthocyanidins Potentiate β-Lactam Antibiotics against Resistant Bacteria
Authors: Gallique Mathias , Wei Kuan , Maisuria Vimal B. , Okshevsky Mira , McKay Geoffrey , Nguyen Dao , Tufenkji Nathalie
Published: March 2021

The emergence of β-lactam-resistantEnterobacteriaceaeand staphylococci compromised the efficiency of β-lactam-based therapy. By acquisition of ESBLs, MBLs, or PBPs, it is highly likely that bacteria may become completely resistant to the most efficient β-lactam agents in the near future.
Oncolytic Foamy Virus: Generation and Properties of a Nonpathogenic Replicating Retroviral Vector System That Targets Chronically Proliferating Cancer Cells
Authors: Budzik Karol M. , Nace Rebecca A. , Ikeda Yasuhiro , Russell Stephen J.
Published: March 2021

The infectivity of certain retroviruses is limited to dividing cells, which makes them attractive tools for targeting cancer cell proliferation. Previously developed replication-competent gammaretroviral vectors spread efficiently in rapidly dividing cancer cells, but not in cancer cells that divide more slowly.
HIV-1 Uncoating Occurs via a Series of Rapid Biomechanical Changes in the Core Related to Individual Stages of Reverse Transcription
Authors: Rankovic Sanela , Deshpande Akshay , Harel Shimon , Aiken Christopher , Rousso Itay
Published: March 2021

For successful infection, the HIV-1 genome, which is enclosed inside a capsid shell, must be reverse transcribed into double-stranded DNA and released from the capsid (in a process known as uncoating) before it can be integrated into the target cell genome. The mechanism of HIV-1 uncoating is a pivotal question of long standing.
Cohesin Subunit Rad21 Binds to the Herpes Simplex Virus 1 Genome near CTCF Insulator Sites during Latency
In Vivo
Authors: Singh Pankaj , Neumann Donna M.
Published: March 2021

CTCF insulators are important for transcriptional control, and increasing evidence suggests that CTCF insulators, together with the cohesin complex, regulate viral transcription in DNA viruses. The CTCF-cohesin interaction is important for the formation of chromatin loops, structures that orient distance-separated elements in close spatial proximity for transcriptional control.
A Vulnerable, Membrane-Proximal Site in Human Respiratory Syncytial Virus F Revealed by a Prefusion-Specific Single-Domain Antibody
Authors: Rossey Iebe , Hsieh Ching-Lin , Sedeyn Koen , Ballegeer Marlies , Schepens Bert , McLellan Jason S. , Saelens Xavier
Published: March 2021

RSV is an important respiratory pathogen. This study describes a prefusion F-specific VHH that primarily binds to antigenic site I of RSV F. This is the first time that a prefusion F-specific antibody that binds this site has been reported. In general, antibodies that bind to site I are poorly neutralizing, whereas the VHH described here neutralizes RSV A at subnanomolar concentrations. Our findings contribute to insights into the RSV F antigenic map.
Trypsin-Enhanced Infection with Porcine Epidemic Diarrhea Virus Is Determined by the S2 Subunit of the Spike Glycoprotein
Authors: Tan Yubei , Sun Limeng , Wang Gang , Shi Yuejun , Dong Wanyu , Fu Yanan , Fu Zhen , Chen Huanchun , Peng Guiqing
Published: March 2021

With the emergence of new variants, PEDV remains a major problem in the global swine industry. Efficient PEDV infection usually requires trypsin, but the mechanism of trypsin dependency is complex.
Draft Genome Sequence of a Salmonella enterica subsp.
enterica
Serotype Choleraesuis Strain Isolated from the Pulp of Muskmelons
Authors: Esteban-Cuesta Irene , Fischer Jennie , Guldimann Claudia
Published: March 2021

Salmonella enterica
subsp.
enterica
serotype Choleraesuis is a foodborne pathogen with zoonotic potential. We report the draft genome sequence and a closed plasmid sequence from a plant-internalized
S. Choleraesuis
strain that was isolated from the pulp of a Spanish Galia melon purchased from a German supermarket in 2015.
Complete Genome Sequence of Bovine Adenovirus Type 7 Strain Fukuroi, Isolated from a Cow with Respiratory Disease
Authors: Kumagai Asuka , Kajikawa Sayo , Miyazaki Ayako , Hatama Shinichi
Published: March 2021

We determined the complete genome sequence of the bovine adenovirus type 7 prototype strain Fukuroi using next-generation sequencing technology. We found that the viral genome is 30,034 bp long and has the shortest inverted terminal repeats among known adenoviruses.
Complete Genome Sequence of Stenotrophomonas maltophilia Siphophage Salva
Authors: Jefferson Brandi , Yao Guichun , Clark James , Le Tram , Gonzalez Carlos , Liu Mei , Burrowes Ben
Published: March 2021

