bluuebunny/crossref_metadata_2025 huggingface dataset:
A systematic review on the outcomes of local anaesthetic transperineal prostate biopsy
Authors: Kanagarajah Abbie , Hogan Donnacha , Yao Henry H. , Dundee Philip , O'Connell Helen E.
Published: September 2022

Objective

To conduct a systematic review of the literature to assess the diagnostic ability, complication rate, patient tolerability, and cost of local anaesthetic (LA) transperineal prostate biopsy.

Methods

Two reviewers searched Medline, the Cochrane Library, and Embase for publications on LA transperineal prostate biopsy up to March 2021. Outcomes of interest included cancer detection rates, complication rates, pain assessments and cost.

Results

A total of 35 publications with 113 944 men were included in this review. The cancer detection rate for LA transperineal prostate biopsy in patients undergoing primary biopsy was 52% (95% confidence interval [CI] 0.45–0.60; I2 = 97) and the clinically significant cancer detection rate (Gleason≥3 + 4) was 37% (95% CI 0.24–0.52; I2 = 99%). The rate of infection‐related complications in the included studies was 0.15% (95% CI 0.0000–0.0043; I2 = 86). The LA transperineal procedures had a low rate of procedural abandonment (26/6954, 0.37%), with the greatest pain scores measured during LA administration. No formal cost analyses on LA transperineal prostate biopsies were identified in the literature. The overall risk of bias in the included studies was high, with considerable study heterogeneity and publication bias.

Conclusion

Transperineal prostate biopsy performed under LA is a viable option for centres interested in avoiding the risk of infection associated with transrectal biopsy, and the logistical burden of general anaesthesia. Further investigation into LA transperineal prostate biopsy with comparative studies is warranted for its consideration as the standard in prostate biopsy technique.
Integrative biology of injury in animals
Authors: Rennolds Corey W. , Bely Alexandra E.
Published: September 2022

Mechanical injury is a prevalent challenge in the lives of animals with myriad potential consequences for organisms, including reduced fitness and death. Research on animal injury has focused on many aspects, including the frequency and severity of wounding in wild populations, the short‐ and long‐term consequences of injury at different biological scales, and the variation in the response to injury within or among individuals, species, ontogenies, and environmental contexts. However, relevant research is scattered across diverse biological subdisciplines, and the study of the effects of injury has lacked synthesis and coherence. Furthermore, the depth of knowledge across injury biology is highly uneven in terms of scope and taxonomic coverage: much injury research is biomedical in focus, using mammalian model systems and investigating cellular and molecular processes, while research at organismal and higher scales, research that is explicitly comparative, and research on invertebrate and non‐mammalian vertebrate species is less common and often less well integrated into the core body of knowledge about injury. The current state of injury research presents an opportunity to unify conceptually work focusing on a range of relevant questions, to synthesize progress to date, and to identify fruitful avenues for future research. The central aim of this review is to synthesize research concerning the broad range of effects of mechanical injury in animals. We organize reviewed work by four broad and loosely defined levels of biological organization: molecular and cellular effects, physiological and organismal effects, behavioural effects, and ecological and evolutionary effects of injury. Throughout, we highlight the diversity of injury consequences within and among taxonomic groups while emphasizing the gaps in taxonomic coverage, causal understanding, and biological endpoints considered. We additionally discuss the importance of integrating knowledge within and across biological levels, including how initial, localized responses to injury can lead to long‐term consequences at the scale of the individual animal and beyond. We also suggest important avenues for future injury biology research, including distinguishing better between related yet distinct injury phenomena, expanding the subjects of injury research to include a greater variety of species, and testing how intrinsic and extrinsic conditions affect the scope and sensitivity of injury responses. It is our hope that this review will not only strengthen understanding of animal injury but will contribute to building a foundation for a more cohesive field of ‘injury biology’.
Pigmentary anomaly caused by mosaic 3q22.2q29 duplication
Authors: Martinez-Falero Beatriz Suarez , Koutalopoulou Anastasia , Douglas Andrew G. L. , Kharbanda Mira , Collinson Morag N. , Lotery Andrew , Lotery Helen
Published: September 2022

A 39-year-old woman sought advice regarding potential risks to her offspring due to previous possible diagnosis of incontinentia pigmenti. She had linear hyperpigmentation along the lines of Blaschko affecting the upper and lower limbs, and skin-coloured papules on the left palm. Ophthalmoscopy revealed hypopigmented spots in the macular region of the retina in each eye due to focal areas of depigmentation of the retinal pigment epithelium. An array comparative genomic hybridization on DNA extracted from a skin biopsy revealed a 63.63-Mb duplication, arr[GRCh37] 3q22.2q29(134212001_197837069)x3, on the long arm of chromosome 3. This case is an example of genetic mosaicism resulting from a de novo genetic defect arising at some point in embryonic development.

Click here for the corresponding questions to this CME article.
What do (future) civil servants think of bribery and corruption? Evidence from India
Authors: Verma Rajiv , Gupta Saurabh , Birner Regina
Published: September 2022

Motivation

Civil servants are often seen as key actors responsible for systemic corruption in emerging economies. Yet, there is a dearth of empirical studies on what public officials think of bribery and corruption. Owing to the limitations of enrolling in‐service bureaucrats into research on the sensitive topic of bribery, the study tries to understand the perceptions of future bureaucrats.

