bluuebunny/crossref_metadata_2025 huggingface dataset:
A search for millisecond radio bursts from Messier 82
Authors: Paine S , Hawkins T , Lorimer D R , Stanley J , Kania J , Crawford F , Fairfield N
Published: February 2024

Fast radio bursts (FRBs) are short-duration radio pulses of cosmological origin. Among the most common sources predicted to explain this phenomenon are bright pulses from a class of extremely highly magnetized neutron stars known as magnetars. Motivated by the discovery of an FRB-like pulse from the Galactic magnetar SGR 1935+2154, we searched for similar events in Messier 82 (M82). With a star formation rate 40 times that of the Milky Way, one might expect that the implied rate of events similar to that seen from SGR 1935+2154 from M82 should be 40 times higher than that of the Milky Way. We observed M82 at 1.4 GHz with the 20-m telescope at the Green Bank Observatory for 34.8 d. While we found many candidate events, none had a signal-to-noise ratio greater than 8. We also show that there are insufficient numbers of repeating low-significance events at similar dispersion measures to constitute a statistically significant detection. From these results, we place an upper bound for the rate of radio pulses from M82 to be 30 yr−1 above a fluence limit of 8.5 Jy ms. While this is less than nine times the rate of radio bursts from magnetars in the Milky Way inferred from the previous radio detections of SGR 1935+2154, it is possible that propagation effects from interstellar scattering are currently limiting our ability to detect sources in M82. Further searches of M82 and other nearby galaxies are encouraged to probe this putative FRB population.
Cold diffuse interstellar medium of Magellanic Clouds: II. Physical conditions from excitation of C i and H2
Authors: Kosenko D N , Balashev S A , Klimenko V V
Published: February 2024

We present a comprehensive study of the excitation of C i fine-structure levels along 57 sight lines in the Large and Small Magellanic Clouds (LMC and SMC). The sightlines were selected by the detection of H2 in FUSE spectra. Using archival HST/COS and HST/STIS spectra, we detected absorption of C i fine-structure levels and measured their populations for 29 and 28 sightlines in the LMC and SMC, respectively. The C i column density ranges from 1013 to $10^{14}\, {\rm cm}^{-2}$ for the LMC and 1013 to $10^{15.4}\, {\rm cm}^{-2}$ for the SMC. We found excitation of C i fine-structure levels in the LMC and SMC to be 2–3 times higher than typical values in local diffuse interstellar medium (ISM). Comparing excitation of both C i fine-structure levels and H2 rotational levels with a grid of PDR Meudon models, we find that neutral cold gas in the LMC and SMC is illuminated by a stronger UV field than in local ISM ($\chi =5^{+7}_{-3}$ units of Mathis field for the LMC and $2^{+4}_{-1}$ for the SMC) and has on average higher thermal pressure (log p/k = 4.2 ± 0.4 and 4.3 ± 0.5, respectively). Magellanic Clouds sight lines likely probe regions near star-formation sites, which also affects the thermal state and C i/H2 relative abundances. At the same time, obtained enhanced UV field is consistent with some measurements at high redshifts. Together with low metallicities, this make Magellanic Clouds an interesting test case to study the central parts of high redshift galaxies.
Deeper than DEEP: a spectroscopic survey of z > 3 Ly α emitters in the Extended Groth Strip
Authors: Stawinski Stephanie M Urbano , Cooper M C , Finkelstein Steven L , Jung Intae , Pérez-González Pablo G , Bagley Micaela B , Casey Caitlin M , Cooper Olivia R , Hathi Nimish P , Holwerda Benne W , Koekemoer Anton M , Kartaltepe Jeyhan S , Fernández Vital , Larson Rebecca L , Lucas Ray A , Yung L Y Aaron
Published: February 2024

We present a spectroscopic survey of Ly α emitters in the Extended Groth Strip (EGS) field, targeting the regime near the Epoch of Reionization. Using Keck/DEep Imaging Multi-Object Spectrograph, we observed 947 high-z candidates with photometric redshifts from 3 < zphot < 7 and down to an H-band (Hubble Space Telescope/Wide Field Camera 3 F160W) magnitude limit of <27.5. Observations were taken over the course of eight nights, with integration times ranging from 4 to 7.8 h. Our survey secured 137 unique redshifts, 126 of which are Ly α emitters at 2.8 < z < 6.3 with a mean redshift of $\overline{z} = 4.3$. We provide a comprehensive redshift catalogue for our targets, as well as the reduced one- and two-dimensional spectra for each object. These observations will provide an important auxiliary data set for the JWST Directors Discretionary Early Release Science programme the Cosmic Evolution Early Release Science Survey, which recently completed near- and mid-infrared imaging and spectroscopy of galaxies in the EGS field.
Radio spectral properties of star-forming galaxies between 150 and 5000 MHz in the ELAIS-N1 field
Authors: An Fangxia , Vaccari M , Best P N , Ocran E F , Ishwara-Chandra C H , Taylor A R , Leslie S K , Röttgering H J A , Kondapally R , Haskell Paul , Collier J D , Bonato M
Published: February 2024

