bluuebunny/crossref_metadata_2025 huggingface dataset:
Probiotic Bacteria, Anaerobic Soil Disinfestation, and Mustard Cover Crop Biofumigation Suppress Soilborne Disease and Increase Yield of Strawberry in a Perennial Organic Production System
Authors: Rahman Mahfuz , Islam Tofazzal , Jett Lewis , Kotcon James
Published: February 2023

Black root rot complex and crown rot of strawberry caused by soilborne fungi limit sustainable strawberry production in the northeastern United States, especially in perennial systems, including matted row and plasticulture. As pathogen populations build up over time in the rhizosphere and infect the root system, feeder roots are pruned, which diminishes nutrient and water uptake and causes stunted plant growth or death. Alternative management options are needed for many organic and small growers who can’t use chemical fumigants due to new regulations and potential health hazards. Strawberry plug plants were grown on beneficial microbe-inoculated or uninoculated planting mix followed by transplanting in fruiting field plots that either was biofumigated with mustard cover crop (MCC), anaerobically disinfested (ASD), or left untreated. Different combinations of plug plants and field plot treatments were used to determine the efficacy of individual treatments or synergistic effects from combination treatment. Plug plants were transplanted in pretreated plastic mulched raised beds and grown following a typical organically recommended production system. Plants grown on TerraGrow (TG)-inoculated planting mix showed enhanced plant vigor in the fruiting field compared with untreated plants. Weeds that grew through planting holes were significantly (P ≤ 0.045) suppressed in ASD plots compared with untreated plots in the first year. Plants treated with a combination treatment of TG and ASD had significantly higher fruit yield in both years (2019 and 2020), although the difference was greater in the second year. Plant vigor and survival in treated plots except MCC were also significantly higher in the second year compared with the untreated control. Suppression of pathogenic microbes and plant vigor improvement in treated plots appear to be the factors providing beneficial effects and higher net economic return. Taken together, our results suggest that a combination of beneficial microbes and ASD could be an alternative to synthetic fumigation in a perennial strawberry production system.
METTL3 inhibits autoreactive Th17 cell responses in experimental autoimmune uveitis via stabilizing ASH1L mRNA
Authors: Zhao Lu , Liu Yuling , Ma Binyun , Liu Xun , Wei Ruihua , Nian Hong
Published: February 2023

Methyltransferase like 3 (METTL3), a primary N6‐methyladenosine (m6A) methyltransferase, has been implicated in various biological and pathological processes including immune responses. However, the functions and mechanisms of METTL3 in pathogenic T helper (Th)17 cells are poorly understood. Here we found significantly decreased METTL3 expression along with reduced m6A levels in eyeballs and T cells of experimental autoimmune uveitis (EAU). Overexpression of METTL3 ameliorated the development of EAU and suppressed pathogenic Th17 cell responses in vivo and in vitro. Mechanistically, METTL3 promoted the expression of absent, small, or homeotic‐like 1 (ASH1L) via enhancing its stability in a YT521‐B homology domain containing 2 (YTHDC2)‐dependent manner, which further decreased the expression of IL‐17 and IL‐23 receptor (IL‐23R), resulting in reduced pathogenic Th17 responses. Together, our data reveal a pivotal role of METTL3 in regulating pathogenic Th17 responses, which may contribute to human uveitis therapy.
Machine‐learning methods applied to integrated transcriptomic data from bovine blastocysts and elongating conceptuses to identify genes predictive of embryonic competence
Authors: Rabaglino Maria Belen , Salilew‐Wondim Dessie , Zolini Adriana , Tesfaye Dawit , Hoelker Michael , Lonergan Pat , Hansen Peter J.
Published: February 2023

Early pregnancy loss markedly impacts reproductive efficiency in cattle. The objectives were to model a biologically relevant gene signature predicting embryonic competence for survival after integrating transcriptomic data from blastocysts and elongating conceptuses with different developmental capacities and to validate the potential biomarkers with independent embryonic data sets through the application of machine‐learning algorithms. First, two data sets from in vivo‐produced blastocysts competent or not to sustain a pregnancy were integrated with a data set from long and short day‐15 conceptuses. A statistical contrast determined differentially expressed genes (DEG) increasing in expression from a competent blastocyst to a long conceptus and vice versa; these were enriched for KEGG pathways related to glycolysis/gluconeogenesis and RNA processing, respectively. Next, the most discriminative DEG between blastocysts that resulted or did not in pregnancy were selected by linear discriminant analysis. These eight putative biomarker genes were validated by modeling their expression in competent or noncompetent blastocysts through Bayesian logistic regression or neural networks and predicting embryo developmental fate in four external data sets consisting of in vitro‐produced blastocysts (i) competent or not, or (ii) exposed or not to detrimental conditions during culture, and elongated conceptuses (iii) of different length, or (iv) developed in the uteri of high‐ or subfertile heifers. Predictions for each data set were more than 85% accurate, suggesting that these genes play a key role in embryo development and pregnancy establishment. In conclusion, this study integrated transcriptomic data from seven independent experiments to identify a small set of genes capable of predicting embryonic competence for survival.
Acute and postacute COVID-19 outcomes for patients with rheumatoid arthritis: lessons learned and emerging directions 3 years into the pandemic
Authors: Zaccardelli Alessandra , Wallace Zachary S. , Sparks Jeffrey A.
Published: February 2023

Purpose of review

To summarize the findings of studies investigating patients with rheumatoid arthritis (RA) and risk of acute and postacute COVID-19 outcomes 3 years into the pandemic.