Stenotrophomonas maltophilia
is a Gram-negative pathogen causing severe and often refractory illnesses such as pneumonia and bacteremia. We present the genome of phage Salva, a novel
S. maltophilia
phage that is not closely related to any phages currently deposited in GenBank. The genome is 60,789 bp, containing 102 putative protein-coding genes.
Genome Sequences of Subcluster M2 Mycobacteriophages Estes and Aziz
Authors: Fitzgerald Sara K. , Johnson Eleanor H. , Storz Sophie H. R. , Ballard Claire , Battaglia Samantha , Boice Mikelle , Bramwell-Butcher Joshua , Dedinsky Megan , DeKlotz Joshua , Diaz Izabel , Engley Andrew , Ernst Lindsey , Gonzales Erica , Groscost Alyssa , Grosser Paige , Haider Alicia , Harrison Morgan , Husler Kurt , Lau Jalisa , Monlux Melina , Paratore Jason , Ruesch Trevor , Schlesinger Mikaela , Scholes Anthony , Poxleitner Marianne K. , Anders Kirk R.
Published: March 2021

Estes and Aziz are mycobacteriophages that were isolated on
Mycolicibacterium smegmatis
mc
2
155 at room temperature from soil samples collected in Spokane, WA. Their genome sequences are 83,601 and 83,412 bp long, respectively, and they are members of subcluster M2. Each contains 21 tRNA genes and short conserved repeats characteristic of cluster M phages.
Complete Genome Sequence of
Rhodococcus
sp. Strain M8, a Platform Strain for Acrylic Monomer Production
Authors: Novikov Andrey D. , Lavrov Konstantin V. , Kasianov Artem S. , Topchiy Maxim A. , Gerasimova Tatyana V. , Yanenko Alexander S.
Published: March 2021

We report a 6.27-Mbp complete genome of
Rhodococcus
sp. strain M8, an originally discovered strain that is now under investigation for production of acrylic monomers. The genome consists of a 6.1-Mbp circular chromosome and a 173.2-kbp plasmid.
Complete Genome Sequence of Brucella abortus 68, Isolated from Aborted Fetal Sheep in Ukraine
Authors: Bolotin Vitaliy , Kovalenko Ganna , Marchenko Nataliia , Solodiankin Oleksii , Rudova Nataliia , Kutsenko Valentina , Bortz Eric , Gerilovych Anton , Drown Devin M.
Published: March 2021

The complete genome sequence of
Brucella abortus
68, isolated from an aborted sheep fetus in Luhansk, Ukraine, was assembled using Nanopore sequences. Two circular chromosomes totaling 3,281,317 bp (
N
50
, 2,124,943 bp) comprised the complete genome sequence. The strain encodes the fosfomycin antibiotic resistance gene
FosX
, highlighting the risk of cross-species livestock and human infection.
Robotic assistant spinal angiography: a case report and technical considerations
Authors: Tateshima Satoshi , Saber Hamidreza , Colby Geoffrey P , Enzmann Dieter , Duckwiler Gary
Published: March 2021

Robotic-assisted technology has shown to be promising in coronary and peripheral vascular interventions. Early case reports have also demonstrated its efficacy in neuro-interventions. However, there is no prior report demonstrating use of the robotic-assisted platform for spinal angiography. We report the feasibility of the robotic-assisted thoracic and lumbar spinal angiography.
Herpes zoster reactivation during head and neck cancer therapy: interpreting post-treatment positron emission tomography/CT imaging
Authors: Bommakanti Krishna , Coffey Charles
Published: March 2021

The risk of herpes zoster reactivation in patients undergoing cancer treatment is significant, though this phenomenon has rarely been reported in the head and neck squamous cell carcinoma (HNSCC) population. We aim to report the potential for infection to lead to false-positive findings on positron emission tomography/CT in these patients. This case highlights the potential for herpes zoster reactivation to result in false-positive findings on post-treatment imaging following chemoradiation for HNSCC. It is therefore imperative for providers to be aware of this when evaluating patients during and after treatment for HNSCC.
Distinguishing cerebral salt wasting syndrome and syndrome of inappropriate ADH in a patient with traumatic brain injury
Authors: Mohamed Hassan , Shorten George
Published: March 2021

A previously healthy 48-year-old woman was referred to our intensive care unit (ICU) from a neurosurgical ward due to deterioration of her conscious level. She had a road traffic accident 6 days earlier. On admission to the hospital, a brain CT demonstrated subarachnoid haemorrhage which was considered not amenable to surgical intervention. A second CT brain performed shortly after admission to ICU showed no change in comparison to the initial CT. Serum sodium level on ICU admission was 108 mEq/L; serum and urine osmolalities were 223 mOsm/kg and 438 mOsm/kg, respectively. Her hyponatraemia was initially attributed to syndrome of inappropriate antidiuretic hormone. However, a clinical impression of low volume status raised the suspicion of cerebral salt wasting syndrome. She was managed by infusion of hypertonic saline and fluids for 5 days and discharged from ICU after improvement of her conscious level and normalisation of serum sodium.
Caecal volvulus: untwisting the mystery
Authors: Kedrzycki Martha Sara , Roy Choudhury Jaya , Hakky Sherif
Published: March 2021

