bluuebunny/crossref_metadata_2025_split huggingface dataset:
Podoconiosis instruction at nursing schools in Kenya, Rwanda, and Uganda
Authors: Wampande Lilian Nantume , Nyabuga Lamek Mageto , Fowler Kelly , Okengwu Grace Chinelo , Bayisenge Ursin , Schurer Janna M. 
Published: February 2022

AbstractBackgroundPodoconiosis is a preventable, progressive, and non-infectious form of elephantiasis that can contribute to significant disability and economic burden when not treated early. Nurses play a critical role in early detection and response in rural Africa, but it is unclear if they receive adequate training on podoconiosis. We aimed to characterize podoconiosis instruction at all government accredited, post-secondary nursing institutions in three African countries.MethodsData for this cross-sectional study was collected through a quantitative survey with several open-answer questions. Through a rigorous online search, we identified all post-secondary institutions in Kenya, Rwanda and Uganda accredited to teach human nursing. A total of 289 accredited programs, including 85 certificate, 56 degree and 148 diploma programs were invited to participate. Respondents completed surveys online or by telephone. Measures focused on podoconiosis knowledge, perceptions of quality/quantity of podoconiosis instruction, and barriers to sufficient podoconiosis education.ResultsWe obtained information about 212 curricula across 149 nursing institutions in the three countries (participation rate: 73.4%). Podoconiosis coverage was limited across programs (certificate—24.1%; diploma—55.6%; degree—30.3%). Most respondents felt that the quality and quantity of instruction were insufficient (60.6%, 62.9%), respectively. Exclusion from government curricula, low priority and faculty lack of knowledge were commonly reported barriers to podoconiosis inclusion.ConclusionsThis study demonstrated clear gaps in podoconiosis training for nurses across the three countries and highlights a serious challenge in eliminating podoconiosis as a public health problem. Interventions to improve nurses’ knowledge could include the development and free distribution of podoconiosis teaching materials, designed for integration into pre-existing courses.
Molecular and biochemical basis of softening in tomato
Authors: Wang Duoduo , Seymour Graham B. 
Published: February 2022

AbstractWe review the latest information related to the control of fruit softening in tomato and where relevant compare the events with texture changes in other fleshy fruits. Development of an acceptable texture is essential for consumer acceptance, but also determines the postharvest life of fruits. The complex modern supply chain demands effective control of shelf life in tomato without compromising colour and flavour.The control of softening and ripening in tomato (Solanum lycopersicum) are discussed with respect to hormonal cues, epigenetic regulation and transcriptional modulation of cell wall structure-related genes. In the last section we focus on the biochemical changes closely linked with softening in tomato including key aspects of cell wall disassembly. Some important elements of the softening process have been identified, but our understanding of the mechanistic basis of the process in tomato and other fruits remains incomplete, especially the precise relationship between changes in cell wall structure and alterations in fruit texture.
Studying driving behavior and risk perception: a road safety perspective in Egypt
Authors: Sayed Islam , Abdelgawad Hossam , Said Dalia 
Published: February 2022

AbstractRoadway safety research indicates a correlation between drivers’ behavior, the demographics, and the local environment affecting the risk perception and roadway crashes. This research examines these issues in an Egyptian context by addressing three groups: private cars drivers, truck drivers, and public transportation drivers. A Driver Behavior Questionnaire (DBQ) was developed to capture information about drivers’ behavior, personal characteristics, risk perception, and involvement in crashes. The risk perception was captured subjectively by exposing participants to various visual scenarios representing specific local conditions to rank their perception of the situation from a safety perspective.Results indicated that the human factor, in particular, failure of keeping a safe following distance, was a major cause of crashes. The analyzed data was used to predict expected crash frequency based on personal attributes, such as age, driving experience, personality traits, and driving behavior, using negative binomial models. The study recommends that the DBQ technique, combined with risk perception scenarios, can be used to understand drivers’ characteristics and behaviors and collect information on the crashes they experience.Practically the study findings could provide series of recommendations to the local authorities about the introduction of the traffic management and noise control act; raising awareness of driving etiquette; setting and enforcing driving hours’ regulations, and consider specific training programs for beginners drivers.
Intron-Retention Neoantigen Load Predicts Favorable Prognosis in Pancreatic Cancer
Authors: Dong Chuanpeng , Reiter Jill L. , Dong Edward , Wang Yue , Lee Kelvin P. , Lu Xiongbin , Liu Yunlong 
Published: February 2022

