bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression of the Type III Secretion System Genes in Epiphytic Erwinia amylovora Cells on Apple Stigmas Benefits Endophytic Infection at the Hypanthium
Authors: Cui Zhouqi , Huntley Regan B. , Schultes Neil P , Kakar Kaleem U. , Yang Ching-Hong , Zeng Quan 
Published: October 2021

Erwinia amylovora causes fire blight on rosaceous plants. One of the major entry points of E. amylovora into hosts is flowers, where E. amylovora proliferates epiphytically on stigmatic and hypanthium surfaces and, subsequently, causes endophytic infection at the hypanthium. The type III secretion system (T3SS) is an important virulence factor in E. amylovora. Although the role of T3SS during endophytic infection is well characterized, its expression during epiphytic colonization and role in the subsequent infection is less understood. Here, we investigated T3SS gene expression in epiphytic E. amylovora on stigma and hypanthium of apple flowers under different relative humidities (RH). On stigma surfaces, T3SS was expressed in a high percentage of E. amylovora cells, and its expression promoted epiphytic growth. On hypanthium surfaces, however, T3SS was expressed in fewer E. amylovora cells than on the stigma, and displayed no correlation with epiphytic growth, even though T3SS expression is essential for infection. E. amylovora cells grown on stigmatic surfaces and then flushed down to the hypanthium displayed a higher level of T3SS expression than cells grown on the hypanthium surface alone. Furthermore, E. amylovora cells precultured on stigma had a higher potential to infect flowers than E. amylovora cells precultured in a T3SS-repressive medium. This suggests that T3SS induction during the stigmatic epiphytic colonization may be beneficial for subsequent infection. Finally, epiphytic expression of T3SS was influenced by RH. Higher percentage of stigmatic E. amylovora cells expressed T3SS under high RH than under low RH. [Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Opioid-induced Hyperalgesia in Patients With Chronic Pain
Authors: Guichard Leah , Hirve Axel , Demiri Migena , Martinez Valeria 
Published: October 2021

Introduction:
Opioid-induced hyperalgesia (OIH) remains an issue in patients with chronic pain. Multiple cases of OIH in patients with chronic pain exposed to opioids have been reported worldwide. The objective of this systematic review was to summarize the evidence of OIH from clinical reports.

Methods:
We searched the PubMed, Cochrane, EMBASE, and LILACS databases for case reports and case series of OIH published up to December 2020, with the aim to summarize the evidence for OIH in patients with chronic pain from clinical reports and to discuss issues relevant to the clinical diagnosis and management of OIH.

Results:
We retrieved and reviewed 41 articles describing 72 cases. Clinical features of OIH were observed in patients of both sexes, all ages, and with various types of pain treated with different classes of opioids. OIH was reported at all doses, but most published studies reported a pattern of OIH following treatment with very high daily doses of opioids (median oral morphine equivalent dose of 850 mg). OIH was diagnosed clinically in all cases. Three different strategies for OIH management were described: opioid rotation, opioid cessation, and the use of adjuvant pharmacotherapies. All had statistically similar success rates for OIH treatment: 72%, 57%, and 79%, respectively. The decrease in pain was achieved rapidly (mean: 8 d; range: 1 to 28 d). Adjuvant therapies resulted in the largest decrease in dose. Ketamine and dexmedetomidine were the most widely used adjuvant drugs.

Conclusion:
The key finding is that clinical symptoms of OIH can be resolved when this condition is diagnosed and managed.
A Systematic Review and Synthesis of Psychometric Properties of the Numeric Pain Rating Scale and the Visual Analog Scale for Use in People With Neck Pain
Authors: Modarresi Shirin , Lukacs Michael J. , Ghodrati Maryam , Salim Shahan , MacDermid Joy C. , Walton David M. 
Published: October 2021

Objectives:
To conduct a systematic search and synthesis of evidence about the measurement properties of the Numeric Pain Rating Scale (NPRS) and the Visual Analog Scale (VAS) as patient-reported outcome measures in neck pain research.

Methods and Materials:
CINAHL, Embase, PsychInfo, and MedLine databases were searched to identify studies evaluating the psychometric properties of the NPRS and the VAS used in samples of which >50% of participants were people with neck pain. Quality and consistency of findings were synthesized to arrive at recommendations.

