bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic stratification of inherited and sporadic phaeochromocytoma and paraganglioma: implications for precision medicine
Authors: Casey Ruth , Neumann Hartmut P H , Maher Eamonn R
Published: October 2020

Over the past two decades advances in genomic technologies have transformed knowledge of the genetic basis of phaeochromocytoma and paraganglioma (PPGL). Though traditional teaching suggested that inherited cases accounted for only 10% of all phaeochromocytoma diagnosis, current estimates are at least three times this proportion. Inherited PPGL is a highly genetically heterogeneous disorder but the most frequently results from inactivating variants in genes encoding subunits of succinate dehydrogenase. Expanding knowledge of the genetics of PPGL has been translated into clinical practice by the provision of widespread testing for inherited PPGL. In this review, we explore how the molecular stratification of PPGL is being utilized to enable more personalized strategies for investigation, surveillance and management of affected individuals and their families. Translating recent genetic research advances into clinical service can not only bring benefits through more accurate diagnosis and risk prediction but also challenges when there is a suboptimal evidence base for the clinical consequences or significance of rare genotypes. In such cases, clinical, biochemical, pathological and functional imaging assessments can all contribute to more accurate interpretation and clinical management.
Teamwork in hip preservation: the ISHA 2019 Annual Scientific Meeting
Authors: Lall Ajay C , Walsh John P , Maldonado David R , Pinto Leonardo E , Ashberg Lyall J , Lodhia Parth , Radha Sarkhell , Correia António Pedro Robalo , Domb Benjamin G , Perez-Carro Luis , Marín-Peña Oliver , Griffin Damian R
Published: October 2020

Hip preservation surgery is now an established part of orthopedic surgery and sports medicine. This report describes the key findings of the 11th Annual Scientific Meeting of International Society for Hip Arthroscopy—the International Hip Preservation Society—in Madrid, Spain from 16 to 19 October 2019. Lectures, seminars and debates explored the most up-to-date and expert views on a wide variety of subjects, including: diagnostic problems in groin pain, buttock pain and low back pain; surgical techniques in acetabular dysplasia, hip instability, femoroacetabular impingement syndrome, labral repair and reconstruction, cartilage defects, adolescent hips and gluteus medius and hamstring tears; and new ideas about femoral torsion, hip–spine syndrome, hip capsule surgery, impact of particular sports on hip injuries, registries, robotics and training for hip preservation specialists. Surgeons, sports physicians, radiologists and physiotherapists looking after young people with hip problems have an increasingly sophisticated armoury of ideas and techniques with which to help their patients. The concept of hip preservation has developed incredibly fast over the last decade; now it is clear that the best results can only be achieved by a multidisciplinary team working together. The 2020s will be the decade of ‘Teamwork in Hip Preservation’.
Surgical resection of the primary lesion for osteosarcoma patients with metastasis at initial diagnosis
Authors: Zhang Liuzhe , Akiyama Toru , Fukushima Takashi , Iwata Shintaro , Takeshita Katsushi , Kawai Akira , Tanaka Sakae , Kobayashi Hiroshi
Published: October 2020

Background

Approximately 10–20% of osteosarcoma patients present with metastasis on diagnosis. Completely resecting the lesion is associated with better prognosis. However, evidence regarding optimal surgical strategies for patients with unresectable metastasis is limited.

Methods

This retrospective analysis was based on the Japanese Nationwide Bone and Soft Tissue Tumor registry. In total, 335 patients diagnosed with osteosarcoma with metastasis were included. Factors affecting overall survival were identified using multivariate analysis. Kaplan–Meier method was used to compare the overall survival by the status of surgical intervention. Two hundred and four patients who did not undergo surgery for metastasis were divided into two groups, depending on whether they underwent surgery for the primary lesion. The background differences between these two groups were adjusted with propensity score matching, with 43 patients per group. The overall survival was calculated using the Kaplan–Meier method and compared with a log-rank test.

Results

Factors positively impacting overall survival were age <40, female sex, extremity origin, surgery for the primary lesions, surgery for metastasis and radiotherapy without surgery. For patients with unresectable metastasis, after propensity score matching, the survival rate was higher in the group that underwent primary lesion surgery than the group without surgery. Their median survival was 19 (95% confidence interval: 11.7–26.3) and 11 months (95% confidence interval: 4.5–17.5) (P = 0.02), respectively.

Conclusions

Surgical resection of the primary osteosarcoma lesion did not worsen prognosis, even in patients with unresectable metastasis. Further study is needed to identify which patient group will benefit from primary lesion resection.
Analysing India’s Open Acreage Licensing Policy: problems and perspectives
Authors: Pratik Dixit
Published: October 2020

In recent decades, India has increasingly felt the need to reduce its dependence on imported crude oil by augmenting domestic production. In such pursuance, India recently enacted the Hydrocarbon Exploration Licensing Policy (HELP) to attract private investments in India’s upstream oil and gas sector. One of the salient features of HELP is the Open Acreage Licensing Policy (OALP), which sought to liberalize auctioning and licensing process of upstream oil and gas sector in India. This article analyses the salient features of the OALP to argue that it has remedied most of the problems associated with previous licensing regimes. Even though India has significantly liberalized the auction and licensing process, the fiscal terms governing the revenue sharing between the operator and the government have served as a deterrent to make India an attractive destination for foreign investors. Therefore, this article suggests that India must offer more attractive fiscal terms to oil companies to incentivize them to undertake the risk of investing in India’s upstream sector.
Analysis of wind-speed profiles and optical turbulence above Gaomeigu and the Tibetan Plateau using ERA5 data
Authors: Han Yajuan , Yang Qike , Liu Nana , Zhang Kun , Qing Chun , Li Xuebin , Wu Xiaoqing , Luo Tao
Published: October 2020

