bluuebunny/crossref_metadata_2025_split huggingface dataset:
Normal feline reproduction: The queen
Authors: Johnson Aime K 
Published: February 2022

Practical relevance: Cats are seasonally polyestrous, meaning they exhibit multiple estrous cycles within a season, followed by a period of non-cyclicity. Cats cycle when the day length is long but can be induced to cycle year-round with 14 h of continuous artificial lighting. The feline estrous cycle includes the following stages: proestrus, estrus, interestrus and, if ovulation occurs, diestrus. Cats are induced ovulators and ovulate in response to multiple natural matings. Successful breeding in a cattery requires knowledge of the female’s reproductive cycle, behavior and management, and often improper management can be the sole cause of infertility. Aim: The aim of this review is to provide readers with an overview of normal anatomy, cyclicity, management and behavior of the queen. It includes a series of questions veterinarians can ask to obtain a baseline knowledge of the management of the specific breeding set-up. Evidence base: The information in this article is based on the author’s experience, as well as drawing on historical and current literature, and provides the most up-to-date review as possible.
Feline breeding and pregnancy management: What is normal and when to intervene
Authors: Holst Bodil Ström 
Published: February 2022

Practical relevance: Cats are common pets worldwide. Successful breeding of cats starts with the selection of suitable breeding animals, and care should be taken to avoid inbreeding. Keeping cats in smaller groups reduces stress and facilitates management. Clinical challenges: Breeding cats is challenging in many ways. Group housing is a common scenario, and care should be taken not to have groups that are too large, because of the risk of stress and infectious diseases. Feline pregnancy and parturition both vary in length, which is one reason why it may be challenging to diagnose dystocia. In queens with pyometra, a vaginal discharge may not be evident due to their meticulous cleaning habits. Audience: This review is aimed at clinicians in small animal practice, especially those in contact with cat breeders. Patient group: Reproductive emergencies occur in both intentionally and unintentionally bred cats, and more often in young or middle-aged queens. Pyometra tends to be a disease of older queens. Evidence base: Evidence is poor for many conditions in the breeding queen, and information is extrapolated from the dog or based on case reports and case series.
Disorders of sexual development in the cat: Current state of knowledge and diagnostic approach
Authors: Foster Robert A 
Published: February 2022

Practical relevance: Any congenital or developmental abnormality of any part of the male or female reproductive tract is a ‘disorder of sexual development’ (DSD). The tricolored male cat phenotype, cryptorchidism, gonadal hypoplasia and incidental abnormalities such as cystic remnants or embryonic ducts are well-known feline DSDs. Clinical challenges: Full characterization of DSDs requires sex chromosome determination and identification of genes related to development of the gonads, internal tubular genitalia and external genitalia. Fortunately, affected cats are seen sporadically and the clinical effects are usually minimal. Classification: The classification nomenclature has changed. In place of intersex, hermaphrodite, pseudohermaphrodite and sex reversal, the newer standard classification, based on sex chromosomes, designates sex chromosome DSD when there is an abnormality in the sex chromosomes, and XX (female) and XY (male) DSDs where there is not. Identification of the gonadal type (testes, ovaries, ovotestes or gonadal dysgenesis) and documentation of the internal and external genital components completes the classification. Evidence base: The original basis of the DSD classification was a consensus reached in humans. It was quickly accepted in veterinary pathology, courtesy of its logic and ease of application, and it has subsequently begun to appear in peer-reviewed papers and clinical reviews. This article reviewing the various disorders in cats is based on application of the classification and draws on the feline peer-reviewed literature encompassing chromosome analysis and definition of reproductive abnormalities, syndromes and diseases.
Agreement between face-to-face and tele-assessment of upper limb disability in lung cancer survivors during COVID-19 era
Authors: Heredia-Ciuró Alejandro , Lazo-Prados Antonio , Blasco-Valls Paula , Calvache-Mateo Andrés , Lopez-Lopez Laura , Martin-Nuñez Javier , Valenza Marie C 
Published: February 2022

