bluuebunny/crossref_metadata_2025 huggingface dataset:
The Second Annual Symposium of the Midwest Aging Consortium: The Future of Aging Research in the Midwestern United States
Authors: Green Cara L , Englund Davis A , Das Srijit , Herrerias Mariana M , Yousefzadeh Matthew J , Grant Rogan A , Clark Josef , Pak Heidi H , Liu Peiduo , Bai Hua , Prahlad Veena , Lamming Dudley W , Chusyd Daniella E
Published: July 2021

While the average human life span continues to increase, there is little evidence that this is leading to a contemporaneous increase in “healthy years” experienced by our aging population. Consequently, many scientists focus their research on understanding the process of aging and trialing interventions that can promote healthspan. The 2021 Midwest Aging Consortium consensus statement is to develop and further the understanding of aging and age-related disease using the wealth of expertise across universities in the Midwestern United States. This report summarizes the cutting-edge research covered in a virtual symposium held by a consortium of researchers in the Midwestern United States, spanning topics such as senescence biomarkers, serotonin-induced DNA protection, immune system development, multisystem impacts of aging, neural decline following severe infection, the unique transcriptional impact of calorie restriction of different fat depots, the pivotal role of fasting in calorie restriction, the impact of peroxisome dysfunction, and the influence of early life trauma on health. The symposium speakers presented data from studies conducted in a variety of common laboratory animals as well as less-common species, including Caenorhabditis elegans, Drosophila, mice, rhesus macaques, elephants, and humans. The consensus of the symposium speakers is that this consortium highlights the strength of aging research in the Midwestern United States as well as the benefits of a collaborative and diverse approach to geroscience.
Healthy Aging Data Reports: Measures of Community Health to Identify Disparities and Spur Age-Friendly Progress
Authors: Dugan Elizabeth , Porell Frank , Silverstein Nina M , Lee Chae Man
Published: July 2021

Background and Objectives

This translational research had 2 aims: first, to analyze and translate data from multiple original data sources to provide accurate, unbiased local community and statewide information about healthy aging; second, to work with stakeholders to use the tools to identify disparities in healthy aging and to support their efforts to advance healthy aging.

Research Design and Methods

Data sources from the Centers for Medicare and Medicaid Services, Behavioral Risk Factor Surveillance System, U.S. Census American Community Survey, and other sources were analyzed using small area estimation techniques to determine age/gender-adjusted local community rates in Connecticut (CT), Massachusetts (MA), New Hampshire (NH), and Rhode Island (RI).

Results

State-level analyses revealed gender and racial/ethnic disparities in healthy aging. A factor analysis identified 4 dimensions of community population healthy aging/morbidity: serious complex chronic disease, indolent conditions, physical disability, and psychological disability.

Discussion and Implications

Healthy Aging Data Reports now exist for MA (2014, 2015, and 2018), NH (2019), RI (2016 and 2020), and CT (2021) and demonstrate differences in health by place. Each report includes community profiles for every city, town, and some urban neighborhoods with more than 170–197 indicators. The reports include maps of the statewide distribution of rates, an infographic, highlights report with state-specific multivariate analyses, and 18 interactive web maps, 18 regional interactive web maps, and technical documentation about data sources and methods. Overall, the research has identified variations in healthy aging and provided tools to track change over time to support age-friendly efforts in the region.
Joint tomographic inversion of crustal structure beneath the eastern Tibetan Plateau with ambient noise and gravity data
Authors: Du Nanqiao , Li Zhiwei , Hao Tianyao , Xia Xin , Shi Yutao , Xu Ya
Published: July 2021

We have developed a joint tomographic inversion method with seismic surface wave dispersion and gravity data for obtaining more reliable crustal 3-D shear wave structures. We take the eikonal-based direct surface wave tomographic method and adaptive gravity modelling method in spherical coordinates in the inverse problem. Based on the empirical relations between seismic velocity and density parameters, our method combines surface wave dispersion curves (i.e. surface wave traveltimes at different periods) and Bouguer gravity anomaly data together to invert for 3-D shear wave velocity structures. In our method, off-great-circle propagation of the surface wave and the earth's curvature is considered in the forward modelling. Synthetic tests suggest that the joint tomographic method could improve the reliability and obtain more convincing results than individual seismic surface wave tomography. The gravity data can provide more constraints into the model resolution and help restore the crustal anomalies better. The inversion results in the eastern Tibetan Plateau and Sichuan basin indicate complex distributions of low-velocity zone in the mid-crust of the eastern Tibetan Plateau and a craton-like basement of the Sichuan basin, which supports the crust channel flow model. Although both the 3-D shear wave velocity model from joint inversion and the individual seismic surface wave inversion can fit the surface wave data almost equally well, the joint inversion model can better match the gravity data We also found that the 3-D model from joint inversion in this study shows similar structural characteristics with the surface wave tomographic model, which indicates the icing on the cake effects of gravity data.
Social networking sites: a new source of child feeding information for parents in Thailand
Authors: Supthanasup Abhirat , Yiengprugsawan Vasoontara Sbirakos , Kelly Matthew , Banwell Cathy
Published: July 2021

