bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simultaneous bilateral extracapsular proximal femur fractures in the elderly. A case report
Authors: Rodríguez-Zamorano Patricia , Galán-Olleros María , Garcia-Coiradas Javier , Llanos Sergio , Valle-Cruz José Antonio , Marco Fernando 
Published: July 2022

Abstract
Simultaneous and bilateral proximal femoral fractures (PFF) are rare and have scarcely been reported in the literature. A case of a bilateral extracapsular PFF is herein presented. Besides, an exhaustive review of the literature was performed, analyzing the information of all previously reported cases.
An 81-year-old woman, who suffered a casual fall, was diagnosed with bilateral PFF consisting of both a subtrochanteric and an intertrochanteric fracture. She underwent concurrent intramedullary fixation for both fractures without any relevant complication and started early ambulation. Simultaneous bilateral extracapsular PFF are exceptional, with only 23 cases described in the current literature. In the elderly, they deserve special attention with treatment strategies in between the ones for unilateral hip fractures and those provided to old multiply injured patients. PFF management is not well established. Minimal reaming and careful nailing can be safely performed bilaterally under close monitoring, in order to start an early functional recovery.
A rare case of a congenital pancreatic duplication cyst in an infant complicated by an upper GI bleed, pancreatitis, cyst infection and gastric outlet obstruction
Authors: Cadili Lina , Cullen Krystal L , Finn Nicola J , Singh Andrew , Webber Eric , Hayashi Allen H 
Published: July 2022

Abstract
Enteric duplication cysts are rare congenital entities most commonly found in the esophagus, ileum or colon but can be in remote locations such as the biliary tree, liver or pancreas. Pancreatic duplication cysts are very uncommon and usually present in adulthood with pancreatitis or abdominal pain. Here, we present a unique and complex case of an infant with a pancreatic duplication cyst initially presenting with an upper gastrointestinal bleed followed by pancreatitis, cyst infection and gastric outlet obstruction.
Erectile Dysfunction in a U.S. National Sample of Male Military Veterans
Authors: Way Bailey M , Griffin Kaelyn R , Kraus Shane W , Tsai Jack , Pietrzak Robert H 
Published: July 2022

ABSTRACT

Introduction
Erectile dysfunction (ED) is one of the most prevalent sexual dysfunctions in men and often co-occurs with physical and mental health issues. Military veterans are at elevated risk for many comorbid physical and mental health issues, including ED, although little research has examined the prevalence and health burden of ED in the general U.S. veteran population. The present study calculated the weighted lifetime prevalence of ED and its association with physical and mental health conditions in a nationally representative sample of U.S. veterans.

Materials and Methods
Using data from a nationally representative sample of 921 male U.S. veterans, self-report assessments assessed major depressive disorder (MDD), generalized anxiety disorder, probable post-traumatic stress disorder (PTSD), at-risk/problem gambling, and past two-week suicidal ideation and attempts, as well as 22 physical health conditions.

Results
The weighted lifetime prevalence of ED among veterans was 14.2% (95% CI = 12.0%-16.0%). Veterans with ED were more likely to be older than 60, unemployed, to have served less than four years in the military, and to have served in combat roles and in the Vietnam War. Relative to veterans without ED, veterans with ED had higher rates of sleep disorders (adjusted odds ratio [aOR] = 3.23), arthritis (aOR = 2.60), high cholesterol (aOR = 2.30), diabetes (aOR = 2.29), high blood pressure (aOR = 2.14), obesity (aOR = 2.12), heart disease (aOR = 2.10), cancer (aOR = 2.07), respiratory illness (aOR = 2.02), and chronic pain (aOR = 1.86). After adjusting for sociodemographic characteristics and physical health conditions, ED was associated with increased odds of MDD (aOR = 2.88), at-risk/problem gambling (aOR = 2.45), and suicidal ideation (aOR = 1.91) but not for generalized anxiety disorder (aOR = 1.69) or probable PTSD (aOR = 1.63). When considered in the context of all mental health variables, MDD was independently associated with ED (aOR = 3.39).