Purpose

The study is a novel attempt to analyse how the select candidates aspiring to join the highly competitive elite civil services in India respond to experimental bribery situations. What deters potential bribe‐takers from accepting bribes, and what do they think about corruption in public life?

Methods and approach

The study employs mixed‐methods research to answer these questions. Experimental bribery games were administered to examine the impact of varying degrees of “punishment,” “monitoring,” and “public loss” and their relation to the varying “bribery amount.” In addition, focus group discussions (FGDs) were conducted with these participants to explore the dynamics of corruption.

Findings

The findings suggest that high public loss and high severity of punishment were able to deter bribery even when the bribe was high. On the other hand, the impact of a high level of monitoring was only effective in cases where the bribe was low. FGDs revealed that social acceptance of corruption, and the low rate of convictions in corruption cases, are the main reasons for continuing corruption in the public sphere.

Policy implications

The study suggests that in India and other countries in which corruption is systemic and socially accepted, it is imperative to move anti‐corruption policies away from their present fixation with strict monitoring to strict punishment. Monitoring alone without severe punishment is not sufficient. Corruption cases ought to have swift trials and a better rate of conviction. It is equally important to inculcate the values of social good and integrity in public life.
A rare cause of dyspnea: Primary large B cell lymphoma causes giant cardiac mass
Authors: Aksu Uğur , Korucu Cem , Atilgan Kivanç , Aybek Tayfun , Gökaslan Çiğdem Özer , Aksu Derya , Özdemir Çiğdem
Published: September 2022

Cardiac lymphoma (CL) is a rare and life‐threatening clinical condition. Most cases are diagnosed late period. Although the definitive diagnosis is made by biopsy, a biopsy could not be performed in most cardiac masses due to the high mortality rate and therefore the exact incidence is not known. In this case report, we present a case of giant CL filling both the pericardial area and right heart cavities and treated with surgical resection in a previously healthy male patient who presented with symptoms of heart failure.
Ecological and habitat preferences of diatoms in lakes of Lützow‐Holm Bay, East Antarctica
Authors: Rudd Rachel Claire , Tyler Jonathan James , Tibby John , Tanabe Yukiko , Kudoh Sakae
Published: September 2022

Lakes and ponds along the Antarctic coastline provide an opportunity for palaeoclimate reconstructions to complement ice core records from the interior of the continent, including via their diatom records.

Diatom palaeoecological studies in remote Antarctica are partially undermined by uncertainty concerning the relative influence of climate, water quality and substrate on diatom species assemblages.

The relative abundance and distribution of diatoms across a range of substrates and water depths were analysed from nine lakes in the coastal ice‐free regions of Lützow‐Holm Bay, East Antarctica.

Specific conductivity and sample position (whether from the shallow, littoral zone, or from deeper parts of the lake) were identified as significant variables in explaining diatom distribution, using non‐metric multidimensional scaling and regression tree analysis to identify statistically significant groupings of diatom assemblages and associated environmental variables.

In contrast to the significant difference between the diatom assemblages from the shallow littoral region and the lake floor at most sites, the diatom flora from different substrates in the littoral zone were not significantly different, which may be related to the extent of ice cover.

Humodophila australis was the most common species in the lakes with lowest specific conductivity, whereas Halamphora vyvermaniana was associated with lake‐floor habitats and Psammothidium papilio with samples from littoral zones at several sites.

These observations hold significance for the interpretation of lake sediment diatom assemblages in Lützow‐Holm Bay as archives of past climate and indicate that sampling strategies should consider a range of locations in lakes, with samples from the lake floor prioritised for the interpretation of sediment core diatom records.
Alternative pathway dysregulation in tissues drives sustained complement activation and predicts outcome across the disease course in COVID‐19
Authors: Siggins Matthew K. , Davies Kate , Fellows Rosie , Thwaites Ryan S. , Baillie J. Kenneth , Semple Malcolm G. , Openshaw Peter J. M. , Zelek Wioleta M. , Harris Claire L. , Morgan B. Paul ,   the ISARIC4C Investigators
Published: September 2022

Complement, a critical defence against pathogens, has been implicated as a driver of pathology in COVID‐19. Complement activation products are detected in plasma and tissues and complement blockade is considered for therapy. To delineate roles of complement in immunopathogenesis, we undertook the largest comprehensive study of complement in COVID‐19 to date, comprehensive profiling of 16 complement biomarkers, including key components, regulators and activation products, in 966 plasma samples from 682 hospitalized COVID‐19 patients collected across the hospitalization period as part of the UK ISARIC4C (International Acute Respiratory and Emerging Infection Consortium) study. Unsupervised clustering of complement biomarkers mapped to disease severity and supervised machine learning identified marker sets in early samples that predicted peak severity. Compared to healthy controls, complement proteins and activation products (Ba, iC3b, terminal complement complex) were significantly altered in COVID‐19 admission samples in all severity groups. Elevated alternative pathway activation markers (Ba and iC3b) and decreased alternative pathway regulator (properdin) in admission samples were associated with more severe disease and risk of death. Levels of most complement biomarkers were reduced in severe disease, consistent with consumption and tissue deposition. Latent class mixed modelling and cumulative incidence analysis identified the trajectory of increase of Ba to be a strong predictor of peak COVID‐19 disease severity and death. The data demonstrate that early‐onset, uncontrolled activation of complement, driven by sustained and progressive amplification through the alternative pathway amplification loop is a ubiquitous feature of COVID‐19, further exacerbated in severe disease. These findings provide novel insights into COVID‐19 immunopathogenesis and inform strategies for therapeutic intervention.
Prioritizing municipal lead mitigation projects as a relaxed knapsack optimization: a method and case study
Authors: Slavitt Isaac
Published: September 2022

