bluuebunny/crossref_metadata_2025 huggingface dataset:
Feedback on Instagram posts for a gestational weight gain intervention
Authors: Waring Molly E , Pagoto Sherry L , Moore Simas Tiffany A , Heersping Grace , Rudin Lauren R , Arcangel Kaylei
Published: February 2022

Lay Summary

Lifestyle interventions can facilitate healthy gestational weight gain but attending in-person meetings can be challenging. The majority of young women use Instagram and pregnancy is a popular topic, suggesting that Instagram might be a means to deliver a pregnancy weight gain intervention. In this study, we asked pregnant women with pre-pregnancy overweight or obesity to join a private group on Instagram and provide feedback on intervention posts about healthy eating and physical activity during pregnancy. All participants followed the moderator’s account, 73% followed all other participants, participants engaged with 100% of study posts, 82% felt comfortable sharing in the group, and 73% would participate in a similar group if pregnant in the future. Participants shared their opinions of the posts in a focus group. While participants felt that the posts were visually attractive and included helpful information, they wanted more personalized content and felt reluctant to post photos they felt were not “Instagram worthy”. Moderators should foster an environment in which participants feel comfortable posting unedited, authentic photos of their lives, perhaps by sharing personal photos that are relatable and represent their own imperfect lives. These findings will inform further development and testing of an Instagram-delivered gestational weight gain intervention.
Qualitative inquiry with primary care providers and specialists about adult weight management care and referrals
Authors: Bailey-Davis Lisa , Pinto Angela Marinilli , Hanna David J , Rethorst Chad D , Still Christopher D , Foster Gary D
Published: February 2022

Obesity is a highly prevalent disease and providers are expected to offer or refer patients for weight management yet increasingly fewer clinical visits address obesity. Challenges to offering care are known but less is known about referrals and how specialists who treat obesity-related comorbidities address care and referrals. This study explored perceptions of primary care providers (PCPs) and specialty providers regarding care and referrals for weight management, specifically referrals to programs in the community setting. A qualitative design was used to interview 33 PCPs (mean age 54 years) and 31 specialists (cardiology, gynecology, endocrinology, and orthopedics [mean age 62 years]) in the USA during 2019. Each interview was conducted by telephone, audio-recorded, and transcribed verbatim. Inductive analysis was used and followed the constant comparative method. Four themes emerged from the data including (a) Clinical guidelines and provider discretion influence obesity care; (b) Facilitators and barriers to discussing weight and small step strategies; (c) Informal referrals are made for weight management in community settings; and (d) Opportunities and challenges for integrating clinical and community services for weight management. Facilitating referrals to effective programs, ideally with a feedback loop could coordinate care and enhance accountability, but education, compliance, and cost issues need addressed. Care may be offered but not be well-aligned with clinical guidelines. Knowledge gaps regarding community programs’ offerings and efficacy were evident. Referrals could be systematically promoted, facilitated, and tracked to advance weight management objectives.
Inhibition of lncRNA RET enhances radio-sensitivity of tumor cells via miR-3179/Slug/PTEN axis
Authors: Liang Xinxin , Li Xueping , Wang Ping , Chen Zhongmin , Yan Ziyan , Ao Xingkun , Liu Yuhao , Zhu Jiaojiao , Xi Tingting , Zhou Shenghui , Li Zhongqiu , Li Chao , Zhu Maoxiang , Zhou Ping-Kun , Gu Yongqing
Published: February 2022

Radioresistance is one of the key obstacles that may lead to the failure of cancer treatment. The underlying mechanisms of radioresistance remain largely unknown; however, increasing evidence has shown that long noncoding RNAs (lncRNAs) are involved in radiotherapy resistance of several cancers. In the present study, we demonstrated that radiation-elevated transcript (RET), a newly identified lnRNA, was highly expressed in cancer cells. Knockdown of RET significantly inhibited the proliferation and colony formation of cancer cells and markedly inhibited apoptosis. Furthermore, downregulation of RET in cancer cells significantly inhibited cell growth, decreased colony survival fractions, and promoted apoptosis in response to radiation treatment, indicating a role in radiation resistance. Moreover, RET knockdown significantly increased the expression of γ-H2AX, an indicator of DNA double strand damage, and reversed radiation-induced EMT, both of which contributed to its radiation resistance. In addition, a negative correlation was found between the expression of RET and PTEN. Rescue assays confirmed RET knockdown enhanced radiosensitivity of cancer cells by upregulating the expression of PTEN. Mechanistically, RET positively regulated Slug, a repressor of PTEN transcription, by acting as a molecular sponge of miR-3179. Our present study showed that RET conferred radioresistance by regulating miR-3179/Slug/PTEN axis, indicating that RET may be a potential target for the clinical application in cancer patients with radioresistance.
Microvesicle-Derived miRNAs Regulate Proinflammatory Macrophage Activation in the Lung Following Ozone Exposure
Authors: Carnino Jonathan M , Lee Heedoo , Smith Ley Cody , Sunil Vasanthi R , Rancourt Raymond C , Vayas Kinal , Cervelli Jessica , Kwok Zhi Hao , Ni Kareemah , Laskin Jeffrey D , Jin Yang , Laskin Debra L
Published: February 2022

