bluuebunny/crossref_metadata_2025 huggingface dataset:
Can Treatment With Citicoline Eyedrops Reduce Progression in Glaucoma? The Results of a Randomized Placebo-controlled Clinical Trial
Authors: Rossetti Luca , Iester Michele , Tranchina Laura , Ottobelli Laura , Coco Giulia , Calcatelli Elisabetta , Ancona Chiara , Cirafici Paola , Manni Gianluca
Published: June 2020

Precis:

Citicoline eyedrops in patients with progressing glaucoma.

Purpose:

This study aimed to test whether the additional therapy with citicoline eyedrops to intraocular pressure (IOP)-lowering treatment could slow glaucoma progression in patients with worsening of damage and IOP 18 mm Hg or less.

Design:

This was a randomized, double-masked, placebo-controlled, multicenter 3-year study.

Outcomes:

The outcomes studied were difference in the visual field (mean deviation, MD, of 24-2; MD of 10-2) rates of progression and difference in retinal nerve fiber layer (RNFL) thickness change between the 2 study groups at 3 years.

Methods:

Patients with mild to moderate open-angle glaucoma (OAG) showing damage progression of at least −0.5 dB/y in the 2 years before enrollment despite IOP ≤18 mm Hg were randomized to receive citicoline eyedrops or placebo 3 times daily for 3 years. Patients were followed every 3 months and underwent a visual field examination with 24-2 and 10-2 strategies and RNFL assessment. Analysis of variance and linear models were used to test the differences between groups.

Results:

Eighty patients were randomized in the trial. The mean 3-year rates of progression were −1.03 (2.14) dB in the citicoline group and −1.92 (2.23) dB in the placebo group (P=0.07) for 24-2 MD and −0.41 (3.45) dB in the citicoline group and −2.22 (3.63) dB in the placebo group (P=0.02) for 10-2 MD. On average, patients receiving citicoline eyedrops lost 1.86 μm of RNFL in 3 years, versus 2.99 μm in the placebo group (P=0.02).

Conclusions:

Additional treatment with citicoline eyedrops to IOP-lowering treatment might reduce disease progression in patients with progressing glaucoma despite IOP ≤18 mm Hg.
Prevention and management of refractive prediction errors following cataract surgery
Authors: Kieval Jeremy Z. , Al-Hashimi Saba , Davidson Richard S. , Hamilton D. Rex , Jackson Mitchell A. , LaBorwit Scott , Patterson Larry E. , Stonecipher Karl G. , Donaldson Kendall ,   for the ASCRS Refractive Cataract Surgery Subcommittee
Published: June 2020

Patient satisfaction after modern day cataract surgery requires excellent surgical technique but increasingly demands superior refractive outcomes as well. In many cases, there exists an expectation from patients, as well as surgeons, to achieve emmetropia after cataract surgery. This is particularly true in patients electing premium intraocular lens technology to correct astigmatism and presbyopia to minimize spectacle dependence. Despite continued advances in preoperative and intraoperative diagnostics, refractive planning, and surgical technology, residual refractive error remains a primary source of dissatisfaction after cataract surgery. The need to enhance refractive outcomes and treat residual astigmatic or spherical refractive errors postoperatively becomes paramount to meeting the expectations of patients in their surgical outcome. This article reviews the potential preoperative and intraoperative pitfalls that can be the source of refractive error, the various options to enhance refractive outcomes, and potential future technologies to limit residual refractive error after cataract surgery.
Repetitive stress in mice causes migraine-like behaviors and calcitonin gene-related peptide-dependent hyperalgesic priming to a migraine trigger
Authors: Avona Amanda , Mason Bianca N. , Lackovic Jacob , Wajahat Naureen , Motina Marina , Quigley Lilyana , Burgos-Vega Carolina , Moldovan Loomis Cristina , Garcia-Martinez Leon F. , Akopian Armen N. , Price Theodore J. , Dussor Gregory
Published: June 2020

Migraine is one of the most disabling disorders worldwide but the underlying mechanisms are poorly understood. Stress is consistently reported as a common trigger of migraine attacks. Here, we show that repeated stress in mice causes migraine-like behaviors that are responsive to a migraine therapeutic. Adult female and male mice were exposed to 2 hours of restraint stress for 3 consecutive days, after which they demonstrated facial mechanical hypersensitivity and facial grimace responses that were resolved by 14 days after stress. Hypersensitivity or grimace was not observed in either control animals or those stressed for only 1 day. After return to baseline, the nitric oxide donor sodium nitroprusside (SNP; 0.1 mg/kg) elicited mechanical hypersensitivity in stressed but not in control animals, demonstrating the presence of hyperalgesic priming. This suggests the presence of a migraine-like state, because nitric oxide donors are reliable triggers of attacks in migraine patients but not controls. The stress paradigm also caused priming responses to dural pH 7.0 treatment. The presence of this primed state after stress is not permanent because it was no longer present at 35 days after stress. Finally, mice received either the calcitonin gene-related peptide monoclonal antibody ALD405 (10 mg/kg) 24 hours before SNP or a coinjection of sumatriptan (0.6 mg/kg). ALD405, but not sumatriptan, blocked the facial hypersensitivity due to SNP. This stress paradigm in mice and the subsequent primed state caused by stress allow further preclinical investigation of mechanisms contributing to migraine, particularly those caused by common triggers of attacks.
Impact of self-measured blood pressure monitoring on hypertension management
Authors: Swaminathan Renugadevi , Cohen Emily , Philley Maddie , Hokanson John , Young Kendra
Published: June 2020

Background

An estimated 31% of adults in the USA have hypertension. The American Heart Association’s Check. Change. Control. (CCC) program is an ongoing evidence-based hypertension management program that encourages participants to use remote blood pressure (BP) monitoring to take control of their cardiovascular health. The purpose of this study was to identify the effectiveness of self-measured blood pressure (SMBP) monitoring and tracking on high BP control among participants of the CCC program.