Lead pipe remediation budgets are limited and ought to maximize public health impact. This goal implies a nontrivial optimization problem; lead service lines connect water mains to individual houses, but any realistic replacement strategy must batch replacements at a larger scale. Additionally, planners typically lack a principled method for comparing the relative public health value of potential interventions and often plan projects based on nonhealth factors. This paper describes a simple process for estimating child health impact at a parcel level by cleaning and synthesizing municipal datasets that are commonly available but seldom joined due to data quality issues. Using geocoding as the core record linkage mechanism, parcel‐level toxicity data can be combined with school enrollment records to indicate where young children and lead lines coexist. A harm metric of estimated exposure‐years is described at the parcel level, which can then be aggregated to the project level and minimized globally by posing project selection as a 0/1 knapsack problem. Simplifying for use by nonexperts, the implied linear programming relaxation is solved with the greedy algorithm; ordering projects by benefit cost ratio produces a priority list that planners can then consider holistically alongside harder to quantify factors. A case study demonstrates the successful application of this framework to a small U.S. city's existing data to prioritize federal infrastructure funding.
Signal detection shapes ornament allometry in functionally convergent Caribbean Anolis and Southeast Asian Draco lizards
Authors: Summers Thomas C. , Ord Terry J.
Published: September 2022

Visual ornaments have long been assumed to evolve hyper‐allometry as an outcome of sexual selection. Yet growing evidence suggests many sexually selected morphologies can exhibit other scaling patterns with body size, including hypo‐allometry. The large conspicuous throat fan, or dewlap, of arboreal Caribbean Anolis lizards was one ornament previously thought to conform to the classical expectation of hyper‐allometry. We re‐evaluated this classic example alongside a second arboreal group of lizards that has also independently evolved a functionally equivalent dewlap, the Southeast Asian Draco lizards. Across multiple closely related species in both genera, the Anolis and Draco dewlaps were either isometric or had hypo‐allometric scaling patterns. In the case of the Anolis dewlap, variation in dewlap allometry was predicted by the distance of conspecifics and the light environment in which the dewlap was typically viewed. Signal efficacy, therefore, appears to have driven the evolution of hypo‐allometry in what was originally thought to be a sexually selected ornament with hyper‐allometry. Our findings suggest that other elaborate morphological structures used in social communication might similarly exhibit isometric or hypo‐allometric scaling patterns because of environmental constraints on signal detection.
Measuring, comparing and interpreting phenotypic selection on floral scent
Authors: Opedal Øystein H. , Gross Karin , Chapurlat Elodie , Parachnowitsch Amy , Joffard Nina , Sletvold Nina , Ovaskainen Otso , Friberg Magne
Published: September 2022

Natural selection on floral scent composition is a key element of the hypothesis that pollinators and other floral visitors drive scent evolution. The measure of such selection is complicated by the high‐dimensional nature of floral scent data and uncertainty about the cognitive processes involved in scent‐mediated communication. We use dimension reduction through reduced‐rank regression to jointly estimate a scent composite trait under selection and the strength of selection acting on this trait. To assess and compare variation in selection on scent across species, time and space, we reanalyse 22 datasets on six species from four previous studies. The results agreed qualitatively with previous analyses in terms of identifying populations and scent compounds subject to stronger selection but also allowed us to evaluate and compare the strength of selection on scent across studies. Doing so revealed that selection on floral scent was highly variable, and overall about as common and as strong as selection on other phenotypic traits involved in pollinator attraction or pollen transfer. These results are consistent with an important role of floral scent in pollinator attraction. Our approach should be useful for further studies of plant–animal communication and for studies of selection on other high‐dimensional phenotypes. In particular, our approach will be useful for studies of pollinator‐mediated selection on complex scent blends comprising many volatiles, and when no prior information on the physiological responses of pollinators to scent compounds is available.
QUARTZITIC SANDSTONES IN THE NAMURIAN AND LOWER WESTPHALIAN SUCCESSION OF THE SOUTHERN NORTH SEA: A NEW HIGH‐PERMEABILITY CARBONIFEROUS RESERVOIR TYPE
Authors: Blackbourn G. A. , Collinson J. D.
Published: September 2022

Most of the potential sandstone reservoirs within the Namurian and lower Westphalian succession of the Southern North Sea Basin are originally feldspathic sands in which the feldspar has mainly been altered to microporous kaolinite clays. The sandstones provide a moderate porosity (typically 8‐15%, depending mainly on grain size), but permeability is severely limited owing to the microporous nature of much of the porosity. Permeability is typically 1 mD or less, rising to a few tens of millidarcies in occasional coarse‐ and very coarse‐grained sands. Predicting the presence of higher‐permeability reservoir zones is therefore a critical exploration problem in these successions.