Conclusion
This study examined both mental and physical health conditions associated with ED in a U.S. nationally representative sample of veterans. ED is prevalent in veterans and associated with elevated physical and mental health burden. Results highlight the importance of considering ED in disease prevention and treatment efforts in this population. These findings may help inform prevention approaches as well as clinical targets for early screening and treatment in vulnerable subgroups of this population. Notably, data collected relied on self-report assessments; data on race and socioeconomic status were not collected.
CD4+ T cell metabolism, gut microbiota, and autoimmune diseases: implication in precision medicine of autoimmune diseases
Authors: Yang Wenjing , Yu Tianming , Cong Yingzi 
Published: July 2022

AbstractCD4+ T cells are critical to the development of autoimmune disorders. Glucose, fatty acids, and glutamine metabolisms are the primary metabolic pathways in immune cells, including CD4+ T cells. The distinct metabolic programs in CD4+ T cell subsets are recognized to reflect the bioenergetic requirements, which are compatible with their functional demands. Gut microbiota affects T cell responses by providing a series of antigens and metabolites. Accumulating data indicate that CD4+ T cell metabolic pathways underlie aberrant T cell functions, thereby regulating the pathogenesis of autoimmune disorders, including inflammatory bowel diseases, systemic lupus erythematosus, and rheumatoid arthritis. Here, we summarize the current progress of CD4+ T cell metabolic programs, gut microbiota regulation of T cell metabolism, and T cell metabolic adaptions to autoimmune disorders to shed light on potential metabolic therapeutics for autoimmune diseases.
Entropy production in a longitudinally expanding Yang–Mills field with use of the Husimi function: semiclassical approximation
Authors: Matsuda Hidefumi , Kunihiro Teiji , Ohnishi Akira , Takahashi Toru T 
Published: July 2022

Abstract
We investigate the possible thermalization process of the highly occupied and weakly coupled Yang–Mills fields expanding along the beam axis through an evaluation of the entropy, particle number, and pressure anisotropy. The time evolution of the system is calculated by solving the equation of motion for the Wigner function in the semiclassical approximation with initial conditions mimicking the glasma. For the evaluation of the entropy, we adopt Husimi–Wehrl (HW) entropy, which is obtained by using the Husimi function, a positive semidefinite quantum distribution function given by smearing the Wigner function. By numerical calculations at g = 0.1 and 0.2, the entropy production is found to occur together with the particle creation in two distinct stages: In the first stage, the particle number and entropy at low longitudinal momenta grow rapidly. In the second stage, the particle number and entropy of higher longitudinal momentum modes show a slower increase. The pressure anisotropy remains in our simulation and implies that the system is still out of equilibrium.
Settlements of property for persons lacking capacity: principles, practices, and problems
Authors: Lynn Andrew 
Published: July 2022

Abstract
The settlement of property for persons who lack capacity under the statutory powers conferred by mental health legislation requires courts and practitioners to have a firm understanding of the fundamentals of trust law as well as a clear appreciation of the administration of trusts in practice. This article considers, making reference to recent case authority from England and Hong Kong, the following aspects of the issue: (i) whether there is any presumption or starting point under the statutory regime in favour of appointing deputies rather than establishing trusts; (ii) the factors that should be considered by the courts in deciding whether to establish trusts for persons lacking capacity; (iii) whether and to what extent trusts have a role to play in solving or reducing any perceived resource deficit in the supervisory machinery established under the statutory regime; and (iv) difficulties encountered with complex trusts.
Automated Quantitative Measurement of Yellow Halos Suggests Activity of Necrotrophic Effectors in Septoria tritici Blotch
Authors: Anderegg Jonas , Kirchgessner Norbert , Kronenberg Lukas , McDonald Bruce A. 
Published: July 2022