Appropriate knowledge of wind-speed distributions and optical turbulence at existing and potential astronomical observatories is crucial for siting ground-based telescopes and applying adaptive optics (AO) systems. In this paper, the wind-speed and optical-turbulence characteristics above Gaomeigu and the Tibetan Plateau are studied by employing the 20-yr (1999–2018) European Centre for Medium-Range Weather Forecasts’ fifth set of reanalysis data (ERA5). First, the meteorological parameters derived from ERA5 data are evaluated with coinciding radiosonde measurements. Results show that the meteorological parameters of ERA5 data in the free atmosphere have quite good reliability, with bias and root mean square error basically lower than 1.2 K in temperature and basically smaller than 2 m s−1 for wind speed. Then, vertical distributions and seasonal behaviour of the wind speed at Gaomeigu and Lhasa station above the Tibetan Plateau are analysed. Thirdly, the Richardson number (Ri) in the free atmosphere is calculated to provides us with a map of relative probability of different periods and regions of optical turbulence being developed above the two sites. In general, the atmospheric stability of Gaomeigu is higher than that of Lhasa station. Particularly in June, for Gaomeigu, the atmospheric stability within 6–30 km a.s.l. is basically superior or equal to the stable condition found at two mid-latitude sites: Oukaimeden and La Palma. Moreover, Lhasa station has a relative higher stability during June–September than other months. Furthermore, we provide the $( {C_n^2} )$ profiles using ERA5 data at Gaomeigu and Lhasa. The results indicate that the choice of an appropriate outer-scale model is crucial for revealing local turbulence characteristics.
Characterizing the possible interior structures of the nearby Exoplanets Proxima Centauri b and Ross-128 b
Authors: Herath Mahesh , Gunesekera Saraj , Jayaratne Chandana
Published: October 2020

We developed a new numerical model to constrain the interior structure of rocky Exoplanets, and applied it to the nearby planets Proxima Centauri b and Ross-128 b. The recently measured elemental abundances of red dwarfs and Alpha Centauri were utilized to infer the bulk composition of each planet, and to measure their core mass fractions (CMFs). The results of our model predicted that the radius of Proxima b at its minimum mass may be 1.036 ± 0.040 R⊕, and if its mass is as high as 2 M⊕, 1.170 ± 0.040 R⊕. The radius of Ross-128 b at minimum mass may be 1.034 ± 0.040 R⊕, with its radius at an upper bound mass of 2 M⊕ being 1.150 ± 0.040 R⊕. Both planets may have thin mantles with similar conditions to Earth, but not convecting as vigorously. The CMFs might lie in the ranges of 20–59 per cent and 34–59 per cent for Proxima b and Ross-128 b, respectively, making it very likely they have massive iron cores. Their central temperatures may be high enough to partially melt the cores, and possibly generate magnetic fields. If they have magnetic fields at present, they are most likely to be multipolar in nature due to slow rotation speeds resulting from stellar tidal effects. The field strengths were predicted to have values of 0.06–0.23 G for Proxima b, and 0.07–0.14 G for Ross-128 b. If either planet contains more than 10 per cent of their mass in volatiles, magnetic fields would either be non-existent or very weak. The conditions of both planets may be hostile for habitability.
Unravelling the enigmatic ISM conditions in Minkowski’s object
Authors: Zovaro Henry R M , Sharp Robert , Nesvadba Nicole P H , Kewley Lisa , Sutherland Ralph , Taylor Philip , Groves Brent , Wagner Alexander Y , Mukherjee Dipanjan , Bicknell Geoffrey V
Published: October 2020

Local examples of jet-induced star formation lend valuable insight into its significance in galaxy evolution and can provide important observational constraints for theoretical models of positive feedback. Using optical integral field spectroscopy, we present an analysis of the ISM conditions in Minkowski’s object (z = 0.0189), a peculiar star-forming dwarf galaxy located in the path of a radio jet from the galaxy NGC 541. Full spectral fitting with ppxf indicates that Minkowski’s object primarily consists of a young stellar population $\sim \! 10\, \rm Myr$ old, confirming that the bulk of the object’s stellar mass formed during a recent jet interaction. Minkowski’s object exhibits line ratios largely consistent with star formation, although there is evidence for a low level ($\lesssim \! 15 \, \rm per \, cent$) of contamination from a non-stellar ionizing source. Strong-line diagnostics reveal a significant variation in the gas-phase metallicity within the object, with $\log \left(\rm O / H \right) + 12$ varying by $\sim \! 0.5\, \rm dex$, which cannot be explained by in-situ star formation, an enriched outflow from the jet, or enrichment of gas in the stellar bridge between NGC 541 and NGC 545/547. We hypothesize that Minkowski’s object either (i) was formed as a result of jet-induced star formation in pre-existing gas clumps in the stellar bridge, or (ii) is a gas-rich dwarf galaxy that is experiencing an elevation in its star formation rate due to a jet interaction, and will eventually redden and fade, becoming an ultradiffuse galaxy as it is processed by the cluster.
H i deficiencies and asymmetries in HIPASS galaxies
Authors: Reynolds T N , Westmeier T , Staveley-Smith L
Published: October 2020

