bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ethanol Exposure During the Intravenous Administration of Chemotherapeutic Drugs: An Analysis of Clinical Practice and a Literature Review
Authors: Hiver Quentin , Henry Héloïse , Vasseur Michèle , Cuvelier Elodie , Le Rhun Émilie , Turpin Anthony , Décaudin Bertrand , Odou Pascal , Simon Nicolas 
Published: January 2022

PURPOSE: Injectable cytotoxics may be formulated with ethanol. This study sought to quantify the amount of ethanol exposure during chemotherapy infusions. MATERIALS AND METHODS: We first reviewed the antineoplastic drugs (Anatomical Therapeutic and Chemical code L01) and oncologic supportive care drugs (eg, antiemetics) currently available in France, to identify preparations containing ethanol. The amount of ethanol in the final chemotherapy preparation was calculated. Next, we performed a 2-year, single-center, retrospective analysis of injectable antineoplastic drug compounding in routine clinical practice in a French university medical center. Finally, we reviewed our results with regard to the literature data. RESULTS: Ten of the 60 cytotoxic products on the market contained ethanol at concentrations of up to 790 mg/mL, depending on the drug, formulation, and supplier. Several final preparations contained more than 3 g of ethanol per infusion (the maximum recommended by the European Medicines Agency); this was notably the case for gemcitabine, paclitaxel (up to 20 g ethanol per injection, for both), and etoposide (up to 50 g ethanol per infusion). The analysis of our compounding activity showed that 3,172 (4.99%) of the 63,613 chemotherapy preparations (notably paclitaxel) contained more than 3 g of ethanol. None of the oncologic supportive care drugs contained ethanol. CONCLUSION: Patients are exposed to ethanol during the infusion of antineoplastic drugs. With a view to better patient care, physicians and pharmacists should carefully evaluate the risk of ethanol exposure throughout the course of cytotoxic drug treatment.
Frameless Robot-Assisted vs Frame-Based Awake Deep Brain Stimulation Surgery: An Evaluation of Technique and New Challenges
Authors: Fenoy Albert J. , Conner Christopher R. 
Published: January 2022

BACKGROUND:
Methodological approaches to deep brain stimulation (DBS) continue to evolve from awake frame-based to asleep frameless procedures with robotic assistance, primarily directed to optimize operative efficiency, lead accuracy, and patient comfort. Comparison between the 2 is scarce.

OBJECTIVE:
To analyze the impacts of methodological differences on operative efficiency and stereotactic accuracy using a frame compared with a frameless robotic platform while maintaining the awake state and use of multiple microelectrode recording (MER) trajectories.

METHODS:
Thirty-four consecutive patients who underwent bilateral awake frameless robot-assisted DBS were compared with a previous cohort of 30 patients who underwent frame-based surgery. Patient demographics, operative times, and MER data were collected for both cohorts. Two-dimensional radial errors of lead placements were calculated.

RESULTS:
Preoperative setup, surgical, and total operating room times were all significantly greater for the robot-assisted cohort (P < .001). The need for computed tomography imaging when referencing the robotic fiducials led to increased setup duration because of patient transport, unnecessary for the frame-based cohort. Multiple simultaneous MER trajectories increased surgical time (mean 26 min) for the robot-assisted cohort only. The mean radial errors in the robot-assisted and frame cohorts were 0.98 ± 0.66 and 0.74 ± 0.49 mm (P = .03), respectively.

CONCLUSION:
The use of a truly frameless robotic platform such as the Mazor Renaissance (Mazor Robotics Ltd) presented challenges when implementing techniques used during awake frame-based surgery. Maintaining good accuracy, intraoperative reference imaging, and limited MER trajectories will help integrate frameless robot assistance into the awake DBS surgical workflow.
Position of Retrosigmoid Craniotomy in Hearing Preservation Surgery for Vestibular Schwannoma
Authors: Franz Leonardo , Mazzoni Antonio , Martini Alessandro , d’Avella Domenico , Zanoletti Elisabetta 
Published: January 2022

BACKGROUND:
Surgical access to the internal auditory canal (IAC) fundus is a crucial aspect of the retrosigmoid approach for hearing preservation surgery in vestibular schwannoma. An appropriate positioning of the retrosigmoid craniotomy is necessary to obtain an adequate surgical corridor for full fundus exposure and labyrinth preservation.

