bluuebunny/crossref_metadata_2025_split huggingface dataset:
In a Case of Death Involving Steroids, Hair Testing is More Informative than Blood or Urine Testing
Authors: Kintz Pascal , Gheddar Laurie , Blanchot Adeline , Ameline Alice , Raul Jean-Sébastien 
Published: May 2021

Abstract
A 59-year-old male was found dead at home, with two empty vials of an oily preparation obtained from a manufacturer from East Europe. There was no label on the vial. The subject was a former weightlifter, also known as an anabolic steroids abuser. The local prosecutor ordered a body examination, which was unremarkable, and allowed collecting femoral blood, urine and scalp hair (6 cm, brown). He was treated for cardiac insufficiency with quinidine. Biological specimens were submitted not only to standard toxicological analyses including a screening with liquid chromatography (LC)–quadrupole time of flight, but also to a specific LC–tandem mass spectrometry method for anabolic steroids testing. Ethanol was not found in both blood and urine. Quinidine blood concentration (791 ng/mL) was therapeutic. No drug of abuse was identified. In blood, testosterone was less that 1 ng/mL and no other steroid was identified. In urine, testosterone/epitestosterone was 1.56 and boldenone was present at a concentration of 9 ng/mL. The hair test results, performed on the whole length, demonstrated repetitive steroids abuse, including not only testosterone (140 pg/mg), testosterone propionate (605 pg/mg) and testosterone decanoate (249 pg/mg), but also boldenone (160 pg/mg), trenbolone (143 pg/mg) and metandienone (60 pg/mg). Since forensic laboratories have limited access to steroid urinary metabolite reference material due to specific regulations (to avoid testing athletes before anti-doping verifications), hair analyses seem to be the best approach to document anabolic agents abuse. Indeed, in hair, the target drug is the parent compound; in addition, when compared to blood or urine, this matrix has a much larger window of detection. The pathologist concluded cardiac insufficiency in a context involving repetitive abuse of anabolic drugs. This case indicates that more attention should be paid to anabolic steroids, in a context of sudden cardiac death.
11-Year Study of Fentanyl in Driving Under the Influence of Drugs Casework
Authors: Chan-Hosokawa Ayako , Bierly Jolene J 
Published: May 2021

Abstract
Prior to 2017, heroin and other prescription opioids were the most prevalent opioids implicated in driving under the influence of drugs (DUID) investigation cases, and fentanyl was rarely included in the scope of toxicological analysis. Fentanyl has become the most frequently identified opioid in DUID cases, with many suspected heroin cases turning out to be only fentanyl. A review of fentanyl-positive DUID cases at NMS Labs was performed to provide prevalence information, change in concentration, patterns of combined drug use, indicators of impairment and driving behavior in order to assist with the toxicological interpretation of DUID scenarios involving fentanyl. Fentanyl-positive DUID cases received between January 2010 and December 2020 were examined. Blood results were confirmed and quantitated for fentanyl, norfentanyl and acetylfentanyl using a liquid chromatography--tandem mass spectrometry analysis with a limit of quantitation of 0.10, 0.20 and 0.10 ng/mL, respectively. Of 153,234 blood cases examined for DUID over 11 years, fentanyl was confirmed positive in 6,779 (4.4%) cases. However, there were significant changes in positivity over time. Fentanyl percentage positivity increased from 0.60% in 2010 to 12% in 2020. Of 5,976 confirmed fentanyl-positive cases in 2018–2020, blood concentrations &gt;4.0 ng/mL were observed in 44% (2018), 55% (2019) and 59% (2020) of cases. Polypharmacy was common with 87% of blood samples confirmed positive for fentanyl and at least one other compound. Stimulant was the most commonly identified drug class in cases where at least one additional drug class was present. This study illustrates the importance of including fentanyl in a routine blood DUID panel.
Implementing video visits into an orthopedic hip arthroscopy practice: a case study
Authors: Wickman John , Ferlotti Colleen , Ferrell Justin , Hutyra Carolyn , Phinney Donna , Wahl Megan , Mather Richard C 
Published: May 2021

