bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Landmark-guided, Nerve Stimulation–guided, and Ultrasound-guided Techniques for Pediatric Caudal Epidural Anesthesia
Authors: Ponde Vrushali , Singh Neha , Nair Abhijit , Ongaigui Corinna J. , Nagdev Tripti 
Published: November 2021

Objectives:
Traditionally, caudal epidurals are performed by a landmark-guided approach using the loss of resistance technique. Improvisations to increase the success rate can be attained by implementing modalities, namely neurostimulation and ultrasound, but there is a paucity of literature comparing these 3 approaches. Here, we compare the 3 techniques in terms of the success rate.

Materials and Methods:
The primary outcome of this study was to compare the success rate of the 3 techniques, and the secondary outcome was the blood or cerebrospinal fluid aspiration during the procedure. It was a prospective, randomized, open-label parallel-group study. Three hundred children aged 1 to 5 years scheduled for circumcision, hypospadias repair, and minor lower extremity surgeries were enrolled after taking written informed consent from the parents.

Results:
Demographic profiles were comparable in terms of age, weight, sex distribution, and types of surgeries. Success rates in landmark-guided, neurostimulation-guided, and ultrasound-guided were 97%, 97%, and 98%, respectively which was comparable (P=0.879). There was no significant difference in the incidence of blood or cerebrospinal fluid aspiration.

Discussion:
We found a similar success rate of the caudal epidural block by using landmark-guided, nerve stimulation–guided, or ultrasound-guided techniques in children aged 1 to 5 years with normal anatomy.
Development and validation of a nomogram for predicting survival of breast cancer patients with ipsilateral supraclavicular lymph node metastasis
Authors: Lyu Min-Hao , Ma You-Zhao , Tian Pei-Qi , Guo Hui-Hui , Wang Chao , Liu Zhen-Zhen , Chen Xiu-Chun 
Published: November 2021

Abstract

Background:
Breast cancer patients with ipsilateral supraclavicular lymph node metastasis (ISLNM) but without distant metastasis are considered to have a poor prognosis. This study aimed to develop a nomogram to predict the overall survival (OS) of breast cancer patients with ISLNM but without distant metastasis.

Methods:
Medical records of breast cancer patients who received surgical treatment at the Affiliated Cancer Hospital of Zhengzhou University, Jiyuan People's Hospital and Huaxian People's Hospital between December 21, 2012 and June 30, 2020 were reviewed retrospectively. Overall, 345 patients with pathologically confirmed ISLNM and without evidence of distant metastasis were identified. They were further randomized 2:1 and divided into training (n = 231) and validation (n = 114) cohorts. A nomogram to predict the probability of OS was constructed based on clinicopathologic variables identified by the univariable and multivariable analyses. The predictive accuracy and discriminative ability were measured by calibration plots, concordance index (C-index), and risk group stratification.

Results:
Univariable analysis showed that estrogen receptor-positive (ER+), progesterone receptor-positive (PR+), human epidermal growth factor receptor 2-positive (HER2+) with Herceptin treatment, and a low axillary lymph node ratio (ALNR) were prognostic factors for better OS. PR+, HER2+ with Herceptin treatment, and a low ALNR remained independent prognostic factors for better OS on multivariable analysis. These variables were incorporated into a nomogram to predict the 1-, 3-, and 5-year OS of breast cancer patients with ISLNM. The C-indexes of the nomogram were 0.737 (95% confidence interval [CI]: 0.660–0.813) and 0.759 (95% CI: 0.636–0.881) for the training and the validation cohorts, respectively. The calibration plots presented excellent agreement between the nomogram prediction and actual observation for 3 and 5 years, but not 1 year, OS in both the cohorts. The nomogram was also able to stratify patients into different risk groups.