PURPOSEHigh tumor mutation burden (TMB) in many cancer types is associated with the production of tumor-specific neoantigens, a favorable outcome and response to immune checkpoint blockade (ICB) therapy. Besides mutation-derived neoantigens, aberrant intron retention also produces tumor neopeptides that could trigger an immune response. The relationship between intron-retention–derived tumor neoantigens (IR-neoAg) and clinical outcomes in pancreatic cancer remains uncertain. Here, we quantify IR-neoAg in pancreatic cancer and evaluate whether IR-neoAg load might serve as a biomarker for selecting patients who may benefit from ICB therapy.METHODSWe developed a computational approach to estimate patient-specific IR-neoAg load from transcriptome data available in The Cancer Genome Atlas pancreatic cancer cohort. Associations between IR-neoAg load and patient overall survival were evaluated using Kaplan-Meier estimates and Cox regression. Differential expression of immune checkpoint and HLA-I genes was evaluated in tumors with high IR-neoAg load.RESULTSHigh IR-neoAg load predicted better overall survival in pancreatic cancer, although no association was found for TMB. IR-neoAg load remained a significant prognostic factor after adjusting for patient age, sex, tumor stage and grade, and TMB. Moreover, pancreatic tumors with both high IR-neoAg load and high HLA-I gene expression had similar gene expression profiles as other tumor types that showed response to anti–programmed cell death protein 1 therapy.CONCLUSIONIR-neoAg load is associated with favorable survival in pancreatic cancer. These findings provide strong evidence for considering IR-neoAgs when selecting patients who might benefit from ICB therapy.
Acetaminophen (APAP, Paracetamol) Interferes With the First Trimester Human Fetal Ovary Development in an Ex Vivo Model
Authors: Lecante Laetitia L , Leverrier-Penna Sabrina , Gicquel Thomas , Giton Frank , Costet Nathalie , Desdoits-Lethimonier Christèle , Lesné Laurianne , Fromenty Bernard , Lavoué Vincent , Rolland Antoine D , Mazaud-Guittot Séverine 
Published: February 2022

Abstract

Context
Acetaminophen (APAP, paracetamol) is widely used by pregnant women. Although long considered safe, growing evidence indicates that APAP is an endocrine disruptor since in utero exposure may be associated with a higher risk of male genital tract abnormalities. In rodents, fetal exposure has long-term effects on the reproductive function of female offspring. Human studies have also suggested harmful APAP exposure effects.

Objective
Given that disruption of fetal ovarian development may impact women’s reproductive health, we investigated the effects of APAP on fetal human ovaries in culture.

Design and Setting
Human ovarian fragments from 284 fetuses aged 7 to 12 developmental weeks (DW) were cultivated ex vivo for 7 days in the presence of human-relevant concentrations of APAP (10−8 to 10−3 M) or vehicle control.

Main Outcome Measures
Outcomes included examination of postculture tissue morphology, cell viability, apoptosis, and quantification of hormones, APAP, and APAP metabolites in conditioned culture media.

Results
APAP reduced the total cell number specifically in 10- to 12-DW ovaries, induced cell death, and decreased KI67-positive cell density independently of fetal age. APAP targeted subpopulations of germ cells and disrupted human fetal ovarian steroidogenesis, without affecting prostaglandin or inhibin B production. Human fetal ovaries were able to metabolize APAP.

Conclusions
Our data indicate that APAP can impact first trimester human fetal ovarian development, especially during a 10- to 12-DW window of heightened sensitivity. Overall, APAP behaves as an endocrine disruptor in the fetal human ovary.
Emergency Subglottic Airway Training and Assessment of Skills Retention of Attending Anesthesiologists With Simulation Mastery-Based Learning
Authors: Clark Carlee A. , Mester Robert A. , Redding Amanda T. , Wilson Dulaney A. , Zeiler Lydia L. , Jones Wanda R. , Reves Jerry G. , Reeves Scott T. , Schaefer John J. 
Published: February 2022

BACKGROUND:
Although included within the American Society of Anesthesiologists difficult airway algorithm, the use of “invasive airway access” is rarely needed clinically. In conjunction with highly associated morbidity and liability risks, it is a challenge for the average anesthesiologist to develop and maintain competency. The advancement of high-fidelity simulators allows for practice of rarely encountered clinical scenarios, specifically those requiring invasive subglottic airway techniques.