Recent findings

Most studies early in the pandemic included all patients with systemic autoimmune rheumatic diseases (SARDs), not only those with RA, due to limited sample size. Many of these studies found that patients with SARDs were at higher risk of COVID-19 infection and severe outcomes, including hospitalization, hyperinflammation, mechanical ventilation, and death. Studies performed later were able to focus on RA and found similar associations, while also identifying RA-specific factors such as immunosuppressive medications, disease activity/severity, and interstitial lung disease as risk factors for severe COVID-19. After COVID-19 vaccination, the risks for COVID-19 infection and severity were reduced for patients with RA, but a gap between the general population persisted, and some patients with RA are susceptible to breakthrough infection after vaccination. Preexposure prophylaxis, effective treatments, and changes in viral variants have also contributed to improved COVID-19 outcomes throughout the pandemic. Emerging data suggest that patients with RA may be at risk for postacute sequelae of COVID-19 (PASC).

Although COVID-19 outcomes have improved over the pandemic for patients with RA, some experience poor acute and postacute outcomes after COVID-19. Clinicians and patients should remain vigilant about risk mitigation for infection and consider early treatment for RA patients with COVID-19. Future studies are needed to investigate clinical outcomes and mechanisms of PASC among patients with RA.
Higher Rates of Readmission After Acute Total Hip Arthroplasty Versus Open Reduction Internal Fixation for Elderly Acetabular Fractures, a National Study From 2010 to 2019
Authors: Upfill-Brown Alexander , Shi Brendan , Maturana Carlos , Brodke Dane , Shah Akash A. , Kelley Benjamin V. , Mayer Erik N. , Devana Sai K. , Lee Christopher
Published: February 2023

Objectives:

To evaluate the initial complications and short-term readmissions and reoperations after open reduction internal fixation (ORIF) versus acute total hip arthroplasty (THA) for elderly acetabular fractures.

Design:

Retrospective database review.

Setting:

All hospitalizations in the National Readmissions Database and National Inpatient Sample.

Patients/Participants:

Patients 60 years of age or older with closed acetabular fractures managed surgically identified from the National Readmissions Database or National Inpatient Sample between 2010 and 2019.

Intervention:

Acute THA with or without ORIF.

Main Outcome Measurements:

30-, 90-, and 180-day readmissions and reoperations and index hospitalization complications.

Results:

An estimated 12,538 surgically managed acetabular fractures in elderly patients occurred nationally between 2010 and 2019, with 10,008 (79.8%) undergoing ORIF and 2529 (20.2%) undergoing THA. Length of stay was 1.7 days shorter (P < 0.001) and probability of nonhome discharge was reduced (OR 0.68, P = 0.009) for THA patients than for ORIF patients. THA was associated with lower rates of pneumonia (4.6 vs. 9.1%, P < 0.001) and other respiratory complications (10.2 vs. 17.6%) when compared with ORIF. At 30 days, THA patients had higher rates of readmission (13.9 vs. 10.1%, P = 0.007), related readmission (5.4 vs. 1.2%, P < 0.001), readmission for dislocation (3.1 vs. 0.3%, P < 0.001), and reoperations (2.9 vs. 0.9%, P = 0.002). At 180 days, THA patients had higher rates of related readmission (10.1% vs. 3.9%, P < 0.001), readmission for dislocation (5.1% vs. 1.3%, P < 0.001), and readmission for SSI (3.4 vs. 0.8%, P = 0.005).

Conclusions:

Acute THA is associated with lower length of stay and certain index hospitalization complications, but higher rates of readmissions for related reasons and specifically for dislocation.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
The Use of the Piriformis Fossa Radiographic Landmark to Predict “In-Out-In” Placement of the Posterosuperior Femoral Neck Screw
Authors: Kuttner Nicolas P. , Hoggard Timothy M. , Cancio-Bello Alexandra M. , Hidden Krystin A. , Yuan Brandon J. , Adams John D.
Published: February 2023

Objectives:

To investigate the correlation between a screw's radiographic relationship to the piriformis fossa with position on CT in the clinical setting.

Methods:

Intraoperative fluoroscopic images of patients treated with cannulated screw fixation of a femoral neck fracture, who also had a postoperative CT scan, were retrospectively evaluated by 4 fellowship-trained orthopaedic trauma surgeons. The posterosuperior screw on the AP fluoroscopic view was determined to be above the piriformis fossa (APF) or below the piriformis fossa (BPF). Using CT scan to determine IOI placement, the ability to predict IOI position based on fluoroscopic imaging was evaluated by calculating accuracy, sensitivity, specificity, and interobserver reliability.

Results:

73 patients met inclusion criteria. The incidence of IOI screw placement was 59% on CT evaluation. The use of the PF landmark accurately predicted CT findings in 89% of patients. A screw placed APF was 90% sensitive and 88% specific in predicting cortical breach, with near-perfect interobserver agreement (κ = 0.81).

Conclusion:

The use of the PF radiographic landmark is highly sensitive and specific in predicting the placement of an IOI posterosuperior femoral neck screw.

