bluuebunny/crossref_metadata_2025 huggingface dataset:
Using Panel Community Surveys to Track the Impact of Crop Pests Over Time and Space – The Case of Maize Lethal Necrosis (MLN) Disease in Kenya from 2013 to 2018
Authors: De Groote Hugo , Munyua Bernard G. , Palmas Sebastian , Suresh L. M. , Bruce Anani Y. , Kimenju Simon
Published: December 2020

Maize lethal necrosis (MLN) disease appeared in Kenya in 2011, causing major damage. In a first survey of 121 communities in 2013, participants estimated the proportion of households affected and the yield loss in affected areas; from this survey, the overall loss was estimated at 22%, concentrated in western Kenya (94%). Efforts to combat the disease included planting resistant varieties, creating awareness of MLN management, and producing pathogen-free seed. In 2018, the same communities were revisited and asked the same questions, establishing a panel community survey. The results showed that incidents of MLN had greatly decreased, and the number of communities that had observed it had reduced from 76% in 2013 to 26% by the long rains of 2018; while still common in western Kenya (60%), MLN had greatly reduced elsewhere (to 10%). In 2013, 40% of farmers were affected, yield loss among affected farmers was estimated at 44%, and total yield loss was estimated at 22% (a production loss of 0.5 million metric tons/year), valued at US$187 million. By the long rains of 2018, 23% of farmers were affected, with a loss among affected farmers of 36%; overall annual loss was estimated at 8.5% or 0.37 million metric tons, valued at US$109 million, concentrated in western Kenya (79%). Of the recommended control measures, only the removal of diseased plants was commonly used (by 62% of affected communities), but not the use of agronomic practices (11%) or resistant varieties (9.5%). The reasons for the reduction in MLN are not well understood; external factors such as spraying insecticide against fall armyworm and unfavorable weather likely played a role, as did using disease-free seed, but not the use of resistant varieties or appropriate management practices. Still, as the pathogen remains in the fields, it is important to keep disseminating these control methods, particularly resistant varieties.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Anaerobic Soil Disinfestation Efficacy AgainstFusarium oxysporumIs Affected by Soil Temperature, Amendment Type, Rate, and C:N Ratio
Authors: Shrestha Utsala , Ownley Bonnie H. , Bruce Alex , Rosskopf Erin N. , Butler David M.
Published: December 2020

A meta-analysis of anaerobic soil disinfestation (ASD) efficacy against Fusarium oxysporum and F. oxysporum f. sp. lycopersici was conducted emphasizing effects of environment and organic amendment characteristics and pot and field studies conducted on ASD amendment C:N ratio and soil temperature effects on F. oxysporum f. sp. lycopersici inoculum survival. In a pot study, two organic amendments, dry molasses-based or wheat bran-based, applied at 4 mg of C/g of soil, with 40:1, 30:1, 20:1, and 10:1 C:N ratios, were evaluated against F. oxysporum f. sp. lycopersici at 15 to 25°C. This study was followed by a pot study with temperature regimes of 15 to 25°C and 25 to 35°C and two C:N ratios (20:1 and 40:1), and a field study at 40:1, 30:1, 20:1, and 10:1 C:N ratios, a 30:1 C:N ratio at a lower C rate (2 mg of C/g of soil), and an anaerobic control. Soil temperature >25°C and more labile amendments increased ASD suppression of F. oxysporum/F. oxysporum f. sp. lycopersici in the meta-analysis. In pot studies, F. oxysporum f. sp. lycopersici survival was reduced for molasses-based mixtures at 20:1 and 30:1 C:N ratios compared with wheat bran-based mixtures but not compared with the anaerobic control. At 25 to 35°C, all ASD treatments suppressed F. oxysporum f. sp. lycopersici relative to controls. In the field, all ASD treatments reduced F. oxysporum f. sp. lycopersici survival compared with the anaerobic control, and 4 mg of C/g of soil amendment rates induced higher anaerobic conditions and higher F. oxysporum f. sp. lycopersici mortality compared with the 2 mg of C/g of soil rate. Although amendment C:N ratios from 10 to 40:1 were similarly suppressive of F. oxysporum, lower temperatures reduced ASD effectiveness against F. oxysporum/F. oxysporum f. sp. lycopersici and further work is warranted to enhance suppression at soil temperatures <25°C.
Preoperative Versus Postoperative Scalp Block Combined With Incision Line Infiltration for Pain Control After Supratentorial Craniotomy
Authors: Kulikov Alexander , Tere Valentina , Sergi Paola G. , Pugliese Francesco , Lubnin Andrey , Bilotta Federico
Published: December 2020

Objective:

Postoperative pain after craniotomy is a significant clinical problem that is sometimes underestimated, although moderate or severe pain in early postoperative period complicates up to 60% of cases. The purpose of this prospective randomized multicenter trial was to determine the optimal timing for selective scalp block in patients undergoing general anesthesia for supratentorial craniotomy.

Materials and Methods:

After ethics committee approval and informed consent, 56 adult patients were enrolled, and randomly assigned to receive a selective scalp block combined with incision line infiltration preoperatively or postoperatively.

Results:

Postoperative pain at 24 hours after the procedure was recorded in all 56 enrolled patients. In patients assigned to receive a scalp block preoperatively, median VAS score at 24 hours after surgery was 0 (0 to 2), and in patients assigned to receive a scalp block postoperatively it was 0 (0 to 3) (P>0.05). There was no difference in severity of pain at 24, 12, 6, and 2 hours after surgery between the 2 study groups, but the amount of fentanyl administered intraoperatively was lower in patients assigned to the preoperative scalp block group (1.6±0.7 vs. 2.4±0.7 mkg/kg/h, P=0.01).

