bluuebunny/crossref_metadata_2025_split huggingface dataset:
First Report of Mycosphaerella dearnessii, Teleomorph of Lecanosticta acicola, in Europe
Authors: Mesanza Nebai , Hernández Mónica , Raposo Rosa , Iturritxa Eugenia 
Published: July 2021

Conifers severely affected by brown needle blight disease caused by the ascomycete Lecanosticta acicola (Thüm.) Syd. show defoliation, reduced growth, and death. Although L. acicola has been known in Europe since 1942, its teleomorph, Mycosphaerella dearnessii Rostrup, has not yet been found. In this brief, we address the occurrence of Mycosphaerella dearnessii in dead needles cast from Pinus radiata D. Don collected in the north of Spain (Basque country). To our knowledge, this is the first report of M. dearnessii, teleomorph of L. acicola, in Europe.
Admission Hyperglycemia Is a Risk Factor for Deep Surgical-Site Infection in Orthopaedic Trauma Patients
Authors: Anderson Braden M. , Wise Brent T. , Joshi Manjari , Castillo Renan , O'Toole Robert V. , Richards Justin E. 
Published: July 2021

Objectives:
To evaluate the association of admission blood glucose ≥200 mg/dL and surgical site infection in orthopaedic trauma surgery.

Design:
Retrospective, case control study.

Setting:
Academic trauma center.

Patients:
Four hundred sixty-five nondiabetic, noncritically ill orthopaedic trauma patients with an extremity, pelvic, or acetabular fracture and requiring open reduction and internal fixation or intramedullary nailing.

Intervention:
None.

Main Outcome Measurements:
Ninety-day deep surgical site infection.

Results:
Admission blood glucose ≥200 mg/dL was significantly associated with the primary outcome (8/128, 6.3% vs. 35/337, 1.8%; P = 0.01). Multivariable logistic regression modeling demonstrated that admission blood glucose ≥200 mg/dL was a significant risk factor for deep surgical site infections [odds ratio (OR): 4.7, 95% confidence interval (CI) 1.4–15.7], after controlling for male gender (OR: 1.8, 95% CI: 1.1–3.1), prior drug or alcohol abuse (OR: 1.9, 95% CI 0.9–4.0), open fracture (OR: 6.4, 95% CI 3.7–11.0), and fracture region (upper extremity OR: reference; pelvis/hip OR: 3.9, 95% CI 1.6–9.7; femur OR: 2.0, 95% CI 0.88–4.8; tibia/ankle OR: 3.3, 95% CI 1.7–6.2; and foot OR: 2.7, 95% CI 1.2–6.3).

Conclusions:
Admission glucose ≥200 mg/dL was a significant independent risk factor for 90-day deep surgical site infections in orthopaedic trauma patients and may serve as an important marker for infection risk.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Periprosthetic Supracondylar Femoral Fractures Above a Total Knee Replacement: An Updated Compatibility and Technique Guide for Fixation With a Retrograde Intramedullary Nail
Authors: Gerow Daniel E. , Ross Hunter L. , Bodrogi Andrew , Johnson Kory J. , Endres Terrence J. 
Published: July 2021

Background:
Multiple studies have described retrograde nailing as a treatment of periprosthetic supracondylar femoral fractures (OTA/AO type 33A-C) above total knee replacements (TKRs). It is often difficult to discern which TKRs will be compatible with intramedullary nailing because the femoral component design and intercondylar distance is highly variable among total knee designs. The goal of our study is 3-fold: (1) Review and update previous work of intercondylar distances of all currently available prostheses in the United States. (2) Review retrograde nails currently on the market and associated driving end to nail shaft diameter mismatch and opening reamer sizing. (3) Review technical tricks for executing a retrograde femoral nail for the treatment of periprosthetic supracondylar femur fractures.

Methods:
Data for the intercondylar distance of the femoral components, diameter of retrograde nails and reamers, and notch compatibility were gathered.

Results:
The results were compiled and recorded. A “technical tricks” section was included that highlights reduction and fixation techniques.

Conclusions:
This update further empowers surgeons to use all the tools available when treating periprosthetic femur fractures and allows efficient identification of the compatibility of different TKR designs with various intramedullary nails.

