bluuebunny/crossref_metadata_2025_split huggingface dataset:
TP10.2.6Open appendicectomy under spinal anaesthesia – a valuable alternative during COVID-19
Authors: Van Chi Mai Dinh , Sagar Alex , Claydon Oliver , Park Ji Young , Tapuria Niteen , Keeler Barrie David 
Published: October 2021

Abstract

Introduction
Concerns relating to COVID-19 and general anaesthesia prompted our department to consider that open appendicectomy under spinal anaesthesia (SA) avoids aerosolisation from intubation and laparoscopy. Whilst common in developing nations, it is unusual in the United Kingdom (UK). We present the first UK case series and discuss its potential role during and after this pandemic.

Methods
We prospectively studied patients with appendicitis at a British district general hospital who were unsuitable for conservative management and consequently underwent open appendicectomy under SA. We also reviewed patient satisfaction after 30 days. This ran for 5 weeks from 25th March 2020 until the surgical department reverted to laparoscopic appendicectomy as the standard of care. Main outcomes were 30-day complication rates and patient satisfaction.

Results
None of the included seven patients were COVID positive. The majority (4/7) had complicated appendicitis. There were no major adverse (Clavien-Dindo grade III to V) post-operative events. Two patients suffered minor post-operative complications. Two experienced intra-operative pain. Mean operative time was 44 minutes. Median length of stay and return to activity was 1 and 14 days respectively. Although four stated preference in hindsight for general anaesthesia (GA), the majority (5/7) were satisfied with the operative experience under SA.

Discussion
Although contraindications, risk of pain, and specific complications may be limiting, our series demonstrates open appendicectomy under SA to be safe, feasible and acceptable in the UK. The technique could be a valuable contingency for COVID suspected cases and patients with high-risk respiratory disease.
TP10.2.10A Prospective Analysis of Imaging Modalities in Appendicitis during the COVID-19 Pandemic
Authors: Saravanan Nivetha , Javanmard-Emamghissi Hannah , Lund Jonathan , Tierney Gillian 
Published: October 2021

Abstract

Aims
Acute appendicitis is a common general surgical emergency, occurring in 90-100 per 100,000 patients per year. Clinical practice in the UK involves either a clinical or ultrasound (US) diagnosis, with computed tomography (CT) reserved for cases of suspected complicated appendicitis. Due to the COVID-19 pandemic management pathways were altered, this study sought to capture that.

Methods
This prospective study included adult patients with suspected appendicitis at a single UK centre from March-June 2020. The primary outcome measures were rates of US and CT imaging. Secondary outcomes included subsequent operative and histological findings.

Results
Seventy-five patients were included. A clinical diagnosis of appendicitis was made in 11 (15%). Thirty-five (47%) patients had CT, 22 (29%) had an US and 7 (9%) had both. The appendix was visualised in only 10 patients and a radiological diagnosis of appendicitis was made in 6 cases. Appendicitis was confirmed on histology in 67% of subsequently operated cases.
CT evidence of appendicitis correlated with operative appendicitis in 93% (28/30) of cases. There were two cases of appendiceal malignancy not demonstrated on CT. Correlation of complicated appendicitis between CT and operative findings was poor; one third (10/28) of patients had appendiceal perforation not identified on CT.

Conclusions
The use of CT for diagnosing appendicitis was markedly increased during the first wave of the pandemic. The appendix was visualised infrequently on ultrasound, but when seen correlated well with histological findings. CT was superior at detecting appendicitis but failed to differentiate well between complicated and uncomplicated disease.
Male opportunistic mating increases with intensity of female sexual cannibalism in 3 web-building spiders
Authors: Ma (马玉冰) Yubing , Hua (华泽远) Zeyuan , Mao (毛艾佳) Aijia , Li (李代芹) Daiqin , Zhang (张士昶) Shichang 
Published: October 2021