We present an analysis of the sky distribution of neutral hydrogen (H i) deficiency and spectral asymmetry for galaxies detected by the H i Parkes All-Sky Survey (HIPASS) as a function of projected environment density. Previous studies of galaxy H i deficiency using HIPASS were sensitive to galaxies that are extremely H i rich or poor. We use an updated binning statistic for measuring the global sky distribution of H i deficiency that is sensitive to the average deficiencies. Our analysis confirms the result from previous studies that galaxies residing in denser environments, such as Virgo, are on average more H i deficient than galaxies at lower densities. However, many other individual groups and clusters are not found to be on average significantly H i poor, in contradiction to previous work. In terms of H i spectral asymmetries, we do not recover any significant trend of increasing asymmetry with environment density as found for other galaxy samples. We also investigate the correlation between H i asymmetry and deficiency, but find no variation in the mean asymmetry of galaxies that are H i rich, normal, or poor. This indicates that there is either no dependence of asymmetry on H i deficiency, or a galaxy’s H i deficiency only has a small influence on the measured H i asymmetry that we are unable to observe using only integrated spectra.
IMG/VR v3: an integrated ecological and evolutionary framework for interrogating genomes of uncultivated viruses
Authors: Roux Simon , Páez-Espino David , Chen I-Min A , Palaniappan Krishna , Ratner Anna , Chu Ken , Reddy T B K , Nayfach Stephen , Schulz Frederik , Call Lee , Neches Russell Y , Woyke Tanja , Ivanova Natalia N , Eloe-Fadrosh Emiley A , Kyrpides Nikos C
Published: October 2020

Viruses are integral components of all ecosystems and microbiomes on Earth. Through pervasive infections of their cellular hosts, viruses can reshape microbial community structure and drive global nutrient cycling. Over the past decade, viral sequences identified from genomes and metagenomes have provided an unprecedented view of viral genome diversity in nature. Since 2016, the IMG/VR database has provided access to the largest collection of viral sequences obtained from (meta)genomes. Here, we present the third version of IMG/VR, composed of 18 373 cultivated and 2 314 329 uncultivated viral genomes (UViGs), nearly tripling the total number of sequences compared to the previous version. These clustered into 935 362 viral Operational Taxonomic Units (vOTUs), including 188 930 with two or more members. UViGs in IMG/VR are now reported as single viral contigs, integrated proviruses or genome bins, and are annotated with a new standardized pipeline including genome quality estimation using CheckV, taxonomic classification reflecting the latest ICTV update, and expanded host taxonomy prediction. The new IMG/VR interface enables users to efficiently browse, search, and select UViGs based on genome features and/or sequence similarity. IMG/VR v3 is available at https://img.jgi.doe.gov/vr, and the underlying data are available to download at https://genome.jgi.doe.gov/portal/IMG_VR.
The international nucleotide sequence database collaboration
Authors: Arita Masanori , Karsch-Mizrachi Ilene , Cochrane Guy
Published: October 2020

The International Nucleotide Sequence Database Collaboration (INSDC; http://www.insdc.org/) has been the core infrastructure for collecting and providing nucleotide sequence data and metadata for >30 years. Three partner organizations, the DNA Data Bank of Japan (DDBJ) at the National Institute of Genetics in Mishima, Japan; the European Nucleotide Archive (ENA) at the European Molecular Biology Laboratory's European Bioinformatics Institute (EMBL-EBI) in Hinxton, UK; and GenBank at National Center for Biotechnology Information (NCBI), National Library of Medicine, National Institutes of Health in Bethesda, Maryland, USA have been collaboratively maintaining the INSDC for the benefit of not only science but all types of community worldwide.
The structure of APOBEC1 and insights into its RNA and DNA substrate selectivity
Authors: Wolfe Aaron D , Li Shuxing , Goedderz Cody , Chen Xiaojiang S
Published: October 2020

APOBEC1 (APO1), a member of AID/APOBEC nucleic acid cytosine deaminase family, can edit apolipoprotein B mRNA to regulate cholesterol metabolism. This APO1 RNA editing activity requires a cellular cofactor to achieve tight regulation. However, no cofactors are required for deamination on DNA by APO1 and other AID/APOBEC members, and aberrant deamination on genomic DNA by AID/APOBEC deaminases has been linked to cancer. Here, we present the crystal structure of APO1, which reveals a typical APOBEC deaminase core structure, plus a unique well-folded C-terminal domain that is highly hydrophobic. This APO1 C-terminal hydrophobic domain (A1HD) interacts to form a stable dimer mainly through hydrophobic interactions within the dimer interface to create a four-stranded β-sheet positively charged surface. Structure-guided mutagenesis within this and other regions of APO1 clarified the importance of the A1HD in directing RNA and cofactor interactions, providing insights into the structural basis of selectivity on DNA or RNA substrates.
aYChr-DB: a database of ancient human Y haplogroups
Authors: Freeman Laurence , Brimacombe Conrad Stephen , Elhaik Eran
Published: October 2020