Methods

We performed a retrospective cohort study among hypertensive men (n = 912) and women (n = 2021) using the 2016–2017 CCC national data. Demographics were examined among participants who checked their BP readings frequently, with a minimum of eight BP readings over four months, versus those who did not check their BP as often. Multivariable logistic regression evaluated the association of SMBP monitoring and BP reduction.

Results

A greater proportion of participants who frequently checked their BP readings had BP reduction (17.7%), compared to participants who did not check their BP readings frequently (3.9%, P < 0.001). Men were 40% less likely to have BP reduction compared to women (P = 0.02); African Americans and Hispanic Americans were 63% (P < 0.0001) and 37% (P = 0.07) less likely to have BP reduction as compared to Caucasian Americans, respectively. After adjusting for sex and race/ethnicity, the odds of BP reduction was 4.88 times (95% confidence interval, 2.66–8.95) higher for participants who checked their BP readings frequently, compared to those who did not frequently check their BP readings.

Conclusion

Hypertensive participants who monitor their BP readings frequently using a self-management program have better BP control.
High Patient Disease Burden in a Cross‐sectional, Multicenter Contact Registry Study of Eosinophilic Gastrointestinal Diseases
Authors: Jensen Elizabeth T. , Aceves Seema S. , Bonis Peter A. , Bray Kimberly , Book Wendy , Chehade Mirna , Collins Margaret H. , Dellon Evan S. , Falk Gary W. , Gonsalves Nirmala , Gupta Sandeep K. , Hirano Ikuo , Katzka David A. , Kyle Shay , Mack Denise , Kodroff Ellyn , Leung John , Mukkada Vincent A. , Scott Melissa , Paliana Ally , Sable Kathleen , Spergel Jonathan M. , Strobel Mary Jo , Krischer Jeffrey , Rothenberg Marc E. , Abonia Pablo ,   CEGIR Investigator group
Published: June 2020

Objectives:

Clinical features of eosinophilic esophagitis (EoE) have been well‐described in the literature, however, characterization of features experienced by patients with other eosinophilic gastrointestinal diseases (EGIDs) is lacking. Using data collected from a patient contact registry, we sought to characterize and contrast patient‐reported gastrointestinal and extragastrointestinal symptoms and comorbidities in non‐EoE EGIDs, including eosinophilic gastritis, gastroenteritis and colitis, relative to EoE.

Methods:

We conducted a cross‐sectional study of contact registry data collected from 2015 to 2018. Statistical comparisons were made using chi‐square (categorical measures) and the Mann‐Whitney U test (continuous measures). Multivariable analyses were used to evaluate associations between treatment and feelings of isolation.

Results:

Of the 715 reporting an EGID diagnosis (n = 525 EoE; n = 190 non‐EoE EGID), a higher proportion of those with a non‐EoE EGID reported more frequent specific and nonspecific gastrointestinal symptoms, including nausea, abdominal pain, diarrhea, constipation, and bloating (P < 0.01 for all). Participants with a non‐EoE EGID were more likely to report higher frequency of fatigue, isolation, and deep muscle or joint pain (P < 0.01 for all). Specific food elimination and elemental formula treatments were associated with increased odds of more frequent (at least weekly) feelings of isolation for participants with EoE (adjusted odds rtaio [aOR]: 2.4; 95% confidence interval [CI]: 1.5‐‐4.1 for specific food elimination and adjusted OR: 1.9; 95% CI: 1.2‐‐3.3 for elemental formula).

Conclusions:

Significant differences exist in the symptoms and comorbidities experienced between those with EoE versus non‐EoE EGIDs. Additional investigation is needed to elucidate the factors that may contribute to the high disease burden of these poorly understood conditions.
Psychometric and Linguistic Evaluation of a Coping Scale for Breast Cancer Survivors in Taiwan
Authors: Huang Chiung-Yu , Perng Shoa-Jen , Chen Chun-I , Lu Chu-Yun
Published: June 2020

Background

Coping strategies are essential in dealing with threatening situations or difficulties for better psychological adjustments and quality of life. A short-form modified Ways of Coping Questionnaire (MWCQ) would be useful to quickly assess the coping strategies used by breast cancer survivors.

Objectives

The aim of this study was to evaluate the psychometric properties of a Chinese version of a brief version of the MWCQ in breast cancer survivors.

Methods

A methodological, cross-sectional design was used in this study. The study has internal consistency reliability, face/content, construct, and convergent/divergent validity. Factor analysis and confirmatory factor analysis were used to examine the psychometric properties of the MWCQ-brief in a convenience sample of 207 women with breast cancer from 2 general hospitals in Taiwan.

Results

From the initial 35-item coping scale, factor analysis results supported a 24-item questionnaire, and the following 4 factors were extracted: effective coping, optimistic coping, unpractical coping, and escape coping. Confirmatory factor analysis results revealed an 18-item questionnaire with 3 factors extracted: active coping, avoidance coping, and minimizing the situation.

Conclusions

The 24- and 18-item MWCQ-brief versions demonstrate fair psychometric properties to measure adaptability among women with breast cancer in Taiwan. This scale is simple but contains 4 or 3 concepts for coping that can be appropriately used to assess underlying states of adaptation in women with breast cancer.