Discussion:

This study confirms and extends available clinical evidence on the safety and efficacy of selective scalp blocks for the prevention of postoperative pain. Recorded data suggest that there is no difference in terms of occurrence and severity of postoperative pain regardless of whether the scalp block is performed preoperatively (after general anesthesia induction) or postoperatively (before extubation). Patients assigned to receive a scalp block combined with incision line infiltration preoperatively needed less intraoperative opioids than those assigned to postoperative scalp block.
Impact of New Motor Deficit on HRQOL After Adult Spinal Deformity Surgery
Authors: Saigal Rajiv , Lau Darryl , Berven Sigurd H. , Carreon Leah , Dekutoski Mark B. , Kebaish Khaled M. , Qiu Yong , Matsuyama Yukihiro , Kelly Michael , Dahl Benny T. , Mehdian Hossein , Pellisé Ferran , Lewis Stephen J. , Cheung Kenneth M.C. , Shaffrey Christopher I. , Fehlings Michael G. , Lenke Lawrence G. , Ames Christopher P.
Published: December 2020

Study Design.

International, multicenter, prospective, longitudinal observational cohort.

Objective.

To assess how new motor deficits affect patient reported quality of life scores after adult deformity surgery.

Summary of Background Data.

Adult spinal deformity surgery is associated with high morbidity, including risk of new postoperative motor deficit. It is unclear what effect new motor deficit has on Health-related Quality of Life scores (HRQOL) scores.

Methods.

Adult spinal deformity patients were enrolled prospectively at 15 sites worldwide. Other inclusion criteria included major Cobb more than 80°, C7–L2 curve apex, and any patient undergoing three column osteotomy. American Spinal Injury Association (ASIA) scores and standard HRQOL scores were recorded pre-op, 6 weeks, 6 months, and 2 years.

Results.

Two hundred seventy two complex adult spinal deformity (ASD) patients enrolled. HRQOL scores were worse for patients with lower extremity motor score (LEMS). Mean HRQOL changes at 6 weeks and 2 years compared with pre-op for patients with motor worsening were: ODI (+12.4 at 6 weeks and –4.7 at 2 years), SF-36v2 physical (–4.5 at 6 weeks and +2.3 at 2 years), SRS-22r (0.0 at 6 weeks and +0.4 at 2 years). Mean HRQOL changes for motor-neutral patients were: ODI (+0.6 at 6 weeks and –12.1 at 2 years), SF-36v2 physical (–1.6 at 6 weeks and +5.9 at 2 years), and SRS-22r (+0.4 at 6 weeks and +0.7 at 2 years). For patients with LEMS improvement, mean HRQOL changes were: ODI (–0.6 at 6 weeks and –16.3 at 2 years), SF-36v2 physical (+1.0 at 6 weeks and +7.0 at 2 years), and SRS-22r (+0.5 at 6 weeks and +0.9 at 2 years).

Conclusion.

In the subgroup of deformity patients who developed a new motor deficit, total HRQOLs and HRQOL changes were negatively impacted. Patients with more than 2 points of LEMS worsening had the worst changes, but still showed overall HRQOL improvement at 6 months and 2 years compared with pre-op baseline.

Level of Evidence: 3
Changes in Muscle Morphology in Female Chronic Neck Pain Patients Using Magnetic Resonance Imaging
Authors: Van Looveren Eveline , Cagnie Barbara , Coppieters Iris , Meeus Mira , De Pauw Robby
Published: December 2020

Study Design.

Population-based cross-sectional study.

Objective.

The aim of this study was to gain a better understanding of changes in muscle morphology in patients with chronic idiopathic neck pain (CINP) and chronic whiplash-associated disorder (CWAD).

Summary of Background Data.

Worldwide, neck pain (NP) is a common health problem with high socioeconomic burden. A high percentage of these patients evolves toward chronic symptoms. Efficacy of treatments for these complaints remains variable. In current literature, changes in muscle morphology (muscle fat infiltration and cross-sectional area) have been reported in patients with NP, both CWAD and CINP. However, no strong conclusions could be made.

Methods.

In this study, magnetic resonance imaging was used to obtain data on muscle morphology from 14 cervical flexor and extensor muscles in 117 female subjects with NP (CWAD = 37; CINP = 45) and healthy controls (HC = 35).

Results.

The CWAD group had a significantly larger muscle fat infiltration in some extensor (semispinalis and splenius capitis, trapezius, obliquus capitis inferior) and flexor (sternocleidomastoid) muscles compared to the CINP and/or HC group. A significantly larger (muscle) cross-sectional area was found in some extensor (levator scapulae, semispinalis capitis, trapezius) and flexor (longus colli, longus capitis, sternocleidomastoid) muscles in the HC group compared to the CINP and/or CWAD group. No clear associations were found between group differences and factors as pain duration, kinesiophobia, and disability.

Conclusion.

The results in this study suggest changes in muscle morphology in both NP cohorts. These results show some similarities with earlier findings in this research domain. Further studies based on controlled longitudinal designs are needed to facilitate data compilation, to draw stronger conclusions, and to integrate them into the treatment of patients with chronic NP.

Level of Evidence: 4
Do Markers of Inflammation and/or Muscle Regeneration in Lumbar Multifidus Muscle and Fat Differ Between Individuals with Good or Poor Outcome Following Microdiscectomy for Lumbar Disc Herniation?
Authors: Chen Xiaolong , Hodges Paul W. , James Gregory , Diwan Ashish D.
Published: December 2020

Study Design.

Observational study.

Objective.