Introduction Upper limb disability can limit the quality of life of lung cancer survivors. The COVID-19 era has required a finding of alternatives to attend the monitoring of presented disturbances with the minor risk of spread. Tele-assessment offers new possibilities for clinical assessment demonstrating good reliability compared to traditional face-to-face assessment in a variety of patients. No previous study has applied this type of assessment in lung cancer survivors. For this reason, the aim of this study was to evaluate the level of agreement between upper limb disability assessment using tele-assessment and the face-to-face method in lung cancer survivors. Methods A reliability study was conducted with 20 lung cancer survivors recruited from the Oncological Radiotherapy Service of the “Hospital PTS” (Granada). Patients attended a session for clinical face-to-face and real-time online tele-assessment. The main outcome measurements of the study included upper limb function (shirt task) and musculoskeletal disturbances (active range of movement and trigger points), and these outcomes were recorded by two independent researchers. Results The outcome measures showed good agreement between both assessments. The active range of movement presented heterogeneous results, being excellent reliability ( ρ > 0.75) in extension, internal rotation, homolateral adduction, and contralateral abduction, good (0.4 <  ρ < 0.75) for flexion, homolateral abduction, contralateral adduction and contralateral external rotation, and poor ( ρ < 0.4) for homolateral external rotation. The measure evaluating upper limb function and trigger points show the highest interrater reliability with confidence interval lower limits ≥0.99. Discussion The tele-assessment of upper limb function and musculoskeletal disorders of lung cancer survivors present a good interrater reliability compared to face-to-face assessment. It could be useful for monitoring the disability presented by cancer survivors whose access is difficult by the residential situation, physical limitations or the risk of COVID-19 spread.
Acupuncture in Patients Undergoing Cancer Therapy: Their Interest and Belief in Acupuncture is High, But Few are Using It
Authors: Widgren Ylva , Fransson Per , Efverman Anna 
Published: February 2022

Objectives: Since pre-existing expectations, that is, beliefs, in a treatment may modify outcomes, and acupuncture studies often fail to measure expectations, we wanted to investigate the use of acupuncture, interest, and belief in acupuncture effects among patients undergoing cancer therapy. Method: A cross-sectional design, where the participants answered a study-specific questionnaire with questions regarding their use of, interest and belief in acupuncture treatment. Results: A total of 457 patients with cancer (48% men, mean age 65 years) answered the questionnaire. Acupuncture was used by 4 (1%) patients during their cancer therapy, and 368 (83%) expressed an interest in receiving acupuncture. Of the 457 patients, 289 (63%) believed acupuncture to be effective for at least 1 of 17 requested symptoms, most commonly pain (56% of the patients) and muscle tension (40%). They believed acupuncture to be effective for a mean value 3 of the 17 requested symptoms. Women ( P < .001), and patients 41 to 65 years ( P < .001), expressed a stronger belief in acupuncture effects than others. Conclusions: Men and older patients expressed weaker beliefs in acupuncture effects than other patients, indicating the importance of collecting expectancy data in future randomized sham-controlled acupuncture studies to be able to treat expectancy as an effect-modifier. The high interest and beliefs in acupuncture effects found also indicate that acupuncture should be available for patients with cancer, for side effects where acupuncture has shown to be effective. In a clinical setting, older men might need more encouragement regarding positive expected outcomes of the acupuncture treatment than younger women.
Implications on the Use of the Phylogenetic Species Concept in the Risk Categories Assignment: The Case of the Birds of Mexico
Authors: Galindo-Cruz Alejandra , Sahagún-Sánchez Francisco Javier , Rojas-Soto Octavio 
Published: February 2022