Quartzitic sands have been discovered in places, especially for example in the Trent field (block 43/24), where physical reworking of sands during the transgressions that preceded the deposition of marine bands removed much of the feldspar, so that less clay was formed during burial diagenesis. Although these sandstones display moderately elevated permeabilities, commonly several to several tens of millidarcies, they are usually fine‐grained, which limits their reservoir potential.

A particular type of quartzitic sandstone reservoir has been identified quite widely within the Namurian and lower Westphalian succession of the Southern North Sea. This type is indistinguishable in terms of sedimentology and inferred detrital composition from the originally feldspathic facies which now form the widespread kaolinite‐rich, low‐permeability sandstones. However, it has a very low kaolinite content (commonly 1‐2%, compared with a more usual 5‐20%) so that these sandstones display permeabilities of the order of several hundred millidarcies.

Wireline log data from nineteen wells within UK Quadrants 43 and 44 have been examined, and all relevant core logged in order to compare the depositional settings of the quartzitic and non‐quartzitic sandstones. Existing data from over 500 petrographic thin sections from the area have been reviewed and 78 new thin sections analysed to determine the petrographic controls on reservoir quality in both sandstone types. The diagenetic histories of each type have been interpreted. The dissolution of feldspars during diagenesis of the quartzitic sandstones, without a substantial residue of kaolinite or other aluminium‐rich mineral, is attributed to the mobilisation of aluminium within organic complexes. This is thought to require the presence of certain organic acids.
A comparison of harmonic and traditional sharp staphylectomy techniques in 15 brachycephalic dogs
Authors: Gilman O. , Moreira L. , Dobromylskyj M. , Doran I.
Published: September 2022

Objectives

The objective was to compare sharp staphylectomy and staphylectomy using harmonic focus shears, assess surgical time, intraoperative haemorrhage and outcome. Our hypothesis was that harmonic staphylectomy would result in reduced surgical time, decreased intraoperative haemorrhage and greater relative improvement.

Materials and Methods

Dogs that were presented to Highcroft Veterinary Referrals between July 2020 and September 2021 with brachycephalic obstructive airway syndrome and underwent surgical correction were prospectively enrolled. Surgical technique was randomised, and surgical time, staphylectomy time, intraoperative haemorrhage, hospitalisation and change in patients' Cambridge BOAS Grade at a 14‐day recheck were recorded.

Results

Fifteen dogs were enrolled: seven dogs underwent sharp and eight underwent harmonic staphylectomy. Nine patients returned for follow‐up, four of seven and five of eight, respectively. Harmonic staphylectomy was associated with less haemorrhage (0 versus 9 cotton buds) and a shorter average staphylectomy time (3 minutes 36 seconds versus 14 minutes 50 seconds). No statistically significant differences were observed in total surgery time, number of nights hospitalised, or change in Cambridge BOAS Grade. An average of 0.68 mm of thermal necrosis was seen at the cut edges of soft palates removed by harmonic staphylectomy.

Clinical Significance

Harmonic staphylectomy can result in a reduction in staphylectomy time and degree of intraoperative haemorrhage compared to sharp staphylectomy, with no deleterious impact on postoperative recovery or the long‐term outcome of patients.
A meta–reinforcement learning algorithm for traffic signal control to automatically switch different reward functions according to the saturation level of traffic flows
Authors: Kim Gyeongjun , Kang Jiwon , Sohn Keemin
Published: September 2022

Reinforcement learning (RL) algorithms have been widely applied in solving traffic signal control problems. Traffic environments, however, are intrinsically nonstationary, which creates a convergence problem that RL algorithms struggle to overcome. Basically, as a target problem for an RL algorithm, the Markov decision process (MDP) can be solved only when both the transition and reward functions do not vary. Unfortunately, the environment for traffic signal control is not stationary since the goal of traffic signal control varies according to congestion levels. For unsaturated traffic conditions, the objective of traffic signal control should be to minimize vehicle delay. On the other hand, the objective must be to maximize the throughput when traffic flow is saturated. A multiregime analysis is possible for varying conditions, but classifying the traffic regime creates another complex task. The present study provides a meta‐RL algorithm that embeds a latent vector to recognize the different contexts of an environment in order to automatically classify traffic regimes and apply a customized reward for each context. In simulation experiments, the proposed meta‐RL algorithm succeeded in differentiating rewards according to the saturation level of traffic conditions.
Engineering multicellular living systems—a Keystone Symposia report
Authors: Cable Jennifer , Arlotta Paola , Parker Kevin Kit , Hughes Alex J. , Goodwin Katharine , Mummery Christine L. , Kamm Roger D. , Engle Sandra J. , Tagle Danilo A. , Boj Sylvia F. , Stanton Alice E. , Morishita Yoshihiro , Kemp Melissa L. , Norfleet Dennis A. , May Elebeoba E. , Lu Aric , Bashir Rashid , Feinberg Adam W. , Hull Sarah M. , Gonzalez Anjelica L. , Blatchley Michael R. , Montserrat Pulido Núria , Morizane Ryuji , McDevitt Todd C. , Mishra Deepak , Mulero‐Russe Adriana
Published: September 2022