The aim of this study was to evaluate whether inflammatory and/or muscle regeneration markers in paraspinal tissues (multifidus muscle/fat) during microdiscectomy surgery in patients with lumbar disc herniation (LDH) with radiculopathy, differ between individuals with good or poor outcome.

Summary of Background Data.

Structural back muscle changes, including fat infiltration, muscle atrophy, and fiber changes, are ubiquitous with LBP and are thought to be regulated by inflammatory and regeneration processes. Muscle changes might be relevant for recovery after microdiscectomy, but a link between expression of inflammatory and muscle regeneration genes in paraspinal tissues and clinical outcome has not been tested.

Method.

Paraspinal tissues from deep multifidus muscles and fat (intramuscular, sub-cutaneous, epidural) were harvested from twenty-one patients with LDH undergoing microdiscectomy surgery. Quantitative polymerase chain reaction (qPCR) measured expression of 10 genes. Outcome was defined as good (visual analogue scale (VAS) low back pain (LBP)+) or poor (VAS LBP−) by an improvement of >33% or ≤33% on the pain VAS, respectively. Good functional improvement was defined as 25% improvement on the physical functioning scale (PFS).

Results.

Brain-derived neurotrophic factor expression in deep multifidus was 91% lower (P = 0.014) in the VAS LBP- than VAS LBP+ group. Expression of interleukin-1β in subcutaneous fat was 48% higher (P = 0.026) in the VAS LBP– than VAS LBP+ group. No markers differed based on PFS.

Conclusion.

Results show a relationship between impaired muscle regeneration profile in multifidus muscle and poor outcome following microdiscectomy for LDH. Inflammatory dysregulation in subcutaneous fat overlying the back region might predict poor surgical outcome.

Level of Evidence: 4
Comparison of Outcomes Between Single-level Lateral Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion
Authors: Tan Marcus Wei Ping , Sayampanathan Andrew A. , Jiang Lei , Guo Chang Ming
Published: December 2020

Study Design:

This is a meta-analysis and systematic review of the available literature.

Objective:

This study aims to compare the clinical and radiologic outcomes of single-level lateral lumbar interbody fusion (LLIF) with single-level transforaminal lumbar interbody fusion (TLIF).

Summary of Background Data:

In the treatment of adult spinal deformity, LLIF allows interbody fusion while avoiding complications associated with an anterior or transforaminal approach, although the clinical outcomes of LLIF compared with other approaches have not been well established.

Methods:

We searched PubMed, Embase, and Scopus for 385 unique studies. On the basis of our exclusion criteria, 8 studies remained for our systematic review. Data were analyzed using Review Manager 5.3 using Mantel-Haenszel statistics and random effect models. This study identified self-reported Visual Analog Scale (VAS), Oswestry Disability Index, length of stay, blood loss, complication rate, and radiologic parameters (disk height, lumbar lordosis, segmental lordosis).

Results:

Our meta-analysis showed that LLIF contributed to decreased blood loss [mean difference (MD)=−67.62 mL, 95% confidence interval (CI): −104 to −30.90, P<0.001], superior restoration of segmental lordosis (MD=1.91 degrees, 95% CI: 0.71–3.10, P=0.002), lumbar lordosis (MD=1.95 degrees, 95% CI: 0.15–3.74, P=0.03), and disk height (MD=2.18 mm, 95% CI: 1.18–3.17, P<0.001) when compared with TLIF. However, current data suggests no significant difference in clinical outcomes between LLIF and TLIF based on overall complication rates (P=0.22), length of hospital stay (P=0.65), postoperative Oswestry Disability Index (P=0.13), postoperative VAS Back Pain (P=0.47) and VAS Leg Pain (P=0.16).

Conclusions:

LLIF is an increasingly popular option for single-level anterior column reconstruction. When compared with single-level TLIF, single-level LLIF is associated with greater changes in lumbar lordosis and disk height. The single-level LLIF is a viable alternative to TLIF, demonstrating comparable clinical outcomes and better restoration of spinopelvic parameters.

Level of Evidence:

Level III.
A Retrospective Cohort Study of Effects of Antihypertensive and Anticholinergic Medications on Outcomes Following Elective Posterior Lumbar Spine Surgery
Authors: Golubovsky Joshua L. , Karnuta Jaret M. , Lee Maxwell , Enders Jacob , Banerjee Aditya , Grits Daniel , Nowacki Amy , Ilyas Haariss , Steinmetz Michael P.
Published: December 2020

Study Design:

This was a retrospective consecutive cohort analysis.

Objective:

This study aimed to examine the association between commonly prescribed medications and outcomes following posterior lumbar spine surgery.

Summary of Background Data:

Postoperative complications and prolonged length of stay significantly increase costs following posterior lumbar spine surgery and worsen patient outcomes. To control costs and complications, providers should focus on modifiable risk factors, such as preoperative medications. Antihypertensive and anticholinergic drugs are among the most commonly prescribed medications but can carry significant risks in the perioperative period.

Materials and Methods:

This study was a retrospective cohort analysis of patients undergoing posterior lumbar spine surgery from January 2014 through December 2015 at a large tertiary care center. The variable selection followed by multivariable logistic and negative binomial regressions were performed. An α threshold of 0.0056 was used for significance after correction for multiple comparisons. A secondary analysis was performed to evaluate confounding or effect modifying variables.

Results:

This study included 1577 patients. Postoperative urinary retention risk was increased in patients taking loop diuretics. Acute kidney injury risk was increased for patients on nondihydropyridine calcium-channel blockers. Surgical site infection risk was increased for patients on aldosterone receptor blockers. Urinary tract infection risk was increased for patients on anticholinergics for urinary incontinence. Length of stay was decreased for patients on angiotensin II antagonists and angiotensin-converting enzyme inhibitors.