AbstractSexual conflict is common in animals, and female sexual cannibalism represents an extreme form of sexual conflict. Males in many species have evolved a variety of strategies to circumvent or decrease the risk of female sexual cannibalism. Opportunistic mating, by which a male mates with a female when she is disturbed or when she is feeding or undertaking moulting, is one of such kinds of strategies, and widely occurs in many animals, especially in spiders. However, whether the occurrence of male opportunistic mating depends on the intensity of female sexual cannibalism remains largely unexplored. We predicted a positive correlation between them. In this study, we tested this prediction by performing a series of mating trials in the laboratory using 3 species of web-building spiders with different intensities of female sexual cannibalism: Nephila pilipes, Nephilengys malabarensis, and Parasteatoda tepidariorum. We found that the occurrence of male opportunistic mating was positively, though not statistically significantly, correlated with the intensity of female sexual cannibalism, thus supporting our hypothesis. All together, we provide evidence that male opportunistic mating may have evolved to respond to the selection pressure posed by female sexual cannibalism.
Role of environmentally induced epigenetic transgenerational inheritance in evolutionary biology: Unified Evolution Theory
Authors: Skinner Michael K , Nilsson Eric E 
Published: October 2021

AbstractThe current evolutionary biology theory primarily involves genetic alterations and random DNA sequence mutations to generate the phenotypic variation required for Darwinian natural selection to act. This neo-Darwinian evolution is termed the Modern Evolution Synthesis and has been the primary paradigm for nearly 100 years. Although environmental factors have a role in neo-Darwinian natural selection, Modern Evolution Synthesis does not consider environment to impact the basic molecular processes involved in evolution. An Extended Evolutionary Synthesis has recently developed that extends the modern synthesis to consider non-genetic processes. Over the past few decades, environmental epigenetics research has been demonstrated to regulate genetic processes and directly generate phenotypic variation independent of genetic sequence alterations. Therefore, the environment can on a molecular level through non-genetic (i.e. epigenetic) mechanisms directly influence phenotypic variation, genetic variation, inheritance and adaptation. This direct action of the environment to alter phenotype that is heritable is a neo-Lamarckian concept that can facilitate neo-Darwinian (i.e. Modern Synthesis) evolution. The integration of genetics, epigenetics, Darwinian theory, Lamarckian concepts, environment, and epigenetic inheritance provides a paradigm shift in evolution theory. The role of environmental-induced epigenetic transgenerational inheritance in evolution is presented to describe a more unified theory of evolutionary biology.
Acute ischaemia of the lower limb due to non-bacterial thrombotic endocarditis with recent venous thrombo-embolic disease as the initial manifestation of lung adenocarcinoma: a case report
Authors: Polo Julien , Raufast Daniele , Cornand Dimitri , Elias Antoine 
Published: October 2021

Abstract

Background
Non-bacterial thrombotic endocarditis is a rare condition. Optimal management is based on early diagnosis which remains difficult.

Case summary
A 75-year-old male patient was admitted to the hospital with acute ischaemia of the left lower limb due to popliteal artery occlusion despite anticoagulation with rivaroxaban for pulmonary embolism diagnosed 2 weeks earlier. Transoesophageal echocardiography (TOE) showed a mobile vegetation with mild mitral valve regurgitation. Positron emission tomography (PET) scan did not show hyperfixation at the mitral valve but rather lymphadenopathy hyperfixation at different sites. Biopsy of a lymph node from Barety’s space identified a bronchopulmonary adenocarcinoma. The outcome was favourable after popliteal artery thrombectomy and low-molecular-weight heparin treatment. The patient was referred to the department of onco-pneumology for further care.

Discussion
Upon clinical presentation, the combination of an arterial and prior venous thrombotic event suggested that the origin could be either a patent foramen ovale (PFO) or a thrombosis from an underlying cancer. A transthoracic echocardiography and TOE excluded a PFO and demonstrated a mobile echogenic mass at the mitral valve site together with a mild regurgitation. The diagnosis of non-bacterial thrombotic endocarditis was suggested given the absence of clinical and biological infectious signs, negative blood cultures and serology for endocarditis, the presence of both arterial and venous thrombosis, as well as the presence of intra-thoracic lymphadenopathy hyperfixation on the PET scan for which a biopsy demonstrated lung adenocarcinoma.
A dashboard for exploring clinical trials sponsorship and potential virtual monopolies
Authors: Graham S Scott , Majdik Zoltan P , Barbour Joshua B , Rousseau Justin F 
Published: October 2021

Abstract

Objective
To create a data visualization dashboard to advance research related to clinical trials sponsorship and monopolistic practices in the pharmaceuticals industry.