Ancient Y-Chromosomal DNA is an invaluable tool for dating and discerning the origins of migration routes and demographic processes that occurred thousands of years ago. Driven by the adoption of high-throughput sequencing and capture enrichment methods in paleogenomics, the number of published ancient genomes has nearly quadrupled within the last three years (2018–2020). Whereas ancient mtDNA haplogroup repositories are available, no similar resource exists for ancient Y-Chromosomal haplogroups. Here, we present aYChr-DB—a comprehensive collection of 1797 ancient Eurasian human Y-Chromosome haplogroups ranging from 44 930 BC to 1945 AD. We include descriptors of age, location, genomic coverage and associated archaeological cultures. We also produced a visualization of ancient Y haplogroup distribution over time. The aYChr-DB database is a valuable resource for population genomic and paleogenomic studies.
scAIDE: clustering of large-scale single-cell RNA-seq data reveals putative and rare cell types
Authors: Xie Kaikun , Huang Yu , Zeng Feng , Liu Zehua , Chen Ting
Published: October 2020

Recent advancements in both single-cell RNA-sequencing technology and computational resources facilitate the study of cell types on global populations. Up to millions of cells can now be sequenced in one experiment; thus, accurate and efficient computational methods are needed to provide clustering and post-analysis of assigning putative and rare cell types. Here, we present a novel unsupervised deep learning clustering framework that is robust and highly scalable. To overcome the high level of noise, scAIDE first incorporates an autoencoder-imputation network with a distance-preserved embedding network (AIDE) to learn a good representation of data, and then applies a random projection hashing based k-means algorithm to accommodate the detection of rare cell types. We analyzed a 1.3 million neural cell dataset within 30 min, obtaining 64 clusters which were mapped to 19 putative cell types. In particular, we further identified three different neural stem cell developmental trajectories in these clusters. We also classified two subpopulations of malignant cells in a small glioblastoma dataset using scAIDE. We anticipate that scAIDE would provide a more in-depth understanding of cell development and diseases.
Property Regimes
Authors: Canfield Matthew
Published: October 2020

Property regimes refer to the political, legal, and economic systems through which societies order their relationships between people with respect to valued things. Anthropologists and legal scholars have long been engaged in a dynamic dialogue about the organization and practice of property regimes. However, whereas legal theory has been uniquely concerned with ownership and private property as a system for allocating scarce goods and resources, anthropologists have investigated how property is constructed and shaped by everyday practice, illuminating how the distinctions between law and practice mutually constitute power relations. This chapter reviews how anthropologists have attended to aporias of property theory by ethnographically analysing conflicts and transformations between property regimes. It surveys anthropological insights into three continuing processes of property regime transformation: decolonization, privatization, and enclosure. In addition, it analyses two emergent processes around which property claims are being reconfigured: dematerialization and rematerialization. The dematerialization of property through informational and financial capitalism is occurring at a time when industrial modes of carbon-dependent accumulation are facing ecological limits brought on by climate change. However, technologies of informationalization and financialization are also rematerializing property regimes by constructing new calculative devices and global markets for increasingly limited natural resources. How these emerging regimes shape social relations between people, the distribution of social entitlements, and the boundaries between persons and things offers an important field of ethnographic enquiry.
An open-source research tool to study triaxial inertial sensors for monitoring selected behaviors in sheep
Authors: dos Reis Barbara R , Fuka Daniel R , Easton Zachary M , White Robin R
Published: October 2020

The use of automated systems for monitoring animal behavior provides information on individual animal behavior and can be used to enhance animal productivity. However, the advancement of this industry is hampered by technology costs, challenges with power supplies, limited data accessibility, and inconsistent testing approaches for confirming the detection of livestock behaviors. Development of open-source research tools similar to commercially available wearable technologies may contribute to the development of more-efficient and affordable technologies. The objective of this study was to demonstrate an open-source, microprocessor-based sensor designed to monitor and enable differentiation among selected behaviors of adult wethers. The sensor was comprised of an inexpensive espressif ESP-32-WROOM-32 microprocessor with Bluetooth communication, a generic MPU92/50 motion sensor that contains a three-axis accelerometer, three-axis magnetometer, a three-axis gyroscope, and a 5-V rechargeable lithium-ion battery. The open-source Arduino IDE software was used to program the microprocessor and to adjust the frequency of sampling, the data packet to send, and the operating conditions. For demonstration purposes, sensors were placed on six housed sheep for three 1-h increments with concurrent visual behavioral observation. Sensor readings (x-, y-, and z-axis) were summarized (mean and SD) within a minute and compared to animal behavior observations (also on a by-minute basis) using a linear mixed-effect model with animal as a random effect and behavioral classifier as a fixed effect. This analysis demonstrated the basic utility of the sensor to differentiate among animal behaviors based on sensed data (P < 0.001). Although substantial additional work is needed for algorithm development, power source testing, and network optimization, this open-source platform appears to be a promising strategy to research wearable sensors in a generalizable manner.
PET/CT Demonstration of Lymphatic Spread of Malignant Pelvic Neoplasms
Authors: Aminsharifi Jamie , Banks Kevin P. , Bui-Mansfield Liem T.
Published: October 2020

Nodal evaluation is a vital part of cancer staging that has critical implications for a patient's treatment. Radiologists must be knowledgeable about the normal nodal pathways of the malignancies they evaluate. This article reviews the anatomy and nomenclature of the pelvic lymph node stations and describes the pathways of nodal spread of primary pelvic genitourinary malignancies: prostate, bladder, testicular, penile, vulvar, ovarian, endometrial, and cervical cancers. Furthermore, this article discusses the utility of 18-fluoro-2-deoxyglucose positron emission tomography/CT (18F-FDG-PET/CT) in assessing the nodal spread of each of these malignancies for both staging and follow-up.
Displaced distal femur metaphyseal fractures: clinical and radiographic outcome in children aged 6–16 years treated by elastic stable intramedullary nailing
Authors: Canavese Federico , Alberghina Flavia , Dimeglio Alain , Pavone Vito , Andreacchio Antonio
Published: October 2020

