bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating population level 24-h sodium excretion using spot urine samples in older adults in rural South Africa
Authors: Du Toit Jacques D. , Kapaon David , Crowther Nigel J. , Abrahams-Gessel Shafika , Fabian June , Kabudula Chodziwadziwa W. , Wade Alisha N. , Tollman Stephen , Gaziano Thomas A.
Published: December 2022

Background:

South Africa has introduced regulations to reduce sodium in processed foods. Assessing salt consumption with 24-h urine collection is logistically challenging and expensive. We assess the accuracy of using spot urine samples to estimate 24-h urine sodium (24hrUNa) excretion at the population level in a cohort of older adults in rural South Africa.

Methods:

24hrUNa excretion was measured and compared to that estimated from matched spot urine samples in 399 individuals, aged 40–75 years, from rural Mpumalanga, South Africa. We used the Tanaka, Kawasaki, International Study of Sodium, Potassium, and Blood Pressure (INTERSALT), and Population Mean Volume (PMV) method to predict 24hrUNa at the individual and population level.

Results:

The population median 24hrUNa excretion from our samples collected in 2017 was 2.6 g (interquartile range: 1.53–4.21) equal to an average daily salt intake of 6.6 g, whereas 65.4% of participants had a salt excretion above the WHO recommended 5 g/day. Estimated population median 24hrUNa derived from the INTERSALT, both with and without potassium, showed a nonsignificant difference of 0.25 g (P = 0.59) and 0.21 g (P = 0.67), respectively. In contrast, the Tanaka, Kawasaki, and PMV formulas were markedly higher than the measured 24hrUNa, with a median difference of 0.51 g (P = 0.004), 0.99 g (P = 0.00), and 1.05 g (P = 0.00) respectively. All formulas however performed poorly when predicting an individual's 24hrUNa,

Conclusion:

In this population, the INTERSALT formulas are a well suited and cost-effective alternative to 24-h urine collection for the evaluation of population median 24hrUNa excretion. This could play an important role for governments and public health agencies in evaluating local salt regulations and identifying at-risk populations.
Polyhexamethylene Biguanide Multipurpose Solutions on Bacterial Disinfection: A Comparison Study of Effectiveness in a Developing Country
Authors: de Azevedo Magalhães Otávio , Ribeiro dos Santos Débora , Coch Broetto Bruno Guilherme , Corção Gertrudes
Published: December 2022

Objective:

The aim of this study was to compare the antimicrobial action of commercially available multipurpose disinfection solutions (MPDS) with and without hydrogel contact lens for disinfection of isolated corneal bacteria.

Methods:

Five commercially available MPDS in Brazil (BioSoak, Clear Lens, OPTI-FREE, Renu, and UltraSept) were tested against Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis. All five MPDS were also tested on P. aeruginosa and S. aureus biofilm in a Hioxifilcon A lens.

Results:

OPTI-FREE and Renu were effective against all bacterial isolates without contact lenses. BioSoak was effective in inhibiting P. aeruginosa and S. epidermidis but not against S. aureus. UltraSept was effective for inhibiting S. epidermidis and S. aureus but not against P. aeruginosa. Clear Lens was effective in inhibiting only S. epidermidis but not P. aeruginosa and S. aureus. In contact lens bacterial biofilms, OPTI-FREE was the only MPDS to demonstrate significantly higher disinfection.

Conclusions:

MPDS containing dual biocides polyquaternium-1 and myristamidopropyl dimethylamine possess the highest disinfection action against multiple ocular pathogens with and without contact lenses when compared with other MPDS. Current single-action polyhexamethylene biguanide solutions are not entirely effective and should not be recommended.
Risk of Mania After Methylphenidate in Patients With Bipolar Disorder
Authors: Jefsen Oskar Hougaard , Østergaard Søren Dinesen , Rohde Christopher
Published: December 2022

Background

Bipolar disorder and attention-deficit/hyperactivity disorder are common comorbidities. Attention-deficit/hyperactivity disorder is commonly treated with stimulants (eg, methylphenidate), which, however, have been suggested to cause treatment-emergent mania in patients with bipolar disorder. Here, we assessed the risk of mania, depressive episodes, and psychiatric admissions after initiation of methylphenidate treatment in patients with bipolar disorder.

Methods

Using Danish health registries, we identified all individuals registered with a diagnosis of bipolar disorder from January 1, 2000, to January 1, 2018, who were treated with methylphenidate. We applied a 1-year mirror-image model to compare the occurrence of mania, depression, and psychiatric admissions in the period leading up to and after methylphenidate treatment initiation. We furthermore assessed the trend in these outcomes from 4 years before to 1 year after initiation of methylphenidate treatment.

Results

A total of 1043 patients with bipolar disorder initiated treatment with methylphenidate. The number of manic episodes decreased by 48% after methylphenidate treatment initiation (P = 0.01), both among patients using mood stabilizers (−50%) and among patients not using mood stabilizers (−45%). The number of manic episodes, however, peaked approximately 6 months before methylphenidate. The results were similar for the secondary outcomes.