Level of Evidence:

Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
A Longer Duration of Myelopathy Symptoms is Associated With the Lack of Intraoperative Motor Evoked Potential Improvement During Decompressive Cervical Myelopathy Surgery
Authors: Loh Jing Loong Moses , Jiang Lei , Woo Bo Jun , Zhu Lisha , Fong Poh Ling , Guo Chang Ming , Soh Reuben Chee Cheong
Published: February 2023

Study Design:

Retrospective cohort study.

Objective:

We aim to investigate the relationship between the intraoperative motor evoked potential (MEP) signal changes during surgical treatment of cervical myelopathy with postoperative functional outcomes and determine what factors correlate with MEP signal changes.

Summary of Background Data:

Intraoperative neurophysiologic monitoring with MEP for cervical cord decompression can potentially predict postoperative neurological complications.

Materials and Methods:

We prospectively collected data from 114 consecutive cervical compressive myelopathy patients who underwent decompressive cervical spine surgery. Functional outcomes were measured preoperatively and postoperatively at the 6-month mark, using the modified Japanese Orthopedic Association score.

Results:

Among the 114 patients, 87 patients showed significant MEP improvement, 1 patient with MEP degeneration, 3 patients with no change in MEP, and 23 patients with MEP change, but which eventually returned to baseline. Univariate analysis showed that patients with MEP improvement had similar 6-month functional and Japanese Orthopedic Association scores compared with patients who did not have MEP improvement. Critically, a longer duration of symptoms was shown to have a statistically significant relationship with patients who did not have MEP improvement on univariate analysis (49.2 wk in patients with no MEP improvement compared with 34.59 wk in patients with MEP improvement, P = 0.03) but this did not translate to differences in functional outcomes. There was also no statistically significant association between the functional outcome scores and demographics, surgical, or radiologic factors.

Conclusions:

Our study shows that the duration of symptoms is not attributed to lower functional outcomes but is associated with a lack of MEP improvement.

Level of Evidence:

Level III.
Pulmonary rehabilitation restores limb muscle mitochondria and improves the intramuscular metabolic profile
Authors: Qumu Shiwei , Sun Weiliang , Guo Jing , Zhang Yuting , Cai Lesi , Si Chaozeng , Xu Xia , Yang Lulu , Situ Xuanming , Yang Tianyi , He Jiaze , Shi Minghui , Liu Dongyan , Ren Xiaoxia , Huang Ke , Niu Hongtao , Li Hong , Yu Chang’An , Chen Yang , Yang Ting
Published: February 2023

Background:

Exercise, as the cornerstone of pulmonary rehabilitation, is recommended to chronic obstructive pulmonary disease (COPD) patients. The underlying molecular basis and metabolic process were not fully elucidated.

Methods:

Sprague-Dawley rats were classified into five groups: non-COPD/rest (n = 8), non-COPD/exercise (n = 7), COPD/rest (n = 7), COPD/medium exercise (n = 10), and COPD/intensive exercise (n = 10). COPD animals were exposed to cigarette smoke and lipopolysaccharide instillation for 90 days, while the non-COPD control animals were exposed to room air. Non-COPD/exercise and COPD/medium exercise animals were trained on a treadmill at a decline of 5° and a speed of 15 m/min while animals in the COPD/intensive exercise group were trained at a decline of 5° and a speed of 18 m/min. After eight weeks of exercise/rest, we used ultrasonography, immunohistochemistry, transmission electron microscopy, oxidative capacity of mitochondria, airflow-assisted desorption electrospray ionization-mass spectrometry imaging (AFADESI-MSI), and transcriptomics analyses to assess rectal femoris (RF).

Results:

At the end of 90 days, COPD rats’ weight gain was smaller than control by 59.48 ± 15.33 g (P = 0.0005). The oxidative muscle fibers proportion was lower (P < 0.0001). At the end of additional eight weeks of exercise/rest, compared to COPD/rest, COPD/medium exercise group showed advantages in weight gain, femoral artery peak flow velocity (Δ58.22 mm/s, 95% CI: 13.85–102.60 mm/s, P = 0.0104), RF diameters (Δ0.16 mm, 95% CI: 0.04–0.28 mm, P = 0.0093), myofibrils diameter (Δ0.06 μm, 95% CI: 0.02–0.10 μm, P = 0.006), oxidative muscle fiber percentage (Δ4.84%, 95% CI: 0.15–9.53%, P = 0.0434), mitochondria oxidative phosphorylate capacity (P < 0.0001). Biomolecules spatial distribution in situ and bioinformatic analyses of transcriptomics suggested COPD-related alteration in metabolites and gene expression, which can be impacted by exercise.

Conclusion:

COPD rat model had multi-level structure and function impairment, which can be mitigated by exercise.
Modeling spontaneous opioid withdrawal in male and female outbred mice using traditional endpoints and hyperalgesia
Authors: Brewer Abigail L. , Lewis Christina C. , Eggerman Liudmyla , Blokker Alexis , Burkland John A. , Johnsen Megan , Quock Raymond M.
Published: February 2023

Introduction

Opioid withdrawal significantly impacts drug dependence cycles as hyperalgesia associated with withdrawal is often a reason for continued drug use. Animal models of addiction are important tools for studying how drug dependence and withdrawal impact not only normal neurocircuitry but also the effectiveness of potential treatments for dependence and withdrawal. We conducted a study of the time course of spontaneous morphine withdrawal in outbred male and female mice that can be used to examine sex differences in male and female mice using both traditional somatic endpoints and mechanical hyperalgesia as an endpoint of withdrawal.

