bluuebunny/crossref_metadata_2025_split huggingface dataset:
A rare case of retained sabot after close-range shotgun injury
Authors: Flippin J. Alford , Kishawi Sami , Braunstein Hannah , Lasinski Alaina M. 
Published: June 2021

Abstract
Background
Shotgun injuries are a relatively uncommon type of trauma, and therefore may present a challenge in management for trauma surgeons. This is particularly true in the case of surgeons unfamiliar with the unique characteristics of shotgun wounds and the mechanics of shotguns. In many cases, the shot pellets are the primary source of injury. However, a broad understanding of shotgun mechanics is important in recognizing alternative presentations. This article details a case of sabot (a stabilization device used with certain projectiles) retention after a close-range shotgun injury, reviews underlying shotgun mechanics, and discusses strategies for the detection and mitigation of these injuries. The aim of this case report is to increase awareness of and reduce the potential morbidity of close-range shotgun injuries.

Case presentation
A middle-aged female presented to the Emergency Department with wounds to her right hip and flank after suffering a shotgun injury. A contrast computed tomography scan demonstrated no evidence of hollow viscous or vascular injury, but was otherwise severely limited by scatter artifact from the numerous embedded pellets. The patient was admitted for wound care and discharged 2 days later with a clean wound bed and no evidence of tissue necrosis. Six days after injury, she reported an “unusual” smell associated with severe pain in her right hip wound. She was evaluated in clinic where examination revealed a retained foreign body, identified to be a shotgun shell sabot, which was removed in clinic. She presented again several days before scheduled follow-up with a persistent foul smell from her wound and was noted to have necrotic tissue at the base and margins of the wound that required hospital readmission for operative debridement and closure with negative pressure wound therapy. The patient had an uncomplicated recovery after surgical debridement.

Conclusions
Although shotgun sabot penetration and retention are rare, they are associated with significant morbidity. Sabot penetration should be considered if injury narrative, physical examination, or radiographic characteristics indicate a distance from shotgun to patient of less than 2 m. A high degree of suspicion is indicated at less than 1 m.
Flavonoids, alkaloids and saponins: are these plant-derived compounds an alternative to the treatment of rheumatoid arthritis? A literature review
Authors: Santiago Luis Ângelo Macedo , Neto Roberval Nascimento Moraes , Santos Ataíde Ana Caroline , Fonseca Dâmaris Cristina Sousa Carvalho , Soares Enio Fernandes Aragão , de Sá Sousa Joicy Cortez , Mondego-Oliveira Renata , Ribeiro Rachel Melo , de Sousa Cartágenes Maria do Socorro , Lima-Neto Lídio Gonçalves , Carvalho Rafael Cardoso , de Sousa Eduardo Martins 
Published: June 2021

AbstractRheumatoid arthritis (RA) is a systemic inflammatory disease characterized by synovial inflammation leading to progressive joint erosion and, eventually, joint deformities. RA treatment includes anti-inflammatories, corticosteroids, synthetic disease-modifying antirheumatic drugs (DMARDs), and immunosuppressants. Drug administration is associated with adverse reactions, as gastrointestinal ulcers, cardiovascular complications, and opportunistic infections. Wherefore, different plant-derived phytochemical compounds are studied like new therapeutic approach to treatment of RA. Among the phytochemical compounds of plants for treatment of RA, flavonoids, alkaloids and saponins are related for present anti-inflammatory activity and act as physiological and metabolic regulators. They have low toxicity compared to other active plant compounds, so their therapeutic properties are widely studied. The intention of the review is to present an overview of the therapeutics of flavonoids, alkaloids, and saponins for RA. An extensive literature survey was undertaken through different online platforms:PubMed, SciELO, and Virtual Health Library databases, to identify phytochemical compounds used in RA treatment and the descriptors used were medicinal plants, herbal medicines, and rheumatoid arthritis. Seventy-five research and review articles were found to be apt for inclusion into the review. The present study summarizes the phytochemicals isolated from plants that have therapeutic effects on RA models, in vitro and in vivo. The studied substances exerted anti-inflammatory, chondroprotective, immunoregulatory, anti-angiogenic, and antioxidant activities and the most compounds possess good therapeutic properties, valuable for further research for treatment of RA.
How to foster successful implementation of a patient reported experience measurement in the disability sector: an example of developing strategies in co-creation
Authors: van Rooijen Marjolein , van Dijk-de Vries Anneke , Lenzen Stephanie , Dalemans Ruth , Moser Albine , Beurskens Anna 
Published: June 2021

Abstract
Background
The integrated uptake of patient-reported experience measures, using outcomes for the micro, meso and macro level, calls for a successful implementation process which depends on how stakeholders are involved in this process. Currently, the impact of stakeholders on strategies to improve the integrated use is rarely reported, and information about how stakeholders can be engaged, including care-users who are communication vulnerable, is limited. This study illustrates the impact of all stakeholders on developing tailored implementation strategies and provides insights into supportive conditions to involve care-users who are communication vulnerable.

