bluuebunny/crossref_metadata_2025 huggingface dataset:
Climate Change and Recreation in the Western United States: Effects and Opportunities for Adaptation
Authors: Miller Anna B , Winter Patricia L , Sánchez José J , Peterson David L , Smith Jordan W
Published: February 2022

Climate change is affecting natural resources globally, altering ecosystems that support outdoor recreation. In the western United States, effects such as warming temperatures, increased drought, reduced snowpack, and widespread wildfires will change the outdoor recreation landscape. In this article, we synthesize the state of science regarding the effects of climate change on outdoor recreation in the western US and summarize adaptation options that can reduce the consequences of climate change, considering the adaptive capacities of recreationists and managers. We draw from a series of climate change assessments in which researchers and managers collaborated to understand recreation vulnerability to climate change and develop effective adaptations. We conclude that building climate resilience requires a shift in planning and resource allocation decisions, including (1) longer-term planning timeframes, (2) interdisciplinary teams, and (3) collaboration among agencies, recreation providers, and communities.

Study Implications: Outdoor recreation in the western US is changing due to the effects of climate change. Organized by five recreational categories, this study describes the vulnerability of outdoor recreation to climate change and synthesizes strategies to adapt recreation management to these vulnerabilities. Multiple direct and indirect factors influence individual recreationists’ and land managers’ capacities to adapt to climate change, as we describe through a diagram. Climate-resilient land management requires long-term planning, integration of multiple resource areas, and collaboration across agencies, recreation providers, and communities.
Maxillary Odontogenic Keratocyst
Authors: Walsh Michael , Hussein Mansoor A , Carter Marguerite , Abdulrahman Shawkat
Published: February 2022

The Odontogenic Keratocyst (OKC) is one of the most aggressive odontogenic cysts. OKCs of the maxilla are particularly rare with less than 1% of cases reported in the literature. A 29-year-old female patient presented with pain and loose upper molars. Imaging confirmed an ectopic tooth at the osteomeatal complex and a maxillary OKC. These were endoscopically surgically removed and two teeth were encountered at the maxillary antrum. Histopathology confirmed the diagnosis of OKC of the maxilla. Surveillance with CT imaging and clinical assessment at 6 months shows no evidence of recurrence.
High C-Reactive Protein-to-Lymphocyte Ratio Is Predictive of Unfavorable Prognosis in HBV-Associated Decompensated Cirrhosis
Authors: Ye Bin , Ding QiuMing , He Xia , Liu XiaoYun , Shen Jianjiang
Published: February 2022

Objective

Hepatitis B virus–associated decompensated cirrhosis (HBV-DeCi) is difficult to cure and has a very high risk of mortality. However, prediction of its prognosis is challenging. The C-reactive protein–to–lymphocyte ratio (CLR) is a newly discovered inflammatory indicator, but its role in HBV-DeCi remains unclear. In the present study, we sought to determine the prognostic role of the CLR in patients with HBV-DeCi.

Materials and Methods

This retrospective study enrolled 134 patients with HBV-DeCi. Independent prognostic markers were identified using multivariate regression analysis.

Results

The 30-day mortality rate was 12.7% (n = 17). The CLR was markedly higher in nonsurvivors compared with survivors. The multivariate analysis identified a high CLR as an independent risk factor for mortality.

Conclusion

We found that the CLR is an effective and simple prognostic marker in patients with HBV-DeCi.
Diagnosis of mucormycosis using an intercalating dye-based quantitative PCR
Authors: Bigot Jeanne , Godmer Alexandre , Prudenté Lysa , Angebault Cécile , Brissot Eolia , Bige Naike , Voiriot Guillaume , Leger Pierre-Louis , Petit-Hoang Camille , Atallah Sarah , Gouache Elodie , Senghor Yaye , Valot Stéphane , Hennequin Christophe , Guitard Juliette
Published: February 2022

PCR-based methods applied to various body fluids emerged in recent years as a promising approach for the diagnosis of mucormycosis. In this study, we set up and assess the value of a qPCR to detect a wide variety of Mucorales species in a single tube. A pair of degenerated primers targeting the rDNA operon was used in a qPCR utilizing an intercalating fluorescent dye. Analytical assessment, using a wide variety of both Mucorales strains (8 genera, 11 species) and non-Mucorales strains (9 genera, 14 species), showed 100% sensitivity and specificity rates with a limit of detection at 3 rDNA copy/qPCR reaction. Subsequently, 364 clinical specimens from 166 at-risk patients were prospectively tested with the assay. All the seven patients classified as proven/probable mucormycosis using the EORTC-MSG criteria had a positive qPCR as well as a patient with a proven uncharacterized invasive mold infection. In addition, three out of seven patients with possible mold invasive infections had at least one positive qPCR test. Sensitivity was calculated between 73.33 and 100% and specificity between 98.10 and 100%. The qPCR method proposed showed excellent performances and would be an important adjunctive tool for the difficult diagnosis of mucormycosis diagnosis.