Ozone is a ubiquitous air pollutant that causes lung damage and altered functioning. Evidence suggests that proinflammatory macrophages contribute to ozone toxicity. Herein, we analyzed the role of extracellular vesicles (EVs) and microRNA (miRNA) cargo in ozone-induced macrophage activation. Exposure of mice to ozone (0.8 ppm, 3 h) resulted in increases in bronchoalveolar lavage fluid EVs, which were comprised predominantly of microvesicles (MVs). NanoFACS analysis revealed that MVs generated following both air and ozone exposure was largely from CD45+ myeloid cells; these MVs were readily taken up by macrophages. Functionally, MVs from ozone, but not air treated mice, upregulated mRNA expression of inflammatory proteins in macrophages including inducible nitric oxide synthase (iNOS), CXCL-1, CXCL-2, and interleukin (IL)-1β. The miRNA profile of MVs in bronchoalveolar lavage fluid (BALF) was altered after ozone exposure; thus, increases in miR-21, miR-145, miR320a, miR-155, let-7b, miR744, miR181, miR-17, miR-92a, and miR-199a-3p were observed, whereas miR-24-3p and miR-20 were reduced. Ingenuity pathway analysis revealed that these miRNAs regulate pathways that promote inflammatory macrophage activation, and predicted that let-7a-5p/let-7b, miR-24-3p, miR-21-5p, miR-17, and miR-181a-5p are key upstream regulators of inflammatory proteins. After ozone exposure, miR-199a-3p, but not precursor miR-199a-3p, was increased in lung macrophages, indicating that it is derived from MV-mediated delivery. Furthermore, lung macrophage mRNA expression of IL-1β was upregulated after administration of MVs containing miR-199a-3p mimic but downregulated by miR-199a-3p inhibitor. Collectively, these data suggest that MVs generated following ozone exposure contribute to proinflammatory macrophage activation via MV-derived miRNAs including miR-199a-3p. These findings identify a novel pathway regulating macrophage inflammatory responses to inhaled ozone.
RNAi-Based Gene Silencing of RXLR Effectors Protects Plants Against the Oomycete Pathogen Phytophthora capsici
Authors: Cheng Wei , Lin Menglan , Chu Moli , Xiang Guixiang , Guo Jianwen , Jiang Yan , Guan Deyi , He Shuilin
Published: February 2022

Phytophthora capsici is a broad–host range oomycete pathogen that can cause severe phytophthora blight disease of pepper and hundreds of other plant species worldwide. Natural resistance against P. capsici is inadequate, and it is very difficult to control by most of existing chemical fungicides. Therefore, it is urgent to develop alternative strategies to control this pathogen. Recently, host-induced or spray-induced gene silencing of essential or virulent pathogen genes provided an effective strategy for disease controls. Here, we demonstrate that P. capsici can effectively take up small interfering RNAs (siRNAs) from the environment. According to RNA-seq and quantitative reverse transcription PCR analysis, we identified four P. capsici RXLR effector genes that are significantly up-regulated during the infection stage. Transient overexpression and promote-infection assays indicated that RXLR1 and RXLR4 could promote pathogen infection. Using a virus-induced gene silencing system in pepper plants, we found that in planta–expressing RNA interference (RNAi) constructs that target RXLR1 or RXLR4 could significantly reduce pathogen infection, while co-interfering RXLR1 and RXLR4 could confer a more enhanced resistance to P. capsici. We also found that exogenously applying siRNAs that target RXLR1 or RXLR4 could restrict growth of P. capsici on the pepper and Nicotiana benthamiana leaves; when targeting RXLR1 and RXLR4 simultaneously, the control effect was more remarkable. These data suggested that RNAi-based gene silencing of RXLR effectors has great potential for application in crop improvement against P. capsici and also provides an important basis for the development of RNA-based antioomycete agents.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Molecular and Cytogenetic Identification of Stem Rust Resistant Wheat–Thinopyrum intermedium Introgression Lines
Authors: Li Jianbo , Bao Yinguang , Han Ran , Wang Xiaolu , Xu Wenjing , Li Guangrong , Yang Zujun , Zhang Xiaojun , Li Xin , Liu Aifeng , Li Haosheng , Liu Jianjun , Zhang Peng , Liu Cheng
Published: February 2022

Thinopyrum intermedium (JJJsJsStSt, 2n = 6x = 42), a wild relative of common wheat, possesses many desirable agronomic genes for wheat improvement. The production of wheat–Thinopyrum intermedium introgression lines is a key step for transferring these beneficial genes into wheat. In this study, we characterized three wheat–Thinopyrum intermedium introgression lines TA3681, TA5566, and TA5567 using non-denaturing fluorescence in situ hybridization, genomic in situ hybridization, PCR-based landmark unique gene, and intron targeting markers. Our results showed that TA3681 is a wheat–Thinopyrum intermedium 1St disomic addition line, TA5566 is a wheat–Thinopyrum intermedium non-Robertsonian translocation line carrying two pairs of 3A-7Js translocation chromosomes, and that TA5567 is a wheat–Thinopyrum intermedium non-Robertsonian translocation line carrying a pair of 3A-7Js translocation chromosomes. We developed 13, 36, and 15 Thinopyrum intermedium chromosome-specific markers for detecting the introgressed Thinopyrum chromosomes in TA3681, TA5566, and TA5567, respectively. Stem rust assessment revealed that TA3681 exhibited a high level of seedling resistance to Chinese-prevalent Puccinia graminis f. sp. tritici pathotypes, and both TA5566 and TA5567 were highly resistant to Australian P. graminis f. sp. tritici pathotypes, indicating that Thinopyrum intermedium chromosomes 1St and 7Js might carry new stem rust resistance genes. Therefore, the new identified introgression lines may be useful for improving wheat stem rust resistance.
Molecular Mapping of a Recessive Gene for Stripe Rust Resistance at the YrCf75 Locus Using Bulked Segregant Analysis Combined with Single Nucleotide Polymorphism Genotyping Arrays and Bulked Segregant RNA-Sequencing
Authors: Zhao Minghui , Su Bei , Zhang Xiaoxu , Zhang Xiaomei , Li Ruobing , Cheng Peng , Wang Baotong , Li Qiang
Published: February 2022