Methods
With the use of participatory action research, implementation strategies were co-created by care-users who are communication vulnerable (n = 8), professionals (n = 12), management (n = 6) and researchers (n = 5) over 9 months. Data collection consisted of audiotapes, reports, and researchers’ notes. Conventional content analysis was performed.

Results
The impact of care-users concerned the strategies’ look and feel, understandability and relevance. Professionals influenced impact on how to use strategies and terminology. The impact of management was on showing the gap between policy and practice, and learning from previous improvement failures. Researchers showed impact on analysis, direction of strategy changes and translating academic and development experience into practice. The engagement of care-users who are communication vulnerable was supported, taking into account organisational issues and the presentation of information.

Conclusions
The impact of all engaged stakeholders was identified over the different levels strategies focused on. Care-users who are communication vulnerable were valuable engaged in co-creation implementation strategies by equipping them to their needs and routines, which requires adaptation in communication, delimited meetings and a safe group environment.

Trial registration
Reviewed by the Medical Ethics Committee of Zuyderland-Zuyd (METCZ20190006). NL7594 registred at https://www.trialregister.nl/.
Response of sweet pepper plants to foliar application of compost tea and dry yeast under soilless conditions
Authors: Abd-Alrahman Hanaa Ali , Aboud Fatma Sayed 
Published: June 2021

Abstract
Background
Sweet pepper is considered one of the most important vegetable crops cultivated for local consumption and exportation. Under greenhouse conditions, the effects of different rates of yeast and compost tea on vegetative growth, leaves mineral content, fruit yield and quality were studied for two consecutive years 2018/2019 and 2019/2020 under soilless conditions. Nine treatments of compost tea (CT) and or dry yeast (DY) were applied using control (sprayed with distilled water); CT (10L/fed.); CT (20 L/fed.); DY (3 g/L); DY (6 g/L); CT (10L/fed.) + DY (3 g/L); CT (20L/fed.) + DY (3 g/L); CT (10L/fed.) + DY (6 g/L) and CT (20L/fed.) + DY (6 g/L).

Results
Results showed that the mixture of compost tea and dry yeast at a rate of 20 L./fed. plus 6 g/L, respectively, had significantly increased vegetative growth, fruit physical quality (length, diameter and fresh weight), total yield, leaves mineral content (N, P and K) and fruit nutritional value content (calcium and vitamin C). The maximum return or profit comes from the CT (20 L/fed) + DY (6 g/L) followed by CT (20 L/fed) + DY (3 g/L.)

Conclusion
It is clear that all treatments enhanced the yield and the fruit physical parameters of the studied plants as well as all treatments are economically feasible including the control treatment. However, looking at the Revenue/Cost ratio (R/C), one can find that the maximum net revenue comes from the mixture of CT (20 L/fed) plus DY (6 g/L) with a net revenue about 192.72 L.E./m2 and R/C ratio of 1.90, followed by CT (20 L/fed) + DY (3 g/L.).
Small bowel obstruction due to internal herniation through a defect in the falciform ligament: a rare case report and review of the literature
Authors: Esmat Habib Ahmad , Naseri Mohammad Wali 
Published: June 2021

Abstract
Background
The falciform ligament hernia is a type of internal herniation, caused by a defect in the falciform ligament of the liver. The etiology for this defect may be congenital or iatrogenic, created after the laparoscopic intervention.

Case presentation
A 45-year-old male was presented to our hospital, complaining of abdominal pain for 2 days. The physical examination revealed diffuse abdominal tenderness and guarding. The abdominal X-ray was suggestive of intestinal obstruction. On abdominal CT images, dilated proximal ileal loops between the left hepatic lobe and anterior abdominal wall, forming a closed-loop with mesenteric edema and fat stranding, were observed. There were findings of ileus in the jejunal loops proximal to this segment, but the ileal loops and the colon were completely collapsed, consistent with small bowel obstruction due to internal herniation through a defect in the falciform ligament. The patient underwent surgical intervention, reduction of the herniated bowel loops, and repairing the hernia defect. He had an uneventful recovery with a favorable outcome.