Methods

Male and female national institute of health (NIH) Swiss mice were made dependent upon morphine using an escalating dosing schedule. Injections were stopped after 5 days. Withdrawal behavior was assessed at time intervals up to 106 h after the final injection. Numbers of forepaw tremors, wet-dog shakes, jumps and other behaviors were scored to create a global score. Paw pressure readings were then also taken to track changes in sensitivity to a painful stimulus over time.

Results

Male and female mice had approximately similar withdrawal severity peaking at 24 h after the final injection as measured by composite global scores. Females did exhibit an earlier and greater frequency of tremors than males. Although males and females showed similar hyperalgesia during withdrawal, females recovered faster.

Conclusion

Spontaneous opioid withdrawal peaking at 24 h was demonstrated in male and female NIH Swiss mice. We also successfully demonstrated that hyperalgesia is an endpoint that varies over the course of withdrawal.
Mitragynine, a primary constituent of kratom reinstates morphine-seeking behaviour in rats
Authors: Japarin Rima Atria , Harun Norsyifa , Hassan Zurina , Shoaib Mohammed
Published: February 2023

Mitragynine (MG) is a pharmacologically active alkaloid derived from the leaves of Mitragyna speciosa Korth (Kratom). This plant has sparked significant interest as a potential alternative treatment for managing opioid dependence and withdrawal due to its opioid-like pharmacological effects. However, whether MG exposure would trigger opioid-seeking behaviour following abstinence has not been investigated. The present study examined the effects of MG priming on morphine-seeking behaviour in rats. Male Sprague-Dawley rats were initially trained to intravenously self-administer morphine (0.5 mg/kg/infusion) under a fixed ratio-3 schedule of reinforcement. Removal of both morphine infusions and drug-associated cues led to the subsequent extinction of the drug-seeking behaviour. Tests of reinstatement were made following exposure to a randomised order of intraperitoneal injections of MG (3, 10 and 30 mg/kg), morphine (5 mg/kg) and vehicle. Significant levels of drug-seeking behaviour were observed following extended access to morphine self-administration, which was extinguished following removal of morphine and cues indicative of morphine-seeking behaviour, supporting the relapse model. The present finding demonstrated that MG priming in a dose of 10 mg/kg resulted in the reinstatement of morphine-seeking behaviour, whereas the higher MG dose (30 mg/kg) tested suppressed the seeking response. This study indicated that exposure to a low MG dose may increase the likelihood of relapsing to opioids, suggesting that the potential of MG as a treatment for opioid management merits further scientific assessment of its ability to trigger relapse to opioid abuse.
Surgeons need to know more about intraocular lens design for accurate power calculation
Authors: Olsen Thomas , Cooke David L. , Findl Oliver , Gatinel Damien , Koch Douglas , Langenbucher Achim , Melles Ronald B. , Yeo Tun K.
Published: February 2023

Improvement in biometry and formulas has raised the bar for accurate intraocular lens (IOL) power calculation. However, when we look closely at the performance of a specific IOL model, we often find that the prediction error varies with the implant power. This phenomenon has no explanation other than that the optic design of the IOL has shifted over the power range, thereby disrupting the assumptions of the calculations. By this report, we call the industry to be more transparent and disclose the basic information about the IOL design that is important for accurate IOL power calculation. The relevant information concerns the refractive index, the central optic thickness, the anterior and posterior curvature radii, the toricity location, the spherical aberration, and haptic angulation. The goal is to predict possible shifts in principal planes or IOL position over the power range causing a refractive surprise if not corrected for.
Application of Orthognathic Surgery Principles and Techniques in the Management of Craniomaxillofacial Trauma
Authors: Bhandari Kishor , Ho Cheng-Ting , Liao Han-Tsung
Published: February 2023

Background

Posttraumatic secondary deformities of facial skeleton may occur because of nonmanagement or ill management of primary injuries, whereas some unexpectedly occur even after dedicated management attempts. Orthognathic surgery (OGS) principles and techniques can be used as an efficient tool to correct posttraumatic craniomaxillofacial deformities or skeletal developmental deformities during trauma management.

Aim and Objectives

The aims of this study were to describe the different types of posttraumatic secondary deformity and address how to use the principles of orthognathic techniques to correct them.

Materials and Methods

Patients with orthognathic surgical osteotomies during primary or secondary management of facial trauma (referred to as trauma-OGS) during the period of 2010 to 2018 were retrospectively reviewed. Variables pertaining to patients and surgery were collected, including trauma diagnosis, etiology, duration between trauma/primary surgery and secondary presentation, suggested reason for secondary deformity, intervention undertaken to address, and the surgical outcome.

Results

Twenty-seven patients were eligible and extensively reviewed. Etiological categorization of trauma-OGS could be done into posttraumatic deformities (18) and developmental deformities (9). The former group was further categorized as OGS done as primary procedure (8) that included immobile Le Fort fractures and delayed initial treatment, and OGS done as secondary procedure (10) that included complex fractures and condylar fractures. The developmental deformity group was categorized into OGS done simultaneously during trauma management (5) or done as a secondary procedure after trauma management (4).