The ability to engineer complex multicellular systems has enormous potential to inform our understanding of biological processes and disease and alter the drug development process. Engineering living systems to emulate natural processes or to incorporate new functions relies on a detailed understanding of the biochemical, mechanical, and other cues between cells and between cells and their environment that result in the coordinated action of multicellular systems. On April 3–6, 2022, experts in the field met at the Keystone symposium “Engineering Multicellular Living Systems” to discuss recent advances in understanding how cells cooperate within a multicellular system, as well as recent efforts to engineer systems like organ‐on‐a‐chip models, biological robots, and organoids. Given the similarities and common themes, this meeting was held in conjunction with the symposium “Organoids as Tools for Fundamental Discovery and Translation”.
Cervical Spine Fracture Prediction by Simple Plain X‐Ray in Ankylosing Spondylitis Patients after Low‐Energy Trauma
Authors: Liu Bingchuan , Gao Yitian , Ye Kaifeng , Yang Zhongwei , Hou Guojin , Zhang Zhishan , Ji Hongquan , Zhou Fang , Tian Yun
Published: September 2022

Objective

Timely diagnosis is essential in the management of cervical spine fracture (CSF) in ankylosing spondylitis (AS) patients. However, the value of simple plain X‐ray in the early management of ASCSF has not been well‐studied. This study aimed to explore the prediction ability of simple plain X‐ray for CSF in AS patients who suffer from low‐energy trauma (LET).

Methods

From January 2010 to December 2020, AS patients who experienced LET were retrospectively reviewed. Clinical data including gender, age, body mass index, time interval between AS diagnosis and trauma, smoking or not, and a presence of continuous bony bridge between anterior margin of C1 and C2 body or not were collected. Morphological features including atlanto‐occipital gap, Pavlov ratio of C2–7, Angle A–D, Borden's index, and Harrison's value were measured by the lateral cervical X‐ray. All data was compared between patients who had CSF and those who did not. Binary logistic regression analysis and receiver operator characteristic (ROC) curves were applied to discriminate and assess the predictive parameters.

Results

A total of 129 AS patients were divided into Fracture group (41 cases) and Non‐fracture group (88 cases) based on whether CSF existed. Twelve parameters showed significant differences between two groups (p < 0.05). According to the binary logistic regression model, four of the 12 parameters showed a further correlation with the occurrence of CSF, namely, mean Pavlov ratio (p < 0.001, OR = 0.067, 95% CI: 0.023 to 0.194), Angle D (p = 0.031, OR = 1.057, 95% CI: 1.005 to 1.112), Borden's index (p = 0.042, OR = 1.131, 95% CI: 0.994 to 1.287), the time interval between the AS diagnosis and the trauma (p < 0.020, OR = 0.935, 95% CI: 0.883 to 0.990). The ROC curve further revealed the mean Pavlov ratio had the largest AUC (0.793) with the cut‐off of 0.72. While the optimal cut‐off value was 45.65° for Angle D (sensitivity = 61.0%, specificity = 78.4%), 9.79 for Borden's index (sensitivity = 87.8%, specificity = 37.5%), 15.50 years for the time interval between AS diagnosis and trauma (sensitivity = 70.7%, specificity = 56.8%).

Conclusions

The time interval between the AS diagnosis and the trauma, mean Pavlov ratio, Angle D, and Borden's index showed predictive ability for the occurrence of CSF in AS patients who encounter LET. Surgeons should consider measuring these parameters in the management of AS patient.
Outcomes of V‐cut Osteotomy on the First Metatarsal Head Combined with Fixation in Mortise‐shaped Bone Groove‐Plasty and Akin Osteotomy on the First Toe for Hallux Valgus Correction
Authors: Jiao Xin , Gan Yaokai , Li Yiming , Xu Chen , Wang Zengguang , Sun Xin , Shi Dingwei , Zhao Jie , Dai Kerong
Published: September 2022

Objective

Hallux valgus (HV) is a common foot deformity, and recurrence is one of the most serious complications after HV correction. As a result, the surgical technique with a lower recurrence rate is a dream. The purpose of the article should be to observe the correction effect of hallux valgus using a novel “V‐cut” osteotomy on the first metatarsal head combined with fixation in mortise‐shaped bone groove‐plasty technique.

Methods

Twenty‐three consecutive patients (40 feet) with HV were included from March 2019 to May 2020, who were all treated using single screw fixation with V‐cut osteotomy on the first metatarsal head combined with mortise‐shaped metatarsal bone groove‐plasty and Akin osteotomy on the first toe for hallux valgus correction. With a mean follow‐up time of 21.7 months, the visual analogue scale (VAS) score and American Orthopedic Foot and Ankle Society (AOFAS) forefoot score and the changes of the hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA) were evaluated during the clinical follow‐up. The paired t test was used for analytical statistics.

Results

The VAS score improved from 6.78 ± 1.74 to 1.87 ± 1.45 and the AOFAS score improved from 53.9 ± 12.3 preoperatively to 94.7 ± 6.8 in the latest follow‐up postoperatively (P < 0.01). Besides, the HVA improved from 30.0 ± 6.1° to 5.7 ± 2.8° (P < 0.01); the IMA changed from 13.1 ± 2.8° into 3.3 ± 1.6° (P < 0.01); and the DMAA ameliorated from 27.0 ± 8.4° to 5.9 ± 3.5° (P < 0.01). Only five toes had slight numbness and stiffness in early postoperative period, and these symptoms disappeared completely at 6 months after the surgery. Only one foot was corrected to excess. One screw stern protruding beneath the skin happened, which needed secondary screw removal under local anesthesia.