Wheat stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), is one of the most important diseases in wheat worldwide. Planting resistant varieties is the most economical, effective, and environment-friendly measure to control wheat stripe rust. Changfeng 75, a Chinese winter wheat variety, shows high stripe rust resistance in both seedling and adult-plant stages. The seedling tests of F1, F2, and F2:3 populations derived from Mingxian 169/Changfeng 75 inoculated with Chinese predominant Pst race CYR34 showed that the stripe rust resistance of Changfeng 75 was controlled by a single recessive gene. The locus was temporarily designated as YrCf75. Bulked segregant analysis (BSA) combined with the wheat 660K single-nucleotide polymorphism (SNP) array and bulked segregant RNA-sequencing indicated that the proportion of polymorphic SNPs on wheat chromosome 2A was the highest, which suggested that YrCf75 was likely located on chromosome 2A. Two hundred and twenty-five Kompetitive allele-specific PCR (KASP) and 75 simple sequence repeat (SSR) markers on chromosome 2A were used to map YrCf75 using the BSA approach. Linkage analysis indicated that 31 KASP markers and one SSR marker were linked to YrCf75, and the genetic distances of the two closest flanking KASP markers, AX-1110060462 and AX-111004763, were 1.2 and 2.7 cM, respectively. YrCf75 was located on wheat chromosome 2AL. The molecular detection, resistance specificity, and chromosome location showed that YrCf75 is likely a new gene that is different from the known stripe rust resistance genes (Yr1 and Yr32) on wheat chromosome 2AL.
Intensive Care Pressure Injuries: A Cohort Study Using the CALCULATE and Braden Scales
Authors: Vocci Marcelli Cristine , Lopes Saranholi Taís , Amante Miot Hélio , Fernandes Abbade Luciana Patricia
Published: February 2022

OBJECTIVE

Identify both the risk of developing pressure injuries (PIs) by applying the CALCULATE (CriticAL Care pressure ULcer Assessment Tool made Easy) and Braden Scales and the incidence of PIs in adult patients in intensive care.

METHODS

This prospective cohort study was conducted from March 2016 to February 2017 in an adult ICU. The Braden and CALCULATE scales were applied every 48 hours until medical discharge, death, or PI development.

RESULTS

The sample included 100 patients. The investigators obtained 818 evaluations (409 Braden and 409 CALCULATE) with an average of 4.1 observations per patient. According to the CALCULATE scale, 49 participants (49%) were classified as very high risk, compared with 40 participants (40%; P = .204) according to the Braden Scale. Thirty-five patients developed 37 PIs, with a total incidence of 35%. The mean age of patients who developed PIs was 60.3 (SD, 13.7) years, and they averaged 9.2 (SD, 6.8) days of hospitalization, with diagnoses related to cardiorespiratory and neurologic diseases and associated comorbidities of hypertension, diabetes mellitus, and smoking. The most affected site was the sacral region; 64.9% of the injuries were classified as stage 1.

CONCLUSIONS

Patients in intensive care were high risk according to both PI scales, and many developed PIs. It is evident that even when preventive measures are used, they are insufficient without the implementation of preventive protocols.
Neonatal Skin Structure: Pressure Injury Staging Challenges
Authors: Nie Ann Marie , Johnson Deanna , Reed Robyn C.
Published: February 2022

GENERAL PURPOSE

To review neonatal pressure injuries (PIs), including clinical features and challenges in evaluation and staging related to the unique anatomic features of preterm neonatal skin as well as the common sites and mechanisms of injury.

TARGET AUDIENCE

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES

After participating in this educational activity, the participant will:

1. Recognize the causes of PIs in preterm neonates.

2. Choose the outcomes of PIs in preterm neonates.

3. Distinguish the common characteristics of preterm neonates’ skin.

4. Summarize the challenges clinicians face when classifying the PIs of preterm neonates.

OBJECTIVE

To review neonatal pressure injuries (PIs), including clinical features and challenges in evaluation and staging related to the unique anatomic features of preterm neonatal skin, as well as the common sites and mechanisms of injury.

METHODS

A review of the literature and discussion of clinical experiences at a large children’s hospital. Specific topics include the nature and mechanism of PIs, histomorphometric features of skin development in preterm neonates and how these features inform bedside evaluation of PI, and experience-based observations of challenges in evaluating PIs in this vulnerable population.

RESULTS

Pressure injury staging in preterm neonates presents unique challenges: (1) The National Pressure Injury Advisory Panel PI staging model is based on visual identification of depth of injury, but because of the immaturity of the preterm neonate, skin lacks many of the visual cues present in adult PIs. Specific qualitative and quantitative differences in skin development impact the macroscopic appearance of skin at different gestational ages. (2) The most common cause of PIs in this population is related to noninvasive respiratory devices, but these injuries may be extremely small and difficult to evaluate visually.