Conclusions

Application of principles and techniques of OGS in indicated primary or secondary management of facial trauma patients should always be considered. The categorization of scenarios presented in this article relating facial trauma and OGS may further help to understand the application.
Comparison of the Effectiveness Between Conventional and Modified Cinch Suture Techniques in LeFort I Osteotomy
Authors: Yang Jia-Ruei , Chu Yu-Ying , Liao Han-Tsung , Lee Che-Hsiung
Published: February 2023

Background

LeFort I osteotomy changes the morphology of the nose. The cinch suture has been proven to prevent the increase in nasal base and alar width. Different types of cinch sutures have been proposed. However, their effectiveness is unclear.

Aim and Objectives

The aim of this study was to compare the surgical outcomes between conventional and modified cinch techniques through a systematic review and meta-analysis of randomized control trials (RCTs).

Material and Methods

We performed systematic search from Embase, PubMed, and the Cochrane Library according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement up to March 2021. The surgical techniques of different cinch sutures were reviewed, and the outcomes of nasal alar width and alar base width were compared between modified and conventional methods.

Results

A total of 4 eligible RCTs were included in this meta-analysis. Pooled data showed no significant difference in alar base width change between modified and conventional methods (mean difference, −0.37; 95% confidence interval, −1.32 to 0.57; P = 0.44). Pooled data of 3 studies also showed no significant difference in nasal alar width change (mean difference, −0.11; 95% confidence interval, −1.18 to 0.95; P = 0.83).

Conclusion

Based on the current data pooled from the available RCTs, no significant difference was found between the conventional cinch technique and the modified technique.
Selective Myectomy and Myotomy In Situ for the Management of Refractory Blepharospasm in Meige Syndrome
Authors: Lai Chung-Sheng , Wang Yu-Chi , Ramachandran Savitha , Chang Yang-Pei , Huang Shu-Hung , Hsieh Meng-Chien Willie
Published: February 2023

Background

Meige syndrome is characterized by involuntary blepharospasm and varied subphenotypes of oromandibular tonic-clonic muscle contraction. Despite botulinum toxin (BTx) being the mainstay of treatment for Meige syndrome, a small subset of patients remain refractory to its effects because the disease is a form of functional blindness. An integrative surgical procedure combining selective myectomy and myotomy in situ of eyelid protractors, blepharoptosis correction, and tightening of the lower eyelid laxity was first applied to treat refractory blepharospasm in patients with Meige syndrome.

Materials and Methods

This study is a retrospective review conducted on 24 patients with refractory Meige syndrome between 2013 and 2020. Besides selective myectomy and myotomy in situ of eyelid protractors, levator plication and lateral tarsoplasty or canthopexy was performed for blepharoptosis correction and lower eyelid tightening, respectively. Patient demographics, associated diseases, medical treatment history, associated surgical procedures, final aesthetic outcomes, and therapeutic effects as reflected by changes in function disability score and Botox (BTx) treatment were thoroughly recorded and analyzed.

Results

The mean age of the patients was 65.2 ± 8.9 years. Twenty-one patients (87.5%) received blepharoptosis correction by levator plication with an average of 11.2 ± 2.9 mm in length. Lateral tarsoplasty was performed in 16 patients (66.7%) by pentagonal tarsal resection with an average of 3.9 ± 0.8 mm in width. Five patients (20.8%) received lateral canthopexy. Among the total of 96 operated eyelids, scar revision with fat graft was performed in 3 eyelids (3.1%). The average amount of BTx treatment decreased from 49.2 ± 12.8 U once every 2.7 ± 0.8 months before surgery to 35.4 ± 7.8 U once every 3.8 ± 0.7 months after surgery. Function disability score improved from 76.7 ± 17.5% preoperatively to 15.6 ± 9.9% postoperatively (P < 0.001). Only 3 upper eyelids (3.1%) received scar revision and fat grafting due to minor postoperative contour depression. All patients expressed high satisfaction with both functional and aesthetic outcomes (Likert scale 4.5 ± 0.5).

Conclusions

Selective myectomy and myotomy in situ of eyelid protractors combining blepharoplasty correction and lower eyelid tightening can produce long-lasting functional and aesthetic results with minimal complication in patients with refractory Meige syndrome.
Analysis of Patient-Reported Outcomes After Breast Reconstruction: A Retrospective Study
Authors: Wang Yi , Li Guangxue , Yang Kai , Bi Ye , Liu, Yan , Mu Dali , Liu Chunjun , Xin Minqiang , Liu Yuanbo , Mu Lan
Published: February 2023

Objective

This study aimed to investigate the effects of surgical timing, procedure, and age, on complication rates, health-related quality of life, and postoperative satisfaction, in patients who underwent breast reconstruction.

Methods

The data of 80 patients who underwent breast reconstruction surgery between August 2004 and June 2018 were reviewed. Patients were grouped according to surgical timing, procedure, and age. The evaluation indicators included complications and BREAST-Q scores. The statistical methods used included the Mann-Whitney U test and analyses of variance and covariance.

Results

The incidence of complications was 15.0% (12/80). The complication rates were similar in each group (P > 0.05). The postsurgical scores of patient satisfaction with breast, psychosocial well-being, and sexual well-being were higher than the presurgical scores (P < 0.05). The postoperative psychosocial and sexual well-being scores of patients in the immediate group were higher than those in the delayed group (P < 0.05). The satisfaction with the outcome in the abdominal flap group was higher than that in the other group, whereas the sexual well-being score of the abdominal flap group was lower than that of the other group (P < 0.05). The scores of the postoperative physical well-being of the chest and abdomen in the younger group were higher than that in the older group (P < 0.05).