By combining high-sensitivity LOFAR 150 MHz, uGMRT 400 MHz and 1250 MHz, GMRT 610 MHz, and VLA 5 GHz data in the ELAIS-N1 field, we study the radio spectral properties of radio-detected star-forming galaxies (SFGs) at observer-frame frequencies of 150–5000 MHz. We select ∼3500 SFGs that have both LOFAR 150 MHz and GMRT 610 MHz detections, and obtain a median two-point spectral index of $\alpha _{150}^{610}=-0.51\pm 0.01$. The photometric redshift of these SFGs spans z = 0.01−6.21. We also measure the two-point radio spectral indices at 150–400–610–1250 MHz and 150–610–5000 MHz, respectively, for the GMRT 610-MHz-detected SFGs, and find that, on average, the radio spectrum of SFGs is flatter at low frequency than at high frequency. At observer-frame 150–5000 MHz, we find that the radio spectrum slightly steepens with increasing stellar mass. However, we only find that the radio spectrum flattens with increasing optical depth at V band at $\nu \lesssim 1$ GHz. We suggest that spectral ageing due to the energy loss of CR electrons and thermal free–free absorption could be among the possible main physical mechanisms that drive the above two correlations, respectively. In addition, both of these mechanisms could physically explain why the radio spectrum is flatter at low frequency than at high frequency.
Introducing urea into tirapazamine derivatives to enhance anticancer therapy
Authors: Xu Yajun , Lv Jianlin , Kong Chaoying , Liu Ya , Wang Kun , Tang Zhaohui , Chen Xuesi
Published: February 2024

Tirapazamine (TPZ) has been approved for multiple clinical trials relying on its excellent anticancer potential. However, as a typical hypoxia-activated prodrug (HAP), TPZ did not exhibit survival advantages in Phase III clinical trials when used in combination therapy due to the insufficient hypoxia levels in patients’ tumors. In this study, to improve the therapeutic effects of TPZ, we first introduced urea to synthesize a series of urea-containing derivatives of TPZ. All urea-containing TPZ derivatives showed increased hypoxic cytotoxicity (9.51–30.85-fold) compared with TPZ, while maintaining hypoxic selectivity. TPZP, one of these derivatives, showed 20-fold higher cytotoxicity than TPZ while maintaining a similar hypoxic cytotoxicity ratio. To highly efficiently deliver TPZP to the tumors and reduce its side effects on healthy tissues, we further prepared TPZP into a nanodrug with fibrin-targeting ability: FT11-TPZP-NPs. CA4-NPs, a vascular disrupting agent, was used to increase the fibrin level within tumors and exacerbate tumor hypoxia. By being combined with CA4-NPs, FT11-TPZP-NPs can accumulate in the hypoxia-aggravated tumors and activate sufficiently to kill tumor cells. After a single-dose treatment, FT11-TPZP-NPs + CA4-NPs showed a high inhibition rate of 98.1% against CT26 tumor models with an initial volume of ∼480 mm3 and four out of six tumors were completely eliminated; it thereby exerted a significant antitumor effect. This study provides a new strategy for improving the therapeutic effect of TPZ and other HAPs in anticancer therapy.
Uncovering key salt-tolerant regulators through a combined eQTL and GWAS analysis using the super pan-genome in rice
Authors: Wei Hua , Wang Xianmeng , Zhang Zhipeng , Yang Longbo , Zhang Qianqian , Li Yilin , He Huiying , Chen Dandan , Zhang Bin , Zheng Chongke , Leng Yue , Cao Xinglan , Cui Yan , Shi Chuanlin , Liu Yifan , Lv Yang , Ma Jie , He Wenchuang , Liu Xiangpei , Xu Qiang , Yuan Qiaoling , Yu Xiaoman , Wang Tianyi , Qian Hongge , Li Xiaoxia , Zhang Bintao , Zhang Hong , Chen Wu , Guo Mingliang , Dai Xiaofan , Wang Yuexing , Zheng Xiaoming , Guo Longbiao , Xie Xianzhi , Qian Qian , Shang Lianguang
Published: February 2024

For sessile plants, gene expression plays a pivotal role in responding to salinity stress by activating or suppressing specific genes. However, our knowledge of genetic variations governing gene expression in response to salt stress remains limited in natural germplasm. Through transcriptome analysis of the Global Mini-Core Rice Collection consisting of a panel of 202 accessions, we identified 22 345 and 27 610 expression quantitative trait loci associated with the expression of 7787 and 9361 eGenes under normal and salt-stress conditions, respectively, leveraging the super pan-genome map. Notably, combined with genome-wide association studies, we swiftly pinpointed the potential candidate gene STG5—a major salt-tolerant locus known as qSTS5. Intriguingly, STG5 is required for maintaining Na+/K+ homeostasis by directly regulating the transcription of multiple members of the OsHKT gene family. Our study sheds light on how genetic variants influence the dynamic changes in gene expression responding to salinity stress and provides a valuable resource for the mining of salt-tolerant genes in the future.
Culture, conditions and care support mental health of healthcare workers during crises
Authors: Maple J L , Whiteside M , Smallwood N , Putland M , Baldwin P , Bismark M , Harrex W , Johnson D , Karimi L , Willis K
Published: February 2024

Background

The coronavirus disease 2019 (COVID-19) pandemic has presented immense challenges to health systems worldwide and significantly impacted the mental health of frontline healthcare workers.

Aims

This study drew on the experiences of frontline healthcare workers to examine organizational strategies needed to support the mental health and well-being of healthcare workers during times of crisis.

Methods

Semi-structured focus groups or individual interviews were conducted with healthcare workers to examine their perspectives on organizational strategies for enhancing staff mental health and well-being during crises. Data were analysed thematically. Following this, evidence for the identified strategies was reviewed to assess alignment with participant views and recommendations.

