bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of Intraocular Pressure and Time to Blindness for Glaucoma Patients at Felege Hiwot Referral Hospital, Bahir Bar, Ethiopia: A Comparison of Separate and Joint Models
Authors: Muluneh Mitiku Wale , Tegegne Awoke Seyoum
Published: September 2021

Background:

Due to the substantial increase in the number of glaucoma cases within the next several decades, glaucoma is a significant public health issue. The main objective of this study was to investigate the determinant factors of intraocular pressure and time to blindness of glaucoma patients under treatment at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia.

Methods:

A retrospective study design was conducted on 328 randomly selected glaucoma patients using simple random sampling based on the identification number of patients in an ophthalmology clinic at the hospital under the follow-up period from January 2014 to December 2018. A linear mixed effects model for intraocular pressure data, a semi-parametric survival model for the time-to-blindness data and joint modeling of the 2 responses were used for data analysis. However, the primary outcome was survival time of glaucoma patients.

Results:

The comparison of joint and separate models revealed that joint model was more adequate and efficient inferences because of its smaller standard errors in parameter estimations. This was also approved using AIC, BIC, and based on a significant likelihood ratio test as well. The estimated association parameter (α) in the joint model was .0160 and statistically significant ( P-value = .0349). This indicated that there was strong evidence for positive association between the effects of intraocular pressure and the risk of blindness. The result indicated that the higher value of intraocular pressure was associated with the higher risk of blindness. Age, hypertension, type of medication, cup-disk ratio significantly affects both average intraocular pressure and survival time of glaucoma patients ( P-value < .05).

Conclusion:

The predictors; age, hypertension, type of medication, and cup-disk ratio were significantly associated with the 2 responses of glaucoma patients. Health professionals give more attention to patients who have blood pressure and cup-disk ratio greater than 0.7 during the follow-up time to reduce the risk of blindness of glaucoma patients.
Knowledge and Practice of Infants Exposure to Sunlight Among Lactating Mothers Attending at Yirgalem Hospital, Sidama Regional State
Authors: Bezabih Addisu Seneshaw , Eshetu Daniel , Yohanis Nigussie , Hirigo Agete Tadewos
Published: September 2021

Background:

Exposure to sunlight is vital for the synthesis of vitamin-D and vitamin D plays an important role in growth and bones strength. Therefore, this study aimed to assess the knowledge and practice of infants exposure to sunlight among lactating women.

Methods:

A cross-sectional study was conducted from May 01 to 30, 2019 among 327 infant coupled lactating mothers attended at Yirgalem General Hospital. An interviewer-administered questionnaire was used to collect relevant data through a convenient sampling technique.

Results:

A total of 84.7% of respondents exposed infants to sunlight. More than 94% knew the benefit of exposing infants to sunlight. About 20.9%, 25.6%, and 19.9% of mothers exposed infants to sunlight within 15, 16 to 30, and 31 to 45 days of birth, respectively. In addition, 59.9% of respondents exposed infants to sunshine daily and 72.2% exposed without clothing the infants’ body. Moreover, 63.5% of mothers have applied lubricants and overall 54.5% of mothers exposed infants to sunlight in good practice. Unemployed women were 4.7 times more likely (aOR; 95%CI: 4.7; 2.0-11.4) to expose infants to sunlight when compared to those employed, while women whose husbands have at least secondary education level were 5.1 times more likely (aOR; 95%CI: 5.1; 1.6-16.1) to expose infants to sunlight when compared to those unable to read and write.

Conclusion:

More than 45% and more than one-third of lactating mothers had poor practice and exposed infants to sunlight for inadequate time, respectively. Therefore, the finding indicates a need for awareness creation to increase women’s knowledge and practice toward the exposure of infants to sunlight.
Parents’ parenting styles differences are associated with lifetime suicidal ideation: Evidence from Chinese medical college students
Authors: Gui Zhen , Ren Xuehan , Li Xiao , Zhou Chengchao , Sun Long
Published: September 2021

This study aims to explore the association between parents parenting styles differences and lifetime suicidal ideation (LSI). The sample included 2598 Chinese medical students. Results showed that 10.5% of students reported LSI. Moreover, total differences in parenting styles (OR = 1.04, 95% CI = 1.02, 1.06), parental nurture rejects differences (OR = 1.11, 95% CI = 1.04, 1.18), parental emotional warmth differences (OR = 1.08, 95% CI = 1.03, 1.14), and parental overprotective differences (OR = 1.11, 95% CI = 1.06, 1.16), obtain a scholarship, physical disease and mental health were associated with LSI. The major finding reminds us of the importance of consistent parenting style for suicide prevention.
Anthropomorphic tendencies in autism: A conceptual replication and extension of White and Remington (2019) and preliminary development of a novel anthropomorphism measure
Authors: Clutterbuck Rachel A , Shah Punit , Leung Hok Sze , Callan Mitchell J , Gjersoe Natalia , Livingston Lucy A
Published: September 2021

White and Remington (2019) found that autistic people may have increased anthropomorphic tendencies to ascribe human-like attributes to non-human agents. However, it was unclear from their study whether this relationship holds after accounting for socio-demographic variables known to be associated with anthropomorphism. The psychometric properties of the anthropomorphism questionnaire they used has also not been investigated, raising concerns about whether it measures the same construct in people with differing levels of autistic traits. Addressing these issues, we re-examined the relationship between autism and anthropomorphism in a large sample of adults ( N = 492). Conceptually replicating White and Remington, we found that autistic traits were significantly associated with greater anthropomorphic tendencies, even after accounting for age and sex (Study 1). Equally, psychometric concerns with the anthropomorphism questionnaire were revealed, leading us to refine this measure and re-analyse the data. A less clear-cut but significant association between autistic traits and anthropomorphism was found (Study 2). Our refined anthropomorphism measure also had improved psychometric properties, particularly showing that it is suitable for future autism research. Our findings are discussed in relation to individual differences in social-cognitive processing and we outline future directions for investigating mechanisms linking anthropomorphism and social cognition in autism.