Materials and Methods
This R Shiny application aggregates data from ClinicialTrials.gov resulting from user’s queries by terms. Returned data are visualized through an interactive dashboard.

Results
The Clinical Trials Sponsorship Network Dashboard (CTSND) uses force-directed network mapping algorithms to visualize clinical trials sponsorship data. Interpretation of network visualization is further supported with data on sponsor classes, sponsorship timelines, evaluated products, and target conditions. The source code for the CTSND is available at https://github.com/sscottgraham/ConflictMetrics.

Discussion
Monopolistic practices have been identified as a likely contributor to high drug prices in the United States. CTSND data and visualizations support the analysis of clinical trials sponsorship networks and may aid in identifying current and emerging monopolistic practices.

Conclusions
CTSND data can support more robust deliberation about an understudied area of drug pricing.
Tönnis Grade 1 dysplastic hips have improved patient-reported outcome scores when intraarticular pathology is treated during periacetabular osteotomy
Authors: Panos Joseph A , Gutierrez Claudia N , Wyles Cody C , Bingham Joshua S , Mara Kristin C , Trousdale Robert T , Sierra Rafael J 
Published: October 2021

ABSTRACTIt is unclear whether treatment of intraarticular pathology should be performed during periacetabular osteotomy (PAO) to improve outcomes. Therefore, we asked: (i) What are the clinical results of PAO in patients with and without intraarticular intervention? (ii) Is there a difference in reoperations with and without intraarticular intervention? and (iii) Is there a difference in clinical results and reoperations depending on preoperative Tönnis Grade if intraarticular intervention is performed? Prospective evaluation of 161 PAO in 146 patients was performed. The cohort was 84.5% female, mean age was 26.7 ± 7.9 years and mean follow-up was 2.4 years; 112 hips had Grade 0 changes and 49 hips had Grade 1 changes. Patients were classified into three groups based on treatments during PAO: major (labral repair, femoral head–neck osteochondroplasty), minor (labral debridement, femoral/acetabular chondroplasty) or no intervention. A subset of eight patient-reported outcome measures (PROMs) was analyzed to determine whether the minimal clinically important difference (MCID) was achieved. Major, minor and no intervention groups exceeded the MCID in 5, 8 and 8, of 8 PROMs (P ≥ 0.20), respectively; intraarticular interventions did not influence reoperation-free survival (P ≥ 0.35). By Tönnis Grade, PROMs exceeding MCID decreased in Grade 1 versus 0 receiving no intervention (P &lt; 0.001) but did not decrease for either intervention (P ≥ 0.14); intraarticular interventions did not influence reoperation-free survival (P ≥ 0.38). Overall, intraarticular intervention was associated with excellent PROMs and reoperation-free survival. Although Grade 1 patients had fewer PROM which achieved MCID, intraarticular interventions attenuated this decrease, suggesting a therapeutic advantage of intraarticular procedures for more advanced pathology.
A Longitudinal Study of Prevalence Ratios for Musculoskeletal Back Injury Among U.S. Navy and Marine Corps Personnel, 2009-2015
Authors: Mullinax Lcdr Ross A , Grunwald Lindsay , Banaag Amanda , Olsen Cara , Koehlmoos Tracey P 
Published: October 2021

ABSTRACT

Introduction
Medical readiness to deploy is an increasingly important issue within the military. Musculoskeletal back pain is one of the most common medical problems that affects service members. This study demonstrates the associations between risk factors and the prevalence of musculoskeletal back pain among active duty sailors and Marines within the Department of the Navy (DoN).

Materials and Methods
Utilizing the Military Health System Data Repository, we conducted a retrospective cross-sectional review of administrative healthcare claim data for all active duty DoN personnel with at least one medical encounter during fiscal years 2009-2015. For each fiscal year, we identified all claims with an ICD-9 code for back pain and calculated prevalence. We compared those with and without back pain across all variables (age, gender, rank, race, body mass index, tobacco use, occupation, and branch of service) using chi-square analysis. Unadjusted and adjusted log-binomial regressions were used to calculate prevalence ratios and examine associated risk factors for back pain.