Results:
A total of 46 manuscripts were included. Syntheses indicated high-to-moderate-quality evidence of good-to-excellent (intraclass correlation coefficient 0.58 to 0.93) test-retest reliability over an interval of 7 hours to 4 weeks. Moderate evidence of a clinically important difference of 1.5 to 2.5 points was found, while minimum detectable change ranged from 2.6 to 4.1 points. Moderate evidence of a moderate association (r=0.48 to 0.54) between the NPRS or VAS and the Neck Disability Index. Findings from other patient-reported outcomes indicated stronger associations with ratings of physical function than emotional status. There is limited research addressing the extent that these measures reflect outcomes that are important to patients.

Discussion:
It is clear NPRS and the VAS ratings are feasible to implement, provide reliable scores and relate to multi-item patient-reported outcome measures. Responsiveness (meaningful change) of the scales and interpretation of change scores requires further refinement. The NPRS can be a useful single-item assessment complimenting more comprehensive multi-item patient-reported outcome measures in neck pain research and practice.
The Right to Pain Relief
Authors: Sullivan Mark D. , Ballantyne Jane C. 
Published: October 2021

Objectives:
The claim of a right to pain relief was made in recent decades by pain professionals, courts, and patient advocacy groups and likely contributed to increased opioid prescribing, overdose deaths, and addictions, but the origins and nature of this right have not been investigated.

Materials and Methods:
Relevant clinical, ethical, and legal literature concerning patient rights to pain care was reviewed.

Results:
The record describes the effort to improve end-of-life and cancer pain care in the 1980s and 1990s, which simultaneously legitimated pain relief as an independent goal of medical care and opioids as a safe and effective means to achieve this relief. In 1997, the US Supreme Court denied the right to assisted suicide but affirmed a right to palliative care to prevent dying in overwhelming pain. Other guidelines and regulations extended this right to pain relief from end-of-life care to chronic pain care, along with the titrate-to-effect principle, which specified that the correct opioid dose was the dose that relieved pain.

Discussion:
The most important consequence of combining the right to pain relief with the titrate-to-effect principle was the idea that a high pain score must not be ignored. This extension of the right to pain relief neglected important differences between end-of-life care and chronic pain care including: time frame, clinical setting and context, target of titration, and nature of iatrogenic harms. To help end our current opioid epidemic and prevent a future epidemic, we need to demedicalize pain and reintegrate it with the rest of human suffering as an experience connected to other personal behaviors and meanings.
Did COVID-19 impact osteoarthritis – clinical perspective?
Authors: Alhassan Eaman , Siaton Bernadette C. , Hochberg Marc C. 
Published: October 2021

Purpose of review
To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on patients with osteoarthritis (OA).

Recent findings
The COVID-19 pandemic negatively affected patients with OA irrespective of them contracting the infection. Patients with OA had a disruption in access to the healthcare system, which resulted in delays in joint replacement surgeries from cancellations of elective surgical procedures. On the other hand, the pandemic accelerated the drive towards telemedicine and telerehabilitation, with many nonurgent services being delivered remotely whenever possible. Cross-sectional studies showed that the majority of patients with OA were willing to accept the increased risks of contracting the COVID-19 infection and proceed with elective joint replacement surgeries.

Summary
The American College of Rheumatology and the European League Against Rheumatism issued guidelines for managing immune-mediated rheumatic diseases during the pandemic. However, these guidelines did not include recommendations for patients with OA.
Healthcare providers, including physical therapists, should aim to schedule more frequent telemedicine follow-up appointments to maximize medical management while patients await elective joint procedures.
Playing High School Football Is Not Associated With an Increased Risk for Suicidality in Early Adulthood
Authors: Iverson Grant L. , Merz Zachary C. , Terry Douglas P. 
Published: October 2021

Objective:
To determine if playing high school football is associated with suicide ideation between the ages of 24 and 32 years.

Design:
Data were analyzed from the National Longitudinal Study of Adolescent to Adult Health. This prospective cohort study sampled nationally representative US participants at 4 time points from 1994 to 2008.