Conclusion
Herniation through a defect in the falciform ligament is extremely rare but should be considered in the differential diagnosis of acute abdomen. The clinical manifestations of falciform ligament hernia are nonspecific and may underestimate the diagnosis, leading to a delayed treatment that affects the management outcome. Computed tomography plays an important role in the timely diagnosis and planning of surgical intervention, precluding intestinal strangulation.
Respiratory coinfections in COVID-19 patients evaluated by BioFire Pneumonia Panel
Authors: Assal Hebatallah Hany , Salah Maged , Ibrahim Ayman Kamal , Alfishawy Mostafa , Khater Rawia , Masoud Hossam Hosny , Eldemerdash Ahmed Monier , AbdelHalim Mohamed Ali 
Published: June 2021

Abstract
Background
Routine administration of antibacterials in patients with Covid-19 has been a subject of debate, with no solid data about the true prevalence of respiratory coinfections in Covid-19 patients in different geographic areas. The aim of the current study was to identify respiratory coinfections in Covid-19 patients admitted to the hospital and to identify its genetic resistance pattern using the respiratory multiplex polymerase chain reaction (PCR).

Results
The study included 40 patients, 32 males (80%) and 8 (20%) females with a mean age of 59.3 ± 12.6. Half of the patients had respiratory bacterial coinfections documented by pneumonia (PN) panel. The most common isolate was Klebsiella pneumoniae (10/20, 50%), followed by Acinetobacter calcoaceticus baumanni complex (7/20, 35%). Regarding genetic resistance, thirteen (13/20, 65%) isolates were proven extended spectrum beta lactamase (ESBL)-producing Enterobacteriaceae. Thirteen (13/20, 65%) isolates were proven carbapenemase-producing organisms testing positive for New Delhi metallo-β-lactamase (NDM), oxacillinase β-lactamases (OXA-48), and Verona Integron-Encoded Metallo-β-Lactamase (VIM) (7/20, 35%; 5/20, 25%; 1/20, 5%, respectively). The four isolated Staphylococcus aureus were methicillin-resistant (4/20, 20%).

Conclusion
In our cohort, there was 50% rate of bacterial respiratory coinfection in patients with severe Covid-19 admitted to the ICU with high rates of carbapenemase-producing gram-negative bacteria that required escalation of antibacterials and represented a challenge to clinicians.
Molecular detection of porcine circovirus type 3 in Shanxi Province, China
Authors: Yue Weidong , Liu Yihui , Zhang Xinrong , Ma Haili , He Junping 
Published: June 2021

AbstractPorcine circovirus type 3 (PCV3), which was first detected in the United States of America in 2015, is a potential threat to the swine industry. However, the prevalence of PCV3 in Shanxi Province, China, is unclear. In this research, the prevalence and genetic diversity of PCV3 were investigated in above area. Lung tissue samples (n = 491) from 19 pig slaughterhouses across 11 cities throughout Shanxi Province were analyzed for PCV3 infection by PCR in 2019. The results showed that PCV3 positive rates in slaughterhouses and individuals were 100% (19/19) and 86.76% (426/491), respectively. PCV2 and PCV3 double-positive rates in slaughterhouses and individuals were 100% (19/19) and 59.27% (291/491), respectively. PCR positive samples were further sequenced and 8 PCV3 isolates were identified. The nucleotide homology of these isolates with other PCV3 isolates in NCBI database was 97.45–99.90%. A phylogenetic analysis, based on the complete genomic sequence and ORF2, divided these PCV3 strains into 2 major groups. Based on A24/V and R27/K amino acid mutations of capsid protein, the 8 identified PCV3 strains were separated to 2 clades. This was the first detailed investigation into the epidemiology of PCV3 in Shanxi Province. Our findings enabled us to assess the possibility of widespread transmission from this region. Thus, current findings establish a basis for further studies of genetic variations in PCV3 strains circulating in China.
‘Five hours to sort out your life’: qualitative study of the experiences of university students who access mental health support
Authors: Barnett Phoebe , Arundell Laura-Louise , Matthews Hannah , Saunders Rob , Pilling Stephen 
Published: June 2021

Background
Previous qualitative research suggests that university students feel that current service provision does not meet their needs. Exploring the reasons for this may help to promote service change, encourage the uptake of care, improve outcomes and increase satisfaction within university services.