Conclusion:

A care path should be established in the perioperative period for patients who are deemed to be at higher risk due to medication status to either modify medications or improve postoperative monitoring.

Level of Evidence:

Level III.
Comparing Surgical Treatments for Spondylolysis
Authors: Tarpada Sandip P. , Kim Dongyoung , Levine Nicole L. , Morris Matthew T. , Cho Woojin
Published: December 2020

Study Design:

Narrative review.

Objective:

To compare the various surgical methods of repairing spondylolysis defects in regard to improving pain, restoration of function, radiographic improvement, and complication rate.

Summary of Background Data:

Spondylolysis is a defect in the pars interarticularis of the vertebral arch, typically in the lumbar vertebra. Treatment can be nonoperative and/or surgical. There are various types of surgical repair including spinal compression, fusion, and direct pars repair.

Methods:

A comprehensive review of the English literature was performed utilizing Medline, Embase, and Web of Science. Inclusion criteria included papers or abstracts that evaluated the surgical techniques. Exclusion criteria included non–English-language papers or abstracts with inadequate information about outcomes.

Results:

Postoperative pain levels and patient function were consistently improved, regardless of surgical technique chosen. Positive clinical outcomes after surgery were seen more often in patients under age 20 and those who underwent minimally invasive repairs. Positive radiographic improvements were reported broadly, although some reported higher rates of nonunion with spinal compression. Complication rates were low throughout and minimally invasive techniques reported decreased blood loss and shorter hospital stays.

Conclusions:

Present surgical options appear largely comparable in terms of their ability to provide meaningful treatment for spondylolysis where conservative treatments have failed or otherwise remain unattempted.
Experiences of Faculty Members Giving Corrective Feedback to Medical Trainees in a Clinical Setting
Authors: Davila-Cervantes Andrea , Foulds Jessica L. , Gomaa Nahla A. , Rashid Marghalara
Published: December 2020

Introduction:

Imperative to medical training is the observation and provision of feedback. In this era of competency-based medical education, feedback is one of the core components of this new model. A better understanding of the medical faculty's attitudes and experiences when providing feedback is essential. Currently, there are limited qualitative studies that have explored attitudes and experiences of faculty members when giving corrective feedback to medical trainees.

Methods:

To allow an in-depth exploration of this phenomenon, a hermeneutics phenomenology approach was used, by conducting semistructured interviews with 10 faculty members representing six disciplines and used thematic analysis to create data-driven codes and identify key themes through an iterative consensus-building process.

Results:

Four themes were identified by the authors: (1) Elements of effective feedback, (2) Faculty members' perception of giving corrective feedback, (3) Challenges as it relates to the assessment culture of the institution, and (4) Providing effective corrective feedback as a mutual process focused on relationship building between learners and preceptors.

Discussion:

By exploring faculty members' perceptions of providing perceived corrective feedback, we identified actionable recommendations based on the study participants' experiences, expectations, and challenges which could be addressed involving future faculty development with the focus on modifying concepts of feedback and institutional changes that will promote an attitudinal and a cultural shift.
Pharmacological evaluation of NO/cGMP/KATP channels pathway in the antidepressant-like effect of carbamazepine in mice
Authors: Ajaman Mostafa , Naserzadeh Reza , Ghorbanzadeh Behnam
Published: December 2020

Carbamazepine, an anticonvulsant drug, has shown antidepressant effects in clinical and experimental models. Nitric oxide (NO) is a neurotransmitter in the central nervous system and has been involved in a variety of diseases including depression. In the present study, the involvement of NO/cyclic GMP/KATP channels pathway in the antidepressant action of carbamazepine was investigated in mice. The antidepressant-like activity was assessed in the forced swim test (FST) behavioral paradigm. Carbamazepine reduced (40 mg/kg, intraperitoneal) immobility period. The antidepressant-like effect of carbamazepine (40 mg/kg, intraperitoneal) was prevented by pretreatment with L-arginine [substrate for NO synthase (NOS), 750 mg/kg, intraperitoneal], sildenafil (a PDE-5 inhibitor, 5 mg/kg, intraperitoneal) and diazoxide (K+ channels opener, 10 mg/kg). Pretreatment of mice with L-NAME (a non-selective NOS inhibitor, 10 mg/kg, intraperitoneal), methylene blue (direct inhibitor of both NOS and soluble guanylate cyclase, 10 mg/kg, intraperitoneal) and glibenclamide (an ATP-sensitive K+ channel blocker, 1 mg/kg, intraperitoneal) produced potentiation of the action of a sub-effective dose of carbamazepine (30 mg/kg, intraperitoneal). Also, carbamazepine (30 mg/kg) potentiated the antidepressant-like effect of fluoxetine through NO modulation. The various modulators used in the study did not produce any changes in locomotor activity per se. The results demonstrated that the antidepressant-like effect of carbamazepine in the FST involved an interaction with the NO/cGMP/KATP channels pathway.
MULTIMODAL IMAGING OF ACUTE MULTIFOCAL HEMORRHAGIC RETINAL VASCULITIS: A CASE REPORT
Authors: Meng Ping-Ping , Lin Chun-Ju , Hsia Ning-Yi , Lai Chun-Ting , Bair Henry , Lin Jane-Ming , Tsai Yi-Yu
Published: December 2020

Purpose:

To report a case of acute multifocal hemorrhagic retinal vasculitis and demonstrate the multimodal imaging.

Methods:

Interventional case report.