Background and Aims Conservation efforts require a rational basis for taxa prioritization; it is essential to recognize the evolutionary independence of units, typically recognized as species. Because different criteria on species limits lead to different conservation assessment priorities, conceptual problems limit the possibility to accurately assess the conservation status that species are undergoing to protect them effectively. Methods We analyze the implications of using the phylogenetic species concept (PSC) in the risk categories determination, based on the analysis of the Mexican endemic avifauna. We modeled the potential distribution areas with the MaxEnt algorithm for those species that have had or could be susceptible to taxonomic updates based on the PSC. Results Of the 93 studied species, 68 were highly restricted, and 23 have high scores according to the evaluation of the Partners In Flight conservation status, so they can be considered species with high vulnerability or risk of extinction. Additionally, based on the recognition of several allopatric populations as independent phylogenetic species, 45% are susceptible to reconsideration of their risk categories due to a decrease in the extent of areas where they are potentially distributed. Implications for Conservation The use of a taxonomic perspective focused on the phylogenetic relationship of the different populations would directly impact the definition of risk categories, particularly for those endemic or restricted distribution evolutionary units for which there is usually very little information available and which, undoubtedly, are the ones that most need to be studied and, particularly, protected.
Vigilance is key: Metastatic teratoma in an enlarging retroperitoneal mass after treatment of advanced seminoma – a case report
Authors: Abu-Salha Yousef M , Ahlschlager Lauren , Milowsky Matthew I , Saunders Katherine , Rose Tracy L , Wobker Sara E , Bjurlin Marc A 
Published: February 2022

We present the case of a patient with pure seminoma in the orchiectomy specimen with retroperitoneal mass and a minimally elevated alpha fetoprotein (AFP). The patient received chemotherapy with positron emission tomography (PET) imaging demonstrating minimal fluorodeoxyglucose (FDG) uptake consistent with no viable tumour. Subsequent imaging revealed slow growth in the residual mass with a mildly elevated fluctuating AFP. A robotic-assisted laparoscopic retroperitoneal lymph node dissection was performed revealing metastatic teratoma. This case illustrates the potential for a missed or ‘burned out’ occult NSGCT in a patient with pure seminoma and the importance of post-treatment surveillance. In advanced seminoma, PET may be used to distinguish viable tumour from necrosis in post-chemotherapy residual masses. However, it is unable to distinguish between teratoma and necrosis in non-seminomatous germ cell tumours (NSGCT). Minimally elevated AFP could be a normal variant or signify a component of NSGCT in such cases. Level of evidence: 4
Risk Factors of Postoperative Delirium in Elderly Patients With Intertrochanteric Fracture: An Age-Stratified Retrospective Analysis of 2307 Patients
Authors: Wang Tao , Guo Junfei , Hou Zhiyong , Zhang Yingze 
Published: February 2022

Background Postoperative delirium (POD) is a serious and common complication of intertrochanteric fracture (IF). However, the risk factors for POD remain debated. The purpose of this study was to explore risk factors for POD after IF surgery in elderly patients by age-stratified analysis. Methods A total of 2307 patients who underwent IF surgery in our hospital between Jan. 2017 and Nov. 2020 were included. 128 patients suffering from POD were regarded as the delirium group (DG) and the other patients as the normal group (NG). Univariate and multivariate analyses were conducted. Results In our study, the occurrence of POD after IF surgery in elderly patients was 5.55% (128 of 2307). The results of univariate and multivariate analysis showed that advanced age and patients with a history of dementia were identified as the risk factors for POD. Age-stratified analysis showed different comorbidities influencing POD at different stages of age. Additionally, POD markedly increased along with age. Moreover, compared with younger than 70 years in male patients and younger than 80 years in female patients, patients over the age of 70 for males and over the age of 80 for females had a higher rate of POD. Conclusions Advanced age and patients with a history of dementia were independent risks of delirium after IF surgery in both univariate and multivariate analyses. 70 years old in male patients and 80 years old in female patients may be the cut-off values for a significantly increased rate of POD. Preoperative measures should be taken to lower the incidence of POD. Level of Evidence Prognostic Level III.
Utility of Anterior Atlantodens Interval Widening on Cervical Spine CT for Assessing Transverse Atlantal Ligament Injury
Authors: Fiester Peter , Orallo Peaches , Soule Erik , Rao Dinesh , Tavanaiepour Daryoush 
Published: February 2022