OBJECTIVE:
To describe how the position of the posterior edge of the access related to the probability of exposing the fundus and to propose novel criteria for positioning the retrosigmoid craniotomy.

METHODS:
Data on fundus exposure were retrospectively collected in 33 consecutive cases of sporadic vestibular schwannoma, submitted to the retrosigmoid craniotomy in a park-bench position. Patients' computed tomography images were analyzed to calculate the position of the posterior edge of the craniotomy with reference to the fundus–labyrinth line (FLL), which starts at the fundus and, running just posterior to the labyrinth, reaches the occipital squama. A logistic regression model was used to correlate the craniotomy position with the probability of exposing the fundus.

RESULTS:
The fundus exposure rate was significantly higher (P = .005) for craniotomies located posteromedially to the FLL. In a logistic regression model, the probability of exposing the fundus reached 95% for craniotomies located 11.3 mm posteromedially to the FLL.

CONCLUSION:
This study showed a strong association between craniotomy position and fundus exposure rate. Our findings suggest that the posteromedial edge of the retrosigmoid craniotomy should lie approximately 11 mm posteromedially to FLL to maximize the chances of exposing the fundus.
A novel intramandibular joint facilitates feeding versatility in the sixbar distichodus
Authors: Martinez Christopher M. , Tovar Angelly J. , Wainwright Peter C. 
Published: January 2022

ABSTRACT
The intramandibular joint (IMJ) is a secondary point of movement between the two major bones of the lower jaw. It has independently evolved in several groups of teleost fishes, each time representing a departure from related species in which the mandible functions as a single structure rotating only at the quadratomandibular joint (QMJ). In this study, we examine kinematic consequences of the IMJ novelty in a freshwater characiform fish, the herbivorous Distichodus sexfasciatus. We combine traditional kinematic approaches with trajectory-based analysis of motion shapes to compare patterns of prey capture movements during substrate biting, the fish's native feeding mode, and suction of prey from the water column. We find that the IMJ enables complex jaw motions and contributes to feeding versatility by allowing the fish to modulate its kinematics in response to different prey and to various scenarios of jaw–substrate interaction. Implications of the IMJ include context-dependent movements of lower versus upper jaws, enhanced lower jaw protrusion, and the ability to maintain contact between the teeth and substrate throughout the jaw closing or biting phase of the motion. The IMJ in D. sexfasciatus appears to be an adaptation for removing attached benthic prey, consistent with its function in other groups that have evolved the joint. This study builds on our understanding of the role of the IMJ during prey capture and provides insights into broader implications of the innovative trait.
Prognostic value of 18F-FDG PET/CT and MRI features in patients with high-risk and very-high-risk cutaneous squamous cell carcinoma
Authors: Kawaguchi Masaya , Kato Hiroki , Matsuyama Kanako , Noda Yoshifumi , Hyodo Fuminori , Matsuo Masayuki 
Published: January 2022

Objective:
This study aimed to evaluate the prognostic value of 18F-fludeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and MRI features in patients with high-risk and very-high-risk cutaneous squamous cell carcinoma (cSCC).

Methods:
This study included 54 consecutive patients with surgically resected primary high-risk and very-high-risk cSCC who underwent pre-operative FDG-PET/CT and/or MRI. Among them, 14 patients (26%) had recurrences. We retrospectively reviewed the FDG-PET/CT (n = 34) and MRI (n = 48) and investigated the clinical significance and prognostic value of imaging features in cSCC.

Results:
On FDG-PET/CT, the maximum standardized uptake value (SUVmax) of the primary tumor (13.0 ± 6.4 vs. 6.9 ± 5.3, p &lt; 0.05) was higher in cSCC with recurrence than in cSCC without recurrence. On MRI, the maximum diameter of the lesion (46.8 ± 24.1 mm vs 30.4 ± 17.0 mm, p &lt; 0.05) and the frequency of muscle/tendon/bone invasion (42% vs 11%, p &lt; 0.05) were significantly greater in cSCC with recurrence than in cSCC without recurrence. In the univariate analysis, prognostic factors for recurrence were SUVmax of the primary tumor (p &lt; 0.01), the maximum diameter of the lesion (p &lt; 0.05), and depth of invasion (p &lt; 0.05). The areas under the receiver operating characteristic curves of the SUVmax (0.78) were superior to those of the maximum diameter (0.71) and depth of invasion (0.60).