Lay abstract

Anthropomorphism is the tendency to attribute human-like qualities (e.g. thoughts and feelings) to non-human entities (e.g. objects and weather systems). Research by White and Remington (2019) suggested that anthropomorphism is more common in autistic compared to neurotypical adults, which is interesting given that autistic individuals sometimes misunderstand the thoughts and feelings of other people. In this article, we re-examined the link between autism and anthropomorphism in a large sample of adults with varying degrees of autistic traits, with several important methodological advances on previous research. Across two studies, we found that individuals with more autistic traits reported greater anthropomorphic tendencies. As part of these analyses, we had to develop a new, refined measure of anthropomorphism, which showed better reliability and validity than the original measure. This measure will be useful in future autism-related research. Overall, advancing White and Remington’s study, these findings help us to better understand individual differences in socially relevant processes, including those that may be enhanced in autism (e.g. anthropomorphism).
HyperStorylines: Interactively untangling dynamic hypergraphs
Authors: Peña-Araya Vanessa , Xue Tong , Pietriga Emmanuel , Amsaleg Laurent , Bezerianos Anastasia
Published: September 2021

We present the design and evaluation of HyperStorylines, a technique that generalizes Storylines to visualize the evolution of relationships involving multiple types of entities such as, for example, people, locations, and companies. Datasets which describe such multi-entity relationships are often modeled as hypergraphs, that can be difficult to visualize, especially when these relationships evolve over time. HyperStorylines builds upon Storylines, enabling the aggregation and nesting of these dynamic, multi-entity relationships. We report on the design process of HyperStorylines, which was informed by discussions and workshops with data journalists; and on the results of a comparative study in which participants had to answer questions inspired by the tasks that journalists typically perform with such data. We observe that although HyperStorylines takes some practice to master, it performs better for identifying and characterizing relationships than the selected baseline visualization (PAOHVis) and was preferred overall.
Questions in secondary classrooms: Toward a theory of questioning
Authors: Alexander Kimberly , Gonzalez Charles H. , Vermette Paul J. , Di Marco Sabrina
Published: September 2021

At the heart of the teaching practice is the art of questioning. Costa and Kallick noted that questions are the means by which insights unlock thinking. Effective questioning is essential to effective teaching. Despite this, a cohesive theory on the method of questioning has yet to be developed. A discussion of questioning is vital to moving the teaching profession forward. In this article, we propose a model of effective questioning that we see as the first step toward identifying a unifying theory of questioning. Our model contains the following three components: (1) a well-structured item (a good question), (2) clear expectations for the response (which we call ‘the five considerations’), and (3) a constructivist conversation. This work succeeds in bridging the gap between practice and theory that may otherwise limit good teachers from utilizing their questions in the most effective manner. Because of this, our model should be of use to teachers, teacher educators, professional developers, educational researchers, and theoreticians. We hope that a continued discussion of questioning ensues in all of these circles, so that our field can move closer toward the development of a theory of questioning.
Dewesternizing Precarity in Turkish TV Drama Production through the Body and the Law
Authors: Bulut Ergin
Published: September 2021

Beneath Turkish TV dramas’ global glamor lie workplace accidents, systemic injuries on workers’ bodies, and deaths. In response, workers seek to impose restraints on what can be done to their bodies by resorting to law and evoking ideals of equality as they struggle for workplace safety, healthcare, and dignity. Drawing on ethnographic research across production sets, industry summits, union meetings and more than fifty interviews since 2015, this article documents drama workers’ bodily vulnerabilities, arguing that precarity in this global media industry is a bodily phenomenon legally sanctioned by the state. I dewesternize the notion of precarity in creative industries by foregrounding the materiality of the body and the regulative power of law as centers of exploitation and resistance. Critical scholars of media production could learn from non-Western contexts in identifying how creative workers do not only demand stable incomes but also legal recognition and protection of their bodies.
Spinal Cord Ischemia in the Setting of Acute Type B Aortic Dissection: Successful Rescue with Thoracic Endovascular Aortic Repair
Authors: Kano Masaki , Iwahashi Toru , Nishibe Toshiya , Kamiya Kentaro , Ogino Hitoshi
Published: September 2021