Results:

A 54-year-old woman without significant past medical history complained of redness and blurred vision in both eyes. Her visual acuity was counting fingers and 20/60. Mild conjunctival injection, anterior chamber cells, and vitreous haze were noted. Fundus showed multifocal intraretinal hemorrhages. Fluorescein angiography revealed vasculitic process with intraretinal hemorrhage blocking defects and retinal ischemic changes in both eyes. Anterior chamber tap fluid polymerase chain reaction for varicella zoster virus, herpes simplex virus I/II, cytomegalovirus, and Epstein-Barr virus was unremarkable. Rheumatology was consulted and systemic vasculitis was ruled out. Her vision improved to 20/50 and 20/20 after pulse methylprednisolone therapy, oral methotrexate, and prednisolone treatment.

Conclusion:

Acute multifocal hemorrhagic retinal vasculitis can occur in an immunocompetent patient. Multimodal Imaging is useful in the diagnosis and follow-up. Patients could benefit from early and aggressive immunosuppressive therapy.
Descemet Membrane Endothelial Keratoplasty Using a Pull-Through Technique With Novel Infusion Forceps
Authors: Jabbour Samir , Jun Albert S. , Shekhawat Nakul S. , Woreta Fasika A. , Krick Tracy W. , Srikumaran Divya
Published: December 2020

Purpose:

To describe a surgical technique of Descemet membrane endothelial keratoplasty (DMEK) using an endothelium-in pull-through technique with novel infusion forceps and report 6-month clinical outcomes.

Methods:

This is a retrospective case series of 33 cases with Fuchs endothelial corneal dystrophy who underwent either DMEK alone (n = 5), DMEK combined with phacoemulsification (n = 27), or DMEK combined with intraocular lens exchange (n = 1) performed by surgeons at the beginning of the DMEK learning curve. Best-corrected visual acuity (BCVA), manifest refraction, central corneal thickness, endothelial cell density, intraoperative and postoperative complications, and need for additional surgeries including rebubbling were evaluated through 6 months postoperatively.

Results:

Preoperative BCVA was 0.37 ± 0.34 logarithm of the minimum angle of resolution and improved to 0.09 ± 0.10 logarithm of the minimum angle of resolution at 6 months (P < 0.001). Eighty-two percent of eyes obtained a BCVA of 20/25 or better. Central corneal thickness decreased significantly at 6 months (P < 0.001). Endothelial cell loss was 29.1% at 6 months (available for 20 of 33 eyes). All surgeries were uneventful. Six eyes required rebubbling for graft detachments. There were no primary or secondary graft failures at 6 months.

Conclusions:

DMEK with infusion microforceps is efficacious and safe in eyes with Fuchs endothelial corneal dystrophy and could offer a more controlled surgery, making it suitable for both novice and experienced DMEK surgeons.
Changes of Contamination Rate and Microorganism Evaluation in Organ-Cultured Human Corneas: A 14-Year Review From a French Regional Eye Bank
Authors: Fabre Laura , Puyraveau Marc , Jeanvoine Audrey , Thibaud Garcin , Pizzuto Joëlle , Pouthier Fabienne , Delbosc Bernard , Gauthier Anne Sophie
Published: December 2020

Purpose:

This study aimed to assess how the contamination rate of organ-cultured corneas has evolved and to analyze the evolution of microorganisms involved.

Methods:

Data from the Besançon eye bank were reviewed over 14 years (2005–2018). The changes in the contamination rate and the contaminant species found during the organ culture storage were analyzed. Microbiological tests were performed twice on the storage media—at day 5 and before the deswelling phase.

Results:

Among the 17,979 donor corneas collected, 1240 corneas were microbiological-test positive. The average annual contamination rate was 6.8% (range: 5.2%–8.9%). Seventy-five percent of contaminations were bacterial. The most frequently found bacterium was Staphylococcus spp. (31.3%), followed by non-Enterobacteriaceae Gram-negative Bacilli (GNB) (27.3%), with most Sphingomonas spp. and Pseudomonas spp. Fungal contamination (21.9%) was dominated by Candida (82.7%). Seventy-seven types of microorganisms were identified. The Staphylococcus rate tended to decrease, whereas non-Enterobacteriaceae GNB rate has increased in the past few years to reach 46% of bacteria. Most of the contaminations were detected in the early phase of organ culture at day 5 (89.2%). The second microbiological test found 44.8% of fungal contaminations (predominantly Candida spp.).

Conclusions:

The annual contamination rate was stable and remains low, but the types of contaminating microorganisms varied from year to year. Staphylococcus spp. and non-Enterobacteriaceae GNB accounted for a significant proportion of the contaminations. We found a significant proportion of contamination, especially fungal, at the late phase of storage. Reassessing the antibiotics and antifungals in the storage medium may be useful to limit corneal disposal.
Effect of Sensitivity Disparity Between the Two Eyes on Pointwise Monocular Sensitivity Under Binocular Viewing in Patients With Glaucoma
Authors: Wakayama Akemi , Nomoto Hiroki , Chiba Yasutaka , Matsumoto Chota , Kusaka Shunji
Published: December 2020

Précis:

A difference between monocular sensitivities measured with and without occlusion was observed in glaucoma. Monocular sensitivity without occlusion could have been affected differently by binocular interaction due to the sensitivity disparity between both eyes.

Purpose:

To investigate the influence of sensitivity disparity between both eyes on visual field results under binocular viewing in glaucoma.