Implications for Practice

The MWCQ-brief is a valid and reliable tool to understand the adaptability states of female breast cancer survivors by exploring reactions to the disease. Healthcare professionals can provide appropriate psychosocial interventions based on assessment results.
Restorative Quality Improvement
Authors: Johnson Hannah
Published: June 2020

Background:

Six Sigma is a quality improvement (QI) method used in hospitals, but not typically in nursing homes (NHs), to reduce service variability and expenditures.

Local Problem:

The existing QI process for functional maintenance program (FMP) charting/auditing in an urban NH allowed variability and lost revenue.

Methods:

A single-group pre/posttest design with analysis of variance and t-test analysis was used to implement Six Sigma for the FMP process.

Intervention:

Phases of Define, Measure, Analyze, Improve, and Control addressed performance objectives of FMP capacity; staff retention; congruence between prescribed, performed, and charted FMPs; and month-end summaries of resident status on FMPs.

Results:

With the existing staff, capability was increased by 17 residents ($200 000 revenue) and 90% to 100% charting congruence was achieved. Limited success was attributed to lack of skill diffusion, team communication, manager availability, and project prioritization.

Conclusions:

Six Sigma was moderately successful when applied in a single NH for QI.
An Assessment of Predatory Publication Use in Reviews
Authors: Collom Charles D. , Oermann Marilyn H. , Sabol Valerie K. , Heintz Phyllis A.
Published: June 2020

Purpose/Aims

Predatory journals, characterized by poor editorial practices and questionable peer review, constitute a threat to academic literature. Citations to predatory journals in reviews of research potentially weaken the strength of these reviews, which are relied upon by nurses as evidence for practice. The purposes of this study were to assess the (a) extent to which reviews have relied on articles published in predatory journals, (b) nursing research practice areas most reliant on predatory journal citations, and (c) extent to which predatory journal citations are being used in reviews that guide the care of sensitive or vulnerable groups.

Methods

Literature and other types of reviews with 1 or more citations to a predatory journal (n = 78) were assessed. The reviews were classified by topic (clinical practice, education, and management).

Results

The 78 reviews contained 275 citations to articles published in predatory journals; 51 reviews (65%) substantively used these references.

Conclusions

Predatory journal articles, which may not have been subjected to an adequate peer review, are being cited in review articles published in legitimate nursing journals, weakening the strength of these reviews as evidence for practice.
Niemann-Pick Disease Type B in Traumatic Splenic Rupture
Authors: Zhao Shuquan , Shi Qing , Deng Weinian , Zhou Yiwu
Published: June 2020

The rupture of spleen is common in clinical and forensic practice. Trauma is the most common cause of splenic rupture. Although rare, traumatic splenic rupture may occur in these individuals with asymptomatic underlying disease, and clinical and forensic pathologists may neglect the disease and diagnose only the traumatic splenic rupture. Here, we present a case of postinjury splenic rupture resulting in splenectomy, where the patient was diagnosed with Niemann-Pick disease type B through histopathological examination and genetic testing. In forensic practice, in cases of isolation splenic rupture, full microscopy should be done to differentiate traumatic rupture from a spontaneous bleed due to an underlying disease process.
Evidence-Based Perioperative Nutrition Recommendations: Optimizing Results and Minimizing Risks
Authors: Knackstedt Rebecca , Oliver Jeremie , Gatherwright James
Published: June 2020

Plastic surgery patients span the nutritional spectrum from generally healthy, nutritionally competent patients to inherently catabolic, nutritionally deficient, and chronic wound patients. Therefore, plastic and reconstructive surgery affords the opportunity to investigate the impact of nutrition across a heterogeneous patient population following a wide variety of procedures. Although patients may be nutritionally deficient in certain vitamins warranting perioperative repletion, other supplements have the potential to benefit all patients, regardless of nutritional status. Despite these putative benefits, there is a dearth of information regarding nutritional optimization, with the limited, available literature focusing mostly on herbal supplements and their potential side effects. A significant barrier to supplement use is the lack of education and available supporting information regarding the indications, contraindications, and physiology of these adjuncts. The goal of this article is to provide a comprehensive, evidence-based review of available nutritional supplements that can be considered for the plastic surgery patient in the perioperative period to optimize surgical outcomes while minimizing risk. Prospective, well-designed studies using validated, high-quality supplements will be critical in determining the significance that perioperative supplementation can have for surgical outcomes. Until well-done prospective studies are performed, the supplement, dose, and duration should be determined on an individual, patient-per-patient basis at the discretion of the operating surgeon.
The Impact of an Optimism Training Intervention on Biological Measures Associated With Cardiovascular Health: Data From a Randomized Controlled Trial
Authors: Mohammadi Narges , Aghayousefi Alireza , Nikrahan Gholam Reza , King Franklin , Alipour Ahmad , Sadeghi Masoumeh , Roohafza Hamidreza , Celano Christopher M. , Gomez Perla Romero , Huffman Jeff C.
Published: June 2020

Objective

Positive psychological constructs, such as optimism, are associated with cardiovascular health, and changes in biological measures associated with heart health have been proposed as potential mediators of these relationships. In this analysis of data from a randomized controlled trial, we examined the impact of an optimism training intervention on biological measures associated with cardiac health in patients with coronary artery disease.

Methods

We analyzed data from an 8-week, randomized, controlled trial of a group-based optimism training intervention in 61 patients with coronary artery disease. High-sensitivity C-reactive protein (hs-CRP), interleukin 6, irisin, and fibrinogen were measured at baseline, 8 weeks, and 16 weeks. Mixed-effects regression analyses were performed to examine the effects of the intervention on changes in biological measures at 8 and 16 weeks.