Conclusions:
In this study, we established and validated a novel nomogram for predicting survival of patients with ISLNM. This nomogram may, to some extent, allow clinicians to more accurately estimate prognosis and to make personalized therapeutic decisions for individual patients with ISLNM.
Ball of Death
Authors: Naveen Alagarasan , Sahu Manas Ranjan , Maharik Sasank Shekhar , Mohanty Manoj Kumar , Padhi Kimi Soumya 
Published: November 2021

Abstract
Crude bombs are country-made explosive weapons, usually prepared from locally available materials such as firecrackers or explosives used in mines. These are generally concealed inside the fruits, such as jackfruit, pineapple, and watermelon, to kill wild boars or other animals by poachers in India. Occasionally, crude bombs are remodeled resembling fruit or a ball and placed on the fields, where animals usually raid their crops. Such crude bombs may result in accidental explosions and contribute to the death of unintended targets, including humans. Despite these sporadic incidents reported in media, scientific data are lacking. Here, we report a young child who sustained injuries after an accidental explosion of such a crude bomb. It exploded when the child apparently mistook it for a ball and grasped it firmly while playing with his brother. This case is the first to report the accidental death of a child after the crude bomb's fatal explosion to the best of our knowledge. This report also briefly overviews the emerging menace of crude bombs in India.
Using CT Perfusion in the Interictal State
Authors: Sheikh Irfan S. , Park Sihyeong , Ali Imran 
Published: November 2021

Summary:
Periodic discharges seen in patients undergoing continuous EEG pose a challenge to physicians in falling into the interictal–ictal continuum and need for appropriate diagnostic and management approach. The authors herein present an 83-year-old male patient with an acute subdural hematoma who developed intermittent right upper and lower extremity weakness with change in mental status post craniotomy and hematoma evacuation. The patient was intubated and sedated with midazolam and propofol and placed on anti-seizure medications to control seizures. He was placed on continuous EEG monitoring and later developed lateralized periodic discharges. To guide treatment, a computed tomography perfusion study of the brain was performed. The results were consistent with an ictal phenomenon because of the presence of left hemispheric hyperemia. This increased cerebral blood volume and blood flow was used as a diagnostic tool to warrant more aggressive antiepileptic regimen. The patient was then started on an additional anti-seizure medication and dosages were further optimized. This led to an improvement in the patient's EEG and clinical state. There are numerous studies that show lateralized periodic discharges are seen as examples of subclinical status epilepticus and demonstrate hypermetabolism and hyperemia on positron emission tomography and single-photon emission computed tomography scans. When such imaging modalities are unavailable, cortical hyperperfusion on a computed tomography perfusion study might be a valid predictor of ongoing, subclinical, ictal activity and may be used as a complementary diagnostic tool to EEG to guide treatment.
Effect of Maximum Repetition of Pelvic Floor Stabilization Exercise in Stress Urinary Incontinence
Authors: Khatun Iren , Hossain Mohammad Anwar , Hossain K M Amran , Urme Nadia Afrin 
Published: November 2021

AbstractBackgroundStress urinary incontinence (SUI) in females is a common gynecological issue that impedes lifestyle. Exercise had a significant effect; however, studies did not determine the exercise frequency and intensity for pelvic floor stabilization in stress urinary incontinence.AimThe aim of the study is to determine if maximum repetition of pelvic stabilization exercise impacts the management of stress urinary incontinence in females.MethodologyOne arm quasi-experimental study design was used. 40 patients having SUI and associated musculoskeletal complaints were recruited from the outpatient unit of Physiotherapy department of the Centre for the Rehabilitation of the Paralysed (CRP), Bangladesh. The study was conducted over 4weeks. Outcome measurement was included pelvic floor and abdominal muscle strength, endurance, and incontinence measurement.ResultPelvic floor muscle and abdominal strength, and endurance had a positive and significant result in maximum repetition (P .001). Pelvic floor strength has been significantly improvement in week 2 (P .001), and week 3 (P .01). Interference in activities (P .003), and ICIQ total (P .001) had improvement but majority of the improvement was noted in weeks 2-3. There was a significant improvement in the frequency of urine leakage in the first week (P .001), and week 3 (P .005) and week 4 (P .001).ConclusionPelvic floor exercise with increasing repetition is an effective approach to improve stress urinary incontinence in females. The study had a significant impact on incontinence frequency, amount, and associated quality of life for women with stress urinary incontinence with pelvic floor exercise with maximum repetition.
On the Effect of Intralocus Recombination on Triplet-Based Species Tree Estimation
Authors: Hill Max , Roch Sebastien 
Published: November 2021