METHODS:
Sixty board-certified academic anesthesiologists were enrolled and trained in dyads in a simulation-based, mastery-based learning (MBL) course directed at 2 emergency airway subglottic techniques: transtracheal jet ventilation (TTJV) and bougie cricothyrotomy (BC). Performance metrics included: pretest, posttest, specific skill step error tracking, and 15-month period retest. All were pretested and trained once on the Melker cricothyrotomy (MC) kit. All pretest assessment, training, posttesting, and 15-month retesting were performed by a single expert clinical and educational airway management faculty member.

RESULTS:
Initial testing showed a success rate of 14.8% for TTJV, 19.7% for BC, and 25% for MC. After mastery-based practice, all anesthesiologists achieved successful invasive airway placement with TTJV, BC, and MC. Repeated performance of each skill improved speed with zero safety breaches. BC was noted to be the fastest performed technique. Fifteen months later, retesting showed that 80.4% and 82.6% performed successful airway securement for TTJV and BC, respectively. For safety, average placement time and costs, MC was discarded after initial training results.

CONCLUSIONS:
We discovered that only ~20% of practicing anesthesiologists were able to successfully place an invasive airway in a simulated life or death clinical setting. Using mobile simulation (training performed in department conference room) during a 2.5-hour session using mastery-based training pedagogy, we increased our success rate of invasive airway placement to 100%, while also increasing the successful speed to ventilation (TTJV, 32 seconds average; BC, 29 seconds average). Finally, we determined that there was a 15-month 80% retention rate of the airway skills learned, indicating that skills last at least a year before retraining is required using this training methodology.
Clinical Experiences of 3-Dimensional Biportal Endoscopic Spine Surgery for Lumbar Degenerative Disease
Authors: Heo Dong Hwa , Kim Ji Yeon , Park Jeong-Yoon , Kim Jin Sung , Kim Hyeun Sung , Roh Jeffrey , Park Choon Keun , Chung Hungtae 
Published: February 2022

BACKGROUND:
The lack of stereoscopic vision in endoscopic spine surgery may lead to a risk of neural or vascular injury during endoscopic surgery. Three-dimensional (3D) endoscopy has not yet been attempted in the field of spinal endoscopic surgery.

OBJECTIVE:
To present the technique, clinical efficacy, and safety of the 3D biportal endoscopic approach for the treatment of lumbar degenerative disease.

METHODS:
We attempted 3D biportal endoscopic surgery for lumbar degenerative disease in a series of patients. Clinical outcomes and complications were evaluated postoperatively using a short questionnaire about 3D biportal endoscopic spine surgery that solicited respondents’ opinions on the advantages and disadvantages of 3D biportal endoscopic surgery compared to the conventional 2D biportal endoscopic approach.

RESULTS:
We performed 3D biportal endoscopic spine surgery in 38 patients with lumbar degenerative disease. Optimal neural decompression was revealed by postoperative magnetic resonance imaging in all enrolled patients. The 3D endoscopic vision clearly demonstrated the surgical anatomy starting with the exposure of ligamentum flavum, dura, and nerve root, and 3D endoscopy precisely depicted pathologic lesions such as bony osteophytes and ruptured disc herniation. There were no major complications including neural injury or durotomy.

CONCLUSION:
The 3D endoscope may be able to distinguish between normal structures and lesions. The stereognosis and depth sensation of 3D biportal endoscopic spinal surgery might have a favorable impact on the safety of patients during endoscopic spine surgery.
The “Binder Ring” Bypass: Transection, Rerouting, and Reanastomosis as an Alternative to Macrovascular Decompression of a Dolichoectatic Vertebral Artery
Authors: Srinivasan Visish M. , Labib Mohamed A. , Furey Charuta G. , Catapano Joshua S. , Lawton Michael T. 
Published: February 2022

BACKGROUND:
In cases of extreme vertebrobasilar dolichoectasia, padding the cranial nerves (CNs) (microvascular decompression [MVD]) and clip-assisted sling transposition of the tortuous artery (macrovascular decompression [MaVD]) may be ineffective because the sling does not reduce the redundancy. Transposition may not decompress the nerves or may kink the artery. An alternative solution is needed.