Abstract
Telehealth videoconferencing has been shown to be feasible, cost-effective and safe in numerous fields of medicine. In an effort to increase access and improve the quality of care offered to patients we implemented a telehealth initiative allowing for remote orthopedic clinic visits at a major academic medical center. Here we report on our experience and early outcomes. A telehealth platform was launched for a single fellowship trained orthopedic surgeon at a major academic hospital in August 2018. New patients residing outside the metro area, all return patients and patients with an uncomplicated post-operative course were offered the option to complete patient encounters remotely via a telehealth platform. Each patient was offered a Patient Satisfaction Survey following video visit. Patient zip codes were used to estimate patient commutes. Ninety-six percent of patients agreed/strongly agreed with the statement ‘I was satisfied with my Telehealth experience’ while 51% agreed/strongly agreed with the statement ‘This visit was just as good as a face to face visit’. In all, 94% of patients agreed/strongly agreed with the statement ‘Having a telehealth visit made receiving care more accessible for me’. The median miles saved on commutes were 123.3 miles. The no show rate for telehealth visits was 8.2% versus 3.2% for in-person (P &lt; 0.001). Telehealth video visits provided patients with a modality for completing orthopedic clinic visits while maintaining a high-quality care and patient satisfaction. Patient convenience was optimized with video visits with elimination of long commutes. Level of evidence: IV.
Surgical upstaging rates in patients meeting the eligibility for active surveillance trials
Authors: Iwamoto Naoko , Nara Miyako , Horiguchi Shin-ichiro , Aruga Tomoyuki 
Published: May 2021

Abstract

Purpose
Four clinical active surveillance trials including LORIS, COMET, LORD and LORETTA, are being conducted to assess whether women with low-risk ductal carcinoma in situ can safely avoid surgery. The present study aimed to determine the rate of upstaging to invasive cancer among patients with a preoperative diagnosis of ductal carcinoma in situ and to evaluate the incidence of upstaging in patients meeting the eligibility criteria for four active surveillance clinical trials.

Methods
The present study initially enrolled 180 patients with 183 calcifications who received the diagnosis of ductal carcinoma in situ by biopsy. Patients were classified as eligible for four clinical trials according to the respective inclusion criteria.

Results
In total, 152 patients with 155 calcifications were analyzed. Of these, 32 (21%) were upstaged to invasive disease based on the final pathological analysis of surgical specimens. Of the 152 patients, 53 (35%), 90 (59%), 24 (16%) and 34 (22%) met the eligibility criteria for the LORIS, COMET, LORD and LORETTA trial, respectively. Among patients with low-risk ductal carcinoma in situ, 10 (19%), 14 (16%), 6 (25%) and 4 (12%) patients were upstaged to invasive disease in LORIS, COMET, LORD and LORETTA, respectively. The upstaging to pT1b or higher rates were 2% (1/53), 3% (3/90), 0% (0/24) and 3% (1/34) in LORIS, COMET, LORD and LORETTA, respectively.

Conclusions
The upstaging rate in patients eligible for the clinical active surveillance trials was 12–25%. Although the rate of upstaging to pT1b or higher was low, further studies are required to determine the rates of upstaging to invasive cancer and the risk factors among patients with low-risk ductal carcinoma in situ.
Expression and Prognostic Value of the Immune Checkpoints Galectin-9 and PD-L1 in Glioblastomas
Authors: Knudsen Arnon Møldrup , Rudkjøbing Sisse Josephine , Sørensen Mia Dahl , Dahlrot Rikke Hedegaard , Kristensen Bjarne Winther 
Published: May 2021

Abstract
Immunotherapeutic targeting of the PD-1/PD-L1 axis has been widely implemented for treatment of several cancer types but shown disappointing results in glioblastomas (GBMs), potentially due to compensatory mechanisms of other expressed immune checkpoints. Galectin-9 is an immune-checkpoint protein that facilitates T-cell exhaustion and apoptosis and could be a potential target for immune-checkpoint inhibition. A total of 163 GBMs IDH wildtype were immunostained with anti-Galectin-9 and PD-L1 antibodies. Software-based quantitation of immunostainings was performed and co-expression was investigated using double immunofluorescence. Both Galectin-9 and PD-L1 protein expression were found in all 163 tumors and showed a significant positive correlation (p = 0.0017). Galectin-9 expression varied from 0.01% to 32% (mean = 6.61%), while PD-L1 membrane expression ranged from 0.003% to 0.14% (mean = 0.048%) of total tumor area. Expression of Galectin-9 and PD-L1 was found on both microglia/macrophages and tumor cells, and colocalization of both markers was found in 88.3% of tumors. In multivariate analysis, neither Galectin-9 (HR = 0.99), PD-L1 (HR = 1.05), nor their combinations showed prognostic value. Galectin-9 and PD-L1 were expressed in all investigated GBMs and the majority of patients had co-expression, which may provide rationale for multi-targeted immune checkpoint inhibition.
Application of Genome-Wide DNA Methylation Analysis to Differentiate a Case of Radiation-Induced Glioblastoma From Late-Relapsed Medulloblastoma
Authors: Hiraki Takamasa , Fukuoka Kohei , Mori Makiko , Arakawa Yuki , Matsushita Yuko , Hibiya Yuko , Honda Satoko , Kobayashi Masao , Tanami Yutaka , Ichimura Koichi , Hirato Junko , Kurihara Jun , Nakazawa Atsuko , Koh Katsuyoshi 
Published: May 2021