Fractures of the distal femur metaphysis (DFM) are rare. The main objective of this study was to retrospectively evaluate the clinical and radiographic outcomes of displaced DFM fractures in children treated by elastic stable intramedullary nailing (ESIN). We retrospectively reviewed 24 DFM fractures, including five pathological fractures secondary to non-ossifying fibroma (mean age, 10.9 years; range, 6-16) who underwent surgical treatment by ESIN. The patients were followed radiographically and clinically on a regular basis. Sixteen boys and eight girls were included in the study. Radiographically, all fractures healed, but five healed with complications. Most of the DFM fractures were transverse (n = 18, 75%), and all patients but two (91.7%) underwent closed reduction and stabilization of the fracture. All the patients were pain-free at their last follow-up. All regained full normal activities, although five patients developed a postoperative complication (20.8%). At the last follow-up visit, all fractures achieved union including the two cases of nonunion; moreover, none of the patients showed any signs of growth arrest or disturbances in radiological and clinical assessment. On the ESIN outcome measure scale, 12/24 patients (50%) had excellent results, 11/24 (45.8%) had good-satisfactory results and 1/24 (4.2%) had poor results. Fracture of the DFM can be challenging due to the relatively short length of the distal fragment, the proximity of the growth plate and the tendency of the distal fragment to displace. Following the surgical principles and understanding the anatomical constraints of the distal femur help to obtain satisfactory clinical and radiological results.
A Method for Examining Geographic Variation When Denominators Are Unknown, Populations Vary, and Time is of the Essence
Authors: Weeks William B. , Weinstein James N.
Published: October 2020

Level of Evidence: 3
Are Patient Outcomes Affected by the Presence of a Fellow or Resident in Lumbar Decompression Surgery?
Authors: Divi Srikanth N. , Goyal Dhruv K.C. , Galetta Matthew S. , Guzek Ryan , Kaye Ian David , Kurd Mark F. , Woods Barrett I. , Radcliff Kristen E. , Rihn Jeffrey A. , Anderson David Greg , Hilibrand Alan S. , Kepler Christopher K. , Vaccaro Alexander R. , Schroeder Gregory D.
Published: October 2020

Study Design.

Retrospective cohort study.

Objective.

The aim of this study was to determine whether the presence of a fellow or resident (F/R) compared to a physician assistant (PA) affected surgical variables or short-term patient outcomes.

Summary of Background Data.

Although orthopedic spine fellows and residents must participate in minimum number of decompression surgeries to gain competency, the impact of trainee presence on patient outcomes has not been assessed.

Methods.

One hundred and seventy-one patients that underwent a one- to three-level lumbar spine decompression procedure at a high-volume academic center were retrospectively identified. Operative reports from all cases were examined and patients were placed into one of two groups based on whether the first assist was a F/R or a PA. Univariate analysis was used to compare differences in total surgery duration, 30-day and 90-day readmissions, infection and revision rates, patient-reported outcome measures (Short Form-12 Physical Component Score and Mental Component Score, Oswestry Disability Index, Visual Analog Scale [VAS] Back, VAS Leg) between groups. Multiple linear regression was used to assess change in each patient reported outcome and multiple binary logistic regression was used to determine significant predictors of revision, infection, and 30- or 90-day readmission.

Results.

Seventy-eight patients were included in the F/R group compared to 93 patients in the PA group. There were no differences between groups for total surgery time, 30-day or 90-day readmissions, infection, or revision rates. Using univariate analysis, there were no differences between the two groups pre- or postoperatively (P > 0.05). Using multivariate analysis, presence of a surgical trainee did not significantly influence any patient reported outcome and did not affect infection, revision, or 30- and 90-day readmission rates.

Conclusion.

This is one of the first studies to show that the presence of an orthopedic spine fellow or resident does not affect patient short-term outcomes in lumbar decompression surgery.

Level of Evidence: 3
A Novel Clinical Scoring System for Perioperative Morbidity in Metastatic Spinal Tumor Surgery
Authors: De la Garza Ramos Rafael , Benton Joshua A. , Gelfand Yaroslav , Echt Murray , Hamad Mousa K. , Kinon Merritt D. , Yanamadala Vijay , Yassari Reza
Published: October 2020

Study Design.

Retrospective cohort study.

Objective.

To evaluate a scoring system to predict morbidity for patients undergoing metastatic spinal tumor surgery (MSTS).

Summary of Background Data.

Multiple scoring systems exist to predict survival for patients with spinal metastasis. The potential benefits and risks of surgery need to be evaluated for patients with disseminated cancer and limited life expectancy. Few scoring systems exist to predict perioperative morbidity after MSTS.

Methods.

We reviewed records of patients who underwent MSTS at our institution between 2013 and 2019. All perioperative complications occurring within 30 days were recorded. A clinical scoring system consisting of five variables (age ≥ 70 yr, hypoalbuminemia, poor preoperative functional status [Karnofsky ≤ 40], Frankel Grade A-C, and multilevel disease ≥2 continuous vertebral bodies) was evaluated as a predictive tool for morbidity; every parameter was assigned a value of 0 if absent or 1 if present (total possible score = 5). The effect of the scoring system on morbidity was evaluated using stepwise multiple logistic regression. Model accuracy was calculated by receiver operating characteristic analysis.