Social networking sites (SNSs) provide opportunities for health and nutrition communication. Data are lacking on whether these SNSs influence Thai parent’s food provisioning to young children. In the current study, we examined the prevalence and characteristics of Thai parents who reported participating in child food and nutrition-SNSs and investigated the association between participation in these sites and parents’ perceptions and feeding practices. A sample of 379 Thai parents completed a survey about the use of child food and nutrition-SNSs, and feeding practices and child eating behavior. Around 70% of participants, especially female millennials with their first child, have participated in SNSs that provide information about children’s diets. High engagement was more common among younger and less educated participants, as well as rural dwellers and those with abnormal body mass index. Among these SNSs’ participants, those with higher engagement had higher levels of trust in the nutritional information shared on SNSs. Further analyses showed that parents who have joined these sites had positive associations with not only providing children with more fresh fruits and vegetable but also more processed meats. Further investigations are needed to explore the information these SNSs provided and what influences they have on parents’ perceptions around feeding children.
Re-Thinking a Matrilineal Myth of Healing: Tuareg Medicine Women, Islam, and the Market in Niger
Authors: Rasmussen Susan
Published: July 2021

This article explores the changing metaphoric logic and contextual uses of a mythical-historical popular religious account of matrilineal origins of herbal medicine women among Tuareg in northern Niger. Medicine women both reproduce and modify this origin myth’s motif in their Tamajaq-speaking, Muslim, traditionally ranked, and semi-nomadic communities, where many have faced religious, socioeconomic, and political upheavals challenging local women’s material wealth and symbolic/cultural capital of authoritative medico-ritual healing. How is medicine women’s healing legacy evoked and re-interpreted in encounters with Qur’anic healing and western biomedicine, as impacted by recent religious debates, neoliberal structural adjustments, droughts, sedentarization, and political violence? The Tuareg data offer fresh perspectives on how religion and economy co-produce each other in some contexts, but contradict each other in others. More broadly, this article critically disrupts categories of sacred and secular, tradition and modernity, and brings mythico-histories into discussions of intertwining religious and economic idioms, practices, and infrastructures.
An Unusual Presentation to the Burns Unit—A Cautionary Tale
Authors: Faderani Ryan , Ali Stephen R , Yarrow Jeremy
Published: July 2021

The authors report a case of a 34-year-old female with systemic lupus erythematosus (SLE) and lupus nephritis who was referred to the regional burns service with a suspected contact burn to the left flank and hypogastrium from a hot water bottle. The patient had been applying a hot water bottle to the area at night for pain relief and after 3 days she noticed a localized area of erythema which became larger and began to blister over a period of 5 days. The blistered areas were erythematous and wet; however, the capillary refill time was sluggish. The lesion was initially diagnosed and treated as a superficial partial thickness burn that had developed secondary to prolonged contact with a hot water bottle. However, due to the history of immunosuppression as well as elements of the lesion being unusual for a burn, we consequently diagnosed this as herpes zoster infection. This case highlights the importance of always thinking of alternative diagnoses. There are several cases in the literature where shingles has been dangerously misdiagnosed, furthermore leading to patients being mistakenly treated and even operated on. In the early stages, abdominal shingles may present very similarly to superficial partial thickness burns, both with neuropathic pain, erythema, and blistering. It is important for the burns surgeon to be aware of this diagnosis as a differential in atypical presentations, and to pay particular attention to the timeline of events is the key to diagnosis.
Design of wood-like metallic material using metal sheet architecture
Authors: Han Seong-Sik , Eom Hyeonjin , Lee Minsu , Yim Tai Hong , Kim Heung-Kyu
Published: July 2021

This study proposed a new metal-based material design with a modulus of elasticity and thermal conductivity comparable to that of wood by architecturing of metal sheets. The proposed new material is designed in a form in which metal sheets of the same shape with beads are repeatedly stacked. In order to find a design with the target modulus of elasticity and thermal conductivity values, designs were derived using the Design of Experiment (DOE) and the material properties were predicted accordingly. For the prediction of material properties designed in the shape of a metal sheet architecture, finite element analysis combined with the homogenization method was used in consideration of the repeatability of the material microstructure. The reliability of the prediction of material properties based on the finite element analysis using a unit cell was verified by comparison with the results obtained from the compression test and the temperature wave method for the specimen. By analysing the modulus of elasticity and thermal conductivity data corresponding to the designs derived by DOE, we evaluated the effect of the design variables of the metal sheet architecture on the material properties. In addition, we investigated whether the material properties comparable to wood or leather were included within the derived design domain, and presented detailed design data of a metal sheet architecture that provides targeted material properties. It can be inferred from this study that the use of architecturing of metal sheets enables the development of new metal-based materials that can simulate the properties of other materials while utilizing the advantages of fire resistance and recyclability inherent in metals.
Breast cancer subtypes affect the ultrasound performance for axillary lymph node status evaluation after neoadjuvant chemotherapy: a retrospective analysis
Authors: Fei Jie , Wang Guan Qun , Meng Yuan Yuan , Zhong Xin , Ma Jin Zhu , Sun Ning Ning , Chen Jing Jing
Published: July 2021

Purpose

The aim of our study was to investigate the effect of breast cancer subtypes on the diagnostic value of axillary ultrasound for node status evaluation after neoadjuvant chemotherapy.

Patients and methods

Pathologic node-positive breast cancer patients underwent axillary ultrasound imaging after neoadjuvant chemotherapy were retrospectively reviewed. The enrolled patients were classified into four subtypes: Luminal A, Luminal B, human epidermal growth factor receptor 2-enriched and triple-negative. Ultrasound images of axillary nodes were reviewed and were evaluated as normal or abnormal and were associated with final pathologic results. Diagnostic value of axillary ultrasound was assessed in four subtypes based on sensitivity, specificity, positive predictive value and negative predictive value. The diagnostic value of axillary ultrasound as well as clinical and pathological characteristics was compared between four breast cancer subtypes using chi-square test or fisher’s exact test.