Conclusions

Initiation of methylphenidate treatment was not associated with an increased risk of mania in patients with bipolar disorder. A decrease in mania, depressive episodes, and psychiatric admissions was observed after methylphenidate. However, these decreases seemed to be driven by regression to the mean after clinical deterioration preceding methylphenidate treatment, rather than by the methylphenidate treatment itself.
Acupuncture Legislation in Virginia, United States: A Personal Experience and Beyond
Authors: Fan Arthur Yin
Published: December 2022

Virginia was once considered as one of three states in the United States that was particularly resistant to acupuncture and its legislation, due to the historically strong conservative force in Virginia. In this article, the author aims to review and discuss the history and the current situation of acupuncture legislation in Virginia, and provides some insights for the related legislations in other states and at federal level. This study was based on author’s personal experience and an interview with Mr. Floyd Herdrich, former president of the Acupuncture Society of Virginia, who made the biggest contribution to this legislation. Led by the Acupuncture Society of Virginia, and supported by the School Tai Sophia Institute, Virginia acupuncture legislation began in 1988 and the law was implemented in 1994. Virginia is the 27th state in the United States to legalize acupuncture practice, and it has been 28 years since then. The author’s insights are: the first important factor is dedications as the persistent efforts in legislation usually take many years to materialize. The second factor is the strategy, that is, legislation through the executive or administrative system is probably a much easier route or shortcut.
Development of Chinese Medicine Education in the United States: Two Examples of Pacific College of Health and Science New York and Eastern School of Acupuncture and Traditional Medicine
Authors: Jin Qi-Hui , Zhou Yan , Kouo Thomas , Xiao Bin
Published: December 2022

Chinese medicine originated in China and has taken root all over the world. In the United States, Chinese medicine belongs to the category of complementary and alternative medicine and has a history of over 50 years as a recognized profession. The education of Chinese medicine is undoubtedly the foundation for the development and growth of Chinese medicine practice. In this article, we briefly introduced the history of acupuncture profession and its development in the United States. Pacific College of Health and Science New York and Eastern School of Acupuncture and Traditional Medicine were discussed and analyzed. This article aims to discuss two examples of acupuncture schools in the United States to provide an overview of the history and current development of Chinese medicine education in the United States.
Consumer wearable device-based measures of physical activity and energy expenditure in community-dwelling older adults with different levels of frailty: A STROBE compliant study
Authors: Park Kyue-nam , Kim Si-hyun
Published: December 2022

Physical activity is important for positive health outcomes, and wearable activity devices are useful for tracking physical activity patterns and energy expenditure. This study investigated differences in, and correlations of, duration of physical activity according to activity intensity and energy expenditure among community-dwelling older adults with different levels of frailty. This cross-sectional study enrolled 88 adults older than 65 years from communities between June 2019 and January 2020. The participants were divided into non-frail, pre-frail, and frail groups according to the frailty criteria. Outcomes included the frailty score, duration of physical activity according to the intensity of activity (sedentary, light, fairly active, fairly to very active, and very active), and energy expenditure measured by a consumer wearable device. The duration of physical activity according to the intensity of activity and energy expenditure were compared among non-frail, pre-frail, and frail groups. In addition, linear correlation analysis was used to identify significant associations of objectively measured physical activity and energy expenditure with frailty. Non-frail older adults showed significantly longer daily duration of light to very active physical activity and increased energy expenditure compared to the frail group (P < .05). Additionally, non-frail older adults engaged in significantly more light and fairly to very active physical activity, and showed increased energy expenditure, compared to the pre-frail group (P < .05). The non-frail group showed a significantly lower duration of sedentary behavior compared to the pre-frail group. Correlation analysis showed that frailty was significantly associated with decreased light to very active physical activity and energy expenditure, as well as increased sedentary behavior (P < .05). This study provides evidence of differences in objectively measured physical activity and energy expenditure between frail and non-frail older adults, and reveals an association of frailty with physical activity and energy expenditure. Daily physical activity that exceeds low-intensity, low-energy expenditure activity should be encouraged among older adults with frailty.
The diagnostic value of imaging techniques for keratoacanthoma: A review
Authors: Zhang Xiujuan , Shi Jiahong , Sun Zhixia , Dai Ting
Published: December 2022

Keratoacanthoma (KA) is a fast-growing skin tumor with solitary KA being the most common type. KAs rarely metastasize and subside spontaneously. Although histopathology is the gold standard for the diagnosis of KA, its histopathological features are sometimes difficult to distinguish from those of other skin tumors. Imaging studies have certain advantages in the preoperative diagnosis of KA; they not only show the exact shape of the lesion but can also accurately determine the extent of the lesion. Combined with histopathological examination, these findings help establish a diagnosis. By summarizing the imaging features of KA, this article aimed to improve radiologists’ understanding of the disease and help in the clinical and differential diagnosis of KA.
Efficacy and safety of endostar combined with cisplatin in treatment of non-small cell lung cancer with malignant pleural effusion: A meta-analysis
Authors: Hu Yongqi , Zhou Zhenke , Luo Miao
Published: December 2022

Background:

Although there are new treatments for non-small cell lung cancer with malignant pleural effusion, these therapies are prone to recurrent pleural effusion and poor in efficacy. And recombinant human endostatin is a new type of anti-tumor angiogenesis drug independently developed in my country. It has the effect of inhibiting tumor angiogenesis, inhibiting tumor proliferation and differentiation, and effectively inhibiting the formation and recurrence of malignant pleural effusion. Therefore, this study is aim to systematically review the efficacy and safety of intrapleural injection of endostar combined with cisplatin in the treatment of non-small cell lung cancer (NSCLC) with malignant pleural effusion.