Many necrotrophic plant pathogens utilize host-selective toxins or necrotrophic effectors during the infection process. We hypothesized that the chlorotic yellow halos frequently observed around necrotic lesions caused by the wheat pathogen Zymoseptoria tritici could result from the activity of necrotrophic effectors interacting with the products of toxin sensitivity genes. As an initial step toward testing this hypothesis, we developed an automated image analysis (AIA) workflow that could quantify the degree of yellow halo formation occurring in wheat leaves naturally infected by a highly diverse pathogen population under field conditions. This AIA based on statistical learning was applied to more than 10,000 naturally infected leaves collected from 335 wheat cultivars grown in a replicated field experiment. We estimated a high heritability ( h2 = 0.71) for the degree of yellow halo formation, suggesting that this quantitative trait has a significant genetic component. Using genome-wide association mapping, we identified six chromosome segments significantly associated with the yellow halo phenotype. Most of these segments contained candidate genes associated with targets of necrotrophic effectors in other necrotrophic pathogens. Our findings conform with the hypothesis that toxin sensitivity genes could account for a significant fraction of the observed variation in quantitative resistance to Septoria tritici blotch. [Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Residency Program Responses to Early COVID-19 Surges Highlight Tension as to Whether Residents Are Learners or Essential Workers
Authors: Martin Shannon K. , Finn Kathleen M. , Kisielewski Michael , Simmons Rachel , Zaas Aimee K. 
Published: July 2022

PurposeTo quantify the extent to which internal medicine (IM) residents provided care for patients with COVID-19 and examine characteristics of residency programs with or without plans (at some point) to exclude residents from COVID-19 care during the first 6 months of the pandemic.MethodThe authors used data from a nationally representative, annually recurring survey of U.S. IM program directors (PDs) to quantify early (March–August 2020) resident participation in COVID-19 care. The survey was fielded from August to December 2020. PDs reported whether they had planned to exclude residents from COVID-19 care (i.e., PTE status). PTE status was tested for association with program and COVID-19 temporal characteristics, resident schedule accommodations, and resident COVID-19 cases.ResultsThe response rate was 61.5% (264/429). Nearly half of PDs (45.4%, 118/260) reported their program had planned at some point to exclude residents from COVID-19 care. Northeastern U.S. programs represented a smaller percentage of PTE than non-PTE programs (26.3% vs 36.6%;P= .050). PTE programs represented a higher percentage of programs with later surges than non-PTE programs (33.0% vs 13.6%,P= .048). Median percentage of residents involved in COVID-19 care was 75.0 (interquartile range [IQR]: 22.5–100.0) for PTE programs, compared with 95.0 (IQR: 60.0–100.0) for non-PTE programs (P< .001). Residents participated most in intensive care units (87.6%, 227/259) and inpatient wards (80.8%, 210/260). Accommodations did not differ by PTE status. PTE programs reported fewer resident COVID-19 cases than non-PTE programs (median percentage = 2.7 [IQR: 0.0–8.6] vs 5.1 [IQR: 1.6–10.7];P= .011).ConclusionsIM programs varied widely in their reported plans to exclude residents from COVID-19 care during the early pandemic. A high percentage of residents provided COVID-19 care, even in PTE programs. Thus, the pandemic highlighted the tension as to whether residents are learners or employees.
Effect of Postoperative Femoral Neck Shaft Angle on Femoral Head Sphericity Following Proximal Femoral Osteotomy in Legg-Calve-Perthes Disease
Authors: Kim Sungmin , Oh Ho-Seok , Lee Minsu , Jung Sung Taek 
Published: July 2022

Background:
Herein, we aimed to examine the relationship between the postoperative neck shaft angle (NSA) and the Stulberg outcome at skeletal maturity in patients with Legg-Calvé-Perthes disease (LCPD) who underwent proximal femoral varus osteotomy (PFVO) and to determine the optimal angle of varization.

Methods:
In this retrospective study, we analyzed the data of 90 patients aged older than 6 years at the time of diagnosis with LCPD who underwent PFVO at our institution between 1979 and 2014. Univariate and multivariate logistic regression analyses were used to examine the effects of variables on the sphericity of the femoral head at skeletal maturity, including the age at onset, sex, stage at operation, extent of epiphyseal involvement and epiphyseal collapse, presence of specific epiphyseal, metaphyseal, and acetabular changes, and postoperative NSA. The sphericity of the femoral head on the final plain follow-up radiographs of the hip joint at skeletal maturity was assessed using the Stulberg classification. Cases of spherical femoral head (Stulberg I or II) were rated as good, whereas those of ovoid or flat femoral head (Stulberg III, IV, or V) were rated as bad.