Caecal volvulus is an infrequent cause of acute surgical abdomen, where an abnormally mobile cecum twists on its own axis. It can lead to the development of closed-loop obstruction, small bowel ischaemia and perforation. Early recognition and prompt treatment is key; however, due to the rarity of this pathology, it is seldom listed as a differential diagnosis. Here, we present a single-centre case series of two patients presenting with caecal volvulus to an Emergency Surgery Unit at a University Hospital.
Peripheral T-cell lymphoma presenting as fever of unknown origin in a man with deranged liver function tests and pancytopenia
Authors: McKay Catharine , Hong Lin-Tse , Uddin A K M Nizam
Published: March 2021

Peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) is a relatively rare condition in Australia. Here, we report a case of PTCL, NOS in a patient who presented with persistent fever and progressive pancytopenia on a background of mediastinal lymphadenopathy, initially presumed reactive and hepatosplenomegaly with deranged liver function tests. The diagnosis was challenging, with multiple negative blood cultures and inconclusive bone marrow studies, and it required extensive investigations that ultimately revealed the characteristic clinical, histopathological and immunophenotypic features of PTCL, NOS. The patient underwent multiple rounds of multiagent chemotherapy after the diagnosis. This case highlights the difficulty in diagnosing PTCL, NOS and the importance of including it as a differential diagnosis in younger patients who present with constitutional symptoms and hepatosplenomegaly.
A rare case of acute abdomen: spontaneous rupture of degenerated fibroid
Authors: Goswami Nidhi , Alalade Aderemi
Published: March 2021

A 29-year-old nulliparous woman presented with an acute abdomen. She had a large uterus with multiple fibroids and was on the waiting list for elective surgery. An urgent CT scan demonstrated an extensive intraperitoneal fluid collection suspicious for fibroid rupture. She required an emergency laparotomy which identified a rupture of the largest degenerative fibroid. There was 2 Litres of pus in the peritoneal cavity. This case was a rare presentation of spontaneous fibroid rupture due to degeneration and necrosis, and acute abdomen from peritoneal irritation. Imaging was vital in making the diagnosis, and urgent surgical intervention was essential to reduce morbidity and mortality.
Staphylococcus pseudintermedius: a common zoonotic pathogen causing postprocedural urosepsis in humans
Authors: Subedi Pawina , Syed Masood Pasha , Kate Yugandhara , Koirala Bibek
Published: March 2021

Staphylococcus pseudintermediusis a common cause of zoonotic infections in dogs and cats. Recently, there has been an increasing number of infections being reported in humans caused by this organism. We report a case of complicated urinary tract infection in an elderly patient with recent bilateral ureteral stent placement caused by this organism with associated persistent high-grade bacteraemia.
Diagnostic challenges in neoplastic meningitis presenting as intracranial hypertension
Authors: Andugulapati Santosh Sriram , Chheda Akash , Desai Karan , Ravat Sangeeta Hasmukh
Published: March 2021

A diagnosis of idiopathic intracranial hypertension should be considered only after careful exclusion of all possible aetiologies. We report a case of neoplastic meningitis presenting as intracranial hypertension with inconclusive repeated cerebrospinal fluid (CSF) cytology and MRI of brain, emphasising the importance of meticulous CSF analysis and role of early whole-body PET–CT scan for diagnosis of systemic malignancy.
Rupture of portal vein pseudoaneurysm caused by impinging infected walled off pancreatic necrosis (WOPN): a rare complication
Authors: Mulpuri Venu Bhargava , Kumar Vipan , Rana Surinder , Gupta Rajesh
Published: March 2021

We report a case of walled off pancreatic necrosis in a patient with alcoholic pancreatitis who underwent endoscopic ultrasound-guided multiple pigtail catheter drainage. 10 days later patient presented with massive haemorrhage likely due to erosion of portal vein pseudoaneurysm caused by decubitus of pigtails. Patient required emergent portal venorrhaphy to arrest haemorrhage.
Gorham-Stout disease: interesting cause of pleural effusion
Authors: Olea-Mendoza Daniel , Terrigno Vittorio Romeo , Balogun Ayobamidele , Caprio Colleen
Published: March 2021

Gorham-Stout disease (GSD) is a rare disorder characterised by massive painless osteolysis due to lymphangiomatous tissue progression. GSD’s pathogenesis is still unclear, but osteoclasts' activation may play a role in its pathogenesis. There are multiple complications associated with GSD. One of the most severe and life-threatening complications is a chylothorax. Herein we discuss a case of a patient with a history of GSD who presented to the hospital with progressive dyspnoea secondary to a large left-sided pleural effusion, which was later confirmed to be a chylothorax. We will further discuss the current literature and treatment of chylothorax associated with GSD.
Thinking out of the box: management of valproic acid toxicity with carbapenems
Authors: Sanivarapu Raghavendra , Sharma Robin , Akella Jagadish
Published: March 2021