Methods:

Databases including Cochrane Library, PubMed, CBM, Embase, CNKI, and WanFang Data were searched to collect randomized controlled trials about endostar combined with cisplatin for NSCLC with malignant pleural effusion from inception to April 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias in included studies. Finally, the meta-analysis was made by using RevMan 5.4.1 software.

Results:

A total of 11 randomized controlled trials involving 814 patients were finally included. The results of the meta-analysis showed that: The overall response rate and the improvement rate of quality of life in the endostar combined with cisplatin group were higher than that of the cisplatin alone group (relative risk = 1.58, 95% confidence interval = 1.42–1.76, P < .00001; relative risk = 1.63, 95% confidence interval = 1.38–1.93, P < .00001, respectively). Meanwhile, there were no significant differences between the 2 groups in the incidence of gastrointestinal reaction, the incidence of leucopenia, the incidence of thrombocytopenia, and the incidence of hypodynamia (all P values > .05).

Conclusion:

Compared with cisplatin, intrapleural injection of endostar combined with cisplatin could improve the overall response rate and the quality of life of NSCLC patients with malignant pleural effusion. Due to the limited quality and quantity of included studies, more high-quality studies are needed to verify the above conclusion.
Citation trends in ophthalmology articles and keywords in mainland China, Hong Kong, and Taiwan since 2013 using temporal bar graphs (TBGs): Bibliometric analysis
Authors: Hsu Sheng-Yao , Chien Tsair-Wei , Yeh Yu-Tsen , Kuo Shu-Chun
Published: December 2022

Background:

We selected authors from mainland China, Hong Kong, and Taiwan (CHT) to examine citation trends on articles and keywords. The existence of suitable temporal bar graphs (TBGs) for displaying citation trends is unknown. It is necessary to enhance the traditional TBGs to provide readers with more information about the citation trend. The purpose of this study was to propose an advanced TBG that can be applied to understand the most worth-reading articles by ophthalmology authors in the CHT.

Methods:

Using the search engine of the Web of Science core collection, we conducted bibliometric analyses to examine the article citation trends of ophthalmology authors in CHT since 2013. A total of 6695 metadata was collected from articles and review articles. Using radar plots, the Y-index, and the combining the Y-index with the CJAL scores (CJAL) scores, we could determine the dominance of publications by year, region, institute, journal, department, and author. A choropleth map, a dot plot, and a 4-quadrant radar plot were used to visualize the results. A TBG was designed and provided for readers to display citation trends on articles and keywords.

Results:

We found that the majority of publications were published in 2017 (2275), Shanghai city (935), Sun Yat-Sen University (China) (689), the international journal Ophthalmology (1399), the Department of Ophthalmology (3035), and the author Peizeng Yang (Chongqing) (65); the highest CAJL scores were also from Guangdong (2767.22), Sun Yat-Sen University (China) (2147.35), and the Ophthalmology Department (7130.96); the author Peizeng Yang (Chongqing) (170.16) had the highest CAJL; and the enhanced TBG features maximum counts and recent growth trends that are not included in traditional TBGs.

Conclusion:

Using the Y-index and the CJAL score compared with research achievements of ophthalmology authors in CHT, a 4-quadrant radar plot was provided. The enhanced TBGs and the CJAL scores are recommended for future bibliographical studies.
Adult sacrococcygeal teratoma: A review
Authors: Guo Jia-Xing , Zhao Jian-Guo , Bao Ying-Na
Published: December 2022

Sacrococcygeal teratomas (SCT) in adults are extremely rare, and most SCTs are located either mainly outside the pelvis, with a small number of intrapelvic components, or mostly in the pelvis (types III and IV). The etiology of teratomas remains unknown. Most teratomas are benign, and approximately 1 to 2% of teratomas undergo malignant transformation, including squamous cell carcinoma, adenocarcinoma, sarcoma, and other malignancies. Most SCTs grow insidiously, and their symptoms are not easily detected in the early stages. Some cases may only be discovered through physical examination or compression symptoms when the tumor reaches a detectable size. Computed tomography and magnetic resonance imaging have high detection rates for presacral space-occupying lesions and can provide imaging details with guiding significance for the selection of surgical methods. Surgical resection is the preferred treatment option for SCT and can determine the pathological type. Common sacrococcygeal malignancies are mainly immature teratomas and mature teratomas. When the presence of malignant components is confirmed, the treatment model should be adjusted according to pathological type.
Coexisting amyotrophic lateral sclerosis and chorea: A case report and literature review
Authors: Zhang Anni , Xu Hongbei , Huang Jing , Gong Huilan , Guo Shipeng , Lei Xiaoyang , He Dian
Published: December 2022

Background:

Amyotrophic lateral sclerosis (ALS) coexisting with chorea is very rare.

Case report:

We present the case of a 48-year-old man with ALS and chorea; the diagnostic certainty was high based on clinical examination results. Combining the data from literature, we analyzed the characteristics of patients with ALS and chorea. We found that ALS coexisting with chorea is very rare, but is often hereditary with a genetic mutation. Most patients with ALS and chorea are caused by abnormal amplification of a CAG sequence in the HTT gene, and these patients have a mild course of disease. The FUS, VCP, and SETX genes also have low mutation frequencies in patients with ALS and chorea.