Conclusions

Single screw fixation with V‐cut osteotomy on the first metatarsal head combined with fixation in mortise‐shaped metatarsal bone groove‐plasty and Akin osteotomy on the first toe is an effective way with low recurrence rate for HV correction.
Assessing pediatric perioperative affect: A concise review of research and clinically relevant scales
Authors: Yun Romy , Hess Olivia , Kennedy Kristin , Stricker Paul A. , Blake Lindsay , Caruso Thomas J.
Published: September 2022

Perioperative anxiety and distress are common in pediatric patients undergoing general anesthesia and increase the risk for immediate and long‐term postoperative complications. This concise review outlines key research and clinically‐relevant scales that measure pediatric perioperative affect. Strengths and weaknesses of each scale are highlighted. A literature review identified 11 articles with the following inclusion criteria: patients less than or equal to 18 years, perioperative anxiety or distress, and original studies with reliability or validity data. Although robust research‐based assessment tools to measure anxiety have been developed, such as the Modified Yale Preoperative Anxiety Scale, they are too complex and time‐consuming to complete by clinicians also providing anesthesia. Clinically‐based anxiety measurement scales tend to be easier to use, however they require further testing before widespread standard utilization. The HRAD ± scale (Happy, Relaxed, Anxious, Distressed, with a yes/no answer to cooperation) may be a promising observational anxiety scale that is efficient and includes an assessment of compliance. Further studies are needed to refine a clinically‐relevant anxiety assessment tool and appraise interventions that reduce perioperative distress.
Association of scalp block with intraoperative hemodynamic profiles and postoperative pain outcomes at 24–48 hours following craniotomy: An updated systematic review and meta‐analysis of randomized controlled studies
Authors: Fu Pei‐Han , Teng I‐Chia , Liu Wei‐Cheng , Chen I‐Wen , Ho Chun‐Ning , Hsing Chung‐Hsi , Sun Cheuk‐Kwan , Hung Kuo‐Chuan
Published: September 2022

Background

Despite the demonstrated analgesic efficacy of scalp block (SB) during the immediate postoperative period, the impact of SB on pain outcomes at postoperative 24 and 48 h in adults receiving craniotomy remains unclear.

Methods

The databases of Medline, Embase, and Cochrane Central Register were searched from inception to January 2022 for available randomized controlled trials (RCTs). The primary outcome was the severity of pain at postoperative 24 and 48 h, while the secondary outcomes included morphine consumption, hemodynamic profiles after surgical incision and in the postanesthesia care unit (PACU), and risk of postoperative nausea/vomiting (PONV).

Results

Meta‐analysis of 12 studies revealed a lower pain score [MD = −0.83, p = 0.03, 375 patients, certainty of evidence (COE): low] and morphine consumption (MD = −9.21 mg, p = 0.03, 246 patients, COE: low) at postoperative 24 h, while there were no differences in these pain outcomes at postoperative 48 h (COE: low). The use of SB significantly decreased intraoperative heart rate (MD = −10.9 beats/min, p < 0.0001, 189 patients, COE: moderate) and mean blood pressure (MD = −13.02 mmHg, p < 0.00001, 189 patients, COE: moderate) after surgical incision, but these hemodynamic profiles were comparable in both groups in the PACU setting. There was also no difference in the risk of PONV between the two groups (RR = 0.78, p = 0.2, 299 patients, COE: high).

Conclusion

This meta‐analysis demonstrated that scalp block not only provided hemodynamic stability immediately after surgical incision but was also associated with a lower pain score and morphine consumption at postoperative 24 h. Further studies are needed for elucidation of its findings.
Dynamic evolution of a scalp congenital melanocytic nevus with poliosis and cutis verticis gyrata
Authors: Barry Kelly K. , Blundell Andrew R. , Hawryluk Elena B.
Published: September 2022

Cutis verticis gyrata (CVG), characterized by cerebriform overgrowth of the scalp, is rarely observed in congenital melanocytic nevi (CMN). We describe a 13‐year‐old male with autism and a large CMN of the scalp with numerous satellite nevi whose scalp nevus exhibited evolution with poliosis and CVG. Given the potential association of CVG (independent of CMN) with seizures, neuropsychiatric, and ophthalmologic disorders, and nevus‐associated CVG (cerebriform intradermal nevus) with melanoma, multidisciplinary evaluation of CMN patients with CVG is important to guide management and treatment.
A 9‐year‐old girl with blisters on the hands and face: An early presentation of variegate porphyria
Authors: Moshayedi Aref , Mochel Mark C. , Brooks Amy N. , Laver Joseph , Salkey Kimberly S.
Published: September 2022

Variegate porphyria (VP) is a rare subtype of porphyrias characterized by dysfunction of enzymes in the heme biosynthesis pathway leading to an accumulation of porphyrins and their precursors. The resulting buildup can manifest as neuropsychiatric symptoms and photosensitive blistering eruptions on sun‐exposed skin. We report a case of VP in a 9‐year‐old girl with many confounding medical factors that warranted alternative explanations for her cutaneous lesions. VP has been reported infrequently in the pediatric population and is associated with more severe neuropsychiatric outcomes compared to adult‐onset disease.
Analysis of long‐term renal function in patients with malignant solid tumors: Retrospective analysis using the estimated glomerular filtration rate
Authors: Sano Hirozumi , Kobayashi Ryoji , Matsushima Satoru , Hori Daiki , Yanagi Masato , Kodama Koya , Suzuki Daisuke , Kobayashi Kunihiko
Published: September 2022

Background

Childhood cancer survivors are at an increased risk of impaired renal function. The aim of the present study was to assess the frequency of and risk factors for long‐term renal dysfunction in patients with solid tumors using the estimated glomerular filtration rate (eGFR).