Results.

One hundred and five patients were identified, with a male prevalence of 58.1% and average age at surgery of 61 years. The overall 30-day complication rate was 36.2%. The perioperative morbidity was 4.6%, 30.0%, 53.9%, and 64.7% for patients with scores of 0, 1, 2, and ≥3 points, respectively (P < 0.001). On multiple logistic regression analysis controlling for covariates not present in the model, the scoring system was significantly associated with 30-day morbidity (OR 3.11; 95% CI, 1.72–5.59; P < 0.001). The model's accuracy was estimated at 0.75.

Conclusion.

Our proposed model was found to accurately predict perioperative morbidity after MSTS. The Spine Oncology Morbidity Assessment (SOMA) score may prove useful for risk stratification and possibly decision-making, though further validation is needed.

Level of Evidence: 4
Reliability and Validity of the Simplified Chinese Early-onset Scoliosis Quality of Life 24-item Questionnaire
Authors: Gao Rongxuan , Sun Baosheng , Zhang Xuejun , Guo Dong , Fan Jingyi , Yao Ziming , Cao Jun , Li Hao , Sun Lin , Li Chengxin , Qi Xinyu , Bai Yunsong
Published: October 2020

Study Design.

Questionnaire translation and validation.

Objective.

The aim of this study was to translate the Early-Onset Scoliosis 24-Item Questionnaire (EOSQ-24) into simplified Chinese and to evaluate the reliability and validity of this questionnaire in children with early-onset scoliosis (EOS) in mainland China.

Summary of Background Data.

The EOSQ-24 is a validated quality of life questionnaire in children with EOS and has been translated into multiple languages and used worldwide. However, there is currently no simplified Chinese version available for use in mainland China.

Methods.

The English version of the EOSQ-24 questionnaire was translated into simplified Chinese based on the recommendations of the International Quality of Life Assessment (IQoLA) group. The reliability of the scale was evaluated using test–retest reliability and internal consistency, and construct validity was examined through factor analysis. Hundred childrenwith EOS were enrolled in the study. To assess the test–retest reliability of the scale, the parents or caregivers of 38 of participants repeated the questionnaire after 2 weeks.

Results.

Test–retest reliability was excellent overall (intraclass correlation coefficient [ICC] = 0.935) and ranged from moderate to excellent for each domain (ICC = 0.681–0.945). The overall internal consistency was excellent (Cronbach α = 0.893) and had a variable range for each domain (Cronbach α = 0.560–0.889). Factor analysis was performed, and seven principal components were extracted that accounted for 70.1% of the variance.

Conclusion.

The simplified Chinese version of the EOSQ-24 scale has acceptable reliability and construct validity, and it can be used for the assessment of health-related quality of life (HRQL), caretaker burden, and satisfaction for children with EOS in mainland China.

Level of Evidence: 3
Single-center randomized trial comparing conventional chemoembolization versus doxorubicin-loaded polyethylene glycol microspheres for early- and intermediate-stage hepatocellular carcinoma
Authors: Gjoreski Aleksandar , Jovanoska Ivona , Risteski Filip , Prgova Veljanova Biljana , Nedelkovski Dane , Dimov Vladimir , Popova Jovanovska Rozalinda , Grozdanovska Angelovska Biljana , Mitrevski Nenad , Dimova Biljana
Published: October 2020

According to Barcelona Clinic Liver Cancer classification, transarterial chemoembolization (TACE) is preferred treatment for stage B and in certain cases for stage A hepatocellular carcinoma (HCC). Conventional TACE (c-TACE) and drug-eluting microspheres TACE (DEM-TACE) are available intraarterial therapies. Screening of patients with cirrhosis is of great importance for early detection of malignant liver nodules. Primary endpoint of this study was to compare DEM-TACE with c-TACE in terms of 12- and 24-month survival. Secondary endpoints were comparison of intensity and duration of the postembolization syndrome (PES) and severe adverse events. We randomized 60 patients with unresectable HCC one-to-one with c-TACE or DEM-TACE and followed them for at least 24 months or until death. TACE was repeated ‘on-demand. Most patients underwent two TACE sessions and the median hospital stay was 3 days for c-TACE and 2 days for DEM-TACE group. The overall 12- and 24-month survival rates were 89.8 and 70.7%, respectively, precisely 85.7 and 63.6% after c-TACE and 90.2 and 75.8% after DEM-TACE, without any significant difference (P = 0.18). Median overall survival was 21.1 months. Significant difference in the overall 12- and 24-month survival was found in patients with Child-Pugh A compared to Child-Pugh B class (P = 0.001). Child-Pugh class, aspartate aminotransferase levels and ascites independently predicted survival (P = 0.003). Both, DEM-TACE and c-TACE showed excellent 12- and 24-month survival rates. No significant difference in terms of adverse events was found. PES was slightly more severe after c-TACE, because of elevated temperature. DEM-TACE requires shorter in-hospital stay.
Long-term risk of stroke and myocardial infarction in middle-aged men with a hypertensive response to exercise: a 44-year follow-up study
Authors: Giang Kok W. , Hansson Per-Olof , Mandalenakis Zackarias , Persson Carina U. , Grimby Gunnar , Svärdsudd Kurt , Wilhelmsen Lars , Börjesson Mats , Ladenvall Per
Published: October 2020

Introduction:

Data on the prognostic value of hypertensive response to exercise in cardiovascular disease are limited. The aim was to determine whether SBP reactions during exercise have any prognostic value in relation to the long-term risk of stroke and myocardial infarction (MI).