Valproic acid (VPA) is commonly used medication to treat seizure disorder and as prophylaxis for bipolar disorder. Acute VPA toxicity can cause varied symptoms ranging from mild drowsiness to severe cerebral oedema and coma. The therapeutic level of VPA is around 50–100 µg/mL and most of it is protein bound. It is mainly metabolised by liver and is eliminated via bile. The metabolites of VPA interfere with urea cycle and cause deficiency in carnitine leading to increase in ammonia levels. The use of carnitine to treat VPA toxicity is well known but it is still unclear if it lowers VPA levels. We report a case of VPA toxicity that did not respond to use of carnitine at 6000 mg orally but was successfully treated using meropenem leading to lowering of VPA levels and also clinical improvement of patient.
Severe vitamin deficiencies in pregnancy complicated by progressive familial intrahepatic cholestasis
Authors: Mahle Amanda Caroline , Morris Bernard David , Frazer Zane , Novak Christopher
Published: March 2021

Progressive familial intrahepatic cholestasis (PFIC) is a rare disease of impaired bile acid excretion which can lead to nutritional deficiencies. Vitamin deficiencies during pregnancy can result in adverse maternal and fetal outcomes. A 20-year-old primiparous woman at 30 4/7 weeks with PFIC type 2 presented with worsening cholestasis, coagulopathy and fat-soluble vitamin deficiency. She developed visual deficits and was found to have severe vitamin A deficiency. Her coagulopathy and visual deficits improved following vitamin K and A supplementation, respectively. She delivered at 32 2/7 weeks following preterm labour. This case highlights several unique aspects in the care of pregnant women with liver disease. These patients are at risk for fat-soluble vitamin deficiencies which can result in significant coagulopathy and rarely, visual deficits due to vitamin A deficiency. Prompt treatment is necessary to prevent permanent sequelae.
Delayed presentation of pericardial tamponade following blunt chest trauma
Authors: Matthia Eldon , Altshuler Ellery , Naik Dhaval K
Published: March 2021

We present a case of delayed-onset pericardial tamponade nine weeks after a blunt chest trauma. The patient is a 77-year-old man who presented with shortness of breath nine weeks after fracturing his sternum in a head-on motor vehicle collision. CT and echocardiography revealed a massive pericardial effusion prompting pericardiocentesis. Eight hundred millilitres (mL) of fluid were drained, which rapidly improved his symptoms. This is the longest reported interval between the development of tamponade and a blunt chest trauma. Our case illustrates the importance of maintaining a clinical suspicion for effusion and tamponade even weeks after non-penetrating chest wall injuries.
Selective hemivertebrae resection in congenital scoliosis with multiple hemivertebrae
Authors: Garg Bhavuk , Mehta Nishank
Published: March 2021

There are no established guidelines regarding the surgical strategy to be adopted in congenital scoliosis with multiple hemivertebrae—decision has to be guided taking into account the contribution of each hemivertebra to the deformity and its growth potential. We describe a case of a 12-year-old woman with congenital scoliosis due to unbalanced multiple hemivertebrae. Preoperative imaging revealed the presence of three hemivertebrae—at D7, D10 and L5. Our surgical strategy was guided by various factors—the morphology of the hemivertebrae, the location, the contribution of each hemivertebra to the deformity and their relationship to each other. Based on this, we performed a selective hemivertebrae resection—completely resecting L5 hemivertebra and performing ‘egg-shell’ decancellation of D7 hemivertebra and in situ fusion of D10 hemivertebra, yielding satisfactory results. This case report illustrates a rational thought process that can guide a paediatric spinal deformity surgeon in treating scoliosis with multiple hemivertebrae.
Ectopic sphenoid sinus pituitary adenoma masquerading as metastatic head and neck cancer
Authors: Chai Augustine , Soon Alvin Yong Quan , Manish Bundele , Tan Jian Li
Published: March 2021

A 68-year-old Chinese man was found to have a lobular mass in the sphenoid sinus which extended to the clivus and the roof of the nasopharynx on a staging MRI scan performed for his high-grade parotid salivary duct carcinoma. Further positron emission tomography scan showed that this lesion was fluorodeoxyglucose (FDG) avid. This proved to be a diagnostic dilemma. The patient underwent a total parotidectomy, left selective neck dissection and a transphenoidal biopsy of his nasal lesion. Final histology revealed that this lesion was a synchronous ectopic sphenoid sinus pituitary adenoma (ESSPA). Initial differential diagnoses that were considered included a chordoma, metastatic carcinoma and nasopharyngeal carcinoma. However, an important differential with a neoplastic appearance and a tendency for positive FDG uptake is an ESSPA. It requires dedicated immunohistochemical staining to diagnose, and its mainstay of treatment is surgical excision.
Rare case of rapidly reaccumulating ascites
Authors: Jalal Erica , Metzger Megan , Surathi Pratibha , Pergament Kathleen Mangunay
Published: March 2021