Conclusion:
SUVmax, maximum diameter, and depth of invasion were useful parameters for prognostic factors predicting recurrence in patients with high-risk and very-high-risk cSCC.

Advances in knowledge:
SUVmax represents a prognostic factor.
Male genital injuries treated at a tertiary hospital in the western region of Nepal: A two-year snapshot.
Authors: Atreya Alok , Baral Suman , Menezes Ritesh G , Nepal Samata 
Published: January 2022

Background: Male genital injuries are urological emergencies which if not promptly treated with correct therapeutic intervention may lead to loss of fertility due to infections and anatomical disruption of normalcy. This study highlights the clinical scenarios, etiology and outcome of male genital injury cases that were managed at a tertiary care center in Nepal. Such injuries are not frequently encountered as patients are hesitant to report such injuries. The present study is the first from Nepal which depicts a comprehensive report on male genital injuries. Methods: A retrospective analysis of discharge summaries of the cases of male genital injuries was reviewed during June 2020. All the treated cases during the two-year period from April 2018 to April 2020 at Lumbini Medical College, Nepal were included in the study. Results: There were eight cases of genital trauma admitted and treated during the study period. All the patients were males and age ranged from six to 71 years with a mean age of 33 ± 21.45 years. Fall injury and road traffic accidents (RTA) were observed to be the primary cause in the majority of cases. Conclusion: Superficial injuries to the penis and scrotum do not require surgical exploration and could be managed conservatively. However, deeper and complicated injuries, testicular preservation, the functionality of the part and cosmetic issues are taken into consideration which might require a multi-disciplinary approach. Apart from the medical issues pertaining to genital injuries, there are legal and psychological aspects of such events too which should not be ignored.
Hygienic knowledge and practices of milk vending machine handlers in the informal settlements of Nairobi, Kenya
Authors: Kevin Holi , Njue Lucy , Abong George 
Published: January 2022

Background: Poor milk handling practices due to lack of knowledge or deliberate adulteration compromises the safety of milk and that of the consumer. With the increase of milk vending machines in informal settlements, the knowledge and practices of vendors concerning milk hygiene are critical in determining milk safety. The operation of milk vending machines is guided by strict regulations that aim at ensuring proper practices among milk handlers, but the level of implementation among milk vendors is questionable. This study sought to establish hygienic knowledge and handling practices of vendors operating milk vending machines in Nairobi’s informal settlements of Kibra and Dagoretti North. Methods: Using a cross-sectional study design, 37 milk vendors were interviewed at the study setting with the aid of questionnaires. Data was then recorded in datasheets and analyzed using frequencies, correlation, and t-test with the aid of Statistical Package for Social Sciences software. Results: The mean percentage score for knowledge and practices was 68.83% and 54.05%, respectively. The knowledge and practices of vendors significantly improved with the increase in their level of education (p=0.04 and p=0.02). There was a significantly positive correlation between knowledge and practices (r=0.626, p=0.000). Conclusions: There is a low level of hygienic knowledge and poor practices among vendors operating milk vending machines in the study area. The efforts by the regulator to ensure proper implementation of the regulations was also not sufficient. Training is required to improve the hygienic knowledge and practices of milk vending machine handlers in informal settlements. Frequent inspections should also be carried out in the informal settlements to ensure proper implementation of regulations on the operation of milk vending machines.
Affordable and effective optokinetic response methods to assess visual acuity and contrast sensitivity in larval to juvenile zebrafish
Authors: Gómez Sánchez Alicia , Álvarez Yolanda , Colligris Basilio , Kennedy Breandán N. 
Published: January 2022

