bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blackout Brownie: A Final Dessert Case Study
Authors: Kedzierski Nancy , Hernandez Melanie 
Published: February 2022

Abstract
Cannabis products have been becoming more widely accepted as a recreational drug and for medicinal purposes to aid in various ailments. This paper reports a death after acute ingestion of an edible cannabis brownie. The 65-year-old female decedent with a history of chronic pain ingested an edible cannabis brownie after other alternative edibles and prescribed medication produced no desired effects. After consuming the cannabis product with her husband, both began feeling high and nauseated. The decedent was last seen alive stopped part way up the stairs by her husband prior to him going to sleep. She was found expired at the base of the stairs the following morning with no apparent trauma. The autopsy concluded the decedent was obese with severe ischemic cardiovascular disease. The toxicology report detected delta-9-tetrahydrocannabinol present at &gt;5,000 ng/mL in the decedent’s central blood at the time of sample collection. The final cause of death was ruled as natural due to cardiovascular disease with cannabis present in her system.
Twisted extreme trans-Neptunian orbital parameter space: statistically significant asymmetries confirmed
Authors: de la Fuente Marcos C , de la Fuente Marcos R 
Published: February 2022

ABSTRACT
Asymmetric debris discs have been found around stars other than the Sun; asymmetries are sometimes attributed to perturbations induced by unseen planets. The presence or absence of asymmetries in our own trans-Neptunian belt remains controversial. The study of sensitive tracers in a sample of objects relatively free from the perturbations exerted by the four known giant planets and most stellar flybys may put an end to this debate. The analysis of the distribution of the mutual nodal distances of the known extreme trans-Neptunian objects (ETNOs) that measure how close two orbits may get to each other could be such a game changer. Here, we use a sample of 51 ETNOs together with random shufflings of this sample and two unbiased scattered-disc orbital models to confirm a statistically significant (62σ) asymmetry between the shortest mutual ascending and descending nodal distances as well as the existence of multiple highly improbably (p &lt; 0.0002) correlated pairs of orbits with mutual nodal distances as low as 0.2 au at 152 au from the Solar system’s barycentre or 1.3 au at 339 au. We conclude that these findings fit best with the notion that trans-Plutonian planets exist.
What happens when a settlor or powerholder loses capacity?
Authors: Piskorz Emilia , Steen Peter 
Published: February 2022

Abstract
Capacity issues are a common feature of the landscape of wills and estates. However, such issues tend to arise much less frequently in the context of discretionary trusts. This relative absence is perhaps attributable to (often) the lack of direct benefit to anyone alleging the existence of mental incapacity issues in relation to a discretionary trust. There are significant consequences that can arise from successfully challenging capacity in the context of, say, a specific legacy under a will, whereas a discretionary beneficiary who raises mental incapacity issues usually remains merely a discretionary beneficiary. However, in the climate of ever increasing life expectancy and rising rates of dementia diagnoses, mental capacity issues in the trusts context are on the rise, and it is essential to understand what happens when settlors and power holders remain in place despite questions over their mental capacity. After all, “having capacity to exercise a power is ‘of the essence of a power’”.1 In this article, we look at the sorts of mental capacity issues that can arise in the trusts context and what can be done about them.
Comparative Effectiveness of Landmark-guided Greater Occipital Nerve (GON) Block at the Superior Nuchal Line Versus Ultrasound-guided GON Block at the Level of C2
Authors: Kissoon Narayan R. , O’Brien Travis G. , Bendel Markus A. , Eldrige Jason S. , Hagedorn Jonathan M. , Mauck William D. , Moeschler Susan M. , Olatoye Oludare O. , Pittelkow Thomas P. , Watson James C. , Pingree Matthew J. 
Published: February 2022

Objectives:
The purpose of this single center, prospective randomized controlled trial was to compare clinical outcomes between an ultrasound-guided greater occipital nerve block (GONB) at the C2 vertebral level versus landmark-based GONB at the superior nuchal line.