AbstractWe consider species tree estimation from multiple loci subject to intralocus recombination. We focus onR*, a summary coalescent-based methods using rooted triplets. We demonstrate analytically that intralocus recombination gives rise to an inconsistency zone, in which correct inference is not assured even in the limit of infinite amount of data. In addition, we validate and characterize this inconsistency zone through a simulation study that suggests that differential rates of recombination between closely related taxa can amplify the effect of incomplete lineage sorting and contribute to inconsistency.
Modelling the coupling of the M-clock and C-clock in lymphatic muscle cells
Authors: Hancock E.J. , Zawieja S.D. , Macaskill C. , Davis M.J. , Bertram C.D. 
Published: November 2021

ABSTRACTLymphoedema develops due to chronic dysfunction of the lymphatic vascular system which results in fluid accumulation between cells. The condition is commonly acquired secondary to diseases such as cancer or the therapies associated with it. The primary driving force for fluid return through the lymphatic vasculature is provided by contractions of the muscularized lymphatic collecting vessels, driven by electrical oscillations. However, there is an incomplete understanding of the molecular and bioelectric mechanisms involved in lymphatic muscle cell excitation, hampering the development and use of pharmacological therapies. Modelling in silico has contributed greatly to understanding the contributions of specific ion channels to the cardiac action potential, but modelling of these processes in lymphatic muscle remains limited. Here, we propose a model of oscillations in the membrane voltage (M-clock) and intracellular calcium concentrations (C-clock) of lymphatic muscle cells. We modify a model by Imtiaz and colleagues to enable the M-clock to drive the C-clock oscillations. This approach differs from typical models of calcium oscillators in lymphatic and related cell types, but is required to fit recent experimental data. We include an additional voltage dependence in the gating variable control for the L-type calcium channel, enabling the M-clock to oscillate independently of the C-clock. We use phase-plane analysis to show that these M-clock oscillations are qualitatively similar to those of a generalised FitzHugh-Nagumo model. We also provide phase plane analysis to understand the interaction of the M-clock and C-clock oscillations. The model and methods have the potential to help determine mechanisms and find targets for pharmacological treatment of lymphoedema.
The role of robots in the green economy
Authors: Bogue Robert 
Published: November 2021

Purpose
This aims to illustrate the role robotic technology is playing in the key sectors of the green economy.

Design/methodology/approach
Following a short introduction, this paper discusses existing and potential robotic applications in three key sectors of green economy: renewable energy, recycling and waste management and sustainable transport. This is followed by a discussion and concluding comments.

Findings
Robots are playing critical and growing roles in each of the three sectors of the green economy considered. Uses are expanding in the production of renewable energy systems and in their inspection and maintenance. Advances in AI and machine vision have enabled robotic mixed waste sorting which plays a vital role in recycling, and the robotic disassembly of electronic products is also gaining pace. Robots are being used extensively in the sustainable transport sector in the manufacture of electric vehicles and also in the production and recycling of electric vehicle batteries. Emerging applications include robotic vehicle recharging and battery swapping.

Originality/value
This provides an insight into the many ways in which robots are contributing to key sectors of the green economy.
Pain, suffering, and jury awards: A study of the cost of wrongful convictions
Authors: Cohen Mark A. 
Published: November 2021

Research summaryThis paper estimates the cost of wrongful convictions based on analysis of jury awards and settlements for individuals who were wrongfully convicted and incarcerated for crimes they did not commit. Key variables of interest are number of days spent in prison, days on probation, and demographics of wrongfully convicted and their families. The average “cost” of a wrongful conviction is estimated to be $6.1 million, or $1334 per day of incarceration, while the marginal cost decreases over time: initial incarceration is valued at over $50,000 for the first day; year one is valued at $1.5 million ($4000/day), while the marginal cost of the 10th year is estimated to be approximately $350,000 ($950/day).Policy implicationsState mandated compensation for wrongfully convicted individuals who oftentimes spend years in prison for crimes they did not commit is highly variable and in many cases bears little relationship to either the monetary or nonmonetary harms endured. In addition to providing benchmarks for more appropriate compensation, these estimates provide a foundation for future benefit‐cost analyses of policies that might reduce wrongful convictions such as increased expenditures for DNA testing or indigent defense counsel.
Radiological features and clinical implications of persistent congenital mesocolon: Pictorial essay
Authors: Ghahremani Gary G 
Published: November 2021