Results

Thirty-two healthcare workers from diverse disciplines (10 allied health, 11 nursing, 11 medical) participated in the study. Data analysis identified three broad themes contributing to supporting mental health and well-being. These themes can be encapsulated as the ‘Three Cs’—culture (building an organizational culture that prioritizes mental health); conditions (implementing proactive organizational strategies during crises) and care (ensuring fit-for-purpose strategies to support mental health and well-being).

Conclusions

Study findings underscore the necessity of an integrated and systemic organizational approach to address mental health and well-being in the healthcare workplace. This approach must be long term with the components of the ‘Three Cs’, particularly cultural change and conditions, viewed as a part of a suite of strategies to ensure crisis preparedness. It is imperative that organizations collaborate with their staff, providing support and fostering a safe and inclusive work environment that ultimately benefits patients, their care and staff well-being.
Changes in Body Mass Index Over Time in People With and Without HIV Infection
Authors: Lam Jennifer O , Leyden Wendy A , Alexeeff Stacey , Lea Alexandra N , Hechter Rulin C , Hu Haihong , Marcus Julia L , Pitts Lakecia , Yuan Qing , Towner William J , Horberg Michael A , Silverberg Michael J
Published: February 2024

Background

Excess weight gain is an important health concern among people with HIV (PWH) on antiretroviral therapy (ART). The extent to which ART contributes to body mass index (BMI) changes is incompletely understood.

Methods

We conducted a retrospective study of PWH initiating ART and demographically matched people without HIV (PWoH). Data on baseline BMI (kg/m2; categorized as underweight/normal, overweight, or obese) and ART class (integrase strand transfer inhibitor [INSTI], non-nucleoside reverse transcriptase inhibitor [NNRTI], protease inhibitor [PI]) were obtained from electronic health records. BMI was evaluated longitudinally using piecewise linear splines in mixed effects models by HIV status, baseline BMI, and ART class. Models were adjusted for sociodemographics, comorbidities, and substance use.

Results

The study included 8256 PWH and 129 966 PWoH (mean baseline age, 40.9 and 42.2 years, respectively; 88% men). In adjusted models, the average annual change in BMI in the first 2 years after ART initiation was 0.53 for PWH and 0.12 for PWoH (P < .001). BMI increases among PWH were observed for all ART classes: 0.69 for INSTIs, 0.69 for PIs, and 0.40 for NNRTIs vs 0.12 among PWoH. For PWH initiating INSTIs, BMI increases were observed regardless of baseline BMI. Overall BMI changes >2 years after ART initiation were similar by HIV status (0.02 average annual increase for PWH and PWoH).

Conclusions

PWH initiating ART gained excess weight in the first 2 years, emphasizing the importance of monitoring weight and cardiometabolic health among ART-treated PWH.
Personalized Infant Risk Prediction for Severe Respiratory Syncytial Virus Lower Respiratory Tract Infection Requiring Intensive Care Unit Admission
Authors: Snyder Brittney M , Achten Niek B , Gebretsadik Tebeb , Wu Pingsheng , Mitchel Edward F , Escobar Gabriel , Bont Louis J , Hartert Tina V
Published: February 2024

Background

Currently, there are no available tools to identify infants at the highest risk of significant morbidity and mortality from respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) who would benefit most from RSV prevention products. The objective was to develop and internally validate a personalized risk prediction tool for use among all newborns that uses readily available birth/postnatal data to predict RSV LRTI requiring intensive care unit (ICU) admission.

Methods

We conducted a population-based birth cohort study of infants born from 1995 to 2007, insured by the Tennessee Medicaid Program, and who did not receive RSV immunoprophylaxis during the first year of life. The primary outcome was severe RSV LRTI requiring ICU admission during the first year of life. We built a multivariable logistic regression model including demographic and clinical variables available at or shortly after birth to predict the primary outcome.

Results

In a population-based sample of 429 365 infants, 713 (0.2%) had severe RSV LRTI requiring ICU admission. The median age of admission was 66 days (interquartile range, 37–120). Our tool, including 19 variables, demonstrated good predictive accuracy (area under the curve, 0.78; 95% confidence interval, 0.77-0.80) and identified infants who did not qualify for palivizumab, based on American Academy of Pediatrics guidelines, but had higher predicted risk levels than infants who qualified (27% of noneligible infants with >0.16% predicted probabilities [lower quartile for eligible infants]).

Conclusions

We developed a personalized tool that identified infants at increased risk for severe RSV LRTI requiring ICU admission, expected to benefit most from immunoprophylaxis.
Pregnancy in antiphospholipid syndrome: what should a rheumatologist know?
Authors: Andreoli Laura , Regola Francesca , Caproli Alessia , Crisafulli Francesca , Fredi Micaela , Lazzaroni Maria-Grazia , Nalli Cecilia , Piantoni Silvia , Zatti Sonia , Franceschini Franco , Tincani Angela
Published: February 2024

This review focuses on the management of reproductive issues in women who have antiphospholipid syndrome (APS) or are carriers of antiphospholipid antibodies (aPL). The importance of aPL detection during preconception counselling relies on their pathogenic potential for placental insufficiency and related obstetric complications. The risk of adverse pregnancy outcomes can be minimized by individualized risk stratification and tailored treatment aimed at preventing placental insufficiency. Combination therapy of low-dose acetylsalicylic acid and heparin is the mainstay of prophylaxis during pregnancy; immunomodulation, especially with hydroxychloroquine, should be considered in refractory cases. Supplementary ultrasound surveillance is useful to detect fetal growth restriction and correctly tailor the time of delivery. The individual aPL profile must be considered in the stratification of thrombotic risk, such as during assisted reproduction techniques requiring hormonal ovarian stimulation or during the follow-up after pregnancy in order to prevent the first vascular event.
Revealing novel genomic insights and therapeutic targets for juvenile idiopathic arthritis through omics
Authors: Fan Jingxian , Li Xiumei , Yang Jie , Zhang Sipeng , Qu Hui-Qi , Ji Dandan , Glessner Joseph T , Hao Jian , Ding Zhiyong , Wang Nan , Meng Xinyi , Xia Qianghua , Hakonarson Hakon , Wei Wei , Li Jin
Published: February 2024

Background

The genetic architecture of JIA remains only partially comprehended. There is a clear imperative for continued endeavours to uncover insights into the underlying causes of JIA.