Methods

We retrospectively evaluated eGFR in 52 patients with solid tumors (25 females, 27 males) who received chemotherapy and were regularly followed up in our institute. Decreased eGFR was defined as <90 ml/min/1.73 m2. Cases under treatment and of death were excluded.

Results

Median age at the diagnosis of the primary disease was 2.4 years (range, 0.0–23.9 years) and the median follow‐up period was 98.4 months (range, 14.4–231.6 months). The mean cumulative incidence of decreased eGFR was 24.7 ± 2.2%. Multivariate analysis showed that decreased eGFR correlated with an older age at diagnosis (≥2.3 years) (hazard ratio 7.330, p = 0.018).

Conclusion

Although previous studies have indicated that the risk of long‐term nephrotoxicity is higher in patients treated at a younger age, the present study showed that patients treated at an older age were at an increased risk of decreased eGFR.
Correlated change in sense of purpose and romantic relationship quality
Authors: Pfund Gabrielle N. , Hill Patrick L.
Published: September 2022

Sense of purpose, or feeling that one has personally meaningful goals and directions guiding them through life, consistently predicts a variety of desirable well‐being, health, and social outcomes. However, work has been limited with respect to evaluating it as a predictor and promoter of romantic relationships or how purpose may develop in these contexts. For instance, healthy romantic relationships could also help individuals develop and maintain a higher sense of purpose. With cross‐sectional evidence finding positive associations between sense of purpose and romantic relationship commitment and satisfaction, the current study expanded on past work by using longitudinal data with three months between two measurement occasions (Time 1: N = 2243; Time 2: N = 1284) to evaluate whether sense of purpose predicted relationship status over time and how changes in relationship quality and sense of purpose were associated. Results showed that a greater sense of purpose predicted maintaining a romantic relationship but did not predict later romantic relationship quality, although higher romantic relationship quality predicted an increase in sense of purpose. Findings are discussed regarding why people with a higher sense of purpose may be more likely to stay in relationships as well as the role that positive romantic relationships may play in helping maintain a higher sense of purpose.
Identification and expression pattern analysis of PtCarA and PtCarB genes in Populus trichocarpa under different nitrogen treatments
Authors: Hu Z. , Zhang S. , Zhang H. , Cao L. , Chang R. , Liu Z. , Zhang H. , Xu Z. , Liu G.
Published: September 2022

Carbamoyl phosphate synthetase (CPS) catalyses the synthesis of ammonia carbamoyl phosphate (CP), which plays a key role in the biosynthesis of arginine and pyrimidine nucleotides. There are two subunits of the CPS enzyme in Populus trichocarpa, CarA (small subunit) and CarB (large subunit). Only when they coexist can CPS catalyse synthesis of CP. However, it is not clear how CPS responds to nitrogen (N) to affect arginine and pyrimidine nucleotide biosynthesis.

In this study, bioinformatics methods were used to analyse the expression patterns of genes encoding CarA and CarB, and qRT‐PCR and RNA‐seq were used to investigate their molecular responses under different N concentrations.

Phylogenetic analysis revealed that the phylogenetic trees of CarA and CarB had similar topologies. qRT‐PCR showed that the PtCarA and PtCarB genes were regulated by N, while their N‐regulated patterns differed in different tissues. The expression patterns of PtCarA and PtCarB show a significant positive correlation according to qRT‐PCR and RNA‐seq. The analysis of promoter cis‐acting elements showed that the promoter regions of PtCarA1, PtCarA2 and PtCarB contained some identical cis‐acting elements. According to analysis of the phylogenetic tree, expression patterns and promoter elements, we speculate that there might be coevolution among PtCarA1, PtCarA2 and PtCarB.

This study provides valuable information for further understanding the function of CPS in poplar, especially for N response, and provides new ideas for studying the evolution of gene families related to heteromultimers.
Co‐amelioration of red soil acidity and fertility with pig manure rather than liming
Authors: Cai Zejiang , Yang Changfu , Carswell Alison M. , Zhang Lu , Wen Shilin , Xu Minggang
Published: September 2022

