bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional anesthesia in coronavirus disease 2019 pandemic
Authors: Heijnen Tyler , Vandebergh Vincent , Vandepitte Catherine , Buck Robbert 
Published: August 2021

Purpose of review
Coronavirus disease 19 (COVID-19) has presented numerous challenges to healthcare systems worldwide. The virus is highly contagious and infectious since transmission can occur via multiple routes. General measures to prevent viral transmission to patients and healthcare personnel, such as a reduction in clinical load and routine testing, must be coupled with multiple additional safety measures in perioperative services.

Recent findings
Regional anesthesia preserves respiratory function and reduces aerosol-generating procedures typically associated with airway management in general anesthesia, making it the first choice for a suspected or confirmed COVID-19 patient in need of surgery with anesthesia. A well thought out regional anesthetic plan, implementation of hygiene and (personal) safety measures are necessary to ensure the best possible outcome for both the patient and the healthcare staff.

Summary
The present review addresses both practical and recommended measures for performing regional anesthesia in the pandemic, to ensure patient and staff safety, and equipment protection. Further research and evidence-based guidelines are necessary to devise an established standard of care during the current COVID-19 and possible future pandemics.
Impact of Women’s Domination in Plastic Surgery Residency Program in Indonesia
Authors: Aulia Indri , Mustika Rita , Menaldi Sri L. 
Published: August 2021

Background:
A shift in gender dominance from man to woman in the medical field has occurred from time to time globally, including in Indonesia’s plastic surgery community. This shift may alter the education and clinical settings of plastic surgery. This study aimed to explore the effect of the phenomenon of women’s dominance in plastic surgery residency programs in Indonesia.

Methods:
This qualitative study was conducted using a phenomenological approach on three plastic surgery residency programs in Indonesia. Academic report review, focus group discussions, and in-depth interviews of residents, lecturers, residency program managers, and alumni user groups were selected using the maximum variation sampling method. Data obtained were analyzed and processed thematically.

Results:
Three themes emerged based on the educational process timeline: pre-education, intra-education, and post-education. Each timeline had several themes that mutually influenced the educational process. In the pre-educational process, residents’ personal characters were affected by societies’ positive and negative perceptions. The working environment, impact of women’s dominance, and cultural dimension affected the intra-educational process. When entering the career life, residents expected an ideal working environment and had particular workplace preferences to achieve their well-being.

Conclusions:
The impact of women’s dominance during the educational program affected residents’ daily dynamics. However, this dominance did not affect the quality of education and workloads.
Open Conjunctival Approach for Sub-Tenon’s Xen Gel Stent Placement and Bleb Morphology by Anterior Segment Optical Coherence Tomography
Authors: Dangda Sonal , Radell Jake E. , Mavrommatis Maria A. , Lee Rachel , Do Anna , Sidoti Paul A. , Panarelli Joseph F. 
Published: August 2021

Précis:
Sub-Tenon’s implantation of the Xen Gel stent resulted in significant intraocular pressure (IOP) lowering along with a low rate of postoperative bleb needling, and a favorable bleb morphology on anterior segment optical coherence tomography (AS-OCT).

Purpose:
The aim was to assess clinical outcomes and bleb morphology following sub-Tenon’s implantation of the Xen Gel Stent.

Methods:
The medical records of patients who underwent sub-Tenon’s Xen Gel Stent implantation with intraoperative mitomycin-C through an open conjunctival approach were reviewed. Postoperative IOP and number of glaucoma medications at 1, 3, 6, 9, and 12 months were assessed. Bleb morphology was analyzed at various timepoints using AS-OCT (Topcon DRI OCT version 1.1.1).

Results:
Twenty-six eyes were included in the study. Mean age was 69.4±8.0 years. Mean preoperative IOP was 28.1±7.8 mm Hg on an average of 3.5±0.9 glaucoma medications. Mean IOP at postoperative month 12 (n=23 eyes) was 12.9±4.0 mm Hg (P<0.01) on an average of 0.3±0.6 (P<0.01) glaucoma medications. Three eyes (12%) required postoperative needle revision. Bleb morphology in the early postoperative period (≤3 mo) was characterized by multiple small subconjunctival microcysts on AS-OCT. At the intermediate (6 to 12 mo) and long-term (>12 mo) timepoints, reduction in microcysts with multiple internal parallel layers of aqueous flow and a uniform pattern were more frequently noted. All functional blebs were characterized by the presence of a posterior episcleral fluid lake. Failed blebs showed absence of aqueous humor around the distal end of the microshunt.