Level of Evidence:
Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.
Virtual Coordinate System in Unicoronal Synostosis
Authors: Lu Xiaona , Jorge Forte Antonio , Persing John A. 
Published: July 2021

Background:
We propose a landmark-based, virtual coordinate system, specifically designed for assessment of asymmetrical craniofacial anatomy associated with unicoronal synostosis.

Method:
CT scans of 33 patients with nonsyndromic unicoronal synostosis were included. Proposed mid-sagittal plane was compared with commonly used sagittal planes: (1) nasion, sella, and basion (N-S-BA); (2) midplane of bilateral frontozygomatic sutures (midFZ); and (3) the skull gravity center plane, to evaluate reliability and validity in the assessments of the anterior and posterior skull base.

Results:
The proposed midplane is similar to the midFZ plane in describing the direction of the anterior skull base. However, it has less bias than the N-S-BA (P < 0.001), and the gravity center planes (P < 0.001). The proposed midplane measures the direction of the posterior skull base plane, similar to the midFZ and gravity center planes, but it has less measurement deviation than the N-S-BA plane (P < 0.001). The most protrusive point on the frontal bone in unicoronal patients is contralateral to the fused suture and distant from the mid-sagittal plane by 13.93 ± 4.01 mm. In addition, it is more anteriorly positioned, by 5.32 mm (P < 0.001), when compared with the corresponding point on the synostotic side. The uppermost point of the supraorbital rim on the synostotic side is cephalic to that of the contralateral side by 4.09 mm (P < 0.001).

Conclusions:
Prioritized orientation of an averaged Frankfort horizontal plane, followed by the location of the mid-sagittal and coronal planes, can generate a reliable and valid coordinate framework for the assessment of asymmetric skull shape in unicoronal synostosis.
Surgical Management of Chronic Encapsulated Abdominal Wall Seroma 8 Years after Abdominoplasty
Authors: Morris Bryn E. , Thornburg Danielle A. , Teven Chad M. , Kruger Erwin A. 
Published: July 2021

Summary:
Seroma is a common complication of body-contouring surgery. Current literature focuses on prevention or initial management of seroma formation; however, no definitive evidence exists to guide management of chronic or recurrent seromas. We describe a case of a recurrent abdominal wall seroma following abdominoplasty. The seroma was present for 8 years despite employing multiple treatment modalities. After presentation to our clinic, the patient was taken to the operating room, where the seroma pseudocapsule was excised, progressive tension sutures were utilized, and drains were placed. To date, there has been no recurrence of the seroma. We propose that chronicity, recurrence, and persistence of seroma are indications for surgical intervention.
Attitudes of Canadian Plastic Surgeons on Temporal Artery Biopsy in Giant Cell Arteritis Management
Authors: Lafreniere Ann-Sophie , Hartley Rebecca , Ponich Brett , Nickerson Duncan , Temple-Oberle Claire F. 
Published: July 2021

Background:
Temporal artery biopsies (TAB) rarely impact management of patients with suspected giant cell arteritis and carry complications. We sought plastic surgeons’ perspectives on this procedure’s risks and benefits.

Methods:
An email survey was designed, piloted, and refined to elicit Canadian Society of Plastic Surgeons (CSPS) members about TAB’s diagnostic contribution, complications, usefulness as a resident education tool, and surgeons’ insight into emerging diagnostic modalities like ultrasound. Text comments were sought at each question. A reminder was emailed one week later. Data was compared and analyzed using the chi-squared test and student t-test.

Results:
An estimated 83 responses were received from 435 surgeons (19%). Of the surgeons, 20% voiced uncertainty regarding TAB indications; 40% were unsure if TAB results changed steroid duration and dose; 83% did not see patients postoperatively. Surgeons recalled 29 cases of hematoma and three facial nerve injuries from TAB. In total, 80% felt TAB was a valuable learning opportunity for residents, although residents were involved in only 21% of cases; 65% of surgeons supported a changeover to ultrasound as primary diagnostic modality. Analysis of text comments revealed a sense of futility from TAB and disdain toward being mere technicians. Several participants wished for stakeholders to collaborate and potentially endorse noninvasive diagnostic modalities.