The optokinetic response (OKR) is an effective behavioural assay to investigate functional vision in zebrafish. The rapid and widespread use of gene editing, drug screening and environmental modulation technologies has resulted in a broader need for visual neuroscience researchers to access affordable and more sensitive OKR, contrast sensitivity (CS) and visual acuity (VA) assays. Here, we demonstrate how 2D- and 3D-printed, striped patterns or drums coupled with a motorised base and microscope provide a simple, cost-effective but efficient means to assay OKR, CS and VA in larval-juvenile zebrafish. In wild-type, five days post-fertilisation (dpf) zebrafish, the 2D or 3D set-ups of 0.02 cycles per degree (cpd) (standard OKR stimulus) and 100% black-white contrast evoked equivalent responses of 24.2±3.9 or 21.8±3.9 saccades per minute, respectively. Furthermore, although the OKR number was significantly reduced compared to the 0.02 cpd drum (p<0.0001), 0.06 and 0.2 cpd drums elicited equivalent responses with both set-ups. Notably, standard OKRs varied with time of day; peak responses of 29.8±7 saccades per minute occurred in the early afternoon with significantly reduced responses occurring in the early morning or late afternoon (18.5±3 and 18.4±4.5 saccades per minute, respectively). A customised series of 2D printed drums enabled analysis of VA and CS in 5-21 dpf zebrafish. The saccadic frequency in VA assays was inversely proportional to age and spatial frequency and in CS assays was inversely proportional to age and directly proportional to contrast of the stimulus. OKR, VA and CS of zebrafish larvae can be efficiently measured using 2D- or 3D-printed striped drums. For data consistency the luminance of the OKR light source, the time of day when the analysis is performed, and the order of presentation of VA and CS drums must be considered. These simple methods allow effective and more sensitive analysis of functional vision in zebrafish.
Changing perceptions of telemedicine in a surgical outpatients clinic
Authors: Sammut Mark , Sammut Matthew , Chircop Daniel M , Chircop Kurt-Lee , Muscat Craig , El Hadi Zakria , Caruana Clifford 
Published: January 2022

Background/Aims Before the COVID-19 pandemic, telemedicine was not widely used in surgical departments. Despite its increased use during the pandemic, there is a lack of data on the patient perspective. This study investigated patients' views of telemedicine in a surgical outpatients clinic setting. Method A single-centre cross-sectional study was performed, involving patients who were due to attend the surgical outpatients clinic of one surgical team. Independent investigators contacted the patients by telephone after their virtual telephone consultation to administer the questionnaire. Patient satisfaction rates were recorded using the PSQ-18 questionnaire. Patient consultation preferences were recorded and analysed. Results A total of 223 patients participated in this study. The majority of patients' perceptions shifted in favour of virtual consultations after the onset of the pandemic (P<0.05). Sub-group analysis showed no significant differences between the preferences of older and younger patients before or after the onset of the pandemic. Overall, patients reported high satisfaction rates with their virtual consultations. Conclusions Patient perceptions are changing in favour of virtual telemedicine consultations. Training healthcare providers in this method of service delivery is essential to maintain a good quality of care.
Kinematic analysis and visualization of Tetraselmis microalgae 3D
motility by digital holography
Authors: Sirico Daniele Gaetano , Cavalletti Elena , Miccio Lisa , Bianco Vittorio , Memmolo Pasquale , Sardo Angela , Ferraro Pietro 
Published: January 2022

A study on locomotion in a 3D environment of Tetraselmis microalgae by digital holographic microscopy is reported. In particular, a fast and semiautomatic criterion is revealed for tracking and analyzing the swimming path of a microalga (i.e., Tetraselmis species) in a 3D volume. Digital holography (DH) in a microscope off-axis configuration is exploited as a useful method to enable fast autofocusing and recognition of objects in the field of view, thus coupling DH with appropriate numerical algorithms. Through the proposed method we measure, simultaneously, the tri-dimensional paths followed by the flagellate microorganism and the full set of the kinematic parameters that describe the swimming behavior of the analyzed microorganisms by means of a polynomial fitting and segmentation. Furthermore, the method is capable to furnish the accurate morphology of the microorganisms at any instant of time along its 3D trajectory. This work launches a promising trend having as the main objective the combined use of DH and motility microorganism analysis as a label-free and non-invasive environmental monitoring tool, employable also for in situ measurements. Finally, we show that the locomotion can be visualized intriguingly by different modalities to furnish marine biologists with a clear 3D representation of all the parameters of the kinematic set in order to better understand the behavior of the microorganism under investigation.
Factors associated with excess all-cause mortality in the first wave of the COVID-19 pandemic in the UK: A time series analysis using the Clinical Practice Research Datalink
Authors: Strongman Helen , Carreira Helena , De Stavola Bianca L. , Bhaskaran Krishnan , Leon David A. 
Published: January 2022