Methods

This study encompassed a comprehensive spectrum of endeavours, including conducting a JIA genome-wide association study (GWAS) meta-analysis that incorporated data from 4550 JIA cases and 18 446 controls. We employed in silico and genome-editing approaches to prioritizing target genes. To investigate pleiotropic effects, we conducted phenome-wide association studies. Cell-type enrichment analyses were performed by integrating bulk and single-cell sequencing data. Finally, we delved into potential druggable targets for JIA.

Results

Fourteen genome-wide significant non-HLA loci were identified, including four novel loci, each exhibiting pleiotropic associations with other autoimmune diseases or musculoskeletal traits. We uncovered strong genetic correlation between JIA and BMD traits at 52 genomic regions, including three GWAS loci for JIA. Candidate genes with immune functions were captured by in silico analyses at each novel locus, with additional findings identified through our experimental approach. Cell-type enrichment analysis revealed 21 specific immune cell types crucial for the affected organs in JIA, indicating their potential contribution to the disease. Finally, 24 known or candidate druggable target genes were prioritized.

Conclusions

Our identification of four novel JIA-associated genes, CD247, RHOH, COLEC10 and IRF8, broadens the novel potential drug repositioning opportunities. We established a new genetic link between COLEC10, TNFRSF11B and JIA/BMD. Additionally, the identification of RHOH underscores its role in positive thymocyte selection, thereby illuminating a critical facet of JIA’s underlying biological mechanisms.
Efficacy and safety of neoadjuvant sintilimab in combination with FLOT chemotherapy in patients with HER2-negative locally advanced gastric or gastroesophageal junction adenocarcinoma: an investigator-initiated, single-arm, open-label, phase II study
Authors: Li Ning , Li Zhi , Fu Qiang , Zhang Bin , Zhang Jian , Wan Xiang-Bin , Lu Chao-Min , Wang Jin-Bang , Deng Wen-Ying , Ma Yi-Jie , Bie Liang-Yu , Wang Meng-Yu , Li Jing , Xia Qing-Xin , Wei Chen , Luo Su-Xia
Published: February 2024

Background:

The addition of immune checkpoint inhibitors to neoadjuvant chemotherapy in operable advanced gastric or gastroesophageal junction (G/GEJ) cancer aroused wide interest. This study was designed to assess the efficacy and safety of neoadjuvant sintilimab, a programmed cell death protein-1 (PD-1) inhibitor, in combination with fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) chemotherapy for HER2-negative locally advanced G/GEJ cancer.

Methods:

Eligible patients with clinical stage cT4 and/or cN+M0 G/GEJ cancer were enroled in this phase II study. Patients received neoadjuvant sintilimab (200 mg every 3 weeks) for three cycles plus FLOT (50 mg/m2 docetaxel, 80 mg/m2 oxaliplatin, 200 mg/m2 calcium levofolinate, 2600 mg/m2 5-fluorouracil every 2 weeks) for four cycles before surgery, followed by four cycles of adjuvant FLOT with same dosages after resection. The primary endpoint was the pathological complete response (pCR) rate.

Results:

Thirty-two patients were enroled between August 2019 and September 2021, with a median follow-up of 34.8 (95% CI, 32.8–42.9) months. Thirty-two (100%) patients received neoadjuvant therapy, and 29 underwent surgery with an R0 resection rate of 93.1%. The pCR (TRG0) was achieved in 5 (17.2%; 95% CI, 5.8–35.8%) patients, and the major pathological response was 55.2%. Twenty-three (79.3%) patients had T downstaging, 21 (72.4%) had N downstaging, and 19 (65.5%) had overall TNM downstaging. Six (20.7%) patients experienced recurrence. Patients achieving pCR showed better event-free survival (EFS), disease-free survival (DFS), and overall survival (OS) than non-pCR. The estimated 3-year EFS rate, 3-year DFS rate, and 3-year OS rate were 71.4% (95% CI, 57.2–89.2%), 78.8% (95% CI, 65.1–95.5%), and 70.9% (95% CI, 54.8–91.6%), respectively. The objective response rate and disease control rate were 84.4% (95% CI, 68.3–93.1%) and 96.9% (95% CI, 84.3–99.5%), respectively. Twenty-five (86.2%) received adjuvant therapy. The main grade ≥3 treatment-related adverse events (TRAEs) were lymphopenia (34.4%), neutropenia (28.1%), and leukopenia (15.6%). no patients died from TRAE. The LDH level exhibited a better predictive value to pathological responses than PD-L1 and MSI status.