Conclusion:

The abnormal amplification of a CAG sequence in the HTT gene in ALS with chorea has an obvious familial genetic tendency, and most patients have a mild disease course.
Frequent self-monitoring of intraocular pressure can determine effectiveness of medications in eyes with normal tension glaucoma: A case report
Authors: Mizohata Hideki , Ikesugi Kengo , Kondo Mineo
Published: December 2022

Rationale:

It is difficult to follow changes in the intraocular pressure (IOP) in glaucomatous eyes comprehensively because of the limited number of outpatient examinations. We report our findings in a case of normal tension glaucoma (NTG) in which frequent self-measurements of the IOP were used to evaluate the IOP-lowering effect of different medications.

Patient concerns:

A 50-year-old man with NTG had a nasal step visual field defect in his right eye and was being treated with 0.005% latanoprost (LAT) ophthalmic solution (XALATAN®).

Diagnosis:

The patient was diagnosed with NTG.

Interventions:

The patient had a mean IOP in the right eye of 10.9 ± 1.5 mm Hg (68 measurements in 1 month, Period A) during treatment with 0.005% LAT ophthalmic solution. During the second month (Period B), the mean IOP in the same eye was 9.8 ± 1.7 mm Hg (59 measurements) with treatment with a LAT and carteolol fixed combination (LCFC). And during the third month (Period C), the mean IOP was 7.4 ± 1.1 mm Hg (57 measurements) on the same right eye after the addition of brimonidine and brinzolamide fixed combination ophthalmic solution to the LCFC ophthalmic solution.

Outcomes:

Comparisons of the IOPs between Periods A and B and between B and C showed that the reductions in the IOP were significant.

Conclusion:

We conclude that frequent self-measurements of the IOP can determine that small changes of the IOPs are significant.
Changes in Medicaid enrollment during the COVID-19 pandemic across 6 states
Authors: Sun Ran , Staiger Becky , Chan Antonia , Baker Laurence C. , Hernandez-Boussard Tina
Published: December 2022

The coronavirus disease 2019 public health emergency (PHE) caused extensive job loss and loss of employer-sponsored insurance. State Medicaid programs experienced a related increase in enrollment during the PHE. However, the composition of enrollment and enrollee changes during the pandemic is unknown. This study examined changes in Medicaid enrollment and population characteristics during the PHE. A retrospective study documenting changes in Medicaid new enrollment and disenrollment, and enrollee characteristics between March and October 2020 compared to the same time in 2019 using full-state Medicaid populations from 6 states of a wide geographical region. The primary outcomes were Medicaid enrollment and disenrollment during the PHE. New enrollment included persons enrolled in Medicaid between March and October 2020 who were not enrolled in January or February, 2020. Disenrollment included persons who were enrolled in March of 2020 but not enrolled in October 2020. The study included 8.50 million Medicaid enrollees in 2020 and 8.46 million in 2019. Overall, enrollment increased by 13.0% (1.19 million) in the selected states during the PHE compared to 2019. New enrollment accounted for 24.9% of the relative increase, while the remaining 75.1% was due to disenrollment. A larger proportion of new enrollment in 2020 was among adults aged 27 to 44 (28.3% vs 23.6%), Hispanics (34.3% vs 32.5%) and in the financial needy (44.0% vs 39.0%) category compared to 2019. Disenrollment included a larger proportion of older adults (26.1% vs 8.1%) and non-Hispanics (70.3% vs 66.4%) than in 2019. Medicaid enrollment grew considerably during the PHE, and most enrollment growth was attributed to decreases in disenrollment rather than increases in new enrollment. Our results highlight the impact of coronavirus disease 2019 on state health programs and can guide federal and state budgetary planning once the PHE ends.
Case report of anosognosia for hemiplegia: A fMRI study
Authors: Formica Caterina , De Salvo Simona , Corallo Francesco , Latella Desiree , Mìcchia Katia , Bonanno Lilla , Quartarone Angelo , Marino Silvia
Published: December 2022

Objective:

The aim of this study is to verify the functional activation in a patient with anosognosia for hemiplegia following left brain lesions.

Methods:

We report a case of a 53-year-old right-handed female patient. She came to our rehabilitative unit with a diagnosis of an ischemic major stroke in the left internal carotid artery and important hemiplegia to the right side. She underwent functional magnetic resonance imaging (fMRI), during which she performed a motor imagery task.

Results:

The fMRI assessment showed an ischemic lesion in the frontotemporal and insular left areas. In the fMRI experiment, we revealed activation of the residual neural patterns of both hemispheres.

Conclusion:

We underlined an interest in the compensation mechanism that involved neural networks near brain lesions and some areas of the contro-lesional hemisphere, suggesting that the synaptic plasticity permitted an intra and inter-hemispheric reorganization of the cerebral system.
Mortality and comorbidities in patients with bronchiectasis over a 3-year follow-up
Authors: Mateus Simone Paulo , Ribeiro-Alves Marcelo , Salles Raquel Esteves Brandão , Costa Walter , Costa Claudia Henrique da , Lopes Agnaldo José , Bártholo Thiago Prudente , Mafort Thiago Thomaz , Tura Bernardo Rangel , Rufino Rogério
Published: December 2022

