bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations of Telehealth Care Delivery with Pediatric Health Care Provider Well-Being
Authors: deMayo Richelle , Huang Yungui , Lin En-Ju D. , Lee Jennifer A. , Heggland Andrew , Im Jane , Grindle Christopher , Chandawarkar Aarti 
Published: February 2022

Abstract
Background The rapid, large-scale deployment of new health technologies can introduce challenges to clinicians who are already under stress. The novel coronavirus disease 19 (COVID-19) pandemic transformed health care in the United States to include a telehealth model of care delivery. Clarifying paths through which telehealth technology use is associated with change in provider well-being and interest in sustaining virtual care delivery can inform planning and optimization efforts.
Objective This study aimed to characterize provider-reported changes in well-being and daily work associated with the pandemic-accelerated expansion of telehealth and assess the relationship of provider perceptions of telehealth effectiveness, efficiency, and work–life balance with desire for future telehealth.
Methods A cross-sectional survey study was conducted October through November 2020, 6 months after the outbreak of COVID-19 at three children's hospitals. Factor analysis and structural equation modeling (SEM) were used to examine telehealth factors associated with reported change in well-being and desire for future telehealth.
Results A total of 947 nontrainee physicians, advanced practice providers, and psychologists were surveyed. Of them, 502 (53.0%) providers responded and 467 (49.3%) met inclusion criteria of telehealth use during the study period. Of these, 325 (69.6%) were female, 301 (65.6%) were physicians, and 220 (47.1%) were medical subspecialists. Providers were 4.77 times as likely (95% confidence interval [CI]: 3.29–7.06) to report improved versus worsened well-being associated with telehealth. Also, 95.5% of providers (95% CI: 93.2–97.2%) wish to continue performing telehealth postpandemic. Our model explains 66% of the variance in telehealth-attributed provider well-being and 59% of the variance for future telehealth preference and suggests telehealth resources significantly influence provider-perceived telehealth care effectiveness which in turn significantly influences provider well-being and desire to perform telehealth.
Conclusion Telehealth has potential to promote provider well-being; telehealth-related changes in provider well-being are associated with both provider-perceived effectiveness of telemedicine for patients and adequacy of telehealth resources.
Metastatic Lobular Carcinoma of the Male Breast Masquerading as a Pancreatic Head Mass, a Diagnostic Dilemma—Rare Case and Literature Review
Authors: Mor Akash G. , Das Subhasree , Joshi Shalaka P. , Chaudhari Vikram A. , Desai Sangeeta 
Published: February 2022

AbstractMale breast cancer comprises of 1% of all and invasive lobular carcinomas (ILC) are even rarer in males. ILC are known to have unusual metastatic sites. We report a case of a 51-year-old male diagnosed with breast cancer, who presented with a recurrent chest wall nodule and icterus after 24 months of disease-free interval. On further investigations, he was found to have pancreatic head mass associated with conjugated hyperbilirubinemia suggestive of obstructive jaundice and a left parasternal soft tissue recurrence. A self-expandable metallic stent was inserted for recurrent cholangitis. Biopsy from the chest wall nodule was recurrence of ILC and pancreatic head mass was suspected to be either a second primary or an isolated pancreatic head metastasis of ILC on imaging. In either case surgical resection if operable and localized was planned. However, on staging laparoscopy, the patient was found to have mild ascites and multiple peritoneal nodules, which on biopsy proved to be metastases from ILC. Patient was treated with second-line hormonal therapy with luteinizing hormone-releasing hormone agonist and an aromatase inhibitor. ILC may present with unusual sites of metastasis leading to diagnostic dilemma. A high index of suspicion of metastases and appropriate biopsies can help one embark upon the most appropriate plan.
Breast Imaging: Past and Present
Authors: Haria Purvi , Thakur M. H. , Popat Palak , Katdare Aparna , Chauhan Sonal 
Published: February 2022