AbstractIn human foetus, the mesenteries that carry vascular and neural supply to the alimentary tube play an important role in its development and anatomical location within the abdominal cavity. The mesenteric attachments of the small bowel, transverse colon and sigmoid allow them to be intraperitoneally mobile structures. In contrast, the ascending and descending colon lose their mesenteries by fusion with the parietal peritoneum and become fixed in retroperitoneal position along the posterolateral walls of the abdomen. In about 2%–4% of individuals, this process is disrupted, causing a complete or partial retention of their congenital mesocolon. The ascending or descending colon will then remain intraperitoneally mobile, affecting the normal visceral anatomy and causing potential complications. This article reviews the spectrum of radiological manifestations and clinical consequences of these anomalies.
A framework to model a web of linkage disequilibria for natural allotetraploid populations
Authors: Yang Dengcheng , Li Fan , Wang Jing , Dong Ang , Wu Rongling 
Published: November 2021

Abstract

Linkage disequilibrium (LD) is an important genetic parameter used to infer the genetic diversity of natural populations and their evolutionary history. Traditionally, LD is defined as the non‐random association of non‐alleles at different loci in gametes for diploids, but has a limited use for polyploids.

We formulate a framework to define tetraploid‐specific LD including (a) Hardy–Weinberg disequilibria at each locus, (b) composite digenic disequilibrium, (c) trigenic disequilibrium and (d) composite quadrigenic disequilibrium at different loci. These four types of disequilibria affect population variation singly or jointly through a web. We implement the EM algorithm to estimate each disequilibrium parameter and test its significance in allotetraploid populations.

We perform computer simulation to examine the statistical properties of our computational model. Through analysing a population genetic data of allotetraploid switchgrass, we chart the genomic distribution of LD on different chromosomes from which the evolutionary history of switchgrass is inferred, demonstrating the practical usefulness of the model.

We have developed a statistical model for LD analysis in allotetraploids. The model can be generalized as a tool to study the population diversity and evolution of polyploid populations.
Intolerance of uncertainty and novelty facilitated extinction: The impact of reinforcement schedule
Authors: Wake Shannon , Dodd Helen , Morriss Jayne 
Published: November 2021

AbstractIndividuals who score high in intolerance of uncertainty (IU) display reduced threat extinction. Recently, it was shown that replacing threat associations with novel associations during extinction learning (i.e., presenting a novel tone 100% of the time) can promote threat extinction retention in individuals with high IU. This novelty facilitated extinction (NFE) effect could be driven by the tone's novelty or reliability. Here, we sought to address this question by adjusting the reliability of the novel tone (i.e., the reinforcement rate) during NFE. We measured skin conductance response during an associative learning task in which participants (n = 92) were assigned to one of three experimental groups: standard extinction, NFE 100% reinforcement, or NFE 50% reinforcement. For standard extinction, compared to NFE 100% and 50% reinforcement groups, we observed a trend for greater recovery of the conditioned response during extinction retention. Individuals with high IU relative to low IU in the standard extinction group demonstrated a larger recovery of the conditioned response during extinction retention. These findings tentatively suggest that NFE effects are driven by the novelty rather than the reliability of the new stimulus. The implications of these findings for translational and clinical research in anxiety disorder pathology are discussed.
Warmed and humidified insufflation to prevent perioperative hypothermia and improve the quality of recovery in elective laparoscopic colorectal resection patients: a feasibility study for a triple‐blind randomized controlled trial
Authors: Reeves Nicola , White Judith , Bird Samuel , Shinkwin Michael , Cornish Julie , Torkington Jared 
Published: November 2021