Eosinophilic ascites is a rare type of exudative ascites most commonly caused by eosinophilic gastroenteritis. Here, a 57-year-old man presents with sudden-onset abdominal distension associated with nausea, vomiting and decreased appetite for 10 days. Physical examination revealed significant abdominal distention and fluid wave. Initial labs showed leucocytosis and mild peripheral eosinophilia. Imaging of his abdomen revealed severe ascites, no features of cirrhosis and diffuse inflammatory changes involving the jejunum and ileum. Diagnostic paracentesis showed exudative, ascitic fluid with predominant eosinophilia. Cytology of the ascitic fluid and blind biopsies taken during oesophagogastroduodenoscopy and enteroscopy were both negative for malignancy. The ascites reaccumulated rapidly, requiring five rounds of large-volume paracentesis during hospitalisation. Empiric treatment for suspected eosinophilic gastroenteritis with intravenous steroids improved and stabilised the patient’s ascites for discharge. Parasitic workup resulted positively forToxocaraantibodies on ELISA. On 2-week outpatient follow-up, a course of albendazole resolved all gastrointestinal symptoms.
Rare cutaneous metastasis from sarcomatoid carcinoma of lung
Authors: Tollan Clare Josephine , Moyes Colin , Malyon Andrew
Published: March 2021

We present the case of a 57-year-old woman diagnosed with stage 4 sarcomatoid carcinoma of the lung who concurrently developed a scalp lesion, thought to be a cyst, which continued to grow and ulcerate. Excision revealed a rare case, only four previously reported in the literature, of metastatic sarcomatoid carcinoma of the lung. While a very unusual case, we would like to emphasise the importance of considering skin metastases when presented with unusual skin lesions, and importantly listening to the patient’s concerns, showing empathy and respecting their autonomy and referring to an appropriate specialist when considering the management of what may seem to be a minor skin report.
Haemophagocytic lymphohistiocytosis secondary to brucellosis in a young child
Authors: Mittal Jashan , Kumar Prawin , Goyal Jagdish Prasad , Purohit Abhishek
Published: March 2021

Brucellosis is a common zoonotic disease worldwide. It has protean clinical manifestation and sometimes may has a life-threatening complication. A 4-year-old boy presented with a history of fever, myalgia and appetite loss for 3 weeks. On examination, he had hepatosplenomegaly. The initial working diagnosis was an infection, autoimmune disease and malignancy. Investigations showed positiveBrucellaserology, and he was started on rifampicin and cotrimoxazole. He was further investigated because of persistent fever, which revealed evidence of haemophagocytic lymphohistiocytosis (HLH). He continued treatment for brucellosis, except rifampicin which was replaced with doxycyclin due to a worsening liver function. The child showed complete clinical and biochemical improvement after 6 weeks of therapy. HLH is a life-threatening condition and should be suspected in children with brucellosis, who did not respond to appropriate antibiotics treatment. Secondary HLH does not always require specific therapy; it may improve with adequate treatment of the underlying condition.
Visible haematuria—an unusual presentation of metastatic testicular mixed germ cell tumour
Authors: Sugrue Diarmuid Declan , Ryan James , Harris Johnathon , Cheema Ijaz
Published: March 2021

A 29-year-old male patient presented to the emergency department with haematuria and flank pain. Ten months agopreviously, he had undergone orchidectomy and adjuvant chemotherapy for a testicular mixed germ cell tumour. Cystoscopy revealed a large bladder wall mass. The final diagnosis of yolk sac tumour was established after transurethral resection of the lesion. The patient was treated with salvage chemotherapy and placed on short-interval biochemical and radiological surveillance to assess treatment response.
Prolonged fever and hyperferritinaemia: a puzzling diagnosis of neonatal herpes simplex virus infection during COVID-19 pandemic
Authors: Badawy Mohammed Kamal , Hurrell Sophie , Baldwin Catherine , Hassan Heba
Published: March 2021

Neonatal herpes simplex virus (HSV) infection is rare, with an estimated incidence of 3.58 per 100 000 live births in the UK and should be suspected in any newborn with fever and bacterial culture-negative sepsis. We describe a case of a previously well full-term male neonate who presented with persistent fever and elevated ferritin level that was carried out during the era of the COVID-19 pandemic as part of SARS-CoV-2 panel investigations. Despite the initial negative HSV serology, HSV-1 PCR from a scalp lesion returned positive. He made a full recovery after acyclovir therapy. This case highlights the importance of maintaining a high clinical index of suspicion of HSV infection in any febrile neonate even with absence of maternal history and negative serology, particularly if associated with hyperferritinaemia. We also address the challenge of interpreting inflammatory biomarkers’ results for SARS-CoV-2 infection in neonates.
Treatment of advanced gastroenteropancreatic neuroendocrine neoplasia, are we on the way to personalised medicine?
Authors: Rinke Anja , Auernhammer Christoph J , Bodei Lisa , Kidd Mark , Krug Sebastian , Lawlor Rita , Marinoni Ilaria , Perren Aurel , Scarpa Aldo , Sorbye Halfdan , Pavel Marianne Ellen , Weber Matthias M , Modlin Irvin , Gress Thomas M
Published: March 2021