Result

Luminal A subtype had highest positive predictive value (92.1%), lowest sensitivity (43.8%) and lowest negative predictive value (11.8%). Triple-negative subtype had lowest positive predictive value (73.2%), highest sensitivity (76.9%) and highest negative predictive value (59.1%) (P < 0.05). Luminal B and human epidermal growth factor receptor 2-enriched subtypes had medium sensitivity, positive predictive value and negative predictive value.

Conclusion

The diagnostic value of axillary ultrasound for node residue disease assessment after neoadjuvant chemotherapy is different between four breast cancer subtypes.
Interspecific interactions affect N and P uptake rather than N:P ratios of plant species: evidence from intercropping
Authors: Zhang Wei-Ping , Fornara Dario , Liu Guang-Cai , Peñuelas Josep , Sardans Jordi , Sun Jian-Hao , Zhang Li-Zhen , Li Long
Published: July 2021

Quantifying stoichiometry of crop N and P acquisition (i.e. removal from farmland) under different agronomic practices is essential for understanding nutrient budgets and optimizing N and P fertilizer application in agroecosystems. It is not clear how plant N and P uptake and N:P stoichiometry vary between monoculture and intercropping throughout an entire growing season under different N fertilization and mulching practices. Here, we addressed how plant interspecific competition for nutrients have affected the temporal dynamics of crop N and P uptake (and N:P ratios) in five cropping systems (wheat, maize and barley monocultures, and wheat/maize and barley/maize intercropping), under two N levels (0 and 225 kg N ha−1) and two maize mulching treatments (with and without). Wheat and barley had greater N and P competitive ability than maize, leading to an increase in N and P uptake of wheat and barley and a decrease in N and P uptake of maize during co-growth stages in intercropping. N:P ratios of three crop species decreased with plant growth. Crop-level N:P ratios were either not affected by intercropping or did not change consistently with N fertilization while film mulching decreased maize N:P ratios. Community-level N:P ratios of the two intercrops were different from those of the corresponding monoculture at maturity. Because (i) the proportion of N and P removal from intercropping differs from monocultures, and (ii) N and P uptake by crops is decoupled under N fertilization and mulching, these findings may have practical implications for the nutrient budget of intercropping systems.
Semi-solid extrusion 3D printing of starch-based soft dosage forms for the treatment of paediatric latent tuberculosis infection
Authors: Chatzitaki Aikaterini-Theodora , Mystiridou Emmanouela , Bouropoulos Nikolaos , Ritzoulis Christos , Karavasili Christina , Fatouros Dimitrios G
Published: July 2021

Objectives

The development of age-appropriate dosage forms is essential for effective pharmacotherapy, especially when long-term drug treatment is required, as in the case of latent tuberculosis infection treatment with up to 9 months of daily isoniazid (ISO). Herein, we describe the fabrication of starch-based soft dosage forms of ISO using semi-solid extrusion (SSE) 3D printing.

Methods

Corn starch was used for ink preparation using ISO as model drug. The inks were characterized physicochemically and their viscoelastic properties were assessed with rheological analysis. The morphology of the printed dosage forms was visualized with scanning electron microscopy and their textural properties were evaluated using texture analysis. Dose accuracy was verified before in-vitro swelling and dissolution studies in simulated gastric fluid (SGF).

Key findings

Starch inks were printed with good resolution and high drug dose accuracy. The printed dosage forms had a soft texture to ease administration in paediatric patients and a highly porous microstructure facilitating water penetration and ISO diffusion in SGF, resulting in almost total drug release within 45 min.

Conclusions

The ease of preparation and fabrication combined with the cost-effectiveness of the starting materials constitutes SSE 3D printing of starch-based soft dosage forms a viable approach for paediatric-friendly formulations in low-resource settings.
Diffuse large B cell lymphoma within an anal fistula: a case report with an intriguing possible aetiology
Authors: Kent James , Joske David , Parry Jeremy
Published: July 2021

Described is a case of diffuse large B cell lymphoma that presented within a typical fistula tract, possibly secondary to oxidative stress within the fistula tract itself and consequent malignant change rather than a fistula as a consequence of necrosis in a lymphoma. If so it would be unique in the world literature. A 42-year-old fitness instructor presented with a typical appearing left lateral anal fistula. Biopsy of the fistulous tract revealed B cell lymphoma, graded 1E. Although chemotherapy cured the lymphoma, surgical treatment by ligation of the inter-sphincteric fistula tract was required to heal the fistula. At 3-year follow-up, there has been no recurrence of the lymphoma or the fistula. Neoplasia arising secondary to oxidative stress within an anal fistula is a well-established phenomenon. Early diagnosis of rare conditions associated with anal fistula can only be accomplished by routine biopsy of every fistula tract.
Hubble diagram at higher redshifts: model independent calibration of quasars
Authors: Li Xiaolei , Keeley Ryan E , Shafieloo Arman , Zheng Xiaogang , Cao Shuo , Biesiada Marek , Zhu Zong-Hong
Published: July 2021