AbstractBreast imaging has evolved over several decades; however, a significant leap has happened in the past couple of decades. Multiple modalities are available for the evaluation of breast diseases; Mammography, Digital Breast Tomosynthesis, Ultrasound, Magnetic Resonance Imaging (MRI), and Contrast Enhanced Mammography (CEM) are a few of the frequently used ones. Image-guided interventions have further evolved, core needle biopsy, vacuum-assisted biopsy, clip placements, and wire localization to name a few. At times, it is difficult to choose between the modalities for disease evaluation and intervention. In this article, we have tried to cover in brief the evolution of breast imaging over years and have discussed the imaging approach to some frequent clinical presentations along with the approach to the evaluation of mammography.
Seed priming with zinc sulfate and zinc chloride affects physio-biochemical traits, grain yield and biofortification of bread wheat (
Authors: Rehman Abdul , Farooq Muhammad , Ullah Aman , Nawaz Ahmad , ud Din Muhammad Moeen , Shahzad Babar 
Published: February 2022

Zinc deficiency impedes wheat productivity and is major cause of malnutrition in humans consuming wheat products low in Zn, especially in developing countries, which experience low rates of soil and foliar Zn application owing to high cost of chemical Zn fertilisers. This pot study was conducted to evaluate the potential of seed priming with Zn for improving performance and grain biofortification of bread wheat (Triticum aestivum L.). Seeds of wheat cultivars Faisalabad-2008 and Lasani-2008 received one of four Zn treatments involving soaking in aerated solutions of ZnCl2 (0.05 or 0.1 M Zn) or ZnSO4 (0.1 or 0.5 M Zn); untreated seeds were taken as a control. All Zn seed priming treatments improved wheat performance. Seed priming with 0.1 M ZnCl2 advanced seedling emergence, whereas seed priming with 0.5 M ZnSO4 improved leaf elongation/expansion, chlorophyll content, shoot Zn concentration and plant photosynthetic traits. Seed priming with 0.1 and 0.5 M ZnSO4 improved plant water relations. Moreover, seed priming with 0.5 M ZnSO4 improved grain yield (63.1%), and grain Zn concentration (43.1%) and content (93.1%), with low [phytate]:[Zn] compared with non-primed seeds. Faisalabad-2008 performed better than Lasani-2008. In conclusion, seeds of bread wheat may be primed with 0.5 M ZnSO4 as a Zn source for improving plant physiology, yield and grain biofortification.
Aesthetic Nonexcisional Arm Contouring
Authors: Ibrahiem Saad Mohamed Saad 
Published: February 2022

Abstract

Background
Surgical excision remains the gold-standard therapy for arm skin laxity. However, many patients refuse surgical treatment for fear of the prominent long scars associated with brachioplasty.

Objectives
The objective of the study was to compare the aesthetic outcome of 2 energy-assisted liposuction arm-contouring techniques, radiofrequency-assisted liposuction (RFAL; Group A) and Renuvion helium subdermal coagulation (Group B), with a control group treated with VASER-assisted liposuction (VAL) alone (Group C).

Methods
This is a randomized controlled study of 176 patients seeking arm contouring, who were treated between February 2017 and December 2020. All of the patients underwent VAL, followed by either RFAL (53 patients, Group A) with the BodyTite RF platform or subdermal coagulation (66 patients, Group B) with the Renuvion platform; 57 patients in the control group (Group C) received VAL alone. Patient data, marking techniques, operative details, complications (and tips and tricks to avoid them), and aesthetic outcomes were recorded and tabulated. Surgical team, third-party, and patient satisfaction surveys were conducted 6 months postoperatively.

Results
The study included 176 patients (153 female and 23 male) with a mean age of 32 years (range, 20-59 years). All patients were followed up for a minimum of 6 months. In total, 96 (80.6%) patients reported their satisfaction with the overall technique. An independent plastic surgeon considered the result good to excellent in 97 of 119 cases of the studied group.

Conclusions
The umbrella of nonexcisional arm contouring can be extended to include treatment of difficult cases of arm laxity with energy-producing machines. The procedure can achieve a reduction in fat deposits and significant improvements in skin laxity.