Lay abstract

qPCR-based diagnosis is the most reliable approach for mucormycosis. We set up a pan-Mucorales qPCR able to detect in a single reaction not less than 11 different species. Both analytical and clinical performances support its use in the clinical setting.
Cosmic-ray generated bubbles around their sources
Authors: Schroer B , Pezzi O , Caprioli D , Haggerty C C , Blasi P
Published: February 2022

Cosmic rays (CRs) are thought to escape their sources streaming along the local magnetic field lines. We show that this phenomenon generally leads to the excitation of both resonant and non-resonant streaming instabilities. The self-generated magnetic fluctuations induce particle diffusion in extended regions around the source, so that CRs build up a large pressure gradient. By means of two-dimensional (2D) and three-dimensional (3D) hybrid particle-in-cell simulations, we show that such a pressure gradient excavates a cavity around the source and leads to the formation of a cosmic ray dominated bubble, inside which diffusivity is strongly suppressed. Based on the trends extracted from self-consistent simulations, we estimate that, in the absence of severe damping of the self-generated magnetic fields, the bubble should keep expanding until pressure balance with the surrounding medium is reached, corresponding to a radius of ∼10–50 pc. The implications of the formation of these regions of low diffusivity for sources of Galactic CRs are discussed. Special care is devoted to estimating the self-generated diffusion coefficient and the grammage that CRs might accumulate in the bubbles before moving into the interstellar medium. Based on the results of 3D simulations, general considerations on the morphology of the γ-ray and synchrotron emission from these extended regions also are outlined.
Modelling stars with Gaussian Process Regression: augmenting stellar model grid
Authors: Li Tanda , Davies Guy R , Lyttle Alexander J , Ball Warrick H , Carboneau Lindsey M , García Rafael A
Published: February 2022

Grid-based modelling is widely used for estimating stellar parameters. However, stellar model grid is sparse because of the computational cost. This paper demonstrates an application of a machine-learning algorithm using the Gaussian Process (GP) Regression that turns a sparse model grid on to a continuous function. We train GP models to map five fundamental inputs (mass, equivalent evolutionary phase, initial metallicity, initial helium fraction, and the mixing-length parameter) to observable outputs (effective temperature, surface gravity, radius, surface metallicity, and stellar age). We test the GP predictions for the five outputs using off-grid stellar models and find no obvious systematic offsets, indicating good accuracy in predictions. As a further validation, we apply these GP models to characterize 1000 fake stars. Inferred masses and ages determined with GP models well recover true values within one standard deviation. An important consequence of using GP-based interpolation is that stellar ages are more precise than those estimated with the original sparse grid because of the full sampling of fundamental inputs.
Cannabidiol inhibits RAD51 and sensitizes glioblastoma to temozolomide in multiple orthotopic tumor models
Authors: Soroceanu Liliana , Singer Eric , Dighe Pratiksha , Sidorov Max , Limbad Chandani , Rodriquez-Brotons Aida , Rix Peter , Woo Rinette W L , Dickinson Lawrence , Desprez Pierre-Yves , McAllister Sean D
Published: February 2022

Background

Cannabidiol (CBD), a nonpsychoactive cannabinoid with a low toxicity profile, has been shown to produce antitumor activity across cancers in part through selective production of reactive oxygen species (ROS) in tumor cells. The alkylating agent, temozolomide (TMZ), is standard of care for treatment of glioblastoma (GBM). It can trigger increased ROS to induce DNA damage. It has also been reported that downregulating the expression of RAD51, an important DNA damage repair protein, leads to sensitization of GBM to TMZ.

Methods

We determined the extent to which CBD enhanced the antitumor activity of TMZ in multiple orthotopic models of GBM. In addition, we investigated the potential for CBD to enhance the antitumor activity of TMZ through production of ROS and modulation of DNA repair pathways.

Results

CBD enhanced the activity of TMZ in U87 MG and U251 GBM cell lines and in patient-derived primary GBM163 cells leading to stimulation of ROS, activation of the ROS sensor AMP-activated protein kinase (AMPK), and upregulation of the autophagy marker LC3A. CBD produced a sensitization of U87 and GBM163-derived intracranial (i.c.) tumors to TMZ and significantly increased survival of tumor-bearing mice. However, these effects were not observed in orthotopic models derived from GBM with intact methylguanine methyltransferase (MGMT) expression. We further demonstrate that CBD inhibited RAD51 expression in MGMT-methylated models of GBM, providing a potential mechanism for tumor sensitization to TMZ by CBD.

Conclusion

These data support the potential therapeutic benefits of using CBD to enhance the antitumor activity of TMZ in GBM patients.
Assessing mobility in primary brain tumor patients: A descriptive feasibility study using two established mobility tests
Authors: Rogers James L , De La Cruz Minyety Julianie , Vera Elizabeth , Acquaye Alvina A , Payén Samuel S , Weinberg Jeffrey S , Armstrong Terri S , Weathers Shiao-Pei S
Published: February 2022

Background

Patients with primary brain tumors (PBT) face significant mobility issues related to their disease and/or treatment. Here, the authors describe the preliminary utility and feasibility of two established mobility measures, the Timed-Up-and-Go (TUG) and Five-Times Sit-to-Stand (TSS) tests, in quickly and objectively assessing the mobility status of PBT patients at a single institution’s neuro-oncology clinic.

Methods

Adult patients undergoing routine PBT care completed the TUG/TSS tests and MD Anderson Symptom Inventory-Brain Tumor module (MDASI-BT), which assessed symptom burden and interference with daily life, during clinic visits over a 6-month period. Research staff assessed feasibility metrics, including test completion times/rates, and collected demographic, clinical, and treatment data. Mann–Whitney tests, Kruskal–Wallis tests, and Spearman’s rho correlations were used to interrogate relationships between TUG/TSS test completion times and patient characteristics.

Results

The study cohort included 66 PBT patients, 59% male, with a median age of 47 years (range: 20–77). TUG/TSS tests were completed by 62 (94%) patients. Older patients (P < .001) and those who were newly diagnosed (P = .024), on corticosteroids (P = .025), or had poor (≤80) KPS (P < .01) took longer to complete the TUG/TSS tests. Worse activity-related (work, activity, and walking) interference was associated with longer TUG/TSS test completion times (P < .001).