In this paper, we present a model-independent approach to calibrate the largest quasar sample. Calibrating quasar samples is essentially constraining the parameters of the linear relation between the log  of the ultraviolet (UV) and X-ray luminosities. This calibration allows quasars to be used as standardized candles. There is a strong correlation between the parameters characterizing the quasar luminosity relation and the cosmological distances inferred from using quasars as standardized candles. We break this degeneracy by using Gaussian process regression to model-independently reconstruct the expansion history of the Universe from the latest type Ia supernova observations. Using the calibrated quasar data set, we further reconstruct the expansion history up to redshift of z ∼ 7.5. Finally, we test the consistency between the calibrated quasar sample and the standard Lambda cold dark matter ($\rm {\Lambda }CDM$) model based on the posterior probability distribution of the GP hyperparameters. Our results show that the quasar sample is in good agreement with the standard $\rm {\Lambda }CDM$ model in the redshift range of the supernova, despite the 2−3σ significant deviations taking place at higher redshifts. Fitting the standard $\rm {\Lambda }CDM$ model to the calibrated quasar sample, we obtain a high value of the matter density parameter $\Omega _m = 0.382^{+0.045}_{-0.042}$, which is marginally consistent with the constraints from other cosmological observations.
Handcuffing intrinsically disordered regions in Mlh1–Pms1 disrupts mismatch repair
Authors: Furman Christopher M , Wang Ting-Yi , Zhao Qiuye , Yugandhar Kumar , Yu Haiyuan , Alani Eric
Published: July 2021

The DNA mismatch repair (MMR) factor Mlh1–Pms1 contains long intrinsically disordered regions (IDRs) whose exact functions remain elusive. We performed cross-linking mass spectrometry to identify interactions within Mlh1–Pms1 and used this information to insert FRB and FKBP dimerization domains into their IDRs. Baker's yeast strains bearing these constructs were grown with rapamycin to induce dimerization. A strain containing FRB and FKBP domains in the Mlh1 IDR displayed a complete defect in MMR when grown with rapamycin. but removing rapamycin restored MMR functions. Strains in which FRB was inserted into the IDR of one MLH subunit and FKBP into the other subunit were also MMR defective. The MLH complex containing FRB and FKBP domains in the Mlh1 IDR displayed a rapamycin-dependent defect in Mlh1–Pms1 endonuclease activity. In contrast, linking the Mlh1 and Pms1 IDRs through FRB-FKBP dimerization inappropriately activated Mlh1–Pms1 endonuclease activity. We conclude that dynamic and coordinated rearrangements of the MLH IDRs both positively and negatively regulate how the MLH complex acts in MMR. The application of the FRB-FKBP dimerization system to interrogate in vivo functions of a critical repair complex will be useful for probing IDRs in diverse enzymes and to probe transient loss of MMR on demand.
Discordant Virus-Specific Antibody Levels, Antibody Neutralization Capacity, and T-cell Responses Following 3 Doses of SARS-CoV-2 Vaccination in a Patient With Connective Tissue Disease
Authors: Peluso Michael J , Munter Sadie E , Lynch Kara L , Yun Cassandra , Torres Leonel , Iyer Nikita S , Donatelli Joanna , Ryan Lindsay , Deitchman Amelia N , Deeks Steven G , Rutishauser Rachel L , Henrich Timothy J
Published: July 2021

We report a patient with connective tissue disease who developed modest severe acute respiratory syndrome coronavirus 2 receptor binding domain–specific antibody levels and a lack of neutralization capacity, despite having received 3 mRNA coronavirus disease 2019 vaccines and holding anti-B-cell therapy for >7 months before vaccination. The patient developed virus-specific T-cell responses.
Serological and RT-PCR Surveillance for COVID-19 in an Asymptomatic US Army Trainee Population
Authors: Hakre Shilpa , Sanborn Aaron D , Krauss Stephen W , Burns Jennifer L , Jackson Kenya N , McCauley Melanie D , Shepherd Brittany L Ober , McHenry Samantha , Stahlman Shauna L , Bianchi Elizabeth J , Freeman Joanna , Ouellette Jason , Stubbs Jeremiah , Brigantti Crystal , Hall Tara L , Beagle Milford H , Kwon Paul O , Pieri Jason A , Frambes Timothy R , Murray Clinton K , Cersovsky Steven B , Modjarrad Kayvon , Peel Sheila A , Scott Paul T
Published: July 2021

Background

Significant variability exists in the application of infection control policy throughout the US Army initial entry training environment. To generate actionable information for the prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/coronavirus disease 2019 (COVID-19) transmission among new recruits, active enhanced surveillance was conducted for evidence of and exposure to SARS-CoV-2/COVID-19.

Methods

We serially tested recruits with a reverse transcriptase polymerase chain reaction (RT-PCR) COVID-19 and/or total antibody to SARS-CoV-2 tests at days 0, 14, and week 10 upon arrival for basic combat training at a location in the Southern United States.

Results

Among 1403 recruits who were enrolled over a 6-week period from August 25 through October 11, 2020, 84 recruits tested positive by RT-PCR, with more than half (55%, 46/84) testing positive at arrival and almost two-thirds (63%, 53/84) also testing seropositive at arrival. Similarly, among an overall 146 recruits who tested seropositive for SARS-CoV-2 during the period of observation, a majority (86%) tested seropositive at arrival; no hospitalizations were observed among seropositive recruits, and antibody response increased at week 10.

