bluuebunny/crossref_metadata_2025 huggingface dataset:
Major Revisions in Pancrustacean Phylogeny and Evidence of Sensitivity to Taxon Sampling
Authors: Bernot James P , Owen Christopher L , Wolfe Joanna M , Meland Kenneth , Olesen Jørgen , Crandall Keith A
Published: August 2023

The clade Pancrustacea, comprising crustaceans and hexapods, is the most diverse group of animals on earth, containing over 80% of animal species and half of animal biomass. It has been the subject of several recent phylogenomic analyses, yet relationships within Pancrustacea show a notable lack of stability. Here, the phylogeny is estimated with expanded taxon sampling, particularly of malacostracans. We show small changes in taxon sampling have large impacts on phylogenetic estimation. By analyzing identical orthologs between two slightly different taxon sets, we show that the differences in the resulting topologies are due primarily to the effects of taxon sampling on the phylogenetic reconstruction method. We compare trees resulting from our phylogenomic analyses with those from the literature to explore the large tree space of pancrustacean phylogenetic hypotheses and find that statistical topology tests reject the previously published trees in favor of the maximum likelihood trees produced here. Our results reject several clades including Caridoida, Eucarida, Multicrustacea, Vericrustacea, and Syncarida. Notably, we find Copepoda nested within Allotriocarida with high support and recover a novel relationship between decapods, euphausiids, and syncarids that we refer to as the Syneucarida. With denser taxon sampling, we find Stomatopoda sister to this latter clade, which we collectively name Stomatocarida, dividing Malacostraca into three clades: Leptostraca, Peracarida, and Stomatocarida. A new Bayesian divergence time estimation is conducted using 13 vetted fossils. We review our results in the context of other pancrustacean phylogenetic hypotheses and highlight 15 key taxa to sample in future studies.
On the non-uniqueness problem in integrated information theory
Authors: Hanson Jake R , Walker Sara I
Published: August 2023

Integrated Information Theory (IIT) 3.0 is among the leading theories of consciousness in contemporary neuroscience. The core of the theory relies on the calculation of a scalar mathematical measure of consciousness, Φ, which is inspired by the phenomenological axioms of the theory. Here, we show that despite its widespread application, Φ is not a well-defined mathematical concept in the sense that the value it specifies is non-unique. To demonstrate this, we introduce an algorithm that calculates all possible Φ values for a given system in strict accordance with the mathematical definition from the theory. We show that, to date, all published Φ values under consideration are selected arbitrarily from a multitude of equally valid alternatives. Crucially, both $\Phi=0$ and $\Phi\gt0$ are often predicted simultaneously, rendering any interpretation of these systems as conscious or not, non-decidable in the current formulation of IIT.
The impact of gut microbiome-targeted therapy on liver enzymes in patients with nonalcoholic fatty liver disease: an umbrella meta-analysis
Authors: Amini-Salehi Ehsan , Hassanipour Soheil , Keivanlou Mohammad-Hossein , Shahdkar Milad , Orang Goorabzarmakhi Mahdi , Vakilpour Azin , Joukar Farahnaz , Hashemi Mohammad , Sattari Nazila , Javid Mohammadreza , Mansour-Ghanaei Fariborz
Published: August 2023

Context

Nonalcoholic fatty liver disease (NAFLD) is considered the leading cause of chronic liver disease worldwide. To date, no confirmed medication is available for the treatment of NAFLD. Previous studies showed the promising effects of gut microbiome–targeted therapies; however, the results were controversial and the strength of the evidence and their clinical significance remained unclear.

Objectives

This umbrella study summarizes the results of meta-analyses investigating the effects of probiotics, prebiotics, and synbiotics on liver enzymes in the NAFLD population.

Data Source

A comprehensive search of the PubMed, Scopus, Web of Science, and Cochrane Library databases was done up to December 20, 2022, to find meta-analyses on randomized control trials reporting the effects of gut microbial therapy on patients with NAFLD.

Data Extraction

Two independent investigators extracted data on the characteristics of meta-analyses, and any discrepancies were resolved by a third researcher. The AMSTAR2 checklist was used for evaluating the quality of studies.

Data Analysis

A final total of 15 studies were included in the analysis. Results showed that microbiome-targeted therapies could significantly reduce levels of alanine aminotransferase (ALT; effect size [ES], −10.21; 95% confidence interval [CI], −13.29, −7.14; P < 0.001), aspartate aminotransferase (AST; ES, −8.86; 95%CI, −11.39, −6.32; P < 0.001), and γ-glutamyltransferase (ES, −5.56; 95%CI, −7.92, −3.31; P < 0.001) in patients with NAFLD. Results of subgroup analysis based on intervention showed probiotics could significantly reduce levels of AST (ES, −8.69; 95%CI, −11.01, −6.37; P < 0.001) and ALT (ES, −9.82; 95%CI, −11.59, −8.05; P < 0.001). Synbiotics could significantly reduce levels of AST (ES, −11.40; 95%CI, −13.91, −8.88; P < 0.001) and ALT (ES, −11.87; 95%CI, −13.80, −9.95; P < 0.001). Prebiotics had no significant effects on AST and ALT levels (ES, −2.96; 95%CI, −8.12, 2.18, P = 0.259; and ES, −4.69; 95%CI, −13.53, 4.15, P = 0.299, respectively).

