bluuebunny/crossref_metadata_2025_split huggingface dataset:
Qualitative Sensory Testing in Outcome Prediction of Transforaminal Epidural Steroid Injection for Chronic Painful Unilateral Lumbosacral Radiculopathy: Prospective Observational Study
Authors: Vaitkus Alfredas , Šipylaitė Jūratė 
Published: January 2021

AbstractBackgroundTransforaminal epidural steroid injection (TFESI) is widely practiced for the treatment of radicular pain. As its effectiveness is still subject to debate, a better patient selection for TFESI is necessary. We aimed to evaluate the potential of bedside‐suitable qualitative sensory testing (QualST) to determine the early effectiveness of TFESI for the treatment of chronic lumbosacral radiculopathy (LSR)‐related pain.MethodsThirty‐six patients with chronic painful unilateral LSR were evaluated in a prospective observational study using five standardized sensory tests (10 g monofilament, 200 to 400 mN brush, Lindblom rollers with controlled 25 and 40°C temperature, and 40 g neurological pin). Quality of sensory perceptions on the painful leg was compared to the non‐painful leg and rated as normal sensitivity, hyposensitivity, or hypersensitivity. Pain and related characteristics were evaluated before TFESI, 1 week after and 4 weeks after intervention.ResultsSeven sensory phenotypes were distinguished according to individual sets of sensory disturbances acquired with five sensory tests. Patients were grouped into four groups of allied phenotypes (normal sensitivity, hyposensitivity to 1 to 3 modalities, hyposensitivity to 4 to 5 modalities, and hypersensitivity). The whole study group showed significant improvement in most parameters of outcome measurements. Statistical analysis revealed some significant differences between sensory groups in patient‐reported treatment effect scales after 4 weeks. We also detected significant differences between sensory groups in repeated measures after 1 and 4 weeks in some pain intensity characteristics and patient‐reported treatment effect scales.ConclusionQualST might be clinically applicable for detecting patient subgroups that could differ in the early treatment results of radicular pain by TFESI.
Diagnosing the Nation: Scientists, Mothers, and Physicians Confront Nuclear Testing and Civil Defense Through Medical Activism, 1958–1963
Authors: Whitehurst John Robert 
Published: January 2021

AbstractThe Limited Test Ban Treaty of 1963, which banned atmospheric nuclear testing, is one of the most powerful treaties regarding nuclear weapons ever passed. This legislation was pushed forward by the Kennedy Administration following the publicization of scientific and medical tests that warned readers about the introduction of man‐made radioisotopes into the bones and bodies of American infants. These scientific and medical tests were performed, publicized, and analyzed by a combination of scientists, concerned mothers, and physicians who respectively organized between 1958 and 1961. Each of these “medical activist” groups worked together during the early Cold War and was able to influence the Kennedy administration, who encouraged their involvement and even partially credited it with the garnishing of public support for the treaty. This multi‐constitutent response to the dangers of radioisotopes offers a window into the nexus of Cold War era concerns over national security, scientific and technological advances, and public health.
Seedling‐derived leaf and root tip as alternative explants for callus induction and plant regeneration in maize
Authors: Wang Chenchen , Ma Haizhen , Zhu Weiwei , Zhang Jiedao , Zhao Xiangyu , Li Xinzheng 
Published: January 2021

AbstractWhile being one of the world's most important crops, maize (Zea mays L.) is still relatively difficult to regenerate in tissue culture, which severely limits its improvement by genetic engineering. Currently, immature zygotic embryos provide the predominant material for transformation and regeneration. However, the procedures involved are often laborious and season‐dependent. Therefore, new explants to replace or complement immature embryos are desirable. Here, we exploited root tips and young leaves isolated from 3‐day‐old dark‐grown seedlings as alternative explant sources for establishing plant regeneration. As novel explants, the root tips could generate embryogenic calli similar to that from the young leaves. The rate of primary callus induction from root tips reached 97.2% and almost as high as 98.8% from immature embryos. The difference in callus induction rates among these explants may be closely related to the differences in expression level of stem cell‐related genes in callus tissue. Moreover, the alternative explants are easy to obtain in large quantities. These combined results indicate that explants from seedling‐derived root tips and leaf tissue have the potential to replace immature embryos for plant regeneration and transformation.
Assessing the Trump White House
Authors: Hult Karen M. 
Published: January 2021