We report 2 cases of successful thoracic endovascular aortic repair (TEVAR) for acute type B aortic dissection (ABAD) complicated with spinal cord ischemia (SCI). Case 1. A 70-year-old gentleman found with an uncomplicated ABAD with false lumen occluded, developed SCI shortly after admission during the initial medical management. Cerebrospinal fluid drainage (CSFD) was initiated followed by emergent TEVAR. SCI improved, and the patient was discharged. Case 2. A 52-year-old gentleman developed uncomplicated ABAD with patent false lumen. 5 hours after admission, he developed SCI during the initial medical management. Emergent TEVAR was performed followed by CSFD, and the SCI improved before discharge. These cases prompted us to address prompt TEVAR for primary entry closure and true lumen dilatation with postoperative hypertensive management to relieve the dynamic obstruction of the segmental arteries responsible for the compromised spinal cord circulation in complicated ABAD.
Endovascular Treatment of a Giant Renal Vein Aneurysm Arising from a High-Flow Arteriovenous Fistula
Authors: Kalemci Serdar , Kizilay Fuat , Ergun Kasim E. , Yurtseven Emre , Cinar Celal
Published: September 2021

Background: Renal vein aneurysms (RVAs) are considered rare clinical entities. RVAs can be secondary to thrombosis, venous hypertension, or renal arteriovenous fistula (RAVF). RVAs secondary to RAVF are rare. Patients with RVA may present with hypertension, abdominal pain, hematuria, or may even be asymptomatic. However, there may be life-threatening emergencies including aneurysm rupture, thrombosis, and pulmonary embolism. The treatment of RVAs includes reconstruction of the renal vein, nephrectomy, and endovascular treatment. Purpose: In this technical note, we report the endovascular treatment of a giant RVA that developed secondary to an acquired RAVF by the placement of multiple vascular plugs. Conclusion: Endovascular occlusion of the RAVF with vascular plugs is effective to prevent a life-threatening rupture of RVA. Clinical follow-up is crucial to detect leakage or migration of the vascular plugs.
Prognostic Utility of Serum Biomarkers in Intracerebral Hemorrhage: A Systematic Review
Authors: Troiani Zachary , Ascanio Luis , Rossitto Christina P. , Ali Muhammad , Mohammadi Nicki , Majidi Shahram , Mocco J , Kellner Christopher P.
Published: September 2021

Background. Intracerebral hemorrhage (ICH) accounts for 10–20% of all strokes and is associated with high morbidity and mortality. Recent studies have identified serum biomarkers as a means to improve outcome prognostication in poor grade ICH patients. Poor prognosis of ICH patients and complex pathophysiology of the disease necessitate prognostic serum biomarkers to help guide treatment recommendations. Objective. The objective is to systematically review all biomarkers used to predict long-term functional outcome in patients with spontaneous intracerebral hemorrhage. Results. We identified 36 studies investigating the predictive utility of 50 discrete biomarkers. Data from 4865 ICH patients were reviewed. Inflammatory biomarkers (11/50) were most often studied, followed by oxidative (8/50), then neuron and astrocyte-specific (7/50). S100 calcium binding protein B, white blood cell count, and copeptin were the most often studied individual biomarkers. The prognostic utility of 23 biomarkers was analyzed using receiver operating characteristic curves. Area under the curve (AUC) values for all available biomarkers except neutrophil/lymphocyte ratio were acceptable. Twenty of the 23 biomarkers were characterized by at least one excellent AUC value. Vascular endothelial growth factor, glial fibrillary astrocyte protein, and S100 calcium binding protein B were characterized by outstanding AUC. Conclusions. We identified the inflammatory and neuron and astrocyte-specific biomarker categories as having the greatest number of significant individual biomarker predictors of long-term outcome. Further investigation utilizing cross-validation of prediction models in a second independent group and blinded assessment of outcomes for the predictive utility of biomarkers in patients with ICH is warranted.
Toxoplasmosis in immunocompetent Saudi women: Correlation with vitamin D
Authors: Rasheed Zafar , Shariq Ali , AlQefari Ghaida B , Alwahbi Ghayda S , Aljuaythin Amal I , Alsuhaibani Fidaa S , Alotaibi Daliyah F , Aljohani Shahad S , Alghasham Ruqiah , Alsaeed Thamir , Alharbi Nada A , Rugaie Osamah Al , Abdulmonem Waleed Al , Sharaf Osama F
Published: September 2021

Objective:

Toxoplasma gondii ( T. gondii) is a life-threatening parasite particularly infecting the immunocompromised women. Deficiency of vitamin D is well reported in several infectious disorders. This study was undertaken to investigate a correlation of vitamin D deficiency with the onset of T. gondii infection in immunocompetent women from the central of Saudi Arabia.

Methods:

Blood samples were collected from 304 Saudi women from the Qassim region of Saudi Arabia. Specific immunoassays were used to determine the levels of T. gondii immunoglobulin G and vitamin D. The SPSS and the Prism Graph Pad statistical software were used for the data analysis.

Results:

Out of 304 women, 18.8% were found to be positive for toxoplasmosis. Interestingly, the serum levels of vitamin D in toxoplasma positive cases were found to be significantly low as compared with the levels of vitamin D in toxoplasma negative cases. Moreover, sociodemographic risk factors such as age, residence location, and consumption of fruits/vegetables were also found to be associated with vitamin D deficiency and with the seroprevalence of toxoplasmosis.