Patients and methods:

A representative cohort of men from Gothenburg, Sweden, born in 1913, who performed a maximum exercise test at age 54 years, (n = 604), was followed-up for a maximum of 44 years with regard to stroke and MI.

Results:

Among the 604 men, the mean resting and maximum SBP was 141.5 (SD 18.8) and 212.1 (SD 24.6) mmHg, respectively. For maximum SBP, the risk of stroke increased by 34% (hazard ratio 1.34, 95% confidence interval 1.11–1.61) per 1-SD increase, while no risk increase was observed for MI. The highest risk of stroke among blood pressure groups was observed among men with a resting SBP of at least 140 mmHg and a maximum SBP of at least 210 mmHg with an hazard ratio of 2.09 (95% confidence interval 1.29–3.40), compared with men with a resting SBP of less than 140 mmHg and a maximum SBP of less than 210 mmHg, independent of smoking, blood glucose, cholesterol and BMI.

Conclusion:

Among middle-aged men with high resting and maximum blood pressure during maximum exercise workload, an increased risk of stroke was observed but not for MI. Further studies with larger sample sizes are needed to investigate the underlying mechanisms of the increased risk of stroke among individuals with hypertensive response to exercise.
Tolerance to Light of Patients Suffering From Infectious Keratitis
Authors: Courrier Emilie , Lambert Victor , Renault Didier , Garcin Thibaud , Moine Baptiste , Herbepin Pascal , Thuret Gilles , Gain Philippe
Published: October 2020

Purpose:

With very photophobic patients, the advantages of red or near infrared light to develop new ophthalmology imaging devices seem obvious: no or little glare, possibility of long signal integration, no phototoxicity, and lesser autofluorescence of ocular tissues. Nevertheless, in this range, the shortest possible wavelength facilitates signal detection. The aim of this study was, thus, to determine the maximal irradiance tolerated with 6 wavelengths: 2 red, 2 far red, and 1 near infrared lights to determine the shortest wavelength well tolerated by patients, in comparison with the standard cobalt blue light of ophthalmology slitlamp.

Methods:

An interventional, monocentric, single-group assignment study was conducted on 30 eyes of 30 patients with infectious keratitis. Thanks to a customized machine, the photophobic eye was exposed to the 6 lights with increasing intensity. The patients switched off the light when the discomfort was too elevated. The maximal cumulative irradiance possible at 482, 650, 675, 700, 750, and 800 nm were 171, 689, 759, 862, 920, and 889 mW/cm2, respectively.

Results:

The maximal cumulative irradiance tolerated by patients increased significantly with wavelength (P < 0.001), but the difference was not significant between each increment: red at 675 nm gave a significantly higher cumulative irradiance than blue at 482 nm; red at 700 nm did not provide significant gain compared with 675 nm; and far red at 750 nm still provided additional gain compared with 700 nm, but no significant gain was observed between 750 and 800 nm. The shortest wavelengths were stopped more quickly, and more than 50% of patients reached the maximum irradiance delivered by the source at 750 and 800 nm.

Conclusions:

We demonstrate that a light source at 750 and 800 nm can be used for ophthalmic imaging with good tolerance in photophobic patients.

Clinical trial registration:

NCT03586505.
Worry About the Future Health Issues of Smoking and Intention to Screen for Lung Cancer With Low-Dose Computed Tomography
Authors: Poghosyan Hermine , Mello Susan , Robinson Kathryn N. , Tan Andy S.L.
Published: October 2020

Background

Early diagnosis of lung cancer is key to improving the long-term prognosis for many individuals. Still, utilization rates of lung cancer screening (LCS) remain low.

Objective

To investigate the association between worry about future health issues of smoking and intention to undergo recommended LCS with low-dose computed tomography (LDCT) within the next 3 months.

Methods

A cross-sectional online survey was conducted using the Qualtrics Panel to recruit adult smokers between ages 54 and 75 years, with no history of lung cancer, and at least 30-pack-year smoking history (n = 152). The survey gathered demographic, socioeconomic, and psychographic information, including intention to screen for lung cancer with LDCT and worry about the future health issues of smoking. Data were analyzed using multivariable logistic regression.

Results

Approximately 43.0% were White, 21.7% were Black, and 60.0% were female. Most (86.0%) reported intentions to undergo recommended LCS with LDCT in the next 3 months. More than one-third (32.0%) reported moderately/very worried about the future health issues of smoking. Smokers who were moderately/very worried had 20% (P = .022) higher odds of reporting an intention to undergo LCS with LDCT than those who were not at all or a little worried.

Conclusions

Most eligible adults reported intentions to undergo LCS with LDCT. Our study also highlights sex, racial, and socioeconomic differences in LCS behavior.