Results:
The mean age at diagnosis was 7.93 (range, 6.0-12.33) years. The average follow-up period was 10.11 (range, 5.25-22.92) years. The pre and postoperative mean NSAs were 137.31±6.86 degrees (range, 115.7-158 degrees) and 115.7±9.83 degrees (range, 88.6-137.6 degrees), respectively. The age at diagnosis, lateral pillar classification, and postoperative NSA were found to be closely related to the sphericity of the femoral head at skeletal maturity. Patients with a postoperative NSA of <105 degree or more than 125 degree were less likely to have a spherical femoral head.

Conclusions:
Our study showed that patients with a postoperative NSA between 105 and 125 degrees were more likely to have a spherical femoral head. When performing PFVO in patients with LCPD, reasonable varus angulation of PFVO should be taken into consideration for the success of the operation.

Level of Evidence:
Level III retrospective cohort study.
Dermal Cystine Crystals: An Incidental Finding During Mohs Surgery
Authors: Kwan Zhenli , Balachandran Pushpaharan , Daruish Maged , Stefanato Catherine M. , Kiely Clare 
Published: July 2022

Abstract:
Cystinosis is an autosomal recessive lysosomal storage disorder with intracellular cystine accumulation caused by mutations in the CTNS gene. We present a case of a 48-year-old woman with a history of cystinosis and squamous cell carcinoma treated with Mohs micrographic surgery where widespread deposition of cystine crystals were noted on frozen sections of the Mohs layers. These were rectangular to polygonal refractile crystals within the cytoplasm of dermal fibroblasts and macrophages which were highlighted by polarized light microscopy. This case illustrates the use of frozen section processing to demonstrate the presence of intracellular cystine crystals. Moreover, because patients with cystinosis may be predisposed to developing carcinomas postrenal transplantation, Mohs surgeons should be aware of this unusual phenomenon when evaluating the slides.
Mechanical circulatory support in the treatment of cardiogenic shock
Authors: Fernando Shannon M. , Price Susanna , Mathew Rebecca , Slutsky Arthur S. , Combes Alain , Brodie Daniel 
Published: July 2022

Purpose of review
Cardiogenic shock is a condition that is characterized by end-organ hypoperfusion secondary to reduced cardiac output, and is associated with substantial mortality. The mainstay of therapy for cardiogenic shock is reversal of the underlying cause, and concomitant supportive care with vasoactive medications (vasopressors and inotropes). Patients who continue to deteriorate despite these measures may require mechanical circulatory support (MCS). Here, we review the devices available for MCS, and their associated benefits and risks.

Recent findings
Despite growing use worldwide, there is little randomized evidence supporting the routine use of any specific device for MCS in cardiogenic shock. A large randomized trial of the intra-aortic balloon pump did not demonstrate short- or long-term improvement in mortality. The TandemHeart and Impella devices which assist in left ventricular unloading have only been evaluated in small randomized trials, which showed an increase in adverse events without improvement in mortality. Finally, venoarterial extracorporeal membrane oxygenation (provides both circulatory and respiratory support) and is currently being evaluated in large randomized clinical trials.

Summary
Various devices for MCS in cardiogenic shock are available, but routine use is not supported by high-quality randomized evidence. Given the resources required for initiation of MCS, use of these treatments should be limited to centers experienced in advanced cardiac care, and future research should focus on what role (if any) these devices have in clinical practice.
Novel insights in Turner syndrome
Authors: Aly Jasmine , Kruszka Paul 
Published: July 2022

Purpose of review
Turner syndrome is the most common sex chromosome abnormality in female individuals, affecting 1/2000–1/2500 female newborns. Despite the high incidence of this condition, the mechanisms underlying the development of multiorgan dysfunction have not been elucidated.