Materials and Methods:

Thirteen glaucoma patients tested by Humphrey Field Analyzer (HFA) and imo were reviewed retrospectively. On the basis of their HFA results, we defined the eye with a better HFA-MD as “the better eye” and the fellow eye with a worse HFA-MD as “the worse eye.” Depending on the pointwise pattern deviation (PD) of both eyes, all evaluated test points were classified into 4 groups: normal PD in both eyes (N/N), normal PD in the better eye but abnormal in the worse eye (N/A), abnormal PD in the better eye but normal in the worse eye (A/N), and abnormal PD in both eyes (A/A). Using imo, which can measure sensitivity with and without occluding the nontested eye, the better eye’s sensitivities with and without occlusion were compared in each group using weighted data. The weight was derived by applying the inverse probability weighting.

Results:

Monocular sensitivity without occlusion was higher than that with occlusion in N/N (P<0.01) and the opposite was observed in A/A (P<0.05). No significant sensitivity difference between both conditions was seen in N/A or A/N. In N/A, the points showing a higher sensitivity without occlusion decreased as the sensitivity difference between both eyes increased.

Conclusions:

A difference between sensitivities measured with and without occlusion was observed in glaucoma. Owing to the sensitivity disparity between both eyes, monocular sensitivity without occlusion could have been affected differently by binocular interaction.
Predicting Hearing Outcomes in Conservatively Managed Vestibular Schwannoma Patients Utilizing Magnetic Resonance Imaging
Authors: Selleck Anne Morgan , Rodriguez Justin D. , Brown Kevin D.
Published: December 2020

Objective:

Management of small vestibular schwannomas has evolved to where observation with interval imaging is an accepted treatment strategy. Loss of residual hearing is a known complication of observation. Magnetic resonance imaging (MRI) may provide critical information to assist in determining which tumors are at highest risk of hearing loss. We wished to determine what effect fundal cap size and cochlear fluid-attenuated inversion recovery (FLAIR) signal had on the progression of hearing loss in a large cohort of observed subjects.

Study Design:

Retrospective chart review.

Setting:

Tertiary academic referral center.

Patients:

Three hundred ninety-three adults with a vestibular schwannoma who underwent expectant management with serial audiograms and MRI.

Interventions:

Audiogram and MRI.

Main Outcome Measures:

Hearing outcomes included pure-tone average and word discrimination score (WRS). Cochlear FLAIR signal was measured as a ratio between the affected and nonaffected cochlea. Cerebrospinal fluid fundal cap was measured from the most lateral aspect of the tumor to the fundus of the internal auditory canal.

Results:

An increased cochlear FLAIR ratio was associated with a worse initial WRS (p = 0.0001, β=−0.25). A multivariate regression analysis demonstrated the variables fundal cap and initial WRS to significantly predict change in WRS over time. The larger the fundal cap size, the smaller the change in the WRS (p = 0.047, β=−0.35).

Conclusions:

Cerebrospinal fluid fundal cap size predicts the natural history of hearing in vestibular schwannoma patients. The presence of a smaller fundal cap is correlated with a greater risk of progression of hearing loss and should be a variable considered in the management of small vestibular schwannomas.
Principles of Executive Functioning Interventions for Children With Cochlear Implants: Guidance From Research Findings and Clinical Experience
Authors: McConkey Robbins Amy , Kronenberger William G.
Published: December 2020

Children with cochlear implants (CIs) are at risk for experiencing deficits in the development of neurocognitive processes known as executive functions (EF). Such deficits likely arise as a consequence of early-onset deafness, the degraded auditory input provided by CIs, and delays in spoken language development. Interventions specifically designed for pediatric CI users are needed to address challenges and delays in EF because of the unique influences of hearing loss and language delay on EF development, which have deleterious, cascading effects on speech and language development and subsequent reading and academic achievement. Because patterns of EF weakness emerge even in the preschool years, interventions to improve EF should be implemented at early ages, while children are young and neuroplasticity is high. Drawing on previous research findings and clinical experience, this paper highlights 10 principles to guide the development of EF interventions for children with CIs.
Protein absorption and kinetics in critical illness
Authors: Liebau Felix , Deane Adam M. , Rooyackers Olav
Published: December 2020

Purpose of review

Timing, dose, and route of protein feeding in critically ill patients treated in an ICU is controversial. This is because of conflicting outcomes observed in randomized controlled trials (RCTs). This inconsistency between RCTs may occur as the physiology of protein metabolism and protein handling in the critically ill is substantially different from the healthy with limited mechanistic data to inform design of RCTs. This review will outline the current knowledge and gaps in the understanding of protein absorption and kinetics during critical illness.

Recent findings

Critically ill patients, both children and adults, lose muscle protein because of substantial increases in protein degradation with initially normal, and over time increasing, protein synthesis rates. Critically ill patients appear to retain the capacity to absorb dietary protein and to use it for building body protein; however, the extent and possible benefit of this needs to be elucidated. More sophisticated methods to study protein absorption and digestion have recently been described but these have yet to be used in the critically ill.

Adequate understanding of protein absorption and kinetics during critical illness will help the design of better interventional studies in the future. Because of the complexity of measuring protein absorption and kinetics in the critically ill, very few investigations are executed. Recent data using isotope-labelled amino acids suggests that critically ill patients are able to absorb enteral protein and to synthesize new body protein. However, the magnitude of absorption and anabolism that occurs, and possible benefits for the patients need to be elucidated.
Pseudomonas aeruginosa Pyomyositis in a Child With Acute Lymphoblastic Leukemia: A Case Report and Review of Literature
Authors: Migliarino Vanessa , Naviglio Samuele , Barbi Egidio , Rabusin Marco
Published: December 2020

Background:

We report the case of an 11-year-old girl with a recent diagnosis of common B-cell acute lymphoblastic leukemia who presented with Pseudomonas aeruginosa pyomyositis of the left lower limb during severe neutropenia associated with the induction phase of chemotherapy.