Abstract
Recurrent medulloblastoma can be difficult to diagnose with conventional diagnostic methods because other lesions mimic tumor relapse, particularly at later stages. We report 2 cases of medulloblastoma, both of which seemed to develop late recurrences. Case 1 was a 6-year-old girl who had a medulloblastoma with focal desmoplasia. She was in complete remission for 9 years after treatment but developed an intradural lesion in her thoracic spine, which was pathologically confirmed as tumor recurrence by biopsy. Case 2 was a 10-year-old girl who had a nonmetastatic medulloblastoma. She developed a left cerebellar mass 5 years after the initial diagnosis; the pathological diagnosis was tumor relapse. We performed t-distributed stochastic neighbor embedding of the methylation data from these cases and reference data. In contrast to the consistency of methylation profiling and copy number abnormalities between primary and recurrent tumors of Case 1, the analysis of the recurrent tumor in Case 2 was distinct from medulloblastomas and clustered with “IDH-wild type glioblastomas,” suggesting that the recurrent tumor was a radiation-induced glioblastoma. This report highlights the clinical utility of molecular genetic/epigenetic analysis combined with a standard diagnostic approach to confirm the diagnosis of brain tumor recurrence.
Collision between molecular clouds – III: the effects of cloud initial density profile on head-on collisions
Authors: Tanvir Tabassum S , Dale James E 
Published: May 2021

ABSTRACT
In this third paper of our cloud collision series, we present the results from simulations of head-on collisions with a strongly centrally condensed initial density profile of ρ ∝ R−2. We investigate the impact of these density profiles on the overall evolution of the simulations: the structures formed, their dynamical evolution, and their star formation activity. We consider clouds that are globally bound and globally unbound, leading to three different scenarios – the collision of a bound cloud with a bound cloud, the collision of two unbound clouds, or the collision of one cloud of each type.
In all the simulations, dense star clusters form before the collisions occur, and we find that star formation remains confined to these systems and is little affected by the collisions. If the clouds are both initially bound, the collision forms a filamentary structure, but otherwise this does not occur. We observe that rotating structures form around the clusters, but they also form in our non-colliding control simulations, so are not a consequence of the collisions. The dissipation of kinetic energy in these simulations is inefficient because of the substructure created in the clouds by turbulence before the collisions. As a result, although some gas is left bound in the COM frame, the star clusters formed in the simulations do not become bound to each other.
A kinematic analysis of the CO clouds toward a reflection nebula NGC 2023 observed using the Nobeyama 45 m telescope: Further evidence for a cloud–cloud collision in the Orion region
Authors: Yamada Rin I , Enokiya Rei , Sano Hidetoshi , Fujita Shinji , Kohno Mikito , Tsutsumi Daichi , Nishimura Atsushi , Tachihara Kengo , Fukui Yasuo 
Published: May 2021

