bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spare Parts Surgery with a Free Posterior Interosseous Artery Perforator Flap for Thumb Tip
Authors: Kamei Wataru , Murakami Masami , Nakamoto Kan , Osa Nagisa , Niimi Yosuke , Sakurai Hiroyuki 
Published: June 2021

Summary:
Replantation is an ideal method for treating fingertip amputation. However, in some cases, replantation is known to be a challenging issue. This report described a successful thumb tip reconstruction performed with bone and nail bed salvaged as spare parts, and a free posterior interosseous artery perforator (PIAP) flap. A 75-year-old man accidentally amputated his left thumb with an electric saw, and emergency replantation was started under brachial plexus block. However, the distal stump of digital artery was unable to be identified, forcing the initial plan to change to flap reconstruction. After vascular anastomosis, complex tissue containing nail bed and side nail fold was grafted on the adipofascial tissue of PIAP flap. Both PIAP flap and the complex tissue survived completely. At 12 months after surgery, only a slight deformity in the nail plate was observed. Spare parts surgery is a surgical procedure effectively salvaging and utilizing tissue that is going to be discarded in severe limb trauma. This idea can be applied to treatment for the finger amputation. In this case, replantation would be difficult in the thumb tip amputation, so spare parts surgery was performed with a PIAP flap. The innervated PIAP flap is reported, including the posterior antebrachial cutaneous nerve. In this case, the cutaneous nerve was able to be identified, neurorrhaphy was performed, and sufficient sensory recovery was obtained. Surgical procedure with PIAP flaps was found to be a useful method for immediate reconstruction with salvaged spare parts after fingertip replantation was considered to be difficult intraoperatively.
Enterovirus-A71 Rhombencephalitis Outbreak in Catalonia: Characteristics, Management and Outcome
Authors: Wörner Núria , Rodrigo-García Rocío , Antón Andrés , Castellarnau Ester , Delgado Ignacio , Vazquez Èlida , González Sebastià , Mayol Lluís , Méndez Maria , Solé Eduard , Rosal Jaume , Andrés Cristina , Casquero Alejandro , Lera Esther , Sancosmed Mónica , Campins Magda , Pumarola Tomàs , Rodrigo Carlos 
Published: June 2021

Background:
Between April and June 2016, an outbreak of rhombencephalitis (RE) caused by enterovirus (EV) A71 was detected in Catalonia, Spain—the first documented in Western Europe. The clinical characteristics and outcome of patients with this condition differed from those reported in outbreaks occurring in Southeast Asia.

Methods:
Observational, multicenter study analyzing characteristics, treatment and outcome of patients with EV-A71 rhombencephalitis diagnosed in 6 publicly funded hospitals within the Catalonian Health Institute. A review of clinical characteristics, diagnosis, treatment and outcome of these patients was conducted.

Results:
Sixty-four patients met the clinical and virologic criteria for rhombencephalitis caused by EV-A71. All patients had symptoms suggesting viral disease, mainly fever, lethargy, ataxia and tremor, with 30% of hand-foot-mouth disease. Intravenous immunoglobulin therapy was given to 44/64 (69%) patients and methylprednisolone to 27/64 (42%). Six patients (9%) required pediatric intensive care unit admission. Three patients had acute flaccid paralysis of 1 limb, and another had autonomic nervous system (ANS) dysfunction with cardiorespiratory arrest. Outcome in all patients (except the patient with hypoxic-ischemic encephalopathy) was good, with complete resolution of the symptoms.

Conclusions:
During the 2016 outbreak, rhombencephalitis without ANS symptoms was the predominant form of presentation and most patients showed no hand-foot-mouth disease. These findings contrast with those of other patient series reporting associated ANS dysfunction (10%–15%) and hand-foot-mouth disease (60%–80%). Complete recovery occurred in almost all cases. In light of the favorable outcome in untreated mild cases, therapies for this condition should be reserved for patients with moderate-severe infection. The main relevance of this study is to provide useful information for setting priorities, management approaches and adequate use of resources in future EV-A71 associated rhombencephalitis outbreaks.
Effects of joint and nerve mobilisation on neuroimmune responses in animals and humans with neuromusculoskeletal conditions: a systematic review and meta-analysis
Authors: Lutke Schipholt Ivo J. , Coppieters Michel W. , Meijer Onno G. , Tompra Nefeli , de Vries Rob B. M. , Scholten-Peeters Gwendolyne G. M. 
Published: June 2021