To identify the risk factors associated with all-cause mortality in patients with noncystic fibrosis bronchiectasis (NCFB). This prospective cohort study included 120 adult patients with NCFB, who were regularly treated at a specialized outpatient clinic of a university hospital between January 2017 and June 2020. All patients were diagnosed using high-resolution computed tomography. Demographic and clinical data, pulmonary function tests, and the Euro-quality-of-life 5-domain 3-level questionnaire were analyzed. The factors associated with death were determined using the Cox proportional hazards model. The all-cause mortality rate at 41 months was 10.8%. Adjusted multivariate analysis showed that the main contributing predictors for mortality were female sex, smoking, diabetes, chronic obstructive pulmonary disease, emergency visits, use of antibiotics due to exacerbation, secretion color change, exacerbation, predicted forced expiratory volume in 1 second, predicted forced vital capacity, lack of respiratory physiotherapy, absence of vaccination against pneumococci, and mobility domain. Multiple factors contribute to unfavorable outcomes in patients with NCFB, and early recognition of these factors may improve care management.
The efficacy of modified HuangLian JieDu decoction for early enteral nutrition in patients with sepsis: A randomized controlled study
Authors: Wang Yifei , Li Yue , Ye Yanyang , Xuan Lusha , Xu Lijie , Li Guofa , Zhou Yang , Ma Huanggang , Zhou Lingjie , Chen Yanjun , Wu Weifei , Zhu Weidong , Zhang Yunhua
Published: December 2022

Objective:

This study aimed to evaluate the efficacy of modified HuangLian JieDu decoction (MHLJDD) as a supplementary medication for early enteral nutrition in septic patients.

Methods:

This study was designed as a randomized controlled preliminary study. Septic patients were randomly divided into control (treated with the base treatment) and intervention (co-treated with MHLJDD and the base treatment) groups. The primary outcomes of this study were 60-day (d) mortality rate, length of mechanical ventilation (MV), and length of stay in the intensive care unit (ICU).

Results:

Of the 86 included patients, 44 and 42 were allocated to the intervention and control groups, respectively. Lengths of MV and ICU stay were significantly shorter in the intervention group than in the control group (10.31 ± 3.92 d vs 8.66 ± 2.84 d, P = .028; and 11.88 ± 5.25 d vs 10.41 ± 3.14 d, P = .029; respectively). However, the difference in 60-d mortality rate between the 2 groups was not statistically significant (20.45% vs 38.10%, P = .071). The enteral-nutrition tolerance score of the control group was higher than that of the intervention group (6.81 ± 4.28 vs 4.68 ± 4.04, P = .020). Incidence of hyperglycemia and gastric retention (gastric residual volume > 250 mL) was higher in the control group than in the intervention group (59.52% vs 29.55%, P = .005; and 28.57% vs 11.36%, P = .020, respectively).

Conclusions:

MHLJDD can shorten the MV and ICU stay of septic patients.
Distal tibial tubercle-high tibial osteotomy with assistance of modifiable spreader in the treatment of varus knee osteoarthritis: A retrospective observational study
Authors: Fu Qiang , Yan Shijie , Hou Xizhi , He Zeyang , Lu Quanxiu , Yuan Weijie , Hu Hongliang
Published: December 2022

As one of the knee preservation surgical approaches, good clinical outcomes of high tibial osteotomy were reported. Aims of this study were to analyze the clinical outcome and pre- and postoperative radiographical parameter and knee functional score between distal tibial tubercle high tibial osteotomy (DTTHTO) and open wedge- high tibial osteotomy (OWHTO) in patients with varus knee osteoarthritis after more than 1 year following-up. A total of 194 consecutive patients in our joint center from March 2016 to October 2021 were enrolled, according to the surgical method, patients were divided into DDTHTO and OWHTO groups. Radiographic parameters of Kellgren-Lawrence grading, hip-knee-ankle angle, weight bearing line ratio and medial tibial plateau angle, knee functional score of American knee society (AKS) score, western Ontario and McMaster universities arthritis index (WOMAC) score, visual analogue score (VAS) were introduced to evaluate clinical outcome for patients who received DDTHTO and OWHTO. There were 103 knees and 89 knees in the OWHTO and DTTHTO group, respectively. Mean weight bearing line ratio for OWHTO and DTTHTO were 25.1 ± 11.7 and 25.2 ± 12.0% respectively, medial tibial plateau angle and hip-knee-ankle angle angle demonstrated that all patients in the present study inherited a varus angle ranges from 3.4° to 9.5°. Preoperative AKS, WOMAC and VAS were 68.4 ± 5.7 versus 69.0 ± 5.9, 109.3 ± 15.0 versus 107.7 ± 14.0 and 6.8 ± 1.0 versus 6.9 ± 0.8, and there was no significant difference between 2 groups (P > .05). Mean postoperative AKS and WOMAC score for patients in both OWHTO and DTTHTO group were significantly improved, moreover, postoperative VAS of DTTHTO patients was lower than that in OWHTO group (P < .05). When comparing the operation time, intraoperative blood loss and bone union time, DHHTO group shows a superiority in these variables over patients in OWHTO (121 ± 29.6 vs 145.7 ± 35.2 minutes, 115.0 ± 20.8 vs 103.3 ± 17.3 mL, 13.7 ± 4.1 vs 12.0 ± 2.8 weeks; P < .005) and incidence of complication was lower for DTTHTO group. DTTHTO in patients with varus knee osteoarthritis has good clinical outcomes, and it can achieve a better postoperative alignment. Operation time and surgical trauma were also less in patients who underwent DTTHTO.
Lesion or Pseudolesion? A Comprehensive Description of Perfusion-Based Liver Alterations on Contrast-Enhanced Computed Tomography and Literature Review
Authors: Cè Maurizio , Gibelli Daniele , Martinenghi Carlo , Alì Marco , Schifano Eliana , Cellina Michaela
Published: December 2022