Conclusions:
This survey demonstrated varying attitudes to TAB. Generally, plastic surgeons were uncertain of TAB’s contribution to treatment, tended not to follow-up on results or patients, and recognized a number of complications. Conversations are desired regarding switching from scalpel to probe to evaluate the temporal artery.
Frozen Shoulder Related to Influenza Vaccine Administration
Authors: Waninger Kevin N. , Slenker Nicholas 
Published: July 2021

Abstract:
Shoulder pain is often a transient physical finding after vaccination. We present the case of a 46-year-old woman who presented clinically with frozen shoulder that was progressively worse and temporally related to her yearly influenza vaccination. The patient failed conservative management, and 7 months postvaccination, the patient underwent shoulder manipulation under anesthesia with good results. Vaccination-related shoulder dysfunction after high-deltoid intramuscular penetration and infiltration into the subdeltoid/subacromial bursa can cause a severe local inflammatory response that clinically may present as frozen shoulder. A case report and review of the literature on suspected frozen shoulder injury related to vaccine administration is presented. A greater understanding of the shoulder anatomy and use of the correct intramuscular vaccination administration technique is important to prevent this rare postvaccination complication.
Challenging traditional carbohydrate intake recommendations for optimizing performance at high altitude
Authors: Pasiakos Stefan M. , Karl J. Philip , Margolis Lee M. 
Published: July 2021

Purpose of review
To highlight emerging evidence challenging traditional recommendations to increase carbohydrate intake to optimize performance at high altitude.

Recent findings
Several studies have now clearly demonstrated that, compared with sea level, exogenous carbohydrate oxidation during aerobic exercise is blunted in lowlanders during initial exposure to high altitude. There is also no apparent ergogenic effect of ingesting carbohydrate during aerobic exercise on subsequent performance at high altitude, either initially after arriving or even after up to 22 days of acclimatization. The inability to oxidize and functionally benefit from exogenous carbohydrate intake during exercise after arriving at high altitude coincides with hyperinsulinemia, accelerated glycogenolysis, and reduced peripheral glucose uptake. Collectively, these responses are consistent with a hypoxia-mediated metabolic dysregulation reflective of insulin resistance. Parallel lines of evidence have also recently demonstrated roles for the gut microbiome in host metabolism, bioenergetics, and physiologic responses to high altitude, implicating the gut microbiome as one potential mediator of hypoxia-mediated metabolic dysregulation.

Summary
Identification of novel and well tolerated nutrition and/or pharmacological approaches for alleviating hypoxia-mediated metabolic dysregulation and enhancing exogenous carbohydrate oxidation may be more effective for optimizing performance of lowlanders newly arrived at high altitude than traditional carbohydrate recommendations.
Pediatric Foreign Body Aspiration
Authors: Paap Michael K. , Leuin Shelby , Carvalho Daniela 
Published: July 2021

Objectives
The goal of this study was to assess which factors could affect outcomes in pediatric patients undergoing bronchoscopy for foreign body aspiration (FBA).

Methods
This is a retrospective case series study evaluating patients who underwent bronchoscopies because of FBA at a tertiary pediatric hospital between January 1, 2010, and December 6. 2018. Data collected included demographic information, time of the aspiration event, history of developmental delay, time of the procedure, duration of the procedure, and outcome (discharged, admission to the hospital or pediatric intensive care unit [PICU], or deceased). Statistical analysis was performed using standard regression analysis and analysis of variance.

Results
There were a total of 114 patients who underwent bronchoscopy for FBA (61% male and 39% female). The mean ± SD age was 2.8 ± 3.4 years, and 16% had developmental delay. The mean age for patients with developmental delay was 3.43 years, compared with 1.69 years for patients without developmental delay. The age difference between these 2 groups was statistically significant (P = 0.0047). The most commonly aspirated object was food (57%), and patients were usually with their parents at the time of aspiration (78%). Most aspiration events (57%) happened between 4 pm to 4 am. The mean ± SD time of procedure was 38 ± 28 minutes. The probability of admission to the hospital, PICU, and death increased with the duration of the procedure (P < 0.001). Patients with procedures longer than 60 minutes had a 40% probability of admission to the PICU, and patients with cases longer than 120 minutes had 13% probability of mortality.