Abstract
Several animal and human studies revealed that joint and nerve mobilisations positively influence neuroimmune responses in neuromusculoskeletal conditions. However, no systematic review and meta-analysis has been performed. Therefore, this study aimed to synthesize the effects of joint and nerve mobilisation compared with sham or no intervention on neuroimmune responses in animals and humans with neuromusculoskeletal conditions. Four electronic databases were searched for controlled trials. Two reviewers independently selected studies, extracted data, assessed the risk of bias, and graded the certainty of the evidence. Where possible, meta-analyses using random effects models were used to pool the results. Preliminary evidence from 13 animal studies report neuroimmune responses after joint and nerve mobilisations. In neuropathic pain models, meta-analysis revealed decreased spinal cord levels of glial fibrillary acidic protein, dorsal root ganglion levels of interleukin-1β, number of dorsal root ganglion nonneuronal cells, and increased spinal cord interleukin-10 levels. The 5 included human studies showed mixed effects of spinal manipulation on salivary/serum cortisol levels in people with spinal pain, and no significant effects on serum β-endorphin or interleukin-1β levels in people with spinal pain. There is evidence that joint and nerve mobilisations positively influence various neuroimmune responses. However, as most findings are based on single studies, the certainty of the evidence is low to very low. Further studies are needed.
Magnetoencephalography reveals increased slow-to-fast alpha power ratios in patients with chronic pain
Authors: Witjes Bart , Baillet Sylvain , Roy Mathieu , Oostenveld Robert , J.P.M. Huygen Frank , C. de Vos Cecile 
Published: June 2021

Abstract

Introduction:
Objective disease markers are a key for diagnosis and personalized interventions. In chronic pain, such markers are still not available, and therapy relies on individual patients' reports. However, several pain studies have reported group-based differences in functional magnetic resonance imaging, electroencephalography, and magnetoencephalography (MEG).

Objectives:
We aimed to explore spectral differences in resting-state MEG brain signals between patients with chronic pain and pain-free controls and to characterize the cortical and subcortical regions involved.

Methods:
We estimated power spectral density over 5 minutes of resting-state MEG recordings in patients with chronic pain and controls and derived 7 spectral features at the sensor and source levels: alpha peak frequency, alpha power ratio (power 7–9 Hz divided by power 9–11 Hz), and average power in theta, alpha, beta, low-gamma, and high-gamma bands. We performed nonparametric permutation t tests (false discovery rate corrected) to assess between-group differences in these 7 spectral features.

Results:
Twenty-one patients with chronic pain and 25 controls were included. No significant group differences were found in alpha peak frequency or average power in any frequency band. The alpha power ratio was significantly higher (P < 0.05) in patients with chronic pain at both the sensor and brain source levels. The brain regions showing significantly higher ratios included the occipital, parietal, temporal and frontal lobe areas, insular and cingulate cortex, and right thalamus.

Conclusion:
The alpha power ratio is a simple, promising signal marker of chronic pain, affecting an expansive range of cortical and subcortical regions, including known pain-processing areas.
Dissociative and analgesic properties of ketamine are independent and unaltered by sevoflurane general anesthesia
Authors: Hahm Eunice Y. , Chamadia Shubham , Locascio Joseph J. , Pedemonte Juan C. , Gitlin Jacob , Mekonnen Jennifer , Ibala Reine , Ethridge Breanna R. , Colon Katia M. , Qu Jason , Akeju Oluwaseun 
Published: June 2021

Abstract

Introduction:
Ketamine, an anesthetic adjunct, is routinely administered as part of a balanced general anesthetic technique. We recently showed that the acute analgesic and dissociation properties of ketamine are separable to suggest that distinct neural circuits underlie these states.

