Looking beyond, around and within cultural differences and dialogues across the open access ecosystem.

Céspedes and Maggio turn a lens on publication practices in their contribution to this special issue's focus on cross‐cultural dialogue.

Impact of Aphasia on Brain Activation to Motor Commands in Patients with Acute Intracerebral Hemorrhage.

Background: Brain activation to motor commands is seen in 15% of clinically unresponsive patients with acute brain injury. This state called cognitive motor dissociation (CMD) is detectable by electroencephalogram (EEG) or functional magnetic resonance imaging, predicts long-term recovery, and is recommended by recent guidelines to support prognostication. However, false negative CMD results are a particular concern, and occult aphasia in clinically unresponsive patients may be a major factor.

Deregulated DNA ADP-ribosylation impairs telomere replication.

The recognition that DNA can be ADP ribosylated provides an unexpected regulatory level of how ADP-ribosylation contributes to genome stability, epigenetics and immunity. Yet, it remains unknown whether DNA ADP-ribosylation (DNA-ADPr) promotes genome stability and how it is regulated. Here, we show that telomeres are subject to DNA-ADPr catalyzed by PARP1 and removed by TARG1.

'My doctor self and my human self': A qualitative study of physicians' presentation of self on social media.

Introduction: When using social media, physicians are encouraged and trained to maintain separate professional and personal identities. However, this separation is difficult and even undesirable, as the blurring of personal and professional online presence can influence patient trust. Thus, it is necessary to develop policies and educational resources that are more responsive to the blurring of personal and professional boundaries on social media.

The Impact of Aging Drivers and Vehicles on the Injury Severity of Crash Victims.

Against a general trend of increasing driver longevity, the injuries suffered by vehicle occupants in Spanish road traffic crashes are analyzed by the level of severity of their bodily injuries (BI). Generalized linear mixed models are applied to model the proportion of non-serious, serious, and fatal victims. The dependence between vehicles involved in the same crash is captured by including random effects.

Tumour-induced osteomalacia due to residual benign glomangioma.

Tumour-induced osteomalacia (TIO) is a rare paraneoplastic syndrome. The constellation of findings of unprovoked fractures, hypophosphataemia, urinary phosphate wasting and a negative genetic evaluation suggest a TIO diagnosis. Tumours leading to TIO are often small and difficult to localise using standard imaging studies.

Predicting Shunt Dependency from the Effect of Cerebrospinal Fluid Drainage on Ventricular Size.

Background: Prolonged external ventricular drainage (EVD) in patients with subarachnoid hemorrhage (SAH) leads to morbidity, whereas early removal can have untoward effects related to recurrent hydrocephalus. A metric to help determine the optimal time for EVD removal or ventriculoperitoneal shunt (VPS) placement would be beneficial in preventing the prolonged, unnecessary use of EVD. This study aimed to identify whether dynamics of cerebrospinal fluid (CSF) biometrics can temporally predict VPS dependency after SAH.

A Benign Medullary Thyroid Cancer.

Metastatic dissemination occurs in up to 90% of patients with medullary thyroid cancer (MTC) greater than 4 cm in diameter, and elevated calcitonin levels of more than 500 pg/ml preoperatively have been shown to predict the failure to achieve biochemical remission. Herein, we present a patient with a large tumor and extremely elevated calcitonin level, who was subsequently found to show a "benign" behavior with no evidence of metastasis. The relatively benign behavior of this patient's MTC despite its size and extremely elevated calcitonin levels is thought to be suggestive of certain mutation types in MTC to be more associated with better prognostic outcomes.

The Case of Sean Smith: A Three-Part Interactive Module on Transgender Health for Second-Year Medical Students.

Introduction: While great strides have been made in favor of the LGBT community overall, transgender individuals are still facing many legal challenges and suffer from more marked health issues and disparities compared to other members of the LGBT community. Our multimodal transgender curriculum was designed in accordance with the Kern model to address educational gaps in the area of transgender health.

Methods: This three-part module consists of: (1) a didactic PowerPoint presentation reviewing unique health issues and disparities experienced by transgender patients, (2) a small-group session viewing and analyzing a pair of videos showcasing competent and poor communication between a provider and a transgender patient, and (3) a large-group patient panel featuring members of the transgender community.

Coexistence of Two Different Thyroid Malignancies: A Collision Phenomenon.

The term "collision tumor" is described as the coexistence of two or more histologically distinct neoplastic morphologies separated by normal tissue in the same organ. Simultaneous papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) of the same thyroid lobe is a very rare pathology. Herein, we report a case of PTC and FTC of the same thyroid lobe.

Glucocorticoid-Associated Demise of a Patient With Duchenne Muscular Dystrophy.