Conclusion:
Following an open conjunctival approach, sub-Tenon’s placement of the Xen Gel Stent with significant IOP lowering was achieved. In eyes with good shunt function, bleb morphology by AS-OCT showed a posterior episcleral fluid lake similar to findings following trabeculectomy.
The natural history of COVID-19 in patients with inflammatory bowel disease: a nationwide study by the Hellenic Society for the study of IBD
Authors: Bamias Giorgos , Kokkotis Georgios , Christidou Angeliki , Christodoulou Dimitrios K. , Delis Vasileios , Diamantopoulou Georgia , Fessatou Smaragdi , Gatopoulou Anthia , Giouleme Olga , Kafritsa Panagiota , Kalantzis Chrisostomos , Kapsoritakis Andreas , Karatzas Pantelis , Karmiris Konstantinos , Katsanos Konstantinos , Kevrekidou Polyxeni , Kosmidis Charalampos , Mantaka Aikaterini , Mathou Nicoletta , Michalopoulos George , Michopoulos Spyridon , Papaconstantinou Ioannis , Papatheodoridis George , Polymeros Dimitrios , Potamianos Spyros , Poulopoulos Georgios , Protopapas Andreas , Sklavaina Maria , Soufleris Konstantinos , Theocharis Georgios , Theodoropoulou Angeliki , Triantafillidis John K. , Triantafyllou Konstantinos , Tsiolakidou Georgia , Tsironi Eftychia , Tzouvala Maria , Viazis Nikos , Xourgias Vasileios , Zacharopoulou Eirini , Zampeli Evanthia , Mantzaris Gerasimos J. 
Published: August 2021

Objectives
COVID-19 has evolved into a global health crisis, variably affecting the management of patients with chronic illnesses. Patients with inflammatory bowel disease (IBD) may represent a vulnerable population due to frequent administration of immune-modifying treatments. We aimed to depict the natural history of COVID-19 infection in Greek patients with IBD at a nationwide level via unbiased reporting of all cases that were registered during the sequential waves of the pandemic.

Methods
Following a national call from the Hellenic Society for the study of IBD, we enrolled all IBD patients with established diagnoses of COVID-19. Clinical and epidemiological data, including COVID-19 modifying factors and IBD-associated therapies, were analyzed against adverse outcomes (hospitalization, ICU admission and death).

Results
We identified 154 IBD patients who were diagnosed with COVID-19 (men: 58.4%; mean age=41.7 years [SD = 14.9]; CD: 64.3%). Adverse outcomes were reported in 34 patients (22.1%), including 3 ICU admissions (1.9%) and two deaths (1.3%). Multivariate logistic regression analysis showed that age (OR = 1.04, 95% CI, 1–1.08) and dyspnea at presentation (OR = 7.36, 95% CI, 1.84–29.46) were associated with worse outcomes of COVID-19 infection. In contrast, treatment with biologics, in particular anti-TNF agents, exerted a protective effect against an unfavorable COVID-19 disease course (OR = 0.4, 95% CI, 0.16–0.99). Patients on subcutaneous biologics were more likely to halt treatment due to the infection as compared to those on intravenous biologics.

Conclusions
IBD patients who developed COVID-19 had a benign course with adverse outcomes being infrequent. Treatment with anti-TNF biologics had a protective effect, thus, supporting continuation of therapy during the pandemic.
The impact of undiagnosed primary biliary cholangitis
Authors: Garrido Isabel , Liberal Rodrigo , Cardoso Maria João , Macedo Guilherme 
Published: August 2021

Background
Primary biliary cholangitis (PBC) is a chronic autoimmune disease characterized by symptoms with a major impact on the quality of life. The aim of this study was to identify patients with undiagnosed PBC who are not under hepatology follow-up and to assess the clinical impact of lack of adequate treatment and surveillance.

Methods
Adult patients with a positive antimitochondrial antibodies (AMA) titer were identified from local biochemistry records. Patients with probable PBC who were not known by the hepatology services were invited to accurately stage their disease and optimize medical management.

Results
A total of 214 AMA-positive patients were identified, 148 of whom had diagnostic criteria for PBC. Twenty-three patients were not known by the hepatology services, most of them followed by specialties other than gastroenterology. These patients had significantly higher liver stiffness compared to those followed by the hepatology services (14.3 kPa vs. 6.2 kPa; P = 0.009). A large percentage of untreated individuals reported fatigue (72.7%) and pruritus (27.3%).