Conclusion

Gut microbiome–targeted therapies could be a promising therapeutic approach in the improvement of hepatic damage in patients with NAFLD. However, more studies are needed to better determine the best bacterial strains, duration of treatment, and optimum dosage of gut microbiome–targeted therapies in the treatment of the NAFLD population.

Systematic Review Registration

PROSPERO registration no. CRD42022346998.
The role of zinc on nutritional status, sarcopenia, and frailty in older adults: a scoping review
Authors: Abeywickrama Hansani Madushika , Uchiyama Mieko , Sumiyoshi Tomoko , Okuda Akiko , Koyama Yu
Published: August 2023

Background

Zinc (Zn) deficiency, malnutrition, sarcopenia, and frailty are prevalent among older adults and are prominent factors contributing to disability and mortality.

Objective

This scoping review was conducted to aid understanding of the extent and types of research addressing the role of Zn in nutritional status, sarcopenia, and frailty, among older individuals.

Method

A systematic search was performed in August 2022 of 3 electronic databases (PubMed, Web of Science, and ProQuest) using predefined search terms. The review was conducted referring to the Arksey and O’Malley framework and PRISMA-ScR.

Results

The search retrieved 16 018 records, and a total of 49 studies were included in this review after the screening. Of those, 30 were based on dietary Zn intake, 18 on tissue Zn levels, and 1 on both. Most studies were based on cross-sectional data from community-dwelling older adults. Studies addressing the associations between Zn status and individual anthropometric and sarcopenia-related variables reported inconsistent results. However, most studies reported inverse associations between malnutrition, frailty, and Zn status.

Conclusion

There was more consistent evidence of the relationship of Zn status with malnutrition, sarcopenia, and frailty rather than with individual nutritional parameters. Validated screening and assessment tools and criteria and prospective studies are required to elucidate the relationship of Zn with sarcopenia and frailty in the older population.
Plant foods, healthy plant-based diets, and type 2 diabetes: a review of the evidence
Authors: del Carmen Fernández-Fígares Jiménez Mariana
Published: August 2023

Type 2 diabetes (T2D) is a metabolic chronic disease in which insulin resistance and insufficient insulin production lead to elevated blood glucose levels. The prevalence of T2D is growing worldwide, mainly due to obesity and the adoption of Western diets. Replacing animal foods with healthy plant foods is associated with a lower risk of T2D in prospective studies. In randomized controlled trials, the consumption of healthy plant foods in place of animal foods led to cardiometabolic improvements in patients with T2D or who were at high risk of the disease. Dietary patterns that limit or exclude animal foods and focus on healthy plant foods (eg, fruits, vegetables, whole grains, nuts, legumes), known as healthy, plant-based diets, are consistently associated with a lower risk of T2D in cohort studies. The aim of this review is to examine the differential effects of plant foods and animal foods on T2D risk and to describe the existing literature about the role of healthy, plant-based diets, particularly healthy vegan diets, in T2D prevention and management. The evidence from cohort studies and randomized controlled trials will be reported, in addition to the potential biological mechanisms that seem to be involved.
Comparison of Tocilizumab vs Baricitinib in Clinical Outcomes Among Hospitalized Patients With COVID-19: Experience From a Public Hospital System in New York City
Authors: Sunny Subin , Tran Ami , Lee Jennifer , Abdallah Marie , Chaudhry Nimra , Quale John
Published: August 2023

Background

Tocilizumab and baricitinib are immunomodulators that have been repurposed for the treatment of coronavirus disease 2019 (COVID-19). Whether one medication should be preferred over the other has not been established.

Methods

This multicenter retrospective cohort study comprised hospitalized patients with COVID-19 who received either tocilizumab or baricitinib. The primary outcome was improvement in respiratory status (at least 1-point reduction on the respiratory ordinal scale) at day 7 and up to day 28. Secondary outcomes included mortality, disposition, deep vein thrombosis, pulmonary embolism, or positive blood culture. Outcomes were stratified by baseline respiratory status and variant-predominating periods. Results were reported for the overall and propensity-matched cohorts.

Results

A total of 921 patients received tocilizumab and 638 received baricitinib. The propensity-matched cohort included 597 patients in each group. At day 7 in the overall and propensity-matched cohorts, significantly more patients had improvement in respiratory status in the baricitinib group. These improvements were seen in patients requiring supplemental oxygen and noninvasive ventilation/high-flow oxygen but not in patients requiring mechanical ventilation. Favorable outcomes with baricitinib were observed during the Alpha and Omicron periods. By day 28, there were no differences in the changes of respiratory status for the treatment groups in either cohort. Also, no differences were seen in mortality, disposition, development of deep vein thrombosis/pulmonary embolism, or bloodstream infections.

Conclusions

Baricitinib treatment was associated with more favorable respiratory improvement at day 7 when compared with tocilizumab, but no differences were observed up to day 28.
Effects of therapeutic exercise in primary dysmenorrhea: an umbrella and mapping review
Authors: Fuentes-Aparicio Laura , Cuenca-Martínez Ferran , Muñoz-Gómez Elena , Mollà-Casanova Sara , Aguilar-Rodríguez Marta , Sempere-Rubio Núria
Published: August 2023

Purpose

Primary dysmenorrhea (PD) is 1 of the most prevalent gynecologic conditions. The main aim of this umbrella review was to assess the effects of therapeutic exercise (TE) on PD.