CONCLUSIONS

The National Pressure Injury Advisory Panel staging system can be difficult to implement accurately in the neonatal population. Further study is warranted to determine whether an alternative staging system may provide more accurate and actionable information for this population.
Seated vs. standing workstations
Authors: Daniels Kelly , Mihalic Kara , Valdes Kristin
Published: February 2022

Although nurses are constantly on their feet caring for patients, they still work on the computer at seated or standing workstations. This study examines workers' self-reported pain and discomfort while using these two workstation designs and their risk of developing musculoskeletal disorders.
Isolated systolic hypertension is associated with increased left ventricular mass index and aortic stiffness in adolescents: a cardiac magnetic resonance study
Authors: Sarnecki Jędrzej , Obrycki Łukasz , Feber Janusz , Chełstowska Sylwia , Jurkiewicz Elżbieta , Litwin Mieczysław
Published: February 2022

Objectives:

Despite the high prevalence of isolated systolic hypertension (ISH) among hypertensive adolescents, its clinical significance is not determined. In addition, it is hypothesized that ISH with normal central blood pressure (BP) in young patients is a benign phenomenon and was hence labeled spurious hypertension (sHTN).

Methods:

Using cardiac magnetic resonance we evaluated a group of 73 patients with suspected primary hypertension, aged 13–17 years (median: 16.9, interquartile range 15.8–17.4; 13 girls), in whom, based on 24-h ambulatory BP monitoring either ISH (n = 30) or white-coat hypertension (WCH) (n = 43) was diagnosed. Based on noninvasive central BP measurement 13 participants in the ISH group were classified as having sHTN and 17 were diagnosed with true hypertension.

Results:

Compared with WCH adolescents, ISH patients presented with higher indexed left ventricular mass index (LVMI) (P 
< 0.001), maximal left ventricular (LV) wall thickness (P 
< 0.001), LV concentricity (P 
= 0.001) and more often had LV hypertrophy (47 vs. 14%, P 
= 0.002). They had higher average pulse wave velocity (PWV) in the proximal aorta (P = 0.016) and the whole thoracic aorta (P = 0.008). In addition, we observed higher indexed LV stroke volume (P 
= 0.025) in patients with ISH. The sHTN subgroup had significantly higher LVMI and aortic PWV, and more often had LV hypertrophy compared with the WCH group. The sHTN and true hypertension subgroups did not differ in terms of aortic PWV, LVMI or LV geometry.

Conclusion:

Compared with adolescents with WCH patients with ISH, including the sHTN subtype, have more pronounced markers of cardiac end-organ damage, higher aortic stiffness and stroke volume.
Why “Measurand” Is the First Scientific Word We Should Teach Health Physicists
Authors: Strom Daniel J. , Tabatadze George
Published: February 2022

The word “measurand” means “the quantity intended to be measured.” The authors argue that health physicists should distinguish between measurands and measurement results because the former exist in the domain of theory, while the latter exist in the domain of reality in which we make measurements and observations. The authors demonstrate the importance of separating the quantities used in theory and those used in experiment, clearing up conceptual confusions in three examples of problems routinely encountered in health physics: (1) detection and quantification of radioactive material; (2) multiple definitions of “activity,” and (3) the relationship between radiation and health effects. The first example looks into probabilities of various measurement results (mi
) given the measurand (μ) in comparison with the inverse problem: determining probable values of the measurand (μ) based on observed measurement results (mi
). The second example addresses the distinction between measurands and measurement results given two definitions of activity A provided by the International Commission on Radiation Units and Measurements. Additional consideration is given to use of N + 1 counts in (activity) calculations when we have observed N counts, which results from correctly stating and solving the inverse problem. This makes our measurement uncertainties more accurate and our detection decisions more reliable. The last example emphasizes how the observational results of epidemiology, animal experiments, and other radiation biology studies are used to estimate the probability of a particular cancer in an individual—a measurand that is not otherwise accessible to direct observation. Our measurement results, and our use of those results, are more easily understood when we understand the difference between a measurand and a measurement result and can choose the best calculational approach.
Association of Primary Open-angle Glaucoma With Tinnitus: A Nationwide Population-Based Study
Authors: Kuang Tung-Mei , Xirasagar Sudha , Cheng Yen-Fu , Kuo Nai-Wen , Lin Herng-Ching
Published: February 2022

Précis:

This study aims to investigate the association between primary open-angle glaucoma (POAG) and tinnitus. We found that tinnitus was significantly associated with preexisting POAG [adjusted odds ratio (OR)=1.298].

Purpose:

The purpose of this study was to investigate the association between POAG and tinnitus using nationwide population-based data from Taiwan.

Methods:

Data for this case-control study were retrieved from the Taiwan National Health Insurance Research Database for all 542,682 patients with a first-time diagnosis of tinnitus (cases), and 1,628,046 propensity score–matched controls from Taiwan’s National Health Insurance system. We performed multiple logistic regression analysis to estimate the odds (ORs) of prior POAG among cases versus controls.

Results:

Of total 2,170,728 study patients, 85,257 (3.93%) had POAG before the index date of tinnitus, 25,496 (4.70%) among cases and 59,761 (3.67%) among controls (P<0.001). Multiple logistic regression analysis showed a significant association between prior POAG and tinnitus (OR=1.298, 95% confidence interval: 1.278-1.318) after adjusting for age, sex, monthly income, geographic location and residential urbanization level, hyperlipidemia, diabetes, obesity, anemia, rheumatoid arthritis, alcohol abuse, nicotine dependence, anxiety disorder, depressive disorder, and hypertension.