Conclusion:

This study investigated a direct correlation of vitamin D deficiency with the severity of the toxoplasmosis in Saudi women. Therefore, it is predicted that vitamin D supplementation may provide protection against toxoplasma infection.
An AdaBoost-based tree augmented naive Bayesian classifier for transient stability assessment of power systems
Authors: Wang Huimin , Li Zhaojun Steven
Published: September 2021

By focusing on the accuracy limitations of the naive Bayesian classifier in the transient stability assessment of power systems, a tree augmented naive Bayesian (TAN) classifier is adopted for the power system transient stability assessment. The adaptive Boosting (AdaBoost) algorithm is used in the TAN classifier to form an AdaBoost-based tree augmented naive Bayesian (ATAN) classifier for further classification performance improvement. To construct the ATAN classifier, eight attributes that reasonably reflect the transient stability or transient instability of a power system are selected as inputs of the proposed classifier. In addition, the class-attribute interdependence maximization (CAIM) algorithm is used to discretize the attributes. Then, the operating mechanism of the power system is used to obtain the dependencies between the attributes, and the parameters of the ATAN classifier are learned according to the Bayes’ theorem and the criterion of maximizing a posterior estimation. Four evaluation indicators of the ATAN classifier are used, that is, the value of Kappa, the area under the receiver operating characteristic curve (AUC), F1 score, and the average evaluation indicator. Lastly, experiments are implemented on the IEEE 3-generator 9-bus system and IEEE 10-generator 39-bus system. The simulation results show that the ATAN classifier can significantly improve the classification performance of the transient stability assessment of the power system.
Validity and reliability of Polar Team Pro GPS units for assessing maximum sprint speed in soccer players
Authors: Sagiroglu İsa , Akyildiz Zeki , Yildiz Mehmet , Clemente Filipe Manuel
Published: September 2021

Previous research has reported inconsistencies in the validity and reliability of different brands of global positioning systems (GPS). Therefore, it should be questioned whether GPS units measure the maximum speed measurements validly and reliably. The current study aimed to analyze the validity and reliability of Polar Team Pro GPS units (10 Hz) when used to measure maximum sprint speed. Sixteen amateur soccer players (age: 27.22 ± 4.70 years; height: 177 ± 6.05 cm; body mass: 73.66 ± 5.63 kg) were tested in the 40 m sprint. Two Polar Team Pro GPS units were positioned on each player, while the radar was placed on a 1 m high tripod placed 10 m behind the starting point. The data obtained from the Polar Team Pro GPS units were compared to determine inter-unit reliability. The data obtained from one of the Polar Team Pro GPS units and radar gun (gold standard) were compared to determine validity. Good inter-unit reliability between the Polar Team Pro GPS units was reported for maximum sprint speed, with low coefficients of variation (5%–6%) and low smallest worthwhile changes (0.4 for all systems). Regarding validity, the coefficient of correlation was extremely high for maximum sprint speed ( r = 0.938, p < 0.001). Moreover, measurement differences between both systems were statistically insignificant (Mean Bias error = 0.144, R2 = 0.879, MAPE = 1.6%, MAE = 0.688, and RMSE = 0.697). Consequently, good reliability and perfect validity were observed, indicating that the Polar Team Pro GPS unit is suitable for maximum sprint speed measurements.
Ramucirumab plus paclitaxel as second-line treatment in patients with advanced gastric or gastroesophageal junction adenocarcinoma: a nationwide real-world outcomes in Korea study (KCSG-ST19-16)
Authors: Han Hye Sook , Kim Bum Jun , Jee Hee-Jung , Ryu Min-Hee , Park Se Hoon , Rha Sun Young , Kim Jong Gwang , Bae Woo Kyun , Lee Keun-Wook , Oh Do-Youn , Kim In-Ho , Sym Sun Jin , Oh So Yeon , Kim Hyeong Su , Byun Ji-Hye , Kim Dong Sook , Suh Young Ju , An Hyonggin , Zang Dae Young
Published: September 2021

Background:

Ramucirumab as monotherapy or in combination with paclitaxel is a second-line treatment option recommended for patients with locally advanced unresectable or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma. However, real-world data from large study cohorts focused on ramucirumab plus paclitaxel in gastric cancer are limited.

Methods:

The study population comprised all patients with gastric or GEJ cancer who received ramucirumab plus paclitaxel in South Korea between 1 May 2018 and 31 December 2018. We included patients with advanced gastric or GEJ adenocarcinoma and disease progression after first-line platinum and fluoropyrimidine-containing combination chemotherapy.

Results:

In total, 1063 patients were included in the present study. The objective response rate and disease control rate were 15.1% and 57.7%, respectively. The median progression-free survival was 4.03 months (95% confidence interval, 3.80–4.27) and the median overall survival was 10.03 months (95% confidence interval, 9.33–10.73). Grade 3 or higher treatment-related adverse events with incidence of ⩾5% were neutropenia (35.1%) and anemia (10.5%). Based on multivariable analysis, overall survival was negatively associated with Eastern Cooperative Oncology Group performance status ⩾2, weight loss ⩾10% in the previous 3 months, GEJ of primary tumor, poor or unknown histologic grade, number of metastatic sites ⩾3, presence of peritoneal metastasis, no prior gastrectomy, and time to second-line since first-line treatment <6 months.