Setting:
In-home assessment.

Participants:
There were 3147 boys (age: median = 14.9, SD = 1.8) who participated during adolescence in 1994 to 1995 (wave I), of whom 2353 were reinterviewed in 2008 (wave IV, age: median = 29.1, SD = 1.8).

Assessment of Risk Factors:
Football participation, history of psychological counseling, suicide ideation, and a suicide attempt in the past year during high school.

Main Outcome Measures:
Lifetime history of depression, suicide ideation within the past year, and feeling depressed in the past 7 days at wave IV.

Results:
Men who played high school football, compared with those who did not, reported similar rates of lifetime diagnosis of depression, suicide ideation in the past year, and feeling depressed in the past 7 days. Those who played football reported similar rates of suicide ideation in the past year when they were in their early 20s. Individuals who underwent psychological counseling during adolescence were more likely to report a lifetime history of depression and suicide ideation in the past year.

Conclusions:
Young men who played high school football are not at an increased risk for suicide ideation during both their early 20s and late 20s. By contrast, those who experienced mental health problems in high school were much more likely to experience suicide ideation during their 20s.
Delayed Facial Nerve Palsy Following Resection of Vestibular Schwannoma: Clinical and Surgical Characteristics
Authors: MacDonald Bridget V. , Ren Yin , Shahrvini Bita , Tawfik Kareem O. , Moshtaghi Omid , Schwartz Marc S. , Friedman Rick A. 
Published: October 2021

Objective:
Analyze delayed facial nerve palsy (DFNP) following resection of vestibular schwannoma (VS) to describe distinct characteristics and facial nerve (FN) functional course.

Study Design:
Prospective cohort with retrospective review.

Setting:
Academic medical center.

Patients:
Consecutive patients undergoing VS resection 11/2017 to 08/2020. Exclusion criteria: preoperative House-Brackmann (HB) ≥ III, postoperative HB ≥ III without delayed palsy, <30 days follow-up.

Interventions:
VS resection with intraoperative electromyographic monitoring.

Main Outcome Measures:
FN outcomes utilizing the HB scale; comparison between patients with DFNP (deterioration greater than one HB grade 24 hours to 30 days postoperatively) vs. those with HBI–II throughout.

Results:
Two hundred eighty-eight patients met criteria: mean age 47.6 years, 36.1% male; 24.0% middle cranial fossa, 28.5% retrosigmoid, 47.6% translabyrinthine. DFNP occurred in 31 (10.8%) patients with average time to onset of 8.1 days. Of these, 22 (71.0%) recovered HBI–II and 3 (9.7%) recovered HBIII. Patients who experienced DFNP, on average, had larger maximum tumor diameter (23.4 vs. 18.7 mm, p = 0.014), lower rate of gross-total resection (54.8% vs. 75.5%, p = 0.014), and lower rate of ≥100 μV FN response to 0.05 mA stimulus intraoperatively (80.6% vs. 94.9%, p = 0.002). Compared to overall incidence of DFNP, translabyrinthine approach demonstrated higher incidence (15.3%, p = 0.017) while retrosigmoid lower (3.7%, p = 0.014). In multivariable logistic regression, patients with FN response ≥100 μV to 0.05 mA stimulus were 72.0% less likely to develop DFNP (p = 0.021).

Conclusions:
Intraoperative electromyographic facial nerve response, tumor size, surgical approach, and extent of resection may play a role in development of DFNP following resection of VS. Most patients who develop DFNP recover near-normal function.
Occupational exposures and sarcoidosis: current understanding and knowledge gaps
Authors: Lin Nancy W. , Maier Lisa A. 
Published: October 2021

Purpose of review
Sarcoidosis is an idiopathic granulomatous disease that primarily affects the lungs. Several lines of evidence suggest that occupational exposures are associated with disease risk. This review critically evaluates studies using the Bradford Hill criteria for causation to determine if a causal relationship can be established between occupational exposure and sarcoidosis.