Conclusions

These findings that suggest serological testing may complement current test-based measures and provide another tool to incorporate in COVID-19 mitigation measures among trainees in the US Army.
Cold-Injection Molded Gentamicin-Impregnated Polymethyl Methacrylate Implants for Cranioplasty
Authors: Fahem Mena Mekhael , Ali Nabeel Hameed , Duddu Joseph Ravindra , Luther Harleen
Published: July 2021

BACKGROUND

Cranioplasty can be carried out using either fresh, frozen autologous bone or synthetic substitutes. Ordering artificial 3 dimensional (3D) implants is challenging and time consuming depending on geographical location. In this article, we share our experience using a streamlined process of producing 3D computer-assisted design (CAD) implants using commercially available 3D printers and silicone molds that can be easily replicated with consistent results and are associated with good outcomes.

OBJECTIVE

To develop patient-specific implants for patients with cranial defects that are accurate, consistent, low cost, and easy to replicate while reducing operator-dependent factors.

METHODS

We present data from 15 patients who underwent cranioplasty with 3D CAD-designed gentamicin-impregnated bone cement implants that were molded using the cold injection technique.

RESULTS

The technique was consistent in result production, required little postdemolding manipulation, and showed no dimensional variation in design. Postoperative computed tomography scans showed excellent implant fit, and patients had a low complication rate.

CONCLUSION

We have demonstrated a technique of mold preparation that is efficient and that produces a reliable result. Polymethyl methacrylate implants molded using this technique showed better reproducibility, higher accuracy, and precision than other types of implants and required minimal postdemolding clean-up.
Effect of Pregabalin on the Median Effective Plasma Concentration of Intravenous Alfentanil in Capsaicin-Induced Pain
Authors: Wallace Mark S
Published: July 2021

Objective

To apply the sequential up–down method to a human experimental pain model in order to examine the opioid-sparing effect of oral pregabalin on intravenous alfentanil.

Design

Double-blind, randomized, crossover.

Setting

Academic university medical center.

Subjects

Thirty-one healthy males.

Methods

The median effective plasma concentration of intravenous alfentanil was determined under two conditions: alfentanil alone (phase I) and alfentanil+ pregabalin (300 mg orally) (phase II). The alfentanil plasma level (after a computer-controlled infusion) producing a success criterion (at least 30% intradermal capsaicin-induced pain reduction compared with placebo) was used to determine higher or lower doses for each sequential subject. The median dose producing a success criterion and its confidence interval were determined.

Results

On the basis of the t test for a difference across phase and regression coefficients across groups, there was no opioid-sparing effect of pregabalin on alfentanil. Four subjects in phase I and five subjects in phase II did not complete the study. Two in phase I were technical failures, with the rest in both phases stopped because of side effects. Of the subjects who completed the study, six of 19 subjects in phase I and 11 of 12 subjects in phase II reported side effects.

Conclusions

When the intradermal capsaicin-induced pain model was used in healthy volunteers, oral pregabalin had no opioid-sparing effects on intravenous alfentanil. This experimental model may be useful in studying analgesic interactions.
Enhanced Recovery Components for Posterior Lumbar Spine Fusion
Authors: Echt Murray , Poeran Jashvant , Zubizarreta Nicole , Girdler Steven J. , Mazumdar Madhu , Galatz Leesa M. , Memtsoudis Stavros G. , Hecht Andrew C. , Chaudhary Saad
Published: July 2021

Study Design:

This was a retrospective cohort study.

Objective:

The aim of this study was to assess the most commonly used components of enhanced recovery after surgery (ERAS) combinations and their relative effectiveness.

Summary of Background Data:

Data is lacking on use and effectiveness of various ERAS combinations which are increasingly used in spine surgery.

Materials and Methods:

Posterior lumbar fusion cases were extracted from the Premier Healthcare claims database (2006−2016). Seven commonly included components in spine ERAS protocols were identified: (1) multimodal analgesia, (2) tranexamic acid, (3) antiemetics on the day of surgery, (4) early physical therapy, (5) no urinary catheter, (6) no patient-controlled analgesia, and (7) no wound drains. Outcomes were: length of stay, “any complication,” blood transfusion, and hospitalization cost. Mixed-effects models measured associations between the most common ERAS combinations and outcomes, separately for 2006−2012 and 2013−2016. Odds ratios (ORs) and 95% confidence intervals (CIs) are reported.

Results:

Among 97,419 (74%; 2006−2012) and 34,932 (26%; 2013−2016) cases ERAS component variations decreased over time. The most commonly used combinations included multimodal analgesia, antiemetics, early physical therapy, avoidance of a urinary catheter, patient-controlled analgesia and drains (10% n=9401 and 19% n=6635 in 2006−2012 and 2013−2016, respectively), and did not include tranexamic acid. Multivariable models revealed minor differences between ERAS combinations in terms of length of stay and costs. The most pronounced beneficial effects in 2006−2012 were seen for the second most commonly (compared with less often) used ERAS combination(s) in terms of blood transfusion (OR: 0.65; CI: 0.59−0.71) and “any complication” (OR: 0.73; CI: 0.66−0.80), both P<0.05. In 2013−2016 the third most commonly used ERAS combination showed the strongest effect: blood transfusion OR: 0.63; CI: 0.50−0.78, P<0.05.