Methods:
Patients with occipital neuralgia or cervicogenic headache were randomized to receive either a landmark-based GONB with sham ultrasound at the superior nuchal line or ultrasound-guided GONB at the C2 vertebral level with blinding of patients and data analysis investigators. Clinical outcomes were assessed at 30 minutes, 2 weeks, and 4 weeks postinjection.

Results:
Thirty-two patients were recruited with 16 participants in each group. Despite randomization, the ultrasound-guided GONB group reported higher numeric rating scale (NRS) scores at baseline. Those in the ultrasound-guided GONB group had a significant decrease in NRS from baseline compared with the landmark-based GONB group at 30 minutes (change of NRS of 4.0 vs. 2.0) and 4-week time points (change of NRS of 2.5 vs. −0.5). Both groups were found to have significant decreases in Headache Impact Test-6. The ultrasound-guided GONB had significant improvements in NRS, severe headache days, and analgesic use at 4 weeks when compared with baseline. No serious adverse events occurred in either group.

Conclusions:
Ultrasound-guided GONBs may provide superior pain reduction at 4 weeks when compared with landmark-based GONBs for patients with occipital neuralgia or cervicogenic headache.
Effects of Gabapentin Enacarbil on Postoperative Pain After Hip and Knee Arthroplasty
Authors: Ayad Sabry S. , Makarova Natalya , Niazi Azfar K. , Khoshknabi Dilara S. , Stang Taylor , Raza Syed , Kim Daniel D. 
Published: February 2022

Objectives:
Total joint arthroplasties are among the most common elective procedures performed in the United States, and they are associated with postoperative pain. Gabapentin enacarbil is a prodrug with an extended-release formulation that has been proposed for multimodal postoperative analgesia, but the drug’s efficacy for major arthroplasties remains unclear.

Materials and Methods:
We enrolled 60 adult patients scheduled for primary knee or hip arthroplasty expected to remain hospitalized for at least 3 days. Eligible patients were randomly assigned to placebo or gabapentin enacarbil 600 mg twice daily starting the day before surgery continuing for 3 days thereafter.
The primary outcome was analyzed using a joint hypothesis framework of pain (0 to 10 verbal response scores) and cumulative opioid consumption (mg of morphine equivalent) within the first 72 hours. Secondary outcomes were nausea and vomiting, pain persisting 90 days after surgery, duration of hospitalization, and early postoperative health status using quality of recovery score (QoR-15).

Results:
Twenty-eight patient in gabapentin enacarbil group and 32 in placebo group were analyzed. Since pain scores did not differ significantly (difference of means: −0.2 in pain scores; 95% confidence interval: −1.1, 0.7), nor did opioid consumption, conditions for joint hypothesis testing were not met. Moreover, there were no significant differences between groups for secondary outcomes.

Discussion:
We did not identify statistically significant or clinically meaningful differences in our primary and secondary outcomes related to perioperative use of gabapentin enacarbil in patients having primary hip or knee arthroplasties.
Bone Graft Volume by Reamer Head Size Using the RIA 2
Authors: Robison John Weston , Grau-Cruz Emilio E. , Bruggers Jennifer , Becher Stephen 
Published: February 2022

Introduction:
The purpose of the study was to quantify the volume of graft that is obtained using sequential upsizing of reamers using the modularity of the second generation Reamer-Irrigator-Aspirator (RIA 2) system and determine any fracture or perforation risk with upsizing. We hypothesize that graft volume may be predicted using radiographic variables that can be measured before reaming.

Materials and Methods:
Eleven cadaveric specimens were used to evaluate the sequential amount of graft taken using the RIA 2 modular system. Each cadaveric specimen had bone graft harvested from the tibia and femur. Using a radiographic ruler, estimations of the canal size for both the femur and tibia were performed. Average graft volume with SD per incremental increase of reamer was calculated for both the femur and the tibia.

Results:
There were no perforations of the femur during any reaming. There were 5 perforations or fractures of the tibias during progressive reaming including 3 during the second pass and 2 during the third pass, with a significant increase in perforation in the tibial specimens (P=0.03). There was no significant difference in graft volume after 3 passes from either tibia or femoral harvesting. However, there was a significant decrease in graft volume on the second pass of the femur that was not seen in tibial harvesting (P=0.0013).