Lime (calcium oxide), animal manure and crop straw soil treatments have been shown to ameliorate soil acidity, yet their effectiveness at concurrently enhancing soil fertility status and improving crop yields is less well understood. In this study, an acidic nutrient deficient red soil (Ferralic Cambisol) received these treatments at various dosage rates (% of DW soil) in pot experiments with maize plants. Lime was applied at four dosage rates (0.05%, 0.10%, 0.15% and 0.20%), pig manure at three rates (0.50%, 1.00% and 1.50%), maize straw or milk vetch at two rates (0.50% and 1.00%) and combinations of lime (0.10% or 0.15%) with maize straw (0.50%) and/or pig manure (0.50%). Soils treated with and without chemical fertilizers were also included as controls. Measurements of soil pH, exchangeable acidity, plant available nutrients and maize shoot biomass were recorded. Maize shoot biomass increased by 4.7–7.6 times under pig manure treatments, 1.1–1.6 times under milk vetch, 0.4–1.5 times under lime and 1.1–6.2 times under combination treatments, compared with the control. Soil pH increased by 0.5–0.9 units under lime, by 0.2–0.4 units under pig manure and by 0.7 pH units under the combination treatment relative to the control. Variance partitioning analysis showed that on an individual basis, soil acidity amelioration (pH, exchangeable H+ and Al3+) or nutrient input (C, N, P, K, Ca, Mg, Zn) explained only 4.3% and 5.6% of improved maize growth, respectively. Whereas, their interaction explained 85.9% of the variation. We also report that the over‐application of pig manure could lead to P saturation and negative impacts on aquatic systems in the wider environment. Therefore, we recommend a combination of lime, pig manure and straw provides an optimal solution for addressing soil acidity and limiting P saturation in acid soils.
Haecceitism and counterpart theory
Authors: De Michael
Published: September 2022

David Lewis argues at length against haecceitism and goes as far as claiming that, on a certain counterpart‐theoretic construal, the doctrine is unintelligible or inconsistent. I argue, contra Lewis, that both qualitative and non‐qualitative counterpart theory are in fact committed to haecceitism, but that this commitment is harmless since what is really at stake for a counterpart theorist such as Lewis are more general supervenience claims that are independent of haecceitism. I further argue that Lewis's formulation of the doctrine suffers from two important defects that, once remedied, free counterpart theory of its haecceitistic commitments. Along the way I discuss an objection to the effect that the cheap substitute is inconsistent in the presence of an ‘actually’ operator. This paper therefore brings together important critical discussion on haecceitism and counterpart theory.
Auxin triggers pectin modification during rootlet emergence in white lupin
Authors: Jobert François , Soriano Alexandre , Brottier Laurent , Casset Célia , Divol Fanchon , Safran Josip , Lefebvre Valérie , Pelloux Jérôme , Robert Stéphanie , Péret Benjamin
Published: September 2022

Emergence of secondary roots through parental tissue is a highly controlled developmental process. Although the model plant Arabidopsis has been useful to uncover the predominant role of auxin in this process, its simple root structure is not representative of how emergence takes place in most plants, which display more complex root anatomy. White lupin is a legume crop producing structures called cluster roots, where closely spaced rootlets emerge synchronously. Rootlet primordia push their way through several cortical cell layers while maintaining the parent root integrity, reflecting more generally the lateral root emergence process in most multilayered species. In this study, we showed that lupin rootlet emergence is associated with an upregulation of cell wall pectin modifying and degrading genes under the active control of auxin. Among them, we identified LaPG3, a polygalacturonase gene typically expressed in cells surrounding the rootlet primordium and we showed that its downregulation delays emergence. Immunolabeling of pectin epitopes and their quantification uncovered a gradual pectin demethylesterification in the emergence zone, which was further enhanced by auxin treatment, revealing a direct hormonal control of cell wall properties. We also report rhamnogalacturonan‐I modifications affecting cortical cells that undergo separation as a consequence of primordium outgrowth. In conclusion, we describe a model of how external tissues in front of rootlet primordia display cell wall modifications to allow for the passage of newly formed rootlets.
Endogenous transport costs and international trade
Authors: Hafner Kurt A. , Kleinert Jörn , Spies Julia
Published: September 2022

In this paper, we model a manufacturing and a transport sector and use export volumes to determine the demand for transport services. If trade exceeds a particular level, transport service suppliers maximise profit by investing in an advanced transport technology, which lowers their marginal costs and reduces equilibrium transport prices. Transport costs thus vary according to two characteristics: the distance between two locations and the endogenous firm decision to invest in transportation. A simulation exercise reveals that ignoring the effect of the investment decision on transport costs biases empirical results. We apply this insight in our empirical estimations which rely on repeatedly collected transport price data from the United Parcel Service. We use an instrumental variable estimator to account for the endogeneity of the investment decision. Our estimation results confirm that transport prices are influenced by both the distance and the level of exports between two countries. We find that trading partners with 10% more exports enjoy on average 0.6% lower transport prices.
Aerodynamic Performance of Symmetric and Cambered Airfoils at Low Reynolds Numbers
Authors: Cruz Abdiel , Rodriguez Arturo , Kotteda V. M. Krushnarao , Paez Brandon , Villanueva Daniel , Chijioke Clinton , Terrazas Jose , Kumar Vinod
Published: September 2022

The aerodynamics of airfoils has been extensively studied at high Reynolds numbers, where approximations of variables such as drag, and lift can easily be obtained based on computational fluid dynamics or panel methods. Advancement in aeronautical technology, in this case, Micro Air Vehicles (MAVs), the aerodynamics have not been studied extensively through simulations. Physical experiments have been performed, and they have not been emulated in simulation software, one of them being XFOIL. The purpose of this paper is to establish the potential and the gaps within XFOIL. Where can XFOIL provide correct solutions to drag and lift coefficients, and where does it fail? In this problem, we establish a parametric study to vary the Reynolds Number, type of airfoil, Mach Number, and angle of attack. We determine to what extent XFOIL can be used for the NACA-6409, NACA-0021, and NACA-0009 airfoil types at low Reynolds numbers.