Conclusions

The TUG/TSS tests are feasible for use among PBT patients and may aid in clinical care. Older age, being newly diagnosed, using corticosteroids, poor (≤80) KPS, and high activity-related interference were associated with significant mobility impairment, highlighting the tests’ potential clinical utility. Future investigations are warranted to longitudinally explore feasibility and utility in other practice and disease settings.
Impact of neurofibromatosis type 1 in an adult community population
Authors: Gregory Timothy A , Molina Peter Simon B , Phillips Gregory D , Henson John W
Published: February 2022

Background

Neurofibromatosis type 1 (NF1) is a common tumor predisposition syndrome with varying manifestations and severity. Adult NF1 patients often experience fragmented care, so we sought to characterize the health and demographic features of a community-based population of adults with NF1 and hypothesized that lack of a specialty clinic for adult NF1 patients correlates with unmet needs.

Methods

Retrospective case-control study of all adult cases of NF1 among 4.06 million medical records in a Pacific Northwest population. 122 case charts were reviewed to ascertain NF1 disease features, comorbidities, and severity of disease. A 1:1 control cohort was selected by matching case/control by age, sex, and ZIP code to compare demographic features and health status.

Results

Adult NF1 patients were less likely to have private insurance, be employed, and have children, but were equally likely to be married. One half of cases had disease features compromising health and well-being, and care involved 26 different specialties. Excluding neurofibromas, 43% of cases had cancer compared to 10% of controls [P < .0001, OR 5.38 (2.53–11.4)]. Only 27% of women ages 30–50 had undergone age-appropriate enhanced breast cancer surveillance. Behavioral health problems were found in 60% of NF1 patients compared to 37% of controls [P < .001, OR 2.61 (1.52–4.50)]. 93% of cases referred to a NF1 specialty center underwent a change in management upon establishing care.

Conclusions

NF1 patients may benefit from coordinated management of care in a specialty center.
Splenic Abscess in the New Millennium: A Descriptive, Retrospective Case Series
Authors: Radcliffe Christopher , Tang Zeyu , Gisriel Savanah D , Grant Matthew
Published: February 2022

Background

Splenic abscess is a rare infection often resulting from hematogenous spread. Immunocompromised states are commonly comorbid, and the microbiology is heterogeneous.

Methods

We conducted a retrospective review of 33 cases identified by convenience sampling. Cases were treated in our institution’s hospital system between May 2012 and February 2021 and classified as proven or probable based on predetermined criteria.

Results

The median age was 57 years, and 58% were men. Common underlying diseases included diabetes mellitus (30%), pancreatic disease (30%), and hematological malignancy (15%). The most common mechanism of pathogenesis was hematogenous spread (n = 13). Escherichia coli, enterococcal spp., and anaerobes were frequently implicated. One case was discovered at autopsy and excluded from subsequent analyses. The median duration of antimicrobial therapy (range) was 45 (5–525) days, and the median length of index hospitalization was 20 days. Percutaneous drainage by interventional radiology was common (17 of 32; 53%), and 6 patients underwent splenectomy. Treatment success was achieved in 14 of 32 cases (44%), with clinical stability in 3 of 32 cases (9%). Failures occurred in 13 of 32 (41%) cases, 2 of whom died from splenic abscesses. Two patients (2 of 32) were lost to follow-up.

Conclusions

To our knowledge, this is the largest North American series since the turn of the century and the first to distinguish between proven and probable cases. As reflected in our series, patients with splenic abscess may require prolonged hospitalizations and courses of antimicrobial therapy. Improvements in management are needed.
Economic Significance in Corporate Finance
Authors: Mitton Todd
Published: February 2022

Reporting the economic significance of findings in corporate finance has become increasingly common, but a review of the literature reveals shortcomings in typical reporting practices. Researchers can more effectively communicate the practical importance of findings by using standard measures of economic significance scaled by the standard deviation of the dependent variable, by providing all statistics necessary to calculate economic significance, and by providing benchmarks by which to evaluate the magnitude of economic significance. To support these objectives, I show why measures scaled by the standard deviation are preferable, and I provide benchmarks based on hundreds of established findings from the literature. (JEL C18, C52, G30).
The emergence and transmission dynamics of HIV-1 CRF07_BC in Mainland China
Authors: Li Xingguang , Li Yanping , Liu Haizhou , Trovão Nídia S , Foley Brian T
Published: February 2022

A total of 1155 partial pol gene sequences of human immunodeficiency virus (HIV)-1 CRF07_BC were sampled between 1997 and 2015, spanning 13 provinces in Mainland China and risk groups [heterosexual, injecting drug users (IDU), and men who have sex with men (MSM)] to investigate the evolution, adaptation, spatiotemporal and risk group dynamics, migration patterns, and protein structure of HIV-1 CRF07_BC. Due to the unequal distribution of sequences across time, location, and risk group in the complete dataset (‘full1155’), subsampling methods were used. Maximum-likelihood and Bayesian phylogenetic analysis as well as discrete trait analysis of geographical location and risk group were carried out. To study mutations of a cluster of HIV-1 CRF07_BC (CRF07-1), we performed a comparative analysis of this cluster to the other CRF07_BC sequences (‘backbone_295’) and mapped the mutations observed in the respective protein structure. Our findings showed that HIV-1 CRF07_BC most likely originated among IDU in Yunnan Province between October 1992 to July 1993 [95 per cent hightest posterior density (HPD): May 1989–August 1995] and that IDU in Yunnan Province and MSM in Guangdong Province likely served as the viral sources during the early and more recent spread in Mainland China. We also revealed that HIV-1 CRF07-1 has been spreading for roughly 20 years and continues to cause local transmission in Mainland China and worldwide. Overall, our study sheds light on the dynamics of HIV-1 CRF07_BC distribution patterns in Mainland China. Our research may also be useful in formulating public health policies aimed at controlling acquired immune deficiency syndrome in Mainland China and globally.
Phycova — a tool for exploring covariates of pathogen spread
Authors: Blokker Tim , Baele Guy , Lemey Philippe , Dellicour Simon
Published: February 2022