Discussion:
The RIA 2’s reamer head modularity allows multiple passes of the reamer, which gives surgeons the ability to upsize if more autograft is needed. Total autograft volume was similar between the femur and tibia; however, caution should be used in the tibia because of increased perforation risk.

Level of Evidence:
Level IV—therapeutic study.
Promise, perils and cautious optimism: the next frontier in long-acting modalities for the treatment and prevention of HIV
Authors: Philbin Morgan M. , Perez-Brumer Amaya 
Published: February 2022

Purpose of review
This paper provides a critical review of recent therapeutic advances in long-acting (LA) modalities for human immunodeficiency virus (HIV) treatment and prevention.

Recent findings
LA injectable antiretroviral therapy (ART) has been approved in the United States, Canada and Europe; the United States also has approved LA injectable preexposure prophylaxis (PrEP) and the World Health Organization has recommended the vaginal PrEP ring. Current LA PrEP modalities in clinical trials include injections, films, rings, and implants; LA ART modalities in trials include subcutaneous injections and long-term oral pills. Although LA modalities hold incredible promise, global availability is inhibited by long-standing multilevel perils including declining multilateral funding, patent protections and lack of political will. Once available, access and uptake are limited by factors such as insurance coverage, clinic access, labor markets, stigma, and structural racism and sexism. These must be addressed to facilitate equitable access for all.

Summary
There have been tremendous recent advances in the efficacy of LA ART and PrEP modalities, providing renewed hope that ‘ending the HIV epidemic’ is within reach. However, pervasive socio-structural inequities limit the promise of LA modalities, highlighting the need for cautious optimism in light of the embedded inequities in the trajectory of research, development, and population-level implementation.
Is the exoscope ready to replace the operative microscope in transoral surgery?
Authors: Paderno Alberto , Deganello Alberto , Lancini Davide , Piazza Cesare 
Published: February 2022

Purpose of review
Exoscopes are external digital devices that provide enhanced and magnified visualization of the surgical field. They usually have dedicated digital controls and a more compact mechanical structure than operative microscopes and current robotic surgical systems. This technology has significant potential in otolaryngology – head and neck surgery, especially concerning the field of transoral approaches. We herein analysed the overall technical characteristics of currently available exoscopic systems and contextualized their advantages and drawbacks in the setting of transoral surgery.

Recent findings
The actual advantages of exoscopy are still indeterminate, as it has only been applied to limited surgical series. However, its specific properties are herein compared with conventional transoral microsurgery and transoral robotic surgery, discussing the available literature on such a topic, filtered on the basis of the authors’ experience and its possible future evolutions. Finally, a summary of current experiences in the field of three-dimensional (3D) transoral exoscopic surgery is presented, highlighting differences compared with standard approaches.

Summary
3D-exoscopic transoral surgery will possibly play an essential role in future management of early laryngeal and oropharyngeal lesions, significantly shifting the paradigms of this type of procedures.
A Case of Esophageal Duplication Cyst Identified on Cardiac Point-of-Care Ultrasound
Authors: Grandjean-Blanchet Charlotte , Harel-Sterling Maya , Tessaro Mark O. 
Published: February 2022

Abstract
Esophageal duplication cysts are rare congenital anomalies that are often symptomatic because of compression of surrounding structures. They are commonly diagnosed during childhood, with affected patients often presenting with abdominal pain or chest pain. Point-of-care ultrasound can be used as part of the emergency department evaluation of pediatric chest pain. We present a case of a 6-year-old boy who presented to the emergency department with worsening abdominal and chest pain, where point-of-care cardiac ultrasound identified a cystic structure in the posterior mediastinum.
Stress-induced analgesia: an evaluation of effects on temporal summation of pain and the role of endogenous opioid mechanisms
Authors: Bruehl Stephen , Morris Matthew C. , al'Absi Mustafa 
Published: February 2022

Abstract

Introduction:
Acute stress reduces responses to static evoked pain stimuli (stress-induced analgesia [SIA]). Whether SIA inhibits temporal summation of pain, a dynamic evoked pain measure indexing central sensitization, has been little studied and mechanisms were not evaluated.