Objective:
We aimed to study whether this finding is robust to the substantial neural circuit alterations associated with general anesthesia.

Methods:
We conducted a single-site, open-label, randomized controlled, cross-over study of sevoflurane and sevoflurane-plus-ketamine (SK) general anesthesia in healthy subjects (n = 12). Before and after general anesthesia, we assessed precalibrated cuff pain intensity and nociceptive pain quality as well as dissociation using the Clinician-Administered Dissociative States Scale (CADSS). For statistical inference, we ran a variation of backward elimination repeated-measures analysis of covariance. Models with CADSS as a covariate term were used to assess whether dissociation mediated the effect of ketamine on pain intensity and quality.

Results:
Sevoflurane-plus-ketamine general anesthesia was associated with a significant (P = 0.0002) pain intensity decline of 3 (SE, 0.44). There was an order effect for dissociation such that SK was associated with a significant (P = 0.0043) CADSS increase of 17.8 (3.2) when the SK treatment came first. When the pain intensity model was reanalyzed with CADSS as an additional covariate, the effect of CADSS was not significant. These results were also conserved for pain quality.

Conclusions:
Our findings suggest that the analgesic and dissociation properties of ketamine remain separable despite general anesthesia. Thus, ketamine may be used as a probe to advance our knowledge of dissociation independent pain circuits.
MRI of Sinonasal Malignancies
Authors: Famuyide Akinrinola , Juliano Amy , Moonis Gul 
Published: June 2021

Abstract
Sinonasal cavity is an important subsite in head and neck tumors. There are a myriad of malignancies that present within this area. Adequate staging for treatment planning requires multimodality evaluation. Magnetic resonance imaging (MRI) forms an important component in the evaluation of sinonasal tumors. We sought to review the most common sinonasal tumors, including sinonasal anatomy, clinical features, and common imaging features. A literature review was performed to evaluate common sinonasal tumors. Owing to the different tissue types within the sinonasal cavity, there are multiple different tumor pathologies within the sinonasal compartment. Most present in adults although some present in the young. Many of these tumor types have imaging overlaps, although some have a characteristic appearance. MRI can aid in soft tissue delineation, evaluation of multicompartmental extension, intracranial spread, and perineural spread. Sinonasal tumors are a heterogeneous group for which soft tissue delineation via MRI forms an important role in ensuring adequate treatment planning to improve outcomes, decreasing morbidity, and improve functional outcomes.
Doing Great With DOTATATE
Authors: Zlochower Avraham B. , Steinklein Jared M. 
Published: June 2021

Abstract
Sinonasal tumors are relatively rare and radiographically challenging to evaluate due to their wide variety of pathologies and imaging features. However, sinonasal tumors possessing somatostatin receptor overexpression have the benefit of utilizing a multimodality anatomic and functional imaging for a more comprehensive evaluation. This is particularly evident with esthesioneuroblastoma, with computed tomography and magnetic resonance imaging defining the anatomic extent of the tumor, whereas somatostatin receptor imaging, particularly with gallium-68 DOTATATE positron emission tomography/computed tomography, is used to assess the presence of metastatic disease for staging purposes as well as in the surveillance for tumor recurrence. In addition, areas which accumulate gallium-68 DOTATATE are potentially amenable to treatment with peptide receptor radionuclide therapy. In this manner, a combined approach of anatomic and functional imaging is critical for optimal imaging evaluation and treatment strategy of patients with sinonasal tumors.
Electric demand response and bounded rationality: mean-field control for large populations of heterogeneous bounded-rational agents
Authors: Marín Radoszynski Andrea , Pinson Pierre 
Published: June 2021