Pseudolesions on contrast-enhanced computed tomography represent a diagnostic challenge for radiologists because they could be difficult to distinguish from true space-occupying lesions. This article aims to provide a detailed overview of these entities based on radiological criteria (hyperattenuation or hypoattenuation, localization, morphology), as well as a brief review of the hepatic vascular anatomy and pathophysiological process. Relevant examples from hospital case series are reported as helpful hints to assist radiologists in recognizing and correctly diagnosing these abnormalities.
Trends in Medicare Reimbursement for the Top 20 Surgical Procedures in Craniofacial Trauma
Authors: Kandi Lyndsay A. , Jarvis Tyler L. , Shrout Max , Thornburg Danielle A. , Howard Michael A. , Ellis Marco , Teven Chad M.
Published: December 2022

Background:

Research regarding financial trends in craniofacial trauma surgery is limited. Understanding these trends is important to the evolvement of suitable reimbursement models in craniofacial plastic surgery. The purpose of this study was to evaluate the trends in Medicare reimbursement rates for the top 20 most utilized surgical procedures for facial trauma.

Methods:

The 20 most commonly utilized Current Procedural Terminology (CPT) codes for facial trauma repairs in 2018 were queried from The National Summary Data File from the Centers for Medicare & Medicaid Services (CMS). Reimbursement data for each procedure was then extracted from The Physician Fee Schedule Lookup Tool. Changes to the United States consumer price index (CPI) were used to adjust all gathered data for inflation to 2021 US dollars (USD). The average annual and the total percent change in reimbursement were calculated for the included procedures based on the adjusted trends from the years 2000 to 2021.

Results:

From 2000 to 2021, the average reimbursement for all procedures decreased by 16.6% after adjusting for inflation. Closed treatment of temporomandibular joint dislocation and closed treatment of nasal bone fractures without manipulation demonstrated the greatest decrease in mean adjusted reimbursement at −48.7% and −48.3%, respectively, while closed treatment of nasal bone fractures without stabilization demonstrated the smallest mean decrease at −1.4% during the study period. Open treatment of nasal septal fractures with or without stabilization demonstrated the greatest increase in mean adjusted reimbursement at 18.9%, while closed treatment of nasal septal fractures with or without stabilization demonstrated the smallest increase at 1.2%. The average reimbursement for all closed procedures in the top 20 decreased by 19.3%, while that for all open procedures decreased by 15.5%. The adjusted reimbursement rate for all top 20 procedures decreased by an average of 0.8% each year.

Conclusions:

To the best of our knowledge, this is the first study to comprehensively evaluate trends in Medicare reimbursement for facial trauma surgical repairs. Adjusting for inflation, Medicare reimbursement for the top 20 most commonly utilized procedures has largely decreased from 2000 to 2021. Consideration of these trends by surgeons, hospital systems, and policymakers will be important to assure continued access to meaningful surgical facial trauma care in the United States.
Diagnostic Accuracy of Microdialysis in Postoperative Flap Monitoring
Authors: Hwang Se Jin
Published: December 2022

Postoperative monitoring plays an important role in achieving success in microvascular free tissue transfer. A systematic review was designed to evaluate the clinical outcomes of microdialysis in flap monitoring and a meta-analysis was conducted for diagnostic accuracies. The search terms “microdialysis” and “flap” were used in a PubMed and Scopus search, resulting in 60 and 78 results, respectively. Among 78 titles, 15 articles were excluded. Among 63 abstracts, 43 abstracts were excluded. From 20 full texts, 7 articles were excluded because they did not have sufficient content (ie, the statistical values in question). A systematic review was conducted of the final 13 articles. The overall sensitivity was 97.24% [95% confidence interval (CI)=93.67%–99.10%]. Eleven of the 13 studies showed 100% sensitivity and 2 studies had 2 and 3 false negative results, resulting in sensitivity values of 85.8% and 95.3%. Specificity ranged from 91.89% to 100%, and the overall value was 98.15% (95% CI=96.80%–99.04%). The positive predictive value ranged from 84.62% to 100%, with an overall value of 93.62% (95% CI=89.33%–96.26%). The negative predictive value ranged from 94.44% to 100%, with an overall value of 99.22% (95% CI=98.17%–99.67%). The overall flap success rate (survival rate) was 93.7% (786/839). The lowest flap survival rate was 86.7% and the highest was 100%. Microdialysis provides excellent diagnostic accuracy and enables the early detection of ischemia in postoperative flap monitoring. Although microdialysis is not the most popular choice among surgeons, it should be considered adjacent to conventional clinical monitoring. Cost-effectiveness, availability, and ease of application remain hurdles.
Achieving Equity in Organ Transplantation: Recommendations for Action Based on the National Academies of Sciences, Engineering, and Medicine Report
Authors: Dageforde Leigh Anne , English Rebecca A. , Kizer Kenneth W.
Published: December 2022