AbstractThis essay examines and assesses the dynamics of the White House and broader executive branch under President Donald J. Trump. It probes the performance of key institutional responsibilities, focusing on selected areas of policy and of administration. Evaluated on the effectiveness of achieving the administration's goals and on implications for governance, the Trump presidency receives at best a mixed review. Its accomplishments included boosting conservative presence on the federal courts and moving from multilateral to more dyadic relations in international affairs. Yet, it achieved considerably fewer of its deregulatory goals while neglecting pressing problems and reinforcing concerns with presidential capacity and loss of trust in government.
Ligation of the ligamentum arteriosum and aberrant left subclavian artery in five dogs in which persistent right aortic arch had been diagnosed
Authors: Regier Penny J. , Case J. Brad , Fox‐Alvarez W. Alexander 
Published: January 2021

AbstractObjectiveTo determine and report the diagnosis, treatment, and outcome in dogs with persistent right aortic arch (PRAA) with an aberrant left subclavian artery (ALS) that underwent thoracoscopic surgery.AnimalsDogs with PRAA and an ALS (n = 5).Study designShort case series.MethodsMedical records were reviewed from 2014 to 2019. Dogs that underwent thoracoscopy for PRAA with an ALS at an academic referral hospital were included. Signalment, clinical signs, diagnostic imaging, surgical approach, complications, and short‐ and long‐term outcomes were recorded.ResultsPersistent right aortic arch with an ALS was identified in five dogs. Dogs initially underwent a three‐port intercostal thoracoscopic approach, and an intercostal thoracotomy was performed in converted cases. In all five dogs, the ligamentum arteriosum (LA) and ALS were divided; three were performed by a thoracoscopy alone. Two cases were converted because of poor exposure (1) and requirement to temporary occlude an ALS (1). The ALS was ligated and divided in all dogs without apparent negative effects. No intraoperative or postoperative complications occurred. Four dogs had resolution of regurgitation, three of which required diet modification. One dog had reported regurgitation when it was excited. Median follow‐up was 188 days (range, 150‐1133).ConclusionLigation and division of both the LA and the ALS in all dogs in this case series was safe and allowed for improvement in clinical signs and good to excellent long‐term outcomes. In addition, both thoracoscopy and thoracotomy were used safely and successfully for ligation and transection of the LA and ALS in all dogs.
Impact of ENaC downregulation in transgenic mice on the outcomes of acute lung injury induced by bleomycin
Authors: Aubin Vega Mélissa , Chupin Cécile , Massé Chantal , Dagenais André , Berthiaume Yves , Brochiero Emmanuelle 
Published: January 2021

New Findings

What is the central question of this study?
How does the downregulation of ENaC, the major driving force for alveolar fluid clearance, impact acute lung injury outcomes induced by bleomycin, featuring alveolar damage, as observed during ARDS exudative phase?

What is the main finding and its importance?
ENaC downregulation in αENaC(−/−)Tg+ mice did not elicit a substantial worsening impact on the main bleomycin outcomes. In ARDS patients, both ENaC alteration and alveolar damage are observed. Thus, novel therapeutic avenues, favouring alveolar integrity restauration, in addition to lung oedema resolution capacity, mainly driven by ENaC, would be essential.

AbstractThe exudative phase of acute respiratory distress syndrome (ARDS) is characterized by extended alveolar damage, resulting in accumulation of protein‐rich inflammatory oedematous fluid in the alveolar space. Na+ reabsorption through ENaC channels is a major driving force for alveolar fluid clearance (AFC) in physiological and pathological conditions. It has previously been shown that partial αENaC impairment in transgenic (αENaC(−/−)Tg+) mice results in reduced AFC in basal conditions and increased wet/dry ratio after thiourea‐induced lung oedema, a model in which the integrity of the alveolar epithelium is preserved. The goal of this study was to further investigate the impact of αENaC downregulation in αENaC(−/−)Tg+ mice using an experimental model of acute lung injury induced by bleomycin. A non‐significant trend in enhanced weight loss and mortality rates was observed after the bleomycin challenge in αENaC(−/−)Tg+ compared to wild‐type (WT) mice. Bronchoalveolar lavage analyses revealed increased TNFα levels and protein concentrations, as indexes of lung inflammation and alveolar damage, in αENaC(−/−)Tg+ mice, compared to WT, at day 3 post‐bleomycin, although a statistical difference was no longer measured at day 7. Differential immune cell counts were similar in WT and αENaC(−/−)Tg+ mice challenged with bleomycin. Moreover, lung weight measurements indicated similar oedema levels in WT mice and in transgenic mice with impaired ENaC channels. Altogether, our data indicated that change in ENaC expression does not elicit a significant impact on lung oedema level/resolution in the bleomycin model, featuring alveolar damage.
Influence of Blade Tip Surface Roughness on the Performance of a Single-Stage Axial Flow Compressor
Authors: Kodancha Pradyumna , Salunkhe Pramod B. 
Published: January 2021