Conclusions:

The study demonstrated an encouraging efficacy and manageable safety profile of neoadjuvant sintilimab plus FLOT in HER2-negative locally advanced G/GEJ cancer, which suggested a potential therapeutic option for this population.
Vascular Complications and Outcomes Following Transcatheter Aortic Valve Replacement in Patients on Chronic Steroid Therapy. A meta-analysis
Authors: Ang Song Peng , Chia Jia Ee , Jaiswal Vikash , Hanif Muhammed , Vadhera Ananya , Gautam Sudarshan , Raut Anuradha , Rafaqat Saira , Borra Vamsikalyan Reddy , Khandait Harshwardhan , Shrestha Abhigan Babu , Iglesias Jose
Published: February 2024

Background:

Chronic steroid (CS) therapy was reportedly linked to increased vascular complications following percutaneous coronary intervention. However, its association with vascular complications after transcatheter aortic valve replacement (TAVR) remained uncertain, with conflicting results being reported.

Objective:

We aimed to compare the rate of vascular complications and outcomes between patients with and without (CS) use after TAVR.

Methods:

We conducted a comprehensive literature search in PubMed, Embase and Cochrane databases from their inception until 18th April 2022 for relevant studies. Endpoints were described according to Valve Academic Research Consortium-2 definitions. Effect sizes were pooled using DerSimonian and Laird random-effects model as risk ratio (RR) with 95% confidence intervals (CI).

Results:

5 studies with 6136 patients undergoing TAVR were included in the analysis. The included studies were published between 2015 and 2022. The mean ages of patients in both study groups were similar, with the CS group averaging 80 years and the non-steroid group averaging 82 years. Notably, a higher proportion of patients in the CS group were female (56%) compared to the non-steroid group (54%). CS use was associated with a significantly higher risk of major vascular complications (12.5% vs. 6.7%, RR 2.32, 95% CI 1.73-3.11,P<0.001), major bleeding (16.8% vs. 13.1%, RR 1.61, 95% CI 1.27-2.05,P<0.001), and aortic annulus rupture (2.3% vs. 0.6%, RR 4.66, 95% CI 1.67-13.01,P<0.001). There was no significant difference in terms of minor vascular complications (RR 1.43, 95% CI 1.00-2.04,P=0.05), in-hospital mortality (2.3% vs. 1.4%, RR 1.86, 95% CI 0.74-4.70,P=0.19), and 30-day mortality (2.9% vs. 3.1%, RR 1.14, 95% CI 0.53-2.46,P=0.74) between both groups.

Conclusion:

Our study showed that CS therapy is associated with increased major vascular complications, major bleeding, and annulus rupture following TAVR. Further large multicenter studies or randomized controlled trials are warranted to validate these findings.
Comparison of ESIN and other minimally invasive techniques for anterior pelvic ring injury: a finite element analysis and case-control study
Authors: Xia Weijie , Jiang Hongyi , Tao Endong , Ye Jianjun , Wang Fulin , Wang Xianyu , Cai Leyi , Feng Yongzeng
Published: February 2024

Object:

A novel technique, percutaneous elastic stable intramedullary nail fixation (ESIN), proposed by our team for the treatment of anterior pelvic ring injury. Finite element analysis and retrospective case-control study were used to compare biomechanical properties and clinical outcomes between ESIN and other techniques.

Methods:

Four groups of finite element models of pelvic anterior ring injury were simulated, including ESIN (model A), retrograde transpubic screw fixation (RTSF, model B), subcutaneous internal fixator (model C), and external fixator (model D), and a vertical downward load of 500 N was applied to the S1 vertebral endplate. Stress and displacement distributions of intact pelvis, displacement distributions of pubic fracture fragments, and stress distributions of fixation devices were analyzed. Then 31 patients with anterior pelvic ring injury (15 in the ESIN group and 16 in the RTSF group) were reviewed. Clinical outcomes were evaluated at the final follow-up. Postoperative complications were also recorded.

Results:

Under 500N loading, the intact stability of the pelvis was compared as follows: model B (20.58 mm, 121.82 MPa), model A (20.80 mm, 129.97 MPa), model C (22.02 mm, 141.70 MPa), and model D (22.57 mm, 147.06MPa). The regional stability of superior pubic ramus was compared as follows: model B (9.48 mm), model A (10.16 mm), model C (10.52 mm), and model D (10.76 mm). All 31 patients received follow-up at least 12 months post-surgery (range 12–20 months). Age, sex, injury mechanism, fracture type, time between the injury and operation, American Society of Anesthesiologists score, intraoperative blood loss, hospital stay, follow-up period, time to union and Majeed scores did not differ significantly between the two groups (P>0.05). However, the differences in the duration of unilateral surgery, unilateral intraoperative fluoroscopy and one-time success rate were significant (P<0.05).

Conclusions:

With sufficient biomechanical stability and minimally invasive advantage, the percutaneous technique using ESIN can be used to successfully treat anterior pelvic ring injuries. In addition, advantages over RTSF include a shorter duration of surgery, reduced requirement for intraoperative fluoroscopy and a higher one-time success rate. ESIN therefore constitutes a good alternative to RTSF.
Healthcare associated infection management in 62 intensive care units for patients with congenital heart disease in China, a survey study
Authors: Wang Xiaofeng , Li Shuo , Huo Da , Wang Shilin , Wang Wenlong , He Hongxia , Zhang Qian , Li Jiantao , Wang Xu
Published: February 2024

Objectives:

All patients with congenital heart disease (CHD) receive postoperative management in ICUs. Infection prevention and control (IPC) has a significant impact on prognosis. This study provides a preliminary understanding of the fundamental aspects of IPC in ICUs following CHD surgery in China.