Conclusions

Breast reconstruction can significantly improve patients' health-related quality of life and satisfaction. Immediate breast reconstruction can reduce the adverse psychological and physical effects that breast loss exerts on patients, leading to better postoperative satisfaction. Patients who underwent breast reconstruction with abdominal flaps had higher postoperative satisfaction. Breast reconstruction in elderly patients was associated with considerable postoperative satisfaction.
Application of Trapezoid Orbital Septum Membrane Flap in Double-Eyelid Blepharoplasty
Authors: Yang Zhenyu , Tan Xiaoyan , Bahadur Aneesh , Zitkovsky Helen , Zeng Pingying , Mi Zijing
Published: February 2023

Background

For a long time, to achieve the natural shape of double-eyelid crease, multiple techniques of double-eyelid plastic surgery have been developed. We describe the trapezoid orbital septum membrane flap in blepharoplasty to achieve a dynamic double-eyelid crease and avoid a depressed static scar.

Methods

The authors developed a trapezoid orbital septum membrane flap in double-eyelid blepharoplasty. The flap base is fixed on the pretarsal plate with the distal end of the flap positioned between the superior and inferior edges of the incision. Layer-by-layer contraposition suturing is then performed.

Results

One hundred ninety-one cases of double-eyelid blepharoplasty were performed by a senior surgeon using the trapezoid orbital septum flap method. Patients were followed for 6 to 17 months. Twelve cases were revised secondarily. Patients were satisfied with the palpebral folds, which showed a dynamic crease followed with movements of the eyelids.

Conclusions

The authors introduce a trapezoid orbital septum flap in upper eyelid blepharoplasty. The flap relies on the elasticity of the orbital septum flap as the levator aponeurosis extension segment to produce a natural crease without a depressed static scar.
Static and Dynamic Stabilization of the Shoulder After Total Scapulectomy in an Electric Burn Patient
Authors: May Jessica M. , Pathak Abraham , Pientka William F. , Meade Anna E. , Duque Sofia , Farewell Jordyn T. , Zhang Andrew Y.
Published: February 2023

An otherwise healthy 49-year-old man experienced a high-voltage electrical injury to the left shoulder resulting in total scapulectomy, partial calviculectomy, and a substantial soft tissue defect. The majority of the muscles around his shoulder were debrided because of necrosis, with only the pectoralis and latissimus dorsi muscles remaining attached to the humerus. Surprisingly, the patient's brachial plexus remained intact, and his left elbow, wrist, and hand function were preserved. A novel combination of 3 static and dynamic suspension techniques were used to stabilize his shoulder and prevent traction injury to the brachial plexus. Postoperative follow-up at 1 year demonstrated excellent stability of his reconstructed shoulder, which allowed him to ambulate independently and return to employment.
Periumbilical Anatomy of Scarpa's Fascia
Authors: Amakiri Uchechukwu O. , Doo Florence Xini , Kuruvilla Annet , Ibelli Taylor J. , Jesús Gabrielle Hernaiz-De , Kagen Alexander , Henderson Peter W.
Published: February 2023

Background

Intraoperative observation of Scarpa's fascia (SF) has suggested attenuation in the periumbilical region. This study's purpose was to objectively evaluate SF anatomy in the periumbilical region and assess clinical outcomes of a novel, modified SF closure technique of transverse abdominal wall incisions that only reapproximates SF where it is definitively present.

Methods

Women were identified who had undergone abdominal magnetic resonance (MR) angiography before their abdominal-based autologous breast reconstruction that used the modified SF closure technique. Statistical analysis of SF presentation on the MR images was performed. Intraoperative measurements from dissected panniculectomy specimens were used to validate MR analysis. Donor site complications were recorded in patients undergoing modified SF closure.

Results

Sixty-six patients were included in the retrospective MR imaging analysis; this revealed an average attenuation of SF of 4.7 cm (SEM = 0.25 cm), 4.5 cm (SEM = 0.23 cm), 4.6 cm (SEM = 0.23 cm), and 4.2 cm (SEM = 0.22 cm) to the left of, right of, cranial to, and caudal to the umbilicus, respectively. The mean surface area of radiologic SF absence was 56.3 cm2 (SEM = 3.57 cm2). There was a significant difference in SF presentation based on patient age (P = 0.013) and body mass index (P = 0.005). Five of the 66 patients (7.6%) experienced abdominal closure site complications.

Conclusions

This study objectively confirms that there is attenuation of SF in the periumbilical region, describes a novel SF closure technique, and provides evidence to support its adoption when closing transverse abdominal wall incisions.
Ballistic Facial Trauma Reconstruction
Authors: Lee Clara J. , Calvo Richard , Rosales Ricardo , Akhter Maheen , Sise Michael J. , Krzyzaniak Andrea , Lance Samuel
Published: February 2023

Background

Management of nonfatal ballistic facial trauma is well described in the literature for wounds secondary to military combat. However, there is little literature describing such management in civilian practice. We aimed to describe nonmilitary patients with recent nonfatal facial injuries from ballistic trauma using the California Office of Statewide Health Planning and Development patient database.