Abstract
Numerical investigations are carried out in a single-stage subsonic axial flow compressor to unravel the influence of blade tip surface roughness on the tip leakage flow characteristics and hence the compressor performance. The studies were carried out at different tip clearance of 0.38τ, 0.77τ, 1.15τ, and 1.54τ and blade tip surface roughness of 0.31ε and 0.62ε. The tip clearance of 0.38τ with blade tip surface roughness of 0.62ε resulted in the highest stall margin and pressure rise of 20.3% and 4.3%, respectively. The compressor blade loading was found to be improved by 5.9% after incorporating the blade tip surface roughness. The isosurfaces of vorticity contour plotted using the Q-criterion showed the reduction in strength of the tip leakage vortex. The tip leakage trajectory was found to be shifted toward the suction surface of the blade for the blade tip with surface roughness. This positive alteration in the tip leakage flow structure led to the improved performance for the blade tip with surface roughness.
Effects of Varying Overground Walking Speeds on Lower-Extremity Muscle Synergies in Healthy Individuals
Authors: Escalona Manuel J. , Bourbonnais Daniel , Goyette Michel , Le Flem Damien , Duclos Cyril , Gagnon Dany H. 
Published: January 2021

The effects of walking speeds on lower-extremity muscle synergies (MSs) were investigated among 20 adults who walked 20 m at SLOW (0.6 ± 0.2 m/s), natural (NAT; 1.4 ± 0.1 m/s), and FAST (1.9 ± 0.1 m/s) speeds. Surface electromyography of eight lower-extremity muscles was recorded before extracting MSs using a nonnegative matrix factorization algorithm. Increasing walking speed tended to merge MSs associated with weight acceptance and limb deceleration, whereas reducing walking speed does not change the number and composition of MSs. Varying gait speed, particularly decreasing speed, may represent a gait training strategy needing additional attention given its effects on MSs.
IL-21 arming potentiates the anti-tumor activity of an oncolytic vaccinia virus in monotherapy and combination therapy
Authors: Chen Tianyue , Ding Xiangqing , Liao Qibin , Gao Nan , Chen Ye , Zhao Chen , Zhang Xiaoyan , Xu Jianqing 
Published: January 2021

BackgroundOncolytic viruses (OVs) have shown promise in containing cancer progression in both animal models and clinical trials. How to further improve the efficacy of OVs are intensively explored. Arming OVs with immunoregulatory molecules has emerged as an important means to enhance their oncolytic activities majorly based on the mechanism of reverting the immunosuppressive nature of tumor environment. In this study, we aimed to identify the optimal combination of different OVs and immunomodulatory molecules for solid tumor treatment as well as the underlying mechanism, and subsequently evaluated its potential synergy with other immunotherapies.MethodsPanels of oncolytic viruses and cells stably expressing immunoregulatory molecules were separately evaluated for treating solid tumors in mouse model. A tumor-targeted replicating vaccinia virus Tian Tan strain with deletion of TK gene (TTVΔTK) was armed rationally with IL-21 to create rTTVΔTK-IL21 through recombination. CAR-T cells and iNKT cells were generated from human peripheral blood mononuclear cells. The impact of rTTVΔTK-IL21 on tumor-infiltrating lymphocytes was assessed by flow cytometry, and its therapeutic efficacy as monotherapy or in combination with CAR-T and iNKT therapy was assessed in mouse tumor models.ResultsIL-21 and TTV was respectively identified as most potent immunomodulatory molecule and oncolytic virus for solid tumor suppression in mouse models. A novel recombinant oncolytic virus that resulted from their combination, namely rTTVΔTK-mIL21, led to significant tumor regression in mice, even for noninjected distant tumor. Mechanistically, rTTV∆TK-mIL21 induced a selective enrichment of immune effector cells over Treg cells and engage a systemic response of therapeutic effect. Moreover, its human form showed a notable synergy with CAR-T or iNKT therapy for tumor treatment when coupled in humanized mice.ConclusionWith a strong potency of shaping tumor microenvironment toward favoring TIL activities, rTTVΔTK-IL21 represents a new opportunity worthy of further exploration in clinical settings for solid tumor control, particularly in combinatorial strategies with other immunotherapies.One sentence summaryIL21-armed recombinant oncolytic vaccinia virus has potent anti-tumor activities as monotherapy and in combination with other immunotherapies.
Rapid sequence induction
Authors: Fry R , Scott T 
Published: January 2021