Conclusions
A substantial number of patients with PBC are not known to have hepatology services with a significant long-term impact from a lack of follow-up and therapy. Strategies must be established to identify these patients and reduce the disease’s progressive nature.
Long-standing effect of cholecystectomy in patients with metabolic-associated fatty liver disease
Authors: Méndez-Sánchez Nahum , Valencia-Rodríguez Alejandro , Cerda-Reyes Eira , Montejo-Velázquez César , Higuera de la Tijera Fátima , Servin-Caamaño Alfredo , Icaza-Chávez María E. , Chi-Cervera Luis A. , Montalvo-Gordon Iaarah , Qi Xingshun , Jiménez-Gutiérrez Carlos 
Published: August 2021

Objective
The role of cholecystectomy as a risk factor in patients with metabolic-associated fatty liver disease (MAFLD) remains unclear. This study aimed to investigate if long-standing cholecystectomy is associated with advanced liver fibrosis and cirrhosis in patients with recently diagnosed MAFLD.

Methods
A retrospective observational study was performed in four hospitals in Mexico including patients with recently diagnosed MAFLD and a history of cholecystectomy. Subjects were divided into those with cholecystectomy ≥6 months before MAFLD diagnosis (ChBM), and those with cholecystectomy at the time of MAFLD diagnosis (ChAM). Odds ratios (OR) for the association of advanced liver fibrosis and cirrhosis with the timing of cholecystectomy were calculated.

Results
Mean age of 211 participants was 49.06 ± 15.12 years and the majority were female (72.5%). Patients from the ChBM (n = 70) group were significantly older (53.14 vs. 47.03 years; P = 0.003), had higher BMI (30.54 vs. 28.52 kg/m2; P = 0.011) and lower platelet count (236.23 vs. 266.72 × 103/µL; P = 0.046) compared with patients from ChAM group (n = 141). In multivariable-adjusted analysis, age (OR = 2.37; P = 0.024), dyslipidemia (OR = 4.28; P = 0.005) and severe liver fibrosis (OR = 4.68; P = 0.0) were independent risk factors associated with long-standing cholecystectomy.

Conclusion
Patients with long-standing cholecystectomy (≥6 months) are at increased risk of severe liver fibrosis and cirrhosis at the time of MAFLD diagnosis compared to those with recently done cholecystectomy. Advanced age (>50 years) and dyslipidemia are also commonly found in these subjects.
Assessment of avoidant restrictive food intake disorder, pica and rumination disorder: interview and questionnaire measures
Authors: Dinkler Lisa , Bryant-Waugh Rachel 
Published: August 2021

Purpose of review
This article reviews available assessment instruments for three of the feeding and eating disorder diagnostic categories: avoidant restrictive food intake disorder (ARFID), pica, and rumination disorder (RD). It includes an overview of the current status of screening tools, questionnaire measures, and diagnostic instruments.

Recent findings
Screening instruments are available for all three disorders; however, for pica and RD, these typically include single screening items only and do not cover any specific features of these presentations. Only one questionnaire suitable for clinical populations is included, covering ARFID only. Standardized diagnostic interviews are limited to two covering both pica and RD, only one of which provides further clinical information. Of the five diagnostic instruments for ARFID described here, two include diagnostic items as well as allowing more detailed assessment of clinical features.

Summary
There are a limited number of assessment measures available for all three disorders, with instruments for ARFID being the greatest in number and widest in terms of scope. A commonly encountered difficulty is that many assessment instruments do not adequately cover diagnostic exclusion criteria, which raises the likelihood of false positive findings. All currently available measures require further study to determine their reliability and validity.
Association between Neighborhood Socioeconomic Status and Executive System Activation in Youth
Authors: Murtha Kristin , Larsen Bart , Pines Adam , Parkes Linden , Moore Tyler M. , Adebimpe Azeez , Alexander-Bloch Aaron , Calkins Monica E. , Davila Diego G. , Lindquist Martin A. , Mackey Allyson P. , Roalf David R. , Scott J. Cobb , Wolf Daniel H. , Gur Ruben C. , Gur Raquel E. , Barzilay Ran , Satterthwaite Theodore D. 
Published: August 2021