Methods

A retrospective study was performed using the California Office of Statewide Health Planning and Development Ambulatory Surgery and Inpatient datasets. All adults with the International Classification of Diseases, 10th Revision codes of severe nonfatal facial trauma from firearms requiring emergent surgery during 2016–2018 were included. Outcomes assessed include number and type of facial procedures performed, hospital length of stay, number of admissions, timing of definitive management, and lifetime hospitalization costs.

Results

A total of 331 traceable patients were identified over this 3-year period. The average age was 35.4 years (SD, 15.2), and 87% were male. The median index admission length of stay was 8 days (interquartile range, 3–15 days). Subsequent readmission was required for 123 (37.2%) patients with 10% mortality in the index admission. Total median charges per patient for all admissions were $257,804 (interquartile range, $105,601–$531,916). A total of 215 patients (65%) had at least 1 facial repair performed. Of all 331 patients, 64.3% underwent musculoskeletal repair (n = 213), 31.4% underwent digestive system repair (n = 104), and 29.6% underwent respiratory system repair (n = 98). The average number of repairs per patient was 2.52 (SD, 3.38), with 35% not having any of the specified International Classification of Diseases, 10th Revision repair codes. A total of 27% of patients had 1 procedure performed, whereas 38% received 2 or more, for an average of 3.87 (SD, 3.5) repairs over the study duration.

Discussion

To our knowledge, this is the first assessment of civilian characteristics of nonfatal ballistic facial trauma in California. Nonfatal facial ballistic trauma results in complex injuries to multiple body systems, requiring long admissions, costly hospital stays, and coordination of care across several surgical specialties. Many patients require a variety of procedures over multiple admissions, highlighting the overall morbidity of these injuries. Future studies will look at how care for these patients differs between various hospitals and geographic regions and whether current civilian management aligns with well-defined military reconstructive protocols for facial ballistic injuries.
The Impact of Prior Infection With SARS-Cov-2 on Surgical Outcomes in Patients Undergoing Abdominal Body Contouring Procedures
Authors: Wang Fei , Rothchild Evan , Ricci Joseph A.
Published: February 2023

Background

There is evidence of increased postoperative complications in patients who have recovered from SARS-CoV-2. However, previous studies have not examined this effect in abdominal contouring procedures.

Methods

A retrospective review was conducted for all patients who underwent abdominoplasty or panniculectomy at our institution from March 2020 to November 2021. Patients were separated into cohorts via preoperative history of SARS-CoV-2 infections. Variables collected include demographic data, concurrent comorbidities, postoperative complications, readmission/reoperation, and length of stay. Parametric, nonparametric, and multivariable regression modeling was used for analysis.

Results

Of the 181 patients included, 14 (7.7%) had a prior SARS-CoV-2 infection. Average time from infection to surgery was 250 days. The mean age and Charlson Comorbidity Index for nonexposed and exposed patients were 45.4 and 45.9 years, and 1.24 and 1.36 points. Patients with prior SARS-CoV-2 infection were more likely to have chronic kidney disease (odds ratio [OR], 6.79; P = 0.017) and undergo abdominoplasties compared with panniculectomies (OR, 4.43; P = 0.039). There were no other significant differences in patient or operative characteristics between the cohorts. Compared with those with no history of infection, patients with prior infections had increased odds of postoperative complications such as delayed wound healing (OR, 27.67; P < 0.001). No other significant associations were found between prior SARS-CoV-2 infection and perioperative outcomes.

Conclusion

Prior SARS-CoV-2 infections may be associated with increased incidence of delayed wound healing despite a significant time lag between the time of infection and operation. Further studies are needed to elucidate the exact relationship and mechanism of action behind these findings.
Severe Increase in Nursing Labor Cost and Effect on Surgical Department Financial Margins at an Academic, Tertiary Medical Center
Authors: Brinster Clayton J , Escousse G Thomas , Hayson Aaron , Sternbergh WC , Money Samuel R
Published: February 2023

Background:

A pre-existing nationwide nursing shortage drastically worsened during the pandemic, causing a significant increase in nursing labor costs. We examined the financial impact of these changes on department of surgery financial margins.

Study Design:

Operating room, inpatient, and outpatient financial metrics were analyzed. Monthly averages from a 14-month control cohort, January 2019-February 2020 (Pre-COVID), were compared to a 21-month cohort, March 2020-November 2021 (COVID). True revenue and cost data from hospital accounting records, not estimates or administrative projections, were analyzed. Statistics were performed with standard student’s T-test and the Anderson-Darling normality test.

Results:

Monthly surgical nursing costs increased significantly, with concomitant significant decreases in departmental contribution to margin (Table 1). No significant change was observed in case volume per month, length of stay per case, or surgical acuity, as standardized by CMS Case Mix Index. In order to obviate insurance payor mix as a variable and standardize cost data, surgical nursing expense per RVU was analyzed, demonstrating a significant increase. Hospital-wide agency nursing costs increased from $5.1 to $13.5 million/month (+165%) in 2021.