Conclusions:

ERAS component variations decreased over time; maximum benefits were particularly seen in terms of transfusion and complication risk reduction. These findings may inform future ERAS utilization and clinical trials comparing various ERAS protocols.
Safety and Efficacy of the Combination of Sacubitril/Valsartan and SGLT2i in HFrEF Patients (SECSI Registry)
Authors: Jiménez-Blanco Bravo Marta , Valle Alfonso , Gayán Ordás Jara , del Prado Díaz Susana , Cordero Pereda David , Morillas Climent Herminio , Bascompte Claret Ramón , Seller Moya Julia , Zamorano Gómez José Luis , Alonso Salinas Gonzalo Luis
Published: July 2021

Recent studies have proven benefit of SGLT2i drugs in patients with heart failure with reduced ejection fraction (HFrEF), but their safety when combined with angiotensin-neprilysin inhibitor (ARNI) has not been established. The Safety and Efficacy of the Combination of Sacubitril/Valsartan and SGLT2i in HFrEF Patients registry was conducted to address this issue. SECSI registry is a consecutive, observational, retrospective, multicentre study conducted in 3 Heart Failure Units in Spain. It included 144 HFrEF patients who were treated with ARNI and iSGLT2. Data were collected at baseline, month 2, and month 6. The primary endpoint was the estimated glomerular filtration rate (eGFR), after the initiation of ARNI and sodium-glucose cotransporter-2 inhibitors (SGLT2i). Secondary endpoints included potassium levels and functional class (New York Heart Association class). There were 3 prespecified subgroup analyses: Elderly patients (≥70 years), patients with chronic kidney disease (KDIGO classification G3), and the sequence of drug initiation. Mean age was 69.9 ± 10.1 years, and 110 (76.4%) were men. Left ventricular ejection fraction was 32 ± 7.8%, and most patients were symptomatic [123 (87.2%) New York Heart Association II/III/IV]. eGFR decreased at month 2 and this trend was maintained at month 6 [eGFR baseline 68.5 ± 17.3, month 2 62 ± 19.7 and month 6 64.7 ± 8.6 mL/min/1.73 m2 (P < 0.01 for both)]. In prespecified analysis, elder patients and those who simultaneously initiate both treatments showed the steeper decrease in eGFR. To conclude, co-administration of SGLT2i and ARNI in routine care in HFrEF patients produced a slight decrease in eGFR at 6 months of follow-up. This decrease was especially significant in elder patients and those who initiate both drugs simultaneously.
Impact of Lisinopril on Cardiometabolic Risk Factors in Men With Hypertension and Early-onset Androgenetic Alopecia: A Pilot Study
Authors: Krysiak Robert , Basiak Marcin , Okopień Bogusław
Published: July 2021

Women with polycystic ovary syndrome are at a high cardiometabolic risk. Early-onset male-pattern baldness is considered the phenotypic equivalent of polycystic ovary syndrome in men. The aim of this study was to assess whether early-onset androgenetic alopecia modifies cardiometabolic effects of lisinopril in men with arterial hypertension. The study population consisted of 62 young men with grade 1 hypertension, 31 of whom were diagnosed with early-onset male-pattern baldness (group A). Thirty-one blood pressure–matched men with normal hair growth (group B) served as a control group. All participants were treated with lisinopril (10–40 mg daily). Blood pressure, glucose homeostasis markers, urinary albumin-to-creatinine ratio (UACR), as well as plasma levels of uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen, homocysteine, total and calculated free testosterone, dehydroepiandrosterone sulfate, and estradiol were assessed before lisinopril treatment and 6 months later. At baseline, levels of all cardiometabolic risk factors were higher in group A than group B. Although lisinopril reduced systolic and diastolic blood pressure, UACR, hsCRP, and fibrinogen in both study groups, these effects were stronger in group B than in group A. Only in group B, the drug decreased levels of uric acid and homocysteine, as well as improved insulin sensitivity. The impact of lisinopril on uric acid, hsCRP, fibrinogen, homocysteine, and UACR correlated weakly with its hypotensive properties, androgen levels, and insulin sensitivity. The obtained results suggest that cardiometabolic effects of lisinopril in men are less pronounced in case of coexisting early-onset androgenetic alopecia.
CircSCAP Aggravates Oxidized Low-density Lipoprotein-induced Macrophage Injury by Upregulating PDE3B by miR-221-5p in Atherosclerosis
Authors: He Qian , Shao Dandan , Hao Shengyun , Yuan Yuan , Liu Hanling , Liu Fuyi , Mu Qiong
Published: July 2021

Atherosclerosis (AS) is a major risk factor for cardiovascular disease, in which circular RNAs play important regulatory roles. This research aimed to explore the biological role of circular RNA Sterol Regulatory Element Binding Transcription Factor Chaperone (circSCAP) (hsa_circ_0001292) in AS development. Real-time PCR or Western blot assay was conducted to analyze RNA or protein expression. Cell proliferation and apoptosis were analyzed by CCK-8 assay and flow cytometry. The levels of lipid accumulation–associated indicators and oxidative stress factors were detected using commercial kits. The levels of inflammatory cytokines were examined using enzyme-linked immunosorbent assay. Intermolecular interaction was verified by dual-luciferase reporter analysis or RNA pull-down analysis. CircSCAP and phosphodiesterase 3B (PDE3B) levels were elevated, whereas the miR-221-5p level was decreased in patients with AS and oxidized low-density lipoprotein (ox-LDL)-induced THP-1 cells. CircSCAP absence suppressed lipid deposition, inflammation, and oxidative stress in ox-LDL–induced THP-1 cells. MiR-221-5p was a target of circSCAP, and anti–miR-221-5p largely reversed si-circSCAP–induced effects in ox-LDL–induced THP-1 cells. PDE3B was a target of miR-221-5p, and PDE3B overexpression largely counteracted miR-221-5p accumulation–mediated effects in ox-LDL–induced THP-1 cells. NF-κB signaling pathway was regulated by circSCAP/miR-221-5p/PDE3B axis in ox-LDL–induced THP-1 cells. In conclusion, circSCAP facilitated lipid accumulation, inflammation, and oxidative stress in ox-LDL–induced THP-1 macrophages by regulating miR-221-5p/PDE3B axis.
Parent–Child Agreement on Quality of Life in Children With Hearing Loss Using the HEAR-QL
Authors: Zhang Amy L. , Wahba Brandon Malik , Lieu Judith E. C.
Published: July 2021

Objective:

We explored whether children with hearing loss (HL) and their parents perceive the child's quality of life (QOL) similarly using the Hearing Environment And Reflections on Quality of Life (HEAR-QL) survey.