Objectives:
We tested whether acute laboratory stressors reduce temporal summation and whether endogenous opioid (EO) mechanisms contributed.

Methods:
Participants were 72 healthy individuals who attended 2 laboratory sessions, receiving either oral naltrexone (50 mg; opioid antagonist) or placebo (randomized, counterbalanced order). In each session, participants underwent a temporal summation protocol with evoked heat pain stimuli, once after extended rest and once after experiencing 2 acute stressors (public speaking and mental arithmetic challenge). Reduced temporal summation in the stress/pain relative to rest/pain condition indexed SIA.

Results:
Analyses in the placebo condition indicated significant SIA on initial pain ratings but not temporal summation slope (index of central sensitization). This SIA effect was moderated by stress reactivity, with SIA only observed in high stress responders. Analyses comparing SIA across the drug conditions did not reveal any evidence of stress-related EO inhibition of temporal summation outcomes. Moderation analyses revealed that high, but not low, stress responders exhibited paradoxical analgesic effects of naltrexone on initial pain ratings but not temporal summation slopes. Independent of stress effects, significant EO inhibition of temporal summation slopes was observed, but only in females.

Conclusions:
Results suggest that acute stress may reduce initial ratings in temporal summation protocols via nonopioid mechanisms but does not alter the temporal summation slope commonly used to index central sensitization.
Synchronous Pseudomonas Infection in Nose and Maxillery Sinus After Septorhinoplasty
Authors: Demir Can Ilker , Yaşar Emrah Kağan , Alagöz Murat Şahin 
Published: February 2022

Abstract
A 50-year-old patient who underwent secondary rhinoplasty 1 year after the operation presented with signs of localized infection on the postoperative twentieth day. An abscess due to Pseudomonas aeruginosa was detected in the nose and maxillary sinus. The infection regressed after surgical debridement combined with intravenous antibiotic therapy.
Pseudomonas infection has been reported in only six patients after septorhinoplasty. Rhinoplasty was combined with other aesthetic procedures in three patients. The mean time of onset of complaints was 33.25 days. The most common complaint was pain. The mean time to complete regression of complaints after treatment was 44.5 days.
Pseudomonas infection risk is especially increased in patients with combined surgical procedures and complicated revision rhinoplasty surgery. Careful examination of the patient, early and aggressive therapy, and surgical debridement are essential. The treatment of infection is incision and drainage of the affected areas. Antibiotic therapy followed by sensitivity-specific regimens should be administered.”
Beta HPV8 E6 Induces Micronuclei Formation and Promotes Chromothripsis
Authors: Dacus Dalton , Stancic Steven , Pollina Sarah R. , Riforgiate Elizabeth , Palinski Rachel , Wallace Nicholas A. 
Published: February 2022

AbstractCutaneous beta genus human papillomaviruses (β-HPV) are suspected to promote the development of non-melanoma skin cancer (NMSC) by destabilizing the host genome. Multiple studies have established the genome destabilizing capacities of β-HPV proteins E6 and E7 as a co-factor with UV. However, the E6 protein from β-HPV8 (HPV8 E6) induces tumors in mice without UV exposure. Here, we examined a UV-independent mechanism of HPV8 E6-induced genome destabilization. We showed that HPV8 E6 reduced the abundance of anaphase bridge resolving helicase, Bloom syndrome protein (BLM). The diminished BLM was associated with increased segregation errors and micronuclei. These HPV8 E6-induced micronuclei had disordered micronuclear envelopes yet retained replication and transcription competence. HPV8 E6 decreased antiproliferative responses to micronuclei and time-lapse imaging revealed HPV8 E6 promoted cells with micronuclei to complete mitosis. Finally, whole genome sequencing revealed that HPV8 E6 induced chromothripsis in 9 chromosomes. These data provide insight into mechanisms by which HPV8 E6-induces genome instability independent of UV exposure.ImportanceSome beta genus human papillomaviruses (β-HPVs) may promote skin carcinogenesis by inducing mutations in the host genome. Supporting this, the E6 protein from β-HPV8 (8E6) promotes skin cancer in mice with or without UV exposure. Many mechanisms by which 8E6 increases mutations caused by UV have been elucidated, but less is known about how 8E6 induces mutations without UV. We address that knowledge gap by showing 8E6 causes mutations stemming from mitotic errors. Specifically, 8E6 reduces the abundance of BLM, a helicase that resolves and prevents anaphase bridges. This hinders anaphase bridge resolution and increases their frequency. 8E6 makes the micronuclei that can result from anaphase bridges more common. These micronuclei often have disrupted envelopes yet retain localization of nuclear-trafficked proteins. 8E6 promotes the growth of cells with micronuclei and causes chromothripsis, a mutagenic process where hundreds to thousands of mutations occur in a chromosome.
Sugar alcohols have the potential as bee-safe feeding stimulants for wasp control
Authors: Neupert Stefanie , Jandt Jennifer M. , Szyszka Paul 
Published: February 2022