Conclusions:

Our results demonstrate a significant increase in surgical nursing labor costs with a resultant erosion of department of surgery financial margins. Utilization of real-time accounting data instead of commonly touted administrative approximations or Medicare projections increases both the accuracy and generalizability of the data. The long-term impact of both direct costs from supply chain interruption and indirect costs, such as limited OR and ICU access, will require further study. Clearly this ominous trend is not viable, and fiscal recovery will require sustained, strategic workforce allocation.
Phosphodiesterase inhibitor and selective serotonin reuptake inhibitor combination therapy versus monotherapy for the treatment of major depressive disorder: a systematic review and meta-analysis
Authors: Nawras Mohamad , Beran Azizullah , Yazdi Vahid , Hecht Mordechai , Lewis Chandani
Published: February 2023

Selective serotonin reuptakeinhibitors (SSRIs) are the gold standard treatment for major depressive disorder (MDD). However, the use of phosphodiesterase (PDE) inhibitors in the treatment of MDD remains unclear. Our study aims to compare the effect of PDE inhibitor combination therapy to SSRI monotherapy for the treatment of MDD. We performed a comprehensive literature search using PubMed, EMBASE, and Web of Science databases, for studies that assess the impact of PDE inhibitor therapy on MDD patients. The primary outcome of our study was treatment response rate at the end of study time. Pooled odds ratio (OR) and corresponding 95% confidence intervals (CIs) were calculated using the random-effects model. A P-value <0.05 was considered statistically significant. A total of four randomized control trials (RCTs), including 270 patients with MDD, were included in the analysis. Follow-up periods ranged from 6 to 12 weeks. The PDE inhibitor group was associated with a significantly higher treatment response rate (OR, 4.77; 95% CI, 2.05–11.12; P = 0.0003). Our meta-analysis demonstrated that MDD patients receiving PDE inhibitor combination therapy had a higher treatment response rate than MDD patients receiving SSRI monotherapy. Further large-scale RCTs with long-term follow-ups are necessary to validate our findings.
Remission of treatment-resistant obsessive-compulsive disorder with 600 milligrams of fluvoxamine daily: a case report
Authors: Kocamer Şahin Şengül , Demir Bahadir , Altindağ Abdurrahman
Published: February 2023

First-line drugs for obsessive-compulsive disorder (OCD) pharmacotherapy are selective serotonin reuptake inhibitors (SSRI). The medication must be continued for at least 12 weeks at an effective dosage to find the most effective SSRI. For treatment, the drug dose should be titrated to the highest tolerated dose. The manufacturer’s recommended maximum dose of fluvoxamine is 300 mg per day. We reported remission after about 1 month of 600 mg (high dose) fluvoxamine, which was tolerated by a patient with OCD. The patient continued at this dose for 3 months and remained in remission.
John Graham Ramsay. 17 June 1931—12 January 2021
Authors: Dewey FRS J. F. , Graham R.
Published: February 2023

John Ramsay was a scientific polymath, the finest structural geologist of his generation, with superb field mapping skills and a solid grasp of mathematics and engineering. He was also accomplished as a cellist, painter in oils, runner, cyclist, linguist, poet, cook, skier and rock climber. He was a gifted scientist and aesthete who saw beauty in the natural world and sought it in all his work. His fundamental contributions, in 94 papers and four books, modernized structural geology, enabling us to understand the deformation of rocks in completely new ways. He was ‘Father’ of modern structural geology, great scientist and renaissance man.
Richard Edwin Hills. 30 September 1945—5 June 2022
Authors: Longair CBE FRS Malcolm S.
Published: February 2023

Richard Hills was a pioneering, world-leading millimetre astronomer. As fresh graduate students, he and Michael Janssen built the world’s first millimetre interferometer. His research was characterized by the full range of experimental, observational and theoretical activities as the telescopes became more powerful and the scientific opportunities broadened out. The highlights of his contributions include his key roles as project scientist for the James Clerk Maxwell Telescope in Hawaii, still the world’s largest single dish for submillimetre astronomy, and for the ALMA millimetre/submillimetre array in Chile. His career spanned the evolution of millimetre astronomy from the ‘Wild West’ of the 1960s to the sophisticated aperture synthesis ALMA array which is revolutionizing our understanding of star and planet formation and the astrophysics of the distant Universe of galaxies.
Cells as the first data scientists
Authors: Wong Michael L. , Prabhu Anirudh
Published: February 2023

The concepts that we generally associate with the field of data science are strikingly descriptive of the way that life, in general, processes information about its environment. The ‘information life cycle’, which enumerates the stages of information treatment in data science endeavours, also captures the steps of data collection and handling in biological systems. Similarly, the ‘data–information–knowledge ecosystem’, developed to illuminate the role of informatics in translating raw data into knowledge, can be a framework for understanding how information is constantly being transferred between life and the environment. By placing the principles of data science in a broader biological context, we see the activities of data scientists as the latest development in life's ongoing journey to better understand and predict its environment. Finally, we propose that informatics frameworks can be used to understand the similarities and differences between abiotic complex evolving systems and life.
Missing observations in regression: a conditional approach
Authors: Battey H. S. , Cox D. R.
Published: February 2023

This note presents an alternative to multiple imputation and other approaches to regression analysis in the presence of missing covariate data. Our recommendation, based on factorial and fractional factorial arrangements, is more faithful to ancillarity considerations of regression analysis and involves assessing the sensitivity of inference on each regression parameter to missingness in each of the explanatory variables. The ideas are illustrated on a medical example concerned with the success of hematopoietic stem cell transplantation in children, and on a sociological example concerned with socio-economic inequalities in educational attainment.