Conclusion:

Our large-scale, nationwide, real-world data analysis of an unselected real-world population adds evidence for the efficacy and safety of second-line ramucirumab plus paclitaxel in patients with locally advanced unresectable or metastatic gastric or GEJ adenocarcinoma.
Updates on adjuvant and neoadjuvant treatment strategies for surgically resectable and borderline resectable pancreatic ductal adenocarcinoma
Authors: Iyengar Siddharth , Nevala-Plagemann Christopher , Garrido-Laguna Ignacio
Published: September 2021

Pancreatic cancer is the third leading cause of cancer-related mortality in the US. Outcomes for patients with pancreatic cancer are poor as curative approaches are only available to the minority of patients who have localized tumors for which surgery may be an option. The past decade has established fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) as the new standard of care following resection for fit patients with resectable pancreatic tumors. However, most patients will relapse and a large number of patients treated with upfront resection are unable to receive or complete adjuvant chemotherapy. There is therefore considerable interest in neoadjuvant treatment strategies for patients with resectable and borderline resectable pancreatic cancer as a way to provide early systemic treatment of micrometastatic disease, facilitate lymph node downstaging, and increase the likelihood of negative resection margins (R0). This review will focus on key aspects of completed trials evaluating adjuvant therapy in resectable pancreatic cancer and will provide an overview of emerging evidence supporting the use of neoadjuvant treatment strategies for both resectable and borderline resectable pancreatic cancer.
Clozapine discontinuation withdrawal symptoms in schizophrenia
Authors: Blackman Graham , Oloyede Ebenezer
Published: September 2021

Clozapine is an atypical antipsychotic used in treatment-resistant schizophrenia. Whilst clozapine is highly effective, there are some clinical scenarios, such as the emergence of severe side effects, that necessitate its discontinuation. There is an emerging literature suggesting that discontinuing antipsychotics, in particular clozapine, can cause an array of withdrawal symptoms. We review the evidence for the existence of clozapine-induced withdrawal symptoms, and in particular focus on withdrawal-associated psychosis, cholinergic rebound, catatonia and serotonergic discontinuation symptoms. To date, there has been surprisingly little clinical guidance on how to minimise the likeliness of withdrawal symptoms in patients who are stopped on clozapine abruptly or gradually. We discuss the key outstanding questions in this area and why there is a need for guidance on the management of withdrawal symptoms associated with clozapine discontinuation.
Hepatic angiosarcoma: Pitfalls in establishing a diagnosis
Authors: Flabouris Katerina , McKeen Suzanne , Chaves Gomes Deborah , Chaudhuri Debajyoti , Russell Patrick
Published: September 2021

Hepatic angiosarcomas are rare, deceptive and aggressive malignancies that remain notoriously difficult to diagnose and treat. This case report discusses some of the common challenges faced by clinicians, and potential clinical, radiological and histological clues to this often elusive diagnosis.
Siliceous algae response to the “Great Acceleration” of the mid-20th century in Crawford Lake (Ontario, Canada): A potential candidate for the Anthropocene GSSP
Authors: Gushulak Cale AC , Marshall Matthew , Cumming Brian F , Llew-Williams Brendan , Timothy Patterson R , McCarthy Francine MG
Published: September 2021

Diatom and chrysophyte assemblages from varved sediments of meromictic Crawford Lake, Ontario record major environmental changes resulting from spatially broadening anthropogenic environmental stressors related to the “Great Acceleration” in the mid-20th century. Biannual assessment of diatom and chrysophyte assemblages over the last ~200 years allowed for rate of change analysis between adjacent samples that increased substantially during the mid-20th century, concurrent with significant generalized additive model trends. Changes in diatom and chrysophyte assemblages were likely driven by multiple anthropogenic stressors including local forestry harvesting, agriculture, and milling activities, acidic deposition from regional industrial processes, and anthropogenic climate warming. Novel siliceous algal assemblages now exist in Crawford Lake, likely related to the complexities of the above mentioned local and regional stressors. The major assemblage changes at the proposed base of the Anthropocene Epoch detected in this study support the laminated sequence from Crawford Lake as a strong potential candidate for the Anthropocene GSSP.
Ultrasound-guided erector spinae interfascial plane block for spinal surgery in three cats
Authors: Alza Salvatierra Diego N , Herrera Linares Manuel E , Motta Luca , Martinez Miguel
Published: September 2021

Case series summary

The erector spinae plane (ESP) block consists of an interfascial injection of local anaesthetic between the erector spinae muscle group and the transverse processes of the thoracic vertebrae. This block targets the dorsal rami of the thoracic spinal nerves to desensitise the cutaneous area near the dorsal midline, the paraspinal muscles, the dorsal vertebral laminae and the facet joints. The purpose of this case series is to describe the perioperative analgesic effect and complications of ultrasound-guided ESP block with bupivacaine in three cats undergoing spinal surgery. Only one cardiovascular response was recorded in this case series. Just one cat received intraoperative rescue analgesia. Cats 1 and 2 recorded just one high pain score in the first 24 h postoperatively, and cat 3 recorded three high pain scores. The total amount of methadone given in the 24 h postoperatively was 0.6 mg/kg in cat 1, 0.9 mg/kg in cat 2 and 0.8 mg/kg in cat 3. All three cats suffered mild and transient intraoperative complications, which were easily addressed. There were no postoperative complications.