Conclusions:

Patients with POAG have a higher risk of tinnitus compared with those without the disease. Ophthalmologists should be aware of this association and further studies are needed to understand underlying mechanisms.
Emergency Endoscopic Retrograde Cholangiopancreatography Did Not Increase the Incidence of Postprocedural Pancreatitis Compared With Elective Cases
Authors: Nakai Yoshitaka , Kusumoto Kiyonori , Itokawa Yoshio , Inatomi Osamu , Bamba Shigeki , Doi Toshifumi , Kawakami Takumi , Suzuki Takahiro , Suzuki Azumi , Endoh Bunji , Chikugo Koki , Mizumoto Yoshinori , Tanaka Kiyohito
Published: February 2022

Objective

The aim of this study was to identify the incidence of and risk factors for post–endoscopic retrograde cholangiopancreatography pancreatitis (PEP) after emergency endoscopic retrograde cholangiopancreatography (ERCP).

Methods

We performed a prospective multicenter observational study of 3914 patients who underwent ERCP. We compared the incidence of PEP after emergency and elective ERCP.

Results

A total of 3410 patients were enrolled in this study. Post-ERCP pancreatitis occurred in 44 of 800 patients (5.5%) and in 190 of 2418 patients (7.9%) in the emergency and elective groups, respectively. No significant difference was noted between the groups (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.52–1.03; P = 0.07). Multivariate analysis showed that the following factors increased the risk for PEP after emergency ERCP: contrast medium injection into the pancreatic duct (OR, 2.56; 95% CI, 1.30–5.03; P = 0.005), >4 cannulation attempts (OR, 5.72; 95% CI, 2.61–12.50; P < 0.001), and endoscopic papillary balloon dilatation (OR, 9.24; 95% CI, 2.13–40.10; P < 0.001).

Conclusions

No significant difference was noted in the incidence of PEP in patients after emergency and elective ERCP. We may prevent PEP even after emergency ERCP by avoiding contrast injection into the pancreatic duct, multiple cannulation attempts, and endoscopic papillary balloon dilatation.
Observation Versus Resection for Small, Localized, and Nonfunctional Pancreatic Neuroendocrine Tumors
Authors: Zhu Jisheng , Fu Chengchao , Zhang Yang , Zhou Xin , Xiao Weidong , Li Yong
Published: February 2022

Objectives

The best treatment modalities for small (1–2 cm), localized, and nonfunctional pancreatic neuroendocrine tumors remain controversial. Therefore, we aimed to evaluate whether surgical resection provides survival benefit over observation in those patients.

Methods

From 1973 to 2015, all eligible patients were retrieved from the Surveillance, Epidemiology, and End Results database. Propensity score matching (1:2) method was performed. The primary endpoints evaluated were overall survival (OS) and cancer-specific survival (CSS).

Results

We identified 681 patients, of which 122 and 559 patients received observation and resection, respectively. Propensity score–matched patients who underwent surgery (n = 183) had significantly improved OS (P = 0.008) compared with matched patients who underwent observation (n = 106), but there was no difference in CSS (P = 0.310). On multivariate analysis, resection could improve OS but not CSS. Besides, poorly differentiated/undifferentiated tumor had a worse OS and CSS. Subgroup analysis showed that patients 60 years and older who underwent resection could achieve a longer OS and CSS.

Conclusions

This disease exhibits a very good prognosis. Patients undergoing resection were associated with comparable 5-year CSS but longer 5-year OS compared with those receiving observation. Elderly patients (≥60) may obtain benefit from surgery, whereas the treatment of younger patients should be individualized.
Minimal Change Patients Versus Obvious Chronic Pancreatitis
Authors: Nadella Sandeep , Lieb John G.
Published: February 2022

Objectives

The objective was to assess if the peak bicarbonate level during secretin stimulation testing (SST) differs between patients with minimal change (or small duct) chronic pancreatitis (CP) versus those with obvious CP (or large duct) versus those without CP.

Methods

Two hundred nineteen patient records at the University of Florida who had been referred for SST were analyzed for peak bicarbonate, total volume of juice collected, age, sex, and clinical presentation.

Results

Fifty-one patients with minimal change CP were identified. Thirty-three patients were felt to have advanced CP, and 135 patients did not have CP by clinical criteria. The peak bicarbonate and total volume of pancreatic juice collected was significantly different (P < 0.001) between all 3 groups by multiple comparison testing. The peak bicarbonate of advanced CP and minimal change groups was less than controls (P < 0.001). There was a significant difference (P < 0.05) on direct testing between peak bicarbonate in advanced CP and minimal change CP.

Conclusions

The peak bicarbonate and volume measured during SST differs among patients with minimal change CP, advanced CP and in disease controls. These results could be useful in diagnosing minimal change/early CP.
Which high-intensity interval training program is more effective in patients with coronary artery disease?
Authors: Okur Ismail , Aksoy Cihan Caner , Yaman Fatima , Sen Taner
Published: February 2022