OBJECTIVE:
To introduce the “binder ring” bypass as a novel solution to this unusual macrovascular compression problem.

METHODS:
The binder ring denotes the opening and closing of the offending vascular loop with standard bypass techniques with the artery transected, rerouted lateral to the CNs, and reanastomosed. An example case study is presented for a 72-year-old man whose severe vertebral artery tortuosity could not be relieved by MVD or MaVD. His pathology was exposed with an extended retrosigmoid craniotomy, the V4 segment was transected, the free ends were mobilized lateral to CN VII/VIII, and an end-to-end reanastomosis was performed with intraluminal suturing.

RESULTS:
The example binder ring bypass was patent angiographically, and the patient experienced immediate and lasting symptom relief without complications.

CONCLUSION:
The binder ring bypass applies standard bypass techniques to macrovascular compression but represents a significant escalation in technical challenges relative to traditional techniques. Patient tolerance to temporary arterial occlusion during reanastomosis depends on the location of the compressive arterial loop and the anatomy of collateral circulation. The binder ring bypass should be used as a last resort after medical therapy and MaVD techniques fail and performed only by neurosurgeons with advanced bypass skills.
Associating Surgeon Feedback With Material Physical Properties in the Development Process of a Resective Epilepsy Surgery Simulator
Authors: Thiong'o Grace M. , Mayer Haley , Looi Thomas , Kulkarni Abhaya V. , Drake James M. 
Published: February 2022

BACKGROUND:
Hands-on neurosurgical simulations, specifically techniques involving white matter disconnection, are underdeveloped owing to the paucity of low indentation materials that can adequately mimic brain dissection.

OBJECTIVE:
To describe the discovery phase of developing a resective epilepsy surgery simulator by quantifying the physical properties of 6 materials and correlating the scores with surgeon feedback data.

METHODS:
Six materials, silicone, TissueMatrix, gel support, Synaptive hydrogel, dry SUP706, and moist SUP706 of equal dimension, were evaluated for hardness by measuring their resistance to indentation. Temporal lobe prototypes, 1 for each material, were dissected by 2 neurosurgeons and ordinal ranking assigned. Two null hypotheses were tested: one is that no differences in the indentation properties of the 6 materials analyzed would be elicited and the other is that there would be no correlation between indentation and surgeon feedback scores. Statistical comparison of the means of the different materials was performed using one-way analysis of variance. Surgeon feedback data and indentation score associations were analyzed using the Kendall rank correlation coefficient.

RESULTS:
A statistically significant effect (P value <.0001; α 0.05) was measured. Gel support and Synaptive hydrogel had the lowest indentation scores and similar physical properties. Moist support material scored lower than dry support (P = .0067). A strong positive correlation (Kendall tau = 0.9333, P < .0001) was ascertained between the surgeon feedback ranking and indentation scores.

CONCLUSION:
Reasonable material options for developing a resective epilepsy surgery are proposed and ranked in this article. Early involvement of surgeons is useful in the discovery phase of simulator invention.
Reliability of slice-encoding for metal artefact correction (SEMAC) MRI to identify prosthesis loosening in patients with painful total hip arthroplasty – a single centre, prospective, surgical validation study
Authors: Takahashi Tsuneari , Thaker Siddharth , Lettieri Giovanni , Redmond Anthony , Backhouse Michael R. , Stone Martin , Pandit Hemant , O'Connor Philip 
Published: February 2022

Objectives:
To validate reliability of slice-encoding for metal artefact correction (SEMAC)-MRI findings in prosthesis loosening detection by comparing them to surgical outcomes (gold standard) in symptomatic patients following hip arthroplasties. To evaluate periprosthetic anatomical structures in symptomatic patients to identify an alternative cause of hip symptoms.

Methods:
We prospectively followed 47 symptomatic patients (55 hips, 39 painful hips – group P and 16 control hips – group C) at our institution from 2011 to 2016. We acquired 1.5 T MRI conventional and SEMAC-MRI images for all patients. Two consultants scored MRI for osteolysis and marrow oedema zone-wise using predefined signal characteristics and settled scoring variations by consensus. We used Spearman Rank-Order Correlation for correlation analysis and used OMERACT (Outcome Measures in Rheumatology) filter pillars to validate SEMAC-MRI findings.