Methods:

From September to October 2023, we initiated a survey on HAI management in hospitals that perform CHD surgeries independently. The questionnaires were jointly completed by the ICU physicians and IPC personnel. Duplicate or unqualified questionnaires were excluded from the study. The contents of our questionnaires covered hospital and ICU capacity, performance of the infection control department, HAI surveillance, implementation of IPC measures, and antimicrobial stewardship (AMS). Qualified questionnaires were compared according to the volume of annual CHD surgeries performed in different ICUs. Group 1 was defined as volume > 300 cases and group 2 was defined as volume ≤300 cases.

Results:

62 of the 118 questionnaires were completed, with a response rate of 53%. The CHD surgical volume in 2022 of the 62 hospitals was 36342, accounting for 52% of the annual CHD surgical volume (69672) across the country. The postoperative infection rates obtained from the 15 ICUs varied from 1.3% to 15%, with a median rate of 4.5%. A total of 16 ICUs provided data on drug-resistant bacteria, Klebsiella pneumoniae exhibiting the highest frequency. More than 95% of ICUs have established complete HAI management systems. Information-based HAI surveillance was conducted in 89% of ICUs. Approximately 67% of ICUs stopped prophylactic antibiotics within 48 hours after surgery. In complex cases, carbapenems were administered empirically in 89% of ICUs. Group 1 had an advantage over group 2 in preventing multidrug-resistant organisms (all instruments should be used alone 100% vs. 86%, P=0.047; cleaning and disinfection of environmental surfaces, 100% vs. 81%, P=0.035; antibiotic consumption control 85% vs. 61%, P=0.044) and in preventing surgical site infections (perioperative blood glucose monitoring, 88% vs. 67%, P=0.048). However, Group 1 did not perform well in preventing catheter-related bloodstream infection (delayed catheter removal due to convenience of laboratory tests, 31% vs. 6%, P=0.021) and catheter-associated urinary tract infection (delayed catheter removal due to muscle relaxant administration, 88% vs. 58%, P=0.022).

Conclusions:

A relatively complete HAI management system has been established throughout the country in ICUs for CHD patients. Information-based surveillance of HAI needs to be promoted, and actions should be taken to facilitate the implementation of IPC measures and AMS bundles. Training and feedback are critical for implementing IPC measures.
Internal jugular vein pressure monitoring guided venous reconstruction could improve perioperative safety after superior vena cava resection for mediastinal tumors: a cohort study
Authors: Hao Xiuxiu , Gu Zhitao , Liu Haoran , Zhang Xuefei , Xu Ning , Mao Teng , Fang Wentao
Published: February 2024

Introduction:

After superior vena cava (SVC) resection, the decision on unilateral or bilateral reconstruction was mostly based on the expertise of surgeons without objective measurements. This study explored the use of internal jugular vein pressure (IJVP) monitoring to guide the SVC reconstruction strategy.

Methods:

In a retrospective cohort, perioperative outcomes of unilateral and bilateral reconstruction based on surgeons’ experience were compared. Then, IJVP threshold was measured when temporarily clamping the left innominate vein (LIV) in a testing cohort. Venous reconstruction according to IJVP monitoring was performed in a prospective validation cohort afterwards. Perioperative outcomes were compared between the prospective and the retrospective cohorts. For some interested variables, intuitive explanations would be given using Bayesian methods. Potential risk factors for postoperative complications were investigated by multivariable analysis.

Results:

From March 2009 to September 2022, 57 patients underwent SVC reconstruction based on surgeons’ experience. Bayesian analysis indicated a posterior probability of 80.49% that unilateral reconstruction had less blood loss than bilateral reconstruction (median 550 mL vs. 1200 mL). Cerebral edema occurred in 2 patients after unilateral reconstruction. In the testing cohort, median IJVP was 22.7 (18-27) cmH2O after temporary LIV clamping in 10 patients. In the prospective cohort, unilateral reconstruction only was performed if the contralateral IJVP was<30 cmH2O in 16 patients. Bilateral reconstruction was performed if IJVP was≥30 cmH2O after unilateral bypass in 9 patients. No cerebral edema occurred in the prospective cohort. Less postoperative complications occurred in the prospective cohort than the retrospective cohort (12.0% vs. 38.6%, P=0.016). Upon multivariable analysis, IJVP-monitoring guided SVC reconstruction was associated with significantly less postoperative complications (P=0.033).

Conclusions:

Intraoperative IJVP-monitoring is a useful strategy for selection of unilateral or bilateral SVC reconstruction and improving perioperative safety in patients with mediastinal tumors.
Superficial Temporal Artery Posterior Branch Flap for Reconstruction of Composite Oral/Perioral Defects
Authors: Baghaki Semih , Yalcin Can E. , Celik Ugur , Cinar Fatih
Published: February 2024

Purpose

Defects involving total lower and/or upper lip often extend to intraoral and/or perioral areas. Flaps based on superficial temporal artery, either as pedicled or free flaps, can be used for reconstruction of various head and neck defects. In this clinical study, we tried to demonstrate the application of a pedicled flap based on the posterior branch of superficial temporal artery in 3-dimensional reconstruction of these composite oral/perioral defects as a successful alternative in cases where microvascular tissue transfer cannot be performed.

Patients and Methods

Six male patients with composite perioral/oral defects who underwent reconstruction with a pedicled flap based on the posterior branch of the superficial temporal artery between April 2020 and December 2020 were evaluated retrospectively. Demographic data, topographic data of defects, and the dimensions of the flaps were gathered from patient files. All patients required reconstruction after tumor resection.

Results

All flaps survived without any signs of partial or total necrosis. Postoperatively, the patients did not report any oral incompetence or drooling, and they were able to fully close their mouths.