The aim of the study is to examine high-intensity interval training (HIIT) programs and a moderate-intensity continuous training (MICT) program, which are frequently used in cardiac rehabilitation programs in terms of their effects on the functional capacity and quality of life of patients with coronary artery disease (CAD). The study included 20 patients with CAD (mean age, 60.95 ± 5.08 years) who had undergone revascularization surgery. The participants were randomized into HIIT-short, HIIT-long, and MICT groups. All the groups participated in a 24-session exercise-based cardiac rehabilitation program. The participants’ exercise capacity was evaluated using the maximal exercise test and estimated VO2max values, functional capacity using the 6-min walk test (6MWT), and quality of life using the Short Form-36 survey and MacNew Heart Disease Health-related Quality of Life (MacNew) questionnaire. It was determined that the estimated VO2max values statistically significantly improved after treatment (P < 0.05), and both HIIT groups were superior to the MICT group (P < 0.05). Only the HIIT groups achieved the minimal clinically important difference in the 6MWT distance. After treatment, only the MICT group had a statistically significant improvement in quality of life. There was no statistically significant difference between the groups in relation to the improvement in the 6MWT distance and quality of life (P > 0.05). The results of our study showed that both HIIT programs were superior to MICT in improving the maximal exercise capacity of patients with CAD, and the three programs had a similar effect on quality of life.
An Integrative Review of Body Art in Nursing
Authors: Pittman Alison , Gary Jodie , Pepper Catherine
Published: February 2022

Background:

Schools of nursing and health care facilities frequently have policies prohibiting the visibility of body art (tattoos and piercings). The authors sought to understand literature specific to nursing regarding such policies.

Purpose:

This integrative review examined literature regarding body art in nursing.

Methods:

A systematic electronic database search was conducted for publications between 2010 and 2021. Thematic analysis of both empirical studies and nonresearch articles was completed.

Results:

Thirty articles were analyzed, revealing 3 themes and 8 subthemes related to body art in nursing practice: level of acceptability (subthemes were positive perception, stigmatizing, and personal meaning); professional image (subthemes were appearance matters, policy, and trust and confidence); and infection concern (subthemes were hygiene and contamination).

Conclusions:

Current understanding from literature regarding body art in nursing was summarized.
Ultrasensitive RNA In Situ Hybridization for Kappa and Lambda Light Chains Assists in the Differential Diagnosis of Nodular Lymphocyte-predominant Hodgkin Lymphoma
Authors: Kaseb Hatem , Wang Zhen , Cook James R.
Published: February 2022

Establishing a diagnosis of nodular lymphocyte-predominant Hodgkin lymphoma (nLPHL) is often challenging as the differential diagnosis is broad, including classic Hodgkin lymphoma (cHL), progressive transformation of germinal centers (PTGC), and other lymphoproliferative disorders. In this study, we investigate the utility of a recently described ultrasensitive in situ hybridization assay for kappa and lambda immunoglobulin light chains in distinguishing nLPHL, cHL, and PTGC. A total of 72 cases were examined (21 nLPHL, 33 cHL, and 18 PTGC). In nLPHL, the large neoplastic cells were light chain restricted in 21/21 (100%) cases (16 kappa, 5 lambda). In contrast, Reed-Sternberg cells of cHL were negative for kappa and lambda in all cases (0/33, 0%; P<0.001). In PTGC, polytypic B cells were noted in mantle zones and germinal centers in all cases, with 1 case (5%) also showing focal collections of light chain restricted large B cells. Background monotypic small B cells were identified in 3 cases, including 1 nLPHL and 2 cHL (1 of which arose in chronic lymphocytic leukemia). Ultrasensitive in situ hybridization for kappa and lambda is a useful addition to a standard immunophenotyping panel for the evaluation of suspected nLPHL.
The 27 Facial Sutures: Timing and Clinical Consequences of Closure
Authors: Wang Maxwell M. , Haveles Christos S. , Zukotynski Brian K. , Reid Russell R. , Lee Justine C.
Published: February 2022

Facial sutures contribute significantly to postnatal facial development, but their potential role in craniofacial disease is understudied. Since interest in their development and physiology peaked in the mid–twentieth century, facial sutures have not garnered nearly the same clinical research interest as calvarial sutures or cranial base endochondral articulations. In addition to reinforcing the complex structure of the facial skeleton, facial sutures absorb mechanical stress and generally remain patent into and beyond adolescence, as they mediate growth and refine the shape of facial bones. However, premature closure of these sites of postnatal osteogenesis leads to disrupted growth vectors and consequent dysmorphologies. Although abnormality in individual sutures results in isolated facial deformities, we posit that generalized abnormality across multiple sutures may be involved in complex craniofacial conditions such as syndromic craniosynostosis. In this work, the authors comprehensively review 27 key facial sutures, including physiologic maturation and closure, contributions to postnatal facial development, and clinical consequences of premature closure.
The Age Factor in Postbariatric Body Contouring Surgery Outcome
Authors: Fliss Ehud , Manheim Sharon , Zoabi Tariq , Bashi Tomer , Meilik Bar , Fliss-Isakov Naomi , Gur Eyal , Meilik Benjamin
Published: February 2022

Background:

Increasing life expectancy will likely lead greater numbers of older patients to seek postbariatric body contouring plastic surgery. The impact of age on body contouring plastic surgery outcome is undetermined.

Methods:

A retrospective cohort study of 317 postbariatric body contouring plastic surgery cases was performed. Patient demographics and operative and postoperative data were collected. Patients were categorized into three age groups, and univariate analysis examined group differences. Multivariate logistic regression analysis assessed independent associations between age and surgical outcome measures.