Methods

A systematic search was carried out in PubMed, Embase, SPORTDiscus, CINAHL, and PEDro (December 10, 2022). The outcome measures assessed were menstrual pain intensity, menstrual pain duration, and quality of life. Methodological quality was analyzed using the AMSTAR and ROBIS scales, and the strength of evidence was established according to the advisory committee grading criteria guidelines.

Results

Nine systematic reviews were included. The results showed that TE, regardless of the exercise model and intensity, has a clinical effect in improving menstrual pain intensity in women with PD with moderate quality of evidence. In addition, the results showed that TE has a clinical effect in improving the duration of menstrual pain in women with PD with a limited quality of evidence. However, the results are controversial on the improvement of quality of life in women with PD with a limited quality of evidence.

Conclusions

TE seems an effective option to implement in women with PD to improve the intensity and duration of menstrual pain. We cannot draw robust results for quality of life due to the low number of primary studies. More research in this field can help us establish more robust conclusions, as well as to assess whether there is one exercise model or intensity of training that is more effective than others.

PROSPERO number: This review was previously registered in PROSPERO (CRD42022371428).
The central helicase domain holds the major conformational epitopes of melanoma differentiation–associated gene 5 autoantibodies
Authors: Mo Yongxin , Ye Yan , Peng Lisheng , Sun Xiaobo , Zhong Xiaofen , Wu Rui
Published: August 2023

Objective

Autoantibodies against MDA5 (melanoma differentiation-associated protein 5) serve as a biomarker for DM (dermatomyositis) and indicate a risk factor for interstitial lung disease (ILD). MDA5 is a protein responsible for sensing RNA virus infection and activating signalling pathways against it. However, little is known about the antigen epitopes on MDA5 autoantibodies. We aimed to determine the interaction of the MDA5 autoantibody–antigen epitope.

Methods

Cell-based assays (CBAs), immunoprecipitation-immunoblot assays, and various immunoblotting techniques were used in the study.

Results

We demonstrated that DM patient autoantibodies recognize MDA5 epitopes in a native conformation–dependent manner. Furthermore, we identified the central helicase domain （3Hel） formed by Hel1, Hel2i, Hel2, and pincer as the major epitopes. As proof of principle, the purified 3Hel efficiently absorbed MDA5 autoantibodies from patient sera through immunoprecipitation-immunoblot assay.

Conclusion

Our study uncovered the nature of the antigen epitopes on MDA5 and can provide guidance for diagnosis and a targeted therapeutic approach development.
Competing Priorities? Testing Multiple Mechanisms That Connect Adolescent Religiosity to Marriage in Young Adulthood
Authors: Hayward George M , Gilliland Claire Chipman , Denton Melinda
Published: August 2023

Religion and family remain tightly linked institutions, but the increasingly varied period of emerging adulthood, which includes delays in marriage transition and reduced religiosity overall, calls for additional research into this relationship. Religious involvement continues to be associated with earlier age at first marriage, for example, but the specific mechanisms responsible for this connection are often only implied or untested. Accordingly, we build on prior literature and hypothesize about three mechanisms that could explain the link between adolescent religiosity and marriage transition in young adulthood: the importance of completing milestone goals prior to marriage, such as completing one’s education and establishing a career, the importance of cohabitation before marriage, and the ideal age of marriage. We use longitudinal data from the National Study of Youth and Religion to investigate each of these mechanisms for a recent cohort of young adults. Using structural equation modeling and measures for adolescent religious attendance, importance, and affiliation, we find that adolescent religiosity is related to the marriage transition primarily through the mechanism of cohabitation. Specifically, religious attendance and importance in adolescence are associated with less support for cohabitation, which in turn is associated with a higher likelihood of marriage transition during young adulthood. Findings for religious affiliation were not as consistent. In the context of demographic shifts in marriage patterns and religious involvement, these analyses provide an important illustration of how these social institutions are still connected.
Analyses of Multilocus Sequences and Morphological Features Reveal Ilyonectria Species Associated with Black Rot Disease of Gastrodia elata
Authors: Qiao Min , Jing Tingting , Wan Yake , Yu Zefen
Published: August 2023

Black rot is a common disease of Gastrodia elata, causing serious threats to G. elata production. In this study, a total of 17 Cylindrocarpon-like strains were isolated from G. elata black rot tissues. Multilocus sequence analyses based on ITS, HIS, TEF, and TUB combined with morphological characterizations were performed to identify six Ilyonectria species, including four new species, Ilyonectria longispora, I. sinensis, I. xiaocaobaensis, and I. yunnanensis, and two known species, I. changbaiensis and I. robusta. The pathogenicity of 11 isolates comprising type strains of the four new species and representative isolates from each of the six species was tested on healthy tissues of G. elata. All isolates were pathogenic to G. elata tissues, and symptoms were identical to black rot disease, confirming that our isolates were the causal agents of black rot disease of G. elata.
Identification of Gonatophragmium mori Causing Mulberry Zonate Leaf Spot Disease and Characterization of Their Biological Enemies in Guangxi, China
Authors: Luo Longhui , Zhang Xingnan , Wu Xiaomei , Liu Weifu , Liu Jiping
Published: August 2023