Results:
Eleven patients needed revision surgery, all from group P. None from group C required revision surgery. Remaining 28 hips in the group P were managed conservatively pain completely resolved in 21 hips, eight hips had trochanteric bursitis, eight had extraarticular cause and the remaining five hips had spontaneous pain resolution. We found moderate-to-weak correlation between SEMAC-MRI findings for prosthesis loosening and revision surgery outcomes. Sensitivity, Specificity, PPV and NPV in Group P were (72.7, 64.3, 44.4, 85.7%) in T1W-SEMAC, (90.9, 46.4, 40.0, 92.9%) in STIR-SEMAC and (36.3, 78.5, 40.0, 75.8%) in PDW-SEMAC.

Conclusion:
Negative SEMAC-MRI results can effectively exclude prosthesis loosening confirmed on revision surgery and SEMAC-MRI can detect alternative cause of hip pain accurately.

Advances in knowledge:
Negative SEMAC-MRI in painful THA patients can effectively exclude prosthesis loosening as a cause.
Gonad irradiation from fluoroscopy during upper limb orthopaedic procedures in a UK District General Hospital
Authors: Dadabhoy Maria , Waldock Peter , Brammar Timothy , Pryke Steven , Coomber Ross 
Published: February 2022

Objectives: To perform a dose assessment of radiation received to the surgeon’s gonads when performing upper limb fluoroscopy-guided procedures when the C-arm may be positioned in between the surgeon’s legs. Methods: A calibrated MDH-Radcal 2025 electrometer was used to read the radiation dose for a single exposure and a 5-s screening radiograph with the C-arm firing up and down. These were performed with and without a lead gown positioned over the ionisation chamber where it would ordinarily lie over gonads during surgery. Results: With the tube firing down and lead apron in place the single exposure (SE) recorded<0.01 uSv and screening exposure (SC) recorded 0.01 uSv. With the tube firing up, with lead the SE recorded 0.09 uSv and the SC 0.54 uSv. In the same situation without lead, the recordings were 0.13 uSv SE and 0. 65 uSv SC. Conclusions: With the X-ray tube firing up, there is a measurable radiation dose to the area where the surgeons’ gonads lie. The standard lead apron does not provide shielding of the gonads for a surgeon sitting down performing the operation with the tube firing up since the principal source of the radiation is below the edge of the apron and thus scatters up into the unprotected groin. Advances in knowledge: Fluoroscopy with conventional C-arm in upper limb procedures can cause scatter irradiation to gonads. The X-ray beam should always be fired from top to bottom otherwise large doses can be emitted and the lead gown is less protective.
Sexual health risk indicators and their associations with caries status and gingival health of adolescents resident in sub-urban South-West Nigeria
Authors: Folayan Morenike Oluwatoyin , El Tantawi Maha , Yassin Randa , Arowolo Olaniyi , Sam-Agudu Nadia A. 
Published: February 2022

Background: Adolescents are at high risk of poor sexual and oral health. We investigated for sexual risk factors associated with caries experience and gingival health among adolescents in Nigeria. Methods: This cross-sectional study collected data from 10-19-year-old adolescents in Ile-Ife, South-West Nigeria through a household survey conducted between December 2018 and January 2019. Information collected included age; sex; socioeconomic status; sexual practices (vaginal, oral, anal sex); sexual (transactional sex, multiple sex partners, condom use at last sexual intercourse) and oral health (frequency of tooth brushing, use of fluoridated toothpaste, dental service utilization in the last 12 months, consumption of refined carbohydrates in-between meals) risk behaviors; caries experience; and gingival health. Logistic regression was used to determine associations between explanatory variables (sexual and oral health risk behaviors) and outcome variables (caries experience and gingivitis). Results: There were no significant associations between caries experience and history of sexual intercourse (OR:1.00); condom use at last sex act (OR:0.68); and having one (OR:2.27) or more sexual partners. Also, there was no significant association between moderate/severe gingivitis and a history of anal (OR:2.96), oral (OR:2.69), or vaginal (OR:1.40) sex; and a report of having one (OR:1.71) or more (OR:2.57) sex partners. Conclusions: Some sexual health risk indicators insignificantly increase the risk for caries and moderate/severe gingivitis. Screening for sexual risk behaviors during dental care may be a suitable wellness programs approach for adolescents.