Level of Evidence: 4
Where was WAIR in avian flight evolution?
Authors: Kuznetsov Alexander N , Panyutina Aleksandra A 
Published: February 2022

Abstract
The popular hypothesis that the flapping flight of birds evolved through the stage of wing-assisted incline running (WAIR) is tested through calculations of external forces acting on the wings in the downstroke and upstroke during WAIR activity of an adult chukar partridge (Alectoris chukar). Contrary to previous studies of WAIR, it is found that the total vertical impulse provided by the wings is negative (i.e. downward directed). Thus, the wings cancel out about half of the positive (upward-directed) impulse provided by the legs. The function of the wings in WAIR is not to lift the body, but to push it towards the steep slope. It is like a wing, or aerofoil, of a race car, which is tilted at a negative angle of attack to press the car to the ground for greater friction and adhesion of the wheels and to prevent the race car from becoming airborne. The calculated force pattern suggests that the dominant external forces acting on the wings in the sagittal plane during WAIR are not the virtual forces of inertia but the aerodynamic forces. More specifically, it is only the aerodynamic lift that can be responsible for the wing force component acting at right angles to the wingbeat plane in both the downstroke and the upstroke during WAIR. The lift towards the slope during the WAIR upstroke is ensured by separation of the primary flight feathers and their setting at a negative angle of attack. Analysis of the force pattern in the anatomical coordinate space of a bird’s body shows that the main wing muscles in the WAIR downstroke are the humeral retractor muscles and in the WAIR upstroke the humeral elevator muscles. The humeral protractor muscles are not required at all during WAIR. Therefore, the morphologically necessary protractor state of the supracoracoideus muscle in a ‘semi-flying’ ancestor, which is logically explained by the classical hypothesis of a gliding ancestor, does not fit the WAIR hypothesis of flapping flight origin. Wing-assisted incline running should be regarded as a crown locomotor specialization of birds and is not an appropriate model for locomotion in avian ancestors.
Genetic structure and evolution of diploidCochleariain Iceland
Authors: Olsen Luka N , Brandrud Marie K , Mandáková Terezie , Lysak Martin A , Bjorå Charlotte S , Cires Eduardo , Nordal Inger , Brysting Anne K 
Published: February 2022

AbstractIn northern European Cochlearia (Brassicaceae), considerable chromosome variation has taken place without corresponding morphological differentiation, resulting in an intricate species complex including two base chromosome numbers and several ploidies. Here, we investigate the situation in Iceland. The distribution, genetic structure, taxonomy and origin of the two Cochlearia cytotypes (2n = 12 and 2n = 14) present in Iceland are discussed. Chromosome counts indicate that both cytotypes occur along the coast, but 2n = 12 populations dominate (eight 2n = 12 vs. two 2n = 14 among the investigated populations), whereas 2n = 14 was reported for the two inland alpine populations investigated here. RADseq data support geographically structured genetic variation along the Icelandic coast and environmentally structured genetic differentiation between coastal and alpine populations. The alpine populations show genetic and morphological affiliation with C. groenlandica (2n = 14), which is widely distributed in the Arctic, but more comprehensive sampling is needed to draw conclusions concerning the taxonomic status of the Icelandic coastal plants. To uncover the origin of and phylogenomic relationships between the two chromosome variants, comparative whole-genome sequencing should be performed.
Assessment of temperature optimum signatures of corals at both latitudinal extremes of the Red Sea
Authors: Banc-Prandi Guilhem , Evensen Nicolas R , Barshis Daniel J , Perna Gabriela , Moussa Omar Youssouf , Fine Maoz 
Published: February 2022