Mulberry zonate leaf spot disease (MZLSD) is an important fungal disease of mulberry trees, which seriously affects the productivity and quality of mulberry leaves. MZLSD has been widely reported in sericultural production areas in Guangxi, China, in recent years. In this study, the causal agent of MZLSD was isolated from symptomatic samples and identified as Gonatophragmium mori (Acrospermaceae) based on morphological characterization and molecular analyses using nucleotide sequences of the internal transcribed spacer (ITS) and large subunit ribosomal DNA (LSU rDNA). Pathogenicity tests confirmed that G. mori is the pathogen responsible for MZLSD. Furthermore, we isolated antagonistic endophytic bacteria (AEB) from healthy mulberry leaves. Plate confrontation experiments showed that the lipopeptide crude extracts (LPCE) of three endophytic bacteria can inhibit the growth of G. mori, and the diameter of the antibacterial circle reaches more than 60 mm when their concentration of LPCE is 200 mg/ml. Light microscopy and scanning electron microscopy revealed that LPCE caused drastic changes in mycelial morphology. Fluorescence microscopy and transmission electron microscopy showed that the LPCE-induced apoptosis-like cell death in G. mori hyphae. Finally, based on morphological and molecular features, we identified the three isolates as Bacillus subtilis DS07, B. subtilis DS32, and B. velezensis Q6, respectively. To our knowledge, this is the first time to identify G. mori by combining characterization and molecular analyses, and we provide timely information about the use of biocontrol agents for suppression of G. mori.
Evaluating the Readability and Quality of Online Patient Education Materials for Pediatric ACL Tears
Authors: Thomas Nicholas D. , Mahler Raegan , Rohde Matthew , Segovia Nicole , Shea Kevin G.
Published: August 2023

Background:

As the rate of anterior cruciate ligament (ACL) tears increases in children, the internet has become a major source of information and education. In the United States, the average adult reads at about an eighth grade level. The National Institutes of Health recommends that patient education materials do not exceed a sixth-grade reading level. Therefore, the most accessed resources on the internet should be created with this in mind. The purpose of this study is to assess the readability and quality of online patient resources for pediatric ACL tears.

Methods:

Google was queried using the term “Pediatric ACL Tear” on May 26, 2022. The most popular sites were identified through page one of a Google search. All content was evaluated to assure information was directed toward patients. To determine reading difficulty, the most widely accepted readability tests: Flesch Reading Ease Index, Flesch-Kincaid Grade Level, and Gunning Fog Index were calculated through plain text in Microsoft Word and URL in online readability checker Readable.io.

Results:

The average grade level for all resources was above the recommended reading level based on both Microsoft Word and Readable.io calculations. Each source exceeded the NIH recommendation by 2.6 grade levels on average (Mean grade level readability was 8.6 ± 1.9). Four of the 6 sites were above the average US reading level, exceeding the eighth grade by an average of 1.5 grade levels. All 6 sites analyzed had a mean DISCERN score of 61.9, meeting the ‘good quality’ criteria.

Conclusion:

The most readily available online materials for Pediatric ACL tears were of ‘good quality’ but above both the NIH-recommended readability level and the average US adult reading level. With the increasing need for treatment of ACL tears in pediatric and adolescent patients and greater internet accessibility in these populations, it is important to consider the readability of these resources in support of increased health literacy and improved outcomes.

Clinical Relevance:

It is important for physicians treating young patients with ACL tears to be aware of all sources of information and support, including content shared online as these platforms are increasingly utilized, especially by patients and families of lower socioeconomic status.
Circulating tumor DNA in breast cancer: a biomarker for patient selection
Authors: Agostinetto Elisa , Nader-Marta Guilherme , Ignatiadis Michail
Published: August 2023

Purpose of review

This review aims to explore the role of circulating tumor DNA (ctDNA) as a biomarker for patient selection in breast cancer. We describe the current evidence and the main ongoing trials both in the early and metastatic setting.

Recent findings

In the metastatic setting, the analysis of ctDNA can identify specific genetic alterations amenable of molecularly targeted treatments. Several assays are now approved for the detection of genetic alterations in plasma cell-free DNA to guide treatment decision (e.g., PIK3CA mutations for PI3K inhibitors, and ESR1 mutations for the selective estrogen receptor degrader elacestrant). In the early setting, emerging evidence is demonstrating that ctDNA can identify a disease relapse with a lead-time of approximately 10 months before imaging. This could help select patients who may benefit from escalation treatment strategy, although this hypothesis needs to be first prospectively validated.

Liquid biopsy for ctDNA detection represents an exciting new field in rapid evolution. Several trials are ongoing to validate the clinical utility of ctDNA in daily practice in the early setting and to expand its current indications in the metastatic one.
Early Sleep Differences in Young Infants with Autism Spectrum Disorder
Authors: Foster Miranda , Federico Alexis , Klaiman Cheryl , Bradshaw Jessica
Published: August 2023

Objective:

Children with autism spectrum disorder (ASD) experience greater sleep challenges than their neurotypical peers, but sleep patterns for infants later diagnosed with ASD are unknown. This study examined differences in total sleep duration and proportion of sleep experienced at night within the first 6 months of life among infants later diagnosed with ASD, infants who demonstrated subclinical characteristics of ASD and were classified as exhibiting the broad autism phenotype (BAP), and their typically developing (TD) peers. In addition, associations between infant sleep variables and developmental outcomes at 24 months were explored.