Relevance and novel information

This case series documents a novel locoregional anaesthesia technique as an alternative to traditional systemic analgesia. The technique is part of a multimodal analgesia approach for spinal surgery in cats. Perioperative analgesic effect and complications presented in this case series are evaluated and discussed.
Abdominal Pain: A Silent and Unlikely Cause
Authors: Farraj Kristen , Sinha Atul , Kaliounji Aboud , Kagolanu Deepthi , Rizvon Kaleem , Subramani Krishnaiyer
Published: September 2021

While diverticulosis is a common phenomenon in the large intestine, it is a rare disease found in the small intestine accounting for only 0.06% to 1.3% of cases. Although most cases are asymptomatic, roughly 30% to 40%, it is crucial that it is on the differential of acute abdominal pain as it can be life-threatening and potentially require surgical management. Here, we describe a case of a 61-year-old Hispanic man who was found to have a perforated jejunal diverticula after initially presenting with left upper quadrant abdominal pain.
Impact of Pharmacist Involvement on the Utility of a Gram-Negative Blood Culture Identification Panel on Antimicrobial Usage
Authors: Bowman Caitlin , Holloway Melissa , Scott Lisa , Russell Carmen , Lott Sonia , Amin Raid
Published: September 2021

Background: A rapid molecular diagnostic test (MDT) is a test used to identify several different species of gram-negative bacteria and their genetic resistance markers. However, the impact of rapid MDT has not been established when combined with pharmacist involvement. Objective: To determine the impact of pharmacy involvement on patient outcomes when using rapid MDT. The primary outcome is the time from gram stain result to the first dose of the targeted antibiotic. Methods: This is a single-center, quasi-experimental, 1-group pretest-posttest design study of patients with gram-negative bacteremia in a community hospital. Hospitalized patients 18 years or older were included if they had a gram-negative blood culture. Patients were excluded if they were discharged or expired prior to culture results. Outcomes were compared between patients prior to and after implementation of the automated MDT. This research was determined to be exempt from institutional review board oversight consistent with West Florida Healthcare and in accordance with institutional policy. Results: The use of rapid MDT combined with pharmacist intervention resulted in a statistically significant decrease in the time to targeted antibiotic therapy (pre-intervention group, n = 77, 44.8 ± 17.8 hours versus post-intervention group, n= 80, 4.4 ± 5.8 hours; P ≤.001). There was no significant difference found between secondary outcomes. Limitations included small sample size as well as inconsistent documentation. Conclusions: The use of rapid MDT combined with pharmacist intervention resulted in a statistically significant decrease in the time to targeted antibiotic therapy.
Neural-Fuzzy-Based Adaptive Sliding Mode Automatic Steering Control of Vision-based Unmanned Electric Vehicles
Authors: Guo Jinghua , Li Keqiang , Fan Jingjing , Luo Yugong , Wang Jingyao
Published: September 2021

This paper presents a novel neural-fuzzy-based adaptive sliding mode automatic steering control strategy to improve the driving performance of vision-based unmanned electric vehicles with time-varying and uncertain parameters. Primarily, the kinematic and dynamic models which accurately express the steering behaviors of vehicles are constructed, and in which the relationship between the look-ahead time and vehicle velocity is revealed. Then, in order to overcome the external disturbances, parametric uncertainties and time-varying features of vehicles, a neural-fuzzy-based adaptive sliding mode automatic steering controller is proposed to supervise the lateral dynamic behavior of unmanned electric vehicles, which includes an equivalent control law and an adaptive variable structure control law. In this novel automatic steering control system of vehicles, a neural network system is utilized for approximating the switching control gain of variable structure control law, and a fuzzy inference system is presented to adjust the thickness of boundary layer in real-time. The stability of closed-loop neural-fuzzy-based adaptive sliding mode automatic steering control system is proven using the Lyapunov theory. Finally, the results illustrate that the presented control scheme has the excellent properties in term of error convergence and robustness.
Efficacy and safety of erenumab in Japanese migraine patients with prior preventive treatment failure or concomitant preventive treatment: subgroup analyses of a phase 3, randomized trial
Authors: Hirata Koichi , Sakai Fumihiko , Takeshima Takao , Imai Noboru , Matsumori Yasuhiko , Yoshida Ryuji , Numachi Yotaro , Peng Cheng , Mikol Daniel D. , Cheng Sunfa
Published: September 2021

Background

These subgroup analyses of a Phase 3, randomized, double-blind, placebo-controlled study evaluated the efficacy and safety of erenumab 70 mg in Japanese migraine patients with/without prior preventive treatment failure(s) (“failed-yes” and “failed-no” subgroups) and with/without concomitant preventive treatment (“concomitant preventive-yes” and “concomitant preventive-no” subgroups).

Methods

Overall, 261 patients were randomized; 130 and 131 patients to erenumab 70 mg and placebo, respectively. Subgroup analyses evaluated the change from baseline to Months 4–6 in mean monthly migraine days (MMD) (primary endpoint), achievement of a ≥50% reduction in mean MMD, and change from baseline in mean monthly acute migraine-specific medication (MSM) treatment days. Treatment-emergent adverse events were also evaluated.

Results

Of the 261 patients randomized, 117 (44.8%) and 92 (35.3%) patients were in the failed-yes and concomitant preventive-yes subgroups, respectively. Erenumab 70 mg demonstrated consistent efficacy across all subgroups, with greater reductions from baseline in mean MMD versus placebo at Months 4–6 (treatment difference versus placebo [95% CI], failed-yes: − 1.9 [− 3.3, − 0.4]; failed-no: − 1.4 [− 2.6, − 0.3]; concomitant preventive-yes: − 1.7 [− 3.3, 0.0]; concomitant preventive-no: − 1.6 [− 2.6, − 0.5]). Similar results were seen for achievement of ≥50% reduction in mean MMD and change from baseline in mean monthly acute MSM treatment days. The safety profile of erenumab 70 mg was similar across subgroups, and similar to placebo in each subgroup.