Gastroenteropancreatic neuroendocrine neoplasia (GEPNEN) comprises clinically as well as prognostically diverse tumour entities often diagnosed at late stage. Current classification provides a uniform terminology and a Ki67-based grading system, thereby facilitating management. Advances in the study of genomic and epigenetic landscapes have amplified knowledge of tumour biology and enhanced identification of prognostic and potentially predictive treatment subgroups. Translation of this genomic and mechanistic biology into advanced GEPNEN management is limited. ‘Targeted’ treatments such as somatostatin analogues, peptide receptor radiotherapy, tyrosine kinase inhibitors and mammalian target of rapamycin inhibitors are treatment options but predictive tools are lacking. The inability to identify clonal heterogeneity and define critical oncoregulatory pathways prior to therapy, restrict therapeutic efficacy as does the inability to monitor disease status in real time. Chemotherapy in the poor prognosis NEN G3 group, though associated with acceptable response rates, only leads to short-term tumour control and their molecular biology requires delineation to provide new and more specific treatment options.

The future requires an exploration of the NEN tumour genome, its microenvironment and an identification of critical oncologic checkpoints for precise drug targeting. In the advance to personalised medical treatment of patients with GEPNEN, clinical trials need to be based on mechanistic and multidimensional characterisation of each tumour in order to identify the therapeutic agent effective for the individual tumour.

This review surveys advances in NEN research and delineates the current status of translation with a view to laying the basis for a genome-based personalised medicine management of advanced GEPNEN.
Targeting cancer-associated fibroblast-secreted WNT2 restores dendritic cell-mediated antitumour immunity
Authors: Huang Tu-Xiong , Tan Xiang-Yu , Huang Hui-Si , Li Yu-Ting , Liu Bei-Lei , Liu Kai-Sheng , Chen Xinchun , Chen Zhe , Guan Xin-Yuan , Zou Chang , Fu Li
Published: March 2021

Objective

Solid tumours respond poorly to immune checkpoint inhibitor (ICI) therapies. One major therapeutic obstacle is the immunosuppressive tumour microenvironment (TME). Cancer-associated fibroblasts (CAFs) are a key component of the TME and negatively regulate antitumour T-cell response. Here, we aimed to uncover the mechanism underlying CAFs-mediated tumour immune evasion and to develop novel therapeutic strategies targeting CAFs for enhancing ICI efficacy in oesophageal squamous cell carcinoma (OSCC) and colorectal cancer (CRC).

Design

Anti-WNT2 monoclonal antibody (mAb) was used to treat immunocompetent C57BL/6 mice bearing subcutaneously grafted mEC25 or CMT93 alone or combined with anti-programmed cell death protein 1 (PD-1), and the antitumour efficiency and immune response were assessed. CAFs-induced suppression of dendritic cell (DC)-differentiation and DC-mediated antitumour immunity were analysed by interfering with CAFs-derived WNT2, either by anti-WNT2 mAb or with short hairpin RNA-mediated knockdown. The molecular mechanism underlying CAFs-induced DC suppression was further explored by RNA-sequencing and western blot analyses.

Results

A negative correlation between WNT2+CAFs and active CD8+T cells was detected in primary OSCC tumours. Anti-WNT2 mAb significantly restored antitumour T-cell responses within tumours and enhanced the efficacy of anti-PD-1 by increasing active DC in both mouse OSCC and CRC syngeneic tumour models. Directly interfering with CAFs-derived WNT2 restored DC differentiation and DC-mediated antitumour T-cell responses. Mechanistic analyses further demonstrated that CAFs-secreted WNT2 suppresses the DC-mediated antitumour T-cell response via the SOCS3/p-JAK2/p-STAT3 signalling cascades.

Conclusions

CAFs could suppress antitumour immunity through WNT2 secretion. Targeting WNT2 might enhance the ICI efficacy and represent a new anticancer immunotherapy.
Implementing a telemedicine curriculum for internal medicine residents during a pandemic: the Cleveland Clinic experience
Authors: Savage David J , Gutierrez Omar , Montané Bryce Edward , Singh Achintya Dinesh , Yudelevich Eric , Mahar Jamal , Brateanu Andrei , Khatri Lakshmi , Fleisher Catherine , Jolly Stacey E
Published: March 2021