Abstract
We performed fully sampled J = 1–0 line observations of 12CO and 13CO toward the reflection nebula NGC 2023 using the Nobeyama 45 m telescope. It covered the entire NGC 2023 region with angular and velocity resolutions of 19″ corresponding to 0.04 pc and 0.33 km s−1, respectively. We analyzed the data focusing on gas dynamics and revealed two velocity components, each with a mass of $\sim\! 3000 \mbox{$\, {M}_\odot $}$, at radial velocities of 10 and 12 km s−1. These components show spatially complementary distributions and are connected in velocity, both of which are the typical signatures of cloud–cloud collision (CCC). Although previous studies favored a scheme of triggering by the H ii region of IC 434, our results show that the effect of the H ii region is limited only to the surface of the molecular cloud, and does not contribute to the entire gas compression and the overall star formation. Comparing the present results with those for neighboring NGC 2024, we find that their active star formation can be explained by a single CCC event. We suggest that the 10 and 12 km s−1 clouds collided ∼0.4 Myr ago, which is common to the regions, but triggered the B1.5V-type star HD 37903 as well as ∼20 low-mass stars in NGC 2023, and ∼20 OB stars in NGC 2024. The column density in NGC 2023 is two to three times lower than that of NGC 2024, which may result in the different star formation activity suggested by the trend of ∼50 other CCC-triggered star-forming regions in the literature.
Genome-wide association study reveals the genetic architecture of 27 agronomic traits in tomato
Authors: Ye Jie , Wang Xin , Wang Wenqian , Yu Huiyang , Ai Guo , Li Changxing , Sun Pengya , Wang Xianyu , Li Hanxia , Ouyang Bo , Zhang Junhong , Zhang Yuyang , Han Heyou , Giovannoni James J , Fei Zhangjun , Ye Zhibiao 
Published: May 2021

Abstract
Tomato (Solanum lycopersicum) is a highly valuable fruit crop, and yield is one of the most important agronomic traits. However, the genetic architecture underlying tomato yield-related traits has not been fully addressed. Based on ∼4.4 million single nucleotide polymorphisms obtained from 605 diverse accessions, we performed a comprehensive genome-wide association study for 27 agronomic traits in tomato. A total of 239 significant associations corresponding to 129 loci, harboring many previously reported and additional genes related to vegetative and reproductive development, were identified, and these loci explained an average of ∼8.8% of the phenotypic variance. A total of 51 loci associated with 25 traits have been under selection during tomato domestication and improvement. Furthermore, a candidate gene, Sl-ACTIVATED MALATE TRANSPORTER15, that encodes an aluminum-activated malate transporter was functionally characterized and shown to act as a pivotal regulator of leaf stomata formation, thereby affecting photosynthesis and drought resistance. This study provides valuable information for tomato genetic research and breeding.
Physical Work Exposures of Older Workers: Does Measurement Make a Difference?
Authors: Andrasfay Theresa , Pebley Anne R , Goldman Noreen 
Published: May 2021

AbstractPhysically demanding work at later ages, which is especially prevalent among disadvantaged groups, is associated with long-term health outcomes and may contribute to health inequality over the life course. Past studies of these issues have relied on occupational characteristics from the Occupational Information Network (O*NET), but few have assessed how O*NET compares to survey reports when measuring occupational exposures in analyses of socioeconomic status, work conditions, and health. We compare Health and Retirement Study (HRS, N = 16,683 working respondents) and O*NET measurements of general physical activity, frequency of lifting/handling objects, and frequency of stooping-related postures required at work. Pearson correlations between the HRS items and corresponding O*NET items vary from weak to moderate for lifting/handling and stooping-related postures to relatively large for general physical activity. Though they are measured on different scales, both the HRS and O*NET measures of physical demands reveal similar sex, racial/ethnic, and educational differentials in exposure to physically strenuous work. We fit random effects Poisson models to assess how these measures predict accumulation of functional limitations, a potential long-term consequence of strenuous working conditions. Comparable HRS and O*NET measures have similar associations with functional limitations. We also consider an average of physical demand items available in O*NET, finding that this measure has similar associations with functional limitations as the O*NET measure of general physical activity. These results suggest that O*NET characteristics and HRS respondent reports produce comparable disparities in physical work exposures (PWEs) and associations between physically demanding work and declines in physical functioning.
Synthesis and Characterization of a Copper‐Based Macrocyclic Chelate for Quantitation and Sequestration of Oxalate: the Major Component of Kidney Stones
Authors: VanWert Adam L , Hensley Jayden L , Hontz David S , Torsiello Maria L , Venditto Michael L , Luchetta Jared L , Lucent Del L , Terzaghi William L 
Published: May 2021