The United States organ transplantation system has recently reached a historic milestone of a cumulative 1 million transplants. Despite this considerable success in providing life-saving organ transplants to patients with end organ failure, there are ample opportunities for improvement, particularly with regard to achieving equity. Recognizing this, Congress directed the National Institutes of Health to fund the National Academies of Sciences, Engineering, and Medicine in conducting a study on deceased donor organ procurement, allocation, and distribution, recommending ways to improve equity and accountability. The National Academies of Sciences, Engineering, and Medicine study committee’s report, Realizing the Promise of Equity in the Organ Transplantation System, reached multiple conclusions and agreed on 14 recommendations for action that can be grouped into 3 areas: (1) achieving equity, (2) improving system performance, and (3) increasing the utilization of available organs. Here, we review overarching areas for improvement, highlighting key recommendations, and suggest implementing actions.
Subset-specific Retention of Donor Myeloid Cells After Major Histocompatibility Complex-matched and Mismatched Liver Transplantation
Authors: Dart Sarah J. , Prosser Amy C. , Huang Wen Hua , Liu Liu , Lucas Andrew D. , Delriviere Luc , Gaudieri Silvana , Jeffrey Gary P. , Lucas Michaela
Published: December 2022

Background.

During solid organ transplantation, donor leukocytes, including myeloid cells, are transferred within the organ to the recipient. Both tolerogenic and alloreactive roles have been attributed to donor myeloid cells; however, their subset-specific retention posttransplantation has not been investigated in detail.

Methods.

Major histocompatibility complex (MHC)–matched and mismatched liver transplants were performed in mice, and the fate of donor and recipient myeloid cells was assessed.

Results.

Following MHC-matched transplantation, a proportion of donor myeloid cells was retained in the graft, whereas others egressed and persisted in the blood, spleen, and bone marrow but not the lymph nodes. In contrast, after MHC-mismatched transplantation, all donor myeloid cells, except Kupffer cells, were depleted. This depletion was caused by recipient T and B cells because all donor myeloid subsets were retained in MHC-mismatched grafts when recipients lacked T and B cells. Recipient myeloid cells rapidly infiltrated MHC-matched and, to a greater extent, MHC-mismatched liver grafts. MHC-mismatched grafts underwent a transient rejection episode on day 7, coinciding with a transition in macrophages to a regulatory phenotype, after which rejection resolved.

Conclusions.

Phenotypic and kinetic differences in the myeloid cell responses between MHC-matched and mismatched grafts were identified. A detailed understanding of the dynamics of immune responses to transplantation is critical to improving graft outcomes.
SATB2 organizes the 3D genome architecture of cognition in cortical neurons
Authors: Wahl Nico , Espeso-Gil Sergio , Chietera Paola , Laighneach Aodán , Morris Derek W. , Rajarajan Prashanth , Akbarian Schahram , Dechant Georg , Apostolova Galina
Published: December 2022

SATB2is genetically associated with human intelligence. Since SATB2 protein structure predicts a function in DNA looping, we analyzed the impact of SATB2 on 3D genome architecture and chromatin accessibility in cortical neurons. Our data reveal strong effects of SATB2 on chromatin looping between enhancers and promoters of neuronal activity-regulated genes, which closely correlate with gene expression. We furthermore identify SATB2-dependent alterations at all 3D genome architectural levels, including compartments, Topologically Associated Domains and Frequently Interacting Regions. Genes linked to SATB2-dependent 3D genome changes are implicated in highly specialized neuronal functions and contribute to cognitive ability and risk for neuropsychiatric and neurodevelopmental disorders. The altered non-coding regions are enriched for common variants associated with educational attainment, intelligence and schizophrenia. Our data establish SATB2 as a 3D genome organizer, which operates both independently and in cooperation with CTCF to set up the chromatin landscape of pyramidal neurons for cognitive processes.
Directly and indirectly determinable rate constants in Michaelian enzyme-catalyzed reactions
Authors: Udema Ikechukwu Iloh
Published: December 2022

Backed by kinetic schemes, attempts had been made to derive equations for the calculation of all zero-order first-order rate constants (ZOFORC) for the activation of the enzyme-substrate (ES) complex and its deactivation,k+2andk−2, respectively. The values of ZOFORC, including the kind for the dissociation of the enzyme-product complex (EP) to free enzyme (E) and product (P), are hardly reported. The methods of research were primarily Bernfeld and Lineweaver methods. The goal of the research was to determine ways for the utilization of experimental data for the determination of verifiable and quantifiable rate constants, with the following objectives: 1) To derive equations for the first order rate constants,k+2andk-2, for the activation of ES and its deactivation, respectively; 2) to quantify by calculation the first order rate constant for product release; 3) ultimately quantify the rate constants,k-2andk+2; and 4) to advise the reactor, process, chemical engineers,etc. in different industrial concerns on the usefulness ofk-2andk+2. The value of ZOFORC for the dissociation of EP to free E and P is 3.155 exp. (+5)/min; the values ofk+2andk-2are 3.513 exp. (+4) and 2.377 exp. (+8)/min, respectively. Ultimately, it is imperative for all stakeholder groups to devise means of controlling the enzymatic rate of catalysis by manipulating the magnitudes ofk+2andk-2in particular. The derived equations can be fitted to the experimentally generated and calculated data. A future research project should entail conducting the assay under optimum conditions so as to verify possible variations in the ZOFORC values when compared with values generated outside optimum conditions.
A Clinically Useful and Biologically Informative Genomic Classifier for Papillary Thyroid Cancer
Authors: Craig Steven , Stretch Cynthia , Farshidfar Farshad , Sheka Dropen , Alabi Nikolay , Siddiqui Ashar , Kopciuk Karen , Park Young Joo , Khalil Moosa , Khan Faisal , Harvey Adrian , Bathe Oliver F.
Published: December 2022