Results:

Patients 60 years and older had a higher mean preoperative body mass index (30.8 ± 3.6 kg/m2, p < 0.001) and higher rates of hypertension (48.9 percent, p < 0.001), dyslipidemia (38.3 percent, p < 0.001), and diabetes mellitus (17 percent, p = 0.012) compared to the younger age groups. They also sustained significantly higher complication rates (any minor complications, p = 0.004; minor surgical site infections, p = 0.005; minor hematomas, p = 0.007; any major complications, p < 0.001; major surgical-site infections, p < 0.001; and major dehiscence, p < 0.001). Increasing age was a significant risk factor for any major complications (p = 0.005), reoperation (p = 0.02), and readmission (p = 0.001). Age greater than or equal to 60 years was a significant risk factor solely for readmission (OR, 3.32; p = 0.03).

Conclusions:

Increasing age was a risk factor for adverse postoperative outcome in postbariatric body contouring plastic surgery patients; however, age greater than or equal to 60 years in and of itself was an independent risk factor for readmission only. These findings may aid plastic surgeons in patient consultation and in decision making regarding suitable candidates for these procedures.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, II.
Comparison of Yield, Purity, and Functional Properties of Large-Volume Exosome Isolation Using Ultrafiltration and Polymer-Based Precipitation
Authors: Gao Min , Cai Junrong , Zitkovsky Helen S. , Chen Bin , Guo Lifei
Published: February 2022

Background:

Mesenchymal stem cell–derived exosomes are known to produce effects similar to those of source cells and therefore represent a new approach in cell-free regenerative medicine. Their potential clinical application demands efficient isolation of stable and functional exosomes from a large volume of biological fluid.

Methods:

Exosomes from adipose-tissue conditioned medium of the same volume were isolated using either (1) ultrafiltration with size exclusion or (2) ExoQuick-TC. The isolated exosomes were characterized by protein concentration, particle size, exosomal marker expression, RNA expression profiles, and roles in dermal fibroblast proliferation and migration.

Results:

Both isolation methods produced exosomes within the size range defined for exosomes (50 to 200 nm) and common markers were enriched. Compared to the ExoQuick-TC precipitation method, the ultrafiltration method produced a significantly higher protein yield (p < 0.001) but a lower particle-to-protein ratio (p < 0.05); it also yielded higher RNA contents from the same fat tissue indicated by housekeeping genes, but with overall lower purity. The expression of several mRNAs and miRNAs related to tissue regeneration showed that there was no statistical difference between both methods, except miR-155 and miR-223 (p < 0.05). However, there was no difference in overall fibroblast proliferation and migration between exosomes isolated by these two methods.

Conclusions:

Ultrafiltration with size exclusion demonstrated higher yields, acceptable purity, and comparable biophysical properties and biological functions to the more expensive commercial precipitation method. Therefore, it may conceivably be translated into yield-efficient and cost-effective modalities for therapeutic purposes.

Clinical Relevance Statement:

Ultrafiltration with size exclusion may be amenable for exosome isolation from large-volume complex fluids such as tissue conditioned media for clinical application in future regenerative medicine.
Flowthrough Omental Flap for Vascularized Lymph Node Transplant of the Lower Extremity
Authors: Lee Broderick S. , Granoff Melisa D. , Pardo Jaime , Sun Wei , Critchlow Jonathan F. , Tsai Leo , Upton Joseph , Singhal Dhruv
Published: February 2022

Vascularized lymph node transplantation is a surgical approach for the treatment of chronic lymphedema. However, there is no clinical standard for flap placement nor vascular anastomoses. The authors propose a novel flowthrough configuration for an omental vascularized lymph node transplant in the popliteal space. To prepare the popliteal space for an omental free flap, the medial popliteal fat pad and medial head of the gastrocnemius muscle were debulked. Venous anastomoses were completed with vein couplers, joining the right gastroepiploic vein to the medial sural venae comitantes and the left gastroepiploic vein to the lesser saphenous vein. Arterial anastomoses were hand sewn, joining the right gastroepiploic artery to the proximal medial sural artery and the left gastroepiploic artery to the distal medial sural artery, to create the flowthrough configuration. A retrospective review of patients who underwent this procedure at a single institution was performed. Six patients with chronic lymphedema of the lower extremity underwent vascularized lymph node transplantation from June of 2019 to November of 2020. Five patients underwent at least 3 months of postoperative surveillance, with no postoperative complications reported. In this technique contribution, the authors describe a novel flowthrough configuration for an omental free flap to the popliteal space. The popliteal space offers an aesthetically favorable recipient location when appropriately prepared. The medial sural vessels are ideal recipient vessels for the flowthrough omental flap.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
EPPOCRATIS: Expedited Preoperative Point-of-Care Reduction of Fractures to Normalized Anatomy and Three-Dimensional Printing to Improve Surgical Outcomes
Authors: Sharaf Basel , Kuruoglu Doga , Cantwell Sean R. , Alexander Amy E. , Dickens Hunter J. , Morris Jonathan M.
Published: February 2022

Virtual surgical planning and three-dimensional printing have been invaluable tools in craniomaxillofacial surgery. From planning head and neck reconstruction to orthognathic surgery and secondary reconstruction of maxillofacial trauma, virtual surgical planning and three-dimensional printing allow the surgeon to rehearse the surgical plan and use patient-specific surgical guides for carrying out the plan accurately. However, the process of virtual surgical planning and three-dimensional printing requires time and coordination between the surgeon on one hand and the biomedical engineers and designers on the other hand. Outsourcing to third-party companies contributes to inefficiencies in this process. Advances in surgical planning software and three-dimensional printing technology have enabled the integration of virtual surgical planning and three-dimensional printing at the treating hospital, the point of care. This allows for expedited use of this process in semiurgent surgical cases and acute facial trauma cases by bringing the surgeon, radiologist, biomedical engineers, and designers to the point of care. In this article, the authors present the utility of EPPOCRATIS, expedited preoperative point of care reduction of fractures to normalized anatomy and three-dimensional printing to improve surgical outcomes, in the management of acute facial trauma.
Fragmented Fat Transfer for Massive Weight Loss Gluteal Contouring
Authors: Mendes Flavio Henrique , Viterbo Fausto
Published: February 2022