AbstractRising ocean temperatures are pushing reef-building corals beyond their temperature optima (Topt), resulting in reduced physiological performances and increased risk of bleaching. Identifying refugia with thermally resistant corals and understanding their thermal adaptation strategy is therefore urgent to guide conservation actions. The Gulf of Aqaba (GoA, northern Red Sea) is considered a climate refuge, hosting corals that may originate from populations selected for thermal resistance in the warmer waters of the Gulf of Tadjoura (GoT, entrance to the Red Sea and 2000 km south of the GoA). To better understand the thermal adaptation strategy of GoA corals, we compared the temperature optima (Topt) of six common reef-building coral species from the GoA and the GoT by measuring oxygen production and consumption rates as well as photophysiological performance (i.e. chlorophyll fluorescence) in response to a short heat stress. Most species displayed similar Topt between the two locations, highlighting an exceptional continuity in their respective physiological performances across such a large latitudinal range, supporting the GoA refuge theory. Stylophora pistillata showed a significantly lower Topt in the GoA, which may suggest an ongoing population-level selection (i.e. adaptation) to the cooler waters of the GoA and subsequent loss of thermal resistance. Interestingly, all Topt were significantly above the local maximum monthly mean seawater temperatures in the GoA (27.1°C) and close or below in the GoT (30.9°C), indicating that GoA corals, unlike those in the GoT, may survive ocean warming in the next few decades. Finally, Acropora muricata and Porites lobata displayed higher photophysiological performance than most species, which may translate to dominance in local reef communities under future thermal scenarios. Overall, this study is the first to compare the Topt of common reef-building coral species over such a latitudinal range and provides insights into their thermal adaptation in the Red Sea.
O01 Trends in antimicrobial resistance amongst pathogens isolated from blood and cerebrospinal fluid cultures in Pakistan (2011–15): a retrospective cross-sectional study
Authors: Javaid Nida , Sultana Qamar , Rasool Karam , Gandra Sumanth , Ahmad Fayyaz , Chaudhary Safee Ullah , Mirza Shaper 
Published: February 2022

Abstract

Background
While antimicrobial resistance (AMR) continues to be a major public health problem in Pakistan, data regarding trends of resistance among pathogenic bacteria remain scarce, with few studies presenting long-term trends in AMR. This study was therefore designed to analyse long-term AMR trends at a national level in Pakistan.

Methods
We report here results of a comprehensive analysis of resistance among pathogens isolated from blood and CSF, between 2011 and 2015. Susceptibility data were obtained from a local laboratory with collection points all across Pakistan (Chughtai Laboratory). Resistance proportions to most commonly used antimicrobials were calculated for each pathogen over a period of 5 years.

Results
While Acinetobacter species demonstrated highest resistance rates to all tested antimicrobials, a sharp increase in carbapenem resistance was the most noticeable (50%–95%) between 2011 and 2015. Our results also highlight the presence of third and fourth generation cephalosporins resistance in Salmonella enterica serovar Typhi in Pakistan. Interestingly, where a rise in AMR was being observed in some major invasive pathogens, decreasing resistance trends were observed in Staphylococcus aureus to commonly used antimicrobials.

Conclusions
Overall pathogens isolated from blood and CSF between 2011 and 2015 showed an increase in resistance towards commonly used antimicrobials.
P01 The increasing incidence of Gram-negative bacteraemias in the UK: confounding effects of the Sepsis 6 campaign
Authors: Baltas Ioannis , Democratis Jane 
Published: February 2022

Abstract

Introduction
The 2019–20 English Surveillance Programme for Antimicrobial Utilisation and Resistance Report (ESPAUR) stated that the incidence of bacteraemias in key bacterial species has increased 17% between 2015 and 2019, continuing the trend observed since mandatory national reporting of Escherichia coli bacteraemias was initiated in 2011. PHE estimates the incidence of infections by calculating the rate of bacteraemias per 100 000 population or per 100 000 bed days for acute Trusts. We hypothesized that the incidence of infections is also affected by the number of blood cultures performed, given that collection of blood cultures for critically unwell patients has been persistently promoted in the UK during the 2010s as part of the Sepsis 6 bundle.

Methods
We compared the incidence of E. coli bacteraemias in an acute NHS Trust from financial year 2012–13 through to 2018–19, with and without adjusting for the number of blood cultures performed, using centrally reported Trust data.