Aims
This study aimed to improve the understanding of how students experience the process of accessing and using mental health support, barriers and facilitators to treatment, and how students would adapt provision to improve experiences.

Method
Semi-structured interviews were conducted with 16 full-time students who had used mental health services at university. Data were analysed using thematic analysis.

Results
Five higher-order themes were identified: personalisation and informed choice, simplifying the process, feeling abandoned ignored or invisible, stigma, and superiority of private and external services. Sixteen subthemes were identified within these themes.

Conclusions
Findings indicate that access to mental health support should be simplified, with collaboration across university and external health and care services, to prevent students feeling lost or abandoned when seeking care. An inclusive approach to support access and provision of services for all presentations of mental health problems should be developed.
Salivary Profiles of 11-oxygenated Androgens Follow a Diurnal Rhythm in Patients With Congenital Adrenal Hyperplasia
Authors: Nowotny Hanna Franziska , Auer Matthias K , Lottspeich Christian , Schmidt Heinrich , Dubinski Ilja , Bidlingmaier Martin , Adaway Jo , Hawley James , Keevil Brian , Reisch Nicole 
Published: June 2021

Abstract

Context
Several studies have highlighted the importance of the 11-oxygenated 19-carbon (11oxC19) adrenal-derived steroids as potential biomarkers for monitoring patients with 21-hydroxylase deficiency (21OHD).

Objective
To analyze circadian rhythmicity of 11oxC19 steroids in saliva profiles and evaluate their relevance as potential monitoring parameters in 21OHD.

Design, Setting, and Participants
Cross-sectional single-center study including 59 patients with classic 21OHD (men = 30; women = 29) and 49 body mass index- and age-matched controls (men = 19; women = 30).

Outcome Measures
Salivary concentrations of the following steroids were analyzed by liquid chromatography-tandem mass spectrometry: 17-hydroxyprogesterone (17OHP), androstenedione (A4), testosterone (T), 11β-hydroxyandrostenedione (11OHA4), and 11-ketotestosterone (11KT).

Results
Similar to the previously described rhythmicity of 17OHP, 11OHA4 and 11KT concentrations followed a distinct diurnal rhythm in both patients and controls with highest concentrations in the early morning and declining throughout the day (11-OHA4: mean reduction of hormone concentrations between timepoint 1 and 5 (Δ mean) in male patients = 66%; male controls Δ mean = 83%; female patients Δ mean = 47%; female controls Δ mean = 86%; 11KT: male patients Δ mean = 57%; male controls Δ mean = 63%; female patients Δ mean = 50%; female controls Δ mean = 76%). Significant correlations between the area under the curve for 17OHP and 11KT (rpmale = 0.773&lt;0.0001; rpfemale = 0.737&lt;0.0001), and 11OHA4 (rpmale = 0.6330.0002; rpfemale = 0.5640.0014) were observed in patients but not present or reduced in controls.

Conclusions
Adrenal 11oxC19 androgens are secreted following a diurnal pattern. This should be considered when evaluating their utility for monitoring treatment control.
Engendering Protest and Rethinking “Azadi” in Kashmir in Vishal Bhardwaj’s Haider
Authors: Sarkar Sreyoshi 
Published: June 2021

Abstract
Women living in the South Asian conflict zone of Kashmir have been represented by mainstream media and film as mainly victims of the Indian state power’s political and sexual violence, as protestors who are supporting their men’s insurgency in Kashmir, or as aligned with local Islamic militant groups. This obscures their nuanced testimonies, political objectives, and multivalent agencies within the conflict zone. The author shows how Vishal Bharadwaj’s 2014 film Haider, an adaptation of Shakespeare’s Hamlet, disrupts such erasures to highlight Kashmiri women’s lived experiences in the conflict zone at intersections of everyday and extraordinary violence. By close reading scenes from the film via cinematic structure, dialogue, acting, camerawork, and mise-en-scène, the author shows how Haider not only mounts a scathing critique of the Indian occupation of Kashmir but also underscores the need for more capacious considerations of postcolonial feminisms as emergent from lived experiences versus adhering to established checklists approved by Euro-American feminism. The film’s investments in its female protagonists—Ghazala and Arshia—more than the men also uncovers the former’s redefinitions of azadi (freedom) as not just about Kashmiri political autonomy from India and Pakistan but also about nonviolence, equality, and justice for women and by extension all marginalized populations in Kashmir.
Ethical Reckoning
Authors: Chowdhury Elora Halim 
Published: June 2021