Study Design:

Cross-sectional study.

Setting:

Pediatric otolaryngology clinic.

Patients:

7 to 14 year old children with unilateral or bilateral HL and their parents.

Interventions:

None.

Main Outcome Measure:

The HEAR-QL is a validated hearing-related QOL survey and has three domains and total score, ranging from 0 to 100; higher scores indicate higher QOL.

Results:

HEAR-QL total score (r = 0.520, p = 0.011), Activities (r = 0.608, p = 0.002), and Feelings (r = 0.657, p = 0.001) domains correlated strongly, but the hearing Environments domain (r = 0.291, p = 0.178) correlated weakly. Children with mild HL scored total and Environments domains lower than their parents (mean difference [MD] −13.9 [95% CI −34.3, 6.6] and −19.2 [95% CI −41.2, 2.7]; Hedge's g 0.67, 0.77, respectively) compared to children with moderate-to-severe HL (moderate HL MD 8.3 [95% CI −15.7, 32.4] and 13.1 [95% CI −25.2, 51.5]; severe HL MD 9.5 [95% CI 0.6, 18.4] and 14.4 [95% CI 4.3, 24.6]).

Discussion:

Children and their parents correlated strongly on observable Feelings And Activities domains scores but correlated weakly on hearing difficulty in Environments scores. Parents of children with mild HL perceived their children's QOL to be better than the children themselves, differing from the moderate-to-severe HL groups.
Effects of Lifestyle Modification on Vestibular Migraine
Authors: Roberts Richard A. , Watford Kenneth E. , Picou Erin M. , Hatton Kelsey , Trone Timothy H. , Brignola Emily Y.
Published: July 2021

Objective:

To evaluate effects of lifestyle modification on symptoms of dizziness and headache in patients diagnosed with definite vestibular migraine.

Study Design:

Prospective within-participants repeated-measures study.

Setting:

Otolaryngology tertiary care.

Participants:

Twenty-eight adults with definite vestibular migraine who were willing to be treated without pharmacological intervention.

Intervention(s):

Information and instructions were provided on lifestyle modification; participants were instructed to improve restful sleep, exercise, eat at regulated mealtimes, and avoid dietary triggers. Participants were asked to maintain the modifications for at least 60 days.

Main Outcome Measure(s):

Two self-report inventories were used pre- and post-intervention to evaluate participants’ perceived dizziness handicap and headache disability using the Dizziness Handicap Inventory and Headache Disability Inventory, respectively. Questions were also used to evaluate the extent to which participants reported compliance with lifestyle factors pre- and post-intervention.

Results:

Significant improvement was observed after the lifestyle intervention with mean improvements in Dizziness Handicap Inventory and Headache Disability Inventory of 14.3 points. As a group, improvement in restful sleep was related to improvement in both dizziness and headache symptoms. At the individual participant level, 39% and 18% of participants reported significant reduction in dizziness handicap and headache disability, respectively.

Conclusions:

Lifestyle modifications are an effective intervention for symptoms of dizziness and headache in participants with definite vestibular migraine. Participants who reported a larger increase in restful sleep were more likely to also report larger improvements in dizziness handicap and headache disability. Effect sizes using the current intervention were comparable or better than some reported pharmacological interventions but less than others. Our lifestyle modification intervention produced significant improvement in dizziness for a larger percentage of individual participants and in headache for a similar percentage of participants compared to data reported with other lifestyle modification interventions. Lifestyle modifications, especially restful sleep, have the potential to reduce the impact of vestibular migraine on patients’ lives, with limited risk.

Clinical Trials Registration: NCT03979677.
Impact of Hearing Disability and Ear Discharge on Quality-of-Life in Patients with Chronic Otitis Media: Data from the Multinational Collaborative COMQ-12 Study
Authors: Phillips John S. , Tailor Bhavesh V. , Nunney Ian , Yung Matthew W. , Doruk Can , Kara Hakan , Kong Taehoon , Quaranta Nicola , Peñaranda Augusto , Bernardeschi Daniele , Dai Chunfu , Kania Romain , Denoyelle Françoise , Tono Tetsuya
Published: July 2021

Objective:

This study aimed to assess how two disease-related factors, hearing disability and ear discharge, affect health-related quality-of-life (HRQoL) in patients with chronic otitis media (COM).

Study Design:

Multinational prospective cohort study.

Setting:

Nine otology referral centers in eight countries.

Patients:

Adult patients suffering from COM.

Main Outcome Measure(s):

Hearing disability and ear discharge were assessed by audiometry (Department of Health and Social Security formula) and otoscopy, respectively. Participants completed a native version of the Chronic Otitis Media Questionnaire-12 (COMQ-12). We determined how the two disease-related factors affect HRQoL by performing two separate analyses: (1) using a 6-item score combining responses to COMQ-12 items independent of hearing loss and ear discharge and (2) using item 12 alone as a proxy for global HRQoL.