Results
The number of active duty subjects per fiscal year ranged from 424,460 to 437,053. The prevalence of back pain showed an upward trend, ranging from 9.99% in 2009 to 12.09% in 2015. Personnel aged 35 years and older had the strongest adjusted prevalence ration (APR) for back pain (APR 2.59; 95% CI, 2.53-2.66). There were also strong associations with obese body mass index (APR 1.76; 95% CI, 1.66-1.86), overweight body mass index (APR 1.29; 95% CI, 1.27-1.32), and tobacco use (APR 1.39; 95% CI, 1.36-1.42). Females were more likely to have back pain than males (APR 1.43; 95% CI, 1.40-1.47) and Marines more likely than sailors (APR 1.39; 95% CI, 1.36-1.42). The occupation with the highest prevalence ratio was healthcare (APR 1.34; 95% CI, 1.29-1.40) when compared to the reference group of combat specialists.

Conclusions
There was an increasing prevalence of back pain across the DoN from 2009 to 2015. Different occupational categories demonstrate different prevalence of back pain. Surprisingly, combat occupations and aviators were among the groups with the lowest prevalence. Lifestyle factors such as excess body weight and use of tobacco products are clearly associated with increased prevalence. These results could inform military leaders with regard to setting policies that could increase medical readiness.
Newborn Outcomes Among Veterans Utilizing VHA Maternity Benefits, 2016-2020
Authors: Kinney Rebecca L , Copeland Laurel A , Kroll-Desrosiers Aimee R , Walker Lorrie , Marteeny Valerie , Mattocks Kristin M 
Published: October 2021

ABSTRACT

Introduction
Public Law 111-163 Section 206 of the Caregivers and Veteran Omnibus Health Services Act amended the Veterans Health Administration’s (VHA) medical benefits package to include 7 days of medical care for newborns delivered by Veterans. We examined the newborn outcomes among a cohort of women Veterans receiving VHA maternity benefits and care coordination.

Materials and Methods
We conducted a secondary analysis of phone interview data from Veterans enrolled in the COMFORT (Center for Maternal and Infant Outcomes Research in Translation) study 2016–2020. Multivariable regression estimated associations with newborn outcomes (preterm birth; low birthweight).

Results
During the study period, 829 infants were born to 811 Veterans. Mothers reported “excellent health” for 94% of infants. The prevalence of preterm birth was slightly higher in our cohort (11% vs. 10%), as were low birthweight (9%) deliveries, compared to the general population (8.28%). Additionally, 42% of infants in our cohort required follow-up care for non-routine health conditions; 11% were uninsured at 2 months of age. Adverse newborn outcomes were more common for mothers who were older in age, self-identified as non-white in race and/or of Hispanic ethnicity, had a diagnosis of posttraumatic stress disorder, or had gestational comorbidities.

Conclusions
The current VHA maternity coverage appears to be an effective policy for ensuring the well-being and health care coverage for the majority of Veterans and their newborns in the first days of life, thereby reducing the risk of inadequate prenatal and neonatal care. Future research should examine costs associated with extending coverage to 14 days or longer, comparing those to the projected excess costs of neonatal health problems. VHA policy should continue to support expanding care and resources through the Maternity Care Coordinator model.
Comprehensive understanding of Tn5 insertion preference improves transcription regulatory element identification
Authors: Zhang Houyu , Lu Ting , Liu Shan , Yang Jianyu , Sun Guohuan , Cheng Tao , Xu Jin , Chen Fangyao , Yen Kuangyu 
Published: October 2021