AbstractEmergency tracheal intubation undertaken by Rapid sequence induction (RSI) is a fundamental component of military anaesthesia. This common emergency procedure has evolved in both civilian and military practice, since it was first described, as new drugs have become available. Current practice now differs significantly from that undertaken by the procedure’s initial advocates. This is particularly the case in the deployed military environment. As military medicine continues to improve injury survivability, RSI will be undertaken in increasingly unstable casualties, requiring a bespoke emergency induction not commonly practised in the civilian setting.This article will discuss RSI as first described, explore how this technique has been modified in domestic practice and describe how it can be adapted for use in austere environments for our most severely injured personnel.
An overview of common diseases of the nasal cavity and paranasal sinuses
Authors: Easto R , Shukla R , Williams R 
Published: January 2021

AbstractDiseases of the nasal cavity and paranasal sinuses are a common complaint amongst the general population and service personnel. Chronic rhinosinusitis, with or without nasal polyps, and nasal deformity leading to airway obstruction are some of the commonest ear, nose and throat (ENT) conditions encountered. However, hidden within this generally benign group of conditions are some potentially lethal problems that clinicians need to be able to recognise.This article aims to provide an overview of common conditions affecting the nose and paranasal sinuses, including fractured nasal bones, acute rhinosinusitis and its complications, and chronic rhinosinusitis. Epistaxis and sinonasal malignancies are largely outside the scope of this paper. Background information on pathogenesis will be described, along with guidance on diagnosis and management with particular stress on emergency pre-hospital treatment and indications for referral to an ENT specialist.
The management of acute hip pain in the military
Authors: Green NM , Matthews JJ 
Published: January 2021

AbstractAcute hip pain is a common presenting complaint amongst the military population. It can present in a variety of ways, with a broad range of differential diagnoses to consider. Most cases of acute hip pain in military patients tend to be traumatic in origin. Pathology within the hip can be a diagnostic challenge, as symptoms often overlap between differential diagnoses and examination findings are not always sensitive or specific. Any hip injury will potentially downgrade a military patient and can also be a significant cause of long-term morbidity. Being able to manage the patient with acute hip pain effectively will ensure that patients spend less time in the diagnostic chain and reach the definitive treatment they require to continue to carry out their primary role.This paper describes how best to manage military patients who present with acute hip pain. It covers the diagnostic challenges faced by clinicians, the differential diagnoses of acute hip pain and describes the management of some common injuries of the hip: tears of the acetabular labrum and femoral neck stress fractures.
Sir Gilbert Blane FRS: the man and his legacy
Authors: Penn-Barwell Jowan G 
Published: January 2021

Sir Gilbert Blane (1749-1834) was a Medical Officer in the Royal Navy who saw action against both the French and Spanish fleets, and later served as a Commissioner on the Sick and Wounded Board of the Admiralty. His work to improve the living conditions and health of sailors, and the significant reductions in sickness rates this achieved, brought him national recognition and honoursIn 1830, Sir Gilbert Blane established a legacy with the Royal College of Surgeons of England for the award of a Gold Medal in his name to be awarded to medical officers‘who have brought about an advancement….or improvement in any matter affecting the health or living conditions of Naval personnel’. The first two Gilbert Blane medals were awarded in 1832, and the eponymous award continues to this day, 182 years after his death.
Algorithm for cavo-tricuspid isthmus flutter on surface ECGs: the ACTIONS study
Authors: Frisch Daniel R , Frankel Eitan , Gill Deanna , Danaf Jad Al 
Published: January 2021