ABSTRACTPest insects are often baited with poisoned feeding stimulants, the most common of which are sugars. However, sugars are attractive for most animal species, which makes it difficult to target only a specific pest insect species. Here, we assessed different sugar alcohols for their potential as more species-selective feeding stimulants for pest insects. We tested the attractiveness of the sugar alcohols sorbitol, xylitol and erythritol with a capillary feeder assay in wasps (as potential pest insects, because introduced wasps are a pest in many regions) and bees (as non-target insects). For the common wasp (Vespula vulgaris), sorbitol and xylitol acted as nutritive feeding stimulants, and erythritol acted as a non-nutritive feeding stimulant. For the buff-tailed bumble bee (Bombus terrestris), sorbitol acted as a feeding stimulant, while for the honey bee (Apis mellifera), none of the sugar alcohols acted as feeding stimulant. The species-specific preferences for sugar alcohols suggest their potential as species-selective insect baits. The wasp-specific preference for xylitol suggests its potential as bee-safe alternative to sugar-containing bait for wasp pest control.GRAPHICAL ABSTRACTWe tested the attractiveness of sugar alcohols with a capillary feeder assay in wasps and bees. Species-specific preferences suggests that sugar alcohols have the potential for being used as bee-safe insect baits.
Fingerprints of brain disease: Connectome identifiability in cognitive decline and Alzheimer’s disease
Authors: Stampacchia Sara , Asadi Saina , Tomczyk Szymon , Ribaldi Federica , Scheffler Max , Lövblad Karl-Olof , Pievani Michela , Fall Aïda B. , Preti Maria Giulia , Unshuld Paul G. , De Ville Dimitri Van , Blanke Olaf , Frisoni Giovanni B. , Garibotto Valentina , Amico Enrico ,   the Alzheimer’s Disease Neuroimaging Initiative
Published: February 2022

AbstractIn analogy to the friction ridges of a human finger, the functional connectivity patterns of the human brain can be used to identify a given individual from a population. In other words, functional connectivity patterns constitute a marker of human identity, or a ‘brain fingerprint’. Yet remarkably, very little is known about whether brain fingerprints are preserved in brain ageing and in the presence of cognitive decline due to Alzheimer’s disease (AD). Using fMRI data from two independent datasets of healthy and pathologically ageing subjects, here we show that individual functional connectivity profiles remain unique and highly heterogeneous across early and late stages of cognitive decline due to AD. Yet, the patterns of functional connectivity making subjects identifiable,changeacross health and disease, revealing a functional reconfiguration of the brain fingerprint. We observed a fingerprint change towards between-functional system connections when transitioning from healthy to dementia, and to lower-order cognitive functions in the earliest stages of the disease. These findings show that functional connectivity carries important individualised information to evaluate regional and network dysfunction in cognitive impairment and highlight the importance of switching the focus from group differences to individual variability when studying functional alterations in AD. The present data establish the foundation for clinical fingerprinting of brain diseases by showing that functional connectivity profiles maintain their uniqueness, yet go through functional reconfiguration, during cognitive decline. These results pave the way for a more personalised understanding of functional alterations during cognitive decline, moving towards brain fingerprinting in personalised medicine and treatment optimization during cognitive decline.