Methods:

Participants included 79 infants enrolled in a prospective, longitudinal study of the early development of ASD. Between ages 1 week and 6 months, participants completed a monthly retrospective 24-hour sleep log. At 24 months, participants received a comprehensive diagnostic evaluation, including the Autism Diagnostic Observation Schedule-2 and Mullen Scales of Early Learning and Vineland-II and were clinically characterized as ASD, BAP, or TD.

Results:

When accounting for the influence of age, infants later diagnosed with ASD slept less within the 24-hour period than infants in TD or BAP groups from 0 to 6 months (p = 0.04). Percentage of sleep experienced during nighttime hours did not significantly differ between groups from 0 to 6 months (p = 0.25). Greater nighttime sleep percentage at 6 months predicted higher receptive language (p < 0.001) and fine motor scores (p < 0.0001) at 24 months. Total sleep duration at 6 months did not predict any developmental outcomes at 24 months.

Conclusion:

Findings suggest that differences in sleep may occur among autistic individuals earlier in life than previously documented and have cascading effects on development.
Feasibility of Implementing a Total Worker Health ® Intervention During the COVID-19 Pandemic in Small and Medium Businesses
Authors: McAden Emily P. , Leff Maija S. , Staley John A. , Greenberg Rosa W. , Nylander-French Leena A. , Linnan Laura A.
Published: August 2023

Objective

In response to the COVID-19 pandemic’s disruptive effect on employers and workers, an interdisciplinary team launched the Carolina Promoting Safe Practices for Employees’ Return study to assess the feasibility of providing tailored technical assistance to small and medium North Carolina businesses using a Total Worker Health (TWH)® approach.

Methods

Feasibility of the approach was assessed via surveys and interviews of business representatives from four participating businesses ranging in size from 3 to 110 employees.

Results

The TWH approach is feasible, that is, in demand, practical, and acceptable to protect and promote worker safety, health, and well-being. Potential challenges include implementation cost, difficulty engaging all employees, and difficulty accessing tailored health and safety materials in a timely manner.

Conclusions

Additional refinement and testing of the TWH approach postpandemic with more worksites is warranted.
Effectiveness of Internet-Based Cognitive Behavioral Therapy for Patients With Cancer
Authors: Yu Shuanghan , Liu Yantong , Cao Minglu , Tian Qi , Xu Mengmeng , Yu Lin , Yang Shu , Zhang Wei
Published: August 2023

Background

Internet-based cognitive behavioral therapy (ICBT) is a relatively new therapy with unknown effectiveness in patients with cancer. In addition, therapist-guided and self-guided ICBT patient-specific outcomes for cancer patients remain to be explored.

Objective

To explore the effects of ICBT on psychological outcomes, physical outcomes, and daily life outcomes in patients with cancer.

Methods

Electronic databases such as PubMed, Web of Science, Cochrane Library, EMBASE, APA PsycINFO, ProQuest, and ClinicalTrials.gov were searched for relevant studies published from their inception to October 2022. Five GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) considerations were used to assess the quality of relevant evidence. Data analysis was performed via RevMan 5.4 (The Cochrane Collaboration, London, United Kingdom) and Stata 15.0 (StataCorp, College Station, Texas).

Results

Three thousand two hundred forty-nine participants from 20 studies were included in the meta-analysis. Statistically significant effects of ICBT were found on psychological distress, quality of life (QOL), anxiety, and depression, after the intervention. A separate analysis of follow-up data showed that ICBT had a sustainable effect on psychological distress, anxiety, and depression. Subgroup analyses showed that therapist-guided ICBT was more effective for psychological distress and QOL.

Conclusion

Internet-based cognitive behavioral therapy can improve symptom management for patients with cancer.

Implications for Practice

Internet-based cognitive behavioral therapy effectively improves psychological distress, anxiety, and depression in patients with cancer after intervention and at follow-up. Internet-based cognitive behavioral therapy improved QOL for cancer patients postintervention but not during follow-up. Internet-based cognitive behavioral therapy did not relieve fatigue or fear of recurrence in cancer patients. Therapist-guided ICBT is recommended for its superior outcomes in alleviating psychological distress and improving overall QOL in adults with cancer when compared with self-guided ICBT.
Assessment of Cognitive and Mood Changes in Older Survivors of COVID-19
Authors: Ozdemir Cagla , Tastemur Mercan
Published: August 2023

The long-term effects of coronavirus disease 2019 (COVID-19) infection are not fully known. In this study, we aimed to evaluate cognitive function and mood changes with 1-year follow-up in the elderly after COVID-19 disease. Ninety COVID-19 survivors and 90 healthy controls were included in the study between April 2022 and 2023. The patients were evaluated at the 1st, 6th, and 12th months for cognition, depression, and sleep quality. Cognitive function is assessed by the Montreal Cognitive Assessment (MoCA), sleep quality by the Pittsburgh Sleep Quality Index, and depression by the Yesavage Geriatric Depression Scale. COVID-19 survivors secured lower scores in certain domains of the MoCA in comparison with the controls at the first and sixth months. However, at the 12th month, no difference was observed in total MoCA (p = 0.100), Yesavage Geriatric Depression Scale (p = 0.503), and Pittsburgh Sleep Quality Index (p = 0.907) between survivors and controls. Older patients who recovered from COVID-19 have lower cognitive function compared with controls up to 12 months. However, cognitive function scores were similar at the end of the first year except for memory scores.
Associations Between Cumulative Social Adversities and Substance Use Comorbidity in a Statewide Sample of Individuals in Treatment for Mental Illnesses
Authors: Compton Michael T. , Frimpong Eric Y. , Fu En , Ehntholt Amy , Chaudhry Sahil , Ferdousi Wahida , Rowan Grace A. , Swetnam Hannah , Radigan Marleen , Smith Thomas E. , Rotter Merrill
Published: August 2023