Results

At 8 weeks, the intervention led to significantly greater reductions in hs-CRP (B = −0.851 [standard error {SE} = 0.273, p = .002) and fibrinogen (B = −0.148 [SE = 0.062], p = .016), and a greater increase in irisin (B = 0.252 [SE = 0.114], p = .027) compared with the control condition. These changes persisted at 16 weeks (hs-CRP: B = −1.078 [SE = 0.276], p < .001; fibrinogen: B = −0.270 [SE = 0.062], p < .001; irisin: B = 0.525 [SE = 0.116], p < .001), and interleukin 6 additionally was impacted at this time point (B = −0.214 [SE = 0.064], p = .001). Exploratory mediation analyses failed to identify significant psychological or health behavior mediators of these relationships.

Conclusions

A group-based optimism training intervention resulted in significant, robust, and sustained changes in biological measures associated with cardiac health. Further studies are needed to confirm these findings in a larger sample and identify potential mediating variables.

Trial Registration: Iran Registry of Clinical Trials No. 2016070328769 N1.
The Possible Relationship Between Familial Mediterranean Fever and Chronic Nonbacterial Osteomyelitis
Authors: Çiçek Sümeyra Özdemir , Şahin Nihal , Karaman Zehra Filiz , Taşkın Sema Nur , Kısaarslan Ayşenur Paç , Gündüz Zübeyde , Poyrazoğlu Muammer Hakan , Düşünsel Ruhan
Published: June 2020

Background/Objectives

Chronic nonbacterial osteomyelitis (CNO) is an inflammatory disease characterized by recurrent attacks and remissions due to sterile bone inflammation. The CNO may be accompanied by various inflammatory diseases. The aims of our study were to determine the clinical, laboratory, and radiological characteristics of children with CNO, and to investigate the possible effect of concomitant diseases on the course of CNO.

Methods

Twenty-three patients who were diagnosed with CNO between 2012 and 2019 were analyzed. Demographic characteristics, clinical courses, laboratory and imaging findings, and concomitant diseases were recorded. The characteristics of the CNO patients with and without concomitant diseases were compared.

Results

The mean ± SD age of patients at the time of diagnosis and the last follow-up was 10.46 ± 4.1 and 12.47 ± 4.47 years, respectively. The median (range) time interval between disease onset and diagnosis was 5.33 (1–55) months. The mean ± SD duration of disease was 24.71 ± 16.76 months. Twelve patients (52.2%) were male. The most commonly affected areas were femur (74%), tibia/fibula (74%), and pelvis (52.2%). Age at symptom onset, age at diagnosis, mean number of lesions, presence of sacroiliitis, acute phase reactants at the start of disease, clinical and radiological remission rates, and treatment responses were not significantly different between the 13 patients with concomitant diseases and those without. Eight patients (34.8%) had familial Mediterranean fever (FMF), and all of them had exon 10 mutations. Four patients (17.4%) had juvenile spondylarthritis, one had inflammatory bowel disease, and one had psoriatic arthritis as concomitant diseases. Clinical remission was achieved in 19 patients (82.6%) and complete remission in 11 patients (47.8%) at the time of follow-up.

Conclusions

In our cohort, half of the patients with CNO had concomitant diseases, with FMF being the most common. We think that the coexistence of FMF and CNO is not a coincidental one and that both may result due to an abnormality of a common pathogenetic pathway.
Temporal Fat Grafting in Children With Craniofacial Anomalies
Authors: Fahradyan Artur , Goel Pedram , Williams Madeline , Liu Alice , Gould Daniel G. , Urata Mark M.
Published: June 2020

Background

Fat grafting is a common adjunct procedure used to treat temporal fat hollowing in children with craniofacial anomalies. The goal of this study was to assess the surgical and aesthetic outcomes of this procedure.

Methods

We retrospectively reviewed patients who underwent temporal fat grafting at a single tertiary pediatric craniofacial center. The surgical outcome was assessed based on intraoperativeand 30-day postoperative complication rates. The aesthetic outcome was assessed by 3 independent investigators using a 3-point grading scale for preoperative temporal hollowing severity (1 = mild, 2 = moderate, 3 = severe) and a 5-point scale for postoperative improvement (0 = no, 1 = mild, 2 = moderate, 3 = significant, and 4 = complete improvement).

Results

Forty-three patients met inclusion criteria. Twenty-seven (63%) were male, 39 (91%) had a history of craniosynostosis, and 18 (42%) had associated syndromes. The mean age at fat grafting was 9.9 years (2.7–20.4, SD = 5.5) with an average follow-up time of 1.6 years (0–5.8, SD = 1.8). The average volume of fat grafted was 8.6 mL (0–30, SD = 5.9) to the right temporal region and 8.6 mL (0–30, SD = 5.8) to the left. There were no intraoperative or postoperative complications. The mean improvement score was 2.9 (1–4, SD = 0.7), demonstrating that most patients experienced moderate to significant improvement. Multiple linear regression analysis demonstrated that syndromic status had a negative impact on the aesthetic outcome (P < 0.001).

Conclusions

These findings demonstrate that fat grafting is an effective method to treat temporal hollowing in children with craniofacial anomalies with no perioperative complications.
Facial Plastic and Reconstructive Surgery During the COVID-19 Pandemic
Authors: Shokri Tom , Saadi Robert A. , Liaw Jeffrey , Bann Darrin V. , Patel Vijay A. , Goyal Neerav , Lighthall Jessyka G.
Published: June 2020

Background

The global COVID-19 pandemic has had a profound impact on facial plastic and reconstructive surgery. Our review serves as a safety resource based on the current literature and is aimed at providing best-practice recommendations. Specifically, this article is focused on considerations in the management of craniomaxillofacial trauma as well as reconstructive procedures after head and neck oncologic resection.