Recent findings
Clinical features involve multiple organ systems and include short stature, dysmorphic facial features, delayed puberty and gonadal failure, cardiac and renal abnormalities, audiologic abnormalities, and a high prevalence of endocrine and autoimmune disorders. Paucity of available genotype/phenotype correlation limits the ability of clinicians to provide accurate guidance and management. Given the advent of robust genetic testing and analysis platforms, developments in the genetic basis of disease are materializing at a rapid pace.

Summary
The objective of this review is to highlight the recent advances in knowledge and to provide a framework with which to apply new data to the foundational understanding of the condition.
Characterization of Patients Seeking Care at a Sexual Health Clinic Who Report Engaging in Exchange Sex
Authors: Bole Medhavi , Khosropour Christine M. , Glick Sara N. , Barbee Lindley A. , Golden Matthew R. , Dhanireddy Shireesha , Dombrowski Julia C. 
Published: July 2022

Background
People who exchange sex (PWES) for money or drugs are at increased risk for poor health outcomes and may be reluctant to engage in health services.

Methods
We conducted a cross-sectional analysis of patients seen for new problem visits at the Public Health—Seattle and King County Sexual Health Clinic between October 2010 and March 2020 who reported exchanging sex for drugs or money in a computer assisted self-interview. We analyzed demographics; sexually transmitted infections (STIs), human immunodeficiency virus (HIV), and hepatitis C virus (HCV) history; and HIV preexposure prophylaxis (PrEP) use, stratified by gender. We compared characteristics of people who ever versus never exchanged sex using χ2 tests and analyzed the visit reason and outcomes among PWES.

Results
Among 30,327 patients, 1611 (5%) reported ever exchanging sex: 981 (61%) cisgender men, 545 (34%) cisgender women, and 85 (5%) transgender and gender diverse persons. Compared with people who never exchanged sex, PWES were more likely to report homelessness (29% vs 7%, P < 0.001), injection drug use (39% vs 4%, P < 0.001), prior STIs (36% vs 19%, P < 0.001), prior HIV diagnosis (13% vs 5%, P < 0.001), and prior HCV diagnosis (13% vs 2%, P < 0.001). People who exchange sex came to the clinic seeking STI tests (60%), HIV tests (45%), and care for STI symptoms (38%). Overall, 320 (20%) PWES were diagnosed with STIs, 15 (1%) were newly diagnosed with HIV, and 12 (1%) initiated PrEP at the visit.

Conclusion
People who exchange sex have complex barriers to care, and sexual health clinic visits present an opportunity to improve health services for this population.
A statewide mixed-methods study of provider knowledge and behavior administering Expedited Partner Therapy for chlamydia and gonorrhea
Authors: Groene Emily A , Boraas Christy , Smith Kumi , Lofgren Sarah , Rothenberger Megan , Enns Eva 
Published: July 2022

Background
Expedited Partner Therapy (EPT) refers to the practice of having patients diagnosed with chlamydia or gonorrhea deliver medication directly to their partner(s) to treat them presumptively for infection. While EPT facilitates timely treatment and prevents reinfection, it remains underutilized. We used findings from key informant interviews to design and implement a statewide survey to estimate knowledge and utilization of EPT and to identify barriers and facilitators to EPT among Minnesota providers.

Methods
From November to December 2020, we carried out 15 interviews with health providers who currently provide EPT and coded interviews by recurring themes. We then conducted a statewide online survey on sexually transmitted infection (STI) treatment and barriers to EPT, from December 2020 to March 2021. We disseminated the survey to all licensed Minnesota health providers, and those who reported treating bacterial STIs in the past year were included in the study.

Results
Interview themes included the importance of direct provision of partner medication, administrative/pharmacy barriers to treatment, inclusive EPT eligibility, and patient counseling. Of the 623 health providers who completed the online survey, only 70% thought EPT was legal and only 37% currently offer EPT. Of those who did not provide EPT, 78% said they would under certain circumstances. Barriers included concerns about safety/liability of prescribing without a medical exam, administrative concerns about prescriptions, and patient acceptance.

Conclusions
Given that over a quarter of respondents did not know EPT’s legal status, improving provider education may increase EPT provision. More research is needed on system-level barriers and patient acceptance of solutions identified in this study.