Observations:

Presenting signs included fever, leg pain, and refusal to walk. Popliteal knee ultrasonography was unremarkable, whereas magnetic resonance imaging showed 2 intramuscular fluid collections requiring surgically drainage.

Conclusion:

A review of medical literature showed that pyomyositis is an infrequent complication in children with hematological malignancies, and most cases are due to Staphylococcus aureus, whereas Pseudomonas aeruginosa appears to be rarely involved.
Effects of fatigue and kinesiophobia on functional capacity, physical activity and quality of life in Parkinson’s disease
Authors: Sütçü Gülşah , Ayvat Ender , Kilinç Muhammed
Published: December 2020

The aim of this study was to investigate the effects of fatigue and fatigue-related kinesiophobia on functional capacity, physical activity and quality of life in patients with Parkinson’s disease. Twenty patients with Parkinson’s disease were included in the study. The fatigue severity was assessed by the Fatigue Severity Scale, kinesiophobia by the Tampa Kinesiophobia Scale, functional capacity with the Six-Minute Walk Test, and quality of life was evaluated by the Parkinson’s Disease Questionnaire. In addition, the physical activity level of each patient, such as the number of steps, active energy expenditure and total energy expenditure, were recorded for one week with an activity monitor mounted on the patients’ arms. The mean age of the patients (10 female/10 male) was 69.85 ± 9.38. According to the multiple regression analysis, a significant correlation was found between fatigue with 6-min walking test score (P = 0.039) and number of steps (P = 0.030). Also, a significant correlation was found between kinesiophobia with total energy expenditure (P = 0.013) and quality of life (P = 0.042). While fatigue was a significant determinant for functional capacity and number of steps, kinesiophobia was a significant determinant for total energy expenditure and quality of life. Fatigue and kinesiophobia are emphasized less compared to other findings in Parkinson’s disease. However, fatigue and kinesiophobia symptoms negatively affect the functional capacity, physical activity and quality of life of patients. The results of this study revealed the need to evaluate fatigue and kinesiophobia, and the need to use physiotherapy and rehabilitation interventions to reduce these symptoms.
Analysis of the Sonopet Ultrasonic Bone Aspirator to Traditional Instrumentation for Endoscopic Suturectomy for Craniosynostosis
Authors: Imahiyerobo Thomas A. , Premaratne Ishani D. , Kocharian Gary , O’Connor Ashley , Thomas Charlene , Rabbin-Birnbaum Corinne , Souweidane Mark M. , Hoffman Caitlin E.
Published: December 2020

Objective:

The goal of endoscopic treatment for craniosynostosis is to remove the fused suture and achieve calvarial remodeling with external orthosis. To reduce the need for secondary surgery and to minimize blood loss, instruments that maximize bone removal while minimizing blood loss and risk of dural injury are evolving. The authors therefore assess the safety and efficacy of the Sonopet Ultrasonic Bone Aspirator (UBA) (Stryker, Kalamazoo, MI) for endoscopic suturectomy compared to traditional instrumentation at our institution.

Methods:

Retrospective chart review of consecutive endoscopic suturectomies performed from 2011 to 2019 at Weill Cornell Medical Center was conducted, including demographics, cephalic index, surgical indications, operative time, cosmetic and functional results, complications, estimated blood loss (EBL), re-operation rate, length of stay, and length of helmet therapy. These variables were then compared between the Sonopet and non-Sonopet cohorts.

Results:

Of the 60 patients who underwent endoscopic suturectomy, 16 cases (26.7%) utilized the Sonopet. Mean operative time was 2.8 ± 0.4 hours in the Sonopet group, compared to 3.2 ± 1.2 hours (P = 0.05) without the Sonopet. EBL was 17.8 ± 23.9 cc versus 34.7 ± 75.5 cc (P = 0.20) with versus without the Sonopet respectively. Length of stay and duration of helmet therapy were similar in both groups, ranging from 1 to 3 days (P = 0.68) and 7.25 to 12 months (P = 0.30) respectively. There were no reoperations in the Sonopet group with a mean follow up of 9.18 months. There were 3 reoperations in the non-Sonopet group with a mean follow up of 11.3 months. Among the cases utilizing the Sonopet, 13 (81%) were metopic and three (19%) were coronal synostoses. Of the non-Sonopet cases, 27 (61%) were sagittal, 8 (18%) were metopic, 7 (16%) were coronal, and 2 (5%) were lambdoid synostoses.

Conclusions:

The use of the Sonopet resulted in a mean decrease in operative time at our institution (P = 0.18). Lower EBL and reoperation rates with comparable LOS and helmet therapy duration were also seen. This modality should be considered a safe and effective adjunct in appropriate endoscopic craniosynostosis cases.
The Radiographic Effect of Bone Marrow Aspirate Concentrate on Bone Maturation During Mandibular Distraction Osteogenesis
Authors: Elhadidi Yasser Nabil , Sleem Heba , Elkassaby Marwa
Published: December 2020

Background:

This study aims to evaluate the effect of bone marrow aspirate concentrate (BMAC) during distraction on the consolidation period.

Methods:

The study had 2 groups each had 6 patients. In the control, the distraction had no enhancement; while, the study group was enhanced by BMAC. The bone quality and quantity were assessed using cone beam computed tomography (CBCT).

Results:

The assessment of bone density showed non-significant (NS) (P = 0.06) increase in bone density in the study group (M = 293 ± 100 HU) compared to the control group (M = 176 ± 94 HU). The Assessment of bone volume showed a NS (P = 0.15) increase in bone volume in Study group with average bone volume/total volume (M = 49.47% ± 4.5%) compared to Control group (M = 43.9% ± 7.5%).