We sought to investigate associations of cumulative social adversities in four areas (low education, unemployment, homelessness, and criminal/legal involvement) with presence of comorbid alcohol and drug use disorders among individuals in treatment for mental illnesses. Using data from 103,416 adults in mental health treatment, generalized estimating equation modified Poisson models were used to estimate increased risk of having comorbid substance use disorders based on individual and/or cumulative number of social adversities present. Controlling for effects of sex, race/ethnicity, and region (New York City vs. the rest of the State), as well as for the other social adversities, each of four social adversities was associated with presence of substance use comorbidity. Relative to having none of the social adversities, the presence of one, two, three, or four was associated with an increased prevalence ratio (PR) of having substance use comorbidity: 1.44, 2.10, 2.66, and 2.92; all p's < 0.0001. PRs were greater among female patients, and among Hispanics and those classified as other or multiracial compared with non-Hispanic Whites or non-Hispanic Blacks. Findings indicate substantial associations between four social adversities and presence of substance use comorbidity; the strength of association with the four social adversities is cumulative.
Computed Tomography–Based Predictive Model for the Probability of Lymph Node Metastasis in Gastric Cancer: A Meta-analysis
Authors: Teng Fei , Fu Yu-Fei , Wu An-Le , Xian Yu-Tao , Lin Jia , Han Rui , Yin Yong-Fang
Published: August 2023

Objectives

Whether or not a gastric cancer (GC) patient exhibits lymph node metastasis (LNM) is critical to accurately guiding their treatment and prognostic evaluation, necessitating the ability to reliably predict preoperative LNM status. The present meta-analysis sought to examine the diagnostic value of computed tomography (CT)–based predictive models as a tool to gauge the preoperative LNM status of patients with GC.

Methods

Relevant articles were identified in the PubMed, Web of Science, and Wanfang databases. These studies were used to conduct pooled analyses examining sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) values, and area under the curve values were computed for summary receiver operating characteristic curves.

Results

The final meta-analysis incorporated data from 15 studies, all of which were conducted in China, enrolling 3,817 patients with GC (LNM+: 1790; LNM−: 2027). The developed CT-based predictive model exhibited respective pooled sensitivity, specificity, PLR, and NLR values of 84% (95% confidence interval [CI], 0.79–0.87), 81% (95% CI, 0.76–0.85), 4.39 (95% CI, 3.40–5.67), and 0.20 (95% CI, 0.16–0.26). The identified results were not associated with significant potential for publication bias (P = 0.071). Similarly, CT-based analyses of LN status exhibited respective pooled sensitivity, specificity, PLR, and NLR values of 62% (95% CI, 0.53–0.70), 77% (95% CI, 0.72–0.81), 2.71 (95% CI, 2.20–3.33), and 0.49 (95% CI, 0.40–0.61), with no significant risk of publication bias (P = 0.984).

Conclusions

Overall, the present meta-analysis revealed that a CT-based predictive model may outperform CT-based analyses alone when assessing the preoperative LNM status of patients with GC, offering superior diagnostic utility.
Metastatic Pulmonary Calcification: Single-Center Review of Typical and Atypical Imaging Features
Authors: Chen Tina , Hossain Rydhwana , Jeudy Jean , Chelala Lydia , White Charles
Published: August 2023

Purpose

The purpose of this study is to bring attention to an atypical form of metastatic pulmonary calcification, which is conventionally described as a metabolic process with upper lobe predominance in patients with a specific clinical history, which has not been reported as a distinct entity.

Methods

Patients with metastatic pulmonary calcification (MPC) were first identified with mPower keyword search, including MPC or metastatic calcifications on computed tomography chest radiological reports. Patients were then filtered on likelihood of MPC based off imaging reports. Images were then reviewed by three senior radiologists for pertinent characteristics such as location of MPC, degree of calcifications and pleural effusions. Based on the predominant location of MPC, cases were labeled as either typical or atypical. Clinical and imaging characteristics relevant to MPC were noted and compared across typical and atypical cases.

Results

In our study, we describe 25 patients with MPC, 13 defined as typical MPC and 12 with atypical MPC. Through consensus of senior radiologists, MPC was deemed to be mild (52%), moderate (44%), or severe (4%). Twenty-three patients (92%) had underlying renal disease including 21 requiring dialysis at the time of diagnosis. Outside of age at diagnosis, there was no significant clinical difference between the two groups. Evaluation of imaging characteristics (average HU attenuation, 267; range, 186–295), pattern and distribution of calcification, and clinical history strongly supported a diagnosis of atypical MPC.