Results:

This study included 478 participants suffering from COM. There was a significant association between HRQoL and hearing disability in the adjusted analysis. For every unit increase in the Department of Health and Social Security average hearing threshold (1) there was an increase of 0.06 (95% CI [0.007, 0.121], p = 0.0282) in the 6-item score and (2) the adjusted odds of having a higher item 12 score was 1.03 (95% CI [1.01, 1.04], p = 0.0004). There was no association between the presence of ear discharge and HRQoL in both COMQ-12 score analyses.

Conclusions:

Knowledge of disease-related factors that influence HRQoL will aid interpretation of patient-reported measures for COM. Patients with a greater degree of hearing impairment appear to have poorer HRQoL, which is not exacerbated by the presence of ear discharge. The magnitude of postoperative hearing improvement rather than the attainment of a dry ear may be a better indicator of surgical success from the patient's perspective.
A Novel Topical Treatment for Keratosis Obturans
Authors: Zwemstra Max , Ebbens Fenna , de Wolf Maarten , van Spronsen Erik
Published: July 2021

Objective:

To present and evaluate the treatment of keratosis obturans (KO) using miconazole/triamcinolone 0.1% crème gauzes.

Study Design:

A retrospective clinical capsule report.

Patients:

Twelve patients diagnosed with KO between January 2000 and July 2020 visiting our tertiary hospital setting, were retrospectively reviewed.

Interventions:

Either miconazole/triamcinolone 0.1% crème gauzes or periodic microscopic removal of the keratin plug.

Main Outcome Measures:

No evidence of disease during microscopic inspection of the ear canal.

Results:

Successful treatment with miconazole/triamcinolone 0.1% gauzes was seen in 4/7 patients (57%) and successful treatment of periodic cleaning of the ear canal was seen in 1/5 patients (20%).

Conclusions:

Topical treatment of KO with miconazole/triamcinolone 0.1% crème gauzes in the ear canal could be considered as a treatment option for patients diagnosed with KO.
Sudden Sensorineural Hearing Loss and Metabolic Syndrome: A Systematic Review and Meta-analysis
Authors: Lam Megan , Bao Yueyang , Hua Gordon B. , Sommer Doron D.
Published: July 2021

Objective:

The objective of this systematic review and meta-analysis is to examine the association between sudden sensorineural hearing loss (SSNHL) and risk of metabolic syndrome (MetS), and the association between MetS and prognosis of SSNHL.

Databases Reviewed:

We systematically searched MEDLINE, Embase, and Cochrane Central Register electronic databases from their dates of conception to February 4, 2020.

Methods:

We included observational studies analyzing 1) the prevalence of MetS among SSNHL patients, or 2) the prognosis of SSNHL patients in MetS patients. A standardized form was completed in duplicate extracting data on study characteristics, participant demographics, and SSNHL outcome or recovery measures. Random-effects meta-analyses were performed pooling odds ratios using the generic inverse method. Risk of bias was assessed using the Newcastle Ottawa Scale.

Results:

Three studies examining the prevalence of MetS among patients with SSNHL (11,890 total participants; 3,034 SSNHL participants) yielded a significantly increased risk of MetS among SSNHL, with a pooled odds ratio of 1.88 (95% CI, 1.01–3.50). Three studies examining the association of SSNHL prognosis in patients with MetS (608 SSNHL participants, 234 concomitant SSNHL, and MetS participants) demonstrated that SSNHL patients with MetS were significantly more likely to have poorer recovery compared to SSNHL patients without MetS (pooled odds ratio 2.77; 95% CI, 2.33–3.28).

Conclusion:

Our findings suggest an association between prevalence of MetS and SSNHL, as well as poorer prognosis of SSNHL in patients with concomitant MetS.
Reconstruction of the Anterior External Auditory Canal With Mastoid Cortex Autologous Bone Graft
Authors: Lovett Braeden L. , Shearer Sarah C. , Kim H. Jeffrey
Published: July 2021

Objective:

To describe the surgical management of temporomandibular joint (TMJ) herniation with external auditory canal (EAC) reconstruction using autologous bone grafting from the mastoid cortex.

Study Design:

Retrospective case series.

Setting:

A tertiary university medical center.

Patients:

Three patients who presented to our Otolaryngology clinic with evidence of TMJ herniation through an anterior EAC defect, both on otoscopy and computed tomography (CT) imaging.

Interventions:

Reconstruction of the anterior EAC with mastoid cortex bone grafting using an endaural approach.

Main Outcome Measures:

Successful reconstruction of anterior EAC bony defect without recurrence of herniation.

Results:

All three patients presented with otalgia, hearing loss, and either tinnitus or a clicking sensation with jaw movement. Etiologies for TMJ herniation included osteoradionecrosis following external beam radiation therapy for head and neck carcinoma and iatrogenic injury following multiple tympanoplasties and canalplasties. A mastoid cortex bone graft was placed and secured anterior to the bony EAC defect through an endaural approach. Two patients wore a dental retainer postoperatively to keep the condyle in an open position. After reconstruction, patients reported an improvement in their presenting symptoms. There was no recurrence of TMJ herniation in all cases after 1, 4, and 9 years.

Conclusions:

Anterior EAC reconstruction with autologous bone grafting can be an effective definitive treatment in TMJ herniation. To our knowledge, this is the first report of the use of bone grafting to reconstruct the canal defect in TMJ herniation.

Level of Evidence: V.