Methods

Relevant clinical data were obtained from peer-reviewed journal articles, task force recommendations, and published guidelines from multiple medical organizations utilizing data sources including PubMed, Google Scholar, MEDLINE, and Google search queries. Relevant publications were utilized to develop practice guidelines and recommendations.

Conclusions

The global COVID-19 pandemic has placed a significant strain on health care resources with resultant impacts on patient care. Surgeons operating in the head and neck are particularly at risk of occupational COVID-19 exposure during diagnostic and therapeutic procedures and must therefore be cognizant of protocols in place to mitigate exposure risk and optimize patient care.
Early Diagnosis and Intervention for Airway-Obstructing Neonatal Plexiform Neurofirbomatosis
Authors: Day Kristopher M. , Roward Simin , Gillispie Alexandra , Attra James , Kelley Patrick
Published: June 2020

Background:

Respiratory distress is a frequent occurrence in neonates, typically caused by a variety of pulmonary conditions. Accurate diagnosis of the cause is vital to appropriately treat neonates and prevent long-term complications. Neck masses rarely cause respiratory distress in this setting but should be considered when clinical signs indicate.

Methods:

The authors present the patient with a neonate born at term who developed stertor, respiratory distress requiring intubation, and repeated failure to extubate.

Results:

Physical examination showed right-sided lower and midface enlargement with a firm mass mostly over the parotid and right neck. Both computerized and magnetic resonance tomography demonstrated a right-sided neck mass. Surgical exploration revealed extensive tumor burden emanating from the great auricular, hypoglossal, and other nerves of the neck, including invasion of the carotid sheath encasing the artery. Excisional biopsy showed plexiform neurofibroma, and pathognomonic for neurofibromatosis type 1. The decision was made to pursue medical management, as complete excision would have resulted in increased morbidity due to the involvement of multiple cranial nerves. The patient underwent microlaryngoscopy, bronchoscopy, and tracheostomy and was started on Trametinib chemotherapy.

Conclusion:

Neonatal airway obstruction can rarely be caused by unanticipated mass lesion, such as plexiform neurofibroma. A high index of suspicion must be maintained for early onset mass lesions causing respiratory obstruction to inhibit early disease progression and avoid potentially fatal sequelae.
Lingual Lateral Canal Mimicking Mandible Fracture
Authors: Zambrana Jéssica Rabelo Mina , Carneiro Ana Luiza Esteves , Zambrana Nataly Rabelo Mina , Neto Henrique Tuzzolo , Salgado Daniela Miranda Richarte de Andrade , Ribeiro Rodrigo Alves , Costa Claudio
Published: June 2020

Lingual lateral canal is a rare variation in the trajectory of the mandibular canal, and is usually detected as an incidental finding on radiographic exams, especially on cone-beam computed tomography. Due to its radiographic characteristics, this anatomical variation might be confused with a mandible fracture. Therefore, the knowledge of its presence is essential not only to differentiate it from a fracture, but also for the success of surgical procedures performed in the mandible, making it easier to avoid clinical complications such as swelling, bruising, bleeding, and neurovascular disorders. This report shows the case of a lingual lateral canal mimicking a fracture on the mandibular body.
Optical Coherence Tomography Findings Following Orbital Fractures
Authors: De Cillà Stefano , Muraca Andrea , Brucoli Matteo , Boffano Paolo , Benech Arnaldo
Published: June 2020

Introduction:

A closed globe trauma is often associated with orbital wall fractures. In addition to diplopia, further eye disturbances can be observed. The aim of this preliminary prospective study was to investigate the optical coherence tomography (OCT) findings in patients that presented with orbital fractures in association with diplopia but without decreased visual acuity or further ocular symptoms.

Methods:

Only patients who were admitted and surgically treated for orbital wall fractures and that presented diplopia were included in this study. Patients with post traumatic ocular symptoms were excluded. All the patients that were diagnosed with an orbital fracture underwent an ophthalmological assessment, including best-corrected visual acuity (BCVA), examination of fundus oculi, Hess Scheme, OCT, and OCT angiography.

Results:

Five patients met the inclusion criteria and were enrolled. Hess Scheme examinations confirmed the presence of diplopia in all the included patients. The examination of fundus oculi did not reveal any pathology in 4 patients, whereas in a patient a commotio retinae (Berlin's Edema) was diagnosed in the infero-papillary field. Following OCT assessment, a pachycoroid was observed in 4 patients.

Conclusions:

A thorough ophthalmological assessment in patients that have suffered from orbital fractures is fundamental. In particular, OCT examinations seem to provide more insight into the detection and monitoring of choroidal changes after ocular trauma without visible macular changes.
Increased Intraoperative Faculty Entrustment and Resident Entrustability Does Not Compromise Patient Outcomes After General Surgery Procedures
Authors: Williams Aaron M. , Karmakar Monita , Thompson-Burdine Julie , Matusko Niki , Ji Sunjong , Kamdar Neil , Seiler Kristian , Minter Rebecca M. , Sandhu Gurjit
Published: June 2020

Background:

Intraoperative resident autonomy has been compromised secondary to expectations for increased supervision without defined parameters for safe progressive independence, diffusion of training experience, and more to learn with less time. Surgical residents who are insufficiently entrusted during training attain less autonomy, confidence, and even clinical competency, potentially affecting future patient outcomes.

Objective:

To determine if OpTrust, an educational intervention for increasing intraoperative faculty entrustment and resident entrustability, negatively impacts patient outcomes after general surgery procedures.

Methods:

Surgical faculty and residents received OpTrust training and instruction to promote intraoperative faculty entrustment and resident entrustability. A post-intervention OpTrust cohort was compared to historical and pre-intervention OpTrust cohorts. Multivariable logistic and negative binomial regression was used to evaluate the impact of the OpTrust intervention and time on patient outcomes.