Conclusion

Erenumab was associated with clinically relevant improvements in all efficacy endpoints and was well tolerated across all subgroups of Japanese migraine patients with/without prior preventive treatment failure(s) and with/without concomitant preventive treatment.

Trial registration

Clinicaltrials.gov. NCT03812224. Registered January 23, 2019.
Return to physical activity and change in body mass index after hypoallergenic medial mobile-bearing unicompartmental knee arthroplasty
Authors: D’Ambrosi Riccardo , Nuara Alessandro , Mariani Ilaria , Corona Katia , Mogos Stefan , Catellani Francesco , Hantes Michael , Ursino Nicola
Published: September 2021

Background

The primary purpose of the present prospective study was to consecutively analyse the outcomes of the return to sports activity of patients with positive patch tests undergoing a medial mobile-bearing titanium niobium nitride (TiNbN) unicompartmental knee arthroplasty (UKA). The secondary purpose was to ascertain if a higher grade of physical activity leads to a reduction in the body mass index (BMI) of the patients.

Material and methods

Forty-one patients with positive skin patch tests were included in this prospective study. The clinical evaluation consisted of the University of California, Los Angeles (UCLA) activity scale and the High-Activity Arthroplasty Score (HAAS). Each patient was evaluated the day before surgery (T0), after 12.37 ± 0.70 months (T1), and on the day of the final follow-up, after 67.03 ± 18.2 months (T2). Furthermore, the BMI of each patient was analysed before surgery and during the final follow-up.

Results

The UCLA and HAAS mean preoperative values ranged from 3.68 ± 1.1.7 and 6.15 ± 0.76 to 6.1 ± 0.76 and 10.34 ± 1.3, respectively, at T1 (p < 0.0001) and to the final values of 6.34 ± 0.62 and 11.0 ± 8.9, respectively, at T2 (UCLA: T2 versus T1: p = 0.132; T2 versus T0: p < 0.0001; HAAS: T2 versus T1: p = 0.0027; T2 versus T0: p < 0.001). BMI ranged from a preoperative value of 27.97 ± 3.63 to a final value of 26.84 ± 3.11 (p < 0.0001). The only differences within the subgroups concerned patients with BMI ≥ 28, showing a superior HAAS at each follow-up (p < 0.05). A positive correlation was found between BMI and HAAS at T0 and T2 (p < 0.05).

Conclusions

This is the first study to evaluate the rate of the return to sports activities and change in BMI following hypoallergenic UKA. The majority of patients reduced their weight following UKA and improved their physical activity, showing outcomes that were comparable to the standard cobalt–chrome (CoCr) prostheses, regardless of gender, age, BMI and implant size.

Level of evidence

IV – Prospective Cohort Study.

Trial registration researchregistry5978—Research Registry www.researchregistry.com
Limited value of serum neutrophil-to-lymphocyte ratio in the diagnosis of chronic periprosthetic joint infection
Authors: Ye Yongyu , Chen Weishen , Gu Minghui , Liu Qiaoli , Xian Guoyan , Pan Baiqi , Zheng Linli , Chen Xiaoling , Zhang Ziji , Sheng Puyi
Published: September 2021

Background

Diagnosing chronic periprosthetic joint infection (PJI) is challenging. No single biomarker can accurately recognize PJI preoperatively in a timely manner. Therefore, the aim of the present study was to investigate the usefulness of the serum neutrophil-to-lymphocyte ratio (NLR) in aiding the diagnosis of chronic PJI.

Materials and methods

We retrospectively evaluated the medical records of 158 patients who had undergone revision arthroplasty (104 with aseptic mechanic failure and 54 with chronic PJI) from July 2011 to July 2020. Univariate analysis followed by multivariate logistic regression was applied to compare NLR, C-reactive protein (CRP), and erythrocyte sedimentation ratio (ESR) between the two groups. The receiver operating characteristic (ROC) curve was used to assess the diagnostic performance of NLR alone and in combination with CRP and ESR.

Results

NLR, CRP, and ESR were significantly higher in patients with chronic PJI than in the aseptic revision group (p < 0.05). ROC curve analysis revealed that NLR had a sensitivity of 57.41% and a specificity of 77.88% with an optimal threshold of 2.56. The optimal threshold for CRP and ESR was 7.00 mg/L (sensitivity 62.50% and specificity 83.12%) and 43 mm/h (sensitivity 59.38% and specificity 80.52%), respectively. The combined diagnostic value of NLR with CRP and ESR was shown to have no additional diagnostic value in predicting chronic PJI.

Conclusion

Compared with traditional inflammatory biomarkers (ESR and CRP), the value of serum NLR alone or combined with CRP and ESR for diagnosing chronic PJI is limited.

Level of evidence

Level 3.
DELEAT: gene essentiality prediction and deletion design for bacterial genome reduction
Authors: Solana Jimena , Garrote-Sánchez Emilio , Gil Rosario
Published: September 2021

Background

The study of gene essentiality is fundamental to understand the basic principles of life, as well as for applications in many fields. In recent decades, dozens of sets of essential genes have been determined using different experimental and bioinformatics approaches, and this information has been useful for genome reduction of model organisms. Multiple in silico strategies have been developed to predict gene essentiality, but no optimal algorithm or set of gene features has been found yet, especially for non-model organisms with incomplete functional annotation.