Telemedicine training was not a substantial element of most residency programmes prior to the COVID-19 pandemic. Social distancing measures changed this. The Cleveland Clinic Internal Medicine Residency Programme (IMRP) is one of the largest programmes in the USA, which made the task of implementing a telemedicine curriculum more complex. Here we describe our experience implementing an effective, expedited telemedicine curriculum for our ambulatory resident clinics. This study was started in April 2020 when we implemented a resident-led curriculum and training programme for providing ambulatory telemedicine care. The curriculum was finalised in less than 5 weeks. It entailed introducing a formal training programme for residents, creating a resource guide for different video communication tools and training preceptors to safely supervise care in this new paradigm. Residents were surveyed before the curriculum to assess prior experience with telemedicine, and then afterward to assess the curriculum's effectiveness. We also created a mini-CEX assessment for residents to solicit feedback on their performance during virtual appointments. Over 2000 virtual visits were performed by residents in a span of 10 weeks. Of 148 residents, 38% responded to the pre-participation survey. A majority had no prior telemedicine experience and expressed only slight comfort with the modality. Through collaboration with experienced residents and faculty, we expeditiously deployed an enhancement to our ambulatory care curriculum to teach residents how to provide virtual care and help faculty with supervision. We share our insights on this experience for other residency programmes to use.
Early prognostication of COVID-19 to guide hospitalisation versus outpatient monitoring using a point-of-test risk prediction score
Authors: Chua Felix , Vancheeswaran Rama , Draper Adrian , Vaghela Tejal , Knight Matthew , Mogal Rahul , Singh Jaswinder , Spencer Lisa G , Thwaite Erica , Mitchell Harry , Calmonson Sam , Mahdi Noor , Assadullah Shershah , Leung Matthew , O'Neill Aisling , Popat Chhaya , Kumar Radhika , Humphries Thomas , Talbutt Rebecca , Raghunath Sarika , Molyneaux Philip L , Schechter Miriam , Lowe Jeremy , Barlow Andrew
Published: March 2021

Introduction

Risk factors of adverse outcomes in COVID-19 are defined but stratification of mortality using non-laboratory measured scores, particularly at the time of prehospital SARS-CoV-2 testing, is lacking.

Methods

Multivariate regression with bootstrapping was used to identify independent mortality predictors in patients admitted to an acute hospital with a confirmed diagnosis of COVID-19. Predictions were externally validated in a large random sample of the ISARIC cohort (N=14 231) and a smaller cohort from Aintree (N=290).

Results

983 patients (median age 70, IQR 53–83; in-hospital mortality 29.9%) were recruited over an 11-week study period. Through sequential modelling, a five-predictor score termed SOARS (
S
pO2,
O
besity,
A
ge,
R
espiratory rate,
S
troke history) was developed to correlate COVID-19 severity across low, moderate and high strata of mortality risk. The score discriminated well for in-hospital death, with area under the receiver operating characteristic values of 0.82, 0.80 and 0.74 in the derivation, Aintree and ISARIC validation cohorts, respectively. Its predictive accuracy (calibration) in both external cohorts was consistently higher in patients with milder disease (SOARS 0–1), the same individuals who could be identified for safe outpatient monitoring. Prediction of a non-fatal outcome in this group was accompanied by high score sensitivity (99.2%) and negative predictive value (95.9%).

Conclusion

The SOARS score uses constitutive and readily assessed individual characteristics to predict the risk of COVID-19 death. Deployment of the score could potentially inform clinical triage in preadmission settings where expedient and reliable decision-making is key. The resurgence of SARS-CoV-2 transmission provides an opportunity to further validate and update its performance.
Updated skeleton void ratio for gravelly sand mixtures considering effect of grain-size distribution
Authors: Wang Tao , Liu Sihong , Wautier Antoine , Nicot François
Published: March 2021

Recent research on the behavior of gravelly sands advocate for the use of the skeleton void ratio to characterize their density state. The skeleton void ratio corresponds to the void ratio of grains constituting the stress-bearing skeleton. However, such a void ratio relies on parameters difficult to determine in practice, such as the fraction of fine grains that take part actively in the load bearing skeleton. Also, it fails to consider the effect of grain-size distribution (GSD) of gravel and sand grains. Therefore, the skeleton void ratio index introduced by Chang et al. as published in 2015 is revisited to account for the effect of GSD of both gravel and sand grains. Two semi-empirical equations are developed in this paper to connect GSD parameters with skeleton void ratio parameters. The validity of the proposed equations has been checked for a particular class of gravelly sand materials. A series of specially designed drained triaxial tests on gravelly sands were then conducted. Test results show that it is essential to consider the effect of GSD when using the skeleton void ratio index. It also verifies the effectiveness and applicability of the proposed updated skeleton void ratio, which shows advantages in characterizing critical state lines of gravelly sands.
Precursor state of chemi-ionization reactions and confinement of valence electrons by anisotropic intermolecular forces
Authors: Falcinelli Stefano , Vecchiocattivi Franco , Cavalli Simonetta , Pirani Fernando
Published: March 2021

Modifications in atomic alignment and in molecular alignment/orientation determine a different structure of the adduct, formed by collisions of reagents, which represents the precursor state of many elementary chemical–physical processes. The following evolution of the system is directly controlled by the confinement of interacting partners in such a precursor state. However, a deep characterization of these phenomena is still today not fully available, especially when weak intermolecular forces are operative, although the inquiry is of general relevance for the control of the stereodynamics of processes, occurring under a variety of conditions both in gas phase and at surface. In this paper recent advances in the knowledge of the selective role of atomic alignment and molecular orientation effects on the stereodynamics of chemi-ionization reactions will be presented and discussed. These advances represent a basic step along a path whose final target is the complete and internally consistent rationalization and revaluation of the experimental findings already obtained, and published, in our and in other laboratories on chemi-ionization reactions involving as reagent molecules which are of great relevance in several fields. The basic idea is to export important guidelines provided by a recent detailed study of chemi-ionization of noble gas atoms to more complex reactions involving molecules. The main focus of the present paper is on the quantum confinement effects of valence electrons within the reaction transition state.