Genetic analyses of fast-evolving pathogens are frequently undertaken to test the impact of covariates on their dispersal. In particular, a popular approach consists of parameterizing a discrete phylogeographic model as a generalized linear model to identify and analyse the predictors of the dispersal rates of viral lineages among discrete locations. However, such a full probabilistic inference is often computationally demanding and time-consuming. In the face of the increasing amount of viral genomes sequenced in epidemic outbreaks, there is a need for a fast exploration of covariates that might be relevant to consider in formal analyses. We here present PhyCovA (short for ‘Phylogeographic Covariate Analysis’), a web-based application allowing users to rapidly explore the association between candidate covariates and the number of phylogenetically informed transition events among locations. Specifically, PhyCovA takes as input a phylogenetic tree with discrete state annotations at the internal nodes, or reconstructs those states if not available, to subsequently conduct univariate and multivariate linear regression analyses, as well as an exploratory variable selection analysis. In addition, the application can also be used to generate and explore various visualizations related to the regression analyses or to the phylogenetic tree annotated by the ancestral state reconstruction. PhyCovA is freely accessible at https://evolcompvir-kuleuven.shinyapps.io/PhyCovA/ and also distributed in a dockerized form obtainable from https://hub.docker.com/repository/docker/timblokker/phycova. The source code and tutorial are available from the GitHub repository https://github.com/TimBlokker/PhyCovA.
Pathobiology of Myocardial Ischemia and Reperfusion Injury: Models, Modes, Molecular Mechanisms, Modulation, and Clinical Applications
Authors: Buja L. Maximilian
Published: February 2022

This review presents an integrated approach to the analysis of myocardial ischemia and reperfusion injury and the modulating influence of myocardial conditioning during the evolution of acute myocardial infarction (AMI) and other clinical settings. Experimental studies have involved a spectrum of in vitro, ex vivo, and in vivo models, and guidelines have been developed for the conduct of rigorous preclinical studies and for the identification of various forms of cell injury and death in evolving AMI. AMI in vivo is dominated by oncosis (cell injury with swelling) leading to necroptosis and final necrosis of ischemic cardiomyocytes (CMCs), without or with contraction band formation. Early after coronary occlusion, reperfusion salvages a significant amount of ischemic myocardium in the subepicardium while reperfusion injury contributes up to 50% of the final subendocardial infarct. AMI progression is mediated by damage (or danger)-associated molecular patterns, also known as alarmins, which activate pattern recognition receptors and initiate the inflammatory response. In preclinical studies, lethal reperfusion injury can largely be prevented with preconditioning or postconditioning by pharmacologic or physical means due to effects on both the CMC and microvasculature. Conditioning involves triggers, cytosolic mediators, and intracellular effectors. Mitochondria have a central role in the maintenance and loss of viability of CMCs. Reperfusion of severely ischemic myocardium leads to sustained opening of the mitochondrial permeability transition pore (MPTP). Once the MPTP is opened, the mitochondrial membrane potential (ΔΨm) is rapidly lost and energy production ceases. Conditioning blocks the sustained opening of the MPTP. Translation of conditioning strategies to the clinical management of patients has been challenging. The status of translation of experimental findings to approaches to modulate and ameliorate ischemic and reperfusion injury is discussed for the clinical settings of acute coronary syndromes treated with percutaneous interventions and cardiac preservation during open heart surgery and cardiac transplantation.
Robotic Assisted Versus Manual Percutaneous Coronary Intervention: Systematic Review and Meta-Analysis
Authors: Gupta Rahul , Malik Aaqib H. , Chan Jeffrey Shi Kai , Lawrence Huang , Mehta Anila , Venkata Vikramaditya Samala , Aedma Surya K. , Ranchal Purva , Dhaduk Kartik , Aronow Wilbert S. , Vyas Apurva V. , Mehta Sanjay S. , Combs William G. , Frishman William H. , Patel Nainesh C.
Published: February 2022

Introduction:

Robotics in percutaneous coronary intervention (R-PCI) has been one such area of advancement where potential benefits may include reduced operator radiation exposure, improved outcomes, and reduced rate of adverse events. Limited data exist about the benefits of R-PCI versus conventional manual PCI (M-PCI). We appraised the latest evidence in the form of a meta-analysis of observational and retrospective studies.

Methods:

A comprehensive literature search was performed in PubMed, Embase, and Cochrane to identify relevant clinical studies. Summary effects were calculated using a DerSimonian and Laird random-effects model as the pooled odds ratio or mean differences (MDs) with 95% confidence intervals (CIs). All studies adhering to the inclusion criteria of direct comparisons between R-PCI and M-PCI were evaluated.

Results:

Seven studies with a total of 2230 patients were identified. There was significant decrease in the chest-level operator radiation exposure (MD = –442.32; 95% CI = –675.88 to –208.76), fluoroscopy time (MD = –1.46; 95% CI = –2.92 to 0.00), and amount of contrast used (MD = –18.28; 95% CI = –24.16 to –12.41) in the robotic group compared to the manual group. PCI time and the procedural success rate was not statistically different between the 2 groups. Clinical outcomes of major adverse cardiac events, all-cause mortality, and myocardial infarction were not different between the 2 groups.