The increased penetration of renewable energy sources into existing power systems induces challenges in supply–demand balancing. Demand-side flexibility is seen as an option to accommodate variability and limited predictability from renewable energy generation. Heat pumps at residential level, if well coordinated, can be one of those flexibility sources. The complexity involved is high though, since their coordinated operation combines control, population effects and the fact agents may actually not behave as rational decision-makers. We describe here a coordinated control framework that accounts for those aspects altogether. Decentralized model predictive control for large populations of heterogeneous agents is employed. As the cost to be minimized is affected by the population behaviour as a whole through the electricity price, the decentralized control is re-thought as a mean-field game. Existence and uniqueness of a Nash equilibrium are discussed while the Picard–Banach algorithm is used as a solution approach. It is extended to the case of bounded-rational agents. The impact on system dynamics of modelling agents as bounded rational is illustrated through numerical simulations.
This article is part of the theme issue ‘The mathematics of energy systems’.
Welfare-maximizing transmission capacity expansion under uncertainty
Authors: Wogrin S. , Tejada-Arango D. , Downward A. , Philpott A.B. 
Published: June 2021

We apply the JuDGE optimization package to a multistage stochastic leader–follower model that determines a transmission capacity expansion plan to maximize expected social welfare of consumers and producers who act as Cournot oligopolists in each time period. The problem is formulated as a large-scale mixed integer programme and applied to a 5-bus instance over scenario trees of varying size. The computational effort required by JuDGE is compared with solving the deterministic equivalent mixed integer programme using a state-of-the-art integer programming package.
This article is part of the theme issue ‘The mathematics of energy systems’.
Revealing public opinion towards COVID-19 vaccines with Twitter Data in the United States: a spatiotemporal perspective
Authors: Hu Tao , Wang Siqin , Luo Wei , Zhang Mengxi , Huang Xiao , Yan Yingwei , Liu Regina , Ly Kelly , Kacker Viraj , She Bing , Li Zhenlong 
Published: June 2021

AbstractBackgroundThe COVID-19 pandemic has imposed a large, initially uncontrollable, public health crisis both in the US and across the world, with experts looking to vaccines as the ultimate mechanism of defense. The development and deployment of COVID-19 vaccines have been rapidly advancing via global efforts. Hence, it is crucial for governments, public health officials, and policy makers to understand public attitudes and opinions towards vaccines, such that effective interventions and educational campaigns can be designed to promote vaccine acceptance.ObjectiveThe aim of this study is to investigate public opinion and perception on COVID-19 vaccines by investigating the spatiotemporal trends of their sentiment and emotion towards vaccines, as well as how such trends relate to popular topics on Twitter in the US.MethodsWe collected over 300,000 geotagged tweets in the US from March 1, 2020 to February 28, 2021. We examined the spatiotemporal patterns of public sentiment and emotion over time at both national and state scales and identified three phases along the pandemic timeline with the significant changes of public sentiment and emotion, further linking to eleven key events and major topics as the potential drivers to induce such changes via cloud mapping of keywords and topic modelling.ResultsAn increasing trend of positive sentiment in parallel with the decrease of negative sentiment are generally observed in most states, reflecting the rising confidence and anticipation of the public towards vaccines. The overall tendency of the eight types of emotion implies the trustiness and anticipation of the public to vaccination, accompanied by the mixture of fear, sadness and anger. Critical social/international events and/or the announcements of political leaders and authorities may have potential impacts on the public opinion on vaccines. These factors, along with important topics and manual reading of popular posts on eleven key events, help identify underlying themes and validate insights from the analysis.ConclusionsThe analyses of near real-time social media big data benefit public health authorities by enabling them to monitor public attitudes and opinions towards vaccine-related information in a geo-aware manner, address the concerns of vaccine skeptics and promote the confidence of individuals within a certain region or community, towards vaccines.
A Systematic Review and Meta-Analysis of the Mental Health Symptoms during the Covid-19 Pandemic in Southeast Asia
Authors: Pappa Sofia , Chen Jiyao , Barnet Joshua , Chang Anabel , Dong Rebecca Kechen , Xu Wen , Yin Allen , Chen Bryan Z. , Delios Andrew , Chen Richard Z. , Miller Saylor , Wan Xue , Zhang Stephen X. 
Published: June 2021