Setting:

Single tertiary academic center.

Participants:

General surgery faculty and residents.

Main Outcome(s) and Measure(s):

Thirty-day postoperative outcomes, including mortality, any complication, reoperation, readmission, and length of stay.

Results:

A total of 8890 surgical procedures were included. After risk adjustment, overall patient outcomes were similar. Multivariable regression estimating the effect of the OpTrust intervention and time revealed similar patient outcomes with no increased risk (P > 0.05) of mortality {odds ratio (OR), 2.23 [95% confidence interval (CI), 0.87–5.6]}, any complication [OR, 0.98 (95% CI, 0.76–1.3)], reoperation [OR, 0.65 (95% CI, 0.42–1.0)], readmission [OR, 0.82 (95% CI, 0.57–1.2)], and length of stay [OR, 0.99 (95% CI, 0.86–1.1)] compared to the historic and pre-intervention OpTrust cohorts.

Conclusions:

OpTrust, an educational intervention to increase faculty entrustment and resident entrustability, does not compromise postoperative patient outcomes. Integrating faculty and resident development to further enhance entrustment and entrustability through OpTrust may help facilitate increased resident autonomy within the safety net of surgical training without negatively impacting clinical outcomes.
Strategy to Enable and Accelerate Kidney Transplant in Small Children and Results of the First 130 Transplants in Children ≤15 kg in a Single Center
Authors: Feltran Luciana de Santis , Genzani Camila Penteado , Fonseca Mariana Janiques Barcia Magalhaes , da Silva Erica Francisco , Baptista José Carlos , de Carvalho Maria Fernanda Camargo , Koch-Nogueira Paulo Cesar
Published: June 2020

Background.

Proper care of young children in need of kidney transplant (KT) requires many skilled professionals and an expensive hospital structure. Small children have lesser access to KT.

Methods.

We describe a strategy performed in Brazil to enable and accelerate KT in children ≤15 kg based on the establishment of one specialized transplant center, focused on small children, and cooperating with distant centers throughout the country. Actions on 3 fronts were implemented: (a) providing excellent medical assistance, (b) coordinating educational activities to disseminate expertise and establish a professional network, and (c) fostering research to promote scientific knowledge. We presented the number and outcomes of small children KT as a result of this strategy.

Results.

Three hundred forty-six pediatric KTs were performed in the specialized center from 2009 to 2017, being 130 in children ≤15 kg (38%, being 41 children ≤10 kg) and 216 in >15 kg (62%). Patient survival after 1 and 5 years of the transplant was 97% and 95% in the “small children” group, whereas, in the “heavier children” group, it was 99% and 96% (P = 0.923). Regarding graft survival, we observed in the “small children” group, 91% and 87%, whereas in the “heavier children” group, 94% and 87% (P = 0.873). These results are comparable to the literature data. Groups were similar in the incidence of reoperation, vascular thrombosis, posttransplant lymphoproliferative disease, and estimated glomerular filtration rate.

Conclusions.

The strategy allowed an improvement in the number of KT in small children with excellent results. We believe this experience may be useful in other locations.
Socioeconomic Deprivation Does Not Impact Liver Transplantation Outcome for HCC: A Survival Analysis From a National Database
Authors: Menahem Benjamin , Dejardin Olivier , Alves Arnaud , Launay Ludivine , Lubrano Jean , Duvoux Christophe , Laurent Alexis , Launoy and Guy
Published: June 2020

Background.

To investigate the value of European deprivation index (EDI) and hepatocellular carcinoma (HCC) characteristics and their relationships with outcome after liver transplantation (LT).

Methods.

Patients undergoing LT for HCC were included from a national database (from “Agence de la Biomédecine” between 2006 and 2016. Characteristics of the patients were blindly extracted from the database. Thus, EDI was calculated in 5 quintiles and prognosis factors of survival were determined according to a Cox model.

Results.

Among the 3865 included patients, 33.9% were in the fifth quintile (quintile 1, N = 562 [14.5%]; quintile 2, N = 647 [16.7%]; quintile 3, N = 654 [16.9%]; quintile 4, N = 688 [17.8%]). Patients in each quintile were comparable regarding HCC history, especially median size of HCC, number of nodules of HCC and alpha-fetoprotein score. In the univariate analysis of the crude survival, having >2 nodules of HCC before LT and time on waiting list were associated with a higher risk of death (P < 0.0001 and P = 0.03, respectively). EDI, size of HCC, model for end-stage liver disease score, Child-Pugh score were not statistically significant in the crude and net survival. In both survival, time on waiting list and number of HCC ≥2 were independent factor of mortality after LT for HCC (P = 0.009 and 0.001, respectively, and P = 0.03 and 0.02, respectively).

Conclusions.