Conclusion

This study presents several cases of lower lobe subpleural MPC associated with pleural effusions, which has not been reported as a distinct entity, despite comprising a significant portion of MPC cases at our institution.
Surgical Management of Infection Secondary to Cemento-osseous Dysplasia
Authors: Ebrahimi Farin , Ebrahimi Faraz , An Jingang
Published: August 2023

Cemento-osseous dysplasia (COD) of the jaws generally has no clinical manifestations when asymptomatic, thus requiring no treatment. However, secondary infection in COD requires surgical intervention. This study was focused on the evaluation of the surgical treatment of COD patients with secondary infections. The clinical data of COD patients with secondary infections, treated at the Peking University, Hospital of Stomatology between March 2021 and June 2022, were retrospectively reviewed. The data included age, sex, lesion characteristics, number of surgeries, and surgical outcomes. Seven COD patients with secondary infections underwent curettage, and the wounds were repaired using local soft tissue flaps, such as the buccal fat pad. Four of the patients had primary wound healing, while 3 presented with wound dehiscence. Healing occurred in 2 of these 3 patients after ~1 month of dressings. The remaining patient showed no improvement after 9 weeks, and underwent a second surgery, which led to primary wound healing. In conclusion, secondary infection in COD is an indication for surgical intervention, which may arrest the disease progression.
Accuracy of Orbital Shape Reconstruction—Comparative Analysis of Errors in Implant Shape Versus Implant Positioning: A Cadaveric Study
Authors: Hardisty Michael , Wei Yuan Tao , Hontscharuk Rayisa , Ibrahimi Amani , Antonyshyn Oleh , Edwards Glenn , Mainprize James G. , Whyne Cari M.
Published: August 2023

Introduction:

Orbital blowout fractures are commonly reconstructed with implants shaped to repair orbital cavity defects, restore ocular position and projection, and correct diplopia. Orbital implant shaping has traditionally been performed manually by surgeons, with more recent use of computer-assisted design (CAD). Accuracy of implant placement is also key to reconstruction. This study compares the placement accuracy of orbital implants, testing the hypothesis that CAD-shaped implants indexed to patient anatomy will better restore orbit geometry compared with manually shaped implants and manually placed implants.

Methods:

The placement accuracy of orbital implants was assessed within a cadaveric blowout fracture model (3 skulls, 6 orbits) via 3-dimensional CT analysis. Defects were repaired with 4 different techniques: manually placed-manually shaped composite (titanium-reinforced porous polyethylene), manually placed CAD composite, indexed placed CAD composite, and indexed placed CAD titanium mesh.

Results:

Implant placement accuracy differed significantly with the implant preparation method (P=0.01). Indexing significantly improved the placement accuracy (P=0.002). Indexed placed titanium mesh CAD implants (1.42±0.33 mm) were positioned significantly closer to the intact surface versus manually placed-manually shaped composite implants (2.12±0.39 mm).

Discussion:

Computer-assisted design implants indexed to patient geometry yielded average errors below the acceptable threshold (2 mm) for enophthalmos and diplopia. This study highlights the importance of adequately indexing CAD-designed implants to patient geometry to ensure accurate orbital reconstructions.
Preservation of the Nerve to the Mylohyoid Muscle During Submental Island Flaps: An Anatomic Feasibility Study for Facial Nerve Reanimation Procedures
Authors: Ono Kisho , Ibaragi Soichiro , Obata Kyoichi , Okui Tatsuo , Kitagawa Norio , Tubbs R. Shane , Iwanaga Joe
Published: August 2023

The submental island flap is an axial pattern pedicle flap widely used in head and neck surgery because of its ease and success. Indications of the submental island flap range from reconstruction for the malignant tumor resection to loss of temporal bone and facial skin due to trauma. Whereas, intraoperative facial nerve injury is not uncommon. We verified whether it was possible to localize the nerve to the mylohyoid muscle and reanimate the facial nerve during submental island flap procedures by preserving the mylohyoid muscle using human fresh cadaveric specimens. Six cadaveric heads were dissected and the position of the nerve to the mylohyoid muscle identified to the mylohyoid triangle documented. We identified the nerve to the mylohyoid muscle on all sides within the mylohyoid triangle and were able to separate the nerve from the submental island flap completely. Our results suggest that facial nerve reanimation using the nerve to the mylohyoid muscle can be used while reconstructing with a submental island flap in cases of intraoperative facial nerve injury.
Ethical Considerations in Surgery for Single-suture Craniosynostosis
Authors: Selvaggi Gennaro , Maltese Giovanni , Kölby Lars , Elander Anna , Tarnow Peter , Kljajić Marizela
Published: August 2023