Recent findings
Large epidemiological studies have proposed multiple occupational exposures associated with sarcoidosis but lack consistency of results. Many convincing studies demonstrate an association between World Trade Center (WTC) dust and sarcoidosis, which illustrates a causal relationship based on the fulfillment of the Bradford Hill criteria. Studies describing an association between silica/metals and sarcoidosis are intriguing but fulfill a limited number of the Bradford Hill criteria and warrant further investigation before a causal relationship can be determined. Finally, we also discuss preliminary studies associating sarcoidosis phenotypes with specific occupational exposures.

Summary
Using the Bradford Hill criteria for causation, we demonstrate that WTC dust has a causative relationship with sarcoidosis, which reinforces the theory that sarcoidosis is an exposure-related disease. More research is needed to determine other specific occupational exposures causing disease.
A brave new world: the gastrointestinal lab during and after a pandemic
Authors: Subramaniam Sharmila , Al-Kandari Asma , Bhandari Pradeep 
Published: October 2021

Purpose of review
The COVID-19 global pandemic resulted in a radical change in the provision and delivery of endoscopy services worldwide. As we emerge from this pandemic, various strategies were advocated to resume endoscopy whilst prioritizing the safety and wellbeing of patients and staff.

Recent findings
This review summarizes the main changes including infection control and prevention measures in endoscopy and explores the overarching impact of the pandemic on the gastrointestinal lab. Various solutions are outlined to enable the well tolerated resumption of endoscopy services including retention of certain infection control measures, use of personal protective equipment, testing and vaccination. Strategies to deal with the mounting backlog of cases are also discussed.

Summary
The COVID-19 pandemic wreaked havoc on healthcare systems worldwide and affected the provision and delivery of gastrointestinal diagnostic services, such as endoscopy necessitating a new way of working and an emphasis on infection control and better use of technology that are likely to be here to stay in the post pandemic era.
Cui Bono? Identifying Patient Groups That May Benefit From Granulocyte Transfusions in Pediatric Hematology and Oncology
Authors: Johann Pascal D. , Wuchter Patrick , Trojanova Lenka , Sturm Dominik , Lu Kevin Hai-Ning , Kulozik Andreas E. , Kunz Joachim B. 
Published: October 2021

Introduction:
Granulocyte transfusions have long been used to bridge the time to neutrophil recovery in patients with neutropenia and severe infection. Recent randomized controlled trials did not prove a beneficial effect of granulocyte transfusions, but were likely underpowered and suffered from very heterogeneous study populations.

Methods:
We retrospectively reviewed data of all patients treated with granulocyte transfusions at our pediatric center from 2004 to 2019. To identify parameters that predict the success of granulocyte transfusions, we stratified patients in 3 groups. Patients in group 1 cleared their infection, whereas patients in group 2 succumbed to an infection in neutropenia despite granulocyte transfusions. A third group included all patients who died of causes that were not related to infection.

Results:
We demonstrate that patients without respiratory or cardiocirculatory insufficiency are enriched in group 1 and more likely to benefit from granulocyte transfusions than patients who already require these intensive care measures. The effect of granulocyte transfusions correlates with the cell dose per body weight applied per time. With our standard twice weekly dosing, patients with a body weight below 40 kg are more likely to achieve a sufficient leukocyte increment and clear their infection in comparison to patients with a higher body weight.

Discussion/Conclusions:
We suggest that future studies on the benefits of granulocyte transfusions stratify patients according to clinical risk factors that include the need for respiratory or cardiocirculatory support and strive for a sufficient dose density of granulocyte transfusions.
Aesthetic Design of Expanded Bilateral Superficial Temporal Vascular Fascial Pedicled Flap for Repairing Maxillocervical Scars
Authors: Cao Zilong , Liu Liqiang , Fan Jincai , Tian Jia , Gan Cheng , Jiao Hu , Yang Zengjie 
Published: October 2021

Background
Large-scale maxillocervical scars impair face and neck function and damage appearance. The forehead expanded bilateral superficial temporal pedicled flap is a good treatment strategy for this area; however, the traditional cutaneous pedicled flap damages the temporal hair area. This impairs aesthetics and causes alopecia; furthermore, requires an additional pedicle-cut operation.