EDI does not impact overall survival after LT for HCC. Number of HCC and time on waiting list are independent prognostic factors of survival after LT for HCC.
Mental rotation of alphabet characters affects the face-sensitive N170 component
Authors: Tanaka Hideaki
Published: June 2020

Face-sensitive N170 component of event-related potential is sensitive to face inversion, which has been defined as the face-inversion effect. Moreover, a previous study suggested that similar to the face-inversion effect of the face-sensitive N170 affected by mental rotation of the face, object-related N170 of three-dimensional objects was also affected by the mental rotation of two-dimensional objects. The purpose of the present study was to compare the relationship between face-sensitive N170 during face perception (upright and inverted faces) and object-related N170 during character perception (normal and mirror version for alphabet characters). The results indicated that the latency of N170 for mirror version for alphabet characters was significantly longer than that for normal version for alphabet characters, and the latency of N170 for inverted faces was significantly longer than that for upright faces. Therefore, the results of the present study clearly indicate that face-sensitive N170 components are related to the mental rotation of normal and mirror version for alphabet characters. These results suggest the novel possibility that face-sensitive N170 latency can be used as a biomarker for mental rotation and that mental rotation is related to the fusiform area as a neural generator of N170 in the human brain.
Patiriisocius marinistellae gen. nov., sp. nov., isolated from the starfish Patiria pectinifera, and reclassification of Ulvibacter marinus as a member of the genus Patiriisocius comb. nov.
Authors: Kawano Keisuke , Ushijima Natsumi , Kihara Minoru , Itoh Hideomi
Published: June 2020

A marine strain, designated KK4T, was isolated from the surface of a starfish, Patiria pectinifera, which was collected from seawater off the coast of Hokkaido, Japan. Strain KK4T is a Gram-stain-negative, non-spore-forming, rod-shaped, aerobic bacterium that forms yellow-pigmented colonies. A phylogenetic relationship analysis, based on 16S rRNA gene sequences, revealed that strain KK4T was closely related to

Ulvibacter marinus

IMCC12008T,

Ulvibacter antarcticus

IMCC3101T and

Ulvibacter litoralis

KMM 3912T, with similarities of 96.9, 95.8 and 95.6 %, respectively, but low sequence similarities (<94 %) among other genera in the family

Flavobacteriaceae

. Genomic similarities between strain KK4T and the three

Ulvibacter

type strains based on average nucleotide identity and digital DNA–DNA hybridization values were lower than the species delineation thresholds. Moreover, phylogenetic tree based on genome sequences showed that strain KK4T was clustered with

U. marinus

IMCC12008T and formed a branch independent from the cluster including type species of the genera

Ulvibacter

,

Marixanthomonas

,

Marinirhabdus

,

Aureitalea

and

Aequorivita

. Amino acid identity values between strain KK4T/

U. marinus

IMCC12008T and the neighbour type species/strains were 61.9–68.2% and 61.5–67.4 %, which were lower than the genus delineation threshold, implying the novel genus status of strain KK4T. Strain KK4T growth occurred at pH 6.0–9.0, 4–30 °C and in NaCl concentrations of 0.5–5.0 %, and optimally at pH 7.0, 25 °C and 3.0 %, respectively. Unlike

Ulvibacter

strains, strain KK4T could assimilate glucose, mannose, galactose and acetate. The major quinone and fatty acids were menaquinone-6 and iso-C15 : 0 (27.5 %), iso-C15 : 1 G (22.5 %) and iso-C17 : 0 3-OH (12.8 %), respectively. Based on genetic, phylogenetic and phenotypic properties, strain KK4T represents a novel species of the genus Patiriisocius, for which the name Patiriisocius marinistellae gen. nov., sp. nov. is proposed. The type strain is KK4T (=JCM 33344T=KCTC 72225T). In addition, based on the current data,

Ulvibacter marinus

should be reclassified as Patiriisocius marinus comb. nov.
Pukyongiella litopenaei gen. nov., sp. nov., a novel bacterium isolated from the gut content of a whiteleg shrimp Litopenaeus vannamei
Authors: Kim Young-Sam , Kim Sang-Eon , Kim Seong-Jin , Jung Hyun-Kyoung , Kim Kyoung-Ho
Published: June 2020

A Gram-negative, aerobic bacterium, designated as SH-1T, was isolated from the gut content of a whiteleg shrimp, Litopenaeus vannamei collected in a shrimp farm in South Korea. The bacterial cells were ovoid rod-shaped, non-motile, oxidase-positive and catalase-negative. Growth was observed at 20–35 °C (optimum, 30 °C), pH 5.0–9.5 (pH 8.5) and in the presence of 0–6 % (w/v) NaCl (2–3 %). The major polar lipids were phosphatidylglycerol, phosphatidylinositolmannoside, unidentified aminolipid and two unidentified lipids. The G+C content was 66.1 mol% and the predominant respiratory quinone was Q-10. Phylogenetic analysis based on the 16S rRNA gene sequences showed that strain SH-1T was placed in a distinct clade with

Primorskyibacter marinus

PX7T (96.97 % sequence similarity),

Pontibaca methylaminivorans

DSM 21219T (96.03 %) and

Pelagivirga sediminicola

BH-SD19T (95.02 %) in the family

Rhodobacteraceae

and distantly related with them to be a new genus. The digital DNA–DNA hybridization (dDDH), average nucleotide identity (ANI) and average amino acid identity (AAI) values calculated from whole-genome-sequence comparison between the SH-1T and the close species were in the ranges of 19.0–19.8, 73.8–74.9 and 64.1–65.9 %, respectively. Based on the polyphasic analysis presented in this study, we suggest that strain SH-1T represents a novel genus and species in the family

Rhodobacteraceae

, for which the name Pukyongiella litopenaei gen. nov., sp. nov. is proposed. The type strain of Pukyongiella litopenaei is SH-1T (=KCTC 62276T=MCCC 1K04072T).
Hidden in plain sight: The effects of BCG vaccination in COVID-19 pandemic
Authors: Toraih Eman Ali , Sedhom Jessica Ashraf , Dokunmu Titilope Modupe , Hussein Mohammad Hosny , Ruiz Emmanuelle ML , Muthusamy Kunnimalaiyaan , Zerfaoui Mourad , Kandil Emad
Published: June 2020