BackgroundRoughly eighty percent of kidney stones are calcium oxalate‐based. Oxalate is found both in diet and synthesized in the liver. Furthermore, blood‐borne oxalate likely undergoes enteroenteric recirculation via transporters in the small intestine (SLC26A6, secretory) and colon (SLC26A3, absorptive). There is a great need for pharmacotherapeutic options to prevent and treat calcium‐oxalate kidney stones. Furthermore, methods for quantifying oxalate in biological matrices are costly and time consuming.ObjectiveWe aimed to synthesize and further characterize a small‐molecule oxalate binder, with two ultimate goals in mind: (1st) to be employed in a quantitative fluorescence‐based oxalate assay, and (2nd) to prevent colonic oxalate absorption.Methods & ResultsWe optimized the synthesis of a copper‐based chelate (~70% yield) and expanded characterization beyond literature reports: (1) for the first time we crystallized the chelate and determined its lattice unit cell as triclinic via X‐ray crystallography; (2) for the first time we obtained NMR spectra of the chelate; (3) we obtained mass spectra of the two intermediates, showing excellent purity; (4) we confirmed the ability of the chelate to quench eosin Y fluorescence, and to release eosin Y upon oxalate binding; and (5) we have, for the first time, determined that citrate can also give a positive fluorescence response, unlike other acids.ConclusionsThe macrocyclic chelate can be produced readily with high yield and purity. Its crystal structure helps to predict the binding orientation of oxalate, which may lead to more specific oxalate binders. We have found, for the first time, that although the compound is selective for oxalate, contrary to previous reports, it is not specific. These findings indicate that the chelate may serve as a useful tool for quantifying oxalate provided that a strategy for mitigating citrate binding is developed. Furthermore, armed with more thorough knowledge on its specificity for oxalate and other biological chemicals, developing the chelate as prophylaxis for oxalate kidney stones is becoming a promising goal.Support or Funding InformationAll work was funded by Wilkes UniversityThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
Enhanced Recovery After Surgery in Older Adults Undergoing Colorectal Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Thillainadesan Janani , Yumol Minna F. , Suen Michael , Hilmer Sarah , Naganathan Vasi 
Published: May 2021

BACKGROUND:
Enhanced recovery after surgery is increasingly applied in older adults undergoing colorectal surgery.

OBJECTIVE:
This systematic review and meta-analysis evaluated the impact of enhanced recovery protocols on clinical outcomes including hospital-acquired geriatric syndromes in older adults undergoing colorectal surgery.

DATA SOURCES:
This review was conducted according to PRISMA guidelines. Ovid MEDLINE, Embase, PsycINFO, Scopus, Cochrane Central Register of Controlled Trials, CINAHL, and trial registry databases were searched (January 1980 to April 2020).

STUDY SELECTION:
Two researchers independently screened all articles for eligibility. Randomized controlled trials evaluating enhanced recovery protocols in older adults undergoing colorectal surgery were included.

INTERVENTION:
The enhanced recovery protocol was utilized.

MAIN OUTCOME MEASURES:
Primary outcomes of interest were functional decline and delirium. Other outcomes studied were length of stay, complications, readmission, mortality, gut function, mobilization, pain, reoperation, quality of life, and psychological status.

RESULTS:
Seven randomized trials (n = 1277 participants) were included. In terms of hospital-acquired geriatric syndromes, functional decline was reported in 1 study with benefits reported in enhanced recovery after surgery participants, and meta-analyses showed reduced incidence of delirium (risk ratio, 0.45; 95% CI, 0.21–0.98). Meta-analyses also showed reduction in urinary tract infections (risk ratio, 0.53; 95% CI, 0.31–0.90), time to first flatus (standardized mean differences, –1.00; 95% CI, –1.98 to –0.02), time to first stool (standardized mean differences, –0.59; 95% CI, –0.76 to –0.42), time to mobilize postoperatively (standardized mean differences, –0.92; 95% CI, –1.27 to –0.58), time to achieve pain control (standardized mean differences, –0.59; 95% CI, –0.90 to –0.28), and hospital stay (mean differences, –2.20; 95% CI, –3.46 to –0.94).

LIMITATIONS:
The small number of randomized trials in older adults is a limitation of this study.

CONCLUSIONS:
Enhanced recovery protocols in older adults undergoing colorectal surgery appear to reduce the incidence of delirium and functional decline, 2 important hospital-acquired geriatric syndromes, as well as to improve other clinical outcomes. Future research should measure these geriatric syndromes and focus on high-risk older adults including those with frailty.