Conclusions
Most FBA s occurred in the evening while the children were with their parents. Education of families regarding the risk of aspiration is crucial, so they are always attentive to this issue. Although the focus on prevention tends to be with younger patients, it is essential to emphasize the risk of FBA in older patients with developmental delay. Because most episodes of aspiration occur later in the day, it is imperative that tertiary pediatric centers ensure that the evening staff is trained and have the available equipment for these complex cases.
A sensor to monitor limb depth in transtibial sockets with locking pin suspension: a technical note
Authors: Bennett Sam , Gurrey Clement , Wang Horace , Weissinger Mathew , Larsen Brian , Sanders Joan E. 
Published: July 2021

Background:
Monitoring of limb depth in transtibial sockets may provide useful information toward patient education and care.

Objective:
The objective was to develop a sensor to detect the depth of a locking pin in the shuttle lock of a transtibial socket and to monitor the small motions between ratchet clicks during ambulation.

Study design:
Controlled bench testing and single-participant study.

Methods:
A copper wire coil positioned beneath the socket shuttle lock was used with an inductive sensing chip to monitor locking pin depth. A custom jig was used to calibrate the sensor and bench test the system. Repeatability, drift, and the effects of pin length, carbon fiber presence, temperature change, and pin angulation on sensor performance were tested. Testing was conducted on a participant wearing an adjustable socket, walking with the panels at four different radial positions.

Results:
The sensor demonstrated a root mean square error of 0.21% of the full-scale output. Different pins, different pin lengths, and the presence of carbon fiber affected calibration, indicating that the sensor must be calibrated to the individual user's socket and pin. Ratchet clicks and cyclic motion between clicks during walking were evident in the data. During participant testing, enlarging the socket at 1.00 mm radial increments caused significant changes in pin peak-to-peak distance (up and down motion) within a step.

Conclusions:
The sensor is sufficiently accurate to pursue studies investigating utility of the data toward clinical monitoring of socket fit.
Respiratory events after intensive care unit discharge in trauma patients: Epidemiology, outcomes, and risk factors
Authors: Rosen Joshua E. , Bulger Eileen M. , Cuschieri Joseph 
Published: July 2021

BACKGROUND
Respiratory complications are associated with significant morbidity and mortality in trauma patients. The care transition from the intensive care unit (ICU) to the acute care ward is a vulnerable time for injured patients. There is a lack of knowledge about the epidemiology of respiratory events and their outcomes during this transition.

METHODS
Retrospective cohort study in a single Level I trauma center of injured patients 18 years and older initially admitted to the ICU from 2015 to 2019 who survived initial transfer to the acute care ward. The primary outcome was occurrence of a respiratory event, defined as escalation in oxygen therapy beyond nasal cannula or facemask for three or more consecutive hours. Secondary outcomes included unplanned intubation for a primary pulmonary cause, adjudicated via manual chart review, as well as in-hospital mortality and length of stay. Multivariable logistic regression was used to examine patient characteristics associated with posttransfer respiratory events.

RESULTS
There were 6,561 patients that met the inclusion criteria with a mean age of 52.3 years and median Injury Severity Score of 18 (interquartile range, 13–26). Two hundred and sixty-two patients (4.0%) experienced a respiratory event. Respiratory events occurred early after transfer (median, 2 days, interquartile range, 1–5 days), and were associated with high mortality (16% vs. 1.8%, p < 0.001), and ICU readmission rates (52.6% vs. 4.7%, p < 0.001). Increasing age, male sex, severe chest injury, and comorbidities, including preexisting alcohol use disorder, congestive heart failure, and chronic obstructive pulmonary disease, were associated with increased odds of a respiratory event. Fifty-eight patients experienced an unplanned intubation for a primary pulmonary cause, which was associated with an in-hospital mortality of 39.7%.

CONCLUSION
Respiratory events after transfer to the acute care ward occur close to the time of transfer and are associated with high mortality. Interventions targeted at this critical time are warranted to improve patient outcomes.