ObjectiveCavo-tricuspid isthmus atrial flutter (CTI-AFL) is an important arrhythmia to recognise because there is a highly effective and relatively low-risk ablation strategy. However, clinical experience has demonstrated that providers often have difficulty distinguishing AFL from atrial fibrillation.MethodsWe developed a novel ECG-based three-step algorithm to identify CTI-AFL based on established CTI flutter characteristics and verified on consecutive ablation cases of typical flutter, atypical flutter and atrial fibrillation. The algorithm assesses V1/inferior lead F-wave concordance, consistency of P-wave morphology and the presence of isoelectric intervals in the inferior leads. In this observation study, the algorithm was validated on a cohort of 50 second-year medical students. Students were paired in a control and experimental group, and each pair received 10 randomly selected ECGs (from a pool of 50 intracardiac electrogram-proven CTI-AFL and 50 AF or atypical AFL cases). The experimental group received a cover sheet with the CTI algorithm, and the control group received no additional guidance.ResultsThere was a statistically significant difference in the mean number of correctly identified ECGs among the students in the experimental and control groups (8.12 vs 5.68, p<0.001). Students who used the algorithm correctly identified 2.44 more ECGs as being CTI-AFL or not CTI-AFL. Using the electrophysiology study as the gold standard, the algorithm had an accuracy of 81%, sensitivity of 81%, specificity of 82%, positive predictive value of 78% and negative predictive value of 84% in identifying CTI-AFL.ConclusionWe developed a three-step ECG algorithm that provides a simple, sensitive, specific and accurate tool to identify CTI-AFL.
In the great pond snail (Lymnaea stagnalis), two stressors that individually enhance memory in combination block memory formation
Authors: Soudavari Romina , Batabyal Anuradha , Lukowiak Ken 
Published: January 2021

Stress plays an important role in memory formation in the great pond snail (Lymnaea stagnalis (Linnaeus, 1758)). Individual stressors have been shown to enhance or to perturb long-term memory (LTM) formation. However, when snails perceive a combination of two stressors, it is unclear the outcome with regards to LTM formation. Here we first show that when L. stagnalis are exposed individually to either a predator stressor (crayfish effluent (CE), which is a kairomone) or a thermal stressor (30 °C), LTM formation is enhanced. In their natural environment, L. stagnalis may experience temperatures approaching 30 °C and they may encounter crayfish at the same time. How such a combination of stressors alters adaptive behaviour is unknown. Here we show that when these two stressors are combined, LTM formation is blocked. Since boiling CE inactivates the kairomone, we used previously boiled CE that we combined with the thermal stressor and found that LTM formation is again enhanced. These data show that (i) it cannot accurately be predicted how a combination of stressors when combined interact to alter LTM formation and (ii) there is a difference between hot CE and room temperature CE.
Record dynamics of evolving metastable systems: theory and applications
Authors: Sibani Paolo , Boettcher Stefan , Jensen Henrik Jeldtoft 
Published: January 2021

Abstract
Record Dynamics (RD) deals with complex systems evolving through a sequence of metastable stages. These are macroscopically distinguishable and appear stationary, except for the sudden and rapid changes, called quakes, which induce the transitions from one stage to the next. This phenomenology is well known in physics as “physical aging”, but from the vantage point of RD, the evolution of a class of systems of physical, biological, and cultural origin is rooted in a hierarchically structured configuration space and can, therefore, be analyzed by similar statistical tools. This colloquium paper strives to present in a coherent fashion methods and ideas that have gradually evolved over time. To this end, it first describes the differences and similarities between RD and two widespread paradigms of complex dynamics, Self-Organized Criticality and Continuous Time Random Walks. It then outlines the Poissonian nature of records events in white noise time-series, and connects it to the statistics of quakes in metastable hierarchical systems, arguing that the relaxation effects of quakes can generally be described by power laws unrelated to criticality. Several different applications of RD have been developed over the years. Some of these are described, showing the basic RD hypothesis and how the log-time homogeneity of quake dynamics, can be empirically verified in a given context. The discussion summarizes the paper and briefly mentions applications not discussed in detail. Finally, the outlook points to possible improvements and to new areas of research where RD could be of use.

Graphic Abstract