Conclusions:

Robotic PCI is associated with reduced operator radiation exposure, fluoroscopy time, and amount of contrast used. While there is a significant reduction in the procedural characteristics with robotic PCI, the clinical outcomes are not different compared to M-PCI. R-PCI is safe and effective with potential benefits to both the operator and the patient simultaneously.
Costal Cartilage Graft to Prevent Drooping after Free Flap Reconstruction of the Lower Lip
Authors: Kuwahara Masamitsu , Yurugi Satoshi , Mashiba Kumi , Ando Junji , Takeuchi Mika , Miyata Riyo , Harada Masayuki , Masuda Yasumitsu , Kanagawa Saori
Published: February 2022

For large lower lip defects, a thin flap combined with a tendon is the standard reconstructive option. However, this method can result in flap ptosis, which occurred in two of our patients. To correct the ptosis, we transplanted costal cartilage into the reconstructed lower lips, which produced good or moderate results. We report our experience based on long-term follow-up. In case 1, reconstruction was performed with a latissimus dorsi myocutaneous flap. Within 10 years of the first cartilage transplant, two additional surgeries were required due to cartilage/screw breakage. These problems may have been triggered by the bulkiness of the flap and/or the angle at which the cartilage was anchored in place. There have not been any further problems for 3 years. In case 2, reconstruction was performed with a free anterolateral thigh flap. The skin around the flap had poor extensibility, and the patient had marked Class II occlusion. We grafted cartilage without fixing it to the mandible. However, temporary interference with the maxillary dentition was observed. In conclusion, costal cartilage grafts are effective against flap ptosis after free flap reconstruction of the lower lip in patients without Class II occlusion. To achieve long-term stability, the optimal angle and positioning of the cartilage and the extensibility of the skin must be thoroughly investigated before surgery, and a thick piece of cartilage must be firmly fixed in place.
“Idiopathic” Shoulder Pain and Dysfunction from Carpal Tunnel Syndrome and Cubital Tunnel Syndrome
Authors: Hagiwara Yusuke , Nakamura Tatsuo , Sonoki Kentaro , Moroi Keishichiro , Morimoto Shigeru , Natsume Yumiko , Yoshida Ryu
Published: February 2022

Background:

As a referral center for chronic pain, we see many patients with “idiopathic” shoulder pain and limited range of motion. The combination of mild or subclinical carpal tunnel syndrome and cubital tunnel syndrome may be an underrecognized etiology of symptoms in such patients. Here, we report our treatment algorithm and results for such patients.

Methods:

Of patients with a chief complaint of shoulder pain, we identified 56 consecutive patients who had pain or tingling with median nerve compression at the proximal wrist crease and positive Tinel’s around the cubital tunnel. They were first provided a night-time wrist orthosis. If still symptomatic, nerve blocks were given to median and ulnar nerves under ultrasound guidance. If symptoms recurred after nerve blocks, nerve conduction studies and surgical release of affected nerves were performed.

Results:

Six patients had 60% or more pain relief with orthosis (mean 4.7 ± 0.8 (SD) to 2.2 ± 0.8). Twenty-three patients had nerve blocks and had persistent pain relief (6.0 ± 1.7 to 2.1 ± 1.9) and significant shoulder motion improvement. Twenty-seven patients only had temporal relief and required surgery but postoperatively had persistent pain relief (6.2 ± 2.0 to 1.2 ± 1.0) and improved shoulder motion. qDASH improved from 33.4 ± 20.1 preoperatively to 12.2 ± 7.4 postoperatively.

Conclusions:

All patients had substantial improvement in shoulder pain and motion with compressive neuropathy treatments. Targeted physical examination can identify these patients, who can have significant improvement with appropriate diagnosis and treatment. The study sheds light on an underrecognized cause of shoulder dysfunction.
Hand and Upper Extremity Trauma in the Undocumented Immigrant Population in the United States
Authors: Inglesby Dani C. , Okewunmi Jeffrey , Williams Christine S. , Gopman Jared M. , Melamed Eitan
Published: February 2022

Background:

Undocumented immigrants in the United States are at risk for upper extremity trauma due to occupational exposure, and decreased access to healthcare can worsen outcomes. The purpose of this study was to compare documented versus undocumented patients in a large cohort of patients in New York City's most diverse neighborhood in order to characterize upper extremity trauma in this population.

Methods:

The Elmhurst Hospital trauma database was examined for patients admitted with upper extremity trauma from April 2016 to December 2019. Charts were examined for demographic information, documentation status, injury mechanism, and outcomes.

Results:

Of the 1041 patients included, 865 (83.1%) were documented and 176 (16.9%) were undocumented. Undocumented immigrants were younger (40.5 versus 62.4 years, P < 0.0001) and predominantly men (83.5% versus 57.1%, P < 0.0001) with fewer comorbidities (42.6% versus 64.6%, P < 0.0001). Occupational injury was three times as likely in undocumented immigrants (13.6% versus 4.6%, P < 0.0001) and these patients were nearly twice as likely to be harmed from violence (19.9% versus 10.2%, P = 0.0003). Increased rates of injury during bicycle/motorcycle accidents (8.0% versus 3.0%, P = 0.0017) or being struck as a pedestrian (21.6% versus 14.3%, P = 0.0149) were found in the undocumented cohort, with falls (39.8% versus 59.3%, P < 0.0001) or vehicle collisions (0.6% versus 3.5%, P = 0.0402).