Conclusions

Pedicled flaps based on the posterior branch of superficial temporal artery provide reliable results in composite perioral/oral reconstruction.
Comparative Study of the Morphological Characteristics of Perforators of the Transverse and Descending Branches of the Lateral Circumflex Femoral Artery in Anterolateral Thigh Flap Surgery
Authors: Huang Yongtao , Cao Yang , Yang Lin , Gao Qinfeng , Yang Chengpeng , Sun Fengwen , Liu Yucheng , Cheng Junnan , Zhang Tao , Ju Jihui
Published: February 2024

Background

The anterolateral thigh flap (ALTF) is a kind of lateral thigh flap that uses branches of the lateral circumflex femoral artery (LCFA) as the vessel pedicle and is widely used in plastic surgery. During classic ALTF surgery, some perforators from the descending branch of the lateral circumflex femoral artery (LCFA-db) are hard to harvest due to their anatomical variants and individual differences; thus, it is necessary to design an appropriate alternative surgical plan. The transverse branch of the LCFA (LCFA-tb) has unique advantages and can be a potential complement to ALTF vascular pedicle selection. The aim of this study was to compare the difference in morphology between LCFA-db and LCFA-tb, and to verify the feasibility and clinical effect of ALTF with LCFA-tb as the source artery.

Methods

The morphological and clinical data of patients who underwent wound repair of the extremities with the ALTF pedicled with the LCFA-tb and LCFA-db were retrospectively analyzed. This study consisted of the clinical data of 62 patients who accepted an ALTF pedicled with LCFA-tb, and 45 patients accepted an ALTF pedicled with LCFA-db.

Results

A total of 68 cutaneous perforators originating from the LCFA-tb were found in the surgical field, of which 35 perforators were direct cutaneous perforators (51.5%), 28 perforators were septocutaneous perforators (41.2%), and 5 perforators were musculocutaneous perforators (7.3%). Seventy-four cutaneous perforators were found in the LCFA-db group. The proportions of septocutaneous perforators and musculocutaneous perforators were 23% and 77%, respectively, and the number of direct cutaneous perforators was 0. The harvest time of flaps pedicled with LCFA-tb was remarkably shortened. Regarding prognosis, there were no significant differences between the curative effects of the 2 types of flaps.

Conclusions

This study verified that most LCFA-tb perforators are direct cutaneous perforators and that the piercing-in positions of LCFA-tb perforators on superficial fascia were higher than those of LCFA-db perforators. Furthermore, the ALTF pedicled with LCFA-tb can provide satisfactory soft tissue reconstruction and can be used as a useful supplement to the traditional flap design.
Assessing the Benefits and Downsides of Physician Review Websites to Plastic Surgeons
Authors: Yi Victoria N. , Tian William M. , Klifto Kevin , Atia Tim , Sergesketter Amanda R. , Erdmann Detlev
Published: February 2024

Background

Patients often evaluate the reputations of plastic surgeons based on their performances on physician review websites. This article aims to compare rating methodologies and conduct a cost-benefit analysis of physician review websites to further understand how plastic surgeons and their patients can utilize review websites to inform their practice and care.

Methods

A review of online literature, blogs, and 17 of the most common physician review websites was conducted to identify information on review website methodology, cost, and benefits most pertinent to plastic surgeons and their patients.

Results

Physician review websites utilize various combinations of physician-related and unrelated criteria to evaluate plastic surgeons. Across 17 reviewed platforms, most (71%) utilize star ratings to rate physicians, 18% require an appointment to conduct a review, and 35% feature search engine optimization. Many websites (53%) allow physicians to pay for benefits or extension packages, with benefits offered including advertising, search engine optimization, competitor blocking, social media marketing, consultant services, and data analytics. Competitor blocking was provided by the most number of websites who offered additional services for pay (78%).

Conclusions

Appointments are not required to post physician reviews on many review websites, and many websites allow physicians to purchase packages to enhance their search engine optimization or consumer reach. Accordingly, plastic surgeons' reputations on review websites may be influenced by factors extraneous to actual patient care. Patients and physicians should be cognizant that physician review websites may not be reflective of factors related to quality of patient care.
A New Design for Forearm Skin Flaps for Areas that Do not Require Additional Grafting
Authors: Sun Yun-Feng , Feng Da-Jun , Chen Chuan-Jun
Published: February 2024

Forearm skin flaps are widely used to reconstruct oral cancer due to their advantages, such as vascular stability, simple preparation, and a high success rate. However, traditional forearm skin flaps have shortcomings: the donor site requires grafting, which increases surgical trauma by creating a second surgical area, and the scarring at the donor site significantly affects the esthetics of the forearm. Therefore, we have designed a new ^-shaped radial forearm skin flap, in which the flap is designed as 2 semi-elliptical subunits. After the flap is harvested, these 2 subunits are joined, and the reserved skin at the donor site is directly sutured to the outer part of the donor site. The area of the ^-shaped radial forearm skin flap can be as large as that prepared with traditional forearm skin flaps, and there is no need for grafting at the donor site. This avoids additional trauma to the donor site after surgery, significantly reduces related complications, and enhances the esthetic outcome. This paper reports a case of a cheek cancer (carcinoma of the buccal mucosa) patient (T3N0M0), where the flap survived postoperatively, and both the surgical site and donor site healed in the first phase. The patient has no sensory or functional impairments; swallowing and speech functions are satisfactory.
Disappearing Cerebral Communicating Vessels in Embryonic Development—With a Case of Carotid-Vertebrobasilar Artery Anastomosis
Authors: Li Yufeng , Xue Yan , Peng Zeyu , Wang Fei
Published: February 2024

In early embryonic development, anastomoses between carotid and basilar arteries occur in the primitive trigeminal, primitive otic, primitive hypoglossal, and primitive proatlantal arteries, and these anastomoses gradually disappear as the embryo continues to develop. This article reported a case of vascular anastomosis occurring between the external carotid artery and vertebral artery.
Sublingual Ketamine for Depression and Anxiety: A Retrospective Study of Real-World Clinical Outcomes
Authors: Swanson Lauren N. , Jones Lila S. , Aycart Jose Muñoz , Zhu Zhipeng , Rabin David M. , Kuhn Taylor
Published: February 2024

Objective

To evaluate the effectiveness of repeated at-home ketamine treatments for depression, generalized anxiety, and social anxiety and assess safety in terms of adverse effects and tendency towards long-term use.