ABSTRACTAimsThe Covid-19 pandemic has had a substantial impact on the mental health of the general public and high-risk groups worldwide. Due to its proximity and close links to China, Southeast Asia was one of the first regions to be affected by the outbreak. The aim of this systematic review was to evaluate the prevalence of anxiety, depression and insomnia in the general adult population and healthcare workers (HCWs) in Southeast Asia during the course of the first year of the pandemic.MethodsSeveral literature databases were systemically searched for articles published up to February 2021 and two reviewers independently evaluated all relevant studies using pre-determined criteria. The prevalence rates of mental health symptoms were calculated using a random-effect meta-analysis model.ResultsIn total, 32 samples from 25 studies with 20,352 participants were included. Anxiety was assessed in all 25 studies and depression in 15 studies with pooled prevalence rates of 22% and 16% respectively. Only two studies assessed insomnia, which was estimated at 19%. The prevalence of anxiety and depression was similar amongst frontline HCWs (18%), general HCWs (17%), and students (20%) whilst being noticeably higher in the general population (27%).ConclusionsThis is the first systematic review to investigate the mental health impact of the Covid-19 pandemic in Southeast Asia. A considerable proportion of the general population and HCWs reported mild to moderate symptoms of anxiety and depression; the pooled prevalence rater, however, remain significantly lower than those reported in other areas such as China and Europe.
Field evaluation of specificity and sensitivity of a standard SARS-CoV-2 antigen rapid diagnostic test: A prospective study at a teaching hospital in Northern Ghana
Authors: Abdul-Mumin Alhassan , Abubakari Abdulai , Agbozo Faith , Abdul-Karim Abass , Nuertey Benjamin Demah , Mumuni Kareem , Heuschen Anna-Katharina , Hennig Lisa , Denkinger Claudia M. , Müller Olaf , Jahn Albrecht 
Published: June 2021

AbstractBackgroundThe testing capacity for SARS-CoV-2 in Africa is rather limited. Antigen-detection rapid diagnostic tests (Ag-RDTs) are a cheap and rapid alternative to reverse transcriptase-polymerase chain reaction (RT-PCR) tests, but there is little data about their performance under real life conditions in tropical countries.ObjectiveTo evaluate the performance of a standard Ag-RDT in a population of a major hospital in northern Ghana.MethodsProspective, cross-sectional, blinded verification of the performance of the SD Biosensor Standard Q SARS-CoV-2 Ag-RDT under real life conditions in 135 symptomatic patients and 58 contacts of RT-PCR positives at Tamale Teaching Hospital in February 2021. Nasopharyngeal samples were taken under standard conditions and tested against RT-PCR in the hospital laboratory.Results193 participants (median age 35 years, 109 male) were included into the study for which both RT-PCR test and Ag-RDT results were available. A total of 42 (22%) were RT-PCR positive. Of the 42 RT-PCR positives, 27 were Ag-RDT positive, resulting in a sensitivity of 64% (95% CI 49-79). Sensitivity among symptomatic patients was 58% (95% CI 38-78). 123 were identified Ag-RDT negatives of the 151 RT-PCR negatives, resulting in a specificity of 81% (95% CI 75-87).ConclusionsSARS-CoV-2 Ag-RDTs appear to have a rather low sensitivity and particularly a low specificity under real life conditions in Africa. The role of existing Ag-RDTs in countries with high-temperature climates and limited resources still needs more data and discussion.
Alcov: Estimating Variant of Concern Abundance from SARS-CoV-2 Wastewater Sequencing Data
Authors: Ellmen Isaac , Lynch Michael D.J. , Nash Delaney , Cheng Jiujun , Nissimov Jozef I. , Charles Trevor C. 
Published: June 2021

AbstractDetection of SARS-CoV-2 in wastewater is an important strategy for community level surveillance. Variants of concern (VOCs) can be detected in the wastewater samples using next generation sequencing, however it can be challenging to determine the relative abundance of different VOCs since the reads cannot be assembled into complete genomes. Here, we present Alcov (abundance learning of SARS-CoV-2 variants), a tool that uses mutation frequencies in SARS-CoV-2 sequencing data to predict the distribution of VOC lineages in the sample. We used Alcov to predict the distributions of lineages from three wastewater samples which agreed well with clinical data. By predicting not just which VOCs are present, but their relative abundances in the population, Alcov extracts a more complete snapshot of the variants which are circulating in a community.