BackgroundExcess mortality captures the total effect of the Coronavirus Disease 2019 (COVID-19) pandemic on mortality and is not affected by misspecification of cause of death. We aimed to describe how health and demographic factors were associated with excess mortality during, compared to before, the pandemic.Methods and findingsWe analysed a time series dataset including 9,635,613 adults (≥40 years old) registered at United Kingdom general practices contributing to the Clinical Practice Research Datalink. We extracted weekly numbers of deaths and numbers at risk between March 2015 and July 2020, stratified by individual-level factors. Excess mortality during Wave 1 of the UK pandemic (5 March to 27 May 2020) compared to the prepandemic period was estimated using seasonally adjusted negative binomial regression models. Relative rates (RRs) of death for a range of factors were estimated before and during Wave 1 by including interaction terms. We found that all-cause mortality increased by 43% (95% CI 40% to 47%) during Wave 1 compared with prepandemic. Changes to the RR of death associated with most sociodemographic and clinical characteristics were small during Wave 1 compared with prepandemic. However, the mortality RR associated with dementia markedly increased (RR for dementia versus no dementia prepandemic: 3.5, 95% CI 3.4 to 3.5; RR during Wave 1: 5.1, 4.9 to 5.3); a similar pattern was seen for learning disabilities (RR prepandemic: 3.6, 3.4 to 3.5; during Wave 1: 4.8, 4.4 to 5.3), for black or South Asian ethnicity compared to white, and for London compared to other regions. Relative risks for morbidities were stable in multiple sensitivity analyses. However, a limitation of the study is that we cannot assume that the risks observed during Wave 1 would apply to other waves due to changes in population behaviour, virus transmission, and risk perception.ConclusionsThe first wave of the UK COVID-19 pandemic appeared to amplify baseline mortality risk to approximately the same relative degree for most population subgroups. However, disproportionate increases in mortality were seen for those with dementia, learning disabilities, non-white ethnicity, or living in London.
Engaging Female Community Health Volunteers (FCHVs) for cardiovascular diseases risk screening in Nepal
Authors: Rawal Lal B. , Sun Yuewen , Dahal Padam K. , Baral Sushil C. , Khanal Sudeepa , Arjyal Abriti , Manandhar Shraddha , Abdullah Abu S. 
Published: January 2022

Introduction
Non-Communicable Diseases (NCDs) have become the leading public health problems worldwide and the cardiovascular diseases (CVDs) is one of the major NCDs. Female Community Health Volunteers (FCHVs) in Nepal are the key drivers to implementing frontline health services. We explored the potential for engaging FCHVs for CVD risk screening at the community level in Nepal.

Methods
We used multiple approaches (quantitative and qualitative) for data collection. The trained FCHVs administered CVD risk screening questionnaire among 491 adults in rural and urban areas and calculated the CVD risk scores. To maintain consistency and quality, a registered medical doctor also, using the same risk scoring chart, independently calculated the CVD risk scores. Kappa statistics and concordance coefficient were used to compare these two sets of risk screening results. Sensitivity and specificity analyses were conducted. Two focus group discussions among the FCHVs were conducted to determine their experiences with CVD risk screening and willingness to engage with CVD prevention and control efforts.

Results
The mean level of agreement between two sets of risk screening results was 94.5% (Kappa = 0.77, P<0.05). Sensitivity of FCHV screening was 90.3% (95% CI: 0.801–0.964); and the specificity was 97% (95% CI: 0.948, 0.984). FCHVs who participated in the FGDs expressed a strong enthusiasm and readiness to using the CVD risk screening tools. Despite their busy workload, all FCHVs showed high level of motivation and willingness in using CVD risk screening tools and contribute to the prevention and control efforts of NCDs. The FCHVs recommended needs for providing additional training and capacity building opportunities.

Conclusion
We conclude that there is a potential for engaging FCHVs to use simple CVD risk screening tools at the community level. The findings are promising, however, further studies engaging larger number of FCHVs and larger population would warrant feasibility of such tools within the existing healthcare systems in Nepal.