LEVEL OF EVIDENCE
Prognostic and Epidemiological study, level III.
A quest for the origin of the uneven spread of Covid-19 cases
Authors: Bhadra Arunava , Bhattacharya Mahasweta 
Published: July 2021

AbstractFor more than one and a half years now the world is highly impacted by the Covid-19 pandemic. The covid-19 cases are, however, not evenly distributed across the countries; a few countries, particularly high-income countries have been hit harder than the countries of weak economic condition. The reasons for such an asymmetrical distribution are not clearly understood yet. In the present work, we have examined the unevenness of global distribution of Covid-19 incidences till 18th June 2021 in terms of the economic condition of countries. Subsequently, we have tried to identify the main underlying factors behind unequal Covid-19 cases. Our analysis suggests that the degree of Isolation, the diffusion of coronavirus (interconnectivity), and the percentage of elderly people in the population are the main causes of the different unequal spread of Covid-19 cases in different countries. We find that the Covid-19 infected and death cases are well describe by a power law in terms of the stated parameters.
Single-dose respiratory mucosal delivery of next-generation viral-vectored COVID-19 vaccine provides robust protection against both ancestral and variant strains of SARS-CoV-2
Authors: Afkhami Sam , D’Agostino Michael R. , Zhang Ali , Stacey Hannah D. , Marzok Art , Kang Alisha , Singh Ramandeep , Bavananthasivam Jegarubee , Ye Gluke , Luo Xiangqian , Wang Fuan , Ang Jann C. , Zganiacz Anna , Sankar Uma , Kazhdan Natallia , Koenig Joshua F. E. , Phelps Allyssa , Jordana Manel , Wan Yonghong , Mossman Karen L. , Jeyanathan Mangalakumari , Gillgrass Amy , Medina Maria Fe C. , Smaill Fiona , Lichty Brian D. , Miller Matthew S. , Xing Zhou 
Published: July 2021

SummaryThe emerging SARS-CoV-2 variants of concern (VOC) increasingly threaten the effectiveness of current first-generation COVID-19 vaccines that are administered intramuscularly and are designed to only target the spike protein. There is thus a pressing need to develop next-generation vaccine strategies to provide more broad and long-lasting protection. By using adenoviral vectors (Ad) of human and chimpanzee origin, we developed Ad-vectored trivalent COVID-19 vaccines expressing Spike-1, Nucleocapsid and RdRp antigens and evaluated them following single-dose intramuscular or intranasal immunization in murine models. We show that respiratory mucosal immunization, particularly with chimpanzee Ad-vectored vaccine, is superior to intramuscular immunization in induction of the three-arm immunity, consisting of local and systemic antibody responses, mucosal tissue-resident memory T cells, and mucosal trained innate immunity. We further show that single-dose intranasal immunization provides robust protection against not only the ancestral strain of SARS-CoV-2, but also two emerging VOC, B.1.1.7 and B.1.351. Our findings indicate that single-dose respiratory mucosal delivery of an Ad-vectored multivalent vaccine represents an effective next-generation COVID-19 vaccine strategy against current and future VOC. This strategy has great potential to be used not only to boost first-generation vaccine-induced immunity but also to expand the breadth of protective T cell immunity at the respiratory mucosa.
Relative contributions of sex hormones, sex chromosomes, and gonads to sex differences in tissue gene regulation
Authors: Blencowe Montgomery , Chen Xuqi , Zhao Yutian , Itoh Yuichiro , McQuillen Caden , Han Yanjie , Shou Benjamin , McClusky Rebecca , Reue Karen , Arnold Arthur P. , Yang Xia 
Published: July 2021

AbstractSex differences in physiology and disease in mammals result from the effects of three classes of factors that are inherently unequal in males and females: reversible (activational) effects of gonadal hormones, permanent (organizational) effects of gonadal hormones, and cell-autonomous effects of sex chromosomes, as well as genes driven by these classes of factors. Often, these factors act together to cause sex differences in specific phenotypes, but the relative contribution of each and the interactions among them remain unclear. Here, we used the Four Core Genotypes (FCG) mouse model with or without hormone replacement to distinguish the effects of each class of sex-biasing factors on transcriptome regulation in liver and adipose tissues. We found that the activational hormone levels have the strongest influence on gene expression, followed by the organizational gonadal sex effect and, lastly, sex chromosomal effect, along with interactions among the three factors. Tissue specificity was prominent, with a major impact of estradiol on adipose tissue gene regulation, and of testosterone on the liver transcriptome. The networks affected by the three sex-biasing factors include development, immunity and metabolism, and tissue-specific regulators were identified for these networks. Furthermore, the genes affected by individual sex-biasing factors and interactions among factors are associated with human disease traits such as coronary artery disease, diabetes, and inflammatory bowel disease. Our study offers a tissue-specific account of the individual and interactive contributions of major sex-biasing factors to gene regulation that have broad impact on systemic metabolic, endocrine, and immune functions.