Conclusions:

Undocumented patients with upper extremity trauma represent a younger/healthier cohort, but are more likely to be injured at work or by violence. Documentation status plays a role in injury characteristics.
Calcinosis Cutis of the Nasal Dorsum
Authors: Marsh Henry R. , Miyake Bradley A. , Alamiri Nasser N. , Mims Mark M.
Published: February 2022

Calcinosis cutis is a common dermatological problem in patients with systemic sclerosis, dermatomyositis, and systemic lupus erythematous; however, it is rare to occur outside of these diseases. It represents a multidisciplinary problem that involves primary care physicians, dermatologists, and surgeons. The pathophysiology is defined by deposition of calcium salts in the subcutaneous tissue as hydroxyapatite, but the underlying mechanism has yet to be determined. The most common locations of lesions are the scalp, scrotum, extremities, and joints. Rarely does calcinosis cutis occur on the face. We present a unique case of idiopathic calcinosis cutis that occurred in a healthy patient with normal serum calcium and phosphate levels on the nasal dorsum, which was managed surgically. The histology of the calcinosis showed normal morphology, dominated by large deposits of calcium and normal surrounding tissues. This case represents a rare but clinically relevant presentation of idiopathic calcinosis cutis in an otherwise healthy individual.
The Effect of Hypothyroidism on Surgical Outcomes Postabdominoplasty: A Case-control Study
Authors: ElAbd Rawan , Alhallabi Becher , AlSabah Salman , Burezq Hisham
Published: February 2022

Background:

Hypothyroidism is common in surgical patients. The objective of this study is to determine the rate of short- and long-term complications after abdominoplasty for patients treated for hypothyroidism.

Methods:

This is a retrospective chart review that enrolled consecutive patients undergoing abdominoplasty across a 5-year period. Cases had a preoperative diagnosis of overt hypothyroidism requiring thyroid replacement therapy, whereas controls are without thyroid disease. Groups were matched by age, gender, comorbidity status (hypertension and diabetes), smoking, and center of surgery in a 3:1 ratio.

Results:

There was a total of 61 cases and 183 matched controls followed up for 18 months; most were women (n = 240, 98%) and between the ages of 31 and 45 years (n = 142, 58%). There were no significant differences between cases and controls in any of the sociodemographic and comorbidity status except for current BMI, which was higher for cases than the control (P < 0.05). The proportions of all other infections (4.5% versus 1.6%), wound dehiscence (4.7% versus 0.8%), dermatitis (4.7% versus 1.6%), and necrosis (2.3% versus 0%), hematoma (4.7% versus 2.5%) and seroma (2.3% versus 1.6%) formation were higher in cases but not significant (P > 0.05). LTCs were not statistically different across groups (P > 0.05).

Conclusion:

This study did not find a significantly different higher risk of complications after abdominoplasty for patients treated for hypothyroidism.
Restricted dietary pattern may contribute to lowering blood pressure in adolescents with obesity: Study of Cardiovascular Risk in Adolescents
Authors: Neves Morgana E.A. , Souza Marielly R. , Gorgulho Bartira M. , Pereira Rosangela A. , Cunha Diana B. , Souza Amanda M. , Muraro Ana Paula , Ferreira Márcia G. , Rodrigues Paulo R.M.
Published: February 2022

Objective:

Dieting is one of the main target factors for interventions that seek to control and prevent rising blood pressure. This study identified dietary patterns and analyzed their association with adolescents’ blood pressure.

Methods:

This is a cross-sectional study with a probabilistic and nationally representative sample of adolescents aged 12–17 years, who participated in the Study of Cardiovascular Risk in Adolescents (ERICA), carried out in 2013–2014 with Brazilian adolescents (N = 36 956). Food consumption was assessed by 24 h recall. Dietary patterns were identified using the Reduced Rank Regression method, and considering waist circumference, fasting insulin, and dietary polyunsaturated fat/saturated fat ratio as intermediate variables. Multiple linear regression models stratified by weight were developed; SBP and DBP were the dependent variables, and dietary pattern scores were the independent ones, with adjustment for potential confounding factors.

Results:

The following patterns were identified: ‘Brazilian common’, ‘Restricted’ and ‘Added sugar’. The ‘Restricted’ pattern, which included diet/light foods, chicken and chicken-based dishes, leafy greens, vegetables and spices, red meats and dishes based on red meats and tubers, was inversely associated with SBP (β = −1.55; 95% CI = −2.26 to −0.83) and DBP (β = −1.19; 95% CI = −1.70 to −0.68) in adolescents with obesity.

Conclusion:

In adolescents with obesity, a low-energy density diet was associated with reduced blood pressure. These findings are consistent with international recommendations for preventing elevated blood pressure.
MULTIMODAL ASSESSMENTS OF DRUSENOID PIGMENT EPITHELIAL DETACHMENTS IN THE AGE-RELATED EYE DISEASE STUDY 2 ANCILLARY SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY STUDY COHORT
Authors: Thavikulwat Alisa T. , De Silva Tharindu , Agrón Elvira , Keenan Tiarnan D. L. , Toth Cynthia A. , Chew Emily Y. , Cukras Catherine A. ,   for the Age-Related Eye Disease Study 2 Ancillary Spectral Domain Optical Coherence Tomography Study Group
Published: February 2022

Purpose:

To identify features correlating with drusenoid pigment epithelial detachment (DPED) progression in the Age-Related Eye Disease Study 2 Ancillary spectral-domain optical coherence tomography study cohort.

Methods:

In this retrospective analysis of a prospective longitudinal study, eyes with intermediate age-related macular degeneration and DPEDs were followed longitudinally with annual multimodal imaging.