Study Design Retrospective, cross-sectional Objectives To identify trauma patients with confirmed tears of the transverse atlantal ligament on cervical MRI and measure several parameters of atlanto-axial alignment on cervical CT, including the anterior atlantodens interval, to determine which method is most sensitive in predicting transverse atlantal ligament injury. Methods Adult trauma patients who suffered a transverse atlantal ligament tear on cervical MRI were identified retrospectively. The cervical CT and MRI exams for these patients were reviewed for the following: anterior and lateral atlantodens interval widening, lateral C1 mass offset, C1–C2 rotatory subluxation, and transverse atlantal ligament injuries on cervical MRI. Results Twenty-six patients were identified with a tear of the transverse atlantal ligament on cervical MRI. Twelve percent of these patients demonstrated an anterior dens interval measuring greater than 2 mm, 26% of patients demonstrated lateral mass offset of C1 on C2 (average offset of 2.4 mm), 18% of patients demonstrated an asymmetry greater than 1 mm between the left and right lateral atlantodens interval, and one patient demonstrated atlanto-axial rotation measuring greater than 20%. Ten patients had an accompanying C1 burst fracture and eight patients had a C2 fracture. One patient demonstrated widening of the atlanto-occipital joint space greater than 2 mm indicative of craniocervical dissociation injury. Conclusions An anterior atlantodens interval measuring greater than 2 mm is an unreliable methodology to screen trauma patients for transverse altantal ligament injuries and atlanto-axial instability. Moreover, C1 lateral mass offset, lateral atlantodens asymmetry, and atlanto-axial rotation were all poor predictors of transverse atlantal ligament tears.
Aging and Gait Function: Examination of Multiple Factors that Influence Gait Variability
Authors: Gamwell Hope E. , Wait Seaver O. , Royster Jackson T. , Ritch Brody L. , Powell Sarah C. , Skinner Jared W. 
Published: February 2022

This investigation aimed to identify parameters of reduced functionality that are responsible for variations in the normal gait cycle. Sixteen older adults (55–85 years; nine males) and eighteen young adults (18–40 years; eight males) were enrolled. Assessments included walking trials, questionnaires, and assessed maximal and submaximal dorsiflexors (DF) and plantar flexors (PF) force. Multiple relationships were found between the muscular capabilities of the ankle and gait variability in older adults. For both the DF and PF muscles, the older adults produced significantly lower maximal force production and higher levels of force variability than younger adults; physical activity (PA) level was also significantly correlated. The reduction in muscular strength was concurrent with increased force variability and deficits in spatiotemporal gait parameters, suggesting an age-related worsening of the central motor control. Our results found that PA engagement could preserve gait quality and independence. These are essential considerations for further research on the cause and reduction of falls in older adults.
Factors Affecting the Willingness to Undertake Premarital Screening Test Among Prospective Marital Individuals
Authors: Alkalbani Ali , Alharrasi Maryam , Achura Susan , Al Badi Ammar , Al Rumhi Amjad , Alqassabi Khalid , Almamari Raya , Alomari Omar 
Published: February 2022