Implications for Practice

The study findings provide an opportunity for healthcare providers to have in-depth discussions about the benefits of LCS with those who express worry about future health issues of smoking.
Biomaterials in Craniomaxillofacial Reconstruction: Past, Present, and Future
Authors: Crist Taylor E. , Mathew Prakash J. , Plotsker Ethan L. , Sevilla Alec C. , Thaller Seth R.
Published: October 2020

Deformity and tissue loss involving the craniomaxillofacial region occurs frequently as a result of trauma, oncologic resection, or a congenital malformation. In order to maximize the patient's quality of life, reconstruction of the craniomaxillofacial skeleton must seek to restore aesthetics as well as function. Advances in diagnostic technology, surgical technique, instrumentation, and innovative biomaterials used have transformed the way reconstructive surgeons approach their patients’ needs. From the advent of alloplastic reconstruction, surgeons have sought the ideal material for use in craniomaxillofacial surgery. Substances such as metals, ceramics, glasses, and more recently resorbable polymers and bioactive materials have all been utilized.

While autologous bone has remained widely-favored and the gold standard, synthetic alternatives remain a necessity when autologous reconstruction is not readily available. Today, alloplastic material, autografting via microvascular tissue transfer, hormone and growth factor-induced bone formation, and computer-aided design and manufacturing of biocompatible implants represent only a fraction of a wide range of options used in the reconstruction of the craniomaxillofacial skeleton. We present a brief review of the materials used in the repair of deformities of the craniomaxillofacial skeleton as well as a look into the potential future direction of the field.
Roseomonas selenitidurans sp. nov., isolated from urban soil, and emended description of Roseomonas frigidaquae
Authors: Hou Xiaoxiao , Liu Hongliang , Wei Shuzhen , Ding Zhongfeng , Sang Feng , Zhao Yanfang , Dong Yuling , Li Hui , Wang Qian , Zhao Juanjuan , Deng Hongkuan , Zhang Chunyang , Kong Ling , Gao Yan
Published: October 2020

An aerobic, non-motile, Gram-stain-negative, pink, convex, coccobacilli-shaped, mesophilic bacterium, designated strain BU-1T, was isolated from an urban soil sample from Zibo city, Shandong province, PR China. The strain grew at 20–37 °C (optimum, 30 °C), pH 5–10 (optimum, pH 7) and growth occurred with 0–2 % (w/v) NaCl (optimally with 0.5 %). The results of phylogenetic analysis based on 16S rRNA gene sequences indicated that BU-1T was closely related to members of the genus

Roseomonas

and had highest 16S rRNA gene sequence similarities with

Roseomonas frigidaquae

JCM 15073T (97.8 %),

Roseomonas tokyonensis

JCM 14634T (96.9 %),

Roseomonas stagni

JCM 15034T (96.5 %), and

Roseomonas riguiloci

JCM 17520T (95.9 %). BU-1T also formed a subcluster with

R. frigidaquae

JCM 15073T and

R. stagni

JCM 15034T in phylogenetic trees based on genomic sequences. The genome size of BU-1T was 5.79 Mb and the DNA G+C content was 71.7 %. ANI, dDDH and AAI values between BU-1T and

R. frigidaquae

JCM 15073T were 84.0, 27.2 and 86.7 %, respectively. Furthermore, the genome of BU-1T contained 5446 predicted protein coding genes and 4945 (90.8%) of them had classifiable functions. BU-1T contained Q-10 as the main ubiquinone. The predominant fatty acids (>10 %) were summed feature 3, summed feature 8 and C16:0. The polar lipid profile contained diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylcholine and five unidentified aminolipids. Combined data from phenotypic, phylogenetic and chemotaxonomic studies indicated that strain BU-1T is a representative of a novel species of the genus

Roseomonas

. Since strain BU-1T can reduce highly toxic selenite [Se(IV)] to low toxicity elemental selenium [Se(0)], the name Roseomonas selenitidurans sp. nov. is proposed. The type strain is BU-1T (=KACC 21750T =GDMCC 1.1776T).
Decision curve analysis to identify optimal candidates of liver resection for intermediate-stage hepatocellular carcinoma with hepatitis B cirrhosis : A cohort study
Authors: Chen Siyu , Lu Linbin , Hu Xinyu , Lin Shan , Zhu Lijun
Published: October 2020

Background

The selection criterion for liver resection (LR) in intermediate-stage (IM) hepatocellular carcinoma (HCC) is still controversial. This study aims to compare LR and transarterial chemoembolization in the range of predicted death risk

Methods

The multivariable Cox regression model (MVR) was estimated to predict mortality at 5yr. The cut-off values were determined by a two-piece-wise linear regression model, decision curve analysis with MVR model, and hazard ratio curve for treatment plotted against the predicted mortality.

Results

825 IM-HCC with hepatitis B cirrhosis were included for analysis (TACE, n=622; LR, n=203). The 5-yr overall survival rate of LR patients was higher than the TACE group (52.8% vs. 20.8%; P<0.0001). The line of LR and TACE were crossing with predicted death risk at 100% (P for interaction =0.008). The benefit of LR versus TACE decreased progressively as predicted death risk>0.55 (95%CI: 0.45,0.62). When predicted death risk over 0.7, decision curve analysis suggested that LR and TACE did not increase net benefit. Patients were then divided into four subgroups by the cut-off values (<0.45, 0.45≥ /<0.62, 0.62≥ /<0.7, ≥ 0.7). The stratified analysis of treatment in different subgroups, hazard ratios were 0.39 (95%CI: 0.27, 0.56), 0.36 (95%CI: 0.23, 0.56), 0.51 (95%CI: 0.27, 0.98), and 0.46 (95%CI: 0.27, 0.80), respectively.

Conclusions

LR reached the maximal relative utility in the interval of 0.45 to 0.62, and both LR and TACE did not increase net benefit at the 5-yr death risk over 0.7.