Singe-suture craniosynostosis (SSC) describes the premature fusion of one cranial suture, which restricts cranial growth and consequently results in unaffected regions presenting a compensatory expansion. Surgery can redistribute intracranial volume, reduce the risk of elevated intracranial pressure, and improve head shape, potentially leading to improved neurocognitive function and social acceptance. However, there is limited evidence that surgery for SSC improves neurocognitive function and social acceptance. Given the inherent surgical risks and uncertainty of outcomes, the conditions under which this surgery should be allowed remain uncertain. Here, we discuss ethical questions regarding the permissibility of surgery, value of neurocognitive function and social acceptance, research ethics associated with SSC, patient autonomy and parental roles, and the process of recommending surgery and obtaining consent. Because surgery for SSC has become a routine procedure, its practice now presents a relatively low risk of complications. Furthermore, having acquired an understanding of the risks associated with this surgery, such knowledge fulfils the principle of non-maleficence although not beneficence. Thus, we advocate that surgery should only be offered within Institutional Review Board-approved research projects. In these situations, decisions concerning enrollment in scientific research involves health care providers and parents or guardians of the child, with the former acting as gate-keepers upon recognition of a lack of coping skills on the part of the parent or guardian in dealing with unforeseen outcomes. To minimize associated surgical risks and maximize its benefits, there exists a moral obligation to refer patients only to highly specialized centers.
Systematic Reviews and Meta-analyses of the Procedure-specific Risks of Thrombosis and Bleeding in General Abdominal, Colorectal, Upper-Gastrointestinal and Hepatopancreatobiliary Surgery
Authors: Lavikainen Lauri I. , Guyatt Gordon H. , Sallinen Ville J. , Karanicolas Paul J. , Couban Rachel J. , Singh Tino , Lee Yung , Elberkennou Jaana , Aaltonen Riikka , Ahopelto Kaisa , Beilmann-Lehtonen Ines , Blanker Marco H. , Cárdenas Jovita L. , Cartwright Rufus , Craigie Samantha , Devereaux P.J. , Garcia-Perdomo Herney A. , Ge Fang Zhou , Gomaa Huda A. , Halme Alex L.E. , Haukka Jari , Karjalainen Päivi K. , Kilpeläinen Tuomas P. , Kivelä Antti J. , Lampela Hanna , Mattila Anne K. , Najafabadi Borna Tadayon , Nykänen Taina P. , Pandanaboyana Sanjay , Pourjamal Negar , Ratnayake Chathura B. B. , Raudasoja Aleksi R. , Vernooij Robin W. M. , Violette Philippe D. , Wang Yuting , Xiao Yingqi , Yao Liang , Tikkinen Kari A. O. ,   ROTBIGGS Investigators
Published: August 2023

Objective:

To provide procedure-specific estimates of symptomatic venous thromboembolism (VTE) and major bleeding following abdominal surgery.

Summary Background Data:

Use of pharmacological thromboprophylaxis represents a trade-off that depends on VTE and bleeding risks that vary between procedures; their magnitude remains uncertain.

Methods:

We identified observational studies reporting procedure-specific risks of symptomatic VTE or major bleeding after abdominal surgery; adjusted the reported estimates for thromboprophylaxis and length of follow-up; and estimated cumulative incidence at 4 weeks post-surgery, stratified by VTE risk groups; and rated evidence certainty.

Results:

After eligibility screening, 285 studies (8,048,635 patients) reporting on 40 general abdominal, 36 colorectal, 15 upper-gastrointestinal, and 24 hepatopancreatobiliary surgery procedures proved eligible. Evidence certainty proved generally moderate or low for VTE and low or very low for bleeding requiring reintervention. The risk of VTE varied substantially between procedures: in general abdominal surgery from a median of <0.1% in laparoscopic cholecystectomy to a median of 3.7% in open small bowel resection; in colorectal from 0.3% in minimally-invasive sigmoid colectomy to 10.0% in emergency open total proctocolectomy; and in upper-gastrointestinal/hepatopancreatobiliary from 0.2% in laparoscopic sleeve gastrectomy to 6.8% in open distal pancreatectomy for cancer.

Conclusions:

VTE thromboprophylaxis provides net benefit through VTE reduction with small increase in bleeding in some procedures (e.g., open colectomy, open pancreaticoduodenectomy), whereas the opposite is true in others (e.g., laparoscopic cholecystectomy, elective groin hernia repairs). In many procedures, thromboembolism and bleeding risks are similar, and decisions depend on individual risk prediction and values and preferences regarding VTE and bleeding.
Gastrodin facilitates recovery of neurological function of MCAO rats through upregulating miR-20a-5p/XIAP pathway via exosome
Authors: Nan Yinan , Zhu Wenhao , Zhu Bin , Wang Shaoqing
Published: August 2023

Cerebral infarction (CI) is characterised by high morbidity, mortality, and disability rates. Recently, Chinese medicine has been widely used and has gained satisfactory results in the treatment of CI. Our previous study showed that gastrodin could facilitate the recovery of neurological function in middle cerebral artery occlusion (MCAO) rats. This study explores this mechanism. SD rats were separated into control, sham, model, and gastrodin groups. After MCAO surgery, the gastrodin group was administered gastrodin (100 mg/kg), and after 1/3/7 days, the ischaemic hemisphere and serum was collected, and then we extracted the circulating exosomes from the serum. We then tested the levels of XIAP (x-linked inhibitor of apoptosis protein), IAP binding proteins (SMAC, HtrA2, ARTs), and miR-20a-5p (a gastrodin potential effect target) in the brain tissues, circulating exosomes, and serum using various methods. Our results showed that circulating exosomes can penetrate the blood-brain barrier (BBB) and that gastrodin can upregulate the amount of miR-20a-5p in circulating exosomes. The circulating exosomes penetrate the BBB and upregulate the expression of XIAP in the ischaemic hemisphere. Gastrodin can also decrease the amount of IAP binding proteins (SMAC, HtrA2, ARTs). Gastrodin can increase the amount of miR-20a-5p in circulating exosomes, which penetrates the BBB and upregulates XIAP expression in the ischaemic hemisphere. By inhibiting apoptosis of neurones, it can facilitate the recovery of neurological function in MCAO rats.