Introduction Awareness toward premarital screening test and its influence on preventing high risk marriages has become a concern to the health care system in Oman. This is due to the increased rates of inherited diseases and genetic disorders among the Omani population secondary to consanguineous marriages. Objectives This cross-sectional study aims to describe the utilization of premarital screening tests of selected university study participants as future prospective couples. Methods The study included 400 Omani study participants from different majors at a national governmental university that receives students from all over the country. Data was collected using a self-administered questionnaire. Results Out of the 400 study participants 193 [48.3%] were females and 195 [48.8%] were males, and 380 [95%] were unmarried and 19 [4.8%] were married. Personal and family history of hereditary diseases and consanguinity between parents were reported by 40 participants [10%], 158 [39.5%] and 175 [43.8%] respectively. Three hundred and sixty-one [90.3%] of the total participants were aware of the availability of premarital screening tests in Oman. A total of 357 [89.3%] thought it is necessary to do a premarital screening test and 367 [91.8%] agreed to carry out it in the future. The novel contribution of this manuscript is that our logistic regression showed that people with personal or family history of hereditary disease, and have consanguinity between parents, being a female did not show willingness to undertake the screening while those who are married, have higher GPA, and older supported it. Conclusion Usability of the freely available premarital screening is low despite the study participants awareness and willingness. Future studies should target those who have a history of genetic disease and females as we found them not willing to undertake the test in this study. We also recommend putting in place mandatory rules and regulations for premarital screening tests with better counselling strategies.
Early Identification of Mental Illness in Primary School Pupils by School Nurses: A Qualitative Study
Authors: Vejzovic Vedrana , Carlson Lilliann , Löfgren Lisa , Bramhagen Ann-Cathrine 
Published: February 2022

Introduction The World Health Organization has reported that one fifth of all children in the world suffer from poor mental health regardless of cultural differences. Previous studies have shown that working with mental health is an important part of the duties of school nurses in Sweden. Objective The aim of the present study was to describe the experiences of school nurses regarding the identification of mental illness among pupils in primary school. Methods In this inductive qualitative study, interviews were conducted with 11 school nurses in southern Sweden and analyzed using content analysis. Results The results indicate three major themes: (1) the need for shared responsibility, (2) feelings of uncertainty and inadequacy in school nurses, and (3) the importance of establishing relationships. Conclusion This study indicates that school nurses feel responsible for their pupils’ well-being, but also feel that they need support. A lack of guidance in identifying mental illness emerged from the interviews.
Ankle Fracture and Length of Stay in US Adult Population Using Data From the National COVID Cohort Collaborative
Authors: Pitts Charles C. , Levitt Eli B. , Patch David A. , Mihas Alexander K. , Terrero Alfredo , Haendel Melissa A. , Chute Christopher G. , Ponce Brent A. , Theiss Steven M. , Spitler Clay A. , Johnson Michael D. 
Published: February 2022

Background: The National COVID Cohort Collaborative (N3C) is an innovative approach to integrate real-world clinical observations into a harmonized database during the time of the COVID-19 pandemic when clinical research on ankle fracture surgery is otherwise mostly limited to expert opinion and research letters. The purpose of this manuscript is to introduce the largest cohort of US ankle fracture surgery patients to date with a comparison between lab-confirmed COVID-19–positive and COVID-19–negative. Methods: A retrospective cohort of adults with ankle fracture surgery using data from the N3C database with patients undergoing surgery between March 2020 and June 2021. The database is an NIH-funded platform through which the harmonized clinical data from 46 sites is stored. Patient characteristics included body mass index, Charlson Comorbidity Index, and smoking status. Outcomes included 30-day mortality, overall mortality, surgical site infection (SSI), deep SSI, acute kidney injury, pulmonary embolism, deep vein thrombosis, sepsis, time to surgery, and length of stay. COVID-19–positive patients were compared to COVID-19–negative controls to investigate perioperative outcomes during the pandemic. Results: A total population of 8.4 million patient records was queried, identifying 4735 adults with ankle fracture surgery. The COVID-19–positive group (n=158, 3.3%) had significantly longer times to surgery (6.5 ± 6.6 vs 5.1 ± 5.5 days, P = .001) and longer lengths of stay (8.3 ± 23.5 vs 4.3 ± 7.4 days, P < .001), compared to the COVID-19–negative group. The COVID-19–positive group also had a higher rate of 30-day mortality. Conclusion: Patients with ankle fracture surgery had longer time to surgery and prolonged hospitalizations in COVID-19–positive patients compared to those who tested negative (average delay was about 1 day and increased length of hospitalization was about 4 days). Few perioperative events were observed in either group. Overall, the risks associated with COVID-19 were measurable but not substantial. Level of Evidence: Level III, retrospective cohort study.