ABSTRACTLow socioeconomic status has been shown to have detrimental effects on cognitive performance, including working memory (WM). As executive systems that support WM undergo functional neurodevelopment during adolescence, environmental stressors at both individual and community levels may have a particularly strong impact on cognitive outcomes. Here, we sought to examine how neighborhood socioeconomic status (SES) impacts task-related activation of the executive system during adolescence, and to determine whether this effect mediates the relationship between neighborhood SES and WM performance. To address these questions, we studied 1,158 youths (age 8-22) that completed a fractal n-back WM task during fMRI at 3T as part of the Philadelphia Neurodevelopmental Cohort. We found that higher neighborhood SES was associated with greater activation of the executive system to WM load, including the bilateral dorsolateral prefrontal cortex, posterior parietal cortex, and precuneus. These associations remained significant when controlling for related factors like parental education and exposure to traumatic events. Furthermore, high dimensional multivariate mediation analysis identified two distinct patterns of brain activity within the executive system that significantly mediated the relationship between neighborhood SES and task performance. Together, these findings underscore the importance of the neighborhood environment in shaping executive system function and WM in youth.
Clinical Metagenomic Sequencing for Species Identification and Antimicrobial Resistance Prediction in Orthopaedic Device Infection
Authors: Street Teresa L. , Sanderson Nicholas D. , Kolenda Camille , Kavanagh James , Pickford Hayleah , Hoosdally Sarah , Cregan Jack , Taunt Carol , Jones Emma , Oakley Sarah , Atkins Bridget L. , Dudareva Maria , McNally Martin A. , O’Grady Justin , Crook Derrick W. , Eyre David W. 
Published: August 2021

AbstractBackgroundDiagnosis of orthopaedic device-related infection is challenging, and causative pathogens may be difficult to culture. Metagenomic sequencing can diagnose infections without culture, but attempts to detect antimicrobial resistance (AMR) determinants using metagenomic data have been less successful. Human DNA depletion may maximise the amount of microbial DNA sequence data available for analysis.MethodsHuman DNA depletion by saponin was tested in 115 sonication fluid samples generated following revision arthroplasty surgery, comprising 67 where pathogens were detected by culture and 48 culture-negative samples. Metagenomic sequencing was performed on the Oxford Nanopore Technologies GridION platform. Filtering thresholds for detection of true species versus contamination or taxonomic misclassification were determined. Mobile and chromosomal genetic AMR determinants were identified in Staphylococcus aureus-positive samples.ResultsOf 114 samples generating sequence data, species-level sensitivity of metagenomic sequencing was 49/65 (75%; 95%CI 63-85%) and specificity 103/114 (90%; 95%CI 83-95%) compared with culture. Saponin treatment reduced the proportion of human bases sequenced in comparison to 5µm filtration from a median (IQR) 98.1% (87.0%-99.9%) to 11.9% (0.4%-67.0%), improving reference genome coverage at 10-fold depth from 18.7% (0.30%-85.7%) to 84.3% (12.9%-93.8%). Metagenomic sequencing predicted 13/15 (87%) resistant and 74/74 (100%) susceptible phenotypes where sufficient data were available for analysis.ConclusionsMetagenomic nanopore sequencing coupled with human DNA depletion has the potential to detect AMR in addition to species detection in orthopaedic device-related infection. Further work is required to develop pathogen-agnostic human DNA depletion methods, improving AMR determinant detection and allowing its application to other infection types.
An ancient dental signalling centre supports homology of an enamel knot in sharks
Authors: Thiery Alexandre P. , Standing Ariane S. I. , Cooper Rory L. , Fraser Gareth J. 
Published: August 2021

AbstractDevelopment of tooth cusps is regulated by the enamel knot signalling centre. Fgf signalling regulates differential proliferation between the enamel knot and adjacent dental epithelia during tooth development, leading to formation of the dental cusp. The presence of an enamel knot in non-mammalian vertebrates is debated given differences in signalling. Here we show the conservation and restriction of fgf10 and fgf3 to the sites of future dental cusps in the shark (Scyliorhinus canicula), whilst also highlighting striking differences between the shark and mouse. We reveal shifts in tooth size, shape and cusp number following small molecule perturbations of canonical Wnt signalling. Resulting tooth phenotypes mirror observed effects in mammals, where canonical Wnt has been implicated as an upstream regulator of enamel knot signalling. In silico modelling of shark dental morphogenesis demonstrates how subtle changes in activatory and inhibitory signals can alter tooth shape, resembling phenotypes observed following experimental Wnt perturbation. Our results support the functional conservation of an enamel knot-like signalling centre throughout vertebrates and suggest that varied tooth types from sharks to mammals follow a similar developmental bauplan. Lineage-specific differences in signalling are not sufficient in refuting homology of this signalling centre, which is likely older than teeth themselves.
Next generation infection prevention clothing: Non-woven Fabrics Coated with Cranberry Extracts Capable of Inactivating Enveloped Viruses such as SARS-CoV-2 and Multidrug-resistant Bacteria
Authors: Tuñón-Molina Alberto , Cano-Vicent Alba , Martí Miguel , Muramoto Yukiko , Noda Takeshi , Takayama Kazuo , Serrano-Aroca Ángel 
Published: August 2021