Methods
A retrospective study was performed on 7 patients with large-scale maxillocervical scars from January 2014 to August 2018. Forehead expanders were implanted in the first-stage operation for all patients. After the injection and rest period, patients were treated using the forehead expanded bilateral superficial temporal vascular fascial pedicled flap. Superficial temporal vascular fascia pedicles were carefully harvested. The use of an intralesional or hidden retrotragus incision was determined by the presence of a preauricular scar. Patient satisfaction with postoperative neck activity and the incision scar was evaluated.

Results
Intralesional and retrovagus incisions were used in 4 and 3 cases, respectively. One flap developed hematoma, which recovered completely after conservative treatment; all other cases had no complications. All flaps healed well. The neck mobility of the patients was significantly improved with no visible scar in the temporal region. Six cases reported being “very satisfied” and one was “relatively satisfied” with their improvement in neck mobility. All cases reported being “very satisfied” with frontotemporal morphology.

Conclusions
The forehead expanded bilateral superficial temporal vascular fascial pedicled flap is a good choice for patients with large-scale maxillocervical scars. This technique can maintain the aesthetics of temporal hair and reduce patients extra surgical injury.
The Impact of Amyloid PET Disclosure on Quality of Life in Patients With Young Onset Dementia
Authors: van der Doelen Daniël M. , Handels Ron L.H. , Zwan Marissa D. , van Kuijk Sander M.J. , Pelkmans Wiesje , Bouwman Femke H. , Scheltens Philip , Dirksen Carmen D. , Verhey Frans R.J. 
Published: October 2021

Introduction:
The impact of amyloid positron emission tomography (PET) imaging on patient health outcomes for individuals with dementia is unknown. In the present study, we explored the association between diagnostic outcome and clinician’s level of certainty with quality of life (QoL) after [18F]flutemetamol PET results were disclosed in young onset dementia patients in a memory clinic cohort.

Methods:
In 154 patients suspected of dementia, QoL was measured before and after [18F]flutemetamol PET results were disclosed. Multiple regression analyses were conducted with (changed) general and disease-specific QoL measures as dependent factors [QoL-Alzheimer disease (AD) and EQ-5D Dutch tariff] and etiological diagnosis and clinician’s certainty as independent factors.

Results:
(Change in) diagnosis of AD was associated to QOL in 2 of the 4 analyses (utility-based QoL β=0.15, P=0.010; disease-specific QoL β=2.0, P=0.037). Diagnostic certainty was associated to QOL in 1 of the 4 analyses (generic QoL β=0.002, P=0.028).

Discussion:
The diverse results in this explorative analysis do not reflect a univocal association between diagnosis, certainty, and QoL. Nevertheless, this result could be interpreted as a possible potential for advanced diagnostic technologies for AD, which requires confirmation in future research.
Adaptive single-channel EEG artifact removal with applications to clinical monitoring
Authors: Dora Matteo , Holcman David 
Published: October 2021

AbstractObjectiveElectroencephalography (EEG) has become very common in clinical practice due to its relatively low cost, ease of installation, non-invasiveness, and good temporal resolution. Portable EEG devices are increasingly popular in clinical monitoring applications such as sleep scoring or anesthesia monitoring. In these situations, for reasons of speed and simplicity only few electrodes are used and contamination of the EEG signal by artifacts is inevitable. Visual inspection and manual removal of artifacts is often not possible, especially in real-time applications. Our goal is to develop a flexible technique to remove EEG artifacts in these contexts with minimal supervision.MethodsWe propose here a new wavelet-based method which allows to remove artifacts from single-channel EEGs. The method is based on a data-driven renormalization of the wavelet components and is capable of adaptively attenuate artifacts of different nature. We benchmark our method against alternative artifact removal techniques.ResultsWe assessed the performance of the proposed method on publicly available datasets comprising ocular, muscular, and movement artifacts. The proposed method shows superior performances on different kinds of artifacts and signal-to-noise levels. Finally, we present an application of our method to the monitoring of general anesthesia.ConclusionsWe show that our method can successfully attenuate various types of artifacts in single-channel EEG.SignificanceThanks to its data-driven approach and low computational cost, the proposed method provides a valuable tool to remove artifacts in real-time EEG applications with few electrodes, such as monitoring in special care units.