Clinical management of papillary thyroid cancer depends on estimations of prognosis. Standard care, which relies on prognostication based on clinicopathologic features, is inaccurate. We applied a machine learning algorithm (HighLifeR) to 502 cases annotated by The Cancer Genome Atlas Project to derive an accurate molecular prognostic classifier. Unsupervised analysis of the 82 genes that were most closely associated with recurrence after surgery enabled identification of three unique molecular subtypes. One subtype had a high recurrence rate, an immunosuppressed microenvironment, and enrichment of the EZH2-HOTAIR pathway. Two other unique molecular subtypes with a lower rate of recurrence were identified, including one subtype with a paucity of BRAFV600Emutations and a high rate of RAS mutations. The genomic risk classifier, in addition to tumor size and lymph node status, enabled effective prognostication that outperformed the American Thyroid Association clinical risk stratification. The genomic classifier we derived can potentially be applied preoperatively to direct clinical decision-making. Distinct biological features of molecular subtypes also have implications regarding sensitivity to radioactive iodine, EZH2 inhibitors, and immune checkpoint inhibitors.
Prenatal Carotenoid Supplementation with Lutein or Zeaxanthin Ameliorates Oxygen-Induced Retinopathy (OIR) inBco2-/-Macular Pigment Mice
Authors: Arunkumar Ranganathan , Li Binxing , Addo Emmanuel K. , Hartnett M. Elizabeth , Bernstein Paul S.
Published: December 2022

Purpose

Premature infants at risk of retinopathy of prematurity (ROP) miss placental transfer of carotenoids, lutein (L) and zeaxanthin (Z), during the third trimester. We previously demonstrated that prenatal L and Z supplementation raises carotenoid levels in infants at birth in theLutein andZeaxanthin inPregnancy (L-ZIP) study (NCT03750968). Based on their antioxidant effects and bioavailability, we hypothesized that prenatal maternal supplementation with macular carotenoids would reduce risk of ROP. To test this hypothesis, we utilized “macular pigment mice” genetically engineered to take up L and Z into the retina in a model of oxygen-induced retinopathy (OIR).

Methods

PregnantBco2-/-mice were divided into nine experimental subgroups based on the type of supplementation (L, Z, or placebo) and on maternal supplementation start date corresponding to the three trimesters of human fetal development (E0, E11, and P1). Pups and nursing mothers were exposed to 75% O2for 5 days (P7-12) and returned to room air for 5 days (P12-17). Pups were sacrificed at P12 and P17, and their retinas were analyzed for vaso-obliteration (VO) and intravitreal neovascularization (INV).

Results

Pups of pregnant mice supplemented with L or Z had significant reductions in VO and INV areas compared to placebo. Prenatal carotenoid supplementation starting at E0 or E11 was significantly more protective against OIR than postnatal supplementation starting at P1.

Conclusion

Prenatal supplementation with L and Z was beneficial in a mouse OIR model. We recommend testing prenatal L and Z supplementation in future human clinical trials to prevent ROP.
SCellBOW: AI-Driven Tumor Risk Stratification from Single-Cell Transcriptomics Using Phenotype Algebra
Authors: Bhattacharya Namrata , Rockstroh Anja , Deshpande Sanket Suhas , Thomas Sam Koshy , Yadav Anunay , Goswami Chitrita , Chawla Smriti , Solomon Pierre , Fourgeux Cynthia , Ahuja Gaurav , Hollier Brett , Kumar Himanshu , Roquilly Antoine , Poschmann Jeremie , Lehman Melanie , Nelson Colleen C. , Sengupta Debarka
Published: December 2022

Single-cell RNA-sequencing (scRNA-seq) coupled with robust computational analysis facilitates the characterization of phenotypic heterogeneity within tumors. Current scRNA-seq analysis pipelines are capable of identifying a myriad of malignant and non-malignant cell subtypes from single-cell profiling of tumors. However, given the extent of intra-tumoral heterogeneity, it is challenging to assess the risk associated with individual cell subpopulations, primarily due to the complexity of the cancer phenotype space and the lack of clinical annotations associated with tumor scRNA-seq studies. To this end, we introduce SCellBOW, a scRNA-seq analysis framework inspired by document embedding techniques from the domain of Natural Language Processing (NLP). SCellBOW is a novel computational approach that facilitates effective identification and high-quality visualization of single-cell subpopulations. We compared SCellBOW with existing best practice methods for its ability to precisely represent phenotypically divergent cell types across multiple scRNA-seq datasets, including our in-house generated human splenocyte and matched peripheral blood mononuclear cell (PBMC) dataset. For tumor cells, SCellBOW estimates the relative risk associated with each cluster and stratifies them based on their aggressiveness. This is achieved by simulating how the presence or absence of a specific cell subpopulation influences disease prognosis. Using SCellBOW, we identified a hitherto unknown and pervasive AR−/NElow(androgen-receptor-negative, neuroendocrine-low) malignant subpopulation in metastatic prostate cancer with conspicuously high aggressiveness. Overall, the risk-stratification capabilities of SCellBOW hold promise for formulating tailored therapeutic interventions by identifying clinically relevant tumor subpopulations and their impact on prognosis.