AbstractThe Coronavirus Disease (COVID-19) pandemic is demanding rapid action of the authorities and scientific community in order to find new antimicrobial solutions that could inactivate the pathogen SARS-CoV-2 that causes this disease. Gram-positive bacteria contribute to severe pneumonia associated with COVID-19, and their resistance to antibiotics is increasing at an alarming rate. In this regard, non-woven fabrics are currently used for the fabrication of infection prevention clothing such as face masks, caps, scrubs, shirts, trousers, disposable gowns, overalls, hoods, aprons and shoe covers as protective tools against viral and bacterial infections. However, these non-woven fabrics are made of materials that do not possess antimicrobial activity. Thus, we have developed here non-woven fabrics with antimicrobial coatings of cranberry extracts capable of inactivating enveloped viruses such as SARS-CoV-2 and the phage phi 6, and two multidrug-resistant bacteria: the methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis. The non-toxicity of these advanced technology was ensured using a Caenorhabditis elegans in vivo model. These results open up a new prevention path using natural and biodegradable compounds for the fabrication of infection prevention clothing in the current COVID-19 and future pandemics.
Leveraging sequences missing from the human genome to diagnose cancer
Authors: Georgakopoulos-Soares Ilias , Barnea Ofer Yizhar , Mouratidis Ioannis , Chan Candace S.Y. , Bradley Rachael , Mahajan Mayank , Sims Jasmine , Cintron Dianne Laboy , Easterlin Ryder , Kim Julia S. , Chen Emmalyn , Pineda Geovanni , Parada Guillermo E. , Witte John S. , Maher Christopher A. , Feng Felix , Vathiotis Ioannis , Syrigos Nikolaos , Panagiotou Emmanouil , Charpidou Andriani , Syrigos Konstantinos , Chapman Jocelyn , Kvale Mark , Hemberg Martin , Ahituv Nadav 
Published: August 2021

AbstractCancer diagnosis using cell-free DNA (cfDNA) has potential to improve treatment and survival but has several technical limitations. Here, we show that tumor-associated mutations create neomers, DNA sequences 13-17 nucleotides in length that are predominantly absent from genomes of healthy individuals, that can accurately detect cancer, including early stages, and distinguish subtypes and features. Using a neomer-based classifier, we show that we can distinguish twenty-one different tumor-types with higher accuracy than state-of-the-art methods. Refinement of this classifier using a handcrafted set of kmers identified additional cancer features with greater precision. Generation and analysis of 451 cfDNA whole-genome sequences demonstrates that neomers can precisely detect lung and ovarian cancer with an area under the curve (AUC) of 0.93 and 0.89, respectively. In particular, for early stages, we show that neomers can detect lung cancer with an AUC of 0.94 and ovarian cancer, which lacks an early detection test, with an AUC of 0.93. Finally, testing over 9,000 sequences with either promoter or massively parallel reporter assays, we show that neomers can identify cancer-associated mutations that alter regulatory activity. Combined, our results identify a novel, sensitive, specific and simple diagnostic tool that can also identify novel cancer-associated mutations in gene regulatory elements.
Savor the flavor — a randomized double-blind study on taste-enhanced placebo analgesia in healthy volunteers
Authors: Zunhammer Matthias , Goltz Gerrit , Schweifel Maximilian , Stuck Boris A. , Bingel Ulrike 
Published: August 2021

AbstractWe conducted a randomized, double-blind, between-group study to investigate how the taste of oral medication affects placebo analgesia. Over three sub-studies, 318 healthy volunteers (297 included) were subjected to experimental tonic cold water pain (cold pressor test) before and after receiving taste-neutral (water), bitter (quinine), sweet (saccharine), or no placebo drops. Pain ratings indicated that taste enhances placebo analgesia. This effect was small but accounted for a substantial portion of the overall placebo effect and was comparable to WHO stage 1 analgesic effects. Moreover, placebo treatments were associated with an increase in peak heart rate response to cold water. Adverse effects were minimal. These results indicate that added taste may be an easy-to-implement, cost-effective, and safe way to optimize treatment outcomes and that taste-neutral preparations may reduce placebo-related outcome variance in clinical trials. Further studies are needed to test if these findings can be translated into clinical scenarios.