Graphic abstract
Upper limit on first-order electroweak phase transition strength
Authors: AbdusSalam Shehu , Kazemi Mohammad Javad , Kalhor Layla
Published: March 2021

For a cosmological first-order electroweak phase transition, requiring no sphaleron washout of baryon number violating processes leads to a lower bound on the strength of the transition. The velocity of the boundary between the phases, the so-called bubble wall, can become ultrarelativistic if the friction due to the plasma of particles is not sufficient to retard the wall’s acceleration. This bubble “runaway” should not occur if a successful baryon asymmetry generation due to the transition is required. Using Boedeker–Moore criterion for bubble wall runaway, within the context of an extension of the Standard Model of particle physics with a real gauge-single scalar field, we show that a nonrunaway transition requirement puts an upper bound on the strength of the first-order phase transition.
Critical airports of the world air sector network based on the centrality and entropy theory
Authors: Wang Yun , Meng Kou , Wu Huidong , Hu Jun , Wu Peng
Published: March 2021

In this paper, an air sector network (ASN) is built based on the obtained data describing the airspace of world. In the constructed network, nodes and edges represents the airports and airlines respectively. Based on the complex network and the entropy, we find that the airport rank obtained through the centrality and entropy theory is better than that derived through the traditional means. The improved entropy weight algorithm is used to reflect the location information of the nodes in the network, synthesize the centrality of the previous complex network, construct the importance evaluation matrix and finally calculate the ranking results of the importance of the nodes. Finally, through calculation, we found that the ranking result after comprehensive consideration is better than that being determined only through centrality, which illustrates the effectiveness of the method.
Economics of the Sacramental Bread Ordeal in the Russian Princedoms Period
Authors: Maltsev Vladimir Vladimirovich
Published: March 2021

The paper analyses the economics behind the ordeal by sacramental bread — a method of criminal dispute resolution in the Russian Princedoms period. Contributing to the framework advanced by Leeson (2011, 2012a, 2012b) [Trial by battle. Journal of Legal Analysis, 3(1), 341–375; An Austrian approach to law and economics, with special reference to superstition. The Review of Austrian Economics, 25(3), 185–198; Ordeals. The Journal of Law and Economics, 55(3), 691–714], this paper advances a hypothesis that the ordeal could have been designed as a ‘pressure valve’ to reduce scepticism in relation to other ordeals. To prove this, a model is constructed showing that when high scepticism causes fixed-outcome ordeals to become costly, the clergy could resort to creating an ordeal, the verdicts of which would not be argued against through a careful manipulation of its costs and benefits. In this ordeal, guilt was determined by the proband’s inability to swallow the bread due to stress and thus relied on a biological reaction instead of a predetermined outcome. Investigations showed that even if the ordeal delivered false verdicts, appealing the verdict was not beneficial to the proband. This was achieved by only employing the ordeal in resolution of petty theft, which made the potential losses from a false verdict very minimal. Further, the ordeal was staged as a confession, which reduced the possibility of a proband facing social ostracism.
Cordilleran Foreland Tectono-Sedimentary Element, Canadian Northern Interior Plains
Authors: Fallas K. M. , Dixon J. , Hannigan P. K. , MacLean B. C. , MacNaughton R. B.
Published: March 2021

Upper Jurassic–Paleocene siliciclastic strata comprise the Cordilleran Foreland Tectono-Sedimentary Element of Canada's northern Interior Plains. These strata record four major packages deposited on top of Paleozoic shelf strata on the NW margin of the Canadian craton. These packages are a Jurassic interval interpreted to record deposition associated with extension at the Arctic Ocean margin, a Lower Cretaceous, dominantly marine, interval deposited on the flexural margin of the foreland basin, and two Upper Cretaceous intervals of west-to-east progradational marine and non-marine strata deposited on the orogenic margin. The full succession has been affected by Cordilleran deformation within the Mackenzie Plain, Franklin Mountains and Colville Hills. Organic-rich shale is documented from Lower and Upper Cretaceous successions but these strata only reach thermal maturity in deeper parts of the basin, close to the Canadian Cordillera. Potential reservoirs exist within sandstone-dominated intervals throughout the succession, although some locally lack a top seal. One natural gas discovery has been reported from Upper Cretaceous sandstone of the Little Bear Formation at the Stewart D-57 well in the southeastern Mackenzie Plain. Oil sourced from Upper Cretaceous shale is reported from the Mackenzie Plain East Mackay B-45 well.