Results

We have developed DELEAT v0.1 (DELetion design by Essentiality Analysis Tool), an easy-to-use bioinformatic tool which integrates an in silico gene essentiality classifier in a pipeline allowing automatic design of large-scale deletions in any bacterial genome. The essentiality classifier consists of a novel logistic regression model based on only six gene features which are not dependent on experimental data or functional annotation. As a proof of concept, we have applied this pipeline to the determination of dispensable regions in the genome of Bartonella quintana str. Toulouse. In this already reduced genome, 35 possible deletions have been delimited, spanning 29% of the genome.

Conclusions

Built on in silico gene essentiality predictions, we have developed an analysis pipeline which assists researchers throughout multiple stages of bacterial genome reduction projects, and created a novel classifier which is simple, fast, and universally applicable to any bacterial organism with a GenBank annotation file.
Fast and exact quantification of motif occurrences in biological sequences
Authors: Prosperi Mattia , Marini Simone , Boucher Christina
Published: September 2021

Background

Identification of motifs and quantification of their occurrences are important for the study of genetic diseases, gene evolution, transcription sites, and other biological mechanisms. Exact formulae for estimating count distributions of motifs under Markovian assumptions have high computational complexity and are impractical to be used on large motif sets. Approximated formulae, e.g. based on compound Poisson, are faster, but reliable p value calculation remains challenging. Here, we introduce ‘motif_prob’, a fast implementation of an exact formula for motif count distribution through progressive approximation with arbitrary precision. Our implementation speeds up the exact calculation, usually impractical, making it feasible and posit to substitute currently employed heuristics.

Results

We implement motif_prob in both Perl and C+ + languages, using an efficient error-bound iterative process for the exact formula, providing comparison with state-of-the-art tools (e.g. MoSDi) in terms of precision, run time benchmarks, along with a real-world use case on bacterial motif characterization. Our software is able to process a million of motifs (13–31 bases) over genome lengths of 5 million bases within the minute on a regular laptop, and the run times for both the Perl and C+ + code are several orders of magnitude smaller (50–1000× faster) than MoSDi, even when using their fast compound Poisson approximation (60–120× faster). In the real-world use cases, we first show the consistency of motif_prob with MoSDi, and then how the p-value quantification is crucial for enrichment quantification when bacteria have different GC content, using motifs found in antimicrobial resistance genes. The software and the code sources are available under the MIT license at https://github.com/DataIntellSystLab/motif_prob.

Conclusions

The motif_prob software is a multi-platform and efficient open source solution for calculating exact frequency distributions of motifs. It can be integrated with motif discovery/characterization tools for quantifying enrichment and deviation from expected frequency ranges with exact p values, without loss in data processing efficiency.
A complete mitochondrial genome for fragrant Chinese rosewood (Dalbergia odorifera, Fabaceae) with comparative analyses of genome structure and intergenomic sequence transfers
Authors: Hong Zhou , Liao Xuezhu , Ye Yuanjun , Zhang Ningnan , Yang Zengjiang , Zhu Weidong , Gao Wei , Sharbrough Joel , Tembrock Luke R. , Xu Daping , Wu Zhiqiang
Published: September 2021

Background

Dalbergia odorifera is an economically and culturally important species in the Fabaceae because of the high-quality lumber and traditional Chinese medicines made from this plant, however, overexploitation has increased the scarcity of D. odorifera. Given the rarity and the multiple uses of this species, it is important to expand the genomic resources for utilizing in applications such as tracking illegal logging, determining effective population size of wild stands, delineating pedigrees in marker assisted breeding programs, and resolving gene networks in functional genomics studies. Even the nuclear and chloroplast genomes have been published for D. odorifera, the complete mitochondrial genome has not been assembled or assessed for sequence transfer to other genomic compartments until now. Such work is essential in understanding structural and functional genome evolution in a lineage (Fabaceae) with frequent intergenomic sequence transfers.

Results

We integrated Illumina short-reads and PacBio CLR long-reads to assemble and annotate the complete mitochondrial genome of D. odorifera. The mitochondrial genome was organized as a single circular structure of 435 Kb in length containing 33 protein coding genes, 4 rRNA and 17 tRNA genes. Nearly 4.0% (17,386 bp) of the genome was annotated as repetitive DNA. From the sequence transfer analysis, it was found that 114 Kb of DNA originating from the mitochondrial genome has been transferred to the nuclear genome, with most of the transfer events having taken place relatively recently. The high frequency of sequence transfers from the mitochondria to the nuclear genome was similar to that of sequence transfer from the chloroplast to the nuclear genome.

Conclusion

For the first-time, the complete mitochondrial genome of D. odorifera was assembled in this study, which will provide a baseline resource in understanding genomic evolution in the highly specious Fabaceae. In particular, the assessment of intergenomic sequence transfer suggests that transfers have been common and recent indicating a possible role in environmental adaptation as has been found in other lineages. The high turnover rate of genomic colinearly and large differences in mitochondrial genome size found in the comparative analyses herein providing evidence for the rapid evolution of mitochondrial genome structure compared to chloroplasts in Faboideae. While phylogenetic analyses using functional genes indicate that mitochondrial genes are very slowly evolving compared to chloroplast genes.