We describe the clinical deterioration of a 26-yr-old man with Duchenne muscular dystrophy on oral daily high-dose deflazacort. Although this daily regimen was targeted to benefit ambulation and respiration, it resulted in premature death with lethal sequelae from liver failure, decubiti, diabetes mellitus, and morbid obesity. This case illustrates the need for further research weighing risk versus benefit of daily glucocorticoid therapy, specifically deflazacort, in Duchenne muscular dystrophy patients.

Six Collective Challenges for Sustainability of Almería Greenhouse Horticulture.

Globally, current food consumption and trade are placing unprecedented demand on agricultural systems and increasing pressure on natural resources, requiring tradeoffs between food security and environmental impacts especially given the tension between market-driven agriculture and agro-ecological goals. In order to illustrate the wicked social, economic and environmental challenges and processes to find transformative solutions, we focus on the largest concentration of greenhouses in the world located in the semi-arid coastal plain of South-east Spain. Almería family farming, predominantly cooperative, greenhouse intensive production, commenced after the 1960s and has resulted in very significant social and economic benefits for the region, while also having important negative environmental and biodiversity impacts, as well as creating new social challenges.

Diagnosis of cyclic Cushing's disease manifests as early morning hyperglycemia in a patient with previously well-controlled type 1 diabetes.

Background Cyclic Cushing's disease (CCD) is reported to occur in approximately 15% of patients with Cushing's disease (CD). CCD is a rare phenomenon in children. Case presentation A Portuguese female with well-controlled type 1 diabetes (T1DM) on an insulin pump developed transient uncontrolled blood sugar every morning.

An extinct hummingbird species that never was: a cautionary tale about sampling issues in molecular phylogenetics.

The selection of species and individuals for molecular analyses critically affects inferences in various fields of systematic biology including phylogenetics, phylogeography, and species delimitation. Especially in areas like the Neotropical region where molecular analyses have recovered substantial within-species divergence and unexpected affinities of populations (Turchetto-Zolet et al. 2013), biases resulting from incomplete taxonomic or geographic sampling may compromise the understanding of phylogenetic relationships (Avendaño et al.

A non-naturally-occurring P(3HB-co-3HA) is produced by recombinant Pseudomonas sp. from an unrelated carbon source.

Pseudomonas sp. PHA was used as host for PHA biosynthesis genes from Aeromonas sp. to produce 3HB-co-3HA from glucose with no supply of co-substrates.

Combining molecular and bioprocess techniques to produce poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) with controlled monomer composition by Burkholderia sacchari.

Biopolymers as polyhydroxyalkanoates (PHA) composed by different co-monomers 3-hydroxybutyrate and 3-hydroxyhexanoate [P(3HB-co-3HHx)] has attracted interest since its properties are similar to low density polyethylene. Burkholderia sacchari produces this copolymer with a very low 3HHx molar fraction, about 2 mol%. B.

Motivational effects of coronary artery calcium scores on statin adherence and weight loss.

Aim: The aim of this study was to assess the effect on adherence to statin therapy and assess the effect of beneficial changes in behavior that resulted in weight loss in patients who underwent coronary artery calcium (CAC) scoring with cardiac computed tomography.

Background: Despite convincing data demonstrating the benefits of HmGCoA inhibitors for both primary and secondary prevention of coronary heart disease, they remain underused. Also, despite convincing data demonstrating the benefits of weight loss for both primary and secondary prevention of coronary heart disease, it remains difficult to motivate behavioral changes resulting in weight loss.

Use of a soft tissue expander before surgical treatment of clubfoot in children and adolescents.

Primary closure of the skin after surgical correction of severe clubfoot is difficult, sometimes impossible. The authors describe a surgical technique with the use of a soft tissue expander prior to surgical treatment on clubfoot in children and adolescents. They operated on 13 feet (10 patients) with rigid clubfoot, with ages ranging from 3 to 16 years (average 10 years).

Pontine hemorrhage in a patient with pheochromocytoma.

A 24-year-old woman with a two-year history of hypertension was hospitalized for coma and quadriplegia secondary to pontine hemorrhage. A seven-year history of intermittent severe headaches, diaphoresis, and anxiety together with persistent severe hypertension led to the diagnosis of pheochromocytoma. This unusual but devastating manifestation of pheochromocytoma illustrates the importance of excluding remedial forms of hypertension in young patients before initiating antihypertensive therapy.

Hemodialysis ascites in anephric patients.

Six maintenance hemodialysis patients are described in whom ascites was encountered at a time when they were anephric. No etiology for ascites could be found, and it was presumed that these patients were manifesting so-called "hemodialysis ascites". Our findings suggest that the use of bilateral nephrectomy in the treatment of hemodialysis ascites should be re-evaluated.