To investigate the relationship between BCG vaccination and SARS-CoV-2 by bioinformatic approach. Two datasets for Sars-CoV-2 infection group and BCG-vaccinated group were downloaded. Differentially Expressed Genes were identified. Gene ontology and pathways were functionally enriched, and networking was constructed in NetworkAnalyst. Lastly, correlation between post-BCG vaccination and COVID-19 transcriptome signatures were established. A total of 161 DEGs (113 upregulated DEGs and 48 downregulated genes) were identified in the Sars-CoV-2 group. In the pathway enrichment analysis, cross-reference of upregulated KEGG pathways in Sars-CoV-2 with downregulated counterparts in the BCG-vaccinated group, resulted in the intersection of 45 common pathways, accounting for 86.5% of SARS-CoV-2 upregulated pathways. Of these intersecting pathways, a vast majority were immune and inflammatory pathways with top significance in IL-17, TNF, NOD-like receptors, and NF-κB signaling pathways. Our data suggests BCG-vaccination may incur a protective role in COVID-19 patients until a targeted vaccine is developed.

Supplementary Materials

(https://drive.google.com/open?id=15Na738L282XNaQAJUh0cZf1WoG9jJfzJ)
Phase separation induced by cohesin SMC protein complexes
Authors: Ryu Je-Kyung , Bouchoux Celine , Liu Hon Wing , Kim Eugene , Minamino Masashi , de Groot Ralph , Katan Allard J. , Bonato Andrea , Marenduzzo Davide , Michieletto Davide , Uhlmann Frank , Dekker Cees
Published: June 2020

Cohesin is a key protein complex that organizes the spatial structure of chromosomes during interphase. Here, we show that yeast cohesin shows pronounced clustering on DNA in an ATP-independent manner, exhibiting all the hallmarks of phase separation.In vitrovisualization of cohesin on DNA shows DNA-cohesin clusters that exhibit liquid-like behavior. This includes mutual fusion and reversible dissociation upon depleting the cohesin concentration, increasing the ionic strength, or adding 1,6-hexanediol, conditions that disrupt weak interactions. We discuss how bridging-induced phase separation can explain the DNA-cohesin clustering through DNA-cohesin-DNA bridges. We confirm that,in vivo,a fraction of cohesin associates with chromatin in yeast cells in a manner consistent with phase separation. Our findings establish that SMC proteins can exhibit phase separation, which has potential to clarify previously unexplained aspects ofin vivoSMC behavior and constitute an additional principle by which SMC complexes impact genome organization.

One sentence summary

Yeast cohesin complex is observed to phase separate with DNA into liquid droplets, which it accomplishes by ATP-independent DNA bridging.
Pathways of inter- and intrasubunit allosteric signaling in the C-linker disk and cyclic nucleotide-binding domain of HCN2 channels
Authors: Pfleger Christopher , Kusch Jana , Kondapuram Mahesh , Schwabe Tina , Sattler Christian , Benndorf Klaus , Gohlke Holger
Published: June 2020

Opening of hyperpolarization-activated cyclic nucleotide-modulated (HCN) channels is controlled by membrane hyperpolarization and binding of cyclic nucleotides to the tetrameric cyclic nucleotide-binding domain (CNBD), attached to the C-linker disk (CL). Confocal patch-clamp fluorometry revealed a pronounced cooperativity of ligand binding among protomers. However, by which pathways allosteric signal transmission occurs remained elusive. Here, we investigate how changes in the structural dynamics of the CL- CNBD of mouse HCN2 upon cAMP binding relate to inter- and intrasubunit signal transmission. Applying a rigidity theory-based approach, we identify two intersubunit and one intrasubunit pathways that differ in allosteric coupling strength between cAMP binding sites or towards the CL. These predictions agree with results from electrophysiological and patch-clamp fluorometry experiments. Our results map out distinct routes within the CL-CNBD that modulate different cAMP binding responses in HCN2 channels. They signify that functionally relevant submodules may exist within and across structurally discernable subunits in HCN channels.
Differential effect of anesthesia on visual cortex neurons with diverse population coupling
Authors: Lee Heonsoo , Tanabe Sean , Wang Shiyong , Hudetz Anthony G.
Published: June 2020

Introduction

Firing rate (FR) and population coupling (PC) are intrinsic properties of cortical neurons. Neurons with different FR and PC have diverse excitability to stimulation, tuning curve, and synaptic plasticity. Therefore, investigation of the effect of anesthesia on neurons with different FR and PC would be important to understand state-dependent information processing in neuronal circuits.

Methods

To test how anesthesia affects neurons with diverse PC and FR, we measured single-unit activities in deep layers of primary visual cortex at three levels of anesthesia with desflurane and in wakefulness. Based on PC and FR in wakefulness, neurons were classified into three distinct groups: high PC-high FR (HPHF), low PC-high FR (LPHF), and low PC-low FR (LPLF) neurons.

Results

Applying repeated light flashes as visual stimuli, HPHF neurons showed the strongest early response (FR at 20-150ms post-stimulus) among the three groups, whereas the response of LPHF neurons persisted longest (up to 440ms). Anesthesia profoundly altered PC and FR, and differently affected the three neuron groups: (i) PC and FR became strongly correlated suppressing population-independent spike activity; (ii) Pairwise correlation of spikes between neurons could be predicted by a PC-based raster model suggesting uniform neuron-to-neuron coupling; (iii) Contrary to evoked-potential studies under anesthesia, the flash-induced early response of HPHF neurons was attenuated, and their spike timing was split and delayed; (iv) Late response (FR at 200-400ms post-stimulus) was suppressed both in HPHF and LPHF neurons.

Conclusions

Anesthetic-induced association between PC and FR suggests reduced information content in the neural circuit. Altered response of HPHF neurons to visual stimuli suggests that anesthesia interferes with conscious sensory processing in primary sensory cortex.