A recently introduced novel fragmentation technique has made it possible to convert fat tissue from apronectomy into large-scale viable lipograft, providing a glimpse of an alternative to traditional liposuction and its harvesting limitations. The purpose of this study was to assess the initial clinical evidence on fragmented fat transfer to restore volume and enhance deflated gluteal contours in a sample of massive weight loss patients. The authors retrospectively reviewed medical records of 20 women who received autologous buttock fat grafts that were harvested and fragmented following belt lipectomies and/or fleur-de-lis abdominoplasties. The average total volume subcutaneously grafted into the buttocks was 720 ml (bilateral), ranging from 500 ml to 960 ml. No local gluteal complications, such as seroma, infection, fat necrosis, or subcutaneous nodulations, were reported. Photographic observation of postoperative results over a 6- to 14-month follow-up period showed clear enhancement of body contouring in all patients, especially in those in whom fat transfer was combined with circumferential lifts. Fat fragmentation has proved useful and effective in providing great amounts of viable fat graft in a safe, simple, and reproducible technique without noticeable complications. The method eliminates the organic response to the insult of liposuction while using the entirety of formerly discarded apronectomy tissue to provide fine, transferable, autologous fat without increasing operative time. Although preliminary, the authors’ clinical findings with this new technique support further studies of fragmented fat as an alternative to liposuction in gluteal fat grafting. Additional potential applications, including in wound healing and regenerative medicine, are worth exploring. 

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
One Year Into the Pandemic: Evolving COVID-19 Outcomes in Lung Transplant Recipients, a Single-center Experience
Authors: Laothamatas Kemarut , Hum Jamie , Benvenuto Luke , Shah Lori , Grewal Harpreet Singh , Pereira Marcus , Scheffert Jenna , Carroll Maggie , Nolan Margaret , Reilly Genevieve , Lemaitre Philippe , Stanifer Bryan P. , Sonett Joshua R. , D’Ovidio Frank , Robbins Hilary , Arcasoy Selim M.
Published: February 2022

Background.

In the early months of the coronavirus disease 2019 (COVID-19) pandemic, our center reported a mortality rate of 34% in a cohort of 32 lung transplant recipients with COVID-19 between March and May 2020. Since then, there has been evolving knowledge in prevention and treatments of COVID-19. To evaluate the impact of these changes, we describe the clinical presentation, management, and outcomes of a more recent cohort of lung transplant recipients during the second surge and provide a comparison with our first cohort.

Methods.

We conducted a retrospective cohort study that included all consecutive lung transplant recipients who tested positive for severe acute respiratory syndrome coronavirus 2 between November 2020 and February 28, 2021. We compared baseline demographics and major outcomes between the first- and second-surge cohorts.

Results.

We identified 47 lung transplant recipients (median age, 60; 51% female) who tested positive for severe acute respiratory syndrome coronavirus 2 between November 2020 and February 28, 2021. The current cohort had a higher proportion of patients with mild disease (34% versus 16%) and fewer patients with a history of obesity (4% versus 25%). Sixty-six percent (n = 31) required hospitalization and were treated with remdesivir (90%) and dexamethasone (84%). Among those hospitalized, 77% (n = 24) required supplemental oxygen, and 22% (n = 7) required invasive mechanical ventilation. The overall 90-d mortality decreased from 34% to 17% from the first cohort to the second (adjusted odds ratio, 0.26; 95% confidence interval, 0.08-0.85; P = 0.026).

Conclusions.

Although COVID-19–associated mortality rate in lung transplant recipients at our center has decreased over time, COVID-19 continues to be associated with significant morbidity and mortality.
Fractality of tics as a quantitative assessment tool for Tourette syndrome
Authors: Beeler Payton , Jensen Nicholas O. , Kim Soyoung , Robichaux-Viehoever Amy , Schlaggar Bradley L. , Greene Deanna J. , Black Kevin J. , Chakrabarty Rajan K.
Published: February 2022

Tics manifest as brief, purposeless and unintentional movements or noises that, for many individuals, can be suppressed temporarily with effort. Previous work has hypothesized that the chaotic temporal nature of tics could possess an inherent fractality, that is, have neighbour-to-neighbour correlation at all levels of timescale. However, demonstrating this phenomenon has eluded researchers for more than two decades, primarily because of the challenges associated with estimating the scale-invariant, power law exponent—called the fractal dimension
D
f
—from fractional Brownian noise. Here, we confirm this hypothesis and establish the fractality of tics by examining two tic time series datasets collected 6–12 months apart in children with tics, using random walk models and directional statistics. We find that
D
f
is correlated with tic severity as measured by the YGTTS total tic score, and that
D
f
is a sensitive parameter in examining the effect of several tic suppression conditions on the tic time series. Our findings pave the way for using the fractal nature of tics as a robust quantitative tool for estimating tic severity and treatment effectiveness, as well as a possible marker for differentiating typical from functional tics.