Results:

Thirty-one eyes of 25 participants (mean age 72.6 years) in the Age-Related Eye Disease Study 2 Ancillary spectral-domain OCT substudy (A2A study) had DPED identified in color fundus images. Spectral-domain optical coherence tomography inspection confirmed a subretinal pigment epithelium drusenoid elevation of ≥433 µm diameter in 25 eyes (80.6%). Twenty-four of these eyes were followed longitudinally (median 4.0 years), during which 7 eyes (29.2%) underwent DPED collapse (with 3/7 further progressing to geographic atrophy), 6 (25.0%) developing neovascular age-related macular degeneration, and 11 (45.8%) maintaining DPED persistence without late age-related macular degeneration. On Kaplan–Meier analysis, mean time to DPED collapse was 3.9 years. Both DPED collapse and progression to neovascular age-related macular degeneration were preceded by the presence of hyperreflective foci over the DPED.

Conclusion:

The natural history of DPED comprises collapse (sometimes followed by the development of atrophy), vascularization followed by exudation, or DPED persistence. Spectral-domain optical coherence tomography can confirm retinal pigment epithelial elevation caused by drusenoid accumulation and facilitate the identification of high-risk features that correlate with progression.
INFLUENCE OF HIGH MYOPIA ON CHORIOCAPILLARIS PERFUSION AND CHOROIDAL THICKNESS IN DIABETIC PATIENTS WITHOUT DIABETIC RETINOPATHY
Authors: Xiong Kun , Wang Wei , Gong Xia , Ji Yuying , Guo Xiao , Yuan Meng , Li Wangting , Liang Xiaoling , Huang Wenyong , Wen Feng
Published: February 2022

Purpose:

To investigate the impact of high myopia on choriocapillaris perfusion and choroidal thickness (CT) in diabetic patients without diabetic retinopathy.

Methods:

Healthy subjects and patients with diabetes mellitus were recruited from communities in Guangzhou. They were divided into four groups according to the presence of diabetes and high myopia: healthy control (n = 77), diabetes (n = 77), high myopia (n = 77), and diabetes with high myopia (n = 77). Swept-source optical coherence tomography angiography (SS-OCTA) measured choriocapillaris perfusion and CT. Choriocapillaris perfusion was quantified using the choriocapillaris perfusion index (CPI).

Results:

A total of 308 subjects (308 eyes) were included in the study. The average CPI was 91.11 ± 0.84, 90.16 ± 1.46, 89.80 ± 1.42, and 89.36 ± 1.19% in the control, diabetes, high myopia, and diabetes with high myopia groups, respectively (P < 0.001); the average CT was 227.55 ± 43.13, 205.70 ± 59.66, 158.38 ± 45.24, and 144.22 ± 45.12 µm, respectively (P < 0.001). After adjusting for age and sex, the average CPI decreased 0.95 ± 0.20% (P < 0.001) in the diabetes group, 1.33 ± 0.20% (P < 0.001) in the high myopia group, and 1.76 ± 0.20% (P < 0.001) in the diabetes with high myopia group relative to the control group; the average CT decreased 23.53 ± 8.12 (P = 0.004), 70.73 ± 9.41 (P < 0.001), and 85.90 ± 8.12 µm (P < 0.001), respectively. Further adjustment for other risk factors yielded a similar result.

Conclusion:

Diabetes and high myopia significantly affect CPI and CT, and the presence of both conditions is more damaging to CPI and CT than diabetes or high myopia alone.
Intraoperative Perfluorocarbon Liquid Tamponade Technique for Treatment of Extensive Retinal Detachment Secondary to a Myopic Macular Hole
Authors: Lyu Jiao , Xia Fengjie , Zhao Peiquan
Published: February 2022

Background/Purpose:

To report an intraoperative perfluorocarbon liquid (PFCL) tamponade technique in treating extensive retinal detachment secondary to a myopic macular hole (MH) through pars plana vitrectomy.

Methods:

The technique was applied in nine eyes with MH-RD extending two quadrants or more areas. The procedures for pars plana vitrectomy included: 1). thorough drainage of subretinal fluid through the MH with fluid–air exchange; 2). PFCL tamponade on the macular area for more than 10 minutes; and 3). repairing the MH after PFCL was removed.

Results:

All nine eyes gained intraoperative retinal reattachment after PFCL tamponade for 22.22 ± 8.01 minutes and removal of PFCL. Procedures for MH closure included internal limiting membrane peeling in eight eyes, with internal limiting membrane free flap insertion (four eyes), internal limiting membrane inverted flap insertion (two eyes), or lens capsular flap transplantation (three eyes). All eyes received C3F8 tamponade. During 9.11 ± 3.89 months of follow-up, eight of the nine eyes (89%) achieved retinal reattachment and MH closure; one eye achieved anatomical success after reoperations. All eyes had vision improvement at the last follow-up.

Conclusion:

This new technique in pars plana vitrectomy may promote anatomical and functional recovery in the treatment of extensive retinal detachment secondary to a myopic MH.
Modified Trisection Technique: One-Trip Explantation for Foldable Intraocular Lens
Authors: Ye Hongfei , Zhang Shiguang , Cao Liang , Feng Yanqing , Lyu Jiao , Peng Jie , Xu Yu , Chen Jili , Zhao Peiquan
Published: February 2022

Purpose:

We present a new technique that allows an intraocular lens to be explanted through the small incisions used in modern cataract surgery.

Methods and Results:

The intraocular lens optic is cut into three connected pieces at the 1-mm-wide end with scissors. Then, with the stabilizing counterforce provided by a pair of vitreoretinal forceps through a paracentesis, the middle piece is removed first, followed by the two side pieces connected with haptics flipped over at the connected part. These two parts overlap each other when passing through the incision, eventually resulting in the explantation of the intraocular lens, as an intact piece.