AbstractTn5 transposase, which can efficiently tagment the genome, has been widely adopted as a molecular tool in next-generation sequencing, from short-read sequencing to more complex methods such as assay for transposase-accessible chromatin using sequencing (ATAC-seq). Here, we systematically map Tn5 insertion characteristics across several model organisms, finding critical parameters that affect its insertion. On naked genomic DNA, we found that Tn5 insertion is not uniformly distributed or random. To uncover drivers of these biases, we used a machine learning framework, which revealed that DNA shape cooperatively works with DNA motif to affect Tn5 insertion preference. These intrinsic insertion preferences can be modeled using nucleotide dependence information from DNA sequences, and we developed a computational pipeline to correct for these biases in ATAC-seq data. Using our pipeline, we show that bias correction improves the overall performance of ATAC-seq peak detection, recovering many potential false-negative peaks. Furthermore, we found that these peaks are bound by transcription factors, underscoring the biological relevance of capturing this additional information. These findings highlight the benefits of an improved understanding and precise correction of Tn5 insertion preference.
pLS20 is the archetype of a new family of conjugative plasmids harboured byBacillusspecies
Authors: Val-Calvo Jorge , Miguel-Arribas Andrés , Abia David , Wu Ling Juan , Meijer Wilfried J J 
Published: October 2021

AbstractConjugation plays important roles in genome plasticity, adaptation and evolution but is also the major horizontal gene-transfer route responsible for spreading toxin, virulence and antibiotic resistance genes. A better understanding of the conjugation process is required for developing drugs and strategies to impede the conjugation-mediated spread of these genes. So far, only a limited number of conjugative elements have been studied. For most of them, it is not known whether they represent a group of conjugative elements, nor about their distribution patterns. Here we show that pLS20 from the Gram-positive bacterium Bacillus subtilis is the prototype conjugative plasmid of a family of at least 35 members that can be divided into four clades, and which are harboured by different Bacillus species found in different global locations and environmental niches. Analyses of their phylogenetic relationship and their conjugation operons have expanded our understanding of a family of conjugative plasmids of Gram-positive origin.
‘Consciousnessoids’: clues and insights from human cerebral organoids for the study of consciousness
Authors: Lavazza Andrea 
Published: October 2021

Abstract
Human cerebral organoids (HCOs) are an in vitro three-dimensional model of early neural development, aimed at modelling and understanding brain development and neurological disorders. In just a few years, there has been a rapid and considerable progress in the attempt to create a brain model capable of showcasing the structure and functions of the human brain. There are still strong limitations to address, including the absence of vascularization that makes it difficult to feed the central layers of organoids. Nevertheless, some important features of the nervous system have recently been observed: HCOs manifest electrical activity, are sensitive to light stimulation and are able to connect to a spinal cord by sending impulses that make a muscle contract. Recent data show that cortical organoid network development at 10 months resembles some preterm babies’ electroencephalography (EEG) patterns. In the light of the fast pace of research in this field, one might consider the hypothesis that HCOs might become a living laboratory for studying the emergence of consciousness and investigating its mechanisms and neural correlates. HCOs could be also a benchmark for different neuroscientific theories of consciousness. In this paper, I propose some potential lines of research and offer some clues and insights so as to use HCOs in trying to unveil some puzzles concerning our conscious states. Finally, I consider some relevant ethical issues regarding this specific experimentation on HCOs and conclude that some of them could require strict regulation in this field.
On the Treatment of Pneumocystis jirovecii Pneumonia: Current Practice Based on Outdated Evidence
Authors: McDonald Emily G , Butler-Laporte Guillaume , Del Corpo Olivier , Hsu Jimmy M , Lawandi Alexander , Senecal Julien , Sohani Zahra N , Cheng Matthew P , Lee Todd C 
Published: October 2021

Abstract
Pneumocystis jirovecii pneumonia (PCP) is a common opportunistic infection causing more than 400000 cases annually worldwide. Although antiretroviral therapy has reduced the burden of PCP in persons with human immunodeficiency virus (HIV), an increasing proportion of cases occur in other immunocompromised populations. In this review, we synthesize the available randomized controlled trial (RCT) evidence base for PCP treatment. We identified 14 RCTs that were conducted 25–35 years ago, principally in 40-year-old men with HIV. Trimethoprim-sulfamethoxazole, at a dose of 15–20 mg/kg per day, is the treatment of choice based on historical practice rather than on quality comparative, dose-finding studies. Treatment duration is similarly based on historical practice and is not evidence based. Corticosteroids have a demonstrated role in hypoxemic patients with HIV but have yet to be studied in RCTs as an adjunctive therapy in non-HIV populations. The echinocandins are potential synergistic treatments in need of further investigation.