AbstractIn this article the author builds on the idea of Bangladeshi national cinema as human rights cinema to explore its role in documenting and engendering understanding about women, vulnerability, and agency within a Muktijuddho gender ideology. Drawing from feminist sociologist Patricia Hill Collins’s conceptualization of a Black gender ideology, the author proposes that in cinematic traditions, an idealized Muktijuddho gender ideology influences and entrenches gendered social norms and reinforces perceptions of masculinity and femininity in war. These perceptions serve to justify patterns of legibility, recognition, and rejection for discursive practices of national inclusion and exclusion. Specifically, the author analyzes Nasiruddin Yousuff’s Guerrilla (2011), an award-winning film featuring the story of Bilqis Banu, a middle-class, Muslim female combatant who takes on at once the national struggle for self-determination and the gender struggle against patriarchal cultural norms. The film opens up new ways of imagining the category birangona and elicits a deeper appreciation of differentiated agency, vulnerability, and humanity.
Ronin overexpression induces cerebellar degeneration in a mouse model of ataxia
Authors: Zwaka Thomas P. , Skowronska Marta , Richman Ronald , Dejosez Marion 
Published: June 2021

ABSTRACT
Spinocerebellar ataxias (SCAs) are a group of genetically heterogeneous inherited neurodegenerative disorders characterized by progressive ataxia and cerebellar degeneration. Here, we used a mouse model to test a possible connection between SCA and Ronin (Thap11), a polyglutamine-containing transcriptional regulator encoded in a region of human chromosome 16q22.1 that has been genetically linked to SCA type 4. We report that transgenic expression of Ronin in mouse cerebellar Purkinje cells leads to detrimental loss of these cells and the development of severe ataxia as early as 10 weeks after birth. Mechanistically, we find that several SCA-causing genes harbor Ronin DNA-binding motifs and are transcriptionally deregulated in transgenic animals. In addition, ectopic expression of Ronin in embryonic stem cells significantly increases the protein level of Ataxin-1, the protein encoded by Atxn1, alterations of which cause SCA type 1. This increase is also seen in the cerebellum of transgenic animals, although the latter was not statistically significant. Hence, our data provide evidence for a link between Ronin and SCAs, and suggest that Ronin may be involved in the development of other neurodegenerative diseases.
A mechanism linking perinatal 2,3,7,8 tetrachlorodibenzo-p-dioxin exposure to lower urinary tract dysfunction in adulthood
Authors: Turco Anne E. , Oakes Steven R. , Keil Stietz Kimberly P. , Dunham Cheryl L. , Joseph Diya B. , Chathurvedula Thrishna S. , Girardi Nicholas M. , Schneider Andrew J. , Gawdzik Joseph , Sheftel Celeste M. , Wang Peiqing , Wang Zunyi , Bjorling Dale E. , Ricke William A. , Tang Weiping , Hernandez Laura L. , Keast Janet R. , Bonev Adrian D. , Grimes Matthew D. , Strand Douglas W. , Tykocki Nathan R. , Tanguay Robyn L. , Peterson Richard E. , Vezina Chad M. 
Published: June 2021

ABSTRACTBenign prostatic hyperplasia/lower urinary tract dysfunction (LUTD) affects nearly all men. Symptoms typically present in the fifth or sixth decade and progressively worsen over the remainder of life. Here, we identify a surprising origin of this disease that traces back to the intrauterine environment of the developing male, challenging paradigms about when this disease process begins. We delivered a single dose of a widespread environmental contaminant present in the serum of most Americans [2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD), 1 µg/kg], and representative of a broader class of environmental contaminants, to pregnant mice and observed an increase in the abundance of a neurotrophic factor, artemin, in the developing mouse prostate. Artemin is required for noradrenergic axon recruitment across multiple tissues, and TCDD rapidly increases prostatic noradrenergic axon density in the male fetus. The hyperinnervation persists into adulthood, when it is coupled to autonomic hyperactivity of prostatic smooth muscle and abnormal urinary function, including increased urinary frequency. We offer new evidence that prostate neuroanatomical development is malleable and that intrauterine chemical exposures can permanently reprogram prostate neuromuscular function to cause male LUTD in adulthood.