Conclusion:

We believe this method provides a simple and effective way to remove intraocular lens through very small incisions, which could also reduce complications and hasten patient's recovery.
THE NOVEL USE OF HIGH-FLOW POLYIMIDE CANNULAS TO IMPROVE SILICONE OIL INJECTABILITY IN VITREORETINAL SURGERY
Authors: Hammer Maximilian , Schickhardt Sonja K. , Munro Donald , Khoramnia Ramin , Scheuerle Alexander , Mayer Christian S. , Auffarth Gerd U.
Published: February 2022

Purpose:

The injection of high-viscosity silicone oil lengthens injection time. New polyimide cannulas offer a greater inner diameter than conventional metal cannulas at the same gauge. We compared the injection time for polyimide and metal cannulas at 23 G for a variety of silicone oils including a 12,500-mPas prototype oil.

Methods:

In this laboratory study, injection time was measured three times per cannula and per oil. Warming the oil before injection to up to 42°C was also evaluated. Finally, the feasibility of polyimide cannulas was tested in vitrectomized porcine eyes.

Results:

The 23-G polyimide cannula mostly decreased injection times. The time to inject 5 mL of Siluron Xtra and Siluron 5000 decreased by 6:02 (76.9%) minutes (483 vs. 121 seconds) and 12:01 (74.7%) minutes (973 vs. 252 seconds), respectively. Although the 23-G metal cannula failed to inject 12,500 mPas oil, 5 mL was injected in 10:21 minutes using the polyimide cannula. Prewarming Siluron 5000 to 42°C lowered the injection time by 9.0% and by 12.1% when using the metal or polyimide cannula, respectively.

Conclusion:

Polyimide cannulas allow a clinically relevant decrease in injection time. They may not only shorten surgery time but could also ease the use of next-generation ultra-high-viscosity silicone oils. Prewarming silicone oil leads to decreased injection times.
FACTORS AFFECTING RETINAL REDETACHMENT AFTER SILICONE OIL REMOVAL FOR RHEGMATOGENOUS RETINAL DETACHMENTS
Authors: Huang Denis , Starr Matthew R. , Patel Luv G. , Ammar Michael J. , Kaiser Richard S. , Mehta Sonia , Park Carl H. , Khan Mohammed Ali , Gupta Omesh P. , Kuriyan Ajay E. , Yonekawa Yoshihiro , Ho Allen C. , Garg Sunir J. , Cohen Michael N. , Hsu Jason
Published: February 2022

Purpose:

To report factors affecting the retinal redetachment rate after silicone oil removal (SOR) following rhegmatogenous retinal detachment (RRD) repair.

Methods:

Retrospective cohort study from December 1, 2014, to March 1, 2020, of 205 consecutive patients treated for RRD with silicone oil (SO) tamponade and subsequent SOR with at least 6-month follow-up. Primary outcome measure was the rate of retinal redetachment after SOR.

Results:

The retinal redetachment rate after SOR was 18.5%. Preoperative macula and lens status, proliferative vitreoretinopathy, previous retinectomy, retinal detachment size, concomitant phacoemulsification, previous scleral buckling, and endolaser during SOR did not affect the redetachment rate after SOR. Previous SO exchange was associated with increased redetachment (OR 2.53, 95% CI [1.11–5.80], P = 0.0278). Twelve months of SO tamponade had lower redetachment rates compared with 3 months (OR 0.25, 95% CI [0.04–0.09], P = 0.048). Shorter SO tamponade (3 vs. 12 months) had better final visual outcomes after SOR (0.80 ± 0.61 vs. 1.41 ± 0.66, P < 0.0001).

Conclusion:

No preoperative or intraoperative factors in this analysis influenced the risk of redetachment after SOR except duration of SO tamponade and previous SO exchange. Although longer SO tamponade duration may be associated with lower rates of redetachment, visual outcomes may be worse.
Collaborating to Integrate Education and Practice: A Model of a Physical Therapy Academic–Clinical Partnership
Authors: Taylor Sally M. , McMenamin Peter J. , Hilliard Marjorie Johnson
Published: February 2022

Background and Purpose.

Strong academic–clinical partnerships have been advocated to optimize the training of the next generation of health professionals and to best meet the needs of patients and society. Despite the benefits of partnerships, there is a lack of literature describing successful models for collaboration between physical therapist (PT) schools and academic medical center hospitals. The purpose of this article was to describe the formal partnership between the Northwestern University, Feinberg School of Medicine, Department of Physical Therapy and Human Movement Sciences (DPTHMS) and Shirley Ryan AbilityLab in Chicago, Illinois.

Method/Model Description and Evaluation.

The partnership is presented through the lens of D'Amour's 4-dimensional model of collaboration highlighting 4 critical dimensions of collaboration: shared goals and activities, internalization, formalization, and governance.

Outcomes.

The establishment of this partnership has fostered the institutions' achievement of mutual goals supporting their interconnected visions and missions. Examples of the collaboration's shared goal and activities include: the tripling of clinical education experiences for professional Doctor of Physical Therapy (DPT) students; establishment of 2 post professional PT residency programs; proliferation of DPT teaching opportunities for Shirley Ryan AbiltyLab clinical PTs with formal university academic appointments for 6 Shirley Ryan Ability Lab PTs; and clinical appointments for 7 of 34 eligible DPTHMS faculty members. The internalization dimension is evidenced by regularly scheduled communications; promotion of opportunities for mutual acquaintanceship through shared boards and teams; socialization opportunities; and trust-building across institutions. The primary example of formalization is the legal collaboration agreement signed in 2013 and amended in 2019. Partnership governance is achieved through a structure of designated liaisons, shared boards, and regular interinstitutional leadership meetings.

Discussion and Conclusion.

D'Amour's structuration model describes predictors for successful interinstitutional clinical–academic partnerships. The model's 4 collaboration dimensions facilitate the assessment of partnership success for both established partnerships and for institutions in the planning stage of such collaborations.