AbstractAimThe use of standard CO2 for insufflation during laparoscopic colorectal surgery may be associated with cooling and drying of the peritoneal cavity, contributing to perioperative hypothermia. The aim of this work was the assess the feasibility of a study to compare insufflation of warmed, humidified CO2 (WHCO2) (using HumiGard, Fisher and Paykel Healthcare) with standard measures and its impact on the quality of recovery of surgical patients.MethodA single‐centre, triple‐blind, feasibility, randomized controlled trial (RCT) of adults scheduled for planned laparoscopic colorectal surgery. The primary outcome was recruitment. Secondary outcomes included feasibility of blinding, acceptability to patients and suitability of objective measures: patient‐reported quality of recovery using a validated questionnaire (QoR‐40), patient pain scores and semi‐continuous core temperature measurements.ResultsThirty‐nine participants were randomized to either the WHCO2 group (n = 19) or standard care alone (n = 20). Recruitment to the study was successful and acceptable to patients. Blinding of the surgeons, patients and assessors was effective. Response rates to QoR‐40 were high but ceiling effects were observed, indicating that the tool was unsuitable in this population. Fewer patients in the WHCO2 group reported postoperative nausea and vomiting (PONV) at days 1 (53% vs. 65%) and 3 (37% vs. 60%). The median hospital length of stay was 5.5 days in the standard care group and 4 days in the WHCO2 group.ConclusionA study of WHCO2 for insufflation in laparoscopic colorectal surgery would be highly acceptable to both patients and researchers. Potential reductions in PONV and hospital length of stay in patients treated with WHCO2 merit further investigation. The design of the full‐scale RCT will benefit from this feasibility study.
Endobronchial ultrasound‐guided fine needle aspiration diagnosis of metastatic FUS‐ERG‐rearranged extraskeletal Ewing sarcoma following 15 years of untreated metastatic recurrence
Authors: Wang Chiyun , Dickson Brendan C. , Smith Adam C. , Hope Andrew J. , Ko Hyang Mi 
Published: November 2021

This case report demonstrates challenges in the cytological diagnosis of metastatic extraskeletal Ewing sarcoma from an endobronchial ultrasound‐guided fine needle aspiration biopsy and the important role of ancillary molecular analysis. It also adds to the small number of Ewing sarcoma with FUS‐ERG fusion in the literature by highlighting an exceptionally indolent clinical course over 15 years of slowly progressing pulmonary metastases in the absence of any treatment.
Hepatitis E virus and Bell’s palsy
Authors: Fritz‐Weltin Miriam , Niedermeier Lisa , Frommherz Estelle , Isenmann Nora , Csernalabics Benedikt , Boettler Tobias , Neumann‐Haefelin Christoph , Endres Dominique , Panning Marcus , Berger Benjamin 
Published: November 2021

AbstractBackground and purposeAcute hepatitis E virus (HEV) infections have been associated with various neurological disorders, including individual cases with Bell's palsy. Nonetheless, systematic studies in the latter are lacking. Therefore, this retrospective study systematically screened a cohort of patients with Bell's palsy for an acute HEV infection.MethodsOverall, 104 patients with Bell's palsy treated in our clinic between 2008 and 2018 were identified. Serum samples were analyzed for anti‐HEV immunoglobulin (Ig)M and IgG antibodies by enzyme‐linked immunosorbent assay. Additionally, serum samples were tested for HEV RNA by polymerase chain reaction in 92 of these 104 patients presenting within the first 7 days from symptom onset. A large group of 263 healthy individuals served as controls.ResultsNone of the patients with Bell's palsy but two healthy controls (0.8%) had an acute HEV infection. Anti‐HEV IgG seroprevalence indicating previous infection was unexpectedly high in patients with Bell's palsy (34%) and revealed an age‐dependent increase.ConclusionsIn this first systematic study, no cases of Bell's palsy in association with an acute HEV infection were identified. However, based on previous case descriptions, rare associations cannot be excluded. Therefore, large prospective multicenter studies will be necessary for conclusions that are more definitive.