Conclusion:

Further examination is recommended to evaluate the effect of BMAC on the distracted bone. The addition of BMAC made a non-significant improvement in bone quantity and quality.
The Role of Folded Multi-Island Vertical Rectus Abdominis Myocutaneous Flap in Reconstruction of Complex Maxillectomy and Midfacial Defects
Authors: Solter Darko , Pegan Alan , Vagić Davor , Košec Andro
Published: December 2020

The rationale and outcomes for reconstruction of complex maxillectomy and midfacial defects using a folded multi-island vertical rectus abdominis myocutaneous free flap (MI-VRAM) are analyzed in this study.

A retrospective review of prospectively collected database was conducted on all VRAM free flaps used in head and neck reconstruction from 2013 to 2019. A total of 39 cases were identified, of which 21 patients underwent immediate VRAM flap reconstruction for complex maxillectomy and midfacial defects. Variables including age, sex, pathologic subtypes, tumor staging, type of resection, defect classification, adjuvant therapy, complications, follow-up time, and reconstructive details were collected.

Single skin-island VRAM was used in 10 (47.6%) patients. Eleven (52.4%) patients required the use of folded MI-VRAM flap. In 6 (28.6%) patients a triple skin-island VRAM was used and 5 (23.8%) received a double skin-island VRAM. The average size of harvested skin paddle was 15 × 7.2 cm. Secondary flap contouring was required in 6 (28.6%) patients. There were no cases of total flap loss and no major donor site complications recorded.

Folded MI-VRAM flap is a reliable method for reconstruction of complex maxillectomy and midfacial defects. It provides multiple independent skin islands with excellent plasticity and abundant volume of tissue for restoration of facial contours.
Fluoxetine-induced Systemic Hypertension in a 12-Year-Old Girl: A Case Report
Authors: Tanir Yaşar , Özdemir Yahya Esad
Published: December 2020

Fluoxetine, a selective serotonin reuptake inhibitor, is an efficacious medication in social anxiety disorder with a generally well-tolerated adverse effect profile. However, infrequent side effects may occur during treatment. Here, we report a case of systemic hypertension in a 12-year-old female patient with social anxiety disorder receiving fluoxetine treatment. To the best of our knowledge, this is the first report of fluoxetine-induced systemic hypertension in children and adolescences.
Tyrosinase deficiency increases protein carbonyl content in substantia nigra of mice administered retinol palmitate
Authors: Aizawa Shu , Yamamuro Yutaka
Published: December 2020

Tyrosinase is a key enzyme for the biosynthesis of melanin pigments in peripheral tissues such as skin and retina. Although tyrosinase activity is specifically detected in melanocytes, several studies have shown the expression and enzymatic activity of tyrosinase in the central nervous system, especially in the midbrain substantia nigra. In the present study, we investigated the antioxidative effects of tyrosinase on protein damage in the substantia nigra of mice. C57BL/10JMsHir (B10) and tyrosinase-deficient albino B10.C-Tyr
c
/Hir (B10-c) mice were intraperitoneally administered retinol palmitate to induce oxidative stress, and the protein carbonyl content, a hallmark of protein oxidative damage, was examined in the substantia nigra. Retinol palmitate administration was found to decrease catalase activity in the substantia nigra of both B10 and B10-c mice, suggesting the induction of oxidative stress due to imbalanced antioxidant systems. In this model, we found that tyrosinase deficiency markedly increases the protein carbonyl content in the substantia nigra. Thus, we concluded that tyrosinase activity prevents protein damage in the substantia nigra of mice that were challenged with oxidative stress. These findings provide novel insight into the physiological role of tyrosinase in the central nervous system.
The influence of regression models on genome-wide association studies of alcohol dependence: a comparison of binary and quantitative analyses
Authors: Li Wenqianglong , Thygesen Johan Hilge , O’Brien Niamh Louise , Heydtmann Mathis , Smith Iain , Degenhardt Franziska , Nöthen Markus Maria , Morgan Marsha Yvonne , Bass Nicholas James , McQuillin Andrew
Published: December 2020

Introduction

Genome-wide association studies (GWAS) of alcohol dependence syndrome (ADS) offer a platform to detect genetic risk loci. However, the majority of the ADS GWAS undertaken, to date, have utilized a case-control design and have failed to identify consistently replicable loci with the exception of protective variants within the alcohol metabolizing genes, notably ADH1B. The ADS phenotype shows considerable variability which means that the use of quantitative variables as a proxy for the severity of ADS has the potential to facilitate identification of risk loci by increasing statistical power. The current study aims to examine the influences of using binary and adjusted quantitative measures of ADS on GWAS outcomes and on calculated polygenic risk scores (PRS).

Methods

A GWAS was performed in 1251 healthy controls with no history of excess alcohol use and 739 patients with ADS classified using binary DMS-IV criteria. Two additional GWAS were undertaken using a quantitative score based on DSM-IV criteria, which were applied assuming both normal and non-normal distributions of the phenotypic variables. PRS analyses were performed utilizing the data from the binary and the quantitative trait analyses.

Results

No associations were identified at genome-wide significance in any of the individual GWAS; results were comparable in all three. The top associated single nucleotide polymorphism was located on the alcohol dehydrogenase gene cluster on chromosome 4, consistent with previous ADS GWAS. The quantitative trait analysis adjusted for the distribution of the criterion score and the associated PRS had the smallest standard errors and thus the greatest precision

Conclusion

Further exploitation of the use of qualitative trait analysis in GWAS in ADS is warranted.