Methods

This retrospective analysis included patients with depression, generalized anxiety, and/or social anxiety who received ketamine treatment (delivered at-home via low-dose, sublingual lozenges) through a private telehealth provider. Data was collected between May 2022 and April 2023. The primary outcome was change in depression, generalized anxiety, and social anxiety symptoms from baseline to three follow-up time points, measured via Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Assessment (GAD-7), and Social Anxiety Disorder Severity Scale (SAD-D-10), with analysis subgroups established based on baseline diagnosis. Secondary outcomes included side effects, adverse events, long-term use, well-being improvements, and comparison of outcomes between treatment-resistant and non-resistant depression cases.

Results

Of 431 patients (mean [SD] age, 43.6 [10.9] years; 49.2% women), 81 (18.8%) reported minor side effects resolving within 24 hours, and 397 concluded treatment in ≤ 6 months. Statistically significant improvement on the primary outcome was observed at all follow-ups in all three subgroups (p < 0.001). No significant differences were found between treatment-resistant and non-resistant depression outcomes.

Conclusions

Repeated sublingual ketamine significantly reduced depression, generalized anxiety, and social anxiety with no major adverse events and minimal tendency towards long-term use observed. These findings prompt further exploration of ketamine as an alternative or adjunct to medications such as SSRIs and benzodiazepines to minimize response delays and dependence risk.
Severe Acute Respiratory Syndrome Coronavirus 2 – Reactive Salivary Antibody Detection in South Carolina Emergency Healthcare Workers: September 2019–March 2020
Authors: Meltzer Haley C. , Goodwin Jane L. , Fowler Lauren A. , Britt Thomas W. , Pirrallo Ronald G. , Grier Jennifer T.
Published: February 2024

Background

On 19 January 2020, the first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was identified in the US, with the first cases in South Carolina (SC) confirmed on 06 March 2020. Due to initial limited testing capabilities and potential for asymptomatic transmission, it is possible that the virus was present earlier than previously thought while preexisting immunity in at-risk populations was unknown.

Methods

Salivary samples from 55 SC emergency department physicians, Emergency Medical Services (EMS) providers, and medical students working as EMTs were collected from September 2019 to March 2020 as part of a separate study and stored frozen. To determine if antibody-based immunity to SARS-CoV-2 was present prior to the first recorded cases, saliva acquired post-shift was analyzed by Enzyme-Linked Immunosorbent Assay with repeat of positive or inconclusive results and follow-up testing of pre-shift samples.

Results

Two participants were positive for SARS-CoV-2-reactive salivary IgG, confirmed by repeat and follow-up testing. Positive samples were from medical students working in EMS and were collected in October or November of 2019.

Conclusions

The presence of detectable antibodies against SARS-CoV-2 in 2019 suggests that immunity existed in SC, and the US as a whole, prior to the earliest documented cases of COVID-19. Additionally, successful analysis of banked salivary samples demonstrates the feasibility of saliva as a noninvasive tool for surveillance of emerging outbreaks. These findings suggest that emergency healthcare providers represent a high-risk population that should be the focus of infectious disease surveillance.

Article Summary

Retrospective SARS-CoV-2 antibody testing of saliva from emergency healthcare workers pre-pandemic identifies two reactive individuals in late 2019. Findings suggest the importance of emergency healthcare workers for infectious disease surveillance and saliva as an effective diagnostic tool.
Functional 3’-UTR Variants Identify Regulatory Mechanisms Impacting Alcohol Use Disorder and Related Traits
Authors: Chen Andy B. , Yu Xuhong , Thapa Kriti S. , Gao Hongyu , Reiter Jill L , Xuei Xiaoling , Tsai Andy P. , Landreth Gary E. , Lai Dongbing , Wang Yue , Foroud Tatiana M. , Tischfield Jay A. , Edenberg Howard J. , Liu Yunlong
Published: February 2024

Although genome-wide association studies (GWAS) have identified loci associated with alcohol consumption and alcohol use disorder (AUD), they do not identify which variants are functional. To approach this, we evaluated the impact of variants in 3’ untranslated regions (3’-UTRs) of genes in loci associated with substance use and neurological disorders using a massively parallel reporter assay (MPRA) in neuroblastoma and microglia cells. Functionally impactful variants explained a higher proportion of heritability of alcohol traits than non-functional variants. We identified genes whose 3’-UTR activities are associated with AUD and alcohol consumption by combining variant effects from MPRA with GWAS results. We examined their effects by evaluating gene expression after CRISPR inhibition of neuronal cells and stratifying brain tissue samples by MPRA-derived 3’-UTR activity. A pathway analysis of differentially expressed genes identified inflammation response pathways. These analyses suggest that variation in response to inflammation contributes to the propensity to increase alcohol consumption.