Results
During the study period, the total number of E. coli bacteraemias increased from 375 to 691 (84.3%, Table 1). At the same time, the total number of blood cultures performed increased from 18 956 to 32 283 (70.3%), while the total overnight bed occupancy increased from 377 029 to 453 191 (20.2%, Table 1). The bed occupancy adjusted incidence of E. coli bacteraemias increased from 99.5 E. bacteraemias per 100 000 occupied bed days in financial year 2012–13 to 152.5 bacteraemias per 100 000 occupied bed days in 2018–19 (53.2%, Table 2). The blood culture adjusted incidence of E. coli bacteraemias decreased from 52.5 E. coli bacteraemias per 100 000 bed days per 10 000 blood cultures in 2012–13 to 47.2 E. coli bacteraemias per 100 000 bed days per 10 000 blood cultures in 2018–19 (−10%, Table 2). Even when excluding the 2012–13 financial year, which looks like an outlier, the blood culture adjusted incidence of E. coli bacteraemias only increased by 10% between financial years 2013–14 and 2018–19 (Table 2). Correlation analysis showed a strong and statistically significant association between blood cultures performed and E. coli bacteraemias per 100 000 bed days (R = 0.971, R2 = 0.9428, P&lt;0.001).

Conclusions
The number of blood cultures performed is a potential confounder behind the recent increase in the incidence of E. coli bacteraemias. Regulators should consider adjusting for this factor when reporting incidence of these infections.
P13 Development of a consult and antimicrobial stewardship service in Manchester Foundation Trust
Authors: Devine Karen A. , Ng Wai Kein , Dave Farnaz , Chow Cathy , Emery Darcy , Riste Michael 
Published: February 2022

Abstract

Objectives
To prospectively audit the first year of the North Manchester infectious diseases AMS and Consult service June 2020 to June 2021 to: (i) characterize the number of patients who had antibiotic treatment narrowed, duration reduced and/or switch to oral options; (ii) assess documentation of indication and duration of antibiotic prescriptions; (iii) determine whether or not the appropriate microbiological specimens have been performed and with the lab; (iv) identify the impact on antibiotic consumption measured in defined daily dose (DDDs); and (v) establish whether base teams act on the advice given by the Consult/AMS team (data over a 6 week period).

Methods
On weekdays an electronic prescribing list of all patients prescribed piperacillin/tazobactam, meropenem and ciprofloxacin was generated, and the consults team performed either a bedside or notes review. Data was collected prospectively on 730 patients on which infection was treated, which specialty managed the patient, microbiology samples sent, duration and indication of treatment documentation, and advice given by consults team. Data was then collected over a further 6 weeks looking at whether the base specialty carried out the advice of the AMS team.

Results
The main indication for broad spectrum antibiotic use was urinary tract infection (151/720) and hospital acquired pneumonia (104/720). Poor documentation of antimicrobial indication and duration was observed across all specialties (277/720). Just over 50% of appropriate microbiology samples were sent (422/726). For 42% of cases (311/730), colleagues were advised to stop or reduce antibiotic duration. In 30% of cases (220/730), narrowing of antibiotic spectrum was advised. Thirty percent (219/730) were advised on IV to oral switch. There was a modest reduction in antimicrobial consumption in some specialties comparing the year prior to the introduction of the service 2019–20 to 2020–21; 17.4% reduction respiratory (7810/9137), 0.2% increase in medicine (272698/267351) and 2.1% surgery (68722/67309). In 81 patients reviewed to look at outcomes over 6 weeks, 88% of Consult/AMS team advice was actioned by the lead specialties involved in the patients’ care.

Conclusions
(i) There is a substantial need for an AMS service within the hospital. (ii) Outcome data shows the ward teams engage with the service and most follow advice. (iii) The service contributed to limiting inappropriate prescribing during the COVID-19 pandemic. There was a modest rise in hospital-wide consumption. (iv) The AMS service needs to be available to provide patient equity across Manchester Foundation Trust, fostering a city-wide AMS strategy that encompasses education, guidelines, audit and quality improvement.